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refund due shall be mailed within 10 working days of receipt of your audit. The cancellation will be effective even if we have not made or offered a refund. D. The following is added and supersedes any other provision to the contrary Nonrenewal 1. If we decide not to renew this policy we will mail or deliver to 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. 2. Any notice of nonrenewal will be mailed or delivered to the first Named Insured at the last mailing address known to us. If notice is mailed proof of mailing will be sufficient proof of notice. C. Paragraph 5. of the Cancellation Common Policy Condition is replaced by the following 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. If the return premium is not refunded with the notice of cancellation or when this policy is returned to us we will mail the refund within 15 working days after the date cancellation takes effect unless this is an audit policy. If this is an audit policy then subject to your full cooperation with us or our agent in securing the necessary data for audit we will return any premium refund due within 90 days of the date cancellation takes effect. If our audit is not completed within this time limitation then we shall accept your own audit and any premium Page 2 of 2 Insurance Services Office Inc. 2011 CG 02200312
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POLICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 02241093 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE POLICY NUMBER 1000305120181 Number of Days Notice 60 If no entry appears above information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement. For any statutorily permitted reason other than nonpayment of premium the number of days required for notice of cancellation as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement is increased to the number of days shown in the Schedule above. CG 02241093 Copyright Insurance Services Office Inc. 1992 Page 1 of 1
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POLICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Locations Of Covered Operations for them. Any Person or Organization contractually requiring status as an Additional Insured for ongoing operations you perform Locations of Covered Operations specifically requested by written contract or agreement. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by 1. Your acts or omissions or 2. The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional insureds at the locations designated above. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following additional exclusions apply This insurance does not apply to bodily injury or property damage occurring after 1. Al work including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insureds at the location of the covered operations has been completed or 2. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. POLICY NUMBER 1000305120181 CG 20100413 Insurance Services Office Inc. 2012 Page 1 of 1
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LICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 20130413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION PERMITS OR AUTHORIZATIONS RELATING TO PREMISES POLICY NUMBER 1000305120181 This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision The City of Chicago Department of Transportation 121 N. LaSalle Street Room 905 Driveway Permits Chicago IL 60602 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule subject to the following additional provision This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own rent or control and to which this insurance applies 1. The existence maintenance repair construction erection or removal of advertising signs awnings canopies cellar entrances coal holes driveways manholes marquees hoist away openings sidewalk vaults street banners or decorations and similar exposures or 2. The construction erection or removal of elevators or 3. The ownership maintenance or use of any elevators covered by this insurance. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20130413 Page 1 of 1
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POLICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 201504 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED VENDORS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Your Products Vendors who sell or distribute your products All Products Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured any persons or organizations referred to throughout this endorsement as vendor shown in the Schedule but only with respect to bodily injury or property damage arising out of your products shown in the Schedule which are distributed or sold in the regular course of the vendor s business. However 1. The insurance afforded to such vendor only applies to the extent permitted by law and 2. If coverage provided to the vendor is required by a contract or agreement the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. B. With respect to the insurance afforded to these vendors the following additional exclusions apply 1. The insurance afforded the vendor does not apply to a. Bodily injury or property damage for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement b. Any express warranty unauthorized by you c. Any physical or chemical change in the product made intentionally by the vendor d. Repackaging except when unpacked solely for the purpose of inspection demonstration testing or the substitution of parts under instructions from the manufacturer and then repackaged in the original container 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 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. 2 C. With respect to the insurance afforded to these POLICY NUMBER 1000305120181 CG 20150413 Page 1 of 2
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vendors the following is added to Section Il Limits Of Insurance If coverage provided to the vendor is required by a contract or agreement the most we will pay on behalf of the vendor is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 CG20150413
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POLICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 20180413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED MORTGAGEE ASSIGNEE OR RECEIVER This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Persons Or Organizations Designation Of Premises Symetra Life Insurance Company co Thomas D. Wood and 9100 South Dadeland Blvd Ste 700 Miami FL Company 33156. In reference to Store 6395 ATIMA 1718 S. 1st Ave. Maywood IL 60153 Loan 4389 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured any persons or organizations shown in the Schedule but only with respect to their liability as mortgagee assignee or receiver and arising out of the ownership maintenance or use of the premises by you and shown in the Schedule. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. This insurance does not apply to structural alterations new construction and demolition operations performed by or for that person or organization. C. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. POLICY NUMBER 1000305120181 CG 20180413 Page 1 of 1
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POLICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 2026 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Any person or organization for whom you perform work under a written contract that required you to obtain this agreement from us. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf 1. In the performance of your ongoing operations or 2. In connection with your premises owned by or rented to you. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. POLICY NUMBER 1000305120181 CG 2026 0413 Page 1 of 1
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POLICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 2026 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Cleveland Browns Football Company LLC Cleveland Browns Stadium Company LLC JHAC LLC. 76 Lou Groza Blvd Berea OH 44017 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf 1. In the performance of your ongoing operations or 2. In connection with your premises owned by or rented to you. However 1. The insurance afforded to such additional insured only applies to the extent permitted by law and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds the following is added to Section lll Limits Of Insurance If coverage provided to the additional insured is required by a contract or agreement the most we will pay on behalf of the additional insured is the amount of insurance 1. Required by the contract or agreement or 2. Available under the applicable Limits of Insurance shown in the Declarations whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. POLICY NUMBER 1000305120181 CG 2026 0413 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21070514 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA RELATED LIABILITY LIMITED BODILY INJURY EXCEPTION NOT INCLUDED COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following 2. Exclusions This insurance does not apply to p Access Or Disclosure Of Confidential Or Personal Information And Data related Liability Damages arising out of 1 Any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information or The loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of that which is described in Paragraph 1 or 2 above. As used in this exclusion electronic data means information facts or programs 2 This endorsement modifies insurance provided under the following stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information. stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section Coverage B Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Access Or Disclosure Of Confidential Or Personal Information Personal and advertising injury arising out of any access to or disclosure of any person s or organization s confidential or personal information including patents trade secrets processing methods customer lists financial information credit card information health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs credit monitoring expenses forensic expenses public relations expenses or any other loss cost or expense incurred by you or others arising out of any access to or disclosure of any person s or organization s confidential or personal information. CG 21070514 Insurance Services Office Inc. 2013 Page 1 of 1
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POLICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 21351001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION COVERAGE C MEDICAL PAYMENTS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART POLICY NUMBER 1000305120181 SCHEDULE Description And Location Of Premises Or Classification All existing and acquired locations. If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. 2. The following is added to Section Supplementary Payments h. Expenses incurred by the insured for first aid administered to others at the time of an accident for bodily injury to which this insurance applies. With respect to any premises or classification shown in the Schedule 1. Section Coverage C Medical Payments does not apply and none of the references to it in the Coverage Part apply and 2. The following is added to Section Supplementary Payments h. Expenses incurred by the insured for first aid administered to others at the time of an accident for bodily injury to which this insurance applies. CG 21351001 ISO Properties Inc. 2000 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21471207 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYMENT RELATED PRACTICES EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. B. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability This insurance does not apply to Bodily injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment humiliation 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 Whether the insured may be liable as an employer or in any other capacity and 3 To any obligation to share damages with or repay someone else who must pay damages because of the injury. 2 Exclusions of Section Coverage B Personal And Advertising Injury Liability This insurance does not apply to Personal and advertising injury to 1 A person arising out of any a Refusal to employ that person b Termination of that person s employment or c Employment related practices policies acts or omissions such as coercion demotion evaluation reassignment discipline defamation harassment humiliation discrimination or malicious prosecution directed at that person or 2 The spouse child parent brother or sister of that person as a consequence of personal and advertising injury to that person at whom any of the employment related practices described in Paragraphs a b or c above is directed. This exclusion applies 1 Whether the injury causing event described in Paragraphs a b or c above occurs before employment during employment or after employment of that person Whether the insured may be liable as an employer or in any other capacity and To any obligation to share damages with or repay someone else who must pay damages because of the injury. 3 CG 21471207 ISO Properties Inc. 2006 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21651204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A BUILDING HEATING COOLING AND DEHUMIDIFYING EQUIPMENT EXCEPTION AND A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Exclusion f. under Paragraph 2. Exclusions of Section Coverage A Bodily Injury And Property Damage Liability is replaced by the following This insurance does not apply to f. Pollution 1 Bodily injury or property damage which would not have occurred in whole or part but for the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants at any time. This exclusion does not apply to a Bodily injury if sustained within a building which is or was at any time owned or occupied by or rented or loaned to any insured and caused by smoke fumes vapor or soot produced by or originating from equipment that is used to heat cool or dehumidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests or Bodily injury or property damage arising out of heat smoke or fumes from a hostile fire unless that hostile fire occurred or originated i At any premises site or location which b is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste or ii At any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations to test for monitor clean up remove contain treat detoxify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a b Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. is or was at any time used by or for any insured or others for the handling storage disposal processing or treatment of waste or i At any premises site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured s behalf are performing operations to test for monitor clean up remove contain treat detoxify neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a b Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. CG 21651204 ISO Properties Inc. 2003 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 21671204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI OR BACTERIA EXCLUSION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section Coverage A Bodily B. The following exclusion is added to Paragraph 2. Injury And Property Damage Liability Exclusions of Section Coverage B 2. Exclusions Personal And Advertising Injury Liability 2. Exclusions This insurance does not apply to Fungi Or Bacteria This insurance does not apply to Fungi Or Bacteria a. Bodily injury or property damage which would not have occurred in whole or in part but for the actual alleged or threatened inhalation of ingestion of contact with exposure to existence of or presence of any fungi or bacteria on or within a building or structure including its contents regardless of whether any other cause event material or product contributed 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. a. Personal and advertising injury which 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 on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury. 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. This exclusion does not apply to any fungi or C. The following definition is added to the Definitions bacteria that are are on or are contained in a Section good or product intended for bodily Fungi means any type or form of fungus consumption. 9J y typ gus including mold or mildew and any mycotoxins ennree ecrente ar bhunrodiicte orodiiced or 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 which 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 on or within a building or structure including its contents regardless of whether any other cause event material or product contributed concurrently or in any sequence to such injury. 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. CG 21671204 ISO Properties Inc. 2003 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG21710115 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF OTHER ACTS OF TERRORISM COMMITTED OUTSIDE THE UNITED STATES CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The following exclusion is added This insurance does not apply to TERRORISM Any injury or damage arising directly or indirectly out of an other act of terrorism that is committed outside of the United States including its territories and possessions and Puerto Rico but within the coverage territory. However this exclusion applies only when one or more of the following are attributed to such act 1. The total of insured damage to all types of property exceeds 25000000 valued in U.S. dollars. In determining whether the 25000000 threshold is exceeded we will include all insured damage sustained by property of all persons and entities affected by the terrorism and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions or 2. Fifty or more persons sustain death or serious physical injury. For the purposes of this provision serious physical injury means a. Physical injury that involves a substantial risk of death or b. Protracted and disfigurement or c. Protracted loss of or impairment of the function of a bodily member or organ or 3. The terrorism involves the use release or escape of nuclear materials or directly or indirectly results in nuclear reaction or radiation or radioactive contamination or 4. The terrorism is carried out by means of the obvious physical CG 21710115 Insurance Services Office Inc. 2015 dispersal or application of pathogenic or poisonous biological or chemical materials or 5. Pathogenic or poisonous biological or chemical materials are released and it appears that one purpose of the terrorism was to release such materials. With respect to this exclusion Paragraphs 1. and 2. describe the thresholds used to measure the magnitude of an incident of an other act of terrorism and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. B. The following definitions are added 1. For the purposes of this endorsement any injury or damage means any injury or damage covered under any Coverage Part to which this endorsement is applicable and includes but is not limited to bodily injury property damage personal and advertising injury injury or environmental damage as may be defined in any applicable Coverage Part. 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in 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 a. 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 b. The act resulted in damage 1 Within the United States including its territories and possessions and Puerto Rico or Page 1 of 2 dispersal or application of pathogenic or poisonous biological or chemical materials or 5. Pathogenic or poisonous biological or chemical materials are released and it appears that one purpose of the terrorism was to release such materials. With respect to this exclusion Paragraphs 1. and 2. describe the thresholds used to measure the magnitude of an incident of an other act of terrorism and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. B. The following definitions are added 1. For the purposes of this endorsement any injury or damage means any injury or damage covered under any Coverage Part to which this endorsement is applicable and includes but is not limited to bodily injury property damage personal and advertising injury injury or environmental damage as may be defined in any applicable Coverage Part. 2. Certified act of terrorism means an act that is certified by the Secretary of the Treasury in 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 a. 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 b. The act resulted in damage 1 Within the United States including its territories and possessions and Puerto Rico or Page 1 of 2
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2 Outside of the United States in the case of a An air carrier as defined in Section 40102 of title 49 United States Code or United States flag vessel or a vessel based principally in the United States on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States regardless of where the loss occurs or b The premises of any United States mission and c. 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.. Other act of terrorism means a violent act or an act that is dangerous to human life property or infrastructure that is committed by an individual or individuals and that appears to be part of an effort to coerce a civilian population or to influence the policy or affect the conduct of any government by coercion and the act is not a certified act of terrorism. Multiple incidents of an other act of terrorism which occur within a seventy two hour period and appear to be carried out in concert or to have a related purpose or common leadership shall be considered to be one incident. C. The terms and limitations of any terrorism exclusion or the inapplicability or omission of a terrorism exclusion do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. D. 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. Page 2 of 2 Insurance Services Office Inc. 2015 CG21710115
