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Hamlin, WDyn13 County, PonnaylvDnla.
7, Donlod. It Is denlod that plolntlff has fully porformod Its obligations
by providing Insuronoo covorogo or thot tho Insuranoo was lequested or approved
when, In foot, It was only equate whloh was requested.
6, Denied. It Is denied that the defendent breaohed any agreement
when, In foot, he had requosted a cancollatlon of the polley elnoe the quote was too
high end he hod obtained cheaper Insurance.
S. Denied. The pollclee hed been cancelled by the defendent, or
never should hove bllen leeued, wall before the time period set forth by plaintiff,
10. Denied. It Ie denied that eny amounte ore due elnoe the polloy
wes canoe lied and/or ehould not have boan leeued. In fact, tho dofandant hod
procured other Insurance, e copy of which Ie attached hereto and marked Exhibit A.
11. Admitted, with the explanation that the amounte wore not due
and owing.
12. The plaintiff was awere at all tlmelS that the defendant had othar
Insuranoa, a oopy of which Ie ottachad harato and marked Exhibit A.
WHEREFORE, defendent demands judgment agalnet the plaintiff plus
oosts and Interest.
NEW MATTER
13, Defendant Incorporates by reference the answare to paragraphs
one through twelve by reference es If they were ageln set forth at length.
COMMON POLICY CONDITIONS
All Coverolle Ports IIlrludOlj III 1I11S policy nro 6ublocl to Ihe following condlllllnb
A.OANOELLATlON
I, The flrsl Named Insured shown In Ihe Oocloro.
lIon5 may concol Ihls policy by molllnll or
deliverlnll 10 us advllnce wtltton nolice of
cOl1collotlon,
2, We may concellhls polll;y by mollinll ar deliver.
inlllo Ihe first NllfllOd Insured written nollco of
concellollon 01 least:
II 10 days bel ore Iho ellocllve dote 01 cnncollll'
lion If we concoll!)r nonpoyment 01 p.onllllfll;
or
b, 30 days before Iho ollecllve dote 01 concello.
lion il wo cancel fOl ony olher reoson,
3, We will molloI' deliver our Mllce to the first
Named Insured'slost mOlllnll oddren known 10
us,
4, Nollce 01 concellolion will slole the e"ecllve
dote of concellotlon, The policy porlod will end
on Ihot dote,
5 " this policy is concelled. we will send the first
Nom~d Insured ony premium refund due, If wo
cancel, the relund Will be pro mto, II Ihe Iit61
Named Insured cnncols. Ihe refund mny be less
Ihan pro rota, Tho cancellation will be oflectlve
evon If we hovo not made or offered 0 refund,
6, If nollce 15 n'~iled, proal of mollinll will be suffl.
c1ent proof at notice,
B. OHANGES
This policy contains 011 I,he ollreements between
you and us concerninll the insurance allorded, The
Ilt6t Named Insured shown in the Declorollons is
outhorlled to make chanlles In the terms 01 this
policy with our consent. This pOllcy's terms can be
amended or waived only by endorsemenll56ued by
us and made 0 part of this polley,
C, EXAMINATION OF YOUR BOOKS AND
RECORDS
WU may examine and audit your books and records
05 they relate to this policy at any lime durinlltho
policy period and up to three years afterward,
..
IL 00 17 11 85
D. INSPECTIONS AND SURVEYS
Wo "nve Ihe tlllhl but ore nol obllllated to:
I Mako IIlSpOCllons nnd survoys et any lime;
2 G,VO you rllporlb lllllhe conditions we find, and
3 1l0colIl/1wnd cllIH1llOS
Any '''spocllons, 5urvcys, roporls or reconllllenda.
110m loloto only 10 Iflsuroblllty and the premiu/lls to
ho r1lilrHod Wc do nol fllllk<lsaloly Inspecllons, Wo
dl) nlll Ilndertako to porlotllllhe duty 01 any person
or l)t'~"'"lilllon 10 prov'du for Ihe heollh or saf<lty of
work,)ts or the public, Alld we do not warrantlhat
cOIIl/II'Oll5
I At<! sole or '1eullhlul. or
2, Comply with lows, rellulatlons, codes or 5lan-
dOlds,
n115 condition applies not only 10 US, but also to any
rol'n~, ul/vl6ory, rute service or similar orllanllO'
lion which makes "Isurance inspoctlons, surveys.
report~ or recommendations,
E. PREMIUMS
Tile Ii'sl Named Insured shown in the l)eclorotlon5'
1 ",osponslble lor IlIe puymenl of 011 premlullls;
tllld
2 Will be the payec lor any r<lturn premiums we
pay,
F. TRANSFER OF YOUR RIGHTS AND DU.
TIES UNDER THIS POLICY
Your "ghts and duties under this policy may not be
transferred WII.houl our written consent except In
Ihe case or dealh of an individual named Insured,
If you die, your righls and dutlos will be transferred
to your legal representative but only while acting
with,n the scope 01 duties as your 'ellal represen.
tal,ve. Until your legal r>!!presentatlve Is appointed,
anyone having proper temporary custody 01 your
property will have your rillhts and duties but only
wllh rospectto Ihat property,
Copyright, Insurance ~ervlces Ollice, Inc" 1982, 1983
o
-
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PENNSYLVANIA CHANGES.
CANCELLATION AND NONRENEWAL
Thll o"dorlQmonlmo~llI06 Inuurllncu plovhlu<l '/llllur Ihu 10lhlWlllu'
BOILER AND MACIUNEHY COVUlAGE "AIl1
BUBINEBBOWNERU PULlCY
COMMERCIAL AUTO COVEHAGE "All r
COMMERCIAL CRIMi: cnVl'IlAGt: "AIU"
COMMERCIAL GENi:HAL UAllll.lTY CllVEIlAOE PAin
COMMERCIAL PROrrlHY COVfIlAGE PAlH
COMME~CIAL INLANU MAHINE COVEll AGE PAIH
FARM COVERAGE "AIlT
LIQUOR 1.IABILlTY cOVEIlAGE PAIH
POLLUTION LIABILITY COVEHAGE PAIH
PRODUCT6/COMPtE TEll UPERA TIONS LIABILITY COVERAGE PART
· This endorsemenl dous 1101 IIpply 10 coveraue provldod ror omployoo dlshonesly (Covorago Form Alar
public employou dlshollesly (Covuraue Forms 0 IInd PI,
A. The CANCELLATION CUfllIIlI'II Policy CallcllloII
Is replaced by Ihe followlnU
CANCELLATION
1, Tho flrsl Naflled hlSlJ..I' shoWII In Ihe Doelll'
rullons f11I1Y cllllcel Ill,s policy by wrlllnlj or
glvlnu nollee of Clll1Cl!IIIIIIon
2. CANCELLATION OF POLICIES IN EfFECT
FOR LESS THAN GO OAYS
Wo may callcol Ihls policy by mailing or de.
IIverlng 10 Iho flrsl Namod Insured wrlllen
nollce 01 cancollallon at loasl 30 days belore
Iho eJlecllvo dolo oJ clll1collulloll.
3. CANCELLATION OF POLICIES IN EFFECT
FOR GO DAYS OR MORE
IIlhls policy has b00l1l11 ollocl for 60 days or
moro or II Ihls policy IS II ronewlIl of a policy
we Issuod, wo may callcollhls policy only Jar
ono or moro or Ihe following roasons:
a, You havo mad. II fllllturlul mlsropresol1'
lallon which 1I110[IS Iho Il1surablllly 01 Iho
risk, Nollco 01 CIlI1[I!IIl1llon will bo mullod
or dollvorod III lousl 15 duys bolm. Iho
offocllve dolo 01 [an[Ollllllol1,
b. You have follod to pay 0 promlum when
due, whelhor Iho promlum Is payable dl.
reclly 10 us or our agonls or Indlreclly UI1'
der a premium flnanco plan or o~lenslon
01 credit, Nollco 01 cancollatlon will bo
mailed 01 leasl 15 days boloru Iho erroc.
tlve dale or cancollatlon,
...
II. A condlllon. loclor or loss o~perlol1r.o filII'
lerlollo Insuroblllly hon chongod subsllll1'
lIally or 0 subs'ol1l1ol cOl1dlllol1. foclor or
Ion o~porlonc" IIIlIlorllll 10 Insuruulllty
has uocomo known durlnu Ihe policy po.
rlod, Nolleo or concullollol1 will uo mUlled
or dollvored 01 loosl 60 doys boJoro tho
olfutllvo dolo 01 concullllllon.
d, Loss oJ rolnsuroncu or 0 suuslonlllll do.
crooso In rolnsuroncu hos occurrod, which
loss or ducrooso, ollho tlmo 01 cancollo,
lion, sholl bo cor1ll1od 10 Iho Il1surnn[o
Commlsslonor os directly nlfocllnu In.
forco pollclos Nollco oJ ClIncollotlon will
bo moiled or dollvorod III lonsl 60 doys
boforo Iho olfocllvo dotu oJ cllncollollon
e, Molorlal falluro 10 comply wllh policy
lorms, conditions or conlra[lual dutlos,
Nollco 01 concollotlol1 will bo mollod or
dollvored 01 loasl 60 dnys boJoro Iho of.
focllvo dato of cllncollllltoll.
I. Olher rOll60ns thol Ihl! 1116utllnco Com.
missioner moy apllrovo, Notlco 01 COil-
collallon will bo 11111110<1 or dollvored 01
loosl 60 doys boforo Ihe elfocllvo dolo of
r.oncollollon,
This policy moy also be cancolled rrom Incopllon
upon discovery Ihol 'he policy wu oblalnod
Ihrough fraudulenl slolemonls, omissions or
conceolment 01 rocls molorlol to Iho occoptonco
Of Ihe risk or to the halord BSslJmod by us,
IL 02 ~6 06 89
Copyright. Insuronco Sorvlces Qlllco. Inq 1.g86,:.1089
Copyrlghl, 15Q, Commorclol Risk' 60rvlces"lnc:. 1986, t089
Pogo ,1 oJ 2 (J
-,
MC:llCIII\N'I'S Ii IJUI.lIl'mSS MI;;N's Ml)'I'Uf\l, INl.lllHANC~~ COMPANY
C:OMM"I~CIAl. l)ROPEIl'l'Y C:OVERA<J1i: PAR'I'
Policy Number I 372'109;l5-[>P
C:ffective Patol 0'l/1U!91 C:xpiration Datel
Named Inoured I P/\NbA GMPC:N CUO YOUNG ClIUN
~ll)Pl'[,I,MI.N'I'M, OECLMA'I'IONB
[)age
1 of 1
07/18/95
P/B/A
_______...___..___M_____.._____..___________.._________...__._____________...._______
DESCRI P'rION Ol" PREMISJ::S - LOCATION ADDRESS
Prems. Old.
No, No. Stroet City St Zip
1 I EXI'1' 9,1-01, ROU'rE "37 Ill,OOM ING GIlOVE 'rwp. PA 18420
VILI.J\GI:: C:'I'R, I.,ORPS VALLEY, I)IKI:: COUNTY
--- .................. - -... --.. -.... -..-.. --..--.....---..--....-.....- ......-.. ~.............. -............. -- .....................
PC:SCRIPTION OF
Pr.ems. Bldg.
No. No.
PREMISES - OCCUPMlCY /\NO CONSTRUCTION
Const ruct iotl
li'rotection
9
Occupancy
1
1
RESTAURANT-n/ALCOHOL-W/o PANCE NON-COMB
------..............-----..---..-....--....-..---...............--........-----..--_........~........_-...._-----_..
COVJ::RAGES PROVIDEP
p1'ems, Oldg,
No. No. coverage
Limit of Covered Causes
Insuranco of Loss Coins
Ped
Premium
1
1
PJ::RS PROP
250
30000
80\
SPECIAL
-_..-_..----_..-.._~--_..-......_----_.._-_...._..-..-----_._-_..........-_..__.....~-~_..~-~~~"......
OPTIONAL COVERAGES (APPLICABLB ONLY WHBN ENTRIBS ARB MADE IN SCHBDULE BELOW)
Premo, Bldg. Agreed Value Replacement Cost Inf1at ion
No. No, coverage Bxp Pate Amount Incl Stock Guard
- - ~ ~ ~ - .. - . .. .. .. ... ~ ~ ~ ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. - .. .. .. .. .. ... .. ~ .. ... .. .. .. ... .. - .. .. .. .. ~ ... .. .. .. .. .. .. .. .. .. .. - .. .. .. .. ~ - .. - .. .. .. ~ .. -
EX'l'Rl\ EXPENSE I
Premo. Bldg. Extra
No. No. Expense \
BUSINEsa INCOMEJ
Mo, Limit of Max. Limit Qf Bxtended Period
Indemnity Indemnity (Daya)
_.-~~.._..._..-........_......_.......-...._.._--_............__...."..................--..............--------..-......---
MORTGAGE HOLDER/LOSS PAYEE - None
... ------.. -.......... ..................... .......--...... .............-.. -.. ........ ................... .............. ....------...................
FORMS AND ENDORSEMENTS - See Schedule Attached TOTAL PREMIUM FOR
THIS COVERAGE PART I
581l.00
UO-25 (00/80)
DATE - 07/19/94
~
RENF.:WAL
JWODMR/BLL
soo
,-..
POLICY NUMBER, 3727092S-PP
FORM SCHEDULE
l'orm/l and Endonement/l applying to thill Coveraye Part and made a part of this
polioy at time of i/lsuel
COMMERCIAL PJlOP~~Wl'Y
FORMS APPLICABLE TO ALL PREMISES AND COVERAGES
Form Edition Desoription
COMMERCIAL PROPERTY CONDITIONS
STANDARD FIRE POLICY PROVISION
EFIi'EC'rIVE 'l'IME CHANGES - REPLI\CEMEN'l' OF l2 NOON
QUICK RBFli:ltENcE - COMMERCIAL PROPERTY COY PART
PA CHNWES
CP0090 07 08
CPOl21 10 91
IL0022 05 87
lID - 31 06 09
ILOl72 11 93
CP0010 10 91
CP1030 10 91
BUILDING AND PERSONAL PROPERTY COVERAGE FORM
CAUSES OF LOSS - SPECIAL FORM
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COMMI,nCIAL PROPERTY
II'
BUILDING AND PERSONAL
PROPERTY COV~RAGE FORM
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V_rlous p'rovlslons II, 11116 policy r061nel eovurnuo nond 1110 ontlro policy corolully 10 dolormulo
rights, dullos gnd whsl 16 olld IS nol covorod
Throughoul Ihls polley 1110 words 'you" nnd "your" rufur 10 Iho Nomad Illsurod shown In Iho Doc-
lorollona Tho words INO," "us" olld "our' rutol' 10 1110 CompnllY providing this Ihaurotlco,
Olhor Words ond phrnsoG 11101 oppoor In quolollon mnrkG hnvo GpoCIGI n\ool1lng Rofer 10 SECTION
H - DEFINITIONS
A. COVERAGE \
We will pay for dlrucl pl1yslcol 1066 at or
domogo II:i Covorod I'rQp'orly 01 Iho proll1IGos
"'doscr1be'd 'In Iho Oocla' ollons causod by or
resulling tram any Covorod CnUGO 01 Lon,
I. Covorod Proporly
Covorod !'roporly, os UGod In Ihls Cov.
orago PorI. 11100l1G Iho following Iypos ot
proporty tor wlllell 0 L1mll of'lnGurollco
Is sl,owll In thu Ouelnrol'ons
8. Bulldlne, munnu'g thu building or
Glrucluro d06cnbod 111 tho DoclorollotlG.
Inoludltlg
(11 Ccimplotud oddlllons;
, /, (21 Permononlly InGlollod:
(.) Flxluros; .
(b) Moch1nory; and
(0) ~qulpll1onl;
. (3) Ouldoor flxlures.
(4) Personal proporly ownod by you
Ihol 16 UGod 10 11l01111bln or sorvlco
Iho buildll!g or Gtruclure' or IIG
" ,WBmiq~s, Including ':
, Q'I(.) Flro "oKllngulshing equlpmenl;
( '. I
, ' ibl, Outdoor turnlluro;
(01, Floor covonngs; ond
(dl ApplloncuG u60d for rotrlgorol-
'. t Ingh vonlilollng, cooklllg,
I. diu wosl1;ng or loundorlng;
(Il) If nol covorod by olhor InsuronclS:
.. "
'(.) Addllions undor conslructlon.
pltorallons and repairs 10 the
, ,/)Ulldlng, or slruclure;
" ,.
(b) MollSriols, l!lqulpll1onl. Guppllon
. ond lornporory slrucluros, on or
within, '00 teol of Iho doucrlbod
promlGos usod for making addl"
I,ons, ol(orollonG or r,opalrs to
Iho bUilding or slruclure
b, Vour BuslnusD PorDonal Proporly 10-
calod In. or on 1110 building dODcrlbod
in 1110 1J0clorolions or In tno opon lor
111 a yohlclol wllhln 100 tool of 1110
doscnbod promlGOG, conslsling of tl10
following ullloGG oll1orwlso GpOClflod
111 1110 Ooclorol,onG or on 1110 Your
BuslnoGs Porsonol Proporly - Sopo-
ration of Covorogo' form'
(1) Furniluro ond tlxluros';
(21 Mo~hlnqry and oqulp(l1oril;
(3) "Slack";
(41 All oll1or porsonDI proporly ownod
by you ond UGod In your buslnoGs,
(Il) Lobar, molorlols or GorvleoG fur-
nlshod or Drrongod by you qn por-
Gonal prcporly at oloors;
IIlI Your uao Imoroal os 'Ionanl In Im-
proVOmonlG and bOllormqnls, Im-
provomonls' Dnd bollormonls aro
tixluroG, ollorotlons;' Inslollatlons or
addltlonG:
(0) Modo 0 parI at 1110 building or
slrueluro you occuP'/ bul do not
own; ond '
(bl You ocqulrod or modo 01 your
'exponso bul canna! logally ro-
move;
(71 Loaqod porsonal proporlv' for which
I you have 8 contraClual r!lsponslblllly
to Insuro. unloos olhorwloo provldod
,for under Personal Proporty 01
Olhors,
4
4
CP 00 lQ ,W 91 :,GoPVrlghl. ISQJ:omme~clll!,!flI* Sprvlcos.,lnc,.19,9(). 1991
Poge. 1 of 10
0, PorsonDI PropDrly 01 CIllo" Ih" IJs ,
III In your caro, cUSlody ,Iorl bbnlrol; i"
and . ."'~ ' ,
(21 Locplod In or o~ tho bJI~lng d"~ '
Bcnbod Itl Iho Doclarlllons or 1n Iho
opon lor In a vohlclol wllhln '00
fool 01 Iho doscrlbod promlsos
. Howovor, our paymonl lor 10sr 01 or
damago 10 porsonol proporly 0 othors
will only bo , or Iho accolml 0 I ,1110
ownor of ,Iho proporty,
2. ProporlYNol. Covorod
Covurud Proporly douo not Includo:
o. Accounts, bills, curruncy, doods, food
slamps or 011 lOr ov,duncQB 01 dobt,
money, noloa or secunllos Lottery
tlckots held for solo oro not socurlllos,
b. Anlm~ls. 'Union ownod by olhors and
',boarded by you, or II ownod by you I
only os "Block" while Insldo 0
buildings;
o. AlJlomobllos holo , or 0111; .
d, Bridges, roadways, walks, plllos or
olhor pavud surlacos;
D. Conlrabond, or properly In Iho courso
of IlIogal Iranspbrtatlon or trldl;
f, Tho coli of oxcavatlons. gredlng,
backfilling or filling,
^ ,
9, Foundatlona pf bUlldlngah strucluroa.
machinory or boilers If t air founda-
lions aro below:
III Tho lowul basomont floor; or
{21 Tho surlaco of tho ground, If thoro
Is no basomont,
h, Land (including land on which the
proporly Is locatodl, wator, growing
crops or lawns;
I. Personal properly while Ilrborno or
. waterborno;
J, Pilings, plors, wharvos or docks;
k, PropOrly the I Is covorod undor onolhor
covorago form of Ihls or ony othor
policy In which II is moro specifically
doscflbed, .rxcopl for Iha oxcess 01
tho amoun due Iwholhor you can
colloct on 'lor noll' 'rom thaI othor
Insuron&::o,
I. Rotalnlng' walls Ihal oro not parI of Iho
building doscrlbod In tha Declarlllons;
m. Undorground plpos. f1uos or drains;
P'go 2 of 10
,
1;1. TI'O cpsl III r080arch, roplaco or rll-
, 'I,. 9r"t110 IiHormallon on valuablo PI-
.. p,lI~a, ol3U" rocords, ,ncludlng Ihooo
, IWhlcN P)lfst1on oloctronlc or h1.gnllllo
mOd(a, oxcopl os prOVldod In Iho
Covorago extonslons;
o. Vohlclus or 81,l1f .'propollod m'chlnos
IIncllJdhlg alrcroH or wRlorcrl, II Ihot
(1) Arod IICOl180d 'or 1180 on P4~1Ii:
roo 0, or
121 Arb opQrotod prlnclpolly IWlY f~om
tho doscrlbod proml80s. ,
This purugroph dOOG Ilot opply 10;
(01 VohlcloG or solf-propollod nllchlnos
or oulos you l11ulluf ncluro, RroQoss
or wurol1ouoq; .
, (bl Vohlclos pr solf -propollod rnl-
, ....hln08, ',olhor, Ihon outos. you hold
fQr ,solo; or ,
{el Rowboat8 or conoos oulof welor
01 tho doscrlpod promls08;
p, Tho following "proporly whllo oululdo
of bulldlng8:
(11 Grall1; hey, struw or othor cropo;
(21 Foncou. rodlo or tolovl810n anlennn,
, Includlllg Ihelr lond-In wlrlllg, mpsls
or towors, olonG (olhor than elgl18
oUochod 10 bUlldlngsl. Ireos. shrub8
or plel118 lolhor Ihull "810ck" of
troOG, uf\rubs or plnntu!. III except
S5 provldod III tho Covorage Ex-
lon810no,
3, Covorod CRUSOS' Of LOBB
500 uppllcablu CauGos of Lou8 Form 18
shown In tho Docluratlone
4, AoJdlll~l1ol CovorDpoB
e. Dobrl8 Romovel
(II Wo will puy your 0~p01180 to r8-
'. 1110VO dobrl8 0 f Covorod Proporly
cuuGod by or resulting from I
Covorod Cuuso of 1.005 fhat occur8
durlllg Iho, policy porlod Tho ox-
pOl1008 will be pnod only If Ihoy aro
roporlod, to uo In ""fltlng wllhln 180
doyu of ,Iho, dolO 0 f dlrocl phY81cal
'loss or dlunage,
'(21 Tho mool wo will pov undor this
': " Additional Covorege 18 25,., of:
lial Tho amounl we pay for Iho dl-
. rocl physical 1058 of or d,mege
to C6vorod Proporty; plul
"
,
'j,
4
Copyl-Ight. ISQ Commerclel RI8k Sorvlcols. Inc,. 1990. 1991 CP 00 10 10!l;
o
CP
1
Ibl The deductlblo 111 Ihls pollcV np"
, pllcnblp 10 \hol lous or uOlllnob
But thlo IImllQllol1 dOllS nol applv
to nnv nddlllllll1nll'uobrlG- romovdl
" IImll provldou 111' Iho Llmih 01 111-
surnnco soctlon ,
'131 Tills Adl1ltlol1n' Covorogd dppa nol
npply to cosh 10
lo} htrocl "pollutants' Irom t'nl1'd or
wolor, or
Ibl Romovo, rostoro or ,roplaco
pollulDd 10l1d or wator,
b, Pronrvollon of Proporly
If II 10 hoceB6ory to movo,rCovorod
Proporty from tho doscrluod promlsoD
to proDorvo II from 1055 or domngo
by n Covored Causd III Lou, wo 1'1111
pby ':"or ally dtr.ecl, pl~yolcal 1000 or
domago 10 thai proporty, "
III While 'II Is bOlng movod or, whllo
tomporarlly otorod al anolhor lo-
cation/ and
(21 Dilly If the loss or ,domogo occuro
within 10 doyo oltor tho proporty
10 flroi'movod
c, Flro OoporlmOlll SorvloD CherBo
Whon tho flrll doporlmonl Is collod to
sovo or protoct Covorod' Proporty
from a Covorod Couso of LoGS, \'lib
1'111I pay up 10 ~,l.OOO for,yo\l~ lIablllly
for Ilrb cleparlnlont sorvlce cheroos:
(!) Aosumod by contract or egreomonl
prior 10 loos; or '
, (21 f1oqulrer.l ,by local ordinance,
No Doducllblo oppllos to thlo' Addlllonol
Covorage,
d, Pollulunl C400n Up ond Romoval
Wawlll pay' your oMponso to 01l1~8pt
"pollutanls" from land or wotor ot tho
doscrlbud premlsos If the .:.dlschorge,
dlsporsal. "ooopogo" mlgfo\lp.nl r,oloaso
, or oscapo of Iho "pollutul),to'. s causod
by or rosulto from a CO~orod Couso
of Loss that occurs dUring Iho pollcV
pOrlod Tho oMponsos 1'1111 DO paid ol1ly
If \hoy oro roportod to us 111 wrlllng
within 1 eo days of Iho doto on which
tho Covored Couoo of LoGO occuro,
4
Thlo Addlllonal' CoyuroOo dooo 1101
npply 10 Doata to loul fqr, mOllllor or
OGGOSS Ihll "I'loIO/lco/ cohcol1lrotlon or
IIIIIICIG ot "POIIUI.1I15'''ilJl ~1I'wlll pay
lor leslIno whloh Is po f9rmod 111 thb
COllrso of' oMtrllcllno hd "pollulonls"
Irom the 101ld. ellr ,watllr ' , ".'
The mosl wo will pay Imrior Ihls Ad-
<lIIIOnQI Covoreoo 'or ooch qll5cllbod
prunllSUS 10 610,000 for tho sum 01
all covored O~pOI1GIIS arising oul of
CovOlod CQUSOG of Lous occurring
dUring each 09pornlo 12 monlh' porloa
of IhTs polioy . ,
II. Covurouo EXlonll~~s I "
EMcopt os olhorwlso IlroVldod. \1111 101-
lowing EMtol1slons o~p y 10 proPllrtv 10-
coled In or Oil' '~hq undlllg dOIlC,l}Ipod In
tho Doclarallons or 11 thl opon lor In .
vohlclol w,Ulln 100 fool of tho dllcrluod
promises '"
If 0 Co,nsurenco filllrcolltogo of eo,. or
",oro or, a Voluo Roportll1g pllrlod oym-
bol, 10 shown III tho Dllclorollonl. you
may oxlond Iho Inouranoo provided bV Ihls
Covorago Port as followo
8. Nowlv Aoqulrod or Conatructod
Proporly , ,
1Il You m.V o~tond Iho Insl,lrlatloO that
appllos to Bulldlno 10 applv to:
(01 Your hpw.' "ulldlng~ whflrl' blllng
buflt"'6n Ih'o dbacrlbld"prllmlsos;
and ,.
(b) Buildings' ~YO, II OCQUI.rd' ai, 10-
~aUon,. olllor Ihon'lho doscrlbod
promlsoS,lntlJndod for:
m Simllo? USIl ns 1110, building
doacrlbod In Iho Doclorallol1s;
or
UII lJs'o .0 . warilhov.a".."
Tho, mosl we 1'1111, pay for loGS or
damagol,lnCl.,r Ihls E~tol1slpn ,/a 25%
of Iho ~1!l11\. ,of Insurango:' for
Building ',&~own 111 tho DODI"~U9I1S,
but not moro than u250.000 at
eocK bUilding. . ,\
(Z) You ma';; oMt6ndlho Inauranoo 1hot
applies to Your Buslnoss Person.1
Property. to' applv 10 that propl/ty
81 inv locotlon" you ,oqUlre olhor
lhan at fair a or 81'hlbltlon5,' ,
4
CP 00 10 1091', CoPvrlght.'ISQ CommorcloIRlak.Slirvlcas.,lno" ,1990, "1S91 : P'go 3,'of. 10'. 'ID "
'-',
Thl mOIl wo will ply 'or lOBI or
d~mago undor Ihls "Mlo"slon II 10'1'.
01 tho Llmll 01 Inlurlnel lor Your
BU.I""g Porlonll Properly Ihown
In Ihe 11;_llrpllonl. bUI, "QI more
Ihll1 01 0,000 01 olch building
(31 Insural'co undor Ihls EMlenllon lor
oach nowly pcqulrod or constrljcllld
proporly will ond whon any 01 Iho
following IIrsl occuru:
(I) This policy oMplroD
(b) 30 dayl OMplrO altor yOU Icqulro
or begin 10 conslrual Iho prop"
er\y: or
10J, You roport valuos 10 us
Wo will char go you addlllonll pro-
mlum lor valllol rOp'orled Irom Iho
dall conslrucllon blglns or yOU
acquire Iho proporly, ,
b, Poroonll Effoals end Property Of
Olho,.
You may eMtond the Insurance Ihe\
opplles to Your Buslnl6S Persona
PrOperly to epply 10
lit Personll ellocl5 owned by you.
your olllcors. your perlners or
your employoos This eMlenslon
does not apply to lOBI or damage
by tholl
(21 Parsonll,proporty 01 others In your
care. cuslody or control.
Tho most wo will pay for loBS or
domlgo undor thlG EMtenslon Is 02,600
at oach doscrlbod promises, Our pay-
mont lor 1055 alar damage 10 par-
Gonll property of olhors will only bo
for Iho Iccounl of Iho ownor of Iho
proporly,
a, Valuablo Pepors und Rooorql - Cosl
of Roselrah
You mly OMIOlld the Insurancl Ihll
applies 10 Your BUGlnosl Porsonll
PrOporly 10 apply 10 your costs 10
rosoorc", roploco or roslore' Iho losl
Information on 105t or damagod vllu'
oblo pOp'ors and records: Including
tholo which OMlUt on olectronlc or
mognollc modla, for which duplicates
do nol OM'st Tho mosl we will pay
undor this EMlon510n II S 1.000 'I each
dncrlbod premlsos.
Page 4 of 10
,
d, Prop'rIV' Oil -Prlmllle
You "ley IlMlehd Iho Insurance ~OVldUd
by IhllL Covorlge Form to IplV 10
your COY"I/d l'roperlX, oU, f th.n
slock," lhll II 10mPorlr y ., . oa.llon
~ou do 1101 own, 101850 or oPor~le, Thll
Mtonslon doos nol apply 10 Cov"od
roporly:
II) In or on a vohlcle,
(al In Iho cere. custody or conlrol of
your ollosperlons; or
(3) AI al'y Illr or oMhlblllon,
Tho most we will pay lor Iou or
domagCl undor Ihls hllln510n Is 06.000,
.. Outdoor Property
You may oMlond Iho If'SurUI1CIl provldod
by 1I,ls Cover ago Form 10 'pply, 10
your oUldoor Itlncls. rldlo and lole-
vlolon anlonn,s signs (othor Iha,,' signs
a\lachld 10 buildings), !roos, shrubs and
planls (olhor Ihan "Btock" 01 !roOG.
shrubl or planl5l. InclUding dobrls re-
moval e~onse. causod by or resulting
from on 01 Ihe follOWing causOG of
loss If hoy Ira Covoroo Causes 01
Loss:
lit Fire;
(21 Llghlnlng;
(31 eMploslon;
(041 Rlol or Civil Conlmolloti; .\lr
(!II Aircraft
Tha mosl we will pay lor lors or
damogl under Ihls EMlol1slo" Is 0 .000,
bUI nol moro Ihon s260 for InV one
Iroo. shrub or plont
Esch of Ihoso EMlenslons Is addlllonal In~
surnnco, The Addlllonal Condlllon.
Coinsurance. does not apply 10 these ek~
lenslons, "
B. EXCLUSIONS "
50e appllcablo Causes 01 Losp Form 8S
shown In tho 00C18rellon6,
~
Copyrlghl. ISQ Commerclll Risk Servlaos. Ine" la90. 19a1 CP 00 10 10 al
o
C, LIMITS O/' INSURANce
Th'o mool wo will pay lor 1000, pr domaDo
In any ono occurrolico 10 1110 appllcoblo Llnlll
01 Inouranco ,ohown In Iho ,Ool:l.r.llono,
Thl mosl wo Will pay lor Ion or damsoo
10 OLlldoor 010110 allachoti 10 bulldlnoo 10
0' ,000 por OIU.l 111 any <:1110 occurrenco,
Tho IImllo oppllcoblo 10 Iho Covorog.o e~-
lanOlono ond Iho I:lro Ooportmont Gorvlcu
Chorllo and Pollutont Cluol1 Up and Romovol
Addllior,ol CovlOroooo oro ill oddlllon 10 Iho
Llmlls 01 Inouranco
Poymo'lts undor Iho following Addltlol1ol
CovoroDoo will nol 1I1cruaso 1110 appllcoblo
Llmll or Inouronel
t. Prosorvallon 01 Proporly; or
2, Dobr15 Romoval. bul If
I, Tho sum of dlroel phyoleal Iou or
damoo,! ond dobrlo romoval o~ponoo
o~coodo Iho Limll 01 Inouronco; or
b, Tho dobr15 romoval oMponoo oMr.oodo
lho amounl povoblu undor tho 26,.,
hmltotlon In lho Oobrls Romovol Addl-
1I0nol Covorago, '
wo will poy up to on oddltlonal 06,000
for oach location In any ono occurronco
undor tho Dobrlo Romovll Additional
Covorogo," "
~. DEDUCTIBLE ,
Wo will nol pay for loGS or damago In any
ono occurronco until tho anlount of 1005 or
domaoo oMcoods tho Ooductlblo ohoWl1ln Iho
Doclaratlons, Wo will lhon pay tho amount
01 loaD or damago In OMC005 of Iho
Ooductlblo, up 10 the oppllcoblo Llmll of In-
ouranco. oltor any doducllon rog\Jlrod ,by tho
Colnouranco condlllon or lho Agroad Valuo
Optlonol Covoraoo, ,
E, LOSS CONDITIONS
Tho lollowlllg condltlono applv In ,ddlllon 10
lho Common Policy Condlllono .and thll
Commoreiol Proporty Condllloho, "
I, Abllndonmant
Thoro con bo no ohondonmonr of allY
proporty to us
I
4
4
CP 00 10 10 91
2. "'ppr.lul ,
If INO alld you dl5lgrllo on th" valulI of
,Iho proporty or Iho .mount of lon, IJlthor
fnllY ma1\o wrlHon dom,nd forI all op\)ral081
QI 11111 loao In Ihlo ovont, ooch porty will
aolocl b compotonl and Impartial appraloor
Tho lWI> oppralsoro will oolocl on un'plro
If Ihoy comlot ooroo, ollhor moy roquool
Ihol 0010cllol1 bo modo by a ludgo 01 a
courl hovlno IUrl,dlel,on Tho opprolooro
Will ulnlu ooporotolr 1110 valuo of Il1u
\)roporly and amOW1 of 1005 If thOy rOll
to aoroo, thoy Will OUh.1Ul tholr dl for.'
onellO to Iho umplro ^ doclololl aorood
to by ony Iwo wfll bo blfldlfl0 Each parly
will
I. Pay 110 chooon oppraloor; and
b. Boor Iho olhor oMpon08o of Iho op-
proloal Bnd umplro oqually,,,
If Ihoro 10 an appralool. wo will ollll rot Din
our rloht to dohy Iho c10lm
3, Dullos In Thl Evanl Of LOll Or DlmlSo
I. You muol 080 Ihat Iho following ore
dono In the ovolll 0 1000 or damogo
to Coyoror.l Proporly"
III Nollf~ Ihl pollco If , law may havo
be on brokln,
(2) Glvo us prompt notlco of the 1000
or dOh1agl, Includo a doscrlptlon of
tho proporty Involved,
(31 As ooon 00 pooolbl". glva uo a
description of how, when ,nd
whero the 1000 or damaOI occurrod
(4) Toke 'alJ..ro~60nable olOpo to p'rolocl
the CoVorlid Proporty from furlhor
damage by a Covorod Couoe of
Looo If looolblo, 001 tho domogod
proporty ooldo arld In tho 0001
posolblo ordor for oMomlnatlon
Aloo keop 0 rocord of your OM-
pansoo for omorgoncy and tompo.
rlllv . rop.olro, for conolderatlon In
the "601l10mont of lho clolm, Th,o
will nol Incroooo tho Limit of In-
ourancB
Copyright, 15Q Commorclol,'Rlok Sorvlcoo, Ine,. 1990, '991
Page 6 of 10 U
(Ill At our request. glVI ua corplete
Inve"torlea 01 llie damege IIld
und.mlgod property, Incluau qUIll-
lilies, dbst.il v.lulU Ind Imount of
,loss clllml , .
(01 As ollen es may' 'bo l'usonably
required, permit us to Inapuct thll
proporty proving tho los. or' dam-
ago ona o~uml,'o your books Ind
records, .'
Also portnlt us ,to loke sO/nplos 01
domogod and undomagod proporty
for Inspocllon, toallllg m,d onalysls.
and parmI! us 10 maku coplos 'rom
your books and rocords
(71 Sand us a GIUIlOd, Gworn prool 01
loss contalllln(J Iho Inlorn'atlon wo
roquosl, 10 InvoGtlgato tho claim You
muat do thla wllhln 60 daya Iller
our roquDal Wo will aupply yOU
wllh the nocossury lorma
(01 Cooporato with ljG In Iho ,'1Vosll-
gollon or aolllomont 01 the claim,
b, We may o)omlno any Insurod under
'lath, whllo not II, tho prasence 01 Iny
othor If1sured and at auch limes u
may be rOlsonobly roqulred, ubout Iny
mallor relating to this lnaurlnce or thll
claim, Including ,1'1 Inaured'a Qooks Ind
recorda. In tll0 ovonl 01 In e~lmln.-
tlon, on IImjrod's anawors muat be
al(Jned,
4, Lou Payment
a, In Ihe ovont of 1066 or dlmagl cov-
erod by this CovoraglS Form, et our
option. we ,will olther;
(11 PlY tho voluo 01 lost or domlgod
proporty;
(21 Poy tho coot 01 repllrlng or re-
pllclng the loat' or damlged prop-
erty;
131 Toke III or ol1y plll't 01 Ihl property
It,an Igrood or Ipprllsed vllue; or
(4) Repllr. rebuild . or repllce th.
proporty with other property of
like kind end quality,
b, We will jjlve nollce 01 our Intentions
within 30 days alter we recolve' tho
sworn proof 01 Ion
o. We will not pay yOU more th~n your
IInlnclll Interost In the Covllred
Property,
Page 6 of 10
.
d, We may adlust'lossos with the 9wnerl
of losl or dama\l~d properly If oU,er
th.n you. If we pay Ihe ownors, Sllch
ijymbnts will, sallajy your claim.
blnst us for tho ownors' propor,ty,
e will not pay tho ownors n1Qre 111'1
U,olr Ilnanclal fntoroBt In U10 Covored
PrOporly,
Q. We may eluct to dolond you Igllnst
s41ts Irl~lno Irom Qlalms of owners
of property, Wo will do this It our
o~pllnsll.
f, We will pay lor cOVlred Iou or
damage wllhln 30 days ,ltor w, re-
colvo tho sworn proal of Iou. If;
(I) You havp complied with 'all 01 the
terms 01 this Coverage Plrt; and
(2I(a) We hlvo reachod' loroement
Wllh yOU on thl amount of Ion;
or
(bl An oppralsal oward hlB beon
made,
Il. Reo overed Prop arty
If olthlr you or we recovor 'ny property
alter loos aettlomont, Ihotparty must give
the othlr prompt nollcu, At your opllon.
the rroperty wfll be returnld to you, You
mus then return to us' the amount we
r,ald to you for tile property, We will
ay roc overy o~ponaes and tl10 e~p"no88
o ropolr the rucovorod property, ilubjuct
to the Limit of Insursnce, ' ,
6. Vacanoy
If tho building wl1oro Ion or dlmagl
occuro hoo boon Vlcont for more thIn
60 conaocullvo days before thlt Ion or
damlgo. wo will:
a, Not pay fo.' Ol'y Ion or dam,ge
cauaod by any of the lollowlng Bve"
If thBy ore Covorod Cauoes 'of' 1:088:
(II Vlndollsm.
(2) Sprinkler loakage. unlBOS you havo
protocted tho syotem Igllnst
freazlng;
(31 Building gluo broeklge;
(41 Woter dlmaoe;
(Ill Tholt; or
(6) AttemptBd thelt
b. RBduce the Imount we would other~
wloo P'Y for tho Ion or damlge by
15%,
~
Copyright. ISQ Commerclol Rlok Services, Inc,. 1990, 1991 CP 00 10 10 91
o
A bulldh'g 18 VICII,I who!, II dool nol
conl.ln onol/gh bUlh'0I6 por60n.1 prop~
orly 10 condiJcl CUI!omlrv oporlllohl,
BulIdlngl undor '. con.lrucllon .re nol
, con.ldilrod vlclnl ,
1. \I.lulllon
Wo will dolormlno Iho valuo 01 Covorod
Pror,orlV In Iho ovolll of 106S or damago
II ollowI
I, AI aclual cesh veluo 85 01 Iho \lnlll 01
1001 or demlgo, o~copl el provldod
In b.. c,. d" 0, elld f, bolow
b. If thl Llmll 01 hJIl/rlnCO lor Du,lcj,ng
681111101 Ihll Addltlonel Condlllon,
Colnlurenco, and 11'10 C061 10 ropBlr or
rOl'laco 11'10 demagod bUilding proporlv
. II 62,600 or 1060, wo will pev Iho cool
of building ropelrs or roplecomonl
. Thll provl610n dODO nol applv to Iho
ollowlng ovon whol1 ellocl1od \0 Iho
building
III Awnings or floor cOVOrlng6,
(2) Appllancol for rolrlgorellng, vonll-
lallhg, r.ooklng, drsl1wasl1lng or
Iluhaorlng, or
131 Outdoor oqulpmonl or furlllluro
c. "Slock" you havo ol)ld bul 1101 dollv-
orod al Iho soiling prlCO lOGS dlscounls
,Ilnd 0~pons06 you olhorwlso would
hlVD had,
d. Ola66 al Iho COIl of roplacomonl wllh
,r:~~IV glnlng m,~lorlel II roqulro~ b'V
o. Tonanl'6 Improvomonl6 and Bollormonll
at '
III Aclual cIsh valuo 01 Iho 1061 or
damagod proporlV If you mako ro-
Pltr6,promplly,
,,12) A propor~lo'1 of ,your orl\l'nal ,,c061
If you do' nol make ropalrl
prompllv, Wo will dotormlno Iho
proporUonalo "valuo a6 follow6
(0) Mulllply Iho original cosl bV 11'10
numb or 01 devs from Iho 1006
or demego 10 11'10 oxprrallon of
Ihe lea Ie. and
(b) Olvlde Ihe amounl dolormlned In
II) abovo bV Ihe numbor of daVI
Irom the Inllallatlon of Im-
provements 10 Ihe o~plrallon of
Ihe leaso,
4
.
.--~
If your I'll' conlell1l r "lIlllwal
opllon, 11'11 e~~'rStlOIl 0 Ihe ro"
nllwal opllon p rlod will rllpl,oce 11'10
\:, O~p'lrallon 01 111' 10.611 In Ihll prQ-
codl,"" ",' ,
',; 131 Nothing II 0lhor6 PlY for ropelrl
or repllcomenl
f.' V.luabl, PIPOrB .nd Rocord~, Including
, Iho.o which 1l~lst' on' olllctronlc or
magnollc modla (olhor Ihan propeck-
~~~d soltwaro prollramsl, 1\ Iho cosl
III Blank melorlelG lor roproduclf1g Iho
record6, and. .
121' Labor 10 trallGcrlbo or copy Iho
" rocord6 whon Ihoro, II a duplicale
F, ADDITIONAL CONDITIONS
The t'ollowing cOlldltlons applv In addll'on 10
Iho .l=omn\on PollcV Condition I and the
Commorc:lal Proporlv COlldlllons
1, COln"UrlnoD
'II a COln6uranco porcolltago 16 6i10WIl In
Iho Declarallon6, Iho lollowlng eondlllon
applle6
D, We Will nol paV 11'10 full amounl 01
ony loss If Iho valuo 01 Covored
, Proporlv al Iho limo of 1006 limos Iho
COlnsurhnco poreonlDgo shown for II
, '. '11'\ tho DoclDrallons Is ll,'oolor IhDn Iho
, Limit of Insuranco lor The' proporlv,
. ~tirln5tea/j, we will delormlrie .the mosl
WI' will pay using thIS following 610pG
: Ill)! MultlplV the' valuo of Covorod
. .. ProporlV al 11'10,1)1110 QI 106s bV Iho
COhlGUrallCe perconlDgo;
(2) Divide 11'10 L1mll 01 lrisuroneo of Iho
proporlV bV Iho Ilguro 'dolormlnod
In slop (1);
.". (3) MultlplV thetolol, amQ'Gnl of 1066
'..i jJo,fore the appllC4~on.. of anv
, doducllblo, by'lho figure delormlned
In Itop (21; and '
(4) Sublract Iho doductlblo from tho
Ilguro dotorm,nod In 6tOp (31
Wo Will paV Iho amount dolormlnod In
Gtop (4) or Iho limit 01 In6uranee
whlchover Is leu. For Ihe romalnder
you will ISlIher have 10 relv on olher
Inlurance or ebsorb Ihe 10ls vourloll,
CP 100 1;10 '10 91 , Oopyrlght, ISQCommerclal Risk IServJaos, Ino" 1 990.' 1991
Page 7 of' 10 0
", ' ", l:~lmpl.~,Nor: l' (UndarlnaLl\'lncol:
IJ Whl~ "nlth'lqytl. "d' ',," II! I"
1.11 Th~"~ 1:u..~.JIC\IlIICl.~\I;IIJ.:vf 'Ii\\",'
, 'I~' ~ '%,l(~,I':j"I"II'r~T.~ Yo""", "G250 000
Tha COln5lJr'a';co percont~;\\Il" 'J '
'or It 111i,1, P.'1l1/t1..) 'I ll,.~;r,. ," Ir, 80%
TIlo L mlt ,ofll115Urlncl 1,.'lfIl", 1<'
or~~1 '~~1" n '1''1 ,( 1 lilt/'i. ~,! 90,p,OO
lhr" ll~ I lip , '" iI\" "'I 5268
Thll A ~n, ,,1?5e,~$,,;: ~",;,:~, qO,OO
Slop,,! l)./6rl!tQI090 ~',BO~ ",,' G200,C)OO
Itho mll1lmum nmOlJl1I 01 II1BUrilllco to
mq~b V.~,u,r ,~,91f)Bw~n~/l, r~,9ulromonI51
SlOp (21 5100,OOO"~"..G200,000 " 60
Slop ((31: 0i'40,000(tII6QUHG:20,000
Ship '14Y' ~ ;W;OO!:l''J/ ij~!lb'", G Hl,7liO
Wo will pli~'llio' 1r1\'dAP 1116" 519:7Bb, 1
Tho. r.omprqlllllt5QO,~!l0:J11lI nol t:~vorod
,01, '~art\'pl4iI'N,\W.2,(l\l1~'B~~':rM'~Jrnbcol:"
W-"en~ II< .". ~)1J
Tha valun 01 Iho proporty'" "I: , . . " ,
,Ia,' i OUFof 11/:' .;,.. 11~'I;j_,1j ','111 132150,000
Tho ColpBurnnco paroontage " .
lor It Is , ",00'1'.
!~~~!,lmll,oll,IDBUf<:l~C, lIlrl,I', .", ,~200'OOO
:~.' ',Thll [) .9JHII~Y, 'J~/' ,'',;. ~~~'~\ ,., ,;; G250
Thll '51unt",Q;' r:\~.'l"IB\Jc""." ,,:,~)}o.oOO
""Sleo'"-j;l,ll260:08Q, K18W!. ," 5200,000
Ilha'''#IIrllmwm nmount"b~dnl;urnl1co to
1;11?1l\'I\',~uro,crln~urnn,C;1l rl\~!{lr!lmont51
StOp'(21~1 ~200.00n-, ~~OO,OOO " 100
Slep,131: 0.'40,000 K l.QOI" 0110,000
Step J~).}1'O:'b~O' :: ;:~~M ,~, G 39,760
We \NYl. f;1;lVOr, tho "~~~ ",!iO Ip5~ In
O)l.~\hll"'I~ .f, tho: bedqCI l; No ponnlty
BppllBs, t, \Jr. I . I ~- ',( r
II. II 01' 'JJ~ 'If )1.1~ur.J~:~~e:'epPlle5 10
" ,J~~8'(til l#Jffr.~p~~~~i~V b.llt;~~gr.;I\I,'~~
propli~ to 1Whlth ,~,e'l " ,Jlpp1l05
I " q\~~JJl/t'~: 'J,I' !,'ifi."J ;':. .
'f) ~yf2 ,'I; 1',1 III, ~I"; ,;'/j I) '!i~ '
. \HJtI,~,' 'LN.' _ ',1 {i....; "\..... I,
II 'Jil"' fO 'JhH,1 Ii' '0 tl.l c.,'Jf
" ,.I.t 1(,)"" ""11 ...; ..I,,,,,..r
\, I '.' " L't rhf,n., ,. II..
, ':' ~ ~c I Lltl. ~,~,.... 1'. 1.. l"~t1rl"
.
P'ge' 8 ofi 10)', 'i
,~-
~
Ir u,lbllmpl."No/"31\I;~K'" r4,lll'llh", IJ
" lllWhen: ") ,', ;\-iUtl"liJIl "tl',JI)IHI rdt I ':,
.'tHu'Yblllr' orlll'Ol'l8\-iJ:li!"/I\.lJ 'I' , I
, "11 lBtqg.r,' Loob'lpliiNill~lihlJ : 1",,075.000
Bldg. nt Locnllpl1l'Jb;,~y:I\."'nob~Ooo
"oruonol Prol1orly at ,II'," '.11,,'" "
to, 11,' Locnllon No '2'1 , 'In, lI'lh: 671>,000
"i" ""'," , II.. ""J', ""lIr/, (I' \,~:7.P.iO.OOO
Tho Coln6urollco i i<l"() " ,,,
, PQ,rcP'ltqgJl, I@~I,\~ i~WJ /61 . II . ~O".
Tho limit 01 In511ronco :~br'" I
nuildul{JB nntl P.llrriol1nl11 OD , "
Propor~Y'/I.',L9G,nllop ! ,,,II,! '~I1'
NOB. ~1,fiI,'f:ll'I2'!!P . '. ~"iIO~" 00,000
'1110 Ooducllblo'lu, , ,II )11611'"'' Gl,OOO
') 110 nmoUnU 01 ,L06~ 15 '''\1..'''".,,,,
[lldg 'ob,Locollon No, 2 ()llf! ~," ~30,OOO
po'rsorlnl' Pro~ortv' 01' W1I'JI:,Jo~ ".
