PROOF OF INSURANCE (2007) CLOSED` This Spectrum Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any
4 other Forms and Endorsements issued to be a part of the Policy. This insurance is provided by the insurance
IL company of The Hartford Insurance Group shown below.
SBM
INSURER: HARTFORD CASUALTY INSURANCE COMPANY
HARTFORD PLAZA, HARTFORD, CT 06115
COMPANY CODE: 3
Policy Number: 83 SBM NL9477 DV
SPECTRUM POLICY DECLARATIONS ORIGINAL
Named Insured and Mailing Address: BAY ACTUARIAL CONSULTANTS
(No., Street, Town, State, Zip Code)
43 SAN PABLO COURT
MORAGA CA 94556
Policy Period: From 07/17/06 To 07/17/07 1 YEAR
12:01 a.m., Standard time at your mailing address shown above. Exception: 12 noon in New Hampshire.
Name of Agent /Broker: INSURANCE NOODLE, INC /PHS
Code: 551718
Previous Policy Number: 83 SBM NL9477
>
i Named Insured is: INDIVIDUAL
Audit Period: NON - AUDITABLE
Type of Property Coverage: NONE
Insurance Provided: In return for the payment of the premium and subject to all of the terms of this policy, we
agree with you to provide insurance as stated in this policy.
TOTAL ANNUAL PREMIUM IS:
$350 MP
04 �. -
Countersigned by 05/05/06
Authorized Representative Date
Form SS 00 02 11 93 T Printed in U.S.A. (NS) Page 001 (CONTINUED ON NEXT PAGE)
Process Date: 05/05/06 Policy Expiration Date: 07 / 17 / 07
INSURED COPY
SPECTRUM POLICY DECLARATIONS (Continued)
POLICY NUMBER: 83 SBM NL9477
Insured and Schedule of Coverages for Premises as designated by
Location(s), Building(s), Business of Named
Number below.
Location: 001 Building: 001
43 SAN PABLO COURT
MORAGA CA 94556
Description of Business:
CONSULTANT - MANAGEMENT
Deductible: NO COVERAGE
BUILDING AND BUSINESS PERSONAL PROPERTY LIMITS OF INSURANCE
BUILDING
BUSINESS PERSONAL PROPERTY
REPLACEMENT COST
PERSONAL PROPERTY OF OTHERS
REPLACEMENT COST
MONEY AND SEC''URITIES
INSIDE THE PREMISES
OUTSIDE THE PREKISES
Form SS 00 02 11 93 T Printed in U.S.A. (NS)
Process Date: 05/05/06
NO COVERAGE
NO COVERAGE
NO COVERAGE
NO COVERAGE
NO COVERAGE
Page 002 (CONTINUED ON NEXT PAGE)
Policy Expiration Date: 07 / 17 / 07
;PECTRUM POLICY DECLARATIONS (Continued)
POLICY NUMBER: 63 SBM NL9477
BUSINESS LIABILITY
LIABILITY AND MEDICAL EXPENSES
MEDICAL EXPENSES - ANY ONE PERSON
PERSONAL AND ADVERTISING INJURY
T
T
T DAMAGES TO PREMISES RENTED TO YOU
ANY ONE PREMISES
AGGREGATE LIMITS
PRODUCTS- COMPLETED OPERATIONS
FORM SS 05 09
a GENERAL AGGREGATE
z
A BUSINESS LIABILITY OPTIONAL
COVERAGES
HIRED /NON - OWNED AUTO LIABILITY
FORM: SS 04 38
Form SS 00 02 11 93 T Printed in U.S.A. (NS)
Process Date: 0 5/ 0 5/ 0 6
LIMITS OF INSURANCE
$1,000,000
$ 10,000
$1,000,000
$ 300,000
$2,000,000
$2,000,000
$1,000,000
Page 003 (CONTINUED ON NEXT PAGE) d �L
Policy Expiration Date: 07/17/07
SPECTRUM POLICY DECLARATIONS (Continued)
POLICY NUMBER: 83 SBM NL9477
Form Numbers of Forms and Endorsements that apply:
SS 00 01 04 93 SS 00 05 04 05
SS 04 38 06 01 IH 10 01 09 86
G- 3305 -0
SS 00 08 04 05 SS 01 21 08 97
SS 05 09 07 00 SS 05 47 09 01
Form SS 00 02 11 93 T Printed in U.S.A. (NS) Page 004
Policy Expiration Date: 07/17/07
Process Date: 0 5/ 0 5/ 0 6
BUSINESS LIABILITY COVERAGE FORM
2. Applicable To Medical Expenses Coverage
We will not pay expenses for "bodily injury":
a. Any Insured
To any insured, except "volunteer workers ".
