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HomeMy WebLinkAboutIns Policy - Liability Package U.S. SPECIALTY INSURANCE COMPANY COMMON POLICY DECLARATIONS Policy No. CPKG80320109 Replacement No. RPKG80200372 NAMED INSURED AND MAILING ADDRESS: AGENT NAME AND ADDRESS: Town of Southold Corieri&Associates 53095 Route 25 1527 Franklin Avenue Southold,NY t t 97 t Mineola,NY t t 5 0 t AGENT NO.: 601 POLICY PERIOD: From I/l/2Ot2 To I/l/2Ot3 at 12:01 a.m. Standard Time at your mailing address shown above. BUSINESS DESCRIPTION: Municipality In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. This policy consists of the following coverage parts for which a premium is indicated. This premium may be subject to adjustment. COVERAGE PART PREMIUM Property $N/A NOTICE: THESE POLICY FORMS AND Inland Marine $N/A THE APPLICABLE RATES ARE EXEMPT General Liability $ Encluded FROM THE FILING REQUIREMENTS OF Professional Liability $ Included THE NEWYORK STATE INSURANCE Automobile $ Included DEPARTMENT, HOWEVER, SUCH Umbrella $ Included FO RMS AN D RATES M UST M EET TH E MINIMUNM STANDARDS OF THE NEW $ YORK INSURANCE LAW AND $ REGULATIONS. TOTAL PREMIUM $180,139.00 TRIA $1,072.00 NY FIRE FEE $N/A MOTOR VEH I CLE FEE $1,430.00 TOTAL ANNUAL PREMIUM $182,641.00 FORMS APPLICABLE TO ALL COVERAGE PARTS: See Form PKGIL0002 2006 THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART DECLARATIONS, COVERAGE PART COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. COUNTERSIGNED b DATE AUTHORIZED REPRESENTATIVE CLASS CODE: 2-14036 PKG 11-00 16 2006 Includes copyrighted material of Insurance Services Office, Inc.,Wth its permission. Copyright, Insurance Services Office, Inc., 1998 U.S. SPECIALTY INSURANCE COMPANY SCHEDULE OF FORMS AND ENDORSEMENTS Policy No. CPKG80320109 Effective Date: 1/1/2012 12:01 A.M., Standard Time Named Insured Town of Southold Agent No. 601 COVERAGE IS ONLY PROVIDED OR MODIFIED BY THOSE FORMS MARKED WITH AN X. General Forms Form Number Edition Date Description [X] IL0023 0702 Nuclear Energy Liability Exclusion Endt [Xj ILO 183 0808 NY Changes Fraud [Xj ILO 185 0808 NY Changes Calculation of Premium [X] IL0268 0808 NY Changes Cancellation and Nonrenewal [Xj PKGIL0002 2006 Schedule of Forrms and Endorsements [Xj PKGILOO 11 2006 Signature Page [X] PKGIL0012 2006 Governmental Subdivisions Amendatory Endt [Xj PKGILOO 16 2006 FT7 Common Policy Declarations [Xj PKGILNY0002NY 1107 Common Policy Conditions [X] IL0952 0308 Cap on Losses From Certified Acts of Terrorism [Xj IL0985 0108 Disclosure Pursuant to Terrorism Risk Insurance Act PKGIL0002 2006 U.S. SPECIALTY INSURANCE COMPANY General Liability Forms Form Number Edition Date Description [X] CG2412 1185 Boats [Xj PKGLI0005 2006 Designated Operations Exclusion [X] PKGLI0007 2006 Pesticide or Herbicide Applicator Coverage [X] PKGLI0015 2006 Bungee Jumping Exclusion [Xj PKGLIOO 16 2006 Exclusion Governmental Errors and Omissions [X] PKGLI0018 2006 Trampoline Exclusion [X] PKGLI0018NY 0907 NY Application Addendum [Xj PKGLI0022 2006 Amendment of Liquor Liability Exclusion Exception for Scheduled Special Activities [X] PKGLI0037 2006 Additional Insured Engineers,Architects,or Surveyors [Xj PKGLI0040 2006 Blanket Additional Insured Endorsement [X] PKGLI0047 2006 Exclusion Designated Professional Services [Xj PKGLI0052 2006 Exclusion Described Hazards(Carnivals,Circuses and Fairs) [X] PKGLINYOOOINY 0308 General Liability Coverage Form Public Entity [Xj PKGLINY0003 0807 NY Changes General Liability Coverage Form Public Entity [Xj PKGLINY0007 0907 Lead Exclusion [X] PKGLINY0011 0907 NY Contractors Special Conditions [Xj PKGLINYOO 12NY 0907 Sexual Abuse Exclusion NY [Xj PKGLINYOO 15NY 0907 Employee Benefits Liability Coverage Form NY [X] PKGLINY0016NY 0907 NY Declarations Page Addendum [Xj PKGLINYOO 17 0907 Employee Benefits Liability Coverage Pan NY Supplemental Declarations [Xj PKGLINY002ONY 0907 Public Entity NY General Liability Coverage Part Supplemental Declarations [X] CG2170 0108 Cap on Losses From Certified Acts of Terrorism [Xj PKGLIOO 17 2006 Dam Exclusion [Xj PKGLI0020 2006 Exclusion Fireworks [X] PKGLI0035 2006 Deductible Liability Insurance PKGIL0002 2006 U.S. SPECIALTY INSURANCE COMPANY Professional Forms Form Number Edition Date Description [X] PROF-FORM-1 0908 Public Risk Professional Policy [X] PROF-FORM-2 0908 Bodily Injury Definition [X] Stam-NY-032-01 0908 NY Changes Cancellation and Nonrenewal [X] Stam-NY-032-04 0908 NY Disclosure Notice [X] Stam-NY-032-05 0908 NY Disclosure Notice [X] EPL-603 0908 Extension of Coverage [X] LE-402 0908 Line of Duty Death Coverage [X] LE-403 0908 Non Monetary Defense Costs Endt [X] L1AB-SDEC-lA 0908 Liability Coverage Form Supplemental Declaration Page [X] Stam-NY-032-03A 0908 Amendatory Endorsement NY [X] Stam-NY-032-07 0908 NY Regulation t 07 Acknowledgement PKGIL0002 2006 U.S. SPECIALTY INSURANCE COMPANY Auto Forms Form Number Edition Date Description [X] CA0102 0498 NY Changes for Hire Autos [Xj CA0225 0306 NY Changes Cancellation [X] CA2232 0702 NY Mandatory PIP Endt [X] CA2260 0492 NY OBEL Coverage [Xj CA3107 1198 NY Supplementary UM and UIM Endt [X] CA9915 1293 Governmental Bodies Amendatory Endt [X] PKGCA0021 2006 Employees and Volunteers as Insureds [Xj PKGCANY0001a 0807 NY Business Auto Coverage Form [X] PKGCANY0002 0807 NY Changes in Business Auto [X] PKGCANY0007 0807 Business Auto Coverage Form Dee NY [Xj CA2002 1293 Sound Receiving Equipment Coverage Fire,Police and Emergency Vehicles [X] CA2052 0902 NY Emergency Vehicles Volunteer Fir efighters and Workers Injuries [Xj CA2233 0702 Additional PIP NY [X] PKGCA0005 2006 Customized Vehicle Extension Endt [Xj PKGCANY0005 0907 Deductible Liability Coverage PKGIL0002 2006 IL 00 23 07 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (Broad Form) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY NEW YORK DEPARTMENT OF TRANSPORTATION 1. The insurance does not apply: C. Under any Liability Coverage, to "bodily injury" A. Under any Liability Coverage, to "bodily injury" or"property damage" resulting from "hazardous or"property damage": properties"of"nuclear material", if: (1) With respect to which an "insured" under (1) The "nuclear material" (a) is at any"nuclear the policy is also an insured under a nuclear facility" owned by, or operated by or on be- energy liability policy issued by Nuclear En- half of, an "insured" or (b) has been dis- ergy Liability Insurance Association, Mutual charged or dispersed therefrom; Atomic Energy Liability Underwriters, Nu- (2) The"nuclear material" is contained in "spent clear Insurance Association of Canada or fuel" or "waste" at any time possessed, any of their successors, or would be an in- handled, used, processed, stored, trans- sured under any such policy but for its ter- ported or disposed of, by or on behalf of an mination upon exhaustion of its limit of liabil- "insured"; or ity; or (3) The "bodily injury" or "property damage" (2) Resulting from the "hazardous properties" arises out of the furnishing by an "insured" of "nuclear material" and with respect to of services, materials, parts or equipment in which (a) any person or organization is re- connection with the planning, construction, quired to maintain financial protection pur- maintenance, operation or use of any "nu- suant to the Atomic Energy Act of 1954, or clear facility", but if such facility is located any law amendatory thereof, or (b) the "in- within the United States of America, its terri- sured" is, or had this policy not been issued tories or possessions or Canada, this exclu- would be, entitled to indemnity from the sion (3) applies only to"property damage"to United States of America, or any agency such "nuclear facility' and any property thereof, under any agreement entered into thereat. by the United States of America, or any 2. As used in this endorsement: agency thereof, with any person or organi- "Hazardous properties" includes radioactive, toxic zation. B. Under any Medical Payments coverage, to or explosive properties. expenses incurred with respect to"bodily injury" "Nuclear material" means "source material", "Spe- resulting from the "hazardous properties" of cial nuclear material"or"by-product material". "nuclear material" and arising out of the opera- tion of a "nuclear facility' by any person or or- ganization. IL 00 23 07 02 @ ISO Properties, Inc., 2001 Page 1 of 2 "Source material", "special nuclear material", and (c) Any equipment or device used for the pro- "by-product material" have the meanings given cessing, fabricating or alloying of "special nu- them in the Atomic Energy Act of 1954 or in any clear material" if at any time the total amount of law amendatory thereof. such material in the custody of the "insured" at "Spent fuel" means any fuel element or fuel com- the premises where such equipment or device ponent, solid or liquid, which has been used or ex- is located consists of or contains more than 25 posed to radiation in a "nuclear reactor". grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams "Waste" means any waste material (a) containing of uranium 235; "by-product material" other than the tailings or (d) Any structure, basin, excavation, premises or wastes produced by the extraction or concentration place prepared or used for the storage or dis- of uranium or thorium from any ore processed pri- posal of'Waste"; marily for its "source material" content, and (b) re- sulting from the operation by any person or organi- and includes the site on which any of the foregoing zation of any "nuclear facility' included under the is located, all operations conducted on such site first two paragraphs of the definition of"nuclear fa- and all premises used for such operations. cility'. "Nuclear reactor" means any apparatus designed "Nuclear facility' means: or used to sustain nuclear fission in a self- (a) Any"nuclear reactor"; supporting chain reaction or to contain a critical mass of fissionable material. (b) Any equipment or device designed or used for "Property damage" includes all forms of radioac- (1) separating the isotopes of uranium or pluto- tive contamination of property. nium, (2) processing or utilizing "spent fuel", or (3) handling, processing or packaging "waste"; Page 2 of 2 @ ISO Properties, Inc., 2001 IL 00 23 07 02 C3 IL 01 83 08 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK CHANGES - FRAUD This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART—FARM PROPERTY—OTHER FARM PROVISIONS FORM —ADDITIONAL COVERAGES, CONDITIONS, DEFINITIONS FARM COVERAGE PART—LIVESTOCK COVERAGE FORM FARM COVERAGE PART—MOBILE AGRICULTURAL MACHINERY AND EQUIPMENT COVERAGE FORM The CONCEALMENT, MISREPRESENTATION OR FRAUD Condition is replaced by the following: FRAUD We do not provide coverage for any insured ("in- sured") who has made fraudulent statements or en- gaged in fraudulent conduct in connection with any loss ("loss") or damage for which coverage is sought under this policy. However, with respect to insurance provided under the COMMERCIAL AUTOMOBILE COVERAGE PART, we will provide coverage to such "insured" for damages sustained by any person who has not made fraudulent statements or engaged in fraudulent con- duct if such damages are otherwise covered under the policy. IL 01 83 08 08 C) Insurance Services Office, Inc., 2008 Page 1 of 1 13 IL 01 85 08 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK CHANGES - CALCULATION OF PREMIUM This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EM PLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY—NEW YORK A. For policies with fixed terms in excess of one year, b. A material physical change in the property or policies with no stated expiration date, except insured, occurring after issuance or last an- as provided in Paragraph B.,the following applies: niversary renewal date of the policy, causes The premium shown in the Declarations was com- the property to become uninsurable in ac- puted based on rates and rules in effect at the cordance with underwriting standards in ef- time the policy was issued. On each renewal or fect at the time the policy was issued or last continuation of this policy, we will compute the renewed; or premium in accordance with our rates and rules c. A material change in the nature or extent of then in effect. the risk, occurring after issuance or last an- B. For policies with fixed terms in excess of one year, niversary renewal date of the policy, which where premium is computed and paid annually, causes the risk of "loss" to be substantially the following applies: and materially increased beyond that con- templated at the time the policy was issued 1. The premium shown in the Declarations was or last renewed. computed based on rates and rules in effect at 3. If, subsequent to the inception of the current the time the policy was issued. Such rates and policy period, the Limit of Insurance is in- rules will be used to calculate the premium at creased, or Additional Coverages or Causes of each anniversary, for the entire term of the pol- Loss are insured, the rate and rules in effect at icy, unless the specific reasons described in the time of the change will be applied to calcu- Paragraph 2. or 3. apply. late the premium and will continue to apply to 2. The premium will be computed based on the the change at subsequent anniversary dates. rates and rules in effect on the anniversary date of the policy only when, subsequent to the inception of the current policy period, one or more of the following occurs: a. After issuance of the policy or after the last renewal date, discovery of an act or omis- sion, or a violation of any policy condition, that substantially and materially increases the hazard insured against, and that oc- curred subsequent to inception of the cur- rent policy period; IL 01 85 08 08 C) Insurance Services Office, Inc., 2008 Page 1 of 1 13 IL 02 68 08 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EM PLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 1., 2., 3. and 5. of the Cancellation (d) After issuance of the policy or after Common Policy Condition are replaced by the fol- the last renewal date, discovery of lowing: an act or ornission, or a violation of 1. The first Named Insured shown in the Declara- any policy condition, that substantial- tions may cancel this entire policy by mailing or ly and materially increases the haz- delivering to us advance written notice of can- ard insured against, and that oc- cellation. curred subsequent to inception of the 2. Cancellation Of Policies In Effect current policy period; (e) Material physical change in the a. 60 Days Or Less property insured, occurring after is- We may cancel this policy by mailing or de- suance or last annual renewal anni- livering to the first Named Insured written versary date of the policy, that re- notice of cancellation at least: sults in the property becoming unin- (1) 30 days before the effective date of surable in accordance with our ob- cancellation if we cancel for any reason jective, uniformly applied underwrit- not included in Paragraph A.2.a.(2) be- ing standards in effect at the time the low. policy was issued or last renewed; or material change in the nature or ex- (2) 15 days before the effective date of tent of the risk, occurring after issu- cancellation if we cancel for any of the ance or last annual renewal anniver- following reasons: sary date of the policy, that causes (a) Nonpayment of premium, provided the risk of loss to be substantially however, that a notice of cancellation and materially increased beyond that on this ground shall inform the first contemplated at the time the policy Named Insured of the amount due; was issued or last renewed; (b) Conviction of a crime arising out of (f) Required pursuant to a determina- acts increasing the hazard insured tion by the Superintendent that con- against; tinuation of our present premium (c) Discovery of fraud or material mis- volume would jeopardize our solven- representation in the obtaining of the cy or be hazardous to the interest of policy or in the presentation of a our policyholders, our creditors or claim; the public; IL 02 68 08 08 C) Insurance Services Office, Inc., 2008 Page 1 of 5 13 (g) A determination by the Superinten- B. The following is added to the Cancellation Com- dent that the continuation of the poli- mon Policy Condition: cy would violate, or would place us in 7. If one of the reasons for cancellation in Para- violation of, any provision of the In- graph A.2.a.(2) or D.2.b.(2) exists, we may surance Code; or cancel this entire policy, even if the reason for (h) Where we have reason to believe, in cancellation pertains only to a new coverage or good faith and with sufficient cause, endorsement initially effective subsequent to that there is a probable risk of dan- the original issuance of this policy. ger that the insured will destroy, or C. The following conditions are added: permit to be destroyed, the insured property for the purpose of collecting 1. Nonrenewal the insurance proceeds. If we cancel If we decide not to renew this policy we will for this reason, you may make a writ- send notice as provided in Paragraph C.3. be- ten request to the Insurance De- low. partment, within 10 days of receipt of 2. Conditional Renewal this notice, to review our cancellation decision. Also, we will simultaneous- If we conditionally renew this policy subject to ly send a copy of this cancellation a: notice to the Insurance Department. a. Change of limits; b. For More Than 60 Days b. Change in type of coverage; If this policy has been in effect for more c. Reduction of coverage; than 60 days, or if this policy is a renewal or d. Increased deductible; continuation of a policy we issued, we may cancel only for any of the reasons listed in e. Addition of exclusion; or Paragraph A.2.a.(2) above, provided: f. Increased premiums in excess of 10%, (1) We mail the first Named Insured written exclusive of any premium increase due to notice at least 15 days before the effec- and commensurate with insured value add- tive date of cancellation; and ed or increased exposure units; or as a re- (2) If we cancel for nonpayment of premi- sult of experience rating, loss rating, retro- urn, our notice of cancellation informs spective rating or audit; the first Named Insured of the amount we will send notice as provided in Paragraph due. C.3. below. 3. We will mail or deliver our notice, including the 3. Notices Of Nonrenewal And Conditional reason for cancellation, to the first Named In- Renewal sured at the address shown in the policy and to a. If we decide not to renew this policy or to the authorized agent or broker. conditionally renew this policy as provided 5. If this policy is cancelled, we will send the first in Paragraphs C.1. and C.2. above, we will Named Insured any premium refund due. If we mail or deliver written notice to the first cancel, the refund will be pro rata. If the first Named Insured shown in the Declarations Named Insured cancels, the refund may be at least 60 but not more than 120 days be- less than pro rata. fore: However, when the premium is advanced un- (1) The expiration date; or der a premium finance agreement, the cancel- (2) The anniversary date if this is a continu- lation refund will be pro rata. Under such fi- ous policy. nanced policies, we will be entitled to retain a b. Notice will be mailed or delivered to the first minimum earned premium of 10% of the total Named Insured at the address shown in the policy premium or $60, whichever is greater. policy and to the authorized agent or bro- The cancellation will be effective even if we have not made or offered a refund. ker. If notice is mailed, proof of mailing will be sufficient proof of notice. Page 2 of 5 C) Insurance Services Office, Inc., 2008 IL 02 68 08 08 13 c. Notice will include the specific reason(s) for b. The policy insures: nonrenewal or conditional renewal, includ- (1) For loss of or damage to structures, ing the amount of any premium increase for other than hotels or motels, used pre- conditional renewal and description of any dominantly for residential purposes and other changes. consisting of no more than four dwelling d. If we violate any of the provisions of Para- units; or graph C.3.a., b. or c. above by sending the (2) For loss of or damage to personal prop- first Named Insured an incomplete or late erty other than farm personal property or conditional renewal notice or a late nonre- business property; or newal notice: (1) Coverage will remain in effect at the (3) Against damages arising from liability for same terms and conditions of this policy loss of, damage to or injury to persons at the lower of the current rates or the or property, except liability arising from prior period's rates until 60 days after business or farming; and such notice is mailed or delivered, un- c. The portion of the annual premium attribut- less the first Named Insured, during this able to the property and contingencies de- 60 day period, has replaced the cover- scribed in 1.b. exceeds the portion applica- age or elects to cancel. ble to other property and contingencies. (2) On or after the expiration date of this 2. Paragraph 2. of the Cancellation Common policy, coverage will remain in effect at Policy Condition is replaced by the following: the same terms and conditions of this 2. Procedure And Reasons For policy for another policy period, at the Cancellation lower of the current rates or the prior a. We may cancel this entire policy by period's rates, unless the first Named mailing or delivering to the first Named Insured, during this additional policy pe- Insured written notice of cancellation at riod, has replaced the coverage or least: elects to cancel. e. If you elect to renew on the basis of a late (1) 15 days before the effective date of conditional renewal notice, the terms, con- cancellation if we cancel for non- ditions and rates set forth in such notice payment of premium, provided how- shall apply: ever, that a notice of cancellation on this ground shall inform the first (1) Upon expiration of the 60 day period; or Named Insured of the amount due; (2) Notwithstanding the provisions in Para- or graphs d.(1) and d.(2), as of the renewal (2) 30 days before the effective date of date of the policy if we send the first cancellation if we cancel for any oth- Named Insured the conditional renewal erreason. notice at least 30 days prior to the expi- b. But if this policy: ration or anniversary date of the policy. (1) Has been in effect for more than 60 f. We will not send you notice of nonrenewal days; or or conditional renewal if you, your author- ized agent or broker or another insurer of (2) Is a renewal of a policy we issued: yours mails or delivers notice that the policy we may cancel this policy only for one or has been replaced or is no longer desired. more of the following reasons: D. The following provisions apply when the Commer- (1) Nonpayment of premium, provided cial Property Coverage Part, the Farm Coverage however, that a notice of cancellation Part or the Capital Assets Program (Output Policy) on this ground shall inform the first Coverage Part is made a part of this policy: Named Insured of the amount due; 1. Items D.2. and 13.3. apply if this policy meets (2) Conviction of a crime arising out of the following conditions: acts increasing the risk of loss; a. The policy is issued or issued for delivery in (3) Discovery of fraud or material mis- New York State covering property located representation in obtaining the policy in this state; and or in making a claim; IL 02 68 08 08 C) Insurance Services Office, Inc., 2008 Page 3 of 5 13 (4) Discovery of willful or reckless acts (b) Not more than 60 days; or omissions increasing the risk of before the expiration date of the policy. We loss; will mail or deliver our notice to the first (5) Physical changes in the covered Named Insured's last mailing address property that make that property un- known to us. If notice is mailed, proof of insurable in accordance with our ob- mailing will be sufficient proof of notice. De- jective and uniformly applied under- livery of the notice will be the same as mail- writing standards in effect when we: ing. (a) Issued the policy; or E. The following is added to the Farm Property — (b) Last voluntarily renewed the Other Farm Provisions Form — Additional Cover- policy; ages, Conditions, Definitions, the Commercial Property Coverage Part and the Capital Assets (6) The Superintendent of Insurance's Program (Output Policy) Coverage Part: determination that continuing the pol- When the property is subject to the Anti-Arson Ap- icy would violate Chapter 28 of the plication in accordance with New York Insurance Insurance Law; or Department Regulation No. 96, the following pro- (7) Required pursuant to a determina- visions are added: tion by the Superintendent of Insur- ance that the continuation of our If you fail to return the completed, signed and af- present premium volume would be firmed anti-arson application to us: hazardous to the interests of our pol- 1. Or our broker or agent within 45 days of the icyholders, our creditors or the pub- effective date of a new policy, we will cancel lic. the entire policy by giving 20 days' written no- 3. The following are added: tice to you and to the mortgageholder shown in the Declarations. a. Conditional Continuation 2. Before the expiration date of any policy, we will Instead of cancelling this policy, we may cancel the policy by giving written notice to you continue it on the condition that: and to the mortgageholder shown in the Decla- (1) The policy limits be changed; or rations at least 15 days before the effective (2) Any coverage not required by I aw be date of cancellation. eliminated. The cancellation provisions set forth in E.1. and If this policy is conditionally continued, we E.2. above supersede any contrary provisions in will mail or deliver to the first Named In- this policy including this endorsement. sured written notice at least 20 days before If the notice in E.1. or E.2. above is mailed, proof the effective date of the change or elimina- of mailing will be sufficient proof of notice. Delivery tion. We will mail or deliver our notice to the of the notice will be the same as mailing. first Named Insured's last mailing address F. The following applies to the Commercial Property known to us. If notice is mailed, proof of Coverage Part, the Farm Coverage Part and the mailing will be sufficient proof of notice. De- Capital Assets Program (Output Policy) Coverage livery of the notice will be the same as mail- Part: ing. Paragraphs f. and g. of the Mortgageholders b. Nonrenewal Condition are replaced by the following: If, as allowed by the laws of New York f. Cancellation State, we: (1) If we cancel this policy, we will give (1) Do not renew this policy; or written notice to the mortgageholder at (2) Condition policy renewal upon: least: (a) Change of limits; or (a) 10 days before the effective date of (b) Elimination of coverage; cancellation if we cancel for your we will mail or deliver written notice of non- nonpayment of premium; or renewal or conditional renewal: (b) 30 days before the effective date of cancellation if we cancel for any oth- (a) At least 45 days; but erreason. Page 4 of 5 C) Insurance Services Office, Inc., 2008 IL 02 68 08 08 El (2) If you cancel this policy, we will give G. The following provisions apply when the following written notice to the mortgageholder. are made a part of this policy: With respect to the mortgageholder's in- Commercial General Liability Coverage Part terest only, cancellation will become ef- Employment-Related Practices Liability Coverage fective on the later of: Part (a) The effective date of cancellation of Farm Liability Coverage Form the insured's coverage; or Liquor Liability Coverage Part (b) 10 days after we give notice to the Products/Completed Operations Liability Coverage mortga geh older. Part g. Nonrenewal 1. The aggregate limits of this policy as shown in (1) If we elect not to renew this policy, we the Declarations will be increased in proportion will give written notice to the mortgage- to any policy extension provided in accordance holder at least 10 days before the expi- with Paragraph C.3.d. above. ration date of this policy. 2. The last sentence of Limits Of Insurance does (2) If you elect not to renew this policy, we not apply when the policy period is extended will give written notice to the mortgage- because we sent the first Named Insured an holder. With respect to the mortgage- incomplete or late conditional renewal notice or holder's interest only, nonrenewal will a late nonrenewal notice. become effective on the later of: (a) The expiration date of the policy; or (b) 10 days after we give notice to the mortga geh older. IL 02 68 08 08 C) Insurance Services Office, Inc., 2008 Page 5 of 5 13 In Witness Whereof, we have caused this policy to be executed and attested, and, if required by state law, this policy shal I not be valid unless countersigned by our authorized representative. By PRESIDENT SECRETARY Michael J. Schell Randy D. Rinicella PKGIL0011 2006 U.S. SPECIALTY INSURANCE COMPANY ENDORSEMENTNO. ATTACHEDTOAND ENDORSEMENT EFPECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A.M, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, GOVERNMENTAL SUBDIVISIONS AMENDATORY ENDORSEMENT—KNOWLEDGEINOTICE OF OCCURRENCE AND UNINTENTIONAL ERRORS OR OMISSIONS KNOWLEDGE OF OCCURRENCE It is agreed that knowledge of an occurrence by the agent. servant or employee of the insured shall not in itself constitute knowledge by the insured unless the city manager or authorized designee shall have received such notice from its agent, servant, or employee.. NOTICE OF OCCURRENCE It is agreed that if the insured reports an occurrence to its compensation carrier which later develops into a liability claim, coverage for which is provided by the policy to which this endorsement is attached, failure to report such occurrence to the company at the time of occurrence shall not be deemed in violation of the condition entitled "Duties in the Event of Occurrence, Offense, Claim, or Suit." Provided, however that the insured, just as soon as it is definitely made aware of the fact that the particular occurrence is a liability case rather than a compensation case, shall give notification of the aforesaid occurrence to this company. UNINTENTIONAL ERRORS OR OMISSIONS it is agreed that failure of the insured to disclose all hazards existing as of the inception date of the policy shall not prejudice the insurance with respect to the coverage afforded by this policy, provided such failure or omission is not intentional. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGILOQ 12 2006 COMMON POLICY CONDITIONS A. Cancellation b. Give you reports on the conditions we find; 1. The first Named Insured shown in the Declara- and tions may cancel this policy by mailing or deliv- c. Recommend changes. ering to us advance written notice of cancella- 2. We are not obligated to make any inspections, tion. surveys, reports or recommendations and any 2. We may cancel this policy by mailing or deliv- such actions we do undertake relate only to in- ering to the first Named Insured written notice surability and the premiums to be charged. We of cancellation at least: do not make safety inspections. We do not un- a. 10 days before the effective date of cancel- dertake to perform the duty of any person or lation if we cancel for nonpayment of pre- organization to provide for the health or safety of workers or the public.And we do not warrant mium,' or that conditions: b. 30 days before the effective date of cancel- a. Are safe or healthful-, or lation if we cancel for any other reason. b. Comply vvith laws, regulations, codes or 3. We will mail or deliver our notice to the first standards. Named Insured's last mailing address known to us. 3. Paragraphs 1. and 2.of this condition apply riot 4. Notice of cancellation will state the effective only to us, but also to any rating, advisory, rate date of cancellation. The policy period will end service or similar organization which makes in- surance inspections, surveys, reports or rec- on that date, ommendations. 5. If this policy is cancelled, we will send the first 4. Paragraph 2. of this condition does not apply to Named Insured any premium refund due. If we any inspections, surveys, reports or recom- cancel, the refund will be pro rata, If the first mendations we may make relative to certifica- Named Insured cancels, the refund may be tion, under state or municipal statutes, ordi- less than pro rata. The cancellation will be ef- nances or regulations, of boilers, pressure ves- fective even if we have not made or offered a sels or elevators. refund. D. Premiums 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. The first Named Insured shown in the Declara- tions� B. Changes 1. is responsible for the payment of all premiums; This policy contains all the agreements between and you and us concerning the insurance afforded. The first Named Insured shown in the Declara- 2. Will be the payee for any return premiums we tions is authorized to make changes in the terms pay, of this policy with our consent. This policy's terms E. Transfer Of Your Rights And Duties Under This can be amended or waived only by endorsement Policy issued by us and made a part of this policy, Your rights and duties under this policy may not be transferred without our written consent except C. Inspections And Surveys in the case of death of an individual named in- 1. We have the right to, sured. a. Make inspections and surveys at any time; If you die, your rights and duties Vill be transferred to your legal representative but only while acting within the scope of duties as your legal represen- tative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. PKGILNY0002 NY 11107 Includes copyrighted material of Insurance Services Office, Inc., Page I of 1 1998,with its permission. IL 09 52 03 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: BO I LE R AN D MACH I N E RY COVE RAG E PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART STANDARD PROPERTY POLICY A. Cap On Certified Terrorism Losses If aggregate insured losses attributable to terrorist "Certified act of terrorism" means an act that is acts certified under the Terrorism Risk Insurance certified by the Secretary of the Treasury, in con- Act exceed $100 billion in a Program Year (Janu- currence with the Secretary of State and the Attor- ary 1 through December 31) and we have met our ney General of the United States, to be an act of insurer deductible under the Terrorism Risk Insur- terrorism pursuant to the federal Terrorism Risk ance Act, we shall not be liable for the payment of Insurance Act. The criteria contained in the Terror- any portion of the amount of such losses that ex- ism Risk Insurance Act for a "certified act of terror- ceeds $100 billion, and in such case insured loss- ism" include the following: es up to that amount are subject to pro rata alloca- tion in accordance with procedures established by 1. The act resulted in insured losses in excess of the Secretary of the Treasury. $5 million in the aggregate, attributable to all types of insurance subject to the Terrorism B. Application Of Exclusions Risk Insurance Act; and The terms and limitations of any terrorism exclu- 2. The act is a violent act or an act that is dan- sion, or the inapplicability or ornission of a terror- gerous to human life, property or infrastructure ism exclusion, do not serve to create coverage for and is committed by an individual or individuals any loss which would otherwise be excluded under as part of an effort to coerce the civilian popu- this Coverage Part or Policy, such as losses ex- lation of the United States or to influence the cluded by the Nuclear Hazard Exclusion or the policy or affect the conduct of the United States War And Military Action Exclusion. Government by coercion. IL 09 52 03 08 C) Insurance Services Office, Inc., 2008 Page 1 of 1 13 POLICY NUMBER: CPKG80320109 IL 09 85 01 08 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE Terrorism Premium (Certified Acts) $ 1,072.00 This premium is the total Certified Acts premium attributable to the following Coverage Part(s), Cover- age Form(s) and/or Policy(s): Additional information, if any, concerning the terrorism premium: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Disclosure Of Premium C. Cap On Insurer Participation In Payment Of In accordance with the federal Terrorism Risk In- Terrorism Losses surance Act, we are required to provide you with a If aggregate insured losses attributable to terrorist notice disclosing the portion of your premium, if acts certified under the Terrorism Risk Insurance any, attributable to coverage for terrorist acts certi- Act exceed $100 billion in a Program Year (Janu- fied under the Terrorism Risk Insurance Act. The ary 1 through December 31) and we have met our portion of your premium attributable to such cov- insurer deductible under the Terrorism Risk Insur- erage is shown in the Schedule of this endorse- ance Act, we shall not be liable for the payment of ment or in the policy Declarations. any portion of the amount of such losses that ex- B. Disclosure Of Federal Participation In Payment ceeds $100 billion, and in such case insured loss- Of Terrorism Losses es up to that amount are subject to pro rata alloca- tion in accordance with procedures established by The United States Government, Department of the the Secretary of the Treasury. Treasury, will pay a share of terrorism losses in- sured under the federal program. The federal share equals 85% of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 bil- lion in a Program Year (January 1 through De- cember 31), the Treasury shall not make any payment for any portion of the amount of such losses that exceeds$100 billion. IL 09 85 01 08 C) ISO Properties, Inc., 2007 Page 1 of 1 13 U.S. SPECIALTY INSURANCE COMPANY PUBLIC ENTITY— NEWYORK GENERAL LIABILITY COVERAGE PART SUPPLEMENTAL DECLARATIONS These Supplemental Declarations form a part of policy number CPKG80320109 LIMITS OF INSURANCE Each Occurrence Limit $1,000,000 Damage to Premises Rented to You Limit $1,000,000 anyone premises Medical Expense Limit $10,000 anyone person Personal and Advertising Injury Limit $1,000,000 anyone person or organization General Aggregate Limit (other than Products/Completed Operations) $3,000,000 Products/Completed Operations Aggregate Limit $3,000,000 FORM OF BUSINESS Form of business: X Municipality El Special District F-1 Other CLASSIFICATION AND PREMIUM Code UPrernium Rate Advance Premium Classification No. Basis Prem/ Prod/Comp Prem/ Prod/Comp Ops Ops Ops Or)s I ncl. Included Included Included Included Included Included Totals: Included Included FORMS AND ENDORSEMENTS (other than applicable forms and endorsements shown elsewhere in the policy) Forms and endorsements applying to this Coverage Part and made part of this policy at time of issue: See Form PKGIL0002 2006 iiii (a)Area, (c) Total Cost, (m)Admission, (p) Payroll, (s) Gross Sales, (u) Units, (o) Other THIS SUPPLEMENTAL DECLARATIONS AND THE COMMON POLICY DECLARATIONS, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S)AND ENDORSEMENTS COMPLETE THE ABOVE NUMBERED POLICY. PKGLINY0020 NY 09/07 POLICY NUMBER: RPKG80200372 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BOATS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description of Watercraft: All owned watercraft up to 50 feet in length. Additional Premium: Included (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) 1. Exclusion g. of COVERAGE A (Section 1) does not apply to any watercraft owned or used by or rented to the insured shown in the Schedule. 2. WHO IS AN INSURED (Section 11) is amended to include as an insured any person or organization legally responsible for the use of any such watercraft you own, provided the actual use is with your permission. CG 24 12 11 85 Copyright, Insurance Services Office, Inc., 1984, 1992 Page 1 of 1 11 U.S. SPECIALTY INSURANCE COMPANY ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A.M. CPKG8032OtO9 Town of Southold 60t THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED OPERATIONS EXCLUSION This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM - PUBLIC ENTITY SCHEDULE Description of excluded operations: 1. Landfills "Bodily injury", "property damage" or"personal and advertising injury" arising out of: a. The ownership, maintenance or use of the landfill shown in the schedule or any property located on these premises; or b. Operations on those premises or elsewhere which are necessary or incidental to the ownership, maintenance or use of those premises; or c. Goods or products manufactured at, or distributed from those premises. However, this exclusion does not apply to: (1) Your liability for"bodily injury" occurring on these landfills; or (2) Your liability for"property damage"to non-owned autos on these landfills. 2. Jails "Bodily injury", "property damage" or"personal and advertising injury" arising out of the operation, maintenance or use of any jail, jail premises, holding cell, or detention cell. 3. Medical Or Health Facility "Bodily injury", "property damage" or "personal and advertising injury" arising out of any activities at a hospital, clinic, medical center, trauma center, nursing home, convalescent home, home for the aged, home for the physically handicapped or orphaned, mental-psychopathic institution, sanitarium, dispensary, infirmary, institution for the restrained and/or treatment of alcohol, drug, narcotic and/or mental cases and any other health care facility that you own, operate, use, maintain or license or located on any property you rent or lease, including a sublease. 4. Blasting Operations 5. This insurance does not apply to "bodily injury", "property damage" or"personal and advertising injury" arising out of the operations shown in the Schedule above. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0005 2006 U.S. SPECIALTY INSURANCE COMPANY ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A.M. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PESTICIDE OR HERBICIDE APPLICATOR COVERAGE This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM - PUBLIC ENTITY SCHEDULE Subilimilts of Insurance $ 1,000,000 Each Occurrence $ 1,000,000 Aggregate With respect to your operations involving the ordinance, regulation or license requirement of application of pesticides or herbicides: any federal, state or local government which apply 1. Paragraphs (4) and (5) of Exclusion j. of to those operations. SECTION I - COVERAGE A. BODILY INJURY 3. The Sublimits of Insurance shown in the Schedule AND PROPERTY LIABILITY do not apply to are the most we will pay for "property damage" "property damage" occurring as a result of such coverage as provided by this endorsement. The operations. Sublimits; of Insurance are part of, and not in 2. Paragraph (1) (d.) of Exclusion f. of SECTION I - addition to, the Limits of Insurance shown in the COVERAGE A. BODILY INJURY AND Declarations as the Each Occurrence Limit and PROPERTY DAMAGE LIABILITY does not apply the General Aggregate Limit. if the operations meet all standards of any statute, ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0007 2006 ENDORSEMENTNO. ATTACHED TO AND ENDORSEMENT EFFECTIVE INSURED AGENCYANDCODE FORMING A PART OF (Standard Time) POLICY NUMBER MO. DAY YR� __12:0.1 NOON A M. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUNGEE JUMPING EXCLUSION This endorsement modifies insurance provided tinder the following: GENERAL LIABILITY COVERAGE FORM-PUBLIC ENTITY This insurance does not apply to"bodily injury","property damage", or"personal and advertising injury"- 1. To any"participant"while practicing for or participating in any bungee jumping activities; or 2. Arising out of the ownership, maintenance or operation of any bungee jumping equipment owned by, ]eased to, or otherwise in the care,custody, and control of any insured, The term"participant" includes, but is not limited to,jumpers,volunteers, set-tip crew, security personnel, mechanics, stewards, officials,attendants, spectators, crane operators, drivers, or any other person within the designated activity area. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED DATE AUTHORIZED REPRESENTATIVE PKGLI0015 2006 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Copyright,Insurance Services Office,Inc,,1993 ENDORSEMENT NO. ATTACHEDTO AND i�_NDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER mo. DAY YR. 12V— NOON AM. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSIO"OVERNMENTAL ERRORS AND OMISSIONS This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM -PUBLIC ENTITY This insurance does not apply to any claims for damages, other than damages for"bodily injury", "property damage", or "personal and advertising injury", arising from any actual or alleged error or misstatement or act or omission or neglect or violation of any federal or state civil rights, or breach of duty including misfeasance, malfeasance, or nonfeasance by the insured in the discharge of their duties for the Public Entity, individually or collectively. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0016 2006 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Copyright,Insurance Services Office,Inc., 1993 ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE INSURED AGENCY AND CODE FORMING A PART OF (Standard Time) POLICY NUMBER Mo. DAY YR_ —12:01 NOON A.M. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRAMPOLINE EXCLUSION This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM-PUBLIC ENTITY This insurance does not apply to"bodily injury", 'property damage", or"personal and advertising injury", arising out of the ownership, maintenance, operation or use of any trampoline, mini-trampoline or other similar rebound jumping devices. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0018 2006 Includes copyrighted material of Insurani-,e Services Office,InCL,with its permission. Copyright,Insurance services Office,Inc, 1993 NEW YORK APPLICATION ADDENDUM APPLICABLE ONLY TO EMPLOYEE BENEFITS LIABILITY COVERAGE THIS IS A CLAIMS MADE COVERAGE FORM. The Employee Benefits Liability Coverage form provides no coverage for"claims" arising out acts, errors or omissions which took place before to the "retroactive date", if any,shown in the Supplemental Declarations. It covers only "claims" made against you while the policy remains In effect and all coverages under this policy cease upon "termination of coverage", except for the automatic reporting period coverage, unless you purchase the optional extended reporting period coverage. If the coverage is terminated, we will provide a 90 day automatic extended reporting period. You also have the right to purchase an optional extended reporting period. If you purchase the optional extended reporting period endorsement, the extended reporting period will be for one year, starting with the end of the automatic extended reporting period. When the automatic, or optional (if purchased) extended reporting period ends there exists the potential for gaps in coverage since you will not be covered for"claims" made after the expiration date of such extended reporting period. Rates for claims made policies are normally lower in the early years of a "claims made relationship", as compared to occurrence policies, and increase with each renewal until the "claims made relationship" reaches maturity. The rates for any extended reporting period will be based on rates in effect at the beginning of the policy period and the premium for the optional extended reporting period endorsement will be 76% of the annual premium for Employee Benefits Liability Coverage. PKGI-10018 NY 09/07 U.S. SPECIALTY INSURANCE COMPANY ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A.M. CPKG8032OtO9 x Town of Southold 60t THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AM ENDM ENT OF LIQUOR LIABILITY EXCLUSION—EXCEPTION FOR SCHEDULED SPECIAL ACTIVITIES This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM - PUBLIC ENTITY SCHEDULE Description of Special Activity(les): Date of Activity: Events not exceeding 5 days in length Exclusion c., Liquor Liability, of SECTION I This exclusion applies only if you: COVERAGE A. BODILY INJURY AND PROPERTY (1) Manufacture, sell or distribute alcoholic DAMAGE Liability, is deleted and replaced by the beverages; following: This insurance does not apply to "bodily injury" or (2) Serve or furnish alcoholic beverages for a charge "property damage" for which any insured may be held whether or not such activity: liable by reason of: (a) Requires a license; (1) Causing or contributing to the intoxication of any (b) Is for the purpose of financial gain or person; livelihood; or (2) The furnishing of alcoholic beverages to a person (3) Serve or furnish alcoholic beverages without a under the legal drinking age or under the influence charge, if a license is required for such activity. of alcohol; or However, this exclusion does not apply to "bodily (3) Any statute, ordinance or regulation relating to the injury" or "property damage" arising out of the selling, sale, gift, distribution or use of alcoholic serving or furnishing of alcoholic beverages at the beverages. specific activity(ies) described above. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0022 2006 Copyright, Insurance Services Office, Inc., 1989, 1992 ENDORSEMENTNO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard T!mL,) INSURED AGENCY AND CODE POLICY NUMBER MO, DAY YR. 12:01 NOON A.M. THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED—ENGINEERS,ARCHITECTS,OR SURVEYORS This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM-PUBLIC ENTITY A. SECTION 11 -WHO 19 AN INSURED is amended This insurance does not apply to 'bodily injury", to include as an insured any architect, engineer, property damage' or "personal and advertising or surveyor engaged by you but only with respect injury" arising out of the rendering of or the failure to liability arising out of your premises or ongoing to render any professional services by or for you, operations performed by you or on your behalf. including� B. VVith respect to such architects, engineers, or I, The preparing, approving, or failing to prepare surveyors described in Paragraph A. above, the or approve. maps, shop drawings, opinions, follmAring exclusion is added to Paragraph 2., reports, surveys, field orders, change orders Exclusions of SECTION I - COVERAGE A - or drawings and specifications;and BODILY INJURY AND PROPERTY DAMAGE 2. Supervisory, inspection, architectural or LIABIUTY and SECTION I - COVERAGE B - engineering activities- PERSONAL AND ADVERTISING INJURY LIABILITY� ALL OTHER TERMS AND GONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0037 2006 Copyright,Insurance Services Office,InG., 1997 ENDORSEMENT NO. CHED TO AND ENDORSEMENT EFFECTIVE INSURED AGENCY AND CODE FOPMING A PART OF (Standard Time) POLICY NUMBER MO. 12:01 [7t DAY YR. 7 NOON A-M- THIS ENDORSEMENT CHANGES THE POLICY- PLEASE READ IT CAREFULLY, BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM-PUBLIC ENTITY Addiftorial Premium* A. SECTION 11 -WHO IS AN INSURED is amended 3. Coverage is not provided for "bodily injury", to include as an insured any person or �Iproperty damage", or "personal and organization whom you are required to add as an advertising injury" arising out of the sole additional insured to this policy under a written negligence of the additional insured. contract, agreement or permit: C. The insurance provided to the additional insured 1. Currently in effect or which will become does not apply to "bodily injury", 'property effective during the term of the policy; and damage", or 'personal and advertising injury" 2. Executed prior to the "occurrence. which arising out of an architect's, engineer's or results in "bodily injury" or "property damage' surveyors rendering or failure to tender any under Coverage A, or the offense which professional services including: results in "personal and advertising injury' I. The preparing, approving or failing to prepare under Coverage B. or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders B. The insurance provided to this additional insured or drawings and specffications� and is limited as follows: 2. Supervisory, inspection, architectural or 1. That person or organization is an additional engineering activities. insured only with respect to liability arising out D. Coverage provided by this endc)rsement is excess of: over any other valid and collectible insurance a. Premises you own, rent, lease or occupy-, available to the additional insured whether or primary, excess, contingent or on any other basis. b. Your ongoing operations performed for When this insurance is excess, we will have no that additional insured as specified in the duty under COVERAGE A. BODILY INJURY written contract, agreement or permit. AND PROPERTY DAMAGE LIABILI[TY or 2. The limits of insurance applicable to the COVERAGE B. PERSONAL AND additional insured are those specified in the ADVERTISING INJURY LIABIUTY to defend the contract, agreement, permit or in the additional insured against any "suit' if any other Declarations of this policy,whichever are less. insurer has a duty to defend the additional insured These limits of insurance are inclusive of and against that"suit". If no other insurer defends, we not in addition to the Limits of Insurance may undertake to do so, but we will be entitled to shown in the Declarations. the additional insured's rights against all those other insurers. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0040 2006 includes ci)pyrighted material of insurance Services Office,Inc.,with its permission. Copyright,Insurance Services Office,Inc.,1993 U.S. SPECIALTY INSURANCE COMPANY ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A.M. CPKG80320109 Town of Southold 601 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - DESIGNATED PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM - PUBLIC ENTITY SCHEDULE Description of Professional Services: 1. Attorneys or Lawyer's Professional Services 2. 3. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect to any professional services shown in the Schedule, the following exclusion is added to Paragraph 2., Exclusions of SECTION I - COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Paragraph 2., Exclusions of SECTION I - COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY: This insurance does not apply to "bodily injury," "property damage," or "personal and advertising injury" due to the rendering or failure to render any professional service. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0047 2006 Copyright, Insurance Services Office, Inc., 1984 ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POUCY NUMBER MO. DAY YR. 12:01 NOON XM, THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. EXCLUSION-DESCRIBED HAZARDS (CARNIVALS,CIRCUSES AND FAIRS) This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM-PUBLIC ENTITY With respect to the operations of any carnival, circus, or fair, this insurance does not apply to, 1. "Bodily injury"or"property damage" arising out of any mechanically operated amusement device; or 2. "Bodily injury"to any person while practicing for or participating in any sports or athletic contest or exhibition that you sponsor. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0052 2005 Copyright,Insurance Services Office,Inc,1984 U.S. SPECIALTY INSURANCE COMPANY GENERAL LIABILITY COVERAGE FORM PUBLIC ENTITY New York Various provisions in this policy restrict coverage. Read the entire policy carefully to determine Tights, duties and what is and is not covered. Throughout this policy, the words "you", and "your' and "Named Insured' refer to the entity identified as the 'Named Insured" in the Declarations. The words "Insured" or 'Insureds" refer to any person or organization qualifying as an "Insured" under SECTION 11 - WHO IS AN INSURED, The words "we', "us', 'our" and "Company" refer to the Company stated in the Declarations as providing this insurance. Other words and phrases that appear in quotation marks have special meanings. Refer to SECTION V - DEFINITIONS and other provisions of this policy for such meanings. organization for care, loss of services or death SECTION I—COVERAGES resulting at any time from the"bodily injury". COVERAGE A. BODILY INJURY AND PROPERTY 2. Exclusions DAMAGE LIABILITY This insurance does not apply to: 1. Insuring Agreement a. Expected or Intended I nj u ry a. We will pay those sums that the insured "Bodily injury" or "property damage' expected becomes legally obligated to pay as damages because of "bodily injury" or "property or intended from the standpoint of the insured. damage" to which this insurance applies. We This exclusion does not apply to"bodily injury" will have the right and duty to defend the or"property damage" resulting from the use of insured against any 'suit" seeking those reasonable force to protect persons or damages, However, we will have no duty to property. defend the insured against any "suit' seeking b. Contractuall Liability damages for 'bodily injury" or "property 'Bodily injury" or "property damage" for which damage" to which this insurance does not the insured is obligated to pay damages by apply. We may, at our discretion, investigate any"occurrence" and settle any claim or'suit" reason of the assumption of liability in a that may result. But: contract or agreement. This exclusion does (1) The amount we will pay for damages is not apply to liability for damages: limited as described in SECTION ill — (1) That the insured would have in the LIMITS OF INSURANCE; and absence of the contract or agreement; or (2) Our right and duty to defend end when we (2) Assumed in a contract or agreement that have used up the applicable limit of is an 'insured contract", Provided the insurance in the payment of judgments or "bodily injury" or "property damage" settlements under Coverages A or B or occurs subsequent to the execution of the medical expenses under Coverage C. contract or agreement. Solely for the purposes of liability assumed in an No other obligation or liability to pay sums or "insured contract , reasonable attorney perform acts or services is covered unless fees and necessary litigation expenses explicitly provided for under incurred by or for a party other than an SUPPLEMENTARY PAYMENTS insured are deemed to be damages COVERAGES A AND B, because of "bodily injury" or "property b. This insurance applies to "bodily injury" and damage", provided. ,.property damage'only if: (a) Liability to such party for, or for the (1) The"bodily injury' or"property damage" is cost of, that party's defense has also caused by an "occurrence" that takes been assumed in the same 'Insured place in the"coverage territory"; and contracf'-, and (2) The "bodily injury' or "property damage' (b) Such attorney fees and litigation occurs during the policy period- expenses are for defense of that party against a civil or alternative dispute c. Damages because of 'bodily injury" include resolution proceeding in which damages claimed by any person or PKGLINY0001 NY 03/08 1 Of 15 Includes copyrighted material of insurance Services Offir'e,Inc,with its permission. Coppight,Insurance SeMces Office.Inc.,1997 U.S. SPECIALTY INSURANCE COMPANY damages to which this insurance owned or occupied by, or rented or applies are alleged. loaned to, any insured. However, this c. Liquor Liability subparagraph does not apply W "Bodily injury" or "property damage" for which (i) "Bodily injury" if sustained within a any insured may be held liable by reason of- building and caused by smoke, fumes, vapor or soot from (1) Causing or contributing to the intoxication equipment used to heat that of any person; builcling� or (2) The furnishing of alcoholic beverages to a (11) "Bodily injury" or "property person under the legal drinking age or damage" arising out of heat, under the influence of alcohol;or smoke or fumes from a "hostile (3) Any statute, ordinance or regulation fire"; relating to the sale, gift, distribufion or use (iii) "Property damage" to a buliding of alcoholic beverages. or its contents if caused by This exclusion applies only if you are in the sewage resulting from: business of manufacturing, distributing, (aa) The reverse flow of such selling, serving or furnishing alcoholic sewage from within any beverages. sewage facility that you own, d. Workers Compensation and Similar Laws operate or maintain; or Any obligation of the insured under a workers (bb) The escape of sewage from compensation, disability benefits or any fixed conduit that you unemployment compensation law or any own, operate or maintain, similar law. but only if the escape occurs away from land you own or e. Employees Liability lease', "Bodily injury"to: (b) At or from any premises, site or (1) An "employee" of the insured adsing out location which is or was at any time of and in the course of employment by the used by or for any insured or others insured; for the handling, storage, disposal, (2) Any volunteer, including volunteer firemen processing or treatment of waste; or volunteer policemen, arising out of and (c) Which are or were at any time in the course of their duties for any transported, handled, stored, treated, insured, or disposed of, or processed as waste by or for any insured or any person or (3) The spouse, child, parent, brother or organization for whom you may be sister of that"employee" or volunteer as a legally responsible;or consequence of paragraph (1) and (2) (d) At or from any premises, site or above. location on which any insured or any This exclusion applies: contractors or subcontractor's working (1) Whether the insured may be liable as an directly or indirectly on any insured's employer or in any other capacity; and behalf are performing operations if the (2) To any obligation to share damages with pollu.tants" are brought on or to the premises, site or location in or repay someone else who must pay connection with such operations by damages because of the injury. such insured, contractor or This exclusion does not apply to liability subcontractor. However, this assumed by the insured under an "insured subparagraph does not apply to. contract". (1) "Bodily injury" or "property L Pollution damage" arising out of the (1) "Bodily injury" or "property damage" escape of fuels, lubricants or arising out of the actual, alleged or other operating fluids which are threatened discharge, dispersal, seepage, needed to perform the normal migration, release or escape of electrical, hydraulic or mechanical Ll functions necessary for the pollutants': operation of "mobile equipment" (a) At or from any premises, site or or its parts, if such fuels, location which is or was at any time lubricants or other PKGLINY000i NY 03108 2 of 15 Includes mpyrghled mateial of Insurance Servir-es Office,Inc.,with its permiggiDn Copyright Insurance Services Office,Inc.,1997 U.S. SPECIALTY INSURANCE COMPANY operating fluids escape from a However, this paragraph does not apply vehicle part designed to hold, to liability for damages because of store or receive them. This 11property damage" that the insured would exception does not apply if the have in the absence of such request, "bodily injury" or 'property demand, order or statutory or regulatory damage' arises out of the requirement, or such claim or "suit" by or intentional discharge, dispersal or on behalf of a governmental authority. release of the fuels, lubricants or g. A!rcraft,Auto or Watercraft other operating fluids, or if such fuels, lub6cants or other operating "Bodily injury" or "property damage" arising fluids are brought on Or to the out of the ownership, maintenance, use, or premises, site or location with the entrustment to others of any aircraft or "auto" intent that they be discharged, owned or operated by any insured or any dispersed or released as part of aircraft, "auto" or watercraft rented or loaned the operations being performed to any insured. Use includes operation and by such insured, contractor or "loading or unloading". subcontractor, This exclusion applies even if the claims (11) "Bodily injury' or "property against any insured allege negligence of other damage" sustained within a wrongdoing in the super-vision, hiring, building and caused by the employment, training or monitoring of others release of gases, fumes or vapors by that insured, if the "occurrence" which from materials brought into that caused the 'bodily injury" or "property building in connection with damage' involved the ownership, operations being performed by maintenance, use or entrustment to others of you or on your behalf by a any aircraft, "auto" or watercraft that is owned contractor or subcontractor; or or operated by or rented or loaned to any (iiii) "Bodily injury" or "property insured. damage" arising out of heat, This exclusion does not apply to: smoke or fumes from a 'hostile (1) A watercraft while ashore or on premises fire". you own or rent; (e) At or from any premises, site or (2) A watercraft you do not own that is: location on which any insured or any contractors or subcontractors working (a) Less than 26 feet long; and directly or indirectly on any insured's (b Not being used to carry persons or behalf are performing operations if the property for a charge; operations are to test for, monitor, (3) Parking an"auto" on, or on the ways next clean up, remove, contain, treat, to, premises you own or rent, provided the detoxify or neutralize, or in any way .auto' is not owned by or rented or loaned respond to, or assess the effects of, Upollutants", to any insured, (2) Any loss, cost or expense arising out of (4) Liability assumed under any "insured contract." for the ownership, maintenance any: or use of aircraft or watercraft; or (a) Request, demand, order or statutory (5) "Bodily injury" or "property damage" or regulatory requirement that any arising out of the operation of any of the insured or others test for, monitor, equipment listed in paragTaphs f. (2) or f. clean up, remove, contain, treat, (3)of the definition of"mobile equipment". detoxify or neutralize, or in any way respond to, or assess the effects of, h. Mobile Equipment ,.pollutants"; or "Bodily injury" or "property damage" arising (b) Claim or suit by or on behalf of a out of governmental authority for damages (1) The transportation of 'mobile equipment" because of testing for, monitoring, by an "auto" owned or operated by or cleaning up, removing, containing, rented or loaned to any insured; or treating, detoxifying or neutralizing, or in any way responding to, or (2) The use of"mobile equipment` in, or while assessing the effects of,"pollutants". in practice or preparation for a prearranged racing, speed or demolition contest or in any stunting activity. PKGLINY0001 NY 03/08 3 of 15 Includes copyrighted malehal of Insurance Services OfFic'-,Inc.,with its permission. Copyiight,Insurance Services Office,Inc., 1997 U.S. SPECIALTY INSURANCE COMPANY War k. Damage to Your Product "Bodily injury" or "property damage' however "Property damage" to "your product" arising caused, arising, directly or indirectly, out of'. out of it or any part of it. (1)War, including undeclared or civil war; 1. Damage to Your Work (2) Warlike action by a military force, "Property damage" to "your work" arising out including action in hindering or defending of it or any part of it and included in the against an actual or expected attack, by '.prod ucts-completed operations hazard". any government, sovereign or other This exclusion does not apply if the damaged authority using military personnel or other work or the work out of which the damage agents; or arises was performed on your behalf by a (3) Insurrection, rebellion, revolution usurped subcontractor. power, or action taken by governmental m. Damage to Impaired Property or Property authority in hindering or defending against Not Physically Injured any of these. 