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PROOF OF INSURANCE (2023) CLOSED." NBSGOVE-01 CERTIFICATE OF LIABILITY INSURANWCWE _�_....„°A7,�sizoz)ww THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). � W ...... PRODUCER License # OL48969 coNrAcr .. C3 Risk & Insurance Services PHONE,9 FAx 404 Camino Del Rio S. STE 410 LAIC,No, Ext): (61) 233-8 000 A/C No) (619) 864 7106 ............... ..- _. 9 I 63, ._'_.y@!. urance corn San Diego, CA 92108 ollc3ms INSURED NBS Government Finance Group 32605 Temecula Parkway, Suite 100 Temecula, CA 92592 F'. TH COVERAGE'S CERTIFICATE NUMBER: REVISION NUMBER:. ......m........_...._._.., ._.._., .�................... .._..................................�.__.. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -- VD_----------_.-_._............................_,...,......,.,. INSR TYPE SUBR POLICY NUMBER LTRA INSD ..,.,.P,Ol,-.........._._....-........................._.................................................................................. POLICY EFF POLICY EXP LIMITS dl�IBlI�.1_.tI�I9(O.OYJ.... .... _....... .........._.. X COMMERCIALOGENERAL LIABILITY EACH occuRRFNCE � $ 2,000,000 CLAIMS -MADE OCCUR OH3A43196309 DAMAGE TO RENTEDI, 9/24/2022 9/24/2023 II FSIf I VrIO?. 300 000 MmE FXP„LAny„one yerson�S 10,000 ... Rso�uu,Apvlr�Ju�Y 2,000,000 ENI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4 000 000 X POLICY D .Rdn � ❑ LOG �I�,onUcTG.. coma✓O� A� $ w 4,000,000 OTHER $ A AUTOMOBILE LIABILITY ............. �x.�+0108�IN�qEDnnSINGLE. LIMIT ( .lteala, nwpb,Y'ti--------- ----- . ............ ... 1,000,000 ........ __. X ANY AUTO AH3A42745811 .......... .., ...... 9/24/2022 9/24/2023 INJURY OWNED SCHEDULED _430DII.Y -- AUTOS ONLY AUTOS BODILY INJ RX (Perpq; d , _... E� hh9OS��y AUTOS ''Al"I�ID�1"dL�b ......... ONLY ............... --�lo�,i���uI,AAGE..,.rc ...,._�. -------- $ A X UMBRELLA LIAB X OCCUR EACH OCCLIRRENCE $ 1,000,000 EXCESS LIAB CLAIMS -MADE �'. OH3A43196309 9/24/2022 9/24/2023 _. AGGREGATE -- 1,000,000 ...... c! X RETENTION $ a _$ $ ... _.... ........... B WORKERS COMPENSATION PER OTH- XLL+.TIJTE AND EMPLOYERS' LIABILITYYIN WD3A427457 —_-__R__-_ 9/24/2022 9/24/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? Lmm N / A N°° ,EL E.4CHACCIDENT $ ------ ------ ..(Mandatory in NH) .BL O1S,EASE EA,EMPA.OVEE, $. 1 000,000 If yes, describe under C 1000000 DESCRIPTION OF OPERATIONS below C E8�0 Professional Lia VNPLO10991WWWWWWWW uWWWWWWWWWWWWWWWWWW E L DISEASE • POLICY LIMIT $ 9/24/2022 9/24/2023 Ea. Claim/Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Add4ional Ramarks Schedule, maybeattached if more spacer Is reKkulred) ...... Additional insureds are included as/where required by written contract as respects to General Liability„ Auto Liability; General Liability Primary Non - Contributory wording; Auto Liability Primary Non -Contributory wording, General Liability waiver of subrogation, Auto Liability waiver of subrogation, Workers Compensation waiver of subrogation, but limited to the operations of the Insured under said contract, and always subject to all the policy terms, conditions and exclusions per endorsements attached. *THIS CERTIFICATE CANCELS AND SUPERSEDES ANY CERTIFICATE PREVIOUSLY ISSUED' Blanket forms apply when required by written contract: GENERAL LIABILITY: SEE ATTACHED ACORD 101 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of El Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY 9 ACCORDANCE WITH THE POLICY PROVISIONS. 350 Main Street El Segundo, CA 90245 - .... .... AUTHORIZED REPRESENTATIVE 41 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: NBSGOVE-01 ROBLY2 LOC # 7 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY License # OL48969 NAMED INSURED 3 Risk & Insurance Services NBS Government Finance Group �'326105 Temecula Parkway, Suite 100 POLICY NUMBER ]Temecula, CA 92892 SEE PAGE 1 CARRIER NAIC CODE EE PAGE ....1 SEE P 1 EFFECTIVE DATE:... GE 1 SEE PA ADDITIONAL REMARKS ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: 01-13A43196309 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSOWNERS LIABILITY SPECIAL BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM ........ ........ ...�.............. SUMMARY OF COVERAGES Limits Page 1. µAdditional Insured byµContract, Agreement or, Permit ----------....- mmmmmmmmmmm Included. _mmmmITITITITm 2.mmmmmmmAdd tITonalITInsured-mmBroad Form Vendors Included 2 ..................................................................... _ 3. Alienated Premises ....................................................................................................... Included 3 4. Broad Form Property mDamage mmm-mmBorrowed mmEquipment, mmCustomers Includedmmm mmmm mmmmm 3mmmmm Goods and Use of Elevators ._........................... .............................. 5. Incidental Malpractice (Employed Nurses, EMT's and Paramedics) ....... ....... --........................... Included --- ......... ................ 3 dd 6. Personal and Avertising Injury - Broad Form ..................................................._............. Include 4 7. µProduct Recall Expense Included 4 ProductRecallExpenseEachOccurrence Limit $25,000 5 Occurrence .............................................................................................................................................................................................................................................................._. Product Recall Expense Aggregate Limit $50,000 5 µDeductible � ........._..._._���.-mITm Aggregate ....._....�.._... Product Recall $500 5 -n................rr..r.__rrr. — --- tional Failure to Disclose Hazards 8. Unintentional -------- Included --------- —.. 6 9. Unintentional Failure to Notify Included 6 This endorsement amends coverages provided under the Businessowners Coverage Form through new coverages and broader coverage grants. This coverage is subject to the provisions applicable to the Businessowners Coverage Form, except as provided below. The following changes are made to SECTION II - LIABILITY: 1. Additional Insured by Contract, Agreement or Permit The following is added to SECTION II - LIABILITY, C. Who Is An Insured: Additional Insured by Contract, Agreement or Permit a. Any person or organization with whom you agreed in a written contract, written agreement or permit to add such person or organization as an additional insured on your policy is an additional insured 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, but only with respect to: (1) "Your work" for the additional insured(s) designated in the contract, agreement or permit; (2) Premises you own, rent, lease or occupy; or (3) Your maintenance, operation or use of equipment leased to you. b. The insurance afforded to such additional insured described above: (1) Only applies to the extent permitted by law; and (2) Will not be broader than the insurance which you are required by the contract, agreement or permit to provide for such additional insured. (3) Applies on a primary basis if that is required by the written contract, written agreement or permit. (4) Will not be broader than coverage provided to any other insured. (5) Does not apply if the "bodily injury", "property damage" or "personal and advertising injury" is otherwise excluded from coverage under this Coverage Part, including any endorsements thereto. 