'I . Locnllol1,No,,!llni: ",':"1IV,'1'1 ~I ~gg'200
II <"', . {'o'.., "l','l tJll ,~'f, ~'U . 00
Stop 111: 6250,000 K 90%"1;; 5125,000
11110 111II1Imum"nmOUI1t>lo'r In$uronce 10
moot y,Q~r,. C:oII1611ro,nco "roqulremonl~
nndIO..~Wold .")0' pglJoll'(rJlhP.,Y"" 'bolowl
St~p 121: ~ 1 00,000 ',r.'''0:lt26;000 0: ,80
Step (31;' H5'o,OOO"~ ',BOb~:'G40.000,
Stop; ,(AI:bl;fl. 4D,000'1 -1 01.000 0:
539,000/' JI:lq r,"\'~"1~ t;~. tF I,
wo'~~n~!'pny "lib rnciPll~llIhl)."~39.000
Tho romolnlng G 11,000 'i'l'h6't' cbvorod,
2. MorlgD9o' HQI.lllra' ",11 "
.. " I ,. l.',1l ',lil(1 '..;
D. nlll torm "mort gogo holder"I' Includ05
truulee, I . I' ,
b, Wo 'wiii"p:ny 'f~r"c~t~rU 1055 01 or
" dOm~gOI,,109'',I;I~lIdlrg6~. or., 6trucr,ure6 to
, onch:, mor,1 dglt n,i5I"y,r, ~~~6'ym In Ihe
, OoclarBtlon'lh tholr :Rrdllr,Qf precod-
ence. a~ InIO(OBt5'lTidy 'BPPB~r,
III )~!:;mFrl~~~f ~1l~~i~~~S' ~t~ illyhl I~~
mSriSloo, Id~r :~n~.5 tlld 'oroclo-
6UrQ' oF" lIil'r 'action. 'n tho building
, or.' structure.' I '.I,ptl' < ~ ("
I \ n' 'Il. 'P.VKh . ~ 1'.~'nUII
I' ';','., 'j," ,':;1 \:1'" n,;b I,;
h ..~ . ~,u, lid'
~ ',' ,tl
. '.' . ~ 1 (,h ,(
H..! t)1 '! ft.1 I:,"'HJ. 'LU
", \..,JI'.'i>.. r~ .',Ir (t1l)1,
.q 'Iflt, I Itli1' IIP}I')HJ
'.!\'" I'jr'l
.1. "
..
C~Vrlgtitnso. Comm'ercllil Risk 'SorvtclIs. Ino:;;'1990, 1I1f1!l~ cp too, fO 1'0 '91
o
d. If wo dony your claim buc~usu of your
Icto or flqcauso you havo 'Bllud 10
comj;lly wllh Iho torms 01 IhloCovor"
.gl 1'11/'1, tho. mortlllgo I1qldQr Will, o till
hlVII Iho rlghl 10 rocblvo 10GB plymol1t
If tho mongullo holdor
UI Payo al1Y p,rumlum ,dUI ul1dur Ihlo
Covoragu I Irl AI our roquosl II you
havo lBllod 10 do 10,
121 6vbmlls a slgnud, oworn otllumul11
01 loos wlth]n GO dlYs .ltor ro-
COIVll10 not,co Irom UI of your
falluro 10 do 60. .I1d
131 Hn I1ollllud' U6 of Iny chll1g0 111
ownor6hlp,' Occuplncy or oubor.nl,,1
chanpo 11\ rI~~ known 10 Iho morl"
glgo holdur ..
All 0' Iho 10"I11S <)1 Ihlo Cdvorogo Part
will thon Ipply dlroclly 10 tho l11ongago
hOldor,
I. If wo paV tho 1110rlOlOO holdur for al1y
1060 or almago al1d dUl1Y paymol1t 10
you boeluso 01 your Icls or bOCAUSO
you hovo I Rllud 10 comply wllh Iho
lorms of thl6 Covorooo Part'
(I) Tho morlooOo Imldols rlghlS ul1dor
Iho morlOaoo will bo Iransforrud to
U6 19 110 oxlol11 of Iho pmouI11 W8
pay; ond
(21 Tho monOOOo holdor'B rlOhl,to ro"
covor Iho lull om0411r of Iho
monglgo holdor's claim will not bo
, Imp~frod "
At our opllon, wo maV ,Ray 10 Iho
mortgago holdor tho wholo prll1clpal
011 HIe morloogo plus any accruod rl1"
toroal 111 thiS ovont, your mortoage ol1d
nolo w,1I bo Iransforrod 10 US and you
will poy your romaln'n\) mortgooo dobl
to us
f, If wo cancol th,s policy, wo will glvO
wrlltol1 notlco to tho mortgooo hoTellSr
01 loa6t
(11 to days boloro Iho oflocllvo dato
of COnColl,1t,on " wo cOl1col lor
your nonpaymol1\ 01 promlum, or
121 30 dOys boloro tho olfocllvo dato
01 cOl1collal'ol1 If wo cancol lor any
olhor roason
g. If we eloct not 10 r0l10W this policy,
we will glvo wrllton notice to th,
mortgage holder al 1085t '0 dayo be-
fore Iho Oxptratlon dato of Ihlo policy,
4
.
(l, OPTIONAL COVERAGeS
II shoWl1 111 11m Ooclar.IlOl1o, tho following
Opllol1al Covoragus apply uparltoly to II.CI\
Itom ., I'.
Ii'
I, Agrud Valua
a,' Tho Addlllol1al Condllion, CQltloural1lio,
does 1101 apply to" CQvllrod Propurty
10 which IIlls Opllonll Covllr.ge ap-
plloo Wo will pay 110 more for 106s
01 or damago to Ihol property Ihon
tho proporl'on Ihat tho Llmll of Inour-
anco undor illiG Coverago Part 101' Iho
,proPOrlV boarD 10 Ihe Agrf,lod Valuo
Ghown lor It 111 thu Ooclarationo
b. If tho oxplrotlon dato lor thlG Optiol1al
'Coverago Dhown 111 Iho OoclerallOI1O ID
110t, IIxlOl1dod.'lho Additional COl1dltlon,
Coinsurance. Id rOIl1Gtulod and Ihls
Optional Covoraoe oxplrol,.
,0. The lormo of til/0 Opllol1al Covorogo
apply ol1ly to lo~s or domallo thaI
occurs
III On or ollor Iho olfocllvo date of
Ihls Optional Covorooo, and
(21 Ooforo tho Agrood Valuo oxpltatlon
doll!' chown 111 Iho Ooclarol(ol1s or
, tho policy 0 Xpltutlon dolo. wh,ch"
, : ovor occurS' IIrst
2, Infloti'on GUard
i; ,TJ1e'L'(1n11 of";lnoural1co f.or proporlY
r.o 'wh)ch IhlG Optiol1al Coverage ap-
plllld Wnl automatically lI1crouGo -by Ihe
annual porcohtago' shown In tho Dec"
larllloM: '",
b, Tho. illll6'ul11 of Incroa5e will be;
III Tho Limll 01 lI1suranco' Ihel 'oppllod
on Iho mosl roconl of Ihe policy
Incopl'ol1 dolo, Iho policy annlvor"
~arv dolo, or any olhorRollcy
,.." 'lcJ1ongu amending Iho'Llml1 of In-
Duranco; tlmoB .
(21 Tho porCllnlogo of 011l1ual lI1cro05u
showl1 ," tho DocloratIOl1S, OX"
pro~sod A5 a 110c,mol toxample OJ,
IS 001, l,mOG
(31 Tho numbor 01 days oll1co tho bo"
glnnll1g of tho curr0l11 polley year
or the offectlvo doto of the mool
rlcenl policy chAngo amondlng the
LIIM of InGuronco, alvldod by JG5
CP oq 10 10 9' Copyright. ISO Commorclal Risk Sorvlcoa, Inc" '990. 199'
. , '. I I: r . 'Il"" r1r '1- '". , . ".~ I ,.,.
Pogo 9 of 10 i]
COMMEf1CIAL Pf10PEIHY
"'''Ill i lJ.'
COMMERCIAL PROPERTY CONDITIONS
..
Thll CoverlOIl'PIiIt 'II ~ljbIDCIIO Ihll following cotldlllonl. Ihll Common "dllty Condltlonl'lnd Ippllcablll I!ou
Condlllonlllnd Addlllonal Condlllonl In Commlrclal "roperly Co'veragD Forml, . .,
"
A. CONCEALMENT, MISREPRESF.NTATION
OR FRAUD
This Covorooo POri Is void In ony COio of froud
by you os It rololos to this Covorouo Port at ony
limo, II Is 0150 void If you or ony othor Insured.
III ony limo, Inlentlonolly con cool or I11ls.oprelonl
II malarial foci concoll1lno:
" This Covorooo Port;
2, The Coverod Property;
3. Your Inloroltln the Covored Property; or
4. A clohn under this Covereno Po...
8, CONTROL OF PROPERTY
Any Ocl or neglecl 01 ony person otllor Ihon you
boyond your dlroCllon or conlrol will nol ollecl
Ihls Insuronco,
Tho breech of ony condlllon ollhls Coveloge Port
el ony one or mora locations will n.t ollocl cov-
orogo o! eny loco lion who.o, o! tho limo 01 1065
or domogo. Iho h.ooch of conrlltlon do06 110! e~-
16t,
C. INSURANCE UNDER TWO OR MORE
COVERAGES
II two or more 01 this pollcy's covllrooes epply to
Iho some 1050 or domege. we will not poy morll
then Iho actual omounl 01 tho 1060 or domoge.
D, LEGAL ACTION AGAINST US
No ono moy b.lno 0 I~ool octlon 000ln6t us under
Ihls Covorogo Port unloss:
,. There h06 boon lull compllonco wllh oil 01 the
IIltms of Ihl6 Covorono Port; ond
2, Tho ocllon 16 hrouoht wllhln 2 YOO'S oftor Ihe
doto on which Iho dltoCI phys,col 1066 or
dOl11ooo occurred.
E, LIBERALIZATION
II wo odop! any revision thot would broedon tho
coveroge undor Ihls Covereoo Pori wllhout eddl-
tlonol promlum within 46 doys prlol 10 or during
Ihe policy period, the broodonod covoroge will
Immedlelely opply 10 Ihls Covoroge Perl,
..
CP 00 90'07,11.8
, ,
F, NO B~NEFIT TO BAILEE
No porson or orgonlUllon, olhor Ihan you. having
cuslody 01 Covo.od Propotly will honolll "ol11lhlo
In6uronco
G,OTHERINSURANCE
,. You moy hovo olhol 'n6uronco suhlocl 10 Iho
somo pion. torms. conditions and 11/0vlslons
os tho Inouronco under Ihls Covoroge Par.. II
r,ou do, we will pay our shore of the cove/ad
oss or damalle, Our shoro Is Ihe proporllon
Ihol Ihe eppllcoblo limit 01 Insurance undo/
this Coverogo Port beors 10 the L1mlls olin.
SUtonCO of olllnourof1ce covering on tho oome
boslo,
2. IIlhero Is olher Inouronco covorlno Iho ooll1e
Iou or dall1oge. olhe/ Ihon Ihel dosc.lbed In
1, above. we will pey only lor Ihe amount of
covored loss or domooe In excoss of Iho
amount due 110m thol olhel In6uranco.
wholhar you con collecl on It or not. ntH wo
will not pay moro Ihon the oppllcablo Limit 01
Insurance,
H, POLICY PERIOD, COVERAGE TERRITORY
Undor this Coverooe Pori:
" Wo cover loss or del1100e commencing:
8, Du.lng the policy porlod shown In Ihe
Doclorotlons; and
b, Within the coverogo terrllory,
2. The coveroga territory Is:
o. Tho United 510too 01 Amorlco (Including
116 territories end possessions);
b, Puorto Rico; ond
0, Conodo,
Copyright. 152 Commercial: Risk Serv(eOlI,lnc" '!l!l~'r\1l87I' I
PII\JQ,' 'Of 2, 'In
'""'
. " ~
I. TRAN8FER OF RIOHT8 OF J!IOOVjiRV
AGAIN8T OTHI!,,81:Q U!I' I,' ~ ',~ ~'l .... ~ I"
II Inv perlon or orglnlrlllon 10 or for whom w.
m'~I, ",Iv"",nl under Ihll Co~'riUl" ,P,,,,,,~'I
rlghll 10 recover d.mlll" from InCIlI1~r"lhq..
rlghll .re Irlnll"red 10 UI 10 Ih. '~lInl of our
Plvm.nl, Thll "'rlon or O,glt)I~ltJQnl '!WII do
.vlrylhlng n.c....ry 10 I.cure ou,.l; "HI" .lId
mUlt.do nOlhlng lit" Ion 10 Impair Iham, BUI
y,ou mav wolve vour rlghll 101lnll 'nolhlr pnrtv
n wrlllng: "
, t""i
. ~ I, . 1
:10.
, ,
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,
"
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I, t.' 't
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,,:, /1),1 \'thtl'
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; ..t
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"t t' l '. ,...,~ I t \.
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l..IV n.n
lit'" :!II
','!.thur' I'
lh~,".'\
,',
OP 00 90 0'''8
r-
.1" ~rlpr ,10 " ,19." ,10 vour Cov~rnd, Proplrtv or
, i, FO~ar"d 'naoma, " ,
2, Afllr. lOll 10 vour Covlred Proplrty or Cov.
I~~ I/)ppml,onlv If, II 11m. pf 10.ql!ll pertv
I~ 0111 oJ lhl fpllowlng: ,
I. Bomlon. Inlurad bV Ihll InlurenOl1
b,' "'bulln... firml ,,'
(') Own.d or conuollad bV VOUI Or '
(2) ThaI own I or conlroll VOUI or
0, Vour IDn'nnl,
Thl. will nol ,.llrlol vour,lnlur.nOI, ", I '
~ ,
, ,
,11'1 "
~,I' ii n~, 01,
"
~(~tll/l,'l" '1',,1 :1
~1.f'f'I..,,;r n
J,I. .,1
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,.,
III ,
,I Ill! t: Itll'
h"IIIt1
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J,',I,' .Il"
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Copvtli1hl;lll'D. Commll'lll.I'Rlik 6.rvI0....'lnll';'~ f883,I1987 '
Pig.\2b' 12', I')
COMMERCIAL PROPERTY
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
STANDARD FIRE POLICY PROVISIONS
11111 Indolltmunl modlftn Inlullncu pIQ'lldcd un.INlh" 11""),,"11:
COMMERCIAL PROPEIllY COYE IlAlj[ "All!
StANDARD PllOPEIlTY FOlleY
1 h" P"J'/'I'onl ollhe Slandlld Fne l'\JIICy ale Ilal"tlll4!llJ'/l ~Ial,: I,." "'1')"'\ "',11"'''1 I.' ,lllo<h"d 10 a'l pOIlClCI II IllY (ondllionl ollh,l 101111 a'e (onllll'l'tl
II) bt! n10le Ilbltllllhanlny oIh.. 1)I)IIlY (ond,lionl ""'11'. '" tll' I"'''' villi,' I,.I"II'"~ 'j ""HMlI, Ihe con<J'lionl olllHI 10I1Il w,lIlpply.
IN CONSIDERATION OF THE ""<NISIONS AND SIIFlJl^,llJ~:i HI Iii II. Oil "OOlD IllIillO, ANO OF THE PREMIUM SPWFIEll nllhe Deel",hunl 01111
endl)I~l11enll mode 0 port hell1()!, Ihll (ol11pany, 10' Ihe '""n (,I 1'.'.111 If.,':d,,,' ,~ II'. "~/.tI,Jllons lrolll /fJeepl,oo dllc shown III/he Dee/mllonl AI Noon
ISlano,)'d lllne) to e'lll'dlloo (We 1110"il1I11M o..~ldIdlllJm AI 1\<):" ISI"lloM 1"[."1011 ',,-,h,,,, oll~opelly 'nwll'l!<J, 10 011 On1OlJnIIl0l1!A(elotJ,lIl: Ihe III'HI ul
h'b,loly Ifll'c,l'ed In Ihe O<<IQlollonl, tlO<!I illiu'e Ihe IIIllIn.'<I iI,II"I>.,} ," IIII! 0.., IIII,II..'!;I ",'~ "'." lel~ell!nlJl'W\, Ic Ihe I!J,lenl 01 the ocluol mh vJllle ollhe
lyqJ<l"1 ,I Ill! lime of lOll, bul ..ot "'Cl~>dll'.lhe allloulIl "h,,', ,I ",ul~ (0111" "11.1" CI "~IJ(e I Ie plOjlelty w,lh IIlJlcllol 01 like kind Ind 'Iu,"'y ,"11'"1 ,
IOJlOlIAble IlIlIe ollel loch 1015, .,Ihoul JIIQ'Mlllce lOt ally IIlCl['.1\.,j (1)\1 vi '"11.1" ')' "'(OIl~I'u(I")1I by re,lOn 01 Jny Otrllnonce Ot IIlW le2ulelln8 (OIlMllld,on 0'
'.",!iI, 'lid .,Ihoul compenf.!lion lOt lOll ,.lull,n8 "0111 ,"ll'III,pl,':1I 01/)0)\"11'11 0' 1I',)llCl,lCl'M, 1I001nlny ~nlIOlI1lOle Ihen Ihe Inlelelt ollh. '"Iu'ed,
'83111\1 311 OIHECT LOSS BY FIRE, liGHTNING ANOOfllEll PFlmS INSlllIlI) IIGAIN<1 IN THIS l\'lllCY INCLODING REMCNAL FROM PllfMISES ENDANGER[()
BY IHE PERILS INSURED AGAINST IN THIS ~lICY, [X([P11.S HERE IN^' 1[11 PROIlllED 10 \lIe ~rope.ty delwbed In Ihe O<<lo.olionl while localed ()/
(onlB<i\ed AI delC/lbed II1lhlS policy, ()/ pro 1010 101 low daYI al.ach IHOIJe'pl,J(I! 10 wlllch any ollhe propt!~y sholl nemSll/ily ill! remwed 101 pleleMl'oll 100111
the IJeIlI! '"luled a8111111 IIllh,s 1)1)/'(1, bulllol elle.h,l.
A~~I~l1l1lefll QIII1I& poliCY ~hall not be V4lld e).:cepl With the Yt'fllll.?1l (l)flM.nlfJl tlll~ Cnrl1l'i\n~
1/11\ pJll(lll mode and occepled lub/e<:IIO Ih" fo'e80ll'U P'O""Cl11 'lid ~"p",I'onl Jlld "'Oll! he/ell1alter Ilaled, wh'ch Q/e he/ell)' mode ,1 p.lil 0111111 1)1)1,'1,
I"gelhe, .,Ih IUch olher prov,llonl, ., IpulJllOII\ and A&,.elll.nll JI IIlJY 1l4! '~~ed ';...10, " p'o>lded ,n Ihls policy.
, Conc8Ilmanl, ThiS enllle pol,cy 511,111 be VUIII ,I whelhcl
7 frlud. belOle Of ,111tH ,1 IU55. the In'jllll'll hilS wII.
3 lully cOllceoled 01 1I115relJle5.nled "ny lila'
~ lei 1011 1,1ct or circumslance conce/nino Ihl5 1115UI,lnce 01 Ihe
5 lublect therool, 01 the Inlele51 01 Ihe IIliU.ed Iheleln, o. III case
6 01 eny fraud or lnlse sweallno by Ihe In5uled lelolino Iherelo
7 Unlnlurlbla Tills pOlicy sholl nol covel accoonl5, bills,
6 Ind cUl/ency, deod5, evidences 01 debt, monoy 01
9 meplad proparly, securllle5, 110r, unless 5peclllcally named
10 heleon In wrlllllO, bullion 01l11nnu\CIlpl5
II Perlll nol This Compal1Y shall nol be IIalile 10. 1015 by
12 Included, lile O' olher perils 1I15ured "ga1l151 ,n Ihl5
13 polley caused, dlreclly o. II1dlleclly, by' (a)
I~ enemy attock by armed 10lces, Includlno ar.llon "ken by 111111,
15 I.1/Y, naval or air lorce5 In Je51slino an acluol 0/ an IIl1modlalely
16 'mpendlno enemy ollack, (h) Il1va510n; (c) II1M,"."'on, (dl
17 ocbclllon: (e) rel'Olull~n, (II rlvll wa., (g) u5urpell PO",,!r, Ih)
16 mde, 01 any civil oUlho"ly excepl ,,1501 de51111C!II)n ,lllhe IlIl1e
1001 In'llor 1M pUlpose olprevonllllg Ihe 5p/ead olllle. IlfOvlIJod
20 Ihol such lire did nOI OIlolnale 110m ,ny 01 1110 pelll5 ewelude,j
21 by Ihls policy: (I) neolecl 01 Ihe Insured 10 U50 011 le050llBble
22 means to sal'lllnd pro5elve Ihe plope.'y AI and allel a loss, o.
23 when Ihe Plopelly 15 endnnOeled hy Io/e in nelohbollno p,ell1'
2~ ise5, (j) nOI sholllhls Company he hable lor 1055 hy Ihell
25 Olher Inlurlnn. Olhe. Insurance may be flfoh'blled O' Ihe
26 amollnl 01 Insurance lI1ay b. IlIntled by en"
U d0/5emenl all ached helClo
26 Condltlonl 11"Plndlng er reslrlcllno Inluronce, Unlen olher.
20 wile provldee In wrlllng added hereto Ihll Company sholl nol
30 be 1I0bla lor 1011 occurring
31 (,II wit lie 11'11,) Ihu.11tJ I:) UiUC:')~ll;iJ lj~ illly IIltll1l3 '{,Ilhlll lIil; Clifl
:12 1101 o. knowledgc oll/1e 1I151111!1l, .If
:l~ (Ii) wl1,lc a 1l00;whcll liwlil,ng, whelhel ,nll!nll,!~ 101 occupancy
~~ hy oWl1e' 01 tellanl. 15 vac,lnl 01 unUe(Uple~ lleyond a pCllnd 01
CP 01 21 10 9t
35 51~ly con5ecultve days; 01
36 lei as , lesijll of explosion 01 1101. unless 1I1e en!I/I' ,11\11 In
37 IIlal "'!Ill lor 1055 ~y lire only
36 Olher perltl Any'olhel pc III to bo In5ulod 00,\ln51 0/ sub"
30 or lub/eell. lOCI 01 Insurance 10 be coveled In Ihl5 polley
~o sholl be by IndorSUnlonlln w/lllno hmon 01
~ 1 added helelo
~2 Added prevlllenl, The e~lcnl 01 Ihe oppllcolion 01 in5ulallce
~3 under Ihl5 polley and of Ihe conlllbul,on 10
H be made by Ihl5 Company In ca50 01 loss, and any olhe. plO'
~5 viSion 01 oOleement nOI inco/l5lslonl wilh \1'0 P/ovlllons nl Ihl5
~G pohcy, lI1ay be plovlded 101 in wliling added helclO, bulno plO"
47 vision may be waived except such 05 by Iho lel1ll5 0111115 pohey
~8 15 5ubleello chonoe,
~o Waiver No pClllllssion ollecllno Ihl5 InSlI' ance sh,1I
50 provlllonl, ex Is\. 0/ walvel 01 any plovl5ll)0 III! valid,
51 unless o.al1led herein 01 exple55e111l1 wllltno
52 atldel' herolo No p'OV151011, slipulallon or 10.Ielllllo ',/1,111 he
53 helll 10 he waived by any I1!Quuelllenl 01 ploceed,no on Ihl! P.1/1
5~ 01 lIus Company lelollno 10 opplal501 01 10 any e~allllnallOIl
55 plovlded lor heroin.
56 Cencellallon This polley shall be cancelled al any IlIne
57 el pellcy, IIIlho leQue51 ollhe Insured, In which case
58 Ihl5 Company shall, upon tlemand ,nd 5U'"
50 lender 01 Ihis polley, lelund the OXCe55 01 paid p/emlum above
60 Ihe cU510mory shOll roles lor the expiled lime. This pol,
6\ ,cY may be cancelled 01 any time by Ihls Company by g,vlI1O
62 'II Ihe ln511.ed , live days' wrillen nolice 01 cancellal'on Wllh
1i.1 'if ",,1110111 lentlel 01 IIle moss 01 paid plenlllllll abovo Il1e plO
Ii~ "',1 plClIl'Um 101 Iho e~lllred Inlle, which excess, ,I nol 1011'
Gfi llcrcu, chall be rc'unr1p,t on demi1nd Notice 01 r.ancr.lIi1IIf)II :;I1i111
liG :,lalo Ihal e~ce5S prellllum (II nol lendelelll Will lic 'c'
67 fUl1ded on demand
Cony'lllhl. ISO Conlln~/CI,,11115k Selvlc~5, Inc , 1000
paoe 1 of 2 r I
, ,
. , "'f'L" 'l 'I '
If hlSS hQlQlllldOI 15 mono IlGyOblQ, III whlllQ'
01 III POll. 10 0 dOSlglIOIQd morlgaOQO 1101
lIomad IWWIII a51ho 11I511l0d, slIch 111101051111
11115 polley 1II0y hQ cOllcollod by glVlIlg 10 511(11
1I101lgngoo 0 1011 days' 11'111101111011(0 01 Call'
Uti MOrlglgn
6g Inll'llll Ind
10 obllglllonl,
II
n
13 COIlIlIIOIl
14 II 1110 1115Ullld 10115 10 '~lIdollllool 0110115 51/(11 1I1ll1lgogoo, IIPOII
15 1I01lCI, sholllolldol' plool 01 1055 111 Iho 101111 11010111 5POClllell
IG 1'11111111 Sll<1y (GO) llaY5 111010:11101 01111 sholl ho 51/hlllCII0 Iho Pll)'
/I VI"01l5 hOIC01101011l10 10 ,!PP/"'501 o'ld 111110 01 paYlllenl ,111d 01
16 h.llIOllIO II/II It 1111" Clllllp,my 5h>111 clollII Ihol II" 1I,lhlllly 01-
lU '51011 >15 10 Iho 1I101lgaUOI 01 ownel, II ~hall, 10 Ihol'JlolIl 01 pay,
001110111011055,10 Iho 1110110,1000, ho IllblOoolod 10 ,1111110 1111111,
01 gOgOO'5 IIOIIls 01, Ir.COVO'y, hI/I 11"1110111 IlIIpal/l/lg 1II0lluoooo's
02 IIUhl 10 5110, 01 II lilaI' pay 0111110 1II0110aoo 1I0hl 011/1 WQIJIIO
63 all 05S10111l101l111lr./ool 01111011110 1110110000. OlhollllOVI510llG
8~ ,ellllfflQ 10 Ihl? IIllef(lsls ;Ulll olJllv.lltons 01 511Ch lIlotlOlJuee IlliIY
135 he ,1r1tJed helclo by .1grecmClll1ll WIIllI1g
86 Pro 1010 lIabltlty, Th'5 COll1pany ';hall 1101 Ilr. ItillllO 101 " Oloalol
III III0poII'oll 01 ally loss Ihall Ihll >11110lJ/1I
B8 Ile/l~lJy 1I1SlHCd shall IWill 10 IIll! whole II1SlJIilnCe COYl:llrlU llle
Ii~ 11I0pelly a03l11511he p01l1 "'vOI'IIIi, whOIl1ol collocllhlo 0' 1101
~o ROQulremeolll1l rl10 "'IIJled 5hall O'vo llllllletliDlo 11'1111011
~ I COie 10il PC~UII, 1I011(1! III II,,~ COlllpany 01 allY 1055, IHoloel
32 lI1oplllpOlly IIOllllulllIlI1 tlal1l,100, 101ll1wllh
~3 ,eparalO Ihotlalpag\d aliI! ulld.aIlIaQc.tI, limollaIIHqpOIIY" pul
~4 ii, hi IIIC be51.,llosSlill0 QIIIOI, fUllIlsh p cOIIIPlorOr!IIY~fllol~ 01
~5 1110 d05110yed, dalllagod alld ulltlal1lao~d PIOI/olly, 5)1011'1110 111
96 dolall Qualllille5, cosls, aclllal cash valur. allll U/1I01l1I1 of 10~5
91 clalllloll, Hnd williln sixty tlaYI ollor Ihe lOll, IInl6lllpchllme
n II ..1eodld In wrlllog by Ihll Company, Ihe 'Ioiured Iholl ronllel
99 10 Ihll Compery.o prool a /056, Glgllod and swoln 10 ily Iho
100 IIISllIOII, slalulg Iho kllowlodgo anll iloilo I 01 Iho 1115u/01l 015 10
101 1110 1011011'1110: 1110 1ll11Vo111d or'glll Ollho 1055, Iho 111101051 of Ihll
102 1'lsUlod qlld 01 all olhols III Iho PIOPO(ly, lho OCIUo1l cU5h value 01
103 each 110'11 'Ihoreol all'd Iho anlOl/lI1 011055 IhoreIO';' all eneiJllI'
104 il,allCos 111010.0/1,,0111 Olhol cOlltracls OIIllGI/I,lI1Ce, wllelher yalll!
'05 0' 1101, covering any 01 ,\a", IHOpOlly, ,IIII' challoe5 In Iho lillo,
106 1I5e, lICCUpalloll, localloll, PIl,5r.5Sl011 or OXp051/1e\ i,l s;lIIlp.op.
101 elly \II'CO Iho I0511I11U 01 1111\ policy, ill' wholll ,111t1 101 whal
lOll pl/lP050 >1111' lJulldlllO hllell' 1I0~Cl'llell. 0'111 Ihe sovolal palls
109 lholoOI 11'010 Oc<;uploll 01 Iho 111110 01 1055 and wholher or 1101 II
110 Ihllll slood 011 lcasoll 0101/1111, aM shalllu'1I1511 0 copy 01 .1111ho
III dOSClfPllOIlS 01111 ~chodulQ5 In ,111 POllClOS allll, II 'OQ41'1l/J, vo,tIl'OIl
112 plall5 and spcclheaIIOtl~, 01 ,lilY illtllll'ng, III<1l1lOs or 1II,0ch11l01Y
113. de51,t0YOd or damagod, Tho 1115UloII, as 01100 as 1110y ilo loaSOIl'
114 ably reQulrod, 5hall oxhlilillo any pOISOIl d051gll01011 hI' Ihe
115 Company Dlllhal 1011131115 01 allY prOtlOlly herolll desr.r'ilod, and
116 suhmll 10 exollllllallolls ullde, oalh by any P0l5011 110111011 hI' Ihl5
P8g~ ~, ql ~. .,;
to 'j ~
III COlllpallY, jlll~ 511bscrlbe Iho'mlle: nlld, a6 011011 a5 iliaI' ho
116 'mollohly 'olllllle~, sholl ploduce lor exollllnollon 011 book5 01
119 accollnlll, bills, Involc05 Oll~ olher vOl/chm, 0/ cerl"lo~ COpl05
120 11101001"01101/1015 bo losl. 01 such ,monoble 1111I0 ond plocu ,15
121 /11,11' Ilr. dU5l01l,110d by Ihl5 Comp,ll1Y or Its ,oplu50nlnl1vo, 11I1d
I n shall pO'lIl1l uxllllels mid copies Ih%ollo bo modo.
I~:! Alllltolsol. In C050 Iho In5111ed and 11115 COlllp,lny shllll
I ~4 'illl 10 aUIOII 05 10 Iho aCllIIII C05h vallie 0'
I~r, 1110 ;rtn~lInI01105\, Ihun. on 11'11 wllllunllem'"1I1 01 ",II!N, eoch
I~I; ,1',111 ,elocl .1 compololll '"ltl 'Ji~IIIIU1e5Ied OPIII'"501 ",ltl nollly
IU II... 1,lhlll of lho OPlllol5e' ,"IHI~d wlthlll Iwullly 0I0Y5 01 511Ch
1 ~8 11t'lIlill',1 1 ho applo1lsors 5hall IIIsl bolocl 0 COlllPOIUlI1 ,111') d15'
I ~U "'10/051001 l"lIpllO, alll) "lIll1lU 10' /,lInun 11,11'5 10 110100 IIPOII
1:10 511(h IImplIO, Ihon, 'lII 11"111051 ollhe In511111d I)f 11115 Company,
1:11 511c1! I/IIIpnO 5h,111 ho 5eloCII!dlly "1111100 01 a COllI1 ollueo'd In
13111'0 blalll In which 1110 IlIopOlly covelod 15 locolell Tho ap,
I.lJ 1"110,11\ ~h,ll1 Ihon ,lPP',1l50 Ihe 1055, 51.IIII1U bOllaralOly oClual
IJ,I (a~11 valllO o1l1d 1055 10 C,l(h "0111, ,1fI11, la'linu 10 all'CO, shall
135 \1I1111111 Ihon IIlll%nco\, Ollly, 10 Iho UlllpllO An OW,lld III 11"11'
IJG "'U, \0 "olIIl/ed, 01 ally Iwo '"hon II10d WIIIl Ihl5 COlllpany 5holl
131 (It:II'I/11II1I: file .1/l10\HlI of ,lcluJI Cilsl1 vahle ,11HJ IOS!:i Each
1311 ,IPP',I"C' \l1all 110 I},IIO Ill' "'0 p,lIly 50lecllll0 111I11 '"111 Il1e ox'
IJ~ 1"""'1 01 a Pflllll 5011 alld umfll/II slIall 110 pata Ill' Iho partl05
1,10 "<1l1ally
I,ll COIIIIIOllY'5 II 511,111 be oflllonal wuh 11115 CllilllJ.1ny 10
1,1:' 01'110115, Iilkc 0111, 01 any pall, 011111/ P'opolly ,111he
143 ao/e.od 01 appralsod v,11110, illld 0150 10 10'
144 flail, IlIill/lld 01 /oplocn Ihe propelly doslIoyOII or dOlllogod willi
145 011101 01 Ilk!! kind alllt Ql/,llily wllllln a leasollaill~ limo, 011 glv,
14G Inu 11011(0 01 115 Inlollllllll 50 10 110 wllhln Ihlll I' d,ly. ,111e. Ihe
1'" 'ocr"pl ollho ploo10110~5 hOIOlll 10'111110'1
H8 Abonllollmolll, ThOIr. Colli Il<' 110 abailll01l11101l110 Ihis COlll'
149 pailI' 01 allY PIOpolly
150 When Iou Tho al11olllllol ill05S 101 wh'ch Ihls COlllpany
151 poyohle, iliaI' he 11111)111 shall be payalilo 51xly days
152 allel ploof 011055, os ho'eill proylded, 15
153 'l'COlYl'd hI' 11115 COl11p"ilY ,"111 aW,lalnl11enl ollho 1055 Is mallo
15,1 ,,,"'" I)y ilU/Cl'III0111 1l0lwwI 1111 11151l1ell 01111 Ihl5 COlllp,lny ox'
Ir,5 I"C'","d '" wlllmo 1)1 by 1111' 1'''"0 wllh 11Il5 COlllPill1y of 011
, 5li .I'{,,11f1 .1') IltJlClfllHOYIOed
101 Sull, No 5,,11 0' a(I'OII olllhls poliCY lor Iho IUCOV'
151l UI I' 01 aliI' (1,11111 5110111 IlO 5U51alno11110 III ,lilY
159 (01111 01 law or CQUlly Ulll05S all IlIe ,cqullol11011l5 01lhl5 pullcy
160 5hall have hoo/1 (Ol1lpllOll wllh, allll II111oS5 COll1l11o'li:od 1'11111111
161 Iwolvu 1110111115 IIOXI allOlll1CoPIIOII ollho loss,
16~ Suilrogallon, TII15 COl1lpallY 11101' '0'111110 IIol1llho 1115ured
I GJ all .1Sslg11l11elll 01 all/Iohl 01 roeovelY ogall151
11i4 illly 1101111' 10' loss 10 Iho eXloll1 Ihal POYll1oll1 Ihololor Is 1I100de
11;5 hy 11115 Compally
..
1'1,
Q9pyrlgh,1, ISQ Cq/lll11prCloll Illsk Se'VICU5. IQt., 1990
CP 01 2110 P'II I
IL 01 72 " 93
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE ijE,AD IT ~AR~FULLV,
','
I' I' " I ','j .'
PENNSYLVANIA CH~N(3eS',:,," ,'" I
,"
'11 ,I,
'J
.1,.1. " " "
, , , ,',
Thll ."dOlumonl modlllOl Inluron~o IHovldcd undor Iho lollllwln'g'
BOILER AND MACHINERY COVERAGE PART
COMMERCIAL CAIME COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PAIH
COMMERCIAL PROPERTY COVEIIAGF. PAnT
FARM COVERAGE PART
A, FOllnluran~c provldod undor Iho
Bollor and Mochlnory Covuroge 1'11I1
Commer~lel C,llllu Covurego Pert
Commer~lol Inlond Murine Covu/ouu Port
Commorclol PropullY Covuroue Port
Tho TRANSFER OF YOUR RIGHTS AND
DUTIES UNDER THIS POLICY Common Pol.
lroy Condlllonls roplncad hy Iho lollowlno:
F, TRANSFER OF YOUR RIGHTS AND DU.
TIES UNDER THIS POLICY
Youl .Iohls !lfal ,lUlu,s undm 1I11~ polley moy
no\ bo I/ons'ulllld wllhOlJl 01)' Wllll'"1 consunl
OM~Opl In Ihu coso 01 donlh 01 /111 Illlllvlduol
nnmQd intiUUHL
II you dlo. your Iluhls ond dullos will bo
tronllOllod 10 your 10001 ropro60nlOtlVU but
only whllo uctlng within thu 6COpO of dUllus
os you I logol roplelenlutlvo, Unlll your logol
replU6emollvu Is nppolnlod. onyono having
propor lomporory ~uslody of yom propo/ty will
hove your r/ohls ond dullos bUl only wllh ra.
IpocllO Ihol propolly,
II you dlo, Ihls Covoroue 1'011 will /omoln In
offacl os plovldlld In 1.012, bolow, whlchovllr
Is I.tllr:
1. FOI 1 eo dnys ollor yo~" doulh rognrdlos6
ollho polley pO/lad shown In Iho Docloro,
lions, un loss Iho InSUlod p.opu.ly Is 60ld
prior 10 Ihol dnlu; o.
2. Until Iho ond 01 lho policy po.lod 6hown
In Ihe Ooclolollons. unloss Ihe Insurod
proporly Is sold prior 10 Ihol dolo,
Covoroge during Iho pllrlod 01 tlmo of lor your
dll8lh Is IUbjllCllO 011 provisions of Ihls policy
InclUding poymllnt 01 ony promlum duo for Iho
policy porlod shown In Iho Ooclorotlons end
sny oMlonslon Ollhol period,
"
tl101 7.2 H 98
13, 1:0/ Inlu/onco provld.d underlh.:
Conunllrclollnlond MOline Coveroge Port
Conllllorclol p/opolly Covolag. Pert
Furm Covaroou Poll
Thu followlno Is oddod 10 Iho LOSS PAYMENT
Loss Condition and lupolaedes any provision 10
Ihu conl/ory:
NOTICE OF ACCEPTANCE OR DENIAL OF
CLAIM
1, EMcu1l1 os provldud In 3. bolow. we will u,ve
you nollco. within 16 Walking dOYI oher we
'Ilculvu 0 proporly dMecuted prool of loss. Ihot
we: ,
e, Accopl your clolm;
b, Deny your clolm; 01
a, Neod more tlmo 10 delermlne whether YOUl
claim should be accapled or denlsd,
If wo dony your claim. luch nollce will bu In
wrlllng. end will slole ony policy provision,
condlllon or oMcluslon ulod 01 0 basis for Ihu
dunlol,
If we nood moro limo 10 dOlo.mlno whulher
your claim Ihould bo occoplod or denied, Ihu
wrltlon nollco will 11010 Ihe leoson why more
Ilmu la ruqulrod,
2, If wu hove nol comploled our Invesllgollon,
wu will nOllfy you ogoln In WIlling, wllhln 30
days oltur tho dOlO of Iho Inlllol notice os pro.
vlded In 1.0, above. ond Iherooflor '.IVery 46
deYl, The wrlllon nollce will Ilate why moro
tlmo Is noeded 10 Involllgnle your clnlm end
when you may e~pecl UI 10 reach a doclalon
on your claim,
,Gopyrlghl :ln5~rRn~q Sorvlc.e~ QJII~e"\nc,, 19,93
1,1 C,opyrlghl,,)~o.,q9m~or~'~I, Rllk S.0~lcp~"~9i:,. ,1,9.93
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not .pply II WI h,v. . ,...on.bl. blll'l IUP'
port.d by lP.allla Inlorm'llon, to IUIP.ICllhet
~r~b~7:~r~: 1~~I,~:'~~~~~.o1l;e~rllfiV.\' 1,.\ -./ .'
lallvlly, Under .uch olroumlllnoll, we will
nolllv yoU 01 the dl,pollllon 01 your ~1.,'11
within I period 0' lIme ,.lIonlble 10'lilloW lull '..
Invlltlgltlon 01 the olllm! I'''r we ,.o.lve .
p,operlv IN.oul.d prool 01 lOll,
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,J~~OPvtlghl,I"~~'it\'iib:~lerV1C'tIi"mf!C~"lnilr, 1993
.' \liOpyrlb'hl, 'ISQ'\!'oll'iHl'ero ill 'R,*Il~8;Vlo'81,' 'I no,: '19\l3
QU 01' 14 , '\III' C
COMMI:nCIAI. I'FHll'F1ll)
CAUSES OF LOSS - SPECIAL FORM
Wqrdo and phraollo tl1al nppoar 111 quotnllol1 mnrkG
Dllllnlllono,
A, COVERED CAUSES OP LOSS
Whon Spacial 10 0110"''''' 111 Iho DodurallanG
Covorod (nuBos of LOOG monns RISKS Or-
DIRECT PHYSICAL LOSS ullloss Iho loss IG
l. F.~cludod In Socllon U.. E~cluslono, or
2. Llmllod In Soctlon C.. Llmllatlons,
tl1allollow,
B, EXCLUSIONS
t. We will not pay lor 1005 or dsmago
~a\lsed dlroclly or Indlroclly by any of mo
lollowlng. Such 1055 or dal"nge 16 Il~-
cludod regardloss 01 sny olhor csuso or
ovent thsf cOlltrlbutos concurronlly or ,n
any SlSquonce to lho loss
I, Ordlnanoe or Luw
The enlorcomonl 01 any ord,nanco or
low:
III Rogulatlng Iho conGtrucllOI1, UGO or
repslr of. any proporty, or
(21 Requiring lho loorlng down 01 any
proporty, Including tho COGt 01 ro"
moving 115 dobrls
b, Elrth MoVemonl
(II Any earth movomollt lothor thon
Ilnkhole collapso). such B5 an
earlhquako. landslldo, mlnu
subsldonco or oarth Slnkll1g, rlG,ng
or Ghlltlng Bul II 1005 or damago
by lire or o~ploGlon rosullo, wo
Will pay lor that rOGulllng loss or
damage,
(21 Volcanic erupllon. e~ploslon or
elluolon, But II loss or damage
by flro, bUilding glaoo brook age or
I/olcanlc acllon rOGullo, wo win pay
for that rOGultlng 1005 or dam ago
Volcanic action moons dlroct loss
or damago rosultll1g Irom tho
eruption 01 a volcano whon tho loss
or damago Is causod by:
(I) Airborne volcanic blBSt or alr-
borno shock waves;
(b) Aoh. duol or pnrtlculalO mallor,
or
(01 Lal/I 1I0w
All I/olcanlc oruptlons that occur
within any 168 hour porlod will
constitute a single occurronce
.
.
CP 10 30 10 9 1
havo spaCial mantling Rolor 10 Socllon F,
Volcanic acllon doos not IIlcludo tha
cost 10 romovo ash, dust '"
PllllculslO mailer Ihat doDo no'
cause dlroct pl1y~loal loss or dam
ago 10 1110 doscrlbod proporty
D, QOl/ornmontDI Aotlon
SDI~u,. or doalrucliOll of proparty Ill'
ordor of gOl/ommontal autl10rlty
But we will pay lor acls 01 dostrucl,ol1
ordered by govorl1monlal authority nlln
takon at tile tlmo of a flro 10 provol1l
III oproad, If Iho lira would bo coy'
orod undor thlo Covorago Part
d. Nuololr I-tlurd
Nucloar roaclion or radlollon, or ra
dlo,ctlvo contamination, hQwavu'
caused,
But II IQSS or dDll1ago by fila rOGult"
wo will pay for tl1al rnsultlng 10GG '"
damage,
D, Off .PromlBoB SorvlooD
Tho lalluro 01 powor or olhor u\,lIl\
8ervloe 8uppllod to tl10 dascllboc
eremllll. howover causod, II tho f a,1
re occurl away Irom Iho doscllboc
premlsl8.
But If 108a or damago by a Covoro(
Causa 01 L058 r06u1lG, wo will pay f 0'
Ihat resulting lOGS or damago,
r, Wlr And Mllllorv Aotlon
(t) War, Including ulldoclarod or c,v'
war;
(2) Warlike action by D military f orco
Including action In hlndorlng or do
landing against on octual or 0'
pocloo ollock, by OilY p,OVOrI11110ll'
Govorolgn or olhor aut ,ollty 'JG"',
military porsonnol or otl1or agolll~
or
(31 Insurrection. robolllon, rovolul,o'
usurpod powor. or action lokon b
govlirnmontal authorlly In hlndoll'"
or dofondlng Bgolnot Bny 01 tho GO
g. W.t.r
(II Flood. ourlDco wator, wavos, I,do,
tidal WBVO~, ovorllow 01 a'lY boo
of wator. or Iholr Gpray. 011 whotho
driven by wind or not;
(21 Mud811dll or mudllow;
Copyright, ISQ CommorelDI Risk Sorvlces. Ine,. 1990. 1991
Pago , 01 6
131 Wolor Ihot bocks up from a sowor
or drain; or
141 Wator undor Ih" ground surl,ce
prill Ding on, or flowing or sOlplng
through:
(al Foundallonl, walls, 1I00rs or
pavod lurhcoo.
Ibl B8Iomonto. whothor payed or
not; or
(01 Oooro. wlndoWI or olhor
oponlngo
But II Iou or dOl11ogo by flro, oMplo-
IIOr or sp.rlnkler leokogo rOlulh. WI
wll poy lor that rosultlng Iou or
damage,
2. We will not pay for joss or damogo
cauood by or rooulllng rom any of Ilia
lollowlng:
a, Artlllclolly genoraled eloctrlc curronl,
Including oloclrlc arcing. thai dlslurbs
oloclrlcol dovlcos, opplloncoo or wlrel.
But II loss or domogo by flro rGBultl.
NO will pay for Ihol rosultlng Iou or
damage
b, Dalay. 1056 of uso or loGO of market
0, Smoko, vapor or g08 Irom agricultural
smudging or Induslrlal oparatlons.
d, (II Woar end toar;
121 Ruot, corrosion, fungus. docay, de-
lorlorotlon, Illddon or lotont aoloct
or any quality In proporty that
causoo It to domago or aostroy It-
sell;
(31 Smog;
(41 Sollllng, cracking. shrinking or 01<-
panslon;
(51 Inoecto. birds, rodents or other
animals;
(6) Mechanical broakdown. InCluding
rupture or bursting couslSd by
cllntrlfugal forco, HowovlSr, this
does nol apply to any resulting 1086
or damage caused by olovator col-
lision;
(71 Tho following causes of 10ls to
pllrlonal proporty:
I_I Dampnass or drynoss of at-
mosphare;
(b) Changes In or Ilxtrllmel 01
tllmpllrature; or
101 Merrlng or scratching
But II loss or damage by the "specified
causes of loos" or building gla86
breakage results. WIl will pay lor th,t
rllsulting loss or damage, 4
Pago 2 of 6
.
n. ExploSIOll 01 IllIom bollors, utoom
plpos, oloom nnglllos or otollm lurblnos
oW/lod or I04S0U by you. or oparatad
undor Y9ur conlrol Oul If Iou or
dp,"o[lo by lira or combustion oxplo-
lion rosulls, wo will pay for thai ro-
ollllltlg loss or domogo Wo 1'1111 also
pay ror ";Jua or domngo CBusod by or
rOGulllng Irom Iho exploalon of g/"os
or fUlll wl1l1ll11hll fUrJ1oCO of O'ty Irod
vo~ool or w,lhlll tho II\JOS or passages
througll which tha [lOSOS of Clll11-
buollon p06S
I. COlltlf1U<llJS or ropolllod soopogo or
lookogo of wotor Ihol occurli oyor a
perlou of I ~ <loya or moro,
9, Wotor, <llllor 1"llJld';, powdor or molton
molol'lol tllot ollks or flows 'rom
plumbhlU, hoot"'g, air condltlonlllg or
othor oqulpmant 111M copt flr.ll prote~tlve
oyslemsl cousod by or rasurtlng from
froo~lng, unloss:
III You do your bost to maintain hoot
in tho bUilding or slruclure; or
(21 You drain tho oqulpmont and shut
off tho supply If tho hoot Is not
,"olnlolnod
h. Dishonest or criminal oct by you, any
of your portnors. omployooa. directors,
truatells, outhorl~od represontallvos or
onyono to whom you entrust tho
proparty for any purpose:
(II Acting olono or In collusion with
othors; or
(21 Whethar or not occurring during
tho hourr of omploymenl
This exclusion does not apply to ocls
of doetructlon by your omployoos; but
theft by omployoos Is not covored.
