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COMMERCIAL GENERAL LIABILITY CG 00010413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Dec larations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organiza tion qualifying as such under Section Il Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V Definitions. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. We may at our discretion investigate any occurrence and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Il Limits Of Insurance and 2 Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Cov erages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supple mentary Payments Coverages A and B. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property dam age is caused by an occurrence that takes place in the coverage territory 2 The bodily injury or property dam age occurs during the policy period and Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or re sumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section I Who Is An Insured or any employee authorized by you to give or receive notice of an occurr ence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section I Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer 2 Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or 3 3 Becomes aware by any other means that bodily injury or property dam age has occurred or has begun to oceur. Damages because of bodily injury include damages claimed by any person or organ ization for care loss of services or death resulting at any time from the bodily injury. CG 00010413 Insurance Services Office Inc. 2012 Page 1 of 16
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This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employ ment training or monitoring of others by that insured or b Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage invol ved that which is described in Paragraph 1 2 or 3 above. However this exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. For the purposes of this exclusion permitting a person to bring alcoholic beverages on your premises for consumption on your premises whether or not a fee is charged or a license is required for such activity is not by itself considered the business of selling serving or fur nishing alcoholic beverages.. Workers Compensation And Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a con sequence of Paragraph 1 above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. 2. Exclusions This insurance does not apply to a. Expected Or Intended Injury Bodily injury or property damage ex pected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the ab sence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property dam age occurs subsequent to the execu tion of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorneys fees and neces sary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and Such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this in surance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxica tion of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. b Insurance Services Office Inc. 2012 CG 00010413 Page 2 of 16
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d At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing op erations if the pollutants are brought on or to the premises site or location in connection with such operations by such insured con tractor or subcontractor. How ever this subparagraph does not apply to i Bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or me chanical functions necessary for the operation of mobile equip ment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other oper ating fluids are brought on or to the premises site or location with the intent that they be discharged dispersed or re leased as part of the operations being performed by such insured contractor or subcon tractor i Bodily injury or property damage sustained within a building and caused by the re lease of gases fumes or vapors from materials brought into that building in connection with op erations being performed by you or on your behalf by a con tractor or subcontractor or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e At or from any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal see page migration release or escape of pollutants a At or from any premises site or b c location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i Bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests i Bodily injury or property damage for which you may be held liable if you are a con tractor and the owner or lessee of such premises site or loca tion has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises site or location and such premises site or location is not and never was owned or occupied by or rented or loaned to any insured other than that additional insured or iii Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire At or from any premises site or location which is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste Which are or were at any time transported handled stored treat ed disposed of or processed as waste by or for i Any insured or ii Any person or organization for whom you may be legally re sponsible or CG 00010413 Insurance Services Office Inc. 2012 Page 3 of 16
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insured s behalf are performing operations if the operations are to test for monitor clean up remove contain treat detoxify or neutra lize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a Request demand order or stat utory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a governmental authority for dam ages because of testing for mon itoring cleaning up removing containing treating detoxifying or neutralizing or in any way re sponding to or assessing the ef fects of pollutants. However this paragraph does not apply to liability for damages because of property damage that the insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a govern mental authority. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any air craft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or prop erty damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 26 feet long and b b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured 4 Liability assumed under any insured contract for the ownership mainten ance or use of aircraft or watercraft or 5 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mo bile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or The operation of any of the mach inery or equipment listed in Para graph f.2 or.3 of the definition of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equip ment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage how ever caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or de fending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or Insurrection rebellion revolution usurped power or action taken by gov ernmental authority in hindering or defending against any of these. b 3 Insurance Services Office Inc. 2012 CG 00010413 Page 4 of 16
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This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.. Damage To Impaired Property Or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a con tract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use. Recall Of Products Work Or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is with drawn or recalled from the market or from use by any person or organization because of a known or suspected defect defi ciency inadequacy or dangerous condition init. Personal And Advertising Injury Bodily injury arising out of personal and advertising injury. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate elec tronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software Damage To Property Property damage to 1 Property you own rent or occupy including any costs or expenses incur red by you or any other person organization or entity for repair re placement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s prop erty Premises you sell give away or aban don if the property damage arises out of any part of those premises 3 Property loaned to you 4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or sub contractors working directly or indi rectly on your behalf are performing operations if the property damage arises out of those operations or 6 That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Il Limits Of Insurance. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. Damage To Your Product Property damage to your product arising out of it or any part of it. Damage To Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations haz ard. 2 CG 00010413 Insurance Services Office Inc. 2012 Page 5 of 16
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including systems and applications soft ware hard or floppy disks CD ROMs tapes drives cells data processing de vices or any other media which are used with electronically controlled equipment. q. Recording And Distribution Of Material Or Information In Violation Of Law Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transactions Act FACTA or Any federal state or local statute or dinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and addi tions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or dis tribution of material or information. Exclusions. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section Il Limits Of Insurance. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Il Limits Of Insurance and C 2 Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supple mentary Payments Coverages A and B. This insurance applies to personal and advertising injury caused by an offense arising out of your business but only if the offense was committed in the coverage territory during the policy period. 2. Exclusions This insurance does not apply to Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict per sonal and advertising injury. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication in any manner of material if done by or at the direction of the insured with knowledge of its falsity. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication in any manner of material whose first publication took place before the beginning of the policy period. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s adver tising idea in your advertisement. Page 6 of 16 Insurance Services Office Inc. 2012 CG 00010413 CG 00010413
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. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your ad vertisement.. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Infringement Of Copyright Patent Trade mark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. Insureds In Media And Internet Type Businesses Personal and advertising injury com mitted by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 14.a. b. and c. of personal and advertising injury under the Defini tions section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting pub lishing or telecasting. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s poten tial customers.. Pollution Personal and advertising injury arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. Pollution related Any loss cost or expense arising out of any 1 Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a gov ernmental authority for damages be cause of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. 2. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or de fending against an actual or expected attack by any government sovereign or other authority using military per sonnel or other agents or 3 Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to vio late 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law CG 00010413 Insurance Services Office Inc. 2012 Page 7 of 16
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3 The Fair Credit Reporting Act FCRA b. Hired Person and any a. ede of or gddmon to To a person hired to do work for or on such law including the Fair and Ac behalf of any insured or a tenant of any curate Credit Transactions Act insured FACTA or 0 N Iy O ted Premi 4 Any federal state or local statute e Injury On orm y Occupled Premises ordinance or regulation other than the To a person injured on that part of prem TCPA CAN SPAM Act of 2003 or ises you own or rent that the person FCRA and their amendments and normally occupies. additions that addresses prohibits or d. Workers Compensation And Similar Laws limits the printing dissemination dis posal collecting recording sending transmitting communicating or dis tribution of material or information. To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement e. a. We will pay medical expenses as described benefits law or a similar law. Athletics Activities below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the policy period b The expenses are incurred and reported to us within one year of the date of the accident and To a person injured while practicing in structing or participating in any physical exercises or games sports or athletic con tests. Products Completed Operations Hazard Included within the products completed operations hazard. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend c The injured person submits to a. All expenses we incur. examination at our expense by b. U 5.. Up to 250 for cost of bail bonds required physicians fl our choice as often as because of accidents or traffic law vio i we reasonably require. lations arising out of the use of any vehicle. We will make these payments regardless of to which the Bodily Injury Liability fault. These payments will not exceed the Coverage applies. We do not have to applicable limit of insurance. We will pay furnish these bonds. reasonable expenses for c. The cost of bonds to release attachments 1 First aid administered at the time of an but only for bond amounts within the accident applicable Iimit of insurance. We do not 2 Necessary medical surgical X ray and have to furnish these bonds. dental services including prosthetic d. All reasonable expenses incurred by the devices and insured at our request to assist us in the 3 Necessary ambulance hospital profes sional nursing and funeral services. investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from 2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer work ers. work. e. All court costs taxed against the insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the insured. Insurance Services Office Inc. 2012 CG 00010413 Page 8 of 16
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CG 00010413 f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance we will not pay any prejudgment interest based on that period of time after the offer. g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance.. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met a. The suit against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract b. This insurance applies to such liability assumed by the insured c. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract d. The allegations in the suit and the in formation we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the in vestigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit Notify any other insurer whose coverage is available to the indem nitee and Cooperate with us with respect to coordinating other applicable insur ance available to the indemnitee and b c Insurance Services Office Inc. 2012 2 Provides us with written authorization to a Obtain records and other informa tion related to the suit and b Conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met attor neys fees incurred by us in the defense of that indemnitee necessary litigation expenses incur red by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Not withstanding the provisions of Paragraph 2.b.2 of Section I Coverage A Bodily Injury And Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. Our obligation to defend an insured s indem nitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your busi ness. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive of ficers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. Page 9 of 16 Page 9 of 16
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2. Each of the following is also an insured a. Your volunteer workers only while per forming duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partner ship joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and adver tising injury a To you to your partners or mem bers if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business To the spouse child parent brother or sister of that co employee or volunteer worker as a consequence of Paragraph 1a above For which there is any obligation to share damages with or repay some one else who must pay damages because of the injury described in Paragraph 1a or b above or Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volun teer workers any partner or member if you are a partnership or joint ven ture or any member if you are a limited liability company. b c d b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that prop erty and 2 Until your legal representative has been appointed. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organ ization and Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability com pany that is not shown as a Named Insured in the Declarations. SECTION Ill LIMITS OF INSURANCE The Limits of Insurance shown in the Dec larations and the rules below fix the most we will pay regardless of the number of 1. a. b. c. Insureds Claims made or suits brought or Persons or organizations making claims or bringing suits.. The General Aggregate Limit is the most we will pay for the sum of a. b. Medical expenses under Coverage C Damages under Coverage A except dam ages because of bodily injury or prop erty damage included in the products completed operations hazard and Damages under Coverage B. el mem lip or ers if pany n the ent or o the or to rkers ed to are nt t co orker graph dy or ysical r any Insurance Services Office Inc. 2012 CG 00010413 Page 10 of 16
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3. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to Paragraph 2. above the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and ad vertising injury sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence Offense Claim Or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occur rence or offense took place 2 The names and addresses of any in jured persons and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the en forcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any ex pense other than for first aid without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us the insured and the claimant or the claimant s legal representative. CG 00010413 Insurance Services Office Inc. 2012 Page 11 of 16
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4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance wheth er primary excess contingent or on any other basis i That is Fire Extended Cover age Builder s Risk Installation Risk or similar coverage for your worl i That is Fire insurance for prem ises rented to you or tempor arily occupied by you with permission of the owner iii That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section I Coverage A Bodily Injury And Property Damage Liability. Any other primary insurance avail able to you covering liability for damages arising out of the prem ises or operations or the products and completed operations for which you have been added as an additional insured. When this insurance is excess we will have no duty under Coverages A or B to defend the insured against any suit if any other insurer has a duty to defend the insured against that suit. If no other insurer defends we will undertake to do so but we will be entitled to the insured s rights against all those other insurers. b 2 3 When t other in share of that exc a The insu the b The insu othe 4 We wil any wi not des provisio ifically t of Insur of this C c. Method Of If all of the bution by e method als insurer con has paid its none of the first. If any of permit cont contribute each insure of its appli total applic insurers. 5. Premium Audit a. We will c Coverage P and rates. b. Premium st advance pr only. At the will comput period and Insured. T retrospectiv as the due the advanc the policy p premium w first Named c. The first Ne of the info computatior times as we Page 12 of 16 Insurance Services Office Inc. 2012 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a The total amount that all such other insurance would pay for the loss in the absence of this insurance and b The total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought spec ifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contri bution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. C CG 00010413
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6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete b. Those statements are based upon repre sentations you made to us and c. We have issued this policy in reliance upon your representations. Separation Of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Part to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Cov erage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. CG 00010413 Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads in cluding any attached machinery or equip ment or Insurance Services Office Inc. 2012 b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where itis licensed or principally garaged. However auto does not include mobile equipment.. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Coverage territory means a. The United States of America including its territories and possessions Puerto Rico and Canada b. International waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above or c. All other parts of the world if the injury or damage arises out of 1 Goods or products made or sold by you in the territory described in Paragraph a. above 2 The activities of a person whose home is in the territory described in Para graph a. above but is away for a short time on your business or 3 Personal and advertising injury of fenses that take place through the Internet or similar electronic means of communication provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to.. Employee includes a leased worker. Em ployee does not include a temporary worker.. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document.. Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be.. Impaired property means tangible property other than your product or your work that can not be used or is less useful because a. It incorporates your product or your work that is known or thought to be defective deficient inadequate or danger ous or b. You have failed to fulfill the terms of a contract or agreement Page 13 of 16 Je cally assigned in first Named Insured sured were the only sured against whom is brought. overy Against Others recover all or part of iade under this Cov re transferred to us. othing after loss to lest the insured will ose rights to us and v this Coverage Part to the first Named Declarations written 1ot less than 30 days f of mailing will be provi dama merit a. ab. Emp ploye vl Page 13 of 16