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
premises you own or rent that the person
normally occupies.
d. Workers' Compensation And Similar
Laws
To a person, whether or not an
"employee" of any insured, if benefits for
the "bodily injury" are payable or must be
provided under a workers' compensation
or disability benefits law or a similar law.
e. Athletics Activities
To a person injured while practicing,
instructing or participating in any physical
exercises or games, sports or athletic
contests.
L Products-Completed Operations Hazard
Included with the "products - completed
operations hazard ".
g. Business Liability Exclusions
Excluded under Business Liability Coverage.
C. WHO IS AN INSURED
1. If you are designated in the Declarations as:
a. An individual, you and your spouse are
insureds, but only with respect to the
conduct of a business of which you are the
sole owner.
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A limited liability company, you are an
insured. Your members are also insureds,
but only with respect to the conduct of your
business. Your managers are insureds, but
only with respect to their duties as your
managers.
d. An organization other than a partnership,
joint venture or limited liability company, you
are an insured. Your "executive officers" and
directors are insureds, but only with respect
to their duties as your officers or directors.
Your stockholders are also insureds, but only
with respect to their liability as stockholders.
e. A trust, you are an insured. Your trustee,
are also insureds, but only with respect to
their duties as trustees.
2. Each of the following is also an insured:
a. Employees And Volunteer Workers
Your "volunteer workers" only while
performing duties related to the conduct of
your business, or your "employees ", other
than either your "executive officers" (if you
are an organization other than a
partnership, joint venture or limited liability
company) or your managers (if you are a
limited liability company), but only for acts
within the scope of their employment by
you or while performing duties related to
the conduct of your business.
However, none of these "employees" or
"volunteer workers" are insureds for:
(1) "Bodily injury" or "personal and
advertising injury":
(a) To you, to your partners or
members (if you are a partnership
or joint venture), to your members
(if you are a limited liability
company), or to a co- "employee"
while in the course of his or her
employment or performing duties
related to the conduct of your
business, or to your other
"volunteer workers" while
performing duties related to the
conduct of your business;
(b) To the spouse, child, parent,
brother or sister of that co.
"employee" or that "volunteer
worker" as a consequence of
Paragraph (1)(a) above;
(c) For which there is any obligation
to share damages with or repay
someone else who must pay
damages because of the injury
described in Paragraphs (1)(a) or
(b) above; or
(d) Arising out of his or her providing
or failing to provide professional
health care services.
If you are not in the business of
providing professional health care
services, Paragraph (d) does not apply
to any nurse, emergency medical
technician or paramedic employed by
you to provide such services.
(2) "Property damage" to property:
(a) Owned, occupied or used by,
Page 10 of 24 Form SS 00 08 04 05
BUSINESS LIAML1 r r t,uvcrv►�a� rv�m
b. Coverage under this provision does not
(b) Rented to, in the care, custody or
control of, or over which physical
apply to:
"Bodily or "property damage"
control is being exercised for any
(1 ) Y injury"
or
purpose by you, any of your
"employees ", "volunteer workers ",
that occurred;
(2) "Personal and advertising injury
or member (if you are
arising out of an offense committed
any partner
a partnership or joint venture), or
before you acquired or formed the
any member (if you are a limited
organization.
liability company).
4 Operator Of Mobile Equipment
b. Real Estate Manager
With respect to "mobile equipment" registered in
Any person (other than your "employee" or
your name under any motor vehicle registration
"volunteer worker"), or any organization
taw, any person is an insured while driving such
while acting as your real estate manager.
Your
equipment along a public highway with your
or organization
T
c. Temporary Custodians Of
permission. Any other person
responsible for the conduct of such person is
0
Property
Any p arson or organization having proper
also an insured, but only with respect to liability
the operation of the equipment, and
,-'a
if ou
temporary custody of your property y
arising out of
insurance of any kind is available
0
die, but only:
only if no other
to that person or organization for this liability.
(1) With respect to liability arising out of the
However, no person or organization is an insured
rt
maintenance or use of that prope y; and
with respect to:
OD
(2) Until your legal representative has
a. "Bodily injury" to a co- employee" of the
N
been appointed.
person driving the equipment; or
0
d. Legal Representative if You Die
b, Property damage" to property owned by,
Your legal representative if you die, but
rented to, in the charge of or occupied by
only with respect to duties as such. That
you or the employer of any person who is
representative will have all your rights and
an insured under this provision.
duties under this insurance.
