HomeMy WebLinkAbout1967 CASUALTY INSURANCE POLICY
GENERAL POLICY PROVISIONS Form 8089
(1) ~t Chire means the amount incurred for (a) the ~
........ of auw~les, including the entire remuneration of e~
~ ~1~, ~. K~'t.~. t~ employee of the named insured engag~ in the o~ration. . .
such automobdes subject to an average w~kly max~m
~OGAL ~N~ remuneration of $100, and for (b) pick-up, transportat
~ or de very ~rv ce of pro~rty or ~ssengers other t}
~ IT~..-O ~. Ii I such ~rwces ~rformed by motor carriers which are subl
to the s~urity requirements of any motor carri~ law
ordinance. The rates for each $100 of "~st of htre" si
be 5% of the appli~ble hired automo~le rates, provi(
the owner of such hired automo~le has purchased automo
Bodily Injury Liability and Property ~amage Liability
surance ~vering the interest of the nam~ insur~ o~
ACCIDENT AND INDEMNI COMPANY
6~ Asylum Avenue
Hartford, Connecticut 06115
(A stock insurance company, herein called the company)
In consideration of the payment of the premium, in reliance upon the statements in the declarations made a
part hereof and subject to all of the terms of this policy, agrees with the named insured as follows:
COVERAGE
Insurance is afforded by the Coverage Parts forming a part hereof, subject to such limits of liability as are stated therein and subject to ail
the terms of the policy having reference thereto.
SUPPLEMENTARY PAYMENTS
The company will pay, in addition to the applicable limit of
liability:
(a) all expenses incurred by the company, all costs taxed against.
the insured in any suit defended by the company and all interest
on the entire amount of any judgment therein which accrues
after entry of the judgment and before the company has paid
or tendered or deposited in court that part of the, judgment
which does not exceed the limit of the company s liability
thereon;
(b) premiums on appeal bonds required in any such suit, premiums
on bonds to release attachments in any such shit for an amount
not in excess of the applicable limit of liability of this policy,
(c)
(d)
and the cost of bail bonds required of the insured because of
accident or traffic law violation arising out of the use of an}(
vehicle to which this policy applies, not to exceed $250 per bail
bond, but the company shall have no obligation to apply for or
furnish any such bonds;
expenses incurred by the insured for first aid to others at the
time of an accident, for bodily injury to which this policy applies;
reasonable expenses incurred by the insured at the company's
request, including actual loss of wages or salary (but not loss
of other income) not to exceed $25 per day because of his
attendance at hearings or trials at such request.
DEFINITIONS
When used in this policy (including endorsements forming a part
hereof):
"automobile" means a land motor vehicle, trailer or semi-trailer
designed for travel on public roads (including any machinery or
apparatus attached thereto), but does not include mobile equipment;
"bodily injury" means bodily injury, sickness or disease sus-
tained by any person;
"collapse hazard" includes "structural property damage" as
defined herein and property damage to any other property at any
time resulting therefrom. "Structural property damage" means the
collapse of or structural injury to any building or structure due to
(1) grading of land, excavating, borrowing, filling, back-filling,
tunnelling, pile driving, cofferdam work or caisson work or (2)
moving, shoring, underpinning, raising or demolition of any building
or structure or removal or rebuilding of any structural support
thereof. The collapse hazard does not include property damage (1)
arising out of operations performed for the named insured by in-
dependent contractors, or (2) included within the completed operations
hazard or the underground property damage hazard, or (3) for which
liability is assumed by the insured under an incidental contract;
"completed operations hazard" includes bodily injury and
property damage arising out of operations or reliance upon a repre-
sentation or warranty made at any time with respect thereto, but
only if the bodily injury orproperty damage occurs after such opera-
tions have been completedor abandoned and occurs away from
premises owned by or rented to the named insured. "Operations"
include materials, parts or equipment furnished in connection there-
with. Operations shall be deemed completed at the earliest of the
following times:
(1) when all operations to be performed by or on behalf of the
named insured under the contract have been completed,
(2) when all operations to be performed by or on behalf of the
named insured at the site of the operations have been completed,
or
(3) when the portion of the work out of which the injury or damage
arises has been put to its intended use by any person or organiza-
tion other than another contractor or subcontractor engaged in
performing operations for a principal as a part of the same project.
Operations which may require further service or maintenance
work, or correction, repair or replacement because of any defect or
deficiency, but which are otherwise complete, shall be deemed
completed.
The completed operations hasard does not include bodily injury or
property damage arising out of
(a) operations in connection with the transportation of propertT,
unless the bodily injury or property damage arises out of a condi-
tion in or on a vehicle created by the loading or unloading thereof,
(b) the existence of tools, uninstalled equipment or abandoned or
unused materials, or
(c) operations for, which the classification stated in the policy or in
the company s manual specifies "including completed opera-
tions'';
"damages" includes damages for death and for care and loss
of services resulting from bodily injury and damages for loss of use
of property resulting from property damage;
legator means any hmstmg or Iowermg device to connect
floors or landings, whether or not in service, and ail appliances thereof
including any car, platform, shaft hoistway stairway, runway,
power equipment andmachinery but does not include an automobile
servicing hoist, or a hoist without a platform outside a building if
without mechanical power or if not attached to building walls, or
a hod or material hoist used in alteration, construction or demolition
operations, or an inclined conveyor used exclusively for carrying
property or a dumbwaiter used exclusively for carrying property
and having a compartment height not exceeding four feet;
"explosion haaard" includes property damage arising out of
blasting or explosion. The explosion hazard does not include property
damage (1) arising out of the explosion of air or steam vessels, piping
under pressure, prime movers, machinery or power transmitting
equipment, or (2) arising out of operations performed for the named
insured by independent contractors, or (3) included within the com-
pleted aperations hazard or the underground property damage hazard,
or (4) for which liability is assumed by the insured under an incidental
contract;
"t~lctdetltal cotltract" means any written (1) lease of premises,
(2) easement agreement, except in connection with construction or
demolition operations on or adjacent to a railroad, (3) undertaking
to indemnify a municipality required by municipal ordinance except
in connection with work for the municipality, (4) sidetrack agree-
ment, or ($) elevator maintenance agreement;
"tr~ured" means any person or organization qualifying as an
insured in the "Persons Insured"provision of the applicable insur-
ance coverage. The insurance afforded applies separately to each
insured against whom claim is made or suit is brought, except with
respect to the limits of the company's liability;
"mobile equipment" means a land vehicle (including any
machinery or apparatus attached thereto), whether or not self-
propelled, (1) not subject to motor vehicle registration, or (2) main-
tained for use exclusively on premises owned by or rented to the
named insured, including the ways bnmediately ad Oilfing or 3
designed for use principally off pub ic roads, or 4) des gned or main-
rained for the sole purpose of affording mobility to equipment of the
following types forming an integral part of or permanently attached
to such vehicle: power cranes, shovels, loaders, diggers and drills;
concrete mixers (other than the mix-in-transit type); graders,
sffrapers, rollers and other road construction or repair equipment;
air-compressors, pumps and generators, including spraying, welding
and building cleaning equipment; and geophysical exploration and
well servicing equipment;
"named ir~ured" means the person or organization named in
Item 1. of the declarations of this policy;
"named insured's products" means goods or products manu-
factured, sold, handled or distributed by the named insured or by
others trading under his name, including any container thereof
(other than a vehicle), but "~amed insured's products" shall not include
a vending machine or any property other than such container, rented
to or located for use of others but not sold;
"occurrence" means an accident, including injurious exposure
to conditions, which results, during the policy period, in bodily injury
or property damage neither expected nor intended from the stand-
point of the insured;
"policy territory" means:
(1) the United States of America, its territories or possessions, or
Canada, or
(2) international waters or air space, provided the bodily injury or
property damage does not occur in the course of travel or trans-
portation to or from any other country, state or nation, or
(3) anywhere in the world witb respect to damages because of bodily
injury or property damage arising out of a product which was
sold for use or consumption within the territory described in
paragraph (1) above, provided the original suit for such damages
is brought within such territory;
"products hazard" includes bodily injury and property damage
arising out of the named insured's products or reliance upon a repre-
sentation or warranty made at any time with respect thereto, but
only if the bodily injury or property damage occurs away from premises
owned by or rented to the named insured and after physical posses-
sion of such products has been relinquished to others;
"property damage" means injury to or destruction of tangible
property;
"underground property damage hazard" includes under-
ground property damage as defined herein and property damage to
any other property at any time resulting therefrom. "Underground
property damage" means property damage to wires, conduits, pipes,
reruns, sewers, tanks, tunnels, any similar property, and any ap-
paratus in connection therewith, beneath the surface of the ground
or water, caused by and occurring during the use of mechanical
equipment for the purpose of grading land paving excavating,
drilling, borrowing, filling, back-filling or pile driving. The under-
ground property damage hazard does not include property damage (1)
arising out of operations performed for the named insured by in-
dependent contractors, or (2) included within the completed opera-
tions hazard, or (3) for which liability is assumed by the insured
under an incidental contract.