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if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fulfilling the terms of the contract or agreement.. Insured contract means a. A contract for a lease of premises. How ever that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permis sion of the owner is not an insured contract b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demoli tion operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connec tion with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business in cluding an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition opera tions within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tun nel underpass or crossing 2 That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports sur veys field orders change orders or drawings and specifications or Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or b 3 Under which the insured if an architect engineer or surveyor as sumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 10.Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker. 11.Loading or unloading means the handling of property a. After it is moved from the place where it is accepted for movement into or onto an air craft watercraft or auto b. While it is in or on an aircraft watercraft or auto or c. While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. 12.Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equip ment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equip ment of the following types 1 Air compressors pumps and gener ators including spraying welding Insurance Services Office Inc. 2012 CG 00010413 Page 14 of 16
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13. 14. building cleaning geophysical explora tion lighting and well servicing equip ment or 2 Cherry pickers and similar devices used to raise or lower workers f. Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not con struction or resurfacing or c Street cleaning Cherry pickers and similar devices mounted on automobile or truck chas sis and used to raise or lower workers and Air compressors pumps and gener ators including spraying welding building cleaning geophysical explora tion lighting and well servicing equip ment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial respon sibility law or other motor vehicle insurance law are considered autos. Occurrence means an accident including continuous or repeated exposure to substan tially the same general harmful conditions. Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services 2 3 eophysical explora ell servicing equip imilar devices used kers n Paragraph a. b. ained primarily for e transportation of vehicles with the manently attached ile equipment but s primarily for 1ce but not con rfacing or d similar devices bile or truck chas or lower workers oumps and gener spraying welding eophysical explora ell servicing equip 1 t does not include are subject to a sponsibility law or ce law where it is ged. Land vehicles r financial respon r vehicle insurance accident including posure to substan ful conditions. jury means injury dily injury arising llowing offenses r imprisonment om wrongful entry e right of private welling or premises committed by or on lord or lessor on in any manner s or libels a person rages a person s or oducts or services 9. Oral or written publication in any manner of material that violates a person s right of privacy The use of another s advertising idea in your advertisement or Infringing upon another s copyright trade dress or slogan in your advertisement. 15.Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16. Products completed operations hazard b. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earli est of the following times a When all of the work called for in your contract has been completed. When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor work ing on the same project. Work that may need service mainten ance correction repair or replacement but which is otherwise complete will be treated as completed. Does not include bodily injury or prop erty damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or un loading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy Schedule states that products completed operations are sub ject to the General Aggregate Limit. b c Insurance Services Office Inc. 2012 Page 15 of 16 CG 00010413
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17. 18. 19. 20. Property damage means a. Physical injury to tangible property in cluding all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for their work performed for you. 21.Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organization whose business or assets you have ac quired and 2 Containers other than vehicles mater ials parts or equipment furnished in connection with such goods or pro ducts. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22.Your work a. Means 1 Work or operations performed by you or on your behalf and 2 Materials parts or equipment furnished in connection with such work or opera tions. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 The providing of or failure to provide warnings or instructions. i at Insurance Services Office Inc. 2012 CG 00010413 Page 16 of 16
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Z ZURICH Fungi Or Bacteria Exclusion Endorsement THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO 0782528 00 Effective Date 06242021 This endorsement modifies insurance provided under the Commercial General Liability Coverage Part The following exclusion is added to paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi or Bacteria A. Bodily injury property damage or personal and advertising injury caused directly or indirectly by the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any 1. Fungi or bacteria or 2. Substance vapor or gas produced by or arising out of any fungi or bacteria. B. Loss costs or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. C. For the purposes of this exclusion the following definitions are added 1. Fungi means any type or form of fungus including mold or mildew and any mycotoxins spores scents or by products produced or released by fungi. 2. Spores means reproductive bodies produced by or arising out of fungi. 3. Bacteria means any type or form of bacteria and any materials or substances that are produced or released by bacteria. This exclusion applies to all diseases contracted by contact with fungi or bacteria in water water vapor or water droplets including but not limited to Legionnaire s Disease. This exclusion does not apply to any bodily injury or property damage caused by any fungi or bacteria that are are on or are contained in any other edible good or edible product intended for human or animal consumption. All other terms conditions provisions and exclusions of this policy remain the same. U GL1171 B CW 0719 Page 10f 1 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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Z ZURICH Lead Liability Exclusion Policy No. GLO 0782528 00 Eff. Date of Pol. 06242021 Exp. Date of Pol. 061242022 Eff. Date of End. 06242021 Producer No. 37385000 Addl Prem. Return Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part The following exclusion is added to Paragraph 2. Exclusions of Section I Coverage A Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Coverage B Personal And Advertising Injury Liability This insurance does not apply to Lead 03 2 3 Bodily injury property damage or personal and advertising injury ari the actual alleged or threatened ing out of resulting from caused by or related to a Exposure to or existence of lead paint containing lead or any other material product or substance containing lea b Manufacture distribution sale resale re branding installation repair removal encapsulation abatement replacement or handling of lead paint containing lead or any other material product or substance containing lead or whether the lead is or was at any time airborne ingested inhaled absorbed transmitted in any fashion or found in any form whatsoever or whether any other cause event material product or substance contributed concurrently or in any sequence to the injury or damage. Any sums that any insured or other entity must pay repay or reimburse because of any a Request demand order or statutory or regulatory requirement that any insured or others test for sample monitor clean up remove abate cover contain treat mitigate or neutralize lead paint containing lead or any other material product or substance containing lead or in any way respond to or assess the effects of lead in any form or b Claim or suit for damages relating to testing for sampling monitoring cleaning up removing abating covering containing treating mitigating or neutralizing lead paint containing lead or any other material product or substance containing lead or in any way responding to or assessing the effects of lead in any form. Any other loss cost or expense arising out of caused by or relating in any way to lead. U GL1342 A CW 1007 Page 1 of 1
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Z ZURICH General Liability Supplemental Coverage ZURICH Endorsement THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO 0782528 00 Effective Date 06242021 This endorsement modifies insurance provided under the Commercial General Liability Coverage Part The following changes apply to this Coverage Part. However endorsements attached to this Coverage Part will supersede any provisions to the contrary in this General Liability Supplemental Coverage Endorsement. A. Broadened Named Insured 1. The following is added to Section Il Who Is An Insured Any organization of yours other than a partnership or joint venture which is not shown in the Declarations and over which you maintain an ownership interest of more than 50 of such organization as of the effective date of this Coverage Part will qualify as a Named Insured. However such organization will not qualify as a Named Insured under this provision if it a. s newly acquired or formed during the policy period b. Is also an insured under another policy other than a policy written to apply specifically in excess of this Coverage Part or. Would be an insured under another policy but for its termination or the exhaustion of its limits of insurance. Each such organization remains qualified as a Named Insured only while you maintain an ownership interest of more than 50 in the organization during the policy period. 2. The last paragraph of Section Il Who Is An Insured does not apply to this provision to the extent that such paragraph would conflict with this provision. B. Newly Acquired or Formed Organizations as Named Insureds 1. Paragraph 3. of Section Il Who Is An Insured is replaced by the following 3. Any organization you newly acquire or form during the policy period other than a partnership or joint venture and over which you maintain an ownership interest of more than 50 of such organization 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 180 day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. U GL1345 C CW 0320 Page 1 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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An additional premium will apply in accordance with our rules and rates in effect on the date you acquired or formed the organization. 2. The last paragraph of Section Il Who Is An Insured does not apply to this provision to the extent that such paragraph would conflict with this provision. C. Insured Status Employees Paragraph 2.a.1 of Section Il Who Is An Insured is replaced by the following 2. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and advertising injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business b To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of Paragraph 1a above c For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs 1a or b above or d Arising out of his or her providing or failing to provide professional health care services. However Paragraphs 1a and 1d do not apply to your employees or volunteer workers who are not employed by you or volunteering for you as health care professionals for bodily injury arising out of Good Samaritan Acts while the employee or volunteer worker is performing duties related to the conduct of your business. Good Samaritan Acts mean any assistance of a medical nature rendered or provided in an emergency situation for which no remuneration is demanded or received. Paragraphs 1a b and c do not apply to any employee designated as a supervisor or higher in rank with respect to bodily injury to coemployees. As used in this provision employees designated as a supervisor or higher in rank means only employees who are authorized by you to exercise direct or indirect supervision or control over employees or volunteer workers and the manner in which work is performed. D. Additional Insureds Lessees of Premises 1. Section Il Who Is An Insured is amended to include as an additional insured any persons or organizations who leases or rents a part of the premises you own or manage who you are required to add as an additional insured on this policy under a written contract or written agreement but only with respect to liability arising out of your ownership maintenance or repair of that part of the premises which is not reserved for the exclusive use or occupancy of such person or organization or any other tenant or lessee. This provision does not apply after the person or organization ceases to lease or rent premises from you. However the insurance afforded to such additional insured a. Only applies to the extent permitted by law and b. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. With respect to the insurance afforded to the additional insureds under this endorsement the following is added to Section Il Limits Of Insurance U GL1345 C CW 0320 Page 2 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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The most we will pay on behalf of the additional insured is the amount of insurance a. Required by the written contract or written agreement referenced in Subparagraph D.1. above of this endorsement or b. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This Paragraph D. shall not increase the applicable Limits of Insurance shown in the Declarations. E. Additional Insured Vendors 1. The following change applies if this Coverage Part provides insurance to you for bodily injury and property damage included in the products completed operations hazard Section Il Who Is An Insured is amended to include as an additional insured any person or organization referred to throughout this Paragraph E. as vendor who you have agreed in a written contract or written agreement prior to loss to name as an additional insured but only with respect to bodily injury or property damage arising out of your products which are distributed or sold in the regular course of the vendor s business However the insurance afforded to such vendor a. Only applies to the extent permitted by law and b. Will not be broader than that which you are required by the written contract or written agreement to provide for such vendor. 2. With respect to the insurance afforded to these vendors the following additional exclusions apply a. The insurance afforded the vendor does not apply to 1 Bodily injury or property damage for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement 2 Any express warranty unauthorized by you 3 Any physical or chemical change in the product made intentionally by the vendor 4 Repackaging except when unpacked solely for the purpose of inspection demonstration testing or the substitution of parts under instructions from the manufacturer and then repackaged in the original container 5 Any failure to make such inspections adjustments tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the products 6 Demonstration installation servicing or repair operations except such operations performed at the vendor s premises in connection with the sale of the product 7 Products which after distribution or sale by you have been labeled or relabeled or used as a container part or ingredient of any other thing or substance by or for the vendor or 8 Bodily injury or property damage arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However this exclusion does not apply to a The exceptions contained in Subparagraphs 4 or 6 or b Such inspections adjustments tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the products. b. This insurance does not apply to any insured person or organization from whom you have acquired such products or any ingredient part or container entering into accompanying or containing such products. U GL1345 C CW 0320 Page 3 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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c. This insurance does not apply to any of your products for which coverage is excluded under this Coverage Part. With respect to the insurance afforded to the vendor under this endorsement the following is added to Section Il Limits Of Insurance The most we will pay on behalf of the vendor is the amount of insurance a. Required by the written contract or written agreement referenced in Subparagraph E.1. above of this endorsement or b. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This Paragraph E. shall not increase the applicable Limits of Insurance shown in the Declarations. F. Additional Insured Managers Lessors or Governmental Entity 1. 2. 3. Section Il Who Is An Insured is amended to include as an insured any person or organization who is a manager lessor or governmental entity who you are required to add as an additional insured on this policy under a written contract written agreement or permit 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 b. The acts or omission of those acting on your behalf and resulting directly from a. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit b. Ownership maintenance occupancy or use of premises by you or. Maintenance operation or use by you of equipment leased to you by such person or organization. However the insurance afforded to such additional insured a. Only applies to the extent permitted by law and b. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. This provision does not apply a. Unless the written contract or written agreement has been executed or the permit has been issued prior to the bodily injury property damage or offense that caused personal and advertising injury To any person or organization included as an insured under Paragraph 3. of Section Il Who Is An Insured To any lessor of equipment if the occurrence or offense takes place after the equipment lease expires To any 1 Owners or other interests from whom land has been leased by you or 2 Managers or lessors of premises if a The occurrence or offense takes place after the expiration of the lease or you cease to be a tenant in that premises b The bodily injury property damage or personal and advertising injury arises out of the structural alterations new construction or demolition operations performed by or on behalf of the manager or lessor or c The premises are excluded under this Coverage Part. With respect to the insurance afforded to the additional insureds under this endorsement the following is added to Section lll Limits Of Insurance The most we will pay on behalf of the additional insured is the amount of insurance U GL1345 C CW 0320 Page 4 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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a. Required by the written contract or written agreement referenced in Subparagraph F.1. above of this endorsement or b. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This Paragraph F. shall not increase the applicable Limits of Insurance shown in the Declarations. G. Damage to Premises Rented or Occupied by You 1. 