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COMMERCIAL GENERAL LIABILITY CG 219307 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXTENDED REPORTING PERIOD FOR TERRORISM COVERAGE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART CLAIMS MADE VERSION LIQUOR LIABILITY COVERAGE PART CLAIMS MADE VERSION POLLUTION LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART CLAIMS MADE VERSION UNDERGROUND STORAGE TANK POLICY The following provision is added and supersedes any provision to the contrary when an exclusion of terrorism contained in a Conditional Exclusion of Terrorism endorsement attached to this policy goes into effect. If a. An incident of terrorism occurred before the conditional exclusion went into effect but not before November 26 2002 b. A claim arising out of that incident would have been covered under the provisions of this insurance had the claim been made prior to the conditional exclusion taking effect and c. That claim is for any injury or damage arising out of the incident of terrorism and it is made within 5 years after the date the conditional exclusion went into effect that claim will be considered to have been first made prior to the time that the conditional exclusion went into effect. This provision does not apply to claims covered by subsequent insurance you purchase or that would have been covered but for the exhaustion of the amount of insurance applicable to such claims. The phrase any injury or damage means any injury or damage as defined in a Conditional Exclusion of Terrorism endorsement. c. That claim is for any injury or damage arising out of the incident of terrorism and it is made within 5 years after the date the conditional exclusion went into effect that claim will be considered to have been first made prior to the time that the conditional exclusion went into effect. This provision does not apply to claims covered by subsequent insurance you purchase or that would have been covered but for the exhaustion of the amount of insurance applicable to such claims. The phrase any injury or damage means any injury or damage as defined in a Conditional Exclusion of Terrorism endorsement. CG 21930704 ISO Properties Inc. 2004 Page 1 of 1
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COMMERCIAL GENERAL LIABILITY CG 24 0405 09 POLICY NUMBER 1000305120181 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization Any person or organization requiring a waiver of transfer of rights of recovery pursuant to the terms of any contract or agreement you enter into with such person or organization. Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV Conditions We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Insurance Services Office Inc. 2008 Page 1 of 1
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POLICY NUMBER 1000305120181 COMMERCIAL GENERAL LIABILITY CG 24 07 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRODUCTS COMPLETED OPERATIONS HAZARD REDEFINED This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE POLICY NUMBER 1000305120181 VllEUVLRE Description of Premises and Operations Any premises or operation to whom you have provided products or completed operations If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. Paragraph a. of the definition of Products completed operations hazard in the DEFINITIONS Section is replaced by the following Products completed operations hazard a. Includes all bodily injury and property damage that arises out of your products if the bodily injury or property damage occurs after you have relinquished possession of those products. With respect to bodily injury or property damage arising out of your products manufactured sold handled or distributed 1. On from or in connection with the use of any premises described in the Schedule or 2. In connection with the conduct of any operation described in the Schedule when conducted by you or on your behalf CG 24 07 01 96 Copyright Insurance Services Office Inc. 1994 Page 1 of 1
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Composite Rating Plan Premium Endorsement Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies the insurance coverage forms listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policyies carefully. Commercial General Liability Coverage Form Business Auto Coverage Form The Class Code Premium Basis and Rate section of the Policy Declarations is changed to apply as follows A. The premium for this policy will be computed upon a composite basis as shown below in accordance with our rules rates rating plans premiums and minimum premiums and the other policy terms. Premium Coverage Type Estimated Basis Composite Estimated Minimum Deposit CGL or BAS or NS of Premium Rates Premium Premium Premium CGL NS 311431000 0.8981 279698 251728 279698 Totals 279698 251728 279698 B. The Composite Rates shown above apply per 1000 of Sales a basis of premium type defined below or on page 2 of this endorsement. C. If no number or no basis of premium type is inserted for Commercial General Liability Insurance CGL Coverage the rate shall apply per 1000 of Sales or for Business Auto Insurance BA Coverage the rate shall apply per 1 Unit where Unit means a powered covered auto. D. IfSales is selected as the basis of premium such Sales will include both foreign and domestic sales and sales by one named insured to another unless otherwise indicated by x below X Sales do NOT include foreign sales. Sales do NOT include sales by one named insured to another. E. IfUnits is selected as the basis of premium a Unit is an. F. Other Basis of Premium Type Define herein or in Exceptions on Page 3 G. DEFINITIONS OF BASIS OF PREMIUM TYPE Subject to Exceptions if any described below 1. Admissions means the total number of persons other than you your partners and your employees admitted during the policy period to events conducted on premises you own rent lease or otherwise control whether on paid admission tickets complimentary tickets or passes. 0 G 100 1109 Page 10f3 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 2. Cost means the total cost to you for all work performed for you during the policy period by independent contractors and their subcontractors at all levels including the cost of all labor materials equipment and supplies furnished used or delivered for use in the execution of such work whether furnished by the owner by contractors or subcontractors at any level including but not limited to all fees allowances bonuses and commissions either made paid or due as well as taxes other than taxes which you collect as a separate item and remit directly to a governmental division. 3. Receipts means the gross amount of money you have charged others for work that you your partners your employees your contractors and subcontractors at all levels have performed during the policy period including taxes other than taxes which you collect as a separate item and remit directly to a governmental division. 4. Remuneration or Payroll means all of the money or the substitute for money earned during the policy period by you if you are the proprietor of the insured business by all partners if you are a partnership or by all members if you are a Limited Liability Company and by all your employees for their services to you during the policy period subject to the following Total Gross Remuneration or Payroll without limitation or Determined and limited in accordance with our Workers Compensation Insurance Manual s rules respectively for the states in which you have employment or Determined and limited in accordance with our General Liability Insurance Manual s rules respectively for the states in which you have employment. 5. Sales means the gross amount of money you or others trading in your name have charged for all goods and services you or they have sold or distributed during the policy period including charges for delivery installation service and repair and including taxes other than taxes which you or such others collect as a separate item and remit directly to a governmental division. 6. Units means the number of items of the types specified in this endorsement. a. Units that you hold for use in your business shall mean half the sum of their number at the policy s inception and their number at its expiration or termination if terminated then pro rated by the fraction of an annual period that the policy remained in effect. b. Units that you sell to others whether for your own account or the account of another shall mean the total number of such units that you sell during the policy term. 7. Other Definitions a. Subject is a Premium Type that is subject to adjustment under a retrospective rating plan described in an endorsement attached to the policy. Subject is signified on Page 1 by a Premium Type S. b. Non Subject is a Premium Type that is NOT subject to adjustment under a retrospective rating plan described in an endorsement attached to the policy. Non Subject is signified on Page 1 by a Premium Type NS. c. Exceptions 0 G 100 1109 Page 20f3 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp Steve Blakey President Nehen Ihowial Limstlios Nehemiah E. Ginsburg General Counsel 0 G 100 1109 Page 30f3 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Notice and Knowledge of an Occurrence Endorsement Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part It is hereby agreed that SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 2. Duties In The Event Of Occurrence Offense Claim Or Suit paragraph a. is deleted in its entirety and replaced by the following 2. Duties In The Event of Occurrence Offense Claim Or Suit a. You your insurance manager or any other person designated by you and listed in the Scheduled Positions Persons schedule below must see to it that we or our authorized agents are notified promptly of an occurrence or offense which may result in a claim. Scheduled Positions Persons 1 Corporate Risk Manager 2 Manager To the extent possible notice should include 1 how when and where the occurrence or offense took place 2 the names and addresses of any injured persons and witnesses and 3 the nature and location of any injury or damage arising out of the occurrence or offense. Notwithstanding knowledge of either an i occurrence or i offense which may result in a claim by your agent servant or employee is not considered knowledge by you unless your insurance manager or any other person designated by you and listed in the Scheduled Positions Persons schedule above has received notice of same from your agent servant or employee. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY 2 0y Qe m Ihnsial. Biralvs Steve Blakey President Nehemiah E. Ginsburg General Counsel 0 G 102 1014 Page 1 of 1 V. Starr Company an demnity Liability Company. All rights reserved. Ihosial Lolors Nehemiah E. Ginsburg General Counsel Page 1 of 1 demnity Liability Company. Al rights reserved. Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Amendment of Other Insurance Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies insurance provided under the Commercial General Liability Coverage Form It is hereby agreed that SECTION IV Commercial General Liability Conditions 4. Other Insurance b. Excess Insurance is amended to read b. Excess Insurance This insurance is excess over any of the other insurance whether primary excess contingent or on any other basis 1 Unless such insurance is specifically purchased to apply as excess of this policy or 2 you are obligated by contract to provide primary insurance. When this insurance is excess we will have no duty under Coverage A or B to defend any claim or suit that any other insurer has a duty to defend. If no other insurer defends we will undertake to do so but we will be entitled to the insured s rights against all those other insurers. When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of 1 The total amount that all such other insurance would pay for the loss in the absence of this insurance and 2 The total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss if any with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp Y Steve Blakey President Nehen Jilouial Linelry Nehemiah E. Ginsburg General Counsel 0 G 104 1014 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Primary and Non Contributory Condition Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies insurance provided under the Commercial General Liability Coverage Part A. SECTION IV CONDITIONS condition 4. Other Insurance is amended as follows 1. The following is added to paragraph 4.a. of the Other Insurance condition This insurance is primary insurance as respects our coverage to the additional insured where the written contract or written agreement requires that this insurance be primary and non contributory. In that event we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured is a Named Insured. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey Presidnt Nehen Hilowal R Nehemiah E. Ginsburg General Counsel 0 G 107 0411 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Broad Form Named Insured Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies the insurance coverage forms listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policyies carefully. Commercial General Liability Coverage Form Policy Declarations Named Insured is revised to include Named Insured means the person or organization first named as the Named Insured on the Declarations Page of this policy the First Named Insured. Named Insured also includes 1 any other person or organization named as a Named Insured on the Declarations Page 2 any subsidiary associated affiliated allied or acquired company or corporation including subsidiaries thereof of which any insured named as the Named Insured on the Declarations Page has more than 50 ownership interest in or exercises management or financial control over at the inception date of this policy or perform substantially similar operations as the first named insured. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp Steve Blakey President Nehen mz 2 MW Nehemiah E. Ginsburg General Counsel 0 G 111 0611 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY EXTENSION SCHEDULE OF NAMED INSUREDS Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies insurance provided under the Commercial General Liability Coverage Form Liquor Liability Coverage Form Owners and Contractors Protective Liability Coverage Form Products Completed Operations Liability Coverage Form Railroad Protective Liability Coverage Form This policy provides coverage for the first Named Insured shown on the declarations page and the following Named Insureds Checkers Holdings Inc. Checkers of Puerto Rico Inc. Checkers Rally s Restaurants Inc. Official Burger of Tampa Bay Inc. Rally s of Ohio Inc. Checkerco Inc. Checkers Rally s Restaurant Services LLC All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Steve Blakey Presidnt Nehen Ihowial Zimsliow Nehemiah E. Ginsburg General Counsel 0 G 112 0312 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Unintentional Errors and Omissions Endorsement Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies the insurance coverage forms listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policyies carefully. Commercial General Liability Coverage Form Section IV Commercial General Liability Conditions 6. Representations is amended by adding The unintentional failure by you or any Insured to provide accurate and complete representations as of the inception of the policy will not prejudice the coverages afforded by this policy. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey Presidnt Nehen Hilowal R Nehemiah E. Ginsburg General Counsel 0 G 114 0711 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Amendment of Limits of Insurance Per Project or Per Location Aggregate Limit Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM. Your policy is amended to include either a Per Project General Aggregate Limit a Per Location General Aggregate Limit or a Per Project and Per Location General Aggregate Limit. Please select only one of the following 1 Per Project General Aggregate Limit X1 Per Location General Aggregate Limit 2000000 1 Per Project and Per Location General Aggregate Limit 1 Overall Policy Aggregate Limit 2000000 IF NEITHER OF THESE BOXES ARE CHECKED THIS ENDORSEMENT IS VOID. IF MORE THAN ONE OF THE THESE BOXES ARE CHECKED THIS ENDORSEMENT IS VOID. 1. SECTION Il LIMITS OF INSURANCE is amended to include the following 1. The Limits of Insurance and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. 3. Persons or organizations making claims or bringing suits. 4. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. 5. Subject to 2 above the Personal and Advertising Injury Limit is the most we will pay under 0 G 139 0711 Page 10f3 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. 6. Subject to 2 or 3 above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and b. Medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 7. Subject to 5 above the Damage to Premises Rented to You Limit is the most we will pay under Coverage A because of property damage to any one premises while rented to you or in the case of damage by fire while rented to you or temporarily occupied by you with permission by the owner. 8. Subject to 5 above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. 9. Subject to 2 4 5 6 andor 7 above the Per Project Aggregate Limit is the most we will pay under Coverages A B and C combined for the sum of a. Damages under Coverage A b. Damages under Coverage B and c. Medical expenses under Coverage C arising out of the any single Location described above. 10. Subjectto 2 4 5 6 andor 7 above the Per Location Aggregate Limit is the most we will pay under Coverages A B and C combined for the sum of d. Damages under Coverage A e. Damages under Coverage B and f. Medical expenses under Coverage C arising out of the any single Location described above. 11. The Overall Policy Aggregate is the most we will pay in any policy period regardless of number of projects or locations. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. The Limits of Insurance shown in the Declarations are deleted in their entirety and replaced by the Limits of Insurance set forth below. Limits of Insurance General Aggregate Limit 2000000 Each Occurrence Limit 1000000 Products Completed Operations Aggregate Limit 2000000 Personal Advertising Injury Limit 1000000 Damage to Premises Rented to You 1000000 Medical Expense Limit 0 Overall Policy Aggregate Limit Capped At 10000000 0 G 139 0711 Page 20f3 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 IV. SECTION V DEFINITIONS is amended to include the following 23. Location means premises involving the same or connecting lots or premises whose connection is interrupted only by a street roadway waterway or right of way railroad. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp J Steve Blakey President Nehen Jilouial Linelry Nehemiah E. Ginsburg General Counsel 0 G 139 0711 Page 30f3 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ CAREFULLY BODILY INJURY DEFINITION EXTENSION ENDORSEMENT Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section V Definitions 3. Bodily injury is amended to read 3. Bodily injury means physical injury sickness ordisease including death resulting from any of these or the following when accompanied by physical injury sickness or disease mental anguish shock or emotional distress. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Steve Blakey Presidnt Nehen mz 2 MW Nehemiah E. Ginsburg General Counsel 0 G 144 0312 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Alienated Premises Endorsement Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies the insurance coverage forms listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policyies carefully. Commercial General Liability Coverage Form SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions j. Damage to Property 2 is deleted in its entirety. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey Presidnt Nehen Hilowal R Nehemiah E. Ginsburg General Counsel 0 G 158 0412 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Fellow Employee Exclusion Deleted Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies the insurance coverage forms listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policyies carefully. Commercial General Liability Coverage Form Delete any fellow employee exclusion as respects employee and add the following SECTION Il WHO IS AN INSURED 2. a. 1 a is amended to read To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company or to your other volunteer workers while performing duties related to the conduct of your business. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Steve Blakey Presidnt Nehen Ihowial Linstlios Nehemiah E. Ginsburg General Counsel 0 G 169 0412 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Incidental Medical Malpractice Endorsement Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies the insurance coverage forms listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policyies carefully. Commercial General Liability Coverage Form SECTION V DEFINITIONS is amended to add Incidental Medical Malpractice Injury means Bodily Injury arising out of the rendering of or failure to render the following services a. medical surgical dental x ray or nursing service or treatment or the furnishing of food or beverages in connection therewith or b. the furnishing or dispensing of drugs or medical dental or surgical supplies or appliances. SECTION Il WHO IS AN INSURED 2. a. 1 d is deleted in its entirety and replaced with the following d Arising out of his or her providing or failing to provide professional health care services except for bodily injury arising out of Incidental Medical Malpractice Injury by any physician dentist nurse or other medical practitioner employed or retained by you. However the insurance provided hereunder to such persons will not apply to liability arising out of services performed outside of the scope of their duties as your employees. Any series of continuous repeated or related acts will be treated as the occurrence of a single negligent professional healthcare service. The Coverage provided by this endorsement does not apply to you or any insured if you are engaged in the business or occupation of providing any of the services described in the definition of Incidental Medical Malpractice Injury. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey Presidnt Nehen Hilowal B Nehemiah E. Ginsburg General Counsel 0 G 170 0412 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Newly Acquired or Formed Entities Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies the insurance coverage forms listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policyies carefully. Commercial General Liability Coverage Form SECTION Il WHO IS AN INSURED 3. is amended as Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization.However a. Coverage under this provision is afforded only until the 120 day after you acquire or form the organization or to the end of the policy period whichever is earlier. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp J Steve Blakey President Nehen Jilouial Lty Nehemiah E. Ginsburg General Counsel 0 G 172 0412 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY Personal and Advertising Injury Definition Extension Endorsement Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies the insurance coverage forms listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policyies carefully. Commercial General Liability Coverage Form SECTION V DEFINITIONS 14. Personal injury and Advertising injury is amended to read Personal injury and advertising injury means injury including consequential bodily injury humiliation mental anguish or shock arising out of one or more of the following offenses a. b. False arrest detention or imprisonment Malicious prosecution The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies by or in behalf of its owner landlord or lessor Oral or written publication of material in any manner that slanders or libels a person or organization or disparages a person s or organization s goods products or services or Oral or written publication in any manner of material that violates a person s right of privacy. The use of another s advertising idea in your advertisement or Infringing upon another s copyright trade dress slogan trademark service mark or trade name in your advertisement. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY ez w J Steve Blakey President Nehen Jihosial. Binilry Nehemiah E. Ginsburg General Counsel 0 G 174 0412 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 SELF INSURED RETENTION ENDORSEMENT per occurrence Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM INSURING AGREEMENTS SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. INSURING AGREEMENT paragraph a. is deleted in its entirety and replaced with the following a. We will pay on behalf of the Insured those sums in excess of the Retained Limit that the Insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. We will have the right but not the duty to defend any suit seeking those damages. We may at our discretion and expense participate with you in the investigation of any occurrence and the defense or settlement of any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in SECTION IIl LIMITS OF INSURANCE and 2 Our right to defend if we so exercise it ends when we have exhausted the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under ALLOCATED LOSS ADJUSTMENT EXPENSES COVERAGES A AND B. SECTION COVERAGES COVERAGE B PERSONAL AND ADVERTISING INJURY 1. Insuring Agreement paragraph a. is deleted in its entirety and replaced with the following a. We will pay on behalf of the Insured those sums in excess of the Retained Limit that thelnsured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. We will have the right but not the duty to defend any suit seeking those damages. We may at our discretion and expense participate with you in the investigation of any occurrence or offense and the defense or settlement of any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in Section Il LIMITS OF INSURANCE and 2 Our right to defend if we so exercise it ends when we have exhausted the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. 0 G 179 0412 Page10f5 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under ALLOCATED LOSS ADJUSTMENT EXPENSES COVERAGES A AND B. SECTION COVERAGES COVERAGE C MEDICAL PAYMENTS Section 1. Insuring Agreement paragraph a. is deleted in its entirety and replaced with the following a. We will pay medical expenses in excess of the Retained Limit as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that 1 The accident takes place in the coverage territory and during the policy period 2 The expenses are incurred and reported to us within one year of the date of the accident and 8 The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. ALLOCATED LOSS ADJUSTMENT EXPENSES COVERAGES A AND B SECTION COVERAGES SUPPLEMENTARY PAYMENTS COVERAGES A AND B is deleted in its entirety and replaced with the following ALLOCATED LOSS ADJUSTMENT EXPENSES COVERAGES A AND B Allocated Loss Adjustment Expenses we pay will not reduce the Limits of Insurance. You are responsible for the payment of Allocated Loss Adjustment Expenses incurred according to the election indicated by an X below. X A. 100 of the total Allocated Loss Adjustment Expenses up to the Retained Limit. However the most you are responsible for with respect to damages and Allocated Loss Adjustment Expenses combined shall not exceed the Retained Limit. B. 100 of the total Allocated Loss Adjustment Expenses. C. Allor part of the Allocated Loss Adjustment Expenses determined according tothe following i. If we incur NO obligation under the policy to pay damages resulting from a claim you are responsible for all Allocated Loss Adjustment Expenses up to the applicable Retained Limit plus 100.0 of all remaining Allocated Loss Adjustment Expenses. ii. If we DO incur an obligation under the policyies to pay damages resulting from a claim you will be responsible for a percentage of Allocated Loss Adjustment Expenses. That percentage shall be determined by dividing the Retained Limit paid by the total damages paid subject to the Limits of Insurance. D. NoAllocated Loss Adjustment Expenses Your duty to pay for Allocated Loss Adjustment Expenses applies separately to each occurrence for bodily injury or property damage or to each offense for personal and advertising injury. 0 G 179 0412 Page 2015 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 lll. LIMITS OF INSURANCE SECTION Il Limits of Insurance is amended to add the following The Limits of Insurance for each of the Coverages provided by this policy will apply in excess of a Self Insured Retention referred throughout as the Retained Limit. The Retained Limit applying only to damages for occurrences or offenses covered under this policy is 250000 per occurrence or offense. Subject to additional Allocated Loss Adjustment Expenses the Retained Limit is the most an insured will pay for A. The sum of all damages under Coverage B because of all personal and advertising injury sustained by any one person or organization or B. The sum of all damages under Coverage A and medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. IV. BANKRUPTCY Your bankruptcy insolvency inability to pay failure to pay or refusal to pay the Retained Limit will not increase our obligations under the policy. In the event there is insurance whether or not applicable to an occurrence claim or suit within the Retained Limit you will continue to be responsible for the full amount of the Retained Limit before the limits of insurance under this policy apply. In no case will we be required to pay the Retained Limit or any portion thereof. Our obligations will attach only when the entire amount of the Retained Limit has been paid and then only in excess of the Retained Limit and not in excess of the Limits of Insurance adjusted for any reduction in the aggregate limit of our liability. V. NOTICE PROVISIONS Section IV Commercial General Liability Conditions 2. Duties in the Event of Occurrence Offense Claim or Suit is deleted in its entirety and replaced with the following a. Periodic Notices on a annual basis you must provide us with a written summary lossrun of all occurrences offenses claims or suits which have or may result in payments within the Retained Limit. This written summary must show 1. The date and location of the occurrence and 2. The names and addresses of the injured persons or identification of the damaged property and 3. A description of the injury or damage and 4 The amount paid or reserved including Allocated Loss Adjustment Expense resulting from the occurrence offense claim or suit. b. Individual Notices of an offense or an occurrence in addition to the periodic notices provided for in section a. above you must see to it that we are notified as soon as practicable of any occurrence or offense which may result in a claim. Knowledge of an occurrence or an offense by your agent your servant or your employee will not in itself constitute knowledge to you unless the Director of Risk Management or one with similar or equivalent title or his her designee at the address shown in the policy declarations will have received such notice. To The extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured persons and witnesses and 0 G 179 0412 Page3of5 V. Starr Company a jemnity Liability Company. Al rights reserved. Page3of5 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 3 The nature and location of any injury or damage arising out of the occurrence or offense including but not limited to a afatality b paralysis of any part of the body c a major extremity or multiple minor extremity amputations d abrain or brain stern injury f partial or total blindness g loss or impairment of hearing h a heart attack e severe burns or disfigurement i reserves that exceed 50 of the Retained Limit. As respects the above categories You must provide us with any and all additional information material andor data subsequent to the original notice as it becomes available. V1. SPECIAL CONDITIONS SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 2. Duties in the Event of Occurrence Offense Claim or Suit is amended to add the following a. You will employ and pay without any reimbursement from us a firm acceptable to us for the purpose of providing claim services the Claims Administrator. In the event of cancellation expiration or revision of the contract between you and the Claims Administrator you will notify us within ten 10 days of such cancellation expiration or revision. b. Loss settliements made by you or the Claims Administrator will be within the terms conditions and limits of the policy. c. There will be no reduction of the Retained Limit because of payment of claims or suitsarising from claims or suits for which coverage is not afforded by the policy. VII. DEFINITIONS SECTION V DEFINITIONS is amended to include the following additional definitions Allocated Loss Adjustment Expenses means all fees for service of process and court costs and court expenses pre and post judgement interest attorneys fees cost of undercover operative and detective services costs of employing experts costs for legal transcripts copies of any public records and costs of depositions and court reported or recorded statements costs and expenses of subrogation and any similar fee cost or expense reasonably chargeable to the investigation negotiation settlement or defense of a loss or a claim or suit against you or to the protection and perfection of your or our subrogation rights. Allocated Loss Adjustment Expenses shall not include our general overhead the salary and employee benefits of any of our employees nor the fees of any attorney who is our employee or under our permanent retainer nor the fees of any attorney we retain to provide counsel to us about our obligations if any under any policy issued by us or our affiliated companyies with respect to a claim or suit against you or to exercise our right to participate in the investigation of any occurrence subject to this endorsement and the defense of any claim or suit that may result. 0 G 179 0412 Pagedof5 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Sl mp Steve Blakey President Nehen Ihowial Limstlios Nehemiah E. Ginsburg General Counsel 0 G 179 0412 Page 5015 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 ADDITIONAL INSURED WHERE REQUIRED UNDER CONTRACT OR AGREEMENT Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION Il WHO IS AN INSURED is amended to include as an additional insured Any person or organization to whom you become obligated to include as en additional insured under this policy as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy but only with respect to liability arising out of your operations or premises owned by or rented to you. However the insurance provided will not exceed the lesser of. The coverage andor limits of this policy or. The coverage andor limits required by said contract or agreement. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY Qen w Ihanial Znalirs President Steve Blakey Nehemiah E. Ginsburg General Counsel mz 2 MW Nehemiah E. Ginsburg General Counsel 0 G 184 0412 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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Starr Indemnity Liability Company Dallas TX 1 866 519 2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION Policy Number 1000305120181 Effective Date September 30 2018 at 1201 A.M. Named Insured Checkers Drive In Restaurants Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organizations Jefferies Finance LLC As Their Interests May Appear As Administrative Agent for Lenders 520 Madison Avenue New York NY 10022 Information required to complete this Schedule if not shown above will be shown in the Declarations. Section Il Who Is An Insured is amended to include as an additional insured the persons or organizations shown in the Schedule but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf A. In the performance of your ongoing operations or B. In connection with your premises owned by or rented to you. All other terms and conditions of this Policy remain unchanged. Signed for STARR INDEMNITY LIABILITY COMPANY B B Steve Blakey Presidnt Nehen Jihosial. Binilos Nehemiah E. Ginsburg General Counsel 0 G 213 04 1014 Page 1 of 1 Copyright C. V. Starr Company and Starr Indemnity Liability Company. All rights reserved. Includes copyrighted material of ISO Properties Inc. used with ts permission.
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERTCAN. cincinnatioH 452024201 INSURANGE GROUP 513 369 5000 ph Great American ES Insurance Company AES 3061 Ed. 1205 RN WRIRRRRSSE Policy No. PL6420778 07 Renewal Of PL6420778 06 POLICY COMMON DECLARATIONS NAMED INSURED Creative Consumer Concepts Inc. Creative Commons LLC AND ADDRESS 10955 Granada Ln Ste 200 Overland Park KS 66211 1440 IN RETURN FOR PAYMENT OF THE PREMIUM AND SUBJECT TO ALL TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. AGENT S NAME AND ADDRESS CRC Birmingham 1 Metroplex Dr. Suite 400 Birmingham AL 35209 Insurance is afforded by the Company named below a Capital Stock Corporation Great American ES Insurance Company POLICY PERIOD From 12012016 To 12012017 1201 A.M. Standard Time at the address of the Named Insured This Policy consists of the following Coverage Parts for which a premium is indicated. This premium may be subject to adjustment. Commercial Property Commercial General Liability Commercial Crime Commercial Inland Marine Commercial Boiler and Machinery Commercial Auto Commercial Umbrella TOTAL Premium 38975 38975 FORMS AND ENDORSEMENTS applicable to all Coverage Parts and made part of this Policy at time of issue are listed on the attached Forms and Endorsements Schedule IL 88 01 1185. POLICY ALTERNATE MAILING ADDRESS NOTICE See enclosed endorsement for Surplus Lines Notification Commercial Property Commercial General Liability Commercial Crime Commercial Inland Marine Commercial Boiler and Machinery Commercial Auto Commercial Umbrella LR R R Premium 38975 B H BB BB D JLICY ALTERNATE MAILING ADDRESS AES 3061 Ed. 1205 Page 1 0of 1
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERTCAN. cincinnatioH 452024201 INSURANGE GROUP 513 369 5000 ph Great American ES Insurance Company IL 88 01 Ed. 1185 FORMS AND ENDORSEMENTS SCHEDULE It is hereby understood and agreed the following forms and endorsements are attached to and are a part of this policy Date Added or Date Deleted Form Description Declarations Page Employee Benefits Liability Coverage Part Declarations Page General Liability Coverage Part Commercial General Liability Coverage Form Employee Benefits Liability Coverage Form Excluding Fiduciary Liability Amendment Premium Audit Condition Common Policy Conditions Common Policy Conditions Amendment Deductible Liability Insurance General Service of Suit Endorsement Not Applicable in Delaware or Pennsylvania In Witness Clause Named Insured Endorsement Notice of Cancellation to Designated Entities Limited Product Withdrawal Expense Endorsement Specialty Plus Endorsement Additional Insured Grantor of Licenses Automatic Status When Required by Licensor Additional Insured Blanket Primary and Noncontributory Economic and Trade Sanctions Clause Exclusion Access or Disclosure of Confidential or Personal Information and Data Related Liability Limited Bodily Injury Exception Not Included Exclusion Organic Pathogens Exclusion of Claims and Suits Alleging infringement of Intellectual Property or Unfair Competition Exclusion Aircraft Products and Grounding Liability Exclusion Asbestos Exclusion Designated Ongoing Operations Aow N N o o Form and Edition CG7518 0390 CG7400 1185 CG0001 0413 CG7519 1207 AES3004 0501 1L0017 1198 ESM3005 1015 AES3013 0411 AES3012 0811 IL7268 0909 IL7125 0311 AES3259 0711 CG0436 0413 ESG3206 0116 CG2035 0413 AES3068 0411 1L7324 0812 CG2107 0514 ST KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS 19 20 21 22 23 CG8481 0814 CG9029 0516 ESG1010 0816 IL7069 0316 CG2153 0196 KS KS KS KS KS IL 88 01 Ed. 1185 Page 1 0of 2
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Date Added or Date Deleted Form Description Exclusion Employer s Liability Exclusion Employment Related Practices Exclusion Liability Arising Out of Lead Exclusion Metal Gas Fume and Metal By Product Exclusion Nuclear Energy Liability Exclusion Broad Form Exclusion Nuclear Biological or Chemical Exclusion Pre Existing Damage Exclusion Professional Liability Testing and Consulting Errors and Omissions Exclusion Silica or Related Dust Exclusion Total Pollution Exclusion Unmanned Aircraft Personal and Advertising Injury Liability Disclosure Pursuant to Terrorism Risk Insurance Act Exclusion Certified Acts of Terrorism and Exclusion of Other Acts of Terrorism Committed Outside the United States Exclusion Punitive Damages Related to a Certified Act of Terrorism 24 25 26 27 28 29 30 31 32 33 34 35 36 37 Form and Edition ESG3229 0615 CG2147 1207 CG7794 0798 ESG1007 0615 1L0021 0908 CG8366 0605 ESG1001 0913 AES3077 0707 CG8361 0205 CG2149 0999 ESG1011 0916 1L7210 0108 CG2175 0608 CG2176 0108 ST KS KS KS KS KS KS KS KS KS KS KS KS KS KS If not at inception IL 88 01 Ed. 1185 Page 2 of 2
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERTCAN. cincinnatioH 452024201 INSURANGE GROUP 513 369 5000 ph Great American ES Insurance Company CG 75 18 Ed. 0390 Policy No. PL6420778 07 EMPLOYEE BENEFITS LIABILITY COVERAGE PART DECLARATIONS PAGE NAMED INSURED Creative Consumer Concepts Inc. POLICY PERIOD Creative Commons LLC 12012016 to 12012017 LIMITS OF INSURANCE Aggregate Limit 1000000 Each Claim Limit 1000000 Deductible 1000 DESCRIPTION OF BUSINESS Form of Business Individual Joint Venture Partnership X Organization Other than Partnership or Joint Venture Total Advance Premium Included Premium shown is payable Included at inception FORMS AND ENDORSEMENTS applicable to this Coverage Part and made a part of this Policy at the time of issue are listed on the attached Forms and Endorsements Schedule CG 88 01 1185 nit imit CG 75 18 Ed. 0390 Page 1 0of 1
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERTCAN. cincinnatioH 452024201 INSURANGE GROUP 513 369 5000 ph Great American ES Insurance Company CG 74 00 Ed. 1185 Policy No. PL6420778 07 GENERAL LIABILITY COVERAGE PART DECLARATIONS PAGE NAMED INSURED Creative Consumer Concepts Inc. POLICY PERIOD Creative Commons LLC 12012016 to 12012017 LIMITS OF INSURANCE General Aggregate Limit Other Than Products Completed Operations 2000000 Products Completed Operations Aggregate Limit 2000000 Personal and Advertising Injury Limit 1000000 Each Occurrence Limit 1000000 Fire Damage Limit SEE ESG3206 Any One Fire Medical Expense Limit SEE ESG3206 Any One Person RETROACTIVE DATE CG 00 02 ONLY Coverage A of this Insurance does not apply to bodily injury or property damage which occurs before the Retroactive Date if any shown here NONE enter date or none if does not apply DESCRIPTION OF BUSINESS Form of Business Individual Joint Venture Partnership X Organization Other than Partnership or Joint Venture Business Description Manufacturer of marketing products for the restaurant industry Location of All Premises You Own Rent or Occupy PREMIUM Rates Advance Premium Premium Classification Code No. Basis Pr Co All Other Pr Co All Other Toys or Games 59790 d42364000 0.92 Included 38975 Included Manufacturer a Admissions b Area c Each d Gross Sales e Payroll f Total Cost g Units h Other Premium shown is payable Total Advance Premium 38975 38975 at inception FORMS AND ENDORSEMENTS applicable to all Coverage Parts and made part of this policy at time of issue are listed on the attached Forms and Endorsements Schedule CG 88 01 1185 CG 74 00 Ed. 1185 Page 1 0of 1