DESGRIPTION OF TERMS USED AS PREMIUM BASES
When used as a premium basis for: (c) Comprehensive General Liability Insurance;
(a) Comprehensive General Liability Insurance or Owners', Land-
lords and Tenants' Liability Insurance, "admissior~" means
the total number of persons, other than employees of the named
insared, admitted to the event covered by the insurance or to
events conducted on the premises whether on paid admission
tickets, complimentary tickets or passes;
(b) Comprehensive General Liability Insurance Manufacturers'
and Contractors' Liability Insurance; Owners', Landlords' and
Tenants' Liability Insurance; Owners' and Contractors' Pro-
tective Liability Insurance, "cost" means the total cost to the.
namtd insured with respect to operations performed for the
narr~d insured during the policy period by independent con-
tractors of all work let or sub-let ~n con6ection with each specific
project, including the cost of all labor materials and equipment
furnished, used or del vered for use in the execution of such
work, whether furnished by the owner, contractor or subcon-
tractor, including all fees, allowances bonuses or commissions
made, paid or due;
(d)
and Contractors' Liability Insurance; Owners', Landlords' and
Tenants' Liability Insurance or Completed Operations and
Products Liabifity Insurance, "receipts" means the gross
amount of money charged by the named insured for such opera-
tions by the named insured or by others during the policy period
as are rated on a receipts basis other than receipts from tele-
casting, broadcasting or motion pictures, and includes taxes,
other than taxes which the named insured collects as a separate
item and remits directly to a governmental division;
Comprehensive General Liability Insurance; Manufacturers'
and Contractors' Liability Insurance or Owners', Landlords'
and Tenants' Liability Insurance which includes coverage for
structural alterations, new construction and demolition opera-
tions, "remuneration" means the entire remuneration earned
during the policy period by proprietors and by all employee~ of
the named insured, other than chauffeurs (except operators of
mobile equipment) and aircraft pilots and co-pilots, subject to
any overtime earnings or limitation of remuneration rule ap-
plicable in accordance with the manuals in use by the Company;
(e) Comprehensive General Liability Insurance or Completed Oper-
ations and Products Liability Insurance, "sales--means th~
gross amount of money charged by the named insured or by
others trading under h~s name for a goods and products sold
or distributed during the policy per od and charged during the
policy period for installation, servicing or repair, and includes
taxes, 6ther than taxes which the named insured and such others
collect as a separate item and remit directly to a governmental
division;
(f) Contractual Liability Insurance, "cost" means the total co~
to any indemnitee, with respect to any contract which is insured,
of all work let or subdet in connect on with each spec tic project,
including the cost of all labor, materials and equipment fur~/~hed
used or delivered for use in the execut on of such wo-x, whether
furnished by the owner, contractor or the subcontr4ctor, including
all fees, allowances, bonuses or commissiono made, paid or due;
(g) Garage Insurance, "remuneration" means (a) the entire re-
muneration earned during the policy period by each Class A
employee and each Class C employee of the named insured,
subject to an average weekly maximum of $i00 and (b) the
remuneration of each C ass B person at a fixed amount of $2,000
per annum
laSS A means all clef cai office employees
"Class B" means all proprietors and officers active in the
business, and inactive proprietors or officers (other than an
inactive proprietor or officer who is a spouse of an active
proprietor or officer) who customarily drive an automobile
~ned by the named insured; and all salesmen, general man-
agers, service managers and chauffeurs
"Cla~S C" means all other employees;
(h) Comprehensive Automobile Liability Insurance,
(1) "cost of hire" means the amount incurred for (a) the hire
of autonwbiles, including the entire remuneration of each
employee of the named insured engaged in the operation of
such automobiles subject to an average weekly maximum
remuneration of $100, and for (b) pick-up, transportation
or delivery service of property or passengers other than
such services performed by motor carriers which are subject
to the security requirements of any motor carrier law or
ordinance. The rates for each $100 of "COst of hire" shall
be 5% of the applicable hired automobile rates, provided
the owner of such hired automobile has purchased automobile
Bodily Injury Liability and Property Damage Liability in-
surance covering the interest of the named insured on a
direct primary basis as respects such automobile and submits
evidence of such insurance to the named insured;
(2) "Class 1 persons" means the following persons, provided
their usual duties in the business of the named insured in-
clude the use of non-owned automobiles: (a) all employees,
including officers, of the namet insured compensated for the
use of such automobiles by salary, commission, terms of
employment, or specific operating allowance of any sort
(b) all direct agents and representatives of the named insured;
(3) "Class 2 employees" means all employees, includingof-
ricers, of the named insured, not included in Class 1 persons.
NUCLEAR ENERGY LIABILITY
This exclusion modifies the provisions of the policy relating to
ALL LIABILITY AND MEDICAL PAYMENTS INSURANCE
OTHER THAN COMPREHENSIVE PERSONAL AND FARM-
ERS COMPREHENSIVE PERSONAL INSURANCE.
