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POLICY NUMBER XSL G71095824 Policyholder Notice Commercial Lines Deregulation New York NOTICE THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK INSURANCE LAW AND REGULATIONS. HOWEVER THE FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS. CLASS CODE 2 14057 ALL23445b 0713 Page 1 of 1
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POLICY NUMBER XSL G71095824 Chubb Producer Compensation Practices Policies Chubb believes that policyholders should have access to information about Chubb s practices and policies related to the payment of compensation to brokers and independent agents. You can obtain that information by accessing our website at httpwww.chubbproducercompensation.com or by calling the following toll free telephone number 1 866 512 2862. ALL20887 1006 Page 1 of 1
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POLICY NUMBER XSL G71095824 COLORADO FRAUD STATEMENT It is unlawful to knowingly provide false incomplete or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment fines denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false incomplete or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado division of insurance within the department of regulatory agencies. ALL22368 0607 S0 Properties Inc. 2004 Page 1 of 1
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POLICY NUMBER XSL G71095824 ILLINOIS NOTICE TO POLICYHOLDERS REGARDING THE RELIGIOUS FREEDOM PROTECTION AND CIVIL UNION ACT ILN17511 11 Dear Policyholder This is to provide notice that pursuant to lllinois Department of Insurance Company Bulletin 2011 06 CB 2011 06 this policy is in compliance with the lllinois Religious Freedom Protection and Civil Union Act the Act 750 ILL. COMP. STAT. 751. The Act which became effective on June 1 2011 creates a legal relationship between two persons of either the same or opposite sex who establish a civil union. The Act provides that parties to a civil union are entitled to the same legal obligations responsibilities protections and benefits that are afforded or recognized by the law of lllinois to spouses whether they are derived from statute administrative rule policy common law or any source of civil or criminal law. In addition this law requires recognition of a same sex civil union marriage or other substantially similar legal relationship except for common law marriage legally entered into in other jurisdictions. The Act further provides that party to a civil union shall be included in any definition or use of the terms spouse family immediate family dependent next of kin and other terms descriptive of spousal relationships as those terms are used throughout the law. According to CB 2011 06 this includes the terms marriage or married or any variations thereof. CB 2011 06 also states that if policies of insurance provide coverage for children the children of civil unions must also be provided coverage. ILN17511 11 Insurance Services Office Inc. 2011 Page 1 of 1
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POLICY NUMBER XSL G71095824 Important Information to Virginia Policyholders Regarding Your Insurance In the event you need to contact someone about this insurance for any reason please contact your agent. If no agent was involved in the sale of this insurance or if you have additional questions you may contact the insurance company issuing this insurance at the following address and telephone number Chubb Customer Support Service Department P.O. Box 1000 436 Walnut Street Philadelphia PA 19106 1 800 352 4462 If you have been unable to contact or obtain satisfaction from the company or the agent you may contact the Virginia State Corporation Commission s Bureau of Insurance at 1300 East Main Street Tyler Building Richmond VA 23219 Consumer Hot Line 1 800 552 7945 Bureau of Insurance 804 371 9185 Written correspondence is preferable so that a record of your inquiry is maintained. When contacting your agent company or the Bureau of Insurance have your policy number available. ALL7X47a 0206 Page 1 of 1
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POLICY NUMBER XSL G71095824 CcCHUBE Indiana Notice to Policyholders We are here to serve you.... As our policyholder your satisfaction is very important to us. If you have a question about your policy if you need assistance with a problem or if you have a claim you should first contact your insurance agent. If you are unable to reach your agent or if you wish to contact us directly please call our Customer Services Department at 1 800 352 4462. Should you have a valid claim we fully expect to provide a fair settlement in a timely fashion. Should you feel you are not being treated fairly with respect to a claim you may also contact the Indiana Department of Insurance with your complaint. To contact the Department write or call Consumer Services Division Indiana Department of Insurance 311 West Washington Street Suite 300 Indianapolis IN 46204 2787 317 232 2395 or 1 800 622 4461 Complaints can be filed electronically at www.in.govidoi ALL2Y81 0514 Page 1 of 1
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POLICY NUMBER XSL G71095824 NOTICE TO ALL OKLAHOMA POLICYHOLDERS WARNING Any person who knowingly and with intent to injure defraud or deceive any insurer makes any claim for the proceeds of an insurance policy containing any false incomplete or misleading information is guilty of a felony. You are insured by the Company listed on the Signature page which is named on the first page of the Declarations of this policy. It is a Chubb company and has its principal office at 436 Walnut Street PO Box 1000 Philadelphia PA 19106 3703. ALL2U78b 206 Ptd. in U.S. A. Page 1 of 1
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POLICY NUMBER XSL G71095824 Notice To Our Florida Property And Casualty Policyholders Guidelines For Loss Control Plans Florida law requires us to inform you that we have developed guidelines for risk management plan which are available to you at no cost. The guidelines consist of the following A. A booklet entitled Establishing an Effective Loss Control Program. This booklet describes various loss control procedures that can help you in your selection and implementation of actions that eliminate or reduce the frequency and severity of your losses. B. A self inspection checklist that is tailored for your business and when used in inspections it may be of assistance to you in the identification of conditions which could be responsible for losses. Should you require further help in developing and implementing an effective loss control program other loss control services are also available to you for an additional charge. The following services are available from Chubb Loss Control Services A. Loss control management consultation. Through a visit to your facility we will assist you in identifying loss causing conditions evaluating your loss prevention methods and recommending loss control enhancements. B. Training loss control management techniques. This training supports our consulting and is intended to assist you in the implementation of your loss control procedures. The training can be provided to you or your employees. To obtain either the free guidelines for loss control plans or information on additional loss control services please complete the section below and send it to National Manager Jurisdictional Services Chubb Risk Control Services P. O. Box 1000 Philadelphia PA 19105 1000 Tel 866 357 3797 ALL39822 0413 Page 1 of 2
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Send me the free guidelines for the loss control plans Send me information on how can obtain additional loss control services Business Operation Company Name Street Address City State Zip Code Telephone Policy No Person to contact Title Signature ALL39822 0413 Page 2 of 2
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POLICY NUMBER XSL G71095824 IL 09 10 07 02 PENNSYLVANIA NOTICE An Insurance Company its agents employees or service contractors acting on its behalf may provide services to reduce the likelihood of injury death or loss. These services may include any of the following or related services incident to the application for issuance renewal or continuation of a policy of insurance 1. Surveys 2. Consultation or advice or 3. Inspections. The Insurance Consultation Services Exemption Act of Pennsylvania provides that the Insurance Company its agents employees or service contractors acting on its behalf is not liable for damages from injury death or loss occurring as a result of any act or omission by any person in the furnishing of or the failure to furnish these services. The Act does not apply 1. If the injury death or loss occurred during the actual performance of the services and was caused by the negligence of the Insurance Company its agents employees or service contractors. To consultation services required to be performed under a written service contract not related to a policy of insurance or. If any acts or omissions of the Insurance Company its agents employees or service contractors are judicially determined to constitute a crime actual malice or gross negligence. Instruction to Policy Writers Attach the Pennsylvania Notice to all new and renewal certificates insuring risks located in Pennsylvania. ISO Properties Inc. 2001 Page 1 of 1 IL 09 10 07 02
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POLICY NUMBER XSL G71095824 POLICYHOLDER NOTICE OHIO WARNING Any person who with intent to defraud or knowing that he she is facilitating a fraud against an insurer submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud. ALL5W06 795 Page 10f 1
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POLICY NUMBER XSL G71095824 cHUBBE QUESTIONS ABOUT YOUR INSURANCE Answers to questions about your insurance coverage information or assistance in resolving complaints can be obtained by contacting Chubb Customer Support Services Department 436 Walnut Street Philadelphia Pennsylvania 19106 3703 Telephone Number 1 800 352 4462 Email ChubbUSCustomerServiceschubb.com The lllinois Department of Insurance may also be contacted for assistance. Insurance analysts are available to answer general questions by phone at our toll free Consumer Assistance Hotline 866 445 5364. However complaints must be submitted in writing. How to file a complaint with the Insurance Department Complaints may be submitted in the following ways On line at httpsinsurance.illinois.govapplicationsComplaintFormsdefault.aspx and by following the instructions posted. By fax 217 558 2083 By email at consumercomplaintsins.state.il.us By mail 320 W. Washington St. Springfield IL 62767 or 122 S. Michigan Ave. 19th Floor Chicago lllinois 60603 ALL18653d 0714 Page 1 of 1
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POLICY NUMBER XSL G71095824 QUESTIONS ABOUT YOUR INSURANCE Answers to questions about your insurance coverage information or assistance in resolving complaints can be obtained by calling Chubb Customer Support Service Department at 1 800 352 4462. ALLS5X45 11 96 Page 1 of 1
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POLICY NUMBER XSL G71095824 Chubb Risk Control Services 525 W. Monroe Street Chicago IL 60661 Phone 1.866.357.3797 1 Services Fax roe Street 215.640.5084. 60661 www.chubb.com losscontrolreqchubb.com National Manager Jurisdictional Services cHUBBE RE RISK CONTROL SERVICES FOR TEXAS POLICYHOLDERS Commercial Automobile Liability General Liability Professional Liability and Medical Professional Liability Chubb is required by Texas law and regulations to maintain or provide accident prevention services for its commercial automobile general liability professional liability and medical professional liability policyholders. Chubb offers an array of accident prevention services in Texas at no additional charge. These services are intended to help prevent andor minimize loss. These services include but are not limited to individual risk surveys improvement recommendations loss investigation specific loss problem identification and recommended improvement actions. Chubb may recommend one or more of these services based upon hazard experience and size of your Texas operations. You have the choice of receiving or declining any of the services offered. If you wish to decline all of the services or wish to receive only selected risk control service please indicate that by signing and dating this letter in the space provided below. Please e mail mail or fax a response to the appropriate address or fax number listed above. If you decline all of Chubb s risk control services or choose only a support service such as ergonomics survey driving training or other services and not a complete risk survey we still have a responsibility under Texas law and regulation to monitor your losses. In the event you start to have a loss problem and a trend is established andor adverse loss ratio is developed we will contact you and offer to assist you in addressing the situation. Sincerely National Manager Jurisdictional Regulatory Services Chubb Risk Control Services 525 W. Monroe Street Chicago IL 60661 or call toll free at 1 866 357 3797 I am aware of the loss control services offered and decline them. I have made other arrangements for these services. I wish to obtain the following offered accident prevention services I have no risk control services needs now. I reserve the right to request loss control services within the policy period. Signature Print Name Phone Policy Date Company Name Address City State Zip ALL11559 0716 Page 10f1
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POLICY NUMBER XSL G71095824 cHUBBE Tennessee Disclaimer Notice Commercial Lines Deregulation The rate provided for in this policy and all forms utilized are exempt from the filing requirements of Tenn. Code Ann. 56 5 306. The forms which make up this policy contract are exempt from the filing requirements of Tenn. Code Ann. 56 5 306. ALL38629 0712 Page 1 of 1
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POLICY NUMBER XSL G71095824 Texas Notice Information and Complaints IMPORTANT NOTICE To obtain information or make a complaint You may call the Company s toll free telephone number for information or to make a complaint at 1800 352 4462 You may also write to the Company at Chubb Customer Services PO Box 1000 Philadelphia PA 19106 3703 You may contact the Texas Department of Insurance to obtain information on companies coverages rights or complaints at AVISO IMPORTANTE Para obtener informacion o para presentar una queja Usted puede llamar al nimero de telfono gratuito de la Compaiiia para obtener informacion o para presentar una queja al 1800 352 4462 Usted tambin puede escribir a la Compaiiia Chubb Customer Services PO Box 1000 Philadelphia PA 19106 3703 Usted puede comunicarse con el Departamento de Seguros de Texas para obtener informacion sobre compaiiias coberturas derechos o quejas al 1800 352 4462 Usted tambin puede escribir a la Compaiiia Chubb Customer Services PO Box 1000 Philadelphia PA 19106 3703 Usted puede comunicarse con el Departamento de Seguros de Texas para obtener informacion sobre compaiiias coberturas derechos o quejas al 1 800 252 3439 Usted puede escribir al Departamento de Seguros de Texas a P.O. Box 149104 Austin TX 78714 9104 Fax 512 490 1007 Sitio web www.tdi.texas.gov E mail ConsumerProtectiontdi.texas.gov DISPUTAS POR PRIMAS DE SEGUROS O RECLAMACIONES Si tiene una disputa relacionada con su prima de seguro o con una reclamacin usted debe comunicarse con el agente o la compania primero. Si la disputa no es resuelta usted puede comunicarse con el Departamento de Seguros de Texas ADJUNTE ESTE AVISO A SU POLIZA Este aviso es solamente para propdsitos informativos y no se convierte en parte o en condicin del documento adjunto. 1800 252 3439 You may write the Texas Department of Insurance P. 0. Box 149104 Austin TX 78714 9104 Fax 512 490 1007 Web www.tdi.texas.gov E mail ConsumerProtectiontdi.texas.gov PREMIUM OR CLAIM DISPUTES Should you have a dispute concerning your premium or about a claim you should contact your agent or the company first. If the dispute is not resolved you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY This notice is for information only and does not become a part or condition of the attached document. ALL4Y30f 0615 Page 1 of 1