5. Operator of Nonowned Watercraft
e. Unnamed Subsidiary
With respect to watercraft you do not own that
Any subsidiary and subsidiary thereof, of
is less than 51 feet long and is not being used
rile
yours which is a legally incorporated entity
to carry persons for a charge, any person is an
of which you own a financial interest of
insured while operating such watercraft with
more than 50% of the voting stock on the
your permission. Any other person or
of
i�
effective date of this Coverage Part.
organization responsible for the conduct
but only with
The insurance afforded herein for any
shown in the Declarations
such person is also an insured,
respect to liability arising out of the ope ation
subsidiary not
as a named insured does not apply to
of the watercraft, and only other
kind is available to that
injury or damage with respect to which an
is also an
insurance of any
or organization for this liability.
insured under this insurance
insured under another policy or would be
person
However, no person or organization is an
an insured under such policy but for its
insured with respect to:
.�—
termination or upon the exhaustion of its
a. "Bodily injury„ to a co "employee" of the
mom
limits of insurance.
person operating the watercraft; or
am
3. Newly Acquired Or Formed Organization
b, Property damage" to property owned by,
Any organization you newly acquire or form,
rented to, in the charge of or occupied by
is
millill
other than a partnership, joint venture or
you or the employer of any person who
l�
limited liability company, and over which you
an insured under this provision.
�s
maintain financial interest of more than 50% of
will qualify as a Named
g, Additional Insureds When Required By
Written Agreement Or
�
a�
the voting stock,
Insured if there is no other similar insurance
Written Contract,
Permit
available to that organization. However:
The person(s) or organization(s) identified in
a. Coverage under this provision is afforded
Paragraphs a. through f. below are additional
only until the 180th day after you acquire
insureds when you have agreed, in a written
or form the organization or the end of the
policy period, whichever is earlier; and
Page 11 of 24
Form SS 00 08 04 06
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a
(e) Any failure to make suc,
permit issued by a state or political
inspections, adjustments, tests o►
subdivision, that such person or organization
servicing as the vendor has .
be added as an additional insured on your
agreed to make or normally
policy, provided the injury or damage occurs
undertakes to make in the usual
subsequent to the execution of the contract or
course of business, in connection
agreement, or the issuance of the permit.
with the distribution or sale of the
A person or organization is an additional
products;•
insured under this provision only for that
(f) Demonstration, installation,
period of time required by the contract,
servicing or repair operations,
agreement or permit.
except such operations performed
However, no such person or organization is an
at the vendor's premises in
connection with the sale of the
additional insured under this provision if such
product;
person or organization is included as an
additional insured by an endorsement issued
(g) Products which, after distribution
by us and made a part of this Coverage Part,
or sale by you, have been labeled
including all persons or organizations added
or relabeled or used as a
as additional insureds under the specific
container, part or ingredient of any
additional insured coverage grants in Section
other thing or substance by or for
F. — Optional Additional Insured Coverages.
the vendor; or
a. Vendors
(h) "Bodily injury" or "property
Any person(s) or organization(s)
n(s) (referred to
damage" arising out of the sole
below as vendor), but only with rasped to
negligence of the vendor for its
"bodily injury" or "property damage" arising
own acts or omissions or those of
its employees or anyone else
out of "your products" which are distributed
acting on its behalf. However, this
ev
or sold in the regular course of the vendor's
exclusion does not apply
business and only if this Coverage Part
provides coverage for "bodily injury" or
(i) The exceptions contained in
"property damage" Included within the
Subparagraphs (d) or (f); or
"products- completed operations hazard ".
(ii) Such inspections, adjustments,
(1) The insurance afforded to the vendor
tests or servicing as the vendor
is subject to the following additional
has agreed to make or normally
exclusions:
undertakes to make in the usual
This insurance does not apply to:
course of business, in connection with the distribution
(a) "Bodily injury" or "property
or sale of the products.
damage" for which the vendor is
(2) This insurance does not apply to any
obligated to pay damages by
insured person or organization from
reason of the assumption of
whom you have acquired such products,
liability in a contract or agreement.
or any ingredient, part or container,
This exclusion does not apply to
entering into, accompanying or
liability for damages that the
containing such products.
vendor would have in the absence
of the contract or agreement;
b. Lessors Of Equipment
(b) Any express warranty
(1) Any person or organization from
unauthorized by you;
whom you lease equipment; but only
(c) Any physical or chemical change
with respect to their liability for "bodily
in the product made intentionally
injury", property damage or
"personal and advertising injury"
by the vendor;
caused, in whole or in part, by your
(d) Repackaging, except when
maintenance, operation or use of
unpacked solely for the purpose of
equipment leased to you by such
inspection, demonstration, testing,
person or organization.