391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Pagel 06 Policy Number: 01-13A43196309 c. This provision does not apply: (1) Unless the written contract or written agreement was executed or permit was issued prior to the "bodily injury" °"property damage", or "personal injury and advertising injury"". (2) To any person or organization included as an insured by another endorsement issued by us and made part of this Coverage Part. (3) To any lessor of equipment: (a) After the equipment lease expires; or (b) If the "bodily injury", "property damage", "personal and advertising injury" arises out of sole negligence of the lessor. (4) To any: ar1w, nover Insurance Group_ OH3 A431963 1001678 The most we will pay on behalf of the additional insured for a covered claim is the lesser of the amount of insurance: 1. Required by the contract, agreement or permit described in Paragraph a.; or 2. Available under the applicable Limits of Insurance shown in the Declarations. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations e. All other insurinaa� agreements, exclusions, and conditions of t%ie policy apply. 2. Additional Insured - Broad Form Vendors The following is added to SECTION II - LIABILITY, C. Who Is An Insured: Additional Insured - Broad Form Vendors (a) Owners or other interests from whom a. land has been leased if the "occurrence" takes place or the offense is committed after the lease for the land expires; or (b) Managers or lessors of premises if: (1) The "occurrence" takes place or the offense is committed after you cease to be a tenant in that premises; or (ii) The "bodily injury""property damage"", ""personal Injury' or "advertising Injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor. (5) To "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employmient, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" or the offense which caused the "personal and advertising injury" involved the rendering of or failure to render any professional services by or for you. d. With respect to the insurance afforded to these additional insureds, the following is addedto SECTION II - LIABILITY, D. Liability and Medical Expense Limits of Insurance: Any person or organization that is a vendor with whom you agreed in a written contract or written agreement to include as an additional insured under this Coverage Part is an insured, but only with respect to liability for "bodily Injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. b. The insurance afforded to such vendor described above: (1) Only applies to the extent permitted by law; (2) Will not be broader than the insurance which you are required by the contract or agreement to provide for such vendor; (3) Will not be broader than coverage provided to any other insured; and (4) Does not apply if the "bodily injury", "property damage" or "personal and advertising injury" is otherwise excluded from coverage under this Coverage Part, including any endorsements thereto c. With respect to insurance afforded to such vendors, the following additional exclusions apply: The insurance afforded to the vendor does not apply to: (1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reasons of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; 391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 2 of 6 Policy Number: 01-13A43196309 (3) Any physical or chemical change in the product made intentionally by the vendor; (4) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instruction from the manufacturer, and then repackaged in the original container; (5) Any failure to make such inspection, 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 sale of the product; (6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; (8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (a) The exceptions contained within the exclusion in subparagraphs (4) or (6) above; or (b) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (9) "Bodily injury" or "property damage" arising out of an "occurrence" that took place before you have signed the contract or agreement with the vendor. (10)To any person or organization included as an insured by another endorsement issued by us and made part of this Coverage Part. (11)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. The most we will pay on behalf of the vendor for a covered claim is the lesser of the amount of insurance: 1. Required by the contract or agreement described in Paragraph a.; or 2. Available under the applicable Limits of Insurance shown in the Declarations; This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 3. Alienated Premises SECTION II - LIABILITY, B. Exclusions, 1. Applicable To Business Liability Coverage k. Damage to Property, paragraph (2) is replaced by the following: (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises and occurred from hazards that were known by you, or should have reasonably been known by you, at the time the property was transferred or abandoned. 4. Broad Form Property Damage - Borrowed Equipment, Customers Goods, Use of Elevators a. The following is added to SECTION II - LIABILITY, B. Exclusions, 1. Applicable To Business Liability Coverage, k. Damage to Property: Paragraph (4) does not apply to "property damage" to borrowed equipment while at a jobsite and not being used to perform operations. Paragraph (3), (4) and (6) do not apply to "property damage" to "customers goods" while on your premises nor to the use of elevators. b. For the purposes of this endorsement, the following definition is added to SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions: 1. "Customers goods" means property of your customer on your premises for the purpose of being: a. Worked on; or b. Used in your manufacturing process. c. The insurance afforded under this provision is excess over any other valid and collectible property insurance (including deductible) available to the insured whether primary, excess, contingent or on any other basis. 5. Incidental Malpractice - Employed Nurses, EMT's and Paramedics d. With respect to the insurance afforded to SECTION II - LIABILITY, C. Who Is An Insured, these vendors, the following is added to paragraph 2.a.(1)(d) does not apply to a nurse, SECTION II - LIABILITY, D. Liability and Medical Expense Limits of Insurance: 391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 3 of 6 Policy Number: OH3A43196309 emergency medical technician or paramedic employed by you if you are not engaged in the business or occupation of providing medical, paramedical, surgical, dental, x-ray or nursing services. 