'Property damage" to 'impaired property" or Damage to Property property that has not been physically injured, "Property damage"to'. arising out of- (1) Property you own, rent or occupy; (1) A defect, deficiency, inadequacy or dangerous condition in "your producf or (2) Premises you sell, give away or abandon, Your work";or if the "property damage" arises out of any (2) A delay or failure by you or anyone acting part of those premises; on your behalf to perform a contract or (3) Property loaned to you; agreement in accordance with its terms. (4) Personal property in the care, custody or This exclusion does not apply to the loss Of control of the insured; use of other property arising out of sudden (5) That particular part of real property on and accidental physical injury to "your which you or any contractors or product'or"your work' after it has been put to subcontractors working directly or its intended use. indirectly on your behalf are performing n. Recall of Products� Work or Impaired operations, if the "property damage" Property arises out of those operations', or Damages claimed for any loss, cost or (6) That particular part of any property that expense incurred by you or others for the loss must be restored, repaired or replaced of use, withdrawal, recall, inspection, repair, because "your work" was incorrectly replacement, adjustment, removal or disposal performed on it. Of. Paragraphs (1), (3) and (4) of this exclusion (1) "Your product'- do not apply to "property damage" (other than damage by fire) to premises, including the (2) "Your work"; or contents of such premises, rented to you for a (3) "Impaired property"; period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage if such product,work, or property is withdrawn to Premises Rented to You as described in or recalled from the market or from use by any Section III-Limits Of Insurance. person or organization because of a known or Paragraph(2) of this exclusion does not apply suspected defect, deficiency, inadequacy or if the premises are "your work" and were dangerous condition in it. never occupied, rented or held for rental by o. Personal and Advertising Injury you� "Bodily injury" arising out of "personal and Paragraphs (3), (4), (5) and (6) of this advertising injury.' exclusion do not apply to liability assumed p. Failure to Supply under a sidetrack agreement. "Bodily injury" or "property damage" arising Paragraph (6) of this exclusion does not apply out of the failure of any insured to adequately to "Property damage' included in the supply gas, oil, water, electricity or steam by .products-completed operations hazard". any utility, whether owned or not by any insured- PKGLINYODOI NY 03108 4 of 15 Includes copyrighted material of lnsuranc�.e Services Office,Inc,,with its permission. Copyright Insurance Services Office,Inc..1997 U.S. SPECIALTY INSURANCE COMPANY Except for those insureds generating their any premises or portion of any premises used own electric power, this exclusion does not as a hospital or nursing home. apply if the failure results from the sudden and t Professional Health Care Services accidental injury to tangible property owned or used by any insured to procure, produce, "Bodily injury" or "property damage" arising process or transmit the gas, oil, water, out of.. electricity or steam. (1) The rendering or failure to render: q. Employment-Related Practices (a) Medical, surgical, dental, x-ray or "Bodily injury"to: nursing service, treatment, advice or (1) A person arising out of any. instruction, or the related furnishing of food or beverages, or (a) Refusal to employ that person', (b) Any health or therapeutic service, (b) Termination of that person's treatment, advice or instruction, employment; (2) The furnishing or dispensing of drugs or (c) Employment - related practices, medical, dental or surgical supplies or policies, acts or omissions, including appliances; or but not limited to coercion, demotion, (3) The handling or treatment of dead bodies, failure to promote, evaluation, including autopsies, organ donation or reassignment, discipline, defamation, other procedures. harassment, humiliation, or discrimination directed at that person; This exclusion does not apply to"bodily injury" or or "property damage arising out of the emergency health care services of your (d) Any negligent or intentional employees" or volunteers who are misrepresentation made in connection paramedics, emergency medical technicians, with(a), (b), or(c)above;or or licensed or registered nurses qualifying as (2) The spouse, child, parent, brother or an insured under this policy- sister of that person as a consequence of u. Asbestos "bodily injury' to that person at whom any Any claim, "suit", demand or loss that alleges of the employment-related practices "bodily injury", "property damage or"personal described in paragraphs (a), (b), or (c) and adverfising injury" (including but not above is directed. limited to, compliance with any request, This exclusion app5es: demand, order, or statutory or regulatory (1) Vvbether the insured may be liable as an requirement or any other action authorized or employer or in any other capacity; and required by law) including any costs, fees, expenses, penalties, judgments, fines, or (2) To any obligation to share damages with sanctions arising there from, which aftes out or repay someone else who must pay of, or would not have occurred, in whole or in damages because of the injury. part, but for the 'asbestos hazard." As used r, Law Enforcement Activities in this exclusion, "asbestos hazard" means: "Bodily injury" or "property damage" arising (1) actual, alleged or threatened exposure to out of: asbestos in any manner or form whatsoever, either directly or indiredy, or (1) The ownership, maintenance or use of (2) the failure to wam, advise or instruct any premises or portion of the premises related to asbestos in any manner or form used as a police department or law whatsoever, or enforcement department including jails, detention cells and/or holding facilities by (3) the failure to prevent exposure to the insured; or asbestos in any manner or form (2) Any act or omission resulting from law whatsoever, or enforcement activities of your police (4) the presence of asbestos in any place department, or any of your other law whatsoever, whether or not within a enforcement agencies, including their building or structure. agents, volunteers and employees. v. Airport s. Hospital or Nursing Home Premises "Bodily injury". "property damage", "personal "Bodily injury" or 'property damage" arising injury', or "adveffising injury" arising out of out of the ownership, maintenance or use of activities at arty airfield, runway, hanger, PKGLINYD001 NY 03/08 5 of 15 Includes copyrighted material of InFWTance Services Office,Inc,with its permission Copyright Insurance Services Office,Inc,1997 U.S. SPECIALTY INSURANCE COMPANY airport, airpark, heliport, or similar property (3) Arising out of oral or written publication of that you own, operate, use, maintain, license, material whose first publication took place permit, or inspect, or located on any property before the beginning of the policy period; you rent or lease, including a sublease. (4) Arising out of a criminal act.committed by Exclusions c, through n. do not apply to or at the direction of any insured, damage by fire to premises rented to you or (5) For which the insured has assumed temporarily occupied by you with permission liability in a contract or agreement. This of the owner. A separate limit of insurance exclusion does not apply to liability for applies to this coverage as described in damages that the insured would have in SECTION [1I—LIMITS OF INSURANCE. the absence of the contract or agreement; COVERAGE B. PERSONAL AND ADVERTISING (6) Arising out of a breach of contract, except INJURY LIABILITY an implied contract to use another's 1. Insuring Agreement advertising idea in your"advertisement"; a. We will pay those sums that the insured (7) Arising out of the failure of goods, becomes legally obligated to pay as damages products or services to conform with any because of 'Personal and advertising injury" statement of quality or performance made to which this insurance applies. We will have in your"advertisement'; the right and duty to defend the insured (8) Arising out of the wrong description of the against any "suit" seeking those damages. price of goods, products or services However, we will have no duty to defend the stated in your"advertisement"; or insured against any "suit" seeking damages for "personal and advertising injury' to which (9) Committed by an insured whose business this insurance does not apply.We may, at our is advertising, broadcasting, publishing or discretion, investigate any offense and settle telecasting. However, this exclusion does any claim or"suit'that may result. But: not apply to paragraphs 13.a, b. and c, of (1) The amount we will pay for damages is 11 personal and advertising injury" under limited as described in SECTION III SECTION V- DEFINITIONS. LIMITS OF INSURANCE; and b. Professional Health Care Services (2) Our right and duty to defend end when we 'Personal and advertising injury" arising out have used up the applicable limit of Of insurance in the payment of judgments or (1) The rendering or failure to render: settlements under Coverages A or 13 or medical expenses under Coverage Cn (a) Medical, surgical, dental, x-ray or No other obligation or liability to pay sums or nursing service, treatment, advice or instruction, or the related furnishing of perform acts or services is covered unless food or beverages; or explicitly provided for under SUPPLEMENTARY PAYMENTS (b) Any health or therapeutic service, COVERAGES A AND B. treatment, advice or instruction. b. This insurance applies to "personal and (2) The furnishing or dispensing of drugs or advertising injury' caused by an offense medical, dental or surgical supplies or arising out of your business but only if the appliances; or offense was committed in the "coverage (3) The handling or treatment of dead bodies, territory" during the policy period. including autopsies, organ donation or 2. Exclusions other procedures. This insurance does not apply to'. This exclusion does not apply to'personal a. "Personal and advertising injury": and advertising injury" arising out of the emergency health care services of your (1) Caused by or at the direction of the .,ernployees" or volunteers who are insured with the knowledge that the act paramedics, emergency medical would violate the rights of another arid technicians, or licensed or registered would inflict "personal and advertising nurses qualifying as an insured under this injury"; policy. (2) Arising out of oral or written publication of c. Pollution and Pollution -Related material, if done by or at the direction of (1) "Personal and advertising Injury" arising the insured with knowledge of its falsity� out of the actual, alleged or threatened PKGLINY0001 NY 03/08 6 of 15 Includes copyrighted material of Insurance Ser%fices Office,Inc.,with its permission Copyright Insurance Services Office, Inc.,1997 U.S. SPECIALTY INSURANCE COMPANY discharge, dispersal, seepage, migration, used as a police department or law release or escape of "pollutants" at any enforcement department including jails, time. detention cells and/or holding facilities by (2) Any loss, cost Or expense arising out of the insured; or any: (2) Any act or omission resulting from law (a) Request. demand order or statutory enforcement activities of your police or regulatory requirement that any department, or any of your other law insured or others test for, monitor, enforcement agencies, including their clean up, remove, contain, treat, agents, volunteers and employees. detoxify or neutralize, or in any way f. Asbestos respond to, or assess the effects of, "Personal and advertising injury" arising out .pollutants;"or of: (b) Claim or suit by or on behalf of a (1) Inhaling, ingesting or physical exposure to governmental authority for damages asbestos or goods or products containing because of testing for, monitoring, asbestos; or cleaning up, removing, containing, treating, detoxifying or neutralizing, or (2) The use of asbestos in construction or in any way responding to, or manufacturing any good, product or assessing the effects of, "pollutants'. structure; or d. Employment Related Practices (3) The removal of asbestos from any good, "Personal and advertising injury": product or structure� or (4) The manufacture, sale, transportation, (1) To a person arising out of any: storage or disposal of asbestos or goods (a) Refusal to employ that person; or products containing asbestos. (b) Termination of that person's The insurance afforded by this Coverage Part employment; does not apply to payment for the (c) Employment - related practices, investigation or defense of any loss, injury or policies, acts Or Omissions, including damage or any cost, fine or penalty or for any but not limited to coercion, demotion, expense of claim or "suit" related to failure to promote, evaluation, paragraphs(1),(2), (3), or(4) above. reassignment, discipline, defamation, g. War harassment, humiliation, or "Bodily injury" or 'property damage" however discrimination directed at that person; caused, arising, directly or indirectly, out of: or (1)War, including undeclared or civil war; (d) Any negligent or intentional misrepresentation made in connection (2) Warlike action by a military force, with (a), (b), or(c)above; or including action in hindering or defending against an actual or expected attack, by (2) To the spouse, child, parent, brother or any government, sovereign or other sister of that person as a consequence of authority using military personnel or other ,.personal and advertising injury" to that agents; or person at whom any of the employment- related practices described in paragraphs (3) Insurrection, rebellion, revolution usurped (a),(b),or(c)above is directed. power, or action taken by governmental authority in hindering or defending against This exclusion applies: any of these. (1) Whether the �nsured may be liable as an COVERAGE C.MEDICAL PAYMENTS employer or in any other capacity; and 1. Insuring Agreement (2) To any obligation to share damages with or repay someone else who must pay a. We Will pay medical expenses as described damages because of the injury. below for "bodily injury" caused by an accident: e. Law Enforcement Activities (1) On premises you own or rent; "Personal and advertising injury' arising out (2) On ways next to premises you own or Of-. rent;or (1) The ownership, maintenance Or use of any premises or portion of the premises (3) Because of your operations; PKGLI NY000 1 NY 03108 7 of 15 Includes rupyrighted material Df Insurance SerVoces offire,Inc.,with its permissiDn. Copyright,InSUTance-Services Offire,Inc, 1997 U.S. SPECIALTY IINSUIRANCE COMPANY provided that: (1) The accident takes place in the'coverage 1. To any inmate, patient or prisoner: territory"and during the policy period-, (1) Who is being treated. cared for, detained (2) The expenses are incurred and reported or imprisoned in any of the facilities to us within one year of the date of the owned or operated by or for any insured; acc�ident; and or (3) The injured person submits to (2) Because of medical services rendered by examination, at our expense, by you or your"employees" or any person or physicians of our choice as often as we organization under contract with you to reasonably require. provide these medical services. b. We will make these payments regardless of SUPPLEMENTARY PAYMENTS—COVERAGES A fault, These payments will not exceed the AND B applicable limit of insurance. We will pay 1. We will pay with respect to any claim we reasonable expenses for: investigate or settle, or any "suit' against an (1) First aid administered at the time of an insured we defend: accident; a. All expenses we incur. (2) Necessary medical, surgical, x-ray and b. Up to $2000 for cost of ball bonds required dental services, including prosthetic because of accidents or traffic law violations devices; and arising out of the use of any vehicle to which (3) Necessary ambulance, hospital, the Bodily Injury Uability Coverage applies. professional nursing and funeral services. We do not have to furnish these bonds. 2. Exclusions c. The cost of bonds to release attachments, but We will not pay expenses for'bodily injury": only for bond amounts within the applicable limit of insurance. We do not have to furnish a. To any insured. these bonds. b. To a person hired to do work for or on behalf d. All reasonable expenses incurred by the of any insured or a tenant of any insured. insured at our request to assist us in the c. To a person injured on that part of premises investigation or defense of the claim or "suit", you own or rent that the person normally including actual loss of earnings up to $250 a occupies. day because of time off from work. e. All costs taxed against the insured in the d. To a person, whether or not an "employee" of suit7. any insured, if benefits for the "bodily injury" are payable or must be provided under a f� Prejudgment interest awarded against the workers' compensation or disability benefits insured on that part of the judgment we pay. law or a similar law. If we make an offer to pay the applicable limit e. To a person injured while taking part in of insurance, we will not pay any prejudgment athletics. interest based on that period of time after the offer. f. Included within the "products-completed g. All interest on the full amount of any judgment operations hazard". that accrues after entry of the judgment and g. Excluded under Coverage A, before we have paid, offered to pay, or h. However caused, arising directly or indirectly, deposited in court the part of the judgment out of. that is within the applicable limit of insurance. (1)War, including undeclared or Civil war; These payments will not reduce the limits of insurance. (2) Warlike action by a military force, including action in hindering or defending 2. If we defend an insured against a 'suit" and an against an actual Or expected attack, by indemnitee of the insured is also named as a any government, sovereign or other party to the"suit",we will defend that indemnitee if authority using military personnel or other all of the following conditions are met: agents; or a. The "suit" against the indemnitee seeks (3) Insurrection, rebellion, revolution usurped damages for which the insured has assumed power, or action taken by governmental the liability of the indemnitee in a contract or authorty in hindering or defending against agreement that is an"insured contract"; any of these, PKGLINYD001 NY 03108 8 Of 15 Inr.lu6es copyrighted material of insurance SerVices Office,Inc,with its permission- Copyright Insurance Services Office,Inc.,1997 U.S. SPECEALTY INSURANCE COMPANY b, This insurance applies to such liability b. The conditions set forth above, or the terms of the assumed by the insured; agreement described in paragraph f. above, are c. The obligation to defend, or the cost of the no longer met defense of, that indemnitee, has also been SECTION 11—WHO IS AN INSURED assumed by the insured in the same "Insured contract"; 1. The term insured as used herein means the entity d, The allegations in the "suit" and the designated in the Declarafions as the Named information we know about the "occurrence" Insured and, except as excluded by endorsement are such that no conflict appears to exist to this policy,the following-, between the interests of the insured and the a. A governmental agency or subdivision, interests of the indemnitee; department, municipal body, board or a. The indemnitee and the insured ask us to commission, or not-for-profit corporation conduct and control the defense of that which is owned and controlled by you. inderrinitee against such "suit" and agree that b. All persons who were, now are, or shall be we can assign the same counsel to defend elected or appointed or employed members of the insured and the indemniltee; and any board, commission or agency of yours f. The indemnitee: while acting within the scope of their duties. (1) Agrees in writing to, c. Any person while providing services tinder a (a) Cooperate with us in the investigation, mutual aid agreement, joint powers settlement or defense of the"suit"; agreement or similar arrangement, but only with respect to the conduct of your business (b) Immediately send us copies of any and only to the extent of your participation or demands, notices, summonses or your interest- legal papers received in connection but only for - Vith the"suit"; d. Your"employees" and volunteers (c) Notify any other insurer whose acts within the scope of their employment by coverage is available to the you or in the course of their duties for you and indemnitee; and at your direction. (d) Cooperate with us with respect to However, no "employee" or volunteer is an coordinating other applicable insured for: insurance available to the indemnitee; (1) "Bodily injury" or "personal and and advertising injury": (2) Provides us with written authorization to (a) To you or to a ca-"employee" or other (a) Obtain records and other information volunteer while that co-'employee" or related to the'suit"; and other volunteer is either in the course of his or her employment or while (b) Conduct and control the defense of acting at the direction of, and within the indemnitee in such'suit". the scope of their duties for you; So long as the above conditions are met, attorneys (b) To the spouse, child, parent, brother fees incurred by us in the defense of that inderrinitee, or sister of that co-'employee" or necessary litigation expenses incurred by us and other volunteer as a consequence of necessary litigation expenses incurred by the paragraph(a)above; indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the (C) For which there is an obligation to provisions of paragraph 2.b.(2) of COVERAGE A— share damages with or repay BODILY INJURY AND PROPERTY DAMAGE someone else who must pay LIABILITY (Section I — Coverages), such payments damages because of the injury will not be deemed to be damages for 'bodily injury' described in paragraphs (a) or (b) and 'property damage" and will not reduce the limits above; or of insurance. (d) Arising out of his or her providing or Our obligation to defend an insured's indemnitee and failing to provide professional health to pay for attorneys' fees and necessary litigation care services. But this exclusion does expenses as Supplementary Payments ends when: not apply to an "employee" or volunteer of yours who is a a. We have used up the applicable limit of insurance paramedic, emergency medical in the payment of judgments or settlements, or technician, or licensed or registered PKGLINY0001 NY 03/08 9 of 15 Includes copyrighted material of Insurance services office,Inc.,with its permission. Copyright,Insurance services Office,Inc.,1997 U.S. SPECIALTY INSURANCE COMPANY nurse while acting within the scope of 2. The General Aggregate Limit is the most we will their employment by you or in the pay for the sum of: course of their duties for you. a. Medical expenses under Coverage C; (2) "Property damage"to property'. b. Damages under Coverage A, except (a) Owned , occupied, or used by, damages because of "bodily injury" or (b) Rented to, in the care, custody or .property damage" included in the "products- control of, or over which physical completed operations hazard"; and control is being exercised for any c. Damages under Coverage 13- purpose by 3, The Products-Completed Operations Aggregate you, any of your "employees", or any of Limit is the most we will pay under Coverage A for your volunteers. damages because of "bodily injury" and "property 2. With respect to "mobile equipmenf' registered in damage" included in the "products-completed your name under any motor vehicle registration operations hazard", law, any person is an insured while driving such 4. Subject to 2. above, the Personal and Advertising equipment along a public highway with your Injury Limit is the most we will pay under permission. Any other person or organization Coverage B for the sum of all damages because responsible for the conduct of such person is also of all "personal and advertising injury' sustained an insured, but only with respect to liability arising by any one person or organization- out of the operation of the equipment, and only if 5. Subject to 2. or 3. above, whichever applies, the no other insurance of any kind is available to that Each Occurrence Limit is the most we will pay for person or organization for this liability. However, the sum of: no person or organization is an insured wit.h respect to: a. Damages under Coverage A;and a. "Bodily injury' to a co-"emplDyee" of the b. Medical expenses under Coverage C person driving the equipment, or because of all "bodily injury" and "property b. "Property damage" to property owned by, damage"arising out of any one"occurrence", rented to, in the charge of or occupied by you 6. Subject to S. above, the Damage To Premises or the employer of any person who is an Rented To You Limit is the most we will pay under insured under this provision. Coverage A for damages because of "property 3. Any municipality, special district or other entity damage" to any one premises, while rented to you newly acquire or form will qualify as a Named you,or in the case of damage by fire,while rented Insured if there is no other similar insurance to you or temporarily occupied by you with available to that municipality, special district or permission of the owner. other entity. However: 7. Subject to 5. above, the Medical Expense Limit is a. Coverage under this provision is afforded only the most we will pay under Coverage C for all until the 90th day after you acquire or form the medical expenses because of "bodily injury' organization or, the end of the policy period, sustained by any one person. whichever is earlier; The Limits of Insurance of this Coverage Part b. Coverage A does not apply to "bodily injury" apply separately to each consecutive annual or"property damage"that occurred before you period and to any remaining period of less than 12 acquired or formed the organization; and months, starting with the beginning of the policy c. Coverage B does not apply to "personal and period shown in the Declarations, unless the advertising injury" arising out of an offense policy period is extended after issuance for an committed before you acquired or formed the additional period of less than 12 months. In that case, the additional period will be deemed part of organization, the last preceding period for purposes of SECTION III—LIMITS OF INSURANCE determining the Limits of Insurance. 1. The Limits of Insurance shown in the Declarations SECTION IV — PUBLIC ENTITY GENERAL and the rules below fix the Most we will pay LIABILITY CONDITIONS regardless of the number of: 1. Duties In The Event Of Occurrenice, Offense, a. Insureds; Claim Or Suit b. Claims made or'suite brought; or a. You must see to it thatwe are notified as soon c. Persons or organizations making claims or as practicable of an "occurrence" or an bringing"suits". PKGLINY0001 NY 03/08 10 Of 15 Includes copyrighted material of Insurance Services Office,Inc.,with its permisrion.. Copyright,Insurance Services Office,Inc,1997 U.S. SPECIALTY INSURANCE COMPANY offense that may result in a claim, To the liability signed by us, the insured and the claimant extent possible, notice should include: Or the claim ant's legal representative (1) How, when and where the"or-currence" or 3. Other Insurance offense took place; If other valid and collectible insurance is available (2) The names and addresses of any injured to the insured for a loss we cover under Cover�ge persons and witnesses; and A or B of this Coverage Part, our obligations are (3) The nature and location of any injury or limited as follows: damage arising out of the `occurrence" or a. Primary Insurance offense. This insurance is primary except when b. b. If a claim is made or "suit' is brought against below applies. If this insurance is primary, our any insured,you must: obligations are not affected unless any of the (1) immediately record the specifics of the other insurance is also primary. Then, we will claim or"suit"and the date received; and share with all that other insurance by the method described in c.below. (2) Notify us as soon as practicable. b. Excess Insurance You must see to it that we receive written This insurance is excess over� notice of the claim or "suit" as soon as practicable. (1) Any of the other insurance, whether You and any other involved insured must: primary, excess, contingent or on any other basiS'r (1) Immediately send us copies of any (a) That is Fire, Extended Coverage, demands, notices, summonses or legal Builder's Risk, Installation Risk or papers received in connection with the similar coverage for"Your work'; claim or"suit"; (b) That is Fire insurance for premises (2) Authorize US to obtain records and other rented to you or temporarily occupied information; by you with permission of the owner; (3) Cooperate with US in the investigation or (c) That is insurance purchased by you to settlement of the claim or defense against cover your liability as a tenant for the"suit"; and "prop" damage"to premises rented (4) Assist us, upon our request, in the to you or temporarily occupied by you enforcement of any right against any with permission of the owner;or person or organization that may be liable (d) If the loss arises out of the to the insured because of injury or maintenance or use of aircraft, "autos" damage to which this insurance may also or watercraft to the extent not subject apply. to Exclusion g. of Coverage A d. No insureds m4ll, except at their own cost, (Section 1). voluntarily make a payment, assume any (2) Any other primary insurance available to obligation, or incur any expense, other than you covedng liability for damages arising for first aid, without our consent. out of the premises or operations for 2. Legal Action Against Us which you have been added as an No person or organization has a right under this additional insured by attachment of an endorsement Coverage Part: When this insurance is excess, we will have a. To join us as a party or otherwise bring us into no duty under Coverage A or B to defend the a "suit" asking for damages from an insured; insured against any 'suit" if any other insurer or has a duty to defend the insured against that b. To sue us under this Coverage Part unless all suit'. If no other insurer defends, we will of its terms have been fully complied with. undertake to do so, but we will be entitled to A person or organization may sue us to recover the insured's 6ghts against all those other on an agreed settlement or on a judgment against insurers. an insured; but we will not be liable for damages When this insurance is excess over other that are not payable under the terms of this insurance, we will pay only our share of the Coverage Part or that are in excess of the amount of the loss, if any, that exceeds the applicable limit of insurance, An agreed sum of: settlement means a settlement and release of PKGLINYOOD1 NY 03/OB 11 of 15 includes copyrighted material of Insurance Services Office,Inc-,with its permission- Copyright,Insurance Services Office,Inc.,1997 I U.S. SPECIALTY INSURANCE COMPANY (1) The total amount that all such other transfer those rights to us and help Lis enforce insurance would pay for the loss in the them. absence of this insurance; and 8. When We Do Not Renew (2) The total of all deductible and self-insured If we decide not to renew this Coverage Part, we amounts under all that other insurance. will mail or deliver to the first Named Insured We will share the remaining loss, if any, with shown in the Declarations written notice of the any other insurance that is not described in nonrenewal not less than 30 days before the this Excess Insurance provision and was not expiration date. bought specifically to apply in excess of the If notice is mailed, proof of mailing will be Limits of Insurance shown in t.he Declarations sufficient proof of notice. of this Coverage Part. c. Method of Sharing SECTION V—DEFINITIONS If all of the other insurance permits 1. "Advertisement" means a notice that is broadcast contribution by equal shares, we will follow or published to the general public or specific this method also. Under this approach each market segments about your goods, produrts or insurer contributes equal amounts until it has services for the purpose of attracting customers or paid its applicable limit of insurance or none of supporters. the loss remains,whichever comes first. 2. "Auto" means-, If any of the other insurance does not permit a. a land motor vehicle, trailer or semitrailer contribution by equal shares, we will designed for travel on public roads, including contribute by limits. Under this method, each any attached machinery or equipment; or insurer's share is based on the ratio of its applicable limit of insurance to the total b. Any other land vehicle that is subject to a applicable limits of insurance of all insurers. compulsory or financial responsibility law or 4. Bankruptcy or Insolvency other motor vehicle insurance law in the state where it is licensed or principally garaged. The bankruptcy or insolvency of the insured or of However, "auto" does not include "mobile the insured's estate will not relieve us of our equipment. obligations under this Coverage Part- 6. Representations 3. "Bodily injury" means bodily injury, sickness, disease, or mental anguish sustained by a person, By accepting this policy,you agree: including death res0ing from any of these at any a. The statements in the Declarations are time. accurate and complete; 4. "Coverage territory"means: b. Those statements are based upon a. The United States of America (including its representations you made to us; and territories and possessions), Puerto Rico and c. We have issued this policy in reliance upon Canada; your representations. b. International waters or airspace, provided the 6. Separation of Insureds injury or damage does not occur in the course of travel or transportation to or from any place Except with respect to the Limits of Insurance, not included in a. above; or and any rights or duties specifically assigned in c. All parts of the world if: this Coverage Part to the first Named Insured, this insurance applies: (1) The injury or damage arises out of the a. As if each Named Insured were the only activities Of your "employees" whose Named Insured; and home is in the territory described in a. above, but is away for a short time on b. Separately to each insured against whom your business; and claim is made or"suit"is brought. (2) The insured's responsibility to pay 7. Transfer of Rights Of Recovery Against Others damages is determined in a "suit" on the To Us merits, in the territory described in a. If the insured has rights to recover all or part of above or in a settlement we agree to. any payment we have made under this Coverage 6. 'Employee" includes a "leased worker", Part, those rights are transferred to us. The "Employee" does not include a "temporary insured must do nothing after loss to �mpair them. worker", At our request, the insured will bring "suit" or PKGLINY0001 NY 03/08 12 of 15 Includes copyrighted materiial of InSUrance Services Office, Inc.,with its perrn�ssion. C,opyriight,Insurance Services Office,Imn,1997 U.S. SPECIALTY INSURANCE COMPANY 6. "Hostile fire" means one which becomes (2) That indemnifies an architect, engineer or uncontrollable or breaks out from where it is surveyor for injury or damage arising out intended to be. of: 7. "Impaired property" means tangible property, (a) Preparing, approving or failing to other than 'Your prodLict" or "your work", that prepare or approve maps, shop cannot be used or is less useful because: drawings, opinions, reports, surveys, a. It incorporates "your product" or "your work" field orders, change orders or that is known or thought to be defective, drawings and specifications; or deficient, inadequate or dangerous; or (b) Giving directions or instructions, or b. You have failed to fulfill the terms of a contract failing to give them, if that is the or agreement; primary cause of the injury or damage; or if such property can be restored to use by: (3) Under which the insured, if an architect, a. The repair, replacement, adjustment or engineer or surveyor, assumes liability for removal of"your product"or"your work", or any injury or damage arising out of the b. Your fulfilling the terms of the contract or insured's rendering or failure to render agreement. professional services, including those listed in (2) above and supervisory, S. 'Insured contract"means� inspection, architectural or engineering a. A contract for a lease of premises. However, activities. that portion of the contract for a lease of 9. "Leased worker" means a person leased to you by premises that indemnifies any person or a labor leasing firm under an agreement between organization for damage by fire to premises you and the labor leasing firm, to perform duties while rented to you or temporarily occupied by related to the conduct of your business. "Leased you with permission of the owner is not an worker" does not include a"temporary worker". "insured contract",- 10. "Mobile equipmenf means any of the following b. A sidetrack agreement; types of land vehicles, including any attached c. An easement or license agreement, except in machinery or equipment: connection with construction or demolition a. Bulldozers,farm machinery, forklifts and other operations on or within 50 feet of a railroad; vehicles designed for use principally off public d. An obligation, as required by ordinance, to roads; indemnify a municipal�y, except in connection b. Vehicles maintained for use solely on or next with work for a municipality; to premises you own or rent. However, any e. An elevator maintenance agreement; land motor vehicle, trailer, or semi-trailer designed for travel on public roads (including t That part of any other contract or agreement any machinery or apparatus that is attached) pertaining to your business (including an owned or leased by you shall be deemed an indemnification of a municipality in connection �auto" and not "mobile equipment" if the only with work performed for a municipality) under reason for considering it"mobile equipment"is which you assume the tort liability of another that A is maintained for use exclusively on party to pay for 'bodily injury" or "property streets or highways owned by you. damage" to a third person or organization. Tort liability means a liability that would be c. Vehicles that travel on crawler treads; imposed by law in the absence of any contract d. Vehicles, whether self-propelled or not, or agreement. maintained primarily to provide mobility to Paragraph f. does not include that part of any permanently Mounted: contract or agreement: (1) Power cranes, shovels, loaders, diggers (1) That indemnifies a railroad for "bodily or drills; or injury" or"property damage" arising out of (2) Road construction or resurfacing construction or demolition operations, equipment such as graders, scrapers or within 50 feet of any railroad property and rollers-, affecting any railroad bridge or trestle, e. Vehicles not described in a., b., o. or d. above tracks, road-beds, tunnel, underpass or that are not self-propelled and are maintained crossing; primarily to provide mobility to permanently attached equipment of the following types: PKGLINY0001 NY 03/08 13 of 15 Includes copyrighted material of Insurance Services Office,Inc.,With its permission. Copyright Insurance SerOces Office,I nc.,1997 U.S. SPECIALTY INSURANCE COMPANY (1) Air compressors, pumps and generators, f, The use of another's advertising idea in your including spraying, welding, building '.advertisement"; cleaning, geophysical exploration, lighting g. Infringing upon another's copyhght, trade and well servicing equipment; or dress or slogan in Your"advertisernent", (2) Cherry pickers and similar devices used h. False or improper service of process; or to raise or lower workers. L Discrimination claims based on disparate f. Vehicles not described in a., b., c.or d. above impact and for actions alleging vicarious maintained primarily for purposes other than liability arising from discriminatory acts of the transportation of persons or cargo. employees of the insured. However, coverage However, self-propelled vehicles with the shall not apply to such claims if an elected or following types of permanently attached appointed official, officer, director, equipment are not 'mobile equipment" but will commissioner or trustee of the Named be considered "autos` Insured knew or had reason to know of the (1) Equipment designed primarily for'. discriminatory action(s)- (a) Snow removal� 13. "Pollutants' means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, (b) Road maintenance but not vapor, soot, fumes, acids, alkalis, chemicals and construction or resurfacing; or waste. Waste includes materials to be recycled, (c) Street cleaning; reconditioned or reclaimed. (2) Cherry pickers and similar devices 14. "Products-completed operations hazard": mounted on automobile or truck chassis a. Includes all "bodily injury" and "property and used to raise or lower workers; and damage" occur6ng away from premises you (3) Air compressors, pumps and generators, own or rent and arising out of "your product" including spraying, welding, building or'your work"except: cleaning, geophysical exploration, lighting (1) Products that are still in your physical and well servicing equipment. possession; or However, 'mobile equipment' does not (2) Work that has not yet been completed or include any land vehicles that are subject to a abandoned. However, "your work" will be compulsory or financial responsibility law or deemed completed at the earliest of the other motor vehicle insurance law in the state following times: where it is licensed or principally garaged. (a) When all of the work called for in your Land vehicles subject to a compulsory or contract has been completed. financial responsibility law or other motor vehicle insurance law are considered'autos", (b) When all of the work to be done at the 11. "Occurrence" means an accident, including job site has been completed if your continuous or repeated exposure to substantially contract calls for work at more than the same general harmful conditions. one job site. 12, "Personal and advertising injury' means injury, (c) When that part of the work done at a including consequential "bodily injury", arising out job site has been put to its intended of one or more of the following offenses'. use by any person or organization other than another contractor or a. False arrest, detention or imprisonment; subcontractor working on the same b. Malicious prosecution; project- c. The wrongful eviction from, wrongAil entry Work that may reed service, into, or invasion of the right of private maintenance, corTection, repair or occupancy of a room, dwelling or premises replacement, but which is otherwise that a person occupies, committed by or on complete,will be treated as completed. behalf of its owner, landlord or lessor; b. Does not include "bodily injury" or "property d, Oral Or written publication of material that damage"arising out of: slanders or libels a person or organization or (1) The transportation of property, unless the disparages a person's or organization's injury or damage arises out of a condition goods, products or services; in or on a vehicle not owned or operated e. Oral or written publication of mateCiall that by you, and that condition was created by violates a person's right of privacy; the "loading or unloading" of that vehicle by any insured; PKGLINYOD01 NY 03108 14 of 15 Includes cDpyrighted material of Insuranre Services Office,Inc.,with its permission. Copyright,Insurance Services Office,Inc,1997 U.S. SPECIALTY INSURANCE COMPANY (2) The existence of tools, uninstalled 'Your product" does not include vending machines equipment or abandoned or unused or other property rerted to or located for the use materials, or of others but not sold. (3) Products or operations for which the 19. "Your work" means: classification, listed in the Declarations or a. Work or operations performed by you or on in a policy schedule, states that products- your behalf; and completed operations are Subject to the General Aggregate Limit. b. Materials, parts or equipment furnished in 16. "Property damage" means: connection with such work or operations. a. Physical injury to tangible property, including "Your work'includes: all resulting loss of use of that property. All a. Warranties or representations made at any such loss of use shall be deemed to occur at time with respect to the fitness, quality, the time of the physical injury that caused it; durability, performance or use of "your work"; or and b. Loss of use of tangible prop" that is not b. The providing of or failure to provide warnings physically injured. All such loss shall be or instructions. deemed to occur at the time of the "occurrence"that caused it. 16. "Suit" means a civil proceeding in which damages because of "bodily injury', 'property damage", or .personal and advertising injury" to which this insurance applies are alleged. "Suit"includes, a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 17, "Temporary worker' means a person who is furnished to you to substitute for a permanent .employee" on leave or to meet seasonal or short- term workload conditions. 18. "Your product"means: a. Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (1) You; (2) Others trading under your name; or (3) A person or organization whose business or assets you have acquired; and b. Containers (other than vehicles), materials. parts or equipment furnished in connection with such goods or products. "Your product"includes: a. Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product"-, and b. The providing of or failure to provide warnings or instructions. PKGLINY0001 NY 03108 15 of 15 Includes copyrighted material of Insuranm Services Office,Inc.,with its perrnission Copyright, Insurance Services Oftice,Inc.,1997 Endorsement No. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART (Standard Time) INSURED AGENCY AND OF CODE POLICY NUMBER MO DA YR. 12:01 NOO A,M_ NEW YORK CHANGES GENERAL LIABILITY COVERAGE FORM—PUBLIC ENTITY This endorsement modifies insurance provided under the following� General Liability Coverage Form—Public Entity A. Paragraph 1. Insuring Agreement of Section I — No other obligation or liability to pay sums or Coverage A — Bodily Injury And Property Dam- perform acts or services is covered unless age Liability is replaced by the following-. explicitly provided for under Supplementary 1. Insuring Agreement Payments—Coverages A and B. b. This insurance applies to "bodily injury" and a. We will pay those sums that the insured "property damage"only if: becomes legally obligated to pay as dam- ages because of "bodily injury" or "property (1) The"bodily injury" or"property damage" is damage"to which this insurance applies. We caused by an "occurrence" that takes will have the right and duty to defend the in- place in the"coverage territory"; sured against any "suit" seeking those dam- (2) The "bodily injury" or "property damage' ages even if the allegations of the "suit" are occurs during the policy period; and groundless, false or fraudulent, However, we (3) Prior to the policy period, no insured listed will have no duty to defend the insured against any "suit" seeking damages for"bod- under Paragraph 1. of Section 11—Who Is ily injury" or "property damage" to which this An Insured and no"employee" authorized insurance does not apply. We may, at our by you to give or receive notice of an "oc- discretion, investigate any "occurrence" and currence" or claim, knew that the "bodily settle any claim or"suit'that may result. But: injury" or "property damage" had oc- curred, in whole or in part. If such a listed (1) The amount we Will pay for damages is insured or authorized "employee" knew, limited as described in Section III —Limits prior to the policy period, that the "bodily Of Insurance; and injury" or "property damage" occurred, (2) Our right and duty to defend end when we then any continuation, change or resump- have used up the applicable limit of insur- tion of such "bodily injury" or "property ance in the payment of judgments or set- damage" during or after the policy period tlements under Coverages A or B or will be deemed to have been known prior medical expenses under Coverage C. to the policy period. PKGLINY0003 08107 includes copyrighted material of insurance Services Offce, Inc.,with its permis- Page I of 3 sion. Copyright,Insurance Services Office,Inc,,199�� c. "Bodily injury" or"property damage"which 2) Our right and duty to defend end when we occurs during the policy period and was have used up the applicable limit of insur- not, prior to the policy period, known to ance in the payment of judgments or set- have occurred by any insured listed under tlements under Coverages A and B or Paragraph 1. of Section 11-Who Is An In- medical expenses under Coverage C. sured or any "employee" authorized by No other obligation or liability to pay sums or you to give or receive perform acts or services is covered unless notice of an "occurrence" or claim, includes explicitly provided for under Supplementary any continuation, change or resumption of Payments-Coverages A and B. that"bodily injury" or "property damage" after C. The following is added as Paragraph e. to the Du- the end of the policy period. ties In The Event Of Occurrence, Offense, Claim d. "Bodily injury" or "property damage" will be Or Suit Condition (Paragraph 2. of Section IV - deemed to have been known to have oc- Commercial General Liability Conditions): curred at the earliest time when any insured 2. Duties In The Event Of Occurrence,Offense, listed under Paragraph 1. of Section 11-Who Claim Or Suit Is An Insured or any "employee" authorized e. Notice given by or on behalf of the insured, or by you to give or receive notice of an "occur- written notice by or on behalf of the injured rence"or claim: person or any other claimant, to any agent of (1) Reports all, or any part, of the "bodily ours in New York State, with particulars suffi- injury" or "property damage" to us or any cient to identify the insured, shall be consid- other insurer; ered to be notice to us. (2) Receives a written or verbal demand or D.Exclusion - Violation of Statutes that claim for damages because of the "bodily' Govern E-Malls, Fax, Phone Calls or other Meth- injury"or"property damage-, or ods of Sending Material or Information (3) Becomes aware by any other means that a. The following exclusion is added to Para- "bodily injury" or "prop" damage" has graph 2. Exclusions of Section I -Cov- occurred or has begun to occur. erage A - Bodily Injury And Property e. Damages because of "bodily injury" include Damage Liability: damages claimed by any person or organiza- This insurance does not apply to: tion for care, loss of services or death result- DISTRIBUTION OF MATERIAL IN VIOLATION ing at any time from the"bodily injury". OF STATUTES B. Paragraph I.a. of Section I - Coverage B - Per- "Bodily injury' or "property damage" arising di- sonal And Advertising Injury Liability is replaced rectly or indirectly out of any action or omission by the following. that violates or is alleged to violate� 1. Insuring Agreement 1) The Telephone Consumer Protection a. We will pay those sums that the insured Act(TCPA). including any amendment of becomes legally obligated to pay as dam- or addition to such law- or ages because Of "Personal and advertising injury" to which this insurance applies. We 2) The CAN-SPAM Act of 2003, including will'have the right and duty to defend the in- any amendment of or addition to such sured against any "suit" seeking those dam- law;or ages even if the allegations of the "suit" are 3) Any statute, Ordinance or regulation, groundless, false or fraudulent. However, we other than the TCPA or CAN-SPAM Act will have no duty to defend the insured of 2003, that prohibits or limits the send- against any "suit" seeking damages for "per- ing, transmitting, communicating or dis- sonal and advertising injury" to which this in- tribution of material or information. surance does not apply, We may, at Our dis- b. The following exclusion is added to Para- cretion, investigate any offense and settle graph 2., Exclusions of Section I-Cover- any claim or"suit"that may result. But: age B - Personal And Advertising Injury (1) The amount we will pay for damages is Liability: limited as described in Section III - Limits This insurance does not apply to: Of Insurance; and PKGLINY0003 08/07 Includes copyrighted material of Insuranoe Services Office, Inc.,with its pen-nis- Page 2 of 3 sion, Copyright,Insurance Services Office,Inc., 1993 DISTRIBUTION OF MATERIAL IN VIOLATION We agree to take such steps, as we deem ap- OF STATUTES propriate, to avoid a default in, or continue the "Personal and advertising injury" arising directly defense of, such "suits" until such transfer is or indirectly out of any action or omission that completed, provided the appropriate insured is violates or is alleged to violate-, cooperating in completing such transfer. 1) The Telephone Consumer Protection We will take no action whatsoever with respect Act (TCPA), including any amendment of to any claim or "suit" seeking damages that or addition to such law; or would have been subject to that limit, had it not been used up, if the claim or"suit" is reported to 2) The CAN-SPAM Act of 2DO3, including us after that limit of insurance has been used up. any amendment of or addition to such (3) The first Named Insured, and any other insured law; or involved in a "suit" seeking damages subject to 3) Any statute, Ordinance or regulation, that limit, must arrange for the defense of such other than the TGPA or CAN-SPAM Act "suit" within such time period as agreed to be- of 2003, that prohibits or limits the send- tween the appropriate insured and us. Absent ing, transmitting, communicating or dis- any such agreement, arrangements for the de- tribution of material or information. fense of such "suit" must be made as soon as practicable. E.Transfer of Duties When A Limit of Insurance is c. The first Named Insured will reimburse us for ex- Used Up penses we incur in taking those steps we deem ap- The following Condition is added to (Section IV): propriate in accordance with paragraph b.(2) above. Transfer of Duties When a Limit of Insurance Is The duty of the first Named Insured to reimburse us Used Up. will begin on: a. If we conclude that, based on "occurrences," of- (1) The date on which the applicable limit of insur- fenses, claims or "suits" which have been reported ance is used up, if we sent notice in accordance to us and to which this insurance may apply, the: with paragraph a. above; or (1) General Aggregate Limit (other than the Prod- (2) The date on which we sent notice in accordance ucts/Completed Operations Aggregate Limit); with paragraph b.(1) above, if we did not send (2) Products/Completed Operations Aggregate notice in accordance with paragraph a. above. Limit; d. The exhaustion of any limit of insurance by the payments of judgments or settlements, and the re- (3) Personal and Advertising Injury Limit sulting end of our duty to defend, Vill not be affected (4) Each Occurrence Limit; or by our failure to comply with any of the provisions of (5) Fire Damage Limit this Condition. is likely to be used up in the payment of judgments Punitive Damage Exclusion or settlements, we will notify the first Named In- The following exclusion is added to Paragraph 2., Ex- sured, in writing, to that effect. clusions of Section I — Coverage A — Bodily Injury b. When a limit of insurance described in paragraph a. And Property Damage Liability and Coverage B — above has actually been used up in the payment of Personal and Advertising Injury Liability: judgments or settlements: This insurance does not apply to punitive or exemplary (1) We Will notify the first Named Insured, in writing, damages. as soon as practicable,that: Assault and Battery Exclusion (a) Such a limit has actuafly been used up; and The following exclusion is added to Paragraph 2., Ex- (b) Our duty to defend "suits" seeking damages clusions of SectJJon I — Coverage A — Bodily Injury subject to that limit has also ended. And Property Damage Liability: (2) We will initiate, and cooperate in, the transfer of This insurance does not apply to "bodily injury" or control, to any appropriate insured, of all claims 'property damage arising out of., and "suits" seekinp damages which are subject a. Assault and battery committed by any person-, to that limit and which are reported to us before b. The failure to suppress or prevent assault and that limit is used up. That insured must cooper- battery by any person; or ate in the transfer of control of said claims and .,suits". c. Assault and battery resulting from or allegedly related to the negligent hiring, supervision or training of any person. PKGLINY0003 08107 Includes copyrighted material of Insurance Services Office, Inc..vifth its perrn�s- Page 3 of 3 sion, Capyright,insurance Services Office,Inc-, 1993 ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A M. THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following� GENERAL LIABILITY COVERAGE FORM—PUBLIC ENTITY NEW YORK CONTRACTORS SPECIAL CONDITIONS. The following condition has been added to the policy: You will obtain certificates of insurance from all independent contractors providing evidence of: 1, Limits of insurance equal to or greater than the limits provided by this policy-, and 2- Coverage equal to or greater than the coverages provided by this policy. Failure to comply with this condition does not alter the coverage provided by this policy. However, should you fail to comply a premium charge will be made. This premium charge will be based on the"total cost"of all work sublet. 'Total cost"means the cost of all labor, materials and equipment furnished, used or delivered for use in the execution of the work and all fees, bonuses or commissions paid. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLINY0011 0907 Includes copyrighted material of Insurance Services Office,Inc.,with its permission, r-Dpyright,Insurance Services office,Inc,,1993 ENDORSEMENT NO. ATTAcHffD To AND ENDORSEMENT EFFECTIVE INSURED AGENCY FORMING A PART OF (Standard Time) AND CODE POLICY NUMBER Mo. DAY YR. 12:01 -NOON A'K 12:01 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY- LEAD EXCLUSION —GENERAL LIABILITY New York This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM-PUBLIC ENTITY The following exclusion is added to 2. Exclusions of Section I—Coverages-Coverage A, Bodily Injury and Property Damage Liability. This insurance does not apply to bodily injury and property damage arising from: Lead "Occurrences" at or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to, any insured, or from the operations of the insured,which result in: (1) "Bodily injury" arising out of the ingestion, inhalation or absorption of lead in any form-, (2) "Property damage" arising from any form of lead-, (3) Any loss, cost or expense arising out of any request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detox4 or neutralize, or in any way respond to, or assess the effects of, lead;or (4) Any loss, cost or expense arising out of any claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, lead. PKGLINY0007 09 07 NY Includes copyrighted material of insurance services Office,Inc.,with its permission Copyright Insurance Services Office,Inc.,1993 ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. IZ01 NOON A.M. KC001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SEXUAL ABUSE EXCLUSION—NEW YORK This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM - PUBLIC ENTITY This insurance does not apply to "bodily injury" or "personal and advertising injury" sustained by any person arising out of or resulting from "sexual abuse". However, this exclusion shall not apply to the Named Insured if no elected or appointed official, officer, director, commissioner or trustee of the Named Insured knew or had reason to know of the "sexual abuse". This exclusion does not affect our duty to defend, in accordance with the provisions of the policy that applies to Supplementary Payments — Coverages A and B, an insured prior to determining, through the appropriate legal processes, that the insured is responsible for an act of "sexual abuse" or has instructed, directed or provided approval for another concerning such act of"sexual abuse". The following definition is added to Section V— Definitions: "Sexual Abuse" means actual, attempted or alleged sexual conduct by a person, or by persons acting in concert, which causes injury. "Sexual abuse" includes sexual molestation, sexual assault, sexual exploitation, or sexual injury. It does not include sexual harassment. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLINY0012 NY 09/07 Includes copyrighted material of Insurance Services Office, Inc,,with its permission. Copyright, Insurance Services Office, Inc., 1993 U.S. SPECIALTY INSURANCE COMPANY EMPLOYEE BENEFITS LIABILITY COVERAGE PART- New York SUPPLEMENTAL DECLARATIONS Coverage provided by this coverage form is claims made. Please read the coverage form carefully. These Supplemental Declarations form a part of policy number CPKG80320109 RETROACTIVE DATE This insurance does not apply to acts, errors or omissions which occur before the Retroactive Date, if any, shown below. Retroactive Date: NONE (Enter Date or"NONE" if no Retroactive Date applies) LIMITS OF INSURANCE Each Employee Limit $ 1,000,000 Aggregate Limit $ 3,000,000 FORM OF BUSINESS Z Municipality El Public School El Special District El Other: DEDUCTIBLE $ 50,000 This reduces the Limit of Insurance shown as applicable to Each Employee PREMIUM NO. OF EMPLOYEES RATE PER EMPLOYEE ESTIMATED PREMIUM Included Included (first 5,000) $ Included (next 5,000) $ (over 10,000) $ Minimum Premium $ Advance Premium $ FORMS AND ENDORSEMENTS(other than applicable forms and endorsements shown elsewhere in the policy) Forms and endorsements applying to the Coverage Part and made a part of this policy at time of issue: See form PKG I L0002 2006 THIS SUPPLEMENTAL DECLARATIONS AND THE COMMON POLICY DECLARATIONS, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S)AND ENDORSEMENTS COMPLETE THE ABOVE NUMBERED POLICY. PKGLINY0017 09/07 U.S. SPECIALTY INSURANCE COMPANY EMPLOYEE BENEFITS LIABILITY COVERAGE FORM New York THIS FORM PROVIDES CLAIMS-MADE COVERAQE. PLEASE READ THE ENTIRE FORM CAREFULLY. Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy, the words "you" and "your" refer to the Named Insured shown in the Declarations, The words,,we", "us"and" " fer to the Company providing this insurance, The word "insured" means any person or organization qualifying as such under SECTION 11 — WHO IS AN INSURED. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION V11 — DEFINITIONS. SECTION I - COVERAG (11i) The act, error or omission did not occur 1.Insuring Agreement before the "Retroactive Date", if any, a. We will pay those sums that the 'insured shown in the Declarations or after the becomes legally obligated to pay as dam- end of the policy period; and ages because of any act, error or omission Of the insured, or of any other person for (2) A 'claim" for damages, because of the whose acts the insured is legally liable. act, error or omission is first made The art, error or omission must be negli- against any insured, in accordance with gently committed in the "administration' of Paragraph c. below, during the policy your"employee benefit program". period or an Extended Reporting Period We wfli I have the right and duty to defend we provide under Section VI—Extended the insured against any"suit' seeking those Reporting Periods. damages even if the allegations of the"suif' c. A claim" by a person or organization seek- are groundless, false or fraudulent. How- ing damages Will be deemed to have been ever, we will have no duty to defend the in- made when notice of such "claim" is re- sured against any "suit" seeking damages ceived and recorded by any insured or by to which this insurance does not apply. We us,whichever comes first. may, at our discretion, investigate any re- A "claim" received and recorded by the in- port of an act, error or omission and settle sured Within 90 days after the end of the any"claim" or"suit"that may result. But: policy period will be considered to have (1) The amount we will pay for damages is been received within the policy period, if no limited as described section III—LIMITS subsequent policy is available to cover the OF INSURANCE; "claim". (2) Our right and duty to defend ends when All "claims" for damages sustained by any we have used up the applicable limit of one "employee", including the "employee's" insurance in the payment of judgments dependents and beneficiaries, will be or settlements. deemed to have been made at the time the first of those 'claims" is made against any No other obligation or liability to Pay sums insured. or perform acts or services is covered unless explicitly provided for under the 2.Exclusions Paragraph 3. Supplementary Payments. This insurance does not apply to: b. This insurance applies to any act, error or omission of the insured. only if: P KG LI NYOO 15 NY 09107 1 of 7 Includes copyrighted material of Insurance Services Office, Inc.,with its permission, Copyright, Insurance Services Office, Inc., 2006 a. Damage arising out of any intentional, c. All reasonable expenses incurred by the in- dishonest, fraudulent, criminal or malicious sured at our request to assist us in the in- act, error or omission committed by any vestigation or defense of the 'claim" or insured; 11suit," including actual loss of earnings up b. "Bodily injury", "property damage" or to $250 a day because of time off from work, .,personal and advertising injury" d. Ail costs taxed against the insured in the c. Damage arising out of failure or Usuit." performance of contract by any insurer, or any other party, including the insured 9. Prejudgment interest awarded against the obligated to afford benefits-, insured on that part of the judgment we d. Damage arising out of an insufficiency of pay. if we make an offer to pay the appli- funds to meet any obligations under any cable limit of insurance, we will not pay any plan included in the "employee benefit prejudgment interest based on that period of time after the offer. program"; If. All interest on the full amount of any judg- e. Any"claim" or"suit"based upon: ment that accrues after entry of the judg- (1) Failure of any investment to perform or ment and before we have paid, offered to for errors in providing information on the pay or deposited in court the part of the past performance of investment vehi- judgment that is within the applicable limit cles;or of insurance. (2) Advice given to any person to partick These payments will not reduce of the limits of in- pate or not to participate in any benefit surance. included in the "employee benefit pro- gram";or SECTION 11 - WHO IS AN INSURED (3) The investment or non-investment of 1. if you are designated in the Declarations as: funds. f. Any "claim" arising out of your failure to a. A municipality, special district or other public comply with the mandatory provisions of entity,you are an insured. any law concerning workers' compensation, b. A partnership or joint venture, you are an in- unemployment insurance, social security or sured- disability benefits or any similar law; c. An organization other than municipality, public g. Damages for which the insured is liable school, special district, partnership or joint ven- because of liability imposed on a fiduciary ture, you are an insured. Your directors and by the Employee Retirement Income stockholders are also insureds, but only with Security Act of 1974, as now or hereafter respect to their liability as your directors or amended or by any similar federal, state or stockholders.. local laws; 2. Each of your partners, executive officers, board h. Any "claim" for benefits to the extent that members and "employees" who is authorized to such benefits are available from funds administer your"employee benefit program." accrued by the insured for such benefits or 1 Any organization you newly acquire or form, other from collectible insurance; than a partnership, joint venture or limited liability 1. Taxes,fines or penalties, including those company, and over which you maintain ownership imposed under the Internal Revenue Code or majority interest, will qualify as a Named In- or any similar state or local lw sured if no other similar insurance applies to that j. Damages aTising out of wrongful termina- organization. However-. tion of employment, discrimination, or other a. Coverage under this provision is afforded only employment related practices-, until the 90th day after you acquire or form the k. Punitive or exemplary damages� organization or the end of the policy period, whichever is earlier; and 3. Supplementary Payments b. Coverage under this provision does not apply We\Vill pay, with respect to any "claim" or"suit" we to any act, error or omission that occurred be- defend: fore you acquired or formed the organization. a. All expenses we incur. No person or organization is an insured with re- b. The cost of bonds to release attachments, spect to the conduct of any current or past part- but only for bond amounts within the appli- nership, joint venture, or limited liability company cable limit of insurance. We do not have to that is not shown as a Named Insured in the Dec- furnish these bonds. larations. PKGLINY0015 NY D9107 2 of 7 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 2006 SECTION III - LIMITS OF INSURANCE 3. The terms of this insurance, including those with respect to: 1. The Limits of Insurance shown in the Declarations a. Our right and duty to defend any "suits" seek- and the rules below fix the most we will pay re- ing those damages; and gardless of the number of. b. Your duties in the event of an act, error or a. Insureds; omission "claim' or "suit" apply irrespective of b. "Claims" made or"suits" brought; the application of the deductible amount. apply irrespective of the application of the de- c. Persons or organizations making "claims" or ductible amount. bringing "suits"; 4. We may pay any part or all of the deductible d. Acts. errors or omissions which result in loss; amount to effect settlement of any "claim" or"suit" or and, upon notification of the action taken, you e. Benefits included in your "employee benefit shall promptly reimburse us for such part of the program". deductible amount as has been paid by us. 2. The Aggregate Limit is the most we will pay for all damages because of acts, errors or omissions SECTION V — EMPLOYEE BENENFITS negligently committed in the "administration" of LIABILITY CONDITIONS your"employee benefit program". 1 Duties In The Event Of An Act, Error Or 3. Subject to the Aggregate Limit, the Each Em- Omission, "Claim" Or"Suit!' ployee Limit is the most we will pay for all dam- ages sustained by any one "employee", including a. You must see to it that we are notified as damages sustained by such "employee's" de- soon as practicable of an act, error or omis- pendents and beneficiaries as a result of sion which may result in a claim. Notice should include: a. an act, error or omission; or �1) How, when and where the act, error or b. A series of related acts, errors or omissions omission took place; negligently committed in the "administration" of your "employee benefit program" However, The nature of any damage arising out of the amount paid under this Coverage Form shall the act, error or omlsslon� not exceed, and will be subject to, the limits and (2) The names and addresses of any restrictions that apply to the payment of benefits employees" who may suffer dam- included in the'employee benefit program", ages as a result of the act, error or The Limits of Insurance of this Coverage Part apply omission; and separately to each consecutive annual period. and to (3) The names and addresses of any wit- any remaining period of less than 12 months, starting nesses. with the beginning of the policy period shown in the b. If a "claim" is received by any insured you Declarations, unless the policy period is extended must: after issuance for an additional period of less than 12 months. In that case, the additional period will be (1) 1 1.mmediately record the specifics of the deemed part of the last preceding period for purposes claim" and the date received; and of determining the Limits of Insurance. (2) Notify us as soon as practicable- c. You and any other involved insured must: SECTION IV - DEDUCTIBLE (1) Immediately send us copies of any 1. Our obligation to pay damages on behalf of the demands, notices. summonses or legal insured applies only to the amount of damages in papers received in connection with the excess of the deductible amount stated in the .1c[aim"or"suit"; Declarations as applicable to "Each Employee'- (2) Authorize us to obtain records and other The limits of insurance shall not be reduced by the information; amount of this deductible. The Aggregate limit (3) Cooperate Vith us in the investigation or shall not be reduced by the application of such settlement of the"claim" or"suit";and deductible amount. 2. The deductible amount stated in the Declarations (4) Assist us, upon our request, in the en- applies to all damages sustained by an "em- forcement of any right against any per- ployee" because of an act, error or omission cov- son or organization which may be liable ered by this insurance. to the insured because of damage to which this insurance may also apply. PKGLI NY001 5 NY 09/07 3 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 2006 d. No insureds will, except at their own cost, (b) The other -insurance has a policy voluntarily make a payment, assume any period which continues after the Ret- obligation or incur any expense without our roactive Date shown in the Schedule consent. of this insurance. e. Notice given by or on behalf of the insured, (2) When this insurance is excess, we will or written notice by or on behalf of the in- have no duty to defend the insured jured person or any other claimant, to any against any "suit" if any other insurer agent of ours in New York State, with par- has a duty to defend the insured against ticulars sufficient to identify the insured, that "suit'. If no other insurer defends, shall be considered to be notice to us, we will undertake to do so, but we will 2. Legal Action Against Us be entitled to the insured's rights against No person or organization has a right under ali those other insurers. this Coverage Part: (3) When this insurance is excess over a. To join us as a party or otherwise bring us- other insurance, we will pay only our into a "suit" asking for damages from an in- share of the amount of the loss, if any, that exceeds the sum of the total sured; or amount that all such other insurance b. To sue us under this Coverage Part unless would pay for the loss in absence of this all of its terms have been fully complied insurance; and the total of all deductible with. and self-insured amounts under all that A person or organization may sue us to re other insurance. cover on an agreed settlement or on a final (4) We will share the remaining loss, if any, judgment against an insured obtained after with any other insurance that is not de- an actual trial; but we will not be liable for scribed in this Excess Insurance provi- damages that are not payable under the sion and was not bought specifically to terms of this Coverage Part or that are in apply in excess of the Limits of Insur- excess of the applicable limit of insurance. ance shown in the Schedule of this en- An agreed settlement means a settlement dorsement. and release of liability signed by us, the in- c. Method Of Sharing sured and the claimant or the claimant's le gal representative. If all of the other insurance permits contri- 3. Other Insurance bufion by equal shares, we will follow this method also. Under this approach, each If other valid and collectible insurance is avail- insurer contributes equal amounts until it able to the insured for a loss we cover under has paid its applicable limit of insurance or this Coverage Part, our obligations are limited none of the loss remains, whichever comes as follows: first. a. Primary Insurance If any of the other insurance does not per- This insurance is primary except when mit contribution by equal shares, we will Paragraph b. below applies. If this insur- contribute by limits. Under this method, anoe is primary, our obligations are not af- each insurer's share is based on the ratio of fected unless any of the other insurance is its applicable limits of insurance to the total also primary. Then, we will share with all applicable limits of insurance of all insurers. that other insurance by the method de- 4. Bankruptcy or Insolvency. scribed in Paragraph c.below. Bankruptcy or insolvency of the insured or of b. Excess Insurance the insured's estate will not relieve us of our (1) This insurance is excess Over any of the obligations under this Coverage Part. other insurance, whether primary, ex- S. Representations cess, contingent or on any other basis By accepting this policy, you agree: that is effective prior to the beginning of the policy period shown in the Schedule a. The statements in the Declarations are ac- of this insurance and that applies to an curate and complete� act, error or omission on other than a b. Those statements are abased upon repre- claims-made basis, if'. sentations you made to us; and (a) No Retroactive Date is shown in the c. We have issued this policy in reliance upon Schedule of this insurance; or your representations, PKGLINY0015 NY 09/07 4 of 7 Includes copyrighted material of Insurance Services Office, Inc.,with its permission, Copyright, Insurance Services Office, Inc.,2006 5. if you purchase the optional Extended Report- ing Period Endorsement, the Extended Report- S. Separation of Insureds. ing Period will be for one year, starting with the Except with respect to the Limits of Insurance, end of the automatic Extended Reporting Pe- and any rights or duties specifically assigned in riod. We will issue that Endorsement if the first this Coverage Part to the first Named Insured, Named Insured shown in the Declarations this insurance applies� makes a written request for it within the greater a. As if each Named Insured were the only of- Named Insured; and a. 60 days from the effective date of the "ter- b. Separately to each insured against whom mination of coverage;"or "claim"is made or"suit" is brought. b. 30 days from the date of mailing of the ad- 7. Transfer of Rights of Recovery Against Oth- vice of the availability of and the premium for ers To Us. the optional extended repoffing period cover- If the insured has rights to recover all or part of age. any payment we have made under this Cover- The Insured must promptly pay the additional age Part, those rights are transferred to us. premium when due. The optional Extended The insured must do nothing after loss to im- Reporting Period will not take effect unless the pair them. At our request, the insured will additional premium is paid when due. If that bring 'suit" or transfer those Cights to us and premium is paid when due, the endorsement help us enforce them. may not be cancelled. 6. The provisions of the extended reported period SECTION VII EXTENDED REPORTING coverage will not apply, except for the ninety (90) day automaftc extended reporting period if the 'claims made relationship" has been less 1. If there is "termination of coverage", we will than one (1) year and this coverage has been provide, at no extra charge, an automatic Ex- terminated for nonpayment or fraud. tended Reporting Pedod as described in Para- 7. If the named insured has been placed in receiv- graph 2. below or if you purchase it. an op- ership, liquidation or bankruptcy, or perma- tional Extended Reporting Period Endorsement nently ceases operations, then any one qualify- as described in Paragraph 4. ing as an insured has the right to extended 2. The automatic Extended Reporting Period will reporting period coverage issued in the name last for 90 days, starting with the end of the of the named insured for the benefit of all in- policy period of this policy. Any claim reported sureds. The request for such extended report- during the 90 day automatic extended report- ing period coverage must be made within 120 ing period will be considered as having been days of the termination of coverage. made before the termination date, Upon ter- 8. In addition, a person employed or otherwise mination of coverage, the aggregate limit of li- affiliated with the named insured and covered ability for this automatic extended reporting pe- by the named insured's policy during such af- riod shall be equal to the amount remaining in filiation, shall continue to be covered under this this policy's annual aggregate liability limit policy and any extended reporting period cov- 3. This automatic Extended Reporting Period erage after such affiliation has ceased for such applies only if no subsequent insurance you person's covered wrongful act during such af- purchase applies to the"claim", or would apply filiation. but for the exhaustion of its applicable limit of 9. The additional premium for the optional ex- insurance. tended reporting period shall be based upon 4. Within thirty days after termination of coverage, the rates in effect on the date this coverage we will notify the insured named in the declara- was issued or last renewed and shall be one tions, in writing, of the automafic 90 day ex- (1)year at 75%of expiring policy premium. tended reporting period, At the same time, no- Upon"termination of coverage": tice will be given of the availability of, the premium for, and the importance of purchasing a. any return premium due the named insured the optional extended reporting period, If the shall be credited toward the premium for the 'claims-made relationship' has been in effect optional extended reporting perliod coverage if for one year or more, and if this coverage has the named insured elects such coverage. been terminated for nonpayment of premium or fraud, we shall not be required to provide a premium quotation unless requested by the named insured. P KGLI NY001 5 NY 09/07 5 of 7 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services OfFte, Inc., 2DO6 b. if premium is due to us for coverage dur- 4. "Claims Made Relationship" means that period ing the"claims made relationship", any monies of time between the effective date of the first received by US from the insured as payment claims made policy between us and the insured for the extended reporting period coverage and the cancellation or nonrenewal of the last shall first be applied to such premium owing for consecutive claims made policy between such this coverage. parties, where there has been no gap in Gover- age, but does not include any period covered by 11. Limits of liability for such optional extended re- Extended Reporting Period coverage. porting Period shall be: 6. "Deductible" means the amount shown in the a. at lease equal to 100 Percent of the policy's Policy that the insured must contribute to each annual aggregate limit where a "claims made IOS& relationship' has continued for three years or 6. "Employees" includes employees whether act- more; or ively employed, disabled or retired, "Employee" b, if the "claims-made relationship" has contin- includes a "leased worker", "Employee" does ued for less than three years, the limit of liabil- not include a"temporary worker". ity shall be equal to the greater of: 7. "Employee benefit program" means the follow- (1) the amount of coverage remaining in ing plans- such policy's annual aggregate liability limit; a. Group life insurance, group accident or or health insurance, dental, vision and hearing plans, and flexible spending accounts, pro- (2) 50 percent of such policy's annual ag- vided that no one other than an "employee" gregate liability limit. may subscribe to such benefits and such The Extended Reporting Period endorsement will set benefits are made generally available to forth the terms, not inconsistent with this Section, those "employees" who satisfy the plan's applicable to the Extended Reporting Period, includ- eligibility requirements', ing a provision to the effect that the insurance af- b. Profit sharing plans, employee savings forded for 'claim(s)" first received during such period plans, employee stock ownership plans, is excess over any other valid and collectible insur- pension plans and stock subscription plans, ance available under policies in force after any Ex- provided that no one other than an "em- tended Reporting Period starts. ployee" may subscribe to such benefits and such benefits are made generally available to all "employees" who are eligible under SECTION V11 —DEFINITIONS the plan for such benefits; 1. "Administration" means: c. Unemployment insurance, social security a. Counseling "employees", including their benefits, workers' compensation and dis- dependents and beneficiaries, with respect ability benefits-, to the "employee benefit programs". How- d. Vacation plans, including buy and sell pro- ever. counseling does not include the ren- grams; leave of absence programs, inGlud- dering of any legal advice by the insured; ing military, maternity, family, and civil b. Interpreting the "employee benefit pro- leave', tuition assistance plans; transporta- gram-; tion and health club subsidies-, and c. Handling records in connection with the e. Any other similar benefits designated in the "employee benefit program"; or Schedule or added thereto by endorse- d. Effecting or terminating any "employee's" ment. participation in a plan included in the "em- 8. "Personal and advertising injury" means injury ployee benefit program". other than "bodily injury" arising out of one or However, "administration" does not include more of the following offenses'. handling payroll deductions. a. False arrest, detention or imprisonment; 2. "Bodily Injury" means bodily injury, sickness, dis b. Malicious prosecution� ease, disability, shock, mental anguish, mental c. The wrongful eviction from, wrongful entry injury and humiliation, including resulting death into, or invasion of the right of private oc- from any of these at any time. cupancy of a room, dwelling or premises 3. "Claim" means any demand or "suit", made by that a person occupies, committed by or on an "employee" or an 'employee's" dependents behalf of its owner, landlord or lessor; and beneficiaries, for damages as the result of an act, error or omission. PKGLINY0015 NY 09/07 6 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 2006 d. Oral or written publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral or written publication of material that violates a person's right of privacy-, f� The use of another's advertising idea in your"advertisement"; g. Infringing upon another's copyright, trade dress or slogan in your"advertisernent'; h. False or improper service of process; or i. Discrimination claims based on disparate impact and for actions alleging vicarious fi- ability arlising from discriminatory acts of employees of the insured, 9. "Property damage'means: a. Physical injury to tangible property, includ- ing all resulting loss of use of that property; or b. Loss of use of tangible property that is not physically injured. 10. "Retroactive Date" means a date concurrent with the effective date of the policy or a particu- lar date prior to the effective date of the policy upon which we and the insured agree in the policy that policy coverage will be applicable. An unlimited "Retroactive Date" applies unless the policy is endorsed specifying a particular "Retroactive Date." A"Retroactive Date" may not be changed dur- ing the term of the"Claims Made Relationship" and any Extended Reporting Period. 11. "Suit" means a civil proceeding in which dam- ages because of an "act, error or omission" to which this insurance applies are alleged- "Suit" includes: a. An arbitration proceeding in which such damages are claimed and to which the in- sured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 12. "Termination of Coverage" means whether made by us or the insured at any time: a.Cancellation or nonrenewal of a policy, or b. Decrease in limits, reduction of coverage, increased deductible or self-insured reten- tion, new exclusion, or any other change in coverage less favorable to the insured- PKGLINY0015 NY 09/07 7 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 2006 ENDORSEMENT NO. ATTACHED TO AN D ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENGY AND CODE POUCY NUMBER Mo. DAY YR. 1L01 NOON A.M� 12:01 NEW YORK DECLARATIONS PAGE ADDENDUM This Addendum applies only to EMPLOYEE BENEFITS LIABILITY COVERAGE FORM — New York THIS COVERAGE IS WRITTEN ON A CLAIMS MADE BASIS. The Employee Benefits Liability Coverage Form provides no coverage for"claims" arising out acts, errors or omissions which took place before to the 'retroactive date", if any, shown in the Supplemental Declarations. This Coverage Form covers only "claims" made against you while the policy remains in effect. All coverage under this form ceases upon 'termination of coverage", except for the automatic reporting period coverage, unless you purchase the optional extended reporting period coverage. If the policy is terminated,we will provide a 90 day automatic reporting period subject to the terms of the coverage form. You also have the right to purchase an optional extended reporting period endorsement. If you purchase the optional extended reporting period endorsement, the extended reporting period Mi I be for one year, starting with the end of the automatic extended reporting period. When the automatic, or optional (if purchased) extended reporting period ends there exists the potential for gaps in coverage since you will not be covered for "claims" made after the expiration date of such extended reporting period. Rates for claims made policies are normally lower in the early years of a "claims made relationship', as compared to occurrence policies, and can increase, independent of overall rate level increases and sometimes substantially,with each renewal until the"claims made relationship"reaches maturity The rates for the optional extended reporting period will be based on rates in effect at the beginning of the policy period and the premium for the optional extended reporting period endorsement will be 75% of the annual premium for Employee Benefits Liability Coverage. If there is a change in the policy premium as a result of any change in the nature or extent of risk during the coverage period, at the time of the change we will specify a revised premium for the optional extended reporting period coverage. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLINY0016 NY 09 07 COMMERCIAL GENERAL LIABILITY CG 21 70 01 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY If aggregate insured losses attributable to terrorist "Certified act of terrorism" means an act that is certi- acts certified under the federal Terrorism Risk Insur- fied by the Secretary of the Treasury, in concurrence ance Act exceed $100 billion in a Program Year (Jan- with the Secretary of State and the Attorney General uary 1 through December 31) and we have met our of the United States, to be an act of terrorism pursu- insurer deductible under the Terrorism Risk Insurance ant to the federal Terrorism Risk Insurance Act. The Act, we shall not be liable for the payment of any criteria contained in the Terrorism Risk Insurance Act portion of the amount of such losses that exceeds for a "certified act of terrorism" include the following: $100 billion, and in such case insured losses up to 1. The act resulted in insured losses in excess of $5 that amount are subject to pro rata allocation in ac- million in the aggregate, attributable to all types of cordance with procedures established by the Secre- insurance subject to the Terrorism Risk Insurance tary of the Treasury. Act; and 2. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. CG 21 70 01 08 C) ISO Properties, Inc., 2007 Page 1 of 1 13 ENDORSEMENT NO. ENDORSEMENT EPFECTIVE ATTACHEDTOAND AGENCY AND CODE F F ;NSURED _OR _M,NC ORMING A PART OF (Standard Time) P POLJC� OLICY NUMBER Mo. DAY YR. 12:01 NOON F- A.M. t THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DAM EXCLUSION This endorsement modifies insurance provided under the f0llo�#ing: GENERAL LIABILITY COVERAGE FORM-PUBLIC ENTITY This insurance does not apply to'bodily injury", "property damage", or"personal and advertising injury" arising out of the rupture, bursting, overtopping,accidental discharge or strUctural failure of any dam, levee or dike that: 1. you own, operate, use, maintain, license, permit or inspect; or 2. is located on any property you rent, lease or sub-lease. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGL]001 7 2006 ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE INSURED AGENCY AND CODE FFORMING A PART OF (Standard Tirne) PC POLICY NUMBER MO. DAY YR. 12:01 NOON AK THiS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. EXCLUSION—TIREWORKS This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM-PUBLIC ENTITY The following exclusion is added to Paragraph 2., Fireworks include but are not limited to firecrackers exclusions of SECTION I - COVERAGE A. BODILY and all aerial or ground displays. INJURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to "bodily injury" or This insurance does not apply to "bodily injury" or "property damage" arising out of emergency service 1.property damage" arising out of the ignition or you provide in response to an emergency arising out discharge of fireworks in conjunction with any display, of or resulting from fireworks. demonstrabon or show, conducted, sponsored or co- sponsored by any insured. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE EATE PKGLI0020 2006 Includes copyrighted material of Insurance Services office,Inc.,with it5 permission. COPYTight,Insurance services office,Inc., 1993 U.S. SPECIALTY INSURANCE COMPANY ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A.M. CPKG80320109 01 01 2012 Town of Southold 601 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM- PUBLIC ENTITY SCHEDULE Coverage Amount and Basis of Deductible PER CLAIM or PER OCCURRENCE Bodily Injury Liability $ $ OR Property Damage Liability $ $ OR Bodily Injury Liability and/or Property Damage Liability Combined $ $50,000 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) APPLICATION OF ENDORSEMENT (Enter below any limitations on the application of this endorsement. If no limitation is entered, the deductibles apply to damages for all "bodily injury"and "property damage", however caused): A. Our obligation under the Bodily Injury Liability and b. Under Property Damage Liability Property Damage Liability Coverages to pay Coverage, to all damages sustained by damages on your behalf applies only to the any one person because of "property amount of damages in excess of any deductible damage"; or amounts stated in the Schedule above as c. Under Bodily Injury Liability and/or applicable to such coverages. Property Damage Liability Coverage B. You may select a deductible amount on either a Combined, to all damages sustained by per claim or a per "occurrence" basis. Your any one person because of: selected deductible applies to the coverage option (1) "Bodily injury"; and to the basis of the deductible indicated by the placement of the deductible amount in the (2) "Property damage"; or Schedule above. The deductible amount stated in (3) "Bodily injury" and "property damage" the Schedule above applies as follows: combined 1. PER CLAIM BASIS. If the deductible amount indicated in the Schedule above is on a per claim basis, that deductible applies as follows: a. Under Bodily Injury Liability Coverage, to all damages sustained by any one person because of"bodily injury"; PKGLI0035 2006 Page 1 of 2 Copyright, Insurance Services Office, Inc., 1994 U.S. SPECIALTY INSURANCE COMPANY as the result of any one"occurrence". (2) "Property damage"; or If damages are claimed for care, loss of (3) "Bodily injury" and "property damage" services or death resulting at any time from combined "bodily injury", a separate deductible amount as the result of any one "occurrence", will be applied to each person making a claim regardless of the number of persons or for such damages. organizations who sustain damages because With respect to "property damage", person of that "occurrence". includes an organization. C. The terms of this insurance, including those with 2. PER OCCURRENCE BASIS. If the respect to: deductible amount indicated in the Schedule 1. Our right and duty to defend the insured above is on a "per occurrence" basis, that against any "suits" seeking those damages; deductible amount applies as follows: and a. Under Bodily Injury Liability Coverage, to 2. Your duties in the event of an "occurrence", all damages because of"bodily injury"; claim, or"suit" b. Under Property Damage Liability apply irrespective of the application of the Coverage, to all damages because of deductible amount. "property damage"; or c. Under Bodily Injury Liability and/or D. We may pay any part or all of the deductible Property Damage Liability Coverage amount to effect settlement of any claim or "suit" Combined, to all damages because of: and, upon notification of the action taken, you shall promptly reimburse us for such part of the (1) "Bodily injury"; deductible amount as has been paid by us. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGLI0035 2006 Page 2 of 2 Copyright, Insurance Services Office, Inc., 1994 U.S. Specialty Insurance Company Liability Coverage Form Supplemental Declaration Page These supplemental declarations form a part of policy number: CPKG80320109 This policy consists of the following coverage forms for which a limit of liability is shown; if no limit is shown, there is no coverage. COVERAGE Law Enforcement Liability Coverage Form (Occurrence Coverage) $1,000,000 Each Person $1,000,000 Each Law Enforcement Wrongful Act $1,000,000 Annual Aggregate $25,000 Deductible For Each Law Enforcement Wrongful Act Law Enforcement Department or Agency: Public Officials Liability Coverage Form (This is a Claims-Made Coverage.) $1,000,000 Each Public Officials Wrongful Act $1,000,000 Annual Aggregate $10,000 Deductible For Each Public Officials Wrongful Act Employment Practices Liability Coverage Form (This is a Claims-Made Coverage.) $1,000,000 Each Employment Practices Wrongful Act $1,000,000 Annual Aggregate $10,000 Deductible For Each Employment Practices Wrongful Act This supplemental declaration, together with the Common Policy Declarations, Common Policy Conditions, Coverage Part(s), Coverage Form(s) and endorsements, if any, complete the above numbered policy. Disclosure: Please note that 50% of the amount incurred for defense cost will be applied against the deductible. Liab Suppl Dec-1 LIAB-SIDEC-11A Includes copyrighted material of Insurance Services Office, Inc., Page I of 1 (09-08) with its permission PUBLIC RISK PROFESSIONAL POLICY CLAIMS MADE DISCLOSURE: It is important to note that the Public Officials and the Employment Practices Liability Coverages are on a CLAIMS MADE BASIS. This policy consists of one or more of the following coverages: Law Enforcement Lia- bility (Occurrence Coverage), Public Officials Liability (Claims-Made Coverage) and Employment Practices Liability (Claims-Made Coverage). Please refer to the Declarations to determine which of these coverages applies to your insurance pro- gram. Throughout this policy the words "you" and "your" refer to the Named Insured in the Declarations, and any other person or organization qualifying as a Named Insured un- der this policy. The words "we," "us" and "our" refer to the insurance company shown on the Declarations page as the insurer. COMMON POLICY CONDITIONS (Law Enforcement, Public Officials, Employment Practice Liability) All coverages and provisions of this policy are subject to the following additional conditions: 1. Two Or More Coverage Forms. If the Law Enforcement Coverage Form, the Public Officials Liability Coverage Form and/or the Employment Practices Liability Coverage Form apply to the same "claim," the maximum Limit of Liability under all the Coverage Forms shall not exceed the highest applicable Limit of Liability un- der any one Coverage Form. The "deductible" applicable to the Coverage Form providing the highest applicable Limit of Liability will be the "deductible" applied to the "claim." If the limits are the same for all Coverage Forms, the lowest applicable "deductible" will apply. 2. Other Insurance. The insurance afforded by this Coverage Form is excess over any other insurance, whether pri- mary, excess, contingent or on any other basis, except when purchased specifically to apply in excess of this insurance. If this insurance is excess, we will have no duty under this Coverage Form to defend any "claim" or"suit" that any other insurer has a duty to defend. If no other insurer defends, we may undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When both this insurance and the other insurance apply to the "loss" on the same basis, we will not be liable under this Coverage Form for a greater proportion of the "loss" than that stated in the applicable contribution provision below: a. CONTRIBUTION BY EQUAL SHARES. If all of such other valid and collectible insurance pro- vides for contribution by equal shares, we will not be liable for a greater proportion of such "loss" 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 PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page I of 28 with its permission then continue to contribute equal shares of the remaining amount of the "loss" until each such insurer has paid its limits 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, we will not be liable for a greater proportion of such "loss" than that which the applicable Limit of Liability under this Coverage Form, for such "loss," bears to the total appli- cable limit of liability of all valid and collectible insurance against such "loss." 3. Insured's Duties In The event Of A "Claim" Or "Suit" a. In the event of a "claim", written notice containing particulars 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 injured and of available witnesses, will be given by or for the insured to us or any of our authorized agents as soon as practicable; b. If a "claim" is made or a "suit" is brought against the insured, the insured will immediately for- ward to us every demand, notice, summons or other process received by them or their repre- sentative; c. The insured will cooperate with us and, at our request, consent to being examined and ques- tioned by a representative of ours, under oath if necessary, will attend hearings, depositions and trials and assist in effecting settlement, securing and giving evidence, obtaining the at- tendance of witnesses and in the conduct of "suit(s)," as well as in the giving of written state- ment or statements to our representatives and defense. In the event of a "claim" occurring like- ly to involve us hereunder, the insured will not make any payment, assume any liability or incur any expense without our consent first being obtained. We will have full discretion in the han- dling of any "claim", and the insured will give full information and assistance as we may rea- sonably require. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 28 with its permission PUBLIC RISK PROFESSIONAL POLICY COMMON LIABILITY EXCLUSIONS The following exclusions apply to the professional liability coverages: Law Enforcement, Pub- lic Officials and Employment Practices Liability as designated in the Declarations. Refer to the individual coverage forms for additional exclusions. This policy does not apply to: 1. Pollution a. To "bodily injury", "property damage", "personal injury", or any other injury, damage, loss, cost, expense, liability or legal obligation arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release, escape or potential presence in or introduction into the environment of any substance if such substance has, or is alleged to have, the effect of mak- ing the environment impure, harmful or dangerous; or any other such substances that are con- sidered a "pollutant". Environment includes any air, land, structure (or the air within), water- course or other body of water, including underground water; or b. To any loss, cost or expense arising out of any: (1) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way re- spond to, or assess the affects of, "pollutants"; or (2) Any "claim" or "suit" by or on behalf of a government authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutraliz- ing, or in any way responding to, or assessing the affects of, "pollutants". 2. War "Bodily injury", "property damage", "personal injury", "public officials wrongful act", "law enforce- ment wrongful act" or "employment practice wrongful act", however caused, arising, directly or in- directly, out of: a. War, including undeclared or civil war; b. Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or c. Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. 3. Nuclear Energy Liability a. Any "bodily injury", "property damage", "personal injury", or any "wrongful act": (1) With respect to which an insured under the policy is also an insured under a nuclear en- ergy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters, Nuclear Insurance Association of Canada or any of their suc- cessors, or would be an insured under any such policy but for its termination upon ex- haustion of its limit of liability; or (2) Resulting from the "hazardous properties" of"nuclear material" and with respect to which: PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 28 with its permission (a) Any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof; or (b) The insured is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by or with any person or organization. b. Expenses incurred under Medical Payments Coverage, with respect to "Bodily injury" resulting from the "hazardous properties" of"nuclear material" and arising out of the operation of a "nu- clear facility" by any person or organization. c. Any "bodily injury", "property damage", "personal injury", or any "wrongful act" or damage re- sulting 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, han- dled, used, processed, stored, transported or disposed of by or on behalf of an insured; or (3) The injury or damage arises out of the furnishing by an insured of services, materials, parts or equipment in connection with the planning, construction, maintenance, operations or use of any "nuclear facility," but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion C.(3) applies only to 'i property damage" to such "nuclear facility" and any property thereat. As used in this exclusion: "Hazardous properties" includes radioactive, toxic or explosive properties. "Nuclear material" means "source material," "special nuclear material" or"by-product material." "Source material," "special nuclear material" and "by-product material" have the meanings giv- en them in the Atomic Energy Act of 1954 or in any law amendatory thereof. "Spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a "nuclear reactor." "Waste" means any waste material: (a) Containing "by-product material" other than the tailings or wastes produced by the extrac- tion or concentration of uranium or thorium from any ore processed primarily for its .isource material" content; and (b) Resulting from the operation by any person or organization of any "nuclear facility" includ- ed under paragraphs (a) and (b) of the definition of"nuclear facility." "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 (3) Handling, processing or packaging"waste"; PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 28 with its permission (c) Any equipment or device used for the processing, fabricating or alloying of"special nucle- ar material" if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; (d) Any structure, basin excavation, premises or place prepared or used for the storage or disposal of"waste"; 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. "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self- supporting chain reaction or to contain a critical mass of fissionable material. "Bodily injury" and "property damage" include all forms of radioactive contamination of proper- ty. 4. Eminent Domain or Inverse Condemnation Any "loss", injury, or damage(s) arising out of or resulting from a taking, partial taking or controlling of property by any means, method or proceeding that involves or is any way related to the princi- ples of eminent domain, inverse condemnation, adverse possession, right of prescription, dedica- tion by adverse use, by whatever name used, or however characterized; or the resulting diminu- tion of property value . This exclusion applies whether or not any "claim" is made directly against any insured or by virtue of any agreement entered into by or on behalf of any insured. 5. Workers Compensation and Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. 6. Prior or Pending Legal Action Any injury or"loss" based upon, arising out of, attributable to, or in any way directly or indirectly re- lated: a. to any prior or pending legal action or litigation, administrative or regulatory proceeding, "claim", demand, arbitration, decree or judgment against any insured before the effective date of this Policy, including any administrative or regulatory proceeding: (1) resulting from or in consequence of such pending or prior litigation, administrative or regu- latory proceeding; (2) derived in whole or in part from the facts and/or matters averred or alleged in any such pending or prior litigation, administrative or regulatory proceeding; or (3) derived from the same or essentially the same fact, actual or alleged. b. to any fact, circumstance, event, situation, or wrongful act that was the subject of any notice under any similar policy of insurance issued to the insured. 7. Deliberate Violation Any "loss" or damage arising out of the deliberate violation of any federal, state, or local statute, ordinance, rule or regulation committed by or with the knowledge and consent of the insured. PROF-FORM-1 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 28 with its permission 8. Fraud or Dishonesty Any "loss" or damage brought about or contributed to by fraud or dishonesty of an insured. How- ever, notwithstanding the foregoing, the insured will be protected under the terms of this Coverage Form, as to any "claim(s)" upon which "suit" may be brought against them by reason of any al- leged fraud or dishonesty on the part of any insured, unless a judgment or other final adjudication thereof adverse to such insured will establish that acts of active or deliberate dishonesty or fraud committed by such insured was material to the cause of action so adjudicated. 9. Auto, Watercraft, Aircraft "Bodily injury", "property damage", "personal injury", "public official wrongful act", "employment practice wrongful act" or "law enforcement wrongful act" arising out of the ownership, mainte- nance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the "loss" or "claim" against any insured allege negligence in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury", "property damage" or "personal injury" involved the own- ership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. PROF-FORM-1 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 28 with its permission COMMON LIABILITY DEFINITIONS Throughout this policy words and phrases that appear in quotation marks are defined terms. The following definitions apply to the Liability coverages designated in the Declarations. Please refer to the individual coverage forms for additional definitions. 1. "Auto" means: a. A land motor vehicle, trailer or semi-trailer designed for travel on public roads, including any attached machinery or equipment; or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehi- cle insurance law in the state where it is licensed or principally garaged. However, "auto" does not include "mobile equipment". 2. "Bodily Injury" means physical injury to the body, physical pain, sickness, disease, disability and death. It also means shock, mental anguish, emotional distress, but only when it arises from and is accompanied by injury to the claimant's body, sickness, disease or death "bodily injury", mental anguish, emotional distress, sickness or disease sustained by any person, including death, resulting from any of these at any time. 3. "Coverage territory" means all parts of the world if the insured's responsibility to pay damages is deter- mined in a "suit" brought in the United States of America (including its territories and possessions), Puerto Rico or Canada or in a settlement we agree to. 4. "Deductible" means the amount shown in the Declarations that the insured must contribute to "loss" and "loss adjustment expense." 5. "Employee" includes a "leased worker", but does not include a "temporary worker". "Employee" does not include a "volunteer worker". 6. "Employment practices wrongful act(s)" means: Any actual or alleged: a. Refusal to employ; b. Wrongful termination of employment; or c. False arrest, false imprisonment, libel, slander, defamation, harassment, humiliation, discrimination, in- vasion of privacy, wrongful eviction, malicious prosecution, abuse of process, or any other act, omission or policy; based upon or attributable to anyone's employment or application for employment by you. 7. "Law enforcement activities", either singular or plural, means any of the activities or operations performed by you or on your behalf in the enforcement of the law and protection of persons or property. These activi- ties or operations include the ownership, maintenance or use of the premises you rent, lease or borrow in order to perform such activities or operations, and the development, implementation and enforcement of all policies governing law enforcement practices, decisions and actions. 8. "Law enforcement wrongful act" means any actual or alleged act, error or omission, neglect or breach of duty by the insured while conducting "law enforcement activities" which results in: a. "Personal injury"; or b. "Bodily injury"; or PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 28 with its permission c. "Property damage," caused by an "occurrence." 9. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your operations. "Leased worker" does not include: a. An independent contractor; b. A worker furnished to any insured by a "temporary help service"; c. An "employee" of any insured who performs work for any insured pursuant to the terms of a collective bargaining agreement between any insured and a labor union; or d. An "employee" of a "service contractor". 10. "Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an "aircraft," watercraft or"auto," b. While it is in or on an "aircraft," watercraft or"auto" or c. While it is being moved from an "aircraft," watercraft or"auto" to the place where it is finally delivered; but "loading or unloading" does not include the movement of property by means of a mechanical de- vice, other than a hand truck, that is not attached to the "aircraft," watercraft or"auto." 11. "Loss" means any monetary amount which the insured(s) are legally obligated to pay as a result of public official wrongful act(s)", employment practice wrongful act(s)" or law enforcement wrongful act(s)" covered by this Coverage Form and will include but not be limited to judgments and settlements, but "loss" will not include fines imposed by law, or matters which may be deemed uninsurable under the law pursuant to which this Coverage Form will be construed. 12. "Loss adjustment expense" means expenditures including, but not limited to, costs of investigations, ex- perts, adjustment services, legal services, court costs and other similar expenses incurred by us. "Loss ad- justment expense" will not include salaries of our"employees". 13. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads; b. Vehicles maintained for use solely on or next to premises you own or rent. However, any land motor vehicle, trailer or semi-trailer designed for travel on public roads (including any machinery or apparatus that is attached) owned or leased by you shall be deemed an "auto" and not "mobile equipment" if the only reason for considering it "mobile equipment" is that it is maintained for use exclusively on streets or highways owned by you; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mount- ed: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in a., b., c. or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 8 of 28 with its permission (1) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers. f. Vehicles not described in a., b., c. or d. above maintained primarily for purposes other than the trans- portation of persons or cargo. g. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance but not construction or resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. However, "mobile equipment" does not include any land vehicles that are subject to a compulsory or finan- cial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered "autos". 14. "Personal injury" means: a. Assault and battery; b. Discrimination, unless insurance thereof is prohibited by law; c. False arrest, detention or imprisonment, or malicious prosecution; d. False or improper service of process; e. Humiliation or mental distress; f. The publication or utterance of a libel or slander or of other defamatory or disparaging material, or a publication or utterance in violation of an individual's right to privacy; except publications or utterances in the course of or related to advertising, broadcasting or telecasting activities by or on behalf of the in- sured; g. Violation of civil rights protected under 42 USC 1981 et sequential or State Law; h. Violation of property rights; and i. Wrongful entry, eviction or other invasion of the right of public occupancy. 15. "Policy period" means the period beginning with the inception date shown in the Declarations and ending with the earlier of: a. The date of cancellation of this policy; or b. The expiration date shown in the Declarations. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 9 of 28 with its permission 16. "Pollutants" means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals, noise, odor, lights and waste. Waste includes materials to be recy- cled, reconditioned or reclaimed. 17. "Property damage" means: a. Physical injury to or destruction of tangible property, including loss of use thereof at any time resulting there from; or b. Loss of use of tangible property which has not been physically injured or destroyed. 18."Public officials wrongful act" means: Any actual or alleged: a. error or omission, neglect or breach of duty by the insured; b. violation of civil rights protected under 42 USC 1981 et sequential; or c. violation of any state civil rights law; which arises out of the discharge of duties for you, individually or collectively. 19. "Suit" means a civil proceeding in which monetary damages are alleged because of a "public official wrong- ful act(s)", "employment practice wrongful act(s)" or "law enforcement wrongful act(s)" to which this Cover- age Form applies. "Suit" includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. 20. "Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions. "Temporary worker" does not include a "leased worker". 21. "Volunteer worker" means a person who is not your"employee", and who donates his or her work and acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. "Volunteer worker" includes but is not limited to your volunteer firefighters, volunteer nurses, and other volunteer persons acting specifically on your behalf or within the scope of their volunteer work for you. 22. "Wrongful act(s)" means "law enforcement wrongful act(s)," "public officials wrongful act(s)" or"employment practices wrongful acts". PROF-FORM-1 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 10 of 28 with its permission LAW ENFORCEMENT LIABILITY COVERAGE FORM OCCURRENCE COVERAGE Law Enforcement Liability coverage applies only if limits are shown in the Declarations. Within this Coverage Form the word "insured" means any person or organization quali- fying as such under LAW ENFORCEMENT LIABILITY—WHO IS AN INSURED. SECTION I — COVERAGES 1. INSURING AGREEMENT a. We will pay those sums that the insured becomes legally obligated to pay as "loss" because of "bodily injury", "property damage" or "personal injury" to which this insurance applies, only if the "bodily injury", "property damage" or "personal injury" is caused by an "occurrence" that takes place in the "coverage territory"; and (1) Occurs during the course and scope of your"law enforcement activities"; or (2) Arises out of the ownership, maintenance or use of premises by you for the purpose of conducting "law enforcement activities"; and (3) Prior to the "policy period" no insured knew or had reason to know that the "bodily inju- ry", "property damage" or "personal injury" had occurred, in whole or in part. If any in- sured knew or had reason to know, prior to the "policy period" that "bodily injury", 'i property damage" or "personal injury" occurred, then any continuation, change or re- sumption of such "bodily injury", "property damage" or "personal injury" will be deemed to have been known prior to the "policy period". b. "Bodily injury", "property damage" or "personal injury" which occurs, in whole or in part, during the "policy period" and was not, prior to the "policy period", known to have occurred by any in- sured, includes any continuation, change or resumption of such "bodily injury", "property dam- age" or"personal injury" that takes place after the end of the "policy period". c. "Bodily injury", "property damage" or "personal injury" will be deemed to have been known to have occurred at the earliest time when any insured: (1) Reports all, or any part, of the "bodily injury", "property damage" or "personal injury" to us or to any other insurer; (2) Receives written or verbal demand or "claim" for "loss" because of "bodily injury", 'i property damage", "personal injury"; or (3) Becomes aware by any other means that "bodily injury", "property damage" or"person- al injury" has occurred, in whole or in part. The amount we will pay for loss is limited as described in Section V– Limits Of Liability. "Loss" because of "bodily injury" includes "loss" claimed by any person or organization for care, loss of services or death resulting at any time from the "bodily injury". No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Defense and Supplementary Payments. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 11 of 28 with its permission 2. DEFENSE AND SUPPLEMENTARY PAYMENTS We will have the right and duty to defend any covered "suit" against the insured seeking damages to which this insurance applies even if any of the allegations of the "suit" are groundless, false or fraudulent. We may make such investigation of any "claim" or "suit" as we deem expedient. We will not be obligated to pay any "claim" or judgment or to defend any "suit" after the applicable limit of our liability has been exhausted by payment of judgments or settlements. The insured, except at its own cost and for its own account, will not, without our written consent, make any payment, admit any liability, settle any "claim," assume any obligation, or incur any ex- pense. We will have the right, but no duty, to appeal any judgment. We will pay, in addition to the applicable Limit of Liability: a. All expenses incurred by us and all interest on the entire amount of any judgment, which does not exceed the limit of our liability. Expenses, as used here, do not include salaries of officers or"employees" of any public entity; and b. Premium on appeal bonds required in any "suit" defended by us and the cost of attachment or similar bonds. SECTION 11 — EXCLUSIONS Refer to the COMMON LIABILITY EXCLUSIONS for additional exclusions which also apply to this Coverage Form. We will not be obligated to make any payment nor to defend any "suit" in connection with any "claim" made against the insured: 1. Arising out of any employment policies or practices of the insured including, but not limited to, 'i claim(s)" due to demotion, selection, dismissal, and failure to promote; 2. For "claim(s)," demands, or actions seeking relief or redress in any form other than monetary damages, or for any fees, costs or expenses which the insured may become obligated to pay as a result of any adverse judgment for declaratory relief or injunctive relief; however, we will afford de- fense to the insured for such actions, "claim(s)," "suit(s)" or demands in which monetary damages are requested if not otherwise excluded; 3. For any "loss," cost, civil fine, penalty or expense against any insured arising from any complaint or enforcement action from any federal, state or local governmental regulatory agency. 4. Arising out of the rendering of, or failure to render any medical services by any licensed medical personnel. However, any insured who, in good faith, renders emergency medical care or assis- tance to any ill or injured person which results in "personal injury" or "bodily injury" covered by this Coverage Form will not be subject to this exclusion. 5. For liability assumed by the insured under any contract or agreement. This exclusion does not ap- ply to liability for damages: a. Assumed in a contract or agreement that is an "insured contract," provided the "law enforce- ment wrongful act" occurs subsequent to the execution of the contract or agreement; or PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 12 of 28 with its permission b. That the insured would have in the absence of the contract or agreement. 6. For"personal injury" or"bodily injury" to: a. An "employee" of the insured arising out of and in the course of employment by the insured; b. An auxiliary law enforcement officer or volunteer law enforcement officer serving under the di- rection and control of the insured; or c. The spouse, child, parent, brother or sister of that "employee", or auxiliary volunteer law en- forcement officer as a consequence of a. or b. above. The exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an "insured contract". 