I. Volunlory porting wllh any property
by you or anyone DIaD to whOI11 yau
hovo entrustod tho p'roporty II inducod
to do 60 by ony froudulont schemo,
trick. dovlco or 10lGo prolonso,
,. ROIn. snow, ico or sloat to porsonBI
proporty In tho opon,
k. Collopso. oxcopt as provldod bolow In
Ihe Additional Cavaroge for Collepse,
But If loss or damage by 8 Covered
Cause of LOBB rl1sulls at \he dascrlbod
promlsoo. wo will pay for that roouttlng
1000 or demage,
Copyright, ISQ Commarclol Risk Sorvlcos. Inc,. 1990. '991 CP 10 30 10 91
o
I, Olschargo. dlQPllrSal, 'ioopago, fllI'-
lIrallon, roloallJ or oscllpn of
po Ulanls" unl"s6 11m dlUcl1nroo, d16-
plrsal, soopaoq, mlgrallo'1, roroaao or
escnpo 16 IUall CAll60d by IIny of Iho
"spoclflod CnU60Q of 1066' 1M If IOS6
or damngn by Illo'lipoclf,od COUQ06
of 1006" rosun6, WO Will puy for 1110
r06ulllnO dolt1ngo cau6nd hy tllu
"SpUClflOd CUU606 01 1066'
3, Wo Will not pay for IOG6 or uomaoo
~ausod by or rUGultll'o f,ol11 IIllY of 11'0
'01l0Wlll0 Bul If 1066 or d'"11000 by a
Covorod- COU50 of L066 I'n,,,lt5, wo Will
poy for thOI r05ultlng 1051i 01 dilmaou
u. Woathur condlllo'15 nut 11"6 uxcluGlon
only apph06 If woaU,or condlt,0116
contrlbulU In any way W,lIl 0 caU60 or
ovont oxcludod 111 po,agropll t, obovo
10 produco Iho 1065 or dnmogo
b, Act6 01' doc1610n6, 111Cludll'O 1110 100Iuro
to act or dOCldo, of nl1Y porGon, ora up.
orgatllzallon or govurnmol1till body
n, Foully, Inadoquato or dnfoctlvo
(11 Planning, lOnll1g, efuvnlopmoI1', 6ur-
voylng. 6ltmO,
(2) 0061(111, Gpoclflc,1t'on5, workmanah,p,
roplJrr. cotlGtructloll, j'Ollovatlon, rfJ.'
modo ling, grading, comp.1ctI011,
(31 Matorlal6 u60d 111 ropair, con-
6trucllol1, ronovol,on or romodollng,
or
(41 Malnlenanco,
of part or all of any proporty 0'1 or
off Iho doscrlbod pranllsos
4, Spaniol Exclusions
The lollowing prOV'"IOn6 apply only to
tho spoc"lod Covorago FormG
8, lIu61noss lncomo (And Exlto Ex-
penso) Covorogo Form. lIu61no06 In-
nomo (Wlthoul EXlro ExpOMO)
Covorogo Form. or Extm Exponso
Covorogo Form
. Wo Will nol pay lor,
(1) Any IOG6 cau60d by or r06ultlng
from
(0) Damage or d06tructlon of "f,n-
16hed stock"; or
(b) The tlmo required to raproduce
"f,nlshad stock"
This axclU610n doos not apply 10
extra Expon6e
(21 AllY 10GG cauGod by or rOGultlllg
from dlrncl IJhyslcal 1066 or dall1ago
19 radio or lerOVIGloll OlltOllllaG, 111"
oludlng tholr load-Ill wiring, maGIG
or lowors
(3) Any II1~rop6o of 1056 cauaod by or
rOGultll1g from
(0) Dolay III robulldlng, 1'0pBlrtl1g or
roplnclI'g 1110 /)I'opony or ro-
6unlll'g OpOl'ot on6," ouo to In-
torfor~nco at 1110 10clltl011 01 tho
rotJUlldlllU, ropaU' or roplllconlont
bV 61rtkor6 or 011101' pOl' sons, or
(11) SUSpOnGIOn, lopso or cllncollatlol1
of any IIcllnso, 101160 or conlract
Out If lho 6U6p1l11Sl0n, IUpSll or
cancollollOI1 is dlroclly causod
by tho SlJSpOn510n of "opor-
allons," wo Will covor 6UCl1 1055
that offoct6 your nU61110SS In--
como during Iho 'porlod of
r06toratl011"
(41 Any Extra Expal160 CUlJsod by or
r06lJltlllg from sU5pOnSI0I1, lapso or
cOl1collallon 01 0I1y Iiconso, 10060
or conlroct boyol1d '"0 "portod of
r06tor.1tl0I1 "
(6) Any olhor consoqlJontiBl 1056
b. Loooohold 1I110ronl Covurllllo Form
(1) Paragro1ph l3,t,o. OrdlllBl1CO or Low,
dOOG not opply 10 InGurDnco ul1dor
tl116 Covorago Form
(21 We will 1101 pay f or any 1055
causod by:
(01 Your c0l1colllng the 1001GO;
(bl Tllo SlJspol1slon, IOp60 or can-
Collo1t,on 01 any IlC0I1S0, or
(e) Any othor cOl1soquol1tlal los6
e. LOGal Llablllly CovoroGo Form
(1) Tho following Exclusions do not
apply 10 II1SUrr1CO undor 11116 Cov-
orogo Form
(0) POl'o1graph 13.1.0" Ordll1al1ce or
Law;
(bl Paragl'oph 8,1,0" Govorl1mantal
Aclion;
(e) Paragraph B,l,d" Nucloar Huard,
(d) Paragraph 11,1,0" Powor Fellure,
and
(01 Paragraph 8,U., War and Military
Action,
4
4
CP 10 30 1091
Copyright. ISQ Commorclal Risk Services, Inc,. 1990, 1991
Pago 3 of 6
(2) Conlrllolu.1 Llllblllly
'fl' will nol do f and OIlY clolm or
'Gull," or poy domog06 Uiol you 01'0
logolly lIoulo 10 poy, oololy by roo-
Don of your oGGumpllon 01 lIoblllly
In 0 conlrocl or ogroomonl
(31 Nuoloor Hourd
Wo will nol dofond any clolm or
"Dull," or poy ony UOl11ogos, 100G,
o~ponGo or oblll)otloll, rooulllng
from nucloor roocllon or rodlollon,
or rlldl(,ocllVO conlllll\lI""IOn, how"
ovor COUGod
C, LIMITATIONS
I, Wo will nol pay (or 10GG of or uomogo
10'
II, Gloom boiloro, slool11 plpOS, Gloom on-
glnoG or Gloom lurblnos cousou by or
rOGulllng from any condll,oll or Ilvonl
Ir'Gldo Guch Il'lulpmont l3ul wo will
pay for lOGS of or dllll\a!lo 10 such
oqulpmonl COUGod by or roaulilng from
on O~ploGlon o( !lOGO a or fuol wlll1ln
Iho (umoco of ony "rod vosaol or
wlttlln Iho lIuos or posaogos Ihrough
whlc', tho goaoa of COl11buGI'On poas
b, Hol walor boilors or otl1or wOlor
hootln\1 o'l'Jlpmont cousod by or 1'0-
suiting from any condlllon or ovonl
Insldo Guch bollerG or oqu'pmonl, othor
Ihon 01' 0 MploGh:m,
0, Tho 'ntol'lor of any building or Glruc-
lura, or 10 porsonol proporty In tho
bUilding or Gtrueturo, cousod by or
rosulilng from rain, snow, alool, ICO,
sand or dual, wholl1or dnvon by Wind
or not, unloss:
(11 The bUilding or alrucluro Ilral sus-
tolnG damage by 0 Covorod Couao
of Loss 10 lIs roof or wolls U".ough
which tho 1'0111, snow, alool, leo,
sand or dust entorG; or
(21 Tho loss or domogo 15 cousod by
or roGulto from Ihowulg of anow,
sloot or Ico on Iho bUlld,ng or
structure,
d, Building motorlols ond supplloa nol 01-
tochod os port of Iho bUilding or
slruclurob unloGs hold for solo by you,
cousod y or rosulting (rom tholl,
OMCOpt os provldou In C,5,o, bolow,
II, Proporly thaI 10 mlsalng, wl10ro tho
only evldonco of tho loas or domogo
15 0 shortage dlGcloaod on tok Ing in-
vonlory, or other ulstonces whore
thoro Is no physical oVldonce 10 show
who I hopponod 10 tho proporly. 4
Pogo 4 of 6
,
f, QUllllrs and downopouls oouood by or
rllsulllllg from wolght of snow, loil or
aloeL
g, Proporly thaI hOD boon Irons(errod to
o par son or 10 0 ploco ouloldll Ih~
dollcrlbod promlSOO on Iho boolo of
unoulhorllod InGlrucllono
2, Wo will not pay moro for loGS o( or
dlllll1100 10 gl006 Ihot IS port of 0 bvl dl"g
or Gtrueturo II10n s 1 00 for oocl1 plolll~
pono, mulllplo plllto 1I1GuldlU,O 'mil, radllnl
01' noloI' hOlllll1(1 ponol, 1010UGlo, louvor or
"hullor Wo w II not pny morll "'01' sliOO
for 011 losa of 01' domllgo 10 building glon
Ihlll occur S III IIIlY ono limo, ,
TI1IG LUl1,llIllOIl doos nQt apply 10 loss or
dm)\lIgo by tho "spoclflod CaUGOB of lon,"
oxcopl vllndallGt11.
3. Wo will 1101 pay for loss of or damage
10 tho followln\) Iypos of proporly union
Cllullod by tl10 'apoclflou counos of Ion"
or blJlldulg olllaB brook ago'
II. Valuoblo pllporG and rocords, such IS
booko ot nccounl, mOlluGcrlplB, ob-
alrocto, drowlnOG, cord IndoM GYGtoml,
film, tnpo, dIGC, drum, coli or other
data procosa!ng, rocordlng or storage
modln, onu olhor rocords
b, Alllmals, anu Ihon only If thoy nro killed
or tholr dOfllrucllon IG modo nocossary,
c, Frogllo nrllclos Gucl1 es glassware,
Glnlunry, mnrblos, chlnoware and
porcolOlns, If brokon Thin rOGlrlcllon
doos not apply 10:
(1) GloGG that Is porI of 0 building or
Gtructuro;
(2) Conloll,orn of proporty hold for
aolo; or
(3) Photoorophlc or nciontlflc Inslru-
monl lonsos,
d, Buildors' mnchlnory, toolG, and oqulp-
monl you own or Ihol 01'0 onlruslod
to you, wl1,lo owoy frt:>m tho prl!lmloes
doscrtbod In Iho Oocloratlons, oMcepl
on provluod In poragroph C.5,b. bolow,
4, For 10SG or damage by Ihoft, tho fol-
lowing Iypos of proporly 01'0 covered
only up 10 Iho IIrnlls shown:
a, s2,500 for furs, fur gormonts Ind
gormonts trlmmnd with fur,
Copyright, IGQ Commorclol Risk Sorvlcos, Inc, 1990. '991 CP 10 30 10 91
b, 02,1500 for Jawalrv. w'IChel, Wr:ICh
movemenll. ewa I, p,arll. prac OUI
and laml-p OClOU5 IIIal bul lon,
Dold. 5l1var, plathlum on oll1or pro-
CIOU5 allOY5 or mDlol5 r 115 limit tloD5
nOI applv 10 lawolry and waloh05
worU, 0 100 or 1055 por Itom
0, 02,500 lor pallorl1l, d1D5, mold5 and
lorm5
d,.0250 lor BlampG, IIckol5, Includlno
'lollDry tlckDtl hDld f 0r Gala, and Il/lImG
'i,;" 01 credit,
15,:Pulldora' Rlisk Covuro!lu Form Llmlle"
Ilonl
The following prOVl510n5 apply only 10
Iho BulldlSr5' Rllk Covorooa Form
8, lImllotlon Ld, II 'Oplacod bV Ihe fol-
lowing
d. Building mOlonol1 and lupplieG nol
ollochod 01 pori of tho bUilding or
Itrucluro COUlod bv or relu1tlllo
from IhDII
b, LlIllltollon 3,d, II rupl,lCod bV Iho fol-
lOWing
d, Bulldor.' mOCl1'"orv, tools and
oqulpmOnl you own or that oro
onlrUllDd 10 you
6, Wo will nol poV IhD COIl 10 ropalr any
dDfocl 10 a IYllom orappllanco from
which wolor. othor liqUid, POWder or
molton malorlal olcapoG But wo wi! pay
Iho COGl 10 ropOlr or roplace damogl/o
partIal '''0 uMllngUlGh,ng oqulpmonf II
tho damage
o. ROlultl III dllchargo of onv lubGlonce
from an auton1al,c f"o prOlocllon
GYllom, or
b, II dlroctlV caulod by froozIng.
0, ADDITIONAL COVERAGE - COLLAPSE
Wo Will pov for IOG5 or d.lmogo cauIDd bV
or rOGuII'''!l from r1GkG or dllocl PhYllcal
10lG InvolVing collap50 of 0 lJu,ldlng or anV
part of 0 lJulld,ng COUGod only bV ono or
moro of Iho lollowIng
I, Tho "Ipoclfled caulol 01 1005" or
brook ago of bUilding gloll, all only 15 In-
Gurod agolnlt In Ihll Cover ago ParI;
2, HlddDn docaV:
3. Hiddon InGoct or vormln damago;
4, WOlghl of pooplo or porGonol proporly;
5. WOIghl of rain Ihol collocll on a roof;
6, UGO of dofoCl,vO malorlal or mOlhods in.
cOnGlrUCllon, remodoling or ronovatlon If
Iho cOllap50 occura dunng tho cour5e of
tho, ConGlructlon, romOdollng or rono-.
vallon,
CP 10 30 10 91
W" Will not~av lor lOBI or dlTa~o 10 Iho
lollow ng Iy 01 01 proportv, I tharwlla
covor/.Id in hl5 Covorage Prirl, U1' or Itoml
~'i 3.. .." 15. and 6, unlolS the 1001 or d.mago
, , dlroct r05ull 01 Iho collap5e 01 I
ulldlrlg
ouldoor r~dlO or tolovlslon 1I110nn85, h,-
cludlng Iholr laad, II' wiring, mll15 or
10wOrl, ownh'gl, gUllorG olld dOWnG~r,)utl'
yard "..tur05; ouldoor oWlmmlng 0015,
loncol, PlUral whorvoG and dockTl; elch
or dlvlnn p alform$ or appurlan'ncOl.
rotnlnlngalll; walks, roadwaYG and other
pavod sur aclll.
COllapGe d005 nol Include sollllng, Cricking,
5hrlnkago, bulging or 0~pon510n
Thin Additional CovlIragD will not IncraUD
the Llml15 01 Inlurollco provldod In Ihls
Covarago ParI
E, ADDITIONAL COVERAGE EXTENSIONS
I. Proporty In Tranall, Thl5 EMlanslon ap-
plios ollly to your porGOllol property to
which illiG 'orm appllos
a, YOll moV oMtond Iho "1GUraneo provldod
by illiG Covorago Part 10 apply to your
porGollol proporlV (olhur Ihall properly
In Iho caro, cUltody or control of your
lalulpor50nGI In tranlll mOrl Ihln 100
1001 Irom tho dl1lcrlbod preml5OB.
Proporly mUlt bl1 '" or on 8 mOlor
vohlcle you own, 100GO or operale
whllo bo ween pOlnls in tho coveraglS
tOrlltory,
b, L05s or damage mUGl bo caused by
or rOlul1 'rom ono 01 Iho follOWing
cnU505 01 1051
II) Flro, Iighlnlng, oMploslon, wlndGtorm
or hall, riot or civil commotion. or
vandoll5m
(2) Volllclo collision, UPlot or oVerturrl,
Colllllon moanl accldontal contact
of your vohlolo wllh anolhor vehicle
or oblOCI. It dool IIOt moan your
voh'clo's conloct Wllh Iho road bod,
(31 Thoft of an onllro bolo, COIl or
package by lorced rmtry Into 0
securoly 10ckIJd body or comparl-
minI of tho vohlclo Thoro mU51
be vlllblo marks of the forcod
onlry.
o. The mOIl wo Will pay for Iou or
damage undor tllIl EMtonGIon Is 51000,
Thll Covorago EMlolIGIOn 15 additional In-
surance The Additional Condition.
COIt1luronce, dOOG nol applV 10 Ihls EM-
ten510n.
COPYrlghl. ISQ Commorcial Risk Services, Ino,. 1990. 1991
POliO 5 of 6
MI::I MERCHANTS & BUSINESS MENIS MUTUAL INSURANCE COMPANY
COMMERCIAL GENERAL L1ABILllY COVERAGE PART
DECLARATIONS
OCCURRENCE POLICY
Polley Number: 3727092S.PP
PANDA GARDEN
CUO YOUNG CHUN D/B/A
Effective Dato: 07/18/94
12:01 A.M" Standard Time
General Aggregate Limit III 800,000
(Other Than Products-Completed Operetlons)
Products-Completed Operations Aggregate Limit III 600,000
Personal and Advertising Injury Limit $ 300,000
Each Occurrence Limit $ 300,000
Fire Damage Limit $ 50,000 Any One Fire
Medical Expense Limit $ 5,000 Any One Person
Business Description and Location of Premises: See Attached Schedule
CLASSIFICATION:
All Other: See Attached Schedule
Products and Completed Operations: See Attached Schedule (If Applicable)
Total Coverage Part Premium $ 341
Forms and Endorsements (other than applicable Form and Endorsements shown
elsewhere In the polley)
Forms and Endorsements applying to this Coverage Part and made part of this
policy at time of Issue: See Attached Schedule
...
UD-24 (10/93)
07/19/94
COMMERCIAL GENERAL L1ABltITY COVERAGE FORM
VU.IOUK p/ovlllol1l in Ihl5 policy l05111el eOVQ\1I0u,
Rllod Ihu onlllo Ilolley c'ullfully 10 doll"nlno IIOhI5,
dUllol and Whlllll nnd 111101 covQ\od,
ThlouOhoul Ihll policy Ilw wOllfo 'vou' and 'youI'
IuluI III Iho Nlllllud 1115ulud ohown 111 Iho OUCllllll'
1/0111, IInd III1Y olhuI pO/OOI1 01 mOlll1llllllon qUllllfy.
II1U 110 II NllfllUd Il1lulod Ul1dUllhlo pollev, Tho wOldo
'wu,' "uo' IIl1d 'OUI' rulur 10 Iho I:OfllpIlI1Y IIIovldll1U
Ihlu InIUIOI1CII,
T1w wo.d '1I1oU/lld' fllUUI10 OilY PUIOOI1 or monnllll
I/on qUIIllIVll1U 115 ouch Ul1dUI WHO 15 AN INSUIlED
(5ECTION II)
Olhur wOllfo ol1d ph'II'U6 Ihlll "pPllor In qUOlllllol1
11l/"ko hllvlI 1IIIIclolmUIII111111 11010110 DEFINITIONS
(SECTION V).
SECT/ON I . COVERAGES
, I
COVERAGE A. BODILY INJURY AND PROp.
ERTY DAMAGE LIABILITY
1, hllurl110 Agroolllont,
0, WII will PllY Iholu 'UIIIO Ihllllhll Inlurod bo,
COfllOI louolly oblllllllod 10 poy liS d0l1111000
boellu50 01 'bodily II1IU'Y" or 'proporty dOI11'
0011' 10 which Ihlo 1110UrllnCII IIppllol, WO will
hovo Iho Ilohl 1I11l! dUly 10 dlllllnd ony 'lUll"
ouokmo Ihooo d1l1111101lS, Wo fllay III OUI dlo,
crill Ion Il1vOOllOlllo III1Y 'UCCU"III1CII' ond 0011I0
allY claim or 'oulI" Ihol mllY IIIIUII, OUI:
(') Tho omounl wu will pay 101 dll11100UO II
IImllod 01 dU5Cflbud In LIMITS OF IN.
SURANCE (SECTION III). I1l1d
(2) QUI light Ol1r! duly III dullIl1d ond whul1
WII hovo Ullld up Ihll oppllcoblo 1111111 01
1110UIIII1CO In Iho puymol1l 01/ud01110n10 or
sonlomonlo undol Covllrllgul A or B or
modlcol Upll110llS undlll COVIIIOOII C,
No olhol obllgOllol1 O. Iluhlllly 10 puy oumo 01
pOlforl11 IIclo or ollrvlcllo io covllrlld unllloo II~'
pllcltly plovldlld for UI1l!II/ SUPPLEMENTARY
PAYMENTS. COVERAGES A AND B..
b, Thlo Inouruncu opplieo 10 'bodily Injury' and
'proporty domogll' only If:
(1) Tho 'bodily Injury' 0/ 'proporty domogll'
Is CSUllld by un 'OCCU"SI1CO' Ihol lokol
placo In Ihll 'covo/llgo lor/ltory;' and
(2) Tho 'bodily In/ury' or 'propOI1)r domogo'
occurl dUllng Iho policy pOllod.
4
CG 00 01 1 1 BB
0. 01l1110UOI hUCIIUIU 01 'hodlly In/ury' 1I10ludo
dnl11l1glll clllll11l1d by nny pUllon 'or mgllnl/II'
lion '0/ coro. 10ls ollo/Vlcol 0/ denlh l88ulllno
nl nny IImu 1r01111hu 'bodily Il1lury,'
2, boluslona,
Thll In~urollcu <lou~ 1101 IIpply 10:
O. 'Bodily Illlury" 01 'p.opUlly dnl11pgo' o~poclod
0/ Inlull<lod hOI11 Iho ololldpolnl 0' Iho In.
Bu/od, Thll lI~cluuion doos 110\ apply 10 'bod.
lIy Inlury' rusulll110 hOI11 Iho uso 01 ruulonoblu
lorcII 10 p/oloel PIl/OOIlS or P/oporty,
b, 'Oodlly Illju.y' o. "PIOPUlty dOl11ogo' 101
which thu Inourod I~ ohliuulud 10 pay dlll11UOUO
by /uIIson 01 Ihu ussul11pllon 01 Ijllhllity 111 0
conlrOCI or 00r0011101l1, Thll O~CIUIIIlIl, does
nOI apply 10 1I0hlllly lor dOl11nOUI:' , '.
(1) Assumod In 0 conllocl 0/ ngloemonl tho I
il on 'InoUlod conlrocl: p/ovldod Ihll
'bodily Injury' 0/ 'P/oporty dOI11BUO' oc.
curl luhloquonl 10 Iho u~oculIon of Iho
cOIlI/oCI 0/ 00/0011111111; 0/
(2) Thnl the Inlurod would hollu In Iho nb.
sonco of Iho conllucl or o%om,onl,
0, 'Bodily Il1jury' 1)/ 'P/oporty ,damage' 10/
whleh OilY Inourod l11ay bll hold 1I0blo by /00'
ron~ . ,
(1) Clluslng or contrlhullng 10 Ihu Into~lcollon
of any pO/OOI1;
(2) Thll 'urnlshlng 01 alcoholic bovorogol 10 u
pOrlOI1 undel Iho looul drinking age 0/ un.
dor Ihu Inlluunco 01 alcohol; 0/
(3) AllY otolUIU. ordlnoncu or rugulolloll /OIUI'
illg 10 Iho IUlo. gilt. distribution or UIO of
uleohollc hov%gos,
Thlo o~c1uslon oppllol only If you oru In tho
buolno~1 01 monufoclurlng. dlslrlbutlng. sell,
ino, sOIVlno 0/ lurnllhlng alcoholic hovo/agol,
Copyrlght.lnsuranco Servlclll QllIco. Ine,. 19B2. lB8B
Page 1 01 1 2 0
c'bAAMEriCIAl. GENERAL LIABfi:lt~ \'"f I.l! .\lj(\ l.J .I An.'.'
COVERAGE FORM
, d. Anv oblluollon 0' Iho InoLJred LJnd~r,a,workaro'
'. ~ojt1ponoollon, dloobllllV, bonollUl, Or,lLJnem,
r~~vmetll cDmpon50llo~. '~W~ or,a~v,' :olmllnr
e, 'Bodllv Injurv' 10: " ",...1, . 'J ';
(1) An Qfllplovop .ot Iho IIIBLJrod arlolng, out 0'
ond In l,ho ~OLJ'IO of ~~,lplo~lno,~' bV \he
Illfiur,d; 0,1 I, I' "
. (2) Tho IPOUIO.' uhlld. po rOlli, brothur ,or ololor
0' Ihol oll1plovoo 00 0 cDnooquonce,ol (1 )
obovlJ. 'jl.-.I/
Thlo oxclullon OP,,1I05: " . ,I
(1) WhOlher tho Insurod 1l10V bo 1I0hlo 00 on
. omplovor or In onv olho" coponllV; ond
, (2) rci on.v,ob'l/oollonlo, ~hQ';~~,~/noiiBO wllh
or lOpOV 101l100nO olsV who mUlt poV
, , domooes bocouso 0' Iho InllJ;y,
. {, l .
Thls,oxcluslon dou6 nol opplV 10 1I0bllllV el'
6u!)lod bV Iho Insulod unflor,pn 'In6urod con.
tract."
I. (1) 7Bodllv InjulV" 01 "proportv domo~I\"' orlo.
Ino Oul ol.lho oClUol. olleD,od .'?r,thleolonod
dl6cholOo, dl6poIsol. ooopooo, I1\lorollon.
.': ' ,~~,I~lb~,V or 06COpO of p~lIut~~~s:, ',' ,
(0)' Al or 'rom onv p,:ol11loos. ollp 01 loco lion
which 16 or WOS 01 onv limo, ow"ed or
occUpied by, Of .nnled 01 loaned to. onv
Insulod;
'(b) Alar 'rol11 onv plomloos; 1110 or loco lion
which Is or wo's 01 o'nv lime' Usod bV or
'or onv In6ulud or olhoro"ortho hondl.
Ino, slorooo. dlspoool., procosslno or
. Iroolmonl 0' woole; " ,""
(0) Which oro or wllre OI'ehV"llme Irono'
portod" hondlod. olQrO,d. ,lIen\Qd. dlo,
posed 01. or Ploc060ed OO,W05I11 bV or
'or onv Insurod or onv, perlon, or or.
oonllollon '01 whom you mav be laoallv
lospon6lblo; C)f
Pooo '2 01 1 2 .
I ',~
I', ,..,~'j::J /1,/' ,I) t . ) '"'
" 'l.~ I ~. ..
'II" I (d) AI or Irom anv promloao, Ollllllr locallon
",It,,,, 011, which, anv"lnourod, orsnv oonl1lo-
loro or oUbcllnllOcloto,worklno'dltocllv
or Indlr,y~IIV Oll,ony Irl~41~d'0 Qe'lpll ,a(o
. potrormhlp ~Ilolollp',"", " , " "
(II II Iho p"lllulunlu, 010' hlouoht on or
10 Ihe PIOI1lI10S, 1110101 ,locollol1, 111
COl1noollon' Wllh su~h .oporallono bV
uuch In~lJIud, co,IIIOClor,or Dubco,,,,
\fn~lo'. IJI ,
(II) II Ihu ollorollonu 010 10 leOI lorl
11I0nllo., clunn lJIJ, ImllOVO. oonloll1;
!lpnl, dOlu>lIV or nou!lolllO. or In oilY
Way' 101110,"110, or OSAP'S, Iho oUo~,lIi
of Ilollutonts , 'I .'i
5LJbporOllrnphl(01 QI1~J~I~.) d,ol11PHPpJ~
10 'boullV InjulV o'pro ellV p~h\oO~
',II)" "orl~(no 6UI 0' heol. I/l)r~e; r ,fume, "iJ!IlA
hoslllo fllo, '
Ao uoeu In 111,1 oxcluolllr\:' n hoilllo lito
"I meono ono which bocol1loD uncontrollable
, "I,' or breako OUI from whoroll', WOI Inlenuou
"1\1 I' to bu. ' If ,
":"~ '(~), '~~:: '~~o. ,~l)~1 or e~Il,O~,~?"~rlolng OUI 01
;':' ,(0) RI$R~oill. QO'l1Iond 10"'9~1 nr 'Ihoi imV In.
oure~ br olholl lost I, 'o%nllor. c100n
up. romove, conloln, lOB. detoxllv or
noullolllO. 01 In onv WdY lospond to. or
oueu Ihe Offocls of pollUlonl6; or
. 'I ',-
(b) Clolm or 6UII bv or 011 bohol' 01,0 OOV.
arnmenlol oUlhollly lor'domoooo bo.
COUIO 01 losllnn for,l nionltorlno,
cleonlnn up, lomovlno,' conlolnlno.
IroBllno. dUloxllylno bl h~Ulrollllno. or
, In onv wnv .olp'ondlnd'lo:)I"r'06solllno
,Iho oUocl6 01 POIlUIOI1lS" "
,'. Pollulonl6mllon. ony ~olld, IIqul<l.'gBsooUO 01
Iholmlll lilllonl or conlnmlnonl. InchJdmn
sm'okn;" vopor, ~OOI, flJmosl ocld6. 'alkolls,
"" chemlcolu ond WIIslo, Wl1610,lncludoo mOlerl,
01010 bo locvclod, .ucondltloned or reclolmod.
, g,,'BodIlV Injury" ur "propoI"', domooo' orlslno
,I o.ut, 01, Iho ownorshlp, m0ll110nonco. uoo or
ontruotmenl to olhols 0' any, olrcroll. "oUlo'
or WI!I~r~ro'l owned or oper.qtod ~y or,ronlod
6/lool)ed 10 onv Insured '. Uaq 1,~cludIlS bpolo,
lion ol1'd "Ioodlnn ()/ unloBdlnd:
IU'.!'.
I' Ii'll I',~
. 't'
,/'.'1,".' '1-,
~I' I I' . I,
"
"
" '
.
CnpVlloh~,1lnsuronco 'Sfirvlceo QUlce. Inc. 10B2. 10AA
c(foo 01 11 88
" ,....
I '
~
, \
I.. f '....
o
, .
\
11
Thll ONolulloll dool nol Ollply 10:
(1) A wale/clolI whllo uholo on premlul'you
own 01 IUIlI; ,
(21 A watololulI YOl! do 11111 r)wn thai Is:
(II) Lou than 26 fUllllonu; and
Ib) Nol 111/1110 uijud 10 cOl/Y purar,lnl 01
propollY fur 0 r1IQ10U;
(3) Parking nil "oulo" 011, or on Ihu WIlYI l1uxl
to, plemlsI/6 you own or lUl11, Illovldud Iho
"oUIO. is nOI ownod lIy or ronlud or loonod
10 you 01 Ihu 111 ijlJfud ,
(4) Liability. nuumud ul1dur uny "hllurud con.
lIdCI" or Ihu oWl1ur6hlp. I1IUII1IUI1UI1CO or
UIO ololrcrell 01 wulorcrofl; 01
(6) "Bodily Inju.y" or "prolll/.'Y domoou" oris,
Ing oul of Ihu opurollon of OilY 01 Ihl
oqulpmonlllllod III poroUlollh f,(2) or f,(3)
of tho dollnlllon 01 "mobllo equipment"
(50cllon V.B)
h. "Bodily Injury" o. "1lIopurty domooo" 01161110
out of:
(1) The I/On6pOl1OII0l1 of "mobllu oqulpl1lonl"
by en "OUlO" ow nod or oporolod by or
rented or 100l1ud 10 OilY Insuled; or
(2) Tho uso of "mobllo oqulpmOnl" In. or while
In p/lcllco 01 proporoliol1 for, 0 prool/onged
roclng. spood or dOl1\olltlon COil 1011 or In
any slunllno oCllvllY,
I. "Bodily Injury' or "propurty domooo" due 10
wor, whelher or 1101 doclolod. or any OCI or
condlllon Incldonl lr,l wor, Wor Il1cludos civil
war, Insurrectlol1, .obolllol1 or .evolutlol1, This
oxcluslon oppllos only 10 1I0blllly assumed
undor 0 COlllrocl or oo'ool1\ont.
j. "PropOrly domollU" 10
(11 Proporly you OWI1, 'UI1I, or OCCUllY;
(2) Promises you 6,,11, oive IIwuy or uhundon.
IIlhe "propurly domoou" IIlilus oul of ony
pOrl of Iholo promllos;
(3) Proporly loonod 10 you;
(41 Porsonol proporly In Iho core. cuslody or
conl/ol of Ihe Inlured;
.
.
CG 00 01 11 88
COMMEIICIAL mNEIlAL L1AIlILln
COVEIIAGE FOIlM
(6) That palllculor port of 16111 PIOpurly Oil
which you or OilY COl1l1oclorl or auhcol1'
lIoctols workll1U dlroctly 01 Indlruclly 011
your beholl 010 purlol/nll10 opOlotlol1l. if
Iho "ploporlY domllOo" IIrlsUI out 'If IhOijU
oporollol1s; or
(6) Thai porllculor pOlloI OilY plopo.ly Ihul
musl bo rolllollld, lopul.od or ropluc",1 hll
couso 'your wor~" Will Incorroclly Jlur
lormud 01111
POIOllloph (2) ofllllij oxclullon doos nol oppl\
II Iho promls05 010 "rour work" und WUII.
nover occuplod, lontor or hold for .olllul hy
you,
Paragraphs (3). (4). (6) and (6) oflhll ox'
clullon do nOI apply to liability o68umod un,
der 0 sldelrock ogruomont.
Paragraph (6) of Ihll oxcluslon dool not opply
to "properly domogo" ,ncludod In 1110
"producls'Complolod oporollonl hozord."
k, "Proporty domogo" 10 "your product' uljijln\1
out ofll or any PO'I of II
I. "Propurty domooo" 10 "your work" urlllnu OUI
of II or any port of It ond Includod in the
"llIoducts,complolod OpOlOllol1s hOlu.d."
TIlls o~cluslon dool nOI apply litho domolloo
work Qr tho WUlk out of which the damage
orlUB Was perlormed on your boholl by "
subconlroctor,
m, "Proporty domollo" 10 "Impolred properly" 0'
property Ihol has not boon phyijlcolly Injured
orlsll1l1 Oul of:
(1) A dolecl. doflcloncy. Inodoquocy or don
gorous condition In "your producl" 0'
"your work;" or
(21 A deloy or 101luro hy you or onyono octln\:
on your 1I0holl 10 pur form 0 conlraCI o'
"orOOmOnlln OCClJfr!.ulCU wllh It I tOfll'ij,
Thll oxcluslon dOOij nul Ullpl\' 10 Iho lor,ij 0'
UIO of olher propully orlslno OUI of luddc.
and occldonlOI physical Injury 10 "your prod
uct" or "your work" alto. It has boon pullo II'
Intondod use,
n. 0011101l0S claimed lor any loss. COlt or oxpenr.,
Incurrod by you or olhurs for Iho 106S of Uln
wllhdrowol, IOcoll. Itlspoctlon, ropolr, rOjlloco
11\0nl, odjultmont. romovol or dispolul of:
Copyrlnhl. Inluronco Sorvlcos Qfflco, Inc" 19B2. 198B
Puu";) ul " <.
1'1,\,,1 ,I' , ' I .
coMMtMI~L'GeNERAL LIABILITY
COV,~IlA!J" F.oRM , " I" I II',
,,' (1 ) "Y61lt plbducU.' .. '''' r,~t.1I',
)11,\ 1I1.1:1' 'k . I" ,,1,1"
hlUMucj\PlIf ,w.9,r, ,i or. I :,.i,jl' It ,'''
:, (1').1, IIIpohod propurty;~:,. I' '" ,..I
III euoh producl. work; or' pr'opoHy Ie Wllh,
. /IlI.ll~'lIO~ ~uCQllud hpIII,lhe IJW/kIl~/lr f.rl1plueo
'"..bYi<tlIY,per~OIl ,PI QlonI1JzuIIRll,j)Il~QUSO of 0
,mQwtl,ur euepuclod.doloo~ dofloloncy, 'nod.
OQUOCY or dUI1UII/oue condllloll.ln j~
hclllelol1s .0, lh.ouoh 1\" do, 1101 upply,!Q,duf11ouu
by 1110 10 proll1leue,runlud 10 YOI'" A eePOIUIU IImll
01 IIjeurOI1Cu opplluelo, Ihl, coVuroOo Oe ~o6crlbod
In LlMITSllF INSURANCE (SECTlON,JII),
COVEI:IAGE,B. PERSONAL AND:~,YERTlS.
ING ,INJUIWUAIIILITY ,d. 11'",
1, hllurlno Aoroon'1ont, "".. ,."n"I.' ",,)
0'. Wo':wllt poy Iho~o "j1116 Ih'ol'~hli'ln5lJlod bu.
'ConlUtl'leoolly oblluolod 10 'p\1Y"oe dllnloooS
bochu60"01 'poledllol Inlury'"\jYli'~dvo/llelno
Inlury,'"IO which \hle covoroo,,,pQlt opplloe,
Wo will hovo Iho rluhl ond duW,lo,dofond ony
,"~Y,II~ ~~~~Ino UlO,SP d~nloUoe, ,W,O,n\IIY 0\ our
'I dre5r~I!?1l IrlvoslI.UYlo ohy 'occu.t,:~8cQ' or 01.
. r:~S~",O~~II:S/O.I\IOO~V c1olrll,:?r J;~Hlr)!hot moy
1':(1)' T,I,lo:'8,m,ou'I'!'W~ will p.. 0~"foi.'gp'i1ioo06 Ie
'I' rr~l(t,od 05 d05C/lbod In ~1~11.~'OF IN.
Sl:JAANCE (SECTION 1I1)';'qhf",
~2) Our rlOhl ond dUly \0 dOfO~d ,o~d whon
Wo h~vo usod up Ihoo~pll ~~J~,lImll o.
Ineuronco In Iho pOYf1lonl,~,f u~ql1)onl5 or
50tllof1lonlS undor CovordUb "~"'Ol' B or
medical e~ponS05 undor'Covor5~0 'C"
'Nooihoroblloo'tlon or'llo\)ill,~y'l\;'~~y sum5 0'
portorm OclS or so.vlc'd5 1~'cl\V4Y~B' unl05e OK,
pllcltly'pmvlrlodlor undor SUPPbEMEN'rAAY
',' PAYMENTS. COVEAAGES'A AND B.
,r ,',;, it f '. " 'It~'I""lrll
.~ . ., , , ' , . , .
, ": I 11 :) t ~ ,t
',j I, ';", I.
',1'1" If' ,"I
, ,
, ","
"', II' -\ ~I '. 'It
,'.:..... v"" fll'
',,' h~II.I ',;
If tl!' 'I'P/',' -:' t','
. I
1"1 :. "..,1""'\'
",t ' 'H'P,'"
oJ.: I,rl,.
" Itl, "
,I I,'
"
'".'
" ,
.
It ,II
, b~"rtllli "llurollCD appllu '0:, "" 4 I t I
(1) .Personal Injury' CQUlod bvl.a'n, ollonso
" ,nrl.lnll (oUI o' your" bueln"e."'.I.gl~dlnll
odJ~P,!11I.1n\l' pUbllehlno. l?r.oodfD5'lno or
'ololloellhg dono by or 'm you;' I
, (2)' ''''MvilnI5Ino Injury'. c~ueeq 'by'"~ 0llon5e
COl11l11ltlod In Iho courso' ',,' odvertlelno
'. , . ,.yollr ooode. p.orlucl5 or 5ervlco~; (~;)
.:~ IJ'~,~>>I'b~IY II tho oUons~ W06 cori;nilhod In .ho
. ,'" .covmooo lorrllory' rlurlno Iho policy porlod,
I .... "'.11
2iJ~ft"I!~!on6, "'.,,.1,'
:n\I~ In5ulol1co 0.10"6 nol opply 10:. ".'
0, 'Poleonollnlury' or 'orlvollloll1lllnjury:'
, 11')hAlI&lnu oUI 01 orol or wrltlilM!'pu6I1collon
I" "bllnoloHdl, II dono by o'r ot Iho dlroellon
I ,',. ,,'1I10In5urod wllh knowlodoo '0.115 fol51ly;
"('2)'''rI6Ino Qui of oral or wrl1l6n publlcollon
of 1110101101 whoso Ilr51 ,iullllcotlon look
"". "Illdto boforo tho bOlJlnnlno o;Jthe policy
porlod; .
. (3) Arlsln\) Oul a. 11\0 willful vhllotlol\ 01 0
,.f 1 'POhol ~lot"loO/ ordlnol1co ':oll1mlllod by
, or wllh Iho consont o'lho In~ored; or
'''''W(4) For which tho l/fsurod h05 u55umed hbblllly
, ",,'or, In 0 conlroct or ooreof1lont,:.Thfs' eKcluelon
d005 not opply 10 1I0blllly lor'domogoe thol
Iho In5urod would how In tho 'obsenco o.
'I Iho controcl or oo.oonlont.
b. . Advortlslno Inlury' orlsll\O oul of: '
, (1). Breach 01 c,onlfoot. olho,r tnoitmlioppro.
" prlotlqn 01 o<lvertlslno IdODe H"?ft on 1m.
plle<l eon,ro~l' .. , ~ '," 6
" ' ' f , .. .. " , II H.hl"~
,.-" .f
",
'.
'I . .' ~ "f' l:' , ". '\
l
Pego'40fH.
t;oPYrlghl,llneuiulllO'" G""vlce$llfflcol' Ine:. lllll?, 1980
CG"OO' (>'t[J1W 80:> CJ
I
(
I
I
I
)
(2) Tho 'ollulo 0' good I, ploduell Or 1O/'\Ile"l
10 eonform wllh ndvn/II'od quolllY Or PU/'
lIl/monen;
(3) Tho wrong dOlcrlpllon 01 Iho prleo 0'
ooodl. ploduCl1 or '''/'\IlcoI: or
(4) All oHonlO cOllllnlllod by nn Inlulod
wh<l'o bUllno.. It advoIll,lno. broodensl'
Inu, Ilubll,hlno or 1010cIIsllno
COVERAGE C. MEDICAL PAYMENTS
1. Inlurlno Ao",onlont,
I. Wo will POy molllcnl 0~p011l0S 0' dOlcrlbad
bol<lw for "l!<ldlly Inlury" cllusod by on occl.
doni:
(1) On ploml'o' you own or ronl;
(Z) On ways nOkl 10 p.omlsos you own or lonl;
or
(3) Bocauso of yOUI opo/allons;
p/ovldod Ihot:
(1) Tho occldonl lokos placo In tho "eovornoo
10/lilory" and dUJlnOlh.) policy porlod;
(Zl Tho OkponSOI Ole Inculrod ond roportod 10
UI wllhln one y"or 01 Iho dolo of Iho occl.
donI; nnd
(3) Tho Injurod potion Iubmllo to okomlnntlon.
01 OUr okponlO. by phYllclonl of our choice
01 of Ion 01 wo roolonobly roqulro,
b. We will moko the", poymonlo rooordle.. 01
foull, ThOlo paymonll will nol okcood Ihe op.
pllcoblo 11m II of Inluronco, Wo will POy roo.
lonoblo OkponlOO for:
(1) FIlii old ollho tlmo of on accldenl;
(2) Noceuory medical, lurglcol, x-rey ond
donlol sorvlces. Includlno prollhello do.
vlcas; and
,I
4
4
fJ
CG 00 u1 1\ B8
Copyrlohl. In.uronoo Sorvlcos Qlflco. Inc,. 1982, 1988
Pooe 6 of 1 2 Cl
..-'
COMMERCIAL GENERAl. LIABILITY
COVERAGE FORM
(3) Nocol"'ry ombulonco. hOlpllol. prolol'
Ilonel nUlllno end lunornl 10/'\lleol,
2, Ihllllullonl,
Wo will nollloy OkponlOI lor 'bodily In/ury:"
II. To nny Insulod,
b, To n pOllan hlrod 10 do work 'or or on boholf
0' ony Itllurod or 0 10llont of ony Inlulod,
o. To n potion InJurod 011 Ihol port 01 promllos
you own or 'ani Ihal Iho POIIOII normally oc.
eupl,,",
d. To 0 flU/son, wholhor or nol 1111 omployoo 01
nny IlIlurod. II bOllOll16 lor Iho "bodily Injury"
010 poyablo or mUll bo provldod undor n
WalkerI' componlotloll or dlloblllly bellollll
Ilw or 0 Ilmllor low,
D, To 0 p0t6011 Inlured whllo loklnu port In atll'
10tlcI,
f. Included wllhln Iho "producls'C<lmplotod <lP'
orollonl hunrd."
g. Ekcluded undor Covorooe A,
h. Duo 10 wor. wholhor or nOI doclorod. or ony
OCI or condltlOIl ineldonllo wor, Wor Includol
,civil wor, Insu/loctlon, robolllon or rovolutlon,
SUPflLEMENTARY PAYMENTS. COVERAGES
A AND B
We will pay. wllh relpocllO ony clolm or 'lull" we
do'end:
1. All Okpon601 wo Incur.
2, Up to 6260 for C061 0' boll bondl requlrod bo.
COU60 of oceldonls or troHlc low vlolollonl orlllno
oul of Iho use of any vohlcle 10 which tho Bodily
Injury Liability Covoraoe appllol, Wo do not how
10 furnish Ihe", bonde, ",,', '
3, The COli of bondl to reloOlo allo~hmonll. but
only lor bond amounls wllhln Ihe appllcnblo limit
of Inluranco Wo do not havo 10 furnlsli IhOle
bonql, '
, '
COMMEtlCIAL GENERAL LIABILITY
COVERAGE FOtlM
4, All looll)noblu ,"pen'lI Incu/red by Ihe Inluted
01 nur ruquull In 011111 UI In thl In~eJUllello"Jo/
duful1ao n' thu cl~lm IJt 'lull,' Including nctunl
1'16101 uomlnUI up tn 1'000 doy bllcould 01 limo
off frOI11 work, . I' f "
6. All cost I lDxud ooolnlt thu Inlurud In thu 'Iult.'
6, I'roludUl11urllll1lu.Ust uwoldud ooolhnthu 'Inswud
on Ihot port of Ihu JudOl11enl wu IJOY, II wu I11nkn
1111 offo. to IJuy thu oppllcohlu limit 01 Il1sulul1cu.
WII will nol PllY IIny ploludUl11Ul11 Inlurolt bOlud
on 111111 porlod 01111110 IIl1uI tho offel.
7, All Il1lU.Ult Oil thu lull UI110Ul11 of un~' judul11unl
111111 UCCruU6 Allu. untry of Iho judOI11Ul1t ond bu.
loro wo how pAid, ollo.uu 10 puy. n/ uoposllud In
COUll Iho PUll 1)1 Ihu juuumunl Ihul II wllhln thu
IIppllcAblu limit nf Inlu.oncu,
fllull! poymul1ts will nol .uducu Ihu limits, nf Inlur.
lInCl!
SECTION II . WHO IS AN INSURED
1, If you nru dUllonotuu In Iho DuclurUllnl11 AS:
u, An Inulvlduul, you UI1U ynur spnulu uru In.
',wuus. bUlonly wllh 'UlpUCI,IO.thu'conuuct
of II bUllnuls nl wlllch YIlU Are the 1010 nwner,
II A portn\lllhlp 0" 101111 vUl1lut6.lyou 'A'O All In"
llUud, Ynur l11ul11bo'l. ynur purl nUll, 'nnd Ihull'
IpnUIUI A'O uI5n Il15uruds. bUI nnly with ru-
5puctln Iho cnndUCI nf your bUllnu51,
c, All orOAnllUllOI1 nlllur Ihun U llo.Iner5hlp o.
101111 VUl1tUlO, you Aro un Inluruu, Ynur oxocu,
livo offlcorl And ulroclO;I u.u Inlurodl. but
ol1ly with luapectlo tholrdullus' 01 your offl.
cor6 nr dlroclorl, Your 510ckhbldoro oro ullo
Inlu.odl, bUI only with 'OlpUCllO Ihulr lIublllly
A5510ckholdor5, ", ,
2, Ench of Iho fllll,oWlno II nllon'n Inlu,od:
1.1,. "' ,., ,
11, YOUl 0l11ployu'5, otho, thAn ynu, Ol<ocutlvo
01l,co'5. but only for ACII wllhln tllo 5COpO 01
111011 ol11ploYl11ol1t by you, Howovo" no 0111'
ployoo II nn In5u.ud for:
(1) 'Ilnully Inlury' or "polllJOollnjUlY' to you
or In n cn.omplnyoo whllo In tho cnurlu
of hiS O. hUI umplnymonl. or Ihu IpOUIO,
child, puron!, llrolhor m 1IIIor of Ihut en.
umployoo 01 u eonluquonco of luch
'bndlly Inlury' m 'po.lonul injury,' or for
uny oblloullnn 10 Ihoro dl1muool with or
..poy lomoono .110 who mUll poy durn.
UOU. bOeAUGU nf thu Injury; or .
(2) "Bodily Injury" or 'pUllonol InJu,y' orlllno
<Jul of hll or hUl p.ovldlnn o. folllno 10
,
provide pro'uulonol hpol,lI, elle IUIVlcUl1
or
(3) "Proporly donloo'.", 10 P,OPIlrW, pvt'Dod Ot
occupied by or /Qf1lud or Ipened t'O thol
omployee. 'OilY 01 'ynuI olhor ol11plnyool. or
OilY nf ynUr porlnurl or l11embors (If YOll ore
o porlnorlhlp or 101111 vonMo),
b, Any purs'In(olh.r, !lIon, yoyr ~111nloy~0), or
Any 1Jt00nllUllnh whll. oetlno os V'ouf tulll'us.
IAIlll11onoller, "
c, Any por.nn or. OIuonl,Ollol1 hovlno ptopor
IUl11pnrAry custody nf your ptopollY If you dlo,
bUlonly:
(1) Wllh rospoct 10 1I0bllllY orlllno oUI of the
molnlonon~o IJt usu of Ihol PJope,n~;Jnd
(2) Until ynur lugol ,.prOI0I1101Ivo hOI boun
oppolnlod,
d, Your 10001 roprosuntotlvo II y!lu die. bUI only
wllh lOlpeeltn dutlol 01 such, Thol luprOlon.
II1t1vo will hovo 011 ynur IIOhlS ond dutlos undur
thll Covutogo 1'011,
3. Wllh r05pucl In 'l11obllo oQulpmunl" reglslorod In
your nUI110 undur ony maIm vohlele IUOlll,ollnn
luw. IIny porion Is un lt15u.od whllo drlvlno lueh
uqulpmonl olono " public IIIOIJ,'!\'IlY with, ynur
po.mlsllnn, Any olhor po.son ol,nrgonllollon re'
5ponslblo lor Iho conduct n' such person Is olso
An Inlurud, bul only willi .ospuet 10 liability 0,11'
InU oUI of tho Ilpurullon of Iho oqulpmom, ond
only if nn olhor InlOloneu nf ony kind II ovollubl.
tl) thot porson m nrnunllAllon "or Ihll lIublllty,
Howov.., no porson or oroonllotlon II un Inlurud
wllh rOlpocllo:
0, "Bodily Injury" 10 0 QI).ompll)yoe nl Ihe perlon
drlvlnll Iho uqulpmont; or
b, "ProperlY domuuo' tl) p,operty ownod by.
runtud to, In Iho cho.qo 0' or nceuplod bV you
or Iho omployor nf uny purlon who Is on In.
lu.od undor Ihll provlllnn,
4, Any o'oonllallon ynu nowly acquire or form.
olhor Ihon 0 portnorlhlp or lolnl vonturu. end ovor
which ynu molmoln ownorshlp or mojmlly Inlor.
ost, will quullly os 0 Nomod Inlulod IIlhuro II no
olhor .Imllo, Inluroneu ovolloblo 10 that organ'
Ilo!ion, Hnwevur:
o. Cnvo,oou undor thll prnvlllnn II aUordod only
unltllho 90lh doy u'lor you oequlro nr 'orm Iho
o'oonllolll)n m Iho ond 01 tho policy purlod.
whlehuvor Is oorllu.;
1'000 6 of 12
Cnpyrlght. Insuronco SUNleOI QUICO, Inc.. 1982. 1988
co 00 01 11 B8
o
b. Covo,nuo A doos 11111 opply IU "hmlily IIlI~IY"
0' 'fl/OpolIy dOlnollo" Ihot oc':~"od hololB
yo I' .e'lul,ed 0' 'O/modlho uIuonllQllon; olul
o. Cov.r.un B do~s nol npply 10 ",lo,sonnl In'
I~ry" 0' "ndvo,I'slnu Inlury" IlIlslnll 0111'11 1111
ollonlo commlllod hulOlo YUI, OCIIUI/OII IJI
lOlmod Iho OIIIO/ll/ollon
No pOllon 01 OIlIonllollon II nn InlUIBd wllh lOSIII/I:1
10 Iho cond~cl 01 ony cu"onl 01 pilI I pollnu'lhlll IJI
lolnt vonllJ/U lIull Is '\Ill Ihown 'II 0 NlHnlld InsIIlIIII
In Iho Ooclnlnllons
SECTION III . LIMITS OF INSURANCE
1, Tho L1mlls 01 InllJ/oncu ahown III Iho noelolo,
1I0nl ond Iho I~lus hnluw Ilx Ihu lIlos1 wo wlllpllY
,ounldlon ollho fllJlnhol 01
.. InslI,eds;
b. Clnlms mndo 01 "S~IIS" hlll~lIhl, or
O. PO'SOlIS III IU'jOnIIBII'JIls l1Iokinll ,:IOII1lS 01
bllnglllO "sulIs .