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POLICY NUMBER XSL G71095824 IL P 0010104 U.S. TREASURY DEPARTMENT S OFFICE OF FOREIGN ASSETS CONTROL OFAC ADVISORY NOTICE TO POLICYHOLDERS No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions of your policy. You should read your policy and review your Declarations page for complete information on the coverages you are provided. This Notice provides information concerning possible impact on your insurance coverage due to directives issued by OFAC. Please read this Notice carefully. The Office of Foreign Assets Control OFAC administers and enforces sanctions policy based on Presidential declarations of national emergency. OFAC has identified and listed numerous Foreign agents Front organizations Terrorists Terrorist organizations and Narcotics traffickers as Specially Designated Nationals and Blocked Persons. This list can be located on the United States Treas ury s web site httpwww.treas.gov ofac. In accordance with OFAC regulations if it is determined that you or any other insured or any person or entity claiming the benefits of this insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person as identified by OFAC this insurance will be considered a blocked or frozen contract and all provisions of this insurance are immediately subject to OFAC. When an insurance policy is considered to be such a blocked or frozen contract no payments nor premium refunds may be made without authorization from OFAC. Other limitations on the premiums and payments also apply. ISO Properties Inc. 2004 Page 1 of 1 IL P 0010104
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POLICY NUMBER XSL G71095824 Wisconsin Notice to Policyholders KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS PROBLEMS WITH YOUR INSURANCE If you are having problems with your insurance company or agent do not hesitate to contact the insurance company or agent to resolve your problem. Chubb Customer Support Service Department 436 Walnut Street PO Box 1000 Philadelphia PA 19106 3703 1 800 352 4462 You can also contact the OFFICE OF THE COMMISSIONER OF INSURANCE a state agency which enforces Wisconsin s insurance laws and file a complaint. You can contact the OFFICE OF THE COMMISSIONER OF INSURANCE by contacting Office of the Commissioner of Insurance Complaints Department P.O. Box 7873 Madison WI 53707 7873 1 800 236 8517 608 266 0103 ALL5X51a 206 Printed in U.S.A. Page 1 of 1
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CHUB B chubcrow ACE American Insurance Company 436 Walnut Street Philadelphia PA 19106 3703 a stock insurance company Excess Commercial General Liability Policy Declarations POLICY IDENTIFICATION XSL G71095824 NAMED INSURED PRODUCER Forward Air Corporation CODE 272319 LOCKTON COMPANIES LLC 1915 Snaps Ferry Road Greeneville TN 37745 444 WEST 47TH ST SUITE 900 KANSAS CITY MO 64112 1906 POLICY IS NEW OF NAMED INSURED IS Corporation other BUSINESS OF INSURED Transportation POLICY PERIOD FROM 04012018 TO 04012019 1201 AM. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE PREMIUM COMPUTATION AND PAYMENT CONDITIONS AUDIT PERIOD Annual unless otherwise stated Semi Annual Quarterly TOTAL ADVANCE PREMIUM including surcharges 54184.00 Refer to Surcharge Schedule for surcharge amounts. COUNTERSIGNED BY Authorized Representative 915 Snaps Ferry Road reeneville TN 37745 SLLC OF 5 Corporation other JIRED Transportation ROM 04012018 TO 04012019 201 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE other UDIT PERIOD Annual unless otherwise stated Semi Annual Quarterly D S e e A efer to Surcharge Schedule for surcharge amounts. XS6U88e 0610 Page 1 of 4
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DECLARATIONS EXCESS GENERAL LIABILITY POLICY Page 2 XSL G71095824 POLICY IDENTIFICATION LIMITS OF INSURANCE In return for the payment of premium indicated on Page 1 of the Declarations we agree with you to provide insurance at the limits shown subject to all of the terms and conditions of this policy. GENERAL AGGREGATE LIMIT 2000000 PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT 2000000 EACH OCCURRENCE LIMIT 2000000 PERSONAL AND ADVERTISING INJURY LIMIT 1000000 DAMAGE TO PREMISES RENTED TO YOU LIMIT 100000 RETAINED LIMIT EACH OCCURRENCE 3000000 PERSONAL AND ADVERTISING INJURY 3000000 FORMS AND ENDORSEMENTS FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY AT INCEPTION G INJURY LIMIT ED TO YOU LIMIT TISING INJURY SCHEDULE OF NOTICES Description Policyholder Notice Commercial Lines Deregulation New York Chubb Producer Compensation Practices Policies Colorado Fraud Statement Illinois Notice To Policyholders Regarding The Religious Freedom Protection And Civil Union Act Important Information To Virginia Policyholders Regarding Your Insurance Indiana Notice To Policyholders Notice To All Oklahoma Policyholders Notice To Our Florida Property And Casualty Policyholders Guidelines For Loss Control Plans Pennsylvania Notice Policyholder Notice Ohio Questions About Your Insurance Questions About Your Insurance Risk Control Services For Texas Policyholders Tennessee Disclaimer Notice Commercial Lines Deregulation Texas Notice Information And Complaints U.S. Treasury Department s Office Of Foreign Assets Control OFAC Advisory Notice To Policyholders Wisconsin Notice To Policyholders XS6U88e 0610 Form No. ALL23445b0713 ALL208871006 ALL223680607 ILN1751111 ALL7X4720206 ALL2Y810514 ALL2U78b0206 ALL398220413 1L09100702 ALL5W060795 ALL18653d0714 ALL5X451196 ALL115590716 ALL386290712 ALL4Y30f0615 ILP0010104 ALL5X51a0206 Page 2 of 4
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SCHEDULE OF COVERAGE FORMS Form No. Description XS6U91d0610 Excess Commercial General Liability Policy SCHEDULE OF ENDORSEMENTS Form No. Description ALL32677a0412 Kentucky Local Government Premium Tax Schedule ALL224211011 Surcharge Schedule CC1K11h0314 Signatures XS8380050413 2013 Amendatory Endorsement XS6W270995 Additional Insured Employees Fellow Employees Professional Health Care Services XS6W31c0217 Additional Insured Vendors XS21234b0813 Additional Insured Where Required By Written Contract XS202900606 Broad Form Named Insured All23684a0115 Cap On Losses From Certified Acts Of Terrorism LD246710308 Definition Of Insured Contract Amendment ALL205010706 Designated Entity Exclusion ALL10617b0614 Earlier Notice Of Cancellation And Non Renewal Endorsement XS8342601011 Employee Benefits Liability Coverage XS476730316 Exclusion Unmanned Aircraft XS212251106 Fellow Employee Coverage LD453510316 Fungi Or Bacteria Exclusion X21226a0510 Knowledge Of Occurrence XS46601a1115 Limited Electronic Data Loss Coverage Access Collection Release Disclosure Limited Bodily Injury And Property Damage Defense Expenses Borne By Insured LD466861015 Non Owned Watercraft Exception ALL326860111 Notice To Others Endorsement Schedule Notice By Insured s Representative ALL180571211 Notification Of Premium Adjustment XS20726a0817 Pollution Exclusion Exception For Building Heating Equipment XS6W35a0817 Pollution Exclusion Hostile Fire Exception ALL442990215 Reporting Of Data On Claims Within A Retention XS182240405 Silica Or Silica Related Dust Exclusion ALL211011106 Trade Or Economic Sanctions Endorsement LD35048a0113 Truck Broker Exclusion LD2X62a0408 Unintentional Failure To Disclose XS6W340995 Waiver Of Transfer Of Rights Of Recovery Against Others To Us 1L09850115 Disclosure Pursuant To Terrorism Risk Insurance Act LD2S51c1214 Arizona Changes Cancellation And Nonrenewal LD2S53d0811 California Changes Cancellation And Nonrenewal LD2S54a0201 Colorado Changes Cancellation And Nonrenewal LD2S550392 Connecticut Changes Cancellation And Nonrenewal LD3S08b0612 Delaware Changes Cancellation And Nonrenewal LD2S5620201 District Of Columbia Changes Cancellation And Nonrenewal Page 3 of 4 Form No. ALL32677a0412 ALL224211011 CC1K11h0314 XS380050413 XS6W270995 XS6W31c0217 XS21234b0813 XS202900606 All23684a0115 LD246710308 ALL205010706 ALL10617b0614 XS342601011 XS476730316 XS212251106 LD453510316 XS21226a0510 XS46601a1115 36 XS6U88e 0610 LD466861015 ALL326860111 ALL180571211 XS20726a0817 XS6W35a0817 ALL442990215 XS182240405 ALL211011106 LD35048a0113 LD2X62a0408 XS6W340995 1L09850115 LD2S511214 LD2S53d0811 LD2S54a0201 LD28550392 LD3S08b0612 LD2S56a0201
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Endt. No. Form No. Description 37 LD2S57b0201 Florida Changes Cancellation And Nonrenewal 38 XS1V18b0215 Georgia Changes Cancellation And Nonrenewal 39 LD2S61a0201 lllinois Changes Cancellation And Nonrenewal 40 LD2S62a0201 Indiana Changes Cancellation And Nonrenewal 41 LD2S630392 lowa Changes Cancellation And Nonrenewal 42 LD2S64a0201 Kansas Changes Cancellation And Nonrenewal 43 LD2S65a0201 Kentucky Changes Cancellation And Nonrenewal 44 LD2S66c0801 Louisiana Changes Cancellation And Nonrenewal 45 LD2S68c0516 Maryland Changes Cancellation And Nonrenewal 46 LD2S69e0417 Michigan Changes Cancellation And Nonrenewal 47 LD2S70a0201 Minnesota Changes Cancellation And Nonrenewal 48 X223600607 Minnesota Changes Endorsement 49 LD2S71a0201 Mississippi Changes Cancellation And Nonrenewal 50 LD2S72c0805 Missouri Changes Cancellation And Nonrenewal 51 LD2S74a0201 Nebraska Cancellation And Nonrenewal 52 LD3S07a0201 Nevada Changes Cancellation And Nonrenewal 53 LD2S76 New Jersey Changes Cancellation And Nonrenewal 54 ALL252131008 New York Changes 55 LD2S770201 New York Changes Cancellation And Nonrenewal 56 LD2S78b0201 North Carolina Cancellation And Nonrenewal 57 LD2S80c0706 Ohio Changes Cancellation And Nonrenewal 58 LD2S81c1006 Oklahoma Changes Cancellation And Nonrenewal 59 LD2S82a0201 Oregon Changes Cancellation And Nonrenewal 60 LD2S83a0201 Pennsylvania Changes Cancellation And Nonrenewal 61 LD2S86b0810 South Carolina Changes Cancellation Nonrenewal 62 LD2S88a0201 Tennessee Changes Cancellation And Nonrenewal 63 LD2S89a0201 Texas Changes Cancellation And Nonrenewal Provisions For Casualty Lines And Commercial Package Policies 64 LD2S90b0201 Utah Changes Cancellation And Nonrenewal 65 LD2S92d1215 Virginia Changes Cancellation And Nonrenewal 66 LD2S930392 Washington Changes Cancellation And Nonrenewal 67 X380201113 Washington Changes Defense Costs 68 LD2S94a0201 West Virginia Changes Cancellation And Nonrenewal 69 LD2S95a0201 Wisconsin Changes Cancellation And Nonrenewal This declaration and the coverage forms and endorsements if any listed above and attached completes the above numbered policy. XS6U88e 0610 Page 4 of 4
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Kentucky Local Government Premium Tax Schedule Named Insured Forward Air Corporation Endorsement Number 1 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Date of Endorsement Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The premium shown on the Declarations includes the total tax amount for the Kentucky Local Government Premium Tax which is the sum of the tax amounts for each taxing jurisdiction shown below. Each tax amount includes the tax prescribed by the State of Kentucky in accordance with KRS 91A.080 and a collection fee pursuant to KRS. 91A.0804 and 806 KAR. 2090. Taxing Jurisdiction Tax Amount 9999 0 Tax Amount 0 Authorized Representative ALL32677a 0412 Page 1 of 1
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SURCHARGE SCHEDULE Named Insured Forward Air Corporation Endorsement Number 2 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Date of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this schedule is issued subsequent to the preparation of the policy. The following surcharges have been applied at inception of this policy State Name of Surcharge Amount KY Kentucky Domestic Foreign and Alien Insurers Surcharge 4.00 NJ NJ Property Liability Insurance Guarantee Association 9.00 WV WV Premium Surcharge 1.00 Surcharges will be adjusted at audit and concurrent with any other applicable premium adjustment. The rates used to adjust the surcharges are set by the states. The formulae for the adjustment bases used to adjust the surcharges are also set by the states. ALL22421 1011 Page 10f 1
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SIGNATURES Endorsement Number 3 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 TO 04012019 Issued By Name of Insurance Company ACE American Insurance Company Named Insured Forward Air Corporation Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THE ONLY SIGNATURES APPLICABLE TO THIS POLICY ARE THOSE REPRESENTING THE COMPANY NAMED ON THE FIRST PAGE OF THE DECLARATIONS. By signing and delivering the policy to you we state that it is a valid contract. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA A stock company BANKERS STANDARD FIRE AND MARINE COMPANY A stock company BANKERS STANDARD INSURANCE COMPANY A stock company ACE AMERICAN INSURANCE COMPANY A stock company ACE PROPERTY AND CASUALTY INSURANCE COMPANY A stock company INSURANCE COMPANY OF NORTH AMERICA A stock company PACIFIC EMPLOYERS INSURANCE COMPANY A stock company ACE FIRE UNDERWRITERS INSURANCE COMPANY A stock company WESTCHESTER FIRE INSURANCE COMPANY A stock company 436 Walnut Street P.O. Box 1000 Philadelphia Pennsylvania 19106 3703 JOHN J. LUPICA President Plpees A 0l REBECCA L. COLLINS Secretary Authorized Representative Chubb. Insured CC1K11h 0314 Page 1 of 1
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POLICY NUMBER XSL G71095824 Excess Commercial General Liability Policy Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any other person or organization qualifying as a Named Insured under this policy. The words we us and our refer to the company providing this insurance. The word insured means any person or organization qualifying as such under SECTION Il WHO IS AN INSURED. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION V DEFINITIONS. SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay the insured for the ultimate net loss in excess of the retained limit because of bodily injury or property damage to which this insurance applies. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under DEFENSE INVESTIGATION SETTLEMENT LEGAL EXPENSES AND INTEREST ON JUDGMENTS. But the amount we will pay for the ultimate net loss because of damages is limited as described in SECTION Ill LIMITS OF INSURANCE. b. This insurance applies to bodily injury and property damage only if 1 The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory 2 The bodily injury or property damage occurs during the policy period and 3 Prior to the policy period no insured listed under Paragraph 1. of Section Il Who Is An Insured and no employee authorized by you to give or receive notice of an occurrence or claim knew that the bodily injury or property damage had occurred in whole or in part. If such a listed insured or authorized employee knew prior to the policy period that the bodily injury or property damage occurred then any continuation change or resumption of such bodily injury or property damage during or after the policy period will be deemed to have been known prior to the policy period. c. Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. d. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section Il Who Is An Insured or any employee authorized by you to give or receive notice of an occurrence or claim 1 Reports all or any part of the bodily injury or property damage to us or any other insurer 2 Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 1 of 20 Page 1 of 20
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3 Becomes aware by any other means that bodily injury or property damage has occurred or has begun to occur. e. Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. Exclusions This insurance does not apply to a. Expected or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. b. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable 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 a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and b Such 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. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. d. Workers Compensation and Similar Laws Any obligation of the insured under a workers compensation disability benefits or unemployment compensation law or any similar law. e. Employers Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 2 of 20
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b Performing duties related to the conduct of the insured s business 2 The spouse child parent brother or sister of that employee as a consequence of 1 above. This exclusion applies 1 Whether the insured may be liable as an employer or in any other capacity and 2 To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. Pollution Any injury damage expense cost loss liability or legal obligation arising out of or in any way related to pollution however caused. Aircraft Auto or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 51 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured 4 Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or 5 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state 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. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed or demolition contest or in any stunting activity. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 3 of 20
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War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or 3 Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. Damage to Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property 2 Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you 4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or 6 That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section IIl LIMITS OF INSURANCE. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. Damage to Your Product Property damage to your product arising out of it or any part of it. Damage to Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 4 of 20