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PL6420778 07 Great American ES Insurance Company CG 00 01 Ed. 04 13 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this Policy restrict coverage. Read the entire Policy carefully to determine rights duties and what is and is not covered. Throughout this Policy the words you and your refer to the Named Insured shown in the Declara tions and any other person or organization quali fying 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 or ganization qualifying as such under SECTION II 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 Dam age Liability 1. Insuring Agreement a. We will pay those sums that the Insured becomes legally obligated to pay as dam ages because of bodily injury or prop erty damage to which this insurance ap plies. We will have the right and duty to defend the Insured against any suit seek ing those damages. However we will have no duty to defend the Insured against any suit seeking damages for bodily injury or property damage to which this insur ance does not apply. We may at our dis cretion investigate any occurrence and settle any claim or suit that may result. But 1 the amount we will pay for damages is limited as described in SECTION 1lI LIMITS OF INSURANCE and our right and duty to defend ends when we have used up the applicable Limit of Insurance in the payment of judgments or settlements under Cov erages A or B or medical expenses under Coverage C. Copyright ISO Properties Page 1 of 20 00 01 Ed. 0413 No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Sup plementary Payments Coverages A and B.. This insurance applies to bodily injury and property damage only if 1 the bodily injury or property dam age is caused by an occurrence that takes place in the coverage territory 2 the bodily injury or property dam age occurs during the policy period and 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 in sured 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.. 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 oc currence or claim includes any continu ation change or resumption of that bodily injury or property damage after the end of the policy period.. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under paragraph 1. of SEC Inc. 2012 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company TION 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 3 becomes aware by any other means that bodily injury or property dam age has occurred or has begun to oceur.. Damages because of bodily injury include damages claimed by any person or or ganization for care loss of services or death resulting at any time from the bodi ly injury. 2. Exclusions This insurance does not apply to a. 0 01 Ed. 0413 Expected or Intended Injury Bodily injury or property damage ex pected or intended from the standpoint of the Insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. Contractual Liability Bodily injury or property damage for which the Insured is obligated to pay dam ages by reason of the assumption of li ability in a contract or agreement. This ex clusion does not apply to liability for dam ages 1 that the Insured would have in the ab sence of the contract or agreement or assumed in a contract or agreement that is an insured contract provided the bodily injury or property dam age occurs subsequent to the execu tion of the contract or agreement. Solely for the purposes of liability as sumed in an insured contract rea sonable attorneys fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and b such attorneys fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this in surance applies are alleged. c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 causing or contributing to the intoxi cation 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 trans portation with respect to any person that may be under the influence of alcohol if the occurrence which caused the bodily injury or property damage in volved that which is described in para graph 1 2 or 3 above. Copyright ISO Properties Inc. 2012 Page 2 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company However this exclusion applies only if you are in the business of manufacturing dis tributing selling serving or furnishing al coholic 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. 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. Employer s Liability Bodily injury to 1 an employee of the Insured arising out of and in the course of a employment by the Insured or b performing duties related to the conduct of the Insured s business or 2 the spouse child parent brother or sister of that employee as a con sequence of paragraph 1 above. This exclusion applies whether the Insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the Insured under an insured contract. f. Pollution 1 Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seep age migration release or escape of pollutants applies only if you nanufacturing dis g or furnishing al the purposes of g a person to bring your premises for premises whether ed or a license is ity is not by itself s of selling serving everages. ion and Similar Insured under a disability benefits pensation law or the Insured arising urse of the Insured or lies related to the Insured s business parent brother or loyee as a con 1ph 1 above. hether the Insured mployer or in any any obligation to r repay someone mages because of ot apply to liability under an insured property damage actual alleged or 2 dispersal seep ase or escape of a at or from any premises site or b c location which is or was at any time owned or occupied by or rented or loaned to any insured. However this subparagraph does not apply to i bodily injury if sustained within a building and caused by smoke fumes vapor or soot produced by or origi nating from equipment that is used to heat cool or de humidify the building or equipment that is used to heat water for personal use by the building s occupants or their guests ii bodily injury or property damage for which you may be held liable if you are a contractor and the owner or lessee of such premises site or location has been added to your policy as an addi tional insured with respect to your ongoing operations performed for that Addi tional Insured at that prem ises site or location and such premises site or loca tion is not and never was owned or occupied by or rented or loaned to any in sured other than that Addi tional Insured or iii bodily injury or property damage arising out of heat smoke or fumes from a hostile fire at or from any premises site or location which is or was at any time used by or for any insured or others for the handling stor age disposal processing or treatment of waste which are or were at any time transported handled stored treated disposed of or pro cessed as waste by or for i any insured or Copyright ISO Properties Inc. 2012 Page 3 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 413 ii any person or organization for whom you may be legally responsible or d at or from any premises site or location on which any insured or any contractors or subcontrac tors working directly or indirectly on any insured s behalf are per forming operations if the pollu tants are brought on or to the premises site or location in con nection with such operations by such insured contractor or sub contractor. However this sub paragraph does not apply to i bodily injury or property damage arising out of the escape of fuels lubricants or other operating fluids which are needed to per form the normal electrical hydraulic or mechanical functions necessary for the operation of mobile equip ment or its parts if such fuels lubricants or other operating fluids escape from a vehicle part designed to hold store or receive them. This exception does not ap ply if the bodily injury or property damage arises out of the intentional discharge dispersal or release of the fuels lubricants or other operating fluids or if such fuels lubricants or other operating fluids are brought on or to the premises site or location with the intent that they be discharged dis persed or released as part of the operations being per formed by such insured contractor or subcontractor i bodily injury or property damage sustained within a building and caused by the release of gases fumes or vapors from materials brought into that building in connection with operations being performed by you or on your behalf by a contrac tor or subcontractor or bodily injury or property damage arising out of heat smoke or fumes from a hostile fire. e at or from any premises site or location on which any insured or any contractors or subcontrac tors working directly or indirectly on any insured s behalf are per forming operations if the oper ations are to test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants. 2 Any loss cost or expense arising out of any a request demand order or statu tory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neu tralize or in any way respond to or assess the effects of pollu tants or b claim or suit by or on behalf of a governmental authority for dam ages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way re sponding to or assessing the ef fects of pollutants. However this paragraph does not ap ply to liability for damages because of property damage that the Insured would have in the absence of such request demand order or statutory or regulatory requirement or such claim or suit by or on behalf of a gov ernmental authority. g. Aircraft Auto or Watercraft Bodily injury or property damage aris ing out of the ownership maintenance use or entrustment to others of any air Copyright ISO Properties Inc. 2012 Page 4 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company craft auto or watercraft owned or op erated by or rented or loaned to any in sured. 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 hir ing employment training or monitoring of others by that Insured if the occurrence which caused the bodily injury or prop erty damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 a watercraft while ashore on premises you own or rent a watercraft you do not own that is 2 ft y a less than 26 feet long and b not being used to carry persons or property for a charge 3 parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the Insured 4 liability assumed under any insured contract for the ownership mainten ance or use of aircraft or watercraft or s 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 finan cial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged or b the operation of any of the ma chinery or equipment listed in paragraph f.2 or f.3 of the definition of mobile equipment. h. Mobile Equipment Bodily injury or property damage aris ing out of 1 the transportation of mobile equip ment by an auto owned or operated by or rented or loaned to any insured or 2 the use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or in directly out of 1 war including undeclared or civil war 2 warlike action by a military force in cluding action in hindering or defend ing against an actual or expected at tack by any government sovereign or other authority using military personnel or other agents or insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. 3 j. Damage to Property Property damage to 1 property you own rent or occupy including any costs or expenses in curred by you or any other person organization or entity for repair re placement enhancement restoration or maintenance of such property for any reason including prevention of in jury to a person or damage to an other s property 2 premises you sell give away or aban don if the property damage arises out of any part of those premises 3 property loaned to you 4 personal property in the care custody or control of the Insured Copyright ISO Properties Inc. 2012 Ed. 0413 Page 5 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 1 Ed. 0413 5 that particular part of real property on which you or any contractors or sub contractors working directly or indi rectly on your behalf are performing operations if the property damage arises out of those operations or 6 that particular part of any property that must be restored repaired or re placed because your work was in correctly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of seven or fewer con secutive days. A separate Limit of Insur ance applies to Damage to Premises Ren ted to You as described in SECTION Il LIMITS OF INSURANCE. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this ex clusion 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 aris ing out of it or any part of it. Damage to Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations haz ard. 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.. Personal and Adverti m. Damage to Impaired Property or Prop erty Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 a defect deficiency inadequacy or dangerous condition in your product or your work or 2 a delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use.. Recall of Products Work or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 your product 2 your work or 3 impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous con dition in it. ng Injury Bodily injury arising out of personal and advertising injury.. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of in ability to access or inability to manipulate electronic data. Copyright ISO Properties Inc. 2012 Page 6 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company However this exclusion does not apply to Coverage B Personal and Advertising Injury liability for damages because of bodily Liability injury. 1. Insuring Agreement As used in this exclusion electronic data means information facts or programs a. We will pay those sums that the Insured stored as or on created or used on or transmitted to or from computer soft ware including systems and applications software hard or floppy disks CD ROMs tapes drives cells data processing de vices or any other media which are used with electronically controlled equipment. q. Recording and Distribution of Material or Information in Violation of Law Bodily injury or property damage aris ing 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 Ac curate Credit Transactions Act becomes legally obligated to pay as dam ages because of personal and advertising injury to which this insurance applies. We will have the right and duty to defend the Insured against any suit seeking those damages. However we will have no duty to defend the Insured against any suit seeking damages for personal and ad vertising injury to which this insurance does not apply. We may at our discretion investigate any offense and settle any claim or suit that may result. But 1 the amount we will pay for damages is limited as described in SECTION Il LIMITS OF INSURANCE and 2 our right and duty to defend end when we have used up the applicable Limit of Insurance in the payment of judg ments or settiements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Sup plementary Payments Coverages A and B. FACTA or b. This insurance applies to personal and advertising injury caused by an offense inyarizeroarlv rSE a Tacic nloiatlhratl ae Onre arising out of your business but only if the TCPA. CAN SAM A t of 2003 offense was committed in the coverage ct o or territory during the policy period. FCRA and their amendments and addi tions that addresses prohibits or lim. its the printing dissemination disposal 2. Exclusions collecting recording sending trans mitting communicating or distribution This insurance does not apply to of material or information. a. Knowing Violation of Rights of Another Exclusions c. through n. do not apply to dam age by fire to premises while rented to you or temporarily occupied by you with permis sion of the owner. A separate Limit of Insur ance applies to this coverage as described in SECTION 1ll LIMITS OF INSURANCE. Copyright ISO Properties 01 Ed. 0413 Page 7 of 20 Personal and advertising injury caused by or at the direction of the Insured with the knowledge that the act would violate the rights of another and would inflict per sonal and advertising injury. Inc. 2012 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company. Material Published with Knowledge of Falsity Personal and advertising injury arising out of oral or written publication in any man ner of material if done by or at the di rection of the Insured with knowledge of its falsity.. Material Published Prior to Policy Pe riod Personal and advertising injury arising out of oral or written publication in any man ner 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 con tract 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 ser vices to conform with any statement of quality or performance made in your ad vertisement.. Wrong Description of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. th Knowledge of i g injury arising out cation in any man e by or at the di with knowledge of ior to Policy Pe g injury arising out cation in any man e first publication beginning of the I8 g injury arising out ritted by or at the g injury for which d liability in a con is exclusion does r damages that the he absence of the g injury arising out except an implied r s advertising idea ice of Goods Statements Kk g injury arising out products or ser any statement of made in your ad Prices I g injury arising out on of the price of ices stated in your Copyright ISO Properties Page 8 of 20 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 intellec tual property rights. Under this exclusion such other intellectual property rights do not include the use of another s advertis ing 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 commit ted by an insured whose business is 1 advertising broadcasting publishing or telecasting 2 designing or determining content of web sites for others or 3 an Internet search access content or service provider. However this exclusion does not apply to paragraphs 14.a. b. and c. of personal and advertising injury under the Defini tions section. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting.. Electronic Chat Rooms or Bulletin Boards Personal and advertising injury arising out of an electronic chat room or bulletin board the Insured hosts owns or over which the Insured exercises control. Unauthorized Use of Another s Name or Product Personal and advertising injury arising out of the unauthorized use of another s name or product in your e mail address domain Inc. 2012 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 01 Ed. 0413 name or metatag or any other similar tac tics to mislead another s potential custom ers.. Pollution Personal and advertising injury arising out of the actual alleged or threatened dis charge dispersal seepage migration re lease or escape of pollutants at any time. Pollution related Any loss cost or expense arising out of any 1 request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. 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 in cluding action in hindering or defend ing against an actual or expected at tack by any government sovereign or other authority using military personnel or other agents or insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. p. Recording and Distribution of Material or Information in Violation of Law Personal and advertising injury arising di rectly or indirectly out of any action or omission that violates or is alleged to vio late 1 the Telephone Consumer Protection Act TCPA including any amendment of or addition to such law 2 the CAN SPAM Act of 2003 including any amendment of or addition to such law 3 the Fair Credit Reporting Act FCRA and any amendment of or addition to such law including the Fair and Ac curate Credit Transactions Act FACTA or 4 any federal state or local statute or dinance or regulation other than the TCPA CAN SPAM Act of 2003 or FCRA and their amendments and addi tions that addresses prohibits or lim its the printing dissemination disposal collecting recording sending trans mitting communicating or distribution of material or information. Coverage C Medical Payments 1. Insuring Agreement a. We will pay medical expenses as de scribed below for bodily injury caused by an accident 1 on premises you own or rent 2 on ways next to premises you own or rent or 3 because of your operations provided that a the accident takes place in the cov erage territory and during the policy period b the expenses are incurred and report ed to us within one year of the date of the accident and Copyright ISO Properties Inc. 2012 Page 9 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company c the injured person submits to exami nation at our expense by physicians of our choice as often as we reason ably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable Limit of Insurance. We will pay reasonable expenses for 1 first aid administered at the time of an accident 2 necessary medical surgical X ray and dental services including prosthetic devices and 3 necessary ambulance hospital pro fessional nursing and funeral services. 2. Exclusions We will not pay expenses for bodily injury a. Any Insured To any insured except volunteer work ers. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury on Normally Occupied Premises To a person injured on that part of prem ises you own or rent that the person nor mally occupies. d. Workers Compensation and Similar Laws To a person whether or not an employ ee of any insured if benefits for the bodily injury are payable or must be provided under a workers compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing in structing or participating in any physical exercises or games sports or athletic contests. submits to exami f. nse by physicians ten as we reason iyments regardless 9. ts will not exceed Insurance. We will s for Products Completed Operations Hazard Included within the products completed operations hazard. Coverage A Exclusions Excluded under Coverage A. Supplementary Payments Coverages A and B d at the time of an 1. We will pay with respect to any claim we investigate or settle or any suit against an All expenses we incur. Up to 250 for cost of bail bonds re quired because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fur nish these bonds.. The cost of bonds to release attachments but only for bond amounts within the ap plicable Limit of Insurance. We do not have to furnish these bonds.. All reasonable expenses incurred by the Insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work.. All court costs taxed against the Insured in the suit. However these payments do not include attorneys fees or attorneys expenses taxed against the Insured. surgical X ray and insured we defend cluding prosthetic a b. ce hospital pro i funeral services. or bodily injury c volunteer work d lo work for or on or a tenant of any cupied Premises e that part of prem at the person nor f. ion and Similar r not an employ benefits for the yable or must be ers compensation g. or a similar law. hile practicing in g in any physical Prejudgment interest awarded against the Insured on that part of the judgment we pay. If we make an offer to pay the ap plicable Limit of Insurance we will not pay any prejudgment interest based on that period of time after the offer. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid of fered to pay or deposited in court the part of the judgment that is within the applicable Limit of Insurance. sports or athletic These payments will not reduce the Limits of Insurance. Copyright ISO Properties Inc. 2012 Page 10 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 2. If we defend an insured against a suit and an indemnitee of the Insured is also named as a party to the suit we will defend that indem nitee if all of the following conditions are met v e the suit against the indemnitee seeks damages for which the Insured has as sumed the liability of the indemnitee in a contract or agreement that is an insured contract this insurance applies to such liability as sumed by the Insured the obligation to defend or the cost of the defense of that indemnitee has also been assumed by the Insured in the same insured contract the allegations in the suit and the in formation we know about the occur rence are such that no conflict appears to exist between the interests of the Insured and the interests of the indemnitee the indemnitee and the Insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the Insured and the indemnitee and. the indemnitee 1 Agrees in writing to a cooperate with us in the inves tigation settiement or defense of the suit b immediately send us copies of any demands notices summonses or legal papers received in con nection with the suit c notify any other insurer whose coverage is available to the in demnitee and d cooperate with us with respect to coordinating other applicable in surance available to the indem nitee and ainst a suit and an s also named as a jefend that indem conditions are met indemnitee seeks e Insured has as he indemnitee in a that is an insured o such liability as d or the cost of demnitee has also 1sured in the same suit and the in bout the occur conflict appears to ests of the Insured indemnitee Insured ask us to e defense of that h suit and agree same counsel to the indemnitee and us in the inves ent or defense of nd us copies of otices summonses s received in con suit er insurer whose sailable to the in us with respect to ther applicable in le to the indem 2 Provides us with written authorization to a obtain records and other infor mation related to the suit and b conduct and control the defense of the indemnitee in such suit. So long as the above conditions are met at torneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation ex penses incurred by the indemnitee at our re quest will be paid as Supplementary Payments. Notwithstanding the provisions of paragraph 2.b.2 of SECTION COVERAGE A Bodi ly Injury and Property Damage Liability such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the Limits of Insurance. Our obligation to defend an insured s indem nitee and to pay for attorneys fees and nec essary litigation expenses as Supplementary Payments ends when we have used up the applicable Limit of Insurance in the payment of judgments or settlements or the conditions set forth above or the terms of the agree ment described in paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your busi ness. c. A limited liability company you are an in sured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insur eds but only with respect to their duties as your managers. Copyright ISO Properties Inc. 2012 Page 11 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 0 01 Ed. 0413 d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive of ficers and directors are insureds but only with respect to their duties as your of ficers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders.. A trust 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 per forming duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a part nership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers are insureds for 1 Bodily injury or personal and ad vertising injury a to you to your partners or mem bers if you are a partnership or joint venture to your members if you are a limited liability com pany to a coemployee while in the course of his or her em ployment or performing duties related to the conduct of your business or to your other volun teer workers while performing duties related to the conduct of your business b to the spouse child parent brother or sister of that coem ployee or volunteer worker as a consequence of paragraph 1a above c for which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph 1a or b above or d arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a owned occupied or used by b rented to in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volun teer workers any partner or member if you are a partnership or joint ven ture or any member if you are a limited liability company.. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager.. Any person or organization having proper temporary custody of your property if you die but only 1 with respect to liability arising out of the maintenance or use of that prop erty and 2 until your legal representative has been appointed. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part.. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a named insured if there is no other similar insurance available to that organization. However coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier Copyright ISO Properties Inc. 2012 Page 12 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company b. Coverage A does not apply to bodily in jury or property damage that occurred before you acquired or formed the or ganization and o 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 re spect to the conduct of any current or past part nership joint venture or limited liability company that is not shown as a named insured in the Dec larations. SECTION IIl LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declara tions and the rules below fix the most we will pay regardless of the number of a. insureds b. claims made or suits brought or c. persons or organizations making claims or bringing suits. 2. The General Aggregate Limit is the most we will pay for the sum of a. medical expenses under Coverage C b. damages under Coverage A except dam ages because of bodily injury or prop erty damage included in the products completed operations hazard and c. damages under Coverage B. 3. The Products Completed Operations Aggre gate Limit is the most we will pay under Cov erage A for damages because of bodily in jury and property damage included in the products completed operations hazard. 4. Subject to paragraph 2. above the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and adver tising injury sustained by any one person or organization. pply to bodily in age that occurred r formed the or apply to personal arising out of an fore you acquired ion. n insured with re rrent or past part d liability company nsured in the Dec IRANCE wn in the Declara x the most we will er of rought or s making claims or it is the most we Coverage C e A except dam y injury or prop in the products azard and e B. Dperations Aggre jill pay under Cov wuse of bodily in e included in the tions hazard. bove the Personal is the most we will r the sum of all ersonal and adver any one person or 5. Subject to paragraph 2. or 3. above which ever applies the Each Occurrence Limit is the most we will pay for the sum of a. damages under Coverage A and b. medical expenses under Coverage C because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to paragraph 5. above the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages be cause of property damage to any one prem ises while rented to you or in the case of damage by fire while rented to you or tem porarily occupied by you with permission of the owner. 7. Subject to paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual pe riod and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the poli cy period is extended after issuance for an addi tional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determin ing the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABIL ITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the Insured or of the Insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties in the Event of Occurrence Offense Claim or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 how when and where the occur rence or offense took place Copyright ISO Properties Inc. 2012 Page 13 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 2 the names and addresses of any in jured persons and witnesses and 3 the nature and location of any injury or damage arising out of the occurrence or offense. b. If a claim is made or suit is brought against any insured you must 1 immediately record the specifics of the claim or suit and the date re ceived 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 de mands notices summonses or legal papers received in connection with the claim or suit 2 authorize us to obtain records and other information 3 cooperate with us in the investigation or settlement of the claim or defense against the suit and 4 assist us upon our request in the en forcement of any right against any person or organization which may be liable to the Insured because of injury or damage to which this insurance may also apply. e No insured will except at that Insured s own cost voluntarily make a payment as sume any obligation or incur any expense other than for first aid without our con sent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part a. to join us as a party or otherwise bring us into a suit asking for damages from an insured or resses of any in itnesses and on of any injury or f the occurrence suit is brought must the specifics of and the date re practicable. we receive written suit as soon as ed insured must copies of any de mmonses or legal onnection with the otain records and in the investigation claim or defense d request in the en right against any tion which may be because of injury this insurance may t at that Insured s ake a payment as incur any expense without our con has a right under otherwise bring us damages from an b. to sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to re cover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable Limit of Insur ance. An agreed settlement means a settle ment and release of liability signed by us the Insured and the claimant or the claimant s legal representative. Other Insurance If other valid and collectible insurance is avail able to the Insured for a loss we cover under Coverages A or B of this Coverage Part our obligations are limited as follows a. Primary Insurance This insurance is primary except when paragraph b. below applies. If this insur ance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method de scribed in paragraph c. below. b. Excess Insurance 1 This insurance is excess over a Any of the other insurance whether primary excess contin gent or on any other basis i that is Fire Extended Cov erage Builder s Risk Installa tion Risk or similar coverage for your work ii that is Fire insurance for premises rented to you or temporarily occupied by you with permission of the own er iii that is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occu pied by you with permission of the owner or Copyright ISO Properties Inc. 2012 Page 14 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 1 Ed. 0413 iv if the loss arises out of the maintenance or use of air craft autos or watercraft to the extent not subject to exclusion g. of SECTION COVERAGE A Bodily In jury and Property Damage Liability. b Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed oper ations for which you have been added as an additional insured. 2 When this insurance is excess we will have no duty under Coverages A or B to defend the Insured against any suit if any other insurer has a duty to de fend the Insured against that suit. If no other insurer defends we will un dertake to do so but we will be en titled to the Insured s rights against all those other insurers. 3 When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of a the total amount that all such oth er insurance would pay for the loss in the absence of this insur ance and b the total of all deductible and self insured amounts under all that other insurance. 4 We will share the remaining loss if any with any other insurance that is not described in this Excess Insur ance Provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Dec larations of this Coverage Part. c. Method of Sharing If all of the other insurance permits con tribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable Limit of Insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this meth od each insurer s share is based on the ratio of its applicable Limit of Insurance to the total applicable Limits of Insurance of all insurers. 5. Premium Audit. The first We will compute all premiums for this Coverage Part in accordance with our rules and rates.. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and ret rospective 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. Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. 6. Representations By accepting this Policy you agree the statements in the Declarations are ac curate and complete. those statements are based upon repre sentations you made to us and. we have issued this Policy in reliance upon your representations. 7. Separation of Insureds Except with respect to the Limits of Insur ance and any rights or duties specifically as signed in this Coverage Part to the first Named Insured this insurance applies Copyright ISO Properties Inc. 2012 Page 15 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company a. as if each named insured were the only named insured and b. separately to each insured against whom claim is made or suit is brought. 8. Transfer of Rights of Recovery Against Others to Us If the Insured has rights to recover all or part of any payment we have made under this Coverage Part those rights are transferred to us. The Insured must do nothing after loss to impair them. At our request the Insured will bring suit or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written no tice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. notices that are published include material placed on the Internet or on similar elec tronic means of communication and b. regarding web sites only that part of a web site that is about your goods pro ducts 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 in cluding any attached machinery or equip ment or red were the only rred against whom 5 brought. Recovery Against recover all or part made under this are transferred to thing after loss to st the Insured will se rights to us and this Coverage Part the first Named rations written no less than 30 days of mailing will be a notice that is the general public ents about your s for the purpose supporters. For the ed include material or on similar elec nication and nly that part of a your goods pro the purposes of or supporters is ment. ailer or semitrailer public roads in achinery or equip b. any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment.. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Coverage territory means a. the United States of America including its territories and possessions Puerto Rico and Canada b. international waters or airspace but only if the injury or damage occurs in the course of travel or transportation between any places included in paragraph a. above or c. all other parts of the world if the injury or damage arises out of 1 goods or products made or sold by you in the territory described in para graph a. above 2 the activities of a person whose home is in the territory described in para graph a. above but is away for a short time on your business or 3 personal and advertising injury of fenses that take place through the In ternet or similar electronic means of communication provided the Insured s responsibility to pay damages is determined in a suit on the merits in the territory described in paragraph a. above or in a settlement we agree to. Employee includes a leased worker. Em ployee does not include a temporary work er.. Executive officer means a person holding any of the officer positions created by your charter constitution bylaws or any other similar governing document. Copyright ISO Properties Inc. 2012 Page 16 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company. Hostile fire means one which becomes un controllable or breaks out from where it was intended to be.. Impaired property means tangible prop erty 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 de fective deficient inadequate or danger ous 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 remov al of your product or your work or your fulfilling the terms of the contract or agree ment.. Insured contract means a. a contract for a lease of premises. How ever that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or tem porarily occupied by you with permission of the owner is not an insured contract b. asidetrack agreement c. any easement or license agreement ex cept in connection with construction or demolition operations on or within 50 feet of arailroad d. an obligation as required by ordinance to indemnify a municipality except in con nection with work for a municipality e. an elevator maintenance agreement f. that part of any other contract or agree ment 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. hich becomes un from where it was ns tangible prop roduct or your i or is less useful product or your thought to be de 2quate or danger ill the terms of a estored to use by ustment or remov our work or your contract or agree f premises. How he contract for a at indemnifies any for damage by fire d to you or tem u with permission insured contract e agreement ex h construction or n or within 50 feet Paragraph f. does not include that part of any contract or agreement 1 that indemnifies a railroad for bodily 2 injury or property damage arising out of construction or demolition op erations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing that indemnifies an architect engineer or surveyor for injury or damage aris ing out of a preparing approving or failing to prepare or approve maps shop drawings opinions reports sur veys field orders change orders or drawings and specifications or b giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or under which the Insured if an archi tect engineer or surveyor assumes li ability for an injury or damage arising out of the Insured s rendering or fail ure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 10. Leased worker means a person leased to you by a labor leasing firm under an agree ment between you and the labor leasing firm to perform duties related to the conduct of d by ordinance to y except in con municipality your business. Leased worker does not in clude a temporary worker. agreement 1. Loading or unloading means the handling of property contract or agree business including a municipality in performed for a h you assume the party to pay for b. erty damage to a ation. Tort liability uld be imposed by c. f any contract or a. after it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto while it is in or on an aircraft watercraft or auto or while it is being moved from an aircraft watercraft or auto to the place where it is finally delivered Copyright ISO Properties Inc. 2012 Page 17 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 12. 00 01 Ed. 0413 but loading or unloading does not include the movement of property by means of a me chanical device other than a hand truck that is not attached to the aircraft watercraft or auto. Mobile equipment means any of the fol lowing types of land vehicles including any attached machinery or equipment a. bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads b. vehicles maintained for use solely on or next to premises you own or rent c. vehicles that travel on crawler treads d. vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 power cranes shovels loaders dig gers or drills or 2 road construction or resurfacing equipment such as graders scrapers or rollers e. vehicles not described in paragraph a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equip ment of the following types 1 air compressors pumps and gener ators including spraying welding building cleaning geophysical explora tion lighting and well servicing equip ment or 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 13. 14. 1 equipment designed primarily for a snow removal b road maintenance but not con struction or resurfacing or c street cleaning 2 cherry pickers and similar devices mounted on automobile or truck chas sis and used to raise or lower work ers and 3 air compressors pumps and gener ators including spraying welding building cleaning geophysical explora tion lighting and well servicing equip ment. However mobile equipment does not include any land vehicles that are subject to a com pulsory or financial responsibility law or other motor vehicle insurance law where it is Ili censed or principally garaged. Land vehicles subject to a compulsory or financial respon sibility law or other motor vehicle insurance law are considered autos. Occurrence means an accident including continuous or repeated exposure to substan tially the same general harmful conditions. Personal and advertising injury means in jury 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 en try into or invasion of the right of private occupancy of a room dwelling or prem ises 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 ser vices Copyright ISO Properties Inc. 2012 Page 18 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 00 01 Ed. 0413 e. oral or written publication in any manner of material that violates a person s right of privacy f. the use of another s advertising idea in your advertisement or g. infringing upon another s copyright trade dress or slogan in your advertisement. 15. Pollutants mean any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals and waste. Waste includes materials to be recycled reconditioned or reclaimed. 16. Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 products that are still in your physical possession or 2 work that has not yet been completed or abandoned. However your work will be deemed completed at the earli est of the following times a When all of the work called for in your contract has been complet ed. b When all of the work to be done at the job site has been com pleted if your contract calls for work at more than one job site. c When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service main tenance correction repair or replace ment but which is otherwise com plete will be treated as completed. 17. 18. b. Does not include bodily injury or prop erty damage arising out of 1 the transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or un loading of that vehicle by any insured 2 the existence of tools uninstalled equipment or abandoned or unused materials or 3 products or operations for which the classification listed in the Declarations or in a policy Schedule states that products completed operations are subject to the General Aggregate Limit. Property damage means a. physical injury to tangible property in cluding all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the phys ical 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 sys tems and applications software hard or flop py disks CD ROMSs tapes drives cells data processing devices or any other media which are used with electronically controlled equip ment. Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. an arbitration proceeding in which such damages are claimed and to which the In sured must submit or does submit with our consent or Copyright ISO Properties Inc. 2012 Page 19 of 20 er tor CG 00 01 Ed. 0413
