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HomeMy WebLinkAboutInsurance City Policies - Arthur J. Gallagher (2007-2009) CITY OF RENTON
Arthur J. Gallagher Risk Management Services, Inc. MAR 2 7 2009
CITY CLEK SEOFFICE
February 2, 2009
Ms. Paulie Sulky
City of Renton
1055 South Grady Way
Renton, WA 98055
RE: Storage Tank Liability Policy#007786457
Policy Period: January 1, 2009 to January 1, 2010
Dear Paulie:
Enclosed please find the Storage Tank Liability Policy for City of Renton through
Commerce and Industry Insurance Company effective January 1, 2009. We have
reviewed this policy for accuracy and have found it to be correct as it was quoted to you.
Please review and let us know if you have any questions.
Thank you!
Sincerely,
Arthur J. Gallagher Risk Management Services, Inc.
(4,a,C't
ulie Vierra, CISR
Senior Account Manager
JV/j
Enclosure
6399 South Fiddler's Green Circle,Suite 200
Greenwood Village, CO 80111-4949
303.773.9999
Fax 303.773.9776
Toll Free 800.333.3231
www.ajg.com
Fj
Ii
COMMERCE AND INDUSTRY INSURANCE COMPANY
(Executive Offices) (Administrative Offices)
70 PINE STREET 175 WATER STREET
NEW YORK,N.Y. 10270 NEW YORK,N.Y. 10038
A Capital Stock Company
(herein called the"Company")
AIG Environmental 0
STORAGE TANK THIRD-PARTY LIABILITY CORRECTIVE ACTION AND CLEANUP COSTS
j' POLICY
DECLARATIONS
IS IS A CLAIMS-MADE AND REPORTED POLICY. PLEASE READ CAREFULLY.
POLICYNUG1IIB : 007786457
Cityof Renton
Item 1. NAME D INSURED:
ADDRESS: 1055 South Grady Way
Renton, WA 98055
Item2. POLIC PERIOD: FROM 01/01/09 TO 01/01/10
12:01 AM Standard Time at the Address of the Named Insured shown above
Item 3. LIMIT •F LIABILITY: $ 2, 000,000 EACH INCIDENT LIMIT
i
�i $ 2, 000 ,000 AGGREGATE LIMIT
Item 4. DEDU•TIBLE: $ 25,000 EACH INCIDENT
Item 5. COVE-ED STORAGE TANK SYSTEM(S): See Storage Tank Schedule
Item 6. RETR*ACTIVE DATE: See Storage Tank Schedule
Item 7. POLIC PREMIUM: $2,4 3 4. 0 0
Premiu for Certified Acts of Terrorism Coverage Under TRIA 2002;
402 CO Included in Policy Premium
Item 8. FORM.,ENDORSEMENTS AND SCHEDULES ATTACHED TO THIS POLICY: See Attached Form ScI•edule
BROKER: Iha •er Insurance Agency Services
BY
AUTHORIZED REPRESENTATIVE
or countersignature(in states where applicable)
Copyright,American International Group,Inc,2002 Pag 1 of 1
81206(11/02)
CI1948 I CIT0010
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POLICYHOLDER NOTICE
a • I you for purchasing insurance from a member company of American International
•up, Inc. (MG). The MG member companies generally pay compensation to brokers
Etta
d independent agents,and may have paid compensation in connection with your policy.
Y u can review and obtain information about the nature and range of compensation paid
b MG member companies to brokers and independent agents in the United States by
vi,iting our website at www.aigproducercompensation.com or by calling MG at 1-800-
� 7 u 6-3102.
i
•1222(07106)
,
AMERICAN INTERNATIONAL COMPANIES®
i MG ENVIRONMENTAL®
- STO1RA E TANK THIRD-PARTY LIABILITY, CORRECTIVE ACTION AND CLEAN-UP
COSTS POLICY
NOTtCEi 1TH IS A CLAIMS-MADE-AND-REPORTED POLICY. PLEASE READ CAREFULLY. ADDITIONALL .
THIS POLIC HAS CERTAIN-PROVISIONS AND REQUIREMENTS UNIQUE TO IT AND MAY BE DIFFER T
FROM6TH POLICIES THE INSURED MAY HAVE PURCHASED. DEFINED TERMS, OTHER
HEADINGS, PEAR IN BOLD FACE TYPE. .
THE DES;CRI TIONS IN ANY HEADINGS OR SUB-HEADINGS OF THiS POLICY ARE INSERTED SOLELY jF R
CONVENIEN E AND DO NOT CONSTITUTE ANY PART OF THE TERMS OR CONDITIONS HEREOF. 1
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In consideration of the payment of the premium, in reliance upon the statements in the Declarations anti the
AppIIcatk n,annexed hereto and made a part of this Policy or,if not annexed hereto,which are deemed to be annexed
hereto arid made a part of this Policy, and pursuant to all of the terms of this Policy, the Company agrees with the
Named Insured as follows:
L INSURING AGREEMENT
1. CO GES:
CO i GE A—THIRD PARTY BODILY INJURY AND PROPERTY DAMAGE DUE TO A STORAGE TANK
RELEAS
I
To pray on behalf of the Insured,Loss that the Insured becomes legally obligated to pay as a result of Claims
for Bodily Injury or Property Damage resulting from Pollution Conditions from a covered Storage Tank
System, provided such Claims are first made against the insured and reported to the Company In writing
duriz g this Policy Period or during the Extended Reporting'Period. If applicable.The Pollution Condition
must commence on or after the Retroactive Date as shown in Item 6 of the Declarations. I
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CO GE B-CLEAN-UP COSTS OR CORRECTIVE ACTION DUE TO A STORAGE TANK RELEASE
To do behalf of the Insured Clean-Upo pay Costs or Corrective Action that the Insured becomes legally
obi x- , to pay as a result of a Continued Release from a covered Storage Tank System, provided'stch
. Confitm�-. Release is first reported to the Company In writing during the Policy Period or during e
Extend: . Reporting Period, if applicable. The Pollution Condition must commence on or after the
Retroa a Date as shown in Item 6 of the Declarations. 1
2. VEF SE:
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Them any shall have the right and duty to defend any Claims covered under Coverage A or any civi or
adman a proceedings or suits which seek to impose a legal obligation upon the Insured to and ice
Clean-U Costs,or Corrective Action for a Confirmed Release to which Coverage B applies: lihe
Corpan s duty to defend or continue defending any such Claims,civil or administrative proceedings or suits
and Ito y any Loss, Corrective Action, Clean-Up Costs or defense costs, charges and expenses tali
creaseonce the applicable limit of liability, as described In Section V. LIMITS OF LiABILiTYI D
DE UC BLE,has been exhausted.
3. IND PENDENT COUNSEL:
In tie event the Insured is entitled by law to select independent counsel to defend the Insured at the Compa?y s
expense, the attorney fees and all other litigation expenses the Company must pay to that counsel are limited to
81106(i0/05)
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the rates the Company would actually a to counsel
In the de ense of similar Claims in the community wherre ththe
CI Claim arose retains
being defended course of bu mess
if
Additionslly,the Company may exercise the right to require that such counsel have certain minimum qualifications
with respect to their competency,including experience in defending Claims similar to the one pending against the
Insured, and to require such counsel to have errors and omissions insurance coverage. As respects any sr.ch
counsel, a Insured agrees that counsel will timely respond to the Company's request for information regards g
the Clai .The Insured may at any time,by its signed consent,freely and fully waive its right to select independent
counsel.
4. S EMENT:
The I Co pany will present any settlement offers to the Insured, and if the Insured refuses to consent to any
settleme t within the limits of liability of this Policy recommended by the Company and acceptable to the claimant,
the Com any's duty to defend the Insured shall then cease and the Insured shall thereafter negotiate or defend
such CI- m independently of the Company and the Company's liability shall not exceed the amount, less the
Dedil ctth a or any outstanding Deductible balance, for which the Claim could have been settled if such
recom ndation was consented to.
IL EXCLU ONS
1. CO MON EXCLUSIONS-APPLICABLE TO ALL COVERAGES:
is •oiicy does not apply to Claims,Clean-Up Costs or Corrective Action,or Loss:
A. a RIMINAL FINES,PENALTIES,AND ASSESSMENTS:
ue to any criminal fines,criminal penalties or criminal assessments.
B. •ONTRACTUAL LIABILITY:
• ing from liability of others assumed by the Insured under any contract or agreement,unless the Iiabllfty
• the Insured would have attached in the absence of such contract or agreement or the contract or
a.reement Is an Insured Contract.
C. INTENTIONAL NONCOMPLIANCE:
Arising from Pollution Conditions based upon or attributable to any Responsible Insured's intention ,
wilful or deliberate noncompliance with any statute, regulation including those set forth In Title 40 of tte
e of Federal Regulations, ordinance, administrative complaint, notice of violation, notice letter.
• ecutive order,or instructions of any governmental agency or body.
D. I TERNAL EXPENSES:
Fir costs,charges or expenses incurred by the Insured for goods supplied or services performed by the
s -. or salaried employees of the Insured,or its parent,subsidiary or affiliate,except if in response to an
ergency or pursuant to Environmental Laws that require Immediate remediation of Pollutlb
•nditions,or unless such costs,charges or expenses are incurred with the prior written approval of th e
pany in its sole discretion.
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E. NSURED vs. INSURED:
rising from a Claim brought by any Insured against any other person or entity who is also an
nsured under this Policy. This exclusion does not apply to Claims initiated by third parties or Claims
hat arise out of an indemnification given by one Named Insured to another Named Insured in an
nsured Contract.
.I
F. MPLOYER LIABILITY:
rising from Bodily Injury to an Insured or its parent, subsidiary or affiliate arising out of and in the
nurse of employment by the Insured or its parent, subsidiary or affiliate. This exclusion applies
hether the Insured may be liable as an employer or in any other capacity and to any obligation to
-hare damages with or repay third parties who must pay damages because of the injury.
'G. -RIOR KNOWLEDGE/NON-DISCLOSURE:
•rising from Pollution Conditions existing prior to the Inception Date and known by a Responsible
nsured and not disclosed in the application for this Policy, or any previous policy for which this
-olicy is a renewal thereof.
H. OST TO CONFIRM A RELEASE FROM A STORAGE TANK SYSTEM:
or any costs, charges or expenses incurred to investigate or certify that a Confirmed Release has
aken place,
I. OST TO REPAIR, REPLACE OR UPGRADE A STORAGE TANK SYSTEM:
For any costs arising out of the reconstruction, repair, replacement, upgrading or rebuilding of any
Storage Tank System or for any other improvements, site enhancements or routine maintena ce
on, within or under the site at which Storage Tank Systems are located.
J. DIVESTED STORAGE TANK SYSTEMS OR SITES:
Arising from Pollution Conditions or Confirmed Releases which commence after the date that a
covered Storage Tank System, or the site at which the Storage Tank System is located, is sbld,
' given away, abandoned, or subleased, unless the sublease has been approved in writing by the
underwriter prior to the commencement of the sublease.
K. STORAGE TANK SYSTEM CONTENTS:
1. Arising from physical injury, including but not limited to contamination, of the contents of a
Storage Tank System; or
2. Arising out of Property Damage due to physical injury, including but not limited to
contamination, of the contents of a Storage Tank System; or
3. For any costs arising out of the removing, replacing or recycling of the contents of any
Storage Tank System.
L. WAR
•rising directly or indirectly as a result of or in connection with war, whether declared or not or
=ny act or condition incident to war. War includes civil war, insurrection, act of foreign enemy,
ivil commotion, factional civil commotion, military or usurped power, rebellion or revolution.
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III. NOTICE REQUIREMENTS AND CLAIM PROVISIONS
The Ins red shall provide the Company with notice of Confirmed Release, Claim and Pollution Conditi , as
follows:
1. n the event of a Confirmed Release, Claim or Pollution Condition, the Insured shall give wri ten
otice to:
Manager, Pollution Insurance Products Unit
AIG Technical Services, Inc.
Environmental Claims Department
101 Hudson St. • 31" Floor
Jersey City, NJ 07302
Fax: 201-631-5051
or other address(es) as substituted by the Company in writing.
2. he Insured shall give written notice of Claims, a Confirmed Release or Pollution Conditions as oon
•s possible, but in any event during the Policy Period or during the Extended Reporting Perlo., if
=pplicable. Notice under all coverages shall include, at a minimum, information sufficient to identify
he Named Insured, the Storage Tank System, the names of persons with knowledge of the Poll Lion
•nditions and all known and reasonably obtainable information regarding the time, place, ca se,
nature of and other circumstances of the Pollution Conditions. The Insured shall forward the
following to the Company as soon as possible:
la) All reasonably obtainable information with respect to the time, place and circumstances thereof,
and the names and addresses of the claimantls) and available witnesses;
(b) All correspondence between the Insured and any third party Claimant, including but not
limited to any Implementing Agency; and all demands, summonses, notices or other proses or
papers filed with a court of law, administrative agency, Implementing Agency or an investigative
body; and
(c) Other information in the possession of the Insured or its hired experts which the Com any
reasonably deems necessary.
IV. RIGHT` OF THE COMPANY AND DUTIES OF THE INSURED IN THE EVENT OF POLLUTION CONDITIONS
A. The Company's Rights
The Company shall have the right but not the duty to clean up or mitigate Pollution Conditions upon
rec-iving notice as provided in Section III. of this Policy. Any sums expended in taking such action b the
Co pany will be deemed incurred or expended by the Insured and shall be applied against the limi s of
Iiabrility and deductible under this Policy.
B. Dut es of the Insured
The Named Insured shall have the duty to clean up Pollution Conditions to the extent require by
Env ronmental Laws, by retaining competent professional(s) or contractorts) mutually acceptable to the
Co pany and the Named Insured. The Company shall have the right but not the duty to review and
app eve all aspects of any such clean-up. The Named Insured shall notify the Company of actions and
me:sures taken pursuant to this Paragraph.
81106 (10 05)
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V. LIMITS OF LIABILITY AND DEDUCTIBLE
Regardless of the number of Claims, Claimants, Confirmed Releases, Pollution Conditions or insureds
under t is Policy, the following limits of liability apply:
A. 'Co erage A and B Aggregate
The Company's total liability for all Loss covered under Coverage A and Clean-Up Costs and
C ective Action covered under Coverage B shall not exceed the "Aggregate Limit" stated in Item 3
oft e Declarations.
B. Eac Incident Limit
Sub eat to Paragraph V.A. above, the most the Company will pay for all Loss and Clean-Up Costs and
Co ective Action arising from the same, related or continuous Pollution Conditions is the " ach
Incident" limit of coverage stated in Item 3 of the Declarations. "Each Incident" as used within',this P licy
sha I mean each same, related or continuous Pollution Condition.
C. Rel-ted Claims
1, If the Insured first reports a Claim, Confirmed Release or discovers Pollution Conditions 'durn the
Policy Period and reports them to the Company in accordance with Section III., all continuo s or
related Pollution Conditions reported to the Company under a subsequent policy issued by the
' Company or its affiliate providing substantially the same coverages as this Policy shall be dee ed
to have been first discovered and reported during this Policy Period and shall be subject to the
same Limit of Liability.
2. All Claims and reports of Confirmed Releases made during one or more policy periods issue by
the Company or its affiliate providing substantially the same coverages, resulting in Las 1, or
Clean-Up Costs or Corrective Action, or in any combination thereof, and arising out of the same,
or continuous or related Pollution Conditions, shall be considered one incident and will be su li
ject
to the same Limit of Liability. Such Claims or reports of Confirmed Releases shall be deemed first
reported to the Company during the policy period in which the first such Claim or report of
Confirmed Release was reported to the Company or an affiliate and will be subject to the Limit of
Liability applicable to that policy period.
D. De'uctible
Su dear to Paragraphs V. A.. and V. B. above, this Policy will pay Clean-Up Costs, Corrective.Action or
L. in excess of the Deductible amount stated in Item 4 of the Declarations up to but not exceeding the
applicable "Each Incident" limit of coverage.
Th Insured shall promptly reimburse the Company for advancing any element of Clean-Up Cos or
Co active Action or Loss falling within the Deductible.
VI. COND IONS
A. As ignment - This Policy may be assigned with the prior written consent of the Company, w ich
co sent shall not be unreasonably withheld or delayed. Assignment of interest under this Policy hall
not bind the Company until its consent is endorsed thereon.
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B. Su rogation In the event of any payment under this Policy, the Company shall be subrogatel t all
the Insured's rights of recovery therefor against any person or organization and the Insured hall
execute and deliver instruments and papers and do whatever else is necessary to secure such ri hts
81106i�(10105)
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ncl ding without limitation, assignment of the Insured's rights against any person or organize ion
who caused Pollution Conditions on account of which the Company made any payment under his
Poll y. The Insured shall do nothing to prejudice the Company's rights under this Paragr ph
,sub equent to Loss.
Any recovery as a result of subrogation proceedings arising out of the payment of Loss. Chian Up
Cos s or Corrective Action covered under this Policy shall accrue first to the Insured to the extent of
any payments in excess of the limit of coverage; then to the Company to the extent of its payment
and r the Policy; and then to the Insured to the extent of its Deductible. Expenses incurred in such
Subrogation proceedings shall be apportioned among the interested parties in the recovery in the
Proportion that each interested party's share in the recovery bears to the total recovery.
C. Cooperation - The Insured shall cooperate with the Company and offer all reasonable assistance in the
investigation and defense of Claims under the applicable Coverages purchased. The Company may
requ're that the Insured submit to examination under oath, and attend hearings, depositions and trial . In
the ourse of investigation or defense, the Company may require written statements or the Insured's
ate dance at meetings with the Company. The Insured must assist the Company in, of ecting
'sett ement, securing and providing evidence and obtaining the attendance of witnesses.
D. jCha gas - Notice to any agent or knowledge possessed by any agent or by any other person shall not
'effe t a waiver or a change in any part of this Policy or estop the Company from asserting any rights
and r the terms of this Policy; nor shall the terms of this Policy be waived or changed, except by
end rsement issued by the Company to form a part of this Policy.
E. ;Vol ntary Payments - No Insured shall voluntarily enter into any settlement, or make any payment or
ass me any obligation unless in response to an emergency or pursuant to Environmental Laws that
req ire immediate remediation of Pollution Conditions, without the Company's consent which shall not
be nreasonably withheld, except at the Insured's own cost.
F. 'Co cealment or Fraud - This entire Policy shall be void if, whether before or after Clean-Up Cos or
Cor ective Action are incurred or a Claim is first made, the Named Insured has willfully concealed or
mis epresented any fact or circumstance material to the granting of coverage under this policy,
incl ding but not limited to, the description of the Storage Tank System, or the interest of the Insured
the ein.
(G. 'Cancellation -This Policy may be cancelled by the Named Insured by surrender thereof to the Company
or al
ny of its authorized agents or by mailing to the Company written notice stating when thereafter the
Ivan ellation shall be effective. This Policy may be cancelled by the Company only for the reasons stated
bel•w by mailing to the Named Insured at the address shown in,the Policy, written notice stating when,
not less than 60 days (10 days for nonpayment of premium or material misrepresentation by the
Ins red),thereafter such cancellation shall be effective. Proof of mailing of such notice shall be suffi•ient
pro•f of notice.
1_ Material misrepresentation by the Insured;
' 2. The Insured's failure to comply with the material terms, conditions or contractual obligations u der
this Policy, including failure to pay any premium when due;
3. A change in operations at a facility containing a Storage Tank System during the Policy Period that
materially increases a risk covered under this Policy.
Th: time of surrender or the effective date and hour of cancellation stated in the notice shall becOm: the
end of the Policy Period. Delivery of such written notice either by the Named Insured or by the Company
sha I be equivalent to mailing. If the Named Insured cancels, earned premium shall be computed in
accordance with the customary short rate table and procedure. If the Company cancels, earned premium
81106 (10 05)
C12766
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(shall be computed pro-rata. Premium adjustment may be either at the time cancellation is effected or as
ii
soon as practicable after cancellation becomes effective, but payment or tender of unearned premium is
not a condition of cancellation.
H. 'Oth r Insurance - If other valid and collectible insurance or funds from any Tank Fund are availabl to
11
the nsured for Loss, Clean-Up Costs or Corrective Action covered by this Policy, the Insured shall
pro ptly, upon the request of the Company, provide the Company with copies of all such policie or
fund documentation. The Company's obligations are limited as follows:
1. xcept as set forth in subparagraph 3. of this Paragraph, this insurance is primary; and he
ompany's obligations are not affected unless any of the other insurance is also primary. In t at
ase, the Company will share with all such other insurance by the method described in Paragr ph
. below.
2. f all of the other insurance permits contribution by equal shares, the Company will follow his
ethod also. Under this approach each insurer contributes equal amounts until it has paid its
pplicable limit of insurance or none of the loss remains, whichever comes first. If any of the
ther insurance does not permit contribution by equal shares, the Company will contribute by
imits. Under this method, each insurer's share is based on the ratio of its applicable lirni of
nsurance to the total applicable limits of insurance of all insurers.
,3. his insurance shall apply as excess insurance over any Tank Fund, provided that in the even of
' he receivership, insolvency, or inability to pay of any state fund or program, this insurances all
ct as primary insurance. Where this insurance is excess, the Company will pay only its shear of
, he amount of Loss, Clean-Up Costs or Corrective Action, if any, that exceeds the total amo nt
vailable through the Tank Fund.
I. Rig t of Access end Inspection — To the extent the Insured has such rights, any of the Company's
aut orized representatives shall have the right and opportunity but not the obligation to intary ew
per ons employed by the Insured and to inspect at any reasonable time, during the Policy Period or
thereafter, the Storage Tank System or the site at which the Storage Tank System is located. Neither
the Company nor its representatives shall assume any responsibility or duty to the Insured or f o any
loth r party, person or entity, by reason of such right or inspection. Neither the Company's righ to
ryma e inspections, sample and monitor, nor the actual undertaking thereof nor any report thereon shall
con titute an undertaking on behalf of the Insured or others, to determine or warrant that propart yi
or
ape ations are safe, healthful or conform to acceptable engineering practices or are in compliance
wit any law, rule or regulation. The Named Insured agrees to provide appropriate personnel to as ist
the ompany's representatives during any inspection.
J. !A ass to Information - The Named Insured agrees to provide the Company with access to ny
info mation developed or discovered by the Insured concerning Loss, Clean-Up Costs or Corre NsAct on, or Pollution Conditions covered under this Policy, whether or not deemed by the Insured t be
rele ant to such Loss, Clean-Up Costs or Corrective Action, or Pollution Conditions and to provide the
Co party access to interview any Insured and review any documents of the Insured.
K. 'Rep esentations - By acceptance of this Policy, the Named Insured agrees that the statements in the
De iarations, the Application and, if applicable, the Report/Worksheet are their warren ies,
agr ements and representations, that this Policy is issued in reliance upon the truth of ssich
wa ranties, agreements and representations and that this Policy embodies all agreements existing
bet een the Insured and the Company or any of its agents relating to this insurance.
L. Acton Against Company - No third-party action shall lie against the Company, unless as a condition
precedent thereto there shall have been full compliance with all of the terms of this Policy, nor until
the amount of the Insured's obligation to pay shall have been finally determined either by judgment
811061{10l05}
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I�gai st the Insured after actual trial or by written agreement of the Insured, the claimant and the
Corn any.
Any arson or organization or the legal representative thereof who has secured such judgment or written
ggre ment shall thereafter be entitled to recover under this Policy to the extent of the insurance afforded
Loy t e Policy. No person or organization shall have any right under this Policy to join the Company als a
part to any action against the Insured to determine the Insured's liability, nor shall the Company be
imp) aded by the Insured or his legal 'representative. Bankruptcy or insolvency of the Insured or of the
Insu d's estate shall not relieve the Company of any of Its obligations hereunder.
M. Arbi ration - It is hereby understood and agreed that all disputes or differences that may arise un er
or in connection with this Policy, whether arising before or after termination of this Policy, inclu ing
any etermination of the amount of Loss, may be submitted to the American Arbitration Associa ion
j"A A") under and in accordance with the United States Arbitration Act (9 U.S.C.) and the then
prey !ling commercial arbitration rules of the AAA. The arbitrators shall be chosen in the manner and
I�,vith n the time frames provided by such rules. If permitted under such rules, the arbitrators shall be
thre disinterested individuals having knowledge of the legal, corporate management, or irtisura ce
issu s relevant to the matters in dispute.
If4ny party may commence such arbitration proceeding and the arbitration shall be conducted in he
�nsu ed's state of domicile. The arbitrators shall give due consideration to the general principles of the
flaw f the Insured's state of domicile in the construction and interpretation of the provisions of his
Poli y; provided, however, that the terms, conditions, provisions and exclusions of this Policy ar to
be nstrued in an evenhanded fashion as between the parties. Where the language of this Policy is
elle ed to be ambiguous or otherwise unclear, the issue shall be resolved in the manner most
con istent with the relevant terms, conditions, provisions or exclusions of the Policy (without regard
to the authorship of the language, the doctrine of reasonable expectation of the parties and wit lout
any presumption or arbitrary interpretation or construction in favor of either party or parties, an in
laccordance with the intent of the parties).
The written decision of the arbitrators shall set forth its reasoning, shall be provided simultaneously to
bot parties and shell be binding on them. The arbitrators' award shall not include attorney fees or
'other costs. Judgment on the award may be entered in any court of competent jurisdiction Each
part shall bear equally the expenses of the arbitration.
N. Cho ce of Law - In the event that the Insured and the Company dispute the validity or formation of
this Policy or the meaning, interpretation or operation of any term, condition, definition or provisio of
!this Policy resulting in litigation, arbitration or other form of dispute resolution, the Insured and the
Co pany agree that the law of the State of New York shall apply.
O. 'IAck owledgment of Shared Limits - By acceptance of this Policy, the Named Insureds underst nd,
agr:e and acknowledge that the Policy contains an Aggregate Limit that is applicable to, and wil be
sha ed by, all Named Insureds and all other Insureds who are or may become insured hereunder. In
'vie of the operation and nature of this shared Aggregate Limit, the Named Insureds and all o her
Ins reds understand and agree that prior to filing a Claim or reporting a Confirmed Release under the
Poli y, the Aggregate Limit may be exhausted or reduced by prior payments for other Claims, Clan-
Up oats or Corrective Action under the Policy.
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VII. EXTEND D REPORTING PERIOD FOR CLAIMS
1
The NaI ad Insured shall be entitled to an Automatic Extended Reporting Period, and (with certain exceptions
as described in Paragraph B. of this Section) be entitled to purchase an Optional Extended Reporting Period
for any overages terminated, upon termination of coverage as defined in Paragraph B.3. of this Sectin.
Neither t e Automatic nor the Optional Extended Reporting Period shall reinstate or increase any of the brnits
of Liabili y of this Policy.
A. Automatic Extended Reporting Period
1Prov ded that the Named Insured has not purchased any other insurance to replace this insurance nd
whic applies to a Claim or a Confirmed Release otherwise covered hereunder, the Named Insured shall
pav> the right to the following: a period of six (6) months following the effective date of sich
term nation of coverage in which to provide written notice to the Company of a Claim first made Fluting
The 'alley Period or Automatic Extended Reporting Period and first reported within the Autom is
Exte ded Reporting Period, or Confirmed Release first reported within the Automatic Extended Rep ing
Peri.d.
ail
IA C -im first made during the Policy Period or Automatic Extended Reporting Period and first reported
with n the Automatic Extended Reporting Period, or Confirmed Release first reported .within Ithe
Aut.matic Extended Reporting Period will be deemed to have been made on the last day of the Po icy
'Per'.d, provided that the Claim or Confirmed Release arises from Pollution Conditions that commenCed
befo e the end of the Policy Period and is otherwise covered by this Policy. No part of the Automatic
Ext> ded Reporting Period shall apply if the Optional Extended Reporting Period is purchased.
B. 1Opti.nal Extended Reporting Period
The Named Insured shall be entitled to purchase an Optional Extended Reporting Period upon termina:ion
f coverage as defined herein (except in the event of nonpayment of premium), as follows:
1. . Claim first made during the Policy Period or during the Optional Extended Reporting Period end-irst
eported during the Optional Extended Reporting Period, or a Confirmed Release first reported wiEhin
he Optional Extended Reporting Period, if purchased in accordance with the provisions contained in
'aragraph 2. below, will be deemed to have been made on the last day of the Policy Period, provi ed
hat the Claim or Confirmed Release arises from Pollution Conditions that commenced before the nd
.f the Policy Period and is otherwise covered by this Policy.
2. he Company shall issue an endorsement providing an Optional Extended Reporting Period of up to
orty (40) months from termination of coverage hereunder for all Storage Tank Systems, or fbr a
torage Tank System located at a specific facility, provided that the Named Insured:
a) makes a written request for such endorsement which the Company receives within sixty .60)
days after termination of coverage as defined herein; and
(b) pays when due an amount equal to the premium for the Optional Extended Reporting Period
plus any premium for the Policy Period which is owed and has not yet been paid, Ifi these
premiums are paid when due, the Extended Reporting Period may not be cancelled, provided that
all other terms and conditions of the Policy are met.
3. Termination of coverage occurs:
I
(a) at the end of the Policy Period, or -
81106iy(10/05)
CI2766
' 9
(o) at the time the Policy or renewal policy becomes effective with a decrease in the limit of Iiabilti y,
a reduction of coverage, an increased deductible or self-insured retention, new exclusion or any
other change in coverage less favorable to the Insured.
4. he Optional Extended Reporting Period is available to the Named Insured for not more than 1 %
, if the policy premium of this Policy.
VIII. DEFI ITIONS
A. :odily Injury means physical injury, or sickness, disease, mental anguish or emotional distr ss
ustained by any person including death resulting therefrom.
B. laim means a written demand received by an Insured seeking a remedy and alleging liabilit or
r-sponsibility on the part of the Insured for Loss.
C. lean-Up Costs means:
Reasonable and necessary expenses for the investigation, removal or remediation of Pollution
Conditions including associated monitoring, or disposal of soil, surfacewater, groundwater or
other contamination:
(a) To the extent required by Environmental Laws; or
(b) That have been actually incurred by the government or any political subdivision of the Un ted
States of America or any state thereof or Canada or any province thereof, or by third pri
lean-Up Costs also include Restoration Costs.
D. onfirmed Release means Pollution Conditions from a Storage Tank System, including those from
-n overfill of a Storage Tank System, that has been investigated and confirmed by or on behal of
he Insured during the Policy Period through a system tightness test, site check, or other
•rocedure approved by the Implementing Agency in accordance with Environmental Law.
E. orrective Action means:
, Reasonable and necessary costs for response, abatement, investigative, and removal actions
resulting from a Confirmed Release as legally required by Subpart F of the federal underground
storage tank regulations, 40 C.F.R. 280.60 through 280.66, and 280.72, or as leally
required by other applicable federal regulations or by other applicable regulations promulg ed
by a state under an underground storage tank program approved by the United States
Environmental Protection Agency in accordance_ with Section 9004 of the Resource
Conservation and Recovery Act of 1976, as amended;
. Reasonable and necessary costs far the cleanup, pursuant to a written order from the
Implementing Agency and with the prior written approval of the Company, of Pollution
Conditions in soil or groundwater due to a Confirmed Release, including the preparation,
development, modification and implementation of a "corrective action plan" as defined i 40
C.F.R. 280.66, and the monitoring, evaluation and reporting of the results of the
implementation of such plan.
F. Environmental Laws means any federal, state, provincial or local laws (including, but not limte to,
statutes, rules, regulations, ordinances, guidance documents, and governmental, judicial or
administrative orders and directives)that are applicable to Pollution Conditions.
811061(10 05)
C12766
10
G. tended Reporting Period means either the automatic additional period of time or the optional
dditional period of time, whichever is applicable, in which to report Claims or Confirmed Re ea es
ollowing termination of coverage, as described in Section VII. of this Policy.
H. Implementing Agency means the Federal Environmental Protection Agency or a state orl I cal
.gency having jurisdiction pursuant to Environmental Laws.
I. nception Date means the first date set forth in Item 2 of the Declarations.
J. nsured means the Named Insured, and any past or present director, officer, partner or employee
hereof, including a temporary or leased employee, while acting within the scope of his or her duties
s such.
K. nsured Contract means a contract or agreement submitted to and approved by the Company, nd
isted on a Scheduled Insured Contract Endorsement to this Policy.
L. oss means, under the applicable Coverages:
. Monetary awards or settlements of compensatory damages; where allowable by law, punit ve,
exemplary, or multiple damages; and civil fines, penalties, or assessments for Bodily Injury' or
Property Damage; or
. Clean-Up Costs or Corrective Action.
M. amed Insured means the person or entity named in Item 1 of the Declarations acting on be ialf
•f all other Insureds, if any, for the payment or return of any premium, payment of any
I •eductible, receipt and acceptance of any endorsement issued to form a part of this Policy, gh ing
nd receiving notice of cancellation or nonrenewal, and the exercise of the rights provided in the
' Extended Reporting Period clause.
N. Policy Period means the period set forth in Item 2 of the Declarations, or any shorter period ari ing as
a result of:
I 1. Cancellation of this Policy; or
2. With respect to particular Storage Tank System(s):
(a) the deletion or addition of such Storage Tank System from this Policy by the Company at the
Named Insured's written request, but solely with respect to that Storage Tank Systemf
(b) the sale, giving away or abandonment of a Storage Tank System, or the sub-leasing of
such Storage Tank System, unless the sub-lease has been approved in writing by the
Company prior to the commencement of the sub-lease.
O. Pollution Conditions means the discharge, dispersal, release or escape of any solid, liquid, gaseous or
thermal irritant or contaminant, including, but not limited to, smoke, vapors, soot, fumes, aids,
alkalis, toxic chemicals, medical waste and waste materials into or upon land, or any structure on
land, the atmosphere or any watercourse or body of water, including groundwater, provided Such
conditions are not naturally present in the environment in the amounts or concentrations discovered.
81106II(10(05)
CI2766
11
i I
I ,
l. •roperty Damage means:
1. Physical injury to or destruction of tangible property of parties other than the Insured includ ng
the resulting loss of use thereof;
Loss of use of tangible property of parties other than the Insured that has not been physically
injured or destroyed;
' I
'roperty Damage does not include Clean-Up Costs or Corrective Action.
t. 'esponsible Insured means the manager or supervisor of the Named Insured responsible for
nvironmental affairs, control or compliance, or any owner or operator of a Storage Tank System, or
-ny officer, director or partner of the Named Insured.
I I
R. estoration Costs means reasonable and necessary costs incurred by the Insured with [the
ompany's written consent, which consent shall not be unreasonably withheld or delayed, to repair,
place or restore real or personal property to substantially the same condition it was in prior to bging
amaged during work performed in the course of incurring Clean-Up Costs or Corrective Action.
owever, such Restoration Costs shall not exceed the net present value of such property pio to
i curring Clean-Up Costs or Corrective Action. Restoration Costs do not include costs associ ted
ith improvements or betterments.
S. torage Tank System means a stationary tank or tanks owned or operated by the Insured and shown
i Item 5 of the Declarations. Storage Tank System includes any on site integral piping or dispen ing
quipment, ancillary equipment and containment system associated with the tanks.
T. ank Fund means any state storage tank trust fund
, state administered insurance program or
estoration funding for Storage Tank Systems whose owners qualify for reimbursement, or I ny
elf insurance fund established for the purpose of funding Clean-Up Costs or Corrective Action for
•ollution Conditions from a Storage Tank System.
The remain,er of this page has been intentionally left blank, Policy Signature Page shall immediately follo
I �
81106 (10 05)
Cl2766
12
MG ENVIRONMENTAL
NOTICE OF LOSS/NOTICE OF CLAIM
INSTRUCTIONS: PLEASE ATTACH ALL CORRESPONDENCE RELATING TO THIS NOTICE OF LOSS AND MAIL COPIES OF THIS NOTICE
TO EACH ADDR .S BELOW:
Manager, Pollution Insurance Products Dept,
AIG Domestic Claims, Inc.
Attn.:CID
101 Hudson Street, 31"Floor
Jersey City, NJ 07302
Fax: 866-260-0104
Email: severityfnol@aig.corn
Date of Notice:
NAMED INSURED: Telephone: ( )
Contact:
ADDRESS OF IN•URED:
II I
BROKER NI ME: Telephone: { )
Contact:
BROKER ADD' SS:
POLICY INFO' TION:
Policy Number:
Policy Period: F .m: To:
Loss Informati.n:
11
Loss Location:
h� I
Date& Descrip.ion of Loss:
it
4�I
YI
For MG Use On y:
Date Claim Not ce Received:
Date of Chaim:
II "—
Company/Per •n Filing Suit(if applicable):
NOTE:A y pe son who knowingly files a Statement of Claim containing any false or misleading information is subject tl
criminal and c vil penalties.