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m. Damage to Impaired Property or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 A defect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use. n. Recall of Products Work or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it. o. Personal And Advertising Injury Bodily Injury arising out of personal and advertising injury. p. Asbestos Any loss demand claim or suit arising out of or related in any way to asbestos or asbestos containing materials. q. Lead Any injury damage expense cost loss liability or legal obligation arising out of or allegedly arising out of or in any way related to the toxic properties of lead or lead containing products materials or substances. r. Employment Related Practices Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment humiliation or 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 Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 5 of 20 Page 5 of 20
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3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. s. Nuclear Energy Bodily injury or property damage 1 With respect to which an insured under the policy is also an insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association Mutual Atomic Energy Liability Underwriters Nuclear Insurance Association of Canada or any of their successors or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability or Resulting from the hazardous properties of nuclear material and with respect to which a any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954 or any law amendatory thereof or b the insured is or had this policy not been issued would be entitled to indemnity from the United States of America or any agency thereof under any agreement entered into by the United States of America or any agency thereof with any person or organization. 3 Resulting from the hazardous properties of nuclear material if a The nuclear material 1 is at any nuclear facility owned by or operated by or on behalf of an insured or 2 has been discharged or dispersed therefrom b The nuclear material is contained in spent fuel or waste at any time possessed disposed handled used processed stored transported or disposed of by or on behalf of an insured or c The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuclear facility but if such facility is located within the United States of America its territories or possessions this exclusion 3c applies only to property damage to such nuclear facility and any property thereat. 4 As used in this exclusion a Hazardous properties include radioactive toxic or explosive properties b Nuclear material means source material special nuclear material or by product material c Source material special nuclear material and by product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof d Spent fuel means any fuel element or fuel component solid or liquid which has been used or exposed to radiation in a nuclear reactor e 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 any person or organization of any nuclear facility included under the first two paragraphs of the definition of nuclear facility f 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 waste Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 6 of 20 Page 6 of 20
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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 the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 4 Any structure basin excavation premises or place prepared or used for the storage or disposal of waste and 5 The site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations. g 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 h Property damage includes all forms of radioactive contamination of property. t. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. u. 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 Transaction Act FACTA or 4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III LIMITS OF INSURANCE COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay the insured for the ultimate net loss in excess of the retained limit because of personal and advertising injury to which this insurance applies. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under DEFENSE INVESTIGATION SETTLEMENT LEGAL EXPENSES AND INTEREST ON JUDGMENTS. But the amount we will pay for the ultimate net loss because of damages is limited as described in SECTION Il LIMITS OF INSURANCE. 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. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 7 of 20
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2. Exclusions This insurance does not apply to Knowing Violation Of Rights Of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication 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 of material whose first publication took place before the beginning of the policy period. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of the insured. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. Breach Of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement. Quality Or Performance Of Goods Failure To Conform To Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement. Wrong Description Of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Infringement Of Copyright Patent Trademark Or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. Insureds In Media And Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for others or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 13.a. b. and c. of personal and advertising injury under the Definitions Section. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 8 of 20
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For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board the insured hosts owns or over which the insured exercises control. I Unauthorized Use Of Another s Name Or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customers. m. Pollution Personal and advertising injury arising out of any injury damage expense cost loss liability or legal obligation arising out of or in any way related to pollution however caused. n. Asbestos Personal and advertising injury arising out of any loss demand claim or suit arising out of or related in any way to asbestos or asbestos containing materials. o. Employment Related 1 Personal and advertising injury a to a person arising out of any Refusal to employ that person Termination of that person s employment or Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment humiliation or discrimination or malicious prosecution directed at that person or b To the spouse child parent brother or sister of that person as a consequence of personal and advertising injury to that person at whom any of the employment related practices described in paragraphs i ii or iii above is directed. This exclusion applies a Whether the injury causing event described in paragraphs i ii or above occurs before employment during employment or after employment of that person b Whether the insured may be liable as an employer or in any other capacity and c To any obligation to share damages with or repay someone else who must pay damages because of the injury. p. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or 3 Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 9 of 20
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Recording And Distribution Of Material Or Information In Violation Of Law Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law 3 The Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Accurate Credit Transaction Act FACTA or 4 Any federal state or local statute ordinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and additions that addresses prohibits or limits the printing dissemination disposal collecting recording sending transmitting communicating or distribution of material or information. DEFENSE INVESTIGATION SETTLEMENT LEGAL EXPENSES AND INTEREST ON JUDGMENTS 1. Defense Investigation Settlement Legal Expenses and Prejudgment Interest This insurance does not apply to defense investigation settlement or legal expenses or prejudgment interest arising out of any occurrence or offense but we shall have the right and opportunity to assume from the insured the defense and control of any claim or suit including any appeal from a judgment seeking payment of damages covered under this policy that we believe likely to exceed the retained limit. In such event we and the insured shall cooperate fully. 2. Interest on Judgments We shall pay interest only on that amount of any judgment we pay that accrues after entry of the judgment and before we have paid offered to pay or deposited in court that part of the judgment that is within the applicable limit of insurance shown in the Declarations. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership or joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. Atrust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees 2. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization 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 is an insured for Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 10 of 20
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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 or 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 1 a or b above or d Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member If you are a partnership or joint venture or any member if you are a limited liability company. b. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. d. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Policy. 3. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE AND RETAINED LIMIT 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay for the ultimate net loss in excess of the retained limit regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 11 of 20
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2. The General Aggregate Limit is the most we will pay for the sum of all ultimate net loss in excess of the retained limit for a. Damages under Coverage A except damages because of bodily injury and property damage included in the products completed operations hazard and b. Damages under Coverage B. 3. The Products Completed Operations Aggregate Limit is the most we will pay for the ultimate net loss in excess of the retained limit under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 4. Subject to 2. above the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the ultimate net loss in excess of the retained limit for damages because of all personal and advertising injury sustained by any one person or organization. 5. Subject to 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay under Coverage A for the ultimate net loss in excess of the retained limit for damages because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to 5. above the Damage to Premises Rented To You Limit is the most we will pay under Coverage A for the ultimate net loss in excess of the retained limit 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. If the policy aggregate limits as set forth in 2. and 3. above are paid prior to this policy s termination date this policy s premium is fully earned. 8. You agree to assume payment of the retained limit before the Limits of Insurance become applicable. The Limits of Insurance of this policy 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 CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this policy. 2. Duties in the Event of Occurrence 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. b. You must notify us as soon as practicable in writing of any occurrence or offense which may result in a claim or claims involving damages which in the event that you are held liable are likely to exceed 50 of the retained limit. Failure to give notice of any occurrence which at the time of its happening did not appear to exceed 50 of the retained limit but which at a later date would appear to give rise to a claim under this insurance shall not prejudice such claim. c. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and any witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 12 of 20
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d. Ifaclaim is made or a 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. e. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal documents received in connection with the claim or suit 2 3 Authorize us to obtain records and other information Cooperate with us in the investigation or settlement of the claim or any defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. f. You shall make a good faith evaluation of any claim for settlement purposes. 3. Legal Action Against Us No person or organization has a right under this policy a. Tojoin us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this policy 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 obtained after an actual trial but we will not be liable for damages that are not payable under the terms of this policy 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. 4. Other Insurance If other insurance is available to the insured for a loss we cover under this policy this insurance is excess over that other insurance unless that insurance is written specifically to apply in excess of the Limits of Insurance shown in the Declarations. 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 b. The total of all deductible and self insured amounts under all that other insurance and c. The retained limit shown in the Declarations of this policy. Nothing herein shall be construed to make this policy subject to the terms conditions and limitations of other insurance. 5. Premium Audit a. We will compute all premiums for this policy in accordance with our rules and rates. b. Premium shown in this policy as advance premium is 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 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. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 13 of 20 Page 13 of 20
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10. 1. 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. 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. Separation of Insureds Except with respect to the Limits of Insurance the application of the retained limit and any rights or duties specifically assigned in this policy to the first Named Insured this policy 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 policy 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 policy we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. Cancellation a. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. b. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least 1 10 days before the effective date of cancellation if we cancel for nonpayment of premium or 2 60 days before the effective date of cancellation if we cancel for any other reason. c. We may mail or deliver our notice to the first Named Insured s last mailing address known to us. d. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. e. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. f. If notice is mailed proof of mailing will be sufficient proof of notice. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made part of this policy. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 14 of 20
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12. Examination of Your Books and Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. 13. Inspections and Surveys We have the right but are not obligated to a. Make inspections and surveys at any time b. Give you reports on the conditions we find and c. Recommend changes. Any inspections surveys reports or recommendations relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. 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. 14. Premiums The first Named Insured shown in the Declarations a. s responsible for the payment of all premiums and b. Will be the payee for any return premiums we pay. 15. Transfer of Your Rights and Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual Named Insured. If you die your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a web site that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. However auto does not include mobile equipment. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 15 of 20 Page 15 of 20