6. Personal Injury - Broad Form a. SECTION II - LIABILITY, B. Exclusions, 2. Additional Exclusions Applicable only to "Personal and Advertising Injury", paragraph e. is deleted. b. SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions, 14. "Personal and advertising injury", paragraph b. is replaced by the following: b. Malicious prosecution or abuse of process. c. The following is added to SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions, Definition 14. "Personal and advertising injury": "Discrimination" (unless insurance thereof is prohibited by law) that results in injury to the feelings or reputation of a natural person, but only if such "discrimination" is: (1) Not done intentionally by or at the direction of: (a) The insured; (b) Any officer of the corporation, director, stockholder, partner or member of the insured; and (2) Not directly or indirectly related to an "employee", not to the employment, prospective employment or termination of any person or persons by an insured. d. For purposes of this endorsement, the following definition is added to SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions: 1. "Discrimination" means the unlawful treatment of individuals based upon race, color, ethnic origin, gender, religion, age, or sexual preference. "Discrimination" does not include the unlawful treatment of individuals based upon developmental, physical, cognitive, mental, sensory or emotional impairment or any combination of these. e. This coverage does not apply if liability coverage for "personal and advertising injury" is excluded either by the provisions of the Coverage Form or any endorsement thereto. A 043,4431963 1001678 o. Recall of Products, Work or Impaired Property is replaced by the following: o. Recall of Products, Work or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (1) "Your product"; (2) "Your work"; or (3) "Impaired property"; If such product, work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it, but this exclusion does not apply to "product recall expenses" that you incur for the "covered recall" of "your product". However, the exception to the exclusion does not apply to "product recall expenses" resulting from: (4) Failure of any products to accomplish their intended purpose; (5) Breach of warranties of fitness, quality, durability or performance; (6) Loss of customer approval, or any cost incurred to regain customer approval; (7) Redistribution or replacement of "your product" which has been recalled by like products or substitutes; (8) Caprice or whim of the insured; (9) A condition likely to cause loss of which any insured knew or had reason to know at the inception of this insurance; (10)Asbestos, including loss, damage or clean up resulting from asbestos or asbestos containing materials; or (11)Recall of "your products" that have no known or suspected defect solely because a known or suspected defect in another of "your products" has been found. b. The following is added to SECTION II - LIABILITY, C. Who Is An Insured, paragraph 3.b.: 7. Product Recall Expense "Product recall expense" arising out of any a. SECTION II - LIABILITY, B. Exclusions, 1. withdrawal or recall that occurred before you Applicable To Business Liability Coverage, acquired or formed the organization. 391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission, Page 4 of 6 Policy Number: OH3A43196309 c. The following is added to SECTION II - LIABILITY, D. Liability and Medical Expenses Limits of Insurance: Product Recall Expense Limits of Insurance a. The Limits of Insurance shown in the SUMMARY OF COVERAGES of this endorsement and the rules stated below fix the most that we will pay under this Product Recall Expense Coverage regardless of the number of: (1) Insureds; (2) "Covered Recalls" initiated; or (3) Number of "your products" withdrawn. b. The Product Recall Expense Aggregate Limit is the most that we will reimburse you for the sum of all "product recall expenses" incurred for all "covered recalls" initiated during the policy period. c. The Product Recall Each Occurrence Limit is the most we will pay in connection with any one defect or deficiency. d. All "product recall expenses" in connection with substantially the same general harmful condition will be deemed to arise out of the same defect or deficiency and considered one "occurrence". e. Any amount reimbursed for "product recall expenses" in connection with any one "occurrence" will reduce the amount of the Product Recall Expense Aggregate Limit available for reimbursement of "product recall expenses" in connection with any other defect or deficiency. f. If the Product Recall Expense Aggregate Limit has been reduced by reimbursement of "product recall expenses" to an amount that is less than the Product Recall Expense Each Occurrence Limit, the remaining Aggregate Limit is the most that will be available for reimbursement of "product recall expenses" in connection with any other defect or deficiency. g. Product Recall Deductible We will only pay for the amount of "product recall expenses" which are in excess of the $500 Product Recall Deductible. The Product Recall Deductible applies separately to each "covered recall". 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. The Product Recall Expense Limits of Insurance 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 the purposes of determining the Limits of Insurance. d. The following is added to SECTION II - LIABILITY, E. Liability and Medical Expense General Conditions, 2. Duties in the Event of Occurrence, Offense, Claim or Suit: You must see to it that the following are done in the event of an actual or anticipated "covered recall" that may result in "product recall expense": (1) Give us prompt notice of any discovery or notification that "your product" must be withdrawn or recalled. Include a description of "your product" and the reason for the withdrawal or recall; (2) Cease any further release, shipment, consignment or any other method of distribution of like or similar products until it has been determined that all such products are free from defects that could be a cause of loss under this insurance. e. For the purposs of this endorsement, the following definitions are added to SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions: 1. "Covered recall" means a recall made necessary because you or a government body has determined that a known or suspected defect, deficiency, inadequacy, or dangerous condition in "your product" has resulted or will result in "bodily injury" or "property damage". 2. "Product recall expense(s)" means: a. Necessary and reasonable expenses for: (1) Communications, including radio or television announcements or printed advertisements including stationary, envelopes and postage; 391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 5 of 6 Policy Number: OH3A43196309 (2) Shipping the recalled products from any purchaser, distributor or user to the place or places designated by you; (3) Remuneration paid to your regular "employees" for necessary overtime; (4) Hiring additional persons, other than your regular "employees"; (5) Expenses incurred by "employees" including transportation and accommodations; or w► *� rr (1) If the "products - completed operations hazard" is excluded from coverage under this Coverage Part including any endorsement thereto; or (2) To "product recall expense" arising out of any of "your products" that are otherwise excluded from coverage under this Coverage Part including endorsements thereto. 8. Unintentional Failure to Disclose Hazards (6) Expenses to rent additional warehouse or storage space; (7) Disposal of "your product", but only to the extent that specific methods of destruction other than those employed for trash discarding or disposal are 9. required to avoid "bodily injury" or "property damage" as a result of such disposal, you incur exclusively for the purpose of recalling "your product"; and b. Your lost profit resulting from such "covered recall". f. This Product Recall Expense Coverage does not apply: The following is added to SECTION II - LIABILITY, E. Liability and Medical Expenses General Conditions: Representations We will not disclaim coverage under this Coverage Part if you fail to disclose all hazards existing as of the inception date of the policy provided such failure is not intentional. Unintentional Failure to Notify The following is added to SECTION II - LIABILITY, E. Liability and Medical Expenses General Conditions, 2. Duties in the Event of Occurrence, Offense, Claim or Suit: Your rights afforded under this Coverage Part shall not be prejudiced if you fail to give us notice of an "occurrence", offense, claim or "suit", solely due to your reasonable and documented belief that the "bodily injury", "property damage"' or "personal and advertising injury" is not covered under this Policy. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 391-1006 08 16 Includes copyrighted materials of Insurance Services Offices, Inc., with its permission. Page 6 of 6 Policy Number: OH3A43196309 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Name Of Person Or Organization I Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION AS REQUIRED I BY CONTRACT (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) For the purpose of coverage provided by this endorsement, the following changes are made to SECTION II - LIABILITY: A. The following is added to SECTION II - LIABILITY, C. Who Is An Insured: Any person or organization shown in the Schedule above is also an additional insured, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule above, performed for that additional insured and included in the "products -completed operations hazard". However: 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. The following is added to SECTION II - LIABILITY, D. Liability And Medical Expenses 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; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the by law; and applicable Limits of Insurance shown in the 2. If coverage provided to the additional Declarations. insured is required by a contract or ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED, 391-1602 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Policy Number: OH3A43196309 1. SECTION I - PROPERTY, if two or more of this coverage part's coverages apply to the same loss or damage, we will not pay more than the actual amount of the loss or damage. 2. SECTION II - LIABILITY, it is our stated intent that the various Coverage Parts, forms, endorsements or policies issued to the named insured by us, or any company affiliated with us, do not provide any duplication or overlap of coverage for the same claim, "suit", "occurrence", offense, accident, "wrongful act" or loss. We will not pay more than the actual amount of the loss or damage. If this Coverage Part and any other Coverage Part, form, endorsement or policy issued to the named insured by us, or any company affiliated with us, apply to the same claim, "suit", occurrence, offense, accident, "wrongful act" or loss, the maximum Limit of Insurance under all such Coverage Parts, forms, endorsements or policies combined shall not exceed the highest applicable Limit of Insurance under any one Coverage Part, form, endorsement or policy. This condition does not apply to any Excess or Umbrella Policy issued by us specifically to apply as excess insurance over this policy. G. Liberalization If we adopt any revision that would broaden the coverage under this policy without additional premium within 45 days prior to or during the policy period, the broadened coverage will immediately apply to this policy. H. Other Insurance 1. SECTION I -PROPERTY If there is other insurance covering the same loss or damage, we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance, whether you can collect on it or not. But, we will not pay more than the applicable Limit of Insurance of SECTION I - PROPERTY. 2. SECTION II - LIABILITY If other valid and collectible insurance is available to the insured for a loss we cover under SECTION II - LIABILITY, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in paragraph c. below. T}rc in r 4N,]nsurar�c ter r�'P. OH3 A431963 1 GO1678 However, if you agree in a written contract, written agreement, or written permit that the insurance provided to any person or organization included as an Additional Insured under this Coverage Part is primary and non-contributory, we will not seek contribution from any other insurance available to that Additional Insured which covers the Additional Insured as a Named Insured except: (1) For the sole negligence of the Additional Insured; or (2) When the Additional Insured is an Additional Insured under another liability policy. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (b) That is Property Insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to SECTION II - LIABILITY, Exclusion g. Aircraft, Auto or Watercraft; and (2) Any other primary insurance available to you covering liability for damages arising out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured by attachment of an endorsement. When this insurance is excess, we will have no duty under SECTION II - LIABILITY to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the 391-1003 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 79 of 81 Policy Number: OH3A43196309 insured's rights against all those other insurers. c. 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. d. We will share the remaining loss, if any, with any other insurance that is not described in this provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations for this Coverage. e. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable Limit of Insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable Limit of Insurance to the total applicable limits of insurance of all insurers. f. When this insurance is excess, we will have no duty under Business Liability Coverage 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. I. Premiums 1. The first Named Insured shown in the Declarations: a. Is responsible for the payment of all premiums; and b. Will be the payee for any return premiums we pay. 2. The premium shown in the Declarations was computed based on rates in effect at the time the policy was issued. On each renewal, continuation or anniversary of the effective date of this policy, we will compute the premium in accordance with our rates and rules then in effect. 3. With our consent, you may continue this policy in force by paying a continuation premium for each successive one-year period. The premium must be: a. Paid to us prior to the anniversary date; and b. Determined in accordance with paragraph 2. above. Our forms then in effect will apply, If you do not pay the continuation premium, this policy will expire on the first anniversary date that we have not received the premium. 4. Undeclared exposures or change in your business operation, acquisition or use of locations may occur during the policy period that is not shown in the Declarations. If so, we may require an additional premium. That premium will be determined in accordance with our rates and rules then in effect. J. Premium Audit 1. This policy is subject to audit if a premium designated as an advance premium is shown in the Declarations. We will compute the final premium due when we determine your actual exposures. 2. Premium shown in this policy 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 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. 3. 