2. Tho GonO/ol AUIIIUIIOIII lllllll IS Ilw mllsl WU will
pny IOIlho 1~11I ul
II. Medlcol oxpun6u6 umlor COVU'IIIIU C;
b. Oornno06 unduI COVill/III II A, IIxcupl dOlllJllIlIS
lIocnuso of "h'l,jlly 1f111J1Y" or "Ploporly 110111'
ouo" IlIclulJlld In Ihu "plodur.ls' COl1llll010d
opo'Bllons hOlnld," ond
o. OomllOos undo, Covo,ooo II
3. Tho P'od~cls - Complolud OpUJJlIIOnl AIlII,ullolo
Llmll 16 Iho moal wo Will pny undm C,wolnuo A
fO/ domoo06 hucouao 0' 'hodlly InjulY" ond
"plOporlY domollo" Inr.ludod In 11111 "lllOd~CIS-
complotod oplllllllona hlllmd "
4. 5~bjocllo 2, obovo. Iho PUlaonol olld AdvOIllllnu
InJ~ry Llmllll Iho mosl wo will pny undo, Covo"
000 BIoI Iho IUIll <II nil dmnnllol hncnllsn 01 nil
"po,sollnllnluIY" nnd 1111 "1IdvIII1l6Inlllnlllry" 6U6-
Inlnnd hy nny III HI IH!l60n or IlllI'UlI/lll1un
6, Sobluct 10 2, o. :1 IIhuvu, wlncllllVIII nllpllua, 1111I
Ench OCCU/fIHlCII LIfllll16 Ihu 1II0.t WII wlllpllY lelt
Ihn 6um 01:
8. 00mo006 undm Cuvmollll A, ol1d
b, Medlcol oxpnl1sos "'U'UI C<lvo,nuu C
bocou&o of 011 "hodlly IIljlllY" ond "11IOI10/IY
dnmooe" 0'111110 0111 01 nny onll "UCCUIIOl1CO "
4
.
CG 00 01 11 88
CllMMllICllI1 IIl,NIIIAI I IAIIII I ,y
CI)VIIIAllllllIIM
6, l'illhllll:IIU II 1I1"IVII, Ihll Hili 1)/111I111111 1111I11 I. 11111
/11011 WII Will JI/lY IlIlIlIlI CIIVIIIIIIIII 11111I "IIIIHlIIH'
1I0coIIsn ul "1IIUJlllllr "IIInllllu" 1'11"111I11.11' "11111111
10 you ollslI111 ,"11 II OilY 111111 11111
7, l'iUhJUI;IIII II "'"1V", 1111I MIIIIII:1I1 h'llll'''" l'lI'"
" Ihll I1l1lal WII Will III1Y 111111111 CII~l\IlIlIlI C '"I JIll
1II0011,:ul U~IIUII'lIlb h"':III'III 'II "'"Hllly III/IllY" hili,
11I11Iu<I hy III1Y '"111 I 1111 hi III
'hu 1IIIIIIs ullhla CIIVUfIlIl" 1'1111 1IJ1llly blll"lllllllly III
ullrll "'1II6U':IIIIVII "'"IU'11 II""'"' 111101 III III1Y 11111111111
11111 IlIlIlIlII III 111611 1111111 '1 1I11l1llh", .'11I11111' wllh III"
hlllll/IIIIIIIIUI Ihll "1I111:y 1"'"'101 IIIlIlWl1 III 11111 Illlo:ll1
/nll<llIl, 11IIII,.. 1Il1' 11II11I,y 11111111"'11 ".'".lIl111'1I11111 I.
aunllCU 1111 1111 IlI"fllllllllll p"'lIlol III IIIh6 1111111 ,~
1II1l11lh6 III Ihnt ':11.11, 1110 11I111111111I111 1111111111 Will hll
.fllolnOlI 111111 III Ihll Illal 111111:11I111111 1111111111 "" "Ill
IUISIIS III Ifnlllmllllll11111111111111111111 ""'IIIIIIr:H
SECTION IV . COMMEnCIAL OENEnAL
LIABILITY CONDITIONS
1, BOllklll,Jluy,
Illln~III1111:y III IlIhlllvlIllI:V III Ihll I/Ihlll'"' III 1111111I
IIIIIll/llo1'a "hllllll Will .HII IlIhllVII "" III "Ill IIhll
1111'"111611110111/ 1111. CII~"'III1'1 ","I
2, OUllo. III Tho EVIIIII 01 Olllllll'"lIn". CIIII/II
0, SUII,
0, Y'II' IIIIIM 61111 III Illhlll WII 11111 nllllllllll II. SIIIIII
liS III1I1:III:llhlll 1,1 IIn "'":':'11I'"11:11" III 1111 'I'
fOIlSll whll:1I IIII1Y 11161111 III II 1:101111 rll IhIlIlX.
11I111 PIIUlhlll, 11I1111:11 Dhlllllll 11I<l11li11l
(1) ItIIW, Whllll ,",,1 Whlllll Ihll "'11:':111111.11:11"
'" 1I11l1nbll '1I11~ 11111I:11,
(21 II", IIl11nu, '"111 .111'''"''111. III III1Y 111111.11"
JlIIII'IIID 111111 WllllllbDII", 11I111
(31 TlHI IUIIIIIII '"11j 11":1111,", III III1Y II1JulY IJI
""11I111111 '""'11111 11111 III Ihll ",II:,'ll/II11WII" IJI
111111I11111
h, II II d,lI111 '" '"1101" III """II" '" hl'"II1II1<1I1'I1I1.1
'IIII' 111011/11,1, V'"' 1111''''
(1) 11II1I1I/<lIIII<lly /1'1:,",1 'hll 1111111:1111:1 III '"11
Clllllll III 'sIIII" 1111111111I ,111111 '''':lIlvlld, 1111<1
(2) NllIlly liS liS IIllm liD II'III:'":lIhl.
YIIII 1II11h1 S,'" III II 111111 WII IUllolvo Wlllllln
IIlIIICII 'II Ihll <1111111I III "61111" 116 SIlIIII OS IJlIII:'
t1r:ohl"
C<lJlY/lllhl. 'nSlllnnr.n f:lll/vl~oo Olll<:u, 1111:, 1 llll~, lIllIll
Pnu" " III 1 2 []
COMM~RCIAL GENERAl. LIABILITY
COVEflAGE FOflM"
Il. You ond ony othor Involvod Insured IIlUStl
(1) In1tlleqlolely ~D'nd us coplos or Iny,de.
1110nds. notIces, sUIIl1l10l1SU or loosl popors
rocolvod In i:onl1eollol1 wllh the 010"" or
'"8ult;"
(;I) AUlhOrlJe 'us 10 o~toln rocords ond olhor
In'orl11olllln; I
(3) Cooperolo wllh us' In Iho Invoslloollon,
soUlol11onl or dolol1BO of Iho cloll11 or 'sUll:'
and ' '
" (4) AsslsI us. upon our loquesl, In Ihu
onlorcol1)onl 01 ony IIOhl ooolnsl,ony,pu/'
son or oropnlJollon which 1110y ho liable 10
Ihe insured bocouso ollnJuIY or, domooo 10
which Ihls Insuror)co 1I10Y olIo opnly,
d, No Insu/ods will, OH~Opl 01 Iholr own cosl.
volunlo.lly I11lke 0 pOYl11onl. OS6Ul110 ony obll,
OOllon, or i11cur ony uHflonsu, olhol Ihon for
fl.61 Old, wlthoul our conSOI1l, "
3, Leoni Aallon Au"nlt Ue,
No pelson 01 orOPl1lJsllon hos 0 rlohl ,undor Ihls
Cavorooe Pun: '
Q, To loin us 06 0 POI1y or alhorwlso brlnp us'lnlo
o "SUIl" osklno lor domoous 110111 'on Insured;
or ~ ,
b. To sue U6 0.,.\1'6 'COVO/OOO PO(1 unloss 011 01
115 1011115 hove bedn 'ully complhid wllh
A porson or oroonlJollon 1110Y suo U6 10 rocovoI
an on OllfO'ld SoUlol110nl 01 on u flnol ludOl11of1l
ooolnsl on Insulod oblolnod oftor on ocluol trial;
bUI wo will nal bil'lIoblo 'or domooos Ihol 0.0 nol
poyoblo undol Iho lorms of Ihls Covoloon Pori o.
Ihol o.e In OkC06S 01 Iho OPflllcoble Ilmll 0/ In sur'
onco, An oorood soulompnl 11100n6 0 soulol11ol1l
and 1010050 of 1I0blllly slonod hy us..lho Insurod
opd Ihe c1.111110nl ,or Iho c1ollllonl's ,10001 rop.o.
sonlollvo" ,
4, Olhor In6uronao, ,
If olhor volld and C.\llloctlblo Insuronco Is ovol'oblo
10 Ihe inslI/od '01 0 1065 wo cavoI undor COVOI'
0005 A 01 B 01 thls'Covolooe Port. our olillootlons
010 limited 06 'allows:
e, Primary Insurerice
This Insuronce Is prlmory eHcopl when b, bo,
low oppllns, If Ihls Insulonce Is prlmery. our
obllgollans ere nol allocted
Paee 8 01 1 2
r-
,
unlo~s el1Y er 'he olher'!nsuronce Is olso prl.
mory, Than. we will .here with 011 111.1 olh.r
Insuronce by Ihe mplho~ described In Q, ,b.,
low, '" I
b. EHcel8 InsuroMo . I
This Illluronco Is e~ciliss"ovsr OilY 01 Ihe other
"'luroncn, wholhor pllmory, OHcnu, conlin,
DonI or 011 OilY olhor bosls! "
(1) Thol il Fifo, EHlo'ndild Covoroya.,Oullder's
I1llk, IfI8lollolloll fll,k 01 pl",lIor COVllooe
for "yolJl work:'" ' , ,
(2) Thill i. Fifo Inou;ollco'lor promises rellted
10 you; or. ..
(3) II Ihe lass drlsos aUla' Iho molnlol1once
or usn of olrcroll. "oulas' o'i.wolorcrnlt 10
Iho oHlnll1 nOI 6ubjoct 10 EHcluslon 0, 01
COVO.OIlO A (Socllon i),
When Ihl. Insuronco Is o~coss. we will hlvo
110 duty undor Coverooo A,ar 0 to dofond ony
cloi", or "sull" Ihol OilY olhor In6uror h86 0
duly to dololld, II no olhor Insulor dolondl.
wo will Ulldolloke 10 do sa. bUI wo will ba
onllllod 10 Iho Ineured's "Ohls OOOIIlSI Olllhoso
olhor illsurora,
Whon lhls IlIsuro~co Is oXcoss ovo;"olhor In,
suronco, wn will ~ay only ou'y shere 01 Ihe
omount of Iho loss, II ony, Ihol'a~ooads tho
sum 01:
(1) Tho 10101 Of11oUnllhol 011 such alhor insur'
OIlCO would poy lor Ihe lass In Iho obsenco
0' 11115 IlIsuroncii; i1nd
(2) Thu 10101 01 ell doduCllblo ond sell,lnsurad
omaunls undor 011 thol alhor Insursnco,
t t '. I,
We will shore 1110, ronlolnlno loss. II ony, wllh
ony olhol i11$UrOnCa Ilhol is. 110\ d,os,c,lbod In
Ihls EHCOSS Insuronco plovlslon ond W,OI not
bouofll spocillcolly to apply In OHCOSS 01 IIw
Limits ollnsuroncQ shawn In Iho declarations
of Ihls Cavolooo Port:
a, Molhod 01 Shorlrg
II 011 01 Iho ol/1or Insuronco permlls, cllMlrlb.
ullon by equol s/1oras.. wa will 'Iollow Ihls
mOlhod olso, Undor Ihls epplooch asch Insurer
contrlbutos eql/ol omounls unlll' II has paid Its
oppllcoblo Iimll 01 Insurenco or none 01 Ihe
los6 remolns. whichever com86 Ilrst,
.
Capyrlllhl. Insurancn Servlaes Qlllco. Inc.. 1982. 1888
o
CG 00 01 11 80
,
If any ul Iho olhor Insuronco doos nol pormll
Gonlllbullon by oqllol sharos, wo will Gonlrlb.
Ula by limits, Undor Ihls mOlhod, OOGh Insul'
Ol's sholo Is baud on Iho rOllo of lis oppllGoblo
IImll u, Insuronco to Iho 10101 oppllGoble limits
of Insulonco 01 ollll1surors,
6. Premium Audit,
e, Wo will computo 011 promlums lor Ihls COVUl'
000 Pon In oGcOldonco with our 111106 lI11d
rOlos.
b. P,ol1l1um shown 111 Ihls Covorouo POll os 1\11
vonGO promlum Is 0 depusll plomlum ol1ly, AI
Ihe doso of ooch oudll pOllod wo will corn
pUle Iho oorl1od promlum for Ihol porlod, All
dll promlums oro duo ond pllyoblo on nollco
to Iho flrSI Nomod Insurod, If Iho Slim 0' Iho
edvonGo ond oudll premiums pold 101lho Illll
Icy lorm 15 oroolor Ihon tho oOlllod prom IIrn,
wo will rOlUlIl Iho oxcoss 10 Iho fllsl Nomlld
Insured,
o. Tho Ilrsl Nomod I"sured mUsI koop JQGords Il'
Iho Inlormollon wo neod for plomlum cnmllll
lollon. ond sond us coplos 01 such limos liS
WfI moy 10qUOSt,
8. Reprosontollons,
By occopllno this policy. you floroo:
o. The slolomonls In Ihe Dotlolollons 010 occu.
1010 and Gomplolo;
b. Thoso stotomonls 010 bosod upon loprosonl
ollons you modo 10 us; ond
c. Wo hovo Issuod Ihls policy In rallonco UI)l)ll
you I represonlollons,
7. Sopllrollon Of Insurods,
Excopl wllh 10spOGI 10 Iho Llmlls 0' Insuronco.
ond ony IIUhts or dullos spoclflcolly oulumll' In
this COVOllIllO POllIO Iho II1S1 NllmUlI InSUIOd, till'
Insllton<:1I oppllos:
o. As II ollch Nomod IrwlI.OlI woro Ihl/ Ilnly
Nomod Il1slllod. ond
b, SOpOlololy 10 ooch Insurod ooolnet whl)fn
tlolm Is modo or "sllll' Is brouoht
8. Tronofor Of Rlghto Of Recovorv Agelnot
Olhorl To Uo,
If Iho Insulod has rlOhls 10 rocovel 011 or Ilun 0'
any poymonl wo hovo modo wl/fru Ihls Covorl/lIo
.
.
co 00 01 11 811
C:OMMmCIAI mNH1AI,IIAUII.IIV
COVUlAUf f'(lIlM
Pori. Ihoso rllllllS nlll 111111511//1011 10 UI, Thll In.
aUlod l11ual tl'l lIulhlllll uHm lusI 10 Implll, thom
Al OUI lOllucsl. tho 1III\JIOll will ll/IIIU "sUII' 01
Ilons'ol Ihoso ,IUhI5 1'1 l,a und hul" us un'u,<:o
Iholll
O. Whon Wo Do Nol Ilonow,
" we dUI:h'"II11\11I '1l1l0W Ihls CIIVI/IUUO Po,t, wo
will mull III ,fllllvllr 10 Iho 11111 Nomod Insulod
shllwn In 11111 1l0c11llOIl'/I1s wrlllon 1I0llcu 01 Iho
1II/I1101l0WIIIIIOI Ii/tll Ihllll 30 lillY" boloru Iho ox'
pIrOlll," <1111"
It 11I11I<:u II 1","1,"1, pII)l)lollIlIlIlIlI1I will bo suffl.
clolll prllo' 111.111111:11
SECTION V . l)EfINITIONB
1. "Allvllltllllll/ IlIjlllY" 1I101lllS InlulV o.lslno out 01
ono l)/ II1U/ll01 Ihll '"l1uwIIIU offonsos:
II, Orlll ,It WIII'"1 Ill/hllcllllulI 01 mOlollol Ihol
UIOlldI/I' III lihlllll II POIIUII l/I lIIuonlzollon or
<lIIP'"I1I1I1' 1I//IIISI/l1'S or IIII/llollotlon's goods,
Plo<ll/':I. 1)/ .",vl':l/s,
b, ()/JIIIU Willi "'I IIUbll';III1'1Il 01 mlllo,lol thaI vi,
OllltuH II IJI/tbllll'S II(JhIUf prlvocv:
I), MIHIIlllIIOllIlJlllolI 01 IIdVllltlslno Idoos 01 alylll
o',luIIIIII/t'bIIlI/U;l/I '
d, In'rllll/lIl11l111I01 cOPYIIUhl, Iltlo or slog/Ill,
2, 'Autu" 1111I11115 0 lond molo, vohlclo, Irollol or
501l111roll0l dOllOllod '01 lIovol on public loads,
InGludlnu IIIIV ollouhod mochlnory 0' oqulpl11ont,
HUI 'Ol/tll" .111115 nolllleludo "mobile oqulpmont"
3, "Uodlly mllllV' 1I100ns bodily Injllry. slcknoss or
dlsOlllO susllIllIlld by 0 person. IlIcludlng dooth
/JIsultllllllrom IIny 0' Ihoso 01 onv limo.
4. "Covmlll/o IUIIIIIl,y' 11100n6:
n. Ihl/ LJIIII"d 61010s 01 Amorlco (lncludlno lIs
1III/II1ll/IIH '"ld lIossosslolIS), Puerln Rita IInd
Cllna<III, " ,
b, Inl"'"I1I""1111 Wall/II or ol,spoco. provided tho
Inll/ry Of d"'l1l1111/ doos nol OCcur In the course
01 t,ovolur lIonaporlotlon to or "0m ony ploco
not Includod In 0, obovo; 0'
o. All paris e' tho world If:
(11 Tho Injury 01 domogo orlsos out 01:
(0) Gooda or products modo or sold by you
III tho tOlrllory doscrlbod In o. obovo;
or
Cop';rll/hl, !rleurnr,,,,, !lorvlcoap-'jleo. Ine,. 1982.,1988
Pugo 1/ 0'1 ~ [ !
COMMERCIAL GENERAL LIABILITY
COVERAGE FORM
(b) Tho IIcllvlllos 01 a pOIso'n whoso homo
Is 111 lho torrltolY doscrlbod 111 a, obovo.
hul Is owoy for 0 bhort IImu on your
busll105s; IIl1d
(2) Thu 1115u.od'5 I05Jlol151hlllly 10 poy dllm'
uous 16 dotormll1od 111 u 'sull" otllho motlls,
111 Iho lorrllory dOBCtlhod In II, oh,wo 01 In
o solllolnolll wo OUlUO lu,
6, 'ImpolrorJ JlrOJlo.ly' l1100nB 1011f/lh10 plopolly,
olhor Ihon "yuu. JlluduCl' 0' "you. WOI k," Ihlll
connot bo ulod or Is loss usolul hOCIIUBO:
II, II IncorJlI).III"B "your Iltoduct" III "yuur work"
Ihol Is known or Ihounhl 10 hl! dofocllvo. do,
flclol1t. i1lll\joquolo or dllnUOIouB, or
b. You hovlI lollod 10 fulllll tho 101l11B of 0 con.
IrllCI or Onlool11onll
II such proJlolly con bo rOBIOIOd IU U.O by:
n', Tho rllpolr, 'Oplllcofllont, odjU'Il1\OI1I or .0.
movDI of "you. p.oducl" or "yuur work;" o.
b, Your lullllllno Iho IOII11B 01 IhD COnllDcl o.
DorDDJ11DI1I,
6, "Insurod cOl1lrocl" mOIlI1B:
D. A l~pBo of prDI11IBDB;
b. A sldotrDck DOtIJOl11onl;
o. Any ODs0l1101H or IIconso oo.ool11ont. o~copl In
connocllon wllh constfllcllon or domollllon
oporDlIons on or wilhln GO fOOl 01 II roll rood;
d, An oblloDIIOI1, "' .oqulrod by ordil1onco, 10
Il1domnlly 0 mUl1lclpolily, O~CCpl. In con,
nocllol1 wllh work for 0 l11unlclpollly;
0, An olovDtar 111111IH0nllncO Doroofllonl;
f. ThDI port of Dny olhlll conlrucl or Dor00l11011l
pottlllnlno 10 your husln05S (Inclutllnu IIn
Indon1f1lf1collon 01 II l11uniclpollty In r.on-
nocllol1 with work porforl1lOll for 0 mUI1ICI-
pollly) undor which yuu 115.UI110 tho lort
IIDbllllY 01 onolhor pDIly to poy lor "bodily In,
lury" or "propolty dDI11DOo" to 0 third pOISOI1
or orgDnllDllon, Tort IIDblllty mODns 0 IIDblllty
Ihol would bo Imposod by IIIW In tho nbsonco
01 ony conlroct or oorDomonl,
"....,
,
An "Inlurod conlrDcl' daDs nol Includo lhol port
of oily COI"roCI Or ogloomonl:
o. Th~1 Il)dol11nlllol Bny POlSOI1 Qr O;gonllollon
lor "bodily injury' or "proporly d1l111000" oris,
Ino oul 01 C0l15tflJctlnn <H don1ll11l10n opal.
ollons. wllhln GO loot 01 ony rnllrood proporly
ond olfecllnu III1Y .lIllrolld h.l<I\lo or Iroullo.
IIocks. '00<1, 11O<I~, \lJlHlol. un<lolflos6 or C.OB6.
Inu;
b. ThaI- Indofllnill05 IIn o/chllocl, ol1ulneor or
BlJlVOYllf 10. inlu.y 0' <l1I11101l" ",151nn alII of:
(1) P.op",lnu, "PllIO\lln\1 or fllllln\1 III propole
or' OPP'OIlU II1I1P6, <lrowln1l5, opII11on5, tn'
pOrl6, Sl/'VOY6, cllllnllO or<lO'B, dOSIUI1B or
5poclflcollon5; or
(2) 13lvll1U dlrecllan~ o. In51",cllo'.,s. or flllflng
10 Olvo thell1, If 11101 15 Iho p/ll11ory COl/SO
of Ihe Inll/ry Of <10111111)0;
c, Undor which Iho In5"ro<l, il on nrchllor.t, on.
olnoer Or survoyor, 05Bl/1110S 1I0blllly for on In.
jury or dllfllOIlO 01151n\1 oul 01 Ihe Il1nured'5
ronderlno 01' folfllre lu ,under prole56101101 sor.
vlce5. Inr.ludln\1 IhoBO 11510d In b. IIbovo ond
suporvl50ry, Inspocllon or 0110lnoe.lno 50r'
vlceB; or
d, ThDI'ndel11nlfl05 I1I1Y pef5ol1 Or oroonlzOllon
!or domDOo by lire 10 proml50, rel1led or
100110d to YOll,
7, 'Loodino or unloodinu" 11100n5 tho hondllno 01
properly:
o. Aller it i. 1110\lod frol11 1110 ploce whom It Is
nccepte<l lor fIlO\lOl11ent into or 01110 011 air.
croft, wotcrcrnfl or "nulO;"
b, Wllllo It Is In or 011 011 olrc.oll, welercroll or
"ouro;" or
c, Whllo II 16 belnu 1110\lod ftol11 011 olrcroll.
wlltnrcrnlt or "ouIO" 10 tho plllco whem It 15
flnolly dollvorcd;
bl/t "loodl110 or unloodlno" <lOOB nol Includo the
movemenl 01 properly by l11eOn5 01 0 mechanlcol
<lolllco, olher IhDI1 D hOl1d truck. Ihol 15 nOI el.
loched 10 Ihe olrcroll, WOIO.CrDII or "DlIIO:
,
8, "Mobile equlpmenl" meons DI1Y 01 the folfowlno
Iypos of IDnd vohlcle.. II1cludil10 Dny DnDchod
mochlnory Or oqulpment:
.
Pogo 10 0112
Copyright. Irib'lItonco"SeiVlcos'Qlflco. Inc.. 1992. 1988
CG 00 01 11 BB
o
e. BulhJolUJ6, /1I1f1' mochlllllry, fO/kllll1 IIlId olhol
v'''I~I~' dllllUlllld tor UIII IlllilGIH~lIy ,,,, PNbllc
"" ,'/,'l~d~i , ,'I"
b, Vehlal" mllllltolnod fOl ule 1011lly 011 01 110~1
10 pruml&lI& you own 01 IUI1I;
a, Vehicle. Ihlll HOVIII on cluwluI IIOlldl;
d. Vohla/ol. Whlllhol &011, plopllllod 01 nOI main,
lolnod pllmollly 10 provldu moblllly 10 pOlmo,
Ilol1l1y mounlod
(1) POWOI, CI0I10&. Ihovol&, loodllll. dlUuo'1 01
dllll,; 01 ..
" !
(2) Road con&lruclI'm 01 lO&uI/ocino oqulp,
m0l11 such 01 OlOdOlO. ICIOpO,. 01 rOllllll;
,I, Vuhlclo& nol dOlcllbod In a,. b" c, old, Dbovo
. ,hal, 010 nOlloll'PIOpollod ~,I,lQ,OlO Illolnlolnod
PIllllOllly 10 plovldu moblllly 10 palmollonlly
aUllchod oqulpmOnl of Iho followlno Iypo&:
(1) All COl11plO&&O<l, pumpl on,l oonolalorl,
Includln\l IpraYInIl, woldlllo, bulldlllll
cloonlno, uoophYllcol o~plolollon. 1I0hllllll
and 1'1011 IOn/Icing oqulpmom: or
(2) Cholry plckoll ond Ilmllol dovlcol ulod 10
rollo 01 101'101 workora;
t. VohlcluB nol dOBCrlbod 111 0,. b,,'c, 01 d, olloVII
moll1lolnod flrlmllllly for PUlPOBOI <llhol Ihon
tho,lronlpollollon of pO<lOll1 or cOlgo,
HowevoI. &oll'propollod vohlcloB with Iho /01.
lOWing IYPOI of pormonomly ouachod oqulp.
monl nro 1101 "mobllo oqulpmonl" bUI 1'1111 bo
conlldorod "OUIOB:" "
(1) Equlpmolll dOllonod prlmorlly lor:
(D) Snow romovol;
(b) Rood molmononco. but" nOI con.
Blrucllon or rOBurloclng;
(c) Slrool doonlllg;
(2) rhorry Illckora ond 51mllor dovicoB
moulllod 011 aUlomobllo 01 Iruck ChOll15
and ulod 10 rollO or lowor workorB; ond
(3) Air comprol&O<l. pumps ond oonOlOlorB.
Including Bploylng. wOldlng. bUilding
cloAnlng. goophYBlcol o~plorollon. IIghllng
and 1'1011 BOn/lclno oqulpmonl,
,9. 'Occullonco" moon& an accldonl. Including con.
Ilnuoul 01 ropoolod OKpOBUIO 10 lubllontlolly Iho
&Dmo gonoral harmful condlllonl,
.
.
o
G91l,Oql c') ,e.1l
" CopYllght. l'l~u~o,n~u\ Sory)~oA:,o."lcu. ,IIIC:. 19~2, I lIBIl
Poq~ 11, 9.! 1 2
-
COMMEflCIAI. OENEflAL LlAllIlIl Y
COVERAGE FOIlM
10. "PItI11InollnjIIlY" IIlUOnl Inlury, olh~I !hon 'holllly
Inj1lty." oll~lno oul of Olle 01 male ,01 ,tllQ,lolloW
hIli O"O~IO,i ' . , (
, " . 'II
~. FolIO elloll, dolonllon 01 Implllonmonl,
ll, MlIllclOUI PIOlocullon;
I), Tho wlonllllll ovlcllon flam, wlonoful Olll.y
Inlo, or InVOllon of Iho Ilohl 01 pllvOIO OCCII
pllncy 01 0 loom. dwelllno 01 promllol IIl1ll II
pOllon occuplol hy 01 on boholf 01 II10wn1Jl,
IIInlllo.II III 101101;
d, 01111 III Wllllon publication 01 1\1l1lorlol 1hlll
Ilolldoll 01 IIbolB 0 pOll on 01 olOonllOllon or
dl5pOrllo05 0 POIIOII'I 01 orgAn/lllllon'l 1I00d5,
, ,
ploduCIS or 10rv1COI; 01
e. Orol 01 wrlllon plJbllcOIIOn of mOIOllollhll1 VI.
010105 II pOllon'l IIOhl 01 pllvocy,
11,0, "ProducIB.complolod opornllonB hozo.d" III
cludlll 011 "hodlly InlulY" and "proporty 1111111
OliO" occulllno owoV from promllol YOll 0\1\111
III ron1 ond nllBlno oul of "youI ploduCI" 0'
"you. wo.k' lI~copl:
(1) Producl5 Ihol oro 61111 In your phYllclI1
P05101510n; or
(2) Work Ihol has nOI yol boon 'complolod or
obondonod, II' I.'"
, b, "Your work' will be doomed complol.od 011110
oorllesl of tho follOWing tlnieB:
(1) Whon '011 ~I 'Iho work co'lIod lor In YOllr
conlroc't hOI boon COll1plOlod,
(2) Whon BII of Iho wOlk 10 bo dono Ollho Olio
hili hoon comp'lolod If your controcl collI
for work 01 moro Ihon ono 1110,
(3) Whon Ihol pOll of Iho work dono 01 a loll
olIO l1as bllOIl PUllo III Inlondcd UIO hy III1V
p0150" or IIIl1anllollon olhor Iholl ""ollw.
conlrllcror or IlIhconlraClllr worklnllo" II",
501l1lJ Proluct
Wlllk 111/11 moy nood BOn/lco. 11101n10"lInco,
COllocllon, ropolr 01 roplocol11onl. bul which
II (,lll1olwl50 comploto. 1'1111 bo troolod a5
COl11pIOIOd.
0, Thll hua,d dool nOI Includo "bodily Injury"
or "propolly domogo' Allllng oul 01:
"
COMMERCIAL GENERAL LIABILITV
OOVE/lAOE FORM
(1) The Iren.portetlon 01 property, un1b,. Ih,
Injury or domege Irlle. oul 01 . ooheUllon
In or on e vohlclo ~reeled by Ihe 'Ioldlng
or unloodlng" 01 II;
(2) The e~lltenco 01 10lll., unln.lolled equip.
ment or Ibondonod or unueed melerlolel
(3) Producle or opo,oUone lor which Ihe olle.
IlIlcollon In Ihls Covorooo Port or In our
Illonuol of rulus 1,,~ludoe produole or com.
pie Iud opo.ollons,
12. "PlopOlly domogo" moo"s:
I, Phyelcollnlury 10 tongllllo f,oporty, Inoludlng
011 resulllng Ion of uso II Ihol proporty, All
euch'lon oluee Ihell bo deomed 10 occur .1
Ihe Iltno of Iho physlcnl In/ury Ihol cound II;
or
b. Lou 01 uee 01 longlllle ploperty Ihol Ie nOI
phyeloolly InjulOd, All euch Ion eholl bo
doom.d 10 OCCUI 01 Iho 1I1ll0 01 Iho "ocour.
fonce" Ihot coused II,
13. "Sull" moons e civil p.ocoodlng In which domogo
boceuse 01 "Ilodlly ,,,jury." "ploperty domooo."
"poflonollnjury" or 'odvortlolng Injury' tll which
thlslneuronce epplles oro .lIogod, ,"Suit" Includos:
I. An arbllrotlon procoodlng In whloh Buch
demoges It" clolmod and 10 wlllch you muet
submll or do Bubmll with OUf conlont; or
b. Any olher ollolnollvo dlepule lo.olutlon plO'
ceedlng In which such domogol oro clelmed
,
ond 113 which you submit with Qur consonl.
14. "YQur PIOdIICI" moons:
','
.
.
Pogo' 12 01 ~2
.~'
I: Any good. or producl., oth., Ihln ;8'111 prop.
arty, mlnullolured, .old, h.ndled, dl.trlbuled
or dl.po..d 01 by:
(1) VOUI
(2) Olher. Irodlng undel YQur nomOI or
(3) A p8ll0n Qr OIgonlutlon who.o llull;,o..
or 011.1. you hovo Icqulred; .nd
b. Conlolnl" (olhol thon vohlcle.), IllOlollola,
POtl. or aqulpmonl lurnllhod In connlctlQn
wllh .uch gooda or "foduCIB,
'VOUI prodUcl" Inoludos:
a. Wo,rlntles 01 10prosontotlonl mldo 01 Any
tlma with lalpocllO Iho IIlnul. quellly. duro.
blllly. perlormimce 01 ule 01 "your producl;"
ond
b. Tho providing of 01 lalluro 10 prQvlde wOlnlnOB
or InBlrUcllone,
"VQur producl' doos not Inoludo vondlng mo,
chinos 01 olhor proporly rontod 10 or locolod '01
Iho uso of olhore bUI not sold,
15. "VOUI work" moons:
o. WOlk 01 oporollons porformed ,by, YQU or on
youl boholl; ond
b. Melerlale,. pAIU or equlpmenl lurnlehod In
conn~ctlon wllh euch work or opeleUons,
'VQur worl<' IncludoB:
II. Woftontles. or rOplosonlotlone modo 01 any
limo wllh leepecllo tho IIlneee. quolllY. dUlo.
blllly. perlormence 01 use 01 "your work;" ond
b. Tho plovldlng of or IllIure 10 provide wornlnge
or Instruotlon..
"
tOllyrlghl. Inlurancu GlJlVlcoiiQlflrin, Inc.. 19B2, 1988
CO 00 01 1 1 '88
o
THIS ENDORSEMENT CHANGI!51'HE POLICY, 'ILEAIIE READ IT CAREFULLY.
NUCLEAR ENERGY LIABILITY. EXCLUSION
ENDORSEMENT.J ' .
0\"" , " ,",.. ' , (Drnld Forni) .
This qn.jO,..nle'nl"llod(lIe~ Inluronco IIl<lYhlOlll/ndor 1110 lollowlnu:
IiJ' ',II',
o
,'I' ,
"1"
, ,
,0
DUlllNESflPWNERS POLlC)'
COMMERCIAL AUTO COVWAGE PAlH
COMMERCIAL GEN[IlAL L1AOILlTY COVEllAGE PAflT
FARM COVERAGE PAlH
PROQUCT6/COMPLeTED ,OPEllA TION6 L1AIJILll'Y COVEHAGE PART
LIQUOR LIADllITY COVERAGE PAIH
POLLUTION lIAI3IL1TY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE L1AIJILlTY COVERAGI! PART
RAILROAD PROTEcnVE LIABILITY COVERAGE PAIH
flPECIAL PROTEcnVE AND HIGIIWAY 1,IABILITY POLICY NEW YORK DEPARTMENT OF
TRANSPORT A TlON
1. The Insurance doel nol Apply
A, Under Any L10blllly CovorAOO, 10 'bodily Injury'
or 'property "AmAoe '
(II Wllh relpocll\! which IIn "'"lured" undor Ihu
policy II 0150 IIn In lured .mdor II nuclollr Iln-
ergy 1I0blllly policy Illuod by Nuclolll EnurllY
L1Ablllly InlurAnco ASloclllllon, Mululll
Alomlc Enoruy Ullhlllly UndolWnlorl, NucloAr
Inluronco Al6oclAllon or CAnadA <11 ony or
Iholr SUCC0160rl, or would bo un Il1lurod un.
der any luch poliCY hul ror Ila IOlflllnallon
upon e~housllon or Ila IImll 01 IIAbllllY, or
(2) Relulllng from Iho 'holOrdool propertlel'
or 'nuclear mAlorlal' and wllh relpecl 10
which (al eny puraon or OIoonllollon Is roo
qulrod 10 mAlnlllln 1i.1I1ncIIII prolocllon pursu,
ani 10 Iho Alomlc Enoroy Acl 01 '054, or Jlny
low Jlmondolory Ihoruof, or (bllhe 'Inaurod"
15, or hod Ihls policy nol boun Issuod would
boo onlllled 10 Indomnlly Irom Iho Unllod
SlolOl or AmorlcA, or ony oooncy Ihoroor,
wllh Any porIon or OIuonll0110n,
D, Undor ony Modlcal Paymonls covurllllo, 10 OK'
pons05 Incurrod wllh rospocl 10 "hodlly II1Jury'
rOlulllng from Iho "hllln1dous propurllos' 01
"nucloar mAlorlol" IInd 11lI5lnO oul of Iho opllr.
ollon or 0 'nucleAr lac lilly' by any porson or
organlzallon.
C. Under any Llablllly Covorogo, 10 'hodlly Injury'
or 'property damago' rasulllng rrom 'II alard,
001 propertlea" 01 'nucloar mAlerlal,' II
..
IL 00 21 1185 '
(I) Tho 'nucloar malorlal" (Alii 01 any "nucloAr
IIIr.lll1y' owned by or on bohall or, an 'Insurod"
or (hI hn boon dlschorgod or dlBpOllod Ihoru,
Irom,
(2) Tho '/1ucloor 111010rllll' 15 conlolnod 1/1 "spunl
luol' or 'wn'" ' /11 O/1Y limo ponossod, hAn.
dlod, usod, procol5od, 51orod, Ironsportod or
dlspolod 01 by or on hohAII or A/1 ',"Iurod,' or
(31 Tho 'bodily Inlury' or "1lIlJporty dAmAOll'
IlrllOI oul of tho IUll1lshll1g by on "Insuroll" of
sorvlcol, malorloll, po.U or oqulpmonl 1/1 con-
nocllon Wllh Iho planning, cO/1slrucllon, mlllnlu-
nonco, oporallon or UIO of O/1Y '/1ucleor foclllly,'
bul II luch foclllly 15 locolod wllhln tho Unllod
610101 01 Amerlr.o 115 lorrllorlol or pOBsos510ns
or CAnodo, Ihl5 eKclllsl"/1 (JI Oppll06 only to
"proporty domogo" 10 BUel. "nuclear roclllly"
ond Any proporty Ihoronl.
2. As uBed In IhlB undorsomonl
'Holordoul proportlol' Ineludo rodloacllvo, 10Klc
llr UKpl061vo propertlos;
"NllcloAr matorlol" mOA/1S "Iourco molll"ol:
'SpoclAI nucloAr mAlunol' or 'hy.producl llliI'U'
rlnl,"
.Sourco molorlol,' 'spoclIIl/1ueloAr malorlal,' IInd
"by.producl malo rial" hove Iho moonlngo glvo/1
Ihom In tho Alomlc Enorgy Acl or 19ij~ or In ony
lAW amendatory lheroof;
'Sponl fuel' moanl any fuel olomonl or fuol com.
ponenl, lolld or liquid, which hOI boon usod or
o~posod 10 radlallon III a 'nuclonr roaclor;"
Copyrlll"hl,'lnsurnnco 50rvlcOl QlJlco,'lnc""gSQj 198~1
Pall',;',1 or 2 (.J
'1""" J!JudOnJtlUlllUl OhulIWm 'nlll J'lIlley. J'IIlIIJlIl IWlld It O"rlll'ul/y.
'IWO on M()JI.J!J l'OJ.l<JUIJH JIlt:'lllJm flY UB
'rhlQ lllldor/lllJlIOlll modllios 11IIlUl'IlllCll provldlld Ulldol' tho I'ollIlWllIg:
COMMEIlCIAL GENERAl. UADlLl'l'Y COVJ!lRAOE l'AIl'I'
'rho followlllg ill lidded to Hcclillll IV . COllllllerdul (lIlIlOI'oll.lllhiHly COlldltlQlI/\i
A, 'I'wl) or MOJllI'ollcletl 11I/llIlllllly Ull.
If lhlll 1)()lIcy ulld IlIlY olhl!I' Ill)llcy IllllUl!d lo you hy UII 01' IlIlY COllllIIlIl)' ~mll/ltod with
U11111'11 y to tho /lIlIl\U "OCCUl'JllIlCO", "llUrIJllunllnjury" or "lIdvorlllllllg WJury", tho
Illllxhnum Ilmil or Inrllll'llllCIJ ullder Ill/tho IlollcllJll Ilhnllllot OXCl!lJd thll highollt
oppllcllhlollmll of 1IIIl1lrnllce ullder n/lY OIlO pollcy, 'I'hlll condltim\ doc" /lot /lpply to
/lilY policy IQQuod by UIl 01' 1111 uffillntod compollY Blloclficnlly to Dpply /lQ oxe!!""
InBurollco ovcr thin pollcy,
"
I,
i ,
M
UD-4.4(07/69)
.-
--
COMMON POLICY CONDITIONS
All Covoroge Porl51ncludud IlIlhl~ policy ,IrU ~l/hluCllo 1110 lOllI/WillI( ((l'\lJlllon~
A. CANOELLATION
1 The llral Named In6urod 5hown In Iho Doclmo-
IIon5 moy concol IIl1s policy Ily 11101llflll or
dollvorlrlll to U6 IlllvlHleo wrlllon n<lllco 01
concollollon,
II Wo lIluy concollhls policy by IlHllllnll or dollvor,
Inll 10 Iho IIr61 NUI'lod In5urud wrlllon nolll:o of
cAncollallon at lon~t
il 10 daY61J0loro IIw 'II/octlvo <lnlo 01 uHlcollll'
lion 1/ wo cancollor nonpllymont 01 p.unuUI11;
or
IJ. 30 daY6IJolorotho ol/ocllvo dnto 01 CIIIKolln,
tlon If wo cancollor any otlw rea60n.
3. Wo will mall or dellvor our nollCe 10 the llrat
Nomod In5ured'slost 11111ll1ng IIddro6~ ~nown 10
U6.
4, Notice 01 cancellollOIl Will ~toto tho olloctlve
dolo 01 cancellation rho IJollcy porlod will ond
on that dolo,
5 If Ihl6 policy 16 concollo<l, we will sond Iho 11r51
Named In6ured any prol11lum rolund duo, If wo
cancel. Iho relund wllIllo pro rolo. II Iho IIrsl
Nomod In6urod concols, 1/10 rlllund moy bo 105S
tllon pro rata, Tho concollatlon will bo ollocllvo
evon If WII havo nol modo or ol/erod 0 rolund,
6, If notice 16 moiled, proof 01 mailing will be 6ulll-
clent prool 01 notlco,
B, CHANGES
This policy conloln6 1111 tho IIgrool11ont6 botwoon
you and U6 concornlng tho In5uranco ollordod, Tho
Iirst Named In6urod 5hown III Iho Doclaratlon5 15
authorllod 10 ma~o changos In tho torm5 01 this
policy with our con50nt, rhl5 pollcY'5torm5 con bo
amondod or walvod only Ily ondor50mont Issuod by
U5 on<l modo 0 part 01 tillS POliCY,
C. EXAMINATION OF YOUR BOOKS AND
RECORDS
Wo n101Y o~amlno and oudlt your boo~5 and record5
as Ihey rolate to thl5 policy 01 any time during U,11
policy period and up 10 three year5 afterward,
,
ILOO 171185
D, INSPECTIONS AND SURVEYS
Wu hnvo the rlllht hut me not obllgaled to:
I Milko "lspoctlons nn<l SIJrVOYS 01 ony time;
~, GIVI! you 'Oport5 on Iho condillons we find; al1d
3 IlI!Clllllfllol1d cllIlflH"5
AllY '"~"O(II'lI1S, burvoys, lopolls or recoml1lend..,
11000~' ol,lle ollly 10 1115urollllily IInd 1I1e promlums to
ho c1liJIIlOd. Wo do nol mll~o 5111"ty Impecllon5, Wo
do Ilot underln~e to porlorrll Iho duly 01 ony pel'lon
or Orl!'lflllollonto provl<lo lor Iho health or salety 01
workers or the publiC. Alld we do Mt wOlrol1tllmt
condlllon$:
I, Are soIl! or healthlul; or
2, Comply with lows, rogulatlom, COdll5 01' ltnn-
d.1rd5,
This condlllon oppliosnot only 10 U5, but olso to OilY
rating, ndvlsory, rate service or 51mllar organllO'
11011 which l1lo~ns In5urnnCO 1115pecllol1s, survoys,
roporls or rl!commoll<lollom.
E. PREMIUMS
rhe flrsl Nomed In5ured showllIII Ihe Decloratlon5.
1 Is lo~poi1slble for Iho poymol1t 01 all promlums;
iHld
2, WllIllo 11111 payee for any return premiums WI!
pay,
F. TRANSFER OF YOUR RIGHTS AND DU-
TIES UNDER THIS POLICY
Your rrght5 ond dull05 ulldor thl5 policy moy not bu
II'on51errod without oor wrrllon con5ent o~ceplln
II," CilSO 01 death 01 an Indlvlduoll1ol1lod Insurod,
II you dlo, your rlght5 and dulle5 wllllJe transferred
to your logol repre5entatlvo but only while ocllnll
wllhln Iho 5COpO 01 dutle5 ,,'> your legol roprU50ll'
lollV<' Unlll your loglll rop.e~el1tallve Is nppolntud.
OllYOllO Ilovlng proper IOlllpormy custody 01 YOllr
prOPUrlY Will have your rlHht5 nnd duties Ilul only
With respocl to that properly,
Copyrlghl, Insurance ~ervlces Olllco, lI,c., 1982, 1983
II
Q
MANDATORY ENDORSEMENT
POLICYHOLDER MEMBERSHIP IN THE COMPANY
IAllpllcllhl1l Ollly IIILhu NIILlulIWl,l1I M'ILIIII\ IlIlIutlllleu l'uIIIPIIIlY ut lhu
NIIlIullwhlu MlIllIIII VII'u 1IIIIIItllllCU CUIIlPIlIlY III All HlIIWII 1':~Cllpl '1'11""11 lill"dlll'ully I'tuvldlill 1"111'1
III1CIIUIIU Lhlll policy IIIIIIIUIIO hy IIl1llllullllllllurullco ClIlIlpllll)', you IIru II 1I11111lhut uf lhu Cllll1pUII)' whllu Lhlll
111'1111)' ollwt policy 111111 hlreu, Whllu 1I111111111111t )'IIU IIru ollllllL'tl UI UIIU vuw ullly IIllhllr 1IlIlOrUOllllt h)'pm~)'- III
1I11'ulhlll/l o/Ll\Il COlllpllll)'. You IItllllllllllllllLo 1111)' "lvillulI"" which IItll ""c1l1t",1 hy LIU lIolltllof 1l1l'lIdllrll
11110 111'0 IIPllllcllhlu III ClIVUtllll"1I III y"ur IIUlic)', '
Tho IIlllluul IIlellLl1I1l uf '"Ulllhol'lI Ilr Lhu CIIIl1IIIlIl)' Iuollillll )'Ollt pllllc)' Ilhll "'''IlI"IllY III 11I"lelllo" lIlI Lhll
IlccllltlllloIlO'"11l1l1 will ho holdllllhll NUllolIWloll 1'1117.11111 COIUlllhul, Ohhl, UII Lho lItlll'I'hutll"IIY lIr A,II'II,
'I'ho LIIIIO 'II Ll" IIIL'ULlIIIl rOl' Lho NIILlllllwld'J MuLu111 Vim IIIIIUI'III1CO CUIlIPIlIlY IlIll::1O A,M, 1111" Lhlllllllolll
LiIo II1l'llLlllll/llr Lhll NIILlollwl"o MuLullllllllurollco C'"III11I1)'11I 10:00 A,M, W" will 11I1111 lIolleo o/llllY chllllllo
IlIlIIl'llllllll "IILIIK, L1l11l1ur 1IIIIco LII YUIIIIL your u"orollllIIIOL\tIlUWIlto U/I ilL 11111 III 11111 ""YU prior to Lhll I'III1c1l1'''ullltI
IIII1I1LIIlIl OOLII,
Thill pollc)' III 1I1111'1I101l1l1lllhlll, 1l11l1l1l11l(.llhuL )'UU 111'11 llullluhJ,'cllO IIIIY 1I1111111111111<'lIl hu)'olld 1I111pl'OlllluII111 WII
rllllulro f'll' lIuch pullc)' wrlll,
POLICYHOLDER MEMBERSHIP IN THE COMPANY
IAppllcllhlo Ollly III Lilli NullllllWldll MuLIIlI1 11l6urllllCII COIl1I1I1I1Y lIr Lho
NulIlIllWhlu MuLIIlI1 1'11'11 1IIII1I1'1I11CII ClIIIIP"IIY WIII!II 'I'hlu PIlllc)' III IIIIIUl'd III Tho !::illlW 01 'I'1I~1I111
I. MU'I'UALIi.-MI';MIlEItSIIIP ANIl VOTING NO'l'lCIo:. YlIU 111'11 IIllllll,'" lhlll hy Vil'lllll or lhlu pllllcy
Yllu 01'0 I1IIIOmlwl' lIr lho NlIlIllIlwld,'lIIl111JUI IlIlIurllll"" CompllllY III COIUIIII",", Oillll lIr Lho NlIlloI1WI"" MIIlu1I1
1'11'0 hl6urllncII COIIIPIlIlY 01 COhllnhll", Ohio 1111 IIh'I\\'1I011 lhll IlllcluruLloIIII 1'11110 'If Lhl6 pollc)' , 1111" you au!
IInLlLled, 00 III Iuwrolly rn'IlvldoLll1I Lhe "'IIII'llll', CIII1IIllLuUon, UII" b~,IIIWII, III ollly ono volAl rllgllullo61101 Lhll
lIulllhor 01 polldollowlllld 1I1L11111' In l'erMlllllr hy proxy In IIny or Ollll11111lhll!S o/lho cOlllpon)', Tho AnnulIl
MooUnll" 111'0 111I1<1 III our llonll' Otrlce, ilL Colull1hulI, Ohio, on tho IIrol Thurlld/lY 01 April, IlIlIoch your, /lL
0:30 o'clock A,M, rIll' lhll N/llhHlWldll MululIl Flrll IIlIIlJrllneO COlllpoll)'lIno 10:00 o'clock A,M. of Lho O/llllll
00)'/01' lho NlIlIollwlde MUllJ/lllnllllrullce COll1pllllY,
2, MU'I'lJAl.S-l'AJl'l'ICIPATlON CLAUSE WI'l'lIOlJ'I' CONTINGENT J.IAlIll,ITY. No ConLlnllllnl
I.llIbllll)': 'I'hlllpoIlL')'III IIIJIl'/lIl'H'""l1hle, Y OlJ /lrll/ll1lcI1lIJIII' o/lho compuny 1111" IIhllll purl.lclpoto, Lo Lhll o~Lllnl
1111" upon Lho elJl1IHUOIIII IIxI'tllllld dL".l'l'Inhll~1 h)'lhllllollrtl.)f Dlrl'Ctor6111ll111 dlslrlhuUon 01 dlvldlllld6 flI'ovl"l'tt
lIueh doLurll1llluLlolI1I 111'11 In ICL'OI'''"nell wlLh lho provlohJlls of lho Toxuo In,nrullell Codo 0110 oLhllr IIpplle/lhlll
low, which IncluoolI lho rullIlI un" rClllJl/lLloll6 o/lho SLot.o 11001'0 of In6Ur/lIlCII,
IN WI'I'N~:SS W1II,:IlEOl-': N/lll'H1wl"e MUllJ1I1 InIlUr/lIlCII COll1puny, NoUonWlde MUluoll-'lro InOUl'lInCII COI1lPIIIIY
01' N/lUOI1Wldo l'rolll'l'ly 1111,1 ClluUlllly Inlluroneo COlllpuny, whlchovor III L111' IlIlIulllll eom\lony 06 OOOI(.lllllled <HI
lhu OocloroLloll6, hOIl e/lUIIII" Lhlll IlOlIey Lo bo 1I11!Ilcd by ILII ProllldollL IIno !::icerlllllr)' OL ColumbulI, Ohio, 1111"
counlAlrllgnod by 0 ouly lIuLho1'17,00 rcpr060nloLlvo u/Lho eOlllpony,
NM'EBTI
~e..'"hl'~..,
.'it'f:~"lrll
IMU~
CII' 32~8
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
PENNSYLVANIA CHANGES.