2. The last paragraph under Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following Exclusions. through n. do not apply to damage by specific perils to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Damage To Premises Rented To You Limit of Insurance applies to this coverage as described in Section Il Limits Of Insurance. Paragraph 6. of Section lll 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 any one premises while rented to you or in the case of damage by one or more specific perils to any one premises while rented to you or temporarily occupied by you with permission of the owner. H. Broadened Contractual Liability The insured contract definition under the Definitions Section is replaced by the following Insured contract means 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 specific perils to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract A sidetrack agreement Any easement or license agreement An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality An elevator maintenance agreement That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury property damage or personal and advertising injury arising out of the offenses of false arrest detention or imprisonment to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 2 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in Paragraph 1 above and supervisory inspection architectural or engineering activities. Definition Specific Perils The following definition is added to the Definitions Section Specific perils means U GL1345 C CW 0320 Page 5 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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Fire Lightning Explosion Windstorm or hail Smoke Aircraft or vehicles Vandalism R Weight of snow ice or sleet Leakage from fire extinguishing equipment including sprinklers or Accidental discharge or leakage of water or steam from any part of a system or appliance containing water or steam. J. Limited Contractual Liability Coverage Personal and Advertising Injury 1. Exclusion e. of Section Coverage B Personal And Advertising Injury Liability is replaced by the following 2. Exclusions This insurance does not apply to e. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to 1 Liability for damages that the insured would have in the absence of the contract or agreement or 2 Liability for personal and advertising injury if a The personal and advertising injury arises out of the offenses of false arrest detention or imprisonment b The liability pertains to your business and is assumed in a written contract or written agreement in which you assume the tort liability of another. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement and c The personal and advertising injury occurs subsequent to the execution of the written contract or written agreement. Solely for purposes of liability so assumed in such written contract or written agreement reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of personal and advertising injury described in Paragraph a above provided i Liability to such party for or for the cost of that party s defense has also been assumed in the same written contract or written agreement and ii Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. 2. Paragraph 2.d. of Section Supplementary Payments Coverages A and B is replaced by the following d. The allegations in the suit and the information we know about the occurrence or offense are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee 3. The following is added to the paragraph directly following Paragraph 2.f. of Section Supplementary Payments Coverages A and B Notwithstanding the provisions of Paragraph 2.e.2 of Section Coverage B Personal And Advertising Injury Liability such payments will not be deemed to be damages for personal and advertising injury and will not reduce the limits of insurance. U GL1345 C CW 0320 Page 6 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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K. Supplementary Payments The following changes apply to Supplementary Payments Coverages A and B Paragraphs 1.b. and 1.d. are replaced by the following b. Up to 2500 for the 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. 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. L. Broadened Property Damage 1. Property Damage to Contents of Premises Rented Short Term The paragraph directly following Paragraph 6 in Exclusion j. of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following Paragraphs 1 3 and 4 of this exclusion do not apply to property damage to premises other than damage by specific perils including property damage to the contents of such premises rented to you under a rental agreement for a period of 14 or fewer consecutive days. A separate Limit of Insurance applies to Damage to Premises Rented to You as described in Section Il Limits Of Insurance. 2. Elevator Property Damage a. The following is added to Exclusion j. of Section Coverage A Bodily Injury And Property Damage Liability Paragraphs 3 and 4 of this exclusion do not apply to property damage arising out of the use of an elevator at premises you own rent or occupy. b. The following is added to Section lll Limits Of Insurance Subject to Paragraph 5. above the most we will pay under Coverage A for damages because of property damage to property loaned to you or personal property in the care custody or control of the insured arising out of the use of an elevator at premises you own rent or occupy is 25000 per occurrence. 3. Property Damage to Borrowed Equipment a. The following is added to Exclusion j. of Section Coverage A Bodily Injury And Property Damage Liability Paragraph 4 of this exclusion does not apply to property damage to equipment you borrow from others at a jobsite. b. The following is added to Section lll Limits Of Insurance Subject to Paragraph 5. above the most we will pay under Coverage A for damages because of property damage to equipment you borrow from others is 25000 per occurrence. M. Expected or Intended Injury or Damage Exclusion a. of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following a. Expected Or Intended Injury Or Damage 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. N. Definitions Bodily Injury The bodily injury definition under the Definitions Section is replaced by the following Bodily injury means bodily injury sickness or disease sustained by a person including mental anguish mental injury shock fright or death sustained by that person which results from that bodily injury sickness or disease. U GL1345 C CW 0320 Page 7 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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0. Insured Status Amateur Athletic Participants Section Il Who Is An Insured is amended to include as an insured any person you sponsor while participating in amateur athletic activities. However no such person is an insured for a. Bodily injury to 1 Your employee volunteer worker or any person you sponsor while participating in such amateur athletic activities or 2 You any partner or member if you are a partnership or joint venture or any member if you are a limited liability company while participating in such amateur athletic activities or b. Property damage to property owned by occupied or used by rented to in the care custody or control of or over which the physical control is being exercised for any purpose by 1 Your employee volunteer worker or any person you sponsor or 2 You any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. P. Non Owned Aircraft Auto and Watercraft Exclusion g. of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following g. Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercratft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 51 feet long and b Not being used to carry persons for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured 4 Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft 5 An aircraft that is hired or chartered by you or loaned to you with a paid and licensed crew and is not owned in whole or in part by an insured or 6 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or b The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definition of mobile equipment. Q. Definitions Leased Worker Temporary Worker and Labor Leasing Firm 1. The leased worker and temporary worker definitions under the Definitions Section are replaced by the following Leased worker means a person leased to you by a labor leasing firm under a written agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker. U GL1345 C CW 0320 Page 8 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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Temporary worker means a person who is furnished to you to support or supplement your work force during employee absences temporary skill shortages upturns or downturns in business or to meet seasonal or short term workload conditions. Temporary worker does not include a leased worker. 2. The following definition is added to the Definitions Section Labor leasing firm means any person or organization who hires out workers to others including any a. Employment agency contractor or services b. Professional employer organization or c. Temporary help service. R. Definition Mobile Equipment Paragraph f. of the mobile equipment definition under the Definitions Section is replaced by the following f. Vehicles not described in Paragraph a. b.. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However self propelled vehicles with the following types of permanently attached equipment exceeding a combined gross vehicle weight of 1000 pounds are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. S. Definitions Your Product and Your Work The your product and your work definitions under the Definitions Section are replaced by the following Your product a. Means 1 Any goods or products other than real property manufactured sold handled distributed or disposed of by a You b Others trading under your name or c A person or organization whose business or assets you have acquired and 2 Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance use handling maintenance operation or safety of your product and 2 The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. Your work a. Means 1 Work services or operations performed by you or on your behalf and U GL1345 C CW 0320 Page 9 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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2 Materials parts or equipment furnished in connection with such work services or operations. b. Includes 1 Warranties or representations made at any time with respect to the fitness quality durability performance use handling maintenance operation or safety of your work and 2 The providing of or failure to provide warnings or instructions. T. Duties in the Event of Occurrence Offense Claim or Suit Condition The following paragraphs are added to Paragraph 2. Duties In The Event Of Occurrence Offense Claim Or Suit of Section IV Commercial General Liability Conditions Notice of an occurrence or of an offense which may result in a claim under this insurance or notice of a claim or suit shall be given to us as soon as practicable after knowledge of the occurrence offense claim or suit has been reported to any insured listed under Paragraph 1. of Section Il Who Is An Insured or an employee authorized by you to give or receive such notice. Knowledge by other employees of an occurrence offense claim or suit does not imply that you also have such knowledge. In the event that an insured reports an occurrence to the workers compensation carrier of the Named Insured and this occurrence later develops into a General Liability claim covered by this Coverage Part the insured s failure to report such occurrence to us at the time of the occurrence shall not be deemed to be a violation of this Condition. You must however give us notice as soon as practicable after being made aware that the particular claim is a General Liability rather than a Workers Compensation claim. U. Other Insurance Condition Paragraphs 4.a. and 4.b.1 of the Other Insurance Condition of Section IV Commercial General Liability Conditions are replaced by the following 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method described in Paragraph c. below. However this insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that 1 The additional insured is a Named Insured under such other insurance and 2 You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. Other insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contingent or on any other basis i Thatis property insurance Builder s Risk Installation Risk or similar coverage for your work ii That is property insurance purchased by you including any deductible or self insurance portion thereof to cover premises rented to you or temporarily occupied by you with permission of the owner iii That is insurance purchased by you including any deductible or self insurance portion thereof to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner U GL1345 C CW 0320 Page 10 0f 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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b c iv If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to Exclusion g. of Section Coverage A Bodily Injury And Property Damage Liability or v That is property insurance including any deductible or self insurance portion thereof purchased by you to cover damage to Equipment you borrow from others or Property loaned to you or personal property in the care custody or control of the insured arising out of the use of an elevator at premises you own rent or occupy. Any other primary insurance including any deductible or self insurance portion thereof available to the insured covering liability for damages arising out of the premises operations products work or services for which the insured has been granted additional insured status either by policy provision or attachment of any endorsement. Other primary insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities. Any of the other insurance whether primary excess contingent or on any other basis available to an additional insured in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same occurrence claim or suit. This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non contributory basis. V. Unintentional Failure to Disclose All Hazards Paragraph 6. Representations of Section IV Commercial General Liability Conditions is replaced by the following 6. Representations By accepting this policy you agree a. The statements in the Declarations are accurate and complete b. Those statements are based upon representations you made to us and c. We have issued this policy in reliance upon your representations. Coverage will continue to apply if you unintentionally a. Fail to disclose all hazards existing at the inception of this policy or b. Make an error omission or improper description of premises or other statement of information stated in this policy. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to inception of this Coverage Part. W. Waiver of Right of Subrogation Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV Commercial General Liability Conditions is replaced by the following 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. If the insured waives its right to recover payments for injury or damage from another person or organization in a written contract executed prior to a loss we waive any right of recovery we may have against such person or organization because of any payment we have made under this Coverage Part. The written contract will be considered executed when the insured s performance begins or when it is signed whichever happens first. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. X. Liberalization Condition U GL1345 C CW 0320 Page 11 of 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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The following condition is added to Section IV Commercial General Liability Conditions Liberalization Clause If we revise this Coverage Part to broaden coverage without an additional premium charge your policy will automatically provide the additional coverage as of the day the revision is effective in the state shown in the mailing address of your policy. All other terms conditions provisions and exclusions of this policy remain the same. U GL1345 C CW 0320 Page 12 0f 12 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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Z ZURICH Asbestos Exclusion Endorsement Policy No. GLO 0782528 00 Eff. Date of Pol. 06242021 Exp. Date of Pol. 061242022 Eff. Date of End. 06242021 Producer No. 37385000 Addl Prem. Return Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part The following exclusion is added to paragraph 2. Exclusions of Section I Coverage A Bodily Injury And Property Damage Liability and Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Asbestos A. B. C. Bodily injury property damage or personal and advertising injury arising out of or which would not have occurred in whole or in part but for the actual alleged or threatened discharge dispersal release leakage leaching friability flaking escape or presence of asbestos regardless of whether any other cause event material or product contributed concurrently or in any sequence to the injury or damage or Any sums that any insured or other entity must pay repay or reimburse because of any 1. Request demand order statutory or regulatory requirement direction or determination that any insured or others test for investigate monitor clean up remove study contain treat encapsulate control or take any other action regarding asbestos or 2. Claim or suit for damages arising out of or relating in any way to any request demand order statutory or regulatory requirement direction or determination that any insured or others test for investigate monitor clean up remove study contain treat encapsulate control or take any other action regarding asbestos or Any other loss cost or expense arising out of or relating in any way to asbestos. U GL1178 A CW 0703 Page 1 of 1 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 01091185 KANSAS AND OKLAHOMA CHANGES TRANSFER OF RIGHTS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Condition 8. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Section IV does not apply to COVERAGE C. MEDICAL PAYMENTS. CL 205 11 85 CG 01091185 Copyright Insurance Services Office Inc. 1984 Page 1of 1
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Communicable Disease Exclusion Scheduled and Uncontrolled With Limited Exceptions ZURICH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO 0782528 00 Effective Date 06242021 This endorsement modifies insurance provided under the following Commercial General Liability Coverage Form SCHEDULE OF COMMUNICABLE DISEASES Scheduled Communicable Diseases b. Ebola Virus Disease Lassa Fever Crimean Congo hemorrhagic fever Yellow Fever Zika Chikungunya Avian and Other Zoonotic Influenza Pandemic Influenza Middle East Respiratory Syndrome Monkeypox Plague Leptospirosis Meningococcal Meningitis Dengue Fever Smallpox Anthrax Pandemic Coronavirus If b. in the Schedule above is blank only a. shall apply. A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Communicable Disease 1 Bodily injury property damage or personal and advertising injury arising out of the actual alleged or potential presence of transmission of or exposure to communicable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing including but not limited to the a Supervising investigating hiring employing training or monitoring of others who may be infected with or spread a communicable disease b c Failure to prevent the presence of or abate the exposure to a communicable disease d Testing property or persons for the presence of a communicable disease Failure or inability to provide a safe work environment including but not limited to the failure to provide evaluate obtain maintain or require the use of personal protective equipment e Warning or failure to warn of or disclose the presence of or exposure to or the diagnosis of or spread of a communicable disease or f Failure to report or publish the presence of or exposure to or the diagnosis of or transmission of a communicable disease. oronavirus U GL2199 A CW 0720 Page 1 of 2 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of a communicable disease or b Claim or suit for costs or damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of a communicable disease. Such loss cost or expense is excluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss cost or expense. 3 The exclusion of Paragraph 1 does not apply to any bodily injury caused by a any fungi or bacteria that are are on or are contained in an edible good or edible product intended for human or animal consumption b any food contamination or c any Good Samaritan Acts rendered or performed by an insured on or away from the premises of the Named Insured. Subparagraph a of this exception does not apply to diseases contracted by contact with fungi or bacteria in water water vapor or water droplets including but not limited to Legionnaire s Disease. B. For purposes of this endorsement Bacteria means any type or form of bacteria and any materials or substances that are produced or released by bacteria. Communicable disease means 1. all Scheduled Communicable Diseases identified in Schedule of Communicable Diseases above or 2. any uncontrolled communicable disease. Food contamination means outbreak of food poisoning or food related iliness of one or more persons arising out of 1. Tainted food you distributed or purchased 2. Food which has been improperly processed stored handled or prepared in the course of your business operations or 3. Food which has been contaminated by virus or bacteria transmitted through one or more of your employees or temporary workers. Fungi means any type or form of fungus including mold or mildew and any mycotoxins spores scents or by products produced or released by fungi. As used herein spores means reproductive bodies produced by or arising out of fungi. Good Samaritan Act means any assistance of a medical nature rendered or performed in an emergency situation for which no remuneration is requested or received provided that such assistance is rendered or performed for the duration of the emergency and the injured party would have suffered additional injury or death had such assistance not been rendered or performed. Uncontrolled communicable disease means any infectious disease that the World Health Organization WHQO or Center for Disease Control CDC declares to be a public health emergency PHE or for which any U.S. state governor state health agency state health department or similar U.S. public health entity has issued a public health notice or similar declaration of a PHE. All other terms conditions provisions and exclusions of this policy remain the same. U GL2199 A CW 0720 Page2of 2 Includes copyrighted material of Insurance Services Office Inc. with its permission.