91968 (12/0.) PAGE 1 OF 1
C12940
it
FORMS SCHEDULE
Named In ured: City of Renton
Policy Number: 007736457
Effective 12:01 AM: 01/01/09
Form Number/
Form Nam: Edition pate
C&I Stor.-ge Tank 3rd Party Liability Decpage 81206 (11/02)
C&I Stor..ge Tank 3rd Party Liability Policy 31106 (10/05)
Notice o Loss/Notice of Claim 91968 (12/06) C'I 940
Site Sch-dule 81029 (10/ 2)
Schedule of Covered Storage Tank Systems 81017 (10/ 2)
Separation of Insureds Endorsement 31026 (10/$2)
Limitation of Loss for Cert. Acts of Terrorism 31290 (12!/02)
Coverage Territory Endorsement 39644 (07/05)
Washingt.in Amendatory Endorsement 81048 (10/02)
Washington Cancellation/Nonrenewal Amen. Endt 78804 (10/$3)
CI FMSC
CI0226
�' I
ENDORSEMENT
This eid rsement, effective 12:01 AM, 01/01/09
Forms la art of Policy No: 007786457
Issued t City of Renton
By: Coimm:rce and Industry Insurance Company
AIG ENVIRONMENTAL STORAGE TANK
THIRD-PARTY LIABILITY AND CLEAN-UP COSTS POLICY
SITE SCHEDULE
Site# acilit Name/Address, Cit , State, Zi.
1 Maplewood Golf Course
4000 Maple Valley Hwy
1 Renton, WA 98055
2 P/B/PW
3555 NE 2nd Street
Renton, WA 98056
All othe terms, conditions, and exclusions shall remain the same.
1
II
1
1
1
AUTHORIZED REPRESENTATIVE
or countersignature (in states where applicable)
81029 (10/02)
CI2254
ENDORSEMENT
This end() sement, effective 12:01 AM, 01/01/09
Forms a •art of Policy No: 007786457
Issuedlt. : City of Renton
By: Comm=rce and Industry Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SCHEDULE OF COVERED STORAGE TANK SYSTEMS
It is agreed that any previous Schedule of Coverage Storage Tank Systems
is delet=d in its entirety and replaced with the following:
The fofll.wing Storage Tank System(s) are included in Item 5. COVERED
STORAGE ANK SYSTEM (S) of the Declarations, subject to all of the terms
and conditions of the Policy and the Policy Period and Retroactive datee
indicate. below. If no dates are indicated below for Policy Period fo
a subjlec Storage Tank System, the dates indicated in Item 2. Policy
Period o the Declarations shall apply. If no date is indicated belo
for Rqtr. Date for a subject Storage Tank System, the date indicated; i
Item 61. 'etroactive Date of the Declarations shall apply. If a Polic
Period i . indicated below for a subject Storage Tank System, Item. 2
Policy Period of the Declarations is deleted in its entirety and repla ed
with the Policy Period, below, for such Storage Tank System. If a date
is indicted below for Retro Date for a subject Storage Tank System, the
date ind cated in Item 6 . Retroactive Date of the Declarations is del ted
in its entirety and replaced with Retro Date, below, for such Storage
Tank System.
..I I
Site* 'Talk AST/ Install Capacity Tank Effective Expiration ReItrIo
# I # UST Date (Gal. ) Const. Date Date Date
1 UST 1991 550 DF 1/01/09 01/01/10 6/10/91
2 UST 1985 12, 000 DF 1/01/09 01/01/10 6/10)91
2 P UST 1985 12, 000 DF 1/01/09 01/01/10 6/10/91
*Site#, ame and address are located within the Site Schedule attache.
to the P•licy,.
All other terms, conditions, and exclusions shall remain the same.
„ t4—#10rAgge;20.
AUTHORIZED REPRESENTATIVE
or countersignature (in states where applicable)
81017,(1./02)
CI2253
� I
bi
ENDORSEMENT
This'' en.orsement, effective 12:01 AM, 01/01/09
Formal a part of Policy No. : 007786457
Issuled to: City of Renton
By: iCo merce and Industry Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SEPARATION OF INSUREDS CONDITION ENDORSEMENT
It is h reb agreed that the Policy is amended by the addition of the following condition to Section V.
CONDITION•:
Sepi ra ion of Insureds- It is hereby agreed that except with respect to the Limit of Liability, Section I .
E. II(Ins red vs. Insured exclusion), and any rights and duties specifically assigned to the first Nam
Insur- ., this insurance applies:
1. As f each Named Insured were the only Named Insured; and
2. '� Se..rately to each Named Insured against whom a Claim is made.
Misrep esentation, concealment, breach of a term or condition, or violation of any duty under this Poli y
by lone Named Insured shall not prejudice the interest of coverage for another Named insured under]this
Policy. Provided, however, that this Condition shall not apply to any Named Insured who is a parent,
sull sidi•ry or affiliate of the first Named Insured.
Ihl
it
All other to s,conditions,and exclusions shall remain the same.
AUTHORIZED REPRESENTATIVE
or countersignature(in states where applicable)
81026(10/ 2) PAG 1 e F 1
CI190I
ENDORSEMENT NO.
This end•rsement, effective 12 :01 AM, 01/01/09
Forms' a mart of Policy No , : 007786457
Issued t• : City of Renton
By: Cllm erce and Industry Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LIMITATION OF LOSSES FOR CERTIFIED ACTS OF TERRORISM
Our liability or loss, injury, damage, claim or suit, arising directly or indirectly as a result of or in connection
with a certifi-d "act of terrorism" defined by Section 10Z. Definitions., of the Terrorism Risk Insurance Act of
2002 (the Aci), and any revisions or amendments, is limited by Section 103. Terrorism Insurance Program, of the
Act. ;I
All otherl,te s, conditions, and exclusions shall remain the same.
AUTHORIZED REPRESENTATIVE
or countersignature(in states where applicable)
81290(12/0 A) PAGE 1 OF 1
C11980
•
II
I� I
Y
I,
1'
ENDORSEMENT NO.
This Ilenaorsement, effective 12:01 AM, 01/01/09
Form a part of Policy No. : 007786457
Issued o: City of Renton
By Com erce and Industry Insurance Company
it
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COVERAGE TERRITORY ENDORSEMENT
Payment •f loss under this policy shall only be made in full compliance with all United States of America
economic •r trade sanction laws or regulations, including, but not limited to, sanctions, laws and regulations
administe -d and enforced by the U.S. Treasury Department's Office of Foreign Assets Control ("OFAC").
it
it
All other terms,conditions,and exclusions shall remain the same.
AUTHORIZED REPRESENTATIVE
or countersignature(in states where applicable)
89644(7/ 5) PAGE 1 I F 1
C127;I71
11
Ili
ENDORSEMENT NO.
This 'en.orsement, effective 12 :01 AM, 01/01/09
Forms a part of Policy No. : 007786457
Issued ■o: City of Renton
By: Com 'erce and Industry Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
CAREFULLY.
WASHINGTONAMENDATORY ENDORSEMENT
It is hereb agreed that the Policy is amended as follows'
1 The s-cond sub-paragraph of Section VI, CONDITIONS, Paragraph B. Subrogation, is
deletei, in its entirety and replaced with the following:
In Ithe event of any recovery by the Company as result of subrogation proceedings arising
out of a Loss, Clean-Up Costs or Corrective Action covered under this Policy, the
Comp-ny shall, from the funds collected, first pay to the Insured the applicable deductib'e
paid b the Insured less the prorated share of subrogation expenses and only thereafter
retain =ny funds in excess of the deductible portion of the recovery.
2. Se do VI. CONDITIONS, Paragraph N. Choice of Law, is deleted in its entirety.
All other terms and conditions shall remain the same.
AUTHORIZED REPRESENTATIVE
or countersignature (instates where applicable)
81048 00/.2)
C 1192i6
11
il
ENDORSEMENT NO.
This :en•orsement, effective ,12:01 AM, 01/01/09
Forms' a part of Policy No , : 007786457
Issued o: City of Renton
By: Corn erce and Industry Insurance Company
HIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WASHINGTON AMENDATORY ENDORSEMENT
Wherever sed in this endorsement: 1) "Insurer" means the insurance company which issued thils
policy; and 2) "Named Insured", "First Named Insured", and "Insured" mean the Named Corporatlo ,
Namedi Or•anization, Named Sponsor, Named Insured, Named Entity or Insured stated in th
declaration page.
The follpwi g is added and supersedes any provision to the contrary:
A. CAIIVCE LATION
!I
1. The Insured may cancel this policy by mailing or delivering to the Insurer written notice of
can•ellation or by surrender of the policy prior to or on the effective date of such cancellation.
2. The Insurer may cancel this policy by mailing or delivering to the Insured and the Insured'
repr-sentative in charge of the subject of the insurance, if applicable, written notice of
cancellation, including,the actual reason for the cancellation, to the last mailing address known
to th- Insurer, at least:
0 days before the effective date of cancellation if the Insurer cancels for nonpayment of
•remium; or
ti. •5 days before the effective date of cancellation if the Insurer cancels for any other reason.
3 Like notice of cancellation will also be mailed to any mortgage holder, pledgee or other person
sho n in this policy with an interest in any loss which may occur thereunder, at their last mailin
addr=ss known to the Insurer.
4. V'1oti•e of cancellation will state the effective date of cancellation. The policy period will end on
that .ate.
5. If no ice is mailed, proof of mailing will be sufficient proof of notice.
6. If th- policy is cancelled, we will send the first Named Insured any premium refund due. If th
Insu ter cancels, the refund will be pro rata. If the first Named Insured cancels, the refund will be
at lest 90% of the pro rata refund, The cancellation will be effective even if we have not made
or offered a refund.
B. NON,RENEWAL
1. The Insurer may elect not to renew this policy by mailing or delivering written notice of
nonr newel, to the First Named Insured and the First Named Insured's representative in charge
of th subject of the insurance at their respective last mailing addresses known to the Insurer.
The otice of nonrenewal shall state the actual reason for nonrenewal. The Insurer will also
78804 (1:0/03) Page 1 of 2
C12281
ENDORSEMENT NO.
(Continued)
mail to any mortgage holder or other person shown in this policy with an Interest in any loss
whi h may occur thereunder, at their last mailing address known to the Insurer, written notice 'f
lnon enewal. The Insurer will mail or deliver these notices at least 45 days before the:
a
Expiration of the policy; or
h
b. nniversary date of this policy if this policy has been written for a term of more than one
ear.
i
Oth rwise, the Insurer will renew this policy unless:
a. The Insured fails to pay the renewal premium after the Insurer has expressed willingness to
eenew and has sent a statement of the renewal premium to the Insured and the Insured'
e-presentativein charge of the subject of insurance at least 20 days before the expiration
ate;
b. other equivalent coverage has been procured by the Insured prior to the expiration date Jf
t e policy; or
. he contract is evidenced by a written binder containing a clearly stated expiration date
hich has expired according to its terms.
All other term-and conditions shall remain the same.
AUTHORIZED REPRESENTATIVE
or countersignature(instates where applicable)
78804 (11)/03 Page 2 of 2
CI2261
POLICY SIGNATURE PAGE
This Policy Si nature Page,
forms a part .f Policy No: 0077864 57
By signing bel , the President and the Secretary of the Insurer agree on behalf of the Insurer to all the terms of this
Policy.
111PCLIACV94110j
Secretary President
Co merce and Industry Insurance Company Commerce and Industry Insurance Company
This Policy sh.LI not be valid unless signed at the time of issuance by an authorized representative of the Insurer, either
below or on t e Declarations page of the Policy.
Authorized Representative
86697(9/04)
CI2469
AIG TankGuard"
Storage Tank Third Party Liability
TankGuard® Renewal Warranty
Cityof Renton
NAMED INSURED:
INSURER: Commerce and Industry Insurance Company
POLICY NUM ER: PLC007786457
POLICY PERIOD: 1/01/09 to 01/01/10
The under3igned warrants and represents that there have been no changes to the schedule of .
covered to ks or locations:
THIS RENE L WARRANTY DOES NOT BIND THE APPLICANT TO BUY, OR THE COMPANY TO ISSUE THE
INSURANCE, UT IT IS AGREED THAT THIS FORM SHALL BE THE BASIS OF THE CONTRACT SHOULD A POLICY BE
ISSUED, AND IT WILL BE ATTACHED TO THE ORIGINAL APPLICATION AND MADE A PART OF THE POOCY. THE
UNDERSIGNS APPLICANT DECLARES, WARRANTS AND REPRESENTS THAT THE STATEMENTS SET FORTH IN THIS
WARRANTY TRUE AND THAT NO MATERIAL FACTS HAVE BEEN SUPRESSED OR MISSTATED. THE APPLICANT
FURTHER)DE LARES, WARRANTS AND REPRESENTS THAT IF THE INFORMATION SUPPLIED ON THIS WARRANTY
CHANGES BE EN THE EXECUTION DATE OF THE WARRANTY AND THE RENEWAL POLICY EFFECTIVE DATE,THE
APPLICANT WILL IMMEDIATELY NOTIFY THE COMPANY OF SUCH CHANGES,AND THE COMPANY MAY IWI1rHDRAW
OR.MODIFY A OUTSTANDING QUOTATIONS AND/OR AUTHORIZATION OR AGREEMENT TO BIND THE INSURANCE.
ALL WRI STATEMENTS AND MATERIALS FURNISHED TO THE COMPANY IN CONJUNCTION WITH THE MOST
RECENT ILO G FORM APPLICATION AS WELL AS THE RENEWAL WARRANTY SIGNED HEREUNDER ARE
INCORPOItA D BY REFERENCE INTO THIS APPLICATION AND MADE A PART HEREOF.
In the event at the company issues a policy, the undersigned acting on behalf of the applicant and ai1 proposed
insureds,lac owledges that the company, in providing coverage, will have relied upon, as representations, the
declarations d statements which are contained in or attached to or incorporated by reference into this warranty
and whicii are incorporated into the policy.
If insured ould like an indication for higher limits,please indicate.
LIMITS D
RED: (each incident/aggregate)
)$1 million/ 1 million L $1 million/$2 million $2 million/$2 million ()OTHER:
DEDUCTIB DESIRED:(each incident)
� I
'$5,000 ( )$10,000 ( )$25,000 ( )$50,000 ( )$100,000
For Deductibi above$50,000,please include your most current audited financial statement
91177(
C12899
11
•
I I
•
AIG Tanard ••
NOTICE TO ISTRICT OF COLUMBIA APPLICANTS: WARNING: IT IS A CRIME TO PROVIDE FALSE OR MI LEADING
INFORMATION TO AN INSURER FOR THE PURPOSE OF DEFRAUDING THE INSURER OR ANY OTHER PERSON; PENALTIES
INCLUDE IIIMP• SONMENT AND/OR FINES. IN ADDITION, AN INSURER MAY DENY INSURANCE BENEFITS 'F FALSE
INFORMATION MATERIALLY RELATED TO A CLAIM WAS PROVIDED BY THE APPLICANT.
NOTICE TO 'LORIDA APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE, DE UD, OR
DECE
IVE ANY INSURER FILES A STATEMENT OF CLAIM OR AN APPLICATION CONTAINING ANY FALSE, INC0M LETS OR
MISLEADING 1 ORMATION IS GUILTY OF A FELONY IN THE THIRD DEGREE.
NOTICE 1,101
I'O KENTUCKY APPLICANTS:ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY IN URANCE
COMPANY'i O OTHER PERSON FILES AN APPLICATION FOR INSURANCE CONTAINING ANY MATERIALLI FALSE
INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL
THERETO,CO ITS A FRAUDULENT INSURANCE ACT,WHICH IS A CRIME.
NOTICE TO UISIANA APPLICANTS:ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENIii CLAIM FOR
PAYMENTIOF LOSS OR BENEFIT OR KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE
IS GUILTY OF CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON.
NOTICE 9f0 AJNE APPLICANTS: IT IS A CRIME TO KNOWINGLY PROVIDE FALSE, INCOMPLETE OR MISLEADING
INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES MAY
INCLUDE IMPR SONMENT,FINES OR A DENIAL OF INSURANCE BENEFITS.
NOTICE TO, W JERSEY APPLICANTS:ANY PERSON WHO INCLUDES ANY FALSE OR MISLEADING INFORMATIO ON AN
APPLICAT ION R AN INSURANCE POLICY IS SUBJECT TO CRIMINAL AND CIVIL PENALTIES.
NOTICE TO N W YORK APPLICANTS:ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE
COWAN*OR OTHER PERSON FILES AN APPLICATION FOR.INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY
MATERIALLY SE INFORMATION,OR CONCEALS FOR THE PURPOSE OF MISLEADING,INFORMATION CONCERNING ANY
FACT MATER L THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME, AND SHALL ALSO BE
• SUBJECT TO A PAL PENALTY NOT TO EXCEED FIVE THOUSAND DOLLARS AND THE STATED VALUE OF THE CLAIM FOR
EACH SUCH VI LATION.
11
NOTICE TO O IO APPLICANTS:ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING
A FRAUD tiAGA ST AN INSURER, SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE
STATEMENT IS GUILTY OF INSURANCE FRAUD.
NOTICE TO OKLAHOMA APPLICANTS: WARNING: ANY PERSON WHO KNOWINGLY, AND WITH INTENT TO INJURE,
DEFRAUD FOR DECEIVE ANY INSURER,MAKES ANY CLAIM FOR THE PROCEEDS OF AN INSURANCE POLICY CO AWING
ANY FALSE,INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF A FELONY(365:15-1-10,36§3613.1).
NOTICE T,O NNSYLVANIA APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRA ANY
INSURANCE MPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OI CLAIM
CONTAINING A Y MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING,INFOR�4ATION
CONCERNING NY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIIIMEE AND
SUBJECTS SUC PERSON TO CRIMINAL AND CIVIL PENALTIES.
NOTICE TO TE ESSEE AND VIRGINIA APPLICANTS: IT IS A CRIME TO KNOWINGLY PROVIDE FALSE,INCOMPLETE OR
MISLEADING FORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY.
PENALTIES;1INC UDE IMPRISONMENT,FINES AND DENIAL OF INSURANCE BENEFITS. 1
I I
91177(. 06)
CI2865
d '
AIG Ta .Guard`
Renewal Warranty Acknowledgement
,1
1111. it Arthur J. Gallagher & Co. Qf Denve
APPLICANT. BROKER:
(Signetro (Firm)
4ity of Renton 6399 S.Fiddlers Green Cr. , Ste. 20 !
Englewood,
g CO 80111-
APPLICANT:i I
(Print Name) (Street Mailing Address)
DATE: h 1 i (U l 1 O' Ms. Julie Vierra _ €
(Contact Person)
(Phone#,Fax#,Email Address)
(Signature of Broker or Agent)
113080
(License Number and State)
362102482
(Tax I.D.#)
Please note t t if you are planning on adding either additional tanks or locations to this poli�Y, the
Company ireq ires that we first receive a fully complete renewal application within thirty (30)'dayslof the
policy expira on date. Please visit our website www.chamberagent.com to download the application.
NOTICE T AP LICANTS:ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE CO ANY
OR OTHER ?ER ON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY.MATERIALLY
FALSE INFORM 'PION OR, CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT
MATERIAL THERETO,COMMITS A FRAUDULENT ACT,WHICH IS•A CRIME AND MAY SUBJECT SUCH PERSON TO CRIMINAL
AND CIVIL P • LTIES.
NOTICE TO A SAS AND NEW MEXICO APPLICANTS: ANY PERSON WHO KNOWINGLY PRESENTS A F SE OR
FRAUDULENT C AIM FOR PAYMENT OF A LOSS OR BENEFIT, OR KNOWINGLY PRESENTS FALSE INFORMATIO IN AN
APPLICATION F R INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISdN.
NOTICE TO CO RADO APPLICANTS:IT IS UNLAWFUL TO KNOWINGLY PROVIDE FALSE,INCOMPLETE,OR MISLEADING
FACTS OR I TION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING OR ATTEMPTING TO
DEFRAUD THE COMPANY. PENALTIES MAY INCLUDE IMPRISONMENT, FINES, DENIAL OF INSURANCE,, AND CIVIL
DAMAGES. ;�►NY INSURANCE COMPANY OR AGENT OF AN INSURANCE COMPANY WHO KNOWINGLY PROVIDES FALSE,
INCOMPLETE, O MISLEADING FACTS OR INFORMATION TO A POLICYHOLDER OR CLAIMANT FOR THE PURPOSE OF
DEFRAUDING OR ATTEMPTING TO DEFRAUD THE POLICYHOLDER OR CLAIMANT WITH REGARD TO A SETTLEMENT OR
AWARD PAYAB E FROM INSURANCE PROCEEDS SHALL BE REPORTED TO THE COLORADO DIVISION OF INSURANCE
WITHIN THE DE ARTMENT OF REGULATORY AUTHORITIES
91177(61 )
CI2666
CERTIFICATE OF INSURANCE
WASHINGTON
Na e: City of Renton
Adoress : See Schedule Below
Po icy Number: 007786457
En4orsement : Not Applicable
Period of Coverage: From 01/01/09 To 01/01/10
1Na e Of Insurer: Commerce and Industry Insurance Company
�Ad ress Of Insurer: 70 Pine Street
New York, NY 10270
11Na e Of Insured: City of Renton
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!'I dress Of Insured: 1055 South Grady Way
Renton, WA 98055
tE'TIFICATION:
'1. COMMERCE & INDUSTRY INSURANCE COMPANY, the Insurer, as identified
above, hereby certifies that it has issued liability insurances 'overing
th: following underground storage tank(s) :
ise= "Item 5 . Covered Storage Tank System(s) " on policy referen;c d above,
?o "Taking corrective action" and/or compensating third partie for
bo.ily injury and property damage caused by either "sudden accidental
Ire eases" or "nonsudden accidental releases" or "accidental re!l�ases" ;
sn accordance with and subject to the limits of liability, exclusions,
;conditions, and other terms of the policy; if coverage is different for
different tanks or locations, indicate the type of coverage applicable
.to each tank or location arising from operating the underground storage
tank(s) identified above.
The limits of liability are $ 2, 000, 000 each occurrence and $ 2, 000, 000
annual aggregate exclusive of legal defense costs which are subject to a
separate limit under the policy.
'This coverage is provided under 007786457 . The effective date1of said
Policy is 01/01/09 .
'2 . The Insurer further certifies the following with respect to, the
insurance described in Paragraph 1: I
Bankruptcy or insolvency of the Insured shall not relieve the
Insurer of its obligations under the policy to which this
certificate applies.
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. . The Insurer is liable for the payment of amounts within any
deductible applicable to the policy to the provider of corrective
action or damaged third-party with a right of reimbursement by
the Insured for any such payment made by the Insurer. This
provision does not apply with respect to that amount of any
deductible for which coverage is demonstrated under another
mechanism or combination of mechanisms as. specified in WAC 173-
360-413 through 173-360-433 .
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c. Whenever requested by the Director of Washington State D partment
of Ecology, the Insurer agrees to furnish the Director a signed
duplicate original of the policy and all endorsements .
d. Cancellation or any other termination of the insurance by the
Insurer, except for non-payment of premium or misrepresentation
bythe Insured, will be effective onlyupon written notice and
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only after the expiration of sixty(60) days after a copy of such
written notice is received by the Insured. Cancellation for non-
payment of premium or misrepresentation by the Insured will be
effective only upon written notice and only after expiration of
a minimum of ten(10) days after a copy of such written notice is
received by the Insured.
e. The insurance covers claims otherwise covered by the policy that
are reported to the Insurer within six months of the effective
it date of cancellation or non-renewal of the policy exceptiwhere
the new or renewed policy has the same retroactive date r a
retroactive date earlier than that of the prior policy, and which
arise out of any covered occurrence that commenced after the
policy retroactive date, if applicable, and prior to such policy
renewal or termination date. Claims reported during suc1i an
I extended reporting period are subject .to the terms, conditions,
limits, including limits of liability and exclusions of the
policy.
II ereby certify that the wording of this instrument is identical to the
wadding in WAC 173-360-480 and that the Insurer is licensed to transact
th- business of insurance in on or more states.
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ISicnature of Authorized Representative of Insurer I
ISe.In M. Pattwell
Th= Director
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Au horized Representative of Commerce & Industry Insurance Company
Ch_mber Insurance Agency Services
2100 Executive Drive, Suite 200
West Orange, NJ 07052
89720 (8/05)
CI2741
ENDORSEMENT
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Thi;i =ndorsement, effective 12 : 01 AM, 01/01/09
Forms a part of Policy No: 007786457
Issue• to: City of Renton
By: C.mmerce and Industry Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SCHEDULE OF COVERED STORAGE TANK SYSTEMS
It Is agreed that any previous Schedule of Coverage Storage Tank ,Systems
is1de eted in its entirety and replaced with the following:
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The,lf llowing Storage Tank System(s) are included in Item 5 . COVERED
STORA E TANK SYSTEM(S) of the Declarations, subject to all of the flerms
andl c nditions of the Policy and the Policy Period and Retroactive date
indic ted below. If no dates are indicated below for Policy Period for
a subject Storage Tank System, the dates indicated in Item 2 . Pollidy
Periio of the Declarations shall apply. If no date is indicatedibelow
for R tro Date for a subject Storage Tank System, the date indicat�d in
Item . Retroactive Date of the Declarations shall apply. If a Policy
Perin is indicated below for a subject Storage Tank System, Item. 2
Policy Period of the Declarations is deleted in its entirety and replaced
with the Policy Period, below, for such Storage Tank System. If a date
is ,indicated below for Retro Date for a subject Storage Tank System, the
date 'ndicated in Item 6 . Retroactive Date of the Declarations is' deleted
in lit entirety and replaced with Retro Date, below, for such Storage
Tank ystem.
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Site* Tank AST/ Install Capacity Tank Effective Expiration Retro
#i # UST Date (Gal . ) Const. Date Date Date
11 1 UST 1991 550 DF 1/01/09 01/01/10 6)10/91
2 ;; 1 UST 1985 12, 000 DF 1/01/09 01/01/10 6110/91
2 : 2 UST 1985 12, 000 DF 1/01/09 01/01/10 6/10/91
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*Site. , name and address are located within the Site Schedule attached
to lth.- Policy.
All ocher terms, conditions, and exclusions shall remain the same.
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. 361--',/i,
AUTHORIZED REPRESENTATIVE
or countersignature (in states where applicable)
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81017 (10/02)
CI225
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4.11161.
ace usa
CLAIMS REPORTING INFORMATION
All clai functions for your airport and aircraft insurance with Member Insurance Companies of the
ACE U'A Group are handled by ACE USA Aerospace Claims in Chicago. The staff of AC USA
Aerospa e Claims is one of the most experienced and efficient in the aviation claims business. Bryan
Doyle, -xperienced Casualty Claim Specialists, is responsible for administering your claims on day-
to-day •asis. Bryan reports to Dennis Krueger, Senior Aviation Technical Specialist. Sara Meske,
Aerospa e Claims Assistant, is available to accept claims information if Bryan is unavailable.
All alai s should be reported to Aerospace Claims as soon as practicable, in order for us to establish
hutted to contact with claimants and initiate any necessary investigation. An initial report of claim may
be faxe to 877-201-4125. To ensure prompt attention, it is recommended that the fax transmiis ion be
confirm d with a phone call. Upon notification of a claim, an appropriate Accident Statement will be
forward d for your completion. Where possible, pictures of the accident scene should be obtained
durnitg y ur initial investigation.
Becaus ACE USA Claims has gone paperless, it is imperative that you put the addressee's
name a d claim number on all correspondence and note address/Fax changes below.
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FIRST OTICE OF LOSS: Email AerospaceFirstNotice@ace-ina.com
11 Fax 877-201-4125
Contact Phone Fax E-Mail
Primary Bryan Doyle 312-775-7944 866-635-5687 Bryan.Doyle@ace-ina.com
Seconda Sean Finnegan 312-775-7947 866-635-5687 Sean.Finnegan@ace-ma.com
Seconda Sara Meske 312 775-7945 866-635-5687 Sara.Meske@ace-ina.com
Seconda Betty Remblake , 312-775-7910 866-635-5687 Betty.Remblake@ace-ina.com
After Ho rs Dennis Krueger 815-738-2755 866-635-5687 Dennis.Krueger@ace-ina.com
24 Hour .mergency 815-275-1133
All clai s that require reporting after hours, should be directed to Dennis Krueger. All claims involving
large ai craft should be reported immediately to Dennis Krueger.
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If you a e served with a summons or suit, please call immediately and forward the papers via ovemight
delivery
MARLIN ADDRESS OVERNIGHT DELIVERY ADDRESS
ACE U*A Claims ACE USA Aerospace Claims
P. O. Box 25155 525 W. Monroe, 5th Floor
Lehigh alley, PA 18002-5155 Chicago, IL 60661
Should , ou have any questions concerning our claims handling procedures, please feel free to contact
us at a y time.
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One ofilhe AC-Group of Insurance 8 Reinsurance Companies.
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ace usa
ACE Producer Compensation
Practices&Policies
ACE believes that policyholders should have access to information about ACE's practices and policies related
to the '(payment of compensation to brokers and independent agents. You can obtain that information by
acces ng our website at http://www.aceproducercompensation.com or by calling the following toll-free
teleph one number: 1-866-512-2862.
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ALL-20887(10/06)
11.16
SPA
ace usa
AIRPORT OWNERS AND OPERATORS GENERAL LIABILITY POLICY
II
ACE PROPERTY AND CASUALTY INSURANCE COMPANY
436 Walnut Street,
Philadelphia, Pennsylvania, 19106-3703
II IN WITNESS WHEREOF,ACE Property and Casualty Insurance Company has caused this policy
to be executed and attested.This policy is a valid contract when countersigned by an
authorized representative(where required by law).
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e• go d,�.� ./ZG,�t Iry •
GEDHGE D. MULLIGAN, Secretary BRIAN E. DOWD. President
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AAP200(11-99)
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I AIRPORT OWNERS AND OPERATORS'
�� ,. GENERAL LIABILITY POLICY
WA
ace usa DECLARATIONS
This I 'surance Policy is issued By: Policy Number: 1
ACE Property and Casualty Insurance Company AAP N02204289 ,001
436 Walnut Street,
1. Philadelphia, Pennsylvania, 19106-3703 Renewal of:
l' New
amed Insured and Mailing Address:
d ity of Renton
1.
1055 S. Grady Way
1 enton
ashington Zip 98055
he Named Insured is: A Public Corporation
location of the Airport(s)You Own or Operate:
NT Renton Municipal Airport, Renton,WA
36 Will Rogers Wiley Post Memorial Seaplane Base, Renton,WA
Policy Period: From: January 1,2009 To: January 1,2010
at 12.01 a.m.Standard Time at your mailing address shown above.
In return for the payment of the premium, and subject to all of the terms of this policy,we agree with you to
provide the insurance as stated in this policy.
Limits of Insurance:
?roducts-Completed Operations Aggregate Limit $100,000,000
Mersonal Injury and Advertising Injury Aggregate limit $50,000,000
alpractice Aggregate Limit $50,000,000
zach Occurrence Limit $100,000,000
1;ire Damage Limit Any One Fire $500,000
Medical Expense Limit Any One Person $5,000
llangarkeepers Limit Any One occurrence $100,000,000
klangarkeepers Limit Any One Aircraft $100,000,000
Von-Owned Aircraft Liability Limit Any One Occurrence $100,000,000
Deductibles:
ach Occurrence or Offense Deductible Nil
Aggregate Deductible _ Nil
dremium:
vance Premium $43,000
xtended Coverage Endorsement AAP 203(02-03) $3,333
ndorsement Premium Included
errorism Risk Insurance Act Premium $6,667
Tbtal Advance Premium $53,000
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Policy Forms and Endorsements are described in the attached Schedule of Endorsements.
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I Signature:
P201 (11-99) By Authorized Representative
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Policy Nu ber: AAP N02204289 001
Effective ate: January 1, 2009
Insured: City of Renton
SCHEDULE OF ENDORSEMENTS
The'�endorsements listed below form part of this policy at inception and are deemed to have been signed by
the same Authorized Representative that signed the Declarations(form AAP 201 11/99).
Endorsement No.
TITLE and Edition Date
Airp I rt Owwners and Operators General Liability Policy-Jacket AAP 200 (11-99)
Airport Owners and Operators General Liability Policy-Declarations AAP 201 (11-99)
Airport Owners and Operators General Liability Policy- AAP 201S (11-99)
-Schedule of Endorsements
Airport Owners and Operators General Liability Policy-Policy Provisions AAP 202 (11-99)
Extended Coverage-War, Hi-jacking and Other Perils Endorsement AAP 203 (02-08)
Amendment of Noise and Pollution and Other Perils Exclusion AAP 204 (11-03)
Extension-Specific Excess Liability Insurance-Automobile Liability AAP 211 (11/99)
ImmunitWaiver Endorsement AAP 220 (11/99)
Airport Limited Enhanced Coverage Endorsement AAP 234 (11/99)
Nuclear isks Exclusion Clause AAP 237 (11/99)
Voluntee s Endorsement AAP 248 (11/99)
Date Re ognition Exclusion Endorsement AAP 256 (11/99)
Premium Audit Endorsement AAP 257 (11/99)
Amend lent to Include Coverage for Certified Acts of Terrorism; Cap on AAP 270 (02-08)
Losse from Certificed Acts of Terrorism
Disclosu a Pursuant to Terrorism Risk Insurance Act TRIA llb (01-08)
Pollution Endorsement AAP 273 (11-03)
Limited errorism Coverage Endorsement AAP 275 (02-08)
Silica and Silica-Related Dust Exclusion AAP 277 (01-06)
Trade or Economic Sanctions Endorsement ALL-21101 (11-06)
Washington Changes-Cancellation and Nonrenewal AAP WA (11/99)
Washington Changes 9001-WA (11/99)
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AAI: 201 S(11-99)
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AIRPORT OWNERS AND OPERATORS LIABILITY POLICY
INDEX
Please Read Your Policy
SECTION I -COVERAGES 2
COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2
Insuring Agreement 2
Exclusions 2
COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY 6
Insuring Agreement 6
Exclusions 6
COVERAGE C. MEDICAL PAYMENTS 7
Insuring Agreement 7
Exclusions 7
COVERAGE D. HANGARKEEPERS LIABILITY 8
Insuring Agreement 8
Exclusions 8
COVERAGE E. NON-OWNED AIRCRAFT LIABILITY 8
Insuring Agreement 8
Exclusions 9
SUPPLEMENTARY PAYMENTS -COVERAGES A, B, D AND E i 10
SECTION II - COMMON COVERAGE EXCLUSIONS 11
SECTION III -WHO IS AN INSURED 12
ELECTION IV- LIMITS OF INSURANCE AND DEDUCTIBLES 14
SECTION V-CONDITIONS 15
ECTION VI - DEFINITIONS 19
AAP 212 (11-99) Page 1 of 23
AIRPORT OWNERS AND OPERATORS GENERAL LIABILITY POLICY
POLICY PROVISIONS
Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights,
duties and what is and is not covered.
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Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Dec1larations,
and(any other person or organization qualifying as a Named Insured under this policy. The words "we",
"us"and "our" refer to the company providing this insurance.
The word "insured" means any person or organization qualifying as such under WHO IS AN INSURED
(SECT( N III).
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Other ords and phrases that appear in quotation marks have special meaning. Refer to DEF NITIONS
(SECTION VI).
They insurance provided by this policy does not apply to any Coverage or hazard against which the words
Not Insured appear in the Limits of Insurance section of the Declarations.
SECTION I -COVERAGES
COVE- GE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY
1. In uring Agreement.
a. We will pay those sums that the insured becomes legally obligated to pay as damages
because of "bodily injury" or "property damage" to which this insurance applies. We will have
the right and duty to defend any "suit" seeking those damages. We may at our discretion
investigate any"occurrence" and settle any claim or"suit"that may result, but:
(1) The amount we will pay for damages is limited as described in LIMITS OF INSURANCE
(SECTION IV); and
(2) Our duty to defend ends when we have used up the applicable LIMITS OF INSURANCE
in the payment of judgments or settlements under Coverage A.
No other obligation or liability to pay sums or perform acts or services is covered unless
explicitly provided for under SUPPLEMENTARY PAYMENTS -COVERAGES A, B, D AND E.
b. This insurance applies to"bodily injury"and "property damage"only if:
(1) The"bodily injury"or"property damage" is caused by an "occurrence"that takes place
in the "coverage territory"; and
II (2) The"bodilyinjury"or"property dama e"occurs duringthe policyperiod; and
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(3) The"bodily injury"or"property damage"arises out of your"airport operations".
c. Damages because of "bodily injury" include damages claimed by any person or organization
for care, loss of services or death resulting at any time from the "bodily injury".
2. E clusions .
T is insurance does not apply to:
a. Expected or Intended Injury
"Bodily injury"or"property damage"expected or intended from the standpoint of the insured.
This exclusion does not apply to "bodily injury" resulting from the use of reasonable force to
protect persons or property.