CANCELLATION AND NONRENEWAL
Thl' ,ndorumenl modlnos Inaurnnce provided under Ihe rollowlnn
BOilER AND MACHINERY COVERAGE PMT
BUIlINE5BOWNERtl POLICY
COMMERCIAL AUTO COVERAGE PART
COMMERCIAL CRIME COVERAGE PART"
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL PROPr:RTY COVERAGE rMT
COMMERCIAL INLAND MAHINE COVERAGE PART
FARM COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTB/COMPLETED OPERA TlONB LIABILITY COVERAGE PART
· Thll endonemenl does nol opply 10 coverege provided (or employ.. dllhonnty (Coverage Form A) or
pUblic employee cllahollllaly (Coverage Forml 0 Ind PI
A. The CANCELLAl'ION Common Policy Condlllon
II replaced by Ihe rollowlng
CANCEll.ATION
1. The lirsl Nlmod Insurocl shown In Ihe Decll'
mllona mny clncel Ihia policy by wrlllng or
giving nollce or clncellallon
2. CANCELLATION OF POLICIES IN EFFECT
FOR LESS TliAN 60 CAYS
We mlY clncel Ihla policy by mIlling or de-
livering 10 Ihe nrsl Nlmed Inaured wrlNen
notice or clncellltlon II lenl 30 daya berore
Ihe e"ectlve dale or cancollallon,
3. CANCELLATION OF POLICIES IN EFFECT
FOR 10 CAYS OR MORE
IIlhls policy haa been In ellecl lor 60 daya or
more or If Ihla policy Is a ronewal 01 a policy
We luued, we mlY cancellhla policy only lor
one or more 01 Ihe lollowlng relsonl:
e, You hove macle 0 1110lerl01 ml"epresen.
101100 which orrects Ihe Insurablllly 01 Iho
risk. Nollce or concell.1l,on will be mailed
or clellvered 01 leosl 15 days berore Iho
ellectlve dale or cancellallon,
b. You have railed 10 pay a premium when
due, whether Ihe premium la payable <.II-
rectly 10 us or our agenls or Indirectly un-
der a premium finance plan or elCtenllon
01 cradlt. Notice 01 cancellation will be
matled alieni 15 days belore Ihe e"ec-
tlve date or cancellation,
....
IL 02 4808 89
c. A condition. 'aclor or Iou uperlence mo.
lerlallo Inlurablllty has changed subslln.
Ilally or a lubatanllll coMlllon, laclor or
Iou e~perlence malenal 10 Inaurlblllly
hili become known clurlng Ihe policy pc.
nod, Notice 0' cancellallon will be mailed
or <.Iellverecl II leaal 60 doys berore Ihe
e"ectlve dale or cancollnllon.
d. Lon 0' relnaurance or ,) subsl3nllal cle.
crease In relnaurance has occurred, which
Iou or decreue, Illhe lime or clncelll'
lion, ahlll be cer1lnecl 10 Ihe Insurance
Commissioner as cllreclly nrlecllng In.
rorce pollclea, Nollce or concelllllon will
be mailed or dellverecl 01 leasl 60 clays
berore Ihe erlectlve dale 01 concellallon,
e, Malerlal rallure 10 comply wllh policy
lerms, tundll/ons or conlractual dul/es,
Nollce or cancellal/on will bo mailed or
delivered 01 leosl 60 days uerore the ef.
recllve dote or cancellol,on
r. Olher reasons Ihal Ihe Insurllnce COI11.
missioner may approve Nollce 01 con.
cellallon will be moiled or dellverecl 01
leul 60 doya belore Ihe effecllve dole of
cancellal/on,
Thla policy may alao be cancelled rrom Incepllon
upon dllcovery Ihal Ihe policy wu oblalned
Ihrough rraudulenl slalemenl5. omlulon5 or
concealment 0' lactl malerlallo Ihe acceplance
or Ihe rlak or 10 Ihe hazard anumed by U5,
Copyright, Inluranee Bervleel Omee, Inc.. 1988. 1989
Copyright. 15Q Commercial Risk Similce., Ine,. 1988, 1989
Page 1 or 2 [J
BLAN~~T PROTECTUR
CO"M~RCIAL PROPERTY
COVERAGE PART n~CLARATJUNS
~. NATIONWIDE
q ~!~~~~U~I~
lH rulU'tWQ PUJJ. I ~. OtlJ nlll
ISSUED BV NATIONWIDE MUTUAL INSURANCE COMPANV
POLICY NUMoFR 5UPR2~226~-OOOl
POLICY PERIOD fRO" 12/19193 TO 12/1Y/9~ AT
12.01 A.H. STANDARD TIHE AT YOUR HAIlIN~ ADURESS.
---------..----------------------------------------------------------
UESCRIPT10N OF PREMISES
Lue ULUG LOCATION, CUNSTRUCTION AND UCCUPANCV
001 01 SPRING GArWt:N NON CCHBUSTtUI.E
HAMLIN VIlLAGl' CI:NTEI{ IU,STAUIIANTS
In 590
IIAHllN PA 1U427 064
----------...----------------------------------- -------
COVERAGES PROVIDED
(INSURANCE AT THE OESCRIBEO PREMISES APPLIES ONLY FUR COVI:RAGI:S FOR WHICH A
liMIT OF INSURANCE IS SHOWN)
laC
001
aLUG COV~RAGE
01 PERSONAL PMOP~PTY
$
lIMIT Of
INSURANCE
30,000
CUV~IILD CAUS~ ~
OF LOSS
SPFCIAL
COINSURANCE
YO
------------------------------------------------------------------------------
OPTIONAL COVERAGES
(APPLICABLE ONLY WHEN ENTRIES ARE HADE IN THE SCHEDULf BELOW)
REPLACEMENT CUST (X)
LOC BLDG BUILDING
001 01
PERS PROP
PERSONAL
)(
OF IJTHF.RS
PROPERTY INCLUDING srOCK
x
IMPROVMNTS/BETTRMNTS INCLUDING
STOC~
-_.~------------------------------------------
DEOUCTIBLE
. 250 PER OCCURRENCE
----------------------------------------__ J
COMHEKCIAL PRUPERTY PREMIUM $ 355
-----~---------_...------_._------------------------------
fORMS APPLIC^"l~ TO CUMHERCIAL PROPERTY CaVERAGE PART
FORMS APrL1CAULE TO ALL IOCATIONS/CUVERAGES
CP 00 90-0768
FORMS APPLICAULE
FORM NUMBER
CP 00 10-1091
CP 10 30-1091
TO SPECIFIC LOCATIONS/COVERAGES
LOC BLDG COVERAGE
001 01 PERSONAL PROPERTY
001 01 PERSONAL PROPERTY
>l4
12/20/93
150/014
PAGE 002
CAS. 3204-A
COMMERoCI~L PROPERTY CONDITIONS"
. " ,'It\--. " i 11',"'(' ,.' ','.- ; . t,'"
Thla'Covo'i.oo Port lis lii/6'lol;LI~.(i1P.~q{19Wi"IU,~'lil1llllllllll, Iho ~llll1";;Ulli';Cllicy C1l11l1'it10111 ol1d oill;ii~bohlo I. (IPS
Condltlol1' ol1d Addllllll10l COl1dillon. 111 COI1\I1IO.CIIII PIIlpUlly GIIV\lllIIlO !'ml1l1, '''','1 '
. . I" ""I, (I ,I' ., '111""01-' _,
f ,
, t..
,0
A. CONCEALMENT,
OR FRAUD
MISREPRl:!lENri\TION
" I . :-" 'J, ,
Thl. C'1VW11I0 I'lIflolU v(lId III ony 1:/160 01 ,,,,,,01
by Y'lll 06 II '01'"0' 10 Ihl. CovoI~IIOI'1/l11 /II III1Y
limo It Iii ohiO vOid If YI)lJ m 1)11~ UllIlt IIHilJfIUI.
ut /IllY limo, lrll'bnlllihully cOl1coill br'm'161upllliilllil
o n1ll10,'ul foci COI1CUlllllll/
1. Thl. COIIO.OIIO Po. I,
2. Tho COllorod r.opo.ty,
3. Your IIlIO'O.t III Iho CUllu/od Proporty; <lI
4. A c10lm undu/ Ihl. Covurollo Po.\.
8, CONTROL OF PROPERTY
Any ucl 0/ noglocl 01 UI1Y pOl60n olhu. Ihun you
boyond you/ dUOCllol1 <H cOl1trol will 1101 uflocl
Ihlo 111.0'Ul1ce.
Tho h.ouch Ilf OilY c0l1d,1I011 of Ihl. Covnrullo PUll
Ul UI1Y 0110 or mu/o 10CIIII0I1. will 1101 IIflUCI COli'
orago 01 OilY IOCOlll1l1 Whlllll, III Iho limo 01 Iou.
or d'11111100, Iho b.ooch o',:ol1dltlol1 do06 1101 UX,
1.1,
C, INSURANCE UNDER TWO OR MORE
COVERAGES
II two or moro oflhlo policy'. covo.ogo. Ilpply 10
Iho .omo 1000 ur domogo, wo will not poy moro
Ihon tho actual omoonl of tho 1000 or damogo.
0, lEGAL ACTION AGAINST US
No ono moy bring 0 logol oCllon ogoln6lu. undo.
Ihlo COll%go Port un1060:
1. Thoro h06 lIoon foil compllonco wllh 011 uf tho
IOIm6 of Ihlo Covur"oo 1''''1; und
2, Tho OCllon 10 lI.ouohl wilhln 2 yoors "ho/ tho
d"lo on which tho dl'oct phY61col loti6 or
d,,"wgo occurrod,
E, LIBERALIZATION
II wo odopl any .ovl510n Ihol would brood on Iho
covorogo undor Ihlo Covorogo Port wllhout oddl.
tlonol promlum within 45 dayo prior to or during
the policy porlod, Ihe broadoned covarage will
Immedlalaly apply 10 thlo COllorage Port,
..
CP 00;90 07'88'1
COMMlIlCIAL 1'1l01'E/!' Y
, ,
f, NO' DENEfll' TO MllEE, .
No \lIl.6tll\ t)' OIU;lIlllotl'lfl, othm Ihl1(1 yo'LJ; hovlJlO
ciJ610tly III COIIO/Otl P"'p"'ly will hO'l1ollt ,,6111IhI6
IIHilHIJI1l;(I
0, OTtH,Jl INSURANCE
1, YOIJ 11111\' hOllo (lIhur IlIhOfOIlCO 6LJlllo';1 Itl 1110
UllIllIl pllln, 10lln6, ';Olltl1l101l6 olld provlsulfl6
06 Iho 11I6ulllnco Illldur 11116 Covorouo 1'1IIt. II
you do, wo will poy Oil. 6110.0 of Iho covurod
IllOO or domo\1o Ou. 6110.0 10 tho P'OfJOlllol1
Ihllt Iho ofJfJllcohlo 1.111111 01 In6urol\co ul\dur
Ihlo COllorollo POll buo'6 10 Iho Lll1Ills of Ill'
GurUllCO of all 11I61lftlflCO cOIIO/lnll 011 tl10 GIII1IO
lIools
2, II 1110/0 16 01110. 11I6U/UIICO cOllorlllg tho GOl1l0
10'lS or d011l01l0, Oll1u, III/Ill Ihlll dUGcrlhod III
, ObOIlO, wo Will p"y ollly lor tho OI1lOUIII of
covurod 1005 llt dOIlHlIlO In OXCOSG of Iho
amount duo trol11 'hjlt olhor Insuranco,
whuthut you ClJn collllel 011 it ot not. But wo
will 1I0t pay molO Iholl Ihl! ofJpllcoblo L1l11lt of
Insuranco,
H, POLICY PERIOD. COVERAGE TERRITORY
Undor Il1ls Covorago 1'''11:
1, We cOllor 1066 o. domogo cOl1lmol1clng:
0, During Iho policy po/iod 61Hlwn In Iho
Docla.otlon6; olld
b, Within Iho cOllorallo tOftltory,
2, Tho covoroge 10ftllory 10:
0, Tho Unltod Stoto. of Amarlca (Including
11$ 10l/ito/los and pOS6oo$lono);
b, Poorto Rico; and
o. Canada,
CoPVft8tlli q!l!!J.t C8Mlnil'lcl~1 'lllak!S~~liill'&~li\'eH983..lf987 I '
P~lie\f bV12''' 'b
I. TRANSFER OF RIGHTS OF RECOVERV 1. Prlllt 10 4 lOBI 10 your Covarad Prop.l1y Ilr
AGAINST OT~!'" IT~ V" ] VI G:'> V'1' t '.~ ('j n ~~G/~ljl-~1V~~1'~:1 t\lll\n ():)
II any limon or or04nl18llon III or tor whom WIl "'f. . A'loI D lOBI 10 your CovoIQ'd Prop.rty or COY,
m.k~ flDvnlanl under Ih'~ C.Qve~A Pert hil.I Brad Incoll,e on1v If ellh/la ollll~'/ th.llllrty
rtdf\ll'jo,lr'b\1blJ.i' IllrijHgel"rroh,VI i\H8'r"~Hlilb"'" '''fI'',1''16Ior\~'Qn 11l~/j1l6Vo1I,jg!'1 ,,, II In Dl1nlllVn" '
rig hIe 010 l/anerG/lad 10 ue 10 IhU'IlI'h'I:'IJr 'bur'" , : ""Hlll"' ' '" '''''Ii''''b' ",'1"'1",,/1'1114 Inll",'"
.. ~"mOllno Inlurao Y II 1 nllll.nC'1
pOYllIonl, Thol potion or oloonllellon mUll do
av.elYlhlnU nncauelY 10:.llDCUraHll/l\;tI~hllt<lllnd' ,I \"l~I'rA PJt~Jl1n/5~,IIr'Jl;!I"~ ,n1UMJA. 3t)~\',1 '
t.\\l.,\.~o !1~1I11,)g O,'\?l'ol, 10,I,lIW,lJlfollA!l)' ,1l,UI (1) Ownod or conl/ollDd by YOllll:1~ri j ,
(14 fllnY,wolvo Y(l~r rloh1o aoa!I)VI ~p lat, p,brty """'(2) ThaI owns'or conl/ols ybu; or/vo'
n wlllhlO; I ",I" , 'D."VlJuf'1M,riiil..' , "1,;1'11 I, f.J,:.
, ), \IIU~I>'I , ", T,"l,"'~/ii nOI'rQ,lil~typ.u}rl1,ur~n~.;'::"'l:::I/\':'
,,I lJ) t "Jl . l ,', '....lil! ,'I '. 10 'r' II . "III' !Nt 'ftlhl'tl' I,
"', III lilt . ,H'I' .Il'~(j ',r" <'
( 'l(ll\n\lOO ,.,It',
. ,.' , 'I '111" ,I' f:':r\lp~pdl 'I "'I
, ." Ih, I'll; ." ',II"I'oIl):;
'," IU~ \l1~Q,"1i1i 'n ..I'OU'll' L ,'}, ,I, 'II '~t,qn'ill tI ,
" E "th',lljqrl{~ ,
~'I l'r'i "11'1111/".)
, ',.\\ . ~ '.1:1 In " 'I'
I,
"
".
.,
'HI ,q()\
1111 ,
"",I
./1
,. ,
l"t
" ~, "dj
ti 'I
, ,
tlI' " ',n Ii .1';',:, 1"1 ",'lIill" I ,,',hI JI I '''~
" "J' . ,'ltJ ,,(It 11\ l' "I "p' Ifl,l' '_
I,f. I I' I'J' I I '" ,'t' 1.I\~ ", "
'1'".. ., ,,~ r I.' '" i,I';1 j\......
.': ;. t 'JnJo I',,' "l,'lt \lllh I'
tho., .~ II'" It.) fi III' tHlll') ,It') \.IllV \'/ 1'1',',
lCI! n, \1(lb;')llqil" r,'1 null! QH.hl ,'no tl;11 II"
,eonu'"VI,1
Yfl'JTmfllT .'1 'J/'"HaVOO .001"3'1 '{'II,I,)'I I,
JI~." Unp'8\1~O ,="t. hirlll.]
(tfll,lflUlthY'llt' Jllif"nh '(; 11.')1 \1)\.;,) ,'f,;
" " ''''' rid l;'JIWI I~II~[J ant gnIIU(, II
hll~ ,~1l0IlalBlo~"
"h:H'f'.' l'IJI,\I)VO:l orU ni,t'IW .n
"I vIOlhll" egBIOVlJO IIn" :'
tJ ',}, . \ )IlUIHA tl,l ,lltll;\l:: olUlnU ",n
Illnoi':(:'tI.PI"l hI'" n"hnttmu hll
III I "'J.fI rmall'! II
,It.nno:) "
Cff OO;~e Q708@'l
.
'"
'II,
t ,'1, 11.11 "
,
, .
:l(h,.: t 'i(J lor"') llr;
n ,q ~ ,"~
',I.It!. /(,fl
".1,'
'I'"
I, " l' ' ~ ..r' '
,,', I ,. 1'1 '"d II
,.,.t. t,. 'I' '.,.1 ,
t. 'n" Ptl ~'H~H
, I,'
'HII.lM /10 l'l' r n,1rJlIlll BO!.1Af1lJalllI
BBF.lAnaVO;)
i Ilq<lu "..,". ' , ' ""II "n/lo 0"'01 10 01'1" I
UI" " ynq I.' t II,,,> l.'t ItP ,"Ill" \lI p~"l afntH 'I/f~
tlt-tll "rh "~ I;el), r p t, Il. t"';IHtlB 1~IHOfJ DIU . ",it'
tllJ 1 ~1/l'Ard. 1/I01T'OA JAF.ln ;
t~1, llt ..'Ii '" t,OtS ;1(1'
II'tll; . Qrdld "lIrn IHlO e'
Lt..!' "J Jh~9 lJUI11f)'/OO (Il~
" " ,,',' "Dod son 010nl ,I
.(.". "....J lidr lo Iwner
wlllo 1110 ,tllw ~",,^li"
i',tI!! I'"
,. ; " 101100 ttl11 ~,
',I,'.. .10 ulob
t. 'I', ':.'J flonulhb
iAc,n A,$IJAflBflIJ
0111 n~blol11 hluow 'b'" """V'll ynl /qohl OWl'
fJbo IllO/IIIw hB'l O~U')"''': rilrll 10bnu ag^'~VO"
!/""ub III 0110hll ~V' ", e~ ,,'llIlw mU11l10lCI'8nOlI
III" Btj^'O'lon i).I)~hr'i \~ '1.1/ ,holmq yollo,! orli
IIn'! 0111'1"" ',,, ",U "' "lqqB yl.'filh"'"(ll
l"'U 'un. " H ~ till "'I "j
'0 'fil.I I ,i"Vil,.' '?t'l;
~
Cop~{\Il~I..~6itqwl'!e~!iI~\,/llBkell"I't\\l'J,M,'bi) ~DP",l"AlQo:)
Pllge~ Qtl~o 'i:J
-
COMMEI1CIAI. P1I0i'1I1 r y
'I'll ",.."" ,BUfLb"NG AND PERSd,I\IAL
',,;;:~,:, ;~,I':,~I,I1.'R,O~E'RTY COVERAGE FORM
H:
'I, lJ
",
I' .
, ,
, , ,ll~'
VOIlllUI plovlllonl In 1hll policy III 11110. I cU\lmOIlO lIuoll Ihll IIlllllU ,",lIcy cotulully 10 dlllll/tIll/llI IIUhll, <IIIIII'h
olld what II ond,ll no! coye/ed"
Th/oughoutlhll poltcy Ihe wOlds 'yolI" 011<1 "~vow" IullIl Iu 11111 NUllllld Illlulod shown In Ihu DoclolOlloll. 11111
wlIIdl 'wo: ~u~: olld "OUI" 10'01.10 Iho COll1potJy plo\lldlnu tllIli """lonco, ' I, I~ .. I' '.' "
Othel wOldl ond,phlosol,lhot OPPOOI in ~uolollonmO/ks IW\l1I ,pllclolmoonlng, RlIlello 6~CTION It . Drn.
NITION5. .", '"
",'
A. COVIlRAOE " '"
Wo Will pay 101 dlloct ~hVllcbl lolS of 01 domoge
10 Covemd Ploporty ollho plemllUI descllbod In
Iho DeclOlollonl cOUlod by 01 10lultlnll 110m ony
Covoled Coule 01 LoIS.
1. COllored ProPQrty
Coyorod Plopelty. 01 ulod In Ihls COllorooo
Port. moons lite following types pf ploporly for
which fl Limit of Insurance Is IhoWI' In Ihe
DeclolJltiljln~i " .
o. Building,. meaning Ihe bulldlno or slluc,
tUIO delcllbed In the Deololollonl. Includ.
Ing: ".." '''111.
(1) 'Ctiniplo'tell oddlllons;
(2) POlmo'filJntly insldllt!d:
(0)' Flxlures;
(b) Machinery; and
,"JIJ,II'
(0) Equlpmenl;
(3) I,P.V,I~~~I fI~t~r~~:' I
(4) Polsonol .ploporty ownod by you Ihol
'I. used 10 1I10lnloln or serllleu the
. ~uli,y,l,l)O, or, IIrUClure or lis p'omllllS.
InFI,Vy!n.!!:. ". , '
(0) 'Fire oxtlnoulshlno equlpmenl.
(b) OUldoor fiJrr\llu,o;
,'",,'
, ' ('I). FI?ol covell~or; and
(d), AppllQncel" used lor rolrloolollng.
lIenlllotl110. cooking, dllhwoshlng
or loundellrg;
(6) If not eOllorud by other msuronce:
(0) Additions under conslruellon, ohel-
ollons and repairs 10 thll building or
structure; ,.
/'
(b) MOlllllols. equipment, 6uppllos IIl1d
lempolOry slt/Jeturol, 011 or WIlIIIII
100 feol 01 tho dOlellbod P'O/l1lhlll,
uSDd 101 making oddlliol16. lilt",
oUllnl or repairs 10 Iho buildllll/ ll/
5lruelure,
b. Your Buslnon Porsonol Proportv 10
eoted In 01 on Ihll bulldlllgdllserlbud "' Ih"
DodorollollS or III Ihe OpOIl (or III II \111111.
.clo) within 100 IlIel 01 Ihe.. do,clllmd
premjS!ll, eOI1SISllllU of tbo ,'olloWII'!) "".
1065 O\hlllWl~e spoelfllld 1111he Duclnl/ll"l/16
or on'the'YoiJrBusln9Isre(6,oh'ol PrOperly
- 50porollon of COllelb'a'e 'formi'"
(1) Furnl,t,vr, ?nd IIxturos;1. . ,.'
(2) Mochlnory olld uqulpmol\l;
(3) "510c~"; "
(4) All othor.:porsonol properly OWlllld hv
you and used In your buslnoss;
(6), L.ab.ol,r.motorlolstllrdlorvlce~ Iurnlshod
or,arrangod by YOIJ on.porsol1ol prop-
Qrty of olhllls: .
(6) YO/JI u.se "llerosl os lenonlll1 imp'll\lo
monls ond uUllurrnonts.;,1mprovollllllll,
ond,b"lpr()1l1l)ls orll fI~lur~6' OIlOrHIIOII",
InSIOllotlons or oddlllons! '
, (0) . M.IIl1e 0 pol'\ of thll bulldlnll 0'
" ,~lrUClull\ Y\lu;oceupy but do 1101
o~n; or.9. '.
(b) You"ocqulrod or modo ot your II~.
ponso bUI connolleoolly '1I1l10\lU.
(7) LeB60d pellonol p,oporty lor which VOll
hove 0 conl/octuol lesponslblhtv 10 111
5ure. unlo65 olhorwlsll pro\lldod lor llll'
der POllonol Property of Olhll/s.
.
CP 00 10 nO,91,
Copyright. 15Q,Commarelol Risk 50rvICOS, Inc" 1 990
Pogo.1 of 10
1""'",
',..
; t'l Il).j'ltl "'1'
.
II. PoraonDt Property Qf 9.t)If'! ,lhOl.,lp; CO filA ,11" n,~.qIl~llol''''OIl'ch, ,oploco 01 lOSIOllllho
(1) In youl r.ole custAiJylMQlllitrM1/ria~.1 U ~(nllflWljlld/l1 illIl vlllullblll Plllllltl nl1d Ie,
, '.. ". (" -J." 'Ie (:1.::1 , Ill'"' y...pQIP!J .,I11~IVUIIlUIII1l16U whiCh e~lsl 011
(2) LQeollld In Ilr .11, Ih Ilulldlllllrtlll,lol hUll' ..1 \JIUlfllmb\.dll'1l1l1l1nullc 11111111/1, o~cupl 06
In Ihll OuclOlnllol1' 01 In Ihll Oplll1 (01 plllvllled In Ihu CIl\lOIlIIlU E~llIn,'01l6.
111 0 vohlclll) wllhlll tOO luulol Iho du.
scribed III II 111 ISlIs 0, Vohlolos 01 11111, propullud II1nchl11116 (III.
dudlllll 1I1/l:,nll or WllIrJlctllll) Ihlll
HOWOIIO', our poymllnl lor 101. III III d'"Il'
'ogo t01polsonol p'oplllty of Othlll6 wlllol1ly (!) A,'I.lh:II116IliJ 101 ""1/ \111 11IJhll\"'Ulld,,'1l1
hll lor thu lIccullnl III Ihll oWlwr III Ihu (2) Aru opo'otc1lplllll:ipllIlV owoy "dill Ihll
. ".mml}If,IY,,', ,,,I dn~G,lh,ed IlIlIlIlIl;II",. ' " ,,'I
2. Propllrty Not COllorod " , 'Th)sl,lbfnlll'lIph lhllll ''''1 opplV 10' ''I'....
Ctivu'Md'I';llplllly <1011" 1101 il1c1ulh, (0)' Voohlclu6 01 l,i,lI,pIOpolllld 11",,:hlnlls'h,
o. Aceoullts. IlIlIl. Cllllllncv. delld., lood /lUlos Y'II' 11111111llllCIIlIlI, IlIIjC056 oi
stOl11pti 0' othllr 1I\11dllnCUI 01 iJllhl, mOlluy, wOluhlll'llI,
II10teslor'socUrllloa, Ll11lQlY Ilck.IS hold lor (b) Vehlclos or ""I1'P'Upolll<l 1I10<:h"\II';
solo oru 110t Slll:UIIII1l5; , "pl)lP,\ thnn .JlIIO", you,hold lor GII'oI'1l1
b:A~(I~~ls. 'u'nl,""s ownod hy olhlllS lInd ' 'I")' !toWbolll. or ClInoo. 011101 WolOl 1I11ho
'6oo~ddd by you, 0' II OWlll1d hy VOII. ollly , ' doscribo<l p'"I1lII"6; , "
, '''bs "&Iock" whllo Insldo 01 hu,hlll1l1S, p, Tho followlIllI propllrly wh'illl oulsldo 01
J~I"e..l{~"lRR!\~1 huld !,or,.~I:l; hulldlnu.: ,," ,""
d",)3,ldQ.q~I,roodWoY6. walks. j)IlIrQS III othll' '. 11 )"Grnln, hay, sllllW lJr'olhllr crops;
d)oy~q,s~lf"cus; " '(;i(,:~aficOb,' rlldio 0;' Jlll~V15101l ~1lt'II1lll06,
e:I:C~YI(roh/)Ild; ill propllrty III Ihll ClJurSO 01 ' II1c1udlnu Iholr lOll .11.1 wlrl~U' 111/1SIS or
','wllle\lbl'rlbn.porlllllon'or ,,"dll; towors, ';I\l1IS (olho', Ihall 1111111 Ill.
't~"X\'I~,\lIJ'I~,I~~,i 01 lIXCOVIlII,I'r\s: U,odillU, bockllll. q"fnchdd 10 bulldlllOs). IIO"S. Ih,ubs or
n \1111 "I"'pl.rils (olhll' Ihnn"slock" of 1'1I111.
,n, ,nu; , shrubs or plllnls). 011 o~ClIllIllS p,ovldad
g, Foundnll~ns 01 bulldinos. 1lll,cllIIlIS, 1110. Inthu CO\llllllUII ExIIIIl,'ons
chlnery rJ' bolllllS If Iholr fOUlldllllOllS n'lI
blllow: ,3. COllorlld ClIU6US Of Lon
(1) Thll lowc", bnsolllllll' lIoor: or SlIO oppllcllblo CIlUSll5 01 Loss For", liS .hown
III Iho DlIclllIatlolls
(2)'Tho' ,w'acll 01 Ihll orlll,nu. II Ihll/O Is
" 1 110 tioaolllont; 4. Additional COllorn\llla
IH,:LDfld"(lhcludlllO lond on which Ihll prop. 0, Oobrls AClllOII?'
'orty"ls rtoenlcd). wotor. U,owlllU crops or (1) Wll will pnv 'you, lI~pllnso II) rlllllOVO
lowns; ,,, dllorls of CO\l",od ProJlllrly ClluSlld by
-d'," Porsonal property' whitt! 11111101110 or ' ". 10 0'" IOIilJltinu frOI1\ n Covered CIHJSJl of
"WIIlerboll1o: . ': Loss Ihal occurs dl"lno 11111 policy pll'
'" I' ". I ' ' ,'od, Th" II~Jllln"C5 will bo pn'iJ only II
'J.' Pllln'g6. plots, v.hnrV,05 or dock" :d,,""thllY llro roporlOlI III us III WlllI/IU wllhlll
, ~\ ,rfPP,Y,rty thot I. cOYY',lId unum anolhol '1 BO days ollhu d/llll 01 dllocl physical
,CO,lIllra\llI fo,,,, 01 ,ll1ls or OilY' olhllr policy loss or dlllllllOll
Ii, which II IS 11\0,'0 "pllclliclllly doscrlblld. (2) Thll mosl wo will pay undlll Ihls Addl.
except for Ihll llXCOSS of thll amount duo ' ," .\, Ilonol Covu,ooe 15 26% of"
',: 1;7.:i~~d~,~~~u~~:1c~~III1CI on II or not) frol1l "I "(a)Thll Oll'O~1l1 'we poy lor Ihll dlrocl
phya,clIl los. of 0' dOlllllUO 10 Cov'
ItlAellilHlngl wnlls Ihol nrll nol poil 01 Iho " 'lI,od P,oPllrty; plus
"llb'hllllhiOdOSCllbod In Ihe Ollclorollons: "."', '0'''''' "I I..
. ',",<0~#~}ilro'uMpJ'PQ5. fluo, or dro,ns: 4 " . ",",I(lt." ",
"000 '2 of 1'0
COPYllohl. ISQ Con1l1iercloI Risk' SOrVlcosllno" 1 990
CP 001010''911.
,
IIi
I'
'I.
1
~
I
~
')
\1
:>
["10
(b) Tho, doduallblu In Ihla IIoliey 11",,11
coble tu Ihollu56 or dOl11l1lJu
. 1-... ,_
Bul III Is ,II/1111ollon ,loes' nOI OPllly 10
any sddlllonol dobtls IUl110VlII 1111111 "'0
vldud hI Ihu Llinlls uf 11I5UIUIICU boehUII
(3) TIlII Ad,dltlonnl COVellllJe dou5 lIul "'"
plY'lo COKtl to:
(0) EXlloet "llUlluIOlllb" from Inlld 0'
WOIOIIOI
(b) Removu, 11151"'0 or lo"llIeo IIullolllll
land 01 WOIOI
b. Presorvlltlon of ProplIrty
II It II nlleuK50ry 10 UII)\IO CuvlIrlld Proplltty
I,om tho delc,lbod p,on1l5U5 10 prOSUI\l1I II
"0111 Ion Olll!jOI1l0UO !ly u Covurud CIIU.II
of Lou. we will pay fur ony dlmel phY51r.I"
1061 or do moue 10 thuI p,upllrly:
(1) While U is hOlno movud 01 whllu IUIII'
pOlo,lIy stoled at onolllQr loco lion. and
(2) Only If Iho 1055 0' dllmooll ur.eu"
wllhin 10 days Oltlll Ihll P'OpOtly 15 "'"
movlld,
o. FilII DlIpllrtment Servloll Cllorgo
WhOll Iho file depottlllont 15 colllld to 60\10
or p,oloel Covorod I>,opotly from 0 CO\l.
urod Couse 01 L056, Wll will pny up 10
'1.000 for your lIablllly for fire depnrtmonl
sorvlco 9horlleS:
(1) Assullllld by controct or eglllomonl
p,lol 10 1066; or
(2) Roqulllld by local ordlnoneo.
No Deduellblll oppllo5 10 Ihl5 Additional
Coveroge,
d, Pollutont Oloen Up Ilnd RllmovlIl
Wo will po'y your 0'p01l5e to eXlrocl
"pollutonI5' from land or wotllr 01 Ihll dll'
5crlbed preml501II Ihe rI.sr.horge, dlspellol.
SOopoge, mll/lollon, /010050 or 1I5COpe 01
Ihe "pollut'onlS' 15 eOUled by cir 11I5ultl
from 0 COlle,od Cou5e of L055 that occu,s
dUllng tho policy plI,'od, Tho exponses will
be peld onlv If thllY ore rllpolled 10 us In
WIlling wllhln 1 BO days 0' the dete on
which the Cove led Couse of LeISS o~eUIS,
..
4
..JlJ
4
CP00101091
,-
fhla A,'dlllonlll ClIVOl/lUII 1"'115 "lit "1'1"\
10 011111 to 1011 '01, 1110111101 III 115111'5 till'
eXISlenoo, aonaenllolloll or ofluCI. 01
'pollulants.' BUI WU Will poy fm 111.'"'\1
which II pe"lIrlnod III thu C"llISU 01 ,n
1I0ellllg Ihe "pollutollls" frl)lll II,,, 1",,,1 0'
wnle"
Thu 1Il0II wo will PlIV undtl, 111Ib Addllllll,"1
cOVn/a80 fOl ooeh dU5Cllbud In"I1lIOII' Iii
" 0.00 for tho 5Ulll 01 011 ""11"'011 "'
pons1l5 ollslllg out 01 C"\lIIIII., elll/.II. of
LOIS occutllno du,'nll tlI,ch SlIpUIIIl1I , l
month I,urlod of Ihl5 policy
6. Coverogo extensions
E.cept 01 othorwlso provided. Iho fOllllWII'lI
EXlonslonl apply to proPlIlly loco led 111 C)I "n
Iho bulldlnll dlllerlblld In thll Our.I",nllollh 0'
In Ihe opon (or In 0 1I1Ihlclll) wlthlll 100 II,",
of Ihe descrlbod plemisus
If 0 Colnluronce pelcenlogo 01 80% or lIIu,e
or. 0 Voluo Reportlnu pOllod symbol. i6 shuwn
111 the Declo,ollons, you moy 1I"UI1I1 Iho In
sUloneo proVldod by Ihls CO\lO'o{Jo Plitt II.
lollowI:
0, Newlv Aoqulrlld or Construetlld
Property " '
(11 YOUmoy'bxtlfhd Iho In5uronee thai op'
pileI to Blil/dlng 10 lIpply 10:
(0) Your now buildings while IlCIIl\J
built on the doscrlbod prllmls1l5: ond
(b) Bulldlngl you ocqul,o 01 loeutlon5,
othol Ihan the d05c"bod p,eI111606,
Inlondlld for:
(I) S,I/)ll1ar U5e os Iho bUlldinll de
1011 bed In Ihe DeelorOllol15: or
(II) Use os 0 WO'lIhlll/SO,
Thu most WII will pay Ill' los5 or dnl11'
ogll undlllthls blenslon 16 ~5% 01 tho
Limit 01, Ins.uroncll for nllllrJlI1\J 5hown
In Ihll Deelll,r~tions, Ill/I nol n")Il1 thnn
$260,000 Olllueh bUilding,
(2) You m.y e~tllnd the Insu,onee thai op,
pllu to YOUI Buslnllss PO'50nol P,op,
erty 10 apply to Ihot p,opllrty 01 OilY
locsllon you acquire olher Ihon 01 1011.
or exhlblllons,
Copyright, I SQ Caml1lo,eitl Risk Se,lilces. Inc.. 1990'
POOO 3 of 10
Tho 1Il0.t,wo wlllllny 101,1061 ar dum.
000 unde/tl1ls blenllon 15 , Qj(, 01 tho
Limit 01 Inlulonco 101 YOUI BUllnoll
Personal PlopOlly Ihown In tho Decl.-
lollolll. bUtl1nllllOle Ih.n " 00.000 Bl
elleh building,
(3) Insuronco under 1/1IS Exlenslon fOl each
newly uequllod or conslruolud 1',OPOlty
will end whun ony 01 Iho lollowlng 1110'
occurs' .'
(0) Thl$ policy O~IJI/oil
(b) 30 doys',o~plle nllol you ocqullo or
hooln to con511UCI the p'opu/ly; IJI
, .1'
(0) you ruporl vnlulIs 10 U5,
Wo will eh~rgo you additional p,,,mlum
lor lIolues Iupo/led "om Iho dolo con-
Sl,ucllon boglnl or yu'u acquire the
propo'ty,
b, PlIrsonnl Effeots nnd Property of
Others
You may lIxtend Ihe InsulonclI II10t oppllol
10 Your Buslno61 Pelsllnnl Plopolly,lO op.
ply 10:
(1) Pel50nol effuots owned by you. you I
OffICO'5, your pOllnoru or YO,\'? omploy.
U1l5, This e~,qn,slon d01l5 not upply to
1055 or domugo by Ihofl.
(2) PUllo/101 p'oPO/ly of 01/'0'5 In YOUI cOle.
clJslody or cont,ol.
Thu m051 we will poy for 1056 or dsmoge
under Ihl5 Extonslon 15 '2,600 ot ooch de.
sc,lbod prllml5os. Our poymonl fa, 1011 01
or damage 10 pO'5onol p,oporty of olhel5
will only be fo, Ihe nccounl of 1110 ownel
ollhe proplIIty,
e. Volunble Popors end Rocords - Cost
01 Resuurch
You mny Q~lond tho In5urnnco 11101 nppll05
10 Your Buslnol5 PlIt5onol PIOpu,'y loop.
ply 10 your coliS 10 leseorch. ,oploco or
'0510ro Iho' 1051 Infolmnllon on l05t 01
domoglld lIoluoble papers and locprds. In-
cudng thosll which lIxlst on 1I1oetronlc 01
mognlltle media" fOI which dupllcOIGl do
not eXl5t The most we Will poy undelthll
Extlln510n IS 11,000 01 eoch doscllbed
plomlS05
Pogo 4 01 '0
.
d. Pro port 'I' Oll.Proml...
You I1lny lI~lond the 'nsulnnco provldod
by th'l CoVelogo Palm 10 ol,ply to your
Covolod PIO/'OIIY, othol thnn "slack: thnt
Is lomparoll y 01 0 100011011 you do /101
own, 10nsD 0' upOlolo"Thl, bIQl)SIOn doel
not apply 10 CovvIDd Propu/lV:
(1) In 01 0/1 0 YO/lIclo,
(~) In Iho C/l/O. custody 01 C0l1110101 YOUI
,solelpOlS0I1S.01
(3) At O/1Y 101/ or exhlbll/on
Tho mosl wo will pay lor II)SS' 01 damage
under 1I1IS Exlol1SIOn Is 16,000,
e. Outdoor Ploperty
You may o~tol1d'lho Insuro',ic,l' plovlded
by lhll Covologe Fo,ni 10 'op~lv 10 your
ou'door fencos, radio ondlelelllslon on-
lennol. Slg/1S (olhellhnn signs nltoched to
buildings). lIoos.shlUbo ond plnl1l5 (othel
than "sloek" of lIeos. shrubs or plonts).
Includln(J debtll removal e~ponlo, couled
by or re5ultlng f,om 0/1'1' 01 Iho following
COUI05 of lOll If they ore 'Coverod CeUI81
01 LOIS: I'i'
(1 I File; , ,
(2) Llghtnlnll,
(3) Exp10510n;
(4) Bioi 0' CI\lII Commollon; or
(6) AI,croll
Thll most we will poy lor loBS 01 damage
undel this E~lonslon Is I' ,000. but not
mora Ihon 1260 101 anyone 1I11e, shrub 01
plo/11
Ench nllhelll Exlonslons Isoddlllonol Inlulonce,
Thu Addlllonol Condition. Coln5uroncQ, does not
IIpply III Ihllso EXlonsion5"
B. EXCLUSIONS
Seu applicable CII1150S '01 ~OIB FOlm os shown In
Iho Declolollons. '
4
Copyright, ISQ Commorclnl Risk Sorlllelll, Ine" , OgO
CP 0010 lO'S'
C, LIMITII OF INIlURANOIl
Tho 111011 WQ WIIlIIOY lot IbUo;' damoOQ In IIny
ono oneUllaneQ II Ihlt applle~blo Llmll of Inlul'
oneo shown In Iho DlIclolallol\s.
rho I1IOBI wo WIII,IIlY 1011081 01 domll\lo 10 Oul.
dUQI IllIns Ollllelwlt 10 building. 15 . ,000 per
610n IlIlIny Ilno C)I:I:UIIOnCQ.
Tho 11111116 oppllcohlo Illlho COllelouo ExlQn610ns
olld Iho Fllo DllpnrlmUnl 5orlllco ChOlOll ond
Pollulllnl Clolln Up and RlIlllovol Addltlollol
Covorll01l6 11I0 It, lIt1d,"on to Ihe L11l111~ III Insur.
IInce
POYl1l01l15 un.)III thu flllluwlng Addlllonol COVOI'
0\101 will nol InC'OIlIlO Iho opplleoblll Limll of In.
sUlonco
1. PlolO,votlon d P'OPlllty; or
2. Dobll5 Jlemo\llll. hUlll:
0, ThQ sum 01 dlleel phyaleoll056 0' dornogo
and doblls 'ornollol oxpen5e oxcllllds Ihll
Linlll 01 In5lJ1I1I1CO; 0'
b. Tho ItuhllS rlllllollOI oxponse OXClIOtlS tllo
amount poyoble under thll 26% IIn1llllllon
In Iho DlIhll5 Rerllovol Addltlonlll COlla"
age;
wo will PllY up 10 on oddltlonlll 66.000 fo,
each loco lion ,n any ono oeCUllllnCll undoltho
Deblls Ro",ovol Additional Cr,l\IlIIoge.
D. DEDUCTIBLE
Wo will nOI pay for Ion 01 domogo In lIny ono
occurrence until tho amount of 1066 or domogo
oxeoeds the DlIducllblll .hown In \hll Doeloro.
lions, WlI will thon poy Ihe ,omount 01 1055 01
domogo In oxe055 of tho Do'duetlblo. UJI 10 Iho
applleoblo Unlit of In6uroneo. Ofllll any doductllln
requlled by Iho ColnsuIBMe' condlllon 01 tho
Ao,olld Value Optional Covologe.
E LOSS CONDITIONS .'
1 he followl/lU conll.llon5 opplV In oddllion 10 tho
Cl)IllIllOn Policy Condlllons ol)d HIli COlll'"orc,ol
P,oPllrly Condlllon5
1. Abondonmont
Tholo cllr. he no abandonment of any properly
to UI,
10
10
,....
2. /1.'1111011111
II WO ond YI'U dlSnQloO ori'th'y VIII1Io "I 1111'
IlrOpally 01 Ihe anloiJ71 01 16$b, 011110' nlilv
mllko WIIIIQn dQmond or a/I OppllllSlI1 III III"
Ion In IIIIS oV'lIll. 1I11eh polly' will 1,,,10,,, ..
cornpQlonl ond ImllOl\lol opprolsur I I... 1\11011
IIPP'III&0'6 Will &QIQCI on umpllo. IIlhllY ':1111'""
IIIl'UlI, ollhol mllY rlllluoll Ihlll' 8011/1:1'"11 ""
1Il1ldu by IIludoo of 0 eourll'lIv11I1l1'JI""" 1","
Thll OPP1l1l60'6 will 5111111 SQPorolllly II... "01'.".
ullho IlIoperty III11f IImount 01 Iy~s If IIII'Y 1.,,,
to lIu,eQ, lhay Will submll Iholl dlllo'/I'""'''' '"
11111 "Illplru A deCI610n og'lIod 10 by ''''Y 1\110"
wlllho blndlllO Eoch party will:,
II, Poy 116 ehoson IIpp,ollor; IInd
b. SOOl Iho olhor oXIlonsos of Ihu IIPP""""
IInd urnp"o ol)uolly,
Iflhora 15 on oPP'lIlsol, wo will 51,11 '0101111 Ill"
"11 hi 10 <lony Ihe claim,
3, DUtl08 In The Ellont 01 Lo.- Or OOI11I1U"
0, You must SUll Ihot Iho followlnu II'" """I'
In Ihll ovont of 1056 0' dOlllogo 10 CO\l""'"
P,opolly'
(1) NOllfy the pollee If 0 11I\I\I nlilY Ii,,,,,
boon bloken,
(2) GlvQ U5 p'ompl 'notlee of Ihu 10'" Ii'
domollo, Include' 0 dlllcrlptloll 01 Iii..
propo'ly Invollled.
(3) As soon 115 ponlble. glllu us II 01"
5Cllpllon of how, when and \I\Ih",,, (I..,
1066 or dOlllOOO occullod,
(4) Toko 011 ,o050noblo slopS tu p,ol,"I till'
CovlI,ed Propllrly horn funhOl 0111111.1'1"
by 0 CO\lOled COUSlI of L05s If 1"",,I,k
101 thll domooe,d p\ppelly 05ido nnt! III
the b1l51 p0551lile Older for oxomllllll.o"
Also koop II 11Icord of you, U'P""""; !o"
Olllll'Ullncy ond tQmporolY /UP;"'" I,,,
con5ldll,nlion In Ihe'SlIlllulIlItlll III 'Ii"
claim. Till. will not Incre1l50 II", I"""
of Insuranell,
Cf' 00101091
CopYllght. IS!;! Cornmo,elol Risk Sorv1C05. Inc. 1990
PnUlI r, 0110
(6) At OUI loquost. UlvO'lIs',comploll/ III'
VI/OIQlles, 0' Iho dnmouotj and undlllll'
Qued 'p'rop'etly. 11Inlu<lo IIIIOIIIIIIOS, eosls,
:volup,s ~r\d embl>"\1 ,0(1,0'. c)olmod,
(II) An 011011 olmny Ita ,e06onohly 'lI'luho<l,
pOlml1 UI 10 IlIspoCI Iho. plopully plO\l'
Ing ,Ihe loss or IhllllllUO 'and OXlllllllw
YOUI books nlld 'lIcO/dol. '. J'
Also pdtlllllus Id'lbko snhlples 01 <lorn,
ouod and' un<lnllloy'otf'l"o/Iurtv 10' In,
'spllcllon: tllsllriO' ul1d "illililysls, IInd
'01 pOlml1 U5 10 hwkf'cbl1lbO hom yo",
books nnd rqeorda.' '.
,'~ f I' / l, '. . '
(7) 50",j us II slunod. sWOln IIIIJlII of 11Iss
uonlulnlno thll'lnhlHnntlon wo lO'luosl
10 IIlvoIIIgolll Iho.c1alm, You mU51 do
Ihll within' 60: doy~"DJlO' ou' roquosl
We ,will 5UPP'~ XPfJ, vylth Ihu noc1I5sury
'ornls, , '
(B~. COOPO(Otll WIl11,u,s,!11111U, II1v0511001l0n
01 dolllomQl1\ of Iho clall11
b. Wo IIlPV oxpmlnll,any in5u;od undllr 00111.
while not In Ihll'pIQlion'ce 0' unV olhor In,
sUled and 01 such 111110S 05 IIII1Y bu lOll'
sonobly rllqulrlld; obolJl,bny'molllll 1010111111
10 this Insuroncn or'lhoiololm, Includll1U un
II1SUllld's b\loko"III1\1 I,O,cQrd~, 111 Ihu evonl
of on oxomlnolllln, 01] In5ulud'5 1I/15WQl5
lIlusl bll slonlld, , '
4. LoIS Payment
II. In thll lIVOI1l of loss or domogu cOllolllrl by
Ihl5 Covo,oge Form. at OUI opllon. wo will
olther:
(1) Pay Ihe lIolue of losl 01 domogod p,op.
erty:
(~) P~,V "mo cP'S1. .'1'j9Polrlro or replacing
thij oS,I.Qt domouoe prOpo,ly;
I ., ,'I
(3) Toke 011 01 onY,pert of Ihu ploperty 01
on ogloed 0/ opprolsod voluo; or
(4) Repolr.lobullddl roploco Ihll propllrty
with other PIOpOrtY 01 IIko kind ond
quality.
b. We will glllo nollce of our I1110nllons within
30 days after we rocelllO Iho IWO," plool
of lon,
o. We will not pay you more thon your fl.
nonelollnlelllst In Ihe Cove,ud P,ope'ly,
POOll 6 of 10
....-..