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. K. Transfer of Rights of Recovery Against Others to Us Applicable to SECTION I - PROPERTY Coverage: If any person or organization to or for whom we make payment under this policy has rights to recover damages from another, those rights are transferred to us to the extent of our payment. That person or organization must do everything necessary to secure our rights and must do nothing after loss to impair them. But you may waive your rights against another party in writing: 391-1003 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 80 of 81 Policy Number: OH3A43196309 a. Prior to a loss to your Covered Property. b. After a loss to your Covered Property only if, at time of loss, that party is one of the following: (1) Someone insured by this insurance; (2) A business firm: (a) Owned or controlled by you; or (b) That owns or controls you; or (3) Your tenant. You may also accept the usual bills of lading or shipping receipts limiting the liability of carriers. This will not restrict your insurance. 2. Applicable to SECTION II - LIABILITY Coverage: 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 such rights. At our request, the insured will bring "suit' or transfer those rights to us and help us enforce them. Hii ■ �dror M lrasur�a,r�c rn �P— OH3A431963 1001678 We waive any right of recovery we may have against any person or organization with whom you have a written contract, permit or agreement to waive any rights of recovery against such person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This condition does not apply to Medical Expenses Coverage. L. Transfer of Your Rights and Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual Named Insured. If you die, your rights and duties will be transferred to your legal representative but only while that legal representative is acting within the scope of their duties as your legal representative. Until your legal representative is appointed, anyone with proper temporary custody of your property will have your rights and duties but only with respect to that property. 391-1003 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 81 of 81 POLICY NUMBER: AH3A4274581 l COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 09/24/2022 CountersiQ,ned BY: Named Insured: NBS GOVERNMENT FINANCE Authorized Representative) SCHEDULE Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION WHEN REQUIRED BY A WRITTEN CONTRACT, WRITTEN AGREEMENT OR PERMITT. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applica- ble to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 13 Policy Number.AH3A42745811 110110 [IODDROOMOOD 710000110 DOO JOLMIYE1011-00110 ROOD IM DORDIDOLLYD FATCYAJ I Ll 6*1 M 1:4 ZJ:2 j[*]t1RjJTjT 11 I ir M. D -d[ V1 B I I 1 11.1 0 A[J M MII.J101... ... L.] E]rl- nd Ed u Ed -r Ell 111 II F.1 I IMEI DOO[MOOD FIFIDO OF-1001ROOD DORM OODUDOO F.K.1011-1 OF.IYOn.0EIII DDIMIDOO DIIIIIERIIIIII DDIFZIM I I oll?[ Inn [11 11 101IRD In 1 11 1 li:w M I 100 F? I I nFZFZl EIIIR I I I I I I I RO 0 r..] 00 FRIM FRODODRO 000FIRDOO 001IRIM 1.1 IMI rl lN..J1U I-11 I II ID'HU [III Hd[d IV 1111.111 11 di Ir1 IN 11 1111,1 Ill I r 11 1rI111111irr if I L III IIN I I'll ID'I 11 11 1 f l[Il I III Illy uMl T I 11 &Fld I �y 11111 111 dl irl'! 1111111111), PI Ell r J dltl 111M 111111111 TllI TI 11111 I uI ii-iry rum mm iii I ml I lil I II11111 (1111111 IlJIMI 1 1 lk74 ul il 111H III 11-IM11 Ir dI IfI El IIM11111111d I 'I I L 11 Named Insured: 000 0 0 001IROM01 10 F..1HB01I(10 DIF?l F] n Endorsement Effective Date: 01 F2[12022 SCHEDULE Name(s) Of Person(s) Or Organization(s): ODY DOROOD OR OROOD=EODO 0 000 ROOO[ROD DY 11 0 R11DEED DODER01 Information required to complete this Schedule, if not shown above, will be shown in the Declarations au Transfejr.r Of Flights Of Recovery Against Otheirs To Us 000JUu1111 dEIEEI❑ El 10 DDIJy ED EOO I D"000111. I I Er DT. BEIIJBIJE.10LUDO DOM.... F.1 qD E100 0 F.101.1dull F.1 F..-.0 0 OUY ED COO O= I EDEE10I F 1.11111D Ell DOM F.K.Mr, F..fl I F..fl 10 " DEDA 01 0 Or [M I[ ]In 1, Ul di V 0 [11 1[ 1.11D 101 1 D.E.] EUMI 11111111 1 Ir 111 DE1.11.11FUME111 Page 1 of I 461-0500 11 13 MudM... I I I M... 11:9:Ur= 11131 E."IM. 0 11 IM Q 1::::) F.n.f.1 DD I M 111 TIM POLICY NUMBER: AH3A42745811 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. The following is added to SECTION II — LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured: Additional Insured if Required by Contract If you agree in a written contract, written agreement or written permit that a person or organization be added as an additional "insured" under this Coverage Part, such person or organization is an "insured"; but only to the extent that such person or organization qualifies as an "insured" under paragraph A.1.c. of this Section. If you agree in a written contract, written agreement or written permit that a person or organization be added as an additional "insured" under this Coverage Part, the most we will pay on behalf of such additional "insured" is the lesser of: (1) The Limits of Insurance for liability coverage specified in the written contract, written agreement or written permit; or (2) The Limits of Insurance for Liability Coverage shown in the Declarations applicable to this Coverage Part. Such amount shall be part of and not in addition to the Limits of Insurance shown in the Declarations applicable to this Coverage Part. Regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident", the most we will pay for the total of all damages and "covered pollution cost or expense" combined resulting from any one "accident" is the Limit of Insurance for Liability Coverage shown in the Declarations. B. The following is added to SECTION IV — BUSINESS AUTO CONDITIONS, Paragraph B. General Conditions, subparagraph 5. Other Insurance: Primary and Non -Contributory If you agree in a written contract, written agreement or written permit that the insurance provided to a person or organization who qualifies as an additional "insured" under SECTION II — LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured, subparagraph Additional Insured if Required by Contract is primary and non- contributory, the following applies: The liability coverage provided by this Coverage Part is primary to any other insurance available to the additional "insured" as a Named Insured. We will not seek contribution from any other insurance available to the additional "insured" except: (1) For the sole negligence of the additional "insured"; or (2) For negligence arising out of the ownership, maintenance or use of any "auto" not owned by the additional "insured" or by you, unless that "auto" is a "trailer' connected to an "auto" owned by the additional "insured" or by you; or (3) When the additional "insured" is also an additional "insured" under another liability policy. C. This endorsement will apply only if the "accident" occurs: 1. During the policy period; 2. Subsequent to the execution of the written contract or written agreement or the issuance of the written permit; and 3. Prior to the expiration of the period of time that the written contract, written agreement or written permit requires such insurance to be provided to the additional "insured". D. Coverage provided to an additional "insured" will not be broader than coverage provided to any other "insured" under this Coverage Part. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED, Page 1 of 1 461-0478 12 12 Includes copyrighted material of ISO Insurance Services Office, Inc., with its permission Policy Number: AH3A42745811 110 1.1 1 11 111 ) El 1R El D 10 F1 0 0 Ell El 0 0 El 0 0 01 1 [1 0 0 1 Eflyo Lj1l 0000 IFRI 11 ID 110 1 LLY [ I BUSINESS AUTO COVERAGE BROADENING ENDORSEMENT F.