It is agreed that:
I. The policy does not apply:
A. Under any Liability Coverage, to bodily injury or property
damage
(1) with respect to which an insured under the policy is
also an insured under a nuclear energy liability policy
issued by Nuclear Energy Liability Insurance Associa-
tion, Mutual Atomic Energy Liability Underwriters or
Nuclear Insurance Association of Canada, or would be
an insured under any such policy but for its termination
upon exhaustion of its limit of liability; or
(2) resulting from the hazardous properties of nuclear
material and with respect to which (a) any person or
organization is required to maintain financial protec-
tion pursuant to the Atomic Energy Act of 1954, or
any law amendatory thereof, or (b) the insured is, or
had this policy not been issued would be, entitled to
indemnity from the United States of America, or any
agency thereof, under any agreement entered into by
the United States of America, or any agency thereof,
with any person or organization.
B. Under any Medical Payments Coverage, or under any
Supplementary Payments provision relating to first aid, to
expenses incurred with respect to bodily injury resulting
from the hazardous properties of nuclear material and arising
out of the operation of a nuclear facility by any person or
organization.
C. Under any Liability Coverage, to bodily injury or property
damage resulting from the hazardous properties of nuclear
material, if
(1) the nuclear material (a) is at any nuclear.facility owned
by, or operated by or on behalf of, an insured or (b)
has been discharged or dispersed therefrom;
(2) the nuclear material is contained in spent .fuel or waste
at any time possessed, handled, used, processed, stored,
transported or disposed of by or on behalf of an insured;
or
(3) the bodily injury or property damage arises out of the
furnishing by an insured of services, materials, parts
or equipment in connection with the planning, con-
struction, maintenance, operation or use of any nuclear
EXCLUSION
facility, but if such facility is located within the United
States of America, its territories or possessions or
Canada, this exclusion (3) applies only to property
damage to such nuclear facility and any property
thereat.
II. As used in this exclusion:
"hazardons properties" include radioactive, toxic or ex-
plosive properties;
material or byproduct material;
"source material", "special nuclear material", and
"byproduct material" have the meanings given them in the
Atomic Energy Act of 1954 or in any law amendatory thereof;
solid or liquid, which has been used or exposed to radiation
"waste" means any waste material (1) containing byproduct
material and (2) resulting from the operation by any ~erson
or organization of any nuclear facility included within the
definition of nuclear facility under paragraph (a) or (b) thereof;
"nuclear facility" means
(a) any nuclear reactor,
(b) any equipment or device designed or used for (1) separating
the isotopes of uranium or plutonium, (2) processing or
utilizing spent fuel, or ($) handling, processing or packaging
(c) any equipment or device used for the processing, fabri-
cating or alloying of special nuclear material if at any time
the total amount of such material in the custody of the
plutonium or uranium 233 or any combination thereof,
or more than 250 grams of uranium 235,
(d) any structure, basin, excavation, premises or place pre-
and includes the site on which any of the foregoing is located,
all operations conducted on such site and all premises used for
such operations;
contain a critical mass of fissionable material;
"property damage" includes all forms of radioactive con-
tamination of property.
CONDITIONS
1. Premium All premiums for this policy shall be comp~te0 in
accol'dance with the company's rules, rates, rating plans, pren~ums
and minimum premiums applicable to the !,nsurance afforded h,,er~in'
Premium designated in this policy as advance premium is a
deposit premium only which shall be credited to the amount of th~
earned premium due at the end of the policy period. At the close
of each period (or part thereof terminating with the end of the policy
period) designated in the declarations as the audit period the earned
premium shall be computed for such period and, upon notice thereof
to the named insured, shall become due and payable. If the total
earned premium for the policy period is less than the premium pre-
viously paid, the company shall return to the named insured the
unearned portion paid by the named insured.
The named insured shall maiatain records of such information as
is necessary for premium computation, and shall send copies of such
records to the company at the end of the policy period and at such
times during the policy period as the company may direct.
2. Inspection and Audit The company shall be permitted but
not obligated to inspect the named insured's property and operations
at any time. Neither the company's right to make inspections nor
the making thereof nor any report thereon shall constitute an under-
taking, on behalf of or for the benefit of the named insured or others,
to determine or warrant that such property or operations are safe.
The company may examine and hudit the named insurod's books
and records at any time during the policy period and extensions
thereof and within three years after the final termirlation of this
policy, as far as they relate to the subject matter of this insurance.
3. Financial Responsibility Laws When this policy is certified
as proof of financial responsibility for the future under the provisions
of any motor vehicle financial responsibility law, such insurance as
is afforded by this policy for bodily injury liability or for property
damage liability shall comply with the provisions of such law to the
extent of the coverage and limits of liability required by such law.
The insured agrees to reimburse the company for any payment made
by the company which it would not have been obligated to make
under the terms of this policy except for the agreement contained
in this paragraph.
4. lnsured's Duties in the Event of Occurrence, Claim or Suit
(a) In the event of an occurrence, written notice containing partl-
culars sufficient to identify the insured and also reasonably
obtainable information with respect to the time, place and
circumstances thereof, and the names and addresses of the in-
jured and of avaiIable witnesses, shall be given by or for the
insured to the company or any of its authorized agents as soon
as practicable. The named insured shall promptly take at his
expense all reasonable steps to prevent other bodily injury or
property damage from arising out of the same or similar condi-
tifns, but such expense shall not be recoverable under this policy.
(b) If claim is made or suit is brought against the insured, the insured
shall immediately forward to the company every demand,
notice, summons or other process received by him or his repre-
sentative.
(c) The insured shall cooperate with the company and, upon the
company's request assist in making settlements, in the conduct
of suits and in enforcing any right of contribution or indemnity
against any person or organization who may be liable to the
insured because of bodily injury or property damage with respect
to which insurance is afforded under this pobcy; and the insured
shall attend hearings and trials and assist in securing and giving
evidence and obtaining the attendance of wimesses. Theinsured
shall not, except at his own cost, voluntarily make any payment,
assume any obligation or incur any expense other than for first
aid to others at the time of accident.
5. Action Against Company No action shall lie against the
company unless, as a condition precedent thereto, there shall have
been full compliance with all of the terms of this policy, nor until
the amount of the insured's obligation to pay shall have been finally
determined either by judgment against the insured after actual trial
or by written agreement of the insured, the claimant and the com-
pany. .
Any person or organizanon or the legal representative thereof
who has secured such judgment or written agreement shall there-
after be entitled to recover under this policy to the extent of the
insurance afforded by this policy. No person or organization shall
have any right under this policy to join the company as,a party to
any action against the insured to determine the insured s liability,
nor shall the company be impleaded by the insured or his legal repre-
sentative. Bankruptcyorinsolvencyoftheinsuredoroftbeinsured's
e~tate shall not relieve the company of any of its obligations here-
under.
6. Other Insurance The insurance afforded by this policy is
primary insurance, except when stated to epply in ekcess of or con-
tingent upon the absence of other insurance. When this insurance
s primary and the insured has other insurance which is stated to be
app ical~le to the loss on an excess or contingent basis, the amount
of the company's liability under this policy shall not be reduced by
the existence of such other insurance.