7. Arising out of"property damage" to: a. Property which is owned by, rented by, loaned to or occupied by any insured; b. Premises which have been sold, given away, or abandoned by the insured if the "property damage" arises out of any part of those premises; or c. Property in the care, custody and control of any insured. However, part c. of this exclusion does not apply to property on persons at the time of arrest. SECTION III — LAW ENFORCEMENT LIABILITY— WHO IS AN INSURED Each of the following is an Insured: 1. You for activities conducted by the Law Enforcement Department or Agency named in the Decla- rations; 2. All of your full-time or part-time "employees" and all lawfully elected, appointed or employed offi- cials with respect to liability arising out of"law enforcement activities"; 3. All auxiliary and volunteer law enforcement officers who serve under the direction and control of your Law Enforcement Department or Agency; but only for acts within the course and scope of their employment as authorized by you; and 4. The estates, heirs, legal representative or assigns of deceased persons who were insured's at the time of a "law enforcement wrongful act(s)" but only to the extent that they would otherwise be provided coverage under this Coverage Form. SECTION IV — COVERAGE EXTENSIONS The following extension applies to this policy and is additional insurance under this Coverage Form: Animal Mortality – You may extend the insurance provided by this coverage form to include loss caused by accidental death or the consequential destruction because of accidental injury to your an- imals while being used as part of a canine or equestrian patrol during the course and scope "law PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 13 of 28 with its permission enforcement activities" during the "policy period". The most we will pay under this extension is $10,000 in any one occurrence. SECTION V— LIMITS OF LIABILITY Regardless of the number of insureds under this Coverage Form, persons or organizations who sus- tain "loss" or damages payable under this Coverage Form, and/or "suit(s)" brought on account of coverage afforded by this Coverage Form, the most we will pay under this Coverage Form is as fol- lows: 1. The Limit of Liability stated in the Declarations as applicable to each person is the limit of our lia- bility for all "loss" sustained by any one person as the result of any one "law enforcement wrongful act" covered by this Coverage Form; but subject to the above provisions respecting each person, the total limit of our liability for all "loss" sustained by two or more persons as the result of any one "law enforcement wrongful act" covered by this Coverage Form will not exceed the Limit of Liability stated in the Declarations as applicable to each "law enforcement wrongful act." 2. The Limit of Liability stated in the Declarations as applicable to the Annual Aggregate is subject to the above provision respecting each person and each "law enforcement wrongful act," and is the maximum limit of our liability for each "policy period." 3. Subject to the Limits of Liability stated in 1. and 2. above, we will only be liable to pay for damages in excess of the "deductible" shown in the Declarations for each "law enforcement wrongful act." In the event that we expend funds either for"loss", damages or "loss adjustment expense" on behalf of the insured, we will be reimbursed for such expenditures up to the amount of the "deductible" shown in the Declarations. Upon written demand by us, the amount of such "deductible" will be payable to us within thirty (30) days. 4. "Claim(s)" based on or arising out of the same act or interrelated acts of one or more insured(s) will be considered to be based on a single "law enforcement wrongful act" and only one each "law enforcement wrongful act" Limit of Liability and only one "deductible" will be applicable to such single "law enforcement wrongful act." SECTION VI — CONDITONS Refer to the COMMON CONDITIONS FORM which also apply to this Coverage Form. 1. Settlement. We have the right to settle any"claim" or"suit" as we deem expedient without any insured's con- sent. SECTION Vill — DEFINITIONS Refer to the COMMON DEFINITIONS for additional definitions which also apply to this Cover- age Form. Whenever used in this Coverage Form, the following words have these meanings: 1. "Claim" means a written notice from any party that it is their intention to hold an insured responsi- ble for"loss" resulting from a "law enforcement wrongful act" covered by this Coverage Form. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 14 of 28 with its permission 2. "Insured contract" means: a. A lease of premises agreement; b. An elevator maintenance agreement; and c. That part of any other contract or agreement pertaining to "law enforcement activities" under which the insured assumes the tort liability of another political subdivision to pay for "personal injury," "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. An "insured contract" does not include that part of any contract or agreement that indemnifies any person or organization for damage by fire to premises rented or loaned to the insured. 3. "Law enforcement activities" means: a. Those activities conducted by your Law Enforcement Department or Agency shown in the Declarations; and b. Departmentally approved activities which are declared in the application for this insurance. 4. "Law enforcement wrongful act" means any actual or alleged act, error or omission, neglect or breach of duty by the insured while conducting "law enforcement activities" which results in: a. "Personal injury"; or b. "Bodily injury"; or c. "Property damage," caused by an "occurrence." 5. "Occurrence" means an event, including continuous or repeated exposure to substantially the same generally harmful conditions. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 15 of 28 with its permission PUBLIC OFFICIALS LIABILITY COVERAGE FORM CLAIMS-MADE COVERAGE Public Officials Liability coverage applies only if limits are shown in the Declarations. Within this Coverage Form, the word "insured" means any person or organization quali- fying as such under PUBLIC OFFICIALS —WHO IS AN INSURED. SECTION I — COVERAGES 1. INSURING AGREEMENT We will pay on behalf of the insured all "loss" resulting from "public officials wrongful act(s)" but on- ly with respect to "claims" first made against the insured during the "policy period" or Extended Reporting Period. The "public officials wrongful acts" must occur within the "coverage territory." 2. DEFENSE AND SUPPLEMENTARY PAYMENTS We will have the right and duty to defend any covered "suit" against the insured seeking damages to which this insurance applies even if any of the allegations of the "suit" are groundless, false or fraudulent. We may make such investigation of any "claim" or "suit" as we deem expedient. We will not be obligated to pay any "claim" or judgment or to defend any "suit" after the applicable limit of our liability has been exhausted by payment of judgments or settlements. The insured, except at its own cost and for its own account, will not, without our written consent, make any payment, admit any liability, settle any "claim," assume any obligation, or incur any ex- pense. We will have the right, but no duty, to appeal any judgment. We will pay, in addition to the applicable Limit of Liability: a. All expenses incurred by us, and all interest on the entire amount of any judgment therein, which does not exceed the limit of our liability; b. All reasonable expenses incurred by the insured at our request to assist in the investigation or defense of a "claim" or "suit." Expenses, as used here, do not include salaries of your officers or "employees", except for actual loss of earnings, up to $250 a day, because of time off from work; c. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable Limit of Liability, we will not pay any prejudgment interest based on that period of time after the offer; d. Premium on appeal bonds required in any "suit" defended by us and the cost of attachment or similar bonds. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 16 of 28 with its permission SECTION 11 — EXCLUSIONS Refer to the COMMON LIABILITY EXCLUSIONS for additional exclusions which also apply to this Coverage Form. We will not be obligated to make any payment nor to defend any "suit" in connection with any "claim" made against the insured: 1 "Loss" based upon or attributable to any insured gaining profit, advantage or remuneration to which the insured is not entitled; 2. For any damage arising from "bodily injury," sickness, emotional distress, mental anguish, dis- ease or death of any person, or for damage to or destruction of any property, including diminu- tion of value or loss of use thereof; 3. For false arrest, false imprisonment, libel, slander, defamation, invasion of privacy, wrongful eviction, assault, battery, malicious prosecution or abuse of process; 4. "Bodily injury", "property damage" or"personal injury": a. Arising out of any aspect of "law enforcement activities" or operations including but not lim- ited to, the operation, maintenance of or use of jails, jail premises, adult or juvenile detention or holding facilities; b. Arising out of any act or omission connected in any way, either directly or indirectly, to the supervision, management or oversight of "law enforcement activities", police departments, law enforcement agencies, law enforcement agents or "employees", members of commis- sions, boards, vendors or their "employees", volunteers, including "volunteer workers", units operating under a mutual aid agreement or under the jurisdiction of the insured; or anyone or any entity performing "law enforcement activities" ; or c. Arising from any decisions or actions in connection with funding or failure to fund for"law en- forcement activities". 5. "Loss" of any kind as a result of strikes, riots or civil commotion; 6. Arising out of: a. Any "public officials wrongful act" which takes place prior to the "policy period" if the insured had knowledge of circumstances which could reasonably be expected to give rise to a .iclaim"; or b. Any "loss" for which the insured is entitled to indemnity or payment by reason of having giv- en notice of any circumstances which might give rise to a "claim" under any policy or policies the term of which has expired prior to the inception date of this policy; 7. For "claim(s)," demands, or actions seeking relief or redress in any form other than monetary damages, or for any fees, costs or expenses which the insured may become obligated to pay as a result of any adverse judgment for declaratory relief or injunctive relief; however, we will afford defense to the insured for such actions, "claim(s)," "suit(s)" or demands in which monetary dam- ages are requested if not otherwise excluded; 8. For any "loss", cost, civil fine or penalty against any insured arising from any complaint or en- forcement action from any federal, state or local governmental regulatory agency; 9. For"loss" or"claim(s)" arising from: a. Any activity for which the insured is acting in a fiduciary capacity; or PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 17 of 28 with its permission b. Any debt financing, including but not limited to bonds, notes, debentures and guarantees of debt; or C. The formulation of tax rates, the collection of taxes, or the formulation of tax refunds; 10. For"loss" or"claim(s)" arising from: a. Procurement of goods or services; b. Construction contracts; C. Architectural or engineering contracts; d. The process of bidding or awarding contracts; or e. Liability assumed by the insured under any contract or agreement, unless the insured would have been legally liable in the absence of such contract or agreement; 11. Based upon or attributable to any failure or omission of the insured to effect or maintain insur- ance of any kind; 12. For any damages arising out of any actual or alleged: a. Refusal to employ, termination of employment ; b. Arising out of any employment policies or practices of the insured; or c. False arrest, false imprisonment, libel, slander, defamation, harassment, humiliation, discrim- ination, invasion of privacy, wrongful eviction, malicious prosecution, abuse of process, or any other act, omission or policy; based upon or attributable to anyone's employment or ap- plication for employment by you; 13. For any damages arising out of the providing of, or failure to provide, professional services to anyone other than the Named Insured, by any member of the medical profession, or by any law- yer, architect, engineer or accountant; 14. By the Named Insured or on its behalf. 15. Any"loss" or"claim(s)" arising during the policy period for damages resulting directly or indirectly from your failure to remedy dangerous circumstances or conditions known to you prior to the policy period. SECTION III — PUBLIC OFFICIALS — WHO IS AN INSURED Each of the following is an Insured: 1. You; 2. All lawfully elected, appointed or employed officials; 3. Members of commissions, boards or other units operated by you and under your jurisdiction and within apportionment of the total operating budget indicated in the application form, provided that the insurance afforded will not extend to any of the following boards, commissions or units: airports, transit authorities, hospitals, municipally owned gas companies, housing authorities or port authorities. However, no such agency, authority, subdivision, department, municipal body, board or commis- sion, administrative department or other similar unit that is an autonomous entity; or that is wholly subject to independent or outside oversight, control or direction; or whose liability is not the result of the oversight, control or direction of the Named Insured; will be an insured under this policy. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 18 of 28 with its permission 4. All your "employees" and all persons who perform service on a volunteer basis for you and under your direction and control, but only for acts within the course and scope of their employment as authorized by you; 5. Any persons providing services to you under any mutual aid or similar agreement; and 6. The estates, heirs, legal representative or assigns of deceased persons who were insureds at the time of a "public officials wrongful act(s)" but only to the extent that they would otherwise be pro- vided coverage under this Coverage Form. However none of the following are insureds under this Coverage Form: 1. Any insured, including you, with respect to the operation of boards, commissions or other units, the members of which are not afforded coverage under 3. above; and 2. All persons or entities who are on retainer, are a consultant or are under contract for services, for any insured. SECTION IV — COVERAGE EXTENSIONS The following extensions apply to this policy and are additional insurance to the policy unless other- wise stated. 1. Identity Theft Expense We will pay for reimbursement of up to $5,000 to any present Mayor, City Manager, Director or Of- ficer of the Named Insured for expenses incurred as the direct result of any Identity Theft Expense that has been incurred, been discovered and been reported during the policy term. Identity Theft Expense means: a. Costs of notarizing documents required by any financial institution or similar creditors as tes- taments to fraud; b. Costs for certified mail to law enforcement agencies, financial institutions or similar creditors; or c. Loan application fees for re-applying for loan(s) when the original application is rejected solely because of incorrect credit information. 2. Key Individual Replacement Expenses We will pay up to $25,000 for expenses incurred by the Named Insured to replace the Mayor, City Manager, Chief Executive Officer or Executive Director if the person holding that position suffers an injury during the policy term which results in loss of life during the policy term. Key Individual Replacement Expenses mean: (1) The costs of advertising the employment position opening; (2) Travel, lodging and meal expenses incurred in interviewing position applicants for the position opening; and (3) Miscellaneous extra expenses incurred in finding, interviewing and negotiating with the appli- cants to include, but not be limited to, overtime pay, costs to verify the background and refer- ences of the applicants, and legal expenses incurred to draw up employment contracts. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 19 of 28 with its permission 3. Terrorist Travel Reimbursement We will reimburse you up to $5,000 in any one policy year for"Emergency Travel Expenses" in- curred by a Mayor, City Manager, Director or Officer of a Named Insured due to the occurrence of a "Certified Act of Terrorism". "Emergency Travel Expenses" means the additional cost of travel, accommodating and rescue, including funeral expenses or cost of transporting personal baggage, of an insured Mayor, City Manager, Director or Officer of the Named Insured, incurred as a direct result of the cancellation of that insured Mayor, City Manager, Director or Officer's previously scheduled transport that neces- sitates re-scheduling of that previously scheduled transport within forty-eight (48) hours of a "Certi- fied Act of Terrorism". "Certified Act of Terrorism" means an act that is certified by the Secretary of the Treasury, in con- currence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism pursuant to the Federal Terrorism Risk Insurance Act. The criteria contained in that Act for a "Certified Act of Terrorism" includes the following: (a) The act resulted in aggregate losses in excess of$5,000,000; and (b) The act is a violent act or an act that is dangerous to human life, property or infrastructure; and is committed by an individual or individuals acting on behalf of any foreign person or foreign in- terest, as part of an effort to coerce the civilian population of the United State or to influence the Policy or affect the conduct of the United States Government by coercion. SECTION V— LIMITS OF LIABILITY Regardless of the number of insureds under this Coverage Form, persons or organizations who sus- tain "loss" or damages payable under this Coverage Form, and/or claims made or "suit(s)" brought under this Coverage Form, the most we will pay under this Coverage Form is as follows: 1. The Limit of Liability stated in the Declarations as applicable to each "public officials wrongful act" is the limit of our liability for all "loss" arising out of one "public officials wrongful act" covered by this Coverage Form. 2. The Limit of Liability stated in the Declarations as applicable to the Annual Aggregate is subject to the above provision respecting each "public officials wrongful act" and is the maximum limit of our liability for each "policy period." In no event will our total Limit of Liability be increased for any Ex- tended Reporting Period. 3. Subject to the Limits of Liability stated in 1. and 2. above, we will only be liable to pay for damages in excess of the "deductible" shown in the Declarations for each "public officials wrongful act." In the event we expend funds either for "loss" or"loss adjustment expense" on behalf of the insured, we will be reimbursed for such expenditures up to the amount of the "deductible" shown in the Declarations. Upon written demand by us, the amount of such "deductible" will be payable to us within thirty (30) days. 4. All "claim(s)" or "loss" based on or arising out of the same act or interrelated acts of one or more insured(s) will be considered to be based on a single "public officials wrongful act" and only one each "public officials wrongful act" Limit of Liability and only one "deductible"will be applicable to such single"public officials wrongful act." PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 20 of 28 with its permission SECTION VI — CONDITIONS Refer to the COMMON CONDITIONS which also apply to this Coverage Form. 1. Settlement. We have the right to settle any "claim" or "suit" as we deem expedient without any insured's con- sent. 2. Awareness Provision. a. If, during the "policy period" or the Extended Reporting Period, the insured receives oral notice from any party that it is the intention of such party to hold the insured responsible for any"pub- lic officials wrongful act(s)," the insured will give written notice to us of the receipt of such oral notice, during the "policy period" or Extended Reporting Period. Any "claim(s)" made against the insured arising out of such "public officials wrongful act(s)" will, for the purpose of this Cov- erage Form, be treated as a "claim" made during the "policy period" in which such notice was given, or, if given during the Extended Reporting Period, as a "claim" made during the last "policy period"; b. For the purpose of the above clause, notice to the designee named in the Declarations will constitute notice to the insured; c. In the event of any "claim" occurring hereunder, notice to us will be given to the person or firm(s) shown on the Declarations. Notice will be deemed to be received if sent by prepaid mail, properly addressed. SECTION Vill — DEFINITIONS Refer to the COMMON DEFINITIONS for additional definitions which also apply to this Cover- age Form. Whenever used in this Coverage Form, the following words have these meanings: 1. "Claim" means a written notice from any party that it is their intention to hold an insured responsi- ble for"loss" resulting from a "public officials wrongful act" covered by this Coverage Form. 2. "Public officials wrongful act" means: Any actual or alleged: a. error or omission, neglect or breach of duty by the insured; b. violation of civil rights protected under 42 USC 1981 et sequential; or c. violation of any state civil rights law; which arises out of the discharge of duties for you, individually or collectively. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 21 of 28 with its permission SECTION Vill — EXTENDED REPORTING PERIOD — BASIC AND OPTIONAL SUPPLEMENTAL An Extended Reporting Period, described below, will be provided if this Coverage Form is canceled or non-renewed by us, except for nonpayment of premium, or if we renew or replace coverage with in- surance that: a. Has a retroactive date; or b. Provides coverage on other than a Claims-Made basis. 1. A Basic Extended Reporting Period is automatically provided without additional charge. This peri- od begins at the end of the "policy period" and lasts for sixty (60) days. The Basic Extended Re- porting Period does not apply to "claim(s)" covered under any subsequent policy. 2. Coverage for an optional Supplemental Extended Reporting Period must be added by endorse- ment and an additional premium charge must be paid. Such period starts sixty (60) days after the end of the "policy period." 3. You will have a one-time option to elect the period of time for which the Supplemental Extended Reporting Period will apply, which in no event will exceed thirty-six (36) months. The available one-time options and the additional premium charge for each option are listed below: a. Twelve (12) month option-150% of the Annualized Coverage Form Premium; b. Twenty-four (24) month option-200% of the Annualized Coverage Form Premium; c. Thirty-six (36) month option-300% of the Annualized Coverage Form Premium. Once in effect, the Supplemental Extended Reporting Period may not be canceled and the appli- cable premium is fully earned. 4. This right to purchase the Supplemental Extended Reporting Period will terminate unless written notice is given to us no later than sixty (60) days after the effective date of cancellation or non- renewal of this Coverage Form. Payment in full of the Supplemental Extended Reporting Period premium and any outstanding premiums or recoveries owed to us will be made concurrently with such written notice for such Supplemental Extended Reporting Period to become effective. 5. The Extended Reporting Period does not extend the "policy period" or change the scope of cover- age provided. Subject to this Coverage Form's terms, Limits of Liability, exclusions and conditions, this Coverage Form is extended to apply to "claim(s)" first made against the insured during the Basic Extended Reporting Period, or, if purchased, the Supplemental Extended Reporting Period, but only to "claim(s)" due to "public officials wrongful act(s)" committed prior to the end of the "poli- cy period." 6. The Extended Reporting Period does not reinstate or increase this Coverage Form's Limits of Lia- bility. "Claim(s)" which are first received and recorded during the Basic Extended Reporting Period or the Supplemental Extended Reporting Period, if it is in effect, will be deemed to have been made on the last day of the "policy period." PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 22 of 28 with its permission EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM CLAIMS-MADE COVERAGE Employment Practices Liability coverage applies only if limits are shown in the Declarations. Within this Coverage Form, the word "insured" means any person or organization qualifying as such under EMPLOYMENT PRACTICES LIABILITY—WHO IS AN INSURED. SECTION I — COVERAGES 1. INSURING AGREEMENT We will pay on behalf of the insured all "loss" resulting from "employment practices wrongful act(s)" but only with respect to "claims" first made against the insured during the "policy period" or Extended Re- porting Period. The "employment practices wrongful act(s)" must occur within the "coverage territory." 2. DEFENSE AND SUPPLEMENTARY PAYMENTS We will have the right and duty to defend any covered "suit" against the insured seeking damages to which this insurance applies even if any of the allegations of the "suit" are groundless, false or fraudu- lent. We may make such investigation of any "claim" or "suit" as we deem expedient. We will not be ob- ligated to pay any "claim" or judgment or to defend any "suit" after the applicable limit of our liability has been exhausted by payment of judgments or settlements. The insured, except at its own cost and for its own account, will not, without our written consent, make any payment, admit any liability, settle any"claim," assume any obligation, or incur any expense. We will have the right, but no duty, to appeal any judgment. We will pay, in addition to the applicable Limit of Liability: a. All expenses incurred by us, and all interest on the entire amount of any judgment therein, which does not exceed the limit of our liability; b. All reasonable expenses incurred by the insured at our request to assist in the investigation or de- fense of a "claim" or "suit." Expenses, as used here, do not include salaries of your officers or "em- ployees", except for actual loss of earnings, up to$250 a day, because of time off from work; c. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable Limit of Liability, we will not pay any prejudgment interest based on that period of time after the offer; d. Premium on appeal bonds required in any "suit" defended by us and the cost of attachment or simi- lar bonds. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 23 of 28 with its permission SECTION 11 — EXCLUSIONS Refer to the COMMON LIABILITY EXCLUSIONS for additional exclusions which also apply to this Coverage Form. We will not be obligated to make any payment nor to defend any "suit" in connection with any "claim" made against the insured: 1. Based upon or attributable to any insured gaining profit, advantage or remuneration to which the insured is not entitled; 2. For any damage arising from "bodily injury," sickness, disease or death of any person, or for damage to or destruction of any property, including diminution of value or loss of use thereof; however, for the pur- pose of this exclusion, "bodily injury" does not include emotional distress or mental anguish; 3. For assault and battery; 4. Alleging any violation of civil rights other than employment related civil rights; 5. Arising out of: a. Any "employment practices wrongful act(s)" which takes place prior to the "policy period" if the in- sured had knowledge of circumstances which could reasonably be expected to give rise to a "claim"; or b. Any "loss" for which the insured is entitled to indemnity or payment by reason of having given notice of any circumstances which might give rise to a "claim" under any policy or policies the term of which has expired prior to the inception date of this policy; 6. "Loss" based upon or arising out of: a. Any activity for which the insured is acting in a fiduciary capacity; or b. Any activity concerning an employee benefit plan, welfare plan or retirement plan, or self insurance fund, including any obligation under the Employee Retirement Income Security Act, or COBRA, and any subsequent amendments thereto or any similar local, state or federal law or regulation. c. Any liability assumed by the insured under any contract or agreement, unless the insured would have been legally liable in the absence of such contract or agreement; 7. For "claim(s)," demands, or actions seeking relief or redress in any form other than monetary damages, or for any fees, costs or expenses which the insured may become obligated to pay as a result of any adverse judgment for declaratory relief or injunctive relief; however: a. We will afford defense to the insured for such actions, "claim(s)," "suit(s)" or demands in which mon- etary damages are requested if not otherwise excluded; and b. We will indemnify the insured for reasonable costs and fees incurred in the defense of"suit(s)" seek- ing relief or redress in any form other than monetary damages by reason of an "employment practic- es wrongful act" which is otherwise covered by this policy, in accordance with the following addition- al provisions: (1) The insured must report each circumstance which could reasonably be expected to give rise to a "suit" to us during the "policy period" or within the Basic Extended Reporting Period; (2) We will have no duty to investigate or defend any such "suit(s)," but we will have the right, at our option and expense, to investigate or take over the defense of any such "suit(s)"; PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 24 of 28 with its permission (3) We will only be liable to pay for reasonable costs and fees in excess of the "deductible" amount shown in the Declarations. We will have no obligation to pay any salary expense of the insured; (4) The limit of our liability for all such cost and fees will not exceed $10,000 for each "suit" arising out of an "employment practices wrongful act," not to exceed $50,000 for each "policy period"; (5) "Claim(s)" based on or arising out of the same act or interrelated acts of one or more insured(s) will be considered to be based on a single "employment practices wrongful act"; and (6) The Limit of Liability applicable to this provision is in addition to the Limits of Liability otherwise stated in the coverage form; 8. "Claim(s)" by the Named Insured or on its behalf; 9. For back wages, overtime or similar "claim(s)," even if designated as liquidated damages, under any federal, state or local statutes, rules, ordinances or regulations, if such "claim(s)" arise out of an "em- ployment practices wrongful act" committed prior to the effective date of this policy; or for "claim(s)" aris- ing from collective bargaining agreements. SECTION III — EMPLOYMENT PRACTICES LIABILITY— WHO IS AN INSURED Each of the following is an Insured: 1. You; 2. All lawfully elected, appointed or employed officials; 3. Members of commissions, boards or other units operated by and under your jurisdiction and within ap- portionment of the total operating budget indicated in the application form, provided that the insurance afforded will not extend to any of the following boards, commissions or units: airports, transit authorities, hospitals, municipally owned gas companies, housing authorities or port authorities; 4. All "employees" and all persons who perform service on a volunteer basis for you and under your direc- tion and control, but only for acts within the course and scope of their employment as authorized by you; and 5. The estates, heirs, legal representative or assigns of deceased persons who were insureds at the time of a covered "employment practices wrongful act(s)" but only to the extent that they would otherwise be provided coverage under this Coverage Form. However none of the following are insured(s) under this Coverage Form: 1. Any insured, including you, with respect to the operation of boards, commissions or other units, the members of which are not afforded coverage under 3. above; and 2. All persons or entities who are on retainer, are a consultant or are under contract for services, for any insured. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 25 of 28 with its permission SECTION IV — COVERAGE EXTENSIONS The following extensions apply to this policy and are additional insurance to the policy unless other-wise stated: 1. Workplace Violence Counseling We will reimburse you up to $5,000 in any one "policy period" for expenses you incur for the counseling of "employees" of the Named Insured when that counseling is necessary due to an incident of "Work- place Violence." "Workplace Violence" as applicable to this extension means the intentional use of, or threat to use, deadly force by any person with the intent to cause harm; and that results in "bodily injury" or death of a person while on that Named Insured's described premises. SECTION V— LIMITS OF LIABILITY Regardless of the number of insured(s) under this Coverage Form, persons or organizations who sustain "loss" or damages payable under this Coverage Form, and/or "claims" made or "suit(s)" brought under this Coverage Form, the most we will pay under this Coverage Form is as follows: 1. The Limit of Liability stated in the Declarations as applicable to each "employment practices wrongful act" is the limit of our liability for all "loss" arising out of one "employment practices wrongful act" covered by this Coverage Form. 2. The Limit of Liability stated in the Declarations as applicable to the Annual Aggregate is subject to the above provision respecting each "employment practices wrongful act"and is the maximum limit of our liability for each "policy period." In no event will our total Limit of Liability be increased for any Extended Report- ing Period. 3. Subject to the Limits of Liability stated in 1. and 2. above, we will only be liable to pay for damages in excess of the "deductible" shown in the Declarations for each "employment practices wrongful act." In the event we expend funds either for "loss" or "loss adjustment expense" on behalf of the insured, we will be reimbursed for such expenditures up to the amount of the "deductible" shown in the Declarations. Upon written demand by us, the amount of such "deductible" will be payable to us within thirty (30) days. 4. All "claims" or "loss" based on or arising out of the same act or interrelated acts of one or more in- sured(s) will be considered to be based on a single "employment practices wrongful act" and only one Ilemployment practices wrongful act" Limit of Liability and only one "deductible" will be applicable to such single "employment practices wrongful act." 5. Subject to the Limits of Liability stated in 1. and 2. above, we will only be liable to pay $10,000 for dam- ages in excess of $5,000 for back wages, overtime, or similar "claims" arising out of each "employment practices wrongful act," even if designated as liquidated damages under any federal, state or local stat- utes, rules, ordinances or regulations. This limit is part of, and not in addition to, the "employment prac- tices wrongful act" limit shown in the Declarations. Any payments made hereunder will be included in the Annual Aggregate limit of liability stated in the Declarations. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 26 of 28 with its permission SECTION VI — CONDITIONS Refer to the COMMON CONDITIONS which also apply to this Coverage Form. 1. Settlement. We have the right to settle any"claim" or"suit" as we deem expedient without any insured's consent. 2. Awareness Provision. a. If, during the "policy period" or the Extended Reporting Period, the insured receives oral notice from any party that it is the intention of such party to hold the insured responsible for any "public officials wrongful act(s)," the insured will give written notice to us of the receipt of such oral notice, during the "policy period" or Extended Reporting Period. Any "claim(s)," made against the insured arising out of such "employment practices wrongful act(s)" will, for the purpose of this Coverage Form, be treated as a "claim" made during the "policy period" in which such notice was given, or, if given during the Extended Reporting Period, as a "claim" made during the last "policy period"; b. For the purpose of the above clause, notice to the designee named on the Declarations will consti- tute notice to the insured; c. In the event of any "claim" occurring hereunder, notice to us will be given to the person or firm(s) shown on the Declarations. Notice will be deemed to be received if sent by prepaid mail, properly addressed. SECTION Vill — DEFINITIONS Refer to the COMMON DEFINITIONS for additional definitions which also apply to this Coverage Form. Whenever used in this Coverage Form, the following words have these meanings: 1. "Claim" means: a. A written notice from any party that it is their intention to hold the insured responsible for "loss" re- sulting from an "employment practices wrongful act" covered by this Coverage Form; and b. Any notice that requires you to attend an administrative hearing conducted by the EEOC or by any state agency with a similar purpose. 2. "Discrimination" means violation of a person's civil rights with respect to such person's race, color, na- tional origin, religion, gender, marital status, age, sexual orientation or preference, physical or mental condition, or any other protected class or characteristic established by any federal, state or local stat- utes, rules or regulations. 3. "Employment practices wrongful act(s)" means: Any actual or alleged: a. Refusal to employ; b. Wrongful termination of employment; or c. False arrest, false imprisonment, libel, slander, defamation, harassment, humiliation, discrimination, invasion of privacy, wrongful eviction, malicious prosecution, abuse of process, or any other act, omission or policy; based upon or attributable to anyone's employment or application for employment by you. PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 27 of 28 with its permission SECTION Vill — EXTENDED REPORTING PERIOD — BASIC AND OPTIONAL SUPPLEMENTAL An Extended Reporting Period, described below, will be provided if this Coverage Form is canceled or non- renewed by us, except for nonpayment of premium, or if we renew or replace coverage with insurance that: a. Has a retroactive date; or b. Provides coverage on other than a Claims-Made basis. 1. A Basic Extended Reporting Period is automatically provided without additional charge. This period be- gins at the end of the "policy period" and lasts for sixty (60) days. The Basic Extended Reporting Period does not apply to "claim(s)," covered under any subsequent policy. 2. Coverage for an optional Supplemental Extended Reporting Period must be added by endorsement and an additional premium charge must be paid. Such period starts sixty (60) days after the end of the "poli- cy period." 3. You will have a one-time option to elect the period of time for which the Supplemental Extended Report- ing Period will apply, which in no event will exceed thirty-six (36) months. The available one-time options and the additional premium charge for each option are listed below: a. Twelve (12) month option-150% of the Annualized Coverage Form Premium; b. Twenty-four (24) month option-200% of the Annualized Coverage Form Premium; c. Thirty-six (36) month option-300% of the Annualized Coverage Form Premium. Once in effect, the Supplemental Extended Reporting Period may not be canceled and the applicable premium is fully earned. 4. This right to purchase the Supplemental Extended Reporting Period will terminate unless written notice is given to us no later than sixty (60) days after the effective date of cancellation or non-renewal of this Coverage Form. Payment in full of the Supplemental Extended Reporting Period premium and any out- standing premiums or recoveries owed to us will be made concurrently with such written notice for such Supplemental Extended Reporting Period to become effective. 5. The Extended Reporting Period does not extend the "policy period" or change the scope of coverage provided. Subject to this Coverage Form's terms, Limits of Liability, exclusions and conditions, this Cov- erage Form is extended to apply to "claim(s)" first made against the insured during the Basic Extended Reporting Period, or, if purchased, the Supplemental Extended Reporting Period, but only to "claim(s)," due to "employment practices wrongful act(s)" committed prior to the end of the "policy period." 6. The Extended Reporting Period does not reinstate or increase this Coverage Form's Limits of Liability. "Claim(s),"which are first received and recorded during the Basic Extended Reporting Period" or the Supplemental Extended Reporting Period, if it is in effect, will be deemed to have been made on the last day of the "policy period." PROF-FORM-11 (09108) Includes copyrighted material of Insurance Services Office, Inc., Page 28 of 28 with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BODILY INJURY DEFINITION This endorsement modifies insurance provided under the following: LAW ENFORCEMENT LIABILITY COVERAGE FORM PUBLIC OFFICIALS LIABILITY COVERAGE FORM EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM The Common Liability Definitions are amended as follows- Common Definition, 2., "Bodily Injury" is deleted in its entirety and replaced with the following: "Bodily Injury" means physical injury to the body, sickness, disease, disability, shock, mental anguish, emotional distress, mental injury and humiliation, including death resulting from any of these at any time. All other terms and conditions of the policy remain unchanged. 131 Def PROF-FORM-2 Includes copyrighted material of Insurance Services Office, Inc., Page I of I (09-08) with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: PUBLIC RISK PROFESSIONAL POLICY A. The Cancellation Common Policy Condition is replaced by the following: 1. The first Named Insured shown in the Declarations may cancel this entire policy by mailing or delivering to us advance written notice of cancellation. 2. Cancellation Of Policies In Effect a. 60 Days Or Less We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: (1) 30 days before the effective date of cancellation if we cancel for any reason not included in Paragraph A.2.a.(2) below. (2) 15 days before the effective date of cancellation if we cancel for any of the following rea- sons: (a) Nonpayment of premium, provided however, that a notice of cancellation on this ground shall inform the first Named Insured of the amount due; (b) Conviction of a crime arising out of acts increasing the hazard insured against; (c) Discovery of fraud or material misrepresentation in the obtaining of the policy or in the presentation of a claim; (d) After issuance of the policy or after the last renewal date, discovery of an act or omis- sion, or a violation of any policy condition, that substantially and materially increases the hazard insured against, and that occurred subsequent to inception of the current policy period; (e) Material physical change in the property insured, occurring after issuance or last annual renewal anniversary date of the policy, that results in the property becoming uninsura- ble in accordance with our objective, uniformly applied underwriting standards in effect at the time the policy was issued or last renewed; or material change in the nature or extent of the risk, occurring after issuance or last annual renewal anniversary date of the policy, that causes the risk of loss to be substantially and materially increased be- yond that contemplated at the time the policy was issued or last renewed; (f) Required pursuant to a determination by the Superintendent that continuation of our present premium volume would jeopardize our solvency or be hazardous to the interest of our policyholders, our creditors or the public; (g) A determination by the Superintendent that the continuation of the policy would violate, or would place us in violation of, any provision of the Insurance Code; or (h) Where we have reason to believe, in good faith and with sufficient cause, that there is a probable risk of danger that the insured will destroy, or permit to be destroyed, the in- sured property for the purpose of collecting the insurance proceeds. If we cancel for this reason, you may make a written request to the Insurance Department, within 10 days of receipt of this notice, to review our cancellation decision. Also, we will simulta- neously send a copy of this cancellation notice to the Insurance Department. NY-Canc Stam-NY-032-01 Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page I of 3 (09-08) b. For More Than 60 Days If this policy has been in effect for more than 60 days, or if this policy is a renewal or contin- uation of a policy we issued, we may cancel only for any of the reasons listed in Paragraph A.2.a.(2) above, provided: (1)We mail the first Named Insured written notice at least 15 days before the effective date of cancellation; and (2)If we cancel for nonpayment of premium, our notice of cancellation informs the first Named Insured of the amount due. 3. We will mail or deliver our notice, including the reason for cancellation, to the first Named In- sured at the address shown in the policy and to the authorized agent or broker. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. However, when the premium is advanced under a premium finance agreement, the cancellation refund will be pro rata. Under such financed policies, we will be entitled to retain a minimum earned premium of 10% of the total policy premium or $60, whichever is greater. The cancella- tion will be effective even if we have not made or offered a refund. B. The following is added to the Cancellation Common Policy Condition: If one of the reasons for cancellation in Paragraph A.2.a.(2) or D.2.b.(2) exists, we may cancel this entire policy, even if the reason for cancellation pertains only to a new coverage or en- dorsement initially effective subsequent to the original issuance of this policy. C. The following conditions are added: 1. Nonrenewal If we decide not to renew this policy we will send notice as provided in Paragraph C.3. below. 2. Conditional Renewal If we conditionally renew this policy subject to a: a. Change of limits; b. Change in type of coverage; c. Reduction of coverage; d. Increased deductible; e. Addition of exclusion; or f. Increased premiums in excess of 10%, exclusive of any premium increase due to and com- mensurate with insured value added or increased exposure units; or as a result of experience rating, loss rating, retrospective rating or audit; we will send notice as provided in Paragraph C.3. below. 3. Notices Of Nonrenewal And Conditional Renewal a. If we decide not to renew this policy or to conditionally renew this policy as provided in Para- graphs C.1. and C.2. above, we will mail or deliver written notice to the first Named Insured shown in the Declarations at least 60 but not more than 120 days before: (1) The expiration date; or (2) The anniversary date if this is a continuous policy. b. Notice will be mailed or delivered to the first Named Insured at the address shown in the poli- cy and to the authorized agent or broker. If notice is mailed, proof of mailing will be sufficient proof of notice. NY-Canc Stam-NY-032-01 Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page 2 of 3 (09-08) c. Notice will include the specific reason(s) for nonrenewal or conditional renewal, including the amount of any premium increase for conditional renewal and description of any other chang- es. d. If we violate any of the provisions of Paragraph C.3.a., b. or c. above by sending the first Named Insured an incomplete or late conditional renewal notice or a late nonrenewal notice: (1) Coverage will remain in effect at the same terms and conditions of this policy at the lower of the current rates or the prior period's rates until 60 days after such notice is mailed or delivered, unless the first Named Insured, during this 60 day period, has replaced the cov- erage or elects to cancel. (2) On or after the expiration date of this policy, coverage will remain in effect at the same terms and conditions of this policy for another policy period, at the lower of the current rates or the prior period's rates, unless the first Named Insured, during this additional poli- cy period, has replaced the coverage or elects to cancel. e. If you elect to renew on the basis of a late conditional renewal notice, the terms, conditions and rates set forth in such notice shall apply: (1) Upon expiration of the 60 day period; or (2) Notwithstanding the provisions in Paragraphs d.(1) and d.(2), as of the renewal date of the policy if we send the first Named Insured the conditional renewal notice at least 30 days prior to the expiration or anniversary date of the policy. f. We will not send you notice of nonrenewal or conditional renewal if you, your authorized agent or broker or another insurer of yours mails or delivers notice that the policy has been replaced or is no longer desired. NY-Canc Stam-NY-032-01 Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page 3 of 3 (09-08) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEWYORK - DISCLOSURE NOTICE This endorsement modifies insurance provided under the following: PUBLIC OFFICIALS LIABILITY COVERAGE FORM IMPORTANT THIS FORM IS AN ADDENDUM TO YOUR DECLARATIONS PAGE AND APPLICATION AND IS A PART OF YOUR POLICY. THIS FORM DESCRIBES SOME OF THE MAJOR FEATURES OF YOUR PUBLIC OFFICIALS LIABILITY COVERAGE FORM. PLEASE READ IT CAREFULLY. THE PUBLIC OFFICIALS LIABILITY COVERAGE FORM IS WRITTEN ON A "CLAIMS MADE" BASIS. IMPORTANT THE PUBLIC OFFICIALS LIABILITY COVERAGE FORM PROVIDES NO COVERAGE FOR "CLAIMS" ARISING OUT OF INCIDENTS, OCCURRENCES OR ALLEGED "PUBLIC OFFICIALS WRONGFUL ACTS" WHICH TOOK PLACE PRIOR TO THE "RETROACTIVE DATE" STATED IN THIS COVERAGE FORM. IMPORTANT THE PUBLIC OFFICIALS LIABILITY COVERAGE FORM COVERS ONLY "CLAIMS" ACTUALLY MADE AGAINST THE INSURED WHILE THE POLICY REMAINS IN EFFECT. ALL COVERAGE UNDER THE PUBLIC OFFICIALS LIABILITY COVERAGE FORM CEASES UPON THE TERMINATION OF THE POLICY, EXCEPT FOR THE AUTOMATIC BASIC EXTENDED REPORTING PERIOD COVERAGE, UNLESS YOU PURCHASE SUPPLEMENTAL EXTENDED REPORTING PERIOD COVERAGE. IMPORTANT THE LENGTH OF THE AUTOMATIC BASIC EXTENDED REPORTING PERIOD IS NINETY (90) DAYS. IMPORTANT AVOIDING COVERAGE GAPS—IF THIS PUBLIC OFFICIALS LIABILITY COVERAGE FORM IS NOT RENEWED WHEN IT EXPIRES, OR IF SIMILAR COVERAGE IS NOT PURCHASED FROM ANOTHER CARRIER UPON EXPIRATION, A GAP IN COVERAGE PROTECTION WILL RESULT. THIS IS BECAUSE THE AUTOMATIC BASIC EXTENDED REPORTING PERIOD AND THE SUPPLEMENTAL EXTENDED REPORTING PERIOD ONLY PROVIDE AN ADDITIONAL TIME PERIOD WITHIN WHICH TO REPORT "CLAIMS" THAT AROSE FROM "PUBLIC OFFICIALS WRONGFUL ACTS" WHICH OCCURRED AFTER THE "RETROACTIVE DATE" BUT PRIOR TO THE END OF THE "POLICY PERIOD." NY-Disclosure Stam-NY-032-04 Includes copyrighted material of Insurance Services Office, Inc., Page I of 2 (09-08) with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXTENDED REPORTING PERIODS UNDER THE PUBLIC OFFICIALS LIABILITY COVERAGE FORM A Basic Extended Reporting Period is automatically provided under the PUBLIC OFFICIALS LIABILITY COVERAGE FORM without additional charge. This period starts on the date of "termination of coverage" and lasts for ninety (90) days. In addition, you may purchase a Supplemental Extended Reporting Period. This period would start ninety (90) days after the date of "termination of coverage." Following are the available time period options and cost to purchase the optional Supplemental Extended Reporting Period: 1. Twelve (12) Month Option—Costs 70% of the Expiring Annualized Policy Premium. 2. Twenty-four(24) Month Option—Costs 120% of the Expiring Annualized Policy Premium. 3. Thirty-six (36) Month Option—Costs 150% of the Expiring Annualized Premium. If you purchase a Supplemental Extended Reporting Period, the above time periods are the time periods after the Basic Extended Reporting Period has ended within which you can report "claims." However, the only "claims" that are covered and can be reported are those "claims" arising from "public officials wrongful acts" which occurred after the "retroactive date" but prior to the "termination of coverage." INCREASED PREMIUM TO MATURITY If you renew your PUBLIC OFFICIALS LIABILITY COVERAGE FORM on a "claims made" basis, you will experience a percentage increase in the premium for the first, second and third renewal. The original premium for "claims made" is substantially lower than the occurrence form and, as experience matures, the cost rises for the second, third and fourth year. At that time, it is fully mature and the cost is the same as it would be for an occurrence form. NAIMEDN-SURED------------------------------------- TIFTILE-------------------------------------------------- -NO L PC Y N-0 M B E__R------------------------------------- ------------------------------------------ -D A--T E-S-I G__N__E__D---------------------------------------- ACKNOWLEDGMENT BY NAMED INSURED NY-Disclosure Stam-NY-032-04 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2 (09-08) with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEWYORK - DISCLOSURE NOTICE This endorsement modifies insurance provided under the following: EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM IMPORTANT THIS FORM IS AN ADDENDUM TO YOUR DECLARATIONS PAGE AND APPLICATION AND IS A PART OF YOUR POLICY. THIS FORM DESCRIBES SOME OF THE MAJOR FEATURES OF YOUR EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM. PLEASE READ IT CAREFULLY. THE EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM IS WRITTEN ON A "CLAIMS MADE" BASIS. IMPORTANT THE EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM PROVIDES NO COVERAGE FOR "CLAIMS" ARISING OUT OF INCIDENTS, OCCURRENCES OR ALLEGED "EMPLOYMENT PRACTICES WRONGFUL ACTS" WHICH TOOK PLACE PRIOR TO THE "RETROACTIVE DATE" STATED IN THIS COVERAGE FORM. IMPORTANT THE EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM COVERS ONLY "CLAIMS" ACTUALLY MADE AGAINST THE INSURED WHILE THE POLICY REMAINS IN EFFECT. ALL COVERAGE UNDER THE EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM CEASES UPON THE TERMINATION OF THE POLICY, EXCEPT FOR THE AUTOMATIC BASIC EXTENDED REPORTING PERIOD COVERAGE, UNLESS YOU PURCHASE SUPPLEMENTAL EXTENDED REPORTING PERIOD COVERAGE. IMPORTANT THE LENGTH OF THE AUTOMATIC BASIC EXTENDED REPORTING PERIOD IS NINETY (90) DAYS. IMPORTANT AVOIDING COVERAGE GAPS—IF THIS EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM IS NOT RENEWED WHEN IT EXPIRES, OR IF SIMILAR COVERAGE IS NOT PURCHASED FROM ANOTHER CARRIER UPON EXPIRATION, A GAP IN COVERAGE PROTECTION WILL RESULT. THIS IS BECAUSE THE AUTOMATIC BASIC EXTENDED REPORTING PERIOD AND THE SUPPLEMENTAL EXTENDED REPORTING PERIOD ONLY PROVIDE AN ADDITIONAL TIME PERIOD WITHIN WHICH TO REPORT "CLAIMS" THAT AROSE FROM "EMPLOYMENT PRACTICES WRONGFUL ACTS" WHICH OCCURRED AFTER THE "RETROACTIVE DATE" BUT PRIOR TO THE END OF THE "POLICY PERIOD." EXTENDED REPORTING PERIODS UNDER THE EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM A Basic Extended Reporting Period is automatically provided under the EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM without additional charge. This period starts on the date of "termination of coverage" and lasts for ninety (90) days. NY-Disclosure Stam-NY-032-05 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 2 (09-08) with its permission In addition, you may purchase a Supplemental Extended Reporting Period. This period would start ninety (90) days after the date of"termination of coverage." Following are the available time period options and cost to purchase the optional Supplemental Extended Reporting Period: 1. Twelve (12) Month Option—Costs 70% of the Expiring Annualized Policy Premium. 2. Twenty-four(24) Month Option—Costs 120% of the Expiring Annualized Policy Premium. 3. Thirty-six (36) Month Option—Costs 150% of the Expiring Annualized Premium. If you purchase a Supplemental Extended Reporting Period, the above time periods are the time periods after the Basic Extended Reporting Period has ended within which you can report "claims." However, the only "claims" that are covered and can be reported are those "claims" arising from "employment practices wrongful acts" which occurred after the "retroactive date" but prior to the "termination of coverage." INCREASED PREMIUM TO MATURITY If you renew your EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM on a "claims made" basis, you will experience a percentage increase in the premium for the first, second and third renewal. The original premium for "claims made" is substantially lower than the occurrence form and, as experience matures, the cost rises for the second, third and fourth year. At that time, it is fully mature and the cost is the same as it would be for an occurrence form. NAMED INSURED TITLE POLICY NUMBER SIGNATURE DATE SIGNED ACKNOWLEDGMENT BY NAMED INSURED NY-Disclosure Stam-NY-032-05 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2 (09-08) with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXTENSION OF COVERAGE This endorsement modifies insurance provided under the following: Employment Practices Liability Coverage Form The following is added to SECTION 1—COVERAGES; EXTENSION OF COVERAGE We have at our option, the right, but not the obligation to investigate and defend EEOC actions against the insured prior to any"suit" being filed. This is in addition to the coverage otherwise provided by this Coverage Form. However, the insured must promptly notify us and describe the circumstances surrounding each EEOC action submitted for consideration under this provision. The "deductible" does not apply to any expenditures we incur under this extension. If"suit" is filed later, the "deductible" will apply to that "suit." All other terms and conditions of the policy remain unchanged. Ext of Cov EPL-603 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page I of I with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LINE OF DUTY DEATH COVERAGE This endorsement modifies insurance provided under the following: LAW ENFORCEMENT LIABILITY COVERAGE FORM We will indemnify you for an amount not to exceed $50,000 for voluntary payments made to the family or members of the household of a Law Enforcement Officer who is injured as the result of a felony which occurs during the "policy period": a. If death results within one year from the date of the initial injury; and b. The Law Enforcement Officer was under the direct supervision of your Law Enforcement Department or Agency shown in the Declarations at the time the injury occurred; and c. The Law Enforcement Officer was acting within the course and scope of official and departmentally approved law enforcement duties at the time the injury occurred. The maximum limit for this coverage is $100,000 per"policy period." The Limits described in this endorsement are in addition to the Limits of Liability shown on the Declarations. 11. EXCLUSIONS: In addition to the other exclusions set forth in SECTION II—EXCLUSIONS of the Law Enforcement Liability Coverage Form, coverage does not apply if death results directly or indirectly from the following causes or events, whether they occur concurrently with or in any sequence from the felonious injury: a. Suicide; b. Injuries caused by members of the Law Enforcement Officer's immediate family or members of the household or benefit recipient; c. Heart attack or stroke which occurs more than twenty-four (24) hours after such felonious injury; or d. Conditions or symptoms related to HIV, AIDS or any other communicable disease. Ill. CONDITIONS With respect to coverage provided by this endorsement: a. The following is added to COMMON POLICY CONDITION 12. Legal Action Against Us: The insured may not bring a "suit" to recover under this endorsement until ninety (90) days after the insured has given us written proof of a covered fatal injury. No "suit" may Line of DID Cov LE-402(09-08) Includes copyrighted material of Insurance Services Office, Inc., Page I of 2 with its permission be brought more than three (3) years after the date of a covered fatal injury, or as required by law. b. Condition 3. Insured's Duties In The Event Of A "Law Enforcement Wrongful Act," "Claim" or "Suit." of the Law Enforcement Liability Coverage Form is deleted in its entirety and is replaced by the following: 3. Insured's Duties In The Event Of A "Law Enforcement Wrongful Act," "Claim" or 11suit." You must give us written notice of a covered fatal injury as soon as reasonably possible after such fatal injury covered by this endorsement occurs, or as required by law. Such written notice must identify the Law Enforcement Officer who sustained the covered fatal injury, the Named Insured, the policy number, and it must describe the "occurrence" and the nature of the fatal injury. c. The following condition is added to the Law Enforcement Liability Coverage Form: We have the right to request an independent autopsy as allowed by law. All other terms and conditions of the policy remain unchanged. Line of DID Cov LE-402(09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2 with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NON-MONETARY DEFENSE COSTS ENDORSEMENT This endorsement modifies insurance provided under the following: Law Enforcement Liability Coverage Form Schedule Coverage is only provided for the coverage form(s) identified below with an [X]. Limit and premium charge indicated: Premium $_ Included Limits X $10,000 per Suit/ $50,000 per Policy Period $25,000 per Suit/ $50,000 per Policy Period $50,000 per Suit/ $50,000 per Policy Period $100,000 per Suit/ $100,000 per Policy Period In consideration of the premium paid it is understood and agreed that Section 1- COVERAGES - Defense and Supplementary Payments, is amended by the addition of the following: We will pay on behalf of the Insured reasonable costs and fees incurred in the defense of Suits seeking relief or redress by injunctive relief, equitable relief, declarative relief or any other relief or recovery other than monetary amounts due to a Wrongful Act which is otherwise covered by this Policy. We will only be liable to pay these defense costs in excess of the Deductible indicated in the Declarations for the indicated Coverage. The Limits applicable to this provision are in addition to the Limits of Liability stated in the Declarations for the indicated Coverage. All other terms and conditions of this Policy remain the same. Non-Monetary DC Endt LE-403(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of 1 permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDATORY ENDORSEMENT-NEW YORK This endorsement modifies insurance provided under the following: LAW ENFORCEMENT LIABILITY COVERAGE FORM PUBLIC OFFICIALS LIABILITY COVERAGE FORM EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM The definition "loss" does not include any matter deemed uninsurable under the law. The following is added to COMMON POLICY CONDTIONS-Legal Action Against Us: A final judgment means on the facts or the law by a court of the judicial branch of government having original jurisdiction which disposes of a cause of action by declaring that the plaintiff is or is not entitled to the final remedy asked for; but, final judgment does not include default judgment. If a final judgment remains unsatisfied after 30 (thirty) days from the entry of judgment, then an action can be maintained against us. The introductory subparagraph of COMMON POLICY CONDITIONS-Other Insurance - is deleted and re- placed by the following: If the Insured has other insurance that applies to a loss covered by this Policy, this Policy shall be excess over any other valid and collectible insurance and shall then apply only in the amount by which the applicable Limit of Liability of this Policy exceeds the sum of all applicable Limits of Liability for all such insurance. The following is added to COMMON POLICY CONDITIONS-Transfer of Duties When a Limit of Insurance Is Used Up: 1. If we conclude that, based on the number of "claims", wrongful acts, or "suits" which have been reported to us and to which this insurance may apply, the: (a) Aggregate Limit; or (b) Occurrence Limit is likely to be used up in payment of judgments or settlements, we will notify the Insured, in writing to that effect. 2. When a limit of insurance described in paragraph 1. above has actually been used up in the payment of settlements or judgments: a. We will notify the Insured in writing, as soon as practicable, that: (1) Such a limit has been actually been used up; and (2) Our duty to defend "claims" seeking damages subject to that limit has also ended. NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page I of 14 (09-08) with its permission b. We will initiate, and cooperate, in the transfer if control, to any appropriate Insured, of all "claims" and "suits" seeking damages which are subject to that limit and which are reported to us before that limit is used up. That Insured must cooperate in the control of said "claims" and "suits". We agree to take such steps, as we deem appropriate, to avoid a default in, or continue the de- fense of, such "suits" until such transfer is completed, provided the appropriate Insured is cooperat- ing in completing such transfer. We will take no action whatsoever with respect to any "claims" or "suits" seeking damages that would have been subject to that limit, had it not been used up, if the "claim" or "suit" is reported to us after that limit of insurance has been used up. c. The Insured involved in a "claim" seeking damages subject to that limit, must arrange for the de- fense of such "claim" within such time period as agreed to between the appropriate Insured and us. Absent any such agreement, agreements for the defense of such "claim" must be made as soon as practicable. 