.
d. Wu moy odl~kl~los'~as..wllh"hu owners of
lO~1 0\ dYllIP,gp~ I!Iflpurty If olhel Ihon you
If wp ~lav, lIe n,w,mr,. slJol1 poymonl5 Will
satisfy Yl/III /i,IMi~\s,UU911'~IIJ~ ,101 Ih,uoWn,
els' propollY, Wo will nol 'lOy Ihu OWIIOIS
mOlO Ihon ,1I1dll 'Inllncllll InlQlost 111 Ihu
Cllllllrlld plbpbl1~." , '~ '
I 'I "II 'II '
O. Wo 1I10y qlllcl III IMllfllj YIlII oU/llnsl Sll1l5
"'lllllg frOI1l c1alms'lJl ownols 01 ,,,oplllly
Wu will 'do Il\ls'/l1' 011/ b~pon50, ",
f, Wo w\Il";;f1Y' 'or Cll~ulu'I(,lou IJr dllll"I\l1I
wllhln '30 ijnY6 1111", 'wu rllculvlI Iho SWOIII
1)1001 uf los5. II'
(1) : vi1'Il 1I0vII coinpil"'l\ :""11I; /III 01 Ihu 1/llIm
of this COVUIIIOII 1'0'1; olid
(2)(0) Wp hOVoIIyoc,l,lWL,oUlqonlenl wllh
you 011 tho omolml' of Iou: '11
(b) An app'iolsoldWotd 'ilos' boon nllldll
6, RlIQovarud \>rbparly '". '" '
If IIllhllr you 01 wo rlleover any plopolly 01101
loss 101l1e11lYIII, Ihot pallY mU51 plllo Ihu olhuI
I)IOmpt, notleli" AI YPIl' oPlloh, tho PlOPOIlY
will ~1(loifUII)O~ 10 YOII, :Vou musllhun relUfll
10 IlS the amQunt Wll paid 10 you for thll
propellY, WlI wlllpoy rllcollllry lI~plInsos and
Iho o~ponlos 10 lOl,olllho 11Icllllbrod Prollu'ty.
subjuctlo Ihe'tlrnll of Irls11lonell,
6. VOOlirillY .. ,,,.., ,II
II Ihu hulldlnu whQ/1I 1051 or tJlIIll/lllO OCCUII
ha5 IJQon lIoconl fo, mo,o Ihon 60 con6u.;UtlVIl
dOY5 bolore Iholl06a 0' dOlnogll, wo will:
o. Not pay for any 105s 01, Ijomogo eoulod by
any of tho lollowlno e\lon If Ihey ole COV-
IIlqp Cduse5 of L065:
(1) Vondall5ml' ' ,
(2) Sprlnkl\lVo" 'erikoga~' 'unlOS6 you hove
PIOIOCllld the ayslol1l ngolnst IleollllU;
(3) Bulldlnll Oloss hruQkooo;
(4) Wolllt do/noon:'"
, I
(6) Theil; 01 '
t' ..
(6) Allempllld tholl.
b. Redu~e the "ohMSi1i we would' othelwlso
pay 'or Ihe 1061 or damage by 1 6%,
.
,COPyrIOhl, ISQ Commorclol Risk SO/lllcQs. Ine.. 1990
CP00101091
A bulldl/1\l11 lI~e~/1t whon II d"UI nI)l <:uIIIIIII'
Bnoug'\ bUII/1BU pBllon~1 PlOllully III eUllduci
nUllolllory opulollonl, ,
Bulldlngl u/1der e01l511Uc1l0/1 010 nol CUlltild.
orB" yocol11
7, VoluotlO/1
Wu will dlllurllllnll 11111 \llIluo of CuvQ/1/l1 I'lop
oily III 1110 UIIUI1II)lloll 1)/ <Inll"llIlI nl 101h)WI
0, AI oClUol cnsh volllO 05 01 Iho 1111111 ulloti5
or dl)/1I0IlU, ollCUpl nl prollldud In II., u..
d., e, olld f. bulow,
II. II Ihu L1mll of In5uronl:1I lor lllJlldlllU hi"
Islllli Ihll Addillollill COlldlllun,
Colnsulon,;e, ol1d Ihll COtil 10 ropolt u, III,
ploco Ihll domogud IJlJildlt11l prollorly lti
12,600 01 le55, wo will I'OY 1110 CO'1 01
buildlno repol,s 01 ,0plocomol1l,
Thl5 p,ollltilol1 d005 l1ul opply 10 1110 It,I,
lowlno e\lon whul1 nllnchod 10 Iho 11I111<1,
Ino:
(1) Awnln05 Ot 11001 <:0 \1011 11 llti,
(2) Applloncos fo, tlJlllllurnllll0, 1101111111111111,
cooklnll, dllhwntilllllll 01' IlIunduIIIIlJ. 1)/
(3) OUldoor O<IU'Plllol1l or Ill,"lllJ1l1
c. "Slack" you hn\lu tiold hul nol dolivO/od 'Il
Iho solllnll' !idco' lotis dltieol/rll6 ol1d ox.
pon501 you 011l0rwl50 would 1I111111 hod,
d. Glos5 01 tho C051 of roplocomol11 wllh
lololy glozing mOlorinl1l 'lIqulrlld by low,
o. TlInom'5 Improvcmel1lti ond BlIllotlllOnl5
01:
(1) Aclunl c06h \loluc 01 Il,u 1051 or dOIll
oged ,property if YOll nlllko lepnlts
prQrnptly,
(2) A pIa portion 01 YOlll orloll1ol COtil II YOll
do not moko 'ePillt' promptly, We will
dotormino tho ptO!1mtlQllotc vnlun n~
lollows:
(0) Mlllllply Iho mIUII",1 c061 by Ihe
numbor of dnYI I,om thu 1055 or
domooo 10 Ihu ollplrotlol1 01 Ihll
le05e: and
(b) Dlvldo Ihe omounl dOlo,mlnod In
(0) obollo by lho numbll' 01 days
from Iho In51ollollon of Improllo,
monl5 10 Iho OXpl'Ollol1 ollho 100511,
CP,OO 10 10 91
.
.
II youI IUOlB contains n '"nuwnl Oplllll1
lho nlllllrollon III IlIu IIl1lllwnl Opllll1l
pOlIOd will IlIllloclI Ihu IIxllllnlloll III 11111
leofie Il1lhl, PIOCldll'",
(3) Nollllnull olhuli pny lor IIlIHllrti 01 II'
plocnl11l1nl
t. Volunhlll Po pars nll<l HIICOld5, Inl:hI111"1l
Iholo which UXIII Oil Illuctrnlllc 01 1111111'
,,"IIC ","d"1 (olhuf IlInn pIIlIHlt:knulI<l ,011,
WOIO Ill0llrnl1ll), nlll1l1 I:otil of'
(1) Illnnk IllnlUllul1 lot IIIJ1rodllelnu 1110 IU
cordti, ol1d '
(21 Lobo' 10 IInll5cllho 01 CIIJlY Ihu IIICOldti
wlllIn 1110/0 Is 0 dupl1cnlll,
F. ADDITIONAL CONDITIONS
Tllo lollowlllg' c0l1dlllol15 apply 111 olldillol1 10 11111
Commol1 Policy Condlllol16 Ol1d 1110 Comll1utc,,)1
P'opotly C0l1dlll0115,
1, ColnSUIUI101l
If II C0111611101lCll plllcol110IJO 16 "hoWI1 "I 1110
Dcclo1'01I0115, lho lollowll1lJ COl1dlllOIl Ilppho5
O. WII will 1101 pny Iho lull nmOl/111 OIIlI1Y 1,,55
Hille 1I0luII of COIIOllld I'lOpotly 01111111""0
01 IU'6 lImo6 tho Coll1""""'<:o pO'Cel1ll1lJ"
Il1oWI1 10' II In Ihll DlJcliHll\IOl1ti II UIIlIII",
IhOI1 1110 Limit of Il1til/l1Il1l:0 for the pl"P'
arty,
11151110d. WlI will dOlolmll1u 1110 mosl wo
will poy usll1l1tho. 101l0wll111 510pn:
(1) Multiply tho lIoluo 01 CUllo,ud P,oporty
01 Iho 1"110 of 10tis by Iho COl1l5urol1ce
POIClI111000;
(2) Dlllldo Ihc Limit 01 II16lJlonco 01 Iho
proporly by Ihe Huuru dolormll1od 111
5111p (1); ,
(3) MIJllIply tho 101111 11Illo"nl of 1061, 110
10'0 1110 oppllcollol1 "f 'lilY dodUC1Ihle,
hy lho IIOlllO dOI01Ill"",<I III 610p (2),
ol1d
(4) Sllblrncl thll dodllClIhl1l l,om Ihe IllJUlO
dulellll11111d 111 .Iop (3),
We will pay tho omoUl11 dOlormlnod III s1up
(4) or Ihll limit of In5u,oneo, whlchu\lo, Iti
loss, For Ihe 'lIl11olndor. you will oitl101
hovo 10 roly on olhor II1suronClI m nb.orh
Iho 1055 YOU/501l
Copyrlghl. ISQ COl1lmerCilll RI5k Sor\llees'. Inc" 1 990
Pollol7 of \ 0
,.;
. '''",mpl.',Nll,' (Underlnlurence);
Whom" .
'tIN," '~.\~,~::~' Iho 'jll~p'.e'lY "
. $260,000
'Tho ColnluloI1QQ,plllcontego,' " I
-'llr ,II J. , " . 80%
, JhPf~II1.1'h pI If1SU', once , ,
,f""q~,. .' ,,0100,000
."Xlill, 'AAyc,'~le I, 0260
- 111'0 ,p~q~nl \II 1066 II' , 0 40,000
I II ~Wp ,lJ.) ;,025,0,000 x BO% ~ ,029P,OOO (Iho
Itllnlmum 011l0UllI 01 II1SUIQnee' 10 111001
~OUI Colnsur,ol1clI ruqlJlrlll1lonls) "
" "'~top (~): 1,19,0;0.00 ;. $200,000'" ,60
Step (3): $ 40,900 x 60 " $20.000 '"
'O:I~'M (~)i 0 20.000 . $260, ',' 01 g,750 ' :
'.' I,WOlwlll pay 110 mo,o thon 019,760. Tho
rornolnlng 020.260 15 nol COIIllIOd. '
bomplo No.2 (Adoquoto Insulonce):
WI,lon:
, Thol lIolue 01 thll proporly
15 ,
" Tl1"l~olnSUlon~o perconulge
" "",)0. t,ls .
, 'J "I\I',Jlmllllf Insuloneo
01 I.,,, 'w,lt,ls . ,.,0200,000
The DoUucllblo 15 0260
The amount 01 1055 Is $ 40.000
','" Slep (1): 0260.000 x 80% ~ 1200.000 (tho
minimum omounl of Insuloneo 10 moot
, "Y'our Colnsulonce loqulronlllnls)
, , 11'~' I '
Step (2): 0200.000 + $200,000 . 1,00
.,,~.II'P, (3): $ 40,000 x , ,00 ~ $ 401000
'I ",5lep (4): 0 40.000 . $260 N 139.760
. We will eOIlDI the $39.760 105s In exce66
. of, Iho Deduellblo. No penally applies,
'11."'11 one L1mll of In5uronco op'pllel 10 two or
t.,', mOlD"ile'po'OIO lIom5, Ihls condlllon will
opply 10 Ihll tolol of ull ploporty to which
,I ' ',Ihe IImll oppllel. ' "
Il'"
0250.000
80%
,I,:'ql.rr ."
I" n ~. ,.~.
, 1;1
I I.....
,II,
",I ' ,
,-
,
';Ili!fI1f.,l, tIM..m'p'eINoI4\t111l ',', Illlj,IlIJI'lf,.1 f.,
l/tlllt 1 W""mll'~ 1\11':lllH .:d1j 11 . 1t/I.II,jl!1
Th"lIeIUo,llf p,.jp~W~'I~:' 'II,.'"..
.[lI,''''" '.lfIlilltY..,\JooeUOIl,Nl).l"" 'II' "" \,*'76.000
Bldg,' nl,'ocotlon No, 2' ''''''nbo,ooo
. ill"r, I'
PersllnollPlopolly 01 'lo """ .\ J ,
'" "" 'LoClll1o",I~OI 2'1 . "'V, 'ill..ll.QQ
-1/\' I t I', 1fI,lIH))I;Ii'1I I'" ',",! II ,.2..60~OOO
.', i," );\lP.JrnII19Ij!;Qn~", " ,.. ".c' Jl "
, ".\ ," l/prGPI!IRVQ 'o'"II.I~,. "I', ,
The L1mll 01 Insurol1clI for ., ..I)
'" 11"'h"I.l\~I,I~I\lg~.o[1d"I'RI~pl1ul ': ,<I
,I' "ih",:~lIroIlY'I~,'~t ~q~oIlOl\", , ..
',' lIiiqNp~ I I"pnd ,2,1",,~ ' ,$180.000
,I "',,'Thll ,OQdOCllbloll~' , 01.000
, , ..'I , THo OnloUIlI,of,lols. le:Bldg. "
oull.ollotlonl,No\l2'...,'1,' (,", 'II.a 130.000
" .lPoloonot,Proporty 01
,. i ',"ILocotloh,No, '2,,' 'i
90%
lli..ll.QQ
., $60.000
Slep, (1)~ 0260,000 It 00% a 0226,000 (thQ
, In..,lll\1I,I))fJ~'T.1li.II,',n\lUnl. qf, IIJn\l!!l!Ujl!;)to 111001
, , "Ylli/! 'f pl\IP~II\IJP9,j,r~quIJ~rn~nts and 10
ollold ,'D poniJHy 5hownbelqw)
'~/;;plt21'!$\lijO:d~o. +'ml\,oof'.. ,80
, '""'III~ '1>"'~~W;$' ~)I!01In'" 'atj '~,n".'~ "
1"". ,\vP .\IlI,' ,', lit 'IIY,,~ ,~:r, 40,rnOO.
1"'1 ,'Step (4): 1 40,0001', $1.000 ~'139.000.
',1< We 'will pay no 111010 Ihon $39.000, The
" lemolnlng $11.000 is nol covered,
2,,' Mortgage Holder~
D. Tho 10'111 "mo"gooe holde," Includos Irus.
toe.. ' , I
b.' WIi'wlllpoy for covlJtod 105s of 0' domogll
to buildings or SI,ueturos 10' 1I0ch mortgego
.1, "".holdoWlhown 'In'lhe OoclsI8t1tln$ In Ihell
.'1.' ordorr,of: procqdonee. us Inlerests .moy op.
"I 'L lJ'. PQorloi!icol.\1 I "
C. Thll I1\Olloogo holdor hU5 'Ihe rlghl 10 rD.
." I eelllodosl' poymont ollen IUhll mOltgoge
",:.;1 ,holdor., ho~.' 'Ilorted. forllelosuID or 111"1101
r Betlo~ on Ihe building or sIlUCIUIQ,
, f.',' f."II'1
""ll"llt:'''-!' /11,jr"r-I, "II
~!~, II' Iftdnltlll ,,{ , 'v,
.'" 111'1 I", ,<., 1'1"
/1' I ~
'",
,. .1, f.' ," ,
4
Poge'B bf',1,O
Copy,lghl, 15Q, Commlltelol Rlsk,SetvIC,es, InCl. 1990
CPI00'10,10'91' ';
,
i
d. II WII dellY YOUI eltlllll hllCII"IIIII' YIILII Ill:l~
III bllllOUse rOU hnvlI flJlllld 10 COlli ply wllh
the le'lII~ lj 11)16 COVIII~IIO rOil. Ihll 1l1l""
11000 hplilOl 1jI1I( '61111 how Ihl! IllIhl 10 III
cllllle 1055 Illlyllllllll If Ihl! 111111111"11" hohhll
(1) POY5 oily IIIOJilll/lIl <1\111 l/Il<lllt II". COli
O'OOll 1'011 III <HII III'll/Uhl II Y"" IlIllIlI
follod 10 <I" ~O,
(2) Sl/llI1l1ll II blll'HIlI. bWl/II' bll''''"l1lll' 01
It)tili Wllhlll GO dnYtl uflm 1I/I.:I11VIIIO no.
lIeo fUJ/lIllfi of yuw 1l1lllHtJ 10 de) tin. ill1d
(3) HlI~ Illllllill<l lIb 01 lI1lY 1;11<111111] "' own,
U/5hlp. OCClJlIlI'":Y 0' blJII~llInlllll
chollOu III rllk known 10 lilli' ""111111111"
holdel
All of Ihll 11I'I11b 01 thlb COIlIllI1I1I1 I'oil Will
lhllll apply dtrllclly 10 Ihon1l1lluOII" llIlhlur
II, If WU pny IhlllllortUl1ulI holdl]' 10' ""Y 101.
01 domooo olld dOilY pllYtllllnl I" yo" ho,
CQU6Q of your IJctti 01 hUI:nutit] YOlJ hnvu
fnlled 10 cOl11ply wllh tI,o IllII"S of tillS
COllorl1l1o 1'''11:
(1) Thll 11l0"UIIUO h,,'d'!I'~ "Ohh ,,"do, Iho
mottOlJ(Jo WllIlJo ItllIHilL'lIud 10 lJ5 10 11m
(J)(.tunt 01 tho OIll<HJIlI WfI !lilY, iBId
(2) Thll 11l0rtUIIOO ho/dlll" IIUhl 10 IIICO\lOI
Ihll full Ol1loul1l 01 tlllI I1lrHlIIIIUO hold.
lIr'5 elollll Will 1101 bo ""PI111l1d.
At OUI opllol1. WII lIl"Y P"Y 10 tho motluoOll
holdor Ihll whole p'"lelp.llon Ihllllll1/IUI1OU
plus any ar:crued IIllUH~St. In Ihlti OVlll1l.
your mortgogo ond nolu will III] 1""lsfu"od
10 us and YOlJ will pay your U!lIHIII1I1lU
11l0/l{JllgO dollllo l/S
f. "wo concollhl5 poliCY, wu Will \11\10 wrll.
Ion noli co 10 Ih" 11l0/l1l"UIJ IIoldll' 01 luo~1
11) 10 dov5 bulo/ll 1111, "IIu<:II\l1I rill It) 01
cnnclJllulloll If we CIJIlC1JI 101 your 1101l
pnymollt of IlrOlllllllll, or
(2) 30 dOYb hofo/ll Ihll "II"CII\lO <111111 01
coneullollol1 II wu clIIlell1 lor 1I11Y othor
l0050n
g. If WlI oloCI 110t to rlll10W Ihls policy, WlI
will gllle wllulIn notlco 10 Iho morlgoge
holdllr 01 le051 10 dOY5 bll'olQ Iho lIXplIO'
lion dote of Ihl5 policy,
..
.'
..
CP00101091
.....
0. OPTIONAL COVERAGE5
II Sl"IWIl III Iho Ooelu,OtloIl5. Ihll IlllhlW"'IJ Op
lIollul COVOIOtl06 apply SlIllIlIlIloly III ,,"eh 1IIl/ll
1. AUlood Vnluo
II, 1'1111 Addlllolllll COlldlllllll. COlllb"""'"'
If,,,,, 1101 upply 10 CovlIIl/ll l',oplIlIy III
whlclt lit" Opliolllll Cll\llllllUII IIppllllli 'N.,
Will IlIIY lltl I11CHU 'Of hlMi of 1JI dlHllil\J11 10
Ihlll /lflJpolly (I Hill , thlt PlOIHJlIIOf1 Illilt tllP
1.11111\ of IllfiUtlllll:U UI1l1el 111I!! CLlVl!li/\ltl
Pllll hH Iho pfOpUtly IHUllti hI IIH! A~J1I!I!d
VlIIlJl/ .1t0WIl fo, II "' lit" DIIClilrllllom
b. " Iltu oXplrllll'1I1 dlllll fill lI"b Ofllllll'/l1
COVUlO(}U fihown1ln lhu OlH:IHlllljl)fl~ Itl nql
OXIOlldlld, lit II Ad<llllolHlI CIlI,oflllllll,
COI1l611'0IlCll. 15 Inllllllllud '''HI II"" 0"
11011111 COVIIII'llll "'P"u'
C, 1'110 telm!) of 11115 Oplhl1wl CO\ll!rill.llt IIlJply
only to 106601' dU/lllllllJ lhlll OCCt/f11
(1) 011 or nil", Ihll "IfIlClI\l1l ,'"1,. 0' lit"
Oflllollol CO\lIl'"lle, IIl1d
(2) Aurore tho Auruud VillLw 1!)(Pllilllllll 11.1111
5howtl III tho OoclornthHHi 01 thl! policv
o):pirotlon dOlO, whu;IIt.1VtJr OCClJ/~ fll'il
2. 1I1110tl011 GUllrd
o. Tho li/lllt of In5u'"IlCO fOl p,op,"ly 10
which Ih15, Opll,oll~1 Coyurollu opplrlld Will
nUlolllllllcolly 1llc,ou5u by Iho onnuIII flUI
cOlllollu shown Ii, tho Declo'"llon"
b, The 01110UI11 of IIlCI,0I'611 will Ite
(1) Tho l.II1111 01 'nluII,nclI 111111 1If1f1II"d Oil
Iho 111051 ruc0l11 of tho pollt.:y IIlU!fJIIOn
dOlO, tho policy i1fllllVllttillty dUll!, or illlY
olhor polleychllllge 1I/1101ld11lU till' LIIIlII
of IIlSU'OI1Cll. 1111l1l6
(2) The pcrcontnOti of "111 Hili I IIlCII!i1!jl!
shown in thu Daclilfiltl0l15, l!Xprl!~l~ll!d
llS ~\ duclmol (OXlIIllplu n% Hi Ol1). It/lll!~
(3) Thll IllJlllbe, of dllYs 611'CU 111" 1"'\111'
nino of Iho curtont poliCY YUiIf or till!
olfllCll\lo dOlll of 11m m05t 'lIelll11 policy
chango olllol1dlng Ihll l.I""1 01 11l6U'
once. dllllded by 366,
Copyright. ISQ COll1morelol Risk 5orvlcllS, Inc.. ,1990
Pogll 9 of 10
IMlmplll
II:, .
'" "thnppllc.bll'Llmlt'
or Inlu/onol II
Till InnuII po/clnlogl
Intill~BI II
The nu'mbol of dOYI
linea Ihl hog Inning
01 Ihlt polley yeol
(of lIst policy' ,
c,h~nllo) I,
rho Imounl of ItlcroosO II
$100,000 x 08 x I ~6 + 366 ~ 63.200
, , '
.1. Repl.eemont COl.
I, RoplocomO/l1 Cosl (wllhoUI doduello/l fOI
depredlollon) '/bplsCOI Actusl COlh VolulI
111 Iho Lou Condlllon, Voluollo/l. of Ihl.
Cov.,oge Fo,m,
b. Thll Optional Covlrogo doos not OPllly 10
('I) P/opelty 01 olholl:
(2) Conlent' 01 0 ,0sldoncl:
(3) ~onulerlpI5;
(41 Walks 01 lIrl, nntlquol 01 /R'O 'l/lIcl05,
IllQludll1g elchlnqs, PIC\Ur05. 5111luory.
mOlbl05, bronzos, pb'rce olnl nnd IJ,'e.
l.blocl'O/ I, '
(6) "510C~: u'rilen lho Includlnll "Slock"
,011t1~n .Is Ahown In Ihepllclolollon5,
o. You may make 0 do 1m for 1055 or dnmogo
cOlleled' by this In5uronClI on on nClllnl
cosh lIolulI b051s Inllood 01 on II ,oploco.
monl COIl bn515, In IhQ ollllnl you ulocl 10
hove loss or domogu 5111110d on nn oClulI1
cosh lIoluo balls, you 1110Y 5tlll moko 0
elolm fOI tho oddlllonol eOllerooo this Op.
1I0qol COllllroOll p'o\lldlls If you nolofy us
of ,YPflr Il1Ionl 10 do so wllhln 1 BO dtys
0110,1 tl10 1055 or dnmnge,. ,
"
"
"
noo,ooo
0%
1~6
tt'lIpr. "
'J/'j .'
., '....Hl I
, "
~
~
pnlid ld Of 10
,~
d, Wo will nOI PlY I)n I lepIIO""lnt C061 llll
, '''III' lot Iny Iou 01 dlmlgoldj, "
, . '(H"\J.~III"I~D lOll d( '1J~tl\~g,d' pIopellY III
'~\lIubIlY /,pllled or'/iiljloced; and
, , ,
(2) l,Jnlell Iho lOPOItS 0' leplncQIllOnl II/II
"modI/'ll 10011 06' ;09~.bnobly p1lS5111lu
altaI Ilia 1066 0' dOlllogll.
D. Wo will. nOI pny mOlo' for losl 0' dnlll/llIU
on' 0 Ibplocomonl cost hlllls lhdn Ihl! 101111
01:
(I) 'Th,~'tlnllll)lll1sUlnlII)O O'I)~lIeOlllll 11111...
'101,1 Or d,Ol~lllgod PlllP~"V,:,
(2) ,TI!O eqlllo 10plncp.,pl1 tI1e SOI11U P'UI11 ,
1101, the loBI or dnmoged propolly wllh
olhol prqporty:
,'-1'1'.<' " 'I ' . . /.
(Qt. 01 comporoble m./lI/lol Ind qUllllly.
and
(b) Usod .for Ihe 80mp p~rpOle, 0'
(3) lhe ornounl you actually spond thnl 15
nOllll6l0ry 10 101101/ 01 reploeo thll 1001
0' damaged p,uporly. '
H. DEFINITIONS
1. "~01'4tDnts" moon5, ony, oolld. ll"lJId,
on5odUb 6} Ihe'l11ol Irlllnnt '0/ eonlonllnnnl.
IncludlllO smoko. IIOpOI;' 000101 :fum1l5. owl5,
olkollsi 'ohemlcols and Wallo, Welle Ineludll5
mOle"bl, to bo leeycled. reconditioned or 10'
,clollllod.,'
2. "Stock" mennl mOlchondllo held In SIOlnOll
! o/'fo/'sole. row motollols snd In'proees5 0'
flnllhed ooodl. Including suppllol ullId In
, their pocking or shipping.
" .. 'J', .~I I', "
, ,
I , " , " ,y ,
,;
011
"
"I' '/~.
, " fr
. ~t~
, 'I, .
, , .;
/, ''''1 'I
.' "
, "
I
,II
, t.'
"
, It", ,1
", ,.
CoPvrlght, 15Q Commercial Risk Sol'vlaoi, lr1c,; lIioo
Cf!;OO fO 1091
~'
COMMllIC:IAlI'lHlI'lll' Y
CAUSES OF LOSS. SPECIAL FORM
.1
Worde end phllBOS Ihol oppuollll qUlllation I1lnlks h01l1/ Spuclolmonnlnll Hulm hI SI)l:II11n F. ' OUflllllhlll1i
A, COVIIRED CAUSES OF LOSS Volconlc IIclhl/l ,'ous 1101 lI,cludu 11111
Whln 61leclnlll nhown In lhll Duclo'Ollolls. COy. co6l 10 lulllllYlI uoh. dUlt or 1l11l1i':llluII/
orad Cuules of Lo~s Illoons RISK5 OF DIRECT IIlllllur IhllllltJon IlUI CI/IlSU dllllCI Illlyn
PHYSiCAL LOS5 Ilnlu5s Ihu 1010 il: leal lonn or dllllll/llu 10 Iho du,cllllud
. IlIollUrly,
1. hcludud In Sur.lIoll B" Exclunlonll; or I A I
' o. Qo~ornmllntn ctOIl
2, lImltud In SlIcllon C.. 1I1ll110tlons;
II I' II Sullule 01 duUlllclIun ollllopOlly by urdu,
'0 0 OW of OOIlU/llllllll1lnIIIlJlho"ly,
B, EXCLUSION5 aliI we Will PI/Y 101 ucts ql dllltruclloll 0'
1. Wo will not pay fOI loss 01 dlmaue coulld do/ad by uove/lll1lulllol outhollly olld 10kel1
dlloCllr, or Indlllletly by any of the 'ollowlnll. ollhl tlmo of 0 flto 10 prQllenl1l5 spread. If
5uoh ass 01 dOllloou II lIxcludod /ogordloll Iho "10 would bu covlIlod ulldul Ihl5 COy,
0' any olhul causa or ollent that contrlbutos OlnOll POri
coneu/lonlly 01 1/, OilY suquonco 10 tho lou, d. Nuolanr Huonl
0, Ordlllonou or Low NucleOl 11IOCIIIII1 0' ,adlollon, 01 ,udIOUCII\l1I
Thu enfolculllelll of any o/dlnonco 0' low: conlollllnallon. hOWIIIIlII eoulIlId,
(1) Roglllollnu tile cOllsl,ucllon, U50 or 10' Bul II 10Sl or dll/lloOll by fila ,u5uII5. WI!
flair of all" p,operty: or will poy ft)/ Ihl/l IlIoulIlllg laos or dOIllIl{lU
(2) RII'Iulllnll Ihu IUOIlno down of uny o. Off.Promluo Selvllloa
p,opllrly, Includlnu Iho COIl of ,omoll. Tho follulo 01 powu, 01 olh'lIr' ullllty 5UIIIICII
Ing lIs debrl5, iUppllod 10 thu dllscllbod pIlImlle5, how-
b, Eorlh MOllamunt evel cBused. II Ihe failure oeours away flom
(1) Any earth mOllement (olhol than Iho demlbod prollllsos,
slnkholll collopso). such alan 1I0rth. BuIll loss or dUlIla{lo by 1I COllulud CUU50
quoko. lond5l1dll. mlnll sublldunce 01 01 L05s relults, WII will pay 101 Ihal'05ull-
1I0rth Illlklnll, rl5ltl() 01 shilling, BUI If Ing 1050 0' dUIllIIlI1I
1011 or domoOll by fire 01 explosion Ie. f, War Alld Military Aotlon
SU115, WlI will pay fOllhol IlIsulllno Ion
0' domooe (1) WOI. Illcludlll{l undeclorud or CIIIII WI/I.
(2) Volcanic lIruF,lon, explollon 01 (21 WOlllko action by 0 mllllnry lo,clI. ",,
lIUulloll, BUI I 105501 damogo by "'1I. c1udlno nClloll III hlndmlllO 01 dotond,
bulldll111 {Ilon5 hreokoge 01 volcanic InO 0(j1/1/151 UIl 1Ir.IIIOI or O~llllclod
action 'I/SUIl5, wo will pay lor Ihot rll _ alloek. by ony OO\lOllllllllnl. 50\llllol{ln
sul\lno 1061 0' dllmuoe, or Olllm IIIJlhllllly u51nO mlfllo,y pllr,
oOllnlllm Illllllr 1I00l1IS; or
Voleal1lc ;)clloll mllon5 dllect 1056 or
domogo '"5ulllno from tho eruption 01 (3) Insufloclloll. IlIbulllon. 'o\lolutlon.
e lIolcBno when tho 1011 01 damogo Is usulpod powm. or Bellon laken by
coulld by: govolllmenlnl aUlhorlly In, hlndorln[J 0'
( ) AI b I I bl I b dolondlnll aOllln61 OilY of Ihe511,
,u r 0'"0 vo con cOlt or 0 r 0'"0 W
shock WOIIOS; g. alar
(b) A5h. dust or portlculole molter; or (1) Flood. 5urfacu WUlor. waves, ,lId05, lido I
wBvel, ovo,flow of any bOlly of walor.
(0) Lava flow, 01 Ihell sll,ny. nil whelhor drllllln hy
All volclInle oruptlons Ihal oocur wllhln wind III n"l,
any 168 hour period wlIl.constllulu 0 (21 Mudslldu lit n"l/lIIow.
slllOlo OCClJfllInell
.
CP 10 30.10 91
Copyrlghl, ISQ Commercial Risk SONlcos, Ine.., 1990
PlIgll 1 of Ii
IIIllMfM
(3) WOlo, Ihot blick, UII hlll1l 0 IOwor IlJ
droln, Ptll :;:. ,,) I .1 J.I: ': ('J .'
(4) Wotor undollho gloUII<l su,Ioco ll'OS~'
IIIU on, 01 f1owlllO 01 soolll"U Ihrouoh
(0) Fhundhtlo'nk: Wbll~, 110018 'ol'pllvod
6YIIUQIIS; , '",
(b)' BUlomonIB."whothor pnllod or 1101.
or' '. 1111' "
(0) 000;5, WlndOW,lior 11IIlt< OP""I1I\)1
Buill 10~~lflr'J9~I'lUUP'IJy"lillll Yl'pIO~IOII 01
IP"lIklor 1001<11\)11 '"61111, WII will puy 1m
lI1ul 'o~u'lIlno'llisl(o"<Iulnolio':' .
II 11111' ~ ,. 'I
2. W" w/llnot poy for 10"; 01 domuou ,cou,,,,1 by
m ,o5ulllng flol11 oily'of 11111 folllJWlh\)'
II. Arllli\/~lly, qP\'1~,\I\\,JIi,9}~CliIR "~UUUIII. III'
, , ~J~din{I"qrR~/( p.,prqlllu,.},hol ,dI5,1U,'b6 eluc,
"kill dIlVIeOS, IIPIllrllllC05 or ~1'05
Ill" II 1065 or dUI,l,'",U!!, bY"fI"q..'05UIt. Wl!
will PU'! lor 11101 lIl~u1I1110 1056 01 dUl1lno"
b Uuloy, 'I'P'66 ,\l,'^,i~o ad')"" of 'l1lorkCI
<l, S/110,~lIfd\l'YllB\" o,r 'IJO~"hOI11. OllllclIlIlJllI1
"/11U~I}, 'lU ,Qt,,(l1rjll~tr III OIHl'Ollolll
d, (1) WOO!,jIW~IMr:I<Ii' '" '
(ll IR~, lo~8r~Q~I\l,I\, IhJlIlJH,'~" do,ooy, dolll/'
olP 1il'\1;J),IIl\JoP,?' IlIlo'1I"lofocl 01 '"IV
ql!/ 1~" 'fl.1 pr~nptl~ 11101, CUU5U6 II hl
d0ll1009, $[, qU~H\lY, 115911;
(3) SmoO;, .,',
(4) SlIlIlIn\l\'eror.kIIlO, 5hllnkln0 or OXIJ,'",
sian;
(6) InBoeto,'blrd5, rodOl1l6 01 olho, ollllnllh;
(6) Mochanlenl IJ/llnkdowll, Inr.ludlnll tup,
,turo o,r ~H'SllllO"cousod by ~el11t1ll1I1UI
,f9r.'Yflll fl(jwo~eqIt16 doe5 nol upply 10
ony r,lIAplllnu I061i or dOll1ol]o r.JlllSl'd hy
OII\IIMW,,r,01l1510n, .
('I) UIlI,followmu c,,,,,;us 01 105' I" I.""
60nohprQpo,t./
(0) 'Dompn€G6 at dlYllU5S of '1111101
pho/Q, '
\~) CH\1h.iJ~6, 'In 01 e~lrchillli 01 lompe"
ollJro;'or
(0) MBrrlnu or scrolcl1lllUI' ", ,
RUt II 10~B '<11 d,iriiooll by Ihll' ".pecln""
~IlU;'OIi 1111<;155" !ir' hui'rJlnO IJIBIi' hrllo' BIJ"
"" '... "," '.
Ir. I,
'1 t"
, ,'l..,
""".
.
" e~lioBlon 01 \'~n'" bOllolli, 111/11I11 PlpoK,
,~~ ',~ I,' .,' ~Q 1 cli\qUf.J \W j61(i'}1 ""lll/II/S OWIII/d III
1111' od 'by VillI, 01 Op,,"lIlId 11111101 your
cOllllol Bill II lOBi or <lIIIII"U" hy 'I/O <l/
riJ'{I;<<'~I' 1,';~:inftlllr~~~J' I: ?~f~!,I;~ilo~ ~'W~I ~~~
liiJo IlW!la~ I~'" \\~ .lht~I'O" ':1111 ~MA;V oj!
r~6~lliI1Q ~\I11~\, VI!I.,nWlrl'lhm,\',t U~HW or
fllol wlllllll "lII'I,(ur,,"~o ul dllt'ill.'tV,'~ 1111
III wlq'll\, 1111I ,1JI.~~'lq~,'I!,lhlllll'I,~..I/IIII,,"h
ld,kh 1110 Y'I'1l6 of WIIIIll, I): 1'J1b~
(.,1, III l,... ,II t ')1, I' " I . , t
f. C""!'.IlIJqI'S Ilr 19I]~nl~d l"I/PU~~,Or Ipnk"l/l/
01 wnlU~ lI\u\ 'OC':I)/I' OV,tI' 1I \fo/(or! 01 t.l
dllY6 m 1l1OUt. .IH'
'J, Wnll", olhlll 11t/111t1.. 1",WI:I/I"OII:I1"oll,,1I
1ll1l1,C!1I11 \h()),I~I'.~h '1/,'IOWIi fill/II P'!(I1I Il/Il I I.
h~II,Ii)U.,p, \ f81V~Jti,?/,1,lliIJ ,PI ,0,1\111I"II'1IJ1'"
" ""W.l\\,,'~9~cprl,v ,\\%Plql\'~"~'IJ IYIIOlllb)
" C,IIU5,ll<l .llY"W lip IJri(l.l(J ".0111 (1,o.'~III1\). 0'
Imil), "'.'fill \1111 ' I" , "
(1) You de 'IJllir) llo~IJ I,?"tllylplllln 111'111 II'
11'11 lJ1Jllllitj\l or 5itIU;IU,fU; t)t
I" {~)'Vl~lj ;dt~t;l \)h~"k'('llJil~;l;~'nl OIHl I'll II
" "lho'M'rf(JIy ,'~ho 111I01'10 I'lnlnl I' ,"
I \>1"IoIl/H\ '''I k I
h, O"illono,' 01 crlnlnn I,CI 1'/ ' ,
V(lliP dnl'tlilil~ '~Mp'/II,jl!ir, <11"", " ""
,u" ' , "J." 'tI'llihdll~lwil,ijptllfl'rll1\~"'" "" 1I ."""
11/ ,..,.IIr:H,\ you rrithHHI\I1,' IJII)I... ,'Iv' Ifll\,
1tl1olllHiU. '""n1 j', nl"\ fll\ 11
(1 l Aelinoolone '" In , "'ll'illlr wll,' alII
t!tlJ;.OI 111.!IlII! \
(;1) Wht!\I\1lr 'IJ,'ntYl' II i"l'",,,, "I/I.l!) Ih"
"/ioo'ls m er\\lllo'I"I..., I ,
/1' , . P I 1)'11 (ll tHiI} i , "
ITl1161.~~ \I,51111\1 J,Il.i,5 ,q.; "..~'Pl\ '(I H t~, of
d'lOlruellon by Y"l.l i"'JIpl"I'" i 0\;\ Ihofl
b~' omployouG ;Ii ".~t Cl)\I01l!'!. ,"
" ",i:,:~~,~l;ltPsY;&ih~Ylli' vr,.i,','dihi' JlinJo''\y hV y')IJ
UI 011Y.81H\,,~ls~,,11 W';I?1l1 yoo hilI'; ,,",
I' 1I11',lyd,Ilj(I t1WP~!\Y,'( ,,,'!u,c~d 10 do .0 hI'
'" ,Y (rIlW'YI\'i.\'h~~J,~,IIl,l), II'r.k. dOVIClI 0'
:Ij~'f p I ,,111!J(j
'0 " "Hlflll0lJ Ii: ' '
,J. r,",I'I, ",I~m HhP.lfII ~"JU\ \\l JJO'S"I\1I1 JJI'Ii'
"",.:Jtt~;)'I/I~ltPHl~~.\ 1)llIjl- '
k. COIIII!,""', OkV1PI "~\P'Ollidod b'lloWII Ihe
''''''', .1}1l,l1l18",~:"rr..q,~qlllJi~,,tOI. t:oll,qnsc. ,",I It
10SIi 'II irlJmqQIl., lJY '!. Ca\leld. ("011"" rl,
L05. rnSllllS urtl\c'do5c/lhed p',lI)llIe6, I'.
,,' ''11111 O"y fi,V'lhHi Idhl\Il'nfJln\;~\" '" ,'."."
....nil 1;'/1,1
\
;
.
rill! q Ih '.1 ,l(lihllj'rJ, ,ll..rl I' !
II.:' 'II- t )Ilti'j I.~"n tH! r 'I
H:JII', 'l,T;': ',' I '
'l
poge 2 01 6
CilpVtlOlll. ISQ CommtiiclBI.~lok SerVlcoi. ,IdOl) ,~09n
CP " 0 30 "Of!tr'
,,-..
I. DII~holg', dllPIIBOI, SOOPBIIO, 11I10'1111I)11.
,,'oBle 01 elCBpo of "1IOlluI0I1IS" uIIIIIU Iho
dllChllgl, dlsperBBl, leepBIIO, 11I111 rll II 011,
rel.olO or OIClpl Illlulf CBUIOd hy OilY <)1
th. "Ipeclllod COUIOS 0' 1056," lIul 111061
01 dornogo hy Ihll "5POCI"Od CIIUS05 ul
101S' Inulls, wo 1'1111 puy 101 Ihu ,ululllllU
dDIIIOUlI CDUBlld hy Iho "611111:lIll1d I:IIUSIIS
011018"
3, Wo wllll1!)1 pay 101 IU56 l)I dOlllu,," alll/5l1d hy
or rOlullll111 horn III1V of Ihu lolloWlIlu lIul If
Iou 01 damollo by II Covolod CIIU.II I,f Lon
lOIUlls, wo will PIlY IUI Ihol lusullll'" IlIS6 01
damage,
e, Weathel cOlldlllollS, Uut Ihl5 II~CIUSIOI1
only applieD II wllnlhol e0l1dlll01l6 ClJ/1ltlh.
ute In any way wllh I COUIO 1lI OVO/1t ox.
elUded In porogluph 1. obovu 10 Ploduce
tho Ion or dOl1l01l0,
b. Acts 0' dllelllon6. II,cludll1U Ihll IUllu,o 10
BCt or dseldll, of O/1Y pOtlOI1, IIIOIIP, 01,
oonlzollol1 0' uovo/nl11el1tnlbotly
e. Foully. Inodolluulll or dolocllvu
(1) PlonnlllU, 101l111g. dOVllloPllllll11. 6UI'
lIoylng. IIlIng;
(2) Oe5Ig/1. Ipucllicollons, wl),hflllll1shlp.
lepalr. cOlIsl,uallon. r0I10Vallll/1. '0'
modeling. grodll1g. e0I11I10CII0I1.
(3) Moterloll usod In lopolr. conelruetloll.
renovation or ,011l0dollng; III
(4) Molnlenonco:
of porI 01 011 of any Plopurty on 0' 1I11 Ihe
doeerlbod prOlnlslIs
4. Speelol Exelullons
The lollowlng prcvlllons oPJ,Iy only 10 Iho
lpeclfled COllerooe FllI11l5,
o. BuslnesB IlIeorlln (And hlrll hplI/1se)
cOlloroge Forlll. BuslnoBR l/1oomo
(Without him Exponsll) ClIllllrllge
Form. or EKtro Expo/1s11 Cuvorllgo
Form
We will not pny for:
(1) Any 1066 caused by 01 'olulllno Iro",:
(e) Domsgo or destrucllolI 01 "f1t11lhod
slock": 01
(b) The IIIno roqulllld 10 ,ellroduce
"linllhod Ilock,"
This exclusion dOUR 11111 opply III E~lro
EKpunlu
(2) AllY 1055 ~oul8d hy or tQsullII'U 1111111
direct phYllcnlloBl ut dlllllllUU III ',11110
CH telovlllon olllQl1llnl, IIll:h'lllIl" Ihllll
leod .111 wiring, .1110111 01 lownl S
(3) Any Incleoso 01 10ls eOIlBlId IIv I" '"
lulllllg IIOIll
(0) DlIloy In lebulldlng. Ibpnl'II1U 1)1 '"
placll1g Ihu 11Iopolty or 101""11"\1
'OpllOIlOIl5," duo 10 1/11111111'1111<:11 .11
IlIe 10~Ot10Il 01 tho rohulhtl/1", 'IIPOII
01 leploclllllllnt hy 5l/1kll" 0' I)lho,
pOllon5. III
(b) 5ulpllnsl01I, Ilplu 01 eonclllIlIllOI1 ,,,
In,y IIcel1lu, 1011111 'lr eOllltllcl I !ill
If tho IUSlllll1slon, lop5e 0/ (1I/1<:IJIIII
lion IS dlloetly eBused by 11111 II"
pension 01' 'opo,otlo/1s," WlI Will
COVlIt such los~ Ihol Ufflll;lIi vo."
Buslno5s Incol1lo durl/1g Ihll "pIIIIII<I
of '1I510,nllol1."
(4) Any Exltn Explll150 caulou hy ')I ",,"11
Ing frOI11 5U5PU11511l1l, IOJl50 m <:1111''''"''
lion 01 nny hCU/150, lonso l)I 0:0"""10:1
boyolld Iho "pllllod of ruSlmlllll'1I "
(6) Any olhllr C0I1SlI'llluntlollo5S
b. Loo.ehold IntllroBt COlleroge For/l)
(1) POlogroph B.l.lI, Ordinance '" 1.111'1.
doe. nol apply tll Il1lUrlnCO UlldUl Ihl5
COllorogu Form,
(2) We will not pay 101 any Ion CIILJIUlj hv
(0) Your eoneolllny Ihe Ilia Ill;
(b) Tho 5LJ6p01151011, lapse or ellncollll'
lion of any IIClllllll; 01
(e) Any othor cOl1slIquenllollols
Q. Legor LloblHty COlloraQe FOI/ll
(1) The lollowlno Excluslon5 do 1101 IlpplV
10 In5uronclI LJl1dllr Ihls COVlI'"UU r"'lIl
(0) Poroorllph 13.1,11., OrdIlHIII'" '"
Low;
(b) POlooroph B,1,0.. 00\111""'"""'"
Acllon;
(e) Parogloph B.l .d" Nudum HOllltll.
(d) PBleglaph B.l.o., POW9' FO"I"II,
and
(e) Parooroph B,1.1" Wnr OI1U M"IIO'V
Acllon,
.
.
CP 1030 1001
Cllpy"Uhl, 159 Commorelol Hlsk 5u/IIloos. Inc" I 9ao
PaUli :1 of Ii
(2) Oontrontulll Llobllltv
Wo will nol IllIIlInd OilY Olllllll 01 "QUIl.'
01 pay dumouol Ihlll you ole 10gDIIV \I.
ablo to pny, lololy by rellson 01 your
,0llUlllpllllll 1)1 Ilublllly III 0 eont,"el or
OUlolllllllnl
(3) Nuolll/ll HIIJllrd
Wo will nol t1l1fond onv elllll" Clt "slIll."
or pay any dOIllOgOI. 1056, ON pense 01
oblloolllln 1115ulllnU hOIll nur.lulIl III.
/lotion <It 'lIlhallon, 0' IlId,ooellvlI COli-
tomlnllllon, hllwevol coulad
O. LlMITA'rlONB
1. We Will nol PIlY fu, Ion QI 0; domooo 10:
O. 51um bOllors, sloom Il1P06, lIeQlll IInglnos
01 steam lurhlnos coused by 01 ,olultlrlg
'rom OilY condlllon 01 alieni In61do IlIeh
oqulpment, llul wu Will poy fOl 1065 01 0'
dllmlll,lI 10 lueh lIqulpmO/ll cllusod by 01
relull nil ftrllll Oil oNploslon of \lOSOS or 'ulIl
Wllhln the lUlllUce of any 1I,0d VII1501 UI
wllhln tho lIuol or P0550UlIS Ihlouuh which
the gOle5 of cOlllbu5110n H"55
b. Hol wOlor h!)lIII" 0' olhor wlllor heollno
equlpnlllnl r.;u..od by or 'esulllnu f,ullI OilY
condition or ollen! IIIIIdll such bollels or
equlpmenl, olhm than on lIxp10510n,
o. The Inlellol of any building or st,uclule. 01
10 pllllonol p,l)lll1lly III tho bulldlllg or
"'UOIUIO, eou511d by 0' l05ulllng from 10m.
Inow, sleel, leo. 5111ld 01 dU51. whothllr
dllvon by wind or nUl. union:
(1) The bulldlno or sllutllllO "'51 5Uslol1\6
d~muOll by II Cove,od COU50 01 LOIS to
Its 1001 or wolll th,ough which tho rain,
sn\l\y, ,1001, Ice. spnd 01 d411'On\ell; 01
,(2) Thll 1055 or domooo IS eouslld by or reo
IUItS f,ulII IhowlllO of 5now, 511101 or leo
on Ihll l)luhhnU or slrur;lu,o
d: Bulldinu n"l\uII/l16 IIlld SUppllll6 lull 1I1'
lochod o. plln 1)1 Ihu h,"ldll'U or slruclurll,
unlllll hold for 5010 by you. cousod by or
rosultlng houl Ihuh. liNceI'll 115 provldod In
0,6.11. bolow"j , , , I
e, P,oporty IhOI 15 ml65lng, wherll lhe ollly
oVldllneo of Iho loss or domogll Is 0 5hort.
ogo dl5Cl060d ,on Inking Inllq?,lpry, or olher
Inllonees who," Ihelo II no phY61col 0111.
donell 10 HI1I'w Whlll hoppellod 10 thll
plOp"'ly
4
4
Pegll 4 of 6,
,.-
", C\Ull.,. and downspout. oousud by III 10
sultlnu "om wllluhl 0/ snow, 1011 Clt 6111Ul
VI Propolty Ihot hll6 boon IIDnsflllllld 10 0
PO/lOII 01 10 0 1111100 I)ulsldo tho dllHC/lblll'
plomlus on Ihll bU6Is 0' IIlluuthurlf,)l1 1/1,
lItucllOIlS '
~, WII will nOI IIOY 11I011' fo, 10511 0/ ll/ dOlllllUU II)
ullln Ihotlll pull of II huildll'\I 01 61'uelu,u Ihon
.,00101 each pllllo. PllllU. /1lultlplll pllllu In.
sulOllllO unit. 11)111/'"1 III 50101' hOUlIllU p.lIlUI,
IlIlolISlo, 10uVQ/ "' 5hullor Wo Will nlll PIlY
1Il!'"' than .600 fu' 1111 1068 0' or dOlllllUII 10
butldlllg ulnl5 Ihlll lICcull ot anyone limo
lhli LlIlIltollon dl)os 1I0t lIpply 1'0 1066 0'
dAmoOll by thll "6PIICllllld causal of loss," IIX.
copt vondollsm
'3, Wi! will nol poy "" 1055 of or dOl11oUII 10 th"
fOllowing tYPU5 01 III0llelly unfon eou5ud by
Iho "ipuclllud "'ll""~ 1)111)'s" or hUlldlllU Ul1l65
brookAoo'
II. Voluoble I1UIJIII5 olld ,eeords, such III
hooks 01 ACCOUIlI, mOlH/5Cllpll. IIb611i1ell.
dlowln05. "/lId IIldox ly5l0111S, '11111. 10PIl.
dllC, drum. CIIII 0' olhor dOlO IlroeIl5511'0,
lo~o,dlno '" .IlIIIIUO mud 10. olld olho, ,",
Cllrds,
b. Anhlloll. And Ihlln only II they ore killed or
Ih/Jlr, dellrucllolI Is mode nllee650ry
0, Flog lie Olllclos such A5 olulwAre,:sIAtuA'Y.
morbilli. chlnuwA'u ond pOleololns. If h,o.
kon This l05lllcllon dOllS nOI opply "'
(1) Glon IhAI 16 pOll of 0 bulldlllU III
slruelu,":
(2) Conlolnol5 lIf propollV hllld fo! 50 Ill; or
,. ,
(~), PholoO,ophlC or 5clenllllc InWumofll
, lons05
d, Ou[lder6' mochlll'"Y. 10015. IInd 1I'l'"pmU'"
y'!4 'own or 111111 "to 1II11111Sl0d 10 you. willi"
AwaY 110111 thu I1ll1n1l50S dOIC,'hlltJ III Ihu
Duclololion6, "'r.llpl II~ 11101lldlld in P"'A'
ll'oph C.H.h. hulllw
4. Fa, 1055 or dllmooll hy Ihllft. Iho 'olloY/IIIO
tYPlls of propQ/ly 11111 cUIIQ/lld only up 10 Iho
Ii," III shown' ,
n. .2,500 for h1l6, fur llA,monts and gormolll5
tllmmlld wllh fUI
C1lflYlloht, ISQ Comrnlllclol RI5k ,SUMell&, tne, 1990
CP 10 30 10 91
b, U,1l00 101 IlIwelry, WlIlOhu, WIIII:h 111"\111
I11I1I\1S, 10wull, 'PIIOIII, plu~101l5 1111<1 51l'1I1
PflllllllUI ~IOIIOI. hulllqn, ijold., bll\lOl,
plnlllllJlll IIlId olher pro/dOll' 01l0Y5 '"
11101011 Thl6 1111111 dOll5 1I0t "llIIly 10 jUWllltV
IInd Wlllr.hos wo"h 010001 061 ""' lIurll
II, o;z.eGO fUI pIIlIell1S, dlos, molds IIl1d fUlln.
d, O;Z60 fOI IIOl11pS, lickllls, Il1ellldlllll IlllllIIY
lIekuls held 101 51l1e, IIlId lonels of ",,11111
5, Bulldllrs' Risk COllorngo form Llllllt/l"
tlons
Tho 'ollowlng plO\l161011S apply' only 10 11\1/
BUlldors' Rllk COllo,ogu FOlm. '
0, L1l11ltollon 1,d. II 11IIIIncod by Iho loll oW '
Ing
d, Building molo,'oll and lupplle5 /lot III,
IlIched 05 pall 01 Iho blllldll1(J 0' II,uc
111111 cllusod by 01 rosllllll1(J frOI1l Ihlllt
b, Lll1nlllllon 3.d. 15 ,e"loelld by Ih.1 lolluw,
1111/'
d, IlUlldors' I1II1c1nlluIY. 10015 olld IJrllllP
11111111 you OWII <lI Ihol 'lie 1111111'11",1 '"
Y'J11
G Wo Will /101 poy Iho CU51 10 'opolr OilY dufllcl
10 II 5Y51ol1l or OpphllllCIl from which Wllhll,
olhll/ II~Uld. powdu, 01 1Il0lten molelllll III'
eoplls, Bul wo Will pay Iho e05t to IOpOIl UI
lap loco domoged po"1 of flto lIXlIlI(Julshll1g
equlpl11l1nlll Ille domoge:
o. He5ull5 111 dl5eho,Oo 01 any 5ub510llce frOI1l
on oul011l0llc flrll p,olllcllon 5Y611lm: 01
b. Is dlloclly cou5ed by frell~lng,
D. ADDITIONAL COVERAGE. COLLAPSE
Wo will pay lor 1056 01 domogll eou5od by 01 Ill'
suiting 110m ,15k5 of dlleel physical loss In\lollllng
co1l011511 <If 0 lIuildlllO or ony Pllrt 01 II b,"ldlllg
enu511d only by ono or ",UllI of thll followlI1[J
1. fhll "lpllcllllId CnlJI1l6 of 1055" or UlQllk~[Jf) ,,1
UlIlhhlllJ 011111, 1111 Ullly 115 11I5urolj IIIJIII1I51 III
Ihl5 COIIO"'(JO PO,\;
2. Hlddon decllY.
3. Hlddon 1tl511CI or 1I1I/min damage;
4. WlIlOlll of poople 01 por50nol p,oporty,
6. WII10hl 01 'Oln Ihlll colleell on 0 rool.
6. Uso 01 dofoCll\lo mOlorlol or methods In con.
slrucllon, ,emodollng or rnnollollon If Ihe cui.
lople OCCIlI6 durlnu tho courso of the
con5lruClI011, ,nmodllllno or lenOllollon
.