AAP 20' (11-99) Page 2 of 23
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•. Contractual Liability
"Bodily injury" or "property damage" for which the insured is obligated to pay damages by
reason of the assumption of liability in a contract or agreement. This exclusion does not apply
to liability for damages:
(1) Assumed in a contract or agreement that is an "insured contract" provided the "bodily
injury" or "property damage" occurs subsequent to the execution of the contract or
agreement ; or
(2) That the insured would have in the absence of the contract or agreement.
•; Liquor Liability
"Bodily injury"or"property damage"for which the insured may be held liable by reason of:
(1) Causing or contributing to the intoxication of any person;
(2) The furnishing of alcoholic beverages to a person under the legal drinking ae or under
the influence of alcohol; or
(3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of
alcoholic beverages.
This exclusion applies only if you are in the business of manufacturing, distributing, selling,
serving or furnishing alcoholic beverages.
Premises at the "airport" which you lease to others who are in the business of manufacturing,
distributing, selling, serving or furnishing alcoholic beverages, will not be treated as your
business.
•: Workers Compensation and Similar Laws
Any obligation of the insured under a workers' compensation, disability benefits or
unemployment compensation law or any similar law.
Employers Liability
"Bodily injury"to:
(1) An employee of the insured arising out of and in the course of employment by the
insured; or
(2) The spouse, child, parent, brother or sister of that employee as a consequence of (1)
above.
This exclusion applies:
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(1) Whether the insured may be liable as an employer or in any other capacity; and
(2) To any obligation to share damages with or repay someone else who must pay damages
because of the injury.
This exclusion does not apply to liability assumed by the Insured under an "insured contract".
f Aircraft, Auto or Watercraft
"Bodily injury" or "property damage" arising out of the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or watercraft owned or operated by, rented,
loaned or leased to the insured. Use includes operation and "loading or unloading".
This exclusion does not apply to:
(1) An "auto"or watercraft while on the"airport";
AAP 212 (11-99) Page 3 of 23
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(2) An "auto"or watercraft while not on the"airport" if responding to an aviation emergency;
or
(3) Liability assumed under any "insured contract" for the ownership, maintenance or use of
watercraft.
g. Mobile Equipment
"Bodily injury" or"property damage"arising out of:
(1) The transportation of"mobile equipment" by an "auto" owned or operated by or rented or
loaned to the insured; or
(2) The use of "mobile equipment" in, or while in practice or preparation for, a prearranged
racing, speed or demolition contest or in any stunting activity.
I h. Airmeet, Contest or Exhibition
"Bodily injury" or"property damage"arising out of:
(1) The conduct of any airmeet, contest or exhibition permitted, sponsored or participated in
by any insured; or
(2) The ownership maintenance or use of grandstands, bleachers or observation p atforms.
Paragraph(1)of this exclusion does not apply to static displays.
Paragraph (2) of this exclusion does not apply to observation decks or promenade that are
part of a permanent structure on the "airport".
i. Swimming Pools or Lodging Accommodation
"Bodily injury"or"property damage"arising out of the ownership, maintenance or use of:
(1) Swimming pools; or
(2) Lodging accommodation for the general public.
j. Control Tower
"Bodily injury" or "property damage" arising out of the direct operation of a control tower by
any insured.
k. Damage to Property
"Property damage"to:
(1) Property you own, rent or occupy;
(2) Premises you sell, give away or abandon, if the "property damage" arises out of any part
of those premises;
(3) Property loaned or leased to you;
(4) Personal property, other than "aircraft", in the care, custody or control of the insured;
(5) That particular part of real property on which you or any contractors or sybc ntractors
working directly or indirectly on your behalf are performing operations, if the "property
damage"arises out of those operations;
(6) That particular part of any property that must be restored, repaired or replaced because
"your work"was incorrectly performed on it; or
AAP 20 (11-99) Page 4 of 23
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(7) "Aircraft" in your care, custody or control or "aircraft" while being serviced, handled or
maintained by you.
Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never
11 occupied, rented or held for rental by you.
p Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a
sidetrack agreement.
Paragraph(4)of this exclusion does not apply to "property damage":
(a) to an "auto" or "mobile equipment" when your control is solely traffic control, but this
exception does not override Exclusion j. above;
(b) to an "auto"while on the "airport"; or '
(c) to baggage or cargo handled by you, provided you are not handling the baggage or
cargo as bailee for hire.
Paragraph (6) of this exclusion does not apply to "property damage" included in the "products
completed operations hazard".
Paragraph (7) of this exclusion does not apply to "property damage" to "aircraft" when your
control is solely traffic control, but this exception does not override Exclusion j above.
I ! Damage to Your Product
"Property damage"to "your product"arising out of it or any part of it.
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1. Damage to Your Work
'Property damage" to "your work" arising out of it or any part of it and included in the
"products-completed operations hazard".
j This exclusion does not apply if the damaged work or the work out of which the damage arises
was performed on your behalf by a subcontractor.
n. Damage to Impaired Property or Property Not Physically Injured
i "Property damage" to "impaired property" or property that has not been physically injured,
arising out of:
(1) A defect, deficiency, inadequacy or dangerous condition in "your product" or "your work";
or
11 (2) A delay or failure by you or anyone acting on your behalf to perform a contract or
1 agreement in accordance with its terms.
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This exclusion does not apply to the loss of use of other property arising out of sodden and
accidental physical injury to "your product" or "your work" after it has been put to its intended
1 use.
•: Recall of Products,Work or Impaired Property
Damages claimed for any loss, cost or expense incurred by you or others for the loss of use,
withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of:
(1) "Your product";
(2) "Your work"; or
(3) "Impaired property";
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AAP 202 (11-99) Page 5 of 23
if such product, work or property is withdrawn or recalled from the market or from use by any
person or organization because of a known or suspected defect, deficiency, inadequacy or
dangerous condition in it.
E clusions c. through o. do not apply to damage by fire to premises rented to you. A separate limit
of insurance applies to this coverage as described in LIMITS OF INSURANCE (SECTION IV).
COVE GE B. PERSONAL AND ADVERTISING INJURY LIABILITY
1. In-uring Agreement.
a. We will pay those sums that you become legally obligated to pay as damages because of
"personal injury" or "advertising injury" to which this insurance applies. We will have the right
and duty to defend any "suit" seeking those damages. We may at our discretion investigate
any offense and settle any claim or"suit"that may result, but:
(1) The amount we will pay for damages is limited as described in LIMITS OF INSURANCE
(SECTION IV); and
(2) Our duty to defend ends when we have used up the applicable LIMITS OF INSURANCE
in the payment of judgments or settlements under Coverage B.
No other obligation or liability to pay sums or perform acts or services is covered unless
explicitly provided for under SUPPLEMENTARY PAYMENTS-COVERAGES A, B, D AND E.
b. This insurance applies to:
(1) "Personal injury" caused by an offense excluding advertising, publishing, broadcasting or
telecasting done by or for you;
(2) "Advertising injury" caused by an offense committed in the course of advertising your
goods, products or services;
but only if:
(a) The offense was committed or alleged to have been committed unintentionally y you or
any of your employees while engaged in their employment by you; and
(b) The offense was committed or alleged to have been committed in the "coverage territory"
during the policy period and arises out of your"airport operations"
2. E clusions .
This insurance does not apply to:
a. "Personal injury"or"advertising injury":
(1) Arising out of any oral or written publication of material, if done by or at the d'rection of
the insured with knowledge of its falsity;
(2) Arising out of any oral or written publication of material whose first publication ook place
before the beginning of the policy period;
(3) Arising out of the willful violation of a penal statute or ordinance committed by r with the
consent of the insured;
(4) For which the insured has assumed liability in a contract or agreement. 'This exclusion
does not apply to liability for damages that the insured would have in the absence of the
contract or agreement; or
AAP 202 (11-99) Page 6 of 23
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il (5) Arising out of the conduct of any airmeet, contest or exhibition permitted, sponsored or
participated in by any insured. This exclusion does not apply to static displays.
I. "Advertising injury"arising out of:
(1) Breach of contract, other than misappropriation of advertising ideas under an implied
contract;
(2) The failure of goods, products or services to conform with advertised quality or
performance;
(3) The wrong description of the price of goods, products or services; or
1 (4) An offense committed by an insured whose business is advertising, broadcasting,
publishing or telecasting.
•I. Any offense which was committed or alleged to have been committed in any State which does
I not recognize a cause of action for that offense based on negligence.
COVE AGE C. MEDICAL PAYMENTS
1. I 'suring Agreement.
'r
We will pay medical expenses as described below for"bodily injury"caused by an accident:
(1) On your"airport"; or
(2) Because of your"airport operations";
provided that:
i
(1) The accident takes place in the"coverage territory" and during the policy period;i
(2) The expenses are incurred and reported to us within one year of the date of the accident;
and
(3) The injured person submits to examination, at our expense, by physicians of our choice
as often as we reasonably require.
• We will make these payments regardless of fault. These payments will not exceed the
applicable LIMITS OF INSURANCE. We will pay reasonable expenses for:
(1) First aid at the time of an accident;
(2) Necessary medical, surgical, x-ray and dental services, including prosthetic devices; and
(3) Necessary ambulance, hospital, professional nursing and funeral services.
2. xclusions .
ie will not pay expenses for"bodily injury":
a To any insured.
L 1 To a person hired to do work for or on behalf of any insured or a tenant of any insured..
o To a person injured on that part of premises you own or rent that the person normally occupies.
• To a person, whether or not an employee of the insured, if benefits for the "bodily injury" are
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AAP 202 (11 99) Page 7 of 23
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payable or must be provided under a workers' compensation or disability benefits law or a
similar law.
e. To a person injured while taking part in athletics.
f. Included within the "products-completed operations hazard".
g. Excluded under Coverage A.
COVER GE D. HANGARKEEPERS LIABILITY
1. In uring Agreement.
a. We will pay those sums that the insured becomes legally obligated to pay as damages
because of physical injury to "aircraft" to which this insurance applies. We will have the right
and duty to defend any "suit" seeking those damages. We may at our discretion investigate
any"occurrence" and settle any claim or"suit"that may result, but:
(1) The amount we will pay for damages is limited as described in LIMITS OF INSURANCE
(SECTION IV); and
(2) Our duty to defend ends when we have used up the applicable LIMITS OF INSURANCE
in the payment of judgments or settlements under Coverage D.
No other obligation or liability to pay sums or perform acts or services is covered unless
explicitly provided for under SUPPLEMENTARY PAYMENTS -COVERAGES A, B, D AND E.
b. This insurance applies to physical injury only if:
(1) The "aircraft" is in your care, custody or control or while the "aircraft" is being serviced,
handled or repaired by you; and
(2) The physical injury to "aircraft" is caused by an "occurrence" that takes place on
the premises of the"airport"; and
(3) The physical injury to"aircraft"occurs during the policy period.
c. Damages because of physical injury include damages claimed for all resultant loss of use of
such aircraft.
2. Exclusions .
This insurance does not apply to:
a. Physical injury to"aircraft"you own.
b. Physical injury to"aircraft"you rent, lease or which are on loan to you.
c. Physical injury to"aircraft"while "in flight".
d. Physical injury to "aircraft" for which the insured is obligated to pay damages by reason of the
assumption of liability in a contract or agreement. This exclusion does not apply to liability
that the insured would have in the absence of the contract or agreement.
COPE GE E. NON-OWNED AIRCRAFT LIABILITY
1. Insuring Agreement.
a. We will pay those sums that the insured becomes legally obligated to pay as damages
because of"bodily injury"or"property damage"to which this insurance applies. We will have
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AA 120' (11-99) Page 8 of 23 I
the right and duty to defend any "suit" seeking those damages. We may at our discretion
investigate any"occurrence" and settle any claim or"suit"that may result, but:
(1) The amount we will pay for damages is limited as described in LIMITS OF INSURANCE
(SECTION IV); and
(2) Our duty to defend ends when we have used up the applicable limit of insurance in the
payment of judgments or settlements under Coverage E.
I No other obligation or liability to pay sums or perform acts or services is covered unless
I explicitly provided for under SUPPLEMENTARY PAYMENTS-COVERAGES A, B, D AND E.
•. This insurance applies to"bodily injury"and "property damage" only if:
(1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place
in the"coverage territory"; and
(2) The"bodily injury"or"property damage"occurs during the policy period; and
(3) The "bodily injury" or "property damage" arises out of your use of any aircraft, or its use
on your behalf, provided that:
(a) The aircraft is not owned by you in whole or in part;
(b) The aircraft is not on lease to you;
(c) The aircraft is not subject to a lease-purchase agreement to which you are a
party; and
(d) The aircraft is used in connection with your"airport operations".
• Damages because of "bodily injury" include damages claimed by any person or organization
for care, loss of services or death resulting at any time from the"bodily injury".
2. :xclusions
is insurance does not apply to:
. "Bodily injury"or"property damage"expected or intended from the standpoint of the insured.
This exclusion does not apply to "bodily injury" resulting from the use of reasonable force to
protect persons or property.
•� "Bodily injury" or "property damage" for which the insured is obligated to pay damages by
reason of the assumption of liability in a contract or agreement. This exclusion does not apply
to liability for damages:
1 (1) Assumed in a contract or agreement that is an "insured contract" provided the "bodily
1 injury" or "property damage" occurs subsequent to the execution of the contract or
agreement; or
(2) That the insured would have in the absence of the contract or agreement.
"Property damage"to the aircraft.
• Any obligation of the insured under a workers' compensation, disability benefits or
unemployment compensation law or any similar law.
AAP 212(11-99) Page 9 of 23
. I
e. "Bodily injury"to:
(1) An employee of the insured arising out of and in the course of employment by the
insured; or
(2) The spouse, child, parent, brother or sister of that employee as a consequence of (1)
above.
This exclusion applies:
II
(1) Whether the insured may be liable as an employer or in any other capacity; and
(2) To any obligation to share damages with or repay someone else who must pay damages
because of the injury.
This exclusion does not apply to liability assumed by the Insured under an"insured contract".
f. "Bodily injury"or"property damage" included in the "products-completed operations" hagard.
g. "Bodily injury" or "property damage" arising out of your use of any aircraft or its use on your
behalf, if the aircraft is operated "in flight" by a pilot who is not properly certificated and rated
by the F.A.A.for the flight involved.
This exclusion does not apply if the aircraft so operated is without your knowledge or consent.
II h. "Property damage"to:
(1) Property you own, rent or occupy;
(2) Property loaned or leased to you;
(3) Personal property in the care, custody or control of the insured.
I
SUI?PL MENTARY PAYMENTS - COVERAGES A, B, D AND E
We will •ay,with respect to any claim or"suit"we defend:
1. A I expenses we incur.
2. U• to $250 for cost of bail bonds required because of accidents or traffic law violations arising out of
the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to
furnish these bonds.
3. !i The cost of bonds to release attachments, but only for bond amounts within the applicab e LIMITS
�I 0 INSURANCE (SECTION IV). We do not have to furnish these bonds.
4. ; A I reasonable expenses incurred by the insured at our request to assist us in the inves igation or
d fense of the claim or "suit", including actual loss of earnings up to $100 a day because I f time off
fr m work.
5. I A I costs taxed against the insured in the "suit".
6. P ejudgment interest awarded against the insured on that part of the judgment we pay. If we make
a offer to pay the applicable LIMITS OF INSURANCE, we will not pay any prejudgme t interest
b sed on that period of time after the offer.
II I
7. I A I interest on the full amount of any judgment that accrues after entry of the judgment and before
e have paid, offered to pay, or deposited in court the part of the judgment that js Within the
applicable LIMITS OF INSURANCE.
AAP 202 (11-99) Page 10 of 23
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These payments will not reduce the LIMITS OF INSURANCE.
SECTION II - COMMON COVERAGE EXCLUSIONS
All Co erages included in this policy are subject to the following exclusions.
A. Noise and pollution and other perils.
This policy does not cover claims directly or indirectly occasioned by, happening through or in
consequence of:
(a) noise (whether audible to the human ear or not), vibration, sonic boom and any
phenomena associated therewith,
(b) pollution and contamination of any kind whatsoever,
(c) electrical and electromagnetic interference,
(d) interference with the use of property;
unless caused by or resulting in a crash fire explosion or collision or a recorded in-flight
emergency causing abnormal aircraft operation.
d With respect to any provision in the policy concerning our duty to investigate or defend claims,
such provision shall not apply and we shall not be required to defend:
(a) claims excluded by Paragraph 1; or
(b) a claim or claims covered by the policy when combined with any claims eiccluded by
Paragraph 1 (referred to below as"Combined Claims").
In respect of any Combined Claims, we shall (subject to proof of loss and the LIMITS OF
INSURANCE) reimburse you for that portion of the following items which may be allocated to
the claims covered by the policy:
(i) damages awarded against any insured; and
(ii) defense fees and expenses incurred by any insured.
Nothing herein shall override any radioactive contamination or other exclusion clause attached
to or forming part of this policy.
B. , ar, hi-jacking and other perils.
his policy does not cover claims caused by:
(.I) War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war,
rebellion, revolution, insurrection, martial law, military or usurped power or attempts at
usurpation of power.
(o) Any hostile detonation of any weapon of war employing atomic or nuclear fission and/or fusion
or other like reaction or radioactive force or matter.
(,) Strikes, riots, civil commotions or labor disturbances.
(0) Any act of one or more persons, whether or not agents of a sovereign Power, for;political or
terrorist purposes and whether the loss or damage resulting therefrom is accidental or
intentional.
(-) Any malicious act or act of sabotage.
AAP 212(11-99) Page 11 of 23
(f) Confiscation, nationalization, seizure, restraint, detention, appropriation, requisition for title or
use by or under the order of any Government (whether civil military or de facto) or public or
local authority.
(g; Hi-jacking or any unlawful seizure or wrongful exercise of control of the aircraft or crew in flight
(including any attempt at such seizure or control) made by any person or persons on board
the aircraft acting without the consent of the Insured.
Ft rthermore this policy does not cover claims arising while the aircraft is outside the control of the
in.ured by reason of any of the above perils.
T e aircraft shall be deemed to have been restored to the control of the insured on the spfe return
of the aircraft to the insured at an airfield not excluded by the."coverage territory" of this policy, and
e tirely suitable for the operation of the aircraft (such safe return shall require that the dircraft be
p.rked with engines shut down and under no duress).
C. I R.,dioactive Contamination.
1. This policy does not cover:
(a) loss or destruction of or damage to any property whatsoever or any loss of expense
whatsoever resulting or arising therefrom
(b) any legal liability of whatsoever nature
directly or indirectly caused or contributed to by or arising from ionizing radiations or
contamination by radioactivity from any source whatsoever.
I '
2. Loss, destruction, damage, expense or legal liability which, but for the provisions of aragraph
1. of this exclusion, would be covered by this policy, and is directly or indirectly aused or
contributed to by or arises from ionizing radiations or contamination by radioactivity from any
radioactive materials in course of carriage as cargo under International Air Transport
Association Regulations, shall (subject to all other provisions of this policy) be covered,
provided that:
a. it shall be a condition precedent to our liability that the carriage of any, radioactive
material shall in all respects comply with the current regulations issued by the
International Air Transport Association relating to the carriage of restricted articles by air;
b. this policy shall only apply to any claim made against the insured arising o'ut of any
accident or incident occurring during the period of this insurance and any s ch claim
made by the insured against us or by any claimant against the insured shall Dave been
made within three years after the date of the occurrence giving rise to the claim;
c. the cover afforded by this paragraph 2. may be cancelled at any time by us giving seven
days notice of cancellation.
SECTION III -WHO IS AN INSURED
1. If ou are designated in the Declarations as:
a. An individual, you and your spouse are insureds, but only with respect to your "airport
operations".
b A partnership or joint venture, you are an insured. Your members, your partners, and their
spouses are also insureds, but only with respect to your"airport operations".
c. A public corporation, you are an insured. Your elective or appointive officers or members of
any board or commission or agency of yours are also insureds, but only with respect to your
AAF 20' (11-99) Page 12 of 23
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"airport operations".
I
• An organization other than a partnership, joint venture or public corporation, you are an
insured. Your executive officers and directors are insureds, but only with respect to their duties
as your officers or directors. Your stockholders are also insureds, but only with respect to their
liability as stockholders.
2. 'ach of the following is also an insured:
Your employees, other than your executive officers, but only for acts within the scope of their
employment by you with respect to your"airport operations".
b. If you are designated in the Declarations as a public corporation, employees of your boards,
' commissions or agencies, other than executive officers, but only for acts within the scope of
their employment by those boards, commissions or agencies with respect to your "airport
operations".
However, no employee of yours or your boards, commissions or agencies is an insured for:
(1) "Bodily injury" or "personal injury" to you or to a co-employee while in the course of his or
her employment, or the spouse, child, parent, brother or sister of that co-employee as a
consequence of such "bodily injury" or "personal injury", or for any obligation to share
damages with or repay someone else who must pay damages because of the injury; or
(2) "Bodily injury" or "personal injury" arising out of his or her providing or failing:to provide
I professional health care services; or
d
(3) "Property damage" to property owned or occupied by or rented or loaned to that
, employee, any of your other employees, or any of your partners or members (if you are
I
a partnership or joint venture).
•! Any person (other than your employee), or any organization, while acting as your heal estate
manager.
Any person or organization having proper temporary custody of your property if you die, but
only:
(1) With respect to liability arising out of the maintenance or use of that property; and
(2) Until your legal representative has been appointed.
e Your legal representative if you die, but only with respect to duties as such. That
representative will have all your rights and duties under this policy.
3. i
kith respect to "mobile equipment registered in your name under any motor vehicle registration
I w, any person is an insured while driving such equipment along a public highway' with your
pi, rmission. Any other person or organization responsible for the conduct of such person'is also an
i sured, but only with respect to liability arising out of the operation of the equipment, and only if no
o her insurance of any kind is available to that person or organization for this liability. However, no
pp rson or organization is an insured with respect to:
• "Bodily injury"to a co-employee of the person driving the equipment; or
• "Property damage" to property owned by, rented to, in the charge of or occupied by you or the
employer of any person who is an insured under this provision.
o person or organization is an insured with respect to the conduct of any current or past
p.rtnership or joint venture that is not shown as a Named Insured in the Declarations.
AAP 2.2 (11-99) Page 13 of 23
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SECTION IV- LIMITS OF INSURANCE AND DEDUCTIBLES
A. LI ITS OF INSURANCE
1. The LIMITS OF INSURANCE (SECTION IV) shown in the Declarations and the rules below fix
the most we will pay regardless of the number of:
a. Insureds;
b. Claims made or"suits" brought; or
c. Persons or organizations making claims or bringing "suits".
2. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage
A for all damages because of "bodily injury" and "property damage" included in the products-
completed operations hazard".
3. The Personal and Advertising Injury Aggregate Limit is the most we will pay under C verage B
for the sum of all damages because of"personal injury" and "advertising injury".
4. The Malpractice Aggregate Limit is the most we will pay under Coverage A for all damages
because of"malpractice".
5. Subject to 2, 3 or 4 above, whichever applies, the Each Occurrence Limit is the most we will
pay for the sum of:
a. Damages because of all "bodily injury"and "property damage" under Coverages A and E;
and
b. Medical expenses under Coverage C; and
c. Damages because of physical injury to "aircraft" under Coverage D. arising out of one
"occurrence"; and
d. Damages because of all "personal injury" and "advertising injury" under Coverage B
arising out of one offense.
6. Subject to 5. above, the Fire Damage Limit is the most we will pay under Coverage A for
damages because of"property damage"to premises rented to you arising out of any o e fire.
7. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverag C for all
medical expenses because of"bodily injury" sustained by any one person.
8 Subject to 5. above, the Hangarkeepers Limit Any One Aircraft is the most we will pay under
II Coverage D for damages because of physical injury sustained by any one "aircraft" and the
Hangarkeepers Limit Any One Occurrence is the most we will pay under Cover ge D for
physical injury sustained by all "aircraft" in any one"occurrence".
I 9 Subject to 5. above, the Non-Owned Aircraft Liability Limit Any One Occurrence is Ithe most we
will pay under Coverage E for damages because of "bodily injury" and "property damage"
arising from one"occurrence".
T e limits of this policy apply separately to each consecutive annual period and to a y remaining
p-riod of less than 12 months, starting with the beginning of the policy period 'shown in the
D clarations, unless the policy period is extended after issuance for an additional period)o' less than
1 months. In that case, the additional period will be deemed part of the last preceding period for
p rposes of determining the Limits of Insurance.
6 I
AAP 2 2 (11-99) Page 14 of 23
B. DEDUCTIBLES
11
1. Our obligation to pay:
Damages because of"bodily injury" and "property damage" under Coverages A and E and
al. Medical expenses under Coverage C; and
Damages because of physical injury to "aircraft" under Coverage D arising lout of one
occurrence; and
a,. Damages because of "personal injury" and "advertising injury" under Coverage B arising out of
any one offense
pplies only to the amount of damages or medical expenses in excess of the Each Occurrence or
ffense Deductible amount stated in the Declarations, but the LIMITS OF INSURANCE applicable to
each Occurrence will not be reduced by the amount of such deductible, nor will Aggregate limits for
Much coverages be reduced by the application of such deductible amount.
The Aggregate Deductible amount stated in the Declarations is the most you will have to pay
for all deductible amounts under Coverages A, B, C, D and E for all damages and medical
expenses.
3! The terms of this insurance, including those with respect to:
(a) Our right and duty to defend any"suits" seeking those damages; and
(b) Your duties in the event of an "occurrence",claim, or suit
apply irrespective of the application of the deductible amount.
We may pay any part or all of the deductible amount to effect settlement of any claim or suit
and, upon notification of the action taken, you shall promptly reimburse us for such part of the
deductible amount as has been paid by us. I
Tihe Aggregate Deductibles of this policy apply separately to each consecutive annual period and to
any remaining period of less than 12 months, starting with the beginning of the policy period shown
i h the Declarations, unless the policy period is extended after issuance for an additional period of
I ss than 12 months. In that case, the additional period will be deemed the last preceding period for
rposes of determining the aggregate deductibles.
SECTION V-CONDITIONS
1. �'ankruptcy.
Bankruptcy or insolvency of the insured or of the insured's estate will not relieve ;us of our
obligations under this Policy.
2. Duties In The Event Of Occurrence, Offense, Claim Or Suit.
•i You must notify us as soon as practicable of an "occurrence" or an offense which may result in
a claim. To the extent possible, notice should include:
(1) How,when and where the"occurrence"or offense took place;
1 (2) The names and addresses of any injured persons and witnesses; and
(3) The nature and location of any injury or damage arising out of the "occurrence" or
offense.
b If a claim is made or"suit" is brought against any insured, you must:
AAP 2112 (11-99) Page 15 of 23
(1) Immediately record the specifics of the claim or"suit" and the date received; and
(2) Notify us as soon as practicable.
You must see to it that we receive written notice of the claim or"suit" as soon as practic ble.
c. You and any other involved insured must:
(1) Immediately send us copies of any demands, notices, summonses or legal papers
received in connection with the claim or"suit";
(2) Authorize us to obtain records and other information;
(3) Fully cooperate with us in the investigation, settlement or defense of the claim or'suit";
and
(4) Assist us, upon our request, in the enforcement of any right against any person or
organization which may be liable to the insured because of injury or damage to which this
insurance may also apply.
d. No insureds will, except at their own cost, voluntarily make a payment, assume any obligation,
or incur any expense, other than for first aid,without our consent.
3. L.'gal Action Against Us.
N• person or organization has a right under this policy:
a. To join us as a party or otherwise bring us into a"suit"asking for damages from an insured; or
b. To sue us on this policy unless all of its terms have been fully complied with.
jl A person or organization may sue us to recover on an agreed settlement or on a final judgment
against an insured obtained after an actual trial; but we will not be liable for damages that are not
p..yable under the terms of this policy or that are in excess of the applicable LIMITS OF
I SURANCE (SECTION IV). An agreed settlement means a settlement.and release of liability
si•ned by us,the insured and the claimant or the claimant's legal representative.
4. 0 her Insurance.
If other valid and collectible insurance is available to the insured for a loss we cover under Coverage
it A B, D or E of this policy, our obligations are limited as follows:
a Primary Insurance
This insurance is primary except when b. below applies. If this insurance is primary, our
obligations are not affected unless any of the other insurance is also primary. Then, we will
share with all that other insurance by the method described in c. below.
b Excess Insurance
This insurance is excess over any of the other insurance, whether primary, excess, contingent
or on any other basis:
(1) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for
"your work";
(2) That is Fire insurance for premises rented to you; or
ii (3) If the loss arises out of the maintenance or use of "autos" or watercraft to the extent not
subject to Exclusion f. of Coverage A(Section I).
(4) That is Aircraft Liability insurance on any aircraft to which Coverage E (Section I)applies.
AAP 212(11-99) Page 16 of 23
When this insurance is excess, we will have no duty under Coverage A, B, D or E to defend
any claim or "suit" that any other insurer has a duty to defend. If no other insurer defends, we
will undertake to do so, but we will be entitled to the insured's rights against all those other
insurers.
When this insurance is excess over other insurance, we will pay only our share of the amount
of the loss, if any, that exceeds the sum of:
(1) The total amount that all such other insurance would pay for the loss in the absence of
this insurance; and
(2) The total of all deductible and self-insured amounts under all that other insurance.
We will share the remaining loss, if any, with any other insurance that is not described in this
Excess Insurance provision and was not bought specifically to apply in excess of the Limits of
Insurance shown in the Declarations of this Policy.
. Method of Sharing
If all of the other insurance permits contribution by equal shares, we will follow this method
also. Under this approach each insurer contributes equal amounts until it has paid its
applicable limit of insurance or none of the loss remains, whichever comes first.
If any of the other insurance does not permit contribution by equal shares, we will contribute by
limits. Under this method, each insurers share is based on the ratio of its applicable limit of
insurance to the total applicable limits of insurance of all insurers.
5. Iremium Audit.I
We will compute all premiums for this policy in accordance with our rules and rates.
I. Premium shown in this policy as advance premium is a deposit premium only. At the close of
each audit period we will compute the earned premium for that period. Audit premiums are due
and payable on notice to the first Named Insured. If the sum of the advance and audit
premiums paid for the policy term is greater than the earned premium, we will return the
' excess to the first Named Insured.
The first Named Insured must keep records of the information we need for premium
computation, and send us copies at such times as we may request.
6. Representations.
•,'Ni accepting this policy, you agree:
The statements in the Declarations are accurate and complete;
b. Those statements are based upon representations you made to us; and
We have issued this policy in reliance upon your representations.
i
7. eparation Of Insureds.
"xcept with respect to the LIMITS OF INSURANCE (SECTION IV), and any rights or duties
ri
specifically assigned in this policy to the first Named Insured, this insurance applies separately to
-=ch insured against whom claim is made or"suit" is brought.
AAP 202 (11-99) Page 17 of 23
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8. Tr nsfer Of Rights Of Recovery Against Others To Us.
If he insured has rights to recover all or part of any payment we have made under this Policy, those
ri hts are transferred to us. The insured must do nothing after loss to impair them. At our request,
th insured will bring "suit"or transfer those rights to us and help us enforce them.
9. II C anges.
T is policy contains all the agreements between you and us concerning the insurance affo7ded. The
fir t Named Insured shown in the Declarations is authorized to make changes in the terms of this
p licy with our consent. This policy's terms can be amended or waived only by endorsem ent issued
b us and made a part of this policy.
10. Examination of your books and records.
V1r may examine and audit your books and records as they relate to this policy at any ti e during
th policy period and up to three years afterward.
11.1 In pections and surveys.
e have.the right but are not obligated to:
1. Make inspections and surveys at any time;
2. Give you reports on the conditions we find; and
3. Recommend changes.
A y inspections, surveys, reports or recommendations relate only to insurability and,tl1e •remiums
to be charged. We do not make safety inspections. We do not undertake to perform they d ty of any
p rson or organization to provide for the health or safety of workers or the public. And we do not
w rrant that conditions:
1. Are safe or healthful; or
2. Comply with laws, regulations, codes or standards.
Ti is condition applies not only to us, but also to any rating, advisory, rate service or similar
organization which makes insurance inspections, surveys, reports or recommendations.
12.1 Premiums and deductibles.
The first Named Insured shown in the Declarations:
1. Is responsible for the payment of all premiums and deductibles; and
2. Will be the payee for any return premiums we pay.
13. T ansfer of your rights and duties under this policy.
Y ur rights and duties under this policy may not be transferred without our written consent except in
t e case of death of an individual named insured as directed below:
If you die, your rights and duties will be transferred to your legal representative but only while acting
w thin the scope of duties as your legal representative. Until your legal representative is appointed,
a yone having proper temporary custody of your property will have your rights and duties but only
with respect to that property.
AAP 202(11-99) Page 18 of 23
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' SECTION VI - DEFINITIONS
1
1. ' dvertising injury" means injury arising out of one or more of the following offenses:
Oral or written publication of material that slanders or libels a person or organization or
disparages a person's or organization's goods, products or services;
0I Oral or written publication of material that violates a person's right of privacy;
r
Misappropriation of advertising ideas or style of doing business; or
d. Infringement of copyright,title or slogan.
P
2. ircraft" under Coverage D means any aircraft or its parts or equipment.
I
3. "1 irport" means the Airport(s) designated in the Declarations, including ways and means
i mediately adjoining such airport(s).
4. "ikirport operations" means the ownership, maintenance, use or provision of premises, services and
fcilities necessary to the operation of the "airport".
5. "Puto" means a land motor vehicle, trailer or semitrailer designed for travel on public roads,
i cluding any attached machinery or equipment, but"auto"does not include "mobile equipment".
6. ",odily injury" means: 1
Bodily injury, sickness or disease sustained by a person, including death resulting from any of
these at any time; or
Fright or mental anguish sustained by a person.
7. "III overage territory" means:
The United States of America (including its territories and possessions), Puerto Rico and
Canada; I
International waters or airspace, provided the injury or damage does not occur in the course of
travel or transportation to or from any place not included in a. above; or
All parts of the world if:
(1) The injury or damage arises out of:
(a) Goods or products made or sold by you in the territory described in a. above; or
(b) The activities of a person whose home is in the territory described in a. above,
but is away for a short time on your business; and
(2) The insured's responsibility to pay damages is determined in a "suit" on the merits, in the
territory described in a. above or in a settlement we agree to.
8. "Impaired property" means tangible property, other than "your product" or "your work", that cannot
b- used or is less useful because:
a It incorporates "your product" or "your work" that is known or thought to be defective, deficient,
inadequate or dangerous; or
I
b' You have failed to fulfill the terms of a contract or agreement;
if such property can be restored to use by:
a', The repair, replacement, adjustment or removal of"your product"or"your work"; or
AAP 212 (11-99) Page 19 of 23
•
b. Your fulfilling the terms of the contract or agreement.
9. "I flight" means:
a. With respect to a fixed wing aircraft, from the time the aircraft moves forward in attempting to
take off until the aircraft has completed its landing run.
b. With respect to a rotorcraft, while its rotors are in motion as a result of engine power or
autorotation.
10. "I sured contract" means:
a. A lease of premises;
b. A sidetrack agreement;
c. Any easement or license agreement, except in connection with construction or demolition
operations on or within 50 feet of a railroad;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with
work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to your business (including an
indemnification of a municipality in connection with work performed for a municipality) under
which you assume the tort liability of another party to pay for "bodily injury" br "property
damage" to a third person or organization. Tort liability means a liability that would b- imposed
by law in the absence of any contract or agreement.
A "insured contract" does not include that part of any contract or agreement:
a. That indemnifies any person or organization for "bodily injury" or "property damage" -rising out
of construction or demolition operations, within 50 feet of any railroad property an. effecting
any railroad bridge or trestle,tracks, road-beds,tunnel, underpass or crossing;
b. That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(1) Preparing, approving or failing to prepare or approve maps, drawings, opinions, reports,
surveys, change orders, designs or specifications; or
(2) Giving directions or instructions, or failing to give them, if that is the primary ca se of the
injury or damage;
c. Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or
damage arising out of the insured's rendering or failure to render professional services,
including those listed in b. above and supervisory, inspection or engineering services; o
d. That indemnifies any person or organization for damage by fire to premises rented or loaned
to you.
11. " oading or unloading" means the handling of property:
a. After it is moved from the place where it is accepted for movement into or onto an aircraft,
watercraft or"auto";
b While it is in or on an aircraft, watercraft or"auto"; or
c. While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally
delivered;
i
AAI?20' (11-99) Page 20 of 23
j
i .
ut "loading or unloading" does not include the movement of property by means of a mechanical
Ievice, other than a hand truck,that is not attached to the aircraft,watercraft or"auto".
I
12. " 1 alpractice" means malpractice, error or mistake by a physician, surgeon, nurse, medical
t chnician or other person performing medical services on behalf of an insured in the provision of
mergency medical relief.