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Z ZURICH Deductible Endorsement Claims Made Policy No. GLO 0782528 00 Exp. Date of Pol. 06242022 Eff. Date of End. 06242021 Agency No. 37385000 Addl Prem. Return Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Employee Benefits Liability Coverage Part It is agreed that the following deductible provisions are added to the policy as respects the Employee Benefit Liability Coverage Part Deductible 1000 1 The deductible amount stated above shall be deducted from the amount of all claims arising out of the same act error or omission. We shall be liable only for the difference between such deductible amount and the amount of insurance otherwise applicable on a per claim basis. The Aggregate Limit will not be reduced by the application of such deductible. The terms of this Coverage Part apply regardless of the application of the deductible amount. This includes those terms with respect to a. Our rights and duties with respect to the defense of suits and b. The insured s duties in the event of an act error or omission or a claim or suit. We may pay any part or all of the deductible amount to effect settlement of any claim or suit. You shall promptly reimburse us for such part of the deductible amount as has been paid by us after we notify you of our action. U GL850 A CW 796 Page 1of 1
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 21041185 EXCLUSION PRODUCTS COMPLETED OPERATIONS HAZARD This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART This insurance does not apply to bodily injury or property damage included within the products completed operations hazard. CL 267 11 85 CG 21041185 Copyright Insurance Services Office Inc. 1984 Page 1of 1
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COMMERCIAL GENERAL LIABILITY CG 21080514 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION COVERAGE B ONLY This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Adver tising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal infor mation including patents trade secrets pro cessing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or or ganization s confidential or personal infor mation. CG 21080514 Insurance Services Office Inc. 2013 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21320509 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMUNICABLE DISEASE EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Exclusions of Section Coverage B Injury And Property Damage Liability Personal And Advertising Injury Liability 2. Exclusions 2. Exclusions This insurance does not apply to Communicable Disease Bodily injury or property damage arising out of the actual or alleged transmission of a communicable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the a. Supervising hiring employing training or monitoring of others that may be infected with and spread a communicable disease b. Testing for a communicable disease c. Failure to prevent the spread of the disease or d. Failure to report the disease to authorities. This insurance does not apply to Communicable Disease Personal and advertising injury arising out of the actual or alleged transmission of a communicable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the a. Supervising hiring employing training or monitoring of others that may be infected with and spread a communicable disease b. Testing for a communicable disease c. Failure to prevent the spread of the disease or d. Failure to report the disease to authorities. CG 21320509 Insurance Services Office Inc. 2008 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21471207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bod ily Injury And Property Damage Liability This insurance does not apply to Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employ ment or c Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment hu miliation discrimination or malicious prosecution directed at that person or 2 The spouse child parent brother or sister of that person as a consequence of bodily injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after employment of that person 2 Whether the insured may be liable as an employer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay dam ages because of the injury. B. The following exclusion is added to Paragraph 2. Exclusions of Section I Coverage B Per sonal And Advertising Injury Liability This insurance does not apply to Personal and advertising injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employ ment or c Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment hu miliation discrimination or malicious prosecution directed at that person or 2 The spouse child parent brother or sister of that person as a consequence of per sonal and advertising injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after employment of that person 2 Whether the insured may be liable as an employer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay dam ages because of the injury. CG 21471207 Copyright ISO Properties Inc. 2006 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21 55 09 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion f. under Paragraph 2. Exclusions of Sec tion Coverage A Bodily Injury And Property Dam age Liability is replaced by the following This insurance does not apply to f. Pollution 1 Bodily injury or property damage which would not have occurred in whole or part but for the actual alleged or threatened dis charge dispersal seepage migration release or escape of pollutants at any time. This exclusion does not apply to bodily inju ry or property damage arising out of heat smoke or fumes from a hostile fire unless that hostile fire occurred or originated a At any premises site or location which is or was at any time used by or for any in sured or others for the handling storage disposal processing or treatment of waste or b At any premises site or location on which any insured or any contractors or subcon tractors working directly or indirectly on any insured s behalf are performing opera tions to test for monitor clean up re move contain treat detoxify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a b Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up re move contain treat detoxify or neutral ize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a govern mental authority for damages because of testing for monitoring cleaning up re moving containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollut b At any premises site or location on which any insured or any contractors or subcon tractors working directly or indirectly on any insured s behalf are performing opera tions to test for monitor clean up re move contain treat detoxify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a Request demand order or statutory or b regulatory requirement that any insured or others test for monitor clean up re move contain treat detoxify or neutral ize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a govern mental authority for damages because of testing for monitoring cleaning up re moving containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollut ants. CG 215509 99 Page 1 of 1 Copyright Insurance Services Office Inc. 1998
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RISK SPECIALISTS COMPANIES INSURANCE AGENCY INC 500 WEST MADISON STREET SUITE 3000 CHICAGO IL 60661 Date January 28 2014 Attn LAUREN HOUTS LOCKTON COMPANIES 444 W. 47th Street Suite 900 Kansas City MO 64112 RE NEWMAN MEMORIAL COUNTY HOSPITAL Policy Number 6796532 Policy Effective Expiration From January 1 2014 To January 1 2015 Dear Lauren Enclosed are one original and one copy of the policy for the above captioned account. Upon review of the policy we believe it is complete and accurate based upon the binder. However if you discover anything you believe to be incomplete or inaccurate please call me and your concerns will be investigated. In order to complete our file please forward Not applicable. Thank you for the opportunity to be of service to your company on this account. We look forward to working with you on future opportunities. Best regards Jeffrey Ragauskis Production Specialist jeffrey.ragauskisaig.com 312.930.5348 HC0900 304
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FORMS SCHEDULE Named Insured Policy No Effective Date NEWMAN MEMORIAL COUNTY HOSPITAL 6796532 January 1 2014 Endt. No. Form Name XND O AW N 11 12 Policy Declarations Common Policy Provisions Coverage Part Healthcare General Liability Occurrence Form Coverage Part Il Medical Professional Liability Claims Made Schedule of Named Insureds Entities KS Amendatory Endorsement Cancellation and Non Renewal KS Amendatory Endorsement Addendum to Form 68926 KS Amendatory Endorsement Adds HCSF Surcharge to Dec. Page Amendment of Limits Asbestos Exclusion Cross Suits Limitation Economic Sanctions Endorsement Minimum Earned Premium Endorsement Employee Benefits Liability Endorsement Claims Made Specific Additional Insured Any Lessor of Premises or Equipment Specific Additional Insured Form Number Edition Date 68925 68926 68926 68926 68763 52144 69396 69644 78944 68767 68769 89644 74778 68770 68765 68765 1097 1010 1097 0513 1097 1112 1087 1112 0997 1202 0198 0298 1101 0997 0997 0613 0608 0997 0997 0997 jorsement m Endorsement T T CIFMSC Clo226
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company MEDICAL PROFESSIONAL LIABILITY CLAIMS MADE AND COMMERCIAL GENERAL LIABILITY OCCURRENCE DECLARATIONS Various provisions in the Common Policy Provisions and Coverage Parts restrict coverage. Coverage Part is on an occurrence basis while Coverage Part Il is claims made. Please read all Common Policy Provisions and Coverage Parts carefully to determine rights duties and what is and is not covered. POLICY NUMBER 6796532 RENEWAL OF NUMBER 6796532 Item 1. Item 2. NAMED INSURED NEWMAN MEMORIAL COUNTY HOSPITAL ADDRESS 1201 W. 12 AVE. EMPORIA KS 66801 5553 Item 3. RETROACTIVE DATE 07011976 Item 4. POLICY PERIOD From 01012014 To 01012015 at 1201 a.m. Standard Time at your mailing address shown above. Item 5. LIMITS OF INSURANCE l Healthcare General Liability Aggregate Limit 3000000 Products Completed Operations Aggregate Limit 1000000 Each Occurrence Limit 1000000 Personal Advertising Injury Limit 1000000 Fire Damage Limit 50000 Each Fire Medical Expense Limit 5000 Each Injured Person ll Healthcare Professional Liability Aggregate Limit 600000 Each Medical Incident 200000 Administrative Hearing Expense Limit SN A Item 6. PREMIUM Premium 83095 Item 7. FORMS AND ENDORSEMENTS Forms and Endorsements Attached at Inception See Attached Forms Schedule Item 8. PRODUCER NAME AND ADDRESS LOCKTON COMPANIES 444 W. 47 STREET SUITE 900 KANSA CITY MO 64112 ATTN LAUREN HOUTS By By MQML 68925 1 Countersignature Authorized Representative in states where applicable 097 1010 I H rations Aggregate Limit ry Limit lity wpense Limit D00000 00000 00000 00000 50000 Each Fire 5000 Each Injured Person 0000 0000 A 900 1010
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company COMMON POLICY PROVISIONS I DEFINITIONS APPLICABLE TO ALL COVERAGE PARTS A. Auto means a land motor vehicle trailer or semi trailer designed for travel on public roads including any attached machinery or equipment. Auto however does not include mobile equipment. B. Bio Medical Waste means a biological agent or condition which includes but is not limited to an infectious organism or unsafe laboratory condition which may cause or result in bodily injury or property damage. C. Defense costs means 1. fees charged by an attorney designated by us and 2. other fees costs and expenses incurred by us in the investigation adjustment defense and appeal of a claim other than the specific items listed in Common Policy Provisions Section IV. Defense costs does not include salary charges or expenses of our regular employees. D. Executive Officer means a person holding any of the officer positions created by your charter constitution by laws or any other similar governing document. E. Insured means 1. The Named Insured stated in the Declarations. 2. Your employees other than your executive officers or your members if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. No employee however is an Insured for a. Bodily injury or personal injury i. To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company or to a co employee while in the course of his or her employment or while performing duties related to the conduct of your business. it To the spouse child parent brother or sister of that co employee as a consequence of paragraph a.i. above. fii. For which there is an obligation to share damages with or repay another who must pay damages due to an injury described in a. i. or ii. above. iv. Arising out of his or her providing or failing to provide professional health care services. b. Property Damage to property 68926 1097 CP1 0513 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company i. Owned occupied or used by or ii. Rented to in the care of custody or control of or over which physical control is being exercised for any purpose by any Insured any Insured s employees or if any Insured is a partnership or a joint venture by any partner or any member if you are a limited liability company. 3. Any student enrolled in a training program in connection with your professional services but only when acting within the scope of his or her duties. Any of your authorized volunteer workers other than a healthcare provider but only while acting within the scope of their duties as such. 4. Your legal representative if you die but only with respect to his or her duties as a legal representative. 5. Your superintendents administrators directors department heads and heads of the medical staff but only in their capacity as such. 6. Members of your boards and committees but only for conduct arising out of their duties as board or committee members and those who execute orders from your boards or committees but only while in the course and scope of executing those orders. 7. Your trustees and governors but only for the conduct of your business within the course and scope of their employment or their duties as trustees or governors. Each of the following is an Insured under Insuring Agreement A to the extent set forth below 1. Real Estate Manager Any person other than your employee or any organization while acting as your real estate manager. 2. Persons With Temporary Custody Any person or organization having proper temporary custody of your property if you die but only a. With respect to liability arising out of the maintenance or use of that property and b. Until your legal representative has been appointed. 3. Users of Mobile Equipment With respect to mobile equipment registered in your name under any motor vehicle registration law any person is an Insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an Insured but only with respect to liability arising out of the operation of the equipment and only if no other insurance of any kind is available to that person or organization for this liability. No person or organization however is an Insured with respect to 68926 1097 CP2 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 No A Capital Stock Insurance Company Bodily injury to a co employee of the person driving the equipment or Property damage to property owned by rented to occupied by any Insured in any Insured s charge or the employer of any person who is an Insured under this provision. person or organization is an Insured with respect to the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. F. Loading or Unloading means the handling of property 1. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto 2. 3. While it is in or on an aircraft watercraft or auto or While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered But loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. G. Mobile Equipment means any of the following types of land vehicles including any attached machinery or equipment and including but not limited to 1. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads Vehicles maintained for use solely on or next to premises you own or rent Vehicles that travel on crawler treads Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted Power cranes shovels loaders diggers or drills or Road construction or resurfacing equipment such as graders scrapers or rollers Vehicles other than those described in Items 1 2 3 or 4 above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 2. 3 4. a. b. 5. a. b. 6. Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or Cherry pickers and similar devices used to raise or lower workers Vehicles other than those described in Items 1 2 3 or 4 above that are maintained primarily for purposes other than the transportation of persons or cargo. 68926 1097 cP3 05613
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company Self propelled vehicles however with the following types of permanently attached equipment are not mobile equipment but will be considered autos a. Equipment designed primarily for i Snow removal i Road maintenance but not construction or resurfacing fii. Street cleaning b. Cherry pickers and similar devices mounted on auto or truck chassis and used to raise or lower workers and c. Air compressor pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. H. Named Insured means the first entity named in the Declarations of this policy as the Named Insured. 1. If the Named Insured stated in Declarations is a corporation or organization other than a partnership or joint venture the Named Insured and executive officers and directors are Insureds but only with respect to their duties as officers or directors. Stockholders are also Insureds but only with respect to their liability as stockholders. o Any organization that the Named Insured newly acquires or forms while this insurance is in effect is an Insured if maintain ownership or majority interest of it but solely in accordance with Common Policy Provisions Section V e. Mergers Acquisitions. 3. If the Named Insureds are a partnership or joint venture your members your partners and their spouses are also Insureds but only with respect to the conduct of your business. I. Policy Period means the period commencing on the inception date shown in Item 4 of the Declarations and ending on the earlier of the expiration date or the effective date of cancellation of the Policy. J. Pollutants means any solid liquid gaseous or thermal irritant or contaminant including but not limited to smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes but is not limited to bio medical waste nuclear waste and material to be recycled reconditioned or reclaimed. K. Property Damage means 1. Physical injury to tangible property including resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it 2. Loss of use of tangible property that is not physically injured. Solely with respect to Coverage Part I all such loss of use shall be deemed to occur at the time of the occurrence that caused it. 68926 1097 CP4 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor. New York NY 10038 A Capital Stock Insurance Company Suit means a civil proceeding in a court in which damages to which this insurance applies are alleged. Suit includes 1. An arbitration proceeding in which such damages are claimed and to which you must submit or submit with our consent or 2. Any alternative dispute resolution proceeding other than a covered proceeding in which such damages are claimed and to which you submit with our consent.. We us or our means the Company providing insurance under this policy. You or your means the Named Insured under this policy. EXCLUSIONS We will not defend or pay claims against you Workers Compensation and Similar Laws For any obligation you have under a workers compensation disability benefits or unemployment compensation law or any similar law. Employer s Liability For bodily injury to 1. An employee of yours arising out of and in the course of a. Employment by you or b. Performing duties related to the conduct of your business or 2. The spouse child parent brother or sister of that employee as a consequence of paragraph 1 above. This exclusion applies a. Whether you may be liable as an employer or in any other capacity and b. To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by you under an insured contract. Employment Practices For any liability arising out of any refusal to employ termination of employment coercion demotion evaluation reassignment discipline defamation harassment humiliation or other practices or policies related to employment or professional privileges. 68926 1097 CP5 0513 CP5 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company This exclusion does not apply to services by any person as a member of a formal accreditation standards review or similar professional board or committee of any Insured otherwise covered by this policy. D. Damage to Property For property damage to 1. Property any Insured owns rents or occupies 2. Premises any Insured sells gives away or abandons if the property damage arises out of any part of those premises 3. Property loaned to any Insured 4. Personal property in any Insured s care custody or control 5. That particular part of the real property on which any Insured or any contractors or subcontractors working directly or indirectly on any Insureds behalf are performing operations if the property damage arises out of those operations or 6. That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. With respect to Property Damage under Insuring Agreement A. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6. of this exclusion does not apply to property damage included in the products completed operations hazard. E. War For war whether or not declared or any act or condition incident to war. War includes civil war insurrection rebellion or revolution. F. Dishonest Practices For dishonest fraudulent criminal or malicious acts errors or omissions however we will defend claims alleging such acts errors or omissions until final adjudication. 68926 1097 CP6 0513