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PL6420778 07 Great American ES Insurance Company 19. 20. b. any other alternative dispute resolution proceeding in which such damages are claimed and to which the Insured submits with our consent. Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other com pensation by you or anyone else for their work performed for you. 21. Your product a. Means 1 any goods or products other than real property manufactured sold handled distributed or disposed of by you b others trading under your name or c a person or organization whose business or assets you have ac quired and 2 containers other than vehicles ma terials parts or equipment furnished in connection with such goods or pro ducts. b. Includes 1 warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 the providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 22. Your work a. Means 1 work or operations performed by you or on your behalf and 2 materials parts or equipment furnished in connection with such work or op erations. b. Includes 1 warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and 2 the providing of or failure to provide warnings or instructions. b. Includes 1 warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and 2 the providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. Copyright ISO Properties Inc. 2012 Page 20 of 20 CG 00 01 Ed. 0413
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERICAN Ginimaliof 5202 4201 INSURANCE GROUP 513 369 5000 ph Great American ES Insurance Company cG 75 19 Ed. 12 07 EMPLOYEE BENEFITS LIABILITY COVERAGE FORM EXCLUDING FIDUCIARY LIABILITY Various provisions of 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. 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 VI DEFINITIONS. SECTION EMPLOYEE BENEFITS COVERAGES 1. Insuring Agreement a. We will pay those sums that the Insured becomes legally obligated to pay as dam ages sustained by an employee former employee prospective employee or the beneficiaries or legal representatives thereof and caused by any negligent act error or omission of the Insured or any other person for whose acts you are le gally liable in the administration of your employee benefit program. This insurance applies to any negligent act error or omission which occurs in the coverage territory and during the policy period. We will have the right and duty to defend any suit seeking those damages. How ever we will have no duty to defend the Insured against any suit seeking damages for any negligent act error or omission to which this insurance does not apply. We may at our discretion investigate any negligent act error or omission and set tle any claim or suit that may result. But 1 the amount we pay for damages is limited as described in SECTION IlI LIMITS OF INSURANCE. 2 our right and duty to defend end when we have used up the applicable Limit of Insurance in the payment of judg ments or settlements under this Cov erage Part. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Sup plemental Payments. 2. Exclusions This insurance does not apply to a. Damages actually or allegedly arising out of any intentional dishonest fraudulent criminal or malicious act error or omis sion committed by any insured including but not limited to the willful violation of any statute. b. Damages claimed for any bodily injury property damage or personal and ad vertising injury. c. Damages actually or allegedly arising out of any breach of or failure to perform any contract by any insured or insurer. d. Damages arising out of an insufficiency of funds to meet any obligations under any plan included in an employee benefit pro gram. CG 75 19 Ed. 1207 XS Page 1 of 7
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PL6420778 07 e. Damages actually or allegedly arising out of any 1 failure of any investment to perform as predicted expected anticipated advertised or desired 2 advice given to any person with re spect to that person s decision to par ticipate or not to participate in any plan included in the employee benefit program error in providing information on past performance of any investment vehi cle or 4 investment or non investment of funds. f. Damages arising out of your failure to comply with the mandatory provisions of any law concerning workers compensa tion employment compensation insurance social security or disability benefits law or any similar law. Damages for which the Insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Se curity Act of 1974 as now or hereafter amended or by any similar federal state or local law. h. Any claim arising from any failure to pay an employee benefit to the extent such employee benefit is payable from applica ble accrued funds or other collectible in surance with the reasonable effort and cooperation of the Insured. Any tax fine or penalty including but not limited to those imposed under the Inter nal Revenue Code or any similar state or local law. j. Damages actually or allegedly arising out of wrongful termination of employment any unlawful discrimination or any other employment related practice. Supplementary Payments We will pay with respect to any claim we in vestigate or settle or any suit against an insured we defend 1. All expenses we incur. Great American ES Insurance Company 2. The cost of bonds to release attachments but only for bond amounts within the applicable Limit of Insurance. We do not have to furnish these bonds. 3. All reasonable expenses incurred by the In sured at our request to assist us in the inves tigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. 4. All court costs taxed against the Insured in the suit. However these payments do not in clude attorneys fees or attorneys expenses taxed against the Insured. 5. Prejudgment interest awarded against the In sured on that part of the judgment we pay. If we make an offer to pay the applicable Limit of Insurance we will not pay any prejudgment interest based on that period of time after we made the offer. 6. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or de posited in court the part of the judgment that is within the applicable Limit of Insurance. These payments will not reduce the Limits of Insurance. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. An individual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your busi ness. c. A limited liability company you are an in sured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insur eds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive of CG 75 19 Ed. 1207 XS Page 2 of 7
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PL6420778 07 2. ficers and directors are insureds but only with respect to their duties as your of ficers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. A trust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. The following are also insureds a. Each of your employees who is or was authorized to administer your employee benefit program but only with respect to their administration of your employee benefit program. b. Any person organization or employee having proper temporary authorization to administer your employee benefit pro gram if you die but only with respect to their administration of your employee benefit program and 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 Coverage Form. d. Any organization you newly acquire or form other than a partnership joint ven ture 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 1 coverage under this provision is af forded only until the 90th day after you acquire or form the organization or the end of the policy period whichever is earlier coverage does not apply to negligent acts errors or omissions that oc curred 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. Great American ES Insurance Company SECTION Il LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declara tions and the rules below fix the most we will pay regardless of the number of a. insureds b. claims made or suits brought c. persons or organizations making claims or bringing suits d. negligent acts errors or omissions or e. benefits included in your employee bene fit program. 2. The Limits of Liability shown in the Declara tions applicable to Each Claim is subject to the following provision respecting Aggregate the most we will pay for all damages arising out of any covered claim. The Limit of Liability shown in the Declarations as Aggregate is the most we will pay for the sum of all damages on account of all claims. The limits of this Coverage Part apply sepa rately 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 un less the policy period is extended after issu ance 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 DEDUCTIBLE 1. Our obligation to pay damages on your behalf applies only to the amount of damages in excess of the deductible amount stated in the Declarations. The Limits of Insurance shall not be reduced by the amount of the deductible. 2. The terms of this insurance including those with respect to a our right and duty to defend any suits seeking those damages and b your duties and the duties of any other involved insured in the event of a neg ligent act error or omission claim or suit CG 75 19 Ed. 1207 XS Page 3 of 7
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PL6420778 07 apply irrespective of the application of the deductible amount. 3. We may pay any part or all of the deductible amount to effect settlement of any claim or suit and upon notification of the action tak en you shall promptly reimburse us for such part of the deductible amount as has been paid by us. SECTION V EMPLOYEE BENEFITS LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the Insured or of the Insured s estate will not relieve us of our obligations under this Coverage Part. 2. Duties in the Event of a Claim or Suit a. You and any other involved insured must see to it that we are notified as soon as practicable of any negligent act error or omission which may result in a claim. To the extent possible notice should include 1 how when and where the negligent act error or omission took place 2 the names and addresses of any in jured persons and witnesses and 3 the nature of any injury or damage arising out of the negligent act error or omission. b. If a claim is received by an insured or a suit is brought against any insured you must 1 immediately record the specifics of the claim or suit and the date re ceived and 2 notify us as soon as practicable. You and any other involved insured 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 de mands notices summonses or legal papers received in connection with the claim or suit Great American ES Insurance Company 2 authorize us to obtain records and other information 3 cooperate with us in the investigation settlement or defense of the claim or suit and 4 assist us upon our request in the en forcement of any right against any person or organization which may be liable to the Insured because of injury or damage to which this insurance may also apply. d. No insured will except at their own cost voluntarily make a payment assume any obligation or incur any expense without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part a. to join us as a party or bring us into a suit asking for damages from an insured or b. to sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to re cover on an agreed settlement or on a final judgment against an insured but we will not be liable for damages that are not due under the terms of this Coverage Part or that are in excess of the Limits 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 agent.. Other Insurance If other valid and collectible insurance is avail able to the Insured for a loss we cover under this Coverage Part our obligations are limited as follows a Primary Insurance This insurance is primary except when paragraph b. below applies. If this insur ance is primary our obligations are not affected unless any of the other insurance is also primary. Then we will share with all that other insurance by the method de scribed in paragraph c. below. CG 75 19 Ed. 1207 XS Page 4 of 7
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PL6420778 07 Great American ES b Excess Insurance As respects any additional insured added to this Policy by attachment of an en dorsement this insurance is excess over any other insurance available to that In sured that applies on a primary basis to any claim suit negligent act error or omission or damages to which this Policy also applies. When this insurance is excess we will have no duty to defend that Insured against any suit if any other insurer has a duty to defend the Insured against that suit. If no other insurer defends we will undertake to do so but we will be entitled to the Insured s rights against all those other insurers. When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that ex ceeds the sum of 1 the total amount that all such other insurance would pay for the loss in the absence of this insurance and 2 the total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss if any with any other insurance that is not de scribed in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c Method of Sharing If all of the other insurance permits con tribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable Limit of In surance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this meth od each insurer s share is based on the ratio of its applicable Limit of Insurance to the total applicable Limits of Insurance of all insurers. Great American ES Insurance Company 5. Premium Audit onal insured added a. We will compute all premiums for this hment of an en endorsement in accordance with our rules ce is excess over and rates. ailable to that In a primary basis to b. Premium shown as advance premium is a igent act error or deposit premium only. At the close of o which this Policy each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due s excess we will date for audit and retrospective premiums fend that Insured is the date shown as the due date on the other insurer has a bill. sured against that r defends we will If the sum of the advance and audit pre we will be entitled miums paid for the policy term is greater against all those than the earned premium we will return the excess to the first Named Insured. excess over other c. The first Named Insured must keep only our share of records of the information we need for 5 if any that ex premium computation and send us copies at such times as we may request. hat all such other 6. Representations ay for the loss in insurance and By accepting this Policy you agree a. the statements in the Declarations are ac ductible and self curate and complete ider all that other b. those statements are based upon repre sentations you made to us and aining loss if any ce that is not de c. we have issued this Policy in reliance upon nsurance provision your representations. cifically to apply in f Insurance shown 7. Separation of Insureds is Coverage Part. Except with respect to the Limits of Insur ance and any rights or duties specifically as signed to the first Named Insured this insur ance permits con ance applies es we will follow ler this approach a. as if each named insured were the only es equal amounts named insured and icable Limit of In the loss remains b. separately to each insured against whom claim is made or suit is brought. isurance does not 8. Transfer of Rights of Recovery Against equal shares we Others to Us. Under this meth e is based on the If the Insured has rights to recover all or part mit of Insurance to of any payment we have made under this its of Insurance of Coverage Part those rights are transferred to us. The Insured must do nothing after loss to CG 75 19 Ed. 1207 XS Page 5 of 7
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PL6420778 07 impair them. At our request the Insured will bring suit or transfer those rights to us and help us enforce them.. When We Do Not Renew If we decide not to renew this Coverage Part we will mail or deliver to the first Named Insured shown in the Declarations written no tice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. SECTION VI DEFINITIONS 1. Administration means a. giving counsel or providing information to employees or to their dependents or beneficiaries with respect to the eligibility for or scope of any employee benefit program. b. interpreting any employee benefit pro gram c. handling records in connection with any employee benefit program d. effecting enroliment or continuing termi nating or canceling any employee s par ticipation in any benefit included in an employee benefits program provided all such acts are authorized by you. However administration does not include handling any payroll deductions. 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 elec tronic means of communication and c regarding web sites only that part of a web site that is about your goods pro ducts or services for the purpose of at tracting customers or supporters is con sidered an advertisement. 3.. Employee Great American ES Insurance Company Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time.. Cafeteria plans means plans authorized by applicable law to allow employees to elect to pay for certain benefits with their own pretax dollars.. Claim means any demand made or suit brought by an employee or an employee s dependents or beneficiaries for damages as a result of a negligent act error or omission in the administration of your employee benefit program.. Coverage territory means the United States of America including its territories and pos sessions Puerto Rico and Canada. means a person currently or formerly employed on leave of absence dis abled or retired. Employee includes a leased worker. Employee does not include a tem porary worker.. Employee benefit program means a pro gram 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 i no one other than an employee may subscribe to such bene fits and ii such benefits are made gen erally 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 i no one other than an employee may subscribe to such benefits and ii such benefits are made generally available to all employees who are eligible for such benefits under the plan c. unemployment insurance social security benefits workers compensation and dis ability benefits d. vacation plans including buy and sell pro grams leave of absence programs in cluding those for military maternity fam CG 75 19 Ed. 1207 XS Page 6 of 7
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PL6420778 07 9. 10. n. ily and civil leaves tuition assistance plans transportation and health club subsidies and e. any other similar plan designated in the Declarations or added thereto by en dorsement. Leased Worker means a person leased to you by a labor leasing firm under an agree ment between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not in clude a temporary worker. Negligent act error or omission means the failure to execute a required action or the execution of a mistaken action committed in the administration of the Insured s employee benefit program. Personal and advertising injury means in jury 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 en try into or invasion of the right of private occupancy of a room dwelling or prem ises 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 organizations goods products or ser vices e. oral or written publication in any manner of material that violates a person s right of privacy. Great American ES Insurance Company f. the use of another s advertising idea in your advertisement g. infringing upon another s copyright trade dress or slogan in your advertisement. 12. Property damage means 13. Suit 14. a. physical injury to tangible property in cluding all resulting loss of use of that property or b. loss of use of tangible property that is not physically injured. For the purposes of this insurance elec tronic 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 soft ware including systems and applications software or hardware hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically con trolled equipment. means a civil proceeding in which damages because of a negligent act error or omission to which this insurance applies are claimed. Suit includes a. an arbitration proceeding in which such damages are claimed and to which the In sured must submit or does submit with our consent or b. any other alternative dispute resolution proceeding in which such damages are claimed and to which the Insured submits with our consent. Temporary worker means a person who substitutes for a permanent employee on leave or to meet seasonal or short term workload conditions. CG 75 19 Ed. 1207 XS Page 7 of 7