13. " obile equipment" means any of the following types of land vehicles, including any attached
machinery or equipment:
Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public
roads;
1. Vehiclesmaintained for use solely on or next to premises you own or rent;
1 Vehicles that travel on crawler treads;
Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently
mounted:
, (1) Power cranes, shovels, loaders, diggers or drills; or
(2) Road construction or resurfacing equipment such as graders, scrapers or rollers;
e 1 Vehicles not described in a., b., c. or d. above that are not self-propelled and are maintained
1 primarily to provide mobility to permanently attached equipment of the following types:
(1) Air compressors, pumps and generators, including spraying, welding, building cleaning,
geophysical exploration, lighting and well servicing equipment; or
(2) Cherry pickers and similar devices used to raise or lower workers;
f I' Vehicles not described in a., b., c. or d. above maintained primarily for purposes other than the
transportation of persons or cargo.
However, self-propelled vehicles with the following types of permanently attached equipment
are not"mobile equipment" but will be considered "autos":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing;
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to
raise or lower workers; and
I �
(3) Air compressors, pumps and generators, including spraying, welding, building cleaning,
geophysical exploration, lighting and well servicing equipment.
14. "occurrence" means an accident, including continuous or repeated exposure to substantially the
111
slime general harmful conditions.15. "iersonal injury" means injury, other than "bodily injury11, arising out of one or more of the following
o enses:
If
Mistaken arrest, detention or imprisonment;
AAP 2 2 (11-99) Page 21 of 23
b. Malicious prosecution;
c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of
a room, dwelling or premises that a person occupies by or on behalf of its owner I ndlord or
lessor;
d. Oral or written publication of material that slanders or libels a person or organization or
disparages a person's or organization's goods, products or services;
e. Oral or written publication of material that violates a person's right of privacy;
f. Unintentional discrimination;
g. Misdirection of a passenger by an insured to the wrong aircraft, automobile or other c nnecting
transportation; or
The offenses described in paragraph f. of this definition do not include personal injury aris ng out of
th- employment, past employment or future employment of a person by any insured.
16.1 a. "Products-completed operations hazard" includes all "bodily injury" and "property damage"
occurring away from premises you own or rent and arising out of "your product" or "y.ur work"
except:
(1) Products that are still in your physical possession; or
(2) Work that has not yet been completed or abandoned.
b. "Your work"will be deemed completed at the earliest of the following times:
(1) When all of the work called for in your contract has been completed.
(2) When all of the work to be done at the site has been completed if your contra t calls for
work at more than one site.
(3) When that part of the work done at a job site has been put to its intended use by any
person or organization other than another contractor or subcontractor working on the
same project.
Work that may need service, maintenance, correction, repair or replacement, but which is
otherwise complete,will be treated as completed.
c. This hazard does not include "bodily injury"or"property damage" arising out of:
(1) The transportation of property, unless the injury or damage arises out of a,condition in or
on a vehicle created by the"loading or unloading"of it;
(2) The existence of tools, uninstalled equipment or abandoned or unused materials;
(3) Products or operations for which the classification in this policy or in our manu I of rules
includes products or completed operations.
17. ""roperty damage" means:
a Physical injury to tangible property, including all resulting loss of use of that property. All such
loss of use shall be deemed to occur at the time of the physical injury that caused it; or
b Loss of use of tangible property that is not physically injured. All such loss shall be deemed to
occur at the time of the "occurrence"that caused it.
AAP 202(11-99) Page 22 of 23
�' I
18. " uit" means a civil proceeding in which damages because of "bodily injury", "property damage",
ersonal injury" or"advertising injury"to which this insurance applies are alleged. "Suit" includes:
I
1. An arbitration proceeding in which such damages are claimed and to which you must submit or
do submit with our consent; or
Any other alternative dispute resolution proceeding in which such damages are claimed and to
1 which you submit with our consent.
19. " our product" means:
Any goods or products, other than real property, manufactured, sold, handled, distributed or
disposed of by:
(1) You;
(2) Others trading under your name; or
(3) A person or organization whose business or assets you have acquired; and
Containers (other than vehicles), materials, parts or equipment furnished in connection with
such goods or products.
"k our product" includes:
al Warranties or representations made at any time with respect to the fitness, quality; durability,
performance or use of"your product"; and
The providing of or failure to provide warnings or instructions.
" our product" does not include vending machines or other property rented to or located for the use
others but not sold.
20. "III our work" means:
Work or operations performed by you or on your behalf; and
Materials, parts or equipment furnished in connection with such work or operations.
"Your work" includes:
a Warranties or representations made at any time with respect to the fitness, quality, durability,
performance or use of"your work"; and
t The providing of or failure to provide warnings or instructions.
i
Ali
I
AAP 2112 (11-99) Page 23 of 23
i
.
{
This Endorsementeffective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By P e P operty And Casualty Insurance Company
1' I
a '
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
EXTENDED COVERAGE-WAR, HI-JACKING AND OTHER PERILS ENDORSEMENT T
This' e dorsement. modifies the insurance coverage provided under your AIRPORT OWN:RS AND
OPERA ORS GENERAL LIABILITY POLICY.
1. P..ragraphs (a), (c), (d), (e), (f) and (g) of Common Coverage Exclusion B (Section II) do not
apply to Coverages A, C, D, and E of this policy, SUBJECT TO all terms and conditio s of this
e dorsement.
2. T e most we will pay under this endorsement for:
(a! all "bodily injury";and
(b all "property damage"
combined is the Aggregate Limit shown in the Schedule below; and
T e Aggregate Limit shown in the Schedule below is included within, and is not in addition to, the
Li its of Liability shown in the Declarations.
3. T e following definition is added to the policy:
j: "certified act of terrorism" means an act certified by the Secretary of the Treasury, in concLrr-nce
wi h:
(al the Secretary of State; and
(bl the Attorney General of the United States of America,
to be an act of terrorism pursuant to the Terrorism Risk Insurance Act ("TRIA").
T e criteria for a"certified act of terrorism" include that the act:
A resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of
insurance subject to TRIA; and
B. is a violent act or an act that is dangerous to:
(a) human life; or
(b) property or infrastructure
and is part of an effort to:
Endorse ent No. 1
AAR 203(02-08) Page 1 of 3 01/05/2009
This En•i rsement effective January 1,2009
forms p.1I of Policy Number AAP N02204289 001
Issued t iil City of Renton
By Ace property And Casualty Insurance Company
( ) coerce the civilian population of the United States of America; or
(0) influence the policy or affect the conduct of the United States Government by coercion.
4. Ihis endorsement does not apply to:
(-) any damage to property on the ground while outside:
(i) Canada, or
(ii) the United States of America,
unless caused by or arising out of the use of aircraft;
or
(o) "Certified Acts of Terrorism", if the "Amendment to Include Coverage for Certified Acts of
Terrorism; Cap on Losses from Certified Acts of Terrorism Endorsement", is attached to
this policy.
5. I'i the "Amendment to Include Coverage for Certified Acts of Terrorism; Cap on Losses from
certified Acts of Terrorism Endorsement" is not attached to this policy, then if:
(-) aggregate insured losses certified under TRIA exceed $100 billion in a Program Year
(January 1 through December 31); and
(o) our insurer deductible under TRIA is met,
e are not liable for such losses that exceed $100 billion.
11 such case insured losses up to that amount will be pro-rated according to the procedures
e tablished by the Secretary of the Treasury of the United States of America.
6. The termination or cancellation of this endorsement is governed solely by paragraphs 7 and 8
b° low, and not by any other provision of this policy.
7. (-) This endorsement will END AUTOMATICALLY upon the outbreak of war (whether there is a
declaration of war or not) between any of the following:
(i) France,
(ii) the People's Republic of China,
(iii) the Russian Federation,
(iv) the United Kingdom, or
(v) the United States of America.
(o) The coverage provided by deleting paragraph (a) of Common Coverage Exclusion B
(section II)will END AUTOMATICALLY upon the hostile detonation of any weapon of War using:
(i) atomic or nuclear fission and/or fusion; or
Endorse ent No. 1
AAP 20 I(02-08) Page 2 of 3 al/05/2009
• �I
This End.rsement effective January 1,2009
formes pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace P operty And Casualty Insurance Company
1
it (ii) other like reaction or radioactive force or matter,
where or whenever such detonation may occur, and whether or not the insured ircraft is
involved.
II (c All coverage for an insured Aircraft requisitioned for title or use will END AUTOM TICALLY
upon such requisition.
(d) If an insured Aircraft is in the air when 7.(a), (b) or (c) occurs, the coverage pro lid d by this
endorsement (unless otherwise cancelled, terminated or suspended) will remain in effect
until:
(i) the insured Aircraft has completed its first landing thereafter; and
(ii) all passengers have disembarked.
8. i We maygive 7 days notice to review thepremium and/orgeographical limits ofur policy
Y y P Y
at any time.
(.) We may review premium and/or geographical limits on any January 1, April 1, July and
October 1 of the year(s)during the policy period.
ii
(«) We will send a notice advising you of any change in the premium and/or ge graphical
limits at least 7 days before the effective date of any such change.
(.) Following a hostile detonation as specified in 7(b) above, we may give 48 hours notice of a
full or partial cancellation of this endorsement.
(=) This endorsement may be cancelled by us or you by giving 7 days notice at any timer
(f All notices shall be in writing, and are effective after the specified period of notice beginning
at 23.59 hours Greenwich Mean Time on the day notice is given. I
All cthe terms and conditions of this policy remain unchanged.
SCHEDULE
Aggregate Limit: $100,000,000
An ual dditional Premium: $3,333
Premiu Due Hereon: $3,333
' I
Authorized Representative
Endorsement No. 1
AAP 203(02-08) Page 3 of 3 o1ro9/2009
I' I
This En orsement effective January 1,2009
forms pit of Policy Number AAP N02204289 001
Issued t I1 City of Renton
By Ace roperty And Casualty Insurance Company
AMENDMENT OF NOISE AND POLLUTION AND OTHER PERILS EXCLUSION
This Indorsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS
GENjok
L LIABILITY POLICY.
Paragph 1.A.(b) of the Pollution Endorsement AAP 273 (11-03) does not apply to pollution orcontaation of"your product."
Authorized Representative
II
Endorse ent No. 2
AAP 20, (11-03) 01/05/2009
iI
ThisEnd rsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace P operty And Casualty Insurance Company
EXTENSION -SPECIFIC EXCESS LIABILITY INSURANCE
This indorsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS
GENE',A L LIABILITY POLICY.
SCHEDULE
Underly ng Insurance: Automobile Liability Insurance
Underly ng Limits of Liability
("ultima e net loss"): $5,000,000 any one accident
Underly ng Insurers: Washington Cities Insurance Authority
Policy#CT2009 Term 01/01/09-10
Limits o Insurance
E-ch Occurrence Limit: $50,000,000
Aggregate Limit: Not Applicable
Thi policy is amended to include the following coverage:
CO/E- A GE F. SPECIFIC EXCESS LIABILITY
1. I SURING AGREEMENT:
a. We will pay those sums that the insured becomes legally obligated to pay as damages
because of bodily injury or property damage to which this insurance applies.
b. This insurance applies to bodily injury or property damage only if:
(1) The bodily injury or property damage is caused by an "occurrence" that takes place in
the"coverage territory"; and
(2) The bodily injury or property damage occurs during the policy period; and
(3) The bodily injury or property damage arises out of the hazards covered by and defined
in the underlying insurance described in the Schedule.
a ,
(4) The bodily injury or property damage arises out of your"airport operations".
E CLUSIONS:
2.
T is insurance is subject to the Common Coverage Exclusions (Section II) of this policy and, in
f, audition, the same exclusions which are contained in the underlying insurance shov/n in the
S hedule, but only to the extent that they do not conflict with the Common Coverage Exclusions
('ection II)of this policy.
Endorse ent No. 3
AAP 211 (11/99) Page 1 of 3 01/05/2009
This En orsement effective January 1,2009
forms p.it of Policy Number AAP N02204289 001
II
Issued to i City of Renton
By Ace '°roperty And Casualty Insurance Company
EXTENSION -SPECIFIC EXCESS LIABILITY INSURANCE (CONT'D)
3. A TTACHMENT OF LIABILITY AND LIMITS OF LIABILITY:
i e will pay under Coverage F only after the underlying insurers shown in the Schedule have paid
o° have been held liable to pay the full amount of the underlying limits of liability as shown in the
"'chedule.
he most we will pay under Coverage F regardless of the number of:
Insureds;
• Claims made or"suits" brought; or
o Persons or organizations making claims or bringing "suits"
I- the Each Occurrence Limit shown in the Schedule subject, if applicable, to the Aggregate Limit
s own in the Schedule.
4. CONDITIONS:
This insurance is subject to the same terms and conditions contained in or added to the
underlying insurance prior to the happening of an "occurrence" for which a claim is made
under this policy.
This condition 4.a. does not apply to the premium, our obligation to investigate aid defend,
the renewal agreement(if any)and the limits of insurance.
•! The underlying insurance shall be maintained in full effect during the policy period, but:
(1) If the aggregate limit contained in the underlying insurance is reduced or exhausted
because of payment of claims, this policy will apply in excess of the reduced aggregate
limit or will apply as underlying insurance if the aggregate limit is exhausted.
(2) If the insured fails to comply with this condition, this policy shall only apply to the same
extent as would have been the case had the insured complied with this condition.
If a claim or claims arise which appear likely to exceed the underlying limits of iability the
insured must not incur any"costs"without our consent.
•
"Costs" incurred by or on behalf of the insured with our consent and for which the insured is
not covered by the underlying insurers,will be apportioned as follows:
(1) As respects claims which are settled before trial for an amount which does not exceed
the underlying limits of liability, we will not pay any"costs".
(2) As respects claims which are settled before trial for an amount which exceeds the
underlying limits of liability, we will pay the same percentage of the "costs" as the
percentage we pay of the whole "ultimate net loss".
Endorse ent No. 3
AAP 21 (11/99) Page 2 of 3 01/05/2009
1
ThisfiEnd rsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ate P operty And Casualty Insurance Company
EXTENSION -SPECIFIC EXCESS LIABILITY INSURANCE (CONT'D)
ti
i (3) If the insured does not appeal a judgment which exceeds the underlying limits if liability,
we may elect to conduct such an appeal at our own expense including any Essociated
court costs and interest, but the most we will pay for such an appeal is limi ed to the
limits of insurance shown in the Schedule, plus the expenses of the appeal.
e. All recoveries or payments recovered or received subsequent to a claim settlement nder this
policy shall be applied as if recovered or received prior to such settlement. All ecessary
adjustments shall then be made between you and us.
5. ; D FINITIONS:
a. The term "ultimate net loss" means the amount payable in settlement of the liabi ity of the
insured after making deductions for all recoveries and for other valid and collectible insurances,
excepting however the underlying insurance and shall exclude all expenses and "costs".
b. The term "costs" means interest accruing after entry of judgment, investigation, adjustment and
`; legal expense (excluding, however, all expenses for salaried employees and generdil retainer
fees for counsel normally paid by the insured).
6. S-ction V of this policy shall apply to this insurance except condition 4. (Other Insurance).
'
1
Authorized Representative
�I
Endorse ent No. 3
AA 1 211 (11/99) Page 3 of 3 oiiosizoos
This Enoorsement effective January 1,2009
forms p.1it of Policy Number AAP N02204289 001
Issued til City of Renton
By Ace °Iroperty And Casualty Insurance Company
IMMUNITY WAIVER ENDORSEMENT
This e dorsement modifies insurance provided under AIRPORT OWNERS AND OPERATOR GENERAL
LIABIL TY POLICY.
We wi not defend any "suit" seeking damages under Coverages A, B, D, or E on the basis that the
insure. is not liable due to the performance of governmental functions, unless we are required by statute
or are equested by you.
Authorized Representative
Endorse ent No. 4
AAP 221 (11/99) 01/05/2009
This End•rsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace P operty And Casualty Insurance Company
AIRPORT LIMITED ENHANCED COVERAGE ENDORSEMENT
This en•orsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL
LIABILI Y POLICY.
1. ii (a Item 1(c)of Who is an Insured on page 13 of the policy is amended to read:
A public corporation, you are an insured. Your boards, commissions or agencies and their
elective or appointive officers or members thereof are also insureds, but only with r spect to
your"airport operations".
(b Item 1(d)of Who is an Insured on page 13 of the policy is amended to read:
An organization other than a partnership, joint venture or public corporation, you are an
insured. Your subsidiary companies, corporations, firms, affiliates, organizations, including
joint ventures of the Named Insured in Item 1 of the Declarations which are owned, financially
controlled or under your management control are also insureds but only with respect to your
"airport operations". Your executive officers and directors are insureds, but only with respect
to their duties as your officers or directors. Your stockholders are also insureds, but only
with respect to their liability as stockholders.
2. A y reference in the policy to F.A.A. is amended to include its foreign equivalent.
3. ;I Th- following is added to Condition 2 -(Duties In The Event Of Occurrence, Claim or Suit.)
e. Knowledge of an occurrence by your agent, servant or employee shall no constitute
knowledge by you, unless an executive officer, partner, proprietor or an emipldyed risk
manager has received such notice.
4. I C.ndition 6 -(Representations) is amended to include:
I d. Your unintentional failure to disclose facts shall not be a basis for denial of any overage,
provided that it is corrected as soon as it is discovered by an executive officer, partner,
proprietor or employed risk manager.
e. Your inadvertent failure to submit reports or contracts or comply with other notices, except
those required under Condition 2, shall not invalidate this insurance, provided it is orrected
as soon as it is discovered by an executive officer, partner, proprietor or empl yed risk
manager.
5. ; Th- Definition of"airport" is amended to read:
"Ai sort" means the airport(s) designated in the declarations, and other airports owned or ented by
yo , including ways and means immediately adjoining such airports.
6. I Th Definition of"airport operations" is amended to read:
"Ai port operations" means the ownership, maintenance, use or provision of premises, services and
fac lities necessary or incidental to the operation of the"airport".
Endoisement No. 5
AAP 234(11/99) Page 1 of 2 01/05/2009
i �
I
i
This En iorsement effective January 1,2009
forms part of Policy Number AAP N02204289 001
Issued t4 City of Renton
By Ace Property And Casualty Insurance Company
1 AIRPORT LIMITED ENHANCED COVERAGE ENDORSEMENT(CONT'D.)
7. The Definition of"advertising injury" is amended to include:
e. Infringement of trademark, service mark or trade name.
11
8. The Definition of"aircraft" is amended to read:
ircraft" under Coverage D means any aircraft, including its parts, equipment and contents.
9. I gem A.6. under Limits of Insurance is amended to read:
1
Subject to 5. above, the Fire Damage Limit is the most we will pay under Coverage A for
1 damages because of "property damage" to premises rented to you or temporarily occupied by
you, arising out of any one fire.
10. xclusion f of Section I of this policy (Aircraft, Auto or Watercraft) does not apply to wa#ercraft less
Ali an 26 feet in length.
d
11. °xclusion a. of Section I of this policy(Expected or Intended Injury) is amended to read:
This Insurance does not apply to:
II. Expected or Intended Injury
"Bodily injury"or"property damage"expected or intended from the standpoint of the i sured.
This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of
i
reasonable force to protect persons or property.
12. i xclusion h. of Section I of this policy (Air Meet, Contest, Exhibition) may be deleted, subject to 30
ays prior notice to us, at terms to be agreed.
13. tem 2.b. (1)of Who Is An Insured is deleted.
Authorized Representative
II
Endor--ment No. 5
AAP 2 (11/99) Page 2 of 2 01/05/2009
it
I I
I
This Endorsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace P operty And Casualty Insurance Company
NUCLEAR RISKS EXCLUSION CLAUSE
It is understood and agreed that the Radioactive Contamination exclusion under part C. of the Common
Covers a Exclusions(Section II) is deleted and replaced with the following: '
(1) ! Tliis Policy does not cover:
(i) loss of or destruction of or damage to any property whatsoever or any loss or expense
whatsoever resulting or arising therefrom or any consequential loss
(ii any legal liability of whatsoever nature
I di ectly or indirectly caused by or contributed to by or arising from:
1
(a) the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear
assembly or nuclear component thereof;
+, (b the radioactive properties of, or a combination of radioactive properties with toxic, explosive or
1; other hazardous properties of, any other radioactive material in the course of c rriage as
cargo, including storage or handling incidental thereto;
(c) ionizing radiations or contamination by radioactive form, or the toxic, explosive or other
hazardous properties of, any other radioactive source whatsoever.
i
(2) It is understood and agreed that such radioactive material or other radioactive source in paragraph
(1)(b)and (c)above shall not include:
(i) depleted uranium and natural uranium in any form;
(iil radioisotopes which have reached the final stage of fabrication so as to be usable for any
I scientific, medical, agricultural, commercial, educational, or industrial purpose.
(3) ` T is Policy, however, does not cover loss of or destruction of or damage to any property or any
co nsequential loss or any legal liability of whatsoever nature with respect to which:
(i the Insured under this Policy is also an insured or an additional insured under any other
insurance policy, including any nuclear energy liability policy; or
(ii) any person or organization is required to maintain financial protection pursuant to legislation
in any country; or
1', (ii) the Insured under this Policy is, or had this Policy not been issued would be, entitled to
indemnification from any government or agency thereof.
(4) L ss, destruction, damage, expense or legal liability in respect of the nuclear risks not excluded by
r ason of paragraph (2) shall (subject to all other terms, conditions, limitations, warranties and
exclusions of this Policy) be covered, provided that:
1
II
Endorsement No. 6
i
AAP 237(11/99) Page 1 of 2 01/05/2009
1
I 1
This Endorsement effective January 1,2009
forms p 1rt of Policy Number AAP N02204289 001
Issued tit City of Renton
By Ace 'i roperty And Casualty Insurance Company
NUCLEAR RISKS EXCLUSION CLAUSE (CONT'D.)
O in the case of any claim in respect of radioactive material in the course of carriage as cargo,
including storage or handling incidental thereto, such carriage shall in all respects have
complied with the full International Civil Aviation Organization "Technical lnstructidns for the
Safe Transport of Dangerous Goods by Air", unless the carriage shall have been subject to
any more restrictive legislation,when it shall in all respects have complied with such legislation;
("i) this Policy shall only apply to an incident happening during the period of this Policy and where
any claim by the Insured against us or by any claimant against the Insured arising out of such
incident shall have been made within three years after the date thereof;
(ii) in the case of any claim for the loss of or destruction of or damage to or loss of use of an
aircraft caused by or contributed to by radioactive contamination, the level of such
contamination shall have exceeded the maximum permissible level set out in the following
scale:
Emitter Maximum permissible level of non-fixed
radioactive surface contamination
(IAEA Health and Safety Regulations) (Averaged over 300 cm 2 )
Beta, gamma and low toxicity Not exceeding 4 Bequerels/cm 2
alpha emitters (10 -4 microcuries/cm 2 )
All other emitters Not exceeding 0.4 Bequerels/cm 2
(10.5 microcuries/cm 2 )
(i ) the cover afforded hereby may be cancelled by us at any time by giving seven days' notice of
cancellation.
Authorized Representative
Endorse ent No. 6
AAP 23, (11/99) Page 2 of 2 01/05/2009
ThisiEnd.rsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace P operty And Casualty Insurance Company
VOLUNTEERS ENDORSEMENT
In consi eration of the premium at which this policy is written, it is understood and agreed that:
1. herever the word employee appears in this policy, the same is deemed to include the insured's
v lunteers.
2. herever reference is made in this policy to the Insured's employment of an employee, the same
shall be deemed to also refer to the activities of the Insured's volunteers on behalf of the Insured.
Authorized Representative
Endorsement No. 7
AAP 248(11/99) 01/05i2009
it
This En orsement effective January 1,2009
forms p in of Policy Number AAP N02204289 001
Issued tm City of Renton
ll
By Ace 'roperty And Casualty Insurance Company
DATE RECOGNITION EXCLUSION CLAUSE
• ' in' loss, cost, expense or liability (whether in contract,
p licy does not cover any claim, damage, fury, p
tort, n 1'gligence, product liability, misrepresentation, fraud or otherwise) of any nature whatsoever arising
from o 'occasioned by or in consequence of(whether directly or indirectly and whether wholly or partly):
(a) t 'e failure or inability of any computer hardware, software, integrated circuit, chip or information
technology equipment or system (whether in the possession of the Insured or of any third party)
. curately or completely to process, exchange or transfer year, date or time data or information in
•nnection with:
- he change of year from 1999 to 2000; and/or
-II he change of date from 21 August 1999 to 22 August 1999; and/or
-any other change of year, date or time;
hether on or before or after such change of year, date or time;
(b) .1 y implemented or attempted change or modification of any computer hardware, software,
i "tegrated circuit, chip or information technology equipment or system (whether in the Possession
• the Insured or of any third party) in anticipation of or in response to any such change of year,
•":te or time, or any advice given or services performed in connection with any such change or
°odification;
(c) - y non-use or unavailability for use of any property or equipment of any kind whatsoever resulting
f1.m any act, failure to act or decision of the Insured or of any third party related to any such
«!ange of year, date or time;
and a e provision in this policy concerning any duty of Insurers to investigate or defend claims shall not
apply taxi any claims so excluded.
Authorized Representative
Endorse) ent No. 8
AAP 25s(11/99) 01/05/2009
li
This End4rsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace P operty And Casualty Insurance Company
PREMIUM AUDIT ENDORSEMENT
It is agr-ed that the advance premium shown under the Declarations is adjustable as follows:
Product.-Completed Operations:
Gross Receipts Rate Developed
Classif cation policy period per$1,000 Premium
Nevi Ai craft Sales If Any Included Included
Used Aircraft Sales If Any Included Included
Repairs&Service,
includin• parts installed If Any Included Included
Aviatio gas and oil If Any Included Included
Parts net installed If Any Included Included
Earned Premium Included
Less A.vance Premium Included
Additio al/(Return Premium)due Included
Authorized Representative
Endorse ent No. 9
AAP 257(11/99) 01/05/2009
This En orsement effective January 1,2009
forms p. of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace "roperty And Casualty Insurance Company
' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
1 AMENDMENT TO INCLUDE COVERAGE FOR CERTIFIED ACTS OF TERRORISM;
I CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM
This e dorsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL
LIABIL Y POLICY.
i
1. to exclusion of terrorism contained in this policy applies to a "certified act of terrorism".
2. I the event that:
( ) aggregate insured loses certified under the federal Terrorism Risk Insurance Act (hereafter
TRIA)exceed $100 billion in a Program Year(January 1 through December 31); and
O our insurer deductible under TRIA is met,
e are not liable for payment in relation to such losses that exceed $100 billion.
I such case insured losses up to that amount will be pro-rated according to the procedures
tablished by the Secretary of the Treasury of the United States of America.
3. "i! ertified act of terrorism" means an act certified by the Secretary of the Treasury, in concurrence
ith:
(. ) the Secretary of State; and
(I) the Attorney General of the United States of America,
t I be an act of terrorism pursuant to TRIA.
he criteria for a"certified act of terrorism" include that the act:
. resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of
insurance subject to TRIA; and
. is a violent act or an act that is dangerous to:
(a) human life; or
(b) property or infrastructure
and is part of an effort to:
(c) coerce the civilian population of the United States of America; or
(d) influence the policy or affect the conduct of the United States Government by coercion.
4. "remium: Premium as stated on Endorsement TRIA1 1 b(01-08), as attached to this policy.
Authorized Representative
Endors- ent No. 10
AAP 27a (02-08) Page 1 of 1 01/05/2009
This'Endorsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace P operty And Casualty Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLYL
DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT
Dis;clo-ure of Premium
In cc.rdance with the federal Terrorism Risk Insurance Act, we are required to provide you with a
notice .isciosing the portion of your premium, if any, attributable to coverage for terrorist acts certified
under t e Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is
sho n i this endorsement or in the policy Declarations.
Disclo-ure Of Federal Participation In Payment Of Terrorism Losses
They Un ted States Government, Department of the Treasury, will pay a share of terrorism losses insured
under the federal program. The federal share equals 85% of that portion of the amount of such insured
losses hat exceeds the applicable insurer retention. However, if aggregate insured losses attributable
to terro ist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a Program Year
(Jaiva , 1 through December 31), the Treasury shall not make any payment for any portion of the
amount of such losses that exceeds$100 billion.
Cap 0 Insurer Participation In Payment Of Terrorism Losses
If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk'Insurance Act
exceed $100 billion in a Program Year (January 1 through December 31) and we have met our insurer
deducti•le under the Terrorism Risk Insurance Act, we shall not be liable for the payment off any portion
of the :mount of such losses that exceeds $100 billion, and in such case insured losses Op to that
amount are subject to pro rata allocation in accordance with procedures established by the Secretary
of the T easury.
Terrors Risk Insurance Act premium: $6,667
Authorized Representative
�I I
Endorse ent No. 11
Includes copyrighted material of Insurance Services office,Inc.,with its permission
TRIA11b (01-08) 01/05/2009
II •
This En orsement effective January 1,2009
forms p it of Policy Number AAP N02204289 001
Issued t u City of Renton
By Ace roperty And Casualty Insurance Company
POLLUTION ENDORSEMENT
1. ection II, Common Coverage Exclusions, is amended by deleting exclusion A and inserting the
f llowing:
. Noise and pollution and other perils.
This Policy does not cover claims directly or indirectly, occasioned by, happening through, in
consequence of:
(a) noise (whether audible to the human ear or not), vibration, sonic boom and any
phenomena associated therewith;
(b) "Pollution"or contamination of any kind whatsoever;
(c) electrical or electromagnetic emission or interference of any kind whatsoever,;
(d) interference with the use of property;
(e) any direction, obligation, request, demand, order, or statutory or regulatory requirement,
or any voluntary decision to do so, that any "insured" or others test for, monitor, clean
up, remove, contain, treat, detoxify, neutralize, protect against or in any other way
respond to the actual, alleged or threatened presence of"Pollutants" or"Waste".
unless caused by or resulting in a crash, fire, explosion or collision or a recorded in-flight
emergency causing abnormal aircraft operation.
2. 'Nection VI, Definitions, is amended by as follows:
Definition 6,the definition of"bodily injury", shall be amended by adding the following:
"Bodily injury" also means fear of bodily injury, sickness, disease,fright or mental anguish.
• The following definitions are added:
"Pollution" means the mere presence of "Pollutants" in any form, as well as the actual,
alleged or threatened discharge, dispersal, release, escape, seepage, migration or disposal
of"Pollutants" in any form.
"Pollutants" include, without limitation, solid, liquid, gaseous or thermal irritants, any air
emission, contaminant, smoke, vapor, soot, fume, acid, alkali, chemical, "waste", or any
material alleged to be a possible or probable carcinogenic, odor, waste water, oil or other
petroleum product, infectious or medical waste, asbestos or asbestos product, fungus
(including mold or mildew or any mycotoxin, spore, scent or byproduct produced or released
by fungi, other than any fungi intended by the insured for consumption.)
"Waste" includes materials to be recycled, reconditioned or reclaimed, whether or not the
material has been disposed of by you or any person handling the waste.
All oth-r terms and conditions of this Policy remain unchanged.
Authorized Representative
Endors= ent No. 12
AAP 27. (11-03) Page 1 of 1 01/05/2009
• i�
This'Endorsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Alce P operty And Casualty Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
I
LIMITED TERRORISM COVERAGE ENDORSEMENT
This en.orsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL
LIABILI POLICY.
1. A y terrorism exclusion in this policy shall not apply to an "act of terrorism"which:
ji (a results in losses no greater than $5,000,000 in the aggregate, attributable to all types of
insurance; and
(b is not otherwise excluded by this policy.
2. A.ditional definition
"A t of terrorism" means an act that is:
1. (a) dangerous to human life; or
(b) property; or
(c) infrastructure
2. committed by an individual or individuals, and
3. seen as part of an effort to:
II
(a) coerce a civilian population; or
(b) influence the policy or affect the conduct of any government by coercion.
Multiple "acts of terrorism"which:
(a) occur in a seventy-two hour period; and
I'I which appear to:
(b) be carried out in concert; or
(c) have a related purpose; or
(d) have common leadership
shall be deemed one "act of terrorism".
I I
All other erms and conditions of this policy remain unchanged.
Authorized Representative
Endorsem-nt No. 13
II
AAP 275 (32-08) Page 1 of 1 01/05/2009
I
This En orsement effective January 1,2009
forms p ' of Policy Number AAP N02204289 001
Issued t ' City of Renton
By Ace property And Casualty Insurance Company
I
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
I SILICA AND SILICA-RELATED DUST EXCLUSION
It is ag eed that:
1. SECTION I - COVERAGES is amended at COVERAGE A. BODILY INJURY AND PROPERTY
DAMAGE LIABILITY, subsection 2. Exclusions by adding the following new exclusion:
(lust or Particulate Matter
This insurance does not apply to:
11) "Bodily injury" arising out of, resulting from, or in any way related to, in whole or lin part, the
respiration, inspiration, inhalation or breathing in of dust or particulate matter. Dust or
particulate matter may include, but is not limited to: dust, particulate matter, inspirable dust,
I respirable dust, smoke, mist, dirt, fibers, grit, soot, salt, acids, bases, metals, aerosols,
q crystals, minerals, sand, silicates, or silica.; or
1 ) Any loss, cost or expense arising, in whole or in part, out of the abating, testing for,
monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, remediating
II or disposing of, or in any way responding to or assessing the effects of, sdch dust or
t particulate matter, by any insured or by any other person or entity;
unless caused by or resulting in a crash, fire, explosion or collision or recorded in-flight
II emergency causing abnormal aircraft operation.
2. he addition of this endorsement does not imply that other policy provisions, including but not
imited to any pollution exclusion or asbestos exclusion, do not also exclude coverage for dust or
°°articulate matter related injury, damage, expense, cost, loss, liability, or legal obligation.
II
All of ler terms and conditions remain unchanged.
Authorized Representative
Ij I
11
Endor Dement No. 14
AAP 2 7 (01-06) Page 1 of 1 01/05/2009
GG i
i I
'
ThislEnd rsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace P operty And Casualty Insurance Company
II I
TRADE OR ECONOMIC SANCTIONS ENDORSEMENT
II
This en orsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS
GENE 1 L LIABILITY POLICY.
This ins rance does not apply to the extent that trade or economic sanctions or other laws or regulations
prohibit s from providing insurance, including, but not limited to,the payment of claims.
1
All othe terms and conditions of the policy remain unchanged.
I I
j I
i I
li
II
I I
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ill
Authorized Representative
11
EndorIsem-nt No. 15
ALL- 110 (11-06) Page 1 of 1 01/05/2009
it
l
1
II
This En Ilorsement effective January 1,2009
forms p of Policy Number AAP N02204289 001
Issued t 1' City of Renton
By Ace Property And Casualty Insurance Company
WASHINGTON CHANGES -CANCELLATION AND NONRENEWAL I
I
This e�I1idorsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL
LIABILITY POLICY.
CANCELLATION
1. l�he first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us
�alI�tivance written notice of cancellation.
2. UIJe may cancel this policy by mailing or delivering to the first Named Insured and the first Named Insured's
gent or broker written notice of cancellation, including the actual reason for the cancellation, to the last
mailing address known to us, at least:
all 10 days before the effective date of cancellation if we cancel for nonpayment of premium;or
45 days before the effective date of cancellation if we cancel for any other reason.
i
1
3. 11 a will also mail or deliver to any mortgage holder, pledgee or other person shown in this policy to have an
it���terest in any loss which may occur under this policy, at their last mailing address known to us, written notice
of cancellation, prior to the effective date of cancellation.This notice will be the same as that mailed for
delivered to the first Named Insured.
4. otice of cancellation will state the effective date of cancellation. The policy period will end on that date.
5. If this policy is cancelled,we will send the first Named Insured any premium refund due. If we cancel,
the refund will be pro rata.
If the first named insured cancels,the refund will be at least 90%of the pro rata refund.
0! If:
(1) You are an individual; and
(2) The first Named Insured cancels,
the refund will be not less than 90% of any unearned portion not exceeding $100, plus 95% of any
unearned portion over $100 but not exceeding $500, and not less than 97% of any unearned portion in
excess of$500.
01. The cancellation will be effective even if we have not made or offered a refund.
6. I notice is mailed, proof of mailing will be sufficient proof of notice.
NONR NEWAL
1. �, a may elect not to renew this policy by mailing or delivering written notice of nonrenewal; stating the
asons for nonrenewal, to the first Named Insured and the first Named Insured's agent or broker, at their
l',st mailing address known to us. We will also mail to any mortgage holder, pledgee or other person
hown in this policy to have an interest in any loss which may occur under this policy, at their last mailing
s
ddress known to us, written notice of nonrenewal. We will mail or deliver these notices at least 45 days
Oefore the:
Expiration of the policy; or
Anniversary date of this policy if this policy has been written for a term of more than one year!
D therwise,we will renew this policy unless:
. The first Named Insured fails to pay the renewal premium after we have expressed our willingness to
renew, including a statement of the renewal premium, to the first Named Insured and the'first Named
Insured's insurance agent or broker, at least 20 days before the expiration date;or
Other coverage acceptable to the insured has been procured prior to the expiration date of the policy.
Endor 19 ement No. 16 Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 1
Copyright,Insurance Services Office,Inc.1998
AAP r11199
i
This',IEndhrsement effective January 1,2009
forms pa of Policy Number AAP N02204289 001
Issued to City of Renton
By Ace P operty And Casualty Insurance Company
WASHINGTON CHANGES
This e dorsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL
LIA ILI POLICY.