3. The Insured will reimburse us for expenses we deem appropriate in accordance with paragraph 2.b. above. The duty of the Insured to reimburse us will begin on: a. The date on which the applicable limit of insurance is used up, if we sent notice in accordance with paragraph 1. above; or b. The date on which we sent notice in accordance with paragraph 2.a. above, if we did not get notice in accordance with paragraph 1. above. 4. The exhaustion of any limit of insurance by the payments of judgments or settlements, and the resulting end of our duty to defend, will not be affected by our failure to comply with any of the provisions of this Condition. The following is added to Condition 3.-Insured's Duties In The Event Of A "Claim" or "Suit" - of COMMON POLICY CONDITIONS: Notice given by or on behalf of the insured, or written notice by or on behalf of the injured person or any other claimant, to any agent of ours in New York State, with particulars sufficient to identify the insured, shall be considered notice to us. Failure to give any notice within the required time prescribed will not invalidate any "claim" made by the in- sured or by any other claimant if it can be shown that it was not reasonably possible to give such notice within the prescribed time and that notice was given as soon as was reasonably possible Exclusions 2. of SECTION II—EXCLUSIONS - of the LAW ENFORCEMENT LIABILITY COVERAGE FORM are deleted in their entirety and are replaced by the following: We will not be obligated to make any payment nor to defend any "suit" in connection with any "claim" made against the insured: NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 14 (09-08) with its permission For "claim(s)," demands, or actions seeking relief or redress in any form other than monetary damages, or for any fees, costs or expenses which the insured may become obligated to pay as a result of any adverse judgment for declaratory relief or injunctive relief; The following exclusion is added to SECTION II—EXCLUSIONS - of the LAW ENFORCEMENT LIABILITY COVERAGE FORM: We will not be obligated to make any payment nor to defend any "suit" in connection with any "claim" made against the insured: Arising out of the costs of defense or indemnification in cases involving criminal prosecution. Paragraph 3. of SECTION V—LIMITS OF LIABILITY - of the LAW ENFORCEMENT LIABILITY COVERAGE FORM is deleted in its entirety and is replaced by the following: Subject to the Limits of Liability stated above, we will only be liable to pay for damages in excess of the "deductible" shown in the Declarations for each and every "law enforcement wrongful act." In the event that we expend funds either for damages or "loss adjustment expense" on behalf of the insured, we will be re- imbursed for such expenditures up to the amount of the "deductible" shown in the Declarations; however, "loss adjustment expense" charged against the "deductible" will not exceed fifty percent (50%) of such "deductible" and we will assume any "loss adjustment expense" over this amount in regard to such "de- ductible." Payment of "loss adjustment expense" will not reduce the Limits of Liability. Upon written de- mand by us, the amount of such "deductible" will be payable to us within thirty (30) days. The following Conditions are added to SECTION VI—CONDITIONS - of the LAW ENFORCEMENT LIABILITY COVERAGE FORM and supersede any provisions to the contrary: Right To "Claim" And "Law Enforcement Wrongful Act" Information. We will provide the first Named Insured shown in the Declarations the following information relating to this and any preceding Law Enforcement Liability Coverage Form we have issued to you: 1. Information on closed "claims," including date and description of "law enforcement wrongful act" and any payments; 2. Information of open "claims," including date and description of "law enforcement wrongful act," and amounts of payments; and 3. Information on notice of any "law enforcement wrongful act," including date and description of the "law en- forcement wrongful act." Amounts reserved are based on our judgment. They are subject to change and should not be regarded as ul- timate settlement values. We will provide this information only if the first Named Insured or insurance agent, if any, mails or delivers a written request for this loss information. We will provide this information within twenty (20) days of receipt of the request. We compile "claim" and "law enforcement wrongful act" information for our own business purposes and exer- cise reasonable care in doing so. In providing this information to the first Named Insured and insurance agent, NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 14 (09-08) with its permission if any, we make no representations or warranties to insureds, insurance agent, if any, insurers or others to whom this information is furnished by or on behalf of any of you or insurance agent, if any. Cancellation and nonrenewal will be effective even if we inadvertently provide inaccurate information. Transfer of Duties When A Limit Of Insurance Is Used Up. 1. If we conclude that, based on "law enforcement wrongful act(s)," offenses, "claims" or "suits" which have been reported to us and to which this insurance may apply, that the: a. Limit of Liability for each person; or b. Limit of Liability for each Law Enforcement Wrongful Act; or c. Annual Aggregate Limit of Liability; is likely to be used up in the payment of judgments or settlements, we will notify the first Named Insured, in writing, to that effect. 2. When a limit of insurance described in paragraph 1. above has actually been used up in the payment of judgments or settlements: a. We will notify the first Named Insured, in writing, as soon as practicable, that: (1) such a limit has actually been used up; and (2) our duty to defend "suits" seeking damages subject to that limit has also ended. b. We will initiate, and cooperate in, the transfer of control, to any appropriate insured, of all "claims" and 'i suits" seeking damages which are subject to that limit and which are reported to us before that limit is used up. That insured must cooperate in the transfer of control of said "claims" and "suits." We agree to take such steps, as we deem appropriate, to avoid a default in, or continue the defense of, such "suits" until such transfer is completed, provided the appropriate insured is cooperating in competing such transfer. We will take no action whatsoever with respect to any "claim" or "suit" seeking damages that would have been subject to that limit, had it not been used up, if the "claim" or"suit" is reported to us after the limit of insurance has been used up. c. The first Named Insured and any other insured involved in a "suit" seeking damages subject to that lim- it, must arrange for the defense of such "suit" within such time period as agreed to between the appro- priate insured and us. Absent any such agreement, arrangements for the defense of such "suit" must been made as soon as practicable. 3. The first Named Insured will reimburse us for expenses we incur in taking those steps we deem appropri- ate in accordance with paragraph 2.b. above. The duty of the first Named Insured to reimburse us will begin on: a. the date on which the applicable limit of insurance is used up, if we sent notice in accordance with par- agraph 1. above; or b. the date on which we sent notice in accordance with paragraph 2.a. above, if we did not send notice in accordance with paragraph 1. above. NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 14 (09-08) with its permission 4. The exhaustion of any limit of insurance by the payment of judgments or settlements, and the resulting end of our duty to defend, will not be affected by our failure to comply with any of the provisions of the Condi- tion. "Personal injury" under COMMON LIABILITY DEFINITIONS is deleted in its entirety and is replaced by the fol- lowing: "Personal injury" means: a. Discrimination, but only for disparate impact and/or vicarious liability; b. False arrest, detention or imprisonment, or malicious prosecution; c. False or improper service of process; d. Humiliation or mental distress; e. The publication or utterance of a libel or slander or of other defamatory or disparaging material, or a publication or utterance in violation of an individual's right to privacy; except publications or utterances in the course of or related to advertising, broadcasting or telecasting activities by or on behalf of the in- sured; f. Violation of property rights; and g. Wrongful entry, eviction or other invasion of the right of public occupancy. INSURING AGREEMENT of SECTION I—COVERAGES - of the PUBLIC OFFICIALS LIABILITY COVERAGE FORM is deleted in its entirety and is replaced by the following: 1. INSURING AGREEMENT We will pay on behalf of the insured all "loss" resulting from "public officials wrongful act(s)" but only with respect to "claims" first made against the insured during the "policy period" or during any applicable Ex- tended Reporting Period, provided: a. that the "public officials wrongful act" was committed by the insured(s) on or after the "retroactive date" listed in 1.c. below and prior to the end of the "policy period"; and b. that the "claim" is first made against the insured(s) during the "policy period" or during any applicable Extended Reporting Period. c. "Retroactive Date": Exclusions 7. of SECTION II—EXCLUSIONS - of the PUBLIC OFFICIALS LIABILITY COVERAGE FORM are deleted in their entirety and are replaced by the following: We will not be obligated to make any payment nor to defend any "suit" in connection with any "claim" made against the insured: NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 14 (09-08) with its permission For "claim(s)," demands, or actions seeking relief or redress in any form other than monetary damages, or for any fees, costs or expenses which the insured may become obligated to pay as a result of any adverse judgment for declaratory relief or injunctive relief; Paragraphs 2. and 3. of SECTION V—LIMITS OF LIABILITY - of the PUBLIC OFFICIALS LIABILITY COVERAGE FORM are deleted in their entirety and are replaced by the following: 2. The Limit of Liability stated in the Declarations as applicable to the Annual Aggregate is subject to the above provision respecting each "public officials wrongful act" and is the maximum limit of our liability for each "policy period." 3. Subject to the Limits of Liability stated above, we will only be liable to pay for damages in excess of the "deductible" shown in the Declarations for each and every "public officials wrongful act." In the event we expend funds either for damages or "loss adjustment expense" on behalf of the insured, we will be reimbursed for such expenditures up to the amount of the "deductible" shown in the Declarations; how- ever, "loss adjustment expense" charged against the "deductible" will not exceed fifty percent (50%) of such "deductible" and we will assume any "loss adjustment expense" over this amount in regard to such "deductible." Payment of "loss adjustment expense" will not reduce the Limits of Liability. Upon written demand by us, the amount of such "deductible" will be payable to us within thirty (30) days. The following Conditions are added to SECTION VI—CONDITIONS - of the PUBLIC OFFICIALS LIABILITY COVERAGE FORM and supersede any provisions to the contrary: Right To "Claim" And "Public Officials Wrongful Act" Information. We will provide the first Named Insured shown in the Declarations the following information relating to this and any preceding Public Officials Liability Coverage Form we have issued to you: 1. Information on closed "claims," including date and description of "public officials wrongful act" and any payments; 2. Information of open "claims," including date and description of "public officials wrongful act," and amounts of payments; and 3. Information on notice of any "public officials wrongful act," including date and description of the "public offi- cials wrongful act." Amounts reserved are based on our judgment. They are subject to change and should not be regarded as ul- timate settlement values. We will provide this information only if the first Named Insured or insurance agent, if any, mails or delivers a written request for this loss information. We will provide this information within twenty (20) days of receipt of the request. We compile "claim" and "public officials wrongful act" information for our own business purposes and exercise reasonable care in doing so. In providing this information to the first Named Insured and insurance agent, if any, we make no representations or warranties to insureds, insurance agent, if any, insurers or others to whom this information is furnished by or on behalf of any of you or insurance agent, if any. Cancellation and nonrenewal will be effective even if we inadvertently provide inaccurate information. NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 14 (09-08) with its permission Transfer of Duties When A Limit Of Insurance Is Used Up. 1. If we conclude that, based on "public officials wrongful act(s)," offenses, "claims" or "suits" which have been reported to us and to which this insurance may apply, that the: a. Limit of Liability for each Public Officials Wrongful Act; or b. Annual Aggregate Limit of Liability; is likely to be used up in the payment of judgments or settlements, we will notify the first Named Insured, in writing, to that effect. 2. When a limit of insurance described in paragraph 1. above has actually been used up in the payment of judgments or settlements: a. We will notify the first Named Insured, in writing, as soon as practicable, that: (1) such a limit has actually been used up; and (2) our duty to defend "suits" seeking damages subject to that limit has also ended. b. We will initiate, and cooperate in, the transfer of control, to any appropriate insured, of all "claims" and 'i suits" seeking damages which are subject to that limit and which are reported to us before that limit is used up. That insured must cooperate in the transfer of control of said "claims" and "suits." We agree to take such steps, as we deem appropriate, to avoid a default in, or continue the defense of, such "suits" until such transfer is completed, provided the appropriate insured is cooperating in competing such transfer. We will take no action whatsoever with respect to any "claim" or "suit" seeking damages that would have been subject to that limit, had it not been used up, if the "claim" or"suit" is reported to us after the limit of insurance has been used up. c. The first Named Insured and any other insured involved in a "suit" seeking damages subject to that lim- it, must arrange for the defense of such "suit" within such time period as agreed to between the appro- priate insured and us. Absent any such agreement, arrangements for the defense of such "suit" must been made as soon as practicable. 3. The first Named Insured will reimburse us for expenses we incur in taking those steps we deem appropri- ate in accordance with paragraph 2.b. above. The duty of the first Named Insured to reimburse us will begin on: a. the date on which the applicable limit of insurance is used up, if we sent notice in accordance with par- agraph 1. above; or b. the date on which we sent notice in accordance with paragraph 2.a. above, if we did not send notice in accordance with paragraph 1. above. 4. The exhaustion of any limit of insurance by the payment of judgments or settlements, and the resulting end of our duty to defend, will not be affected by our failure to comply with any of the provisions of the Condi- tion. NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 14 (09-08) with its permission The following Definitions are added to SECTION VII—DEFINITIONS - of the PUBLIC OFFICIALS LIABILITY COVERAGE FORM: "Claims made relationship" means that period of time between the effective date of the first claims made Cov- erage Form or policy between you and us and the cancellation or nonrenewal of the last consecutive claims made Coverage Form or policy between such parties, where there has been no gap in coverage, but does not include any period covered by Extended Reporting Period coverage. "Retroactive date" means a date concurrent with the effective date of the policy or a particular date prior to the effective date of the policy upon which we and you agreed in the Coverage Form that the Coverage Form cov- erage will be applicable. An unlimited "retroactive date" applies unless the policy is endorsed specifying a par- ticular "retroactive date." A "retroactive date" may not be changed during the term of the "claims made relationship" or any Extended Reporting Period. "Termination of coverage" means any of the following at any time, whether done by us or by the first Named Insured: 1. cancellation or nonrenewal of a policy; or 2. decrease in limits, reduction in coverage, increased deductible or self-insured retention, new exclusion, or any other change less favorable to the insured. SECTION Vill—EXTENDED REPORTING PERIOD—BASIC AND OPTIONAL SUPPLEMENTAL - of the PUBLIC OFFICIALS LIABILITY COVERAGE FORM is deleted in its entirety and is replaced by the following: EXTENDED REPORTING PERIOD—BASIC AND OPTIONAL SUPPLEMENTAL 1. We will provide one or more Extended Reporting Periods described below where this Coverage Form is a 'i claims made relationship": a. that we terminate for any reason; or b. that we renew or replace with other than a claims made Coverage Form or policy. 2. A Basic Extended Reporting Period is automatically provided without additional charge. The Basic Extend- ed Reporting Period begins on the date of "termination of coverage," and ends ninety (90) days after the date of "termination of coverage." If there is other insurance against any "claim" for which coverage is af- forded under the Basic Extended Reporting Period, the coverage provided under the Basic Extended Re- porting Period will be deemed to be excess over and above the applicable limits of all such other insurance and will afford coverage only after the policy limits of such other insurance have been exhausted. 3. In addition, up to three (3) Supplemental Extended Reporting Periods of twelve months each are available, but only if added by endorsement and for an additional premium charge. The first Supplemental Extended Reporting Period begins ninety (90) days after the date of"termination of coverage." 4. You, subject to the terms and conditions set forth herein, will have the right to select that period to which the Supplemental Extended Reporting Period will apply, which in no event will exceed thirty-six (36) months. The available options and the additional premium charge for each option are listed below: a. Twelve (12) month option-70% of the Expiring Annualized Coverage Form Premium; b. Twenty-four (24) month option-120% of the Expiring Annualized Coverage Form Premium; c. Thirty-six (36) month option-150% of the Expiring Annualized Coverage Form Premium. NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 8 of 14 (09-08) with its permission The premium for the Extended Reporting Period will be commensurate with the coverage provided. Upon "termination of coverage" on a date other than the policy's anniversary date, the cost of Extended Report- ing Period coverage will be appropriately reduced. 5. Within thirty (30) days after the date of"termination of coverage," we will advise you, in writing, of the Basic Extended Reporting Period and the availability of, the premium for, and the importance of purchasing Sup- plemental Extended Reporting Period coverage. You will have the greater of ninety (90) days from the ef- fective date of "termination of coverage," or thirty (30) days from the date of mailing or delivery of our written notice of advice regarding Extended Reporting Period coverage, to submit written acceptance of Extended Reporting Period coverage. All premium for this Coverage Form due us will be paid by the first Named Insured with the written acceptance to effect coverage. Once in effect, the Supplemental Extended Reporting Period may not be canceled. 6. If the "claims made relationship" has continued for at least three (3) years, the Aggregate liability limit for the Supplemental Extended Reporting Period will be at least equal to one hundred percent (100%) of the Coverage Form's Annual Aggregate limit. If the "claims made relationship" has continued for less than three (3) years, the Aggregate liability limit for the Supplemental Extended Reporting Period will at least equal the greater of: a. the limit remaining in the Coverage Form's Annual Aggregate liability limit; or b. fifty percent (50%) of the Coverage Form's Annual Aggregate liability limit. 7. If the policy is canceled due to nonpayment of premium or fraud on the part of the Named Insured, we will not provide you with a premium quotation to purchase a Supplemental Extended Reporting Period unless you request a quotation from us. We will honor your request to purchase a Supplemental Extended Re- porting Period if you have paid all policy premiums owed us. 8. We will provide Extended Reporting Period coverage upon "termination of coverage" to any person cov- ered under the Coverage Form, if: a. the Named Insured has been placed in liquidation or bankruptcy or permanently ceases operations; b. you or your designated trustee does not purchase Extended Reporting Period coverage; and c. such person requests Extended Reporting Period coverage within one hundred and twenty (120) days of the date of"termination of coverage." However, we have no obligation to provide any notice to any such person of the availability of the Extended Reporting Period coverage. We will charge the person for whom Extended Reporting Period coverage is provided a premium commensurate with such coverage. 9. The Extended Reporting Period(s)" do not extend the "policy period" or change the scope of coverage pro- vided. Subject otherwise to this Coverage Form's terms, Limits of Liability, exclusions and conditions, this Coverage Form is extended to apply to "claims" first made during the Basic Extended Reporting Period or, if purchased, the Supplemental Extended Reporting Period, but only by reason of any "public officials wrongful act" committed on or after the policy "retroactive date" but prior to the end of the "policy period." 10. "Claims" for "public officials wrongful act(s)" which are first received during an Extended Reporting Period will be deemed to have been made on the last day of the "policy period." NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 9 of 14 (09-08) with its permission INSURING AGREEMENT of SECTION I—COVERAGES - of the EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM is deleted in its entirety and is replaced by the following: 1. INSURING AGREEMENT We will pay on behalf of the insured all "loss" resulting from "employment practices wrongful act(s)" but on- ly with respect to "claims" first made against the insured during the "policy period" or during any applicable Extended Reporting Period, provided: a. that the "employment practices wrongful act" was committed by the insured(s) on or after the "retroac- tive date" listed in 1.c. below and prior to the end of the "policy period"; and b. that the "claim" is first made against the insured(s) during the "policy period" or during any applicable Extended Reporting Period. c. "Retroactive Date": Exclusions 7. of SECTION II—EXCLUSIONS - of the EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM are deleted in their entirety and are replaced by the following: We will not be obligated to make any payment nor to defend any "suit" in connection with any "claim" made against the insured: For "claim(s)," demands, or actions seeking relief or redress in any form other than monetary damages, or for any fees, costs or expenses which the insured may become obligated to pay as a result of any adverse judgment for declaratory relief or injunctive relief; Paragraphs 2. and 3. of SECTION V—LIMITS OF LIABILITY - of the EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM are deleted in their entirety and are replaced by the following: 2. The Limit of Liability stated in the Declarations as applicable to the Annual Aggregate is subject to the above provision respecting each "employment practices wrongful act" and is the maximum limit of our liability for each "policy period." 3. Subject to the Limits of Liability stated above, we will only be liable to pay for damages in excess of the "deductible" shown in the Declarations for each and every "employment practices wrongful act." In the event we expend funds either for damages or "loss adjustment expense" on behalf of the insured, we will be reimbursed for such expenditures up to the amount of the "deductible" shown in the Declara- tions; however, "loss adjustment expense" charged against the "deductible" will not exceed fifty percent (50%) of such "deductible" and we will assume any "loss adjustment expense" over this amount in re- gard to such "deductible." Payment of "loss adjustment expense" will not reduce the Limits of Liability. Upon written demand by us, the amount of such "deductible" will be payable to us within thirty (30) days. NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 10 of 14 (09-08) with its permission The following Conditions are added to SECTION VI—CONDITIONS - of the EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM and supersede any provisions to the contrary: Right To "Claim" And "Employment Practices Wrongful Act" Information. We will provide the first Named Insured shown in the Declarations the following information relating to this and any preceding Employment Practices Liability Coverage Form we have issued to you: 1. Information on closed "claims," including date and description of "employment practices wrongful act" and any payments; 2. Information of open "claims," including date and description of "employment practices wrongful act," and amounts of payments; and 3. Information on notice of any "employment practices wrongful act," including date and description of the Ilemployment practices wrongful act." Amounts reserved are based on our judgment. They are subject to change and should not be regarded as ul- timate settlement values. We will provide this information only if the first Named Insured or insurance agent, if any, mails or delivers a written request for this loss information. We will provide this information within twenty (20) days of receipt of the request. We compile "claim" and "employment practices wrongful act" information for our own business purposes and exercise reasonable care in doing so. In providing this information to the first Named Insured and insurance agent, if any, we make no representations or warranties to insureds, insurance agent, if any, insurers or others to whom this information is furnished by or on behalf of any of you or insurance agent, if any. Cancellation and nonrenewal will be effective even if we inadvertently provide inaccurate information. Transfer of Duties When A Limit Of Insurance Is Used Up. 1. If we conclude that, based on "employment practices wrongful act(s)," offenses, "claims" or "suits" which have been reported to us and to which this insurance may apply, that the: a. Limit of Liability for each Employment Practices Wrongful Act; or b. Annual Aggregate Limit of Liability; is likely to be used up in the payment of judgments or settlements, we will notify the first Named Insured, in writing, to that effect. 2. When a limit of insurance described in paragraph 1. above has actually been used up in the payment of judgments or settlements: a. We will notify the first Named Insured, in writing, as soon as practicable, that: (1) such a limit has actually been used up; and (2) our duty to defend "suits" seeking damages subject to that limit has also ended. b. We will initiate, and cooperate in, the transfer of control, to any appropriate insured, of all "claims" and 'i suits" seeking damages which are subject to that limit and which are reported to us before that limit is used up. That insured must cooperate in the transfer of control of said "claims" and "suits." NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page I I of 14 (09-08) with its permission We agree to take such steps, as we deem appropriate, to avoid a default in, or continue the defense of, such "suits" until such transfer is completed, provided the appropriate insured is cooperating in competing such transfer. We will take no action whatsoever with respect to any "claim" or "suit" seeking damages that would have been subject to that limit, had it not been used up, if the "claim" or"suit" is reported to us after the limit of insurance has been used up. c. The first Named Insured and any other insured involved in a "suit" seeking damages subject to that lim- it, must arrange for the defense of such "suit" within such time period as agreed to between the appro- priate insured and us. Absent any such agreement, arrangements for the defense of such "suit" must been made as soon as practicable. 3. The first Named Insured will reimburse us for expenses we incur in taking those steps we deem appropri- ate in accordance with paragraph 2.b. above. The duty of the first Named Insured to reimburse us will begin on: a. the date on which the applicable limit of insurance is used up, if we sent notice in accordance with par- agraph 1. above; or b. the date on which we sent notice in accordance with paragraph 2.a. above, if we did not send notice in accordance with paragraph 1. above. 4. The exhaustion of any limit of insurance by the payment of judgments or settlements, and the resulting end of our duty to defend, will not be affected by our failure to comply with any of the provisions of the Condi- tion. "Employment practices wrongful act(s)" of SECTION VII—DEFINITIONS - of the EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM is deleted in its entirety and is replaced by the following: "Employment practices wrongful act(s): means: Any actual or alleged: a. Refusal to employ; b. Termination of employment; c. Discrimination, but only for disparate impact and/or vicarious liability; or d. False arrest, false imprisonment, libel, slander, defamation, harassment, humiliation, invasion of priva- cy, wrongful eviction, malicious prosecution, abuse of process, or any other act, omission or policy. The following Definitions are added to SECTION VII—DEFINITIONS - of the EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM: "Claims made relationship" means that period of time between the effective date of the first claims made Cov- erage Form or policy between you and us and the cancellation or nonrenewal of the last consecutive claims made Coverage Form or policy between such parties, where there has been no gap in coverage, but does not include any period covered by Extended Reporting Period coverage. NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 12 of 14 (09-08) with its permission "Retroactive date" means a date concurrent with the effective date of the policy or a particular date prior to the effective date of the policy upon which we and you agreed in the Coverage Form that the Coverage Form cov- erage will be applicable. An unlimited "retroactive date" applies unless the policy is endorsed specifying a par- ticular "retroactive date." A "retroactive date" may not be changed during the term of the "claims made relationship" or any Extended Reporting Period. "Termination of coverage" means any of the following at any time, whether done by us or by the first Named Insured: 1. cancellation or nonrenewal of a policy; or 2. decrease in limits, reduction in coverage, increased deductible or self-insured retention, new exclusion, or any other change less favorable to the insured. SECTION Vill—EXTENDED REPORTING PERIOD—BASIC AND OPTIONAL SUPPLEMENTAL -of the EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM is deleted in its entirety and is replaced by the fol- lowing: EXTENDED REPORTING PERIOD—BASIC AND OPTIONAL SUPPLEMENTAL 1. We will provide one or more Extended Reporting Periods described below where this Coverage Form is a "claims made relationship": a. that we terminate for any reason; or b. that we renew or replace with other than a claims made Coverage Form or policy. 2. A Basic Extended Reporting Period is automatically provided without additional charge. The Basic Extend- ed Reporting Period begins on the date of "termination of coverage," and ends ninety (90) days after the date of "termination of coverage." If there is other insurance against any "claim" for which coverage is af- forded under the Basic Extended Reporting Period, the coverage provided under the Basic Extended Re- porting Period will be deemed to be excess over and above the applicable limits of all such other insurance and will afford coverage only after the policy limits of such other insurance have been exhausted. 3. In addition, up to three (3) Supplemental Extended Reporting Periods of twelve months each are available, but only if added by endorsement and for an additional premium charge. The first Supplemental Extended Reporting Period begins ninety (90) days after the date of"termination of coverage." 4. You, subject to the terms and conditions set forth herein, will have the right to select that period to which the Supplemental Extended Reporting Period will apply, which in no event will exceed thirty-six (36) months. The available options and the additional premium charge for each option are listed below: a. Twelve (12) month option-70% of the Expiring Annualized Coverage Form Premium; b. Twenty-four (24) month option-120% of the Expiring Annualized Coverage Form Premium; c. Thirty-six (36) month option-150% of the Expiring Annualized Coverage Form Premium. The premium for the Extended Reporting Period will be commensurate with the coverage provided. Upon "ter- mination of coverage" on a date other than the policy's anniversary date, the cost of Extended Reporting Peri- od coverage will be appropriately reduced. 5. Within thirty (30) days after the date of"termination of coverage," we will advise you, in writing, of the Basic Extended Reporting Period and the availability of, the premium for, and the importance of purchasing Sup- NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 13 of 14 (09-08) with its permission plemental Extended Reporting Period coverage. You will have the greater of ninety (90) days from the ef- fective date of"termination of coverage," or thirty (30) days from the date of mailing or delivery of our writ- ten notice of advice regarding Extended Reporting Period coverage, to submit written acceptance of Extended Reporting Period coverage. All premium for this Coverage Form due us will be paid by the first Named Insured with the written acceptance to effect coverage. Once in effect, the Supplemental Extended Reporting Period may not be canceled. 6. If the "claims made relationship" has continued for at least three (3) years, the Aggregate liability limit for the Supplemental Extended Reporting Period will be at least equal to one hundred percent (100%) of the Coverage Form's Annual Aggregate limit. If the "claims made relationship" has continued for less than three (3) years, the Aggregate liability limit for the Supplemental Extended Reporting Period will at least equal the greater of: a. the limit remaining in the Coverage Form's Annual Aggregate liability limit; or b. fifty percent (50%) of the Coverage Form's Annual Aggregate liability limit. 7. If the policy is canceled due to nonpayment of premium or fraud on the part of the Named Insured, we will not provide you with a premium quotation to purchase a Supplemental Extended Reporting Period unless you request a quotation from us. We will honor your request to purchase a Supplemental Extended Re- porting Period if you have paid all policy premiums owed us. 8. We will provide Extended Reporting Period coverage upon "termination of coverage" to any person cov- ered under the Coverage Form, if: a. the Named Insured has been placed in liquidation or bankruptcy or permanently ceases operations; b. you or your designated trustee does not purchase Extended Reporting Period coverage; and c. such person requests Extended Reporting Period coverage within one hundred twenty (120) days of the date of"termination of coverage." However, we have no obligation to provide any notice to any such person of the availability of the Extended Reporting Period coverage. We will charge the person for whom Extended Reporting Period coverage is provided a premium commensurate with such coverage. 9. The Extended Reporting Period(s)" do not extend the "policy period" or change the scope of coverage pro- vided. Subject otherwise to this Coverage Form's terms, Limits of Liability, exclusions and conditions, this Coverage Form is extended to apply to "claims" first made during the Basic Extended Reporting Period or, if purchased, the Supplemental Extended Reporting Period, but only by reason of any "employment prac- tices wrongful act" committed on or after the policy "retroactive date" but prior to the end of the "policy pe- riod." 10. "Claims" for "employment practices wrongful act(s)" which are first received during an Extended Reporting Period will be deemed to have been made on the last day of the "policy period." NY-Amend End Stam-NY-032-03A Includes copyrighted material of Insurance Services Office, Inc., Page 14 of 14 (09-08) with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK - REGULATION 107 ACKNOWLEDGEMENT This endorsement modifies insurance provided under the following: LAW ENFORCEMENT LIABILITY COVERAGE FORM PUBLIC OFFICIALS LIABILITY COVERAGE FORM EMPLOYMENT PRACTICES LIABILITY COVERAGE FORM The following statement shall be attached to, and made a part of, the policy: This will acknowledge that the Insured is aware that up to 50% of legal defense costs that are incurred shall be applied against the deductible and, in such event, that the insurer shall be liable for legal defense costs exceeding that amount or percentage. SIGNATURE OF INSURED DATE Authorized Representative NY-Reg Stam-NY-032-07 Includes copyrighted material of Insurance Services Office, Inc., Page I of 1 (09-08) with its permission U. S. Specialty Insurance Company 13403 Northwest Freeway Houston, Texas 77040 BUSINESS AUTO COVERAGE FORM DECLARATIONS — NEW YORK ITEM ONE NAMED INSURED: Town of Southold BROKER/AGENT: Corieri &Associates MAILING ADDRESS: 53095 Route 25 MAILING ADDRESS: 1527 Franklin Avenue Southold, NY 11971 Mineola, NY 11501 POLICY PERIOD: FROM: 1/11/2012 TO: 1/11/2013 At 12:01 A.M.Standard Time at your mailing address. Form of Business X Municipality Special District Other ITEM TWO SCHEDULE OF COVERAGES AND COVERED AUTOS This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the COVERED AUTO Section of the Business Auto Covera e Form next to the name of the coverage. COVERED AUTOS LIMIT (Entry of one or more of the COVERAGES symbols from the THE MOST WE WILL PAY FOR ANY ONE PREMIUM COVERED AUTOS Section of ACCIDENT OR LOSS the Business Auto Coverage Forrn shows which autos are covered autos) LIABILITY with SUPPLEMENTAL 1 $ 1,000,000 Combined Single Limit Included SPOUSAL LIABILITY INSURANCE* PERSONAL INJURY PROTECTION 5 $50,000 Included OPTIONAL BASIC ECONOMIC LOSS $25,000 ADDED PERSONAL INJURY PROTECTION 5 $100,000 Included AGGREGATE NO-FAULT BENEFITS $175,000 MAXI M U M M 0 NTH LY WO RK LOSS OTHER NECESSARY EXPENSES(parday) DEATH BENEFIT AUTO MEDICAL PAYMENTS 2 $ 10,000 Included UNINSURED MOTORISTS $ NEWYORK SUPPLEMENTARY 6 $1,000,000 Included UNINSURED/UNDERINSURED MOTORISTS ENDORSEMENT— PHYSICAL DAMAGE ACTUAL CASH VALUE OR COST OF REPAIR, COMPREHENSIVE COVERAGE WHICHEVER IS LESS MINUS $ Ded. FOR EACH COVERED AUTO. See ITEM FOUR for hired or borrowed"autos". PHYSICAL DAMAGE ACTUAL CASH VALUE OR COST OF REPAIR, SPECIFIED CAUSES OF LOSS WHICHEVER IS LESS MINUS $ COVERAGE Ded. FOR EACH COVERED AUTO. See ITEM FOUR for hired or borrowed"autos". PHYSICAL DAMAGE ACTUAL CASH VALUE OR COST OF REPAIR, COLLISION COVERAGE WHICHEVER IS LESS MINUS $ Ded. FOR EACH COVERED AUTO. See ITEM FOUR for hired or borrowed"autos". PHYSICAL DAMAGE TOWING AND $50 for each disablement of a private Included LABOR(Not Available in California) passenger"auto" Motor Vehicle Law Enforcement Fee Included You must specifically request Supplemental Spousal Liability Coverage. See NYSSL 1. ** Supplementary Uninsured/Underinsured Motorists. The maximum amount payable under SUM coverage shall be the policy's SUM limits reduced and thus offset by a motor vehicle bodily injury liability policy or bond payments received from, or on behalf of, any negligent party involved in the account,as specified in the SUM endorsement. Premium Motor Vehicle Law Enforcement Fee Premium for Endorsements Total Premium PKGCANY0007 08/07 Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1990 U.S. SPECIALTY INSURANCE COMPANY BUSINESS AUTO COVERAGE FORM DECLARATIONS(Continued) ENDORSEMENTS ATTACHED TO THIS COVERAGE FORM: See Form PKGIL0002 2006 ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN DESCRIPTION VEHICLE IDENTIFICATION TERRITORY Year Model,Trade Name NUMBER(VIN) Town&State where principally garaged Per schedule on file Wth company ITEM FOUR SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS LIABILITY COVERAGE—RATING BASIS,COST OF HIRE STATE ESTIMATED COST OF HIRE RATE PER EACH $100 FACTOR(if Liability PREMIUM FOR EACH STATE COST OF HIRE Coverage is primary) NY Included Included Included Included TOTAL PREMIUM $ Included Cost of hire means the total amount you incur for the hire of"autos"you don't own(not including"autos"you borrow or rent from your partners or mployees or their family members). Cost of hire does not include charges for services performed by motor carriers of property or passengers. PHYSICAL DAMAGE ESTIMATED RATE PER LIMIT OF INSURANCE ANNUAL EACH$100 COVERAGES THE MOST WE WILL PAY COST OF ANNUAL PREMIUM DEDUCTIBLE HIRE COST OF HIRE ACTUAL CASH VALUE,COST OF REPAIRS OR COMPREHENSIVE $ WHICHEVER IS LESS MINUS $ Ded. FOR EACH COVERED AUTO. ACTUAL CASH VALUE,COST OF REPAIRS OR SPECIFIED CAUSES $ WHICHEVER IS LESS MINUS OFLOSS $ Ded. FOR EACH COVERED AUTO. ACTUAL CASH VALUE,COST OF REPAIRS OR COLLISION $ WHICHEVER IS LESS MINUS $ Ded. FOR EACH COVERED AUTO. TOTAL PREMIUM ITEM FIVE SCHEDULE FOR NON-OWNERSHIP LIABILITY Named Insured's Business Rating Basis Number Premium Other than a Number of Employees 309 Included Social Service Agency Number of Partners Social Service Agency Number of Employees Number of Volunteers Total Premium 1 $ Includ PKGCANY0007 08/07 Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1990 POLICY NUMBER: COMMERCIAL AUTO CA 01 02 04 98 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK CHANGES - FOR HIRE AUTOS For a covered "auto" subject to the provisions of Section 370 (a) and (b) of the New York Vehicles and Traffic Laws that is licensed or principally garaged in New York, this endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. The following is added to Paragraph C. Limit Of caused by any one"accident"; Insurance of Section 11 —Liability Coverage: b. $50,000 for "bodily injury" to two or more 1. If the insurance provided by this policy covers persons caused by any one"accident"; and "autos" subject to the provisions of Sections 370 c. $10,000 for "property damage" caused by any (a) and (b) of the New York Vehicles and Traffic one"accident". Laws, we will apply the limit shown in the 2. Our minimum liability for damages for an incident Declarations to first provide the separate limits to death or injuries to persons is based upon the required by the New York Motor Vehicle Safety seating capacity for passengers of the covered Responsibility Act as follows: "auto"described as set forth in the following table: a. $25,000 for"bodily injury"to anyone person Seating capacity of For a judgment or For a judgment or For a judgment or For a judgment or motor vehicle. judgments for judgments for judgments for judgments for damages, including damages, including damages because of damages because of damages for care damages for care death of any one death of two or more and loss of services, and loss of services person in anyone persons in any one because of"bodily because of"bodily "accident". "accident", upon injury"to anyone injury"to two or claims arising out of person in anyone more persons in any the same "accident". one accident, upon transactions claims arising out of connected with the the same same subject of transactions actions to be connected with the apportioned ratably same subject of among the judgment action, to be creditors according apportioned ratably to the amount of among the judgment their respective creditors according judgments. to the amount of their prospective 1 to 7 $25,000 $50,000 $50,000 $100,000 8 to 12 $25,000 $80,000 $50,000 $150,000 13 to 20 $25,000 $120,000 $50,000 $150,000 21 to 30 $25,000 $160,000 $50,000 $200,000 over 30 $25,000 $200,000 $50,000 $250,000 CA 01 02 04 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1 COMMERCIAL AUTO CA 02 25 03 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK CHANGES - CANCELLATION For a covered "auto" licensed or principally garaged in, or for "garage operations" conducted in, New York, this endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE 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 modi- fied by the endorsement. 1. If you are an individual and a covered "auto" you a. Nonpayment of premium, provided, own is predominantly used for non-business pur- however, that a notice of cancellation on poses, the Cancellation Common Policy Condi- this ground shall inform the first Named tion does not apply. The following Condition ap- Insured of the amount due. If we cancel plies instead: for this reason we will mail you at least ENDING THIS POLICY 15 days notice. Payment of premium will be considered on time if made within 15 A. Cancellation days after we mail you notice of cancel- 1. You may cancel the entire policy by return- lation. ing it to us or by giving us advance notice of b. Your driver's license or that of a driver the date cancellation is to take effect. who lives with you or customarily uses 2. When this policy is in effect less than 60 the covered "auto" has been suspended days and is not a renewal or continuation or revoked during the policy period, oth- policy, we may cancel the entire policy for er than a suspension issued pursuant to any reason provided we mail you notice subdivision (1) of Section 510(b) of the within this period. If we cancel for nonpay- Vehicle and Traffic Law, or one or more ment of premium, we will mail you at least administrative suspensions arising out 15 days notice and such notice of cancella- of the same incident which has or have tion on this ground shall inform the first been terminated prior to the effective Named Insured of the amount due. Pay- date of cancellation. If we cancel for this ment of premium will be considered on time reason we will mail you at least 20 days if made within 15 days after we mail you no- notice. tice of cancellation. If we cancel for any c. We replace this policy with another one other reason, we will mail you at least 20 providing similar coverages and the days notice. same limits for a covered "auto" of the 3. When this policy is in effect 60 days or private passenger type. The replace- more or is a renewal or continuation policy, ment policy will take effect when this we may cancel it or any insurance deemed policy is cancelled, and will end a year severable only for one or more of the fol- after this policy begins or on this policy's lowing reasons: expiration date, whichever is earlier. CA 02 25 03 06 C) ISO Properties, Inc., 2005 Page 1 of 4 13 d. This policy has been written for a period 3. We do not have to mail notice of non- of more than one year or without a fixed renewal if you, your agent or broker or an- expiration date. We may cancel for this other insurance company informs us in writ- reason, subject to New York Laws, only ing that you have replaced this policy or at an anniversary of its original effective that you no longer want it. date. If we cancel for this reason we will C. Mailing Of Notices mail you at least 45 but not more than 60 days notice. We will mail or deliver our notice of cancella- e. This policy was obtained through fraud tion, reduction of limits, elimination of coverage or material misrepresentation. If we or nonrenewal to the address shown on the cancel for this reason, we will mail you policy. However, we may deliver any notice in- at least 20 days notice. stead of mailing it. If notice is mailed, a United States Postal Service certificate of mailing will f. Any "insured" made a fraudulent claim. be sufficient proof of notice. If we cancel for this reason, we will mail 11. For all policies other than those specified in Sec- you at least 20 days notice. tion I., the Cancellation Common Policy Condition If one of the reasons listed in this Para- is completely replaced by the following: graph 3. exists, we may cancel the entire ENDING THIS POLICY policy. A. Cancellation 4. Instead of cancellation, we may condition continuation of this policy on a reduction of 1. The first Named Insured shown in the Dec- Liability Coverage or elimination of any oth- larations may cancel the entire policy by re- er coverage. If we do this we will mail you turning it to us or by giving us advance no- notice at least 20 days before the date of tice of the date cancellation is to take effect. the change. 2. When this policy is in effect 60 days or less 5. Notice of cancellation will state the effective and is not a renewal or continuation policy, date of cancellation. The policy period will we may cancel the entire policy by mailing end on that date. to the first Named Insured at least: 6. If this policy is cancelled, we will send you a. 20 days notice if we cancel for any rea- any premium refund due. The refund will be son not included in Paragraph b. below. pro rata. b. 15 days notice if we cancel for any of However, when the premium is advanced the following reasons: under a premium finance agreement, we (1) Nonpayment of premium, provided, will be entitled to retain a minimum earned however, that a notice of cancellation premium of 10% of the total policy premium on this ground shall inform the first or $60, whichever is greater. The cancella- Named Insured of the amount due; tion will be effective even if we have not (2) Conviction of a crime arising out of made or offered a refund. acts increasing the hazard insured B. Nonrenewal against; 1. If this policy is written for a period of less (3) Discovery of fraud or material mis- than one year and we decide, subject to representation in the obtaining of the New York Laws, not to renew or continue it, policy or in the presentation of a or to condition renewal or continuation on a claim thereunder; reduction of Liability Coverage or elimina- (4) After issuance of the policy or after tion of any other coverage, we will mail or the last renewal date, discovery of deliver to you written notice at least 45 but an act or omission, or a violation of not more than 60 days before the end of the any policy condition, that substantial- policy period. ly and materially increases the haz- 2. We will have the right not to renew or con- ard insured against, and which oc- tinue a particular coverage, subject to New curred subsequent to inception of the York Laws, only at the end of each 12 current policy period; month period following the effective date of the first of the successive policy periods in which the coverage was provided. Page 2 of 4 C) ISO Properties, Inc., 2005 CA 02 25 03 06 13 (5) Material physical change in the 3. When this policy is in effect more than 60 property insured, occurring after is- days or is a renewal or continuation policy, suance or last annual renewal anni- we may cancel only for any of the reasons versary date of the policy, which re- listed in Paragraph 2.b. above, provided: sults in the property becoming unin- a. We mail the first Named Insured written surable in accordance with our ob- notice at least 15 days before the effec- jective, uniformly applied underwrit- tive date of cancellation; and ing standards in effect at the time the policy was issued or last renewed; or b. If we cancel for nonpayment of premi- material change in the nature or ex- um, our notice of cancellation informs tent of the risk, occurring after issu- the first Named Insured of the amount ance or last annual renewal anniver- due. sary date of the policy, which causes 4. Regardless of the number of days this the risk of loss to be substantially policy has been in effect, if: and materially increased beyond that a. This policy covers "autos" subject to the contemplated at the time the policy provisions of Section 370 (a) and (b) of was issued or last renewed; the New York Vehicles and Traffic Laws; (6) Required pursuant to a determina- and tion by the Superintendent that con- b. The Commissioner of the Department of tinuation of our present premium Motor Vehicles deems this policy to be volume would jeopardize our solven- insufficient for any reason, cy or be hazardous to the interest of our policyholders, our creditors or we may cancel this policy by giving you no- the public; tice of such insufficiency 45 days before the (7) A determination by the Superinten- effective date of cancellation to permit you dent that the continuation of the poli- to replace this policy. cy would violate, or would place us in 5. If this policy is cancelled, we will send the violation of, any provision of the In- first Named Insured any premium refund surance Code; due. The refund will be pro rata. (8) Where we have reason to believe, in However, when the premium is advanced good faith and with sufficient cause, under a premium finance agreement, we that there is a probable risk of dan- will be entitled to retain a minimum earned ger that the "insured" will destroy, or premium of 10% of the total policy premium permit to be destroyed, the insured or $60, whichever is greater. The cancella- property for the purpose of collecting tion will be effective even if we have not the insurance proceeds. However, if made or offered a refund. we cancel for this reason, the first 6. The effective date of cancellation stated in Named Insured may make a written the notice shall become the end of the poli- request to the Insurance Depart- cy period. ment, within 10 days of receipt of this 7. Notice will include the reason for cancella- notice, to review our cancellation de- tion. We will mail or deliver our notice to the cision. We will also send a copy of first Named Insured at the address shown this notice, simultaneously, to the In- in the policy and to the authorized agent or surance Department; or broker. However, we may deliver any notice (9) Suspension or revocation during the instead of mailing it. Proof of mailing will be required policy period of the driver's sufficient proof of notice. license of any person who continues B. Nonrenewal And Conditional Renewal to operate a covered "auto", other than a suspension issued pursuant 1. If we decide not to renew or continue this to subdivision one of Section 510b of policy we will send notice as provided in the Vehicle and Traffic Law or one or Paragraph 3. below. more administrative suspensions 2. If we condition renewal of this policy upon: arising from the same incident which a. Change of limits; has or have been terminated prior to the effective date of cancellation. b. Change in type of coverage; c. Reduction of coverage; d. Increased deductible; CA 02 25 03 06 C) ISO Properties, Inc., 2005 Page 3 of 4 13 e. Addition of exclusion; b. On or after the expiration date of this f. Increased premiums in excess of 10%, policy, coverage will remain in effect at exclusive of any premium increase due the same terms and conditions of this to and commensurate with insured value policy for another policy period, at the added; or as a result of experience rat- lower of the current rates or the prior ing, retrospective rating or audit; period's rates, unless the first Named Insured, during this additional policy pe- we will send notice as provided in Para- riod, has replaced the coverage or graph 3. below. elects to cancel. 3. If we decide not to renew or continue this 8. If you elect to renew on the basis of a late policy, or to conditionally renew this policy conditional renewal notice, the terms, con- as provided in Paragraphs 1. and 2. above, ditions and rates set forth in such notice we will mail the first Named Insured notice shall apply: at least 60 but not more than 120 days be- a. Upon expiration of the 60 day period; or fore the end of the policy period. If the poli- cy period is other than one year, we will b. Notwithstanding the provisions in Para- have the right not to renew or continue it graphs 7.a. and 7.b. as of the renewal only at an anniversary of its original effec- date of the policy if we send the first tive date. Named Insured the conditional renewal 4. We will not send you notice of nonrenewal notice at least 30 days prior to the expi- or conditional renewal if you, your author- ration or anniversary date of the policy. ized agent or broker or another insurer of C. Paragraph C.1. Aggregate Limit Of Insur- yours mails or delivers notice that you have ance — Garage Operations — Other Than replaced this policy or no longer want it. Covered "Autos" is amended as follows: 5. Any notice of nonrenewal or conditional 1. The Aggregate Limit Of Insurance — "Gar- renewal will be mailed to the first Named age Operations" — Other Than Covered Insured at the address shown in the policy "Autos" as shown in the Declarations will be and to the authorized agent or broker. increased in proportion to any policy exten- However, we may deliver any notice in- sion provided in accordance with Section 11, stead of mailing it. Proof of mailing of any Paragraph B.7. above. notice shall be sufficient proof of notice. 