❑)DIJ11 ElEd I rl E 1011111 1 El Ed MM I EJEUN ]01 IF.] EIr-1 Udl d W d[ r U.I.T. I U11l01.Ifflil IF] BUSINESS AUTO COVERAGE FORM 0 1110 rU p11 11 El [III E)EIEll ra:l I 1-Iro[ Id d Ey l[f In 1.m DOE] R )0 1❑IrOEOL1111 11 Ell ]EIE1 1E)[11TOOD 111 11 On ly UFJEII IF.] El Ed [11.11.d Ey [ EF OEd I f0l 11 101 11.0 10 CANCELLATION EXTENSION DErDErOOO A. CANCELLATION 2. bOEE= COMMON POLICY CONDITIONS IM rO11 DOOd 0 M = MI Ell MO DO [10 d DID OEIMTO EDO OM00a] d DED OOEOOE1E1I= =11 OODOEI Er OI)f 011a rOODEDO SECTION I - COVERED AUTOS 20 EMPLOYEE HIRED "AUTOS" Description Of Covered Auto Designation Symbols; Symbol 8 M1 rODOOOd 4 EDO MIDDIIEED "DUEU E] El y F.1 0 F-1 y [10. 1 00 " "I UE1 J( I' y ED II Ol f I.E.), ElUr.,T::::.1 rF.1FJ1:::]F.1r 01 Irrl❑1. E I D. P... 1. 1 ludEflE.] U[..[fT P yFbir, F 11 1 11 Ey A I OE..y[.Uir dUrIDEID ]]F 1, P..flr M.l:::::l Our, DI I I 111 IF..❑]EII du =F] y I Uir U [ I[M 1-111 1 Ell 111.11 dM.]l::::) udO D y "E. UI.O.... y Flu II OU 1 1, WD, iff.11 11 EIr EI-TTEF. 1 (1100 [ E )I F..❑11 1 yE..Ur. "T.110 III YI 11 1.11' EIr F.11:::3,UF-ETn I I, El Ell iF.❑I.E.IrEl 01 1 1111 F1.1 EI)j 1 1. ElEld I I I SECTION 11 - LIABILITY COVERAGE 30 BROADENED NAMED INSURED min III 111 11 0 0 no 111 11 0 II III A11111111111111111 0 1 1 0 d 1.1 I U I r.DElI I D.❑I.E.) ly[ 1.1 DOED I I IFE.11 T1. 11 IM] 111][MrOl II D'I 10111 Ir, U 11 Do EIDID I i IF.111.1 01111 11) EIr I .. 11 1])1,101.0.11:::::1 0000 1....1[ r1[ ll.ffl I 11111 H Ir. ....❑M 0 ET M Ir F...U.J 01111 10F...F.H.D.... d R..❑1 0 D I EIND)l r 1.1 11 OET.] T1 lI 1Ily 1 11 11 )j Fift Id Er fflTEI d V yF. 1j duirFR[ I l 11.1 J IrCI D= 01 1 M.Hy 0 I I I I M Ell Irl.100 0111F.IdE❑Id Ey 01 Il.r.11 D'E =iI 1 111.1 01110rd17d uOEM El 11 1 FT.. I J IT! I I I I Ir Mrn =11::11.10 001.11 111.11 OF.1 0 1 11111 10l JI Ir DOEUrl I EID,il la: EIETEI I❑I . .... . MEI1::::1 I DU MI d Ey 1 1.11.111 OrEMEEI di li I[..::] r I y 11.0. El Y EluElF111 10[ 11 E-1-74, IdE T, lF.TaW [D do 01 Ell I 1 01 ID ]EILIF-11T.111111 01 100 =Uir-Ed uF.-.dD' 01 0i:::F::.>nr UMEI [ 1E.T.1.1 1 01 11. 1. 1. y ff...T.. n.. j Ed I F-10001 Ul 111111 E10111I.V 1.-.E 0 I ][]:::::I Ed F11EUirEJJ, D. n Uld C:1 11:1.1 101 1 [Ol I.jrEd 001 1 1I 0000n F..❑111I II n M0 11 Ir 1.1111.101 ElE.-Y 001:10l::] M: UirDrD D'Ol Fd I Id I U.J.11H D'IF.T.01110 dOEIO DE1110F.-E1y I 1 11 dIly F.IfflDry" Ell r "DUDD-f y d Do ILI I" I Ir,11111.01 I IfIl 0 Ell I 0E:IEJFdEJ0l:::R.1IjI 13 louii,ii,-F.❑d 11r,011r, I y0uir 1..11 11 Ulff.fl]i I EIr F.Mr,E) F.F.] I M I r 1.01:11LIEll::3 000ry dDEll. IrUlEd [Ili do DET. 1EE.1. I IT.B.F. WED 111 li.::::Yii-nl InEd 0 E.E.Er110 I I❑Fffll U-0 11 10 Ell❑1rl:11J.r[::1::::I 0 F.Offll RID 10 1110 E11.0 01:::3, 0 010FIDEJEJ 001 YrUl 11..I::r1 l::ai,.Iu ❑[.m.IC:::al::::a 0 ErEIM]EI 0 F.UDD, DEII:::::l 461-0155 (9 97) Policy Number AH3A42745811 DO EMPLOYEES AS INSUREDS DOD MIDE11010 11D UddDd 110 EIEIO SECTION 11 - LIABILITY COVERAGE, ODrODrOEIE] 1 OWho Is An Insured DrlE7j11',DO r JO 0 E::Y 1:::::D [:]II:::::YOE] I ]l:::::Iyl luir,[:] [D 01 1 "O.jl Uri d" OF.❑11[::] u l1I.I.T.10 111 17M.11 d " 1 [111' y n.j d D F IF.100D [::::1, Or I IDir, 1. 11 1 1.111 y [::::U ir [::::U 01.1.111 InE.) L_Jr, yIEUr DO SUPPLEMENTARY PAYMENTS DOE] MIDDIU111 DO I1EdO SECTION 11 - LIABILITY COVERAGE, O[7O[7DE1O 20 Coverage Extensions DrOOMOO 01 101 lr= 1.2[ 1111r,01.10F. 1:::::d Ey I.M. [J [F.AlO[ I I.I.F.R 10 1.2 0 0 DOD F.2 [DO [In, O[:::1DOl IH.. I I ][-.do n.l.n ud[1110 I 0Fjd[ I Illlr rl 11 IF.Il..d 1.1.10EHO 100 I 1 1[ 11 11,11 1 E❑IEII..d 1 0.1 1 10 11 J11rI I I E.❑]do I l000n, 10 1 J.J I RrO[ol I I DEI ID 1 1.1 0 1 Irl JErO1 I I Off 11.J.J.JrO[ 101 Ed Ely I OE.l 11.1.11 Oil IDUD 1.100 EA irl E]DEDDII:1 0 DID IDOEDO Ifl1::1rrEd I "IIIIEUrEd" tEll-Jur r[ 1 Ul Ell:,) ED Judl.1.1.11 I 01.11M I J[F❑10 1 IDI E:3, I IT= u I 1 EJD DI DO OdEy I . E101 J.j I El 001.1.0 0 [:::.1E1:1I.T.1100 []I❑ I I DO AMENDED FELLOW EMPLOYEE EXCLUSION 000 MIEEIIIED IM DddDd E10 IIEID SECTION 11 0 LIABILITY COVERAGE, B. Exclusions ODrO[7000 DOFellow Employee 00olu= 01:::111.11101 lu I IfflID dE❑Do DOE❑101:Iljy 0.1 iff I "I . .... dily OHI F.P.I.J.1❑1.0 1.1100 1 11 R UOD 0110 Di 'Ed "I bill l' yl J.j Do 0 1 t I DD DEED I IDEF. K. I ID 111.11101 1 0 11 11 J1.1 Dl::::y rux.lr 3[11I101 MI I F.111 UrF.11 IOD SECTION III -PHYSICAL DAMAGE COVERAGED 70 EXPENSE OF RETURNING A STOLEN "AUTO" DEld SIGN COVERAGE 1100 AIEDIHIO 1111 DddDd 11 SECTION 111 0 PHYSICAL DAMAGE COVERAGE, A.In COVERAGE: dO Expense Of Returning A Stolen "Auto" [::::1 0 oil] I F.❑y 1 100 1 in 101 11 101 1 rOdWirl U.I.E...] I H i:::::Il IF..Irl:::::d "Ell.11113'l J.J I y 1- 1.10 00 Sign Coverage 0 0 0 111 EIF..-..Y F.or I JJJ I UOEd I I JITERE11:1 El I Ir I liuDoIBIQ D1 I I JErOI 1. IDE.W.J.1.0 I JD I 11 DID. 0 DI 0 d [1111 11 y I d 1 0 1 .. I OEM-E. d I'll I u jul o I.I.I.Ir IT 1 01 n01I I I 1 11 Ell I[ I n [11.11 OEY I JEY [::::E. In " I jimid 001!1 1.1110 11 1 I:::lor on DEE:] I Effill I I I IM.... F.❑I I U 1::::) 00 = ON I::JI:::J­[y 11111101 Jj it I JIM 0 [11F...D. 0110 D .1 1 1 1 r 211 01 1.1 1 000DOir'l Ell Ir.11111.0 I Ir r[: E.1 1 11 1 J.J.. Fj d I I ] ol al d I Jr Ell NI JEJ I rOl F.lr'F. 0 1.0.1 11 E.F. 1P.. r D'DEIDTY 1:::::1E11oll J E)I I lid I F. d E).A I 1 0 1- Jr 31 1 E2,0000 00 GLASS BREAKAGE DEDUCTIBLE 01 F.1 I> I 111❑1. HID D.1 I ddl id 11.1 IE] 00 Effil EIDDORDOO DD-nEINII 10 301 Ili fIn . I 11[::::I fflif.1.11H 10 Ord I.... Ir. [::::I [::::Iffl.] I 1 0 OEI 111111 0 OUDIM Or M =IfDOO OE Y dl du011In...10 111 1 ll:::::)D 111.11 J�J ID I ) I l rOl 11100 00 1.1110F.❑110 110 M 1.1111 ludOLI 0 ".1.1 VIE] 101.111 UirF.TJDI:::::l 01 IN J101 10 1 1.11.100 DIM [00 DDIJ I F.1.1010.11 10 I [ME.I..irl 11111101 ED F.❑I 1.11.11.1E.], 1111 1,] 11.. IE❑T. 1 461 0155 (S 97) Policy Number AH3A42745811 I jo[:]) rF.. d "I Un.f (:::IIII if IF 10 1❑J.. y I ]I I r I 1. 100 D'1:::1 I I 111[:I LMI U11 11:11 IOD I..T.T...) rl 11.]E]Md, r[ i! 11.1[r MOD r011 I JJ dl I DO TRANSPORTATION EXPENSE OI7OErOEO DOCoverage ExtensionOOO SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE IHIrOJOEIOd 0 1110 EEO a] 100 =D EID Coverage Extension El I I I 11.1.1I I JEY uO I III 1 1001 ID" d I I III 11-1 01 1111.11.1 U 0 11001000 [111. 1 JEJO J[ Ir[ ty W100111TIOD110 ODODOED 111EWTEd I IV y I::::U 001 F.b DO 1 101 JEJO 11=1 I 001B 000 ITM1.1d 1111T.W.11 11001 111 1[::::] [r[M.T.-M I [y 0[ 1, 0 1::::10 IB D I Lly Ir I I.F..]l 1 11 1 OLO.1 ri d "I II.J11011, MY, DOUO yl U OF.Yry F.R.D[T 0 1 1 1 Frl 11 001 1121 1 r, 0001 JI.P.1.1d 0 1 U Om. I JEL I ED El OF.] t'0000 0 0 0 111 1 Ey M1, 11.1D OF.rI Iry [h ]I JODErl TDI ff.11D JOI T 11 El 10 MEWTEd durUD LIDO D[rl[Td 110010,13111 Z I O[UrD OM I MD [ . Ol IMI [..]Ed I [::::d 1H.U., regardIess af the policy" s explIrafion, 0 F.1 10 n.T 10 O=EA "' I U M 1' 1111 rl [Drl 0 1 UM I r DI 101 y Of 1111 I"ll 10FT I I 100HIRED AUTO PHYSICAL DAMAGE 000 E1111 EDIHIO IHI OddEld OD SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE: DO Hired Auto Physical Damage IDI d I u [ff U U.Ir 1 0 1 ILLrOl I I Ol d I. . 1.1111 OEM D I n I I 11 [11 l[IrOm 00 Eh El I h 11 111 IODM 0 011[1[TA 0 1 111 1! 1[::) OEILOII.1Q [..r U III I.B.Im 111.11 rol I& Id ul Jdl Ir I DIM 0 01 [1'01111 O[TT.] 04 I U I J.U' y I U I f 10' 1 1 111 1 11 11 V DUE 1 D[ JO I 1 11 IN 0 [:::.roll ld 11-0 OaH dF.. d I If I EU I-11 E]" y I U DIM 0 II.T.nl::3,x 0 I.--] drI.J.1-11 r Yy[ 1jr 1 101 11 V00 I I.H. 11 1, I 11.110WOOdrMEr, ODyl wr dE M11r, I In,-.] Ebri I[ F. J1 I DLI DEnJul 11 11.01 lyl Ur I Ul 11.11.11 11 11 1 1F.11, I " I LJI riffid 11030 dl I I Or 1F.❑IO❑, OF11M.,10 111.1d [ Od jF.❑1.1 11 1111 J.111 1111 1 11 n.T 13' y Eu [..I I F.0 I InF11011 EJlOI::::JfflI 0 01 1 or..-..0,000 I lF. rl I01I:::Ild UQ I r I .. 11 1 OF1::JO t Flu [ .. 1, r [JO [ F I N101 JOL:Y00011. 