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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 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 a. above but is away for a short time on your business or 3 Personal and advertising injury offenses that take place through the Internet or similar electronic means of communication. provided the insured s responsibility to pay damages is determined in a suit on the merits in the territory described in Paragraph a. above or in a settlement we agree to. Employee includes a leased worker. Employee does not include a temporary worker. Executive officer means a person holding any of the officer positions created by your charter constitution by laws or any other similar governing document. Impaired property means tangible property other than your product or your work that can not be used or is less useful because a. It incorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by the repair replacement adjustment or removal of your product or your work or your fulfilling the terms of the contract or agreement. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract b. A sidetrack agreement Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement or f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 16 of 20
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Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing 2 Thatindemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for injury or damage arising out of the insured s rendering or failing to render professional services including those listed in 2 above and supervisory inspection or engineering services. 9. 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. 10. Loading or unloading means the handling of property a. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto or b. While itis 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. 11. 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 Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers f. Vehicles not described in 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 Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 17 of 20 Page 17 of 20
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1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. 12. Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. 13. Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution c. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services e. Oral or written publication in any manner of material that violates a person s right of privacy f. The use of another s advertising idea in your advertisement or g. Infringing upon another s copyright trade dress or slogan in your advertisement. 14. Pollution includes the actual alleged or potential presence in or introduction into the environment of any substance if such substance has or is alleged to have the effect of making the environment impure harmful or dangerous. Environment includes any air land structure or the air therein watercourse or water including underground water. 15. Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. b When all of the work to be done at the site has been completed if your contract calls for work at more than one site. c en that part of the work done at a job site has been put to its intended use by any When that part of th k d t a job site has b t to its intended b person or organization other than another contractor or subcontractor working on the same project. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 18 of 20 Page 18 of 20
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Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. b. Does not include bodily injury or property damage arising out of 1 The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy schedule states that products or completed operations are subject to the General Aggregate Limit. 16. Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance electronic data is not tangible property. As used in this definition electronic data means 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. 17. Retained limit means the limit shown in the Declarations and is the amount you must pay before the Limits of Insurance become applicable. In the event there is other insurance whether or not applicable to an occurrence offense claim or suit within the retained limit you will continue to be responsible for the full amount of the retained limit before the Limits of Insurance under this policy apply. In no case will we be required to pay the retained limit or any portion thereof. Retained limit does not include prejudgment interest interest that accrues after entry of the judgment nor any expenses incurred by the insured in the defense of any claim or suit. 18. Suit means a civil proceeding in which damages because of bodily injury property damage personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 19. Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. 20. Ultimate net loss means the total sum after recoveries or salvages collectible that the insured becomes legally obligated to pay as damages by reason of settlements judgments or any arbitration or other alternative dispute method entered into with our written consent and includes interest that accrues after entry of the judgment and deductions for recoveries and salvages which have been or will be paid. Ultimate net loss does not include any of the expenses incurred by the insured or us in connection with defending the claim or suit. 21. 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. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 19 of 20
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22. 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. 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. Does not include vending machines or other property rented to or located for the use of others but not sold. 23. Your work means 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. 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. Includes copyrighted material of Insurance Services Office Inc. with its permission XS6U91d 0610 Page 20 of 20
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2013 AMENDATORY ENDORSEMENT Named Insured Endorsement Number Forward Air Corporation 4 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY Exclusion c. Liquor Liability under SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced by the following c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in a The supervision hiring employment training or monitoring of others by that insured or b Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage involved that which is described in Paragraph 1 2 or 3 above. However this exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. For the purposes of this exclusion permitting a person to bring alcoholic beverages on your premises for consumption on your premises whether or not a fee is charged or a license is required for such activity is not by itself considered the business of selling serving or furnishing alcoholic beverages. Subparagraph 5 of Exclusion g. Aircraft Auto or Watercraft under SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced by the following This exclusion does not apply to 5 Bodily injury or property damage arising out of XS38005 0413 Page 10of 3
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VI VI 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. Exclusion t. Electronic Data under SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced by the following t. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. However this exclusion does not apply to liability for damages because of bodily injury. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. Exclusion b. Material Published With Knowledge Of Falsity under SECTION COVERAGES COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY is deleted and replaced by the following b. Material Published With Knowledge Of Falsity Personal and advertising injury arising out of oral or written publication in any manner of material if done by or at the direction of the insured with knowledge of its falsity. Exclusion c. Material Published Prior to Policy Period under SECTION COVERAGES COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY is deleted and replaced by the following c. Material Published Prior To Policy Period Personal and advertising injury arising out of oral or written publication in any manner of material whose first publication took place before the beginning of the policy period. The definition of auto in SECTION V DEFINITIONS is deleted and replaced by the following Auto means a. A land motor vehicle trailer or semitrailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment. The definition of mobile equipment in SECTION V DEFINITIONS is deleted and replaced by the following Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment XS38005 0413 Page 2 of 3
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a. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. Vehicles maintained for use solely on or next to premises you own or rent c. Vehicles that travel on crawler treads d. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers e. Vehicles not described in Paragraph a. b.. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers f. Vehicles not described in Paragraph a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. Authorized Representative XS38005 0413 Page 3 of 3
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ADDITIONAL INSURED EMPLOYEES FELLOW EMPLOYEES PROFESSIONAL HEALTH CARE SERVICES Named Insured Endorsement Number Forward Air Corporation 5 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY Paragraph 2. a 1 of Section Il WHO IS AN INSURED is deleted. Coverage under this endorsement is excess over any other insurance whether primary excess contingent or on any other basis unless written specifically to apply in excess of this policy. Authorized Agent XS6W27 0995 Ptd. in U.S.A. Page 1 of 1
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ADDITIONAL INSURED VENDORS Named Insured Forward Air Corporation Endorsement Number 6 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement ssued By Name of Insurance Company ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Your Products All of your products. Name of Persons or Organizations VendorAny Vendor whom you have agreed to include as an additional insured under a written contract provided such contract was executed prior to the date of loss. A. SECTION II WHO IS AN INSURED is amended to include as an additional insured any persons or organizations referred to throughout this endorsement as vendor shown in the Schedule but only with respect to bodily injury or property damage arising out of your products shown in the Schedule which are distributed or sold in the regular course of the vendor s business. However 1. The insurance afforded to such vendor only applies to the extent permitted by law and 2. If coverage provided to the vendor is required by a contract or agreement the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. B. With respect to the insurance afforded to these vendors the following additional exclusions apply 1. The insurance afforded the vendor does not apply to a. Bodily injury or property damage for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement b. Any express warranty unauthorized by you c. Any physical or chemical change in the product made intentionally by the vendor d. Repackaging except when unpacked solely for the purpose of inspection demonstration testing or the substitution of parts under instructions from the manufacturer and then repackaged in the original container Includes copyrighted material of Insurance Services Office Inc. with its permission. Page10f2 XS6W31c 0217
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e. 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 f. Demonstration installation servicing or repair operations except such operations performed at the vendor s premises in connection with the sale of the product g. 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 h. Bodily injury or property damage arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However this exclusion does not apply to 1 The exceptions contained in Sub paragraphs d.or f. or 2 Such inspections adjustments tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization from whom you have acquired such products or any ingredient part or container entering into accompanying or containing such products. C. With respect to the insurance afforded to these vendors the following is added to SECTION III LIMITS OF INSURANCE AND RETAINED LIMIT If coverage provided to the vendor is required by a contract or agreement the most we will pay on behalf of the vendor is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the Limits of Insurance shown in the Declarations. Authorized Representative Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 2 XS6W31c 0217
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ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT Named Insured Endorsement Number Forward Air Corporation 7 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company insert the policy number. The remainder of the information is to be completed only when this endorsement is ssued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY The following is added to Section 1.2 Who Is An Insured e. Any person or organization that you are required to include as an additional insured under this policy because of a written contract that 1 s in effect during this policy period and 2 Was executed prior to the occurrence of the bodily injury or property damage and 3 Qualifies as an insured contract as defined in this policy. Any such person or organization is an additional insured only for bodily injury and property damage resulting from a. your work that you do for that additional insured pursuant to such contract or b. your product distributed or sold to that additional insured pursuant to such contract and such person is only an additional insured for occurrences taking place during the period of time required by such contract or until the end of the policy period whichever is sooner. However i The insurance afforded to such additional insured only applies to the extent permitted by law and ii If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract Xx. The insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract and y. This endorsement shall not increase the Limits of Insurance stated in the Declarations under Item 3. Limits of Insurance pertaining to the coverage provided herein. Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary excess contingent or on any other basis unless the written contract specifically requires that this insurance apply on a primary or non contributory basis. XS21234b 0813 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 2
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In accordance with the terms and conditions of the policy and as more fully explained in the policy as soon as practicable each additional insured must give us prompt notice of any occurrence which may result in a claim forward all legal papers to us cooperate in the defense of any actions and otherwise comply with all of the policy s terms and conditions. Authorized Representative XS21234b 0813 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 2
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BROAD FORM NAMED INSURED Named Insured Endorsement Number Forward Air Corporation 8 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY Itis agreed that Throughout this policy the words you and your refer to the Named Insured shown in the Declarations and any business entity incorporated or organized under the laws of the United States of America including any State thereof its territories or possessions or Canada including any Province thereof in which the Named Insured shown in the Declarations owns during the policy period an interest of more than 50 percent. If other valid and collectible insurance is available to any business entity covered by this policy solely by reason of ownership by the Named Insured shown in the Declarations in excess of 50 percent this insurance is excess over the other insurance whether primary excess contingent or any other basis. Authorized Agent Page 1 of 1 X8 20290 0606
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POLICY NUMBER XSL G71095824 Endorsement Number 9 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY CONTRACTUAL INDEMNIFICATION COVERAGE PART If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following 1. The act resulted in insured losses in excess of 5 million in the aggregate attributable to all types of insurance subject to the Terrorism Risk Insurance Act and 2. The act is a violent act or an act that is dangerous to human life property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. All23684a 0115 Includes copyrighted material of ISO Properties Inc. with its permission. Page 1 of 1
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DEFINITION OF INSURED CONTRACT AMENDMENT Named Insured Endorsement Number Forward Air Corporation 10 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM EXCESS COMMERCIAL GENERAL LIABILITY POLICY The definition of Insured Contract is modified as follows Item c. is deleted and replaced with the following c. Any easement or license agreement Item d. is deleted and replaced with the following d. An obligation as required by ordinance to indemnify a municipality Authorized Agent Page 10f 1 LD24671 0308 Ptd. in U.S.A.