2. The last sentence of Aggregate Limits — 6. Notice will include the specific reason(s) for "Garage Operations"—Other Than Covered nonrenewal or conditional renewal, includ- "Autos" does not apply when the policy pe- ing the amount of any premium increase, riod is extended because we sent the first and description of any other changes. Named Insured an incomplete or late condi- 7. If we violate any of the provisions of Para- tional renewal notice or a late nonrenewal graph 3., 5. or 6. above by sending the first notice. Named Insured an incomplete or late condi- tional renewal notice or a late nonrenewal notice: a. Coverage will remain in effect at the same terms and conditions of this policy at the lower of the current rates or the prior period's rates until 60 days after such notice is mailed or delivered, un- less the first Named Insured, during this 60 day period, has replaced the cover- age or elects to cancel. Page 4 of 4 C) ISO Properties, Inc., 2005 CA 02 25 03 06 13 COMMERCIAL AUTO CA 22 32 07 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK MANDATORY PERSONAL INJURY PROTECTION ENDORSEMENT The Company agrees with the named insured, as follows: Section I (a) Medical, hospital (including services rendered Mandatory Personal Injury Protection in compliance with article 41 of the Public The Company will pay first-party benefits to reimburse Health Law, whether or not such services are for basic economic loss sustained by an eligible in- rendered directly by a hospital), surgical, nurs- jured person on account of personal injuries caused ing, dental, ambulance, X-ray, prescription drug by an accident arising out of the use or operation of a and prosthetic services; motor vehicle or a motorcycle during the policy period (b) Psychiatric, physical and occupational therapy and within the United States of America, its territories and rehabilitation; or possessions, or Canada. (c) Any nonmedical remedial care and treatment First-Party Benefits rendered in accordance with a religious method First-party benefits, other than death benefits, are of healing recognized by the laws of New York; payments equal to basic economic loss, reduced by and the following: (d) Any other professional health services. (a) 20 percent of the eligible injured person's loss These medical expenses will not be subject to a time of earnings from work to the extent that an eli- limitation, provided that, within one year after the date gible injured person's basic economic loss con- of the accident, it is ascertainable that further medical sists of such loss of earnings; expenses may be sustained as a result of the injury. (b) Amounts recovered or recoverable on account Payments hereunder for necessary medical expenses of personal injury to an eligible injured person shall be subject to the limitations and requirements of under State or Federal laws providing social section 5108 of the New York Insurance Law. security disability or workers' compensation Work Loss benefits, or disability benefits under article nine Work loss shall consist of the sum of the following of the New York Workers' Compensation Law; losses and expenses, up to a maximum payment of (c) The amount of any applicable deductible, pro- $2,000 per month for a maximum period of three vided that such deductible shall apply to each years from the date of the accident: accident, but only to the total of first-party bene- (a) Loss of earnings from work which the eligible fits otherwise payable to the named insured inj.ured person would have performed had such and any relative as a result of that accident. person not been injured, except that an em- Basic Economic Loss ployee who is entitled to receive monetary Basic economic loss shall consist of medical expense, payments, pursuant to statute or contract with work loss, other expense and, when death occurs, a the employer, or who receives voluntary mone- death benefit as herein provided. Except for such tary benefits paid for by the employer, by rea- death benefit, basic economic loss shall not include son of such employee's inability to work be- any loss sustained on account of death. Basic eco- cause of personal injury arising out of the use nomic loss of each eligible injured person on account or operation of a motor vehicle or a motorcycle, of any single accident shall not exceed $50,000, ex- shall not be entitled to receive first-party bene- cept that any death benefit hereunder shall be in addi- fits for loss of earnings from work to the extent tion thereto. that such monetary payments or benefits from the employer do not result in the employee suf- Medical Expense fering a reduction in income or a reduction in Medical expense shall consist of necessary expenses such employee's level of future benefits arising for: from a subsequent illness or injury; and CA 22 32 07 02 @ ISO Properties, Inc., 2002 Page 1 of 5 (b) Reasonable and necessary expenses sus- (c) The named insured or relative while occupying, tained by the eligible injured person in obtaining or while a pedestrian through being struck by, a services in lieu of those which such person motor vehicle in New York State, other than the would have performed for income. insured motor vehicle, with respect to which the Other Expenses coverage required by the New York Compre- hensive Motor Vehicle Insurance Reparations Other expenses shall consist of all reasonable and Act is in effect; however, this exclusion does necessary expenses, other than medical expense and not apply to personal injury sustained in New work loss, up to $25 per day for a period of one year York State by the named insured or relative from the date of the accident causing injury. while occupying a bus or school bus, as de- Death Benefit fined in sections 104 and 142 of the New York Upon the death of any eligible injured person, caused Vehicle and Traffic Law, unless that person is by an accident to which this coverage applies, the the operator, an owner, or an employee of the Company will pay to the estate of such person a death owner or operator, of such bus or school bus; benefit of$2,000. (d) Any person in New York State while occupying Eligible Injured Person the insured motor vehicle which is a bus or school bus, as defined in sections 104 and 142 Subject to the exclusions and conditions set forth of the New York Vehicle and Traffic Law, but below, an eligible injured person is: only if such person is a named insured or rela- (a) The named insured and any relative who sus- tive under any other policy providing the cover- tains personal injury arising out of the use or age required by the New York Comprehensive operation of any motor vehicle; Motor Vehicle Insurance Reparations Act; how- (b) The named insured and any relative who sus- ever, this exclusion does not apply to the oper- tains personal injury arising out of the use or ator, an owner, or an employee of the owner or operation of any motorcycle, while not occupy- operator, of such bus or school bus; ing a motorcycle; (e) Any person while occupying a motorcycle; (c) Any other person who sustains personal injury (f) Any person who intentionally causes his or her arising out of the use or operation of the in- own personal injury; sured motor vehicle in the State of New York (g) Any person as a result of operating a motor while not occupying another motor vehicle; or vehicle while in an intoxicated condition or while (d) Any New York State resident who sustains his ability to operate such vehicle is impaired by personal injury arising out of the use or opera- the use of a drug (within the meaning of section tion of the insured motor vehicle outside of New 1192 of the New York Vehicle and Traffic Law); York State while not occupying another motor or vehicle. (h) Any person while: Exclusions (1) Committing an act which would constitute a This coverage does not apply to personal injury sus- felony, or seeking to avoid lawful apprehen- tained by: sion or arrest by a law enforcement officer; (a) The named insured while occupying, or while a (11) Operating a motor vehicle in a race or pedestrian through being struck by, any motor speed test; vehicle owned by the named insured with re- (111) Operating or occupying a motor vehicle spect to which the coverage required by the known to that person to be stolen; or New York Comprehensive Motor Vehicle Insur- (lv) Repairing, servicing or otherwise maintain- ance Reparations Act is not in effect; ing a motor vehicle if such conduct is within (b) Any relative while occupying, or while a pedes- the course of a business of repairing, ser- trian through being struck by, any motor vehicle vicing or otherwise maintaining a motor ve- owned by the relative with respect to which the hicle and the injury occurs on the business coverage required by the New York Compre- premises. hensive Motor Vehicle Insurance Reparations (1) The named insured or relative while not occu- Act is not in effect; pying a motor vehicle or a motorcycle when struck by a motorcycle in New York State with respect to which the coverage required by the New York Comprehensive Motor Vehicle Insur- ance Reparations Act is in effect; Page 2 of 5 @ ISO Properties, Inc., 2002 CA 22 32 07 02 (j) Any New York State resident, other than the (d) "Named insured" means the person or organi- named insured or relative injured through the zation named in the declarations; use or operation of the insured motor vehicle (e) "Occupying" means in or upon or entering into outside of New York State if such resident is or alighting from; the owner or a relative of the owner of a motor vehicle insured under another policy providing (f) "Personal injury" means bodily injury, sickness the coverage required by the New York Com- or disease; prehensive Motor Vehicle Insurance Repara- (g) "Relative" means a spouse, child, or other tions Act; person related to the named insured by blood, (k) Any New York State resident, other than the marriage, or adoption (including a ward or fos- named insured or relative injured through the ter child), who regularly resides in the insured's use or operation of the insured motor vehicle household, including any such person who reg- outside of New York State, if such resident is ularly resides in the household, but is temporar- the owner of a motor vehicle for which the cov- ily living elsewhere; and erage required by the New York Comprehen- (h) "Use or operation" of a motor vehicle or a mo- sive Motor Vehicle Insurance Reparations Act torcycle includes the loading or unloading of is not in effect. such vehicle. Other Definitions Conditions When used in reference to this coverage: Action Against Company. No action shall lie against (a) The "insured motor vehicle" means a motor the Company unless, as a condition precedent there- vehicle owned by the named insured and to to, there shall have been full compliance with the which the bodily injury liability insurance of this terms of this coverage. policy applies and for which a specific premium Notice. In the event of an accident, written notice is charged; setting forth details sufficient to identify the eligible (b) "Motorcycle" means a vehicle as defined in injured person, along with reasonably obtainable in- section 123 of the New York Vehicle and Traffic formation regarding the time, place and circurnstanc- Law and which is required to carry financial se- es of the accident, shall be given by, or on behalf of, curity pursuant to article 6, 8 or 48-A of the Ve- each eligible injured person, to the Company, or any hicle and Traffic Law; of the Company's authorized agents, as soon as rea- sonably practicable, but in no event more than 30 (c) "Motor vehicle" means a motor vehicle, as days after the date of the accident, unless the eligible defined in section 311 of the New York Vehicle injured person submits written proof providing clear and Traffic Law, and also includes fire and po- and reasonable justification for the failure to comply lice vehicles, but shall not include any motor with such time limitation . If an eligible injured person vehicle not required to carry financial security or that person's legal representative institutes a pro- pursuant to article 6, 8 or 48-A of the Vehicle ceeding to recover damages for personal injury under and Traffic Law, or a motorcycle as defined section 5104(b) of the New York Insurance Law, a above; copy of the summons and complaint or other process served in connection with such action shall be for- warded as soon as practicable to the Company or any of the Company's authorized agents by such eligible injured person or that person's legal representative. CA 22 32 07 02 @ ISO Properties, Inc., 2002 Page 3 of 5 Proof of Claim; Medical, Work Loss, and Other Reimbursement and Trust Agreement. To the ex- Necessary Expenses. In the case of a claim for tent that the Company pays first-party benefits, the health service expenses, the eligible injured person or Company is entitled to the proceeds of any settlement that person's assignee or representative shall submit or judgment resulting from the exercise of any right of written proof of claim to the Company, including full recovery for damages for personal injury under sec- particulars of the nature and extent of the injuries and tion 5104(b) of the New York Insurance Law. The treatment received and contemplated, as soon as Company shall have a lien upon any such settlement reasonably practicable but, in no event later than 45 or judgment to the extent that the Company has paid days after the date services are rendered. The eligible first-party benefits. An eligible injured person shall: injured person or that person's representative shall (a) Hold in trust, for the Company, all rights of submit written proof of claim for work loss benefits recovery which that person shall have for per- and for other necessary expenses to the Company as sonal injury under section 5104(b) of the New soon as reasonably practicable but, in no event, later York Insurance Law; than 90 days after the work loss is incurred or the other necessary services are rendered. The foregoing (b) Do whatever is proper to secure, and shall do time limitations for the submission of proof of claim nothing to prejudice, such rights; and shall apply unless the eligible injured person or that (c) Execute, and deliver to the Company, instru- person's representative submits written proof provid- ments and papers as may be appropriate to ing clear and reasonable justification for the failure to secure the rights and obligations of such per- comply with such time limitation. Upon request by the son and the Company established by this pro- Company, the eligible injured person or that person's vision. assignee or representative shall: An eligible injured person shall not compromise an (a) Execute a written proof of claim under oath; action to recover damages brought under section (b) As may reasonably be required submit to ex- 5104(b) of the New York Insurance Law, except: aminations under oath by any person named by (a) With the written consent of the Company; the Company and subscribe the same; (b) With approval of the court; or (c) Provide authorization that will enable the Com- (c) Where the amount of the settlement exceeds pany to obtain medical records; and $50,000. (d) Provide any other pertinent information that Other Coverage. Where more than one source of may assist the Company in determining the first-party benefits required by article 51 of the New amount due and payable. York Insurance Law and article 6 or 8 of the New York The eligible injured person shall submit to medical Vehicle and Traffic Law is available and applicable to examination by physicians selected by, or acceptable an eligible injured person in any one accident, this to, the Company, when, and as often as, the Compa- Company is liable to an eligible injured person only for ny may reasonably require. an amount equal to the maximum amount that the Arbitration. In the event any person making a claim eligible injured person is entitled to recover under this for first-party benefits and the Company do not agree coverage, divided by the number of available and regarding any matter relating to the claim, such per- applicable sources of required first-party benefits. An son shall have the option of submitting such disa- eligible injured person shall not recover duplicate greement to arbitration pursuant to procedures prom- benefits for the same elements of loss under this ulgated or approved by the Superintendent of Insur- coverage or any other mandatory first-party motor ance. vehicle or no-fault motor vehicle insurance coverage issued in compliance with the laws of another state. Page 4 of 5 @ ISO Properties, Inc., 2002 CA 22 32 07 02 If the eligible injured person is entitled to benefits Section 11 under any such mandatory first-party motor vehicle or Excess Coverage no-fault motor vehicle insurance for the same ele- If motor vehicle medical payments coverage or any ments of loss under this coverage, this Company shall disability coverages or uninsured motorists coverage be liable only for an amount equal to the proportion are afforded under this policy, such coverages shall that the total amount available under this coverage be excess insurance over any Mandatory PIP, OBEL bears to the surn of the amount available under this or Additional PIP benefits paid or payable or which coverage and the amount available under such other would be paid or payable but for the application of a mandatory insurance for the common elements of deductible under this or any other motor vehicle No- loss. However, where another state's mandatory first- Fault insurance policy. party or no-fault motor vehicle insurance law provides unlimited coverage available to an eligible injured Section III person for an element of loss under this coverage, the obligation of this Company is to share equally for that Constitutionality element of loss with such other mandatory insurance If it is conclusively determined by a court of competent until the $50,000, or $75,000 if Optional Basic Eco- jurisdiction that the New York Comprehensive Motor nomic Loss (OBEL) coverage is purchased, limit of Vehicle Insurance Reparations Act, or any amend- this coverage is exhausted by the payment of that ment thereto, is invalid or unenforceable in whole or in element of loss and any other elements of loss. part, then, subject to the approval of the Superinten- dent of Insurance, the Company may amend this policy and may also recompute the premium for the existing or amended policy. These amendments and recomputations will be effec- tive retroactively to the date that such act or any amendment is deemed to be invalid or unenforceable in whole or in part. CA 22 32 07 02 @ ISO Properties, Inc., 2002 Page 5 of 5 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK OPTIONAL BASIC ECONOMIC LOSS COVERAGE The company agrees with the named insured, subject to all of the provisions, exclusions and conditions of the New York Mandatory Personal Injury Protection (PIP) Endorsement or the New York Mandatory Personal Injury Protection Endorsement - Motorcycles, not expressly modified in this endorsement, as follows: The definition of Basic Economic Loss contained in the (2) To personal injury sustained in New York State New York Mandatory Personal Injury Protection by the named insured or relative while Endorsement or the New York Mandatory Personal occupying a bus or school bus, as defined in Injury Protection Endorsement - Motorcycles is sections 104 and 142 of the New York Vehicle replaced by the following: and Traffic Law, unless that person is the Basic Economic Loss operator, an owner, or an employee of the Basic economic loss shall consist of medical expense, owner or operator, of such bus or school bus. work loss, other expense and, when death occurs, a ELECTION death benefit as herein provided. Except for such death Election of the OBEL option shall be made by the benefit, basic economic loss shall not include any loss eligible injured person or that person's legal sustained on account of death. Basic economic loss of representative after such person has incurred expense each eligible injured person on account of any single aggregating $30,000 in basic economic loss and after accident shall not exceed $75,000, the last $25,000 of receiving the required notices from the company that which represents optional basic economic loss (OBEL) an OBEL election may be made. Failure of the eligible coverage, payable after the first $50,000 of basic injured person or that person's legal representative to economic loss has been exhausted, that the eligible respond to the second notice within 15 calendar days injured person or that person's legal representative after its mailing shall be considered an election by the may specify will be applied to one of the following four eligible injured person to apply OBEL coverage to all options: elements of basic economic loss. Once made by the (1) Basic economic loss; eligible injured person or that person's legal (2) Loss of earnings from work; representative, an OBEL election cannot be changed. However, if claims payable under OBEL coverage have (3) Psychiatric, physical or occupational therapy not yet been received by the company, an eligible and rehabilitation; injured person who has failed to respond to the second (4) A combination of options (2) and (3). notice in a timely manner may make an election. Any death benefit hereunder shall be in addition NOTICE thereto. If OBEL coverage is payable under this policy, but Exclusion (c) set forth in the New York Mandatory Mandatory PIP is being paid under a policy covering Personal Injury Protection Endorsement is replaced by another motor vehicle, then the named insured or the following: relative shall notify the company no later than 90 days (c) The named insured, or any relative while occupying after Mandatory PIP benefits under that other policy or while a pedestrian through being struck by, a have been exhausted. The company shall then send its motor vehicle in New York State, other than the OBEL election notice. insured motor vehicle, with respect to which the coverage required by the New York Comprehensive Motor Vehicle Reparations Act is in effect, however, this exclusion does not apply to: (1) The Optional Basic Economic Loss coverage provided under this endorsement, unless OBEL coverage is provided by the policy covering the other motor vehicle; or CA 22 60 04 92 0 COMMERCIAL AUTO CA 31 07 11 98 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK SUPPLEMENTARY UNINSURED/UNDERINSURED MOTORISTS ENDORSEMENT We, the company, agree with you, as the named insured, in return for payment of the premium for this coverage, to provide Supplementary Uninsured/Underinsured Motorists (SUM) coverage, subject to the following terms and conditions: INSURING AGREEMENTS (2) Neither owner nor driver can be 1 Definitions identified (including a hit-and-run For purposes of this SUM endorsement, the vehicle), and which causes bodily injury following terms have the following meanings. to an insured by physical contact with the insured or with a motor vehicle a. Insured occupied by the insured at the time of The unqualified term "insured" means: the accident, provided that: (1) You, as the named insured and, while (a) The insured or someone on the residents of the same household, your insured's behalf shall have reported spouse and the relatives of either you or the accident within 24 hours or as yourspouse; soon as reasonably possible to a (2) Any other person while occupying: police, peace or judicial officer or to the Commissioner of Motor Vehicles (a) A motor vehicle insured for SUM and shall have filed with the underthis policy; or Company a statement under oath (b) Any other motor vehicle while being that the insured or the insured's operated by you or your spouse; and legal representative has a cause or (3) Any person, with respect to damages causes of action arising out of such such person is entitled to recover, accident for damages against a because of bodily injury to which this person or persons whose identity is coverage applies sustained by an unascertainable, and setting forth insured under Paragraph (1) or (2) the facts in support thereof; and above. (b) At the request of the Company, the b. Bodily Injury insured or the insured's legal The term "bodily injury" means bodily harm, representative makes available for including sickness, disease or death resulting inspection the automobile the therefrom. insured was occupying at the time of the accident; or c. Uninsured Motor Vehicle (3) There is a bodily injury liability insurance The term "uninsured motor vehicle" means a coverage or bond applicable to such motor vehicle that, through its ownership, motor vehicle at the time of the accident, maintenance or use, results in bodily injury to b ut: an insured, and for which: (a) The amount of such insurance (1) No bodily injury liability insurance policy coverage or bond is less than the or bond applies to such vehicle third-party bodily injury liability limit (including a vehicle that was stolen, of this policy; or operated without the owner's permission, (b) The amount of such insurance or unregistered) at the time of the coverage or bond has been reduced, accident; or by payments to other persons injured in the accident, to an amount less than the third-party bodily injury liability limit of this policy; or CA 31 07 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 4 0 (c) The insurer writing such insurance 3. SUM Coverage Period And Territory coverage or bond denies coverage, This SUM coverage applies only to accidents that or such insurer is or becomes occur: insolvent. a. During the policy period shown in the The term "uninsured motor vehicle" does not Declarations; and include a motor vehicle that is: b. In the United States, its territories or (1) Insured under the liability coverage of possessions, or Canada. this policy; or EXCLUSIONS (2) Owned by you, as the named insured, or This SUM coverage does not apply: your spouse residing in your household; or 1. To bodily injury to an insured, including care or (3) Self-insured within the meaning of the loss of services recoverable by an insured, if financial responsibility law of the state in such insured, such insured's legal which the motor vehicle is registered, or representatives, or any person entitled to any similar state or federal law, to the payment under this coverage, without our written extent that the required amount of such consent, settles any lawsuit against any person coverage is equal to, or greater than, the or organization that may be legally liable for such third-party bodily injury liability limits of injury, care or loss of services, but this provision this policy; or shall be subject to Condition 10. (4) Owned by the United States of America, 2. To bodily injury to an insured incurred while Canada, a state, a political subdivision of occupying a motor vehicle owned by that insured, any such government, or an agency of if such motor vehicle is not insured for SUM any of the foregoing; or coverage by the policy under which a claim is made, or is not a newly acquired or replacement (5) A land motor vehicle or trailer, while motor vehicle covered under the terms of this located for use as a residence or policy. premises and not as a vehicle, or while 3. For non-economic loss, resulting from bodily operated on rails or crawler-treads; or inj.ury to an insured and arising from an accident (6) A farm type vehicle or equipment in New York State, unless the insured has designed for use principally off public sustained serious injury as defined in Section roads, except while actually upon public 5102(d) of the New York Insurance Law. roads. CONDITIONS d. Occupying 1. Policy Provisions The term "occupying" means in, upon, None of the Insuring Agreements, Exclusions or entering into, or exiting from a motor vehicle. Conditions of the policy shall apply to this SUM e. State coverage except: "Duties After an Accident or The term "state" includes the District of Loss"; "Fraud"; and "Termination" if applicable. Columbia, a territory or possession of the 2. Notice And Proof Of Claim United States, and a province of Canada. As soon as practicable, the insured or other 2. Damages For Bodily Injury Caused By person making claim shall give us written notice Uninsured Motor Vehicles of claim under this SUM coverage. We will pay all sums that the insured or the As soon as practicable after our written request, insured's legal representative shall be legally the insured or other person making claim shall entitled to recover as damages from the owner or give us written proof of claim, under oath if operator of an uninsured motor vehicle because required, including full particulars of the nature of bodily injury sustained by the insured, caused and extent of the injuries, treatment, and other by an accident arising out of such uninsured details we need to determine the SUM amount motor vehicle's ownership, maintenance or use, payable. subject to the Exclusions, Conditions, Limits and other provisions of this SUM endorsement. Page 2 of 4 Copyright, Insurance Services Office, Inc., 1998 CA 31 07 11 98 0 The insured and every other person making claim 7. Non-Stacking hereunder shall, as may reasonably required, Regardless of the number of vehicles involved, submit to examinations under oath any person persons covered, claims made, vehicles or we name and subscribe the same. Proof of claim premiums shown in this policy, or premium paid, shall be made upon forms furnish unless we fail the limits, whether for uninsured motorists to furnish such forms within 15 days after coverage or supplementary receiving notice of claim uninsured/underinsured motorists coverage, shall 3. Medical Reports never be added together or combined for two or The insured shall submit to physical more vehicles to determine the extent of examinations by physicians we select when and insurance coverage available to an insured as often as we may reasonably require. The injured in the same accident. insured, or in the event of the insured's 8. Priority Of Coverage incapacity, such insured's legal representative (or If an insured is entitled to uninsured motorists in the event of such insured's death, the insured's coverage or supplementary legal representative or the person or persons uninsured/underinsured motorists coverage entitled to sue therefor), shall upon each request under more than one policy, the maximum from us authorize us to obtain relevant medical amount such insured may recover shall not reports and copies of relevant records. exceed the highest limit of such coverage for any 4. Notice Of Legal Action one vehicle under any one policy, and the If the insured or such insured's legal following order of priority shall apply: representative brings any lawsuit against any a. A policy covering a motor vehicle occupied person or organization legally responsible for the by the injured person at the time of the use of a motor vehicle involved in the accident, a accident; copy of the summons and complaint or other b. A policy covering a motor vehicle not process served in connection with the lawsuit involved in the accident under which the shall be forwarded immediately to us by the injured person is a named insured; and insured or the insured's legal representative. c. A policy covering a motor vehicle not 5. SUM Limit involved in the accident under which the The SUM limit payable under this SUM injured person is an insured other than a endorsement shall be: named insured. a. The SUM limit stated in the Declarations; or Coverage available under a lower priority policy b. If the bodily injury results in death, we will applies only to the extent that it exceeds the provide a SUM limit of the higher of the SUM coverage of a higher priority policy. limit stated in the Declarations, or $50,000 9. Exhaustion Required for such bodily injury resulting in death Except as provided in Condition 10, we will pay sustained by one person as the result of any under this SUM coverage only after the limits of one accident and, subject to this per person liability have been used up under all motor limit, $100,000 for such bodily injury resulting vehicle bodily injury liability insurance policies or in death sustained by two or more persons bonds applicable at the time of the accident in as the result of any one accident. regard to any one person who may be legally 6. Maximum SUM Payments liable for the bodily injury sustained by the Regardless of the number of insureds, our insured. maximum payment under this SUM endorsement 10. Release Or Advance shall be the difference between: In accidents involving the insured and one or a. The SUM limit; and more negligent parties, if such insured settles b. The motor vehicle bodily injury liability with any such party for the available limit of the insurance or bond payments received by the motor vehicle bodily injury liability coverage of insured or the insured's legal representative, such party, release may be executed with such from or on behalf of all persons that may be party after thirty calendar days actual written legally liable for the bodily injury sustained by notice to us, unless within this time period we the insured. agree to advance such settlement amounts to the The SUM limit shown on the Declarations is the insured in return for the cooperation of the amount of coverage for all damages due to bodily insured in our lawsuit on behalf of the insured. injury in any one accident. CA 31 07 11 98 Copyright, Insurance Services Office, Inc. 1998 Page 3 of 4 0 We shall have a right to the proceeds of any such Judgment upon the award rendered by the lawsuit equal to the amount advanced to the arbitrator may be entered in any court having insured and any additional amounts paid under jurisdiction thereof, and any such insured and we this SUM coverage. Any excess above those each agree to be bound by any award made by amounts shall be paid to the insured. the arbitrator as to this SUM coverage. For An insured shall not otherwise settle with any purposes of this Condition, the term "insured" negligent party, without our written consent, such includes any person authorized to act on behalf that our rights would be impaired. of the insured. 11. Non-Duplication 13. Subrogation This SUM coverage shall not duplicate any of the If we make a payment under this SUM coverage, following: we have the right to recover the amount of this a. Benefits payable under workers' payment from any person legally responsible for compensation or other similar laws; the bodily injury or loss of the person to whom, or for whose benefit, such payment was made to b. Non-occupational disability benefits under the extent of the payment. The insured or any article nine of the Workers' Compensation person acting on behalf of the insured must do Law or other similar law; whatever is necessary to transfer this right of c. Any amounts recovered or recoverable recovery to us. Except as permitted by Condition pursuant to article fifty-one of the New York 10, such person shall do nothing to prejudice this Insurance Law or any similar motor vehicle right. insurance payable without regard to fault; 14. Payment Of Loss By Company d. Any valid or collectible motor vehicle medical We shall pay any amount due under this SUM payments insurance; or coverage to the insured or, at our option, to a e. Any amounts recovered as bodily injury person authorized by law to receive such damages from sources other than motor payment or to a person legally entitled to recover vehicle bodily injury liability insurance the damages which the payment represents. policies or bonds. 15. Action Against Company 12. Arbitration No lawsuit shall lie against us unless the insured If any insured making claim under this SUM or the insured's legal representative has first fully coverage and we do not agree that such insured complied with all the terms of this SUM coverage. is legally entitled to recover damages from the 16. Survivor Rights owner or operator of an uninsured motor vehicle If you or your spouse, if a resident of the same because of bodily injury sustained by the insured, household, dies, this SUM coverage shall cover: or do not agree as to the amount of payment that may be owing under this SUM coverage, then, at a. The survivor as named insured; the option and upon written demand of such b. The decedent's legal representative as insured, the matter or matters upon which such named insured, but only while acting within insured and we do not agree shall be settled by the scope of such representative's duties as arbitration, administered by the American such; and Arbitration Association, pursuant to procedures c. Any relative who was an insured at the time prescribed or approved by the Superintendent of of such death. Insurance for this purpose. If, however, the maximum amount of SUM coverage provided by this endorsement equals the amount of coverage required to be provided by section 3420(f)(1) of the New York Insurance Law and Article 6 or 8 of the New York Vehicle and Traffic Law, then such disagreement shall be settled by such arbitration procedures upon written demand of either the insured or us. Page 4 of 4 Copyright, Insurance Services Office, Inc., 1998 CA 31 07 11 98 0 COMMERCIAL AUTO CA 99 15 12 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GOVERNMENTAL BODIES AMENDATORY ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Any land motor vehicle or "trailer" you own or lease that is designed for travel on public roads is an "auto" and not "mobile equipment" if the sole reason for considering it "mobile equipment" is such vehicle is used solely on roads you own. CA 99 15 12 93 Copyright, Insurance Services Office, Inc., 1993 Page 1 of 1 0 U.S. SPECIALTY INSURANCE COMPANY ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A.M. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYEES AND VOLUNTEERS AS INSUREDS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Additional Premium: $ Included The following is added to SECTION 11—LIABILITY COVERAGE, A. 1. Who Is An Insured: Any "employee" or volunteer of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGCA0021 2006 Includes copyrighted material of Insurance Services Office, Inc.,Wth its permission. Copyright, Insurance Services Office, Inc., 1997 U. S. Specialty Insurance Company New York BUSINESS AUTO COVERAGE FORM PUBLIC ENTITY Various provisions in thjs'po[icy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations- The words ,;we", "us" and'our" refer to the Company providing this insurance. Other words and phrases that appear in quotation marks have special meaning, Refer to SECTION VI DEFINITIONS. SECTION I—COVERED AUTOS 6 Owned "Autos" Subject To A Compulsory Uninsured Motorists Law. Only those Item Two of the Declarations shows the "autos" that "autos" you own that because of the law in are covered "autos" for each of your coverages. The the state where they are licensed or following numerical symbols describe the"autos"that principally garaged are required to have and may be covered "autos". The symbols entered next cannot reject Uninsured Motorists Coverage. to a coverage on the Declarations designate the only This includes those "autos" you acquire .,autos"that are covered "autos". ownership of after the policy begins provided A. Description Of Covered Auto Designation they are subject to the same state uninsured Symbols motorists requirement, 7 Specifically Described "Autos". Only Symbol Description those "autos" described in ITEM THREE of 1 = Any "Auto". the Declarations for which a premium charge 2 = Owned "Autos" Only. Only those "autos' is shown (and for Liability Coverage any you own (and for Liability Coverage any "trailers" you do not own while attached to "trailers" you do not own while attached to any power unit described in ITEM THREE). power units you own). This includes those 8 Hired "Autos"Only. Only those"autos"you "autos" you acquire ownership of after the lease, hire, rent or borrow. This does not policy begins. include any 'auto,, you lease, hire, rent, or 3 = Owned Private Passenger "Autos" Only. borrow from any of your "employees", Only the private passenger "autos" you own. volunteers, partners or members of -their This includes those private passenger households. ,.autos* you acquire ownership of after the 9 Nonowned "Autos" Only. Only those policy begins. "autos" you do not own, lease, hire, rent or 4 Owned "Autos" Other Than Private borrow that are used in connection with your Passenger "Autos" Only. Only those business- This includes 'autos" owned by ,.autos' you own that are not of the private your "employees", volunteers, partners or passenger type (and for Liability Coverage members of their households but only while any 'trailers" you do not own while attached used in your business or your personal to power units you own). This includes those affairs. .�autos" not of the private passenger type you 19 Mobile Equipment Subject to Compulsory acquire ownership of after the policy begins. or Financial Responsibility or Other Motor 6 Owned "Autos"Subject To No-Fault. Only Vehicle Law Only. Only those "autos" that those "autos" you own that are required to are land vehicles and that would qualify have No-Fault benefits in the state where under the definition of "mobile equipment" they are licensed or principally garaged. under this policy if they were not subject to This includes those 'autos" you acquire compulsory or financial responsibility law or ownership of after the policy begins provided other motor vehicle insurance law where they they are required to have No-Fault benefits in are licensed or principally garaged. the state where they are licensed or principally garaged. B. Owned Autos You Acquire After the Policy Begins PKGCANYDOO 1 a 8/07 NY Page 1 of 12 Includes copyrighted material of Insurance SerVmes Office,Inc,with its permissiDn. Copyright,Insurance Services Office,Inc,, 1996 1. If symbols 1, 2, 3, 4, 6, 6 or 19 are entered which this insurance applies that is caused by next to coverage in ITEM TWO of the the same"accident". Declarations, then you have coverage for We have the right and duty to defend any �.autos"that you acquire of the type described "insured" against a `SLJif' asking for such for the remainder of the policy period. damages or a "covered pollution cost or 2. But, if symbol 7 is entered next to a coverage expense", even if the allegations of the "suit" are in ITEM IWO of the Declarations, an "auto" groundless, false, or fraudulent. However, we you acquire will be a covered "auto" for that have no duty to defend any "insured" against a coverage only if: "suit' seeking damages for "bodily injury" or a. We already cover all "autos" that you 1.property damage" or a "covered pollution cost or own for that coverage or it replaces an expense" to which this insurance does not apply. ,.auto" you previously owned that had We may investigate and settle any claim or"suit" that coverage; and as we consider appropriate. Our duty to defend or settle ends when the Liability Coverage Limit b. You tell us within 30 days after you of Insurance has been exhausted by payment of acquire it that you want us to cover it for judgments or settlements. that coverage. 1. Who Is An Insured C. Certain Trailers, Mobile Equipment And The following are"insureds": Temporary Substitute Autos a. You for any covered"auto". If Liability Coverage is provided by this Coverage Form, the following types of vehicles are also b. Anyone else while using with your covered "autos"for Liability Coverage: permission a covered "auto" you own, 1. "Trailers' with a load capacity of 2,000 hire or borrow except: pounds or less designed primarily for travel (1) The owner or anyone else from on public roads. whom you hire or borrow a covered 2. 'Mobile equipment" while being carried or .auto'. This exception does not towed by a covered"auto". apply if the covered "auto" is a "trailer" connected to a covered 3. Any "auto" you do not own while used with auto"you own. the permission of its owner, as a temporary (2) Your "employee" if the covered substitute for a covered "auto" you own that 1.auto" is owned by that "employee", is out of service because of its* or a member of his or her household. a. Breakdown; (3) Someone using a covered "auto" b. Repair: while he or she is working in a c, Servicing; business of selling, servicing, repairing, parking or storing "autos" d. "Loss"; or unless that business is yours. e. Destruction, (4) Anyone other than your'employees", or a lessee or borrower or any of SECTION 11—LIABILITY COVERAGE their "employees", while moving A. Coverage property to or from a covered"auto". We Wit] Pay 211 sums an "Insured" legally Must c. Anyone liable for the conduct of an pay as damages because of "bodily injury" or "insured" described above but only to the 1.property damage" to which this insurance extent of that liabjlity� applies, caused by an "accident" and resulting 2. Coverage Extensions from the ownership, maintenance or use of a a. Supplementary Payments covered "auto", We will also pay all sums an "insured" legally In addition to the Limit of Insurance, we must pay as a "covered Pollution cost or will pay for the'insured": expense" to which this insurance applies, caused (1) All expenses we incur, by an "accident' and resulting from the (2) Up to $2,000 for cost of bail bonds ownership, maintenance or use of covered autos". However, we will only pay for the (including bonds for related traffic ,.covered polUion cost or expense" if there is law violations) required because of either "bodily injury" or "property damage" to an "accident" we cover. We do not have to furnish these bonds. PKGGANY000 1 a 8/07 NY Page 2 of 12 Includes ropyrighted material of Insurance Services Office, Inc,with its permission. C�opyhght,Insurance Services OfFice, Inc.,1996 (3) The cost of bonds to release a. Assumed in a contract or agreement that attachments in any "suit" we defend, is an "insured rc)ntract7 provided the but only for bond amounts within our "bodily injury" or "property damage" Limit of Insurance, occurs subsequent to the execution of (4) All reasonable expenses incuTred by the contract or agreement-, or the "insured" at our request, b. That the "insured" would have in the including actual loss of earning up to absence of the contract or agreement. $250 a day because of time off from 3� Worker's Compensation work. (6) All costs taxed against the "insured" Any obligation for which the "insured" or the in any "suit" against the "insured" we "insured's" insurer may be held liable under defend. any workers' compensation, disability benefits or unemployment compensation law (6) All interest on the full amount of any or any similar law- judgment that accrues after entry of 4. Employee Indemnification And the judgment in any"suit" against the Employers Liability insured we defend, but our duty to pay interest ends when we have "Bodily injury'to-. paid, offered to pay or deposited in a. An "employee", volunteer or student court the part of the judgment that is teacher of the "insured" arising out of within our Limit of Insurance. and in the course of: b. Out-olf-State Coverage Extensions (1) Employment by the"insured"; or While a covered "auto" is away from the (2) Performing the duties related to the state where it i s I icensed we wi 11: conduct of the "Insured's" business; (1) Increase the Limit of Insurance for or Liability Coverage to meet the limits b. The spouse, child, parent, brother or specified by a compulsory or sister of that "employee", volunteer or financial responsibility law of the student teacher as a Consequence of jurisdiction where the covered "auto" paragraph a.above. is being used. This extension does not apply to the limit or limits This exclusion applies: specified by any law governing motor (1) Whether the "insured" may be liable carriers of passengers or property. as an employer or in any other (2) Provide the minimum amounts and capacity; and types of other coverages, such as (2) To any obligation to share damages no-fault, required of out-of-state with or repay someone else who vehicles by the jurisdiction where the must pay damages because of the covered "auto"is being used. injury. We will not pay anyone more than once But this exclusion does not apply to liability for the same elements of loss because of assumed by the "insured" under an "insured these extensions. contract". B. Exclusions 5. Fellow Employee This insurance does not apply to: "Bodily injury"to any fellow"employee' of the I. Expected Or Intended Injury "insured" arising out of and in the course of "Bodily injury"or"property damage" expected the fellow"employee's" employment or while performing duties related to the conduct of or intended from the standpoint of the your business. 'insured". Z Contractual 6. Care, Custody Or Control "Property damage" to or "covered pollution Liability assumed under any contract or cost or expense" involving property owned or agreement. transported by the "insured" or in the But this exclusion does not apply to liability "insured's" rare, custody or control. But this for damages: exclusion does not apply to liability assumed under a sidetrack agreement, PKGCANY0001 a 8107 NY Page 3 of 12 Includes copyrighted material of Insurance Services OfFice,Inc,,with its permission, Copyright,Insurance Services Office,Inc.,1996 7. Handling Of Property Work that may need service, maintenance, "Bodily injury" or"property damage" resulting correction, repair or replacement, but which from the handling of property: is otherwise complete, will be treated as completed a. Before it is moved from the place where 11. Pollution it is accepted by the "insured" for movement into or onto the covered "Bodily injury" or "property damage" arising .,auto"; or out of the actual, alleged or threatened b. After it is moved from the covered 'auto' discharge, dispersal, seepage, migration, to the place where it is finally delivered release or escape of"pollutants`� by the"insured". a, That are, or that are contained in any 8. Movement Of Property By Mechanical property that is: Device (1) Being transported or towed by, "Bodily injury" or"property damage" resulting handled, or handled for movement into, onto or from, the covered from the movement of property by a "auto"; mechanical device (other than a hand truck) unless the device is attached to the covered (2) Otherwise in the course of transit by "auto". or on behalf of the"insured"; or 9. Operations (3) Being stored, disposed of, treated or processed in or upon the covered "Bodily injury" or "property damage" arising auto"; out of the operation of any equipment listed in paragraphs 6.b. and 6.c. of the definition b. Before the "Pollutants" or any property in of"mobile equipment"- which the "pollutants" are contained are Completed Operations moved from the place where they are accepted by the "insured" for movement "Bodily injury' or "property damage" arising into or onto the covered"auto"; or out of your work after that work has been G. After the "pollutants" or any property in completed or abandoned. which the 'pollutants' are contained are In this exclusion, your work means: moved from the covered "auto" to the a. Work or operations performed by you or place where they are finally delivered, on your behalf; and disposed of or abandoned by the "insured". b. Materials, parts or equipment furnished in connection with such work or Paragraph a. above does not apply to operations. fuels, lubricants, fluids, exhaust gases or other similar"pollutants" that are needed Your work includes warranties or for or result from the normal electrical, representations made at any time with hydraulic or mechanical functioning of respect to the fitness, quality, durability or the covered "auto"or its parts, if. performance of any of the items included in paragraphs a. or b. above. (1) The "pollutants" escape, seep, migrate, or are discharged, Your work will be deemed completed at the dispersed or released directly from earliest of the following times: an "auto" part designed by its (1) When all of the work called for in your manufacturer to hold, store, receive contract has been completed. or dispose of such 'pollutants"; and (2) When all of the work to be done at the (2) The "bodily injury", "property site has been completed if your contract damage" or "covered pollution cost calls for work at more than one site. or expense" does not arise out of the operation of any equipment listed in (3) When that part of the work done at a job paragraphs 6.b. and 6.c. of the site has been put to its intended use by definition of"mobile equipment"- any person or organization other than another contractor or subcontractor Paragraphs b. and c. above of this working on the same project. exclusion do not apply to"accidents"that occur away from premises owned by or rented to an "insured" with respect to PKGC ANY000 1 a 8/07 NY Page 4 of 12 Includes copyrighted material of Insurance Services Office,tnc,.with its permission. Copyright,Insurance Services Office,Inc, 1996 ,.pollutants" not in or upon a covered incurred, for services rendered within three years '.auto"if: from the date of the"accident'. (1) The "pollutants" or any property in B. Who Is An Insured which the "pollutants" are contained 1� You while "Occupying" or, while a pedestrian, are upset, overturned or damaged as when struck by any"auto". a result of the maintenance Or use of a covered"auto"; and 2. Anyone else "Occupying" a covered "@uto" or (2) The discharge, dispersal, seepage, a temporary substitute for a covered "auto", migration, release or escape of the The covered "auto" must be out of service "pollutants" is caused directly by because of its breakdown, repair, servicing, such upset, overturn or damage. loss or destruction. 12. War C. Exclusions "Bodily injury" or "property damage" due to This insurance does not apply to� war, whether or not declared, or any act or 1. "Bodily injury" sustained by an "Insured" condition incident to war- War includes civil while "occupying" a vehicle located for use war, insurrection, rebellion or revolution, or as a premises. any act or condition incident to any of the 2. 'Bodily injury" sustained by you or any foregoing. "family member" while "occupying"or struck 13. Racing by a vehicle (other than a covered "auto") Covered "autos" while used in any owned by you or furnished or available for professional or organized racing or your regular use- demolition contest or stunting activity, or 3. 'Bodily injury" sustained by any "family while practicing for such contest or activity. member" while "occupying" or struck by any This insurance also does not apply while that vehicle (other than a covered "auto") owned covered 'auto" is being prepared for such a by or furnished or available for the regular contest or activity. use of any"family member". C. Limit Of Insurance 4. "Bodily injury" to your "employee" arising out Regardless of the number of covered "autos", of and in the course of employment by you. "insureds", premiums paid, claims made or However, we will cover"bodily injury"to your vehicles involved in the "accident". the most we domestic "employees" if not entitled to will pay for the total of all damages and "covered workers' compensation benefits. For the purposes of this endorsement, a domestic pollution cost or expense" combined, resulting '.employee" is a person engaged in from any one "accident" is the Limit of Insurance household or domestic work performed for Liability Coverage shown in the Declarations. principally in connection with a residence r, All "bodily injury", property damage" and premises. "covered Pollution cost or expense" resulting 6. "Bodily injury" to an 'insured" while working from continuous or repeated exposure to in a business of selling, servicing, repaNng substantially the sarne conditions will be or parking "autos" unless that business is considered as resulting from one"accident". yours. No one will be entitled to receive duplicate 6. "Bodily injury" caused by war, whether or not payments for the same elements of"loss" under declared, civil war, insurrection, rebellion or this Coverage Form and any Medical Payments revolution, or any act or condition incident to Coverage Endorsement, Uninsured Motorists any of the foregoing. Coverage Endorsement or Underinsured Motorists Coverage Endorsement attached to 7. "Bodily injury' to anyone using a vehicle this Coverage Part. without a reasonable belief that the person is entitled to do so. SECTION III—MEDICAL PAYMENTS B. "Bodily injury' sustained by an "insured" A. Coverage while "occupying" any covered "auto' while We will pay reasonable expenses incurred for used in any professional racing or demolition necessary medical and funeral services to oi for contest or stunting activity, or while practicing an "insured" who sustains "bodily injury" caused for such contest or activity- This insurance by "accident", We will pay only those expenses also does not apply to any "bodily injury" sustained by an "insured" while the "auto" is being prepared for such a contest or activity. PKGGANY00G1 a 8/07 NY Page 5 of 12 Includes copyrighted material of Insurance Services Office,Inc.,with its pLrmlssion Capyright,Insurance Services Office.Inc,1996 D. Limit of Insurance 2. Towing Regardless of the number of covered "autos", We will pay up to the limit shown in the 'insureds", premiums paid, claims made or Declarations for towing and labor costs vehicles involved in the "accident", the most we incurred each time a covered "auto" of the will pay for "bodily injury" for each 'insured" private passenger type is disabled. injured in any one "accident" is the Limit Of However, the labor must be performed at the Insurance for Auto Medical Payments Coverage place of disablement. shown in the Declarations. 3. Glass Breakage — Hitting a Bird or No one Vill be entitled to receive duplicate Animal—Failling Objects or Missiles. payment for the same elements of "loss" under If you carry Comprehensive Coverage for the this coverage and any Liability Coverage Form, damaged covered "auto', we will pay for the Uninsured Motorists Coverage Endorsement or following under Comprehensive Coverage� Underinsured Motorists Coverage Endorsement attached to this Coverage Part. a. Glass breakage-, E. Changes in Conditions b. "Loss" caused by hitting a bird or animal; The Conditions are changed for Auto Medical and Payments Coverage as follows: c. "Loss" caused by falling objects or 1. "The Transfer of Rights of Recovery Against missiles. Others to Us Condition does not apply." However, you have the option of having 2. The reference in Other Insurance in this form glass breakage caused by a covered "auto's" to"other collectible insurance" applies only to collision or overturn considered a "loss" other collectible auto medical payments under Collision Coverage. insurance, 4. Coverage Extensions SECTION IV—PHYSICAL DAMAGE COVERAGE a. Hired Auto If hired "autos" are covered "autos" for A. Coverage Liability Cover age and if Comprehensive, 1. We will pay for "loss" to a covered "auto" or Specified Causes of Loss, or Collision its equipment under: coverages are provided under this a. Comprehensive Coverage Coverage Form for any "auto" you own, then the Physical Damage Coverages From any cause except� provided are exterided to "autos" you (1) The covered "auto's' collision with hire, However, this extension does not another object; or apply to any "auto" that is leased, hired, rented or borrowed with a driver. (2) The covered "auto's"overtum. The most we will pay for loss to any b. Specified Causes of Loss Coverage hired "auto" is the lesser of $35,000 or Caused by� Actual Cash Value or Cost of Repair, minus a deductible, The deductible will (1) Fire, lightning or explosion; be equal to the largest deductible (2) Theft; applicable to any owned "auto" for that coverage. No deductible applies to (3) Windstorm, hail or earthquake; "loss" caused by fire or lightning- Subject (4) Flood; to the above limit and deductible provisions, we will pl-ovide coverage (6) Mischief or vandalism; or equal to the broadest coverage (6) The sinking, burning, collision or applicable to any covered "auto" you derailment of any conveyance own. transporting the covered"auto". We will also cover loss of use of the c. Collision Coverage. hired "auto" if it results from an"accident" Caused by: for which you are legally liable and the lessor incurs an actual financial loss, (1) The covered "autos' collision with subject to a maximurn of $500 per another object; or accident", (2) The covered"auto's"overturn. PKGCANYOOO 1 a 8/07 NY Page 6 of 12 Includes copyrighted material of I nsuranre Services Office,Inc,with its permission Copyright,Insurance Services Office,Inc,1996 b. Transportation Expense b. Blowouts, punctures or other road We will pay up to $30 per day to a damage to tires, maximum of $91DO for temporary However, this exclusion does not apply to transportation expense incurred by you "loss"caused by the discharge of an air bag. because of the total theft of a covered ..auto' of the private passenger type. We 4� We will not pay for "loss" to any of the following� will pay only for those covered "autos'for which you carry either Comprehensive or a. Tapes, records, discs or other similar Specified Causes of Loss Coverage. We audio, visual or data electronic devices will pay for transportation expenses designed for use with audio, Visual or incurred during the period beginning 48 data electronic equipment. hours after the theft and ending, b. Any device designed or used to detect regardless of the policy's expiration, speed measuring equipment such as when the covered "auto" is returned to radar or laser detectors and jamming use or we pay for its"Ioss"� apparatus intended to elude or disrupt B. Exclusions speed measurement equipment. 1. We will not pay for "loss" caused by or c. Any electronic equipment, without regard resulting from any of the following. Such to whether this equipment is permanently "Ioss� is excluded regardless of any other installed, that receives or transmits cause or event that contributes concurrently audio, visual or data signals and that is or in any sequence to the"loss". not designed solely for the reproduction a. Nuclear Hazard. ofsound. (1) The explosion of ary weapon d. Any accessories used with the electronic employing atomic fission or fusion-, or equipment described in paragraph c. above. (2) Nuclear reaction or radiation, or Exclusion 4.a. above does not apply to any radioactive contamination, however equipment that is installed in a covered caused. '.auto"which is� lb. War or Military Action (1) Owned by a police or fire (1) War, including undeclared or civil department-, war; (2) Equipped as an emergency vehicle (2) Warlike action by a military force, and owned by a public ertity or any of its including action in hindering or agencies; or defending against an actual or (3) Equipped as an emergency vehicle expected attack, by any government, and owned by a volunteer fire sovereign or other authority using department, volunteer rescue squad or military personnel or other agents; or volunteer ambulance corps. (3) Insurrection, rebellion, revolution, Exclusions 4.c. and 4.d. above do not apply usurped power or action taken by to: governmental authority in hindering or defending against any of these. (1) Equipment designed solely for the 2. We will not pay for 'loss" to any covered re-production of sound and accessories "auto" while used in any professional or used with such equipment, provided organized racing or demolition contest or such equipment is permanently installed stunting activity, or while practicing for such in the covered "auto" at the time of the contest or activity. We will also not pay for "loss" or such equipment is removable "loss" to any covered "auto" while that from a housing unit which is permanently covered "auto" is being prepared for such a installed in the covered "auto" at the time contest or activity. of the "loss", and such equipment is designed to be solely operated by use of 3. We will not pay for "loss" caused by or the power from the `auto's" electrical resulting from any of the follovAng unless system, in or upon the covered"auto"; or caused by other'loss' that is covered by this (2) Any other electronic equipment that insurance� Is: a. Wear and tear, freezing, mechanical or electrical breakdown. PKGCANYODO 1 a 8107 NY Page 7 of 12 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Copyright,Insurance Services Office,Inc.,1996 (a) Necessary for the normal differences to the umpire, A decision agreed operation of the covered "auto" or to by any two will be binding. Each party will-, the monitoring of the covered .1auto's"operating system; or a. Pay its chosen appraiser, and (b) An integral part of the same unit b. Bear the other expenses of the appraisal housing any sound reproducing and umpire equally. equipment described in (1) above If we submit an appraisal, we will still retain and permanently installed in the our right to deny the claim. opening of the dash or console of the 2. Duties In The Event Of Accident, Claim, covered "auto" normally used by the Suit Or Loss. manufacturer for installation of a radio. We have no duty to provide coverage under 5. We will not pay for "loss" to a covered "aLJt0` this policy unless there has been full due to"diminution in value" compliance with the following duties-n a. In the event of "accident", claim, "suit" or C. Limit of Insurance "loss", you must give us or our authorized representative prompt notice 1. The most we will pay for "loss" in any one of the"accident"or"loss". Include: "accident" is the lesser of: (1) How, when and where the "accident" a. The actual cash value of the damaged or or"loss"occurred-, stolen property as of the time of the"loss"; or (2) The "insured's" name and address; b. The cost of repai(ing or replacing the and damaged or stolen property with other (3) To the extent possible, the names property of like kind and quality. and addresses of any injured 2. An adjustment for depreciation and physical persons and witnesses. condition will be made in determining actual b. Additionally, you and any other involved cash value in the event of a total "loss". "insured' must: 3. If a repair or replacement results in better (1) Assume no obligation, make no than like kind or quality, we will not pay for payment or incur no expense without the amount of the betterment. our consent, except at the"insured's' D. Deductible own cost. For each covered 'auto", our obligation to pay (2) Immediately send us copies of any for, repair, return or replace damaged or stolen Tequest, demand, order, notice, property will be reduced by the applicable summons or legal paper received deductible shown in the Declarations. Any Concerning the claim or"suit". Comprehensive Coverage deductible shown in (3) Cooperate with us in the the Declarations does not apply to "Loss' to investigation or settlement of the glass used in the windshield or windows if the claim or defense against the"suit". glass is repaired rather than replaced. (4) Authorize us to obtain medical SECTION V—BUSINESS AUTO CONDITIONS records or other pertinent The following conditions apply in addition to the information Common Policy Conditjons� (5) Submit to examination, at our A. Loss Conditions expense, by physicians of our choice, as often as we reasonably 1. Appraisal For Physical Damage Loss require. If you and we disagree on the amount of c. If there is "IoW to a covered "auto' or its "loss", either may demand an appraisal of the equipment you Must also do the "loss". In this event, each party will select a following: competent appraiser. The two appraisers (1) Promptly notify the police if the will select a competent and impartial umpire, covered "auto" or any of its The appraisers Vill state separately the equipment is stolen, actual cash value and amount of "loss". If they fall to agree, they will submit their (2) Take all reasonable steps to protect the covered "auto" from further PKGCANY0001a 8/07 NY Page 8 of 12 Indudes copyrighted material of Insurance Services Office,Inc.,with its permission, Copyright Insurance Servires Office,Inc,, 1996 damage. Also keep a record Of your Bankruptcy or insolvency of the "insured" or expenses for consideration in the the "insured's" estate will not relieve us of settlement of the claim. any obligations under this Coverage Form, (3) Permit us to inspect the covered 2. Concealment, Misrepresentation Or Fraud "auto" and records proving the "loss" This Coverage Form is void in any case of before its repair or disposition- fraud by you at any time as it relates to this (4) Agree to examinations under oath at Coverage Form. It is also void if you or any our request and give us a signed other 'insured", at any time, intentionally statement of your answers, conceal or misrepresent a material fact 3. Legal Action Against Us concerning! No one may bring a legal action against us a. This Coverage Form-, under this Coverage Form until: b. The covered"auto"; a. There has been full compliance With all c. Your interest in the covered"auto"; or the terms of this Coverage Form, and d. A claim Linder this Coverage Form, b. Under Liability Coverage, we agree in 3. Liberalization writing that the "insured' has an obligation to pay or until the amount of If we revise the Coverage Form to provide th at obligation has finally been more coverage without additional premium determined by judgment after trial. No charge, your policy will automatically provide one has the right under this policy to the additional coverage as of the day the bring us into an action to determine the revision is effective in your state, "insured's" liability. 4. No Benefit To Bailee—Physical Damage 4. Loss Payment — Physical Damage Coverages Coverages We will not recognize any assignment or At our option we may: grant any coverage for the benefit of any a. Pay for, repair or replace damaged or person or organization holding, storing or stolen property; transporting property for a fee regardless of another provision of this Coverage Form, b. Return the stolen property, at our 6. Other Insurance expense. We will pay for any damage that results to the"auto'from the theft-, or a. For any covered "aUtO' YOU own, this c. Take all or any part of the damaged or Coverage Form provides primary stolen property at an agreed or insurance. For any covered "auto" you appraised value- do not own, the insurance provided by this Coverage Form is excess over any If we pay for the "loss", our payment will other collectible insurance. However, include the applicable sales tax for the while a covered "auto"which is a"trailer" damaged or stolen property, is connected to another vehicle, the Liability Coverage this Coverage Form S. Transfer Of Rights Of Recovery Against provides for the"trailer" is: Others To Us (1) Excess while it is connected to a If any person or organization to or for whom motor vehicle you do not own. we make payment under this Coverage Form (2) Primary while it is connected to a has rights to recover damages from another, covered"auto"you own, those rights are transferred to us. That b. For Hired Auto Physical Damage person or organization must do everything coverage, any covered "auto" you lease, necessary to secure our rights and must do hire, rent or borrow is deemed to be a nothing after "accident" or '41oss" to impair covered "auto" you own. However. any them. "auto" that is leased, hired, rented or This condition does not apply to SECTION III borrowed with a driver is not a covered —MEDICAL PAYMENTS. auto". B. General Conditions c. Regardless of the provisions of 1. Bankruptcy paragraph a. above, this Coverage Form's Liability Coverage is primary for PKGCANY000 1 a 8/07 NY Page 9 of 12 Includes copyrighted material of Insurance Services ofrio�,Inr.,with its permission, Copyright Insurance Services Office,Inc., 1996 any liability assumed under an "insured SECTION VI—DEFINITIONS contract". d. When this Coverage Form and any other A. "Accident" includes continuous or repeated Coverage Form or policy covers on the eXPOSUre to the same conditions resulting in same basis, either excess or primary,we "bodily injury"or"property damage", will pay only our share- Our share is the B� "Auto' means: proportion that the Limit of Insurance of 1. A land motor vehicle, "trailer" or semitrailer our Coverage Form bears to the total of designed for travel on public roads; or the limits of all the Coverage Forms and policies covering on the same basis. 