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container;
Page 12 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
'VP
to the insurance afforded
e. Permits Issued By State Or Political
respect
(2) With respe
to these additional insureds, this
Subdivisions
or political subdivision, but
insurance does not apply to any
"occurrence" which takes place after
( state
1) Any with respect to operations
only with
behalf for
you cease to lease that equipment.
performed by y or on your
the state or political subdivision
c. Lessors Of Land Or Premises
which
has issued a permit.
(1) Any person or organization from
(2) With respect to the insurance afforded
whom you lease land or premises, but
to these additional insureds, this
only with respect to liability arising out
insurance does not apply to:
of the ownership, maintenance or use
(a) "Bodily "property damage"
of that part of the land or premises
or peronal and advertising
leased to you.
injury" arising out of operations
(2) With respect to the insurance afforded
performed for the state or
cto
these additional insureds, this
municipality; or
insurance does not apply to:
(b) Bodily injury" or "property damage"
�
,
(a► Any "occurrence which takes
included within the "products-
place after you cease to lease that
completed operations hazard ".
land or be a tenant in that
f. Any Other Party
o�
premises; or
(1) Any other person or organization who
(b) Structural alterations, new
demolition
is not an insured under Paragraphs a.
co 0
construction or
operations performed by or on
through e. above, but only with
to liability for "bodily injury",
o
behalf of such person or
respect
" property damage" or "personal and
H
organization.
advertising injury" caused, in whole or
�
d. Architects, Engineers Or Surveyors
in part, by your acts or omissions or
(1) Any architect, engineer, or surveyor, but
the acts or omissions of those acting
only with respect to liability for bodily
on your behalf:
=
injury ", "property damage or personal
(a) In the performance of your
and advertising injury" caused, in whole
ongoing operations;
or in part, by your ads or omissions or
(b) In connection with your premises
the ads or omissions of those acting on
owned by or rented to you; or
"
your behalf:
In connect ion with your premises;
(c) In connection with "your work" n
the "products-
(a)
or
included within
completed operations hazard ", but
(b) In the performance of your
ongoing operations performed by
only if
The contract or written
you or on your behalf.
(i) written
agreement requires you to
(2) With respect to the insurance afforded
provide such coverage to
to these additional insureds, the
such additional insured; and
sum
following additional exclusion applies:
(ii) This Coverage Part provides
This insurance does not apply to
coverage for "bodily injury" or
0
"bodily injury ", "property damage" or
"property damage" included
�
_
"personal and advertising injury
within the "products -
arising out of the rendering of or the
completed operations hazard ".
failure to render any professional
(2 ) With respect to the insurance afforded
services by or for you, including:
to these additional insureds, this
�
(a) The preparing, approving, or
insurance does not apply to:
failure to prepare or approve,
opinions,
"Bodil y injury", "property damage" or
r
maps, shop drawings,
field orders,
"personal and advertising injury
reports, surveys,
designs or
arising out of the rendering of, or the
change orders,
drawings and specifications; or
failure to render, any professional
engineering or surveying
(b) Supervisory, inspection,
architectural,
services, including:
architectural or engineering
activities.
Page 13 of 24
Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or
failure to prepare or approve,
maps, shop drawings, opinions,
reports, surveys, field orders,
change orders, designs or
drawings and specifications; or
(b) Supervisory, inspection,
architectural or engineering
activities.
The limits of insurance that apply to additional
insureds are described in Section D. — Limits
Of Insurance.
How this insurance applies when other
insurance is available to an additional insured
is described in the Other Insurance Condition
in Section E. — Liability And Medical Expenses
General Conditions.
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.
D. LIABILITY AND MEDICAL EXPENSES
LIMITS OF INSURANCE
1. The Most We Will Pay
The Limits of Insurance shown in the
Declarations 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. Aggregate Limits
The most we will pay for:
a. Damages because of "bodily injury" and
"property property damage included in the
"products - completed operations hazard" is
the Products- Completed Operations
Aggregate Limit shown in the
Declarations.
b. Damages because of all other "bodily
injury", "property damage" or "personal
and advertising injury", including medical
expenses, is the General Aggregate Limit
shown in the Declarations.