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DESIGNATED ENTITY EXCLUSION Named Insured Forward Air Corporation Endorsement Number 1 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 TO 04012019 Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following ALL COVERAGE PARTS INCLUDED IN THIS POLICY ARE SUBJECT TO THE FOLLOWING The coverage afforded by the policy to which this endorsement is attached does not apply to the entity or entities designated in the schedule below and such entity or entities are not insureds Designated Entitys TQI Holdings Inc. Total Quality Inc. TQI Inc. Central States Trucking Co. Central States Logistics Inc. Authorized Agent ALL20501 0706 Page 1 of 1
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EARLIER NOTICE OF CANCELLATION AND NON RENEWAL ENDORSEMENT Named Insured Endorsement Number Forward Air Corporation 12 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following COMMERICIAL GENERAL LIABILITY COVERAGE FORM BUSINESS AUTOMOBILE COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM COMMERCIAL UMBRELLA LIABILITY POLICY EXCESS GENERAL LIABILITY POLICY RAILROAD PROTECTIVE LIABILITY COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM EARLIER NOTICE OF CANCELLATION For any statutorily permitted reason other than nonpayment of premium the minimum number of days required for notice of cancellation as provided in either the Cancellation Condition of the policy or as amended by any applicable state cancellation endorsement is increased to 90 days. If the state cancellation endorsement provides for more than the number of days notice of cancellation shown above this provision does not apply. EARLIER NOTICE OF NON RENEWAL If we decide not to renew this policy for any reason other than nonpayment of premium the minimum number of days for notice of non renewal as provided by any applicable state non renewal endorsement is increased to 90 days. If the state non renewal endorsement provides for more than the number of days notice of non renewal shown above this provision does not apply. Authorized Representative ALL10617b 0614 Page 1 of 1 Chubb. 2016. All rights reserved.
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EMPLOYEE BENEFITS LIABILITY COVERAGE Named Insured Endorsement Number Forward Air Corporation 13 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Tnsert the policy number. The remainder of the information s to be completed only when this endorsement is fssued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT PROVIDES CLAIMS MADE COVERAGE. PLEASE READ THE ENTIRE ENDORSEMENT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Coverage Limit of Insurance Each Employee Deductible Employee Benefit Programs 4000000 each employee N A 4000000 aggregate Retained Limit 3000000 Retroactive Date 4118 A. The following is added to Section Coverages COVERAGE EMPLOYEE BENEFITS LIABILITY 1. Insuring Agreement a. We will pay the insured for the ultimate net loss in excess of the retained limit because of any act error or omission of the insured or of any other person for whose acts the insured is legally liable to which this insurance applies. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under DEFENSE INVESTIGATION SETTLEMENT LEGAL EXPENSES AND INTEREST ON JUDGMENTS. But the amount we will pay for the ultimate net loss because of damages is limited as described in SECTION Il LIMITS OF INSURANCE. b. This insurance applies to damages only if 1 The act error or omission is negligently committed in the administration of your employee benefit program 2 The act error or omission did not take place before the Retroactive Date if any shown in the Schedule nor after the end of the policy period and 3 A claim for damages because of an act error or omission is first made against any insured in accordance with Paragraph c. below during the policy period or an Extended Reporting Period we provide under Paragraph E. of this endorsement. c. Aclaim seeking damages will be deemed to have been made at the earlier of the following times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or 2 When we make settlement in accordance with Paragraph a. above. XS34260 1011 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 6
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A claim received and recorded by the insured within 60 days after the end of the policy period will be considered to have been received within the policy period if no subsequent policy is available to cover the claim. d. All claims for damages made by an employee because of any act error or omission or a series of related acts errors or omissions including damages claimed by such employee s dependents and beneficiaries will be deemed to have been made at the time the first of those claims is made against any insured. 2. Exclusions This insurance does not apply to a. Dishonest Fraudulent Criminal Or Malicious Act Damages arising out of any intentional dishonest fraudulent criminal or malicious act error or omission committed by any insured including the willful or reckless violation of any statute. b. Bodily Injury Property Damage Or Personal And Advertising Injury Bodily injury property damage or personal and advertising injury. c. Failure To Perform A Contract Damages arising out of failure of performance of contract by any insurer. d. Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the employee benefit program. e. Inadequacy Of Performance Of Investment Advice Given With Respect To Participation Any claim based upon 1 Failure of any investment to perform 2 Errors in providing information on past performance of investment vehicles or 3 Advice given to any person with respect to that person s decision to participate or not to participate in any plan included in the employee benefit program.. Workers Compensation And Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers compensation unemployment compensation insurance social security or disability benefits law or any similar law. g. ERISA Damages for which any insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Security Act of 1974 as now or hereafter amended or by any similar federal state or local laws. h. Available Benefits Any claim for benefits to the extent that such benefits are available with reasonable effort and cooperation of the insured from the applicable funds accrued or other collectible insurance.. Taxes Fines Or Penalties Taxes fines or penalties including those imposed under the Internal Revenue Code or any similar state or local law. j. Employment Related Practices Damages arising out of wrongful termination of employment discrimination or other employment related practices. B. For the purposes of the coverage provided by this endorsement Paragraphs 2. and 3. of Section Il Who Is An Insured are replaced by the following 2. Each of the following is also an insured XS34260 1011 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 6
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a. Each of your employees who is or was authorized to administer your employee benefit program. b. Any persons organizations or employees having proper temporary authorization to administer your employee benefit program if you die but only until your legal representative is appointed. c. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Endorsement. 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 no other similar insurance applies to that organization. However a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier. b. Coverage under this provision does not apply to any act error or omission that was committed before you acquired or formed the organization. C. For the purposes of the coverage provided by this endorsement Section Ill Limits Of Insurance is replaced by the following 1. Limits Of Insurance a. The Limits of Insurance shown in the Schedule and the rules below fix the most we will pay for the ultimate net loss in excess of the retained limit regardless of the number of 1 Insureds 2 Claims made or suits brought 3 Persons or organizations making claims or bringing suits 4 Acts errors or omissions or 5 Benefits included in your employee benefit program. b. The Aggregate Limit is the most we will pay for ultimate net loss in excess of the retained limit because of acts errors or omissions negligently committed in the administration of your employee benefit program. c. Subject to the Aggregate Limit the Each Employee Limit is the most we will pay for ultimate net loss in excess of the retained limit for all damages sustained by any one employee including damages sustained by such employee s dependents and beneficiaries as a result of 1 An act error or omission or 2 A series of related acts errors or omissions negligently committed in the administration of your employee benefit program. However the amount paid under this endorsement shall not exceed and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the employee benefit program. d. You agree to assume payment of the retained limit before the Limits of Insurance become applicable. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations of the policy to which this endorsement is attached unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits Of Insurance. 2. Deductible a. We will pay all sums that we become legally obligated to pay in excess of the retained limit up to the Limits of Insurance under this endorsement and you must reimburse us up to the Each Employee Deductible amount. b. The deductible amount stated in the Schedule applies to damages sustained by any one employee including such employee s dependents and beneficiaries because of all acts errors or omissions to which this insurance applies. c. The terms of this insurance including those with respect to XS34260 1011 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 3 of 6 Page 3 of 6
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1 Our right to defend any suits seeking those damages and 2 Your duties and the duties of any other involved insured in the event of an act error or omission or claim apply irrespective of the application of the deductible amount. D. For the purposes of the coverage provided by this endorsement Condition 2.of Section IV Conditions is replaced by the following 2. Duties In The Event Of An Act Error Or Omission Or Claim Or Suit a. You must see to it that we are notified as soon as practicable of an act error or omission which may result in a claim. To the extent possible notice should include 1 What the act error or omission was and when it occurred and 2 The names and addresses of anyone who may suffer damages as a result of the act error or omission. b. If aclaim is made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of an act error or omission to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense without our consent. E. For the purposes of the coverage provided by this endorsement the following Extended Reporting Period provisions are added or if this endorsement is attached to a claims made Coverage Part replaces any similar Section in that Coverage Part EXTENDED REPORTING PERIOD 1. You will have the right to purchase an Extended Reporting Period as described below if a. This endorsement is canceled or not renewed or b. We renew or replace this endorsement with insurance that 1 Has a Retroactive Date later than the date shown in the Schedule of this endorsement or 2 Does not apply to an act error or omission on a claims made basis. 2. The Extended Reporting Period does not extend the policy period or change the scope of coverage provided. It applies only to claims for acts errors or omissions that were first committed before the end of the policy period but not before the Retroactive Date if any shown in the Schedule. Once in effect the Extended Reporting Period may not be canceled. 3. An Extended Reporting Period of five years is available but only by an endorsement and for an extra charge. You must give us a written request for the endorsement within 60 days after the end of the policy period. The Extended Reporting Period will not go into effect unless you pay the additional premium promptly when due. XS34260 1011 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 4 of 6
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We will determine the additional premium in accordance with our rules and rates. In doing so we may take into account the following a. The employee benefit programs insured b. Previous types and amounts of insurance c. Limits of insurance available under this endorsement for future payment of damages and d. Other related factors. The additional premium will not exceed 100 of the annual premium for this endorsement. The Extended Reporting Period endorsement applicable to this coverage shall set forth the terms not inconsistent with this Section applicable to the Extended Reporting Period including a provision to the effect that the insurance afforded for claims first received during such period is excess over any other valid and collectible insurance available under policies in force after the Extended Reporting Period starts. 4. If the Extended Reporting Period is in effect we will provide an extended reporting period aggregate limit of insurance described below but only for claims first received and recorded during the Extended Reporting Period. The extended reporting period aggregate limit of insurance will be equal to the dollar amount shown in the Schedule of this endorsement under Limits of Insurance. Paragraph D.1.b. of this endorsement will be amended accordingly. The Each Employee Limit shown in the Schedule will then continue to apply as set forth in Paragraph D.1.c. F. For the purposes of the coverage provided by this endorsement the following definitions are added to the Defi ns Section 1. Administration means a. Providing information to employees including their dependents and beneficiaries with respect to eligibility for or scope of employee benefit programs b. Handling records in connection with the employee benefit program or c. Effecting continuing or terminating any employee s participation in any benefit included in the employee benefit program. However administration does not include handling payroll deductions. 2. Cafeteria plans means plans authorized by applicable law to allow employees to elect to pay for certain benefits with pre tax dollars. 3. Claim means any demand or suit made by an employee or an employee s dependents and beneficiaries for damages as the result of an act error or omission. Employee benefit program means a program providing some or all of the following benefits to employees whether provided through a cafeteria plan or otherwise a. Group life insurance group accident or health insurance dental vision and hearing plans and flexible spending accounts provided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to those employees who satisfy the plan s eligibility requirements b. Profit sharing plans employee savings plans employee stock ownership plans pension plans and stock subscription plans provided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to all employees who are eligible under the plan for such benefits c. Unemployment insurance social security benefits workers compensation and disability benefits d. Vacation plans including buy and sell programs leave of absence programs including military maternity family and civil leave tuition assistance plans transportation and health club subsidies and e. Any other similar benefits designated in the Schedule or added thereto by endorsement. H. For the purposes of the coverage provided by this endorsement Definitions 5. 17. and 18. in the Definitions Section are replaced by the following XS34260 1011 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 5 of 6
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5. Employee means a person actively employed formerly employed on leave of absence or disabled or retired. Employee includes a leased worker. Employee does not include a temporary worker. 17. Retained limit means the limit shown in the Schedule and is the amount you must pay before the Limits of Insurance become applicable. In the event there is other insurance whether or not applicable to an act error omission claim or suit within the retained limit you will continue to be responsible for the full amount of the retained limit before the Limits of Insurance under this endorsement apply. In no case will we be required to pay the retained limit or any portion thereof. Retained limit does not include prejudgment interest interest that accrues after entry of the judgment nor any expenses incurred by the insured in the defense of any claim or suit. 18. Suit means a civil proceeding in which damages because of an act error or omission to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. Al other terms and conditions of this policy remain unchanged. Authorized Representative XS34260 1011 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 6 of 6
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EXCLUSION UNMANNED AIRCRAFT Named Insured Endorsement Number Forward Air Corporation 14 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY A. Exclusion 2.g. Aircraft Auto Or Watercraft under Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to g. Aircraft Auto Or Watercraft 2 Unmanned Aircraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Use includes operation and loading or unloading. This Paragraph g.1 applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Aircraft Other Than Unmanned Aircraft Auto Or Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft other than unmanned aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading or unloading. This Paragraph g.2 applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft other than unmanned aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This Paragraph g.2 does not apply to a A watercraft while ashore on premises you own or rent b A watercraft you do not own that is i Less than 26 feet long and ii Not being used to carry persons or property for a charge c Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or Bodily injury or property damage arising out of d e XS47673 0316 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 10f 2