.
CP 1 Oi30 lO'Bl,
--
WII Will nul PIIY 1m lOll 01 dllmh(J1I ", 1111I 1111
IQWII1(J lyp06 of Plupully, " 1I111111Wltill CU\lIIIIIII III
thll CO\llllooe Port, ulldol 1I0ltlti 2" 3" 4" 6, ,1111'
II. unlll61 tho 1061 0/ dOl11ouo ./s II Iltrllcl 11161111 ",
Iho COllOPllI III II hUlldlll[J'
ouldoor lodlo or 101ll\llsl011 II 11 1011111 Il 6. III1:hlll
IlIn tl1ol, leod.ln wlllnu: 11111116 <II h'W11I6,
OWI1II1IlI, \lIlIlUII olld d<lwnslllllJl.. y,"o1 III
IlJlUa, lluldoOl sWlinnnnll 110011: fIlIlC06, 11I1I1t,
WhOl\lll' olld dock5, hOIIl:h ur dl\llllll plll"""'"
or nppurt0l10llCOli lolOllnn[J WOIlI, W/JI~,..
1Il1ll1wllYlnnd olho, 111I\lud lurfllCU6,
ColIOIISO dqll5 not Ineludl/ slIllIlnlj. e,"ckllllj,
5h,'nkoUII, hulOlng 01 u~pon61l)n
Thll Addillollol CO\luro(Jo will nOI IIlcrllll~1J Ihu
L1m115 of In5u,oncII IlIO\lldod In 11116 CO\lU/IIilU
Pall
E. ADDITIONAL COVERAGE EXTENSIONS
1. Property In Transit. fhl5 E~lQn5101l IIpplll"
only 10 you, PO'501l01 P"lp"'ly 10 which III"
"mil IIpplllll
n, You I11nv u.wIf)l1d tho IIHiurnnc;n fllO\mllltl
hy 1111. CO\llllllljll Plllt lu IIflply 10 Y'"11
pOl5<,nol 11"JIIOlly (olhu, Ihon p,opully III
Iho cllro. r.uslody 0' C '"1II 01 of yo",
5olo5pll/aOlls) 111 Ulln51l mOlll Ihon 100 ".u,
flOll1 Ihll doscllbod prellllsos, P'OPllrlY
must bo In 01 on 0 motol \lohlclo YIIIl OWIl,
leBle or oporole whllo bolwoon POIIlII III
tho eO\lologll IOllllo,y,
b. Lon 0' dOl1lo(JQ mU51 be COll611d hy ')I IU
5uII from onll 01 Ihll followII'U COU6111 ",
1055:
(1 I FlIlI. 1I0hln1n0, oxplo510n, wUld.lolIlI 0'
hall, /101 or elllll eommotlOIl. 0'
lIondolllm,
(2) VlIhlClo co1l1510n, "1'501 0' O\lIJlI","
COll15101l mOOn5 IIccldllnllll C'lIll'H,1 0'
\IOU, lIohlelo wllh n/lolhor lIollICIo. '"
ohjllr.I, II doos nOllllOlln you, \lul",:I,",
conine I with Iho rond bill!
(3) fhell of on onlllo bolo. coso 11/ pllckll\lll
by fa lead enlry Into 0 50curuly lock",t
body or compllrli"enl of Iho \ll)llIclu
Thalli must be \llslblll mo,k6 01 till!
fOleed onl'y,
e. Tho most wo will poy for 1056 or dlllllll,,"
under 1111s E~len510n Is $1000,
Thll COIIO/oge hlunslon IS oddltlO'H1I 1116'"
onco Thll Addillonol Condition. COII'MII'"l1ll
dool Ilot opplv 10 11115 Exlllf1610n
:OOPYllghl. ISQ Commllrclol Risk SOlVlcos. Ine.. 1 BBO
1'01111 5 01 (j
,-
nLANKET PROfECTO~
COMMERCIAL GENERAL lIABILITY
COVERAGE rA~T OECLA~ATIONS
~l. NATIONWIPE
.x' J INSURANCE
~ NIlIon\.\'hJ' I.u/I )'Uijf .h.l,
IJI( H.llll.lM'lOl''lJJJ,.. (Q..t.JI,DJ&, 0I11Q asill
ISSUED ijY NATIONWIDE MUTUAL INSURANCE COMPANY
POLICY NUMUER 5UPR25226~-OOOI
POLICY PERIOD FROM 12/19/.3 TO 12/19/9~ AT
l~.Ol A.M. SfANDARO TIME AT YOUR "AILING ADURESS
LIMITS OF INSURANL[
G~N(RAL AGGREGAT~ LIMIT
PRODUCT S - COMPlE nu OPERA T lIlNS AGGREGATE LIMIT
I:ACII UCCURI~ENCE L IMI T
PERSONAL ~ ADVERTISING INJURY LIMIT
ANY ONE PERSON OR ORGANIZATION
MEDICAL EXPENSF. LIMIT
ANY ONF PERSON
FIRE DAMAGE LIHlf
ANY ONE FIRE
. '00,000
. !IDD,OOO
$ 500,000
. '00,000
. ~,OOO
$ ~O,OCJO
---------------------------------------------.~--_.~--------------------------
LUCATION OF ALL PREMISES YOU UWN, RENT OR OCCUpy
Lot
(l01
LlLOG
01
AnOI~ES5
SPIUNG GAROEI~
HAMLIN VILLAGE CENTER
In '590
IIAHLIN PI. 18~27 064
---------------------
---
w____
--
CLASS IF lCATlON
RESTAURANTS - WITH NO SALE OF
ALCOIIOLIC BEVERAGES -
WITHOUT DANCE FLOOR
tUDE PREMIUM PRODS/COMP OPS ALL OTHER
NO. BASIS AnY PREM Anv PREM
16U14 30,000 INCLUOED INClUDEU
GROSS SALES
------------------~-----------------------------------_...,-----
('OMMI::I~CIAL GE:NI:I~AL l.[AUILlTV AOVANcr: P'~E'oHUH . ~ur,
--------------------------------------------
-------
-----
FO~H5 APPLICAnLE
IL 00 21-1105
CG 99 01-11.05
T0 COMMERCIAL GEHGRAL LIAeILITY COVE~^GG PART
CO 00 01-110U CAS l39~-OBC7
CG 21 50-0989 GG 2~ 07-1185
,.
12/Z0/93
150/014
00010
PAGE 003
CAS. 3Z03-A
", "I' .THI5ENDOR5EMENTCHAN~E5 THE POLICV,.PLEASE READ IT CAREFULLY,,\\,
. II'.", I., ,ll I" Il' I' . il,l ~I,I""", I "I,jllll,d III t I,' I , t'l 1.1'1111-1'''1..1" unl
:,,'~.UC,L~:AR ,E,N ER~'('LIABI LIlY ,~~C~V.,~,1P N E NDQQ:S:~ ~~T
'q'lI'\'. ." ."', I' . ",',\1 -," (Broad For'm~ ' ,I-,! Ill' "III'Jc~"F)01q
I' I , . . I ~ : I I' I I 'I \ . \ " I , " ,L , ' .,' ',I I ' I, I" ,"1' J "I !,J "
'Thl~~nDdf6an'IJIlI'11l11d"'a~'1I\~urlJ\'itlll)/()v,,'ud Ull<lur 11m follbYllrlH" ", ',\, ','" "J ",.",,'1 ~I",
11\')) I~ll.l"" "}.Ll " lltIJIJI~j~ll) "I IflP.,'l1lJlllh, ulrll '"t 'I ,I ',' I 1 I . /'; " ,11)bu: HH "'llJllljl.l,
,'..J.1UQIN~:jr;OWN;.5IQ~Cy"t"." "" I.. .,.."",,1""0)1111,'
COMMErlCIAl AU ro t<;o,v.f.lJ~G[ ,I',AIH
COMMEflClAL GENERAL L1A 311,IIX C,OVEI'lAGE PAlH · "It. "" " " t" 'u\o1'
, '''FARM'COVEIlAOEI'A'ftl'' "".' ," (." " " """" ""t. (II
'PltODUCT5/COM"LE'Tr:O()rEH~TIONli L1AUILII Y COYf.J,lAq~I?Ml) 'I"". .' f (di
LIQUOR L1A1J1L1TYCoIlEllAtJE PAIH ' ..",.,'", 'I'" '" I I' '.'"
'. .POL.~UTION I:IABILJrY'(!OVEllAOE,PArtflo, ., '." .. ," , " I"
, OWNEIlIS AN,IJ CON,lIlA?TOIl5 PIlOTEC:pvE L.IAp"ITY C9~E~W'lt~ PAIli', ".(1' . ~!'" ,'''I,'
", RAILlIQAIJ 11I0l ECHlVElLIABILII'Y 'COVl.llAGE I AIlI .., '.Jr.'.'!11" ll'''? '" I I
,.~rECIA!. PIlOT[Cn,V~ A~P,I'I~W'<<^X \,\/,lPILlTY POLICY NEW yonK OEPAllrMENT of TRANSPOIHATlON
, j" I' '.' '.' 'I' ',"111'.' I
l",'Thll Insurance does nol apply; '. " "" 'i, .'
A. Under any Cltiblllty dd'lllYq~cI,I'Io,.lIli:Qdlly
"II,' Ihlury" "r "pl6pbrly domtille:' "'IlI"''!
, .t.' I, "" q 1',(1") "\ 'I
(1) W,lh respect to which on "ln5urlld" undor
Ihe poliCY Is allo an In5ured undllr a
nuclllor onllrgy liability policy Issuod by
Nuclear Enorgy Liability Insumncll AS50'
clatlon, Mutual Atomic [nllrgy Liability
Undllrwrltllr5, NucllIor InsulOnclI ASlocia.
tlon of Canada or any of tholr 5UCCe150r5.
or would ba on Insurlld undor any 5uch
policy but for It I tOlmlnatlon upon lIX'
hou5t1on of Itlllmlt 01 liability; or
(2) Relultlng 'rom the "halordoul plopar'
1105" 01 "nucloor motllllal" and with
rQlpectto which (a) any porson or orgonl.
latlon 15 roqulrod to molntoln financial
protllctlon pur5uontto thll Atomic Energy
Act of 1954. or any low amllndotory
thOloof, or (b) tho "lllIured" 15, or hod
this policy nol blllln IS5ued would bll,
entllled to Inrjomnlty from Iho United
Statas of America, or any agoncy thereof.
under any agrOllmant enlerl1d Into by tllll
Unltl1d SIal1l5 of Amllrlca. or IJny ogoncy
thereof. with lIny pllr50n or orgalllwtlon,
B. Undar any Medlcall'aymen15 cO\lerage, 10 ex.
penses Incurred with respecl 10 "bodily In.
jury" relulllng from the "halordoul proper.
tl06" 01 "nuclear material" and orl51ng out of
the operation of 0 "nuclear facility" by any
person or orgonllotlon.
C. Undor any Liability COlleragll, to "bodily
Injury" or "property damage" rasultlng from
the "halardllus properll05" 01 "nuclaor mo.
terlal," II:
...
I/.sPA .U. U~Il~,
(1) Tho "nuclellr Illllterlol" (a) 15 at any "nuclaar
faCIlity" owned by, or operated by or on
hehalf of, on "ln5ured" or (b) has baon d15'
clwgod or dlspllllod thllrllfrom;
(2) 1 hll "nudunr mote rial" 15 contolnad In
"Ipllnl fuel" 01 "woStll" at any tlmll
pOl5ossad. handlod, u511d, proc1l5se,1,
sto,ed. Ir,1n5portlld or dllposad 01 by or
on boh.111 01 on "lnsullId;" or
(3) n'll "bodily Injury" or "propllrly dam.
ago" IInSllS out of tho furnl5hlng by on
"in5ured" of services, motllrlal5, port5 or
eqUlpmalllln connection with thll plan.
nlng, construction. malnlllnancll, opera.
tlon or ula of any "nuclear 'aclllty," but If
luch faclllly II located within tl111 United
Statlls 01 Amllrlca. Itltllrrltorle5 or pos.
seS5ion5 or Canada, thl5 exclusion (3)
applies only to "propllrly damage" 10
luch "nuclear facility" and any properly
thareat.
2. As Ulod In thl5 andorsement:
"Halordous proplIrlles" Include rodlo.1Ctl\le.
loxlc or explosive propllrtllls;
"Nuclaar motarlat" mllonl "sourco l11alll.
rial," "SpeCl.11 nuclear matllrlal" 0' "by.pro.
ducl malenal:"
"SOUlClI malllrlol," "spacial nucloar mate.
rial." and "by.product motorial" hlllle Ihe
mllonlng5 given them In the Atomic Enorgy
Act 01 19640r In any low amendatClIY thllrllol:
"Splint fuol" moons any fual olement or fuel
compononl. 50lld or liquid, which ha5 hoen
u50d or oxpolod 10 radiation In a "nucleor
rcoctor;"
~ If It;)QIlYllgt)lj tln~.\I~n Met !;.\lr,l',I.cc ~,Oflj<<ll ,ln~IIA sea" we4
S 10 S 'Jiopge 1 of 2 U
-.
Ill' ,d'
"Wollrl'l il1dor\6 OilY WO~IO Il1l1ltil,i,1 '(6)'.:<l11111,no" " I I '11(0) lAdy uqulpl1'idn't \jl'dn\ll'~b LsO'd\or thu pill
In8 "by'produ~II1Hltel ",1" ollll1r Ihol1 ,thU,'/lIIII1B' (IISSIl1,1l' fohll~lItlllll or lIIIO~"111 0' "5PU(III'
TM ~~IQI'produ~Clq'bY IhQ Il)lrpcllblf or .;ti~' \ ' . n I \ IIl~jcld~rVliolor1~'" 1I111lin 'lIn(l) Il1bttolill
Cd'nlfnr'on of ular,lul11'or 1I1Orlull1"lrol\1 IIny QrlJ." · ('/ ol11o'ul1t'lIl sue\' 11'lilllIrlnllr 'liill':U5(Ody ul
procelled Ilrlmorlly for 115 "souro.o Qii\'Ib~lal"l IH~()'I fo.1 thll "Insurlld" lit ifIll 1)/'1111115115 Whllrll
COfltOllt, and (h) r05lJIlIIl8 from tho OpOl01l011 by 5ucll lIqulp/1lent 01' dlWICO 1510cotlld COil,
any pOllon or olllonlzlllfon of any ",I\\J<:IUM " 51515QI 0/cQnlOln51l10rllthnfJ "'6 gr,qms 01
loclllly" Includod undor tho flI5t two po'rollrllph5 plutonium 0, r Ulon!Wll 2~3 or any com.
01 the definition of "l1ucllIor IlIclllty," blnollon 1I1orQof, or I'nolq \hO/l ?li(J IlrOl115
"Nucloor 10~llity" 1l1110115, I 01 UropIU\11,2~6; .. ' : ",;; :,,) i
(I) Any "nucloor roocIOI;" (d) Any Il,ucluro, b051n, e~co\lp~lfm, fllll/1l'
I. I', ,. 15P5 01 place IlrOpOrlld or, ulod lor lIlQ
(b) Any oqulpmont or dllv ce deslg/'llltl or ~loroBo or dlsposlll 01 '.'wllllo'" ,
u50d for 0) IlIpololln8 tho 15010p05 01 , ' \
uranium or plutonium (2)Rro~qnln" 01 and Includ/tI'lho 51to on which OilY olll1eforllllo,
utilizing "5penl fuel." ~r (3)ti6n\Jlltis. pro. :'l1k Illocotod, 011 oparbllonl conduclbd!On 5uch
ceulng or pa~~oSlng "waIte;'.' " . &lliI and 011 plomlles u~od lor 5uch oplJ~"bn5;
I' . ' , " '" ".. , , "Nucleor rOBtlQI" moons ony 01;porolu5 dll-
51llned or ulod t05u5toln nucloor fllllon In II soli.
5uppartlng choln rucllon or 10 contain B c:rltlcal
millS or 115.slonable malarial; :
"Ploporty damogQ" Includo5 011 form5 01 radloac.
t1vocontamlnDllon 01 ploperty,
, ,
'I' .11
I'
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""I I ',I,l Ul,ttJf,''''''',II''
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It"'JItU'j '{ II tI,l:' L.o,
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. "Ib,\ '~"1I111"fn
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..
'; I" I "Page 20f 2
',~l, Co~9Allhll'lh&\Jrdlfdo ~ervlcils 'OlfleePlhd!,'1983\' 1984
1[J\:)!12r. ri'06
COMMERCIAL GENERAL LIABILITY COVEHAGE FORM
V,)IIUII. IltIlIl151111l11 III IhlR pulIl:y ""IIICI CI'III'III1"
1111011 1110 enlllo IJollcy CII,ololly hi <1111'1111111\11 "uhIR,
dUtllls and whlllln and Is 1\111 eovOIlld,
Th,oll\lhout Ihls policy Ihll wo,ds 'yolI" /111<1 "yoII'"
,"f'1' 10 Ihll NOl1lod 1Il6111UlI showlI III Ihll lloclllrll'
110115, 011I1 III1V olhll' pur50n or Or\lllllllllllOI1 <lllollfy,
11\11 115 II NlIlllud Ill8l1rod undlll this pullcy rllll words
"W'1," "115" IIl1d "0111" IlIllIr 10 Ihll CorllpllllY pl1l1l111l1l11
IhlR IlllllrllllCII
"Ill wo,d "In5urll<l" IllllllnS III1Y Pll'&OIl III 0'1111111111
(11)11 'IUlllilylng 05 IlIch Ol1dlll WHO IS AN INSURED
(SI:ClION II),
Olhll' word5 IInd phrllsll5 thot Oppllll' 111 'Iuolllllon
'1lo1rk& hOllll 5poclolllloonlllg, RlIfllllo DEFINITION5
(SECTION V),
SECTION I . COVERAGES
COVERAGE A. BODILY INJURY AND PROP.
ERTY DAMAGE LIABILITY
1. Inoullng Agrlloll1ont.
II. Wo will pay Illtlso 5Ul115 thlll Ihll Il16lJrlld bo.
COllle5 1001lllV ohlloOlod to pnv 115 <I II I1100ll 5
hucOUIIO 01 "hodlly Illjll'Y" or "1l'''PII,ly do III ,
ouo" to which Ihl& IIl5urol1co OJlpllOl, Wo Will
IIl1vo tho "Uhl olld dilly 10 dlllolld OilY "5ult"
1I01lklno Ih050 d0l1100e5, Wo I1H1V III our dls.
crlltlon Inllolllglllll III1Y "oceullullclI" IIl1d solllll
any claim or "5ult" Ihol1110Y rllsult, But:
(1) The ol1lount we will pay lor dlll1l00es 15
IImllod os desc,lbed In LIMITS OF IN.
SURANCE (SECTION III); ond
(2) Our ',Ight ond dUlY 10 dlllond lInd whlln
we hOlle u511d up tho Ilppllcoblo IIIllIt 01
In5u,once In tho poymonl of ludUl110nlS or
seulemenl5 under COllllrll\lol A or B 01
medlcel expenllls undor COlllllllge C,
No other obllgollon or 1I0blllly 10 PIlY 5ums or
perform OCl5 or 5orvlcos 15 COIIII/l)(1 unle55 1I~'
pile Illy p,ollldlld 10' undlll SUPPLEMENTARY
PAYMENTS. COVERAGES A AND ll,
II, Thll Insuronco opplles to "bodllv II111Jry" and
"propellY domogo" only If:
(1) The "bodily Injury" or "p'operty demoge"
Is eeused by en "oeeullenco" thet tekes
place In the 'collerogo tellltory;" and
(2) Thll "bodll\i Injury" 01 "properly domege"
occurs dUllng Iho policy period,
.
.
CG 00 01 11 88
II, 1)0001lIIIIIIS hllCIIUSII 01 "bOlhly 11l11llV" 11,<:1<11\11
""'1111111111 cloll1led by OilY IlllrRon III "'11111111'1'
110" 'Ill CIIIII, 1056 01 lervleos 01 dOlllh IIISullll1\1
III ony 1111111 'mill the "bodily Injury "
2, hchJblons,
Th'" "'"UIOIICII dOllS Ilot apply 10:
/I, "Bodily Inlury" or "p,opllrty d1l1l1001l" 1I.'ll!C\l1l1
or lI11ul1dod frolll Ihll 510ndpoll1l 01 11\1' 11\
IIlIIlId Thl5 IIXClu5111n dOlll 1101 IIpply III "ltud
i1V "'jury" lOIlUIlIIl\llrol11 Ihll 11511 01 /III1M1I1IIltl<!
IOICO 10 IltOIQl:1 plll50ns or propolly
b, "llodily Inlu,y" or "proporty dllnUJ\lII" 1<11
which lho IlIsullld Is obllgollld to poy <11111\11\1'111
hV rooson of thll OllslJl11pllon 01 1I011l1llV III II
conlroel or og '1I111l111111 , Thin lIXCl1J5101l <100&
nOlllpply 10 1I0blllly for dOlllooos:
(1) A5SUflllld In II COnl,oct or OUrOOIlWIll thlll
IS on "1l1slJrlld conl,ael," rJ/O\lllllld Ihu
"bodily Injury" 01 "proporty dOIllIl\l'I" or.
CIJ'5 sub50quonl 10 tho oxocullon 01 11111
conllaCI or og,oOl11ol1l; or
(2) That Ihll in5urod would hOllo "' Iho ;Ih
50nco 0' thll contract or Oore0l11l1ll1
e, "Bodily Injury" 0' "plOpolly d 01111111 ,," I",
which any In5u,ud may bo held hohlll hV '00'
50n of:
(1) Causing 01 eonlllbutlng to Ihll Inlo.lcollon
of any person;
(2) Tho lurnlshlng 01 alcoholic bevoloOllS 10 0
pelson undollho legal dllnklno ono or un.
dOllhe Influence of olcohol: or
(3) Any slolule. o,dlnaneo or /DOUlellon '0101
Illg to Ihe nolo. 0111, dl61rlbulloll 0' U511 of
eleoholl'l belleleges,
Thll exclusion oppllel onlv If you 0'0 In Iho
huslnels of manufacturing. d151rlh1J11l111. 5011.
111(1. lel\llng or furnishing alcoholic hO\lO'O(l05
Copy'lghl. Insurence Sorvlcel .Qfflce, Inc.. 1982. 1988
Page 1 of 1 2
co~M'I!Rti~L5b~An:JI)'MLH.'~ ''ITI./ I F.I AU J 1\ H ';II.~:1 l:) J AI::1 H ~~ Ilrllln') ::-~,
COVEIIAGE FonM ~
d, Any oullgollon II' the Ins'IIul1 "1111>>1'0 \1I01kuI6'
, ' eOl11punsotlon.. dl60blllty,,'honolltu or unulll'
ploYlllonl" e0I11I10nSllllon.'IIIW or, any 'sllIlllllr
lnw, '11" "I,' Id, "I'j t '. I I' I
e. "Bodily Injwy" 10 ' : " I ~
(1) An ul11ployuo,ol tho IIl6U,ud'orlSlnu'olJl 01
u/~d ,111, #\~ c9H'P.u ,y' ~.,,,plo~l11y,Il~ bV, Ihn
In4U\p,Ii,;y~, ..I', , , ,"
(~) Thu,lpouse,'llhlld, '1lIIlonl..b/IJlhu, o. 51510r
of Ihol,nllll,loYOI\ 116 n,l:onloquIIIlcu of (1)
lIlu)vu,':q '" , 110 . I". j ; I~!l
rhls u~dlJ510n IIpp1l1l5: 'I
(1,) Whlllhorlho fll51,rod 1Il0Y IHi lIohM' n5 Oil
u"'ployo, 'or IIi 'Ahy o\)1Ur cop,lIeuy; nl"J
, .1. . "..II \'li. I
(2) T" O/,l,YI,fllJl!Upllon"I\l,~'l/IIU, d,O//lIIUPS wllh
or ropov SOllluonll olsy who "'U51 PllY
domd\liid 6Qcduile' 01 1110 Inlury,' ,
"1, Ihl" IllJ'lI
Thl6 u~c1u5IHf1.,dou~ nol apply Itl 1I0hlllly 06,
5ul11ud by Iho lIisq,o\I,/!!ldur'lI1 "IIllu,od con,
Irnc'"
:1.;.
t. (1) "Bol.llly 1.')JulY," W,~'p/OI'UrlY dOl11ooe'"larls'
Ing OfJl of tho, oct~ol, Jl !oJjud or Ih,uo oned
dllehntOll. dI5pu'5111. SlIlIPOOll. ",'u,ollon,
. ;blriusu olllS'cnpo iii pdlhJln1ll5: '
, , ':, Inl j ,"
(0) AI or "0111 any plu11115U5. 5i1U or.I.9r.allon
which 16 0' W05 01 ony tll11u ownod 0'
oceuplod hy; ol'IOhlod or loonud Ii>. any
Insu,od, .." '
(b) AI or from any prul1l15us. 511U 0' hJcalion
which 1501 WQS 01 OilY limo u5ud by or
for nny Insu'dd or otho'6 for Ihll hondl.
Ing. 51ll/0001 ,dI5pOs/ll, p,oe1l55lnu or
l'lIotl11l1nl 0,' ,wnslo; ,
(0) Which 0'0 or iNilto at uny limo trnn..
potted, hondll\d" stor.od".truo,led, d15'
p05ed 01, or pr.oce550d lie Walle by 0'
for, ony Insured"ofo,ony pe'lon, or 01'
onnlwlion for whom you may bo IOOlllly
rUHpon5lbl0; or
:,r
/'"
"""".." (d) AI'OI Itolll,"ny, PIIlI11IUU6.oilo m 10ClIIII1II
1."1,,, '" ,'on ,whh:h any, In6ullllhll' nny COl1lme'.,
10rl,01,suhconlllluI0,0 wmklllUldltlllllly,
"1111'/ '" uJ,Ir1tJJr,Y~"y \lP,lIl1y,111!illl,Ud'u bR'II\lf ~'"
I,ll.' "'" ,PU/1nVII'IlU \lllu.r!I"!lI'~j, " , "'.'
vlll',II" ,'" ,(Il.rllllhu'pollullllI'fllllll,'hrouOhl' Ulllon
ph'u.,. ,I , "IQ.1I10'pIIIIIIISUI,'01l1l tlr 10e1l1l011,,11I
l>,"hl ""',' , ,'eOllllllCll'lI1,wllh slll:h',)plllnllhll0,bV
rillch IllIH'II.Ht. (I)ll!rlll:lor I)t, liubcLlf1.t
1.\11111 t , "olt~qfil~"",ur I, I ("IJ "
r, 1;11. T (II) "'lhoIOpU/UIIOlllI ato Illl,leul. 101;
"'0111"1/, clO1l1I 1If1. "''''U\IlI; Clllllilln,
1111111. dUlflxlly, qr IIIIIIIIIIII/.u, ~r, 1I1,l111YJ
WilY IU5POlld~0, tJ/ u6,'IJIU 1(10 'l(f}l'y,I~,
01 pOllllllllllS, 11 'J J,'
61/bporllllrnphs (~1,!1/l~ (~)~) ".0,11'1\ 9PP.!~,'
10 "bodily IPIU~ 0; '~'o~o,ty dnq\IIQP
'l'."1 'oflilrh?! liiJl1bt,Il r~,J~l1\b !ltl~ri1~I:fr.lljt)'~
hoslllo fI,o, ' 'ii! ,,!, ,I,,"" I', "I J
A5 115ud In IhlS b'X~11I5111n\ 'n h0611111 'fI,J
, , mllons UIIO whlr.h buc\ll~IIU UI1l;UllllollolJlo
..""" 01 bleo~B,pul fmrn:whoru,11 WII5 illlondud
'I'll I' In l>Q" :', I ','f." . ,
',',7;(2) ,~~t~l~ssl '~~st' or: lI~fl~I','~'?', lI'fslng 0111 01
,;,',r1 :,:'i)~,(U) ~o'qllOi,. don1,B"l# ~\ ;.';,"11111i~1'~,I1V In.
, II,'i1 nrurf o~ 01110f5 ,I~~I, ',9" ,11111/)110(, elllon
Up. rUI1lO\lIJ. conlblll. 1'"11 . dOlo~lfy 01
. Ill. ,",' houllnllzo. 0' In oily 'woy 'U5pOfld to. or
'OSS1I5S Ihu 1I110CIS' 0' \1nlluIOIlIS; or
, \,
(b) Clol", or 5'"1 by or unhohlllf 01 n Oov-
.' /1'""'/111101 nuthilllty for' ~lll"'ngus bu.
eous/l 01 IU511nu fur, .,lOnllollng.
clllllrllno IIp,''fur'novlno,' contolnlno,
l'lIollng. dUloxlfylno 0' nodtlllllzlno. or
, , In OilY wny lesponrflnl) to, 0; osses51no
,'n", ,Iho elfOCt5 01 pollu/llnts, ,,,,p,, 0.,'
'I' , :Pollulnll15 mOllns nny 5'01l0..II'1uld: gdStJOU5 or
, ',I ~holrll'nl ' Irrllllnt' 0' C'ol1tlimhiol1t.1i InCludlnlJ
snl'oko, vnpor. soo'i!,' ""ll06. II'JI,jl;!' nlknll5,
chomlcol5 olld W1I510, Walll) II1cludus'1ll0Ic,l.
015 to bll lor.yclod. ,eco'JdiIlOlllld 0' 1.1clnlrnod,
g, ~Bodlly Injury" 0/ "propolly dOllwuo'" lIrl51nu
" I I' oUlr 01 the, oWl1or5hip"molnlononce, use or
OnllUSlment"lo others',ol,ony olrcroll, "oUlo"
, III wOlerelolt ownod ,qr, 01?9[01ed by ol..renled
., olldBtiJl~ to oi1y,IJl5~~old"'Vs'o l~ehJdos opelo-
lion lIr1d 'Ioodlnrr 01 In(oodlnll,
,
:1':',1:
"','.
.
Page 2 01 12
d8~Yllgt\f, Instllon'ce s'Jrvlch 'Qfflce. Ine" 1982, 19B8
cc.'ib6lo1 '1 1 all
, ..J.."-.
. I,..
'I; 'I j
t :.'> \ I
1)
I
w
:,;,)
o
"
,.
I
Thll oxeluslon lIoos nol nPllly 10:
(1) A wnlu/uroll whllo oshoru on prumllos you
own 1lIldnt:
(2) Ii. weloruro't you do nolown thetll:
(0) Leu Ihon 28 rOO\ lonu: IInd
(b) Not bulno uled 10 COllY pOIS0/16 01
proporty for 0 eholOu;
(3) POlklng on "auto" on, 01 on tho WQYs nuxl
to. premllol you own 01 lunt, plovlllud thu
'auto" II not owned by or ,uIHud or 101111",1
10 you 01 the Inlurud;
(4) Llolllllty 06lumlld undor ony "ltl~uroll con.
trocl" fa, Iho ownellhlp. moliHlInO/1Cu 1)1
use 01 aircraft or wlltllrc'oft: 01
(6) "Bodily Injury" 01 "plopelly dllmDge' 0116'
Ino out of Ihe opllrotlon 0' any 01 tho
equlpmontllstod In poroOloph f.(2) or 1 (3)
01 Ihll dollnlllon of "mobllll lI~ulpll1l1rll"
(50ellon V.B.).
Il, 'Bodily Injury" 01 "ploporty domogu" lIrl51no
out 01:
(1) The Ironlportellon of "mobllo lIqulpll1l11ll"
by on "outo" owned 01 OpOIOlud by or
ronted 01 loaned to 1I1lY 11l5urod: or
(2) The uso of "mobile equlpmenl" In, or whllo
In proollco or ploporOtlon fOl, 0 ploorronglld
rDolng, IpOlld or demolition contolt or In
any stunllng octllllty.
I. 'Bodily Injury' 01 "p'opelly damage" dUll to
war whethel 01 nOI doclo/lld, 01 any oct or
condlllon Incident 10 wo,. War Inelude5 elllll
war, Insurrection, ,ellolllon or rOllolullon, This
exclusion opplllls only 10 liability oS5umed
undol a contractor aglo'oment.. .
I. 'P'OPlllty domogo" to:
(1) Propll'ly you own. /lilli, 01 occupy;
(2) P/lImi50S you 5ell. olvu owoy 01 Dbll/1d<ln,
II Ihll "propolty domooo" orlslIs out of any
pOlt 01 th05e premlsos;
(3) Proporty loonod 10 you;
(4) Personsl propelly In the COle, custody or
eonllolof tho Inlured;
.
"I
.
co 00 01 1 1 BB
COMMEAr.IAL GENE/lAL LI All II II Y
COVEIIAm FOllM
(6) That porlleullll IlOrt 01 IUIII IlI0POllY till
which you III IIny e<lnlrucIOt6 01 luhcOIl
IrDet0/6 wOlklnu dlruetly or Indlruclly UIl
youl buhull OlU Ilu/formlno OpUIOllolllI, "
tho '1lIoporty domogo' ollsos out uI 11I<'su
opelolloll.; lI'
(8) rho 1 portleulol pOlloI OilY ploporty Ihlll
11IIJSI hu '1I610,od, IlIpolred 0/ lelllllcOII hu,
clluse "YI'UI wlllk" W05 Ineorructly PilI'
fO//llud on II,
PorOglollh (~) lIf thl5 1I.CIU6101l dous 11<)\ lip Illy
II thll P/U/ll16US 0/1I "youl wo,k" and WII'"
nuvll' occuplod. ranted or huld 101 'IIntol hy
you,
Peroo,ophs (3). (4). (6) olld (6) 01 Ihls 1I.'
clullon do nol apply 10 1I0blllly ossu/llud U/1'
dIll 0 sldlllroek ogloomunt.
POlogroph (6) of Ihl6 exclusion does nOlllpply
to "p,opo,ty damage" Illcludod In Iho
"produel5 'complllled opurotlons hOlO/d"
k. 'Plopu,ty dO/llDue" to "your p,oduet" 1I1l51n(l
OUI 0111 or ony po,t of It,
I, "p/opu,ty rlomooe" to "you, wo,k" orl51n(l OUI
01 II or IIny ,Iort of II and Included In Iho
'p,oduc15,eumpllllod opo,otlons hQzold."
This 1I.clUSlon dous not upply IIlhll dO/lloood
wOlk 01 tho work out 01 which tho domllOo
allIes WDI perfolmed on youl boholf by 0
lubeontroctor,
m, "Plopa/ly damage" to 'Impolrlld plOplllly" or
p/opelly Ihot hOI nOI been physically Injurod.
DIlling out of:
(1) A dlllllCt, dllflclency, Inodoquoey or don-
gorous condition In "your ploduel" or
"youl work;" 01
(2) A delllY or follure by you 01 anyone oetlno
on your buholl to porform 0 eont,oct 0/
nO'llomolll In oceoldoncll with lIs tll,m5
Thl5 O.chJ51lln dOllS not apply 10 tho 1055 of
UIO 01 Othlll (lIOporty o,lslng OUI of 5udd""
and occldenlDI physical Injury 10 'your p,od.
UCI' or "youl wo,k" oftellt hOI bean put 10 It5
Intendad use,
n. DDmagDl clalmod for any lou, Call 01 expon50
Incurred by you or othals fOI tha Ion 01 uso,
wllhdlowol. recall. Inlpactlon, ropall. replace-
mant. adjustment. romollol or dllpolol of:
Copyright, Insuloneo 50rvleas Qfflee. Inc" 1 9B2. 1911B
Page 3 of 12
',I ".,' ',' ,yo,!,) JAI:l>! '1',H~n
coMMEflCIAL tJENERAL LIABILITY
COVllflAGE. FOnM" 1.11'1 II,', "!"I"
"'~1) 'YI)ulil;lJlhii:n"I, '" u,,~ I "I
, '2 (, /.,:,',ulJ 11111 ~l~ ......","'IIl.'. "
"I ) "Y.o'lI,.\'IQI,~t;"P,I'I/I' III,I'U" '.'"
(3) "1I1Ipnlro<l PlopDttY~I""")1" I,ll'
II such Il/ll<luel, WrJlk. oP 'llfopully II with.
d,ow/l Ot ,ucolllla hPn,l/l~ ~1J~lkuL 01 1r11l1\ usu
by ~/lY 1l0lS0nlol .QIlJon u!lonl bocuuslI 01 0
known or SlIslllltlou,duluc4'doflcloncy, Innd.
oqllOCY ')I <IlIn\Ju,ou5 condlllol1 In II.
E,xelllslonll C.,lll/ou\Jhl~I)J1l1 '101 opplyi,lo dOl1louo
by flrll It) plOlnlalls I,olltud 10,yoll..A 50palnla limit
01 11l"'tlHICO lIpplllllllO Ihlll COVOInlJO os d05.:'ih",1
III LIMITS OF INSUflANCf. (SECTION III)
COVERAGE,O. PERBONAL AND ADVERTlB.
ING INJURY LIABILITy,. ':1: 'II ,., ,
1. Insuring AorQQtl1ont:1!J'I,L 1':IUII1IJ'; " .111
1I. Wo will PllY Ih05b'II~Il\" tRoI,'lhiJln5ulod bo-
comos 1IlIJ0lly ohllUlIllI<I 10 'PllY Oil dllmllOos
bocouso 01 'porsollOl.'llljllry"" or "Odlloll1511lg
InjUlY" 10 which, this eOIlOlolJU porl'lIppll1l5,
Wa will hO\l1l Ihe "oht and, duty 10 dllflllld ony
',ult" luok,ny 1/1050 qplflqooP' WlI /ll'l,y oL ou'
dl~c/Il\lo,j'jn~iidtlo~,~e ,q~y "fFcu,riol1co," 01 of.
fon5fl and, 1I0ltl,Q pnY.FI lh\ or ,7sl/ltlo, ,that may
rU6uH. BlJI. I I.... I ,II J ' . '.,
. '(1) Tho. oino'ur.,' t"Wo' Will 'p~y;~for' <jqh,'0005 15
III11I11f.:ris,:lJ.!~~flb'od ,hi' .L(fYlll5 OF IN,
SUf1ANCE (SECTION UI);',ol1d"
(2) 0", rl\JIH ond. dilly 10 .dollln<j ond WIllIll
wo 110VII ulI,qd ,up Ihll'ppplleoblo limit 01
11l51J/onco In the pnyniont, of judlJments or
5oltlllmonls undor CovQ/olio' A or B or
modlcol exponlics undor 'Collllrogo C.
,'." ',I . ,
No otho, obllgntlon 0' 1I0blllly 10 pay surn5 0'
pllrlorm OCIS 01 50rvlce5 15 cov~rlld unllll5 ox.
pllelll~ pr~lIlltod/rof U~ifer'5UPP~EMENT ARY
PAYMENTS': COVEirJl:GES'A AND B.
.. .'....,".'. ,"
" II'
~ " I
,,'1', I.'
".
, n,
j, , :
. '.
. , . . I
Pogo' 4 bf 12
...'
,
111,111'1., , I" I I' Ill"., ' ,. I', II I
, b",Thlo II1Juroncl/' oppllel'tofl ' )' ' . ... , I ,
(1) 'PI/llonol InjulY' cuU~~'d' by"p'n offense
",orlllnn"oul QI WQ~rltbuslnols., o.cl}Jdlng
ou~~Ullln,U, JP,\\b,IJ~I\lr,lp', ..Inooqcolllng 01
toll/cbnllnll Ilona 6y lIY fOI 'ybu;
12)" 'AJv~ft'15,I,I\\1 I,lil('I!YI~,~~~,:J#:,hy' a~ offense
eOl1ll1llllail In 1M, cmr"w ,ill odvertlllng
'," '.'YOUI 1l00ulI. prud~els o"ll'Qrvlco~; II.:
,,~: b:\J't'Qhly,.II:,')'lU'.'MJMi~: ~U~i~0,iiiI1111l0d In tho
'COllI/IOn II lorll!Wy,.,~UlI"q Ih~ pol!'iY pOllod.
2. "~"Il/slona. ,
"1. r, I I. IntH"1 lillI, ,:j "'J \ ,I ;. J f'~ I
ThlslnsUlanco, dO.OII llOloPllly tp: ';."
1/. "POI.ollollnju'V""/)'1 "bdVtlrtlsII\\) InJury:'
, , (1 )AII&lnu' ullll/lit '61';"''Q~'lNlIl'(enllplJb11botlon
, ", v'bf liiolOfldl; "IfIUqli\\I W bY'til llill dlroetlon
I : of Iha IllsOllld wltli 'klidwlbil~1i of 115 falsity;
'(21"AII5In\J;;~" of J~~I"!iI::.:.v!I\!dn :JjubllCl/tlon
01 mnlo,lal wholle 'flrllt publlc6t1on took
" ploclI bl/lbrl/ lliu bbu'llillh'QoI lliii' pofley
po,'od; '. ,,,,.
(3)'rArllll1ll Ollt' of"II\~/'Wlllflll '1IIolhllbr, of 0
"6)1e,,.01 slOIUl1/ ,W'otdfnllnclI 'col1lllllltod by
or wllh' tho CPIl:SI/rlf:ol the IIl~u,dd: 01
'.' (4)" FOI whlch;.ih'O'h'(sl!hfd ill/s iJilsur\llld ',',bblllly
" \ -"In 0 eonlro~l"6lliJ\)toltlllol1t:'l'hlS' exelualon
'.. ,I d005 nOl6ppl~ tiflllihlllly flil dlfml/Oes Ihnt
Ihll In5ured wou[d'hdlle ill'tho ab5enee of
Iho eonI/OOI,OI,pg,ollm,ol1t., ."",
b. . Advertising ["JUlY' arising dillol:' "
('t')~i~q~h', of :e9~,Jpcl:',0\i1Qr., Ihdri''r[SOPPIO'
'. 11(1,0110[1 9/. ody~rtlslpo Idll05 ~.n~it.'"on 1m.
plied ~orll,oc';) " ". " ., ~)'"
r'~ II" I .' I" i .,
:t~' I '. ,{~.' (V,', (, I 1',.'. . 1 It)
Ihrir . ..,"' . 01(1 ,.: " -I ,"'rri"'~" I I~'
'I') rlJ j. r' 11 . l'l',.rll ) ,', ..' 'J' . I \
''''~I'''I, ",
, ~ \ I j 'I '
II.Llh
, (\I. ',' j ,<,,'I.iil
1,1. ' ',r' q. r, '-;'''I''~~ ,t J
t: i "1-4 jilt' '.) h', ~I")
.
tl#l~tlgh'f. InslI'ror\/:o' Sl/rvleoaQ'Iflc'8'.rrn'ii:: 1982, 1908
co ob 0'(' l' foo ' Cl
1\
I
I
:
,
i",
r.
.u
I
!
I
,
: ~.
-
(a) The lollule 01 uoodu, pruduell l)/ Imlllces
to OOnlOl11l wllh otlvmlllud lll,ollty 01 11m.
""monce;
(3) Tho Wlong desollpllon 01 the I"lou 01
goodl. ploduCll1// sorvlcus; or
(4) An ollenlo cUl1llllllled by 011 Insulud
wholo bUllnulI Is otlllerllslnll, ll/ootlcost.
lng, puhlllhlnu 0' 10lecIIsllnll
cOVIIRAOIl C, MIlDICAL PAVMENTS
" Inlurlng Agrllemont.
I, Wo will pay l1Iodlcol 0~punSlI5 liS dOlcllhod
bolow for "bodily Injury" eOllslld hy on occl.
dont:
(1) On plemlsol you own or runt;
(2) On wUYI nll~tlo premllos you own or rant;
or
(3) Beeoule of your oplllollons;
plovlded Ihot:
(1) The eccldent ,okos plocll In Ihe 'eoveroge
territory' ond during Ihe policy !Iollod;
(2) Tho exponlel ore Incutllld ontl repo'tod 10
UI within one veor 01 Iho dOlO 01 Ihe occl.
dent; ond
(3) Thr Inluled po, son Bubl1l115 10 exomlnollon.
al OUI uxpunBe, by phY51clons 01 our oholoe
al often 81 wo ,oosonobly require.
b, Wo, will make these poymonl5 reoordleu 01
fsult. These poyments will nol excqed tho sp-
pllcable limit of Insuronce, We will pay lee-
sonoblo oxpenlos for:
(1) FIISI old 01 Iho lime 01 on oecldllnt:
(2) Nocenery medleel. IUlglcel. x-laY and
dental servlcsl. Including plollhotlc do-
IIlcUB: ond
4
4
o
CG 00 01 1 1 8B
,...
COMMEI1CIAL mN~ItAI IIAIIIIII Y
C[)V~IIAlil HlIlM
(3) NUCUB&oIY ol1lbulolIl:IJ. IlIllplllll, 111111111.
IIUIIUlllUllln\l lInd IUllorrl1 IIIIVII"II
a. ElColullonl.
V'fe Wlllnol pOV OlCpenllel' for "hl/lllly IlIlury"
a, TOllny Inluled
b. Io OlIO/Ion hlrod I'J do wmk 1m III 1111 Iwhllll
01 any InlUled 01 0 101l1lnlllf III1Y ""'1111I1
o. To 0 'IOlSon IlIlurod on Ihlll 111111 III I""I1UI1l6
you OWII 01 lontlhot thll pmlulI 11<1/1l1l1l1y IIC'
euplol,
d, To 0 pUIson. whelhol 01 1101 1111 I1l1lplllYUO 01
ony Inlulod, II bonellts 101 1110 "blldlly IlIluIY"
Olll llOyoblu or IllUlt bo IJlovldod II II tlOI II
wOlkol6' compensellon or dlsoblllly hOlllJflls
low 01 0 Ilmllollow.
o. To 0 parson Inlulod whllll loklng pall III oth
letlcl.
f. Included within Iho "p,oducI5,col1lpl.ll1d op'
elotlonl hourd.'
g. Excludod undlll CovQJoge A
h. Due to war, whelhol or nOI d.clorlld. III any
ocl 0' condlllon Incident 10 wo, Wor IlIdlld..
civil war. Iniurrecllon, ,ell.llmn 0' ,uvolulIon,
SUPPLI!MENTARV PAVMENl'S . COVERAGES
A AND B
Wo will pay. with relpectto any clolm 0' "sull" wo
defend:
1. All lIxponsos wo Incul,
2. Up to $260 fOI Call of boll bondl ,oqlllred be,
couse 01 oceldllnts or Irollle low 111010110115 o,'slno
OUI 01 tho usa of any lIehlr.le to which Ihe Bodily
Injury Liability COllo'ooe oppllo5, Wo do not hOllo
10 furnish Ih050 bonds,
3. The eosl of bondl to reloose olloehmentl, but
only for bond omounll wllhln lho applicable 1111111
of Insu,onee, We do nOI hOllll 10 IlIrnlsh Ihe5e
bondI,
CopYIIghl, Insulance '6prvlo8t g,ffloa,lno.. 19B2, I11BB
Poge 6 01 1 2
'. I",' "II"", 1\4',..
:OMMf.\\Cl;W (I~Nf.IIAL l.IAlllLITY
;OVEIIAliE,FOIIM II.,
I, All /1I0S0/llIhlo D~IIOIlIO~ Incu"IItl hy Ihll liuulod
III ()Ill loquusl 10 06llS1 us iiI Iho II1vIII1IgutluIlIur
Ilullln~~ of, lh!l.clq~m or "~ull." Il1cludll1~ oc\UOI
loss of 0111/1111\11 UplO .,00 0 illlY bOCOU60 of t 11111
ulI ''''Ill wllIk, I ",I ,
I, 1\11 cO~14 lri~od ~di1lnsltho Il1sumd Il1lhe 'sIJlt,"
I. I'rula~lii\;Q~1 ~,,\I,lre~\ oWII"IQ./ diililllSllhll ""SUIll"
Oil thai 110,,'of '11111 jud\lll10llt WII poy, If we 1ll0kll
1111 hllllr to/lilY'11\1I npIlllcllhlo'llri,1I ot IlIalllllllCn,
wn will nUl pny III1Y p,niutl\lll1l1nl 1I1111111s1 hOI'u!