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NATIONAL UNION FIRE INSURANCE CONMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company G. Pollution 1. For any liability which would not have occurred in whole or part but for the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a. at or from any premises site or location which is or was at any time owned or occupied by or rented or loaned to you b. at or from any premises site or location which is or was at any time used by or for you or others for the handling storage disposal processing or treatment of waste c. which are or were at any time transported handled stored treated disposed of or processed as waste by or for you or any person or organization for whom you may be legally responsible or d. at or from any premises site or location on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations. i if the pollutants are brought on or to the premises site or location in connection with such operations by you contractor or subcontractor or ii if the operations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. Subparagraphs di does not apply to bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to perform the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not apply if the fuels lubricants or other operating fluids are intentionally discharged dispersed or released or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent to be discharged dispersed or released as part of the operations being performed by you contractor or subcontractor. Subparagraphs a and di do not apply to bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. 2. For any loss cost or expense arising out of any a. Request demand or order that you or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or b. Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. H. Nuclear Hazards For any liability 1. Resulting from the hazardous properties of nuclear material if 68926 1097 CP7 0513 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2585 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company a. the nuclear material is at any nuclear facility owned or operated by you or on your behalf or has been discharged or dispersed therefrom b. the nuclear material is contained in spent fuel or nuclear waste at anytime possessed handled used processed stored transported or disposed of by you or on your behalf or c. the liability arises out of your furnishing of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuclear facility. If such facility is within the coverage territory this subparagraph applies only to property damage to the nuclear facility and any property thereat 2. With respect to which you are also an Insured under a Nuclear Energy Liability Policy issued by a. Nuclear Energy Liability Insurance Association b. Mutual Atomic Energy Liability Underwriters or c. Nuclear Insurance Association of Canada or any of their successors or would be an Insured under any such policy if it had not terminated due to exhaustion of that policy s limit of liability or 3. Arising from or caused by hazardous properties of nuclear material and with respect to which a any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954 or any subsequent amendment of that Act or b you are or had this Policy not been issued would be entitled to indemnity from the United States of America or any agency thereof under any agreement entered into by the United States of America or any agency thereof with any person or organization. As used in this exclusion Hazardous Properties means radioactive toxic or explosive properties. Nuclear Facility means 1. Any nuclear reactor 2. Any equipment or device designed or used for a. separating the isotopes of uranium or plutonium b. processing or utilizing spent fuel or c. handling processing or packaging nuclear waste 3. Any equipment or device used for the processing fabricating or alloying of special nuclear material if at any time the total amount of such material in your custody at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 68926 1097 CP8 0513
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NATIONAL UNION FIRE INSURANCE CONMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stack Insurance Company 4. Any structure basin excavation premises or place prepared or used for the storage or disposal of nuclear waste or 5. The site on which the above are located all operations conducted on those sites and all premises used for such operations. Nuclear Material means source material special nuclear material or by product material. Nuclear Reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material. Nuclear Waste means any waste material 1. Containing by product material other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its source material content and 2. Resulting from the operation by an entity of any nuclear facility included under the first two paragraphs of the definition of nuclear facility. Source Material Special Nuclear Material and By product Material have the meanings stated in the U.S. Atomic Energy Act of 1954 or any other amendments to that Act. Spent Fuel means any fuel element or fuel component solid gas or liquid which has been used in or exposed to radiation in a nuclear reactor. Sexual Misconduct For any actual alleged attempted or proposed erotic physical contact or any sexual abuse or harassment. However we will defend claims alleging such acts until any such final adjudication. Discrimination Humiliation For discrimination based on but not limited to race color creed sex religion age national origin physical impairment sexual preference etc. whether or not for alleged violation of any federal state or local government law or regulation prohibiting such discrimination. In addition we will not pay claims or defend you for any claim resulting from humiliation or mental anguish arising out of discrimination. OUR DUTY TO DEFEND UNDER THIS POLICY We have the right and duty to defend and appoint an attorney to defend any suit against you for a covered claim even if the suit is groundless false or fraudulent. Our duty to defend any suit ends and we may withdraw from the defense after the applicable Limit of Insurance has been exhausted by settlements judgments awards and interest accruing thereon prior to entry of judgment or issuance of an award. Defense costs are in addition to the applicable Limits of Insurance. 68926 1097 CP9 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company B. We have the right to investigate and settle any claim or suit to the extent we believe is proper.. OTHER PAYMENTS UNDER THIS POLICY In addition to the Limits of Insurance applicable to this Policy we shall pay with respect to any suit we defend A. All expenses we incur. B. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the bodily injury liability coverage applies. We do not have to furnish these bonds. C. The cost of bonds to release attachments but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. D. All reasonable expenses incurred by you at our request including actual loss of earnings up to 500 a day because of time off from work. E. Pre judgment interest awarded against the Insureds on that part of the judgment we pay. If we make an offer to pay the applicable Limit of Insurance we will not pay any pre judgment interest based on that period of time after the offer. F. All interest on the full amount of any judgment that accrues after entry of the judgment and before we paid offered to pay or deposited in court the part of the judgment that is within the applicable Limit of Insurance. G. All costs taxed against the Insured. These payments will not reduce the Limits of Insurance. If we defend an Insured against a suit and an indemnitee of the Insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met A. The suit against the indemnitee seeks damages for which the Insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract B. This insurance applies to such liability assumed by the Insured C. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the Insured in the same insured contract D. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the Insured and the interests of the indemnitee E. The indemnitee and the Insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign and F. The indemnitee 1. Agrees in writing to 68926 1097 CP 10 0513 CP 10 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038. o a. b. So A Capital Stock Insurance Company Cooperate with us in the investigation settlement or defense of the suit Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit Notify any other insurer whose coverage is available to the indemnitee and Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and Provides us with written authorization to Obtain records and other information related to the suit and Conduct and control the defense of the indemnitee in such suit. long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Other Payments Under This Policy. Notwithstanding the provisions of paragraph D. 1. B. 2 of Coverage Part such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the limits of insurance. V. CONDITIONS The following conditions apply A. Duties in the Event Of An Occurrence Claim Suit Medical Incident or Covered Proceeding 1. You must notify us in writing as soon as practicable of an occurrence under Coverage Part. To the extent possible notice should include a. b. c. 2. How when and where the occurrence took place The names and addresses of any injured persons and witnesses and The nature and location of any injury or damage arising out of the occurrence. If a claim suit or covered proceeding is brought against you arising out of an occurrence or medical incident a. b. c. 68926 1097 You must immediately record the specifics of the claim or suit and the date received and You must provide us with written notice of the claim suit or covered proceeding as soon as practicable. You must Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit Authorize us to obtain records and other information Cooperate with us in the investigation settlement or defense of the claim or suit and CP11 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company d. Assist us upon our request in the enforcement of any right against any person or organization which may be liable to you because of injury or damage to which this insurance may also apply. 4. You will not except at your own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent. Notice of Potential Claims If during the policy period you shall become aware of any medical incident which may reasonably be expected to give rise to a claim or covered proceeding being made against any Insured and shall during the policy period give written notice to us of the medical incident any claim or covered proceeding which is subsequently made against any Insured and reported to us arising out of such medical incident shall be considered first made at the time such notice was given. In order to qualify as notice under this paragraph such notice must contain 1. Full particulars of the medical incident including how when and where it took place 2. The names and addresses of injured persons and any witnesses 3. The nature of any injury. Receipt by us of an incident report including but not limited to variance reports will not be considered a claim to us nor will the observance or reporting to you by us of any physical condition or other circumstance as a result of inspections audits engineering loss control or risk management services be considered a claim to us. Knowledge and Notice of Occurrence Knowledge of an occurrence or medical incident on the part of the risk management department or on the part of an executive officer constitutes knowledge by you. If someone other than the risk management department or an executive officer knows but does not tell you this insurance is not invalidated. Notice of a claim may be incorrectly given to a workers compensation carrier. If the claim instead is determined to be a valid occurrence or medical incident otherwise covered by this policy it will be covered in this policy period and by this insurance provided that you notify us immediately. Your unintentional failure to disclose a hazard at policy inception will not prejudice this insurance. Coverage Territory We will cover an occurrence or medical incident in the United States of America its territories and possessions Puerto Rico or Canada provided a claim is made and suit is brought in the United States of America its territories and possessions Puerto Rico or Canada. 68926 1097 CP12 0513 CP12 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company E. Mergers Acquisitions We will cover a newly acquired or formed organization only for sixty 60 days or for the remainder of the policy period whichever is less from the date that you acquire or form it. You are not covered for damages that arise out of bodily injury or property damage that occurred before you acquired or formed the organization or personal injury or advertising injury arising out of an occurrence committed before you acquired or formed the organization. You are not covered for damages that arise out of a medical incident that happened or commenced before you acquired or formed the organization. You shall notify us or our authorized representative in writing within sixty 60 days of such acquisition. If any person or organization became an additional Named Insured under this Policy after the inception date the policy period begins on the date that the person or organization became an additional Named Insured and ends on the earlier of the expiration date or the effective date of cancellation of the Policy. For coverage to apply to the newly acquired or formed organization for more than 60 days you must 1 submit an underwriting application to us and 2 the application must be approved by us. F. Insured Under Coverage Parts An Insured under Coverage Part 1 may or may not be an Insured under another Coverage Part Il. Please refer to the Common Policy Provisions Section Definitions to determine who is an Insured. G. Legal Action Against Us No person or organization has a right under this policy 1. To join us as a party or otherwise bring us into a suit asking for damages from you or 2. To sue us under this policy unless all this policy s terms have been complied with in full. A person or organization may sue us to recover on an agreed settlement or on a final judgment against you obtained after an actual trial but we will not be liable for damages that are not payable under the terms of any Insuring Agreement or that are in excess of the applicable Limit of Insurance. An agreed settlement means a settlement and release of liability signed by us and the claimant or the claimant s legal representative. H. Other Insurance If there is other insurance which applies to the loss resulting from an occurrence or medical incident the other insurance must pay first. This Policy applies to the amount of loss which is more than 1. The Limits of Insurance of the other insurance and 68926 1097 CP13 0513 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York. NY 10038 A Capital Stock Insurance Company 2. The total of all deductibles and self insured amounts under all such other insurance. 1. Muttiple Policies 1. Two or more policies may be issued by us or any company that controls is controlled by or is under common control with us. These policies may provide coverage for a. Claims suits or covered proceedings arising from the same medical incident or b. Persons or organizations covered in those policies that are jointly and severally liable. 2. In such a case we shall not be liable under this Policy for an amount greater than the proportion of the loss that this Policy s applicable Limit of Liability bears to the total applicable Limits of Liability under all such policies. In such a case we shall not be liable under this Policy for an amount greater than the proportion of the loss that this Policy s applicable Limit of Insurance bears to the total applicable Limits of Insurance under all such policies. In addition the total amount payable under all such policies is the highest single applicable Limit of Liability among all such policies. J. Separation of Insureds Except with respect to the Limits of Insurance and deductible and except with respect to any rights or duties specifically assigned in this Palicy to the Named Insured this insurance applies 1. As if each Insured were the only Insured and 2. Separately to each Insured against whom claim is made or suit is brought. K. Bankruptcy The Named Insured s bankruptcy or insolvency will not relieve us of our obligations under this policy. L. Representations By accepting this Policy the Named Insured agrees that 1. The statements in the Declarations andor Applications made part of this Policy are accurate and complete 2. Those statements are based upon representations made to us by the Named Insured and 3. We have issued this Policy in reliance upon the Named Insured s representations. 68926 1097 CP14 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company. Transfer Of Rights Of Recovery Against Others To Us if you have rights to recover all or part of any payment we have made under this Policy those rights are transferred to us. You shall do nothing to impair them. At our request you will bring suit or transfer those rights to us and help us enforce them. Conformance To Statute To the extent that this Policy conflicts with an applicable law statute or regulation of a state this Policy shall conform to the minimum requirements of that law statute or regulation. Assignment Your interest is not assignable without our written consent. Special Rights And Duties Of Named Insured The Named Insured shall act on behalf of all Insureds as to 1. Giving and receiving notice of cancellation 2. Payment of premiums and receipt of return premiums 3. Acceptance of any endorsements to this Policy 4. Purchasing or deciding not to purchase the Optional Extended Reporting Period Endorsement if applicable or 5. Making changes in this Policy or any Coverage Part with our consent. This Policy can only be changed by a written endorsement we issue and make a part of this Policy. Inspections And Surveys We have the right but are not obligated to 1. Make inspections and surveys at any time 2. Give the Named Insured reports on the conditions we find and 3. Recommend changes. Any inspections surveys reports or recommendations are related only to insurability and the premiums to be charged. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. We do not warrant that conditions 1. Are safe or healthful or 2. Comply with laws regulations codes or standards. 68926 1097 CP15 0513 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company This condition applies not only to us but also to any rating advisory rate service or similar organization which makes insurance inspections surveys reports or recommendations. R. Titles Of Paragraphs Titles of paragraphs are inserted solely for convenience of reference and shall not be deemed to limit expand or otherwise affect the provisions to which they relate. Vi. CANCELLATION NON RENEWAL A. When We Do Not Renew If we decide not to renew this Policy we will mail or deliver to the Named Insured at the address designated in the Declarations written notice of the non renewal not less than thirty 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. If we mail or deliver the notice less than thirty 30 days before the expiration we will extend the policy period so that the expiration date will be thirty 30 days after we mail or deliver the notice. You will be charged a pro rata additional premium for the extension. You can terminate the extension at any time but not retroactively. B. Cancellation This Policy may be canceled by the Named Insured by surrendering it to us or any of our authorized agents or by mailing to us written notice stating when thereafter the cancellation shall be effective. We may cancel this policy by mailing or delivering a written notice of cancellation to the Named Insured the address shown in this policy stating when not less than 30 days thereafter cancellation will be effective. However if we cancel this Policy because the Named Insured has failed to pay a premium when due this Policy may be canceled by us by mailing or delivering a written notice of cancellation to the Named Insured at the address shown in this Policy stating when not less than 10 days thereafter such cancellation will be effective. The mailing of notice as aforesaid shall be sufficient proof of notice. The time of the surrender or the effective date and hour of cancellation stated in the notice shall become the end of the policy period. Delivery of such written notice either by the Named Insured or by us shall be the equivalent to mailing. If the Named Insured cancels the unearned premium shall be computed in accordance with the customary short rate table and procedure. If we cancel unearned premium shall be computed pro rata. Premium adjustment may be made either at the time cancellation is effected or as soon as practicable after cancellation becomes effective but payment or tender of unearned premium is not a condition of cancellation. 68926 1097 CP16 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2695 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company By signing below the President and the Secretary of the Insurer agree on behalf of the Insurer to all the terms of this Policy. R EER 2y Secretary President This Policy must be signed at the time of issuance by an authorized representative of the Insurer either below or on the Declarations page of the policy. Authorized Representative 68926 1097 CP17 0513
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company Various provisions in the Common Policy Provisions and Coverage Parts restrict coverage. Coverage Part is on an occurrence basis while Coverage Part Il is on a claims made basis. Please read all Common Policy Provisions and Coverage Parts carefully to determine rights duties and what is and what is not covered. A complete Policy includes the Declarations Common Policy Provisions and the applicable Coverage Parts. COVERAGE PART I HEALTHCARE GENERAL LIABILITY OCCURRENCE FORM In consideration of the payment of the premium and in reliance upon the statements in the Application which is attached hereto and made a part of this Policy and upon the Declarations we agree with you as follows A INSURING AGREEMENTS Insuring Agreement A Bodily Injury and Property Damage We will pay those sums that you become legally obligated to pay as damages because of bodily injury or property damage to which this Coverage Part applies. We will have the right and duty to defend any suit seeking those damages. We may at our discretion investigate any occurrence and settle any claim or suit that may result. This Coverage Part applies to bodily injury and property damage only if 1. The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory and 2. The bodily injury or property damage occurs during the policy period. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. Insuring Agreement B Personal Injury and Advertising Injury We will pay those sums that you become legally obligated to pay as damages because of personal injury or advertising injury to which this Coverage Part applies. This Coverage Part applies 1. to personal injury caused by an offense arising out of your business excluding advertising publishing broadcasting or telecasting done by or for you or 2. to advertising injury caused by an offense committed in the course of advertising your goods products or services but only if the offense was committed in the coverage territory during the policy period. GL1 1112 68926 1097
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company C. Insuring Agreement C Medical Expenses We will pay medical expenses as described below for bodily injury caused by an accident 1. On premises you own or rent 2. On ways next to premises you own or rent or 3. Because of your operations Provided that 1. The accident takes place in the coverage territory and during the policy period 2. The expenses are incurred and reported to us within one year of the date of the accident and 3. The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. We will make these payments regardless of fault. These payments will not exceed the applicable Limit of Insurance. We will pay reasonable expenses for 1. First aid administered at the time of an accident 2. Necessary medical surgical x ray and dental services including prosthetic devices and 3. Necessary ambulance hospital professional nursing and funeral services. Exclusions In addition to Common Policy Provisions Section Il Exclusions the following Exclusions apply to this Coverage Part 1. With respect to Insuring Agreement A bodily injury and property damage we will not defend or pay claims against you a. Expected Or Intended Injury For damages or harm expected or intended from your standpoint. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability For liability arising from bodil jury or property damage for which you are obligated to pay damages by reason of the assumption of liability in a 68926 1097 GL2 11112
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company contract or agreement. This exclusion does not apply to liability for damages i. That you would have in the absence of the contract or agreement. il. Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an Insured are deemed to be damages because of bodily injury or property damage provided 1 liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and 2 such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. Damage to Your Product For property damage to your product arising out of it or any part of it. Damage to Your Work For property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. Damage to Impaired Property or Property Not Physically Injured For property damage to impaired property or property that has not been physically injured arising out of i. A defect deficiency inadequacy or dangerous condition in your product or your work or ii. A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use. Recall of Products Work or Impaired Property For damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of Your product 68926 1097 GL3 1112
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company il. Your work or iii. Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it. Exclusions c. through e. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Limit of Insurance applies to this coverage as described in Limits of Insurance Section IV. Liquor Liability For which you may be held liable by reason of Causing or contributing to the intoxication of any person The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or iii. Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. Aircraft Auto or Watercraft Arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to you. Use includes operation and loading or unloading. This exclusion shall not apply to i. A watercraft while ashore on premises you own or rent ii. 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 iii. Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you iv. Liability assumed under any Insured contract for the ownership maintenance or use of aircraft or watercraft GL4 1112 68926 1097
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company V. The operation of any of the equipment listed in paragraph 6.b. or 6.c. of the definition of mobile equipment or Vi. Loading or unloading of patients. Mobile Equipment Arising out of i. The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any Insured or ii. The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. With respect to Insuring Agreement B Personal Injury and Advertising Injury this Coverage Part shall not apply to Personal Injury or Advertising Injury a. b. Arising out of oral or written publication of material if done by or at the direction of the Named Insured with knowledge of its falsity Arising out of oral or written publication of material whose first publication took place before the beginning of the policy period Arising out of the willful violation of a penal statute or ordinance committed by or with the consent of the Named Insured For which you have assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that you would have in the absence of the contract or agreement. Advertising Injury a. b. Arising out of breach of contract other than misappropriation of advertising ideas under an implied contract Arising out of the failure of goods products or services to conform with advertising quality or performance Arising out of the wrong description of the price of goods products or services or An offense committed by an Insured whose business is advertising broadcasting publishing or telecasting. With respect to Insuring Agreement C Medical Expenses of this Coverage Part we will not pay Medical Expenses for Bodily Injury a. b. To any Insured To a person hired to do work for or on behalf of you or a tenant of yours To a person injured on that part of premises owned or rented by you that the person normally occupies 68926 1097 GL5 1112
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Fioor New York NY 10038 A Capital Stock Insurance Company d. To a person whether or not an employee of the Insured if benefits for the bodil ury are payable or must be provided under a workers compensation or disability benefits law or a similar law To a person injured while taking part in athletics Included within the products completed operations hazard Excluded under Insuring Agreement A of this Coverage Part or Resulting from hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any entity. i. To any patient. A patient means a person seeking or receiving either on an inpatient outpatient or emergency basis any form of medical surgical dental or nursing care or any service or treatment. ERE LIMITS OF INSURANCE The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of 1. Insureds 2. Claims submitted or suits brought or 3. Persons or organizations making claims or bringing suits. The General Aggregate Limit is the most we will pay for the sum of 1. Damages under Insuring Agreement A except damages because of bodil or property damage included in the products completed operations hazard 2. Damages under Insuring Agreement B and 3. Medical expenses under Insuring Agreement C. The Products Completed Operations Aggregate Limit is the most we will pay under Insuring Agreement A for damages because of bodily injury and property damage included in the products completed operations hazard. Subject to B. above the Personal Injury and Advertising Injury Limit is the most we will pay under Insuring Agreement B for the sum of all damages because of all personal injury or advertising injury sustained by any one person or organization. Subject to B. or C. above whichever applies the each occurrence limit is the most we will pay for the sum of 1. Damages under Insuring Agreement A and 2. Medical expenses under Insuring Agreement C because of all bodily injury and property damage arising out of any one occurrence. 68926 1097 GL6 1112
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company Subject to E. above the Fire Damage Limit is the most we will pay under Insuring Agreement A. for damages because of property damage to premises rented to you or temporarily occupied by you with permission of the owner arising out of any one fire. Subject to E. above the Medical Expense Limit is the most we will pay under Insuring Agreement C. for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period. Any remaining period of less than 12 months shall be included in the last preceding annual period starting with the beginning of the policy period shown in the Declarations. If the policy period is extended after issuance for an additional period of less than 12 months the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. All claims arising from continuous related or repeated occurrences shall be treated as arising out of one occurrence. CONDITIONS In addition to Common Policy Provisions Section V Conditions Applicable to All Coverage Parts the following Condition shall apply to this Coverage Part. Insured Under This Coverage Part An Insured under this Coverage Part may or may not be an Insured under another Coverage Part. Please refer to Common Policy Provisions Section Definitions to determine who is an Insured. DEFINITIONS In addition to Common Policy Provisions Section I the following Definitions shall apply to this Coverage Part. Advertising injury means injury arising out of one or more of the following offenses 1. Oral or written publication of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services 2. Oral or written publication of material that violates a person s right to privacy 3. Misappropriation of advertising ideas or style of doing business or 4. Infringement of copyright title or slogan. Bodily Injury means physical injury sickness or disease sustained by any person including death resulting from any of these at any time. Bodily injury does not 68926 1097 GL7 11712
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company include emotional distress or mental anguish unless due to physical injury sickness or disease. Employee includes a leased worker but does not include a temporary worker. Impaired Property means tangible property other than your product or your work that can not be used or is less useful because 1. It incorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or 2. The Insured has failed to fulfill the terms of a contract or agreement if such property can be restored to use by a. The repair replacement adjustment or removal of your product or your waork or b. The Insured fulfilling the terms of the contract or agreement. Insured Contract means 1. A contract for lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract 2. A sidetrack agreement 3. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad 4. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality 5. An elevator maintenance agreement or 6. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph 6. does not include that part of any contract or agreement a. That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing 68926 1097 GL8 11112
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company b. That indemnifies an architect engineer or surveyor for injury or damage arising out of i. Preparing approving or failing to prepare or approve maps drawings opinions reports surveys change orders designs or specifications or il. Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or c. Under which you if an architect engineer or surveyor assumes liability for bodily injury or property damage arising out of the your rendering or failure to render professional services including those listed in b above and supervisory inspection or engineering services. Leased Worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker. Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. Personal Injury means injury other than bodily injury arising out of one or more of the following offenses 1. False arrest detention or imprisonment 2. Malicious prosecution 3. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies by or on behalf of its owner landlord or lessor 4. Oral or written publication of material that slanders or libels a person or organization or disparages a person s or organization s goods products or service or 5. Oral or written publication of material that violates a person s right of privacy. 1. Products completed operations hazard includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work EXCEPT a. Products that are still in your physical possession or b. Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times i. when that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. 68926 1097 GL9 1112
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company ii. when all of the work called for in your contract has been completed. iii. when all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. 2. Your work will be deemed completed at the earliest of the following times a. When all of the work called for in your contract has been completed b. When all of the work to be done at the site has been completed if your contract calls for work at more than one site or c. When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. 3. This hazard does not include bodily injury or property damage arising out of a. The transportation of property unless the injury or damage arises out of a condition in or on a vehicle created by the loading or unloading of it or b. The existence of tools uninstalled equipment or abandoned or unused materials. J. Temporary Worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term work load requirements. K. Your Product means 1. Any goods or products other than real property manufactured sold handled distributed or disposed of by a. You b. Others trading under your name or c. A person or organization whose business or assets you have acquired and 2. Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. Your product includes 68926 1097 GL 10 1112 1112 GL 10
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company 1. Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2. The providing of or failure to provide warnings or instructions. Your product does not include vending machines or other property rented to or located for the use of others but not sold. L. Your Work means 1. Work or operations performed by you or on your behalf and 2. Materials parts or equipment furnished in connection with such work or operations. Your work includes 1. Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 3. Providing of or failure to provide warnings or instructions. GL 11 1112 68926 1097