When both this insurance and other insurance apply to the loss
on the same basis, whether primary excess or contingent, the com-
pany sha not be liable under this policy for a greater proportion
~f the loss than that stated in the applicable contribution provision
below:
(a) Contribution by Equal Shares. If all of such other valid
a~d collectible insurance provides for contribution by eq~lal
share~, the company shall not be liable for a greater proportion
of such lc~a than would be payable if each insurer contributes
an equal share until the share of each insurer equals the lowest
applicable limit of liability under any one policy or the full
amount of the loss is paid, and with respect to any amount of
loss not so paid the remaining insurers then continue to con-
tribute equal shares of the remaining amount of the loss until
each such insurer has paid its limit in full or the full amount
of the loss is paid.
(b) Contribution by Limits. If any of such other insurance does
not provide for contribution by equal shares, the company shall
not be liable for a greater proportion of such loss than the appli-
cable limit of liability under this policy for such loss bears to the
total applicable limit of liability of all valid and collectible in-
surance against such loss.
7. Subrogation In the event of any payment, under this policy,
the company shall be subrogated to all the insured s rights of recovery
therefor against any person or organization and the insured shall
execute and deliver instruments and papers and do whatever else
is necessary to secure such rights. The insured shall do nothing
after loss to prejudice such rights.
8. Changes Notice to any agent or knowledge possessed by any
agent or by any other person shall not effect a waiver or a change
in any part of this poIicy or estop the company from asserting any
right under the terms of this policy; nor shall the terms of this
policy be waived or changed, except by endorsement issued to form
a part of this policy, signed by an authorized representative of the
company.
~. Assignment Assignment of interest under this policy shaIl not
bind the company until its consent is endorsed hereon; if, however,
the named insured shall die, such insurance as is afforded by this
policy shall apply (1) to the named insurod'$ legal representative, as
the named insured, but only while acting within the-scope of his
duties as such, and (2) with respect to the property of the named
insured, to the person having proper temporary custody thereof, as
insured, but only until the appointment and qualification of the legal
representative.
10. Three Year Policy If this policy is issued for a period of
three years, the limits of the company's liability shall apply separately
to each consecutive annual period thereof.
11. Cancellation This policy may be cancelled by the named
insured by surrender thereof to the compar~y or any of its authorized
agents or by mailing to the company written notice stating when
thereafter the cancellation shall be effective. This policy may be
cancelled by the company by mailing to the named insured at the
address shown in this policy, written notice stating when not less
than ten days thereafter such cancellation shall be effective. The
mailing of notice as aforesaid shaII be sufficient proof of notice. The
time of surrender or the effective date and hour of cancellation stated
in the notice shall become the end of the policy period. Delivery
of such written notice either by the named insured or by the company
shall be equivalent to mailing.
If the named insured cancels, earned premium shall be computed
in accordance with the customary short rate table and procedure.
If the company cancels, earned premium shall be computed pro
rata. Premium adjustment may be made either at the time can-
cellation is effected or as soon as practicable after cancellation be-
comes effective, but payment or tender of unearned premium is not
a condition of cancellation.
12. Declarations By acceptance of this pfficy, the named insured
agrees that the statements in the declarations are his agreements
and representations, that this policy is issued in reliance upon the
truth of such representations and that this policy embodies all
agreements existing between himself and the company or any of its
agents relating to this insurance.
In Witness Whereof, the HARTFORD ACCIDENT AND INDEMNITY COMPANY has caused this policy
to be signed by its President and a S&cretary, but the same shall not be binding unless countersigned on the declarations
page by a duly authorized agent of the company.
This Copy of Declarations page, with "GENERAL POLICY PROVISIONS" Form 8089, Coverage Parts, ami endorsements, if any, issued to form
a part thereof, completes the COPY of the belo~ numbered ~asualty Insurance Policy with respect to such Automobile Physical ~amage I~surance as
is aff~d~ t~r.*
~ ~ ~ford Acdd~t ~d ~d~ ~m~y ~ ~ Tw~ Ci~ Fire ~ur~ce ~m~y
l~S~2~2g?~$ ~ ~ Oti~s ~s~ce ~m~ny of New Jeney ~
The iNSURER shah be as named in tim General PoltcyI Co. Code
Provisions and as designated herein by Co. Code:I 5
DECLARATIONS [ ~lo-, ~ottcy No.
Items 10 CL 168481
1. Named Insured and Address
The named ~ Individual ~ Partnership ~ Corporation
insuredls: ]lJointVenture X~Other p/l~l( I~lqT
2. Policy Period
FRED W. KAEL IN
120155
POLICY NO. 12 CL 101464
CUTCHOGUE NEW SUFFOLK PARK DIST
E/S NASSAU POINT ROAD
CUTCHOGUE, SUFFOLK CO., NEV YORK
~From 9 2 0 67 To 9 2 0 68
12:01 A. M., standard time at the address of the named insured as stated
herein.
Audit Period: Annual, unless otherwise stated. [~ Semi-Annual
I [ Quarterly
~J Monthly
The advance premium for this policy is as stated below. Insurance is afforded by the Coverage Parts forming a part hereof,
subject to such limits of liability as are stated therein and subject to all the terms of the policy having reference thereto.
SUMMARY OF ADVANCE PREMIUMS
COVERAGE PARTS
Comprehensive General Liability Insurance
Comprehensive Automobile Liability Insurance
Automobile Medical Payments Insurance
Uninsured Motorists Insurance
Automobile Physical Damage Insurance
Premises Medical Payments Insurance
Contractual Liability Insurance
Personal Injury Liability Insurance
Garage Insurance
ADVANCE
PREMIUM
Form Numbers ot Coverage Parts and endorsements not listed on Coverage Parts iormh~g part of Policy at issue: TOTAL
ADVANCE
L3 003 -0 L3 075 -0 PREMIUM
If Policy Period more than one year: Gross Premium
Premium is payable: On effective date of Polic
4, Business of the named insured is )
5. During the past 3 years no Insurer has cancelled insurance, issued
to the named insured, similar to that afforded hereunder unless
otherwise stated herein.
Discount
RECREAT I ON
TO LOSS PAYEE:
This copy is for information only, having been issued at the
request of the Loss Payee named in the Schedule of Covered
Automobiles. It is not a contract of insurance but attests that
the Policy as numbered herein has been issued by the Com-
pany to the Insured named in Item I of the Declarations.
Said Policy is sub ect to change by endorsement and to assign-
ment, cancellation and termination according to its terms.
For~ A-2135-0 LP Printed in U.S.A. 6-'66
FRED ~/ KAELIN 120155
'12 8 FH
R~ET U R N . p. R E. H I U H $/+/~. 0~00 Named I,~ured and Ad~
Th~ena~mentfom, a~ofPollc~No...~..~.....~..~...-~..~.~.~.~. ........ f CUTCHOGUf ~f~ surr0LK ,~RK O~ST.