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERICAN Ginimaliof 5202 4201 INSURANCE GROUP 513 369 5000 ph Great American ES Insurance Company AES 3004 Ed. 05 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PREMIUM AUDIT CONDITION AMENDMENT Condition 5. Premium Audit Section IV is re placed 5. Premium Audit Minimum Premium Mi by the following mum Retained Premium a. We will compute all premiums for this Coverage Form in accordance with the terms and conditions of this policy. Premium shown in this policy as Advance Premium is a deposit premium. At the close of each audit period we will com pute the earned premium for that period. Audit premiums are due and payable upon notice to the first Named Insured. If the sum of the Advance and Audit Premiums paid for the policy term is greater than the earned premium we will return the excess to the first Named Insured subject to the minimum and minimum retained premiums described below. In no event will the final premium retained by us be less than the minimum premium shown in the Declarations of this policy. If no other premium is designated specifi cally as a minimum premium. Such mini mum premium the Advance Premium shown in the Declarations is the minimum premium. Such minimum premium is sub ject to the short rate or prorate adjust ment according to policy provisions in case of cancellation of the policy.. This policy is also subject to a minimum retained premium of 25 of the Advance Premium shown in the Declarations of this policy. Such minimum retained premium is not subject to prorate or short rate ad justment in the event of cancellation by you and we shall retain no less than the minimum retained premium regardless of the policy term. Cancellation of the policy for non payment of premium shall be deemed a request by you for cancellation of this policy thereby invoking the mini mum retained premium unless the short rate calculation earns more than the mini mum retained premium. 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. AES 3004 Ed. 0501 XS
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PL6420778 07 Great American ES Insurance Company IL 00 17 Ed. 11 98 COMMON POLICY CONDITIONS All Coverage Parts included in this Policy are subject to the following conditions. IL 00 17 Ed. 1198 XS 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 writ ten notice of cancellation at least a. 10 days before the effective date of cancellation if we cancel for nonpay ment 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. 4. Notice of cancellation will state the effec tive 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.. Changes This Policy contains all the agreements be tween you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this Policy with our consent. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this Policy. c. D. 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. Inspections and Surveys 1. We have the right to a. make inspections and surveys at any time b. give you reports on the conditions we find and c. recommend changes. 2. We are not obligated to make any inspec tions surveys reports or recommenda tions and any such actions we do under take relate only to insurability and the pre miums 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. 3. Paragraphs 1. and 2. of this condition ap ply not only to us but also to any rating advisory rate service or similar organiza tion which makes insurance inspections surveys reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections surveys reports or recommendations we may make relative to certification under state or municipal statutes ordinances or regulations of boilers pressure vessels or elevators. Copyright ISO Properties Inc. 1998 Page 1 of 2
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PL6420778 07 Great American ES Insurance Company sent except in the case of death of an in dividual named insured. E. Premiums The first Named Insured shown in the Dec larations 1. is responsible for the payment of all pre miums and 2. will be the payee for any return premiums we pay. F. Transfer of Your Rights and Duties Under this Policy Your rights and duties under this Policy may not be transferred without our written con 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 re presentative is appointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Copyright ISO Properties Inc. 1998 Page 2 of 2 IL 00 17 Ed. 1198 XS
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PL6420778 07 Administrative Officos 301 4th Street GREATAMERICAN cincmation 45202 INSURANCE GROUP 513 360 5000 ph Great American ES Insurance Company ESM 3005 Ed. 1015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMON POLICY CONDITIONS AMENDMENT The following Conditions are added to the COMMON POLICY CONDITIONS of this policy. G. Fraud and Misrepresentation a. This Policy was issued based on the information supplied on an application and other correspondence including your claim or loss history. This information is considered to be part of this Policy. b. You should review this information carefully as the truth of this information was of paramount importance in influencing our decision to issue this Policy. c. You for all the Insureds under this Policy do warrant the truth of such information to the best of your knowledge at the inception date of this Policy. d. If such information is false or misleading it may cause denial of coverage or voiding of the Policy. Premium Financing Cancellation of Financed Policy a. When we receive notification that the premium for this policy has been advanced by a premium financed company we will acknowledge receipt of the premium finance agreement to the finance company on our form when requested but we will not amend or extend this Policy. b. When we otherwise become aware that you financed all or part of this Policy s premium regardless of whether or not we receive a notice of premium financing we will not be bound as respects coverage we provide by the terms of your finance agreement. This Policy alone governs coverage. c. When you sign a premium finance agreement by the terms of the agreement you may be giving the premium finance company the right under certain conditions to cancel this Policy on your behalf. When we receive notice of cancellation from the finance company we will recognize their request for termination of this insurance and we will pay any return premium due as directed by the premium finance company. The return premium will be calculated on a pro rata basis. d. The premium finance company will usually require that payment of any return premium be made directly to them and we will honor that request. If the requested termination date set by the premium finance company conflicts with other policy provisions or the operation of law we will comply with the policy provision andor applicable law. You must resolve any resulting premium differences directly with the finance company. e. The twenty five percent 25 minimum retained premium described in A. Cancellation may not be financed as it is not refundable. This endorsement does not change any other provision of the policy. ESM 3005 Ed. 1015
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERTCAN. cincinnatioH 452024201 INSURANGE GROUP 513 369 5000 ph Great American ES Insurance Company AES 3013 Ed. 0411 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE FORM Schedule DEDUCTIBLE AMOUNT AND COVERAGE DEDUCTIBLE BASIS Bodily Injury Liability per claim Personal and Advertising Injury X peroccurrence Applicable to the sum of damages Property Damage Liability Supplementary Payments and defense costs Bodily Injury and Property Damage Liability 5000 Bodily Injury Personal and Advertising Injury and Property Damage Liability combined If no entry appears above information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. APPLICATION OF ENDORSEMENT Enter below any limitations on the application of this endorsement. If no limitation is entered the deductibles apply to damages for all bodily injury personal and advertising injury and property damage however caused 1. Our obligation under Bodily Injury Liability Personal and Advertising Injury and Property Damage Liability Coverages to pay damages on your behalf applies only to the amount of damages in excess of any deductible amounts stated in the Schedule above as applicable to such coverages. 2. The deductible applies for the deductible amount and coverage option and on the deductible basis indicated in the Schedule above. The deductible amount stated in the Schedule above applies as follows a. PER CLAIM BASIS If the deductible amount indicated in the Schedule is on a per claim basis that deductible applies as follows 1 Under the Bodily Injury Liability Personal and Advertising Injury Liability or Property Damage Liability Coverage respectively a to the sum of damages supplementary payments and defense costs because of bodily injury sustained by any one person DEDUCTIBLE BASIS per claim X peroccurrence Applicable to the sum of damages Supplementary Payments and defense costs AES 3013 Ed. 0411 Page 1 of 3
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b to the sum of damages supplementary payments and defense costs because of personal and advertising injury sustained by any one person or c to the sum of damages supplementary payments and defense costs because of property damage sustained by any one person 2 under Bodily Injury andor Property Damage Liability Coverage combined to the sum of damages supplementary payments and defense costs because of bodily injury and property damage sustained by any one person or 3 under Bodily Injury Personal and Advertising Injury andor Property Damage Liability Coverage combined to the sum of damages supplementary payments and defense costs because of bodily injury personal and advertising injury and property damage sustained by any one person as a result of any one occurrence or offense. If damages are claimed for care loss of services or death resulting at any time from bodily injury a separate deductible amount will be applied to each person making a claim for such damages. With respect to personal and advertising injury and property damage person includes organization. b. PER OCCURRENCE BASIS If the deductible amount indicated in the Schedule is on a per occurrence basis that deductible applies as follows 1 under the Bodily Injury Liability Personal and Advertising Injury Liability or Property Damage Liability Coverage respectively a to the sum of damages supplementary payments and defense costs because of bodily injury b to the sum of damages supplementary payments and defense costs because of personal and advertising injury or c to the sum of damages supplementary payments and defense costs because property damage 2 under Bodily Injury andor Property Damage Liability Coverage combined to the sum of damages supplementary payments and defense costs because of all bodily injury and property damage or 3 under Bodily Injury Personal and Advertising Injury andor Property Damage Liability Coverage combined to the sum of damages supplementary payments and defense costs because of bodily injury personal and advertising injury and property damage as a result of any one occurrence or offense regardless of the number of persons or organizations who sustain damages because of that occurrence or offense. The terms of this insurance including those with respect to a our right and duty to defend any suits seeking those damages and b your duties in the event of an occurrence offense claim or suit apply irrespective of the application of the deductible amount. We may pay any part or all of the deductible amount to effect settiement of any claim or suit and upon notification of the action taken you shall promptly reimburse us for such part of the deductible amount that has been paid by us. The deductible applies whether or not a payment for damages is made Defense Costs mean all expenses incurred in the investigation defense and settlement of any claim or suit under AES 3013 Ed. 0411 Page 2 of 3
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this policy including attorneys fees court reporter fees charges for independent medical examinations and expert witnesses provided such claim expense is incurred by us or with our prior written permission. Defense Costs will not include salaried employees counsel on retainer and office expense of either you or us. AES 3013 Ed. 0411 Page 3 of 3
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PL6420778 07 Great American ES Insurance Company Administrative Officos 301 E 4th Street GREATAMERICAN cincmation 45202 INSURANCE GROUP 513369 5000 ph GENERAL SERVICE OF SUIT ENDORSEMENT Not applicable in Delaware or Pennsylvania Great American ES Insurance Company AES 3012 Ed. 08 11 Pursuant to any statute of any state or district of the United States of America that makes provision therefor the Insurer hereby designates the commissioner superintendent or director of insurance or other officer specified for that purpose in the statute and his or her successors in office and duly authorized deputies as the Insurer s true and lawful attorney for service of legal process in any action suit or proceeding brought in the state where this Policy is issued by or on behalf of an insured or beneficiary against the Insurer arising out of the insurance issued under this Policy. Any legal process received by such attorney for service of legal process shall be forwarded except as provided below to the attention of Eve Cutler Rosen General Counsel Great American Insurance Company 301 E 4th Street Cincinnati Ohio 45202 4201. In California any legal process received by the Insurer s statutory attorney for service of process shall be forwarded to the attention of Nancy Flores The CT Corporation System 818 West Seventh Street Los Angeles California 90017 In the District of Columbia any legal process received by the Insurer s statutory attorney for service of process shall be forwarded to CT Corporation System 1015 15th Street NW Suite 1000 Washington DC 20005 In lllinois the Director at his or her option may forward a copy of the process to the Surplus Line Association of lllinois for delivery to the unauthorized insurer or may deliver the process to unauthorized insurer by another means which the Director considers to be reasonably prompt and certain. To be valid the process must state the names of the Insured and the unauthorized insurer and identify the contract of insurance. In Maine the Insurer hereby designates CT Corporation System as its attorney for service of legal process in any action relating to this Policy and directs that all legal process be mailed to CT Corporation System One Portland Square Portland Maine 04101. In Oregon the Insurer and the Insured policyholder hereby agree to waive the provisions of Oregon Insurance Code section 735.490 requiring that service of legal process in any action relating to this Policy shall be served on the insurance agent who registered or delivered this Policy and instead agree that such service of legal process be mailed directly to Eve Cutler Rosen General Counsel Great American Insurance Company 301 E 4th Street Cincinnati Ohio 45202 4201. In Rhode Island the Insurer hereby designates CT Corporation System as its attorney for service of legal process in any action relating to this Policy and directs that all legal process be mailed to CT Corporation System 10 Weybosset Street Providence Rhode Island 02903. The foregoing designations of attorney for service of legal process upon the Insurer shall not constitute a waiver of the Insurer s rights to remove remand dismiss or transfer any suit or proceeding from any court or to commence any suit or other proceeding in any court of competent jurisdiction. Dated 08012011 AES 3012 Ed. 0811
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERICAN Ginimaliof 5202 4201 INSURANCE GROUP 513 369 5000 ph Great American ES Insurance Company IL 72 68 Ed. 09 09 In Witness Clause In Witness Whereof we have caused this Policy to be executed and attested and if required by state law this Policy shall not be valid unless countersigned by our authorized representative. bre Cottn. e Qemot President Copyright Great American Insurance Co. 2009 IL7268DL 0909 IL 72 68 Ed. 0909 XS
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERTCAN. cincinnatioH 452024201 INSURANGE GROUP 513 369 5000 ph Great American ES Insurance Company IL 71 25 Ed. 0311 NAMED INSURED ENDORSEMENT It is agreed that the Named Insured shown in the Declarations is amended to read as follows Creative Consumer Concepts Inc. Creative Commons LLC C3 International LLC Nemo Ventures LLC Patriot Pillow LLC Water Gill LLC L7125 Ed. 0311 Page 1 0of 1
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERTCAN. cincinnatioH 452024201 INSURANGE GROUP 513 369 5000 ph Great American ES Insurance Company AES 3259 Ed. 0711 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO DESIGNATED ENTITIES This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL PRODUCTS LIABILITY COVERAGE FORM Schedule Per list of certificate holders on file Name of Entity Address of Entity Number of Days Notice of Cancellation 30 Days A. If we cancel this Policy for any reason other than for nonpayment of premium we will mail or deliver notice of the cancellation to the entity named in the above schedule at the address shown for that entity in the above schedule. B. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. C. If notice is mailed proof of mailing will be sufficient proof of notice. AES 3259 Ed. 0711 Page 1 0of 1
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PL6420778 07 Administrative Offices 301 E 4th Street GREATAMERTCAN. cincinnatioH 452024201 INSURANGE GROUP 513 369 5000 ph Great American ES Insurance Company CG 04 36 Ed. 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED PRODUCT WITHDRAWAL EXPENSE ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART Schedule Aggregate Limit 50000 Deductible Amount Per Product Withdrawal 5000 Participation Percentage Per Product Withdrawal Cut off Date 12012016 Information required to complete this Schedule if not shown above will be shown in the Declarations. THIS ENDORSEMENT ONLY PROVIDES REIMBURSEMENT TO YOU FOR EXPENSES INCURRED BECAUSE OF A COVERED PRODUCT WITHDRAWAL. THIS ENDORSEMENT DOES NOT PROVIDE ANY LIABILITY COVERAGE OR COVERAGE FOR THE COST OR EXPENSE OF DEFENDING ANY CLAIM OR SUIT. A. The following is added to SECTION COVERAGES SECTION LIMITED PRODUCT WITHDRAWAL EXPENSE COVERAGE 1. Insuring Agreement a. We will reimburse you for product withdrawal expenses incurred by you because of a product withdrawal to which this insurance applies. The amount of such reimbursement is limited as described in SECTION III LIMITS OF INSURANCE. No other obligation or liability to pay sums or perform acts or services is covered. b. This insurance applies to a product withdrawal only if the product withdrawal is initiated in the coverage territory during the policy period because 1 you determine that the product withdrawal is necessary or 2 an authorized government entity has ordered you to conduct a product withdrawal. c. We will reimburse product withdrawal expenses only if 1 the expenses are incurred within one year of the date the product withdrawal was initiated 2 the expenses are reported to us within one year of the date the expenses were incurred and Insurance Services Office Inc. 2012 Page 1 of 6 CG 04 36 Ed. 0413
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3 the product that is the subject of the product withdrawal was produced after the Cut off Date designated in the Schedule. d. The initiation of a product withdrawal will be deemed to have been made only at the earliest of the following times 1 when you first announced in any manner to the general public your vendors or to your employees other than those employees directly involved in making the determination your decision to conduct or participate in a product withdrawal. This applies regardless of whether the determination to conduct a product withdrawal is made by you or is requested by a third party or 2 when you first received either orally or in writing notification of an order from an authorized government entity to conduct a product withdrawal e. Product withdrawal expenses incurred to withdraw your products which contain the same or substantially similar defects will be deemed to have arisen out of the same product withdrawal. Exclusions This insurance does not apply to product withdrawal expenses arising out of Breach of Warranty and Failure to Conform to Intended Purpose Any product withdrawal initiated due to the failure of your product to accomplish its intended purpose including any breach of warranty of fitness whether written or implied. This exclusion does not apply if such failure has caused or is reasonably expected to cause bodily injury or physical damage to tangible property other than your product. Infringement of Copyright Patent Trade Secret Trade Dress or Trademark Any product withdrawal initiated due to copyright patent trade secret trade dress or trademark infringements Deterioration Decomposition or Chemical Transformation Any product withdrawal initiated due to transformation of a chemical nature deterioration or decomposition of your product. This exclusion does not apply if it is caused by 1 an error in manufacturing design or processing 2 transportation of your product or 3 product tampering. Goodwill Market Share Revenue Profit or Redesign The costs of regaining goodwill market share revenue or profit or the costs of redesigning your product. Expiration of Shelf Life Any product withdrawal initiated due to expiration of the designated shelf life of your product. Insurance Services Office Inc. 2012 Page 2 of 6 CG 04 36 Ed. 0413