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i The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or ii The operation of any of the machinery or equipment listed in Paragraph f.2 or f.3 of the definition of mobile equipment. B. The following exclusion is added to Paragraph 2. Exclusions of Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Unmanned Aircraft Personal and advertising injury arising out of the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. Use includes operation and loading or unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the offense which caused the personal and advertising injury involved the ownership maintenance use or entrustment to others of any aircraft that is an unmanned aircraft. This exclusion does not apply to a. The use of another s advertising idea in your advertisement or b. Infringing upon another s copyright trade dress or slogan in your advertisement. C. The following definition is added to the Definitions section Unmanned aircraft means an aircraft that is not 1. Designed 2. Manufactured or 3. Modified after manufacture to be controlled directly by a person from within or on the aircraft. Authorized Representative XS47673 0316 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 2
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FELLOW EMPLOYEE COVERAGE Named Insured Endorsement Number Forward Air Corporation 15 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY Paragraphs a b and c of 2.a 1 of Section IIl. WHO IS AN INSURED are deleted. Coverage under this endorsement is excess over any other insurance whether primary excess contingent or on any other basis unless written specifically to apply in excess of this policy. Authorized Agent Page 1 of 1 X8 21225 1106 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission
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FUNGI OR BACTERIA EXCLUSION Named Insured Endorsement Number Forward Air Corporation 16 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM EXCESS COMMERCIAL GENERAL LIABILITY POLICY A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage that would not have occurred in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury or damage. b. Any loss cost or expenses arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. This exclusion does not apply to any fungi or bacteria contained in food that is intended for human consumption. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria a. Personal and advertising injury that would not have taken place in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury. b. Any loss cost or expense arising out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of fungi or bacteria by any insured or by any other person or entity. C. The following definition is added to the Definitions Section Fungi means any type or form of fungus including mold or mildew and any mycotoxins spores scents or byproducts produced or released by fungi. Authorized Representative LD45351 0316 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 1
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KNOWLEDGE OF OCCURRENCE Named Insured Endorsement Number Forward Air Corporation 17 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY It is agreed that the following condition is added to 2. Duties in the Event of Occurrence Claim or Suit under SECTION IV CONDITIONS Knowledge of an occurrence claim or suit by the agent servant or employee of any insured shall not in itself constitute knowledge of the insured unless individuals in the following positions shall have received such notice from the agent servant or employee Your executive officers or anyone responsible for administering your insurance program. Authorized Representative XS21226a 0510 Page 1 of 1 Includes copyrighted material of Insurance Services Office Inc. with its permission
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LIMITED ELECTRONIC DATA LOSS COVERAGE ACCESS COLLECTION RELEASE DISCLOSURE LIMITED BODILY INJURY AND PROPERTY DAMAGE DEFENSE EXPENSES BORNE BY INSURED Named Insured Endorsement Number Forward Air Corporation 18 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Tnsert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY DECLARATIONS EXCESS COMMERCIAL GENERAL LIABILITY POLICY A This endorsement provides you with limited electronic data loss coverage as set forth below but only for those losses that fall within the terms of this endorsement. B. This policy does not provide coverage for claims arising out of an electronic data loss other than as provided in this endorsement. C. The LIMITS OF INSURANCE Item of the Excess Commercial General Liability Declarations is amended by adding the following Electronic Data Loss Coverage Limit Coverage A 2000000 Each Occurrence Electronic Data Loss Coverage Limit Coverage B 2000000 Any One Person or Organization D. Exclusion 2.t. of Section Coverages Coverage A Bodily Injury And Property Damage Liability of the Excess Commercial General Liability Policy is deleted in its entirety and replaced by the following wherever it appears in the policy or any endorsement to the policy t. Access Collection Release or Disclosure of Confidential Or Personal Information Damages arising out of an electronic data event. This exclusion does not apply to those damages that constitute an electronic data loss. The following exclusion is added to paragraph 2. Exclusions of Section Coverages Coverage B Personal And Advertising Injury Liability of the Excess Commercial General Liability Policy This insurance does not apply to Access Collection Release or Disclosure Of Confidential Or Personal Information Damages arising out of an electronic data event. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses crisis management expenses or any other security breach expense loss or cost incurred by you or others arising out of any access to collection of release of or disclosure of any person s or organization s confidential or personal information. XS46601a 1115 Page 10f 3
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This exclusion does not apply to those damages that constitute an electronic data loss. The following paragraphs are added to Section Ill Limits Of Insurance and Retained Limit of the Excess Commercial General Liability Policy 9. Subject to 2. and 5. above the Electronic Data Loss Coverage Limit Coverage A is the most we will pay for the ultimate net loss in excess of the retained limit because of all electronic data loss to which this insurance applies arising out of any one occurrence. 10. Subject to 2. and 4. above the Electronic Data Loss Coverage Limit Coverage B shown in the Declarations is the most we will pay under Coverage B for the ultimate net loss in excess of the retained limit because of all electronic data loss arising out of all personal and advertising injury sustained by any one person or organization. If the same electronic data loss is covered under both Coverage A and B hereunder then the maximum applicable coverage limit shall be the highest single limit under Coverage A or B whether such limit applies on a per occurrence basis or applies to any one person or organization. However this provision will not change the application of any aggregate limit under this policy. Notwithstanding anything to the contrary in the foregoing provisions or elsewhere in this policy this insurance does not apply to notification costs credit monitoring expenses forensic expenses public relations expenses crisis management expenses or any other security breach expense loss or cost incurred by you or others arising out of an electronic data event. If there is any provision in this policy or endorsement to this policy providing for the payment or allocation of defense investigation settlement and legal expenses that provision does not apply to coverage provided by this endorsement. You are responsible for payment of any and all expenses costs or other obligations arising out of or relating to an electronic data event and provided for under the Defense Investigation Settlement Legal Expenses and Prejudgment Interest of the policy and you will immediately reimburse us for any such amounts that we incur. Defi ons For purposes of this endorsement only 1. Bodily injury means physical injury sickness or disease sustained by a natural person including a. death resulting from any of these at any time or b. mental injury that subsequently manifests itself after such physical injury sickness or disease is sustained by a natural person. Electronic data means any information facts or programs stored as or on created or used on or transmitted to or from any computer software or system including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media that are used with electronically controlled equipment or other electronic backup facilities and data transmission or storage provided by means of the Internet. Electronic data event means a. any access to collection of release of or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health or medical information or any other type of nonpublic information or XS46601a 1115 Page 2 of 3
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b. the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. All damages caused by the same or similar act or omission of any insured resulting in an electronic data event shall be considered a single electronic data event. Electronic data loss means damages because of bodily injury or property damage arising out of an electronic data event. Property damage means physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it. Electronic data is not tangible property. Security breach means any actual alleged or threatened wrongful access to personal or confidential information while in the care custody or control of or while held on behalf of any insured. All other terms and conditions remain unchanged. Authorized Representative XS46601a 1115 Page 3 of 3
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NON OWNED WATERCRAFT EXCEPTION Named Insured Forward Air Corporation Endorsement Number 19 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM EXCESS COMMERCIAL GENERAL LIABILITY POLICY Notwithstanding any exclusion contained in this policy or any endorsement to this policy to the contrary the Aircraft Auto Or Watercraft exclusion in Paragraph 2.g. of SECTION Coverage A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY does not apply to a watercraft you do not own that is a Less than 51feet long and b Not being used to carry persons or property for a charge. Authorized Representative LD46686 1015 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 1
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NOTICE TO OTHERS ENDORSEMENT SCHEDULE NOTICE BY INSURED S REPRESENTATIVE Named Insured Forward Air Corporation Endorsement Number 20 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 TO 04012019 Effective Date of Endorsement Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A If we cancel this Policy prior to its expiration date by notice to you or the first Named Insured for any reason other than nonpayment of premium we will endeavor as set out in this endorsement to send written notice of cancellation to the persons or organizations listed in the schedule that you or your representative create or maintain the Schedule by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. The notice referenced in this endorsement as provided by your representative is intended only to be a courtesy notification to the persons or organizations named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such persons or organizations. The failure to provide advance notification of cancellation to the persons or organizations shown in the Schedule will impose no obligation or liability of any kind upon us our agents or representatives will not extend any Policy cancellation date and will not negate any cancellation of the Policy. We are not responsible for verifying any information in any Schedule nor are we responsible for any incorrect information that you or your representative may use. We will only be responsible for sending such notice to your representative and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule or in causing your representative to provide the Schedule. This endorsement does not apply in the event that you cancel the Policy. Al other terms and conditions of this Policy remain unchanged. Authorized Representative ALL32686 0111 Page 1 of 1
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NOTIFICATION OF PREMIUM ADJUSTMENT Named Insured Endorsement Number Forward Air Corporation 21 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. For the states and lines of business in which regulatory approval has been granted for the NCCI Large Risk Alternative Rating Option the ISO Large Risk Alternative Rating Option or the independently filed Chubb Large Risk Rating Plan the premiums for this policy will be adjusted in accordance with the Notice of Election signed by you. Authorized Representative ALL18057 1211 Page 1 of 1
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cHUBBE POLLUTION EXCLUSION EXCEPTION FOR BUILDING HEATING EQUIPMENT Named Insured Endorsement Number Forward Air Corporation 22 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Tssued By Name of Insurance Company ACE American Insurance Company Tsert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies all insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY Any pollution exclusion in this policy does not apply to bodily injury arising out of the release of carbon monoxide smoke vapor or gases if release of such carbon monoxide smoke vapor or gases is confined to the interior of a building and solely caused by the combustion of heating fuel in the heating equipment used to heat that building. Notwithstanding the foregoing or any other provision in this policy we shall have no duty to defend or duty to pay defense investigation settlement or legal expenses for defending any insured against any claim or suit or proceeding arising out of or in any way related to pollution. This means that with respect to any claim for which coverage is afforded under the terms of this endorsement Paragraph 1. of DEFENSE INVESTIGATION SETTLEMENT LEGAL EXPENSES AND INTEREST ON JUDGMENTS COVERAGES A AND B is deleted and replaced by the following 1. Defense Investigation Settlement Legal Expenses and Prejudgment Interest This insurance does not cover any defense investigation settlement or legal expenses or prejudgment interest arising out of any occurrence or offense but we shall have the right and opportunity to assume from the insured the defense and control of any claim or suit including any appeal from a judgment seeking payment of damages covered under this policy that we believe likely to exceed the retained limit. In such event we and the insured shall cooperate fully. All other terms and conditions remain unchanged. Authorized Representative Page1of1 XS20726a 0817
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cHUBBE POLLUTION EXCLUSION HOSTILE FIRE EXCEPTION Named Insured Endorsement Number Forward Air Corporation 23 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Tssued By Name of Insurance Company ACE American Insurance Company Tsert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY Exclusion 2.f. of Section I Coverage A is replaced by the following f. Any injury damage expense cost loss liability or legal obligation arising out of or in any way related to pollution however caused. Pollution includes the actual alleged or potential presence in or introduction into the environment of any substance if such substance has or is alleged to have the effect of making the environment impure harmful or dangerous. Environment includes any air land structure or the air therein watercourse or water including underground water. This exclusion does not apply to bodily injury or property damage caused by heat smoke or fumes from a hostile fire 1 Ator from the premises you own rent or occupy or 2 At or from any site or location on which you or any of your contractors working directly or indirectly on your behalf are performing operations if pollutants are brought on or to the site in connection with such operations. A hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be. Notwithstanding the foregoing or any other provision in this policy we shall have no duty to defend or duty to pay defense investigation settlement or legal expenses for defending any insured against any claim or suit or proceeding arising out of or in any way related to pollution. This means that with respect to any claim for which coverage is afforded under the terms of this endorsement Paragraph 1. of DEFENSE INVESTIGATION SETTLEMENT LEGAL EXPENSES AND INTEREST ON JUDGMENTS COVERAGES A AND B is deleted and replaced by the following 1. Defense Investigation Settlement Legal Expenses and Prejudgment Interest This insurance does not cover any defense investigation settlement or legal expenses or prejudgment interest arising out of any occurrence or offense but we shall have the right and opportunity to assume from the insured the defense and control of any claim or suit including any appeal from a judgment seeking payment of damages covered under this policy that we believe likely to exceed the retained limit. In such event we and the insured shall cooperate fully. Authorized Representative Page1of1 XS6W35a 0817
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REPORTING OF DATA ON CLAIMS WITHIN A RETENTION Named Insured Endorsement Number Forward Air Corporation 24 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY EXCESS BUSINESS AUTO COVERAGE FORM The following Claim Reporting Condition is added to the policy You agree to provide or cause your claims administrator to provide any claims information that we may require whether within an applicable retained limit or above. Authorized Representative ALL44299 0215 Page 1 of 1