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company COVERAGE PART i. MEDICAL PROFESSIONAL LIABILITY CLAIMS MADE This is a claims made coverage. Coverage is limited generally to liability for claims first made against an Insured while the coverage is in force. Please review the policy carefully and discuss the policy with your insurance representative. In consideration of the payment of the premium and in reliance upon the statements in the Application which is attached hereto and made a part of this Policy and upon the Declarations we agree with you as follows INSURING AGREEMENTS Insuring Agreement D Medical Professional Liability We will pay those amounts that you are legally required to pay others as damages resulting from a medical incident arising out of professional services provided by the Named Insured or by any Insureds for whose acts or omissions the Named Insured is legally responsible. The medical incident must take place on or after the retroactive date and before the end of the policy period. In addition to our Limit of Insurance we will also pay defense costs. We have the right and duty to defend any claim and we will 1. Do so even if any of the charges of the claim are groundless false or fraudulent and 2. Investigate any claim we feel is appropriate. A claim for a medical incident must be first made against you during the policy period or the extended reporting period if applicable. A claim is first made at the earlier of the following times 1. when you give us written notice that a third party intends to hold you responsible for damages resulting from a medical incident arising out of your professional services or 2. when you give us written notice of specific circumstances involving a particular person which may result in a claim. A patient incident report submitted to us from routine risk management activities does not qualify as notice under this provision. Insuring Agreement E Administrative Hearing Expense We will reimburse the Named Insured for the defense costs incurred in the course of a covered proceeding. The medical incident giving rise to the covered proceeding must take place on or after the retroactive date and before the end of the policy period. Written notice for the covered proceeding must be first made during the policy period or the extended reporting period if applicable. 1112 MP 1 68926 1097
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company EXCLUSIONS In addition to Common Policy Provisions Section Il Exclusions the following Exclusions apply to this Coverage Part. We will not defend or pay claims against you Prior Acts For any liability arising out of acts errors or omissions of which you had knowledge prior to the inception date of the policy period if as of such date you could reasonably foresee a claim might result. Contractual Liability As respects Insuring Agreement D for any liability you assume under any contract or agreement. This exclusion does not apply to liability that you would have in the absence of a contract or agreement or to 1. Liability you assume in a written contract with an a. Health Maintenance Organization b. Preferred Provider Organization c. Independent Practice Association or d. Any other similar organization but only for such liability as is attributable to your alleged negligence arising out of professional services or to 2. A warranty of fitness or quality of any therapeutic agents or supplies you have furnished or supplied in connection with treatment that has been performed. Anti Trust For any liability arising out of actual or alleged involvement in any 1. Antitrust law violation or 2. Agreement or conspiracy to restrain trade. U.S. Department of Health Human Services HHS For any administrative or judicial hearings pertaining to Medicare Medicaid fraud or any other hearing initiated against an Insured by HHS or by any utilization or quality review organization under contract with HHS. 68926 1097 MP 2 1112
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company H. This exclusion does not apply to HHS proceedings that allege the violation of the Emergency Medical Treatment and Labor Act. LIMITS OF INSURANCE The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of 1. Insureds 2. Claims made or suits brought or 3. Persons or organizations making claims or bringing suits. The Aggregate Limit is the most we will pay for the sum of 1. Damages under Insuring Agreement D Medical Professional Liability and 2. Expenses under Insuring Agreement E Administrative Hearing Expense Subject to paragraph B. above the Each Medical Incident Limit stated in the Declarations is the most we will pay under this Coverage Part for damages arising out of a single medical incident. All claims arising from continuous related or repeated medical incidents shall be treated as arising out of one medical incident. Only the Policy in effect when the first such claim is made shall apply to all such claims. Subject to paragraph B. above the Administrative Hearing Expense Limit stated in the Declarations is the most we will pay for the sum of all expenses and fines because of all covered proceedings sustained by any one person or organization. The Limits of Insurance of this Coverage Part apply separately to claims first made against an Insured during each consecutive annual period. Any remaining period of less than 12 months shall be included in the last preceding annual period starting with the beginning of the policy period shown in the Declarations. If the policy period is extended after issuance for an additional period of less than 12 months the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. CONDITIONS In addition to the Common Policy Provisions Section V the following Conditions apply Automatic Extended Reporting Period 1. If this Coverage Part is canceled or not renewed for any reason other than non payment of premium and if the Optional Extended Reporting Period Endorsement is not purchased then we will provide an automatic extended reporting period of sixty 60 days starting with the end of the policy period during which claims arising out of medical incidents which take place on or after the retroactive date but before the end of the policy period may be first made. 11712 68926 1097 MP 3
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company The automatic extended reporting period does not extend the policy period or change the scope of coverage provided. We will consider any claim first made during the automatic extended reporting period to have been made on the last day of the policy period. The automatic extended reporting period however will not apply to claims if other insurance you buy covers them or would cover them if its limits of insurance had not been exhausted. The Aggregate Limits of Insurance applicable to this Coverage Part shall not be increased or reinstated for the automatic extended reporting period. B. Optional Extended Reporting Period 1. If you or we cancel or do not renew this insurance you shall have the right to buy an Optional Extended Reporting Period Endorsement beginning with the end of the policy period. The additional premium for and the term of the Optional Extended Reporting Period Endorsement shall be in accordance with the rates and rules in effect at the time of the purchase. You do not have this right however if we cancel for non payment of premium. The Optional Extended Reporting Period Endorsement applies only to claims first made against the Insured during the Optional Extended Reporting Period and arising from medical incidents which take place on or after the retroactive date and before the end of the policy period. The Aggregate Limits of Insurance applicable to this Coverage Part shall be reinstated for claims under the Endorsement. To obtain an Optional Extended Reporting Period Endorsement you must request it in writing within sixty 60 days after the policy period ends and pay the premium due. If you do so an Extended Reporting Period Endorsement can not be canceled. If we do not receive the written request and payment within sixty 60 days after the policy period ends you may not exercise this right at a later date. The insurance provided under the Extended Reporting Period Endorsement is excess over any other valid and collectible insurance that begins or continues in effect after the Extended Reporting Period Endorsement becomes effective whether the other insurance applies on a primary excess contingent or any other basis. Our offer of terms conditions or premium different from the expiring Policy or Coverage Part shall not be considered a refusal or failure to renew this insurance. DEFINITIONS A. Medical Incident means any act error or omission in the providing of or failure to provide professional services. B. Covered proceeding means a proceeding investigation licensure or privileging hearing to determine whether an Insured violated the Emergency Medical Treatment and Labor Act of the Consolidated Omnibus Budget Reconciliation Act of 1986 COBRA. 1112 MP 4 68926 1097
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NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA 2595 Interstate Drive Suite 103 Harrisburg PA 17110 ADMINISTRATIVE OFFICES 175 Water Street 18 Floor New York NY 10038 A Capital Stock Insurance Company C. Professional Services means 1. Medical surgical dental nursing or other health care services including but not limited to the furnishing of food or beverages in connection with such services the practice of nuclear medicine the furnishing or dispensing of drugs or medical dental or surgical supplies or appliances or the handling or treatment of deceased human bodies including autopsies organ donation or other procedures 2. Services by any person as a member of a formal accreditation standards review or similar professional board or committee of any Insured or 3. Supervising teaching proctoring others at your request. 1112 MP 5 68926 1097
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ENDORSEMENT NO. 1 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA SCHEDULE OF NAMED INSUREDS ENTITIES The policy is hereby amended as follows This policy shall apply to the following Named Insured Entities Named Insured Retroactive Date Newman Memorial County Hospital dba Newman Regional Health Newman Regional Health Foundation Inc. NRHF Hand In Hand Hospice Newman Regional Health Auxiliary It is understood agreed that the following Named Insured shall have the special rights and duties as outlined in Section V p. of the Common Policy Provisions All other terms conditions and exclusions of the policy remain unchanged. Breede Bppnt. Authorized Representative 68763997
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ENDORSEMENT NO. 2 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA. KANSAS AMENDATORY ENDORSEMENT Wherever used in this endorsement 1 we us our and Insurer mean the insurance company which issued this policy and 2 you your named Insured First Named Insured and Insured mean the Named Corporation Named Organization Named Sponsor Named Insured or Insured stated in the declarations page and 3 Other Insureds means all other persons or entities afforded coverage under the policy. In consideration of the premium charged the cancellation provision of this policy is amended as follows CANCELLATION If a policy has been in effect for ninety 90 days or more or if it is a renewal of a policy we issued the Insurer may cancel this policy only if one or more of the following reasons apply a. nonpayment of premium b. the policy was issued because of a material misrepresentation c. the Insured or Other Insureds violated any of the material terms and conditions of the policy d. unfavorable underwriting factors specific to the Insured or Other Insureds exist that were not present at the inception of the policy e. a determination by the commissioner that continuation of coverage could place the Insurer in a hazardous financial condition or in violation of the laws of this state or f. a determination by the commissioner that the Insurer no longer has adequate reinsurance to meet the Insurer s needs. The Insured will be notified in writing at least thirty 30 days before the effective date of cancellation. NONRENEWAL If the Insurer decides not to renew this policy the Insurer or the Insurer s licensed agent will give at least sixty 60 days written notice to the First Named Insured at the last known address. All notices of cancellation or nonrenewal will contain a written explanation specifically detailing the reasons for cancellation or nonrenewal. Brusdof Qo Authorized Representative 52144 1202
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ENDORSEMENT NO. 3 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA KANSAS AMENDATORY ENDORSEMENT ADDENDUM TO POLICY FORM No. 68926 1097 The policy is hereby amended as follows In consideration of the premium charged t is hereby understood and agreed that Section I subsection K and L Exclusions are hereby added to the Policy. EXCLUSIONS K. For any injury arising from the rendering of or failure to render professional service by the Insured during any period of time on or after the Initial Effective Date shown as applicable to Professional Liability in the Declaration the Insured failed to maintain in effect the required basic professional liability insurance as prescribed by the Kansas Health Care Provider Insurance Availability Act. L. For an Insured defined as a health care provider under K.S.A. 40 3401f or amendments there to with respect to any liability imposed upon such Insured as a principal vicariously liable for the wrongful conduct of an agent employee or other third party provided such agent employee or other third party is also defined as a health care provider under K.S.A 40 3401f or amendments thereto. It is further understood and agreed that Section V. Conditions P. Special Rights and Duties of Named Insured is deleted in its entirety and replaced with the following Special Rights and Duties of Named Insured The Named Insured shall act on behalf of all Insureds not defined as a health care provider in K.S.A. 40 340f as to 1. Giving and receiving notice of cancellation 2. Payment of premiums and receipt of return premiums 3. Acceptance of any endorsements to this Policy 4. Purchasing or deciding not to purchase the Optional Extended Reporting Period Endorsement if applicable or 5. Making changes in this Policy or any Coverage Part with our consent. 69393198
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ENDORSEMENT NO. 3 Each insured defined as K.S.A. 40 3401f as a health care provider shall act on it s own behalf in such matters or execute an assignment of rights authorizing the named insured to do so. This Policy can only be changed by a written endorsement we issue and make a part of this Policy. COVERAGE PART Il MEDICAL PROFESSIONAL LIABILITY CLAIMS MADE. In consideration of the premium charged it understood and agreed that Section Hll Limits of Insurance subsection A is deleted in its entirety and replaced with the following A The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of 1. Insureds 2. Claims made or suits brought 3. Persons or organizations making claims or bringing suits The limit of insurance apply separately to each health care provider as defined in K.S.A. 40 3401f.. It is further understood and agreed that Section IV Conditions subsection A is deleted in its entirety. V. it is further understood and agreed that Section IV Conditions subsection B is deleted in its entirety and replaced with the following B. Optional Extended Reporting Period 1. If you or we cancel or do not renew this insurance you shall have the right to buy an Optional Extended Reporting Period Endorsement beginning with the end of the policy period. The additional premium for and the term of the Optional Extended Reporting Endorsement shall be in accordance with the rates and rules in effect at the time of the purchase. You do not have this right however if we cancel for non payment of premium. 2. The Optional extended Reporting Period Endorsement applies only to claims first made against the Insured during the Optional Extended Reporting Period and arising from medical incidents which take place on or after the retroactive date and before the end of the policy period. The aggregate Limits of Insurance applicable to this Coverage Part shall be reinstated for claims under the Endorsement. 69393198
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ENDORSEMENT NO. 3 To obtain an Optional Extended Reporting Period Endorsement you must request it in writing within sixty 60 days after the policy period ends and pay the premium due. If you do so an Extended Reporting Period Endorsement can not be canceled. If we do not receive the written request and payment within 60 days after the policy period ends you may not exercise this right at a later date. The insurance provided under the Extended Reporting Period Endorsement is excess over any other valid and collectible insurance that begins or continues in effect after the Extended Reporting Period Endorsement becomes effective whether the other insurance applies on a primary excess contingent or any other basis. Our offer of terms conditions or premium different from the expiring Policy or Coverage Part shall not be considered a refusal or failure to renew this insurance. Our offer of an Optional Extended Reporting Period shall apply only as excess of the Health Care Stabilization Fund when a health care provider has complied with the requirements of K.S.A. 40 3403m. All other terms conditions and exclusions remain unchanged. Brsoder Gtron Authorized Representative 69393198
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ENDORSEMENT NO. 4 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA MEDICAL PROFESSIONAL LIABILITY KANSAS AMENDATORY ENDORSEMENT HEALTH CARE INSURANCE AVAILABILITY ACT The policy is hereby amended as follows The Declarations Page is hereby amended to add the following Item 9. Health Care Stabilization Fund Surcharge 23668 Hospital Professional Liability Physician Professional Liability The policy is hereby amended as follows Coverage Part II Section IV. Conditions is hereby deleted in its entirety. All other terms conditions and exclusions of the policy remain unchanged. Bronded Gt Authorized Representative 69644298
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ENDORSEMENT NO. 5 This endorsement effective 1201 AM January 1 2014 Forms a part of palicy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA AMENDMENT OF LIMITS The policy is hereby amended as follows ftem 5. LIMITS OF INSURANCE on the Declarations Page is amended as follows Il Medical Professional Liability For medical incidents covered by the Kansas Healthcare Stabilization Fund Aggregate Limit 600000 Each Medical Incident 200000 For medical incidents not covered by the Kansas Healthcare Stabilization Fund Aggregate Limit 3000000 Each Medical Incident 1000000 This limit applies on a shared limit basis to all entities that are Named Insureds and employed miscellaneous medical personnel volunteers and students while performing services for or on behalf of the Named Insureds. ent All other terms conditions and exclusions of the policy remain unchanged. Bronde Gpr. Authorized Representative 78944 1101
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ENDORSEMENT NO. 6 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA ASBESTOS EXCLUSION This policy is hereby amended as follows This insurance does not apply to any liability for property damage bodily injury sickness disease occupational disease disability shock death mental anguish and mental injury at any time arising out of the manufacture of mining of use of sales of installation of distribution of or exposure to asbestos products asbestos fibers or asbestos dust or to any other obligation of the Insured to indemnify any party because of damages arising out of such property damage bodily injury sickness disease occupational disease disability shock death mental anguish and mental injury at any time as a result of the manufacture of mining of use of sales of installation of distribution of or exposure to asbestos products asbestos fibers or asbestos dust. We are not obligated to defend any suit or claim against an Insured alleging bodily injury or property damage and seeking damages if such suit or claim arises from bodily injury or property damage resulting from or contributed to by any and all manufacture of mining of use of sales of installation of distribution of or exposure to asbestos products asbestos fibers or asbestos dust. All other terms conditions and exclusions of the policy remain unchanged. Brsoded Gtor Authorized Representative 68767997