A. E clusion e. of coverage A - Bodily Injury and Property Damage Liability (Section I - Coverages) applies
o ly applies only to "bodily injury" to any "employee" of the insured whose employment is not subject to
th- Industrial Insurance Act of Washington(Washington Revised Code Title 51).
W th respect to "bodily injury" to "employees" of the insured whose employment is subject to the Industrial
in urance Act of Washington, Exclusion e.is replaced with the following:
ti T is insurance does not apply to:
1. Bodily injury"to an"employee"of the insured arising out of and in the course of:
a. Employment by the insured;or
b. Performing duties related to the conduct of the insured's business; or
2. Any obligation to share damages with or repay someone else who must pay damages •ecause of
the injury.
T is exclusion does not apply to liability assumed by the insured under an "insured contract".
B. ! P.ragraph 2.b.(1) of Section III - Who Is An Insured applies only to "employees" of the insuried whose
e ployment is not subject to the Industrial Insurance Act of Washington (Washington Revised Code Title
51). With respect to "employees" of the insured whose employment is subject to the Indust lial Insurance
Al t of Washington, Paragraphs 2.a. and 2.b of Section III -Who Is An Insured are replaced with the f !lowing:
2. Each of the following is also an insured:
a. Your employees, other than your executive officers, but only for acts within the scope of their
employment by you with respect to your"airport operations".
b. If you are designated in the Declarations as a public corporation, employees of your boards,
commissions or agencies, other than executive officers, but only for_acts within th scope of
their employment by those boards, commissions or agencies with respect to yo r "airport
operations".
However, no employee of yours or your boards, commissions or agencies is an insured for:
(1) "Bodily injury" or "personal injury" to you or to a co-employee while in the course of his or
her employment, or for any obligation to share damages with or repay someone else
who must pay damages because of the injury; or
(2) "Bodily Injury" or "personal injury" arising out of his or her providing or failing to provide
professional health care services; or
(3) "Property damage" to property owned or occupied by or rented or loaned to that
employee, any of your other employees, or any of your partners or membeF-s (if you are
a partnership or joint venture).
I
Endorse ent No. 17 Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 1
Copyright,Insurance Services Office,Inc.1998
9001-WA(11/99)
I
CITY OF RENTON
AUG 14 2007
ti`S— Ot HUMAN RESOURCES/ RECEIVED
�% ® RISK MANAGEMENT DEPARTMENT CITY CLERK'S OFFICE
o� MEMORANDUM
DATE: August 14, 2007
TO: Jason Se AAL ` .ity Clerk
FROM: Paulie S -kV
f y-;4t i mid trative Secretary II/R.M. Assistant
SUBJECT: Update Of Excess Workers' Compensation Insurance Policy
Attached is a revised section of the Excess Workers' Compensation Insurance Policy.
This update of coverage is required because of a multitude of items, which include—
➢ An incorrect form, Specific Excess & Aggregate Excess, was issued instead of the
correct form - Specific Excess Coverage
➢ Endorsement terms and conditions not disclosed at the time of policy binding,
which would have resulted in an increase in premium amount
➢ Amendment to Schedule Item 9 — correcting the premium basis to "Rate Per
Worker Hour", instead of per$100 of payroll
All corrections have been noted by the broker, Arthur J. Gallagher, and acknowledged by
the underwriter, Midwest Employers Casualty Company. These amendments/corrections
will not affect our premium for this term, so no additional premium amount is due.
Please place this in the file with the other original 2007 insurance policy documents;
Arthur J. Gallagher, Midwest Employers Casualty Company — Excess Workers'
Compensation - 01/01/07 through 01/01/08.
If you have any questions, please feel free to give me a call at extension 7661.
i:\risk documents\2007 arthur j.gallagher_wcia renewal\ajg_xs_wc\update of xswc endorsements_2007.doc
O1ty of Renton
Received
AUG 1 3 2007
Human Resources&
GArthur J. Gallagher Risk Management Services, Inc. Risk Management
August 9, 2007
Ms. Pauletta Sulky
City of Renton
1055 South Grady Way
Renton, WA 98055
RE: Workers Compensation Policy#EWC005932
Policy Period: January 1, 2007 to January 1, 2008
Dear Paulie:
Enclosed please find the following items applicable to the 2007-08 Excess Workers'
Compensation Policy for City of Renton, all effective January 1, 2007:
• Policy Form for Specific Excess Coverage (the original and incorrect form issued
was for Specific Excess and Aggregate Excess).
• Communicable Disease Endorsement— MWECC requires a $5,000,000 limit for
this coverage, however, we were not made aware of this with your renewal, and
so they agreed to remove the limitation for this year.
• Amendment to Schedule Item 9 — corrects the premium basis to Rate per Man-
hour instead of per $100 of payroll.
There is no change in premium for these corrections. Please review and let us know if
you have any questions.
Thank you!
Sincerely,
Arthur J. Gallagher Risk Management Services, Inc.
Julie Vierra, CISR
Account Manager
JAV/j
Enclosures
6399 South Fiddler's Green Circle, Suite 200
Greenwood Village, CO 80111-4949
303.773.9999
Fax 303.773.9776
Toll Free 800.333.3231
www.ajg.com
4. Punitive or exemplary damages because of bodily injury sustained by any employee; H. Exclusions. Part Two does not cover:
5. Punitive,exemplary or compensatory damages because of your conduct,or the conduct of anyone acting for you: 1. Liability assumed under a contract;
(a) in the investigation,trial or settlement of any workers'compensation claim; 2. Loss payable under the law of any state which is not named in Schedule Item 3,if you are protected from the loss by any other
(b) in failing to pay or delay in payment of any workers'compensation claim. insurance;
6. Any assessment made upon self-insurers,whether imposed by statute,regulation or otherwise. 3. Punitive or exemplary damages because of bodily injury sustained by any employee;
H. Payments You Must Make. You are responsible(without reimbursement from us)for any payments in excess of the benefits regularly 4. Punitive,exemplary or compensatory damages because of your conduct,or the conduct of anyone acting for you:
provided by the workers'compensation law including those required because: (a) in the investigation,trial or settlement of any employers liability claim;
1. Of your serious and willful misconduct; (b) in failing to pay or delay in payment of any employers liability claim.
2. You knowingly employ an employee in violation of law; 5. Bodily injury to an employee while employed in violation of law with your actual knowledge or the actual knowledge of any of your
executive officers;
3. You fail to comply with a health or safety law or regulation;
6. Any obligation imposed by a workers'compensation,occupational disease,unemployment compensation,or disability benefits law,or
4. You discharge,coerce or otherwise discriminate against any employee in violation of the workers'compensation law;or any similar law;
5. You violate or fail to comply with any workers'compensation law. _ - - 7. Bodily injury-intentionally caused or aggravated by you.This exclusion does not apply to claim expenses(listed in subparagraph 3 of the
I. Other Insurance. If,as respects any state named in Schedule Item 3,any other insurance exists protecting you against loss covered by - - definition of loss)related to the injury;
this insurance,this insurance shall apply in excess of the other insurance. 8. Damages arising out of coercion,criticism,demotion,evaluation,reassignment,discipline,defamation,harassment,humiliation,
J. Recovery From Others. We have your rights,and the rights of persons entitled to compensation benefits from you,to recover our loss from discrimination against or termination of any employee,or any personnel practices, policies,acts or omissions;
anyone liable for the injury.You will do everything necessary to protect those rights for us and to help us enforce them.The recovered loss 9. Bodily injury occurring outside the United States of America.This exclusion does not apply to bodily injury to a citizen or resident of the
will first be used to reduce our loss.Then we will pay the balance,if any,to you. Expenses of all proceedings to recover from anyone liable state(s)listed in Item 3 who is temporarily working outside the United States for the Insured;
for injury covered by this policy will be allocated between you and us in the ratio represented by the allocation of any damages which have 10. Damages arising out of operations for which you:
been recovered. (a) have violated or failed to comply with any workers'compensation law,or
PART TWO - EMPLOYERS LIABILITY (b) have rejected any workers'compensation law.
A. How This Part Applies. Part Two applies to loss paid by you for damages imposed upon you by the laws of any state shown in Schedule I. Other Insurance. If,as respects any state named in Schedule Item 3,any other insurance exists protecting you against loss covered by
Item 3. Part Two also applies to loss paid by you for damages imposed upon you by the law of any other state which is not shown in this insurance,this insurance shall apply in excess of the other insurance.
Schedule Item 4.DAMAGES MUST RESULT FROM BODILY INJURY BY ACCIDENT OR BODILY INJURY BY DISEASE SUSTAINED BY
AN EMPLOYEE YOU NORMALLY EMPLOY IN A STATE NAMED IN SCHEDULE ITEM 3.Bodily injury includes resulting death. J. Recovery From Others. We have your rights to recover our loss from anyone liable for an injury covered by this insurance.You will do
everything necessary to protect those rights for us and to help us enforce them.The recovered loss will first be used to reduce our loss.
Bodily injury must arise out of and in the course of the injured employee's employment by you. Then we will pay the balance, if any,to you. Expenses of all proceedings to recover from anyone liable for injury covered by this policy will
be allocated between you and us in the ratio represented by the allocation of any damages which have been recovered.
Bodily injury by accident must occur during the policy period.A disease is not bodily injury by accident unless it results directly from bodily
injury by accident. PART THREE - CLAIMS
Bodily injury by disease must be caused or aggravated by the conditions of your employment.The employee's last day of last exposure to A. Your Claims Handling Duties. It is your responsibility to investigate,settle,defend and appeal any claim made against you. It is also your
the conditions causing or aggravating such bodily injury by disease must occur during the policy period. Bodily injury by disese does not responsibility to investigate,settle,defend and appeal any suit brought or other proceeding instituted against you.
include disease that results directly from bodily injury by accident. Bodily injury by disease includes cumulative trauma. B. Your Claims Reporting Duties. It is important for you to understand that"Written Notice"shall contain complete details of the injury,disease
B. Your Retention. You must retain loss as shown in Schedule Item 6.This retention applies to Part One loss and to Part Two loss together. or death. Providing loss runs does not constitute notice.
IT IS IMPORTANT FOR YOU TO UNDERSTAND THAT YOUR RETENTION FOR DISEASE APPLIES SEPARATELY TO EACH EM- 1. You must give us written notice as soon as you learn of any of the following events involving loss which exceeds(or might in the future
PLOYEE.Naming more than one Insured in Schedule Item 1 does not increase your retention. exceed)50%of your retention:
C. Our Indemnity. We will indemnify you for loss paid by you in excess of your retention.This indemnity may be reduced by a late reporting (a) claim;
penalty. (b) award;
D. Our Limit. The most loss we will reimburse you for with respect to each accident is shown in Schedule Item 7(b).The most loss we will (c) verdict;
reimburse you for with respect to each employee for disease is shown in Schedule Item 8(b). Naming more than one Insured in Schedule ( action;
Item 1 does not increase our limit. -- (e)) suit;t
(f) proceeding;
E. Late Reporting Penalty. As respects each accident or each employee for disease: (g) judgment.
1. If you do not give us written notice within one year of when required by Part Three,our indemnity will be reduced by 15%. 2. You must give us immediate(within 30 days)written notice of any accident involving:
2. If you do not give us written notice within three years of when required by Part Three,our indemnity will be reduced by 40%. (a) fatality;
(b) spinal cord injury;
F. Loss means the amount actually paid by you for damages imposed upon you by law.Loss includes: (c) a permanent total disability as defined in the workers compensation law;
1. The amount paid by you in settlement of claims for legal damages; (d) serious burn injury;
(e) brain injury;
2. The amount paid by you in satisfaction of awards or judgments for damages; (II-amputation-of-a-major-member.
3-Cou costs,interest upon awards and judgments,and allocated investigation,adjustment and legal expenses pertaining to employers
liability claims.This subparagraph 3 does not_inc_lu_d_e__ _ ___ _ _ _ _ __ ___ - _ 3--- - __ w tt = e� a y_ im_m-w __ ___1 rede p yes=disabil y- xceeds-52-wee ,_ ven-if=the claim=is-- - -_
3. You must give us prompt ri en notic f n cla' hichlhe in'u m to e 'it a ks e
(i) salaries paid to your employees; being contested by you;
(ii) service company fees; 4. You must give us immediate(within 30 days)written notice of all occurrences involving two or more of your employees.
(iii) claims administrator fees.
C. Claims Information. You agree to send to us any claim information which we may request.
G. Damages includes:
D. Claims Participation By Us. At our own election and expense,we have the right and shall be given the opportunity to participate with you in
1. Damages for which you are liable to a third party by reason of a claim or suit against you by that third party to recover the damages the settlement,defense or appeal of any claim,suit or proceeding which might involve a loss to us.We have no duty to investigate, handle,
claimed against such third party as a result of injury to your employee;and settle or defend any claims,suits,or proceedings against you.
2. Damages for care and loss of services;and E. Good Faith Settlements. You shall use diligence,prudence and good faith in the investigation,defense and settlement of all claims and
3. Damages for consequential bodily injury to a spouse,child,parent,brother or sister of the injured employee; shall not unreasonably refuse to settle any claim which,in the exercise of sound judgment,should be settled.You agree not to make any
Provided that these damages are the direct consequence of bodily injury that arises out of and in the course of the injured voluntary settlement involving loss to us without our written consent.
employee's employment by you;and F. Proof of Loss. When paid loss exceeds your retention,you must provide us with a payment register listing all payments made on the claim.
4. Damages because of bodily injury to your employee that arise out of and in the course of employment,claimed against you in a capacity We will reimburse you the amount you have paid in excess of your retention,within 30 days of receiving in a form acceptable to us,a
other than as employer. complete and proper proof of loss.
MWE-200 (1-93) -2- MWE-200(1-93) -3-
G. Commutation. Beginning thirty-six(36)months after receipt of notice by us of a claim,we may then,or at any time after,submit the claim MIDWEST EMPLOYERS CASUALTY COMPANY
for commutation. If we so elect,the claim shall be submitted to an actuary or appraiser to be mutually appointed by us and you.Should we
both fail to agree upon an actuary or appraiser,then each party shall select an actuary or appraiser who shall then select an independent Specific Excess
actuary or appraiser who shall fix a lump sum amount.We may pay the lump sum amount,which shall constitute a full and final release of Workers' Compensation and Employers ers LiabilityIndemnityPolicy
liability for the claim.However,such lump sum payment shall not constitute a full and final release of our liability if,after the lump sump y
payment,any supplemental award is made increasing the amount of benefits payable to the Employee and his/her dependents.Any
additional liability,at our election, may immediately be commuted via the process above and we may discharge such liability by payment of In return for the payment of the premium and subject to all terms of this policy,we agree with you as follows:
another lump sum.
GENERAL SECTION
H. Claim Audit. You will let us or our representative examine and audit claim files upon our request.These audits may be conducted during
your regular business hours. A. Self-Insurance. Your acceptance of this policy indicates that you are now and will remain until the end of the policy period a duly qualified
self-insurer in each state named in Schedule Item 3. If you are not a duly qualified self-insurer with respect to any loss covered by this
PART FOUR - PREMIUM policy,this policy will apply as if you were.
A. Deppsit and Adjustment Premiums. At the beginning of the policy period you must pay us the deposit premium shown in the Schedule.At B. Insured. The Insured is named in Item 1 of the Schedule.If the Insured is a partnership or joint venture,each partner or member of the joint
the end of the policy period: veat up_is-ins ued=owl in the pacity as employer of employees of the partnership or joint venture.
1. You will owe us the amount by which the final premium is greater than the deposit premium;or C. The Policy. This policy includes the Schedule and any attached endorsements. It is a contract of insurance between you(the Insured
2. We will owe you the amount by which the deposit premium is greater than the final premium. named in Schedule Item 1)and us(the Insurer named on the Schedule).The only agreements relating to this insurance are stated in this
policy.The terms of this policy may not be changed or waived except by endorsement issued by us to be a part of this policy.Endorsements
B. Payroll Report. Within 45 days after the end of the policy period,send us a report showing the amount of payroll earned by your employees amending Schedule Items 1,3,4,6,7 or 8 apply with respect to accidents and disease exposures occurring at or after 12:01 A.M.on the
during the policy period.The report must show payroll separately for each classification identified in Schedule Item 10. endorsements'effective date.
C. Final Premium. The final premium due us for the policy period will be computed as shown in Schedule Item 9(a). Unless this policy is D. Policy Period means the period of time covered by this policy as shown in Schedule Item 5. If this policy is cancelled,the policy period will
cancelled,final premium will be at least the minimum premium shown in Schedule Item 9(b). end at 12:01 A.M.on the cancellation date.
If we cancel this policy,final premium will be calculated pro rata based on the time this policy was in force. Final premium will not be less E. Workers'Compensation Law includes occupational disease law. It does not include the provisions of any law that provides non-occupational
than the pro rata share of the minimum premium. disability benefits.
If you cancel this policy,final premium will be more than pro rata;it will be based on the time this policy was in force,and increased by the F. State means any state of the United States of America and the District of Columbia.
customary short rate table and procedure.Final premium will not be less than the short rate portion of the minimum premium.
PART ONE - WORKERS' COMPENSATION
D. Payroll means the gross pay of your employees for the policy period plus other amounts and items received by your employees as part of
A. How This Part Applies. Part One applies to loss paid by you because of liability imposed upon you by the workers'compensation law of any
their pay for the policy period.We will send you a payroll reporting form describing what is included in payroll.
state named in Schedule Item 3. Part One also applies to loss paid by you because of liability imposed upon you by the workers'compensa-
E. Records. You will keep records of information needed to compute premium.You will provide us with copies of those records when we ask tion law of any other state which is not shown in Schedule Item 4. LIABILITY MUST RESULT FROM BODILY INJURY BY ACCIDENT OR
for them. BODILY INJURY BY DISEASE SUSTAINED BY AN EMPLOYEE YOU NORMALLY EMPLOY IN A STATE NAMED IN SCHEDULE ITEM 3.
Bodily injury includes resulting death.
F. Audit. You will let us or our representatives examine and audit all your payroll records.The audits may be conducted during your regular
business hours. Bodily injury by accident must occur during the policy period.A disease is not bodily injury by accident unless it results directly from bodily
PART FIVE - CONDITIONS injury by accident.
A. Agreement Upon Terms. Your acceptance of this policy means that you agree with us upon the terms of this policy. Bodily injury by disease must be caused or aggravated by the conditions of your employment.The employee's last day of last exposure to
the conditions causing or aggravating such bodily injury by disease must occur during the policy period.Bodily injury by disease does not
B. Sole Representative. The Insured first named in Schedule Item 1 will act on behalf of all Insureds to change this policy,accept loss include disease that results directly from bodily injury by accident. Bodily injury by disease includes cumulative trauma.
payments,receive return premium and give or receive notice of cancellation. B. Your Retention. You must retain loss as shown in Schedule Item 6.This retention applies to Part One loss and to Part Two loss together.
C. Bankruptcy or Insolvency. Your bankruptcy or insolvency will not relieve us from the payment of any claim covered by this policy.After the IT IS IMPORTANT FOR YOU TO UNDERSTAND THAT YOUR RETENTION FOR DISEASE APPLIES SEPARATELY TO EACH EM-
retention shown on the Schedule has been paid,payments will be made by us as if you had not become bankrupt or insolvent but not in PLOYEE.Naming more than one Insured in Schedule Item 1 does not increase your retention.
excess of the Insurers Limit of Indemnity. Payment will be made to the Trustee in Bankruptcy or as directed by an appropriate court. C. Our Indemnity. We will indemnify you for loss paid by you in excess of your retention.This indemnity may be reduced by a late reporting
D. Transfer of Your Rights and Duties. Your rights or duties under this policy may not be transferred without our written consent.This penalty.
provision does not apply to duties transferred to a service company or a claims administrator. D. Our Limit. The most loss we will reimburse you for with respect to each accident is shown in Schedule Item 7(a).The most loss we will
E. Service and Administration. This Agreement contemplates the concurrent and continued existence of a separate service agreement reimburse you for with respect to each employee for disease is shown in Schedule Item 8(a).Naming more than one Insured in Schedule
between you and the Service Company named in Item 12 of the Schedule.You must notify us within 30 days should you decide to change Item 1 does not increase our limit.
the service company. E. Late Reporting Penalty. As respects each accident or each employee for disease:
F. Cancellation. You may cancel this policy by giving us at least thirty(30)days advance notice by registered mail stating the cancellation
date.We may cancel this policy by giving you at least thirty(30)days advance notice by registered mail stating the cancellation date.Our 1. If you do not give us written notice within one year of when required by Part Three,our indemnity will be reduced by 15%.
mailing of registered notice tpyour address shown in Schedule Item 2 will be sufficient proof that we cancelled this policy. 2. If you do not give us written notice within three years of when required by Part Three,our indemnity will be reduced by 40%.
If you fail to pay premium,we may cancel with 10 days written notice to you. F. Loss means the amount-actually paid by you-for-regular benefits provided-under-the-workers'-compensation law-in effect-upon-the-date-the
We have executed this policy by printing below the facsimile signatures of our President and Secretary and by the actual signature of our accident or disease exposure occurs.Loss includes:
authorized representative on the Schedule. 1. The amount paid by you in settlement of claims for regular benefits under the workers'compensation law;
2. The amount paid by you in satisfaction of awards or judgments for regular benefits under the workers'compensation law;
MIDWEST EMPLOYERS CASUALTY COMPANY 3. Court costs,interest upon awards and judgments,and allocated investigation,adjustment and legal expenses pertaining to workers'
compensation claims.This subparagraph 3 does not include:
(i) salaries paid to your employees;
Countersigned: (ii) service company fees;
/ (iii) claims administrator fees.
-- .ov_ X. �t4��- �/ , eh / J S . G. Exclusions. Part One does not cover:
1. Loss insured by full coverage workers'compensation or employers liability insurance;
SIGNATURE SIGNATURE 2. Loss payable under the workers'compensation law of any state which is not named in Schedule Item 3,if you are protected from the
loss by any other insurance;
Authorized Representative Secretary President 3. Any loss arising out of operations for which you have rejected any workers'compensation law;
MWE-200 (1-93) -4-
MWE-200(1-93) -1-
f
ICI I
Midwest Employers Casualty Company
Endorsement Schedule
Insured: City.Of Renton
11 Policy Term: 01/01/2007 to 01/01/2008
ii Policy No.: EWC005932
Endorsement Code Effective Date Expiration Date Date Created Description
ii
10-31 01/01/2007 01/12/2007
10-32 01/01/2007 01/12/2007
10-38 01/01/2007 01/12/2007
I O-39C 01/01/2007 01/01/2007 01/12/2007
1 O-74A 01/01/2007 01/12/2007
10-83 01/01/2007 01/12/2007
it SO-6 (1) 01/01/2007 01/15/2007
SO-10 01/01/2007 01/15/2007
30-43 01/01/2007 01/15/2007
SO-44 01/01/2007 01/15/2007
SO-78 01/01/2007 01/15/2007
SO-WA 01/01/2007 01/15/2007
I0-60A 01/01/2007 01/25/2007
I O-66WA 01/01/2007 01/25/2007
SO-9 (12-05) .01/01/2007 02/13/2007
I 0-39C 01/01/2007 06/14/2007
Page 1 of 1 ; Print Date: 06/14/2007
1 i J
I
II
1
I
Communicable Disease Endorsement
In consideration of the premium charged, it is understood and agreed that Part One B of the polic
11,
1 tis amended to include thefollowing:
Bodily injury to one or more of your employees infected with the same communicable disease
I; manifested during the policy period shown in Schedule Item 5 of the policy will be treated as one
II loss.
,1
II
9 The phrase "communicable disease" shall mean a disease caused by an infectious organism wh
is transmitted from one source to another, directly or indirectly.
ril
ir
It is further agreed that our limit as respects bodily injury arising from same communicable dise
is Statutory.
I
Endorsement Effective: 01/01/2007
Policy No.: EWC005932
Named Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
4"...v` X. 14s4"."1"-F ?geld& ,/, -.141.441 h-------
Authorized Representative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
IO-39C (11-04) Date Printed: 06/14/2007
1
r
i,
II . . Midwest Employers Casualty Company
ir
il Endorsement Schedule
t ,
Insured: City Of Renton
il Policy Term: 01/01/2007 to 01/01/2008
II Policy No.: EWC005932
li
fI Endorsement Code Effective Date Expiration Date Date Created
10-31 01/01/2007 01/12/2007
10-32 01/01/2007 01/12/2007
10-38 01/01/2007 01/12/2007
I O-39C 01/01/2007 01/12/2007
I O-74A 01/01/2007 01/12/2007
10-83 01/01/2007 01/12/2007
SO-6 (1) 01/01/2007 01/15/2007
SO-10 01/01/2007 01/15/2007
SO-43 01/01/2007 01/15/2007
SO-44 01/01/2007 01/15/2007
50-78 01/01/2007 01/15/2007
SO-WA 01/01/2007 01/15/2007
I O-60A 01/01/2007 01/25/2007
I0-66WA 01/01/2007 01/25/2007
SO-9 (12-05) 01/01/2007 02/13/2007
Page 1 of 1 Print Date: 02/13/2007
I
III t. •�
Ili i
Amendment to Schedule Item 9
Schedule Item 9 is amended to read as follows:
9. Premium:
(a) Rate per Manhour: .0302
(b) Policy Minimum Premium: $30,013
(c) Total Estimated Policy Premium: $33,348
(d) Deposit Premium: $33,348
(e) Deposit Flat Charges: n/a
(f) Total Deposit Premium and Flat Charges Payable as Follows:
Amount Due
Ii $33,348.00 02/09/2007
I'.
it
it
Endorsement Effective: 01/01/2007
Policy No.: EWC005932
Named Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
D x.
4`644'4i7 711401?ee
Authorized Representative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
I I
SO-9 (12-05) Date Printed: 02/13/2007
City of Renton
Arthur J. Gallagher & Co. - Denver Received
MAY 8 0 2007
Human Resources &
May 22, 2007 Risk Management
Ms. Paulette Sulky
City of Renton
1055 South Grady Way
Renton, WA 98055
RE: Equipment Breakdown Policy#BM9307613-04
Commercial Crime Policy#103034286
Underground Storage Tank Policy#007786457
Excess Workers'Compensation Policy#EWC005932, EWC005932
Policy Period: January 1, 2007 to January 1, 2008
Dear Paulie:
Enclosed are your insurance policies as referenced above. We have reviewed the
• policies for accuracy and have found a couple of corrections necessary and have
requested the appropriate endorsements. We will forward those endorsements upon
receipt.
Paulie, we appreciate the opportunity to place these important insurance coverage's for
you. If you have any questions or need additional information, please give us a call
at (303) 773-9999.
Sincerely,
Arthur J. Gallagher Risk Management Services, Inc.
C
J lie Ann Vierra, CISR
Account Manager
JAV/j
Enclosures
• 6399 S. Fiddlers Green Circle
Suite 200
Greenwood Village, CO 801 1 1-4949
303.773.9999
Fax 303.773.9776
Toll Free 800.333.3231
www.ajg.com
• 111
ZURICH
11
ZURICH
Equipment Breakdown Policy
•
•
I„I .
•
Brian Strain;Vice President,•550 W Washington,Suite 1200,Chicago,IL 60661•Phone:(312)496-9241•E-mail:brian.strain@zmichna.com
II
VI
1
I'
EQUIPMENT BREAKDOWN
9 1
• PROTECTION COVERAGE FORM
DECLARATIONS ZURICH
Named Insured: City of Renton
Mailing Address: 1055 S.Grady Way
ii, Renton,WA 98055
Policy N I mb r: BM 9307613-04 '
Annual Premium: $9,911
9100 111 Executive and Legislative Offices
SIC Code I Standard Business Description
Policy Perio From: 01/01/2007 To:01/01/2008 at 12:01 a.m.Standard Time at Named Insured's mailing
address I'
il
Covered iPre ises: See Endorsement#1
11
Contingent Business Income and Extra Expense Covered Premises:Any Location
rv's . :,3 w5- R.+:' r .N It yr' Y 'N
' gar, 'r '#s 'f I z .Ate'.� a e ° '� $. �* e �.k
f v#4..., J.,,,,,,,l'. ..k 4 likK,X.: .t,I.lit.,:t4,11„,V.14)1'.;,.i,:,..61,,,.. ,,..:, tifiq„.,*.„,n:04,:p.,,,:ittt„,,,,, 4,4) .04;v1,
0-.0 .044,?-..i ,'04..1! ) p, ,w, -Ify,A.*:-T, wolimvo- ,-0, 91,---m e.:,:" ,- :, i „,t,coor ,_.1.,4,144.:,.:44e,..,17,.,
,,,,:,,,,,,,.,,,,„,,,,ifi,,,,,-., „*4,02714 ,.':.c:f.t,;:4:4.*:A4.1'.-4-14,,r:FAzi.:04.'firY'or:: ''-'''%''C''.3:`,'Y,,-'4;4..11!.- -V.;'*--k':ece
COVERAGES LIMITS OF OTHER
1.11
li INSURANCE
Policy Limit: $ 50,000,000
Property'Damage: Included
Business Income and Extra Expense: Included Coinsurance does not apply
Extra Expense Only: Excluded
Extended Period of Restoration: 30 Days ; I
Data and Media:(Business Income/Extra Expense) $ 500,000
Expediting Expense: Included
Spoilage Damage: Included Coinsurance does not apply
Utility Interiuption: Included
Newly Acqui ed Premises: Included 365 Days 1
Ordinance or Law: $ 1,000,000
Errors and Omissions: Included
Brands and Labels: Included
Contingent Business Income/Extra Expense: $ 250,000
Contingent Extra Expense Only: : Excluded
Ammonia Contamination: Included Coinsurance does not apply
Consequential Loss: Included
Data and Media:(Property Damage) $ 500,000
Hazardous S;nbstance: $ 500,000 1
Water Diamaige: Included
iiDiagnostic Eiluipment: Excluded
1
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..-.:r-_.. .e;.. ",, a-3L'�� .i'v!: - ��-f, §v +..te,:r:.^4.r_c.+:... t,�- ',-..... .s?,':�....,->i.s;�v�...r'.:vi..i.s.s-}"rr'rkryit�i+a'.:.�"i(t:4s'�rz*-:::'v:iE-
COVERAGBS DEDUCTIBLE
Property Damage: $5,000
Business Income and Extra Expense: Combined
Extra Expense Only: No Coverage Provided
Spoilage Damage: Combined •
Utility Inte ruption: Applicable Business Income/Spoilage damage
deductible to apply after 4 Hour waiting period
Contingent 13usiness Income/Extra Expense: Combined
Contingent Extra Expense Only: No Coverage Provided
Ammonia contamination: Combined
Other
. , .we-" - '„go,-
�;- ��� � � � t . t 4t. � . - . ,
' . ,rx - k:"_..":_ . . ,ez, F �'g : ," ,�- . �Wd �34t �,,. "siw' �,DN_:,,,,!a S .M_
Business Inome Annual Value: • On File 1
Loss Payee: None
Additional Insured: None
Mortgage Folder: None
gAh�
A . •3 . . ,"'Xiw
I',i.� „-.. , : Y :; ,-, w + �,M; ,��r g,m ��c Ia._ I" ^ :vIE4, w�vi�C'A ; � *
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mu s�fi 11 " ° �s� ,w .4. s�2K4� x �-Waya �NA >F � a' "„d' Vi;! i5; V�*-;� T- , �F;P �'g k
.- ", ° "_. a� eap1 , ad .,partu togpo aY litthee mieo p ,io 'tssuanice*,:z f,,-"4, = 4, r eifk
01 I I
• BM 00 20 07 01:Equipment Breakdown Protection Coverage Form
• U�GU-319-E(5/96): In Witness Clause 1
0 • GU 519(11-98): Common Policy Conditions
• ILJ1001 46 09 03: Washington Common Policy Conditions
• U-BMS-180(9/88): Omnibus Location Description-Endorsement#1
• U J1BM$-180(9/88): Buried Equipment Wording-Endorsement#2
I •
f ,
I'
"--(..._ /7-14-1-4—)-- //j / z
Autho ized Representative Date
!1 .
11
II
•
I
111 I1,
I",
1
f
I11.
, IL 01 46 09 03
I
• WASHINGTON COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions.
The conditions in this endorsement replace any simi- e. Fixed and salvageable items have been
lar conditio Is in the policy that are less favorable to removed from the structure, indicating an
the insdred. intent to vacate the structure;
A. Cancellation f. Without reasonable explanation, heat,
1. Th� first Named Insured shown in the Decla- water, sewer, and electricity;are not fur-
rations may cancel this policy by mailing or Wished for the structure for 60 consecutive
delivering to us advance written notice of days; or
cancellation. g. The structure is not maintained in sub-
2. We may cancel this policy by mailing or deliv- stantial compliance with fire, safety and
ering to the first Named Insured and the first building codes.
Named Insured's agent or broker written no- 4. If:
tice of cancellation, including the actual rea- a. You are an individual;
son for the cancellation, to the last mailing
address known to us, at least: b. A covered auto you own is of the "private
a. 10 days before the effective date of can- passenger type"; and
cellation if we cancel for nonpayment of c. The policy does not cover garage, auto-
! premium; or mobile sales agency, repair shop, service
station or public parking place operations
b. 45 days before the effective date of can- hazards;
cellation if we cancel for any other reason;
we may cancel the Commercial Automobile
except as provided in Paragraphs 3. and 4. Coverage Part by mailing or delivering to the
S l below. first Named Insured and the first Named In-
3. II W may cancel the Commercial Property sured's agent or broker written notice of can-
Co erage Part and the Capital Assets Pro- cellation, including the actual reason for can-
grim (Output Policy) Coverage Part, if made cellation, to the last mailing address known to
a art of this policy, by mailing or delivering to us:
the first Named Insured and the first Named a. At least 10 days before the effective date
Insureds agent or broker written notice of of cancellation if we cancel for nonpay-
ca(cellation at least 5 days before the effec- ment of premium; or
tive date of cancellation for any structure
wh re 2 or more of the following conditions b. At least 10 days before the effective date
exi t: of cancellation for any other reason if the
a. Without reasonable explanation, the policy is in effect less than 30 days; or
structure is unoccupied for more than 60 c. At least 20 days before the effective date
consecutive days, or at least 65% of the of cancellation for other than nonpayment
rental units are unoccupied for more than if the policy is in effect 30 days or more;
120 consecutive days unless the structure or
is maintained for seasonal occupancy or d. At least 20 days before the effective date
is under construction or repair; of cancellation if the policy is in effect for
b. Without reasonable explanation, progress 60 days or more or is a renewal or con-
toward completion of permanent repairs tinuation policy, and the reason for can-
to the structure has not occurred within 60 cellation is that your driver's license or
days after receipt of funds following that of any driver who customarily uses a
satisfactory adjustment or adjudication of covered "auto" has been suspended or
_ loss resulting from a fire; revoked during policy period. ,
c. Because of its physical condition, the 5. We will also mail or deliver to any mortgage
structure is in danger of collapse; holder, pledgee or other person;shown in this
4110 i
d. Because of its physical condition, a vaca-
policy to have an interest in any loss which
may occur under this policy, at their last
tion or demolition order has been issued mailing address known to us, written notice of
for the structure, or it has been declared cancellation, prior to the effective date of can-
unsafe in accordance with applicable law; cellation. If cancellation is for reasons other
IL 01 46 09 03 Copyright, ISO Properties, Inc., 2002 Page 1 of 3
UNIFORM
!
ii
BOILER AND MACHINERY
BM 00 20 07 01
I
•
EQUIPMENT BREAKDOWN. PROTECTION
COVERAGE FORM
Various provisions in this policy restrict coverage. However, if coverage for "5..tra Ex-
Read the entire policy carefully to determine rights, pense" Only is indicated in the Decla-
duties and what is and is not covered. rations, then coverage for,"Business
Throughout this policy the words"you"and"your"refer Income"is not provided.
to the Named Insured shown in the Declarations. The We will consider the experience of
words "we", "us" and "our" refer to the Company your business before the "Break-
providingthis insurance. down" and the. probable experience
Other words and phrases that appear in quotation you would have had without the
marks have pecial meaning. Refer to Section F — "Breakdown" in determining the
Definitions amount of our payment.
A. Coverage (2) If you have coverage for "Business
1 I Income" and "Extra Expense" or for
1. Covered Cause Of LossIII "Extra Expense"Only and:
Covered Cause of Loss is,a "Breakdown" to (a) If a number of days is shown in
"Covered Equipment". • the Declarations for Extended
2. Coverages Provided Period of Restoration Coverage, it
Each of the following coverages is provided if will replace the five consecutive
either a limit or the word INCLUDED is shown days in the,definition of"Period of
for that coverage in the Declarations. If nei- Restoration .
then limit nor the word INCLUDED is shown, (b) If you have coverage's for Ordi-
then at coverage is not provided. nance or Law, then the Period of .