2. Any other land vehicle that is subject to a 6. Policy Period, Coverage Territory compulsory or financial responsibility law or other a. Under this Coverage Form, we cover motor vehicle insurance law where it is ..accidents"and "losses"occurring: licensed or principally garaged. (1) During the policy period shown in the However, "auto" does not include "mobile Declarations; and equipment." (2) Within the coverage territory. If you are a governmental entity, any land motor vehicle or "trailer" you own or lease b. The coverage territory is: that is designed for travel on public roads is (1) The United States of America; an "auto" and not "mobile equipment" if the sole reason for considering it "mobile (2) The territories and possessions of equipment" is such vehicle is used solely on the United States of America; roads you own. (3) Puerto Rico� C. "Bodily injury" means bodily injury, sickness or (4) Canada; and disease sustained by any person, including mental anguish or death resulting from any of (5) Anywhere in the world for a covered these at anytime. .auto" that is leased, hired, rented or borrowed without a driver for a D. "Covered pollution cost or expense" means any period of 30 days or less provided cost or expense arising out of: the "insured's" responsibility to pay 1. Any request, demand, order or statutory or damages is determined in a "suit" on regulatory requirement that any "insured" or the merits, in the territory described others test for, monitor, clean up, remove, in paragraph b. (1), (2), (3) Or (4) contain, treat, detoxify or neutralize, or in any above or in a settlement we agree to. way respond to, or assess the effects of We also cover "loss" to, or "accidents" Opollutants"; or involving, a covered "auto" while being 2. Any claim or "suit" by or on behalf of a transported between any of the territories governmental authority for damages because described in paragraph b. (1), (2), (3), or (4) of testing for, monitoring, cleaning up, above. removing, containing, treating, detoxifying or 7. Two Or More Coverage Forms Or Policies neutralizing, or in any way responding to or Issued By Us assessing the effects Of"POWAtants". If this Coverage Form and any other "Covered pollution cost or expense" does not Coverage Form or policy issued to you by us include any cost or expense arising out of the or any company affiliated with us apply to the actual, alleged or threatened discharge. same "accident", the aggregate maximum dispersal, seepage, migration, release or escape Limit of Insurance under all the Coverage of"pollutants". Forms or policies shall not exceed the highest applicable Limit of Insurance under a. That are, or that are contained in any any one Coverage Form or policy. This property that is: condition does not apply to any Coverage (1) Being transported or towed by, Form or policy issued by us or an affiliated handled, or handled for movement company specifically to apply as excess into, onto or from the covered'auto"; insurance over this Coverage Form. (2) Otherwise in the course of transit by or on behalf of the"insured"-, PKGCANY000 1 a 8107 NY Page 10 of 12 Includes GopyCighted material of Insurance Service5 Office,Inc,with its permission. Copyright,Insurance Services Offim Inc, 1996 (3) Being stored, disposed of, treated or of your household, including a ward or foster processed in or upon the covered child. ,.auto"; H. "Insured" means any person or organization b- Before the "pollutants" or any property in qualifying as an insured in the Who Is An Insured which the "pollutants' are contained are provision of the applicable coverage. Except moved from the place where they are with respect to the Limit of Insurance, the accepted by the "Insured' for movement coverage afforded applies separately to each into or onto the covered"auto"; or insured who is seeking coverage or against c. After the "pollutants" or any property in whom a claim or"suit" is brought. which the "pollutants" are contained are 1. "Insured contract" means-, moved from the covered "auto" to the 1. A lease of premises-, place where they are finally delivered, disposed of or abandoned by the 2. A sidetrack agreement-, "insured'. 3. Any easement or license agreement, except Paragraph a. above does not apply to in connection With construction or demolition fuels, lubricants, fluids, exhaust gases or operations on or within 50 feet of a railroad; other similar"pollutants" that are needed 4. An obligation, as required by ordinance, to for or result from the normal electrical, indemnify a municipality, except in hydraulic or mechanical functioning of connection with work for a municipality; the covered "auto"or its parts, if: (1) The "pollutants" escape, seep, 5. That part of any other contract or agreement migrate, or are discharged, pertaining to your business (including an dispersed or released directly from indemnification of a municipality in an "auto" part designed by its connection with work performed for a manufacturer to hold, store, receive municipality) under which you assume the or dispose of such"pollutants"; and tort liability of another to pay for "bodily injury" or "property damage" to a third party (2) The "bodily injury", "property or organization. Tort liability means a liability damage" or "covered pollution cost that would be imposed by law in the absence or expense"does not arise out of the of any contract or agreement; operation of any equipment listed in 6. That part of any contract or agreement paragraphs 6.b. or 6.c. of the entered into, as part of your business, definition of"mobile equipment"- pertaining to the rental or lease, by you or Paragraphs b. and c. above do not apply any of your"employees", of any"auto". to "accidents" that occur away from However, such contract or agreement shall premises owned by oriented to an "insured" with respect to "pollutants" not not be considered an "insured contract" to the extent that it obligates you or any of your in or upon a covered"auto'if: employees" to pay for "property damage" to (1) The "pollutants" or any property in any "auto" rented or ]eased by you or any of which the "pollutants" are contained your"employees". are upset, overturned or damaged as An "Insured contract" does not include that a result of the maintenance or use of part of any contract or agreement: a covered"auto"; and (2) The discharge, dispersal, seepage, a. That indemnifies a railroad for "bodily migration, release or escape of the injury" or "property damage" arising out ..pollutants" is caused directly by of construction or demolition operations, such upset, overturn or damage, within 50 feet of any railroad property and affecting any railroad bridge or E. "Diminution in value!' means the actual or trestle, tracks, roadbeds, tunnel, perceived loss in market value or resale value underpass or crossing; or which results ff orn a direct and accidental "loss", b. That pertains to the loan, lease or rental of an "auto" to you or any of your F� 'Employee" includes a "leased worker'. "employees", if the "auto' is loaned, 'Employee" does not include a "temporary leased or rented with a driver; or worker". c. That holds a person or organization G� "Family member" means a person related to you engaged in the business of transporting by blood, marriage or adoption who is a resident property by "auto" for hire harmless for PKGCANYD0D1 a 8/07 NY Page 11 of 12 Includes copyCighted material of Insurance Services Office,Inc.,with its permission. Copyright,Insurance Services Office,Inc, 1996 your Use of a covered"auto" over a route b. Cherry pickers and similar device or territory that person or organization is mounted on automobile or truck chassiss authorized to serve by public authority. and used to raise or lower workers; and J. "Leased worker" means a person leased to you c. Air compressors, pumps and generators, by a labor leasing firm under an agreement including spraying, welding, building between you and the labor leasing firm, to cleaning, geophysical exploration, perform duties related to the conduct of your lighting or well servicing equipment. business, "Leased worker" does not include a "temporary workeC_ However, "mobile equipment" does not include land vehicles that are subject to a compulsory or K. "Loss" means direct and accidental loss or financial responsibility law or other motor vehicle damage, insurance law where it is licensed or principally L. "Mobile equipment" means any of the following garaged. Land vehicles subject to a compulsory types of land vehicles, including any attached or financial responsibility law or other motor machinery or equipmerit� vehicle insurance 12W are considered"autos". 1. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off M. "Occupying' means in, upon, getting in, on, out public roads; or off. 2. Vehicles maintained for use solely on or next N. "Pollutants" means any solid, liquid, gaseous or to premises you own or rent; thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis. chemicals and 3. Vehicles that travel on crawler treads; waste. Waste includes materials to be recycled, 4. Vehicles, whether self-propelled or not, reconditioned or reclaimed. maintained primarily to provide mobility to 0. "Property damage" means damage to or loss of permanently mounted'. use of tangible property. a. Power cranes, shovels, loaders, diggers P. "Suit"means a civil proceeding in which� or drills; or 1. Damages because of "bodily injury" or b. Road construction or resurfacing property damage"; or equipment such as graders, scrapers or rollers. 2. A"covered pollution cost or expense". S. Vehicles not described in paragraphs 1., 2., to which this insurance applies are alleged. 3., or 4. above that are not self-propelled and "Suit" includes, are maintained primarily to provide mobility a. An arbitration proceeding in which such to permanently attached equipment of the following types: damages or "Covered pollution costs or expenses" are claimed and to which the a. Air compressors, pumps and generators, "insured" Must submit or does submit including spraying, welding, building with our consent; or cleaning, geophysical exploration, b. Any other alternative dispute resolution lighting and well servicing equipment; or proceeding in which such damages or b. Cherry pickers and similar devices used .covered pollution costs or expenses" to raise or lower workers. are claimed and to which the insured 6. Vehicles not described in paragraphs 1., 2., submits with our consent, 3. or 4. above maintained primarily for Q. "Temporary worker" means a person who is purposes other than the transportation of furnished to you to substitute for a permanent persons or cargo, However, self-propelled employee" on leave or to meet seasonal or vehicles with the following types of short-term workload conditions. permanently attached equipment are not "mobile equipment" but will be considered R. 'Trailer"includes semitrailer. .autos": a. Equipment designed primarily fov (1) Snow removal; (2) Road maintenance, but not construction or resurfacing; or (3) Street cleaning; PKGCANY0001 a 8/07 NY Page 12 of 12 Includes copyrighted mater�al of Insurance Services office,Inc-,with its permission. Copyright Insurance services Office,Inc,, 1996 COMMERCIAL AUTO CA 20 02 12 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SOUND RECEIVING EQUIPMENT COVERAGE - FIRE� POLICE AND EMERGENCY VEHICLES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. PHYSICAL DAMAGE COVERAGE is changed as follows: The exclusion relating to Audio, Visual and Data Electronic Equipment does not apply to any equipment that is installed in a covered "auto"which is: 1. Owned by a police or fire department; 2. Equipped as an emergency vehicle and owned by a political body or any of its agencies; or 3. Equipped as an emergency vehicle and owned by a volunteer fire department, volunteer rescue squad or vol- unteer ambulance corps. CA 20 02 12 93 Copyright, Insurance Services Office, Inc., 1993 Page 1 of 1 ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A..M, I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK CHANGES IN BUSINESS AUTO For a covered "auto" licensed or principally garaged in New York, this endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement A. Changes In Liability Coverage But this exclusion does not apply to "bodily 1. Who Is An Insured does not include anyone injury" to domestic "employees" not entitled loading or unloading a covered "auto" except to workers' compensation benefits or to you, your"employees", a lessee or borrower or liability assumed by the "insured" under an any of their"employees". "insured contract". For the purposes of the Coverage Form, a domestic "employee" is 2. The following is added to Supplementary a person engaged in household or domestic Payments: work performed principally in connection (7) We will pay all expenses incurred by an with a residence premises. "insured"for first aid to others at the time of b. The Follow Employee Exclusion is an"accident". amended by the addition of the following-, (8) The cost of appeal bonds. However, this exclusion only applies if the 3. Paragraph b. Out Of State Coverage fellow "employee" is entitled to benefits Extensions is replaced by the following: under any of the following: workers' While a covered "auto" is used or operated in compensation, unemployment any other state or Canadian province we will compensatior or disability benefits law, or provide at least the minimum amount and kind any similar law. of coverage which is required in such cases c. The Handling Of Property Exclusion does under the laws of such jUrisdiGfion. not apply- 4. Exclusions is changed as follows� d. The Movement Of Property By a. The Employee Indemnification And Mechanical Device Exclusion does not Employer's Liability Exclusion is replaced apply. by the following: e. The Operations Exclusion does not apply.. This insurance does not apply to'. f. The Completed Operations Exclusion "Bodily injury" to an "employee" of the does not apply. "Insured"arising out of and in the course of: g. The Pollution Exclusion does not apply. (1) Employment by the"Insured"; or h. The War Exclusion is replaced by the (2) Performing the duties related to the following, conduct of the"inSffed's"business. PKGCANY0002 08 07 NY Page 1 of 5 Includes copyrighted material of Insurance Services Offioe,Inc,with its permission Copyright,insurance ServiGes Office,Inc, 1997 "Bodily injury"or "property damage" caused the limit of insurance shown in the Declarations by war, whether or not declared, civil war, to first provide the separate limits required by insurrection, rebellion or revolution, or any the New York Motor Vehicle Safety act or condition incident to any of the Responsibility Act as follow& foregoing. a. "Bodily injury" not resulting in death of any L The Racing Exclusion does not apply one person caused by any one"accident"; j. The following Exclusion is added: b. "Bodily injury" not resulting in death of two or more persons caused by any one SPOUSAL LIABILITY '$accident"; "Bodily injury" to or "property damage" of c. "Property damage" in any one"accident". the spouse of an "insured". However, we will pay all sums an "insured" legally must This provision will not change Our total limit of pay if named as a third party defendant in a insurance. legal action commenced by his or her All "bodily injury" and "property damage" spouse against another party. resulting from continuous or repeated exposure k.The following Exclusion is added� to substantially the same conditions will be Punitive or exemplary damages. considered as resulting from one"accident". 5. If the limit of insurance shown in the In addition, our �imit of insurance for "bodily Declarations is equal to or greater than injury" resulting in death is as follows. $160,000, the Limit Of Insurance Provision is a. Up to $50,000 for"bodily injury" resulting in changed by the following-. death of any one person caused by any one Limit Of Insurance applies except that we will '$accident"; and apply the limit of insurance shown in the b. Up to $100,000 for "bodily injury" resulting Declarations to first provide the separate limits -in death of two or more persons caused by required by the New York Motor Vehicle Safety any one "accident", subject to a $50,000 Responsibility Act for-. maximum for any one person. a. "Bodily injury" not resulting in death of any If the limit of insurance shown in the one person caused by any one"accident'; Declarations is not exhausted by payment of b. "Bodily injury" not resulting in death of two damages for: or more persons caused by any one a. "Bodily injury" not resulting in death-, "accident"; b. "Property damage"; or c� "Bodily injury" resulting in death of any one c. "Covered pollution cost or expense", person caused by any one"accident"� any remaining amounts will be used to pay d. "Bodily injury" resulting in death of two or damages for "bodily injury" resulting in death, more persons caused by any one to the extent the limit of insurance shown in the '.accidenf'; Declarations is not increased. e. "Property damage" in any one"accidenf'. 7. If forming part of the policy, the Nuclear Energy This provision will not change our total limit of Liability Exclusion (Broad Form) Endorsement insurance. does not apply to the Commercial Auto 6, If the limit of inSUrance shown in the Coverage Part Declarations is less than $160,000, the Limit B. Changes In Physical Damage Coverage Of Insurance Provision is replaced by the 1. The War Or Military Action Exclusion is following-. replaced by the following: Regardless of the number of covered "autos", War, whether or not declared, civil war, "insureds", premiums paid, claims made or insurrection, rebellion or revolution, or any act vehicles involved in the"accident", the most we or condition incident to any of the foregoing, \A411 pay for the total of all damages and .'covered pollution cost or expense" combined, 2. Deductible is replaced by the following: resulting from any one"accident"is the Limit Of For each covered "auto", our obligation to pay Insurance for Liability Coverage shown in the for, return or replace damaged or stolen Declarations, except for those damages for property will be reduced by the applicable "bodily injury"resulting in death. We will apply deductible shown in the Declarations. 3. The following are added to Physical Damage Coverage: PKGCANY0002 08 07 NY Page 2 of 5 Includes copydghted material of Insurance Services Office, Inc.,with its permission Copyright,Insurance Services Office,Inc., 1997 The following provisions apply in place of any c. Recovery Of Stolen Or Abandoned conff icting policy provisions: "Autos" a. Mandatory Inspection For Physical If a private passenger "aLft" insured under Damage Coverage this Coverage Part for physical damage (1) We have the right to inspect any private coverage is stolen or abandoned, we or our passenger "auto", including a non- authorized representative shall, when owned "auto", insured or intended to be notified of the location of the "auto", have insured under this Coverage Part before the right to take custody of the "auto" for physical damage coverage shall be safekeeping, effective, except to the extent that this C. Changes In Conditions right is prescribed and limited by New 1� Paragraphs a. and b.2. of the Duties In The York State Insurance Department Event Of Accident, Claim, Suit Or Loss Regulation No, 79 �1 1 NYCRR 67). Condition replaced by the following' (2) During the term of the Coverage Part, We have no duty to provide coverage under coverage for an additional or this policy if the failure to comply with the replacement private passenger "auto" following duties is prejudicial to us: shall not become effective until you notify us and request coverage for the a. In the event of "accident", claim, "suit" or "auto". However, if you replace a private "loss", you or someone on your behalf must passenger "auto" insured with us for at give US or our authorized representative least 12 months before the replacement notice as soon as reasonably possible of date, we will provide the same coverage the "accident"or"loss". lnclude� which applied to the replaced "auto" for (1) How, when and where the "accident" or 3 days beginning on the date you "loss"occurred'. acquire the replacement "auto". We will (2) The"insured's" name and address; and also provide an additional day of coverage for each Saturday, Sunday or (3) To the extent possible, the names and legal holiday failing within the 3 days. addresses of any injured persons and After 3 days, coverage will not apply witnesses. (This condition is not until You notify us and request coverage applicable to Physical Damage for the"auto", Coverage) (3) When an inspection is required by Lis, Written notice by or on behalf of the injured you must cooperate and make the person or any other claimant to our "auto" available for the inspection. authorized representative shall be deemed b. "Auto" Repairs Under Physical Damage notice to us, Coverage b. Additionally, you and any other involved Payment of a physical damage "loss" shall "insured" must not be conditioned upon the repair of the (2) Send us copies of any request, demand, "auto". We may not require that repairs be order, notice, summons or legal paper made by a particular repair shop or received concerning the claim or "suit" concern. However, we shall be entitled to as soon as reasonably possiblen the following: 2. The Legal Action Against Us Condition is (1) A completed "Certification of Automobile replaced by the following: Repairs" as prescribed by the New York No one may bring a legal action against us State Insurance Department; untit (2) If the "auto" is repaired, an itemized a. There has been full compliance with all of repair invoice prepared by the "auto" the terms of the Coverage Form; and repairer, and b. Under Liability Coverage, we, by written (3) An inspection of the "auto", whether or agreement with the "insured" and the not the"auto" is repaired, claimant, agree that the "insured" has an obligation to pay or until the amount of that obligation has finally been determined by judgment after trial. No person or organization has any right under this policy to bring us into any action to determine the "insured's"liability. PKGCANY0002 08 07 NY Page 3 of 5 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Copyright,insurance services Office,�nc,, 1997 3. The Loss Payment Condition is replaced by g. That part of any other contract or the following: agreement pertaining to your business At our option we may: under which You assume the tort liability of �nother to pay damages because of"bodily a. Pay for or replace damaged or stolen injury" or "Property damage" to a third property; or person or organization, if the contract or b. Return the stolen or damaged property, at agreement is made prior to the "bodily our expense, We will pay for any damage injury" or "property damage". Tort liability that results to the"auto"from the "loss".. means a liability that would be imposed by If we pay for the "loss", our payment will law in the absence of any contract or include the applicable sales tax for the agreement. damaged or stolen property. An "insured contract"does not include that part 4. The Two Or More Coverage Forms Or of any contract Or agreement: Policies Issued By Us Condition in the a. That pertains to the loan, lease or rental of Business Auto, Motor Carrier and Truckers an "auto" to you or any of your employees, Coverage Forms is changed as follows: if the"auto" is loaned, leased or rented with This condition does not apply to liability a driver" coverage. b. That holds a person or organization D. Changes In Definitions engaged in the business of transporting property by"auto"for hire harmless for your The Definitions Section in the Business Auto use of a covered "auto" over a route or Form �s changed as follows-, territory that person or organization is 1. The "covered pollution cost or expense" authorized to serve by public authority-, or definition in all coverage forms, except the c. Under which the "insured" assumes liability Business Auto Physical Damage Coverage for injury or damage caused by the Form, is replaced by the following- dumping, discharge or escape of.- "Covered pollution cost or expense" means any (1) Irritants, pollutants or contaminants that cost or expense arising out of� are, or that are contained in any a. Any request, demand, order or statutory or property that is� regulatory requirement; or (a) Being moved from the place where b. Any claim or "suit" by or on behalf of a such property or pollutants are governmental authority demanding accepted by the "insured" for movement into or onto the covered that the "insured" or others test for, monitor, I.auto"; clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess (b) Being transported or towed by the the effects of"poll utants". covered "auto"; 2. Except with respect to Physical Damage (c) Being moved from the covered Coverage, the "insured contract" definition is 11auto" to the place where such replaced by the following): prop" or pollutants are finally "Insured contracV' means: delivered, disposed of or abandoned by the"insured"; a. A lease of premises; (d) Otherwise in the course of transit� or b. A sidetrack agreement; (e) Being stored, disposed of, treated or c. An easement or license agreement in processed in or upon the covered connection with vehicle or pedestrian "auto" other than fuels, lubricants, private railroad crossings at grade-, fluids, exhaust gases or other similar d. Any other easement agreement, except in pollutants that are needed for, or connection with construction or demolition result from, the normal electrical, operations on or within 50 feet of a railroad; hydraulic or mechanical functioning e. An indemnification of a municipality as of the covered"auto" or its parts. required by ordinance, except in connection (2) Irritants, pollutants or contaminants not with work for a municipality; described in Paragraph (1) above f. That part of any contract or agreement unless� entered into, as part of your business, by you or any of your employees, pertaining to the rental or lease of any"auto"� or PKGCANY0002 08 07 NY Page 4 of 5 Includes copyrighted material of Insuranoe Services Office,Inc,,with its permission. Copyright,Insurance Services Office,Inc, 191V (a) The pollutants or any property in (2) Cherry pickers and similar devices which the pollutants are contained mounted on automobile or truck chassis are upset, overturned or damaged as and used to raise or lower workers". and a result of the maintenance or use of (3) Air compressors, pumps and the covered "auto"; and generators, including spraying, welding, (b) The discharge, dispersal, release or building cleaning, geophysical escape of the pollutants is caused exploration, lighting or well servicing directly by such upset, overturn or equipment, damage, "Mobile equipment" does not include land 3. The "mobile equipment" definition is replaced vehicles that are subject to a compulsory or by the following! financial responsibility law or other motor "Mobile equipment" means any of the follo�iving vehicle insurance law where it is licensed or types of land vehicles, including any attached principally garaged. Land vehicles subject to a machinery or equipment compulsory or financial responsibility law or other motor vehicle insurance law are a. Bulldozers, farm machinery, forklifts and considered "autos". other vehicles designed for use principally However, the operation of: off public roads-, b. Vehicles maintained for use solely on or a. Equipment described in Paragraphs f.(2) next to premises you own or rent; and f.(3)above; or c. Vehicles that travel on crawler treads; b. Machinery or equipment that is on, attached to, or part of, a land vehicle that would d. Vehicles, whether self-propelled or not, qualify under the definition of "mobile maintained primarily to provide mobility to equipment" if it were not subject to a permanently mounted: compulsory or financial responsibility law or (1) Power cranes, shovels, loaders, diggers other motor vehicle insurance law where it or drills; or is licensed or principally garaged (2) Road construction or resurfacing is considered operation of "mobile equipment" equipment such as graders, scrapers or and not operation of an"auto" rollers. E. Changes In Forms And Endorsements e. Vehicles not described in Paragraphs a., b., All references to Underinsured Motorists c. or d. above that are not self-propelled Coverage shall mean Supplementary and are maintained primarily to provide Uninsured/Underinsured Motorists Coverage. mobility to permanently attached equipment of the following types: (1) Air compressors, pumps and generators, including spraying. welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers. f. Vehicles not described in Paragraphs a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipmenf' but will be considered 11autos": (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing, or (c) Street cleaning PKGCANY0002 08 07 NY Page 5 of 5 Includes copyrighted materiai of insurance Services Office,Inc with its permission. Copyright,Insurance Services Office,inc, 1997 COMMERCIAL AUTO CA 20 52 09 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK EMERGENCY VEHICLES - VOLUNTEER FIREFIGHTERS AND WORKERS INJURIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. Liability Coverage is changed by adding the follow- This exclusion applies only if you provide or are ing exclusions: required to provide benefits for the worker under VOLUNTEER FIREFIGHTERS any workers' compensation or disability benefits This insurance does not apply to: law or under any similar law. 2. "Bodily injury"to any fellow volunteer firefighter or 1. "Bodily Injury" to any volunteer firefighter or other other volunteer worker of the "insured" if sus- volunteer worker of the "insured" if sustained tained in the course of volunteer firefighting, res- while such person is using or maintaining a cov- cue squad or ambulance corps operations. ered "auto" or is otherwise engaged in other vol- unteer firefighting, rescue squad or ambulance corps operations of the"insured". CA 20 52 09 02 @ ISO Properties, Inc., 2001 Page 1 of 1 POLICY NUMBER: CPKG80320109 COMMERCIAL AUTO CA 22 33 07 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL PERSONAL INJURY PROTECTION (NEW YORK) The company agrees with the named insured, subject to all of the provisions, exclusions and conditions of the New York Mandatory Personal Injury Protection Endorsement, not expressly modified in this endorsement as follows: SCHEDULE Added Personal Injury Protection (Additional Limits) Without Additional Death Benefit Additional Death Benefit Total Additional Monthly Other Designation Or Personal Injury Work Expenses Description Of Vehicle Protection Limits Loss ay) Premium Limit Premium All Vehicles $100,000 $2,000 $25 $1 ncl. $ $ Is Is Is Is Is $ ADDITIONAL PERSONAL INJURY PROTECTION (d) Any other person who sustains personal injury The company will pay additional first party benefits to arising out of the use or operation of any other reimburse for extended economic loss on account of motor vehicle (other than a public or livery con- personal injuries sustained by an eligible injured per- veyance) while occupying such other motor ve- son and caused by an accident arising out of the use hicle, if such other motor vehicle is being oper- or operation of a motor vehicle or a motorcycle during ated by the named insured or any relative. the policy period. This coverage only applies to motor EXCLUSIONS vehicle accidents within the United States of America, This coverage does not apply to personal injury sus- its territories or possessions, or Canada. tained by: ELIGIBLE INJURED PERSON (a) Any person while occupying a motor vehicle Subject to the exclusions set forth below, an eligible owned by such person with respect to which injured person is: the coverage required by the New York Com- (a) The named insured and any relative who sus- prehensive Motor Vehicle Insurance Repara- tains personal injury arising out of the use or tions Act is not in effect; operation of any motor vehicle; or (b) Any person while occupying, or while a pedes- (b) The named insured and any relative who sus- trian through being struck by, a motor vehicle tains personal injury arising out of the use or owned by the named insured with respect to operation of any motorcycle while not occupy- which additional personal injury protection cov- ing a motorcycle; erage is not provided under this policy; (c) Any other person who sustains personal injury (c) Any relative while occupying, or while a pedes- arising out of the use or operation of the in- trian through being struck by, a motor vehicle sured motor vehicle while occupying the in- owned by such relative with respect to which sured motorvehicle; or additional personal injury protection coverage is not provided under this policy; CA 22 33 07 02 @ ISO Properties, Inc., 2002 Page 1 of 3 (d) Any New York State resident other than the (c) Amounts recovered or recoverable by the eligi- named insured or relative injured through the ble injured person for any element of extended use or operation of a motor vehicle outside of economic loss covered by this endorsement New York State if such resident is the owner of under any mandatory source of first-party au- a motor vehicle for which the coverage required tornobile no-fault benefits required by the laws by the New York Comprehensive Motor Vehicle of any State (other than the State of New York) Insurance Reparations Act is not in effect; of the United States of America, its posses- (e) Any person while occupying a motorcycle; sions or territories, or by the laws of any prov- ince of Canada. (f) Any person who intentionally causes his own EXTENDED ECONOMIC LOSS personal injury; (g) Any person as a result of operating a motor Extended economic loss shall consist of the following: vehicle while in an intoxicated condition or while (a) Basic economic loss sustained on account of his ability to operate such vehicle is impaired by an accident occurring within the United States the use of a drug (within the meaning of Sec- of America, its possessions or territories or tion 1192 of the New York Vehicle and Traffic Canada, which is not recovered or recoverable Law); or under a policy issued in satisfaction of the re- (h) Any person while: quirements of article 6 or 8 of the New York Vehicle and Traffic Law and article 51 of the (1) Committing an act which would constitute a New York Insurance Law; felony, or seeking to avoid lawful apprehen- (b) The difference between: sion or arrest by a law enforcement officer; (11) Operating a motor vehicle in a race or (1) Basic economic loss; and speed test; (11) Basic economic loss recomputed in accord- (IIIIII) Operating or occupying a motor vehicle ance with the time and dollar limits set out known to him to be stolen; or in the declarations; and (Ilv) Repairing, servicing or otherwise maintain- (c) An additional death benefit in the amount set ing a motor vehicle if such conduct is within out in the declarations. the course of a business of repairing, ser- TWO OR MORE VEHICLES INSURED UNDER THIS vicing or otherwise maintaining a motor ve- POLICY hicle and the injury occurs on the business The limit of liability under this endorsement applicable premises. to injuries sustained by an eligible injured person while ADDITIONAL FIRST PARTY BENEFITS occupying, or while a pedestrian through being struck Additional first party benefits are payments equal to by, the insured motor vehicle shall be as stated in the extended economic loss reduced by: declarations for that insured motor vehicle. The limit of liability for injuries covered by this endorsement and (a) 20 percent of the eligible injured person's loss sustained by an eligible injured person while occupy- of earnings from work, to the extent that the ex- ing, or while a pedestrian through being struck by, a tended economic loss covered by this en- motor vehicle, other than the insured motor vehicle, dorsement includes such loss of earnings; shall be the highest limit stated for this coverage in the (b) Amounts recovered or recoverable on account declarations for any insured motor vehicle under this of personal injury to an eligible injured person policy. under State or Federal laws providing social ARBITRATION security disability or workers' compensation In the event any person making a claim for additional benefits or disability benefits under article 9 of first-party benefits and the Company do not agree the New York Workers' Compensation Law, which amounts have not been applied to re- regarding any matter relating to the claim, such per- duce first party benefits recovered or recovera- son shall have the option of submitting such disa- ble under basic economic loss; greement to arbitration pursuant to procedures prom- ulgated or approved by the Superintendent of Insur- ance. Page 2 of 3 @ ISO Properties, Inc., 2002 CA 22 33 07 02 El SUBROGATION When coverage provided under this endorsement In the event of any payment for extended economic applies on an excess basis, it shall apply only in the loss, the Company is subrogated to the event of such amount by which the total limit of liability of New York payments to the rights of the person to whom, or for mandatory and additional personal injury protection whose benefit, such payments were made. Such coverage available under this policy exceeds the total person must execute and deliver instruments and limit of liability for any other applicable New York papers and do whatever else is necessary to secure mandatory and additional personal injury protection such rights. Such person shall do nothing to prejudice coverage. such rights. Subject to the provisions of the preceding three para- OTHER COVERAGE; NONDUPLICATION graphs, if the eligible injured person is entitled to ben- efits under any other optional first party automobile or The eligible injured person shall not recover duplicate no-fault automobile insurance for the same elements benefits for the same elements of loss covered by this of loss covered by this endorsement, this Company endorsement or any other optional first-party automo- shall be liable only for an amount equal to the propor- bile or no-fault automobile insurance coverage. tion that the total amount available under this en- If an eligible injured person is entitled to New York dorsement bears to the sum of the amounts available mandatory and additional personal injury protection under this endorsement and such other optional in- benefits under any other policy, and if such eligible surance, for the same element of loss. ini.ured person is not entitled to New York mandatory personal injury protection benefits under this policy, then the coverage provided under this New York Addi- tional Personal Injury Protection Endorsement shall be excess over such other New York mandatory and additional personal injury protection benefits. CA 22 33 07 02 @ ISO Properties, Inc., 2002 Page 3 of 3 El ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:01 NOON A M. THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. CUSTOMIZED VEHICLE EXTENSION ENDORSEMENT This endorsement modifies insurance provided Linder the following: BUSINESS AUTO COVERAGE FORM For covered "autos' described in the Declarations as a. Custom painting and gold leaf lettering-, chief, captain, police, or administrative vehicles, b. Light bars and sirens: paragraph C. Limit Of Insurance, contained in SECTION IV— PHYSICAL DAMAGE COVERAGE, c. Permanently installed radios and other is amended to inClUde the foliowing� communications equipment; We will pay the additional repair or replacement costs d. Permanently installed computer equipment, and necessary to customize the damaged "auto" with e. Permanently installed cameras. permanently installed equipment of like kind and quality, without deduction for depreciation We will Coverage under this endorsement does not apply to also include the cost to install the equipment onto a any covered"auto"insured on an Agreed Value basis, replacement "auto" if the covered "auto' is not repairable. This customization will include, but is not limited to the following! ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE DATE PKGCA0005 2006 ENDORSEMENT NO. ATTACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART (Standard Time) INSURED AGENCY AND OF CODE POLICY NUMBER MO DAY YR. 12:01 NOON A.M. CPKG80320109 Town of Southold 601 DEDUCTIBLE LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above. SCHEDULE Liability Deductible: $ 25,000 Per"Accident" "Property Damage" Deductible: $ Per"Accident" Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Liability Coverage is changed as follows: A. Liability Coverage Deductible C. Our Right To Reimbursement The damages caused in any one "accident" that To settle any claim or "suit" we will pay all or any would otherwise be payable under Liability part of any deductible shown in the Schedule. You Coverage will be reduced by the Liability must reimburse us for the deductible or the part of Deductible shown in the Schedule prior to the the deductible we paid. application of the Limit of Insurance provision. B. Property Damage Liability Coverage Deductible The damages that would otherwise be payable under Liability Coverage for "property damage" caused in any one "accident" will be reduced by the "Property Damage" Deductible shown in the Schedule prior to the application of the Limit of Insurance provision. PKGCANY0005 09 07 NY Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc.,2005 Policv Number RLTMB80200372 U. S. SPECIALTY CPKG80320109 Renewal of Number INSURANCE COMPANY 13403 Northwest Freeway,Houston,TX 77040 UMBRELLA COVERAGE FORM DECLARATIONS Item 1.Named Insured and Mailing Address Agent Name and Address Town of Southold Corieri &Associates 53095 Route 25 t 5 27 Franklin Avenue Southold,NY 11971 Mineola,NY 11501 Item 2: Policy Period From:1/1/2012 To: 1/1/2013 12:01 A.M.Standard Time at your mailing address. BUSINESS DESCRIPTION: Municipality IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY,WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. Item 3.PREMIUM SCHEDULE Estimated Premium For Tk�s Coverage Part $ Included TRfA $ Included State Surcharge or Fee $ N/A Total Estimated Premium For This Coverage Part $ Included Item 4.LIMITS OF INSURANCE 4.a. Each Occurrence Lin-tit $ 10,000,000 4.b. Products—Completed Operations Aggregate Lin-tit $ 10,000,000 4.c. General Aggregate Limit(Other Than Products—Completed Operations) $ 10,000,000 4.d. Retained Lin-tit(1)Underlying Insurance(See Schedule) or, (2)If no Underlying Insurance............................................ $ 10,000 Item 5. SCHEDULE OF UNDERLYING INSURANCE See Supplemental Schedule Item 6.RETROACTIVE DATE: NONE Item 7.FORMS AND ENDORSEMENTS Form(s)and Endorsement(s)made a part of this policy at time of issue*: See Form GEN-902 (09/08) �'Eritry optional if shown in Common Policy Declarations. *rorms and Endorsements applicable to this Coverage Part ornifted if shown elsewhere in the policy. THESE DECLARATIONS AND THE CONINION POLICY DECLARATIONS,IF APPLICABLE,TOGETHER VVITH THE CONINION POLICY CONDMONS,SUPPLEMENTAL SCHEDULE OF UNDERLYING INSURANCE,COVERAGE FORNI(S)AND FORNIS AND ENDORSEMENTS,IF ANY,ISSUED TO FORM A PART THEREOF,COMPLETE THE ABOVE NUWrBERED POLICY. NOTICE: THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK STATE INSURANCE DEPARTMENT, HOWEVER, SUCH FORMS AND RATES MUST MEET THE MINIMUNM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS Class Code:2-13000 Umb Dec-1 UMB-DEC-1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page I of 3 (09-08) U.S. SPECIALTY INSURANCE COMPANY SCHEDULE OF UNDERLYING INSURANCE - UMBRELLA LIABILITY Policy No. CPKG80320109 Effective Date: 1/11/20112 Named Insured: Town of Southold Agent: Corieri &Associates TYPE OF COVERAGE,INSURER,POLICY NUMBER APPLICABLE LIMITS AND POLICY PERIOD General Liabili07 Insurer's Name $1,000,000 Each Occurrence U,S. Specialty Insurance Company $1,000,000 Personal and Advertising Injury Policy Number CPKG80320109 $3,000,000 General Aggregate(other than products/ Completed operations) Applies per Policy. Policy Period 1/11/20112 to 1/11/20113 $3,000,000 Products/Completed Operations Aggregate Automobile Liabil Insurer's Name $1,000,000 Bodily Injury and Property Damage Limit U,S. Specialty Insurance Company Policy Number CPKG80320109 Policy Period 1/11/20112 to 1/11/20113 Employer's Liabil Ston Gap Liabil Bodily Injury Limit Insurer's Name $ Each Accident(by accident) Not Covered $ Policy Limit(by disease) Policy Number $ Each Employee(by disease) Policy Period *NOTE: If Stop Gap Liability is selected then Bodily Inj ury Limits are included in the General Liability Limits. Umb Dec-1 UMB-DEC-1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page 2 of 3 (09-08) U.S. SPECIALTY INSURANCE COMPANY SCHEDULE OF UNDERLYING INSURANCE - UMBRELLA LIABILITY PolicyNo. CPKG80320109 Effective Date: 1/11/20112 Named Insured:Town of Southold Agent: Corieri &Associates TYPE OF COVERAGE,INSURER,POLICY NUMBER AND APPLICABLE LIMITS POLICY PERIOD Law Enforcement Liabil Insurer's Name $1,000,000 Each Person U.S. Specialty hisurance Company $1,000,000 Each Occurrence Policy Number CPKG80320109 $1,000,000 Annual Aggregate Policy Period 1/11/20112 to 1/11/20113 Public Officials Liabil Insurer's Name $1,000,000 Each Loss U,S. Specialty Insurance Company $1,000,000 Annual Aggregate Policy Number CPKG80320109 Policy Period 1/11/20112 to 1/11/20113 Employment Practices Liabili07 Insurer's Name $1,000,000 Each Loss U,S. Specialty Insurance Company $1,000,000 Aggregate Policy Number CPKG80320109 Policy Period 1/11/20112 to 1/11/20113 Umb Dec-1 UMB-DEC-1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page 3 of 3 (09-08) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FORMS SCHEDULE Policy No. CPKG80320109 Effective Date: 1/1/2012 12:01 A.M., Standard Time Named Insured Town of Southold Agent No. 601 The following forms and endorsements are made part of this policy effective on the inception date unless another date is shown above. COVERAGE IS ONLY PROVIDED OR MODIFIED BY THOSE FORMS MARKED WITH AN X. Umbrella Forms Form Number Edition Date Description 1XI GEN-902 0908 Forms Schedule 1XI PKGIL0011 2008 Signature Page 1XI Stam-NY-032-08 0908 NY Changes Cancellation and Nonrenewal 1XI Umb-804 0908 Asbestos Exclusion 1XI UMB-805 0908 Athletic Participants Exclusion 1XI UMB-807 0908 Coverage B Knowledge of Occurrence 1XI Umb-808 0908 Dam Failure Exclusion 1XI UMB-809 0908 Defense Expense SIR Endt 1XI Umb-813 0908 Lead Exclusion 1XI UMB-818 0908 Schedule of Underlying Insurance 1XI UMB-820 0908 Trampoline Exclusion 1XI UMB-DEC-1 0908 Umbrella Coverage Form Declarations FTZ 1XI UMB-FORM-11 0908 Umbrella Policy 1XI IL0985 0108 Disclosure Pursuant to Terrorism Risk Insurance Act 1XI Umb-811 0908 Failure to Supply Exclusion 1XI UMB-814 0908 Limits of Liability Separate Aggregate Protection Endt 1XI UMB-821 0908 Cap on Losses From Certified Acts of Terrorism 1XI UMB-823 0908 Exclusion of Punitive Damages Related to a Certified Act of Terrorism 1XI UMB-824 0908 Exclusion of Certified NBCR Acts of Terrorism Cap on Losses From Certified Acts of Terrorism All other terms and conditions remain unchanged. Forms Sched GEN-902 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 vAth its permission All other terms and conditions remain unchanged. Forms Sched GEN-902 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 1 vAth its permission In Witness Whereof, we have caused this policy to be executed and attested, and, if required by state law, this policy shal I not be valid unless countersigned by our authorized representative. By PRESIDENT SECRETARY Michael J. Schell Randy D. Rinicella PKGIL0011 2008 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NEW YORK CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: UMBRELLA COVERAGE FORM A. The Cancellation Common Policy Condition are replaced by the following, unless broader terms or notice requirements are offered in the Common Policy Conditions attached to the policy: 1. The first Named Insured shown in the Declarations may cancel this entire policy by mailing or delivering to us advance written notice of cancellation. 2. Cancellation Of Policies In Effect a. 60 Days Or Less We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: (1) 30 days before the effective date of cancellation if we cancel for any reason not included in Paragraph A.2.a.(2) below. (2) 15 days before the effective date of cancellation if we cancel for any of the following rea- sons: (a) Nonpayment of premium, provided however, that a notice of cancellation on this ground shall inform the first Named Insured of the amount due; (b) Conviction of a crime arising out of acts increasing the hazard insured against; (c) Discovery of fraud or material misrepresentation in the obtaining of the policy or in the presentation of a claim; (d) After issuance of the policy or after the last renewal date, discovery of an act or omis- sion, or a violation of any policy condition, that substantially and materially increases the hazard insured against, and that occurred subsequent to inception of the current policy period; (e) Material physical change in the property insured, occurring after issuance or last annual renewal anniversary date of the policy, that results in the property becoming uninsura- ble in accordance with our objective, uniformly applied underwriting standards in effect at the time the policy was issued or last renewed; or material change in the nature or extent of the risk, occurring after issuance or last annual renewal anniversary date of the policy, that causes the risk of loss to be substantially and materially increased be- yond that contemplated at the time the policy was issued or last renewed; (f) Required pursuant to a determination by the Superintendent that continuation of our present premium volume would jeopardize our solvency or be hazardous to the interest of our policyholders, our creditors or the public; NY-Canc Umb Stam-NY-032-08 Includes copyrighted material of Insurance Services Office, Inc., Page I of 6 (09-08) with its permission (g) A determination by the Superintendent that the continuation of the policy would violate, or would place us in violation of, any provision of the Insurance Code; or (h)Where we have reason to believe, in good faith and with sufficient cause, that there is a probable risk of danger that the insured will destroy, or permit to be destroyed, the insured prop- erty for the purpose of collecting the insurance proceeds. If we cancel for this reason, you may make a written request to the Insurance Department, within 10 days of receipt of this notice, to review our cancellation decision. Also, we will simultaneously send a copy of this cancellation notice to the Insurance Department. b. For More Than 60 Days If this policy has been in effect for more than 60 days, or if this policy is a renewal or continua- tion of a policy we issued, we may cancel only for any of the reasons listed in Paragraph A.2.a.(2) above, provided: (1) We mail the first Named Insured written notice at least 15 days before the effective date of cancellation; and (2) If we cancel for nonpayment of premium, our notice of cancellation informs the first Named Insured of the amount due. 3. We will mail or deliver our notice, including the reason for cancellation, to the first Named In- sured at the address shown in the policy and to the authorized agent or broker. 4. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. However, when the premium is advanced under a premium finance agreement, the cancellation refund will be pro rata. Under such financed policies, we will be entitled to retain a minimum earned premium of 10% of the total policy premium or $60, whichever is greater. The cancella- tion will be effective even if we have not made or offered a refund. B. The following is added to the Cancellation Common Policy Condition: If one of the reasons for cancellation in Paragraph A.2.a.(2) or D.2.b.(2) exists, we may cancel this entire policy, even if the reason for cancellation pertains only to a new coverage or en- dorsement initially effective subsequent to the original issuance of this policy. C. The following conditions are added: 1. Nonrenewal If we decide not to renew this policy we will send notice as provided in Paragraph C.3. below. 2. Conditional Renewal If we conditionally renew this policy subject to a: a. Change of limits; b. Change in type of coverage; c. Reduction of coverage; d. Increased deductible; e. Addition of exclusion; or f. Increased premiums in excess of 10%, exclusive of any premium increase due to and com- mensurate with insured value added or increased exposure units; or as a result of experience rating, loss rating, retrospective rating or audit; NY-Canc Umb Stam-NY-032-08 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 6 (09-08) with its permission we will send notice as provided in Paragraph C.3. below. 3. Notices Of Nonrenewal And Conditional Renewal a. If we decide not to renew this policy or to conditionally renew this policy as provided in Para- graphs C.1. and C.2. above, we will mail or deliver written notice to the first Named Insured shown in the Declarations at least 60 but not more than 120 days before: (1) The expiration date; or (2) The anniversary date if this is a continuous policy. b. Notice will be mailed or delivered to the first Named Insured at the address shown in the poli- cy and to the authorized agent or broker. If notice is mailed, proof of mailing will be sufficient proof of notice. c. Notice will include the specific reason(s) for nonrenewal or conditional renewal, including the amount of any premium increase for conditional renewal and description of any other chang- es. d. If we violate any of the provisions of Paragraph C.3.a., b. or c. above by sending the first Named Insured an incomplete or late conditional renewal notice or a late nonrenewal notice: (1) Coverage will remain in effect at the same terms and conditions of this policy at the lower of the current rates or the prior period's rates until 60 days after such notice is mailed or delivered, unless the first Named Insured, during this 60 day period, has replaced the cov- erage or elects to cancel. (2) On or after the expiration date of this policy, coverage will remain in effect at the same terms and conditions of this policy for another policy period, at the lower of the current rates or the prior period's rates, unless the first Named Insured, during this additional poli- cy period, has replaced the coverage or elects to cancel. e. If you elect to renew on the basis of a late conditional renewal notice, the terms, conditions and rates set forth in such notice shall apply: (1) Upon expiration of the 60 day period; or (2) Notwithstanding the provisions in Paragraphs d.(1) and d.(2), as of the renewal date of the policy if we send the first Named Insured the conditional renewal notice at least 30 days prior to the expiration or anniversary date of the policy. f. We will not send you notice of nonrenewal or conditional renewal if you, your authorized agent or broker or another insurer of yours mails or delivers notice that the policy has been replaced or is no longer desired. D. The following provisions apply when the Commercial Property Coverage Part is made a part of this policy: 1. Items D.2. and D.3. apply if this policy meets the following conditions: a. The policy is issued or issued for delivery in New York State covering property located in this state; and b. The policy insures: (1) For loss of or damage to structures, other than hotels or motels, used predominantly for residential purposes and consisting of no more than four dwelling units; or (2) For loss of or damage to personal property other than farm personal property or business property; or NY-Canc Umb Stam-NY-032-08 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 6 (09-08) with its permission (3) Against damages arising from liability for loss of, damage to or injury to persons or proper- ty, except liability arising from business or farming; and c. The portion of the annual premium attributable to the property and contingencies described in 1.b. exceeds the portion applicable to other property and contingencies. 2. Procedure And Reasons For Cancellation a. We may cancel this entire policy by mailing or delivering to the first Named Insured written notice of cancellation at least: (1) 15 days before the effective date of cancellation if we cancel for nonpayment of premi- um, provided however, that a notice of cancellation on this ground shall inform the first Named Insured of the amount due; or (2) 30 days before the effective date of cancellation if we cancel for any other reason. b. But if this policy: (1) Has been in effect for more than 60 days; or (2) Is a renewal of a policy we issued: we may cancel this policy only for one or more of the following reasons: (1) Nonpayment of premium, provided however, that a notice of cancellation on this ground shall inform the first Named Insured of the amount due; (2) Conviction of a crime arising out of acts increasing the risk of loss; (3) Discovery of fraud or material misrepresentation in obtaining the policy or in making a claim; (4) Discovery of willful or reckless acts or omissions increasing the risk of loss; (5) Physical changes in the covered property that make that property uninsurable in ac- cordance with our objective and uniformly applied underwriting standards in effect when we: (a) Issued the policy; or (b) Last voluntarily renewed the policy; (6) The Superintendent of Insurance's determination that continuing the poe icy would vio- late Chapter 28 of the Insurance Law; or (7) Required pursuant to a determination by the Superintendent of Insurance that the con- tinuation of our present premium volume would be hazardous to the interests of our pol- icyholders, our creditors or the public. 3. The following are added: a. Conditional Continuation Instead of cancelling this policy, we may continue it on the condition that: (1) The policy limits be changed; or (2) Any coverage not required by law be eliminated. If this policy is conditionally continued, we will mail or deliver to the first Named Insured writ- ten notice at least 20 days before the effective date of the change or elimination. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. If notice is mailed, proof of mailing will be sufficient proof of notice. Delivery of the notice will be the same as mailing. NY-Canc Umb Stam-NY-032-08 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 6 (09-08) with its permission b. Nonrenewal If, as allowed by the laws of New York State, we: (1) Do not renew this policy; or (2) Condition policy renewal upon: (a) Change of limits; or (b) Elimination of coverage; we will mail or deliver written notice of nonrenewal or conditional renewal: (a) At least 45 days; but (b) Not more than 60 days; before the expiration date of the policy. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. If notice is mailed, proof of mailing will be suffi- cient proof of notice. Delivery of the notice will be the same as mailing. E. The following is added to the Commercial Property Coverage Part: When the property is subject to the Anti-Arson Application in accordance with New York Insurance Department Regulation No. 96, the following provisions are added: If you fail to return the completed, signed and affirmed anti-arson application to us: 1. Or our broker or agent within 45 days of the effective date of a new policy, we will cancel the entire policy by giving 20 days' written notice to you and to the mortgageholder shown in the Declarations. 2. Before the expiration date of any policy, we will cancel the policy by giving written notice to you and to the mortgageholder shown in the Declarations at least 15 days before the effective date of cancellation. The cancellation provisions set forth in E.1. and E.2. above supersede any contrary provisions in this policy including this endorsement. If the notice in E.1. or E.2. above is mailed, proof of mailing will be sufficient proof of notice. Delivery of the notice will be the same as mailing. F. The following applies to the Commercial Property Coverage Part,: The following Mortgageholders Conditions are added: Cancellation (1) If we cancel this policy, we will give written notice to the mortgageholder at least: (a) 10 days before the effective date of cancellation if we cancel for your nonpayment of premium; or (b) 30 days before the effective date of cancellation if we cancel for any other reason. (2) If you cancel this policy, we will give written notice to the mortgageholder. With respect to the mortgageholder's interest only, cancellation will become effective on the later of: (a) The effective date of cancellation of the insured's coverage; or (b) 10 days after we give notice to the mortgageholder. NY-Canc Umb Stam-NY-032-08 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 6 (09-08) with its permission Nonrenewal (1) If we elect not to renew this policy, we will give written notice to the mortgageholder at least 10 days before the expiration date of this policy. (2) If you elect not to renew this policy, we will give written notice to the mortgageholder. With respect to the mortgageholder's interest only, nonrenewal will become effective on the lat- er of: (a) The expiration date of the policy; or (b) 10 days after we give notice to the mortgageholder. G. The following provisions apply when the following are made a part of this policy: Commercial General Liability Coverage Part 1. The aggregate limits of this policy as shown in the Declarations will be increased in proportion to any policy extension provided in accordance with Paragraph C.3.d. above. 