~u~ by THE HART~RD INSU~NCE GROUP core,ny ~
~m~n~ d~i~t~ th~in and ~kes ~t ~ of the ~ve da~ C U T C H 0 G U E S U F F 0 L K C 0, N i ~ Y 0 R K
of ~id ~li~ unl~ ano~ eff~tive ~ s s~t~ h~ein. * '
Eff~ti. date ................ ?..~.~.~.~.~.~ ....................................... Eff~ve hour is ~e .me. sta~ in the D~hm~on. of ~e
PoH~.
IT IS AGREED THAT THE PREMIUH BASIS
PREHISES HEDICAL PAYHENTS INSURANCE
TO READ: 1OO% OF CODE 0332S
PREt~
qS.OO
FOR THE
IS AMENDED
Nothin~ herein contained shall be held to vary, waive, alter, or extend any of the terms, conditions, agreements or declarations of the policy, other than
as herein stated.
This endorsement shall not be binding unles~ countersigned by a duly authorized agent of the company or companies; provided that if}his endorseme .nt
takes effect as of the effective date of the policy and at issue of said policy, forms a part thereof, countersignature on the declarations page of said
policy by a duly authorized agent of the company or companies shal constitute va id countersignature of this endorsement.
INSURANCE GROUP
HARTFORD CONNECTICUT
Hartford Fire Insurance Company New York Unde~w.lters Insurance Company
Hartford Accident and Indemnity Company Twin City Fire Insurance Company
Citizens Insurance Company of
Co..~rs/g.e.d ~~.~ ...............................
Authori~ Agent
LIABILITY
EXTENSION SCHEDULE FOR COMPREHENSIVE GENERAL LIABILITY, OLT OR MC COVERAGE PARTS
by THE HARTFORD INSURANCE GROUP company or companies designated therein, and takes effect as o[ the effective date of said policy
unlezs another effective date is stated herein.
Effective date ..................................................................................... 12:01 A. M., standard time.
RATING CLASSIFICATIONS Code Rates Advance Premiums
l~OHCy, do not ~l~dC~ any of the ot~ef provisions of this policy. NO. B.I. P.D. B. L P.D.
"/S NASSAU POINT ROAD
;UTCHOGUE, SUFFOLK CO., N.Y.
lATHING BEACH, EXCLUDING
lADING POOLS- NO OUTDOOR
ICE-SKATING FACILITIES- NO
)*OHISSION CHARGED 0301 F.C. 178.00 2.30 178.00 2.00
t/S OF NASSAU POINT ROAD
CUTCHOGUE, SUFFOLK CO., N.Y.
;OUTHERLY SIDE OF BAY AVENUE
:UTCHOGUE, SUFFOLK CO., N.Y.
>ARKS O R PLAYGROUNDS
'APPROX. 3 ACRES) 0301E F.C. 1.13 /+.06 11.00 /+.00
189.O0 6.00
( INCL JDED)
THE HARTFORD
New York Underwriters Insurance Company
Twin City Fire Insurance Comlmny
Hartford Fire Insurance Company
Hartford Accident and Indemnity Company
Citizens Insurance Company of New Jersey
COMPREHENSIVE GENERAL *LIABILITY INSURANCE
THE HAIffFORD
l,q~N Sm UeoRnAo.NaCo~E ~G~ Re ~cUcP. COVERAGE PART
This Coverage Part forms a ~t of Policy NO._...~..~.. _~ [.. ~..0 ~.~.6.~ ................ issu~ by THE HARTFORD
Core.ny designat~ therein, and ~kes e~t ~ of the effective date of ~id ~licy un]~ otherwi~ st~t~ herelm
INSURANCE GROUP
(For use only if this Coverage Part is effective after the effective doJe of the Policy) I
I
This Coverage Part is effective .................................................................. (at the hour stated in the policy) and forms a part of the above designated
policy issued to
The Company, in consideration of the payment of the premium and subject to all of the provisions of the policy not expressly modified herein,
agrees with the named insured as follows:
SCHEDULE
The insurance afforded is only with respect to such of the following coverages as are indicated by specific premium charge or char~e~.
The limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms of this policy
reference thereto.
Coverages Advance Premiums Limits of Liability
A -- Bodily Injury Liability $ $ 2 ~ 0 ,m each person
22/4.00 $ 1000 ,m each occurrence
$ ,0~ a~re~ate
B ~ ~operty DamaRe Liability $ ~. 0 0 $ 2 ~ ,~ ~ch ~
$ 2 5 ,~ a~te
Rates Ad~n~ ~e~um
Rating Classifications ~ode Premium Bases
) SEE SCHEDULE ATTACHED 189.00 6.00
NCR. AMTS. BASIC CHGE. 9890 3~.00
A)
Form Numbers of Endorsements [orming part of this Coverage Part at issue: TOTAL ADVKNCE
L301/~ 0 PREMIUMS 224.00 6.00
If the Policy Period is more than one year, the Premium is Payable:
On effective date of Policy $ Ist Anniversary $ 2nd Anniversary $
The conditions and provisions printed on pages CGL-2 and CGL-3 of this form are hereby referred to and made a part hereof.
Th s Coverage Part shall not be binding unless counters gned by a du y authorized agent of the company; provided that if this Coverage Part takes
effect as of the effective date of the policy and at issue of said policy, forms a part thereof, countersignature on the declarations page of sgid policy
by a duly authorized agent of the company shall constitute valid countersignature of this C_/l~w~e Part. ,
.....................
ltol'~ L-3005-0 Printed in U.S.A. 6-'66 CGL-I
COMPREHENSIVE GEI~ERAL 'LIABILITY INSURANCE
COVERAGE PART
(continued)
I. COVERAGE A- BODILY INJURY LIABILITY
COVERAGE B--PROPERTY DAMAGE LIABILITY
The company will pay on behalf of the insured all sums which
the insured shall become legally obligated to pay as damages because
of
Coveral~.e A bodily injury or
Coverage B--property damage
to whlch this insurance applies, caused by an occurrence, and the
company shall have the right and duty to defend any suit against the
insured seeking damages on account of such bodily injury or property
damage, even if any of the allegations of the suit are groundless, false
or fraudulent, and may make such investigation and settlement of
any claim or suit as it deems expedient, but the company shall not be
obligated to pay any claim or judgment or to defend any suit after
the appl cable I m t of the company s bab~ ty has been exhausted~
by payment of judgments or settlements.