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SILICA OR SILICA RELATED DUST EXCLUSION Named Insured Forward Air Corporation Endorsement Number 25 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies all insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability 2. Exclusions This insurance does not apply to Silica Or Silica Related Dust a. b. c. Bodily injury arising in whole or in part out of the actual alleged threatened or suspected inhalation of or ingestion of silica or silica related dust. Property damage arising in whole or in part out of the actual alleged threatened or suspected contact with exposure to existence of or presence of silica or silica related dust. Any loss cost or expense arising in whole or in part 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 silica or silica related dust by any insured or by any other person or entity. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to b. ica Or Silica Related Dust Personal and advertising injury arising in whole or in part out of the actual alleged threa suspected inhalation of ingestion of contact with exposure to existence of or presence of silica related dust. Any loss cost or expense arising in whole or in part 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 silica or silica related dust by any insured or by any other person or entity. C. The following definitions are added to the Definitions Section 1. Silica means silicon dioxide occurring in crystalline amorphous and impure forms silica particles silica dust or silica compounds. 2. Silica related dust means a mixture or combination of silica and other dust or particles. Authorized Agent XS18224 0405 Reprinted with permission of Insurance Services Office Page 1 of 1
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TRADE OR ECONOMIC SANCTIONS ENDORSEMENT Named Insured Forward Air Corporation Endorsement Number 26 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 TO 04012019 Effective Date of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance including but not limited to the payment of claims. All other terms and conditions of the policy remain unchanged. Authorized Agent ALL21101 1106 Ptd. in U.S.A. Page 1 of 1
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TRUCK BROKER EXCLUSION Named Insured Endorsement Number Forward Air Corporation 27 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM EXCESS COMMERCIAL GENERAL LIABILITY POLICY The following is added to paragraph 2. Exclusions of SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY COVERAGE This insurance does not apply to bodily injury or property damage caused by an occurrence and arising out of or related to the insured s operations as a truck broker. However this exclusion does not apply to bodily injury or property damage arising out of your ownership maintenance or use of premises where you are conducting truck broker operations. The following definitions are added to SECTION V DEFINITIONS Truck broker means a person not acting in the capacity of a motor carrier who for compensation arranges or offers to arrange the transportation of property by a motor carrier authorized by the Federal Motor Carrier Safety Administration pursuant to a motor carrier brokerage agreement Motor carrier brokerage agreement means a written contract executed prior to occurrence between a truck broker and a motor carrier authorized by the Federal Motor Carrier Safety Administration the terms of which define the conditions under which the motor carrier will provide transportation services pursuant to its federal authority. Authorized Representative Page 1 of 1 LD35048a 0113
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UNINTENTIONAL FAILURE TO DISCLOSE Named Insured Forward Air Corporation Endorsement Number 28 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies all insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY POLICY OWNERS AND CONTRACTORS PROTECTIVE LIABILITY RAILROAD PROTECTIVE LIABILITY It is agreed that the following is added Your failure to disclose all hazards or prior occurrences existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior occurrences is not intentional. Authorized Agent Includes copyrighted material of Insurance Services Office Inc. with its permission Page 10f 1 LD2X62a 0408
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WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Named Insured Endorsement Number Forward Air Corporation 29 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Person or Organization Any person or organization against whom you have agreed to waive your right of recovery in a written contract provided such contract was executed prior to the date of loss. We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. Authorized Agent XS6W34 0995 Ptd. in U.S.A. Page 1 of 1
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POLICY NUMBER XSL G71095824 POLICY NUMBER XSL G71095824 Endorsement Number 30 IL 09 850115 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE SCHEDULE PART Terrorism Premium Certified Acts 0 This premium is the total Certified Acts premium attributable to the following Coverage Parts Coverage Forms andor Policyies XS6U91d Additional information if any concerning the terrorism premium SCHEDULE PART Il Federal share of terrorism losses 82 Refer to Paragraph B. in this endorsement. Year 20 18 Federal share of terrorism losses 81 Refer to Paragraph B. in this endorsement. Year 20 19 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Disclosure Of Premium Treasury will pay a share of terrorism losses In accordance with the federal Terrorism Risk Insurance Act we are required to provide you with a notice disclosing the portion of your premium if any attributable to coverage for terrorist acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this endorsement or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government Department of the insured under the federal program. The federal share equals a percentage as shown in Part Il of the Schedule of this endorsement or in the policy Declarations of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such losses that exceeds 100 billion. his premium is the total Certified Acts premium attributable to the following Coverage Parts overage Forms andor Policyies S6U91d dditional information if any concerning the terrorism premium Year 20 18 Year 20 19 Insurance Services Office Inc. 2015 Page 1 of 2 IL 09 850115
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C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed 100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act we shall not be liable for the payment of any portion of the amount of such losses that exceeds 100 billion and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. Page 2 of 2 Insurance Services Office Inc. 2015 IL 09 850115
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ARIZONA CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 31 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the Policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this Policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this Policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this Policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. 7. Cancellation Of Policies in Effect For 60 Days Or More If this Policy has been in effect for 60 days or more or if this Policy is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons a. Nonpayment of premium b. Your conviction of a crime arising out of acts increasing the hazard insured against c. Acts or omissions by you or your representative constituting fraud or material misrepresentation in the procurement of this policy in continuing this policy or in presenting a claim under this Policy. d. Substantial change in the risk assumed except to the extent that we should have reasonably foreseen the change or contemplated the risk in writing the contract e. Substantial breach of contractual duties or conditions f. Loss of reinsurance applicable to the risk insured against resulting from termination of treaty or facultative reinsurance initiated by our reinsurer or reinsurers LD2851c 1214 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 3
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g. Determination of the Director of Insurance that the continuation of the Policy would place us in violation of the insurance laws of this state or would jeopardize our solvency or h. Acts or omissions by you or your representative which materially increase the hazard insured against. If we cancel this Policy based on one or more of the above reasons we will mail by certified mail or by first class mail using Intelligent Mail barcode or another similar tracking method used or approved by the United States Postal Service to the first Named Insured and mail to the agent if any written notice of cancellation stating the reasons for cancellation. We will mail this notice to the last mailing addresses known to us at least 1. 10 days before the effective date of cancellation if we cancel for nonpayment of premium. 2. 45 days before the effective date of cancellation if we cancel for any of the other reasons. II. The following Condition supersedes any other condition to the contrary RENEWAL A If we elect to renew this Policy and the renewal is subject to any of the following 1. Increase in premium 2. Change in deductible 3. Reduction in limits of insurance or 4. Substantial reduction in coverage we will mail or deliver written notice of the changes to the first Named Insured at the last mailing address known to us at least 30 days before the anniversary or expiration date of the Policy. B. If renewal is subject to any condition described in A.1. through A.4. above and we fail to provide notice 30 days before the anniversary or expiration date of this Policy the following procedures apply 1. The present policy will remain in effect until the earlier of the following a. 30 days after the date of mailing or delivery of the notice or b. The effective date of replacement coverage obtained by the first Named Insured. 2. If the first Named Insured elects not to renew any earned premium for the period of extension of the terminated policy will be calculated pro rata at the lower of the following rates a. The rates applicable to the terminated policy or b. The rates presently in effect. 3. If the first Named Insured accepts the renewal the premium increase if any and other changes are effective the day following this policy s anniversary or expiration date. NONRENEWAL A. If we elect not to renew this Policy we will mail by certified mail or by first class mail using Intelligent Mail barcode or another similar tracking method used or approved by the United States Postal Service to the first Named Insured and mail to the agent if any written notice of nonrenewal. We will mail this notice to the last mailing addresses known to us at least 45 days prior to the expiration of this policy. B. If notice is mailed proof of mailing will be sufficient proof of notice. C. If either one of the following occurs we are not required to provide written notice of nonrenewal 1. We or a company within the same insurance group has offered to issue a renewal policy or 2. You have obtained replacement coverage or agreed in writing to do so. LD2851c 1214 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 0f 3
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D. If written notice of nonrenewal is mailed less than 45 days prior to expiration of this Policy and neither C.1. nor C.2. applies the coverage shall remain in effect until 45 days after the notice is mailed. Earned premium for any period of coverage that extends beyond the expiration date of this Policy shall be considered pro rata based upon the previous year s rate. Authorized Representative LD2851c 1214 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 30f3
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CALIFORNIA CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 32 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation condition is replaced by the following 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. All Policies In Effect For 60 Days Or Less If this policy has been in effect for 60 days or less and is not a renewal of a policy we have previously issued we may cancel this policy by mailing or delivering to the first Named Insured at the mailing address shown in the policy and to the producer of record advance written notice of cancellation stating the reason for cancellation at least a. 10 days before the effective date of cancellation if we cancel for 2 Nonpayment of premium or Discovery of fraud or material misrepresentation by a Any insured or his or her representative in obtaining this insurance or b You or your representative in pursuing a claim under this policy. b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. All Policies In Effect For More Than 60 Days If this policy has been in effect for more than 60 days or is a renewal of a policy we issued we may cancel this policy only upon the occurrence after the effective date of the policy of one or more of the following 1 Nonpayment of premium including payment due on a prior policy we issued and due during the current policy term covering the same risks. 2 Discovery of fraud or material misrepresentation by a Any insured or his or her representative in obtaining this insurance or b You or your representative in pursuing a claim under this policy. 3 A judgment by a court or an administrative tribunal that you have violated a California or Federal law having as one of its necessary elements an act which materially increases any of the risks insured against. 4 Discovery of willful or grossly negligent acts or omissions or of any violations of state laws or regulations establishing safety standards by you or your representative which materially increase any of the risks insured against. 5 Failure by you or your representative to implement reasonable loss control requirements agreed to by you as a condition of policy issuance or which were conditions precedent to our use of a particular rate or rating plan if that failure materially increases any of the risks insured against. LD2853d 0811 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 2
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6. 6 A determination by the Commissioner of Insurance that the a Loss of or changes in our reinsurance covering all or part of the risk would threaten our financial integrity or solvency or b Continuation of the policy coverage would i Place us in violation of California law or the laws of the state where we are domiciled or ii Threaten our solvency. 7 A change by you or your representative in the activities or property of the commercial or industrial enterprise which results in a materially added increased or changed risk unless the added increased or changed risk is included in the policy. b. We will mail or deliver advance written notice of cancellation stating the reason for cancellation to the first Named Insured at the mailing address shown in the policy and to the producer of record at least 1 10 days before the effective date of cancellation if we cancel for a reason listed in Paragraph 3.a.1 or 3.a.2 or 2 30 days before the effective date of cancellation if we cancel for any other reason listed in Paragraph 3.a. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. The refund if any will be computed on a pro rata basis. However the refund may be less than pro rata if we made a loan to you for the purpose of payment of premiums for this policy. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficent proof of notice. Il. The following Condition supersede any provisions to the contrary Nonrenewal 1. Subject to the provisions of Paragraph 3. below if we decide not to renew this policy we will mail or deliver written notice stating the reason for nonrenewal to the first Named Insured shown in the Declarations and to the producer of record at least 60 days but not more than 120 days before the expiration or anniversary date. We will mail or deliver our notice to the first Named Insured and to the producer of record at the mailing address shown in the policy. We are not required to send notice of nonrenewal in the following situations a. If the transfer or renewal of a policy without any changes in terms conditions or rates is between us and a member of our insurance group. b. If the policy has been extended for 90 days or less provided that notice has been given in accordance with Paragraph 1. c. If you have obtained replacement coverage or if the first Named Insured has agreed in writing within 60 days of the termination of the policy to obtain that coverage. d. If the policy is for a period of no more than 60 days and you are notified at the time of issuance that it will not be renewed. e. Ifthe first Named Insured requests a change in the terms or conditions or risks covered by the policy within 60 days of the end of the policy period. f. If we have made a written offer to the first Named Insured in accordance with the timeframes shown in Paragraph 1. to renew the policy under changed terms or conditions or at an increased premium rate when the increase exceeds 25. Authorized Representative LD2853d 0811 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 0f 2