111
T Restoration" is extended to in-
clude the additional period of time
t V e to s or damage that is a direct result of a
Cove ed Cause of Loss. required for demolition, removal,
repair, remodeling or re-
al, P operty Damage construction.
Iwe will pay for direct damage to"Covered (c) If"Media" is damaged or"Data" is
Property" located at the premises . lost or corrupted, we will pay your
d Iescribed in the Declarations. actual loss of "Business Income"
b1 Ekpediting Expenses and/or"Extra Expense"during the
time necessary to:
With respect ,to direct damage to Coy- i Research, replace or restore
, eked Property we will pay for the extra O P
cost you necessarily incur to: the damaged "Media7 or lost
O Make temporary repairs; and or corrupted"Data"; and
(2) Expedite the permanent repairs or (ii) Reprogram instructions used
covered "Computer
l replacement of the damaged prop- in any
erty. Equipment".
ci'' Business Income And Extra Expense— There shall be no coverage for
any "Media" or "Data" that we
Extra Expense Only
determine is not or cannot be re-
1 (1) We will pay: placed or restored.
(a) Your actual loss of "Business In- Unless a higher limit is shown in
come" during the "Period of the Declarations, we will pay the
Restoration"; and lesser of your actual loss of
(b) The "Extra Expense" you neces- "Business Income" and/or "Extra
• ' .. P
sarilyincUr to erateyour busi-
ness Expense" up to 30 days after the
'o" "Period of Restoration" or
Hess during the,"Period of Resto-
ration". $25,000.
1
BM 00 20i07 Q7 ©ISO Properties, Inc., 2000 Page 1 of 15
1
jI I
• d. Spoilage Damage f. Newly Acquired Premises
•
(1) We will pay.for the spoilage damage We will automatically provide coverage at
to raw materials, property in process newly acquired premises you have
or finished products, provided all of purchased or leased. This coverage be-
the the following conditions are met: gins at the time you acquire the'property
(a) The raw materials, property in and continues for a period not exceeding
process or finished products must the number of days indicated in the Dec-
be in storage or in the course of larations for Newly Acquired Premises,
being manufactured; under the following conditions:
b You must own or be le ally liable (1) You must inform us, in writing, of the
O g newly acquired premises as 'soon as
. under written contract for the raw
materials, property in process or practicable;
finished products; and (2) You agree to pay an additional pre-
(c) The spoilage damage must be mium as determined by us;
due to the lack or excess of (3) The coverage for these premises will
power, light, heat, steam or re- be subject to the same terms, condi-
frigeration. tions, exclusions and limitations as
O We will also pay any necessary ex- other insured premises; and
penses you incur to reduce the (4) If the coverages and deductibles vary
amount of loss under this coverage. for existing premises, then the cover-
We will pay such expenses to the ages for the newly acquired premises
extent that they do not exceed the will be the broadest coverage and
amount of loss that otherwise would highest limits and deductible'applica-
have been payable under this Cover- ble to the existing premises. .
age Form. g. Ordinance Or Law Coverage
a. N;)tility Interruption The following applies despite the Ordi-
Illf you have coverage for Business Income Hance or Law Exclusion and provided
• And Extra Expense—Extra Expense Only these increases in loss are necessitated
and/or Spoilage Damage, that coverage is by.the enforcement of any laws or ordi-
�il 'xtended to include loss resulting from nances that are in force at the time of the
;he interruption of utility services provided "Breakdown", which regulate the demoli-
II of the following conditions are met: tion, construction, repair or use of the
�1) The interruption is the direct result of building or structure. With respect to the
building or structure that was damaged as
a "Breakdown" to "Covered Equip- a result of a"Breakdown":
ment" owned, operated or controlled
by the local private or public utility or (1) We will pay for:
• distributor that directly generates, (a) The loss in value of the' undam-
transmits, distributes or provides util- aged portion of the building or
ity services which you receive; structure as a consequence of
(2) The "Covered Equipment" is used to enforcement of an ordinance or
supply electric power, communication law that requires the demolition of
services, air conditioning, heating, undamaged parts of the same
gas, sewer, water or steam to your building or structure; ' 1
premises; and (b) Your actual cost to demolish and
(3) The interruption of utility service to clear the site of the undamaged
your premises lasts at least the con- parts of the same building or
secutive period of time shown in the - structure as a consequence. of
• Declarations. Once this waiting period enforcement of an ordinance or
is met, coverage will commence at law that requires the demolition of
the initial time of the interruption and such undamaged property; and
will be subject to all applicable (c) The increased cost actually and
deductibles. necessarily expended to:
• (i) Repair or reconstruct the
•
damaged or destroyed por-
tions of the buildingor struc-
ture;
and
Page 2 of 15 ©ISO Properties, Inc., 2000 BM 00 20 07 01
11 1 .
II Reconstruct or remodel the' (b) There is other physical damage
undamaged portion of that that is not covered under this
building or structure with policy; and
buildings or structures of like (c) The building damage in its en-
0
s height, floor area, of
materials, gtirety results in enforcement
and le for like occupancy,
� tYordinance or law;
whether or not demolition is
required on: then we will not pay the full amount of
the loss under this coverage. Instead,
L The same premises or on we will pay only that proportion of .
another premises if you such loss; meaning the proportion
so elect. However if you that the covered "Breakdown" loss
rebuild at another prem- bears to the total physical damage.
ises, the most we will pay
is the increased cost of But if the building or structure sus-
construction that we
tains direct physical damage that is
• would have paid to re- not covered under this policy and
build at the same prem- such damage is the subject of the or-
I dinance or law, then there is no Ordi-
ises; or nance Or Law coverage under this
ii. Another premises if the Coverage Part even if the building
relocation is required byg
q has also sustained damage by a cov-
the ordinance or law.The ered"Breakdown".
most we will pay is the
increased cost of con- h. Errors And Omissions
struction at the new We will pay for any loss or damage,which
premises. is not otherwise payable under this
2) We will not pay for any: Coverage Part solely because of the
items listed below:
j (a) Demolition or site clearing until
the undamaged portions of the (1) Any error or unintentional omission in
illbuildings or structures are actu- the description or location of property •
ally demolished; as insured under this Coverage Part
(b) Increase in loss until the dam- or in any subsequent amendments;
aged or destroyed buildings or (2) Any failure through error'to include
structures are actually rebuilt or any premises owned or occupied by
I replaced and approved by the you at the inception date of this Coy- .
regulating government agency; erage Part; or
(c) Loss due to any ordinance or law (3) Any error or unintentional omission by
that you that results in cancellation of any
. premises insured under this pOlicy.
(i) You were required to comply
with before the loss, even if No coverage is provided as a result of any
' the building was undamaged; error or unintentional omission* you in
and the reporting of values or the coverage
(ii) You failed to comply with; you requested.
s excess of It is a condition of this coverage that such
I
(d) Increase in the loss, errors or unintentional omissions;shall be
the amount required to meet the reported and corrected when discovered.
minimum requirement of anyor- -
II q The policy premium will be adjusted ac
1 dinance or law enforcement at the cordingly to reflect the date the premises
time of the"Breakdown"; or should have been added had inO error or
I (e) Increase in loss resulting from a omission occurred.
substance declared to be haz- i. Brands And Labels
ardous to health or environment
by any government agency. (1) If branded or labeled merchandise
that is "Covered Property" !is dam-
(3) If: aged by a "Breakdown", we may take
• 11I'; (a) The building or structure is dam- all or any part of the property at an
aged by a "Breakdown" that is agreed or appraised value. If so, you
covered under this policy; may:
. 1
BM 00 20 07 01 ©ISO Properties, Inc., 2000 Page 3 of 15
Ir 1
(a) Stamp the word SALVAGE on the The exclusions apply whether or not the loss
merchandise or its containers if event results in widespread damage or affects a
4110 the stamp will not physically substantial area.
damage the merchandise; or 1. Ordinance Or Law
(b) Remove the brands or labels if Increase in loss from the enforcement of any
doing so will not physically dam- ordinance, law, rule, regulation or ruling which
age the merchandise. You must restricts or regulates the repair, replacement,
re-label the merchandise or its alteration, use, operation, construction,
containers to .comply with any installation, clean-up or disposal of "Covered
taw. Property".
(2) We will pay reasonable costs you However the words use and operation shall
incur to perform the activity described be eliminated as respects a covered"Break-
in Paragraphs (1)(a) and (1)(b), but down" to electrical supply and emergency
I
the total we pay for these costs and generating equipment located on'the prem-
� the value of the damaged property will ises of a Hospital.
• not exceed the applicable Limit of
Insurance on such property. 2. Earth Movement
j. Contingent Business Income And Earth movement, including but not limited to
Extra Expense—Extra Expense Only earthquake, landslide, land subsidence, mine
Coverage subsidence or volcanic action.
tothe same terms and con- 3. Water
(1) Subject �
, ditions, the Business Income And a. Flood, surface water, waves, tides, tidal
Extra Expense or Extra Expense Only waves, overflow of any body of water, or
Coverage provided by this Coverage their spray, all whether driven by wind or
Part is extended to cover your loss, if not;
any, resulting from a "Breakdown" to b. Mudflow or mudslide;
"Covered Equipment11 at a premises
c. Water damage caused bybackupof
shown in the Declarations, that is not g
owned or operated by you which: sewer, drains or drainage piping;or
(a) Wholly or partially prevents the d. Water damage caused by the discharge
delivery of services or materials or leakage of a sprinkler system or do-
' shown in the Declarations, to you mestic water piping. i
or from you to others for your ac- 4. Nuclear Hazard
count;or Nuclear reaction or radiation, or radioactive
(b) Results in the loss of sales at contamination, however caused.
your premises shown in the 5. War Or Military Action
Declarations.
( ) You.shall use your influence to induce a. War, including undeclared or civil war;
the contributing or recipient premises b. Warlike action by a military force, in-
to make use of any other machinery, cluding action in hindering or defending
equipment, supplies or premises against an actual or expected attack, by
available in order to resume any. government, sovereign or other
operations and delivery of services or authority using military personnel Or other
materials to you, or the acceptance of agents; or
products or services from you. You c. Insurrection, rebellion, revolution, ;usurped
shall cooperate with the contributing power or action taken by governmental
y or recipient premises to this effect in authority in hindering or defending against
every way, but not financially unless any of these.
authorized by us.
6. An explosion. However, we will pay for direct
B. Exclusi ns loss or damage caused by an explosion of
II
We will not pay for loss or damage caused directly "Covered Equipment' of a kind specified in a.
or indirectly by any of the following. Such loss or through g. below, if not otherwise excluded in
0
damage is excluded regardless of any other this Section B.:
cause orl event that contributes concurrently or in11 a. Steam boiler;
any sequence to the loss.
b. Electric steam generator,
i' c. Steam piping;
I
©ISO Properties, 2000 BM 00 20 07 01
Page4of15 p Inc.,
III
iI
ii
ii. team turbine; b. Your failure to use due diligence land dis-
III I patch and all reasonable means Ito il, oper-
1e. Steam engine; ate your business as nearly normal as
f. Gas turbine; or practicable at the premises shown in the
. g. Moving or rotating machinery when such Declarations; or
j explosion is caused by centrifugal force or• c. The suspension, lapse or cancellation of a
mechanical breakdown. contract following a 'Breakdown" ex-
7. Fire or combustion explosion including those tending beyond the time business could
that: have resumed if the contract had not
a. Result in a
lapsed, been suspended or canceled.
"Breakdown";
II „ 16. Lack or excess of power, light, heat, steam or
b. ccur at the same time as a Break- refrigeration except as provided by the Busi-
down ; or ness Income And Extra Expense, Extra Ex-
c. Ensue from a"Breakdown". pense Only, Spoilage Damage and Utility In-
8. Explosion within the furnace-of a chemical terruption Coverages.
recoiery type boiler or within the passage 17. With respect to Utility Interruption'Coverage,
from the furnace to the atmosphere. any loss resulting from the following additional
9. Damage to "Covered Equipment" undergoing causes of loss whether or not coverage for
a pressure or electrical test. that cause of loss is provided by another
10. Water or other means used to extinguish a policy you have:
fire, even when the attempt is unsuccessful. a. Acts of sabotage;
11. 13 epletion, deterioration, corrosion, erosion, or b. Collapse;
wea r and tear. However, if a "Breakdown" c. ,Deliberate act(s) of load shedding by the
occurs, we will pay the resulting loss or dam- supplying utility;
age. d. Freezing caused by cold weather,,
12. A " reakdown" that is caused by any of the e. Impact of aircraft, missile or vehicle;
follo ing causes of loss if coverage for that .
• cause of loss is provided by another policy of40
f. Impact of objects falling from an aircraft
insurance you have,whether collectible or not: or missile;
aI . Aircraft or vehicles; g. Lightning; •
b. reezing caused by cold weather, h. Riot, civil commotion or vandalism;
III Lightning; I. Sinkhole collapse;
d. Sinkhole collapse; j. Smoke; or •
e. Smoke; . . k. Weight of snow, ice or sleet.
il
ff. Riot, civil commotion or vandalism; or 18. Any indirect result of a "Breakdown" to "Cov-
I ered Equipment" except as provided by the
g. weight of snow, ice or sleet. Business Income And Extra Expense, Extra
11
13. A 'Breakdown" that is caused by Windstorm Expense Only, Spoilage Damage and Utility
or Hail.. Interruption Coverages.
14. A delay in, or an interruption of any business, 19. Neglect by you to use all reasonable means to
�inan ifacturing or processing activity except save and preserve "Covered Property" from ,
as provided by the Business Income And Ex- further damage at and after the time of the
tra Expense, Extra Expense Only and Utility loss.
I nte ption Coverages.
0 • C. Limits Of Insurance
15. With respect to Business Income And Extra 1. The.most we will pay for any and all cover-
Exp nse, Extra Expense Only and Utility In-followingadditional ages for loss or damage from any "One
the
terru tion Coverages,
excl Isions shall apply: Breakdown" is the applicable Limit of Insur-
ance shown in the Declarations.
a. The business that would not or could not 2. Any payment made will not be increased if
11 have been carried on if the "Breakdown"
had not occurred; more than one insured is shown in the Decla-
rations. 1
• 3. For each coverage in Paragraph A.2.if:
a. INCLUDED is shown in the Declarations,
the limit for such coverage is part of, not
I' in addition to, the Limit per Breakdown.
i
BM 00 20 07 01 ©ISO Properties, Inc., 2000 Page 5 of 15
f,
b. A limit is shown in the Declarations, we This coverage applies despite the opera-
swill not pay more than the Limit of Insur- tion of the Ordinance or Law Exclusion.
rice for each such coverage. e. Water Damage
4. For any"Covered Equipment"that is: • . The damage to "Covered Property" by
a. Used solely to supply, utility services to water including any salvage expenses,
lour premises; except no coverage applies to,such Jam-
b. Owned by a public or private utility; age resulting from leakage of a sprinkler
system or domestic water piping.
c. Not in your care, custody or control and D. Deductibles
for which you are legally liable; and
ii 1. Application Of Deductibles
tl overed under this Coverage Form;
We will not pay for loss or damage resulting
the Limit of Insurance for Property Damage stated in the Declarations is deleted and re- from any "One Breakdown" until the.amount
Placed by the sum of one dollar. of covered loss or damage exceeds the de-
ductible shown in the Declarations for each •
If yoti are a public or private utility, 4.b. is applicable coverage. We will then pay the
tlele ed and replaced by the following: amount of covered loss or damage in excess
b. Owned by a public or private utility other of the deductible, up to the applicable Limit of
Ithan you; Insurance.
5. Unless a higher limit or INCLUDED is shown Deductibles apply separately for each appli-
�n the Declarations, the most we will pay for cable•coverage except if:
direct damage as a direct result of a a. A deductible is shown as COMBINED for
''Breakdown" to "Covered Equipment" is any of the coverages in the Declarations,
S25,000 for each of the following. The limits then we will first subtract the combined
are part of, not in addition to, the Limit of In- deductible amount from the, aggregate
surahce for Property Damage or Limit per amount of any loss to which the combined
Breakdown. deductible applies; or
Ia. Ammonia Contamination
III
b. More than one "Covered Equipment" is
' he spoilage to "Covered Property' con- involved in "One Breakdown", then only
iiaminated by ammonia, including any one deductible, the highest, shall apply for
it salvage expense. each of the applicable coverages.,
b. Consequential Loss 2. Determination Of Deductibles I .
The reduction in the value of undamaged a. Dollar Deductible
IStock" parts of a product which becomes If a dollar deductible is shown in the
1. unmarketable. The reduction in value Declarations, we will first subtract the de-
Must be caused by a physical loss or ductible amount from any loss we would
damage to another part of the product otherwise pay.
a;. Data And Media b. Time Deductible
II Your cost to research, replace or restore If a time deductible is shown in the Dec-
damaged "Data" or "Media" including the . larations, we will not be liable foriany loss
cost to reprogram instructions used in any under that coverage that occurs during
'1Computer Equipment". that specified time period immediately
,d. Hazardous Substance following a "Breakdown". If a time de- .
Any additional expenses incurred by you ductible is shown in days, each day shall
,11 mean twenty-four consecutive hours.
for the clean-up, repair or replacement or
disposal of "Covered Property" that is c. Multiple Of Daily Value Deductible
damaged, contaminated or polluted by a If a multiple of daily value is shown in the
"Hazardous Substance". Declarations, this deductible will be cal-
As used here, additional expenses mean culated as follows:
the additional cost incurred over and (1) For the entire premises where the
bove the amount that we would have loss occurred, determine the total
III . 1
I aid had no"Hazardous Substance" beenamount of "Business Income" that
volved with the loss. • would have been earned during the
Ammonia is not considered to be a "Haz- "Period of Restoration" had no
ardous Substance" as respects this limi- "Breakdown"taken place.
tation.
Pane 6 of 15 ©ISO Properties, Inc., 2000 BM 00 20 07 01
f 1
I
I -
I (+) Divide the result in Paragraph (1) by b. Appraisal
S
the number of days the business If we and you disagree on the value of the
would have been open during the property or the amount of loss, either may
"Period of Restoration". The result is make written demand for an appraisal of
the daily value. • the loss. In this event, each party will
( ) Multiply the daily value in Paragraph select a competent and impartial
(2) by the number of days shown in appraiser. The two appraisers will select
the Declarations. We will first subtract an umpire. If they cannot agree, either
• this deductible amount from any loss may request that the selection be made
we would otherwise pay. We will then by a judge of a court having jurisdiction.
pay the.amount of loss or damage in The appraisers will state separately the
excess of the deductible, up to the value of the property and amount of loss.
e theywill submit their
If theyfail to agree,
su ance.
applicable-Limit of In 9re r
d. i ercentage Of Loss Deductible differences to the umpire. A decision
agreed to by any two will be binding.
If a deductible is expressed as a percent
II age of loss in the Declarations, we will not Each party will:
be liable for the indicated percentage of (1) Pay its chosen appraiser; and
gross amount of loss or damage (prior to (2) Bear the other expenses of the ap-
the applicable deductible or coinsurance) praisal and umpire equally.
ihsuredl under the applicable coverage. If there is an appraisal, we will still retain
e. Minimum Or Maximum Deductibles our right to deny the claim. •
(1) If: c. Defense
(a) A minimum dollar amount de- We may elect to defend you against suits
ductible is shown in the Declara- arising from claims of owners of property.
tions; and We will do this at our expense.;
(b) The dollar amount of the Multiple d. Duties In The Event Of Loss Or'
S
of Daily Value or the Percentage Damage
of Loss Deductible is less than
the Minimum Deductible; (1) You must see that the following are
done in the event of loss or damage
• then the Minimum Deductible amount to"Covered Property":
shown in the Declarations will be the
- applicable deductible. (a) Give us a prompt notice of the
loss or damage. Include a de-
(2) If: scription of the property involved.
(a) A maximum dollar amount de- (b) As soon as possible, give us a
ductible is shown in the Declara- • description of how, ;when and
tions; and where the loss or damage oc-
(b) The dollar amount of the Multiple curred.
of Daily Value or the Percentage (c) Allow us a reasonable time and
i of Loss Deductible is greater than opportunity to examine the prop-
the Maximum Deductible; erty and premises before repairs
then the Maximum Deductible amount are undertaken or physical evi-
shown in the Declarations will be the dence of the "Breakdown" is re-
applicable deductible. moved. But you must take what-
E. Equipment Breakdown Protection Conditions ever measures are necessary to
protect the property and premises
Thei'li following conditions apply in addition to the from further damage:
Commo� Policy Conditions: (d) As often as may be reasonably
1. Loss Conditions required, permit us to inspect the
a. Abandonment property proving the loss,or dam-
age and examine your books and
There can be no abandonment of any 1
S records.
property to us. 1
I
i
1 \ BM 00 20 07 01 ©ISO Properties, Inc., 2000 Page 7 of 15
to take samples of (2) We may cancel the policy as allowed
ID I Also permit us p �
damaged and undamaged prop- by the Cancellation Condition. Can-
erty for inspection, testing and cellation ends this agreement as to
analysis, and'permit us to make the loss payee's interest. If we cancel
copies from your books and rc- we will mail you and the loss payee
cords. the same advance notice. '
(e) Send us a signed, sworn proof of (3) If we make any payment'toj the loss
loss containing the information we payee, we will obtain their rights
request to investigate the claim. against any other party.
You must do this within 60.days h. Other Insurance
after our request. We will supply (1) You may have other insurance sub-
jectyou with the necessary forms. to the same plan, terms, condi-
(f) Cooperate with us in the investi- tions and provisions as the insurance
gation or settlement of the claim. under this Coverage Part. If you do, •
(2) We may examine any insured under we will pay our share of the covered
oath, while not in the presence of any loss or damage. Our share is the
that the applicable other insured and at such times as proportion PPlicable Limit of
. may be reasonably required, about Insurance under this Coverage Part
any matter relating to this insurance bears to the Limits of Insurance of all
or the claim, including an insured's insurance covering on the same ba-
books and records. In the event of an sis. ,• .;
examination, an insured's answers (2) If there is other insurance covering
must be signed. the same loss or damage; other than
e. Insurance Under Two Or More that described in Paragraph (1), we
Coverages will pay only for the amount of cov-
If two or more of this policy's coverages ered loss or damage in excess of the
pply to the same loss or damage, we will amount due from that other insur-
not pay more than the actual amount of
ance, whether you can collect on it or
he loss or damage. • not. But we will not pay more than the
applicable Limit of Insurance.)
f. Legal Action Against Us i. Privilege To Adjust With Owner
No one may bring a legal action against In the event of loss or damage involving
us under this Coverage Part unless: property of others in your care; custody or
1 (1) There has been full compliance with control, we have the right to settle the loss
all the terms of this Coverage Part; or damage with the owner of the property.
and A receipt for payment from the owner of
(2) The action is brought within 2 years that property will satisfy any claim of yours
after the date of the"Breakdown";or against us.
3 We agree in writing that you have an j. Reducing Your Loss
to "Breakdown"
obligation to pay for damage As soon as possible after a
"Covered Property" of others or until you must: . 1
the amount of that obligation has• been determined by final judgment or (1) Resume business, partially Ior corn-
arbitration award. No one has the e
tely; I
right under this policy to bring us into (2) Make up for lost business within a
any action to determine your liability. reasonable period of time. This rea-
Loss Pa
yable Clause • sonable period does not(necessarily
end when operations are resumed;
P
1 We will pay you and the loss payee and
shown in the Declarations for loss
a I
"Breakdown" to "Covered (3) Make use of every reasonable means
due to to reduce or avert loss including: •
Equipment", as interests may appear.
The insurance covers the interest of (a) Working extra time or'�overtime at
. the loss payee unless the loss results the premises or at another
01
from conversion, secretion or em- premises you own or; acquire to
bezzlement on your part. carry on the same operations;
(b) Utilizing the property and/or
• services of other concerns;
4 Pao 8 11of 1 ©ISO Properties, Inc. 2000
BM 00
(c) Using merchandise or other (2) If you elect or we require that the re- .
1
property, such' as surplus ma- pair or replacement of the damaged
ea , , duplicate parts, equip-
mt "Covered Equipment" be done in a
Iji meat, supplies and surplus or re- manner that: 1
serve stock you own, control or (a) Improves the environment;
II can obtain; or
(b) Increases efficiency; or
(d) Salvaging the damaged "Covered •
Pro a rty (c) Enhances safety;
P •
k. Transfer Of Rights Of Recovery while maintaining the existing func-
P dgainst Others To Us tion, then we will pay, subject to the
limit of insurance, up to an additional
If any person or organization to or for / 25% of the property damage amount
4lom we make payment under this Coy- for the "Covered Equipment" other-
erage Part has rights to recover damages wise recoverable.
fi-om another, those rights are transferred
to us to the extent of our payment. (3) If:
that person or organiz
ation must do eve- (a) Any damaged "Covered Property"
rything necessary to secure our rights and is protected by an extended
rhust do nothing after loss to impair them. warranty, or maintenance or
But you may waive your rights against . service contract; and
dnother party in writing: (b) That warranty or contract be-
1) Prior a loss to your "Covered "Breakdown";
Property"or covered income. comes void or unusable due to a
2) After a loss to your "Covered Prop- we will reimburse you for the unused
erty" or covered income only if, at costs of non-refundable, non-trans-
time of loss, that party is one of the ferable warranties or contracts.
I following: (4) Unless we agree otherwise in writing,
III
(a) Someone insured by this insur-
ance; if you do not repair or replace the9 property damaged within.24 I months
the date of the Breakdown
• • following ,
(b) A business firm: then we will pay only the smaller of
(i) Owned or controlled by you; the: . •
or (a) Cost it would have taken to repair
(ii) That owns or controls you;or or replace; or
(c) Your tenant. ' (b) Actual cash value at the'time of
I. vhis will not restrict your insurance. the"Breakdown".
aluation (5) If all of the following conditions are
. met;'property held by you for sale will
(1) We will determine,the value of "Coy- be valued at the selling price as if no
• ered Property" in the event of loss or loss or damage had occurred, less
damage as follows: any discounts you offered and
(a) The cost to repair, rebuild or re- expenses you otherwise would have
place the damaged property with had:
• property of same kind, capacity, (a) The property was manufactured
size or quality on the same site or by you;
another site whichever is the less (b) The selling price of the property is
costly; or more than the replacement cost
(b) The cost actually and necessarily of the property; and
li expended in repairing, rebuilding, (c) You are unable to replace the
or replacing on the same site or property before its anticipated
another site whichever is the less
costly; sale.
(6) We will pay for loss to damaged
• 1 except we will not pay for such dam-
• aged property that is obsolete and "Data"or"Media"as follows:
useless to you. (a) Replacement cost for "Data" or
"Media" that are mass produced
and commercially available; and
BM 00 20 07 01 ©ISO Properties, Inc., 2000 Page 9 of 15
.
(b) The cost you actually spend to (3) Coinsurance
S reproduce the records on blank This Coinsurance condition; applies
material for all other "Data" or only if we did not receive your annual
"Media" including the cost of report of values form within three
' gathering or assembling informa- months of the due date as outlined in
tion for such reproduction. Paragraph (1).
However, we will not pay for"Data" or (a) We will not pay the full amount of
"Media" that we determine is not or any loss if:
cannot be replaced with "Data" or
"Media" of like kind and quality or (i) The "Business Income Actual
property of similar functional use. Annual Value" at the time ofloss is greater ; than the
7) We will determine the value of "Cov- "Business Income Estimated I'1 ered Property"
under Spoilage Dam- Annual Value" shown in your
age Coverage as follows: latest report; or
(a) For raw materials, the replace- (ii) Your report was received by
ment cost; i us more than three months
(b) For property in process, the re- after the due date, I or your
I' placement cost of the raw mate- report is overdue.
. rials, the labor expended and the (b) Instead we will determine the
proper proportion of overhead most we will pay using the fol-
charges; and , lowing steps:
(c) For finished products, the selling (i) Divide the "Business Income
price, as if no loss or damage had Estimated Annual Value" by
occurred, less any discounts you the "Business Income Actual
offered and expenses you Annual Value" at the time of
otherwise would have had. the"Breakdown"; 1
ill (8) Any salvage value of property ob- (ii) Multiply the total amount of
tained for temporary repairs or use the covered loss of"Business
following a "Breakdown" which re- Income" by the figure deter-
1 mains after repairs are completed will mined in Step(i); and
be taken into consideration in the (iii) Subtract any applicable de-
adjustment of any loss. ductible from the , amount
m. The following additional conditions apply determined in Step(ii).
to the Business Income and Extra We will pay the amount deter-
Expense Coverage:
� mined in Step(iii)or the Business
(1) Annual Reports Income and Extra Expense limit
I You must complete an Annual Report of insurance, •whichever is less.
For the remainder, you will either
approved byus once
of Values Form a pro
P
each year. Your reports must reach have to rely on other insurance or
us within three months of the annual absorb the loss yourself.
report date shown in the Declarations If coverage is provided for more than
and each anniversary of that date. one premises, then this Coinsurance
Condition applies separately(2) Adjustment Of Prem
ium PP P Y to each
Upon receipt of the annual reports of premises.
values you furnish us, we will deter- 2. General Conditions
mine the amount of premium we a. Additional.Insured
earned for the past year. If the
amount determined is more than the If a person or organization is designated
premium we have already charged for in this Coverage Part as an additional in-
sured, we will consider them to be an in-
difference. If the amount determined this coverage, you must pay the sured under this Coverage Part to the
Sis less than the premium we originally extent of their interest.
P charged,we will refund the difference. b. Bankruptcy
However, the amount we return will The bankruptcy or insolvency of you or
not exceed 75% of the premium we your estate will not relieve us of,our obli-
originally charged. gation under this Coverage Part.
Pane 10 of 15 I ©ISO Properties, Inc.,2000 BM 00 20 07 01
I
c. oncealment, Misrepresentation Or (5) If we pay the mortgageholder'for any
gaud loss and deny payment to you be-
This Coverage Part is void in any case of cause of your acts or because you
• have failed to comply with the terms
f�aud, intentional concealment or misrep- P y
„ resentation of a material fact by you or
of this Coverage Part:
eny other insured, at any time, concern- (a) The mortgageholder's 'rights un-
ing: der the mortgage will be trans-
(1) This Coverage Part; • ferred to us to the extent of the
amount we pay; and
O The"Covered Property";
(b) The mortgageholder's right to re-
• ( ) Your interest in the "Covered Prop- cover the full amount of the
erty"; or mortgageholder's claim will not be
(4) A claim under this Coverage Part. impaired.
At our option, we maypay Liberalization P P y to the
i mortgageholder the whole principal
I!we adopt any standard form revision for on the mortgage plus any accrued
• general use that would broaden coverage interest. In this event, your mortgage
in this Coverage Part without additional
red to us and
premium, the broadened coverage will and note yllyour remaie ning mortgage
• immediately apply to this Coverage Part if debt to us.
Ole revision is effective within 45 days
prior to or during the policy period. (6) If we cancel this policy, we will give
I written notice to the mortgageholder
. ortgageholder at least:
1) The term — mortgageholder — in- (a) 10 days before the effective date
cludes trustee. of cancellation if we cancel for
(2) We will pay for direct damage to nonpayment of premium; or
0 Covered Property' due to a "Break-
down" to "Covered Equipment" to
(b) 30 days before the effective date.
each mortgageholder shown in the of cancellation if we ;cancel for
Declarations in their order of prece- any other reason.
dence,'as interests may appear. (7) if we do not renew this policy, we will
(3) The mortgageholder has the right to give written • notice to the
mortgageholder at least 10 days be-
receive loss payment even if the fore the expiration date of this'policy.
mortgageholder has started fore-
closure or similar action on the "Coy- (8) If we suspend coverage, it will also be
ered Equipment". suspended as respects the mort-
(4) If we deny your claim because of your gageholder. We will give written no-
acts or because you have failed to tice of the suspension to the mort-
comply with the terms of this Cov- gageholder.
erage Part, the mortgageholder will f. No Benefit To Bailee
still have the right to receive loss • No person or organization, other than you,
payment if the mortgageholder: having custody of "Covered Property" will
(a). Pays any premium due under this benefit from this insurance.
Coverage- Part at our request if g, Policy Period, Coverage Territory
you have failed to do so;
V 1Under this Coverage Part:
(b) Submits a signed, sworn proof of
loss within 60 days after receiving (1) We cover loss or damage com-
notice from us of your failure to mencing:
do so; and (a) During the policy period shown in
(c) Has notified us of any change in
the Declarations; and
ownershipor material change in (b) Within the coverage territory.
9
risk known to the mortgage- (2) The coverage territory is:
• holder.
All of the terms of this Coverage Part (a) The United States of America
9 (including its territories and pos-
will then apply directly to the mort- sessions); '
gageholder.
(b) Puerto Rico; and
.
I.
RM 00 10 071 01 ©ISO Properties, Inc., 2000 Page 11 of 15
1
1 (c) Canada. (1) Both the commercial property in-
h. PremiumAnd Adjustments surer(s) and we do not admit to any
• liability; and
You shall report to us 100% of the total (2) Neither the commercial property in-
nsurable values at each premises every surer(s) nor we contend that cover-
1
ear as.of the anniversary date. The val-
age applies under the other iinsurer's
es shall be reported separately for each
f the coverages provided. Premium for policy.
each anniversary will be promulgated for c. The provisions of this condition apply only
the ensuing period on the basis of rates in if all of the following requirements are
effect at the anniversary date and for all met:
'ialues at risk. (1) The commercial property policy car-
you agree to keep the applicable records tied by the named insured, insuring
for each policy year available for inspec- the Covered Property, contains a
tion by our representatives at all times similar provision at the time of the
wring business hours, during the respec- loss or damage, with substantially the
mive policy year, and for a period of twelve same requirements, procedures and
onths after the end of the respective conditions as contained in this condi-
olicy year or after cancellation of this tion;
overage Part. (2) The damage to the Covered Property
i. Suspension
was caused bya loss for which:
Whenever "Covered Equipment" is found (a) Both the commercial property in-
o be in, or exposed to, a dangerous con- surer(s) and we admit to'some Ii-
dition, any of our representatives may ability for payment under the re-
immediately suspend the insurance spective policies; or
gainst loss from a "Breakdown" to that (b) Either:
Covered Equipment". This can be done
III 1 y delivering or mailing a written notice of (i) The commercial property in-
uspension to: • surer(s) does not admit to
any liability for payment, while
(1) Your last known address; or we contend that:
(2) The address where the "Covered i. All liability exists under
Equipment"is located. the commercial property
nce suspended in this way, your insur- policy; or
ance can be reinstated only by an en- ii. Some liability exists
orsement for that"Covered Equipment". under both the commer-
f we suspend your insurance, you will get cial property policy and
pro rata refund of premium for that this equipment] break-
1'Covered Equipment'. But the suspension down protection policy; •
will be effective even if we have not yet (ii) We do not admit to any li-
made or offered a refund. ability for payment, while the
3. Joint Or Disputed Loss Agreement \ commercial property in-
a. This condition is intended to facilitate surer(s)contends that:
payment of insurance proceeds when: I All liability exists under .
this equipment break-
(1) Botha commercial property policy down protection coverage
and this equipment breakdown pro- policy; or
tection policy are in effect;
(2) Damage occurs to Covered Property ii. Some liability; exists un-
that is insured by the commercial der both the commercial
property policy and this equipment property policy and this
breakdown protection policy;and equipment breakdown
, protection policy;or
(3) There is disagreement between the III (iii) Both the commercial property
insurers as to whether there is cover-
age or as to the amount of the loss to insurer(s)and we:
be paid, if any, by each insurer under I. Do not admit to any Ii-
its own policies. ability for payment; and
b. This condition does not apply if: 1
Pane'12,,of 15 ©ISO Properties, Inc.,2000 BM 00 20 07 01
.
I
ii. Contend that some or all e. Arbitration
411 liability exists under the (1) If the circumstances described in
other insurer's policy; and
P Y� Paragraph c.(2)(a) exist and the
(c) The total amount of the loss is commercial property insurer(s) and
agreed to by you, the commercial we agree to submit our differences to
property insurer(s) and us. arbitration, the commercial property
di. I>i the requirements listed in Paragraph c.
insurer(s) and we will determine the
above are satisfied, we and the commer- amount each will pay and will;pay the
I cial property insurer(s) will make pay- insured within 90 days. Arbitration will
ents to the extent, and in the manner, then take place within 90 days after
escribed as follows: payment of the loss under the terms
of this condition.
(1) We will pay, after your written re- (2) If any of the circumstances described
quest, the entire amount of loss that
we have agreed as being covered, if in Paragraph c.(2)(b) exist, then the
any, by this equipment breakdown commercial property insurers) and
protection policy and one-half (1/2) we agree to submit our differences to
the amount of the loss that is in dis- arbitration within 90 days after pay-
theagreement. ment of the loss under the terms of
this condition.