This insurance does not apply:
(a) to liability assumed by the insured under any contract or agree-
ment except an incidental contract; but this exclusion does not
apply to a warranty of fitness or quality of the named insured's
products or a warranty that work performed by or on behalf of
the named insured will be done in a workmanlike manner;
(b) to bodily injury or property damage arising out of the ownership,
maintenance, operation, use, loading or unloading of
(1) any automobile or aircraft owned or operated by or rented or
loaned to the named insured, or
(2) any other automobile or aircraft operated by any person in the
course of his employment by the named insured;
but this exclusion does not apply to the parking of an automobile
on premises owned by, rented to or controlled by the named
insured or the ways immediately adjoining, if such automobile is
not owned by or rented or loaned to the named insured;
(c) tobodilyinjuryorpropertydamagearisingoutofandinthecourse
of the transportation of mobile equipment by an automobile owned
or operated by or rented or loaned to the named insured;
(d) to bodily injury or property damage arising out of the ownership,
maintenance, operation, use, loading or unloading of any water-
craft, if the bodily injury or property damage occurs away from
premises owned by, rented to or controlled by the named insured;
but this exclusion does not apply to bodily injury or property
damage included within the products hazard or the completed opera-
tions hazard or resulting from operations performed for the named
insured by independent contractors or to liability assumed by the
insured under an incidental contract;
(e) to bodily injury or property damage due to war, whether or not
declared, civil war, insurrection, rebellion or revolution or to any
act or condition incident to any of the foregoing, with respect to
(1) liability assumed by the insured under an incidental contract,
or
(2) expenses for first aid under the Supplementary Payments
provision;
(f) to bodily injury or property damage for which the insured or his
indemnitee may be held liable, as a person or organization engaged
in the business of manufacturing, distributing, selling or serving
alcoholic beverages or as an owner or lessor of premises used for
such purposes, by reason of the selling, serving or giving of any
alcoholic beverage
(1) in violation of any statute, ordinance or regulation,
(2) to a minor,
(3) to a person under the influence of alcohol, or
(4) which causes or contributes to the intoxication of any person;
(g)
to any obligation for which the insured or any carrier as his
insurer may be held liable under any workmen's compensation,
unemployment compensation or disability benefits law, or under
any similar law;
(h) to bodily injury to any employee of the insured arising out of and
in the course of his employment by the insured; but this exclusion
does not apply to liability assumed by the insured under an in-
cidental contract;
to property damage to
(1) property owned or occupied by or rented to the insured,
(2) property used by the insured, or
(3) property in the care, custody or control of the insured or as
to which the insured is for any purpose exercising physical
control;
but parts (2) and (3) of this exclusion do not apply with respect
to liability under a written sidetrack agreement and part (3) of
th is exclusion does not apply with respect to property damage (other
than to elevators) arising out of the use of an elevator at premises
owned by, rented to or controlled by the named insured;
(k)
to property damage to premises alienated by the named insured
arising out of such premises or any part thereof;
to bodily injury or prbperty damage resulting' from the fl~ilure of
the named insured's products or work completed by or for the
named insured to perform the function or serve the purpose in-
tended by the named insured, if such failure is due to a mistake
or deficiency in any design, formula, plan, specifications, adver-
tising material or printed instructions prepared or developed by
any insured; but this exclusion does not apply to bodily injury
or property danmge resulting from the active malfunctioning of
such products or work;
(1) to property damage to the named insured's products arising out of
such products or any part of such products;
(m)
to property damage to work performed by or on behalf of the
named insured arising out of the work or any portion thereof, or
out of materials, parts or equipment furnished in connection
therewith;
(n)
to damages claimed for the withdrawal, inspection, repair, replace-
ment, or loss of use of the named insured's products or work com-
pleted by or for the named insured or of any property of which
such products or work form a part, if such products, work or
property are withdrawn from the market or from use because of
any known or suspected defect or deficiency therein;
(o)
to property damage included within:
(1) the explosion hazard in connection with operations identified
in this policy by a classification code number which includes
the symbol "x",
I*orm L-~3-0 CGL-2
THE HARTF0 PREMISES MEDICAL'P~'YMENTS INSURANCE
· , INSURANCE GROU
Co p ny designated therein, and takes effect as of the effective date of said policy unless otherwise stated herein.
(For use only ~f this Coverage Part is effective after the effective date of the Policy)
This Coverage Part is effective (at the hour stated i~! the policy) and forms a part of the above designated
policy issued to
The Company, in consideration of the paynlent of the premium and subject to all of the provisions of the polkT not expressly modified herein,
agrees with the named insured as follows:
SCHEDULE
The insurance afforded is with respect to the following coverage as indicated by specific premium charge or charges. The limit of the
company's liability against such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto.
I Limits of Liability
E Premises Medical Payments $ 89 . 00 $ ] , 000 each person
$ 10 , 000 each accident
Description of Hazards Advance Premiums
la) Premises and Operations
LOC: E/S, W/S NASSAU POINT ROAD
S/S OF BAY AVENUE, CUTCHOGUE,
SUFFOLK CO., NEW YORK (T-16)
BATHING BEACH & LAND OR PARK AREA
lb) Elevators
lc) Sports Activities
Form Numbers of Endorsements torming part of this Coverage Part at issue: ITOTAL ADVANCE
PREMIUM 89 . 00
If the Policy Period is more than one year, the Premium is Payable:
On effective date of Policy $ 1st Anniversary $ 2nd Anniversary $
The conditions and provisions printed on page MP-2 of this form are hereby referred to and made a part hereof.
This Cox erage Part shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this Coverage Part takes
effect as of the effective date of the polic3 and, at issue of said policy, forms a part thereof, countersignature on the declarations page of said policy
by a duly authorized ageut of the company shall constitute valid countersignature of this Qo(~ig~ e Part.
Authorized Agent
Form L-3075-0 Printed i9 U.S.A. 6-'66 MP-I
PREMISES MEDICAL PA'Y~ENTS INSURANCE
COVE'RAGE'PART
(continued)
L COVERAGE E- PREMISES MEDICAL PAYMENTS
The company will pay to or for each person who sustains bodily
injury caused by accident ail reasonable medical expense incurred
within one year from the date of the accident ou account of such
bodily injury, provided such bodily injury arises out of (a) a condition
in the insured premises or (b) operations with respect to which the
named insured is afforded coverage for bodily injury liability under
this policy.