2. The last sentence of Limits Of Insurance does not apply when the policy period is extended be- cause we sent the first Named Insured an incomplete or late conditional renewal notice or a late nonrenewal notice. NY-Canc Umb Stam-NY-032-08 Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 6 (09-08) with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ASBESTOS EXCLUSION This endorsement modifies insurance provided by: UMBRELLA COVERAGE FORM The following exclusion is added: This insurance does not apply to any "bodily injury", "property damage", "personal and advertising injury", or any loss, cost, expense or legal obligation in whole or in part caused by, resulting from, arising out of, or in any way related to asbestos, included but not limited to: 1. The manufacture, sale, distribution, handling, use, installation, removal, abatement, containment, storage, transportation, disposal, existence, presence, emanation, emission, release, inhalation, ingestion, absorption, or transmission of or exposure to asbestos; 2. Any supervision, instructions, recommendations, notices, warnings or advice given or which should have been given in connection with asbestos; 3. Any request, demand or order that any insured or others test for, monitor, clean up, remove, contain, treat detoxify, remediate, neutralize, or in any way respond to or assess the extent or the effects of asbestos; or 4. Any claim, suit or proceeding for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, remediating, neutralizing or in any way responding to, or assessing the effects of asbestos. We shall have no obligation of any kind including but not limited to, any obligation to investigate, defend, pay defense costs, settle, or pay settlements or judgments as to any claim, suit or proceeding involving or allegedly involving asbestos. As used in this exclusion, asbestos includes but is not limited to, the mineral asbestos in any form, whether or not the asbestos is: a. A fiber, particle or dust; b. Used alone or in any combination with any substance or material; c. Contained in, or on, or incorporated into, products, goods or materials; or d. Present, existing at or contained, stored or transported in any part of any building, structure, building material, product or any other real or personal property. This exclusion does not apply to any "bodily injury" or "property damage" that is caused by a sudden, abrupt striking by, or impact with, asbestos, which causes an immediate and conspicuous manifestation of physical injury to persons or property, or to "bodily injury" or "property damage" arising directly out of the "emergency service actions" or "emergency training operations" of your Fire Department or Hazardous Materials Unit. All other terms and conditions of the policy remain unchanged. Abestos Excl UMB-804(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of I permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ATHLETIC PARTICIPANTS EXCLUSION This endorsement modifies insurance provided under the following: UMBRELLA COVERAGE FORM Coverage B of the policy does not apply to any liability arising out of any injury to any person while practicing for, instructing or participating in any games, contest, exhibition or exercise of an athletic or sports nature. All other terms and conditions of the policy remain unchanged. Athletic Participants Excl UMB-805(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of I permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGE B - KNOWLEDGE OF OCCURRENCE This endorsement modifies insurance provided under the following: UMBRELLA COVERAGE FORM THIS POLICY IS SUBJECT TO THE FOLLOWING WITH RESPECT TO: COVERAGE B The following is added to SECTION V. CONDITIONS, 0. Knowledge of Occurrence Knowledge of an occurrence by the agent, servant or employee of any insured shall not in itself constitute knowledge of the insured unless an executive officer or risk manager shall have received such notice from the agent, servant or employee. All Other Terms and Conditions Remain Unchanged. Cov B Know of Occ. UMB-807(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of I permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DAM FAILURE EXCLUSION This endorsement modifies insurance provided under the following: UMBRELLA COVERAGE FORM This policy does not apply to any liability arising out of the rupture, bursting, overtopping, accidental discharge or partial or complete structural failure or any dam. "Dam" means any artificial barrier including levees, together with appurtenant works, which does or may impound or divert water. All other terms and conditions of the policy remain unchanged. Dam Failure Excl UMB-808(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of I permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEFENSE EXPENSE SELF-INSURED RETENTION ENDORSEMENT This endorsement modifies insurance provided under the following: UMBRELLA COVERAGE FORM THIS POLICY IS SUBJECT TO THE FOLLOWING WITH RESPECT TO: COVERAGE B It is agreed that the insured shall bear all legal costs and expenses arising out of occurrence until such time as the self-insured retention as stated in the schedule of Underlying Insurance is exhausted by payments made in satisfaction of judgments or settlements. The Company shall contribute to legal costs and expenses in the ratio which its proportion of the liability for the judgment or settlement bears to the whole amount of judgment or settlement subject to the Company's liability for such injury or damage. All Other Terms and Conditions Remain Unchanged. Defense Exp SIR End UMB-809(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of I permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LEAD EXCLUSION This endorsement modifies insurance provided by: UMBRELLA COVERAGE FORM The following exclusion is added: This insurance does not apply to any "bodily injury", "property damage", "personal and advertising injury", or any other injury, damage, liability, loss, cost or expense in whole or in part caused by, based upon, resulting from, arising out of, caused by or contributed by, or in any way related to the actual alleged or threatened ingestion, inhalation, absorption or exposure to lead in any form from any source; including but not limited to: 1. The manufacture, sale, distribution, handling, installation, use, removal or storage of lead in any form from any source; or 2. The emission, release or transmission of lead in any form from any source; or 3. Any supervision, instructions, recommendations, notices, warnings or advice given or which should have been given in connection with lead or possible lead exposures; or 4. Any loss, cost, expense, liability or other type of obligation arising out of, or resulting from, or in any related to, any: a. Claim, "suit", request, demand, directive or order by or on behalf of any person, entity or governmental authority that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify, abate, neutralize or in any way respond to, or assess the effects of, lead in any form from any source; or to any b. Claim or "suit" by or on behalf of any person, entity or governmental authority for damages or any other relief or remedy because of testing for, monitoring, cleaning up, removing, containing, treating or detoxifying, abating or neutralizing, or in any way responding to, or assessing the effects of, lead in any form. We shall have no obligation of any kind, including but not limited to, any obligation to investigate, to provide defense, to pay defense costs, or to settle or pay settlements or judgments as respects to any claim, "suit" or proceeding involving or allegedly involving lead as excluded in this endorsement. We further shall have no obligation as respects any insured to indemnify or contribute with any part in connection with the matters excluded in this endorsement. As used in this exclusion, lead includes but is not limited to, the mineral lead (chemical element and symbol �lead (Pb)J Atomic Number 82) in any form, whether or not the lead is: (1) Pure; (2) Contained in, on, or incorporated into, products, goods or materials; (3) Solid, liquid, gaseous or in fumes; or Lead Excl UMB-813(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of 2 permission (4) Contained in any part of any building, structure, building material, product or any other real or personal property. This exclusion does not apply to "bodily injury" or "property damage" that is caused by a sudden, abrupt striking by, or impact with, lead which causes an immediate and conspicuous manifestation of physical injury to persons or property. All other terms and conditions of the policy remain unchanged. Lead Excl UMB-813(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page 2 of 2 permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SCHEDULE OF UNDERLYING INSURANCE This endorsement modifies insurance provided under the following: UMBRELLA COVERAGE FORM It is hereby understood and agreed that, as per the Schedule of Underlying Insurance — Umbrella Liability, no coverage is afforded for indemnity of defense of any claims arising out of the following coverage parts as indicated with an "X": General Liability Public Officials Liability Employment Practices Liability Law Enforcement Liability Automobile Liability x Employers Liability Or Stop Gap Liability All other terms and conditions of the policy remain unchanged. Sche of Underlying Ins UMB-818(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of I permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRAMPOLINE EXCLUSION This endorsement modifies insurance provided under the following: UMBRELLA COVERAGE FORM This policy does not apply to any liability arising out of the bodily injury from the use of a trampoline or other rebounding equipment All other terms and conditions of the policy remain unchanged. Trampoline Excl UMB-820(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page 1 of 1 UMBRELLA POLICY THIS POLICY PROVIDES COVERAGE ON A CLAIMS MADE BASIS UNDER COVERAGE A IF THE SCHEDULED UNDERLYING POLICY PROVIDES CLAIMS MADE COVERAGE. IF COVERAGE IS SO PROVIDED ON A CLAIMS MADE BASIS, IT APPLIES ONLY TO CLAIMS MADE AGAINST AN INSURED DURING THE POLICY PERIOD OR EXTENDED REPORTING PERIOD, IF APPLICABLE. PLEASE READ CAREFULLY. Throughout this policy the words "you" and "your" refer to the Named "Insured" shown in the Declarations, and any other person or organization qualifying as a Named "Insured" under this policy. The words "we," "us" and "ours" refer to the Company providing this insurance. Other words and phrases that appear in quotation marks have special meanings found in SECTION VI. DEFINITIONS. SECTION 1. INSURING AGREEMENTS We, the Company, in return for the payment of the premium, agree with you, as follows: A. Coverage A— Excess Following Form Liability Over Underlying Claims made or Occurrence Coverage We will pay, on behalf of the "insured", sums in excess of the amount payable under the terms of any Underlying Insurance as stated in the Schedule of Underlying Insurance that the "insured" becomes legally obligated to pay as damages because of injury or damage to which this insurance applies. This insurance is subject to the same terms, conditions, agreements, exclusions and definitions as the Underlying Insurance except as otherwise provided in this policy. However, in no event will this insurance apply unless the Underlying Insurance applies or would apply but for the exhaustion of its applicable Limit of Liability. If the Scheduled Underlying Policy affords coverage on a claims made basis then for this insurance to apply: 1. The injury or damage must be caused by an occurrence; 2. The claim for the injury or damage must first be made against the "insured" during the Policy Period or the Extended Reporting Period provided herein; and UMB Cov UMB-FORM-1 (09-08)) Includes copyrighted material of Insurance Services Office, Inc., Page I of 25 with its permission 3. The "bodily injury" or"property damage" or the occurrence causing the "personal and advertising injury", or"professional liability" must take place on or after the Retroactive Date shown in the Declarations and before the termination of this policy. If the Scheduled Underlying Policy affords coverage on an occurrence basis then for this insurance to apply: 1. The injury or damage must be caused by an occurrence; and 2. The "bodily injury" or"property damage" or the occurrence causing the "personal and advertising injury", or"professional liability injury" must take place during the Policy Period. B. Coverage B— Umbrella Occurrence Based Liability Coverage Over Retained Limit We will pay, on behalf of the "insured", damages with respect to liability for loss in excess of the Retained Limit as specified in the Declarations or the amount payable by any other insurance whichever is greater, up to the applicable Limits of Insurance shown in the Declarations when liability is imposed on the "insured" by law or when liability is assumed by the "insured" under an "insured contract" because of: 1. "Bodily injury" or"property damage" which occurs during the Policy Period and is caused by an occurrence; and 2. "Personal and advertising injury" to which this coverage applies, caused by an occurrence committed during the Policy Period. Coverage B will NOT apply to any loss for which insurance is afforded under Coverage A or which arises out of subjects of insurance or exposures to loss for which Underlying Policies are required to be maintained under SECTION V— CONDITIONS, 1. MAINTENANCE OF SCHEDULED UNDERLYING INSURANCE. C. Extended Reporting (Applicable to Coverage A Only) 1 Extended Reporting Periods If Scheduled Underlying Policy(ies) provide coverage on a "claims made" basis then, as set forth in SECTION 1, paragraph A above, this policy provides coverage on a "claims made" basis and: a. We will provide a Basic Extended Reporting Period as described in subparagraph 2 below and, if you purchase it, a Supplemental Extended Reporting Period as described in subparagraph 3 below, IF, i.) This insurance is cancelled or not renewed; or ii.) We renew or replace this insurance with other insurance that: a.) Has a Retroactive Date later than the Retroactive Date shown in the Declarations of this policy; or b.) Does NOT apply to injury or damage on a "claims made" basis. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 25 with its permission 2. Basic Extended Reporting Period A Basic Extended Reporting Period, equal in length to the Basic Extended Reporting Period provided in the applicable Underlying Insurance, is automatically provided as set forth above at no additional charge and provided that: a. Claims first made within the Basic Extended Reporting Period; and b. Claims first made after the Basic Extended Reporting Period for injury or damage caused by an occurrence and reported to us in writing within the Basic Extended Reporting Period; will be deemed to have been made during the "Policy Period" of this policy. The Basic Extended Reporting Period provided in the Underlying Policy means that extended reporting period provided at no additional charge. The Basic Extended Reporting Period does NOT apply to claims that are covered under any subsequent insurance you purchase, or that would be covered but for exhaustion of the amount of insurance otherwise applicable to such claims. 3. Supplemental Extended Reporting Period a. A Supplemental Extended Reporting Period is available only by an endorsement and for an additional charge. This period starts at the end of the Basic Extended Reporting Period and will be equal in length to the Supplemental Extended Reporting Period you purchased in the applicable Underlying Insurance. Claims first made during this Supplemental Extended Reporting Period will be deemed to have been made during the "Policy Period" of this policy but will be subject to the separate Aggregate Limits of Liability set forth in subdivision c. below. The Supplemental Extended Reporting Period provided by the Underlying Policy means that extended reporting period provided at an additional charge. If the Underlying Policy does not provide a Supplemental Extended Reporting Period then this policy does not offer a Supplemental Extended Reporting Period. b. The first Named "Insured" listed in Item 1 of the Declarations must give us a written request for the Endorsement within 60 days after the end of the "Policy Period". Payment in full of the Supplemental Extended Reporting Period premium and any premiums or recoveries owed to us will be made concurrently with such written notice for such Supplemental Extended Reporting Period to become effective. C. If said first Named "Insured" complies with subdivision b. above we will issue the Supplemental Extended Reporting Period Endorsement and will provide the separate Aggregate Limits of Liability described below, but only for claims to which this subparagraph 3. applies. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 25 with its permission SECTION 11. LIMITS OF LIABILITY A. Our total Limit of Liability for loss resulting from any one occurrence will NOT exceed the amount specified in the Declarations. This will be true regardless of: 1. The number of persons and organizations who are "insured" under this policy; 2. The number of coverages provided under this policy; 3. The number of"claims made" and "suits" brought against any or all "insureds"; 4. The number of persons or organizations making claims or bringing "suits". B. The Products Completed Operations Aggregate as stated in the policy Declarations is the most we will pay for all damages to which this policy applies under Coverage A and Coverage B because of injury and damages included in the products-completed operations hazard. C. The General Aggregate as stated in the Declarations is the most we will pay for all damages to which this policy applies under Coverage A and Coverage B, except for: 1. Damages included in paragraph B above, and; 2. Coverage's included in the Scheduled Underlying Policy(ies) to which no underlying aggregate(s) applies. D. If the Limit of Liability of the Scheduled Underlying Policy(ies) as stated in the Schedule of Underlying Insurance has been exhausted by payments made on behalf of any "Insured" by the Underlying Insurer, this policy shall apply as the applicable Underlying Insurance subject to all the terms and conditions of such Underlying Insurance and the terms and conditions of this policy. If the Limit of Liability of the Scheduled Underlying Policy(ies) as stated in the Schedule of Underlying Insurance has been reduced by payments made on behalf of any "insured" by the Underlying Insurer, this policy will drop down to become immediately excess of the reduced underlying limit. Such claims or 11suits" will be subject to the terms of Coverage A. E. The Limits of Insurance of the Scheduled Underlying Policy(ies) will be reduced or exhausted only by payments made on behalf of the "insured" for injury or damage to which this insurance would apply, but for the amount of such injury or damage. F. In no event will our liability under this policy be greater than the total of the Products Completed Operations Aggregate and the General Aggregate as stated in the Declarations. G. The Limits of Insurance of this policy apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the Policy Period shown in the Declarations, unless the Policy Period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limit of Insurance. UMB-Cov. UMB-FORM-11 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 25 with its permission The separate Aggregate Limits of Liability will be equal to the dollar amount shown in the Declarations in effect at the end of the Policy Period for: a. General Aggregate Limit; b. Products Completed Operations Aggregate. Paragraphs B and C of SECTION 11 — LIMITS OF LIABILITY will be amended accordingly. The Each Occurrence Limit shown in the Declarations will then continue to apply as set forth in paragraph A. of SECTION 11— LIMITS OF LIABILITY. We will determine the additional premium for the Supplemental Extended Reporting Period in accordance with our rates. The Supplemental Extended Reporting Period Endorsement will set forth the terms, not inconsistent with this section, applicable to the Supplemental Extended Reporting Period, including a provision to the effect that the insurance afforded is excess over any other insurance available under policies in force after the Supplemental Extended Reporting Period starts. H. How Extended Reporting Periods Apply a. Extended Reporting Periods apply ONLY to claims for injury or damage which occur before the end of the "Policy Period" but NOT before the Retroactive Date shown in the Declarations. b. Extended Reporting Periods do NOT: 0 Extend the "Policy Period" or change the scope of coverage provided; ii.) Reinstate or increase the Limits of Liability applicable to any claim to which this insurance applies, except as described in subparagraph 3 of SECTION I — INSURING AGREEMENTS, C. 1. Extended Reporting Periods may NOT be cancelled once in effect. J. Notification Of Injury, Damage or Claim Notification of injury, damage or claim must be in accordance with F. Duties In The Event Of Occurrence, Claim or"Suit" as stated in SECTION V— CONDITIONS of this policy. Any "insured's"failure to comply with any of the Duties In The Event Of Occurrence, Claim or"Suit" will void any Extended Reporting Period coverage under this policy and we will promptly refund any additional premium you paid for the Extended Reporting Period coverage. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 25 with its permission SECTION III. DEFENSE PROVISIONS A. We will assume charge of the settlement or defense of any claim or"suit" against the "insured" when: 1. The aggregate Limit of Liability of the applicable Scheduled Underlying Policy has been exhausted by payment of claims; or 2. Damages are sought for"bodily injury", "property damage", "personal and advertising injury" covered by this policy and to which no Underlying Insurance or other Insurance applies; Provided there is no duty to defend under any Underlying Policy. B. When we assume such charge we will pay in addition to the applicable Limit of Liability: 1. All expenses we incur; and 2. The following to the extent that they are NOT included in the Underlying Insurance: a. The "insured's" expenses incurred at our request, including actual loss of earnings NOT to exceed $150 per day; b. Premiums for attachment bonds for amounts up to the applicable Limit of Liability, and the cost of bail bonds NOT to exceed $2,000. We do NOT have to furnish these bonds; C. All costs taxed against the "insured" in the "suit"; d. Prejudgment interest awarded against the "insured" on that part of the judgment we pay; if we make an offer to pay the judgment or any remaining applicable limit of liability, we will NOT pay any prejudgment interest incurred after the offer; or e. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable Limit of Liability. C. We will NOT defend any"suit" or claim after we have exhausted the applicable aggregate Limit of Liability as stated in the Declarations. D. If we are prevented by law from carrying out this paragraph, we will NOT pay any expense incurred without our written consent. E. In all circumstances for which paragraph A above is not applicable, we will NOT be obligated to assume charge or pay the expenses for the investigation, settlement or defense of any claim made, or"suit" brought, or proceedings instituted against any "insured" . We will, however, have the right in our sole discretion to participate in the defense and trial of any claims, "suits" or proceedings which relate to any occurrence that may involve this policy. If we avail ourselves of this right, we will do so at our expense. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 25 with its permission SECTION IV. EXCLUSIONS The exclusions applicable to the Underlying Insurance also apply to this insurance. Additionally, the following exclusions apply under COVERAGE A and COVERAGE B. This policy will NOT apply to: A. Statutory Obligations To Employees 1. To any obligation for which the "insured" or any company as its insurer may be held liable under: a. Workers' compensation law, b. Unemployment compensation law, C. Disability benefits law, or d. Under any similar state or federal laws. 2. ERISA To liability imposed on the "insured" under the Employees' Retirement Income Security Act (ERISA) of 1974 or any amendments thereto or similar subsequent federal acts or any similar provisions of state statutory or common law. 3. Automobile First Party Coverage To liability imposed on any"insured" under any uninsured/underinsured motorist law or automobile no fault law or first party personal injury law. 4. Owned Property And Damage To "Your Products" or "Your Work" To "property damage" to or loss of use of: a. Property owned or leased by any"insured" or purchased by any "insured" under installment sales contract or property on consignment to any "insured" ; b. "Your product" caused by such product or any of their parts; or C. "Your work" arising out of the work or out of materials, parts or equipment furnished with such work. 5. Product Recall To 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: a. "Your product", UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 25 with its permission b. "Your work", or C. "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. 6. Nuclear Liability To Nuclear Energy Liability (see attached Nuclear Liability Exclusion). B. COVERAGE A ONLY This policy will NOT apply: 1. Pollution Liability a. To any "professional liability" or related defense costs and expenses arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of pollutants. b. To any liability arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of pollutants: 0 At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to, any "insured; ii.) At or from any premises, site or location which is or was at any time used by or for any"insured" or others for the handling, storage, disposal, processing or treatment of"waste"; iii.) Which are or were at any time transported, handled, stored, treated, disposed of or processed as "waste" by or for any "insured" or person or organization for whom you may be legally responsible; iv.) At or from any premises, site or location on which any "insured" or any contractors or subcontractors'working directly or indirectly on any "insured's" behalf are performing operations: (a) If the pollutants are brought on or to the premises, site or location in connection with such operations by such "insured", contractor or subcontractor; or (b) If the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants. C. To any loss, cost or expense arising out of any: UMB-Cov. UMB-FORM-11 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 8 of 25 with its permission 0 Request, demand or order that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants; or ii.) Claim or"suit" by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of pollutants. Pollutants mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and "waste". "waste" includes materials to be recycled, reconditioned or reclaimed. C. COVERAGE B ONLY This policy will NOT apply: 1. To "advertising injury" resulting from: a. Failure of performance of contract, but this exclusion does NOT apply to claims for unauthorized appropriation of ideas based upon alleged breach of an implied contract; b. Infringement of registered trademark, service mark, trade dress or trade name other than titles or slogans, by use on or in connection with goods or services sold, offered for sale or advertised; C. Incorrect description of any article or commodity; d. Mistake in advertised price. 2. Owned or Leased Aircraft And Aircraft Chartered Without Crew To the ownership, entrustment, maintenance, operation, use, loading or unloading of aircraft owned or leased by any"insured" or chartered by or on behalf of any "insured" without crew. 3. Watercraft To any liability arising out of the ownership, maintenance, operation, use, loading or unloading or entrustment to others of any watercraft owned by any"insured" or rented, loaned, or chartered by or on behalf of any"insured". However, this exclusion does not apply to: a. Watercraft while ashore on premises you own or rent; or b. Watercraft you do not own that is: i.) Less than 50 feet long and not being used to carry persons or property for a charge; or ii.) Less than 50 feet long and chartered by you without crew. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 9 of 25 with its permission 4. Fellow Employees: To any employee with respect to injury to or the death of another employee of the same employer in the course of their employment. 5. Damage To "impaired property" To "property damage" to "impaired property" or property that has NOT been physically injured arising out of: a. A defect, deficiency, inadequacy or dangerous condition in "your product" or"your work"; or b. A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does NOT apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or"your work" after it has been put to its intended use. 6. Alcoholic Beverages To liability arising out of your manufacturing, distributing, selling or serving of alcoholic beverages or to your liability as an owner or lessor of premises used for selling or serving alcoholic beverages. 7. Pollution Liability a. To any liability including defense costs and expenses, arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of pollutants; b. Request that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize pollutants. Pollutants mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and "waste". 'i waste" includes materials to be recycled, reconditioned or reclaimed. 8. Autos To the ownership, entrustment, maintenance, operation, use, loading or unloading of autos within the United States of America, including its possessions and territories, Canada and Mexico, or while "autos" are being transported between these places. 9. Employers' Liability a. To any liability of any "insured" arising out of injury of an employee in the course of employment by any"insured" ; and UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 10 of 25 with its permission b. To any liability of any "insured" arising out of injury of the spouse, child, parent, brother or sister of the employee as a consequence of subdivision a. above, whether the "insured" may be liable as an employer or in any other capacity. Also, this exclusion applies to any obligation to share damages with or repay someone else who must pay damages because of the injury. 10. Services: Fiduciary or Professional To liability arising out of: a. The performance of or failure to perform any fiduciary duty or service; or b. The rendering of or failure to render any professional service, in whatever form, by or on behalf of any"insured". 11. War Exclusion To any liability any "insured" may have, directly or indirectly, occasioned by, happening through, or in consequence of war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, terrorism, military terrorism, military or usurped power or confiscation or nationalization or requisition or destruction of or damage to property by or under the order of any government or public or local authority. 12. Coverage A Exclusion Any liability arising out of any occurrence with respect to which any coverage for any other liability, injury or damage is provided by any Underlying Insurance shown in the Schedule of Underlying Insurance. LIMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 11 of 25 with its permission SECTION V. CONDITONS A. Appeals We can appeal a judgment against any "insured" under this agreement if 1 The judgment is for more than the amount of the Retained Limit or the remaining Limits of Liability under the Underlying Insurance, whichever applies; and 2. The "insured" or the Underlying Insurers do not appeal it. If we appeal the judgment, we will pay the costs of the appeal and any interest on those costs. Those payments will be in addition to the Limits of Liability of this policy. B. Audit Of Books And Records We may audit your books and records at any time during the term of this insurance or within three years after its expiration or termination. There is no time limit on auditing your books and records with respect to claims under this policy. C. Financial Impairment Bankruptcy, insolvency, rehabilitation, receivership, liquidation or other financial impairment of any "insured" or any insurer providing Underlying Insurance as stated in the Schedule of Underlying Insurance shall neither relieve nor increase any of our obligations under this policy. In the event there is a diminished recovery or no recovery available to any "insured" as a result of such financial impairment of any insurer providing Underlying Insurance, the coverage under this policy shall apply only in excess of the Limits of Liability stated in the Schedule of Underlying Insurance. Under no circumstances shall we be required to drop down and replace the Underlying Limits of Liability, or assume any other obligations of a financially impaired insurer or the "insured". D. Cancellation The first Named "Insured" in Item I of the Declarations may cancel this policy at any time by sending us a written request or by returning the policy stating the date of cancellation. We may cancel this policy at any time by sending to the first Named "Insured" in Item I of the Declarations a notice of cancellation 30 days (10 days in the event of non-payment of premium) in advance of the cancellation date. Our notice of cancellation will be mailed to the first Named "Insured's" last known address, and will indicate the date on which coverage is terminated. If cancellation is at the request of the first Named "Insured", return premium will be computed at 90% of pro rata. If we cancel, return premium will be computed pro rata. If this policy insures more than one Named "Insured" , cancellation may be effected by the first Named "Insured" listed in Item I of the Declarations for the account of all the Named "Insureds". Notice of cancellation by us to such first Named "Insured" will be deemed UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 12 of 25 with its permission notice to all "Insureds" and payment of any return premium to such first Named "Insured" will be for the account of all Interests. In the event that provisions of this condition conflict with any state law or regulation governing the cancellation/non-renewal of this policy, then such law or regulation shall prevail and this policy is amended to conform with such law or regulation. E. Changes Notice to any agent or knowledge possessed by any agent or by any other person will not effect a waiver or a change in any part of this policy. This policy can only be changed by a written endorsement that becomes part of this policy. The endorsement must be signed by one of our Authorized Representatives. F. Duties In The Event Of Occurrence, Claim Or "Suit" 1. You MUST see to it that we and your Scheduled Underlying Insurers: a. Are notified in writing as soon as possible of any occurrence which may reasonably be believed to result in a claim involving this policy; b. Receive notice of the claim or suit as soon as possible; C. At our request, receive assistance in the enforcement of any right against any person or organization which may be liable to you or any "insured" because of injury or damage to which this insurance may also apply; d. Receive your full cooperation as stated in this policy or any Scheduled Underlying Policy; and e. Receive your full cooperation in the investigation, settlement or defense of the claim or"suit". Notice of an occurrence is not notice of a claim. 2. Additionally, no "insured" will accept at their own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent, or make any admission of liability. All "insured" must fully cooperate in the investigation, settlement or defense of the claim or"suit". 3. Additionally, when we control the defense or a claim or"suit", we will pay for the defense expense. If by mutual agreement or court order any"insured" assumes control before the applicable Limit of Liability is exhausted, we will reimburse the "insured" for reasonable defense expense. However, we will not pay rates for attorney fees which are greater than those actually paid by us to attorneys retained by us in the ordinary course of business when we are defending similar actions in the community where the claim against the "insured" is being defended. 4. As soon as practicable after we become aware that a Limit of Liability under this policy is exhausted: a. We will notify you of any outstanding claims and "suit" subject to that Limit; and UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 13 of 25 with its permission b. You will then arrange to assume control of the defense of all such claims and "suits" against you or any other "insured" when our right or duty to defend them ends. 5. We will assist you in the transfer of control of the defense of claims and "suits" under subparagraphs 3. or 4. above. Until such arrangements are completed, we will take on behalf of any "Insured" those steps that we think appropriate: a. To avoid a default in any claim or"suit" ; or b. To the continued defense of a claim or"suit". You agree that if we take such steps: a. We do not waive or give up our rights under this insurance; and b. You will reimburse us for any defense expense that arises out of such steps if the applicable Limit of Liability has been exhausted. G. First Named "Insured" The person or organization first Named in Item I of the Declarations shall be known as the first Named "Insured" and is primarily responsible for the payment of all premiums. The first Named "Insured" will act on behalf of all other"Insureds" for the giving and receiving of notice of cancellation and the receiving of any return premiums that become payable under this policy. The first Named "Insured" is authorized to request the Supplemental Extended Reporting Period Endorsement and request changes in the terms of this policy. H. Inspection We have the right, but are NOT obligated to inspect your premises and operations at any time. Our inspections are NOT safety inspections. They relate only to the insurability of the premises and operations and the premiums to be charged. We may give you reports on the conditions we find. We may also recommend changes. While they may help reduce losses, we do NOT undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. We do NOT warrant that the premises or operations are safe or healthful, or that they comply with laws, regulations, codes or standards. I. Maintenance Of Scheduled Underlying Insurance While this policy is in effect you agree to maintain the Underlying Insurance listed in the Schedule of Underlying Insurance in full force. THIS MEANS THAT: 1. The Scheduled Underlying Policy(ies) may NOT be cancelled or NON- RENEWED by either you or the Underlying Insurer without notifying us; 2. Renewals or replacements will NOT be more restrictive in coverage; UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 14 of 25 with its permission 3. Terms, conditions and endorsements of the Scheduled Underlying Policy(ies) will NOT materially change; 4. The risk of uncollectability (in whole or in part) of the Scheduled Underlying Policy(ies) limits as listed in the Schedule of Underlying Insurance, or replacements thereof, whether because of financial impairment or insolvency of an Underlying Insurer or for any other reason, is expressly retained by you and is not in any way or under any circumstances"insured" or assumed by us; and 5. Limits of Insurance will NOT change except for any reduction in the aggregate limit or Limits of Insurance by payment of claims hereunder. Your failure and/or your Underlying Insurer's failure to comply with this condition will NOT invalidate this policy but in the event of such failure, we will only be liable to the same extent as if there had been compliance with this condition. 6. Other Insurance If other insurance applies to claims covered by this policy, the insurance under this policy is excess of such other insurance and we will NOT make any payments until the other insurance has been used up. This condition shall not apply, however, if the other insurance is specifically written to be excess over this policy. Except to the extent stated in this policy, this insurance is NOT subject to the terms. conditions or limitations of any other insurance. J. Our Right To Recover Payment Any persons or organizations for whom we make a payment under this insurance must transfer to us their right to recovery against any other party. After a loss they must do everything necessary to secure, and nothing to impair these rights. K. Premium The premium for this policy as stated in Item 3. of the Declarations is a flat premium and is subject to a minimum and deposit premium, if applicable. It is NOT subject to adjustment UNLESS: 1. A rate is shown in Item 3. of the Declarations; or 2. An endorsement or endorsements are attached to this policy changing the Limit of Liability, adding or changing an Underlying Policy, changing the Policy Period or extending the policy reporting period. If a flat premium is charged, and a minimum premium is shown in Item 3. of the Declarations, then that minimum premium is fully earned as of the inception of this policy. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 15 of 25 with its permission L. Representations By accepting this policy, you agree that: 1. The statements in the Declarations are accurate and complete; 2. Those statements are based upon representations you made to us; and 3. We have issued this policy in reliance upon your representations. M. Titles Of Paragraphs The titles of the varied "sections", paragraphs, and subparagraphs of this policy and endorsements attached to this policy, if any, are inserted solely for convenience or reference and are NOT to be deemed in any way to limit or affect the provisions to which they relate. N. Transfer Of Rights And Duties Your rights and duties under this insurance may NOT be transferred without our written consent, except if you die. 0. When Loss Is Payable This policy will NOT apply until the "insured", or the "insured's" Underlying Insurer is obligated to pay the amount of the underlying limit or Retained Limit for an occurrence which is also covered by this policy. When the amount of loss has finally been determined we will promptly pay on behalf of the "insured" the amount of loss which falls within the terms of this policy. If we are required, or at our sole discretion elect, to pay any amounts on behalf of the "insured" within the Retained Limits, the first Named "Insured" listed in Item I of the Declarations will promptly reimburse us for any such amounts. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 16 of 25 with its permission SECTION VI. DEFINITIONS A. Applicable to Coverage A only The terms appearing in this policy in quotation marks have the meanings as set forth in the Underlying Policy(ies); but, if no definition appears in such Underlying Policy(ies) or if Coverage B applies, the definitions in paragraph B immediately below will apply. B. Applicable to Coverage B The terms appearing in this policy in quotation marks have the meanings as set forth below. 1. "Advertising Injury" means one or more of the following offenses: a. Libel, slander or defamation; b. Any infringement of copyright, title or slogan; C. Piracy, or idea misappropriation under an implied contract; or d. Oral or written publication of material that violates a person's right of privacy; committed or alleged to have been committed during the Policy Period in any advertisement, publicity article, broadcast or telecast and arising out of the "insured's" advertising activities. 2. "Auto" means a land motor vehicle, trailer or semi-trailer designed for travel on public roads, including any attached machinery or equipment; but, does NOT include "mobile equipment". 3. "Bodily Injury" means: a. Injury to the body, sickness or disease, including death resulting from any of these at any time, and if arising out of the foregoing, mental anguish, mental injury, disability, shock or fright; b. Assault and battery when committed by you or at your direction for the purpose of protecting persons or property. 4. "Claims Made" means coverage provided under an Underlying Policy that applies to injury or damage caused by an occurrence where: a. The injury or damage takes place on or after the Retroactive Date shown in the Declarations and before the termination of the policy; and b. The claim for such injury or damage is first made against any "insured" during the Policy Period or any Extended Reporting Period purchased under this policy. UMB-Cov. UMB-FORM-11 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 17 of 25 with its permission 5. "Impaired Property" means tangible property, other than "your product" or"your work", that cannot be used or is less useful because: a. It incorporates "your product" or"your work" that is known or thought to be defective, deficient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement relating to "your product" or"your work", if such property can be restored to use by: 0 The repair, replacement, adjustment, or removal of "your product" or"your work, or ii.) Your fulfilling the terms of the contract or agreement. 6. "Insured": Each of the following is an "insured" to the extent set forth below: a. The Named "Insured", and any Additional Named "Insured" stated in any Additional Named "Insured" Endorsement. b. Any subsidiary you newly acquire or form, other than a partnership or joint venture, will qualify as a Named "Insured" if there is no other similar insurance available to that subsidiary. However: i.) Coverage under this provision is afforded only until the 90th day after you acquire or form the subsidiary or the end of the Policy Period, whichever is earlier; ii.) Coverage A does not apply to injury or damage that occurred before you acquired or formed the subsidiary; and iii.) Coverage B does not apply to "bodily injury", "property damage", and "advertising injury" that occurred before you acquired or formed the subsidiary. Subsidiary means a corporation of which the Named "Insured" owns more than fifty percent of the issued and outstanding voting stock, either directly or indirectly, through one or more of its subsidiaries. C. If you are an individual, you and your spouse are "insureds" , but this policy will only apply to the conduct of a business or business properties of which you are a sole owner; d. If you are a partnership or joint venture, any partner or member and their spouses but only with respect to the conduct of your business. This policy will only apply to partnerships or joint ventures designated within Item I of the Declarations as a Named "Insured"; UMB-Cov. UMB-FORM-11 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 18 of 25 with its permission e. Any person or organization (other than you) included as an "insured" in the Scheduled Underlying Insurance but NOT for broader coverage than is available to them under the Scheduled Underlying Insurance; f. Except with respect to the ownership, maintenance, entrustment, operation, use, loading or unloading of aircraft or watercraft; any officer, director, stockholder or employee of yours while acting within the scope of their duties as such, but this subdivision e. will NOT apply if it restricts the insurance granted under subdivision d. above; 9. Any person (other than one of your employees) or organization while acting as your real estate manager; h. If an "insured" dies, then his rights and duties will be transferred to his legal representative, but only while acting within the scope of duties as his legal representative, or to anyone having temporary custody of his property until his legal representative has been appointed. 7. "Insured Contract" means any written or oral agreement entered into by the "insured" in the usual course of the business operations of the "insured" in which the "insured" assumes tort liability of another to pay damages because of"bodily injury", "property damage", and "advertising injury" to a third person or organization where the contract or agreement is made prior to the injury or damage. However, an "insured contract" does not include that part of any contract or agreement: a. That indemnifies an architect, engineer or surveyor for injury or damage arising out of: 0 Preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or ii.) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; b. Under which the "insured", if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the "insured's" rendering or failure to render professional services, including those listed in subdivision a. above and supervisory, inspection or engineering services. 8. "Tort Liability" means a liability that would be imposed by law in the absence of any contract or agreement. 9. "Mobile Equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bull dozers, farm machinery, forklifts and other vehicles designed for use principally off public roads; b. Vehicles maintained for use solely on or next to premises you own or rent; UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 19 of 25 with its permission C. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: 0 Power cranes, shovels, loaders, diggers or drills; or ii.) Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in subdivisions a., b., c., or d, above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: i.) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or ii.) Cherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in subdivisions a., b., c., or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" and will be considered 11autos" : i.) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; (c) Street cleaning; ii.) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and iii.) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. 10. "Occurrence" means: a. An accident, including continuous and repeated exposure to substantially the same general harmful conditions which results in bodily injury or property damage which is neither expected nor intended form the standpoint of the "insured" . All such exposure to substantially the same general conditions will be considered as arising out of one occurrence: UMB-Cov. UMB-FORM-11 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 20 of 25 with its permission b. With respect to personal injury, only the offenses specified in DEFINITION B. 11. All damages arising out of substantially the same offense will be considered as arising out of one occurrence; C. With respect to advertising injury only the offenses listed in DEFINITION B. 1. All damages involving the same injurious material or act, regardless of the frequency or repetition thereof, the number or kind of media used, the number of claimants and all such damages will be considered as arising out of one occurrence; and d. With respect to professional liability a breach of duty, neglect, error, omission, misstatement, misleading statement, or other wrongful act as defined by the scheduled Underlying Insurance. All damages involving the same wrongful act or a series of continuous or interrelated wrongful acts will be considered as arising out of one occurrence. 11. "Other Insurance" means insurance other than Scheduled Underlying Insurance or insurance specifically purchased to be excess of this policy affording coverage that this policy also affords. 12. "Personal Injury" means one or more of the following offenses: a. False arrest, false imprisonment, wrongful detention or malicious prosecution; b. Libel, slander, defamation of character, or oral or written publication of material that violates a person's right of privacy, unless arising out of advertising activities; C. Discrimination EXCEPT: i.) When arising out of the willful violation of a statute; or ii.) When committed by or with knowledge or consent of an "insured" d. Wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies by or on behalf of the owner, landlord or lessor, or by a person claiming to be acting on behalf of the owner, landlord or lessor. 13. "Policy Period" means the period of time stated in Item 2 of the Declarations. 14. "Products-Completed Operations Hazard" means: a. All "bodily injury" and "property damage" arising out of "your product" or "your work" but only if the "bodily injury" and "property damage": i.) Arises from products no longer in your physical possession; or ii.) Occurs after"your work" has been completed or abandoned. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 21 of 25 with its permission b. "Your work" will be considered completed at the earliest of the following times: i.) When all of the work called for in your contract has been completed; or ii.) When all of the work to be done at the site has been completed if your contract calls for work at more than one site; or iii.) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. C. Work that may need service, maintenance, correction, repair or replacement but which is otherwise complete, will be treated as completed; d. The "prod ucts-com pleted operations hazard" does NOT include "bodily injury" or"property damage" arising out of: i.) The transportation of property unless the injury or damage arises out of a condition in or on a vehicle created by the loading or unloading of it; ii.) The existence of tools, uninstalled equipment or abandoned or unused materials. 15. "Professional Liability" means any liability of the "insured" for damages covered by any Scheduled Underlying Insurance arising out of or attributable to any breach of duty, neglect, error, omission, misstatement, misleading statement or other wrongful act as defined in the Scheduled Underlying Insurance. 16. "Property Damage" means: a. Physical injury to tangible property which occurs during the Policy Period, including all resulting loss of use of such property resulting from it at any time; or b. Loss of use of tangible property which has NOT been physically injured or destroyed, provided such loss of use is caused by an occurrence during the Policy Period. 17. "Suit" means a civil proceeding in which damages because of "bodily injury" , 'i property damage" "personal and advertising injury" or "professional liability" to which this insurance applies are alleged, including without limitation: a. An arbitration proceeding in which such damages are claimed and to which you must submit or do submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which you submit with our consent. UMB-Cov. UMB-FORM-11 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 22 of 25 with its permission 18. "Your Product" means: a. Any goods or products (other than real property) manufactured, sold, handled, distributed or disposed of by: 0 You; ii.) Others trading under your name; or iii.) A person or organization whose business or assets you have acquired; and b. Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. "Your product" includes warranties or representations made at any time with respect to the fitness, quality, durability or performance of any of the items included above. Your product also includes the providing of or failure to provide warnings or instructions. "Your product" does NOT include vending machines or other property rented to or located for the use of others but not sold. 19. "Your Work" means: a. Work or operations performed by you or on your behalf; and b. Materials, parts or equipment furnished in connection with such work or operations. "Your work" includes warranties or representations made at any time with respect to the fitness, quality, durability or performance of any of the items included above. "Your work" includes the providing of or failure to provide warnings or instructions. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 23 of 25 with its permission NUCLEAR ENERGY LIABILITY EXCLUSION This policy does NOT apply to "bodily injury", "property damage", "personal and advertising injury", or "professional liability" if applicable: A. 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 Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insurance Association of Canada, or any of their successors, or would be an "insured" under any such policy but for its termination upon exhaustion of its limit of liability; or 2. Resulting from the "hazardous properties" of"nuclear material" and with respect to which: i.) Any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof; or ii.) 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, with any person or organization. B. 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. To "bodily injury" or"property damage" resulting from the "hazardous properties" of nuclear material, if the nuclear material: 1. Is at any""nuclear facility.... owned by, or operated by or on behalf of an "insured" ; or 2. Has been discharged or dispersed there from; 3. 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 4. "Bodily injury" or"property damage" arises out of the furnishing by an "insured" of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any "nuclear facility", but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (4) applies only to "property damage" to such "nuclear facility" and any property thereat. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 24 of 25 with its permission D. As used in this exclusion: 1. "Hazardous Properties" include radioactive, toxic or explosive properties; 2. Nuclear material means "source material", special nuclear material or by-product material; 3. "Source Material", special nuclear material and by-product material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof; 4. "Spent Fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor; 5. "Waste" means any "waste" material: a. Containing by-product material other than the tailings or"waste"s produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its "source material" content; and b. Resulting from the operation by any person or organization of any 'i nuclear facility" included under the first two paragraphs of the definition of"nuclear facility". 6. ""Nuclear Facility means: a. Any "nuclear reactor"; b. Any equipment or device designed or used for: i.) Separating the isotopes of uranium or plutonium, ii.) Processing or utilizing "spent fuel", or iii.) Handling, processing or packaging "waste"; C. Any equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the "insured" at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; d. Any structure, basin, excavation, premises or place prepared for or used for the storage or disposal of"waste"; e. 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; "Nuclear Reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material; "Property Damage" includes all forms of radioactive contamination of property. UMB-Cov. UMB-FORM-1 (09-08) Includes copyrighted material of Insurance Services Office, Inc., Page 25 of 25 with its permission POLICY NUMBER: CPKG80320109 IL 09 85 01 08 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE Terrorism Premium (Certified Acts) $ Included This premium is the total Certified Acts premium attributable to the following Coverage Part(s), Cover- age Form(s) and/or Policy(s): Additional information, if any, concerning the terrorism premium: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Disclosure Of Premium C. Cap On Insurer Participation In Payment Of In accordance with the federal Terrorism Risk In- Terrorism Losses surance Act, we are required to provide you with a If aggregate insured losses attributable to terrorist notice disclosing the portion of your premium, if acts certified under the Terrorism Risk Insurance any, attributable to coverage for terrorist acts certi- Act exceed $100 billion in a Program Year (Janu- fied under the Terrorism Risk Insurance Act. The ary 1 through December 31) and we have met our portion of your premium attributable to such cov- insurer deductible under the Terrorism Risk Insur- erage is shown in the Schedule of this endorse- ance Act, we shall not be liable for the payment of ment or in the policy Declarations. any portion of the amount of such losses that ex- B. Disclosure Of Federal Participation In Payment ceeds $100 billion, and in such case insured loss- Of Terrorism Losses es up to that amount are subject to pro rata alloca- tion in accordance with procedures established by The United States Government, Department of the the Secretary of the Treasury. Treasury, will pay a share of terrorism losses in- sured under the federal program. The federal share equals 85% of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 bil- lion in a Program Year (January 1 through De- cember 31), the Treasury shall not make any payment for any portion of the amount of such losses that exceeds$100 billion. IL 09 85 01 08 C) ISO Properties, Inc., 2007 Page 1 of 1 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FAILURE TO SUPPLY EXCLUSION This endorsement modifies insurance provided under the following: UMBRELLA COVERAGE FORM The policy does not apply to any liability arising out of or contributed to by any complete or partial failure to supply water, electricity, gas, oil, steam, "telecommunications", or any similar utilities. As used in this endorsement, the term "telecommunications" includes but is not limited to messages or information transmitted through use of local, toll and wide area telephone service, private line services, channel services, telegraph services, teletypewriter, telephony, computer exchange services, radio, television, microwave, satellite, cellular mobile telecommunications service, specialized mobile radio, stationary two way radio, paging service, or any other form of mobile and portable one-way or two-way communications; or any other transmission of messages or information by electronic, magnetic electromagnetic, electromechanical, electrochemical or similar means between or among points by wire, cable, fiber-optics, laser, microwave radio, satellite or similar facilities. All other terms and conditions of the policy remain unchanged. Failure To Supply Excl UM B-81 1 (09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of I permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITS OF LIABILITY - SEPARATE AGGREGATE PROTECTION This endorsement modifies insurance provided under the following: UMBRELLA COVERAGE FORM The following is added to Section 11. Limits of Liability, C. 3. However, with respect to Coverage A only, the Aggregate will apply in the same separate manner as the aggregate in each policy listed in the Schedule of Underlying Insurance. All other terms and conditions of the policy remain unchanged. Limits of Liability—Sep Agg Prot UMB-814(09-08) Includes copyrighted material of Insurance Services Office, Inc.,with its Page I of I permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA COVERAGE PART If aggregate insured losses attributable to terrorist "Certified act of terrorism" means an act that is acts certified under the federal Terrorism Risk certified by the Secretary of the Treasury, in Insurance Act exceed $100 billion in a Program Year concurrence with the Secretary of State and the (January 1 through December 31) and we have met Attorney General of the United States, to be an act of our insurer deductible under the Terrorism Risk terrorism pursuant to the federal Terrorism Risk Insurance Act, we shall not be liable for the payment Insurance Act. The criteria contained in the Terrorism of any portion of the amount of such losses that Risk Insurance Act for a "certified act of terrorism" exceeds $100 billion, and in such case insured losses include the following: up to that amount are subject to pro rata allocation in 1. The act resulted in insured losses in excess of $5 accordance with procedures established by the million in the aggregate, attributable to all types of Secretary of the Treasury. insurance subject to the Terrorism Risk Insurance Act; and 2. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. UMB-821 (09-08) Page 1 of 1 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OF TERRORISM This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA COVERAGE PART A. The following exclusion is added: 2. The act is a violent act or an act that is This insurance does not apply to: dangerous to human life, property or infrastructure and is committed by an individual TERRORISM PUNITIVE DAMAGES or individuals as part of an effort to coerce the Damages arising, directly or indirectly, out of a civilian population of the United States or to "certified act of terrorism" that are awarded as influence the policy or affect the conduct of the punitive damages. United States Government by coercion. B. The following definition is added: "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria contained in the Terrorism Risk Insurance Act for a "certified act of terrorism" include the following: 1. The act resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act; and UMB-823 (09-08) Page 1 of 1 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF CERTIFIED NUCLEAR, BIOLOGICAL, CHEMICAL OR RADIOLOGICAL ACTS OF TERRORISM; CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA COVERAGE PART A. The following exclusion is added: 2. "Certified act of terrorism" means an act that is This insurance does not apply to: certified by the Secretary of the Treasury, in concurrence with the Secretary of State and TERRORISM the Attorney General of the United States, to "Any injury or damage" arising, directly or be an act of terrorism pursuant to the federal indirectly, out of a "certified act of terrorism". Terrorism Risk Insurance Act. The criteria However, this exclusion applies only when one or contained in the Terrorism Risk Insurance Act more of the following are attributed to such act: for a "certified act of terrorism" include the 1. The terrorism involves the use, release or following: escape of nuclear materials, or directly or a. The act resulted in insured losses in excess indirectly results in nuclear reaction or radiation of$5 million in the aggregate, attributable to or radioactive contamination; or all types of insurance subject to the 2. The terrorism is carried out by means of the Terrorism Risk Insurance Act; and dispersal or application of pathogenic or b. The act is a violent act or an act that is poisonous biological or chemical materials; or dangerous to human life, property or 3. Pathogenic or poisonous biological or chemical infrastructure and is committed by an materials are released, and it appears that one individual or individuals as part of an effort purpose of the terrorism was to release such to coerce the civilian population of the materials. United States or to influence the policy or affect the conduct of the United States B. The following definitions are added: Government by coercion. 1 For the purposes of this endorsement, "any C. In the event of any incident of a "certified act of injury or damage" means any injury or damage terrorism" that is not subject to this exclusion, covered under any Coverage Part to which this coverage does not apply to any loss or damage endorsement is applicable, and includes but is that is otherwise excluded under this Coverage not limited to "bodily injury", "property Part. damage", "personal and advertising injury", D. If aggregate insured losses attributable to terrorist "injury" or "environmental damage" as may be acts certified under the federal Terrorism Risk defined in any applicable Coverage Part or Insurance Act exceed $100 billion in a Program underlying insurance. Year (January 1 through December 31) and we have met our insurer deductible under the Terrorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. UMB-824(09-08) Page 1 of 1 El