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COLORADO CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 33 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. If this policy has been in effect for less than 60 days we may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. If notice is mailed proof of mailing will be sufficient proof of notice. Cancellation Of Policies in Effect For 60 Days Or More a. If this policy has been in effect for 60 days or more or is a renewal of a policy we issued we may cancel this policy by mailing through first class mail to the first Named Insured written notice of cancellation 1 Including the actual reason at least 10 days before the effective date of cancellation if we cancel for nonpayment of premium or 2 Atleast 45 days before the effective date of cancellation if we cancel for any other reason. We may only cancel this policy based on one or more of the following reasons a Nonpayment of premium b A false statement knowingly made by the insured on the application for insurance or c A substantial change in the exposure or risk other than that indicated in the application and underwritten as of the effective date of the policy unless the first Named Insured has notified us of the change and we accept such change. LD2854a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 2
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The following Condition supersedes any other condition to the contrary NONRENEWAL If we decide not to renew this policy we will mail through first class mail to the first Named Insured shown in the Declarations written notice of the nonrenewal at least 45 days before the expiration date or its anniversary date if it is a policy written for a term of more than one year or with no fixed expiration date. INCREASE IN PREMIUM OR DECREASE IN COVERAGE We will not increase the premium unilaterally or decrease the coverage benefits on renewal of this policy unless we mail through first class mail written notice of our intention including the actual reason to the first Named Insured s last mailing address known to us at least 45 days before the effective date. Any decrease in coverage during the policy term must be based on one or more of the following reasons A. Nonpayment of premium B. A false statement knowingly made by the insured on the application for insurance or C. A substantial change in the exposure or risk other than that indicated in the application and underwritten as of the effective date of the policy unless the first Named Insured has notified us of the change and we accept such change. Authorized Agent LD2854a 0201 Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 0f 2
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CONNECTICUT CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 34 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information s to be completed only when this endorsement is fssued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. The Cancellation Condition is replaced by the following Cancellation A. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. B. Cancellation of policies in effect for less than 60 days If this policy has been in effect for less than 60 days and is not a renewal of a policy we issued we may cancel this policy for any reason by giving you written notice of cancellation at least 1. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or 2. 30 days before the effective date of cancellation if we cancel for any other reason. C. Cancellation of policies in effect for 60 days or more. 1. If this policy has been in effect for 60 days or more or this is a renewal of a policy we issued we may cancel this policy by giving you written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for one or more of the following reasons 1 Nonpayment of premium 2 3 Conviction of a crime arising out of acts increasing the hazard insured against Discovery of fraud or material misrepresentation by you in obtaining the policy or in perfecting any claim thereunder 4 Discovery of any willful or reckless act or omission by you increasing the hazard insured against or 5 A determination by the Commissioner that continuation of the policy would violate or place us in violation of the law or b. 60 days before the effective date of cancellation if we cancel for one or more of the following reasons 1 Physical changes in the property which increase the hazard insured against 2 A material increase in the hazard insured against or 3 A substantial loss of reinsurance by us affecting this particular line of insurance. 2. We may not cancel policies in effect for 60 days or more or renewal policies for any reason other than the reasons described in Paragraph C.1. above. LD2855 0392 Printed in U.S.A. Page 1 of 2
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3. If we cancel for nonpayment of premium you may continue the coverage and avoid the effect of the cancellation by payment in full at any time prior to the effective date of cancellation. 4. Notice of Cancellation will be delivered sent by a Registered mail b Certified mail or c Mail evidenced by a United States Post Office certificate of mailing. D. We will give notice to you at your last mailing address known to us. E. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. F. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. The first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. G. If notice is mailed proof of mailing will be sufficient proof of notice. The following is added and supersedes any other provision to the contrary WHEN WE DO NOT RENEW A. If we decide not to renew this policy we will mail or deliver to you a written notice of nonrenewal stating the reason for nonrenewal at least 60 days before the expiration date of this policy. The notice will be sent to your address last known to us. B. This notice will be delivered or sent by 1. Registered mail 2. Certified mail or 3. Mail evidence by a certificate of mailing. If notice is mailed proof of mailing is sufficient proof of notice. C. However we are not required to send this notice if nonrenewal is due to your failure to pay any advance premium required for renewal. D. With respect to automobile liability insurance policies only your policy shall terminate on the effective date of any other insurance policy you purchase with respect to any automobile designated in both policies. Authorized Agent LD2855 0392 Printed in U.S.A. Page 2 of 2
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DELAWARE CHANGES CANCELLATION AND NONRENEWAL Named Insured Forward Air Corporation Endorsement Number 35 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 60 but not more than 120 days before the effective date of cancellation if we cancel for any other permissible reason. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. Il. The following Condition supersedes any other condition to the contrary WHEN WE DO NOT RENEW A. If we decide not to renew this policy we will mail or deliver written notice of nonrenewal to the first Named Insured at least 60 but not more than 120 days before the expiration date or the anniversary date if this is a policy written for a term of more than one year or with no fixed expiration date. B. Any notice of nonrenewal will be mailed or delivered to the first Named Insured at the last mailing address known to us. Authorized Representative LD3S08b 0612 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 1
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DISTRICT OF COLUMBIA CHANGES CANCELLATION AND NONRENEWAL Named Insured Endorsement Number Forward Air Corporation 36 Policy Symbol Policy Number Policy Period Effective Date of Endorsement G71095824 04012018 to 04012019 Issued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. The Cancellation Condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least 30 days before the effective date of cancellation. At least 5 days before sending notice to the first Named Insured we will notify the agent or broker if any who wrote the policy. If this policy has been in effect 30 days or less and is not a renewal of a policy we issued we may cancel this policy for any reason. If this policy has been in effect more than 30 days or if this policy is a renewal of a policy we issued we may cancel this policy only for one or more of the following reasons a. You have refused or failed to pay a premium due under the terms of the policy b. You have made a material and willful misstatement or omission of fact to us or our employees agents or brokers in connection with any application to our claim against us c. You have transferred your property or other interest to a person other than you or your beneficiary unless the transfer is permitted under the terms of the policy or d. The property interest or use of the property or interest has materially changed with respect to its insurability. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice. d The following Condition supersedes any other provisions to the contrary NONRENEWAL We may elect not to renew this policy by mailing or delivering written notice of nonrenewal to the first Named Insured s last mailing address known to us. We will mail or deliver the notice at least 30 days before the expiration of the policy. At least 5 days before sending notice to the first Named Insured we will notify the agent or broker if any who wrote the policy. If notice is mailed proof of mailing will be sufficient proof of notice. Delivery of the notice will be the same as mailing. Authorized Agent Includes copyrighted material of Insurance Services Office Inc. Page 1 of 1 with its permission LD2856a 0201 Printed in U.S.A. Page 1 of 1
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FLORIDA CHANGES CANCELLATION AND NONRENEWAL Named Insured Forward Air Corporation Endorsement Number 37 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Tssued By Name of Insurance Company ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. If the policy or coverage part to which this endorsement applies contains cancellation or nonrenewal provisions more favorable to the Named Insured than this endorsement then those provisions apply. I. The Cancellation condition is replaced by the following A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. A. CANCELLATION FOR POLICIES IN EFFECT 90 DAYS OR LESS If this policy has been in effect for 90 days or less we may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation accompanied by the reasons for cancellation at least 1. 2. 10 days before the effective date of cancellation if we cancel for nonpayment of premium. 20 days before the effective date of cancellation if we cancel for any other reason except we may cancel immediately if there has been a A material misstatement or misrepresentation or b A failure to comply with underwriting requirements established by the insurer. B. CANCELLATION FOR POLICIES IN EFFECT FOR MORE THAN 90 DAYS If this policy has been in effect for more than 90 days we may cancel this policy only for one or more of the following reasons 1. 2. 3. 4. 5. Nonpayment of premium The policy was obtained by a material misstatement There has been a failure to comply with underwriting requirements within 90 days of the effective date of coverage There has been a substantial change in the risk covered by the policy or The cancellation is for all insureds under such policies for a given class of insureds. If we cancel this policy for any of these reasons we will mail or deliver to the first Named Insured written notice of cancellation accompanied by the reasons for cancellation at least a 10 days before the effective date of cancellation if cancellation is for the reason stated in 2.a. above or b 45 days before the effective date of cancellation if cancellation is for the reasons stated in 2.b d or e above. LD2857b 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 1 of 2
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3. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled we will send the first Named Insured any premium refund due. If we cancel the refund will be pro rata. If the first Named Insured cancels the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed proof of mailing will be sufficient proof of notice II. The following Condition supersedes any other provisions to the contrary. NONRENEWAL A If we decide not to renew this policy we will mail or deliver to the first Named Insured written notice of nonrenewal accompanied by the reason for nonrenewal at least 45 days prior to the expiration of this policy.. Any notice of nonrenewal will be mailed or delivered to the first Named Insured s last mailing address known to us. If notice is mailed proof of mailing will be sufficient proof of notice. Renewal Notification. If we elect to renew this policy we will let you know in writing a. Of our decision to renew this policy and b. The amount of renewal premium payable to us. This notice will be delivered to you or mailed to you at your mailing address shown in the Declarations at least 45 days before the expiration date of this policy. Proof of mailing will be sufficient proof of notice. Authorized Agent LD2857b 0201 Printed in U.S.A. Includes copyrighted material of Insurance Services Office Inc. with its permission Page 2 of 2
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GEORGIA CHANGES CANCELLATION AND NONRENEWAL Named Insured Forward Air Corporation Endorsement Number 38 Policy Symbol XSL Policy Number G71095824 Policy Period 04012018 to 04012019 Effective Dale of Endorsement Issued By Name of Insurance Company ACE American Insurance Company insert the policy number. The remainder of the information s to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following COMMERCIAL UMBRELLA LIABILITY POLICY EXCESS LIABILITY POLICY EXCESS LIABILITY CATASTROPHE POLICY EXCESS COMMERCIAL GENERAL LIABILITY POLICY A. The Cancellation Condition is replaced by the following 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation stating a future date on which the policy is to be cancelled subject to the following a. If only the interest of the first Named Insured is affected the effective date of cancellation will be either the date we receive notice from the first Named Insured or the date specified in the notice whichever is later. However upon receiving a written notice of cancellation from the first Named Insured we may waive the requirement that the notice state the future date of cancellation by confirming the date and time of cancellation in writing to the first Named Insured. b. If by statute regulation or contract this policy may not be cancelled unless notice is given to a governmental agency mortgagee or other third party we will mail or deliver at least 10 days notice to the first Named Insured and the third party as soon as practicable after receiving the first Named Insured s request for cancellation. Our notice will state the effective date of cancellation which will be the later of the following 1 10 days from the date of mailing or delivering our notice or 2 The effective date of cancellation stated in the first Named Insured s notice to us. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium or b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured s last mailing address known to us.. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. Premium Refund a. Ifthis policy is cancelled we will send the first Named Insured any premium refund due. b. If we cancel the refund will be pro rata except as provided in c. below. c. If the cancellation results from failure of the first Named Insured to pay when due any premium to us or any amount when due under a premium finance agreement then the refund may be less than pro rata. Calculation of the return premium at less than pro rata represents a penalty charged on unearned premium. I XS1v18b 0215 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 2 Page 1 of 2
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d. If the first Named Insured cancels the refund may be less than pro rata. e. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed a receipt provided by or such other evidence of mailing as prescribed or accepted by the U.S. Postal Service shall be sufficient proof of notice.. The following is added to the CANCELLATION condition and supersedes any other provisions to the contrary If we decide to 1. Cancel or nonrenew this policy or 2. Increase current policy premium by more than 15 other than any increase due to change in risk exposure or experience modification or resulting from an audit of auditable coverages or 3. Change any policy provision which would limit or restrict coverage then We will mail or deliver notice of our action including the dollar amount of any increase in renewal premium of more than 15 to the first Named Insured and lienholder if any at the last mailing address known to us. Except as applicable as described in Paragraph D. below we will mail or deliver notice at least a. 10 days before the effective date of cancellation if this policy has been in effect less than 60 days or if we cancel for nonpayment of premium or b. 45 days before the effective date of cancellation if this policy has been in effect 60 or more days and we cancel for a reason other than nonpayment of premium or c. 45 days before the expiration date of this policy if we decide to nonrenew increase the premium or limit or restrict coverage.. With respect to a policy that is written to permit an audit the following is added to the Cancellation Common Policy Condition If you fail to submit to or allow an audit for the current or most recently expired term we may cancel this policy subject to the following 1. We will make two documented efforts to send you and your agent notification of potential cancellation. After the second notice has been sent we have the right to cancel this policy by mailing or delivering a written notice of cancellation to the first Named Insured at least 10 days before the effective date of cancellation but not within 20 days of the first documented effort. 2. If we cancel this policy based on your failure to submit to or allow an audit we will send the written notice of cancellation to the first Named Insured at the last known mailing address by certified mail or statutory overnight delivery with return receipt requested. Authorized Representative XS1v18b 0215 Includes copyrighted material of Insurance Services Office Inc. with its permission. Page 2 of 2
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