Exclusions
This insurance does not apply:
(a) to bodily injury
(1) arising out of the ownership, maintenance, operation, use,
loading or unloading of any elevator unless a premium charge
is entered for elevators in the policy with respect to Premises
Medical Payments Coverage;
(2) arising out of the ownership, maintenance, operation, use,
loading or unloading of
(i) any automobile or aircraft owned or operated by or
rented or loaned to the named insured, or
(ii) any other automobile or aircraft operated hy auy person
in the course of his employment by the named insured;
but this exclusion does not apply to the parking of an autonwbile
on the insured premises, if such automobile is not owned by or
rented or loaned to the named insured;
(3) arising out of the ownership, mainteuance, operation, use,
loading or unloading of any watercraft, if the bodily injury
occurs away from the insured premises; or ~ , - ,
(4) arising out of and in the course of the transportation of
mobile equipment by an automobile owned or operated by
or rented or loaned to the named insured;
(b) to bodily injury
(1) iucluded within the completed operations hazard or the
products hazard;
(2) arising out of operations performed for the named insured
by independent contractors other than (1) maintenance and
repair of the insured premises or (ii) structural alterations
at such premises which do not involve changing the size of
or moving buildings or other structures;
(3) resulting from the selling, serving or giving of any alcoholic
beverage (i) in violation of any statute, ordinance or regula-
tion, (ii) to a minor, (iii) to a person under the intluence of
alcohol or (iv) which causes or contributes to the intoxica-
tion of any person; but this exclusion (h) (3) applies only
if the named insured is a person or organization engaged in
the business of manufacturing, distributing, selliug or serv
ins alcoholic beverages or is an owner or lessor of premises
used for such purposes;
(4) due to war, whether or not declared, civil war, insurrection,
rebellion or revolntion, or to any act or condition incident
to any of the foregoing;
(c) to bodily injury
(1) to the named insured, any partner therein, any tenaut or
other person regularly residing on the insured premises or
any employee of any of the foregoing if the bodily injury
arises out of and in the course of his employment therewith;
(2) to any other tenant if the bodily injury occurs on that part
of the insured premises rented from the named insured or
to any employee of such a tenant if the bodily injury ocgnrs
on the tenant's part of the insured premises and arises out
of and in the course of his employment for the tenant;
(3) to any person while engaged in maintenance and repair of
the insured premises or alteration, demolition or new co~-
struction at such premises;
(4) to any person if any benefits for such bodily injury are
payable or required to be provided under any workmen's
compensation, unemployment compensation or disability
benefits law, or under any similar law;
(5) toany person practicing, instructing or participating in any
physical training, sport, athletic activity or contest unless
a premium charge is entered for sports activities in the
policy with respect to Premises Medical Payments Cover-
age;
(d) to any medical expense for services by the named insured, any
employee thereof or any person or organization uuder contract
to the named insured to provide such services.
11. LIMITS OF LIABILITY
The limit of liability for Premises Medical Payments Coverage
stated in the schedule as applicable to "each person" is the limit of
the company's liability for all medical expense for bodily injury to any
one person as the result of any one accident; but subject to the
above provision respecting "each person", the total liability of the
company under Premises Medical Payments Coverage for all medical
expense for bodily injury to two or more persons as the result of any
one accident shall not exceed the limit of liability stated in the schedule
as applicable to "each accident".
When more than one medical payments coverage afforded by this
policy applies to theloss, the company shall not be liable for more
than the amount o['tl~ highest apphcable hnut of liability.
I11. ADDITIONAL DEFINITIONS
When used in reference to this insnrance (including endorsements
forlning a part of the policy):
"insured premises" means all premises owned by or rented to the
named insured with respect to which the named insured is afforded
coverage for bodily injury liability under this policy, and includes
the ways immediately adjoining on land;
"medical expense" means expenses for necessary medical, surgical,
x-ray and dental services, including prosthetic devices, and necessary
ambulance, hospital, professional nursing and funeral services.
IV. POLICY PERIOD; TERRITORY
This insnrance applies only to accidents which occur during the
policy period within the United States of America, its territories or
possessions, or Canada.
V. ADDITIONAL CONDITION
Medical Reports; Proof and Payment of Claim
As soon as practicable the injured person or someone on his behalf
shall give to the company written proof of claim, under oath if required,
aud shaH, after each request from the company, execute authorization
to enable the company to obtain medical reports and copies of records.
The injured person shall submit to physical examination by physicians
selected by the company when and as often as the company may
reasonably require. The company may pay the injured person or any
person or organization rendering the services, and the payment shall
reduce the amount payable hereunder for such injury. Payment
hereunder shall not constitute an admissiou of liability of any person
or, except hereunder, of the company.
Form L-~075-0 MP-2
PUBLIC OFFICIAL DIVISION BONO NO. NP-3~492~3-E
HARTFORD ACCIDENT AND INDEMNITY COMPANY
EXECUTED IN 2~/0 COUNTERPARTS
Hartford, Connecticut
Stock Company
OFFICIAL BOND
Know All Men By These Presents, That we, I*RA~K B. ROGER8
of Main Road, Cutchogue in the State of }low York as Principal,
and the HARTFORD ACCIDENT AND INDEMNITY COMPANY, a corporation duly organized and existing under
and by virtue of the Laws of the State of Connecticut, and authorized to become sole surety on bonds in the State of
New York , as Surety, are held and firmly bound
unto CUTCHOGUE-NEW SUPMOLK PARK DISTRICT
in the State of ~ YORK
, in the full and just sum
of PIVE THOUSAND AND 00/100 .............................. Dollars ($ 5,000e00 )
lawful money of the United States, for payment of which well and truly to be made, we bind ourselves, our heirs, executors,
administrators, successors and assigns, jointly and severally, firmly by these presents.
Signed and sealed this 8th
day of November , A. D. 19 67
Whereas, the said I*RAI~K B. ROGERS
has been duly elected or appointed to the office of Treasurer
in and for the OUTCHOGUE-NEW SUFFOLK PARK DISTRICT, NEW YORK
for the term beginning on the ].st day of
January ,19 68
a,d ending on the 31st day of December ,19 68
Now, Therefore, The Condition of the Above Obligation is Such, that if the above bounden
FRANK B. ROGERS shall, during the aforesaid term, faithfully and
truly perform all the duties of his office and shall pay over and account for all funds coming into his hands by virtue of
his said office of Treasurer
as required by law, then this obligation to be void, otherwise to be and remain in full force and virtue.
In Witness Whereof, the said Principal has hereunto set his hand and seal, and the said HARTFORD ACCIDENT
AND INDEMNITY COMPANY has caused these presents to be signed by its officers prop~ the purpose the day
and year first above written. ~ / I
~r/,~ (~ ~. 0 ~_~._ HARTFORD ACCIDEN'JAND ~N/D~M~N~TTY COMPANY
Resident Agent State of New York ..... :~<~ , ~ '~// ~
JOse~ A; Mc~g~a-Resxden$ vice P~s'i'd'ent
State °f '~c~' ~County of~"-')~l~ )ss. R.E. Doaook-Rosident Assistant SecretaPy
me, this ~ day of ~'~ ~ , A. D.
Before
personally appeared the said PRANIC B. ROGERS
to me known and known to me to be the individual deEribed in and who executed the foregoing bond, and he acknowl-
edged to me that he executed the ~me. , ~., ~ :;~~~~N
OFFICIAL BOND
~OND NO.
HARTFORD ACCIDENT
AND
INDEMNITY COMPANY
Hartford, Connecticut'/
On Behalf of
In favor of
Dated ................................................................. 19 ........
Expires .................................................... :. ~ .......... 19 .....
Printe~[ in U.S.A. 10758
STATE ~)F NEW YORK,
COUNTY OF NASSAU,_ f_ ss.