(2) The commercial property insurer(s) (3) You agree to cooperate with any ar-
will pay, after your written request, the
! entire amount of loss that they have bitration procedures. There I will be
as being covered, if any, by three arbitrators: one will be ap-
agreedthe commercial. property policy and pointed by us, and another will be
one-half(1/2) the amount of loss that appointed by the commercial'property
insurer(s). The two arbitrators will
is in disagreement. select a third arbitrator. If they cannot
3 Payments bythe insurers of the
� ( ) Y agree, either may request that selec-
amounts that are in disagreement, as tion be made by a judge of, a court
described in Paragraphs (1) and (2), having jurisdiction. A decision agreed
do not alter, waive or surrender any to by two of the three arbitrators will
rights of anyinsurer against anyother
g be binding on both parties. Judgment
with regard to the portion of the loss on any award can be entered in any
for which each insurer is liable. court that has jurisdiction.•
. (4) The amount in disagreement to be f. Final Settlement Between Insurers
paid by us under this condition shall
not exceed the amount payable under The insurer(s) found responsible for the
the equivalent Loss Agreement(s) of greater percentage of the ultimate loss
must return the excess contribution to the
the commercial property policy. other insurer(s). In addition, the insurer(s)
(5) The amount to be paid under this found responsible for the greater portion
condition shall not exceed the amount of the loss must pay Liquidated Damages
we would have paid had no to the other insurer(s) on the amount of
commercial property policy been in the excess contribution of the other in-
effect at the time of loss. In no event
surer(s). Liquidated Damages are defined
• will we pay more than the applicable as interest from the date the insured in-
Limit of Insurance shown in the Dec- yokes this Agreement to the date the in-
larations. surer(s) that contributed the excess
(6) Acceptance by you of sums paid un- amount is reimbursed. The interest is
der this condition does not alter, calculated at 1.5 times the highest prime .
waive or surrender any other rights rate from the Money Rates column of the
against us. Wall Street Journal during the period of
the Liquidated Damages. Arbitration ex-
penses are not a part of the excess con-
tribution for which Liquidated Damages
' . are calculated: Arbitration expenses will
IIIbe apportioned between insurers on the
same basis that the ultimate loss is ap-
• portioned.
1
owl nn'n ni Al 0 ISO Properties. Inc..2000 Page1,13 of 15
F. Definitions 5. "Computer Equipment"means:
1. "Breakdown":0
a. Your programmable electronic equipment
a. Means the following direct physical loss,
that is used to store, retrieve and'process
that causes damage to "Covered Equip- data; and
rnent" and necessitates its repair or re- b. Associated peripheral equipment that
lacement: provides communication including input
1) Failure of pressure or vacuum and output functions such as'printing or
auxiliary functions such as data transmis-
equipment; sion.
2) Mechanical failure including rupture or It does not include"Data"or"Media".
bursting caused by centrifugal force;
or 6. "Covered Equipment":
(3) Electrical failure including arcing; a. Means and includes any:
unless such loss or damage is otherwise (1) Equipment built to operate under in-
excluded within this Coverage Form. ternal pressure or vacuum other than
oes not mean or include: weight of contents;
. 1 Malfunction including but not limited (2) Electrical or mechanical equipment
the generation, trans
to adjustment, alignment, calibration, that is used in
cleaning or modification; mission or utilization of energy;
(3) Communication equipment, and•
12) Defects, erasures, errors, limitations "Computer Equipment"; and
or viruses in computer equipment and
programs including the inability to (4) Equipment in Paragraphs (1), (2) and
recognize and process any date or (3)that is owned by a public or private
time or provide instructions to "Coy- utility and used solely to supply utility
ered Equipment"; services to your premises.
III 11 3) Leakage at any valve, fitting, shaft However, if Coverage A.2.e. Utility Inter-
seal, gland packing, joint or connec-
tlon, ruption is provided, then Paragraph .( ) apply.6.a. 4 does not a I .
4) Damage to any vacuum tube, gas Except for Paragraph 6.a.(4), Utility Inter-
tube, or brush; ruption and Contingent Business; Income
• And Extra Expense—Extra Expense Only
�5) Damage to any structure or Coverages, the "Covered Equipment" •
foundation supporting the "Covered
must be located at a premises described
Equipment"or any of its parts; in the Declarations and be owned, leased,
�I (6) The functioning of any safety or pro- or operated under your control.
tective device; or b. Does not mean or include any:
(7) The cracking of any part on an inter-
nal combustion gas turbine exposed
to the products of combustion. (2) Part of pressure or vacuum equip-
2. 'Business Income" means the: ment that is not under internal pres-
sure of its contents or internal vac-
a. et Income (Net Profit or Loss before in-
1 uum;
come taxes)that would have been earned (3) Insulating or refractory material, but
or incurred;and not excluding the glass lining of any
b. Continuing normal operating expenses "Covered Equipment";
incurred,including payroll. (4) Non-metallic pressure or I,vacuum
3. 'Business Income Actual Annual Value" equipment, unless it is constructed
Hems the sum of the net income and con- and used in accordance with the
tinuing normal operating expenses incurred, American Society of Mechanical En-
including payroll that would have been earned gineers (A.S.M.E.) code or,another
had the"Breakdown" not occurred. • appropriate and approved code;
4. �'Bus�iness Income Estimated Annual Value" (5) Catalyst;
0
(6) Vessels, piping and other equipment
means the sum of the net income and con •
-
tinui n g normal operating expenses incurred, that is buried below ground and re-
!Including payroll as estimated by you in the
Most recent business income annual value quires the excavation of materials to
report on file with us. •
inspect, remove, repair or replace;
o".e 4A'rnf is ©ISO Properties. Inc..2000 BM 00 20 07 01 •
I
(7 Structure, foundation, cabinet or a. Programmed and recorded material
ill ` compartment supporting or containing stored on"Media"; and
the "Covered Equipment" or part of b. Programming records used for electronic
the "Covered Equipment" including data processing, or electronically con-
penstock, draft tube or well casing; trolled equipment.
I (8) Vehicle, aircraft, self-propelled 9. "Extra Expense" means the additional cost
equipment or floating vessel including you incur to operate your business during the
any "Covered Equipment" that is "Period of Restoration" over and above the
mounted upon or used solely with any cost that you normally would have incurred to
one or more vehicle(s), aircraft, self- operate the business during the same period
propelled equipment or floating had no"Breakdown"occurred.
vessel; 10. "Hazardous Substance" means any
. ( ) Dragline, excavation, or construction substance other than ammonia that has been
equipment including any "Covered declared to be hazardous to health by a gov-
Equipment" that is'mounted upon or ernment agency.
used solely with any one or more dragline(s), excavation, or construc-
11. "Media" means electronic data processing or
tion equipment storage media such as films, tapes, discs,
• drums or cells. 1
('0)Felt,wire, screen, die, extrusion plate,
12. "One Breakdown" means if an initial "Break-
swing hammer, grinding disc, cutting down" causes other "Breakdowns", all will be
blade, non-electrical cable, chain, considered "One Breakdown". All "Break-
belt, rope, clutch plate, brake pad,non-metal part or any part or tool downs" at any one premises that manifest
subject to periodic replacement; themselves at the same time and are the di-
rect result of the same cause will beconsid-
(11)Machine or apparatus used solely for ered"One Breakdown".
research, diagnosis, medication, sur-gical 13. "Period of Restoration" means the period of
Slogic, therapeutic, dental or patho-logical purposes including any "Cov-
ered Equipment" that is mounted a. Begins at the time of the "Breakdown" or
upon or used solely with any one or 24 hours before we receive notice of
i1 more machine(s) or apparatus unless "Breakdown"whichever is later; and
Diagnostic Equipment is shown as b. Ends 5 consecutive days after the date
INCLUDED in the Declarations; or 1 of such when the damaged property at the prem-
(12)Equipment or any partises described in the Declarations is re-
1 equipment manufactured by you for paired or replaced with reasonable speed
sale. and similar quality.
7. "Covered Property"means any property that: 14. "Stock" means merchandise held in 1 storage
or for sale, raw materials, property:in process
. You own; or or finished products including supplies used in
b. Is in your care, custody or control and for their packing or shipping.
Which you are legally liable. ,
8. '1Data"means: 1
1
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BM 00 20 07 01 ©ISO Properties, Inc., 2000 Page115 of 15
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ZURICH
ImpII 1
or ant Notice - In Witness Clause
In return for he payment of premium and subject to all the terms of the policy,we agree with you to provide insurance as stated in
this policy. This policy shall not be valid unless countersigned by the duly authorized Representative of the Company.
In Witness'Vhereof,this Company has executed and attested these presents and,where required by law,has caused this policy to
be countersigned by its duly authorized Representative.
/il ..-... j. 0.3-.. ..______ ,
i.e( e4.,
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1
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President Corporate Secretary
'
Zurich1Amrican Insurance Company
American uarantee and Liability Insurance Company
0 American urich Insurance Company
Zurich American Insurance Company of Illinois
Administrative Offices
Zu 1 ich Towers
14 0 American Lane
Sc aumburg,Illinois 60196-1056
I,
QUESTI NS ABOUT YOUR INSURANCE? Your agent or broker is best equipped to provide information about your
insurance. Should you require additional information or assistance in resolving a complaint,call or write to the following
(pleasle have your policy or claim number ready):
Zurich North America
Customer Inquiry Center
1400 American Lane
Schaumburg,Illinois 60196-1056
1-800-382-2150(Business Hours: 8 a.m.-4 p.m. [CT])
1111 1
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U-GU-319-E (5/96)
i
IL001711 98
4110 • COMMON POLICY CONDITIONS
11
AU Coverages Parts included in this policy are subject b. Give you reports on the conditions we
to the following conditions. find; and
A. Cancellation c. Recommend changes.
1. The first Named Insured shown in the Decla- 2. We are not.obligated to make any inspec-
rations may cancel this policy by mailing or tions, surveys, reports or recommendations
delivering to us advance written notice of and any such actions we do undertake relate
cance� llation. only to insurability and the premiums to be
2. We may cancel this policy by mailing or deliver- charged. We do not make safety inspections.
ing t the first Named Insured written notice of We do not undertake to perform the duty of
cancellation at least: any person or organization to provide for the
I' 1 health or safety of workers or the public. And
a. 10 days before the effective date of cancel- we do not warrant that conditions:
lation if we cancel for nonpayment of pre-I a. Are safe or healthful; or
mium;or
b. 30 days before the effective date of cancel- b. Comply with laws, regulations, codes or
1 standards.
I tion if we cancel for any other reason.
3. We will mail or deliver our notice to.the first
3. Paragraphs 1. and 2. of this condition apply
Named Insured's last mailing address known not only to us, but also to any rating, advisory,
to u. rate service or similar organization which
makes insurance inspections, surveys,
4. i, oti 6 e of cancellation will state the effective reports or recommendations. 1
Jatelof cancellation. The policy period will end
on that date. 4. Paragraph 2..of this condition does not apply
I' I to any inspections, surveys, reports or rec-
5. if this policy is cancelled,we will send the first•
ommendations we may make relative to cer-
iVarried Insured any premium refund due. If tification, under state or municipal statutes,
we cancel, the refund will be pro rata. If the ordinances or regulations, of boilers, pressure
first Named Insured cancels, the refund may vessels or elevators.
be less than pro rata. The cancellation will be
bffeative even if we have not made or offered E. Premiums
• a refund. The first Named Insured shown in the Declarations:
6. If ntice is mailed, proof of mailing will be 1. Is responsible for the payment of all premiums;
sufficient proof of notice. and
B. Changes 2. Will be the payee for any return premiums we
This,polio contains all the agreements between you pay
and us concerning the insurance afforded. The first F. Transfer Of Your Rights And Duties Under
Named Insured shown in the Declarations is This Policy
auth&oriz d to make changes in the terms of this Your rights and duties under this policy'ma not
olio wig our consent This policy's terms can be g y
policy P be transferred without our written consent except
amendeor waived only by endorsement issued by in the case of death of an individual Named In-
us and made a part of this policy. sured.
C. Exalenintion Of Your Books And Records If you die,your rights and duties will be transferred to
We rnay, examine and audit your books and rec- your legal representative but only while acting within
ords as they relate to this policy at any time during the scope of duties as your legal representative.Until
the i olicy period and up to three years afterward. your legal representative is appointed,anyone having
I, ! 1 D. Inspections And Surveys proper temporary custody of your property will have
i; I your rights and duties but only with respect to that
1. We have the right to: property.
a. Make inspections and surveys at any
• Itime;
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GU 519 (11-98)
IL 001Tj111 98 Copyright,Insurance Services Office,Inc.,1998 Page 1 of 1
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than those contained in Paragraph A.3. b. Give you reports on the conditions we
II
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above, this notice will be the same as that find; and
I ailed or delivered to the first Named In- c. Recommend changes.
�sured. If cancellation is for a reason contained 2. We are not obligated to make any inspec-
in paragraph A.3. above, we will mail or
deliVer this notice at least 20 days prior to the tions, surveys, reports or recommendations
effective date of cancellation. and any such actions we do undertake relate
only to insurability and the premiums to be
6. Noti� a of cancellation will state the effective charged. We do not make safety,inspections.
datd of cancellation. The policy period will end We do not undertake to perform the duty of
ion tat date. any person or organization to provide for the
7. 'If this policy is cancelled, we will send the first health or safety of workers or the public. And
'Named Insured any premium refund due. If we do not warrant that conditions:
we cancel, the refund will be pro rata. If the a. Are safe or healthful; or
firs Named Insured cancels, the refund will b. Corn I with laws, re ulations,1 codes or
'be -t least 90% of the pro rata refund unless standards. g
the following applies:
a. For Division Two — Boiler and Machinery,
3. Paragraphs 1. and 2. of this condition apply
' if the first Named Insured cancels, the not only to us, but also to any rating, advisory,
refund will be at least 75% of the pro rata rate service or similar organization which
refund. makes insurance inspections, surveys, re-
ports or recommendations.
b. If: 4. Paragraph 2. of this condition does not apply
(1) You are an individual; to any inspections, surveys, reports or rec-
(2) A covered auto you own is of the"pri- ommendations we may make relative to certi-
vate passenger type";
fication, under state or municipal statutes, or-
(3) The policy does not cover garage, dinances or regulations, of boilers, pressure
automobile sales agency, repair shop, vessels or elevators.
service station or public parking place E. Premiums
operations hazards; and The first Named Insured shown in the Declara-
(4) The first Named Insured cancels; tions:
the refund will be not less than 90% of 1. Is responsible for the payment of all premi-
any unearned portion not exceeding$100, urns; and
plus 95% of any unearned portion over 2. Will be the payee for any return premiums we
$100 but not exceeding $500, and not pay.
less than 97% of any unearned portion in F. Transfer Of Your Rights And Duties Under
excess of$500. This Policy
II The cancellation will be effective even if we have not made or offered a refund. Your rights and duties under this policy may not
be transferred without our written consent except
l3 I If notice is mailed, proof of mailing will be suf- in the case of death of an individual named in-
ficient proof of notice. cured.
B. Chang esil If you die, your rights and duties will be transferred
The policy contains all the agreements between to your legal representative but only while acting
you nd us concerning the insurance afforded. within the scope of duties as your legal
The first Named Insured shown in the Declara- representative. Until your legal representative is
tions is authorized to make changes in the terms appointed, anyone having proper temporary cus-
of this policy with our consent. This policy's terms tody of your property will have your rights and du-
Can f#e amended or waived only by endorsement ties but only with respect to that property.
issued by us and made a part of this policy. G. Nonrenewal
C. sI Examination Of Your Books And Records 1. We may elect not to renew'this policy by
We may examine and audit your books and rec- mailing or delivering written notice of nonre-
ords as they relate to this policy at any time during newal, stating the reasons for nonrenewal, to
the policy period and up to three years afterward. the first Named Insured and the I first Named
Insured's agent or broker, at their last mailing
41110 D. Inspction� And Surveys addresses known to us. We will also mail to
1. We have the right to: any mortgage holder, pledgee or other person
a.11 ll Make inspections and surveys at any shown in this policy to have an interest in any
time; loss which may occur under this policy, at
their last mailing address known to us, written
Page 2 of 3 Copyright, ISO Properties, Inc., 2002 IL 01 46 03 03
Inotice of nonrenewal. We will mail or deliver station or public parking place operations
thee notices at least 45 days before the: hazards;
•
a. Expiration of the policy; or the following applies to nonrenewal of the
b. Anniversary date of this policy if this policy Commercial Automobile Coverage Part in
has been written for a term of more than place of G.1.:
one year. a. We may elect not to renew or continue
Otherwise, we will renew this policy unless: this policy by mailing or delivering to you
and your agent or broker written notice at
a. The first Named Insured fails to pay the least 20 days before the end of the policy
renewal premium after we have ex- period including the actual reason for
pressed our willingness to renew, includ- nonrenewal. If the policy period is more
ing a statement of the renewal premium, than one year,we will have the right not to
to the first Named Insured and the first renew or continue it only at an anniversary
I Named Insured's insurance agent or bro- of its original effective date. If we offer to
ker, at least 20 days before the expiration renew or continue and you do not accept,
date; this policy will terminate at the end of the
b. Other coverage acceptable to the insured current policy period. Failure to pay the
has been procured prior to the expiration required renewal or continuation premium
date of the policy; or, when due shall mean that you have not
c. The policy clearly states that it is not re- accepted our offer.
newable, and is for. a specific line, sub- b. We will not refuse to renew Liability Coy-
classification, or type of coverage that is • 'erage or Collision Coverage solely be-
not offered on a renewable basis. cause an "insured" has submitted claims
2. If: under Comprehensive Coverage or
Towing and Labor Coverage.
j a. You are an individual; c. If we fail to mail or deliver proper notice of
b. A covered auto you own is of the "private nonrenewal and you obtain other insur-
passenger type"; and ance this policy will end on the effective
ill I c. The policy does not cover garage, auto- date of that insurance.
mobile sales agency, repair shop, service
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0 ZU RI C H BOILER AND MACHINERY
INSURANCE
ENDORSEMENT
Effective 01/01/2007 Policy Number BM 9307613-04 of the Zurich American Insurance Company issued to
City of Renton
(name of insured)
is changed as shown below.
LOCATION ENDORSEMENT
We agreelFwith you that the following locations are inserted in the Location of Objects of the Schedule shown on the Policy Declarations:
OMNIBUS LOCATION DESCRIPTION ,
f
Any loca otn which is either: -
- A. Own d by the Insured,or I
B. iILeaed by and operated under the control of the Insured and located anywhere in the District of Columbia or the states of the
IUnited States,Puerto Rico,and U.S.Virgin Islands including Canada.
I
REPORT OF LOCATIONS AND VALUES
0 It is agreed that the Insured shall prepare as of the date this policy becomes effective,and as of each 12 months therefore,an approved
report of locations and values showing the following:
A. l Eac location owned by,leased by or operated under the control of the Insured on the date for which the report is prepared.
B. ;The Property Damage value of each location as of the date for which the report is prepared.
C. I The Business Interruption value of each such location estimated for the year commencing on the date for which the report is
pre ared.
I
It is furttiier agreed that said report shall be filed with the Company not later than 90 days after each said anniversary date. The Company
shall computes the policy premium as of the anniversary date based on said report as filed with the Company.
III ,
Date 01/25/2007
1 Endorsement No. 1
U-BMS-180(9/88)
iZURICH BOILER AND MACHINERY
INSURANCE
ENDORSEMENT
Effective 01/01/2007 Policy Number BM 9307613-04 of the Zurich American Insurance Company issued to
City of Renton
(name of insured)
is changed 6s shown below.
Buried Equipment Wording
The followin is deleted from the policy:
F. Definitionrs
6. "Covered Equipment"
b. Does not mean or include
(6) Vessels, piping and other equipment that is buried below ground and requires the
excavation of materials to inspect, remove, repair or replace;
All other terms and conditions remain unchanged.
•
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Date 01/25/2007
Endorsement No. 2
U-BMS-180(9/88)
City of Renton
Received
9
losure Statement 2001 ZURICH
•Disclosure
rnan
yRes
, ,.:.�. . . ounce
. /ayr1��9ement�
I.
City of Renton
01/01/2007 M 9307613-04
I
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ZURICH WHOLESALER COMPENSATION DISCLOSURE
Dear Policyholder:
II
On behalf of Zurich, we are glad you have chosen us to help your company manage its risks. We look forward to
meeting'your insurance needs.
Your aglent or broker has chosen to use a Wholesaler to access Zurich for your insurance coverage. Wholesalers are
businesses that specialize in specific types of insurance coverage or serve customer groups with particular insurance
needs. The Wholesaler, like your agent or broker, is an independent businessperson or team of people not employed
by Zurich or any other insurance company.
I'
The information you will find on our Web site describes our commission arrangements with the Wholesaler, if
applicable. Zurich is not a party to the commission arrangement between the Wholesaler and your agent or broker.
Therefore, Zurich does not always know the commission your broker or agent receives as compensation for your
policy.
For an fa explanation of the nature and range of compensation Zurich may pay to the Wholesaler in connection with your
business, please go to http://www.zurichna.com. Click on the information link located on the Agent/Broker
Compensatioon Disclosure section. Where appropriate, insert the Access Code provided below, and you will be able to
view this information. Alternatively, you may call (877) 347-6465 to obtain this type of information.
Thank yyou.
Access Code: 0613392827
1
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U-WHL-E-402-A CW (11/06)
Page 1 of 1
City of Rentor
Receive
TRAVELERS• COMMERCIAL CRIME POLICY
k411Y !? f.1 Aiss,
DECLARATIONS POLIO'NO. 1030342
uman Resources urces &
Travelers Casualty and Surety Company of America Management
Hartford,CT 06183
(Stock Insurance Company,herein called the Company)
This Policy consists of this Declarations Form,the Common Policy Conditions,the Crime General Provisions Form
and the Coverage Forms indicated as applicable.
IN RETURN FOR THE PAYMENT OF THE PREMIUM,AND SUBJECT TO ALL THE TERMS OF THIS
POLICY,WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
I. NAMED INSURED: CITY OF RENTON,WASHINGTON
2. MAILING ADDRESS: 1055 South Grady Way
RENTON,WA 98057
3. POLICY PERIOD: From January 1,2007 To January 1,2010
(12:01 A.M.Standard Time at your mailing address shown above))
4. COVERAGE,LIMITS OF INSURANCE AND DEDUCTIBLE
Coverage Forms Forming Part of This Policy Limit of Insurance Deductible Amount
Cvg Frm 0-Public Emp.Dis.per Loss $1,000,000 $10,000
Cvg Frm B-Forgery Alterations $1,000,000 $10,000
Cvg Frm Cl -Money & Sec on Premises $1,000,000 $10,000
Cvg Frm C2-Money & Sec-Messenger $1,000,000 $10,000
Cvg Frm D1 -Other Property,Premises Not Covered
Cvg Frm D2-Other Property,Messenger Not Covered
Cvg Frm F-Computer Fraud $1,000,000 S 10,000
5. ENDORSEMENTS FORMING PART OF THIS POLICY WHEN ISSUED:
IL-0146 11-88,F-2552 04-97,F-2547A 06-99,F-2546A 06-99,F-2559 06-99,ILT-1021 10-04,F-2709 03-03,F-2565 01-01,
F-2545A 06-99,CR-1026 10-90,CR-1022 01-86,CR-1012 01-86,CR-1027 01-86,F-2543A 06-99,CR-5002 01-86,CR-1044
12-93
6, CANCELLATION OF PRIOR INSURANCE:
By acceptance of this Policy,you give us notice canceling prior Policy or Bond Numbers 7101091272BCM
The cancellation to be effective at the time this Policy becomes effective.
it;ounterstgned t3y(i}required)
F-1697 05-98 Page 1 of 2
COMMON POLICY CONDITIONS
This ` is to the followingconditions. �
• poicy subject
D. INSPECTIONS AND SURVEYS
A. C•NCELLATION
1. he first Named Insured shown in the Declarations We have the right but are not obligated to:
may cancel this policy by mailing or delivering to us 1. Make inspections and surveys at any time;
advance written notice of cancellation.
2. e may cancel this policy by mailing or delivering to 2. Give you reports on the conditions we find;an
the first Named Insured written notice of cancellation 3. Recommend changes.
at least: Any inspections,surveys,reports or recommen-
a. 10 days before the effective date of cancellation if dations relate only to insurability and the,premi ms to
we cancel for nonpayment of premium;or be charged. We do not make safety inspections. We do
b. 30 days before the effective date of cancellation if not undertake to perform the duty of any person or
we cancel for any other reason. organization to provide for the health or sa'-ty of
workers or the public. And we do not,warm t that
3. We will mail or deliver our notice to the first Named conditions:
Insured's last mailing address known to us. I
4. I otice of cancellation will state the effective date of 1. Are safe or healthful;or
ancellation. The policy period will end on that date. 2. Comply with laws,regulations,codes or stan o.rds.
5. I f this policy is cancelled, we will send the first This condition applies not only to us, but also o any
I amed Insured any premium refund due. If we
ancel,the refund will be pro rata. If the first Named rating, advisory, rate service or similar organ zation
I nsured cancels,the refund may be less than pro rata. which makes insurance inspections, surveys, rep its or
he cancellation will be effective even if we have not recommendations.`
ade or offered a refund. E. PREMIUMS
6. f notice is mailed, proof of mailing will be The first Named Insured shown in the Declarations
.ufficient proof of notice
1. Is responsible for the payment of all premiums;and
B. C • GES• Th's policy contains all the agreements between you 2. Will be the payee for any return premiums we ay.F. TRANSFER OF YOUR RIGHTS AND D TIES
ano us concerning the insurance afforded. The first
UNDER THIS POLICY
N. ed Insured shown in the Declarations is authorized
to ake changes in the terms of this policy with our Your rights and duties under this policy may not be
co sent. This policy's terms can be amended or waived transferred without our written consent except n the
, on y by endorsement issued by us and made a part of case of death of an individual named insured.
thi policy.
If you die,your rights and duties will be transferred to
C. I E I•MINATION OF YOUR BOOKS AND your legal representative but only while acting within
R CORDS the scope of duties as your legal representative. Until
W- may examine and audit your books and records as your legal representative is appointed, anyone aving
the relate to this policy at any time during the policy
proper temporary custody of your property will have
pe od and up to three years afterward. your rights and duties but only with respect to that
property.
IN WIT I ESS WHEREOF,theCompany has caused this Policy to be signed by its authorized company officers at
tl
Hartfor. CT.
1 . - 2R. Le&
Executive Vice President Corporate Secretary
Copyright,Insurance Services Office,Inc., 1982, 1983
F-1097 05-98 Page 2 o 2
1111
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gi TRAVELERS COMMERCIAL CRIME
1r v,
I
RENEWAL CERTIFICATE POLICY NO. 103034286
Travelers Casualty and Surety Company of America
Hartford.CT 06183
(Stock Insurance Companies,herein called the Company)
In consideration of a renewal premium,Policy No. 103034286
issued to CITY OF RENTON,WASHINGTON
is renewed for the Policy Period from January 1,2007 to January 1,2010
subject to all the Agreements,Conditions and Limitations,and other terms of said policy.
Premium $25,818.00
Endorsements attached to this policy at renewal:
F-2552(04-97); F-2559(06-99); F-2543A(06-99); F-2545A(06-99); F-2546A(06-99); F-2547A(06-99);
F-2565(01-01); F-2709(03-03); ILT-1021 (10-04); CR-5002(01-86); CR-1026(10-90); CR-1012(01-86);
CR-1022(01-86)
S
1.27007/ 2,/ goo&
Authorized Company Representative
Countersigned by(if required)
F-1430-1 (06-99)
S
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ISSUED :Y:Travelers Casualty and Surety Company of America POLICY NO:103034286
ISSUED 0:CITY OF RENTON,WASHINGTON
• ,,
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1 CRIME GENERAL PROVISIONS
I COMMERCIAL CRIME
I
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Various pr.visions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and w.iat is or is not
covered.
Throughou this policy the words "you" and "your"refer to the Named Insured shown in the Declarations.The words 'we", "us" and
I
"our"refer o the Company providing this insurance.
Words and phrases in quotation marks are defined in the policy.
Unless sta -d otherwise in any Crime Coverage Form, declarations or endorsement, the following General Exclusions, General
Conditions and General Definitions apply to all Crime Coverage Forms forming part of this policy.
1
A. GENE L EXCLUSIONS a. This insurance;
We wi 1 not pay for loss as specified below: b. The Covered Property;
1.1 Act Committed by You or Your Partners: Loss c. Your interest in the Covered Property;or
res lting from any dishonest or criminal act d. A claim under this insurance.
l co miffed by you or any of your partners whether 2. Consolidation-Merger: If through consolidation or
I acti g alone or in collusion with other persons. merger with, or purchase of assets of, some other
2.I Go ernmental Action: Loss resulting from seizure or entity:
1 des ction of property by order of governmental a. Any additional persons become"employees";or
aut ority.
b. You acquire the use and control of any additional
Ind rest Loss:Loss that is an indirect result of any act
3. "premises";
I or "occurrence" covered by this insurance including,
but limited to,loss resulting from: any insurance afforded for"employees" r"premises"
• a. Ilot
our inability to realize income that you would also applies to those additional' em loyees" and
ave realized had there been no loss of, or loss
"premises",but only if you:
jI 'om damage to,Covered Property. a. Give us written notice within 30 da s thereafter;
lb. 'ayment of damages of any type for which you are and
1-gaily liable. But, we will pay compensatory b. Pay us an additional premium. ,
.amages arising directly from a loss covered under 3. Coverage Extensions: Unless stated otherwise in the
I t is insurance. Coverage Form, our liability under any Coverage
lc. 'ayment of costs,fees or other expenses you incur Extension is part of, not in addition to, the Limit of
I i establishing either the existence or the amount Insurance applying to the Coverage r Coverage
of loss under this insurance. Section.
4. ILeg.l Expenses:Expenses related to any legal action. 4. Discovery Period for Loss: We will ay only for
5. it ear: Loss resulting from nuclear reaction,nuclear covered loss discovered no later than o1e year from
the end of the policy period.
radiition or radioactive contamination, or any related
Oct o incident. 5. Duties in the Event of Loss: After you discover a
6. War and Similar Actions: Loss resulting from war, loss or a situation that may result in loss of, or loss
whet er or not declared, warlike action, insurrection, from damage to,Covered Property you mist:
rebe lion or revolution,or any related act or incident. a. Notify us as soon as possible.
B. GENE'• L CONDITIONS b. Submit to examination under oath a our request
II and give us a signed statement of your answers.
1. Con kealment,Misrepresentation or Fraud:This
insur:nce is void in any case of fraud by you as it c. Give us a detailed, sworn proof of los within 120
relat=s to this insurance at any time.It is also void if days.
you .r any other insured, at any time,intentionally d. Cooperate with us in the investigation and
Conc:al or misrepresent a material fact concerning: settlement of any claim.
II
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II Copyright,Insurance Services Office,Inc., 1994
• CR 10 00 06 95 Page 1 of 4
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• 6 Joint Insured:
This insurance became effective at the time of
':
cancellation or termination of the prior insurance;
I a. If more than one Insured is named in the
Declarations, the first named insured will act for (1)and
The loss would have been covered
II itself and for every other insured for all purposes (2) by this
II of this insurance. If the first named insured ceases insurance had it been in effect then the acts or
to be covered, then the next named insured will events causing the loss were' committed or
I become the first named insured. occurred. I
I b. If any insured or partner or officer of that insured b.The insurance under this Condition is part of,not in
has knowledge of any information relevant to this addition to, the Limits of Irisuran a applying to
I insurance, that knowledge is considered this insurance and is limited'to the lesser of the
knowledge of every insured. amount recoverable under:
c. "employee" of any insured is considered to be (1)This insurance as of its effective(date;or
n"employee"of every insured. (2)The prior insurance had it remained in effect.
I d. f this insurance or any of its coverages is 11. Loss Covered Under This Insurance and Prior
ancelled or terminated as to any insured, loss Insurance Issued by Us or Any Affili 1 te: If any loss
ustained by that insured is covered only if is covered:
I iecovered no later than one year from the date of a. Partly by this insurance;and
hat cancellation or termination.
e. e will not pay more for loss sustained by more b. Partly by any prior cancelled r terminated
han one insured than the amount we would pay if insurance that we or any affiliate ha issued to you
or any predecessor in interest;
11 the loss had been sustained by one insured.
7. Leg I Action Against Us: You may not bring any the most we will pay is the larger f the amount
recoverable under this insurance r the prior
I leg 1 action against us involving loss: insurance.
a. nless you have complied with all the terms of this 12. Non-Cumulation of Limit of Insurance: Regardless
i surance;and
of the number of years this insurance remains in force
b. ntil 90 days after you have filed proof of loss or the number of premiums paid, o Limit of
ith us;and Insurance cumulates from year to yea or period to
Ic. nless brought within 2 years from the date you period.
I
iscover the loss. 13. Other Insurance: This insurance does not apply to
O 8. ,Lib ralization: If we adopt any revision that would loss recoverable or recovered under othe insurance or
bro den the coverage under this insurance without indemnity.However,if the limit of the other insurance
addi ional premium within 45 days prior to or during or indemnity is insufficient to cover the nrire amount
I the policy period, the broadened coverage will of the loss,this insurance will apply to t at part of the
Ii diately apply to this insurance. loss, other than that falling within a y deductible
amount, not recoverable or recovered u der the other
9. Los Covered Under More Than One Coverage of insurance or indemnity. However,'this insurance will
Thi Insurance: If two or more coverages of this not apply to the amount of loss that is tore than the
Imsuiance apply to the same loss, we will pay the applicable Limit of Insurance shown in the
lesser of: Declarations. 1
a. T e actual amount of loss; 14. Ownership of Property; Interests C vered: The
b. T e sum of the limits of insurance applicable to property covered under this insurance 's limited to
II t ose coverages. . property:
10. Loss Sustained During Prior Insurance a. That you own or hold;or
a. If you,or any predecessor in interest,sustained loss b. For which you are legally liable.
d ring the period of any prior insurance that you or However, this insurance is for your benefit only. It
th• predecessor in interest could have recovered provides no rights or benefits to any other person or
u der that insurance except that the time within organization.
w ich to discover loss had expired,we will pay for
1 it under this insurance, provided: '
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CR 10 00 06 95 Page 2 of 4
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15. Pol cy Period: (2) Loss of "securities" but only up to and
' a. he Policy Period is shown in the Declarations. including their value at the close of business
on the day the loss was discovered. We may,
b. .ubject to the Loss Sustained During Prior at our option:
I nsurance condition, we will pay only for loss that (a) Pay the value of such 'securities" or
ou sustain through acts committed or events
.ccurring during the Policy Period. replace them in kind, in which event you
must assign to us all your tights, title and
16.' Re ords: You must keep records of all Covered interest in and to those"secu ties";or
Pro•erty so we can verify the amount of any loss.
17I Recoveries (b) Pay the cost of any Lost S curities Bond
• required in connection with issuing
a. •ny recoveries, less the cost of obtaining them, duplicates of the"securities" However,we
ade after settlement of loss covered by this will be liable only for the ayment of so
nsurance will be distributed as follows: much of the cost of the bon as would be
1)To you, until you are reimbursed for any loss charged for a bond having a penalty not
that you sustain that exceeds the Limit of exceeding the lesser of the:
Insurance and the Deductible Amount,if any; i. Value of the"securities"at the close of
2)Then to us, until we are reimbursed for the business on the day the loss was
settlement made; discovered;or
3)Then to you, until you are reimbursed for that ii. Limit of Insurance.
part of the loss equal to the Deductible (3)Loss of, or loss from damage to, "property
Amount,if any. other than money and securities" or loss from
b. damage to the "premises" for not more than
ecoveries do not include any recovery:
the:
1)From insurance, suretyship, reinsurance, (a) Actual cash value of the property on the
security or indemnity taken for our benefit; or day the loss was discovered;
2)Of original"securities" after duplicates of them (b) Cost of repairing the property or
have been issued. "premises";or
18.,Ter itory: This insurance covers only acts committed (c) Cost of replacing the property with
or vents occurring within the United States of property of like kind and quality.
Am rica, U.S. Virgin Islands, Puerto Rico, Canal
Zon ,or Canada. We may, at our option, pay the actual cash
19. Tra sfer of Your Rights of Recovery Against value of the property or repair or replace it.
Oth•rs to Us: You must transfer to us all your rights If we cannot agree with you upon the actual
of r covery against any person or organization for any cash value or the cost of repair o replacement,
loss you sustained and for which we have paid or the value or cost will be d termined by
settl•d. You must also do everything necessary to arbitration.
sec
re those rights and do nothing after loss to impair b. We may, at our option, pay for to s of, or loss
from damage to,property other�than"money":
20. Val ation-Settlements: (1)In the"money" of the country in which the loss
a• 'ubject to the applicable Limit of Insurance occurred;or
.rovision we will pay for: (2)In the United States of America dollar
(t)Loss of"money" but only up to and including equivalent of the "money" of t e country in
its face value. We may, at our option, pay for which the loss occurred determin•d by the rate
loss of "money" issued by any country other of exchange on the day t e loss was
than the United States of America: discovered.