IlIl 11\01 purhu! 01 Ilrllu Ollll/ lhu oflol. , ,', I
I, All Inllll1l51 Iln'lhu full 1I1ll0UIlI 01 OilY julf\lllllllll
Ihlll 1I(I~rUIIll nrll1r ohlly 01 I Ill! 1\JIIUII1I1Ill 01111 11Il'
10riJwII'hll\lll Pllld, ulluru<l II) PIlY, o/llllp05110<l 111
COlli I Ih.) pOll 01 thll jU<l\lIlll!1ll 111111 Is wllhll1 111"
oppllenhlll' III11IL 01 InSU'IIIlCU.
'111l611 POYIllIlI1IS will 110t Illducu Ihll 1I11111s 011116uI'
l!leU,
iECTION II . WHO IS AN INSURED
" II you IIfn oJu610llnlod 111 Iho Ollclo'lItlon6 06:
n. An InoJlvidulIl, you nnd yuul spouso 0'1I' In.
surlldri, but'only wllh ,uspocl 10 Ihll conduct
0' 0 blJalnll6B 0' which you nrll Ihe soleowno,.
b. A Illlrtnnlshlp 01 Jolnl IInIllU'". you orn'nn In.
~ur"<I, Your momho'5, your porlnol5;i)lid'lhlllr
SlHlU6US 11I0 0lsol1l5urlld6, lIuI ollly wllh '0'
6pllcI 10 tlw cOllducl 0' your bU5'11116S.
o. An olgllnlzollon olhor Ihon II po'tllershlp or
Illlnl lIonlurll. you O'U 1111 In6urod, You, ,1IXOCU'
11110 01lleo/5 and dlroClo,s n/o IlIlurod5, but
only wllh I1I6peet to Ihnl, dlltle5 05 your 0111.
CIl/5 or dlreClor5. You, 5tocklloldelsme 11160
Insurllds. but only wllh .05puCllo Ihll!r liability
116 5tockholde'5,
2. Each, of 1he followlnO Is 0150 IIfllllsU,oq:
, '.)
o. Your IlIllployoos, othor IIlni1 your executivu
Off,Cur5. but only 10' uCI' within Ihu 5eopu 01
t111!ir oll1"loymonl by YI)U Ilowu\lor, Illl elll'
plllyeu II IIn Insurod fo,
(1) "Bodily Injury" 0' "pu,"<lI1l1llnjury" to you
or 10 0 cO'lImployou whllo III the eou,slI
of his or hor umploymenl, or Ihu 5pou5e,
child, poronl, b,othlll or 61510' of Ihlll co.
lImployoo 05 0 r.on50quonco of such
"bodily Injury" or ",,0'501101 injury." or for
lIny obllglltlon 10 5t10'0 domogol with or
ropoy lomuonll 0150 who must pay dom.
oges bocou511 of thll Injury: or
(2) "Bodily Injury" 0' "porsonollnjury" 01151ng
out of his or 11Q/ providing or foiling 10
,,-..
,. ,
1)/<1\11111' "'11'/161101101 huullh curn lIullllceo;
III
(3) "PrIJpnllY, <lOI1)OOu:, 10 11IIlPllllY oWI1,d or
oCll4plqd" lly. or" ,e'1lud 01 10DIlRd to that
U"'I)loyon, ~')Y IIf your <lIhor 1Ill1ployoes, 01
IIIlV of yotl', pOftl1UI5 or l1uimhu,s (II ybu DPlI
I' II' ph'lllIDfillill11 or jol111 VQIlIUIO):
:1. .n' . .
h. AllY PP'~91)" \llll10r Ih/lll your 1I1l1pIIlYllo)."or
ullY hlll/lnlzlIl oil whllo /Itl/nu 05 you I lOBI'es.
Will 1ll0no\1nP, ,"
11: Any p",.on Ill' OI\lIII111Ullol1 hDIIlllO 11IOPllP
.' IlImpor/llY custody of y"u, plllpully II you din.
hUIlIllly:
(1) Wllh IlIlIpecl to IInblllly IIIlSlnU out 01 tho
/llllinlnnllllCU a. uso of Ihlll PIllPorty;.ond
(2) Until your leglll ,0p'lIsunto:lve has boon
oppolnled,
d, Your hlUlIl 'epl1l5U111l111110 II VOl) dill, bul only
wllh lospllel 10 dUll05 115 such, That iopl1l6on.
lllllvlI will hllllo 011 your 'luhl5 /Ind dulles undel
this CO\lIl'OOll PII,t,
3, With IIISpllCt 10 "mobllo lIqulpll1l1nl" 'lIgls11lrlld In
your nllll10 lindlll any mol or \llIhlclo ,eo'sl,ollon
Inw. IIIlY pOr5011 Is all 11151J/n<l whllll drlvl110 such
OIIUIIIIlIIIIlI 010111101.11, public luUhwoy with, your
, por1J\1551011, Any 011111' por.nl1 01 oroonlzollon roo
6ponsibln Ill' 1110 :i:Ol1dUCI 01 luch !JlIIslln Is 0160
on In5U'lId. bul only wllh 'OSpllCI 10 1I0blllly oris.
Inl/ oUlbf Ihll optirollon 01 the equlpnillnr. ond
ollly It no olhor Insu,oncn of uny kll1d Is ovolloblu
'10 thol po,son 01 o,onnlzolloll 10' thll liability.
Howllllllr, 110 pursoll or orooniznlion Is nn Insurud
with 'lISpccltO:
0, "Bodily Injury", to 0 co.omployell 01 tho per50n
drllllnu Ihn oqulrllnont; or
b. "Proporly domll\1e" to propo,'Y oWl1od by.
.ontud to. In the ChO/l/lI 01 01 occupllld by you
0' tho olllployor of ony person who 15 on Ill.
5u'lIllundo, Ihls prO\lI.,ol1,
4, Any orUlll1iwllOn you newly ocqul'lI or form.
othllr thol1 U pultnllrshlp or lOin 1 \lenIUPlI. and oller
which you mlllnroln ownorshlp or mojollly Intel'
1I5t. will qualify os 0 Named Insured It Ihe,o Is no
01 her 51mll0/ In5U1oncu available 10 that olgon'
Izollon, HOWOVlIl:
o. CovlIroOll undllr thl5 p,ovl510n Is afforded only
unlilthll OOlh dllY ohe, you acquire or form Ihu
orgonllDtlon or Ihll ond of Ihll policy pOllod.
whlcholler 16 eDrlle,;
.
rllgo 6 0' 12
Copyright. Insurollc$ 'Servleos lJ,fllee. Inc.. '1 9B2, 19BB
co 00 01 11 BB
'.
.I
o
b. COVO/IIUII A doos 11111 apply It, "ho<llly InlulY"
01 "llI",leIlY dlllllnue' Ihul o~elllloll hllllllll
you 1I~IIUIlOII 0/ 10rll1odtho OIUOnl/lllloll; IIlld
Q, COVOIROO II dool 1101 upply 10 'I>ollonol In,
IUlY" III "lIdYlllllllnU Injury" 1I11slnu nul III nn
ollonlo cOnllnlllQd bolmo you lI~llU""d III
lOll1llld IIIIl IlIUlIlIllntlon,
Nu pillIon lit nlUIIIIIlollon lIon Inoullld wllh lOIPIICI
It, Ihll ~llnlhll:1 nl IIny eUllllnl 0' pnll 1I<II1no16hlp III
101111 VOnllJllI IlInl II 1,,1I 6hown III II NO/11oll InslIlod
IIllho OUclOllllllll1'
SECTION III . LIMITS OF INSURANCE
1. Tho lIl1l1ll 01 1115uronce shown In Ihe Ollelora.
lions nl1lllllll 'U11l5 blllow fix thll /110ot Wll wlllpllY
'lIuo,dlull ollho numbol 01:
0, Inlulod5,
b, CIOllllll1llldll or "lulls" broullhl; 0'
o. PorsI1I11 III oruonllnllons ll1nklnu c1nlms or
bllllglll0 "111115."
2. Tho 001111'01 Ano'oOolO Llmll Is Ihll 111011 wo will
pny lor 1110 511111 of,
o. MlIIIII:tIIIJ>ponslIs under COII'lInll1l C,
b. DOl1ln1/1I1 IIl1dllr CovolnOl, A, o~copl domnUII\
bo~nlJ'" 01 "hodlly Injury" or "IIIOPOIlY dOln
Ollll" IIlclodod In Ihe "plOdocI5.eompI1l11l11
opolollonl hnlold;" and
Q. Domo01l5 undlll Coverego B,
3. The Ploducl5.Complolod Dpelotlons AUOleOlltll
Lllnll 15 Ihll 11I0SI we will pay undlll COIIlllIIllll A
fnr dnmnons hecouso of "bodily Inju,y" ond
"proplllly dOl1lnllll" Included 111 Ihll "plOduCIS'
eomplotod 0110'0110115 hUlo,d."
4. Subject 10 2. obnvlI, thll PO'50nol and Adll11llltilnn
Injury limit Is Ihll most we will pay under COile,.
noe B for Ihe 5um of 011 dnmooos bocnll511 of nil
"pn'50nnlll1lury" ond nil 'ndllllrtlnlnll'l1lury" 505'
loinnd hy nny ono p0/501l 0' OIlInllllllllon
6, Suhlocl 10 2 0' 3, ObOIlO, whlcho\ltlr oppll05. tlln
Ench Ocnl/lunco lImllls the mU6t Wll will poy 1m
Ihe 5um of,
o. DomolleS undel Coveroge A; and
b. Modleol e~ponsos ,undllr COlleloge C
boenusll of oil "bodily Injury" and "Il/nplllly
damage" o,'slng oUI of any onD "oceul/eneo,"
.
.
co 00 01 l' aa
COMMEflCIAL OENEflAL l.IA II I 1 II Y
COVEIlAllE /'(lflM
II. !iulllllcl III Ii ohovo. Iho Flro Domollll 1.lmll In "'"
/11051 wo Will PIIY undur Covo,noe A "II donlllllllo
hOllOUSllllf "prolJQlly dn1l1000' to p'lIn1l60ti lOn\lll'
10 you ollllnu oUI 01 any ono 11,0.
7. !illbloCI 10 I) ollow. Ihll Modlcol hPlll110 I.llInl
II 11111 1111161 wo Will IIIIY ondol CI1VIIIOUIl C /lIt /III
muoIlClI1 O~p0I160' bllcIIU6e 01 "b'lIli1y 11110'Y" nllo
11111111<1 hy /lny "1111 IJQ/6llll,
Tho IIInll1 01 11116 CuvlI/lIue 1'011 ollply nllll/l/Ulolv 10
Il/ll:h cnnlOCUIIVII IIl1nllol pllrlod and III nny 'Om/lII1'
IIltI IllIIlod 01 lusn 1111111 12 /11onlhs. "IIIIII1U wuh Ihll
hllilllll1l1lU 01 Iho poliCY 11U/lod II1Ilwn In Ihll IJllclfI'
'flIIIIIlI, lJnlllS5 Ihu policy pOllod II lI~IIIndo<l 111111' 15'
MIIIIICO "" fin n",'"lonol pOllnd 01 11181 Ihfln 12
""lIllhl In Ih/ll "flIO. Iho nddlllonfll pUllod will hll
""Ollllld plitt of Ihll IUSI pl'ocodlnu porlod fOI PilI'
Pllllll of dllle/lllllllnu 1110 Limits 01 Inoulonce
SECTION IV . COMMERCIAL GENERAL
LIABILITY CONDITIONS
1, BllnklulllllY.
ll/lokllJplr:y '" IIlholllllncy 01 11m Inlolod or 01 tho
"'5lJIIlIl'. IIKIIIIII will nOI ,ollllvn us 01 nur ohll,
lI'IIIOI1K 1lI111m Ihll CovlI,ogo Pnr\.
2. OUlllll III Tho EIIQnt Of OOllurrllllllo, Claim
01 Sull.
II. YIJII 11111" IIIU Irl IIlhnl WlI orll nollfled liS 800n
01 l1,ncllcoblo 01 on 'oeourreneo" 01 on Ill,
fonlo which may result In 0 elolm, To Ihll 1I~'
IlInl p05slbl1l, notice Ihould Include:
(1) How, whol1 and whoro Ihll "oecul/onco"
III Oll1l1l511 look plllce;
(2) Thll nomlls and nddlosKlIK of any In/lJtrld
plll60nl ond wllnllssoo; and
(3) Thll nOlur" and locsllon 01 any Injury 0'
domoOll orlsl"G out of thll 'lIccu/lonco" or
OffOfHil}
b. II 0 c1/111n IS IIIodll or "5uit" IS h,ollUhl III)IIIIISI
OilY In'"'"<1, you mUKI:
(1) Imlllll"lilloly rocord thll 5pnciflcI of Ihll
CIOIIll or "5ult" and tho dolll rocolvlld: 1111<1
(2) Notify us os loon 01 plocllenblll,
You mUSI leo to It that we rllcelllll W/lIIIII1
nOllcll 01 tho claim or "sull" 05 soon os 1"0'"
IIcoblo
CopYllght, Inlurnnee SlIl\Ilces Qlflcll. Inc" 1982, 1 BBa
POliO " of 1 2
t:OMMEIlCIAL GENERAL I.IAIIILITY
CQVKRAOE FOflM
a."l\'ou' olld nllY othor 111\IolvoI' Illsurod mUlt:
, """(1) 'ItnmodlQtolY lend us eoplOl 01 OilY dll'
mOlldl,' nbllces. lummonsos ollogol papa's
rooolvod In COllllocllon wl.h tho ololm 0'
I, -suit;"
(2)"AulhollJO us 10 obloln leCOldl ond othol
Inlormolloll; ,
(3)' Cooporotu With Uij Itl Ihll Illveslluollon,
lottlement or I'ulunl" ollho claim or "sull;"
olld '
(4), /\fisls,1 us. upon our lOlluost, In Iho
onlolellmellt of ony "Ohl OUOllllt OilY 110"
son 01 org,olllJOllon which may 1J0 1I0blo 10
thll jlllured 1J0couso of Injury 01 domollo 10
whloh Ihls InsulonclI 1Il0y also apply,
d, No Inlurllds will, oxCOpl 01 Iholl own Cosl,
volunto;lIy 1110ko 0 povmllnl, 051umll ony obl'.
gotlon. or Ineu, any UXPU/lIO, olhor than lor
IIrst nld, wllhoul our conoenl.
3. Logol Aetlon Agelnst Us.
No pOllon or olgonllOtlon h1l5 0 rluht under Ihl5
Covorouo Port'
0, To loin UI os 0 potty 0' olhllrwllll bllng IJ5 InlO
o "5ull" 051<1no for donlllg05 I,om lIn In5urlld,
II or
b,' Tp sue us on Ihls COllorogo Port unl055 011 oi
Itllerml hOllll been fully eompllod Wllh,
~ ,p'e,son 01 olgon!Jollon moy suo U5 10 'oco\lor
on' on og,eed 5elllol1lont 0' on 0 flnolludomllnl
ogolnll 011 In5Ullld outolncoJ oltllr on OCluol 1"01;
but WO will 1101 be 1I0ulo lor domo01l5 Ihot Q/O nol
poyoblo undllr tho 10lm5 01 thl5 Covorooo Po,t or
lII!!t sro I,ll eXC1I5S of Iho oppllcoule limit of Insur.
oneo, An ooreed 501l1011l0nl moon5 0 501l101110nt
and '0100'" of 1I0hllllv .inned hV U5. thll In5l1/ed
and tI!lI c1oll11l1nt or Ihe dnllllonl'5 11IIlOI ,op.e'
sontoll\lll
4. Other Insuronee,
II othol valid and eollocllblll Insurolle.ls ollolloulll
to Iho Insured for 0 1055 we covel undel Covor.
ogos A of B of this Coveloge Port, our obllgotlon5
,olo,lImlled os follow5:
O. Pllmory Insuronco
This InlUlonce Is primary exeopt when b, boo
low applies. If this In5uronce Is pllmory. our
obllgollons orll nOI Affeetod
.
.
Page'8 bf 12
unIon ony 01 Iho 'Olhor '1llsurnnce lij III
" mu/y. ThOll, wo will, shorn wllh ull thll
" I' JnJmqneo by,'ho,mo'hod descllblld In
Ipw, .
b, beuu InlUloncu'
'"
This Inlu,oneu Is UXcess 01101 any 01 Ih
'InlulollcO. whothol pllmolY, I/XClISI, I
oel1t or tin ony dlhullJosl.:
(1) Thill 15 Flio, Exiunl'ud CllvllrOllO, Il
flllk. In5101lqllq~ fllsk III sll11l1o, Cn
for "youl wot\l;' .
(~) ThaI 15 FI'lI l/1suronco fo, p'l/mloo.
10 yuu; 01, '
(3) II Iho Ion o',lsel 'out a' Ihe mollll'
01 usa of nlreleh, 'OUIOS' 01 wolll'.
tho lIXlunt 'not 'Iubjuel 10 ExcIlJ5h)l
CovQ/oou A (5eellon I),
Whel1 Ihls In5ulonco Is OXCOII. WO WI
no duty IJndlll COVOIOOO A 01 13 10 do'"
claim 01 "sull" Ihot any othor i/l5lJ''''
duty 10 dl/fllnd, If /10 olhllr IntilJ/er d,
we will undurloku to do fill, hili Wll '
onlltllld to Ihll insurod'5 rlllhl5 "001/1510'
other Insu,e'5,. ' '"
Whim Ihls In'suroHclI II lIXCU55 OVOl 01'
SUlonce, we wlli"poy Qnly our 5horo
amount of the 1051. If ony. that lIXell.,
sum of: .. 1;IJ."
(1) Tho total amount that 011 5uch olhol
onco would pay fOllho l05s Inlho 0'
of Ihl5 Insurance; and
(2) Thll 10101 of oil doduCllulll O/ld 5011.,
amounts unillll oll'lhot othelln5urol1
" lo. >1., I
WlI 'will 5hore ihll 'leil1olnlno 1055, II on'
any olho, InsulqnclI, Ihol i5 /lot dUICII
thl5 Exc055 IIlS~IO.n.~q proll1510n ond W
boullht Ipoelflcolly to lIpply '" OXCII5S
'Llmlls 01 Insu,oneo \ihown In thu DlIcllI
tlt thl5 CovlIrogo 'Port,
o. Mothoq o,f Shollng
If 011 of theolher Insulonco pllrmlt5 c
ullonby' oqu'ol'lsh'oros. wo. Will folio
method'olso, Undar this opplooeh 1I0ch
l:onlrlbules equal omounl5 unlll II has I
opplicoblo limit of Insuronco 01 nono
Ion lomolns, whlehllllor eome5 fi'5t,
Copyright. 'Inluronce Services Qfflce, Inc., 1982. 1988
CG 00 01 .
"
If Dny 01 the olhur InbU/llIlell dous nol Ilullnlt
oonlllbullol, by equDI shill os, wu will con",h,
ute by IImlls, Undul Ihll mUlhod, 1I0oh InsuI'
pI'S shulo II bplud onlhu 10110 of Its uppllcDblu
limit of In,ulohco 10 tho total Ollpllcoblll IImlll
01 Insurance 0' ulllnsuIl/ls
5. Promlum Audit,
o. Wu will compulo .111 P'lIIllIUIIlS for Ihls (;01111I'
/lUll Port In ocuo,donclI wllh QUI 1t/11l5 on<l
'OIUI,
b. P,ullllllln shown In this (;OVOIOO" Port os /Ill,
lIoncu plomlull115 0 dllp051t plomlum on1v AI
Ihu c1oso 01 each audit pOllod wo will CO 111 ,
putu tho oorned prollllulll fo, Ihol Pllllod, Au,
dll plllmlul11s Ole due and poyoblo on nOllCO
to the fI,st NOl11l1d 1t161l1l1d, If Ihll lum of Iho
odllonco and ou.dll p,ernlum5 paid lOlthll pol.
ICY lelln Is groolur Ihon Iho eOllllld prllnllUI11.
Wll will lolurn thu "XC05. to Iho fj'51 Nornud
Insulod.
o. Thll li,st Nomad Insllled Illusl kllllp lecord5 01
Iho Inlolmollon Wll IlUOl! f<ll P'Oll1IUIll COl11pU'
loll on. and slInd us <:Ollllls 01 such linHl5 05
WlI Illoy 'lIquost,
8. Roprusentotlonl.
By o<:<:ollllno thll polley, vou ogrue:
o. Thll slotO/llents In Ihll DoclolDtlons orll oeeu.
rOlll and complole;
b. Thosll slotomonlS ore hosod upon rllprosllnt.
0110n5 you mode 10 U5: and
o. Wo hOllo IS5ued Ihl5 polley In ,ellonco upon
your rllp,esenletlon5,
7. Suporotlon Of Insurede.
henpt With IBlpoet 10 Iho Llmlt5 of Insu,oneo.
lInd nny "ghI5 01 dutl1l5 5poclflcolly 05slgnlld In
this Cl)\lll,ogll Port to 1110 fll51 Nornlld Insurod. 11111
IllIuronco OPp1l1l5:
o. AI if ooch Nonllld In5u,od WlI'O 1110 only
Nnrnod Insured; and
b. Soporofoly to 'o'oeh Inlured oooln5t whom
claim Is mode 01 "Iult' 15 blought.
II. Tronlfor ,Of Rlg"t~ Of Rooollory Agolnl\
Olllon To UI..
If the Insurlld hOI rights to leCOllOI all or pall of
ony poymonl we helle mede under this COllllloge
.
.
CG 00 01 11 B6
COMMERCIAL GENEflAL lIAlllU I Y
COVEflAOE FOIlM
Pon, Iholo Ilohtl Ole tronslollod to us. rho iiI'
sUlod IIIU.t do nolhlng 01101 loss 10 ItnpIIII thlllll
Al our 10quoll, tha Inlured will bllnll "sulI" ,"
"anllel Ihola Ilgln. to UI and holp us onlorcu
thalli
O. When Wa 00 Not Ronuw,
If wo doni de not III ronow thl. Coval DUO Plllt. Wl/
will 11I011 01 dellvor to thl/ flIst NDmlld h'IUlllt\
Ihllwn In Iho Ooclorollon5 wrlllon nollco 01 Ihl/
nOlllonowol nollu66 thon 30 doyo bololo Iho ox'
plIo lion dDlo,
If nollclI 15 rnollod. plool 01 I11Dlllnll will bo 611111,
ell/nl ploof 01 nQllco,
SECTION V . DEFINITIONS
1. "AdvlI/llllng Injury" mllons Injury OII,'nll oul 01
ono Olllloro 0' Ihe following ollllnses:
o. 0'01 III wrlllOl1 publication of rnolollol Ihnl
slondl/rs 01 IIbols 0 plll50n 01 orgonl,ollon 01
dl5polooos 0 po,son's or OIoonl,01l0n'5 uoodb,
Ir,oduclS or sorvleos;
b, 0101 01 WIllian publico lion of 1l1010rlol thol \II,
010105 0 pOrion'. right olllll\lOCY;
0, MI50pproprlollon 01 Odlllllli5rno Idoos or 51ylll
01 dol/10 buslnoos; or
d, Inlrlnuelllent 01 copyrlohl, 1It111 or slogan,
2. 'AUla" mnons 0 lond 1l1010r 1I1Ihlelo, ttollllr or
.emll,oller designed fOI ttovlIl on public rood5,
Including any olloched mochlnory 01 equlplllllnl.
BUI "OUIO" do05 nOllneludo "mobile equlpmont."
3, 'Bodily Injury" moons bodily Injury. slckno55 or
dl5005o 5u5tolnod by 0 pll'son. Including dooth
,o5ulllno from any 01 th1l50 01 OnY tlrno,
4. "Co\ll/rooe tllllllory" mllons:
a, Tho United 5totss of Amelleo (Includlno Its
lorrltorles ond POIso5slon5). Puorlo Rico onet
Conodo;
b. hllo,n,1110nol wotoro 0' ollspnclI. p,ollldod Ihll
Inju,y or domoge doos not occu, In thll eOIJ'IO
of "0\101 or Ironspoll/lllon 10 0' from any pineo
not Included 111 a. above; 01
o. All ports 01 the wOlld If:
(1 I The Injury or damage oll.as out a.:
(0) Goods or products mode or sold by you
In Ihe territory delerlbdd In o. ObOllll;
or
Copyright. Ins'J,onoe SlIrvleos Qlflco. Ine" 1982, 1888
Page 9 of 1 2 []
COMMEflCIAL OENHIAL LIAUILITV
{:OVEflAOE FOflM
(bl l'he octlllltle6 01 0 PO"1I11 whoso hlllllO
Is III tho tOllUOIY desellbed In 0, ollllvo.
hut II owoy 101 0 IhOl1 lime on 'r'OUI
Iluslnll~s: ond '
(2) Tho Inlu'ed's "isponllbllllY to pay dam.
ogos Is delelmllled In 0 "~ult" olllho /1Iollle,
In Ihu lellUoIV dU5crlllod III 0, above 01 III
o sultle/1lu/ll wu ogroo 10,
6. "Impolrud IlIOpll'ty" moons lonolblo plopelty.
olhu, Ihlln "your P'II<1uCI" or "youl work: thaI
';lInnOI bn u60d or 15 IUlluselul bueoul~;
0, Illnco'lllllOIIlS "you, IlIoduel" 01 "youl Walk"
111111 15 known or thuu\lhl to Ile defective. do.
flClullI, InlldllquQte or dlln\lo,ous; 01
b. Vuu hovll 'oiled 10 fulllll Ihe 10lms of 0 con.
tract 01 IIOlllemont;
II 5uch IlIopu/ly con bu ,e510,od 10 usa by:
0, Tho ,opoll. roploeumonl. odlullmenl 01 10'
1110\1010' "your product' or "youl wOlk;" 01
b. VOUI fulfilling Ihll 10lml 01 the conllocl 01
UO'OOI11~nt,
6. "Insurod conlroet" mllons:
o. A 11Ioso 01 plomlslll;
b. A 51delrllck ogroo/1lont;
o. Any oOloment01 IIcenlo ogleemenl. excoptln
eonnoctlon with construction 01 demolition
oporotlonl on or within 60 foet 01 0 lollrood;
d. An obligation, os loqulred by o,dlnonco, 10
Indemnlly 0 muniCipality. excopl In con.
nectlon with work for 0 munlclpollly;
e. An elelllllor molntononce oOleemenl;
f. Thot purt of lIny olhol conI/oct or Bgreomont
pOl1olnlng to your bU51n1l51 (Ineludlno on
Indemnlflcotlon 01 0 munlelpollly In con.
r,lIcllon wllh wmk pn,'ormod lor 0 n1lJnlcl.
polll,y) undllr which you OS5UI1111 tllQ lort
lIobllily of lInolhcr porty to pay for "bodily In.
jury" or "p,opurty dllmogll" to 0 thl,d pQ/50n
0' oroonlzollon, Tort 1I0blllty moons 0 1I0blllty
Ihot would bo Imposed by low In Ihe eblonce
of any contractor og,ollment.
Page 10 of 1 2
.
An 'Insulod Ullllllocl' do"s not Inolude that pall
<If ony oonlroot 01 eo,eement:
o. 'fI,ol Indemnlllu any pellOIl 01 oroonlrotlon
lor 'bodily Injury' 01 'ploperty dOI11~Oo' OIls.
1110 out 01 uon5lructlon 01 dOl11ollllon OJIIII'
Otlolll. wllhln 60 1001 01 any railroad plOportV
ond ollllcllng any lolhood blldue 01 IIlItlo,
1I0cks, rood.bods. tunnel, undelpon 01 eluss.
Inu:
b. Thllt Indllmnlllu5 IIn B/chllllCI. lInghlo~, 01
SlltVlIYOI 'ollnlury or dOlllllgn ollslno out 0':
(1) Ploporlno, OPlllovlno 0' foiling 10 p'epBlo
or 1I1,pro\lO I1lIlP6, dlnwln\ls, opinions. 10.
ports. lurvevs, chonllo ordn,s. dllllgne or
epnclllellllonl: 0'
(2) Olvlno dlrocllons or Inllluetlone. 01 foiling
10 Illvo thom, II Ihot Is Iho primary couse
of Ihe Injury 01 domolle:
o. Undel which Iho Insu,ed. If on olchltecl. en.
IIlnelllor survOYOI. 015Ul11US 1I0blllty 101 on In.
Jury 01 domollo orl51ng out 01 Iho Insuled's
rllndellno 01 'ollu,e 10 IlInder plofenlollol 001'
vle05, Including Ihoso 115111d In b. ObOllll ond
lupervlsory. Inspecllon 01 englneollng sel.
vlcee; 01
d. That Indllmnlflos any pOIson or orgonlzollon
for domogo by IIIe to prumlsel lontod or
loaned 10 you,
7. 'Loading 01 unloodlng" moons Iho handling 01
property:
e. AltaI It Is moved 'rom thll ploco whale It Is
oeellpted for movemont Inlo 01 onto on air.
cIa ft. wote,c,oftol "0'110;"
b. While It 15 In 01 on on olreroft, woteleleft or
"outo;" ,:Jr
o. Whlfll It Is being mOiled 'rom on aircraft,
wOlorcloft 01 "OUIO" to the ploee whele It Is
finally dllllllolod:
but "Ioodlno 01 unloodlnll" doe5 not Includo tho
mOllemont 01 p,operty by moon5 01 0 meehonlcol
dovlce. othel thon 0 hand t'UCk. Ihot Is not at.
toehod to tho olre,olt. WOIOICloft or 'auto."
B. "Mobile equlpmont" meon5 any of the follpwlng
types 01 land vohlclel. Including eny 8ltoched
m8ehlnory or equlpmom:
.
Copyright, Inluronco 5ervleol Qfflce, Inc., 19B2. 19BB
CO 00 01 1 1 BB
CJ
II. IJulldoUII, lomlmoclllntlly, huklifll ol1d olhur
lIohlclul dUllOl1ud lor use pllnclpully off ,)ubllc
,oodll
b, VohlolOl mohllolned '01 UIO solely on or I1Uxt
to pruOllllls you own III /Ont;
0, Vohlclllllholllovul on clowllll lIeodo:
d, VlIhlclel, whelhel 11I1I. fJIllllOllod or not, 11I0111'
tolnlld Pll1l101lly 10 PIOllldll 1II0bllily 10 IIUlll10'
nuntly Illounled.
(1 I Powur eronos, IhovIIIH. loodll/H, dlUUllrs ,"
.hllls; 01
(2) Roud eOI1SI,uellon <Jt 'lIsu,fooll1g U~Ulp'
ment such 01 urodu'l. IC'lIpurs 01 rolluIs;
II, Vohlellll nol dOlctlbud 111 u" b. C, 01 d, obovo
thot ole nol sell'propollerl ond oro mohlloll1ud
pllmollly to ptolli.lu 11l0bllily "1 pelmol1onlly
olloehod uqulpmunl of Ihu lollowlnll IYP05
(1) All eomp'0560/5, 11I11I111S IInd gonellllo/$,
Including sproylnu. wllldlflg, bulhlll1g
cluonlng, geophyslclII u~pltllollon, 1I0hlln{)
and wlllI 50rllleln{) uqUIIlllllll1l; 01
(2) Chorry plcku'5 IInd ~1I11110' dovlees u5ud III
lolsll or lowll/ wOlkllll.
f. Vohlellls not de5Ctlblld In II, b" C. <11, d, ohll\lo
rnolntOlnod pllmollly 1m pl/'p06d6 olher IIllIn
tho tlonsportotlon of pOl50n5 or cOlgo.
Howellel, snll.propelled lIuhlclel with tho fol.
lowing tYP05 01 pllrmononlly olloched oqulp.
mont ore nol "mobile equlpmunt" but will be
eonllderod 'auto."
(1) Equipment dOllonlld primarily for:
(0) SI10W romollol;
(b) Rood 1I1011llenOneu. bUI nOl con.
Illuellon 01 r05urleclng;
(0) SlIlIel clllunlllll;
(2) Churry plckll/5 1111<1 61mllll/ dovlcu5
n"'l/ntlld on oulOlllollllo 1)/ Iruek ChOSSI5
und u50d 10 101611 or lowo, workllr.; and
(3) Air eompre510r5, pUllll15 ond genurolor5,
Including spraying. welding. bUilding
cloenlng. goophyslc:ol explorotlon. lighting
and wlllI sOli/Icing lIqulpmont
8, .Occurreneo" meon5 on occident, Including con.
tlnlJoul 01 lepeoled lIXPOIUIlI 10 substantially tho
some general helmful conditions,
.
.
CG 00 01 11 88
...
COMMERCIAL tlENEIIAI IIAIIIIIIY
COVEIIAQE I:OIIM
1 O."PullonollnIIJIY" mU0l16 InjulY, olho/ tll/ln "hlll',lv
Injury." oll.lnU outn' 0110 01 mOlu of Ihu lollow
'Ino olfel1ll1ll
'.. FollI "rrOlt, ij~lenllon iJf l~lpllsonlllolll.
b. Mollcl')UI11IOsucullon;
0, .TIle, wrunoful e,vlotlol1 horn, wlonuful '!fIIIV
Inlo. or Invoslon of Ihll "ll hi nf IUIVlllo ot:<:l/
pUlley of 0 loom, dwellll1l1 or IlIolIIlsus Ihlll .1
pelSOI1 occuplul hy 0' 011 boholl of 1\1 OWI1I1I,
londlold 01 III66or;
d, 0'01 1)/ W"lIon publlcollllll 01 IIIll1u,'ol Ihlll
Ilondllls 0' liblll. 0 fill/son 01 o'Ullnllollon ll/
dllllOrO{)eS 0 pellon'. or 011101111011011'. ',Iood6,
producls or IBIVlclll; ur
0: 010'1 or wllllen publlcotlon 01 mOlellol thlll \II
olotos II pell0l1'1 right 01 privacy
11.0, "PIOdl/CII'COlllplolod OPIIIOIIOI1S hOlllrd" Ill,
cludlls nil 'bodily Injury" IInd "p'opll/ty dlllll
000" occurring away froll1 p'"l11lse. you own
01 'ani and ollllno oul o' "yuu, ploduCI" 1)/
'you, Walk' o~copl:
(1 I P'Odl/ClS Ihot OIU 51111 In ynur physico I
p0561156lon; 01
(2) WOlk Ihol has nol yul bOlln complolud ,"
obllndunlld,
"
b, ~Your work. will bo dnomod eomploled 01 Iho
00,11011 of Ihe following tlmlls:
(1) When all of the Walk collud lor In Villi'
conI/oct hn been CO",plllllld,
(2) Whon 011 of Iho work 10 be donll 01 Ihll 01111
hOI hoon complotod If your controet coll5
lor work ot ",010 Ihon 1I110 51111,
(3) When Ihot pOlt o. tho work donll at 0 lob
silo hOB bean put 10 1\5 Inlondod U50 by onv
111116011 0' orgonlzollon Illhlll Ihotl 01101"",
conlrnclor or lubconlrnclo' wr)tklng 011 II",
SIIIllO p,ojoct.
Work Ihlll may nood S'JI\lICl), l1,olnlllnone.),
correcllol1. ,opoll 01 replnelll1llllll. but which
Is olhorwlse completo. will bo lmotlld "6
eompletod,
0, This hOlord does not Include "bodily In,u,y"
01 "propol1y domoge" ollllng OUI of:
CopYllghl. Insuronco 511IVlees Qlflco, Ine.. 1982...1988
Pooe 11 01 1 2
OOlllV"lIlO 111IM..11II11, IVV~lllWIJIMlIll7747
.
8. Oelendentls In bleach of tho aloroBllld Agroemontln thet ho hoe felled to pey the promlums
due to Plelntl" on a timely basis since Morch 28, 1994,
9. Thu ef"resold Insurenco pcllolas lasuod to Durandent were csnceled by Plaintiff on or about
April 1. 19ge for nonpoymentol tho premiums,
10, Altor crodltlng ell peyments recellled to dete by Plaintiff, Including thlllost peyment mede
by the Defendent on July 21. 1993 In the emoul1t 01 01.262.00. there hllustly due and owing from the
Delel1dont tt) PlelnUII the sum 0' 03,988.00.
11, PlelnUff hos !jomended poyment In writing 01 the outetllndlno bulence Ircm Delendant but
Dalondont hUB relused end negleetod, ond stili rofuses end nogleots to pay tho some or any port thereof,
12, In the olto/l1atlllo. Plalntll' hes dsmanded, In writing, t.hllt If Defendant eecured other
Insurence cOllerege lor the some period t)f tlmo, to prollldl/ wrltton prool thoreof, so that Plaintiff may
attempt to obtain 0 refund but Do'ondant hoslolulod al,d lallod to rt5pond to Plaintiff's wrltton requests,
WHEREFORE, Plaint If' domondsludgmentln tha amount 01 03.989,00 plus Interest et the rate of
51x (6%) percant per annum on this amoul1t Irom Merch 28, 1994, plus costs Including the District Justice
judgment COlts of 061.60.
Respectfully submitted.
JOHNSON, DUFI'IE, STEWART & WEIDNER
Dete:4~
allld . DoL e
Attorney 1.0. No. 41687
301 Morkot Stroet
P,O, Sox 109
Lemoyne, FA 17043.0109
Telophone (7171761.4640
Attornoys lor Insuronce & Surety, Ino.
"--
, I
Ij:I.,1 I ,. , ," ,': "_ (I, ,
" t' , . . .
,.N,pti.I.'f=ar II~DND
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'" 'i 1II"l:i4))lji!Wjltl'i~
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,I 'if !:'!11811J','l',~f 1,
t " I; J "Fd.)'"I' 'II:,
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1.......".t)~' ' , '
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aol ~.... ...__
" 0. lkl- lOll I
\.tllo,.... hMtrlnela 1704).O1~
~._.._J-
VS.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 96-6339
CIVIL ACTION" LAW
INSURANCE & SURETY, INC..
Plslntlff
CUO YOUNG CHAN tIs
SPRING GARDEN RESTAURANT,
Oefondant
PLAINTIFF'S RESPONSE TO DEFEN~Nr'6 NEW MA TTfB
13. No response neoossery,
14, Donled. On tho contrery, the Insurance was ordered with the approval of tho Defendsnt In
tho some monnar In which It had been dona In the past, Desplta repeated requests both IIsrbslly snd In
writing, Oefendsnt neller notified Plaintiff of s desire to cancel or that he hsd purchased other Insurance.
16. Oonlod, This allegetlon Is without buls or foundation. Plaintiff's actions wore In
accordence with Pennsylvania law regulating Insurance brokars.
16. Denied. 60e the allegetlons contained In Plaintiff's Complaint,
17. Donled. Dafendent failed tonollty Plaintiff he hod purchesod enother policy deoplle repeeted
requests and also failed to provide any ellldencll of any such polley despite rapeated requasts In wrlllng
and lIerbally.
lB. Denied. It Is uncerteln etth,s time whether Plaintiff will obteln a rafund. Mora ollar. tha
policy was notluued In error but In accordance with the prectlce which hed bean established between
the pertles In the past.
"
OOlll9-llOO I"Do...."., 19961PWP1N1I1I9Z01
"
JlIlU'/CA T/DN
I, JOleph Q, BUYlkowlkl, Vloo Prolldent of Inaureno. III Surety, InD., verily thet the Itetamontl
mlde In the foregoing Reaponle to New Mltter ere true Ind oorreot to the belt of mv knowledge,
Inlormltlon Ind bellel. I underltend thet 'elle Itltemllnt, herein e,. mede lubjeot to the penllltlel 01 18
Pe,C.S. 14804 ,.Ietlng to unlworn 1IIIIIIIollllon to lIuthorlllel.
Dete: /,). ~" '"
INSURANCE III SURETY, INC.
~<
I'
00I1IV.ooJ17/IJt<.mb" IQ, IVVIIDWDlMllIlVlOI
CERTIFlCA TE 0' SERVICE
I, Dlvld W, DeLuce, 01 thellw firm 01 Johnlcn, Dullle, Stewlrt iii Weldnlr, IUomlVI for Plllntl",
Inlurlnae iii Suretv, Ina" do herobv certltv thlt I served e true end aorrect aopv 01 the Ittached Reaponao
10 Defendant'e New Matter bV Unltld Stltea Mell, IIrat alul, pOltlgl prepaid, upon the Counllllllted
below I
Merk A. Prlmroll, eequlre
Primrose, I.vons lit Qulglev
1 7 North Sheth Street
Stroudsburg, PA 18360
Datel I~~j; a/(;~
" ,
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1
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1
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"
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,
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(OMMONW'ALlH o. ,.NN,YLVANIA
.-.-.-----.."tOlJlIoHOMMON ,ii.i
CUMORRL^NO COUNTY
'J t h JUDICIAL DlIIIICI
HOYlCI 0' A,,.AL
110M
DlnRICT JUIlYlCI JUDOMIHT
COMMON 'LIA' Ho. 'II, ~!i:J 3'J C 1 V j 1 To rill
HOYlCI 0' APPIAL
Notic. I, flI- thol the oppeIlooI "",III.d In the obo.. COUll of C",,,n.., PI.o. Ull "I~'.'~ I,.." Ihl juJlI',.,,,1 ,.,.J...d by the Oi,"ld JUltiel "" lho
dote tnlln tho ~01O rntflIioned bel_
lUlIUlI"ll'PIlUIIl--' ,..-- -,...,., .-.
QUO YOUNG CHAN/BPRIN~ GARDEN RBB'I'AlJllAN'I'
OIlllIIU\YlHIII~-----__n_....... ... "lllV'
RTE" 590, VILL^GE CENTER, "AMLiN V^ 10427
~~~'~~~.__-..,~r:~~~~l!~~"&' "nU~E'rY"
CV 19. to No" 3 2.~___m.
LT 19 . ..._,
-rhiObio,C;;'IU be olpd ONlY .;J-,..,- thi'nO.;'li"" I. '.qul...J und",p;':i.cJ>:Jp,t.jQ,.'
10088.
Thl. Nolic. of A"".oI, wh." rwul...d by II.. Oi."ld Ju,'I,., will opOlol1 01 0
S1JPEMSfDEAS to lho judgment 'or po.....I"" In Ihll '0'"
, 11AAll1ll1I'H!l1llH.l1ll1ll1l1. -
O~I~j~:~.I_.. ._.... __.
.'JH!lC>I---
. ~~-~ ---~. S;g"ullpii" ~'Jl r-tijjJkNJiJiiu y '1.,-tJi;'i/'Y
..".._,.. ... ----...---.... .-_.....'..~J-'-'------'-
INC" em ro~.~~~ tlI\Ilm4 RES!'.
~~,~T~-'.----
___.___. ._.__......~__ ____. .__.____. '_'___h_.___
/I appel/lIlIl was CLAIMANT (see Po. R.C,P,J.P, No.
'00' (6)1n lief/oil btllofO Dlstllct Jusf/eo, 110 MUST
FILE A COMPLAINT wll/llll IWIlllly (20) doys aI/or
fI/lllg Ills NOTICE 01 APPEAL.
'____.n .jliAicIPITO ENTIR RULI TO fiLl COMPLAINT-AND RUi..-.'O.'Ii:i-- .n .,..
(Th16 5OCl/0Il ollonn to bo usod ONLY wht!f1IlPl,elliUlt welS DEfENDANT (sac HI, /lCPJP, No 'OO/f7) /II {)CI/o/! bo/C/o 0/6/1le' JU6/lce,
If NOT USED, dotach I.om Cq'.ly 0/ notice 01 ~X!1l1 t<J IX! Sl!IvlHllJfJo/! 1~)()lIacJ,
'RAICIPI. To Prolhonotary
INSURANCB , SURBTY, INC"
Enl.. ruI. upon ______.__.._.u___.._
N,.,.., 01 IJrfJDIW I j
96-5339 civil Term
(Common !'teo. No. __'
, oppefl..(o), 10 fiI. 0 ,omplolnl In thI. oppeoI
) w,lhln I......,y (20) .Joy. of,.,. ...vI.. 01 ,vie or .uf,., ...try of
.~- .
RULI. To
INBUR^NCE & SURETY, INC.
_01_./
, opp....(.),
01 -"'" '" "" IIflJmoy '" _
rw<< A" l'RIMIOm, E9Q~ '
(I) y"" en noHI!tId thot 0 rule I. htroby ...tered upon you to file 0 ,.Inl In thIl oppeoI w1l111n 1_ly (20) dol" oft.. tho dote of
...vIc. 01 thl. """ upon you by perlOf1oi I...k. or by COfIiI!tld or 1'Ifl1.....d mciL
(2) H you do not fil" 0 compIolnt within thI. Hmo, 0 JUOOMENT Of NON PROS WIll II! ENTERED AGAINST YOU,
(3) The doN of _vice 01 thI. """ II ...vI.. WIll by moll I, tho clot. 0' moiling.
Bopt" 26, 96
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PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT
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COMMONWEAL TII 0' PINNIVLVANIA
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AFFIDAVIT: I '''''''lly.,,,,,,, or 1111"", 11,.,1 ""'.~
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NOTICE 01' APPEAL
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DISTRICT ,lUST ICE JUDGMENT
COMMON 1'1.1.11.6 N.
96 - 53 3 9 C i V 11 'I'erm
NOTIOE OF APPEAL
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PRAECIPE: r" P'''lh,,"ol.'y
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96-5339 Civil Term
ICllll111101l PII!jJ~ Nt), _~__~~~ ~ __. _ u _ '__4~__"'_'__) Within IWull'y 1201 tloy' ah.u ,utvic:;u of lulu ot lulfdr un"v 01 !~nl!tlp.:~..'~I)I1, IHm.
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RULE:
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COMMONWEALTH 01' PENNSYLVANIA
C0UNlY 01': CUM1H:ltLAND
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NOTICE OF JUOGMENT/TRANSCRIPT
09-1-01
'.~.AtNTIFf 1.M'llllllJ ~/}OHlllU
'INSURANCE & SURETY, INC,
P,O. 130)( 696
CAMP HILLr PA 17011
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VB.
DEFENDANT'
/CUO YOUNG CHAN'iS'PRINO""GAltDEN
ItT.590, VILLAGE CENTER
HAMLIN, PA 18427
L
Dooket No,: CV-0000322-96
Dete Flied: 7112/96
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CIIAR1,ES A. CLEMEN'r r JIt.
",",.. 1106 CARI,ISLE ROAD
CAMP HILL, PA
,.1
,,,.,,,,,,,,. 17171761-4940 17011
REBT.--J
ATTORNEY DEF PRIVATE I
MARK PRIMROBEr EBQ.
17 N. 6'rH BTREET
STRAUBBUltG, PA 18360
_J
THIS IS TO NOTIFY YOU THAT!
Judgmenl;
00 Judgment was entered tor: (Name)
[!] Judgment was entered against: (Nama)
In the amount 01 $ 4 . 0 5..Q.Ji 0
o Judgment was entered agall1s1
Lal1dlordfTenanl action In tho amount 01 $ on
The amount 01 rent per month, es eslabllshed by Ihe DIstllc1 Jusllce, Is $
[J Damoges will be asoe6sed 011: (Dote & Time)
PEFAlIL'r JUDGMENT PLTF
INBURAN~TY. INC.
CUO YOUNG CHAN/BPRING GARDEN REBT.
on: - (Dale of Judgmenl) 9/16/96
In a
(Date 01 Judgment)
o This coso dismissed without plejudlce.
o
o
o
o
n Objection lotevy has boon tiled and hearing will ba hald:
l~ate:
Lime:
Possession granted.
Posselslon granted II monay judgment II not
s311sfled by time or eviction.
Possession nol granted.
Levy Is stayod lor _ days or 0 genarally stayed.
Rent In al/ealS $
Damages Unjust Detenllon $
Damages 10 PropGl1yl
Residential Lease: $
Less Amt Due Dafendanl - $
Amount 01 Judgment.. $
Judgmant Costs $
Intalesl on Judgment $__
AlIornoy Feas $
3.9B9L9Jl.
61. 50
.00
.00
TOTAL
$
4.050.50
Place:
ANY PARTY HAS THE RIGHT TO APPEAL A .JUDGMENT INVOLVING A RESIDENTIAL LEASE AND AFFECTING THE
DELIVERY Of POSSESSION OF REAL PROPtRTY WITHIN 10 DAYS OF THE DATE OF JUDGMENT BY FILING A
NOTICE Of APPEAL WITf/ THE PROTHONOTARY/CLERK OF THE COURT OF COMM.C?NlJJ.f~,S, CIVIL DIVISION,
ANY PARTY AGORIEVED BY A JUOGMENT FOR MONEY OR A JUDGMENT INVOLVI,..,a AI.NOt-l/i&SfbENTlAL LEASE
MAY APPEAL WITHIN 30 OAtS OF ENTRY OF THE JUOGMENT BY FILING A NOTI~ OF APPEAL WITH THE
PR, OTHONOTARY/CLERl<r~ COURT OF COMJ'10N P,LEAS, C,IVIL DI~I,~IO~_, ,,-., _ I ,-~ ,;'
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__ '1-1 ~-~~ Dato _ (.l - _ - '-' "" . , "', ..,^ /, __ , '~ , _ ,'~ ?(sttiCt Ju'sllce
I cOl1lfy Ihal thiS Is a truufn~ C0r~~ct copy or 1I10(i'cordl~r lheprocoedlng :,.0"' all)~~~~,~gmont.
__ 'J - I (;::J!!-.._ Oalo ~ r ~~_ l' /( " ~_, " ,( "', / Dlsrflcl,Jusllco
My commission explros first Monday of January, 2002, .... ,;;l/J 'S~L '
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IN THE COURT OF COMMON PLEAS
OF COMlIERLAND COUN'rV - PENNSYLVANIA
Insurano. & sur.ty, Ino., I
IHa1nt:irr I NO. 97"5339 civil
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cuo Young Chan tla spring I
Garden Restaurant, I
D.rendant I
UOTICE OF ARBITRhrION HEARING
YOU ARE HEREBY NOTIFIED that the undeuiqned arbitrator.
appointed by the Court in the above oaptioned matter is scheduled
for Thursday, November 13, 1997, at lt30 p.m, on the Seoond Floor
of the Old Courthouse of Cumberland county, corlisle, PennSYlvania,
at whioh time and place you may appear and be heard, toqether with
your witnesses and your oounsel, if you so desire. ShOUld this
time not be oonveniont to any partYr that party must resohedule the
hearing in this matter.
Datedl Ootober 6r 1997
\~~~
...-:... -.--=--
H. n ony ams, squire
Chairman
copies tOI
sally Winder, Esquire
701 E. King street
Shippensburg, PA 17257
Arbitrator
David W. DeLuce, Esquire
301 Market street
P.O. Box 109
Lemoyne, PA 17043-0109
Attorney for Plaintiff
Riohard Webber, Esquire
366 Green spring Road
Newville, PA 17241
Arbitrator
Mark A" primrose, Esquire
17 North sixth street
stroudsburg, PA 18360
Attorney for Defendant
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