This General Aggregate Limit applies
separately to each of your 'locations"
owned by or rented to you.
"Location" means premises involving the
same or connecting lots, or premises
whose connection is interrupted only by a
street, roadway or right -of -way of a
railroad.
Page 14 of 24
This General Aggregate limit does rk,
apply to "property damage" to premise`s:;,
while rented to you or temporarily",
occupied by you with permission of the
owner, arising out of fire, lightning or
explosion.
3. Each Occurrence Limit
Subject to 2.a. or 2.b above, whichever
applies, the most we will pay for the sum of all
damages because of all "bodily injury",
"property damage" and medical expenses
arising out of any one 'occurrence" is the
Liability and Medical Expenses Limit shown in
the Declarations.
The most we will pay for all medical expenses
because of "bodily injury" sustained by any
one person is the Medical Expenses Limit
shown in the Declarations.
4. Personal And Advertising Injury Limit
Subject to 2.b. above, the most we will pay for
the sum of all damages because of all
"personal and advertising injury" sustained by
any one person or organization is the Personal
and Advertising Injury Limit shown in the
Declarations.
6. Damage To Premises Rented To You Limit
The Damage To Premises Rented To You
Limit is the most we will pay under Business
Liability Coverage for damages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
lightning or explosion, while rented to you or
temporarily occupied by you with permission of
the owner.
In the case of damage by fire, lightning or
explosion, the Damage to Premises Rented To
You Limit applies to all damage proximately
caused by the same event, whether such
damage results from fire, lightning or explosion
or any combination of these.
6. How Limits Apply To Additional Insureds
The most we will pay on behalf of a person or
organization who is an additional insured
under this Coverage Part is the lesser of
a. The limits of insurance specified in a
written contract, written agreement or
permit issued by a state or political
subdivision; or
b. The Limits of insurance shown in the
Declarations.
Such amount shall be a part of and not in
addition to the Limits of Insurance shown in
the Declarations and described in this Section.
Form SS 00 08 04 05
Policy No. EO- 828309
EVANSTON INSURANCE COMPANY Prod. No. NEW
L°
MARKE
DECLARATIONS - PROFESSIONAL LIABILITY INSURANCE FOR SPECIFIED PROFESSIONS
Claims Made Policy: This policy is limited to liability for only those CLAIMS THAT ARE FIRST MADE AGAINST THE
INSURED DURING THE POLICY PERIOD. Please review the policy carefully.
1. NAMED INSURED: BAY ACTUARIAL CONSULTANTS
The Named Insured is a(n)
2. PREDECESSOR FIRM: N/A
3. BUSINESS ADDRESS OF THE INSURED
346 RHEEM BLVD SUITE 204
MORAGA, CA 94556
4. PROFESSIONAL SERVICES OF THE INSURED: Actuarial and Consulting Services for others for a fee
5. POLICY PERIOD: From February 6, 2006 to February 6, 2007
12:01 A.M. Standard Time at address of Insured stated above
6. RETROACTIVE DATE: February 6, 2002
7. LIMITS OF LIABILITY:
The liability of the Company for each claim including claim
expenses under this policy shall not exceed $ 1,000,000
and, subject to that limit for each claim, the total limit of the
Company's liability for all claims including claim expenses
under this policy shall not exceed the aggregate $ 1,000,000
8. DEDUCTIBLE:
Applicable to each claim, including claim expenses $ 2,500
9. RATE: Flat
10. PREMIUM
Minimum $
Deposit $
Page 1 (f) t� W
11
12
13
PREMIUM FOR EXTENDED DISCOVERY PERIOD
150% of annual premium as finally determined plus applicable tax_
NUMBER OF MONTHS IN EXTENDED DISCOVERY PERIOD: 12
ENDORSEMENTS ATTACHED AT POLICY INCEPTION:
1. ZZ- 44003 -02 Certified Acts of Terrorism Exclusion
2. EIC 4115 -01 25% Minimum Earned Premium Endorsement
3. ZZ- 49001 -03 California Service of Suit
4. EIC 1941 -01 Additional Exclusions - Actuary/Actuarial Consultant
Policy Form: EIC 801 -3 4/85
Dec: EIC 801 -3 4/85
Date Printed: February 8, 2006
Page 2
Policy No. EO- 828309
ALL CLAIMS TO BE REPORTED DIRECTLY TO
Shand Morahan & Company, Inc.
Ten Parkway North, Suite 100
Deerfield, Illinois 60015
Phone: (847) 572 -6000, Fax: (847) 572 -6338
Authorized Repre ative