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f. Known Defect A product withdrawal initiated because of a defect in your product known to exist by the Named Insured or the Named Insured s executive officers prior to the date when this Coverage Part was first issued to you or prior to the time your product leaves your control or possession. g. Otherwise Excluded Products A recall of any specific products for which bodily injury or property damage is excluded under Coverage A Bodily Injury and Property Damage Liability by endorsement. h. Governmental Ban A recall when your product or a component contained within your product has been 1 banned from the market by an authorized government entity prior to the policy period or 2 distributed or sold by you subsequent to any governmental ban i. Defense of Claim The defense of a claim or suit against you for liability arising out of a product withdrawal. J. Third party Damages Fines and Penalties Any compensatory damages fines penalties punitive or exemplary or other noncompensatory damages imposed upon the Insured. k. Pollution related Expenses Any loss cost or expense due to any 1 request demand order statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. B. For the purposes of this endorsement SECTION IlI LIMITS OF INSURANCE is replaced by the following SECTION Iil LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Schedule and the rules below fix the most we will pay regardiess of the number of a. insureds b. product withdrawals initiated or c. number of your products withdrawn The Aggregate Limit is the most we will reimburse you for the sum of all product withdrawal expenses incurred for all product withdrawals initiated during the policy period. Insurance Services Office Inc. 2012 Page 3 of 6 CG 04 36 Ed. 0413
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3. Deductible and Participation Percentage Provisions Deductible We will only pay for the amount of product withdrawal expenses which are in excess of the deductible amount if any shown in the Schedule of this endorsement. The deductible applies separately to each product withdrawal. The Limits of Insurance will not be reduced by the amount of this deductible. We may or will if required by law pay all or any part of any deductible amount if applicable. Upon notice of our payment of a deductible amount you shall promptly reimburse us for the part of the deductible amount we paid. Participation Percentage If a Participation Percentage is indicated in the Schedule of this endorsement the following provision applies You agree to participate in the payment of product withdrawal expenses which are in excess of the Deductible to the extent of the Participation Percentage indicated in the Schedule. The Participation Percentage will apply separately to each product withdrawal. You also agree that the cost of your participation in each product withdrawal when due and you will not obtain insurance to cover it. will be borne entirely by you The Limits of Insurance of Product Withdrawal Expense Coverage 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.. For the purposes of this endorsement the Duties in the Event of Occurrence Claim or Suit Condition under SECTION IV CONDITIONS is replaced by the following 2. Duties in the Event of a Defect or a Product Withdrawal You must see to it that we are notified as soon as practicable of any actual suspected or threatened defect in your product or any governmental investigation that may result in a product withdrawal. To the extent possible notice should include 1 how when and where the defect was discovered 2 the names and addresses of any injured persons and witnesses and 3 the nature location and circumstances of any injury or damage arising out of use or consumption of your product. If a product withdrawal is initiated you must 1 immediately record the specifics of the product withdrawal and the date it was initiated and 2 notify us as soon as practicable. You must see to it that we receive written notice of the product withdrawal as soon as practicable. Insurance Services Office Inc. 2012 Page 4 of 6 CG 04 36 Ed. 0413
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c. You must promptly take all reasonable steps to mitigate the expenses associated with a product withdrawal. Any profit that you receive from mitigating the expenses will be deducted from the amount of reimbursement that you will receive for product withdrawal expenses. d. You and any other involved insured must 1 immediately send us copies of pertinent correspondence received in connection with the product withdrawal 2 authorize us to obtain records and other information and 3 cooperate with us in our investigation of the product withdrawal.. For the purposes of this endorsement the following condition is added to SECTION IV CONDITIONS Concealment or Fraud We will not provide coverage under Section of this endorsement to you or any other insured who at any time 1. engaged in fraudulent conduct or 2. intentionally concealed or misrepresented a material fact concerning a product withdrawal or product withdrawal expenses incurred by you under Section of this endorsement. The following definitions are added to the Definitions section 1. Defect means a defect deficiency or inadequacy that creates a dangerous condition 2. Product tampering is an act of intentional alteration of your product which has caused or is reasonably expected to cause bodily injury or physical injury to tangible property other than your product When product tampering is known suspected or threatened a product withdrawal will be limited to those batches of your product which are known or suspected to have been tampered with. 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. 3. Product withdrawal means the recall or withdrawal a. from the market or b. from use by any other person or organization of your products or products which contain your products because of known or suspected defects in your product or known or suspected product tampering which has caused or is reasonably expected to cause bodily injury or physical injury to tangible property other than your product. 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 Insurance Services Office Inc. 2012 Page 5 of 6 CG 04 36 Ed. 0413
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disks CD ROMs tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. Product withdrawal expenses means those reasonable and necessary extra expenses listed below paid and directly related to a product withdrawal b. costs of notification costs of stationery envelopes production of announcements and postage or facsimiles costs of overtime paid to your regular nonsalaried employees and costs incurred by your employees including costs of transportation and accommodations costs of computer time costs of hiring independent contractors and other temporary employees costs of transportation shipping or packaging costs of warehouse or storage space or costs of proper disposal of your products or products that contain your products that can not be reused not exceeding your purchase price or your cost to produce the products. Profit means the positive gain from business operation after subtracting for all expenses. Insurance Services Office Inc. 2012 Page 6 of 6 CG 04 36 Ed. 0413
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PL6420778 07 Great American ES Insurance Company S EanSi ESG 3206 ree GRPAWIERIAN Ginginnati OH 45202 INSURANCE GROUP 513369 5000 ph THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ESG 3206 Ed. 0116 SPECIALTY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART This is a summary of the various additional coverages and coverage modifications provided by this endorsement. For complete details on specific coverages consult the Policy wording. Coverage Limit of Insurance Page Non Owned Aircraft Included 2 Non Owned Watercraft Included Medical Payments Increased Limits 20000 Who Is An Insured Broadened Named Insured Included Who Is An Insured Fellow Employee Included Who Is An Insured Newly Formed or Acquired Organizations Included Knowledge of Occurrence Claim or Suit Included Unintentional Errors Or Omissions Included Personal Advertising Injury Amendment of Discrimination or Included Humiliation Incidental Malpractice Liability Included Additional Insured Owners Lessees and Contractors Included Additional Insured Vendors Included Primary and Non Contributory Extension Included Damage to Premises Rented to You Fire Lightning and 500000 Explosion Waiver of Subrogation Included Property Damage Elevators Included 9 ESG 3206 Ed. 0116 Page 1 of 10
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PL6420778 07 Great American ES Insurance Company Coverage Limit of Insurance Page Contractual Liability for Railroad Exposures Included 10 Supplementary Payments Bail Bonds 10 Supplementary Payments Loss of Earnings 10 Amended Bodily Injury Definition Included 10 Non Owned Aircraft Under paragraph 2. Exclusions of SECTION COVERAGES Coverage A Bodily Injury and Property Damage Liability exclusion g. Aircraft Auto or Watercraft does not apply to an aircraft provided 1. itis not owned by any insured 2. itis hired chartered or loaned with a trained paid crew 3. the pilot in command holds a currently effective certificate issued by the duly constituted authority of the United States of America or Canada designating him or her a commercial or airline pilot and 4. itis not being used to carry persons or property for a charge. However the insurance afforded by this provision does not apply if there is available to the Insured other valid and collectible insurance whether primary excess other than insurance written to apply specifically in excess of this Policy contingent or on any other basis that would also apply to the loss covered under this provision. Non Owned Watercraft Under paragraph 2. Exclusions of SECTION COVERAGES Coverage A Bodily Injury and Property Damage Liability subparagraph 2 of exclusion g. Aircraft Auto or Watercraft is replaced by the following This exclusion does not apply to 2 A watercraft you do not own that is a less than 55 feet long and b not being used to carry persons or property for a charge. However the insurance afforded by this provision does not apply to watercraft 27 to 55 feet long if there is available to the Insured other valid and collectible insurance whether primary excess other than insurance written to apply specifically in excess of this Policy contingent or on any other basis that would also apply to the loss covered under this provision. ESG 3206 Ed. 0116 Page 2 of 10
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PL6420778 07 Great American ES Insurance Company C. Medical Payments Increased Limits Unless Coverage C Medical Payments or the Product Completed Operations Hazard has been excluded from this Policy the following applies Under paragraph 2. Exclusions of SECTION COVERAGES Coverage C Medical Payments exclusion f. Products Completed Operations Hazard is replaced by the following f. Product Completed Operations Hazard Included within the products completed operations hazard. However this exclusion does not apply to expenses for dental services. The Medical Expense Limit in paragraph 7. of SECTION Il LIMITS OF INSURANCE is replaced by the following Medical Expense Limit The Medical Expense Limit provided by this Policy shall be the greater of a. 20000 or b. the amount shown in the Declarations for Medical Expense Limit This provision 7. is subject to all the terms of SECTION IIl LIMITS OF INSURANCE Who Is An Insured Broadened Named Insured Under SECTION Il WHO IS AN INSURED the following item 2.e. is added e. Any subsidiary and subsidiary thereof of yours which is a legally incorporated entity of which you own a financial interest of more than 50 of voting stock on the effective date of this Coverage Part. The insurance afforded herein for any subsidiary not named in this Coverage Part as a Named Insured does not apply to injury or damage with respect to which an insured under this Coverage Part is also an insured under another policy or would be an insured under such policy but for its termination or the exhaustion of its Limits of Insurance. Who Is An Insured Fellow Employee 1. The following is added to paragraph 2.a.1 of SECTION Il WHO IS AN INSURED Paragraph a and b above do not apply to bodily injury or personal and advertising injury caused by a coemployee while in the course of his or her employment or performing duties related to the conduct of your business. However none of these coemployees are insureds for bodily injury or personal and advertising injury arising out of their willful conduct which is defined as the purposeful or willful intent to cause bodily injury or personal and advertising injury caused in whole or in part by their intoxication by liquor or controlled substances. Paragraph a and b above do not apply to bodily injury or personal and advertising injury caused by an employee who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the employee s job responsibilities assigned by you including the direct supervision of other employees of yours. However none of these employees are insureds for bodily injury or personal and advertising injury arising out of their willful conduct which is defined as the purposeful or willful intent to cause bodily injury or personal and advertising injury caused in whole or in part by their intoxication by liquor or controlled substances. This coverage is excess over any other valid and collectible insurance available to your employee r volunteer worker. ESG 3206 Ed. 0116 Page 3 of 10
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PL6420778 07 Great American ES Insurance Company F. Who Is An Insured Newly Formed or Acquired Organizations Paragraph 3. of SECTION Il WHO IS AN INSURED is replaced by the following 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. coverage under this provision is afforded only until the next occurring annual anniversary of the beginning of the policy period shown in the Declarations or the end of the policy period whichever is earlier and 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 and d. records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. Knowledge of Occurrence Claim or Suit Under SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS the following is added to Condition 2. Duties in the Event of Occurrence Offense Claim or Suit Knowledge of any occurrence claim or suit by any agent servant or employee of the Named Insured does not in itself constitute knowledge by the Insured unless notice of such occurrence claim or suit shall have been received by a. you if you are an individual b. apartner if you are a partnership or c. an executive officer or insurance manager if you are a corporation. Unintentional Errors or Omissions Under SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS the following is added to Condition 6. Representations If you unintentionally fail to disclose any hazards existing at the inception date of this Policy we will not deny coverage under this Coverage Form because of such failure. However this does not affect our right to collect additional premium exercise our right of cancellation or non renewal or enforce other legal rights based upon a material misrepresentation in response to a specific question in the application for this Policy. Personal and Advertising Injury Amendment of Discrimination or Humiliation Unless Coverage B Personal and Advertising Injury Liability is excluded from this Policy or does not apply the following applies Under SECTION V DEFINITIONS paragraph 14. Personal and Advertising Injury subparagraph h. is added ESG 3206 Ed. 0116 Page 4 of 10
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PL6420778 07 Great American ES Insurance Company h. discrimination or humiliation that results in injury to the feelings or reputation of a natural person but only if such discrimination or humiliation is 1 not done intentionally by or at the direction of a aninsured or b any executive officer director stockholder partner or member of the Insured and 2 not directly or indirectly related to the employment prospective employment or termination of employment of any person or persons by any insured. J. Incidental Malpractice Liability 1. SECTION Il WHO IS AN INSURED is amended by deleting item 2.a.1d in its entirety and replacing it with the following d Arising out of his or her providing or failing to provide professional health care services. However this exclusion does not apply to nurses emergency medical technicians or paramedics who are employed by you to provide medical or paramedical services. 2. Under SECTION V DEFINITIONS paragraph 3. Bodily Injury is replaced by the following 3. Bodily injury means injury sickness disease or incidental medical malpractice sustained by a person including death of a person. Bodily injury also means mental anguish mental injury or shock if directly resulting from physical injury sickness or disease to that person. 3. The following is added to SECTION V DEFINITIONS Incidental medical malpractice means bodily injury arising out of the negligent rendering or failure to render medical or paramedical services to persons by any physician dentist nurse emergency medical technician or paramedic who is employed by you to provide such services provided you are not engaged in the business or occupation of providing any services referred to in this definition. K. Additional Insured 1. Owners Lessees or Contractors a. SECTION Il WHO IS AN INSURED is amended to include as an additional insured 1 Any person or organization but only with respect to liability for bodily injury property damage or personal and advertising injury caused in whole or in part by a premises or equipment you own rent lease or occupy or b. your acts or omissions or c. the acts or omissions of those acting on your behalf In the performance of your ongoing operations for the additional insured. However a the insurance afforded to such additional insured only applies to the extent permitted by law and ESG 3206 Ed. 0116 Page 5 of 10
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PL6420778 07 0778 07 Great American ES Insurance Company b. if coverage provided to the Additional Insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b. With respect to the insurance afforded to these additional insureds the following additional exclusions apply 1 This insurance does not apply to bodily injury or property damage occurring after a all work including materials parts or equipment furnished in connection with such work on the project other than service maintenance or repairs to be performed by or on behalf of the additional insured at the location of the covered operations has been completed or b. that portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. 2 The insurance provided to any additional insured does not apply to bodily injury property damage or personal and advertising injury arising out of an architect s engineer s or surveyor s rendering of or failure to render any professional services including a The preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b. Supervisory inspection architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that Insured if the occurrence which caused the bodily injury or property damage or the offense which caused the personal and advertising injury involved the rendering or the failure to render any professional services by or for you. c. With respect to the insurance afforded to these Additional Insureds the following is added to SECTION IIl LIMITS OF INSURANCE If coverage provided to the Additional Insured is required by a contract or agreement the most we will pay on behalf of the Additional Insured is the amount of insurance 1 Required by the contract or agreement or 2 Available under the applicable Limits of Insurance shown in the Declarations Whichever is less. 2. Vendors a. SECTION Il WHO IS AN INSURED is amended to include as an additional insured 1 Any person or organization referred to below as vendor but only with respect to bodily injury or property damage arising out of your products which are distributed or sold in the regular course of the vendor s business. However ESG 3206 Ed. 0116 Page 6 of 10
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PL6420778 07 0778 07 Great American ES Insurance Company c. a. the insurance afforded to such vendor only applies to the extent permitted by law and b. 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 unless 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 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 by the vendor in full compliance with the manufacturer s written instructions 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 h. bodily injury or property damage arising out of the sole negligence of the vendors for its own acts or omission of those of its employees or anyone else acting on its behalf. However this exclusion does not apply to i the exceptions contained in subparagraphs d. or f. or ii 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.. is insurance does not apply to any insured person or organization from whom you have 2. Th d I i d izati f h hi acquired such products or any ingredient part or container entering into accompanying or containing such products. With respect to the insurance afforded to these vendors the following is added to SECTION IIl LIMITS OF INSURANCE If coverage provided to the vendor is required by a contract or agreement the most we will pay on behalf of the vendor is the most amount of insurance 1 Required by the contract or agreement or ESG 3206 Ed. 0116 Page 7 of 10
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