0 1.1.11 IJ OnO d I dul 10M I I OEUFJ 1 1.0 1 1.1.10 ll 01 JOOdOduOMO 001 1 0 .1-11 11 [10 00d ""I U n.f 1' 11 FI I 1 11 UTI: 1I ]I I I F..) I d0duO[3110 I IF.BOD 1.1fl IIIII I D[ 11 rOMI::1110 d I f 11 1 F..❑IOLIDIMy "IDOn[ V 1.1. 1 .... . . ... ET Ul Ed I- b0 TD I..Iul II.R.11301 1 1.00 IB 110. 1 1 d dl duolmo 1.11 1.1 11 T.F...d 01 1011.1 1 11 1 DIU I rOl Jld. 0 01:01111- [11 1 1 In.A 11 111. U JI I I II"OF. Idl EIE I I JOEDrl LID D-I I[A F.-.b I III 11 I ly O[M.1 Id 'I'll Uffu' Y[11 1 101 J, 11111 Ifn I T N I 11.01IJ IF.] 1=1 I I IOD I LID III 10 1 Do.-J.. I t'111100 1100 110 OF. 1E AD JI I [Hr 0 OFMO y I.. I.A I ro l0OFIly L.F.01.❑I D ODd :1..0 I I I I F❑Ir 111.113jrO [ . .. I I .. B@ I I 1.11RU r❑IIN Iml I 01.n01E[::1d1:::.1I Q 00 01fl cover the lessors ac1ua1 financlW III J:::::IO 11OuOO 001 111 101 11.0d " F.I.j I III I' [Ur I I 01 h.1.1d U Jul I I IT I OLIUM 11 11 1 101 U I d I El 1.0 10 = dE::110 I 100DO I mid EIOQ DU L::11FDOO I F1 0 I B P.1.100 1 1,000 1 Or 00010DOEID 11 DAUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 000 MIEEI= IEI IJddDJ ®SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE: 00 Audio, Visual and Data Electronic Equipment Coverage 0001111 F..y 1BT " lI 1 10 I'l J.j 11 I[ I IF:]ORI 1011.11 1 MERE 1.01 1 IDE-JEFE 10 EludOO 000yrfl.11I Ild D 011EVE. I 0011.0OUrl 10110 F.1 I rRMOD I I 111I.J.10, [MOD I JI.J.111 I I 1 11 rI I [IR JIF.F.100 0ODyr1-11t IQ F.I.Eurl 00 111 rl-EADD I::::) 11.00Q I OEF-I 461 0155 (9 97) Policy Number AH3A42745811 D- 11101100 in] Eud 111 [EDE1 IT d 0011 OUL11111 111d 1JE11I111001I1d1-11=1Id DO 01 1"0 001 11 11.Y TJJ.-.InFfl[d OUlly Rr =r[ITEIJu[1Z0O 1-1-11][JuDdl.] IF.fl I RIO DOOEIII1.1.1 I EJE111 I d 01 0 01IIII DOEFYIE-100 1111111100 011y LUIDE10 or III I01 IC 1111111 lr[] Filly u[ I'i d O[-u [U]0 Oul 110 OETEI 1-joil1ay [III❑all C1 1.111.110 ❑I U EL001 1.1k rl I- I.T.J.1r, 1.1 IF..) n ijai ijairA " DU [ILI' OFIFTIF-1 01D 0 DO [1F.1.11 T.F... I I I I F. KID]I I I FT I 11'F.. d I.I.D. I I 11111 "1 ODIT IT CETI OOu = ETO [111 rOO DIIIIJO MOO 0 [11001111 uUM 11 BLI r011111111 [11 O[I1Clr[1110 DIT09A DID 0 [IMF] 10 OOrO OMEID1 [[0[1[111 Od [[I] [JEIF LIMIT OF INSURANCE I-TOEHIUM DO covered "auto' at the time of the PHYSICAL DAMAGE COVERAGE ""I 1.1a7l, lild ou [I] ali Im 1110 [M Iffl roll ODOd Cy 1110 111100 [E]OO dDOIBOIA M 1111 Ol O[ITO[Ild Cy use of the power from the "auto's" 1 n n[]EI EJ 01 El 0 111111 F. I y F. 11 01 01111l 1)f U110 , EM J u 000 [Irl ""II C:100' F.1 I UdR.0, IF I" d F.InD 01111rild "OU111', 1111ludlujil [HE] 1.1111 IM 11 Il.M 71.1iM..... I ElEd [ Ey 0CIIII❑000 O[J [11][T DOODOODTIEBOO 01111 1 IEID"F.100 u OE.d Ol 1.1.1171 OODOODr , 1MJdOOO IT11000lud0 OEi..jI.T.IT.1 000 1 F.1 0 111[ Ul [ ODOE.Y [11EQ rOOD-dO a d[IDIIJO 000 "1 1 d F. 1 11 1.11111011 1F..❑]EIR....1 ?, DO 11111 71.101 u 011.11.11[:IIJ I 111]l E11F. ly I.In 1 1[".) ODI I I [ 1.10.11 1 1.111IJO 00 0[ IYE110.3[::::I L i )OMOOO DO[::::I C]ROOD, F.I.I.F.1 d ED OOF.d Or' DO 100 OF.F.1007111TY III I EDF.Jul IFHO i"I E001E] M. D'EUD'ly 1 10 01 11=1 L.M 0 00 Oud[T.J..J, OFMAJ OF.Id 1'. )1 1 HI 0111111111 F 11.11.1 M.0'11 11 ION I[ . III OF.UOJO 00[1 [11.]II.IF. 1 11 ly 13.0 1 IF. 10F....r[JOD 011 1 1011 M....1 1 1111 Irl I IEW.110 [::::I" [.3,171JI&A 013,01M r..F..0 I do=[ 1 11 M IrDE10F.I.T.110 I T I dEl. 1001 Id I Y, (.F.J.1100F.F.AO OF.E.1JuO1)TM.O0F..1yO E11i DO D-1 IOD-F.y On.1.0 7.1101 r F.lr[..i D-J. DEII.F.J.10 UEFEd F-Ld El 0 0111 I I[ IDOI , ul d D, F.-Ij IJ I..F.V [::::I D, oEEFJrF. OF I.M.. - OF.J.1 11 1" F. 1 OF. 11.100B D I III Don DED F.M.E.1 U 0 Or I IfI IEE IE Drl u OF.d 0 TO F..0 110 l011 0F.U1110 I co ui] iou.no 2 n 00 F.jd[U[ TM 1 01] FIR' d Or ri E.111.1.111111F..❑I O[-d E. F YF. 11la IC 10 0 111F]DOD'y F.Er EIDO 011-0 11 EIEI::bn:)DJIJO Olfl 1.110 F.dO J.1.1 1111=KIIRn1EI 01 DIIIrl-d dD D'O 11111.1.10 ODIDF.1 0F.1 lOi jJu[ I Flu Fill IT ED 0 O[INKEOD 00 11][10[l.] 011,110 1111[ I.J.-T, 1 1111 DI 1.3 T] the covered "auto's" 0111TET011 1401111 [IT 30 DEAull OEIIE10010 Ell PHYSICAL DAMAGE 2 0 0 Difflo COVERAGE, doomany Ell 111H Dud IM 0 ED El 0[-b D Fill 01 1 1111 1.11EID'Ell 10111 DOEI 0100111001B 011ugDO OOD DOE] 0 UEEBELIJI [110 IF. 0 OLIKI1110 F.1E1.j [::::Id ii"D [:buI 011Li I.T.] F.TJO d 111 Hol d F.F.K.I.071113 F..I.T...] OF.11T V:101 D'I DO I 011 Oy E[Fr = [V FRIF.J.-I 111 1:111y IlIr E Ud 1.1.4 1 IMAF.. I n d r'OEII,F.duO1I1I]O I JO[ 11 UnJ F.11101 I dRI"IE) [1E.1][I1o0[IIJ 01 U[1.11D 0n.l. ... 1 1.1110 OF.0 I d iT..1DT]:JuE-flfl..F.1 DUD IdEd Da= 1.11 111 U F.F.F.P [11 [ 1111101 r[] a 1-1011y Iffl I.T.11 1001 n. R. j "I U 1.1i I", I.. Ed FIT.J[Judoo OOEyir,U00E1.J.Jd 0 IMT.A. . .... DO F.F.011irOODO [ I D, M10 0 1111B 1 F.I.J.-F 1. 0 1 IfflIf 1110 1 OF. JrO 1.1.11I ffD U Or. IOD M .. 1, 11 Of DOEYNEF.IQ .. [ r k . ... 001 RH 10 0 ff. .0 1.11 1 1 461 0155 (9 97) Policy Number AH3A42745811 11 171 [:II TJ i- ILIEr, y F:U [::I v EJ L.1.1 ly 11III-] 1 (.11-1111-1', F-EIy I LJ1.1.1.11- -1 11 I LII If 11111 11-111.1 1. Is l-111 'A F-IF-1, OU U 11.11 dl . duF]LIME uIL-dII1 0111.11 1 O'11III.J I Ell I 1-11-ji-I L]l I � JET [JIFEL-ri: FII 1il . . I 12DRENTAL REIMBURSEMENT EDJ MATERIAL TRANSFER EXPENSE DEE E111DOMID IHI DddDd 00 SECTION Ill - PHYSICAL DAMAGE COVERAGE, A. COVERAGE: 70 Rental Reimbursement and Material Transfer Expense I ]I ED 1101 Erol F.1 Druid 1 10 1 ll.-..1y m:I[-]❑o 1 11 VI UDIJ 1')ET❑1000 1-1 El 1! rED1 . 10 001 ri I 111.111 11"Dr..9 1.10M. 1.1a IE.11 EEO iny M 0 1 11Eal_.A " nj W' d DMIJEW Or d ODMIDOMd 110 DOM EDD 0 1 1.. II.E.1 I [)Ein I i:Io I I oi ErOEEE DEILly I.. I I 1 111 1 I.In I-Ey [F.Tr ED I . 1.1.1 11"OD11I DE.11000F. I I OFd 111111 DEI 11 011 R]flDUii"rDd I yy[ lu DOODU1.10 I IIT 11 DOU' M 0 1 ]1 Ed rDO OM. I II 1001I II.I.I.Ir y I U11" I I EIFID'1.111 I I( Ed I I lj[ffl[::] I IDO Eli 1 1.1.1.1 1111 OrEd "' I WIT DOEY E] ODE❑IDE111M....0 1.1.1p DJdl.13.111.10 (0 1.11 1 DIED 'D [.f.flo Dill i =1[ I 0001-11 101 FOODO I ]I ME110 y Du 00[.0 DOE] DOD rLd Ou WO 0 0 d F.du mm..A I ji 101 1r.1y n.n I IDIIIII 0=1 q 100 0 0 0 3.1 ET..1v DIJY I OF =00 OU I R ii"OE[ICd 1100 ffl]OuirTE.d duirIfflO MD DEIII.Ey DETEIA 11.1.11.11.10o1E 211 Dourl I I JU Ir MD " i I I W.' H❑Jd I EbIIIQ regard1less of ffie poky's F1 .. ElIfl. OEKQ 0 DO 111.10 d 1 11 Or 1 11ID.10 [91 11 I I ]DID I U 0 M [11d I V DO 10 Of 11 1 lul I DDr OOJ Ey I I rElOODE1 11 iy irl IDufflEld 11 1 rDEII Ill Or ri 101111 11 1 1 11.1.1 cowre. d "auto". 1If "loss" is 0 lu OEd Ey 0.1 UED D0[111 I UO I Or Er.ld 1 ....1 I.I.K. ddl Id 1 911.1.11 1 OuLl I Er EDd I y El I.I.1] 1 11.1 ]DO FO II I IEDIII LM I I IED"E d "OURIT FlEd T.01 1001 ri I Bul I I irl III1111 DOODO El w" I ]Fly 0 01 ID [M II DII I I JEd 1 [0. 1 ff.J:J II 110 t' 0011 10 111111 101100 1 10 Du=D 0 Iry F ]EA D1 1D I 11 I IE1 IODDEII IEEII 0 1 ud DID 11 ODO OOu 000 DEED Dul 0 rI 1011 1 IDDOOOD ODD r DM.. d[PO [1111 IDI Ely EIM I 1.0.F. r[..1 Orl I 01 n"I I I t, IrOMED `[:DEUJ' DLEMW I-D y I U 0, yl luir DOI rr..11 110111I:]O [.HOD 1 [00 EDED Fa IMIDD El DO F❑rE d ""I:::DIIIJ, DFJr.InO 1.11E.1 ]ED Ill F1001 11❑]Or ly I Ej 1 11 1 D[H I Ey W dr....Ir UIM I 1I.rE.100 LEly I DEE[ El OUDOOD yOuir rl 11 IED1 ri II.E. I luirl JOEI I Jr. 1.0 Eli T.11 IDOEID 0 O= LI DOO1 Irl Edy DrOWEd [Mr, ul di ir- LODSIEG'rm 11111 P111YSICAL DAMAGE COVERAGE, A., on ii in...uali I 01 1T.12.11flIf 10 13DAIRBAG COVERAGE DEE MIODIHID IHI DddDd 1] SECTION Ill - PHYSICAL DAMAGE COVERAGE, B. Exclusions, ODrEErEE0 30 E]I I I I I r111111 i J.-.101.1111 [J:JJU I 11OI rl".l I 111111EI I III JE[ lI 1111I.-Ii11111 Er'LLIA1.11JI.."I d1I1J__J E]I il II:::I ly LJ 1-11111.711�111 d10.11JE11.11.1.7.1 F1U I 1. JIB 01 1. 