On.......~O~.~'...~ .h,s....~.7 ......................... , before me personally came ........... 0~[~0~...~.,...I~!~.~0~ ........
to me known, who, being by me duly sworn, did depose and say, that he resides in...~.~r3~J,.g.,...~O.~..~'~ ............ ;
that he is the Resident Vice-President of the HARTFORD ACCIDENT AND INDEMNITY COMPANY, the corpora-
tion described in and which executed the within instrument; that he knows the seal of said corporation; that the seal
affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corpora-
tion, and that he signed his name thereto by like order; and the said. ~9.~.~[01~...~.*...~0...124~...~ .......... further said that
he is acquainted with ........... ~.~.,....1).0~.~ .................................................. and knows him to be
of said company; that the signature of the said ........................ l~,~l.~...~0.1~.~.0~ .......................................................................
subscribed to the within instrument is in the genuine handwriting of the said ......... ~.~.*....D.~O.!~ ....................................
and was subscribed thereto by him by like order of the Board of Directors and in the presence of him, the
said ....... ~'~$.~I)~...~.*...~!~g$.~ ..................... ; and that the Superintendent of Insurance of the State of New York, has,
pursuant to chapter 33 of the Laws of the State of New York for the year 1909, as amended, constituting chapter 30 of
Cahill's Consolidated Laws of the State of New York, as amended, issued to the HARTFORD ACCIDENT AND IN-
DEMNITY COMPANY, his certificate that said company is qualified to become and be accepted as surety or guarantor
on all b~pj[ttsy, t03c[e,r.t.a~ki_ng.s' and other obligations or guarantees, as provided in the Insurance Law of the State of New
Yc~ anh""~fl la'~.gVh*h~rLq~dhlory thereof and supplementary thereto; and that snch certificate has not been revoked.
~ary ~-uohc, ~3tate of New York
Qualified in New York County -- '
Gommission expiresMarch 30, 1968
At a regular and lawful meeting of the Board of Directors of the HAR~PFORD ACCIDENT AND INDF/JY, t'NITY
COMPANY, at which a quorum was present, held at tbe office of the Company, in the City of Hartfor*~, State of
Connecticut, on the llth day of July, A. D. 1967, on motion, it was unanimously
"RESOLVED that FRANCIS M. COX, JR., ALLAN I. WOODS, JOSEPH A. McKENNA, and ANGELO
LoBIANCO, Resident Vice-Presidents, be and each of them is hereby authorized and empowered on behalf of the Company
to execute and deliver, and to attach the seal of the Company to, any and all bonds, recognizances, undertakings, guar-
antees, contracts of indemnity, agreements and writings obligatory in the nature thereof within the purview of any of the
following corporate powers and purposes of the Company, to wit: to guarantee the fidelity of persons holding places of
public or private trust; to guarantee the perfornmnce of contracts; to execute or guarantee bonds and undertakings
required or permitted in any and all actions or proceedings or by law allowed; to indemnify banks, bankers, brokers,
financial or moneyed associations, or financial or moneyed corporations against loss of any bills of exchange, notes, drafts,
acceptances of drafts, bonds, securities, evidences of debts, deeds, mortgages, warehouse receipts, bills of lading, documents,
instruments, papers, any evidence of value, currency, money, gold, platinum, silver and other precious metals, refined or
unrefined and articles made therefrom, je~velry, watches, necklaces, bracelets, gems, precious and semi-precious stones,
and also against loss resulting from damage to the insured's premises, furnishings, fixtures, equipment, safes and vaults
therein, caused by burglary, robbery, holdup, theft or larceny, or atte~npt thereat, and without limitation by reason of the
foregoing to become principal, surety, indemnitor, endorser, or otherwise bind itself on, or upon, any bond, recognizance,
undertaking, guarantee, contract of indemnity, agreement and writing obligatory in the nature thereof, and on, or upon,
every obligation whatsoever on, or upon, which any company or insurer, authorized to transact a liability, casualty,
accident, health, fidelity, indemnity or surety business in the jurisdiction involved having the same qualifications in respect
to doing business as the Company, is permitted to bind itself; such bonds, recognizances, undertakings, guarantees,
contracts of indemnity, agreements and writings obligatory in the nature thereof, however, to be attested in every in-
stance by one other of said Resident Vice-Presidents or by WILLIAM GRIFFITHS, WILLIAM P. RIORDAN, or R.
E. DeHECK, Resident Assistant Secretaries."
STATE OF NEW YORK,
COUNTY OF NASSAU, f ss.
I,~.~.~.*...~0.~.l~.s....~0.~.!,~tl~...A.lls.;[.l$.~l!l~...S.o~0.~.~.~ ........ of the HARTFORD ACCIDENT AND
INDEMNITY COMPANY, have compared the foregoing resolution with the original thereof, as recorded in the minute
book of said company, and DO HEREBY CERTIFY that the same is a true and correct transcript therefrom, and of
the whole of the said resolution, and that the same is still in full force and effect.
Given under my hand and the seal of the company, at Mineola, New York on ljo¥omber ~th~ '1967
...... .x-?x .......................................................
Resident Assistant Secretary
Hartford Accident
Hartford, Connecticut
Financial Statement, December
and Indemnity Company
1966
ASSETS
U. S. Government Bonds ....
Bonds of other Governments .
State, County, Municipal and
Miscellaneous Bonds .....
Stocks .........
$71,715,046.16
5,411,486.05
496,443,354.28
262,212,117.00
$835,782,003.49
Real Estate ........ $9,704,586.90
Cash in Offices and Banks .... 4,486,708.54
Agents' Balances (Under 90 Days) 77,475,812.47
Interest Accrued ...... 6,322,038.09
Sundry Assets ....... 18,963,353.37
Total Admitted Assets .... $952,734,502.86
STATE OF NEW YORK,
COUNTY OF NASSAU, f ss.
LIABILITIES
Reserve for Claims
and Claims Expense ..... $453,427,015.28
Reserve for Unearned Premiums . 205,328,199.17
Reserve for Taxes ...... 10,666,622.09
Miscellaneous Liabilities .... 13,717,452.13
Total LtabtBtles ...... $683,139,288.67
Voluntary Reserve . $112,000,000.00
Capital Paid In . 40,000,000.00
Surplus .... 117,595,214.19
Surplus as regards Policyholders . $269,595,214.19
Total Ltabilities~ Gapital Stock
and Surplus ....... $952,734,502.86
I,...R.E,...I:~el~enk,...Resident...Assisgant...Secr. etar~t.. ..................... of the HARTFORD ACCIDENT
AND INDEMNITY COMPANY, do hereby certify that the foregoing m a correct statement of the financial condition
of mid Company, as of the thirty-first day of D~ember, nineteen sixty-s~, to the best of my knowledge and belief.
Sub~ribed and swom~o before me on November 8th, 1967
~Y T. MALO~Y
....... N~t~ ~u~ic,. Sm~. n f.~.e~ .~ .................................... ) (~ ~ '
~~~~ R~sident Assistant Secretary
HARTFORD ACCIDENT
AND
INDEMNITY COMPANY
690 Asylum Avenue
Hartford, Connecticut 06115
PRINCIPAL: FRANK B. ROGERS
OBLIGEE:
CUTCHOGUE-NEW
SUi~MOLK PARK
DISTRICT, NEW YORK
BOND OF TREASURER