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ENDORSEMENT NO. 7 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA CROSS SUITS LIMITATION Coverage Part Il Medical Professional Liability Coverage is hereby amended as follows Coverage Part Il does not apply to any claim made by one Insured against another Insured. This exclusion does not apply to services by any person as a member of a formal accreditation standards review or similar professional board or committee otherwise covered by this policy. All other terms conditions and exclusions of the policy remain unchanged. Braodetd Qpr Authorized Representative 68769997
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ENDORSEMENT NO. 8 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ECONOMIC SANCTIONS ENDORSEMENT This endorsement modifies insurance provided under the following The Insurer shall not be deemed to provide cover and the Insurer shall not be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover payment of such claim or provision of such benefit would expose the Insurer its parent company or its ultimate controlling entity to any sanction prohibition or restriction under United Nations resolutions or the trade or economic sanctions laws or regulations of the European Union or the United States of America. Brsdetd Gpr Authorized Representative or countersignature where required by law 89644 613 HC0658
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ENDORSEMENT NO. 9 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MINIMUM EARNED PREMIUM ENDORSEMENT This endorsement madifies insurance provided under the following GENERAL POLICY PROVISIONS AND CONDITIONS The last Paragraph of Section IV. CANCELLATION beginning with the words The time of the surrender... and ending with the words... condition of cancellation. is deleted in its entirety and replaced with the following The time of the surrender or the effective date and hour of cancellation stated in the notice shall become the end of the policy period. Delivery of such written notice either by the First Named Insured or by us shall be the equivalent to mailing. If the First Named Insured cancels we shall retain an earned premium which shall be the greater of the customary short rate procedure or the minimum earned premium of 20982. If we cancel unearned premium shall be computed pro rata. Premium adjustment may be made either at the time cancellation is effected or as soon as practicable after cancellation becomes effective but payment or tender of unearned premium is not a condition of cancellation. All other terms conditions and exclusions of the policy remain unchanged. Breded Gppni Authorized Representative or countersignature where required by law 74778 608 HC0088
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ENDORSEMENT NO. 10 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA Employee Benefits Liability Endorsement Claims Made Endorsement NOTICE THIS IS A CLAIMS MADE EMPLOYEE BENEFITS LIABILITY ENDORSEMENT. COVERAGE IS LIMITED GENERALLY TO LIABILITY FOR CLAIMS FIRST MADE AGAINST AN INSURED WHILE THE COVERAGE IS IN FORCE. PLEASE REVIEW THE POLICY AND THE EMPLOYEE BENEFITS LIABILITY ENDORSEMENT CAREFULLY AND DISCUSS THEM WITH YOUR INSURANCE AGENT OR BROKER. Employee Benefits Liability Declarations Each Wrongful Act Limit 1000000 Aggregate Limit 1000000 Per Claim Deductible NIL Retroactive Date 07011976 The insurance afforded is only for the following Endorsement indicated by a specific premium charge on the Employee Benefits Liability Declarations. Our Limit of Insurance for this Endorsement shall be as stated in the above Employee Benefits Liability Declarations subject to all the terms conditions and exclusions of this Endorsement and the Policy to which it is attached. Various provisions in this Endorsement restrict coverage. Read the entire Endorsement carefully to determine rights duties and what is and is not covered. I INSURING AGREEMENT We shall pay those sums that the Insured becomes legally obligated to pay any employee or former employee or his her heirs beneficiaries or legal representatives as damages arising out of a wrongful act. We shall have the right and duty to defend the Insured against any suit seeking those damages. We may at our discretion investigate any wrongful act and settle any claim or suit that may result. However a. The amount we shall pay for damages is limited to the Limits of Insurance and b. Our right and duty to defend end when we have used up the applicable Limit of Insurance in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Common Policy Provisions Section 1V Other Payments Under This Palicy. 68770997 NOTICE Limit le
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ENDORSEMENT NO. 10 This Endorsement applies to a wrongful act only if a. The wrongful act takes place in the coverage territory b. The wrongful act occurs on or after the retroactive date if any shown in the Employee Benefits Liability Declarations and before the end of the policy period and c. A claim for damages because of the wrongful act is first made in writing against any Insured in accordance with the policy and during the policy period or any applicable Extended Reporting Period. 1. EXCLUSIONS In addition to the exclusions found in Coverage Part 1 D. Exclusions and in Section Il of the Common Policy Provisions the following exclusions apply to this Endorsement a. Any personal injury bodily injury or property damage. b. Any failure of performance of contract by any Insurer. c. Any failure of any investments including but not limited to stock to perform as represented by an Insured. d. Any advice given by an Insured to an employee whether or not to participate in any investment plan including but not limited to stock subscription plans. e. Any failure of the Insured ar any insurer fiduciary trustee or fiscal agent to perform any of their duties or obligations whether contractual or provided by law or to fulfill any of their guarantees with respect to 1. The payment of benefits under employee benefit programs or 2. The providing handling or investment of funds. However this exclusion does not apply to administration. f. Any Insured not having adequate insurance or bonds to protect the assets of an employee benefit program. g. Any personal profit or advantage gained by the Insured without the legal right to the gain. 18 LIMITS OF INSURANCE a. The Limits of Insurance shown in the Employee Benefits Liability Declarations and the rules below fix the most we shall pay regardless of the number of 1. Insureds 2. Claims made or suits brought or 68770997
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ENDORSEMENT NO. 10 3. Persons or organizations making claims or bringing suits. b. The each Wrongful Act limit shown in the Employee Benefits Liability Declarations is the most we shall pay for all damages incurred as the result of any one wrongful act. c. The each annual Aggregate limit shown in the Employee Benefits Liability Declarations is the most we shall pay for all damages covered under this Endorsement. V. DEDUCTIBLE Each wrongful act shall be subject to the Deductible amount if any shown in the Employee Benefits Liability Declarations. We shall pay only the difference between the Deductible amount and the amount shown for each wrongful act. b. We may pay any part of your Deductible to settle any claim or suit. In such case we shall notify you and you shall promptly reimburse us for whatever portion of your Deductible we have paid. c. All wrongful acts arising out of the same series of continuous related or repeated wrongful acts shall be subject to one deductible. The limits of this Endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy petiod shown in the Employee Benefits Liability Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period shall be deemed part of the last preceding period for purposes of determining the Limits of Insurance. V. CONDITIONS You must notify us as soon as practicable of an incident or wrongful act which may result in a claim. Your duties and responsibilities in the event of an incident or wrongful act are the same as those duties outlined in the Common Policy Provisions Section V a. Please refer to this section to determine what is required of you in the event of an incident or wrongful act. VI EXTENDED REPORTING PERIOD a. If this Endorsement is canceled or not renewed for any reason other than nonpayment of the premium this section shall provide an extended reporting period. There is no additional premium charge for this extended reporting period. b. When this section applies the following is added to the end of the Insuring Agreement A claim first made within twelve 12 months after the policy period ends shall be deemed to have been made on the last day of the policy period provided the claim is for damages because of a wrongful act that occurred before the end of the policy period and after the applicable retroactive date. 68770897
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ENDORSEMENT NO. 10 This Endorsement is excess over any other vz This policy period ends on the date shown in the Employee Benefits Liability Declarations or on the effective date of any cancellation of this Endorsement whichever is earlier. The Extended Reporting Period shall not reinstate or increase the Limits of Insurance or extend the policy period. and collectible insurance available under policies in force after the extended reporting period starts. Vi DEFINITIONS In addition to the definitions found in the Common Policy Pravisions Section and the definitions found in Coverage Part Section IV the following definitions apply to this Endorsement a. Administration means the following activities if authorized by you 1. Conveying information to employees with respect to employee benefit programs 2. Interpreting employee benefit programs 3. Record keeping in connection with employee benefit programs and 4 Enrolling terminating or canceling employees under employee benefit programs. b. Employee benefit programs means 1. Group life insurance group accident or health insurance profit sharing plans pension plans employee stock subscription plans travel savings or vacation plans and except as respects the insurance benefits provided thereunder to employees shall also include workers compensation insurance unemployment compensation insurance social security and disability benefits insurance and 2. Any other similar employee benefits instituted after the effective date of this Endorsement provided we are notified within thirty 30 days after the institution of such benefits. c. Wrongful act means any negligent act error mistake or omission by an Insured or others for whom the Insured is legally responsible in the admil stration of your employee benefit programs. All other terms conditions and exclusions remain unchanged. Bronde Qs Authorized Representative 68770997
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ENDORSEMENT NO. 11 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA SPECIFIC ADDITIONAL INSURED The policy is hereby amended as follows The following is added as an Insured but solely as respects to claims arising from the interest described below Insured Any lessors of premises and any lessors of leased equipment Interest of Named Insured Named Insureds lease premise or equipment All other terms conditions and exclusions of the policy remain unchanged. Brosded Qs Authorized Representative 68765997
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ENDORSEMENT NO. 12 This endorsement effective 1201 AM January 1 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA SPECIFIC ADDITIONAL INSURED The policy is hereby amended as follows The following is added as an Insured but solely as respects to claims arising from the interest described below Insured 1. Quorum Health Resources LLC fna Quorum Health Resources Inc. and its parent corporation Community Health Systems Inc. CHS Community Health Systems Inc. and all subsidiaries with insured interests fka Quorum Health Group Inc. John Rossfield CEO QHR Employee Lyon County Commission and Bank IV Kansas N.A. Kansas Board of Regents Emporia State University National Supplier Clearinghouse Interest of Named Insured 1 2 Management services provided to Named Insured 3. Owner of Newman Regional Health 4. As respects to Newman s Nursing Program 5. As respects to Newman s DME Department All other terms conditions and exclusions of the policy remain unchanged. Brooded Qs Authorized Representative 68765997
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FORMS SCHEDULE NEWMAN MEMORIAL COUNTY HOSPITAL 6796532 January 21 2014 Named Insured Policy No Effective Date Form Number Edition Date 68765 0997 Endt. No. Form Name 13 SPECIFIC ADDITIONAL INSURED CIFMSC Cl0226
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ENDORSEMENT NO. 13 This endorsement effective 1201 AM January 21 2014 Forms a part of policy no. 6796532 Issued to NEWMAN MEMORIAL COUNTY HOSPITAL By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA SPECIFIC ADDITIONAL INSURED The policy is hereby amended as follows The following is added as an Insured but solely as respects to claims arising from the interest described below Insured Deleted 1. Quorum Health Resources LLC fna Quorum Health Resources Inc. and its parent corporation Community Health Systems Inc. CHS Community Health Systems Inc. and all subsidiaries with insured interests fka Quorum Health Group Inc. 2. John Rossfield CEO QHR Employee Interest of Named Insured 1 2 Management services provided to Named Insured All other terms conditions and exclusions of the policy remain unchanged. Bt Gpprns AUTHORIZED REPRESENTATIVE 68765997
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Z ZURICH Insured Name STROBEL ENERGY GROUP LLC Policy Number GLO 9243691 09 Effective Date 05012021 THIS DISCLOSURE IS ATTACHED TO AND MADE PART OF YOUR POLICY. DISCLOSURE OF IMPORTANT INFORMATION RELATING TO TERRORISM RISK INSURANCE ACT SCHEDULE Premium attributable to risk of loss from certified acts of terrorism for lines of insurance subject to TRIA General Liability 938 Any information required to complete this Schedule if not shown above will be shown in the Declarations. A. Disclosure of Premium In accordance with the federal Terrorism Risk Insurance Act TRIA as amended we are required to provide you with a notice disclosing the portion of your premium if any attributable to the risk of loss from terrorist acts certified under that Act for lines subject to TRIA. That portion of premium attributable is shown in the Schedule above. The premium shown in the Schedule above is subject to adjustment upon premium audit if applicable. B. Disclosure of Federal Participation in Payment of Terrorism Losses You should know that where coverage is provided by this policy for losses resulting from certified acts of terrorism the United States Government may pay up to 80 of insured losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. C. Disclosure of 100 Billion Cap on All Insurer and Federal Obligations If aggregate insured losses attributable to terrorist acts certified under TRIA exceed 100 billion in a calendar year January 1 through December 31 and an insurer has met its deductible under the program that insurer shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of Treasury. D. Availability As required by TRIA we have made available to you for lines subject to TRIA coverage for losses resulting from acts of terrorism certified under TRIA with terms amounts and limitations that do not differ materially from those for losses arising from events other than acts of terrorism. E. Definition of Act of Terrorism under TRIA TRIA defines act of terrorism as any act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act TRIA to be an act of terrorism. The Terrorism Risk Insurance Act provides that the Secretary of Treasury shall certify an act of terrorism 1. To be an act of terrorism 2. To be a violent act or an act that is dangerous to human life property or infrastructure 3. To have resulted in damage within the United States or outside of the United States in the case of an air carrier as defined in section 40102 of Title 49 United States Code or a 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 the premises of a United States mission and U GU630 E CW 0120 Copyright 2020 Zurich American Insurance Company Page 1 of 2 Includes copyrighted material of Insurance Services Office Inc.. with its permission. eneral Liability 938
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4. 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. No act may be certified as an act of terrorism if the act is committed as part of the course of a war declared by Congress except for workers compensation or if losses resulting from the act in the aggregate for insurance subject to TRIA do not exceed 5000000. U GU630 E CW 0120 Page 2 0f 2 Copyright 2020 Zurich American Insurance Company Includes copyrighted material of Insurance Services Office Inc.. with its permission.
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Z ZURICH e W ENE e K R CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM Insureds Name Policy Number Effective Endorsement Date Number STROBEL ENERGY GROUP LLC GLO 9243691 09 05012021 THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies your insurance A. Cap on Losses From Certified Terrorism Losses Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with provisions of the federal Terrorism Risk Insurance Act TRIA to be an act of terrorism. The Terrorism Risk Insurance Act provides that the Secretary of Treasury shall certify an act of terrorism 1. To be an act of terrorism 2. To be a violent act or an act that is dangerous to human life property or infrastructure 3. To have resulted in damage within the United States or outside of the United States in the case of an air carrier as defined in section 40102 of Title 49 United States Code or a 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 the premises of a United States mission and 4. 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. No act may be certified as an act of terrorism if the act is committed as part of the course of a war declared by Congress except for workers compensation or if losses resulting from the act in the aggregate for insurance subject to TRIA do not exceed 5000000. If aggregate insured losses attributable to one or more certified acts of terrorism exceed 100 billion in a calendar year January 1 through December 31 and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of Treasury. B. Application of Other Exclusions The terms and limitations of a terrorism exclusion or any other exclusion or the inapplicability or omission of a terrorism exclusion or any other exclusion do not serve to create coverage which would otherwise be excluded limited or restricted under this policy. Copyright 2015 Zurich American Insurance Company Includes copyrighted material of Insurance Services Office Inc. with ts permission. U GU767 8 CW 0115 Page 1 of 1
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Z ZURICH Disclosure Statement Itis our pleasure to present the enclosed policy to you for presentation to your customer. INSTRUCTION TO AGENT OR BROKER WE REQUIRE THAT YOU TRANSMIT THE ATTACHED ENCLOSED DISCLOSURE STATEMENT TO THE CUSTOMER WITH THE POLICY. Once again thank you for your interest and we look forward to meeting your needs and those of your customers. U GU873 A CW 0611 Page 1of 1
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Z ZURICH Disclosure Statement NOTICE OF DISCLOSURE FOR AGENT BROKER COMPENSATION If you want to learn more about the compensation Zurich pays agents and brokers visit httpwww.zurichnaproducercompensation.com or call the following toll free number 866 903 1192. This Notice is provided on behalf of Zurich American Insurance Company and its underwriting subsidiaries. U GU874 ACW 0611 Page 1 of 1
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