1 C::I1 lull Ol 11111 1-10 [.-1111 1--li it 11 IEI I IE-11 II-11I r I II-Il � "JI'll.T01 F] U1.1 W1101.7.11 I I-11, EI 1.111"I If.. Iy [��I [::I 1.1 dEdul 111 111I-111EI 1.ICI 1 . 11. - 111.11 Ej IN_-J[ [1 0 Ill I Irl[--.I(--I[ 1I111Jud0i I 00EYNI001.1d D I Eri.lfl I P.... 0.0DurEEIi 10 0 ETCH07D 0 1=1 1E.011 0 DID DID OD"I 11.11.11 IIMOF.❑I 01 11)yIrl.fflr..1111 EEIEUMI 0 1 H rl=[..] I I IDDO, I.I.B. DO 'I DEEI 461-0155 (9 9-7) Policy Number: AH3A42745811 1ELAUTO LOAN PHYSICAL DAMAGE EXTENSION DEE 1011 EDIDII IM DddDd EO SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance ErE]=ED I I 1101.3 0 1" 1111 Ell, r'1-...11I11j1I I . In 1.1.10 ITIM 1 DOD M. 111 EE.1 11 IN d 1.11 1.1 1 y EU ED I I UIT D D D D I U:]Ij D I y Ell I [.In d R..❑I IU III IF.d I.T.fl I1.11.1 Ell I .11.y, 11.00 D DC:11 D D D 1.11 ET V HEr "k I r i, n av DDi.-.-.i I'° F.-If i Idni F..Fij F.[1 Ir. I Elrl.1111.11 I IT.fl 0 010 DOM Ell 11-JED Ell u 0 DEIFME.) dED ❑01 Or 00 D'DFIF. IrFy 71.11 E. I ffl..ID 1.1010 1 11 11.1001"103 I"Ell r 20 OF.]::I I ulln'.10Ed[DI I 1]1101 1.11l.. I I ]EIll I ramy] II I ]I I, 101.3 1 [::::IC E FJ r.].j D [0 R.I.Ir FEEIDD, 1. li rd u I I 01...-.y 0 DE110, Ell Frdu[ I 01-Y I 1001.1 DEET[ Ii 1 1, ElEll 1.11I.E.❑1, 111 y I IEIII]i"01 10 [Dr, EJE.Jdy 00`1 1 11[::1ENIED 111::::.Il 1.00 1 U 1.1 F.1 10[1] 1 ar U.r.fl 11.11. 1111"[:]El EI . .... J, I] OF. 1 1.11 OUn[:UI-1 DMI 11 my 1.1 . I]l J..jirlD 110 Djr,F..Il 1 11 Kb I IE1.0 Ell J1 1 13❑IEJ nl...-.d I E.Irry [101 113 1 11 101 11] JI I lhr..'EIE.I n.. "Elmi D II 101EIEL".1 1DEIAUTO LEASE PHYSICAL DAMAGE EXTENSION 000 E110DIU10 IHI DddDd ®SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance DE]FIllmoo 1.1.0 U[:]ElajOD EIL]dEJIJ I I d I]I::]Olu I 11.1.1.11E) Or 01110 11 0011 0[::::I1]i r[ d I ff..fl F.1 II I JE] II Ell JrO lM.... I lod U n.1 1% 1 IID 1 III Ell I MIJ 10 000 000111 if. 10 y F.I..j Ell d 001 11 01=1 Ir, F.M I IJ I I 1.111011..d, - F..1 I I' Elm I Dj I U.] dT..M,-[ 11 11 T I DI al I 1 1.1 ME] D] F.Al ll­]U[:A unJnr 0EYEIF.TI.JI 11 1 C. I IMI 1" OF INSUI:ZANCE 'I 0E.Jr, 20U:b EII0 1.10 F..-.UDI I duD 111JI.E.10 F.3.11 0 00 I F.1, ET u I d I Ir, 110[: ] JJTI I [::::I I IDL1.] ID II01 1 ID ElF.1,0111 0131. 1[ EIJ nI 1. 10 I.E.) D]L] II EIDDEd El n111C.] y I U D'D r0nult'll. d M. 013/[1I1 I .. E.❑10 n.l-..y IEEE] lllldl..M.F:UIEJEJ 0 11.1.00 nulJLIIF.11 V DEErdu El 01 y El 0[:]F..T.nol.an if T ]F.IlIll a��Ilaln.m P.1.1 IIET1. d u [ d Or I I1Ell I[ UI [:I11r EE][:]00 1.1.3 1 u F.][�J, ETED'El 1.1 F1 FID, E]E.d DEll" EIr 0111D E) ql=l 10 dOE10F.J.1.10 0[:]DrEllji.)[ d - d I::::: V Lifl[] I 1- 11 111 rI I LIE.111 r I JL.3110AEd ElOnrEJOHEE.), DrEdIlIfl 1D Ell J.jir0EIEJI 101 11 0, 0 01 11.d00EJF.._r I'DO. D1 I[ jlM.V 1.11.11 ll.jil"Ell 100 njrnl]01[::]E Jd I I D1.11 TD. 11 0 D I IDI d D..:Try [::::III' I Ell 00101 1 1 Ilry I] I Irq jr.:ljjjjjo I If...J.11.1 1101 11'011] Ell 17.1 ffl][] [:::lEly El] F.U.] I I 1 100 Illlr fI I I EIU1, lr❑d b F.11 I' I 1011.110 01 10 1 111 1 E.rD UDA.ly [ DID I I ETI]ODJ [ I I Ell D] I r 11 FrODD F.1[i 001]1: L11 I Ell Er' E111 I Efu ir F.❑]111 11 T E1.1.1 0 II01lu rF 017110 SECTION IV -CONDITIONS 1 DE)DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS DED M31111HEI ILD DddDd ®SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Losso dEl 0001311 dI IF] f 11 IE11 "T. El E]T.n I I.j M.1 Or I 1 11 1' 1 1 all 11 1 di DI I nd 1100[ a R.1 10 1 V y I.. U o E10E.Ul 10 11 Plid(jill !'I, E1.11IF.13, "I I.j 1.1.1 EIr I I JEE]' 000 Ell 01 09A Ey 0 I.] I] YF. 1A, F.F.W. F 1.A DrEl I I..] Ud[ElduE. 10 F.2 [] IJ[ U Ir'M.D El" FMI::DrI 11 P.. CI 0 01 JE1EJD' 14 EU EYD 0 01 l"EII 11 11"DII]JI.11 I D' F.3 El 00 1 ID 9 Ii.j DOD 1 1.111.1.3 r or El 0 111 3D-..1F..1" ff..T..Y Du D'( ❑ Irl 11111 I.MDO 170BLANKET WAIVER OF SUBROGATION OD-01rOED 5. Transfer Of Rights Of Recovery Against Others To Us, SECTION IV -BUSINESS AUTO CONDITIONS, A. Loss Conditions EM r0110DOd Ey 110MIDDIMED F.011I:Iludol I DF]EVir'F.Ml E.1111 0 [F EKE] JOD OF. Ir U.J. I I I El ElF.110 F..M 01 Iro 1.1111.1.000 00F.VirffDEQ EHEWT.1.100 DD,[..Il 461 0155 (9 97) Policy Number: AH3A42745811 0E1 Transfer Of Rights Of Recovery Against Others To Us I.. Ol 1 01 K:::ll 11 1 F..Ir Lai ni�:-IIF.Jll 11-g-fl-El M...) I r iffr 1 111:1-1 1 1 11 J 1111 101 11 Y El I.-M.0 u 1::b 01M D I IEII. lr,nl 01 YI I III III irl-11.11E.11 ID III irl JEML11" d I . 11 11.1.3 IEI lrf:::)El U 1'r DIED" El I 1110D U111 1 01 111 1 I11 Ell 0 1 11111 d I.R.th li..i In I Ell I 1 11 JE❑I ).ul 1101 10 "U.1.11 Ul"I d 1 11011 E.11.1, DrI.J.H.M, I n..Dn F.❑IIQ I: Jr OEM 0.0 Ell'1111" I11.1..1 EDI I "I E100101 I I Jr "111 11 f" I I.I.R.111 I r11I.10 Fit I [JEJ] IJ Y[ 1 11 IQ 1111100 rl-110[11.1 III I it E.E. IEED, d I I IDDE) 11r.0 I EIDI:J F.01 r I Ir'D 111111 11:::::l1IIrrId Dul F.1 D111 11 Orl 100 E.Jr EYI ]EDO-111 J11111"I 0 U I El 01 if ry I I ry I In 001].xr,E) IJruir r11111 Et I I Fd El u I I DAD 111 M I I IM, If ID " I 1101d 111 T I I Ir '1I I IEl' D. 11.111 001b 1101 D 0 1 DOUNINTENTIONAL FAILURE TO DISCLOSE INFORMATION DEE] MID01111D 1010ddDd EIISECTION IV BUSINESS AUTO CONDITIONS. B. General Conditions, DDrE13"000 20 Concealment Misrepresentation Or FraudF1 YI Ur ul IMM=1:1 Dirl r IM d 1.1l.T. III I IIME❑ Cr MI!U r 0 ED d 10 11 Ir. 10, 0[:::.Y 0 00.1 [ME11 (JEEMMO DMIr 1.11D EUMI fl.11:13 d I 1111 1 E. 11 11.1111.1 11=1= DD'I I D:::::1m 00011r,l 11061.01 lyPluir I I 'ID. 1 11 IF lul d Jr 1 01111 1 EJEI I IR.Er[ I 1❑1. rl 100.10F.1 di I ]III EUDI:R.1.100 F.Ur r111110 Hl I LIM I .. 00E.dd1-J.JJJMFJ I I Ir .❑... DO [Do I Ir DOEY01.1.1] I I U ir, ir ME] I IF.❑11 11 Ell 11 1 DIM I I Ir, 01111 1 1011 10 1 En HIRED AUTO — WORLDWIDE COVERAGE 000 AIDDIHIII III] DddDd M SECTION IV - Business Auto Conditions, B. General Conditions, 00,00,000 7EPolicy Period, Coverage Territory Ero=Elo 00 1 JuOlIdD Ell I JEl I JJ IrVIlDry dOEIEK11.11 d I.1 I 111I I 11..� I IF,] DI d dl.. I 01.1.1 JJ I F.Irl 00 " ]EDIld 111 1.1 1 Ir 11 II EDI 11 ir-[ 11 J..j I I J.H.❑El 11100 M-10 u 00 1 Ell I 001 ITI]d " I lil [.I l'yl lu 01.6 1 1 1.111.1-lu 0 0 dirlINY, I Ir y EU r I Ell 11 10 11 Mr.: I n 0 JJUFU I I I I dirl-P.11 t, My I ur d).?JIJOMI� 111.1r, 1.110 EurElE.❑I❑DO 001 1 duF...-..[ 111FDO y I . Uir I U 011.1.11 IDEJ MY- I I DEI-R.Id OD30 di YIJ Er DUI:Id Jd EM I J..j I.M1 I D I Jrl u I DO I I 11HED 11110 1 1 O.T.T.I.Ed I I I.E. 11 Ml I I in E) I r I.. M. I I r R.E. I n.11,1111.1rIl irI I ? DEIE1E1nnEIIIDI::::0[ I SECTION V - DEFINITIONS 200MENTAL ANGUISH OErDErDED C. "Bodily injury", SECTION V - DEFINITIONS Ir0rMDEEd Ey EMMIODUDO .dff.Y 111.1nuiry" 0 0EIE10 01 d ffy M. MI ry, I fl 110F. IEEI I t, d 111,00D I I Jul ICI D::1Jd Icy I I 0D,Dl Ji I IDEJudillE.1 dE)I..::l1::1J I I r I 10 11 1.1 01 f r0I Ul 1111. Off 10 1:::::IEY I Elt❑I I 1.1111 ludDO 01 DyirUr. 11 I.Ed E::1 1 111.1 1 911. EUN LIFIF.❑I III Irl 111.11 IE1 I 1 1, 111 1 11 M11 I 11.11D 1 1:::111 10 11B.F.. I I I )I IF. yir[.MEIFJ U[CUrEOF.❑11 1 1 1 DT:111.11` E] I 111I.J1 IQ 101.. D 46T 0155 (9-97) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule OR THIS ENDORSEMENT APPLIES AS A BLANKET WAIVER OF SUBROGATION FOR THOSE PARTIES HAVING A WRITTEN CONTRACT WITH THE POLICYHOLDER REQUIRING A WAIVER OF SUBROGATION FOR WORKERS COMPENSATION COVERAGE OF THE POLICYHOLDERS EMPLOYEES. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. WD3A42745709 Endorsement No. Insured Premium Insurance Company Countersigned by Massachusetts Bay Insurance Company WC 00 03 13 (Ed. 4-84) Copyright 1983 National Council on Compensation Insurance.