(a) At face value in the"money"issued by that c. Any property that we pay for or repla e becomes
country;or our property.
(b) In the United States of America dollar
equivalent determined by the rate of
exchange on the day the loss was
discovered.
Copyright,Insurance Services Office,Inc., 1994
CR 10 00 0. 95 Pag- 3 of 4
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C. •�EN:RAL DEFINITIONS not include any property listed inllany rime Coverage
• Form as Property Not Covered.
1 " mployee"means:
4. "Securities" means negotiable and non-negotiable
a. Any natural person: instruments or contracts representing ither "money"
(1)While in your service (and for 30 days after or other property and includes:
termination of service);and a. Tokens,tickets,revenue and other s amps(whether
(2)Whom you compensate directly by salary, represented by actual stamps li r lun sed value in a
wages or commissions;and meter)in current use;and
(3)Whom you have the right to direct and control b. Evidences of debt issued in connect on with credit
while performing services for you;or or charge cards,which cards are not issued by you;
b. Any natural person employed by an employment but does not include"money".
contractor while that person is subject to your
direction and control and performing services for
{ you excluding, however, any such person while
having care and custody of property outside the
"premises".
But"employee"does not mean any:
(1)Agent, broker, factor, commission merchant,
consignee, independent contractor or
representative of the same general character;or
(2)Director or trustee except while performing
acts coming within the scope of the usual duties
of an employee.
2 " oney"means:
a. Currency, coins and bank notes in current use and
having a face value;and
b. Travelers checks, register checks and money
orders held for sale to the public.
3 "P operty Other Than Money and Securities"
mans any tangible property other than "money" and
"securities" that has intrinsic value but does
/Los&
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Ex-cutive Vice President Corporate Secretary
I, III
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Copyright,Insurance Services Office,Inc., 1994
• CR 1 100 06 95 Pa•e 4 of 4
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• w TRAVELERS
IMPORTANT NOTICE REGARDING INDEPENDENT AGENT AND
BROKER COMPENSATION
For information about how St. Paul Travelers compensates independent
agents and brokers, please visit www.StPaulTravelers.com, or you may
request a written copy from Marketing at One Tower Square, 2GSA,
Hartford, Connecticut 06183.
•
ILT-1037(04-OS)
II
ISSUED B .:Travelers Casualty and Surety Company of America POLICY NO:103034286
• ISSUED T :CITY OF RENTON,WASHINGTON
III
PUBLIC EMPLOYEE DISHONESTY COVERAGE FORM
(COVERAGE FORM 0—PER LOSS)
11
A. COVE GE d. Treasurer or Tax Collector: loss caused by a treasurer
We wil pay loss of, and loss from damage to, Covered
or tax collector by whatever name known. 11
Prope resulting directly from the Covered Cause of e. Damages: damages for which you are legally liable as a
Loss. result of:
1. 1Covered Property: "Money", "securities", and (1)the deprivation or violation of the civil rights of any
ii"pro o erty other than money and securities". person by an"employee";or
2. Covred Cause of Loss: "Employee dishonesty". (2)the tortious conduct of an "employee", except
3. Cov rage Extension conversion of property of other parties held by you
in any capacity.
IEm loyees Temporarily Outside Coverage
Ter itory: We will pay for loss caused by any 2. Additional Conditions:
"em loyee" while temporarily outside the territory a. Cancellation As To Any Employee:
;'specified in the Territory General Condition for a This insurance is cancelled as to any"employee":
peri d not more than 90 days.
B. LIMIT OF INSURANCE (1)Immediately upon discovery by you or any official
or employee authorized to manage,govern or control
The most we will pay for loss in any one "occurrence" is your employees, of any dishonest act committed by
the applicable Limit of Insurance shown in the that "employee" whether before or after becoming
DECLARATIONS. employed by you.
1
C. DEDUCTIBLE (2)On the date specified in a notice mailed to you. That
1. We ill not pay for loss in any one "occurrence" date will be at least 30 days after the date of mailing.
unle s the amount of loss exceeds the Deductible The mailing of notice to you at the last mailing address
,Am unt shown in the DECLARATIONS. We will known to us will be sufficient proof of notice. Delivery
ID • then pay the amount of loss in excess of the of notice is the same as mailing.
Ded ctible Amount,up to the Limit of Insurance. b. Sole Benefit:This insurance is for your sole benefit.No
2. ,You must: legal proceeding of any kind to recover on account of
a. ive us notice as soon as possible of any loss of loss under this coverage may be brought by anyone
other than you.
the type insured under this Coverage Form even
though it falls entirely within the Deductible c. Indemnification: We will indemnify any of your
Amount. officials who are required by law to give bonds for the
faithful performance of their service against loss through
b. Upon our request, give us a statement describing
t e loss. dishonest acts of persons who serve under them,subject
il to the Limit of Insurance.
D. AL DIT ONAL EXCLUSIONS, CONDITIONS AND I
DEFIN TIONS: In addition to the provisions in the 3. Additional Definitions
Crime eneral Provisions, this Coverage Form is subject a. "Employee Dishonesty" in paragraph A.2. means only
to the fdllowing: dishonest acts committed by an "employee", whether
1. Addiitional Exclusions: We will not pay for loss or identified or not, acting alone or in collusion with other
'damages as specified below:
persons,with the manifest intent to:
la. Employee Cancelled Under Prior Insurance: (1)Cause you to sustain loss;and also
loss caused by any "employee" of yours, or (2)Obtain financial benefit (other than employee
predecessor in interest of yours, for whom similar benefits earned in the normal course of,employment,
p or insurance has been cancelled and not including: salaries, commissions, fees, bonuses,
r instated since the last such cancellation. promotions,awards,profit sharing or pensions)for:
b. I ventory Shortages:loss,or that part of any loss, (a) The"employee";or '
II t e proof of which as to its existence or amount is (b) Any person or organization intended by the
dII pendent upon: "employee"to receive that benefit. I
(1)An inventory computation;or b. "Occurrence" means all loss caused by, ,lor involving,
(2)A profit and loss computation. one or more "employees", whether the result of a single
c. Bonded Employee: loss caused by any act or series of acts.
"employee" required by law to be individually
bonded.
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CR 00 16 10 90
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ISSUED BY: Travelers Casualty and Surety Company of America POLICY NO: 103034286
ISSUED,TO: CITY OF RENTON,WASHINGTON i
•
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FORGERY OR ALTERATION COVERAGE FORM
j0 (Coverage Form B)
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A. COVERAGE D. ADDITIONAL EXCLUSION, CONDITIONS AND
We wilt pay for loss involving Covered Instruments DEFINITION
resulting directly from the Covered Causes of Loss. In addition to the provisions in the Crime General
1. iCovered Instruments: Checks, drafts, promissory Provisions Form,this Coverage Form is also subject to the
notes,or similar written promises,orders or directions following:
io paY a sum certain in"money"that are: 1. Additional Exclusion
a. Made or drawn by or drawn upon you; Acts of Employees,Directors,or Trustees: We will
b. Made or drawn by one acting as your agent; not pay for loss resulting from any dishonest or
or that are purported to have been so made or criminal act committed by any of your"employees",
Idrawn. directors,or trustees:
2. ICovred Causes Of Loss: Forgery or alteration of,on a. Whether acting alone or in collusion with other
Ior in any Covered Instrument. persons;
3. (,Coverage Extension or 1
Legal Expenses: If you are sued for refusing to pay b. Whether while performing services for you or
lany hovered Instrument on the basis that it has been otherwise.
forged or altered, and you have our written consent to 2. Additional Conditions
'defend against the suit,we will pay for any reasonable
illegal expenses that you incur and pay in that defense. a. Facsimile Signatures: We will treat
The amount we will pay under this extension is in mechanically reproduced facsimile signatures the
I addition to the Limit of Insurance applicable to this same as handwritten signatures.
• iinsu once. b. General Amendment: As respects this Coverage
B. LIMIT�OF INSURANCE Form, the words Covered Property iin the Crime
General Provisions Form mean Covered
The mo t we will pay for loss in any one "occurrence" is Instruments.
the applicable Limit of Insurance shown in the Proof of Loss: You must include with your proof
Declarations. c. of loss any instrument involved in that loss, or, if
C. DEDUCTIBLE that is not possible, an affidavit setting forth the
We willnot pay for loss in any one "occurrence" unless amount and cause of loss.
the amunt of loss exceeds the Deductible Amount shown d. Territory: We will cover loss you sustain
inithe Declarations. We will then pay the amount of loss anywhere in the world.
in'excess of the Deductible Amount, up to the Limit of
f The Territory General Condition does not apply to this
Insurance. This provision does not apply to legal
expenses paid under the Coverage Extension. Coverage Form.
I3. Additional Definition
II
"Occurrence"means all loss caused by any person or
11 in which that person is involved, whether the loss
involves one or more instruments.
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CROQ03 090
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1,
ISSUED BY:Travelers Casualty and Surety Company of America POLICY NO:103034286
111
ISSUED TO:CITY OF RENTON,WASHINGTON
11
1 THEFT,DISAPPEARANCE AND DESTRUCTION COVERAGE FORM
(Coverage Form C)
A. COVERAGE—We will pay for loss of Covered (2) From any insurance or indemnity carried by,or for
Prope resulting directly from the Covered Causes of the benefit of customers of,the armored motor
II
Loss. vehicle company.
1.Ir Sec ion 1.—Inside The Premises
li a. 1 overed Property: "Money"and"securities" B. LIMIT OF INSURANCE
inside the"premises"or a"banking premises". The most we will pay for loss in any one"occurrence"is
l'i b. overed Causes of Loss I the applicable Limit of Insurance shown in the
1) "Theft" DECLARATIONS.
2) Disappearance C. DEDUCTIBLE
II 3) Destruction We will not pay for loss in any one"occurrence"unless
I 1 the amount of loss exceeds the Deductible Amount shown
c. Coverage Extensions in the DECLARATIONS.We will then pay the amount
I' (1) Containers of Covered Property:We will of loss in excess of the Deductible Amount,up to the
pay for loss of,and loss from damage to,a Limit of Insurance.In the event more than one Deductible
locked safe,vault,cash register,cash box or Amount could apply to the loss,only the highest
cash drawer located in the "premises"resulting Deductible Amount may be applied.
directly from an actual or attempted: D. ADDITIONAL EXCLUSIONS,CONDITION AND
(a) "Theft"of;or DEFINITIONS:In addition to the provisions in the
(b) Unlawful entry into those containers. Crime General Provisions,this Coverage Form is subject
to the following:
2) Premises Damage:We will pay for loss from 1. Additional Exclusions:We will not pay for loss as
III damage to the"premises" or its exterior i
resulting directly from an actual or attempted specified below:
"theft"of Covered Property if you are the a. Accounting or Arithmetical Errors or
owner of the"premises"or are liable for Omissions:Loss resulting from accounting or
• I
I damage to it. arithmetical errors or omissions. 1
2. Section 2.—Outside the Premises b. Acts of Employees,Directors,Trustees or
Reresentatives: Loss a. C overed Property: Money and custody
s di t shones orcriminal al act committed
edb fromany
utside the in"premises" the care and ofa "employees", by anz your
directors,trustees or authorized
messenger„. representatives:
I, b. 'Covered Causes of Loss (1)Acting alone or in collusion with'other persons;
(1) "Theft" or
, (2) Disappearance (2)While performing services for you or
(3) Destruction otherwise.
I c. Coverage Extension
c. Exchanges or Purchases:Loss resulting from the
giving or surrendering of property in any exchange
Conveyance of Property By Armored Motor or purchase.
Vehicle Company: We will pay for loss of
Covered Property resulting directly from the d. Fire:Loss from damage to the"premises"
Covered Causes of Loss while outside the resulting from fire,however caused.,
"premises"in the care and custody of an armored e. Money Operated Devices:Loss of property
motor vehicle company. contained in any money operated device unless the
But,we will pay only for the amount of loss that amount of"money"deposited in it is recorded by a
continuous recording instrument in the device.
you cannot recover:
f. Transfer or Surrender of Property
(1) Under your contract with the armored motor (1)Loss of property after it has been transferred or
vehicle com an and surrendered to a person or place outside the
j' p y' "premises"or"banking premises":
I (over) I
0 I Copyright,Insurance Services Office,Inc., 1984, 1989
C' 00 04 10 90 Page 1 of 2
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(a) On the basis of unauthorized instructions; 2. Additional Condition
or Duties in the Event of Loss:If you have reason to
(b) As a result of a threat to do: believe that any loss of,or loss from damage to,
i. Bodily harm to any person;or Covered Property involves a violationtof law,you
must notify the police.
ii. Damage to any property.
( )But,this exclusion does not apply under 3. Additional Definitions
COVERAGE,Section 2.to loss of Covered a. "Banking Premises"means the interior of that
Property while outside the"premises"or portion of any building occupied by al banking
"banking premises"in the care and custody of a institution or similar safe depository.
"messenger"if you: b. "Messenger"means you,any of your partners or
(a) Had no knowledge of any threat at the time any"employee"while having care and custody of
the conveyance began;or the property outside the"premises".
(b) Had knowledge of a threat at the time the c. "Occurrence"means an:
conveyance began,but the loss was not (1)Act or series of related acts involving one or
related to the threat. more persons;or
g. andalism:Loss from damage to the"premises" (2)Act or event,or a series of related acts or
r its exterior or to containers of Covered Property events not involving any person.
y vandalism or malicious mischief.
h. 1oluntary Parting of Title to or Possession of d. "Premises"means the interior of that portion of
any building you occupy in conducting your
business.
Property:Loss resulting from your,or anyone e
acting on your express or implied authority,being
'Induced by any dishonest act to voluntarily part e. "Theft"means any act of stealing.
ith title to or possession of any property.
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Copyright,Insurance Services Office,Inc., 1984, 1989
C' 00 04 10 90 Page 2 of 2
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ISSUEDD B : Travelers Casualty and Surety Company of America POLICY NO: 103034286
11
ISSUED T : CITY OF RENTON,WASHINGTON
1
COMPUTER FRAUD COVERAGE FORM
(Coverage Form F)
il
A. COVE GE
1. (1) An inventory computation;or
We w 11 pay for loss of, and loss from damage to,
Covered Property resulting directly from the Covered (2) A profit and loss computation.
Cause bf Loss. 2. Additional Conditions
1.111 Co''ered Property: "Money", "Securities" and a. Duties in the Event of Loss: If you have reason to
1 "Pr perry Other Than Money and Securities". believe that any loss of, or loss from damage to,
2.1 Covered Cause of Loss: "Computer Fraud". Covered Property involves a violation of law, you
CI must notify the police. 1
B. LIMIT OF INSURANCE
1 1 b. Special Limit of Insurance for Specified
The most we will pay for loss in any one "occurrence" is Property: We will only pay up to $5,000 for any
th'e applicable Limit of Insurance shown in the one "occurrence" of loss of, and loss from damage
DCLf1RATIONS. to, manuscripts, drawings, or records of any kind
C. DEDUCTIBLE or the cost of reconstructing them or reproducing
Wle wi l not pay for loss in any one "occurrence" unless any information contained in them.
the amount of loss exceeds the Deductible Amount in the 3. Additional Definitions
DECLJ&RATIONS. We will then pay the amount of loss a. "Banking Premises" means the interior of that
in'II exc ss of the Deductible Amount, up to the Limit of portion of any building occupied by a banking
Insura ce.In the event more than one Deductible Amount institution or similar safe depository.
could apply to the loss, only the highest Deductible
Amou t may be applied. b. "Computer Fraud" means "theft" of property
D. AJDDITIONAL EXCLUSIONS, CONDITIONS AND following and directly related to the use of any
computer to fraudulently cause a transfer of that
DEFINITIONS: In addition to the provisions in the property from inside the "premises" or "banking
Cime General Provisions, this Coverage Form is subject premises" to a person (other than a "messenger")
to the rollowing: outside those"premises"or to a place outside those
1!I As ditional Exclusions: We will not pay for loss as "premises".
sp:cified below: c. "Messenger" means you, any of your partners or
a. Acts of Employees, Directors, Trustees or any "employee" while having care and custody of
1 Representatives: Loss resulting from any the property outside the"premises".
dishonest or criminal act committed by any of your d. "Occurrence"means an:
"employees", directors, trustees or authorized
representatives: (1)Act or series of related acts involving one or
more persons;or
(1)Acting alone or in collusion with other persons;
or (2)Act or event, or a series of related acts or
l (2)While performing services for you or events not involving any person.
otherwise. e. "Premises" means the interior of that portion of
any building you occupy in conducting your
b. Inventory Shortages: Loss, or that part of any business.
loss, the proof of which as to its existence or
amount is dependent upon: dam f. "Theft" means any act of stealing.
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Copyright,Insurance Services Office,Inc., 1983, 1989
•
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ISSUED BY: Travelers Casualty and Surety Company of America POLICY NO: 103034286
ISSUED TO:CITY OF RENTON,WASHINGTON
111 COMMON POLICY CONDITIONS—WASHINGTON
All Covierag Parts included in this policy are subject to the f. Without reasonable explanation,heat water,sewer,
following co ditions: and electricity are not furnished for the structure for
A. CANCELLATION 60 consecutive days;or
1. Th first Named Insured shown in the Declarations may g. The structure is not maintained in substantial
I cancel this policy by mailing or delivering to us advance compliance with fire,safety and building codes.
wri-ten notice of cancellation. 4. If
2. 1 W. may cancel this policy by mailing or delivering to a. You are an individual;
the first Named Insured and the first Named Insured's
I age t or broker written notice of cancellation, including b. A covered auto you own is of the"private
the actual reason for the cancellation,to the last mailing passenger type";and
III address known to us,at least: c. The policy does not cover garage; automobile sales
a. 10 days before the effective date of cancellation if agency, repair shop, service station or public
it we cancel for nonpayment of premium;or parking place operations hazards,
b. 45 days before the effective date of cancellation if we may cancel the Commercial Auto Coverage Part by
we cancel for any other reason, mailing or delivering to the first Named Insured and the
first Named Insured's agent or broker written notice of
except as provided in paragraphs 3.and 4.below. cancellation, including the actual reason for
cancellation,to the last mailing address known to us:
3. W may cancel the Commercial Property Coverage Part,
if rliade a part of this policy,by mailing or delivering to a. At least 10 days before the effective date of
the first Named Insured and the first Named Insured's cancellation if we cancel for nonpayment of
agent or broker written notice of cancellation at least 5 premium;or
I' dayis before the effective date of cancellation for any
structure where 2 or more of the following conditions b. At least 10 days before the effective date of
9 exist:
cancellation for any other reason if the policy is in
effect less than 30 days;or
a. Without reasonable explanation, the structure is
unoccupied for more than 60 consecutive days, or c. At least 20 days before the effective date of
at least 65% of the rental units are unoccupied for cancellation for other than nonpayment if the policy
more than 120 consecutive days unless the structure is in effect 30 days or more;or
is maintained for seasonal occupancy or is under d. At least 20 days before the effective date of
II construction or repair; cancellation if the policy is in effect for 60 days or
b. Without reasonable explanation, progress toward more or is a renewal or continuation!policy,and the
completion of permanent repairs to the structure has reason for cancellation is that your driver's license
not occurred within 60 days after receipt of funds or that of any driver who customarily uses a
following satisfactory adjustment or adjudication of covered "auto" has been suspended or revoked
during the policy period.
loss resulting from a fire;
c. Because of its physical condition,the structure is in 5. We will also mail or deliver to any mortgage holder,
danger of collapse; pledgee or other person shown in this policy to have an
interest in any loss which may occur under this policy,
d. Because of its physical condition, a vacation or at their last mailing address known to us,written notice
demolition order has been issued for the structure, of cancellation prior to the effective date of cancellation.
or it has been declared unsafe in accordance with If cancellation is for reasons other than those contained
applicable law; in paragraph A.3. above,this notice will be the same.as
e. Fixed and salvageable items have been removed
that mailed or delivered to the first Named Insured. If
from the structure,indicating an intent to vacate the cancellation is for a reason contained in paragraph A.3.
above, we will mail or deliver this notice at least 20
structure; days prior to the effective date of cancellation.
I° Copyright,Insurance Services Office,Inc., 1986, 1988
Copyright,ISO Commercial Risk Services,Inc., 1986, 1988
IL 01 6 11 88 Page 1 of 3
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6. Notice of cancellation will state the effective date of charged. We do not make safety inspections. We do not
'a° ca cellation.The policy period will end on that date. undertake to perform the duty of any person or organization
0 to provide for the health or safety of workers or the public.
7. a. If this policy is cancelled, we will send the first And we do not warrant that conditions:
III Named Insured any premium refund due. If we
cancel,the refund will be pro rata. 1. Are safe or healthful;or
b. For Division Two-Boiler and Machinery,if the first 2. Comply with laws,regulations,codes or standards.
I Named Insured cancels, the refund will be at least This condition applies not only to us,but also to any rating,
75%of the pro rata refund. advisory, rate service or similar organization which makes
jl c. Except as provided in paragraph b. above and d. insurance inspections,surveys,reports or recommendations.
I below, if the first Named Insured cancels, the E. PREMIUMS
refund will be at least 90%of the pro rata refund. I
d. If: The first Named Insured shown in the Declarations:
(1) You are an individual; 1. Is responsible for the payment of all premiums;and
II
2. Will be the payee for any return premiums we pay.
(2) A covered auto you own is of the "private
passenger type"; F. TRANSFER OF YOUR RIGHTS AND DUTIES UNDER
j l THIS POLICY
i' (3) The policy does not cover garage, automobile
sales agency, repair shop, service station or Your rights and duties under this policy may not be
it public parking place operations hazards;and transferred without our written consent except in the case of
(4) The first Named Insured cancels, death of an individual named insured.
11 the refund will be not less than 90% of any If you die,your rights and duties will be transferred to your
1 unearned portion not exceeding$100, plus 95% of legal representative but only while acting within the scope of
any unearned portion over$100 but not exceeding duties as your legal representative. Until your legal
j $500, and not less than 97% of any unearned representative is appointed, anyone having proper temporary
portion in excess of$500. custody of your property will have your right's and duties but
only with respect to that property.
jr e. The cancellation will be effective even if we G. NONRENEWALAik
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have not made or offered a refund.
8aIf notice is mailed, proof of mailing will be sufficient 1. We may elect not to renew this policy by mailing or
j proof of notice. delivering written notice of nonrenewal, stating the
I
reasons for nonrenewal, to the first Named Insured and
B. CHANGES the first Named Insured's agent or broker, at their last
lil mailing addresses known to us.We will also mail to any
The policy contains all the agreements between you and us mortgage holder,pledgee or other person shown in this
concerning the insurance afforded. The first Named Insured policy to have an interest in any' loss which may occur
shown in the Declarations is authorized to make changes in
1„ under this policy, at their last mailing address known to
the to s of this policy with our consent.This policy's terms
us,written notice of nonrenewal.We will mail or deliver
can be amended or waived only by endorsement issued by us these notices at least 45 days before the:
and m de a part of this policy. I
'I a. Expiration of the policy;or
C. EXA 11,
INATION OF YOUR BOOKS AND RECORDS
b. Anniversary date of this policy if'this policy has
We m y examine and audit your books and records as they been written for a term of more than one year.
relate o this policy at any time during the policy period and
up to t ree years afterward. Otherwise,we will renew this policy unless:
III
D. INSP CTIONS AND SURVEYS a. The first Named Insured fails to pay the renewal
premium after we have expressed our willingness to
We have the right but are not obligated to: I
renew, including a statement of the renewal
1�.' Iviake inspections and surveys at any time; premium, to the first Named Insured and the first
Named Insured's insurance agent or broker at least
21.1 G ve you reports on the conditions we find;and 20 days before the expiration date;or
3L R commend changes. •
Any i j spections, surveys,reports or recommendations relate
only to insurability and the premiums to be
IL 01 4
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b. Oth r coverage acceptable to the "insured" has been policy period including the actual reason for nonrenewal.
proured� prior to the expiration date of the policy. If the policy period is more than one year, we will have
S the right not to renew or continue it only at an
2. If: anniversary of its original effective date. If we offer to
a. You are an individual; renew or continue and you do not accept,this policy will
terminate at the end of the current policy period.Failure
b. A overed auto you own is of the "private passenger to pay the required renewal or continuation premium
typ ';and when due shall mean that you have not accepted our
c. The policy does not cover garage, automobile sales offer.
agency, repair shop, service station or public parking b. We will not refuse to renew Liability Coverage or
place operations hazards, Collision Coverage solely because an "insured" has
thel foll wing applies to nonrenewal of the Commercial Auto submitted claims under Comprehensive, Coverage or
il
C vera a Part in place of G.1.: Towing and Labor Coverage.
a. W may elect not to renew or continue this policy by c. If we fail to mail or deliver proper notice lof nonrenewal
1 ma ling or delivering to you and your agent or broker and you obtain other insurance this policy will end on
written notice at least 20 days before the end of the the effective date of that insurance.
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ISSUED BY:Travelers Casualtyand SuretyCompany of America POLICY NO:103034286
P Y
• ISSUED T :CITY OF RENTON,WASHINGTON
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CREDIT,DEBIT OR CHARGE CARD FORGERY
This endors ment applies only to the FORGERY OR ALTERATION COVERAGE FORM B.
A. S HE)DULE
Limit of Covered
Insurance Instruments
$1 000 000.00
0 includes
El limited to
B. P IROV SIONS
1.' CI vered Instruments either includes or is limited to, whichever is indicated as applicable in the SCHEDULE, written
in truments required in conjunction with any credit,debit or charge card issued to you or any"employee"for business purposes.
2.1 T e most we will pay in any one"occurrence"is the Limit of Insurance shown in the SCHEDULE.
3 I1' T e following Additional Exclusion is added:
N n-Compliance With Credit,Debit or Charge Card Issuer's Requirements: We will not pay for loss arising from any
cr dit,debit or charge card if you have not complied fully with the provisions,conditions or other terms under which the
ca d was issued.
II,
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CR1012 ill 86
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111
ISSUEID BY: Travelers Casualty and Surety Company of America POLICY NO:103034286
• ISSUED T :CITY OF RENTON,WASHINGTON
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
INCLUDE VOLUNTEER WORKERS AS EMPLOYEES
This endors ment applies to the CRIME GENERAL PROVISIONS and all Crime Coverage Forms forming part of the Policy.
PROVISI NS
"Employee" also includes any non-compensated natural person:
1. 0 her than one who is a fund solicitor,while performing services for you that are usual to the duties of an"employee";or
2. While acting as a fund solicitor during fund raising campaigns.
111
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CR 10 22 11 86
ISSUED B :Travelers Casualty and Surety Company of America POLICY NO:103034286
ISSUED T :CITY OF RENTON,WASHINGTON
0
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
INCLUDE SPECIFIED NON-COMPENSATED OFFICERS AS EMPLOYEES
VI Crime Coverage Forms formingpart of the Policy.
This endorsement applies to the CRIME GENERAL PROVISIONS and allg y
A. SCHEDULE
Names))or Titles of Non-Com s ensated Officers
Y
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B. PROV SIONS
"E nplo ee"also includes your non-compensated officers shown in the SCHEDULE.
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CR l b 26 10 90
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ISSUED BY: Travelers Casualty and Surety Company of America POLICY NO: 103034286
01 ISSUED T : CITY OF RENTON,WASHINGTON
i
I, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WELFARE AND PENSION PLAN ERISA COMPLIANCE
Provision 1. of this endorsement applies to the CRIME GENERAL PROVISIONS FORM and all Crime Coverage Forms forming part
of the ,!oli y. The other provisions of this endorsement apply only to the EMPLOYEE DISHONESTY COVERAGE FORM A—
BLANKET
PROV1SI NS
In complia ce with certain provisions of the Employee Retirement Income Security Act(ERISA):
1. "Empl yee"also includes any natural person who is:
a. trustee, an officer, employee, administrator or a manager, except an administrator or a manager who is an independent
contractor,of any Employee Welfare or Pension Benefit Plan(hereafter called Plan)insured under this insurance,and
b.I Your director or trustee while that person is handling funds or other property of any Plan insured under this insurance.
2. If',any Plan is insured jointly with any other entity under this insurance, you or the Plan Administrator must select a Limit of
Insurance for the EMPLOYEE DISHONESTY COVERAGE FORM that is sufficient to provide an amount of insurance for each
Plan th t is at least equal to that required if each Plan were separately insured.
id
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• 3. If the Insured first named in the Declarations is an entity other than a Plan,any payment we make to that Insured for loss sustained
by any Plan will be held by that Insured for the use and benefit of the Plan(s)sustaining the loss.
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4. Ifltwo or more Plans are insured under this insurance,any payment we make for loss:
a.! Sistained by two or more plans or
1.
b!'I f commingled funds or other property of two or more Plans
that a ses out of one "occurrence", is to be shared by each Plan sustaining loss in the proportion that the amount of insurance
II
requir�d for each such Plan under ERISA provisions bears to the total of those amounts.
5. Tpe D.ductible provision of the EMPLOYEE DISHONESTY COVERAGE FORM does not apply to loss sustained by any Plan
siibjec to ERISA which is insured under this insurance.
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CR1027 1186
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ISSUED BY:Travelers Casualty and Surety Company of America POLICY NO:103034286
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ISSUED TO:CITY OF RENTON,WASHINGTON
0
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
it
ADD FAITHFUL PERFORMANCE OF DUTY
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This endorsement applies only to PUBLIC EMPLOYEE DISHONESTY COVERAGE FORM 0 or P.
PROVISIONS
1. The f llowing is added as a Covered Cause of Loss:
1'I
Failure of any "employee" to faithfully perform his or her duties as prescribed by law, when such failure has as its direct and
11
immediate result a loss of your Covered Property.
2. The f Rowing Additional Exclusion is added:
II
Depository Failure: loss resulting from the failure of any entity acting as a depository for your property orproperty for which
y,l u are responsible.
1
3. Part 2.a.(1)of the Coverage Form is deleted and the following substituted:
III
Immediately upon discovery by you or any official or employee authorized to manage,govern or control your employees of any
act or,the part of an"employee"whether before or after becoming employed by you which would constitute a loss covered
finder the terms of this Coverage Form,as amended by this endorsement.
• 4. Part 2.c.of the Coverage Form is deleted and the following substituted:
Inden'inification:We will indemnify any of your officials who are required by law to give bonds for the faithful performance of their
service ag Iinst loss through the failure of any"employee" under the supervision of that official to faithfully perform his or her duties
as prescribed by law,when such failure has as its direct and immediate result a loss of your Covered Property.
1.
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4110 Ili
CR 10 44 12 93
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ISSUED BY:Travelers Casualty and Surety Company of America POLICY NO:103034286
0 I �
ISSUED T' :CITY OF RENTON,WASHINGTON
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
IAMEND TERRITORIAL LIMITS
This endorsement applies to the Crime Coverage Forms designated in the SCHEDULE.
A. SCHEDULE
Coverage ,orm Add Delete
All Add Worldwide
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B. P1OV SIONS
The Terri ory General Condition is amended for any Coverage Form shown in the SCHEDULE by adding or deleting the territory
ishown in t e SCHEDULE.
CR 5U 02 0 l 86
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ISSUED Br Travelers Casualty and Surety Company of America POLICY NO: 103034286
III
ISSUED TO: CITY OF RENTON,WASHINGTON
0
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
I'i AMENDED CANCELLATION AS TO ANY EMPLOYEE
This enl dors,ement applies to the EMPLOYEE DISHONESTY COVERAGE FORM.
11
PROVISIONS
1. Additional Exclusions,subsection Employee Cancelled Under Prior Insurance is deleted in its entirety and replaced by the
following:
Employee Cancelled Under Prior Insurance: loss caused by any"employee"of yours,or predecessor in interest of yours,for
whomI similar prior insurance has been cancelled and not reinstated since the last such cancellation unless the amount of such loss is
$10,000.00 or less.
2.Additional Condition is deleted in its entirety and replaced by the following:
Cancellati n As To Any Employee: This insurance is cancelled as to any"employee":
a.I�Im ediately upon discovery by:
(1) You;or
(2) Any of your partners,officers or directors not in collusion with the employee";
of aiiy dishonest act committed by that"employee"whether
(a) employed by you;or
(b) prior to becoming employed by you provided such dishonest act results
�II in a loss equal to or more than$10,000.00
• 1
and subject to you maintaining full written records concerning knowledge of the
rior dishonest act.
Ho ever,the above provision shall not apply if such dishonest act occurred in the course of,or in connection with,the
"empoyee s"current employment with you.
11
b.On the date specified in a notice mailed to you. That date will be at least 30 days
aft r the date of mailing. The mailing of notice to you at the last mailing address
known to us will be sufficient proof of notice. Delivery of notice is the same as
m.iling.
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F-2543a(16-99)
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ISSUED B :Travelers Casualty and Surety Company of America POLICY NO:103034286
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ISSUED T :CITY OF RENTON,WASHINGTON
•
1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDED DEFINITION OF EMPLOYEE-A
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This endorsement applies to the CRIME GENERAL PROVISIONS FORM and all Crime Coverage Forms forming part of the Policy.
PROVISI NS
Subpart a. 1)of "Employee"in the General Definitions is hereby deleted and replaced by the following:
"Employee"means:
a. Any natural person:
(1) While in your service(and for 90 days after termination of
service);and
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4110 ,
F-254I6a(16-99)
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ISSUED BY: Travelers Casualty and Surety Company of America POLICY NO: 103034286
III
ISSUED TO: CITY OF RENTON,WASHINGTON
•
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDED DUTIES IN EVENT OF LOSS AND JOINT INSURED
This endorsement applies to the CRIME GENERAL PROVISIONS FORM and all Crime Coverage Forms forming part of the policy.
PROVISIONS
GENERA CONDITIONS are amended as follows:
1. Dudes i the Event of Loss is deleted and replaced with the following:
D ties in the Event of Loss
A er any person in your Law,Internal Audit,Risk Management or Corporate Security Departments or any of your
C rporate Officers discovers a loss or a situation that may result in loss of,or damage to,Covered Property yoti must:
a. Notify us as soon as possible.
b. Submit to examination under oath at our request and give us a signed statement of your answers.
c. Give us a detailed,sworn proof of loss within 120 days.
d. Cooperate with us in the investigation and settlement of any claim.
0 2. Subsection b.of the Joint Insured section is deleted and replaced with the following:
Jo nt Insured
b. If any person in your Law,Internal Audit,Risk Management or Corporate Security Departments or any of your Corporate
Officers has knowledge of any information relevant to this insurance,that knowledge is considered knowledge of every
Insured.
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• II
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F-2547a (06-99)
ISSUER B :Travelers Casualty and Surety Company of America POLICY NO:103034286
ISSUED T I :CITY OF RENTON,WASHINGTON
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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ACQUISITION ENDORSEMENT
This ei dors ment applies to the CRIME GENERAL PROVISIONS.
PROVISI NS
GENERAL CONDITIONS,Consolidation-Merger part b is deleted and replaced with the following:
b. You acquire the use and control of any additional"premises";
any insurance afforded for"employees"or"premises"also applies to those
additional"employees"and"premises",but only if you:
a. Give us written notice within 30 days;and
b. Pay us an additional premium.
H wever,we agree to automatically extend such coverage as is afforded
un er this policy to any consolidation or merger with,or purchase of
as ets of,some other entity which has:
1. CI Less than $15.00 in revenues
El Less than $15.00 in assets; and
1110 I' 2. a three year,loss free claim history
without the payment of additional premium for the remainder of the
pr mium period.
F-2545a(06-99)
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ISSUED BY: Travelers Casualty and Surety Company of America POLICY NO: 103034286
111
SISSUED TO: CITY OF RENTON,WASHINGTON
I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
FUNDS TRANSFER FRAUD ENDORSEMENT
1
This endorsement applies to the COMPUTER FRAUD COVERAGE FORM F
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PROVISIONS
A.Covered ered Property is deleted in its entirety and replaced with the following:
1.Covered Property:
a) "Money","Securities",and"Property Other Than Money and Securities"for"Computer Fraud",or
b) "Money"and"Securities"contained in a"Transfer Account"on deposit at a"Financial Institution"resulting
directly from"Funds Transfer Fraud".
B. Covered Cause of Loss is deleted in its entirety and replaced with the following:
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2.Covered Cause of Loss:
II a) "Computer Fraud",or
b) "Funds Transfer Fraud".
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C.Additio al Definitions is amended to include the following:
11
Ii g."Funds Transfer Fraud"means:
(1) electronic, telegraphic, cable, teletype or telephone instructions fraudulently transmitted to a "Financial
Institution"directing such institution to debit a"Transfer Account" and to transfer,pay or deliver"Money" or
"Securities"from such"Transfer Account"which instructions purport to have been transmitted by you but were
• aC• in fact fraudulently transmitted by someone other than you without your knowledge or consent,or
(2) fraudulent written instructions (other than those covered under Coverage Form B) issued to a "Financial
i Institution,> "Transfer such institution to debit a Accountre and to transfer, pay or deliver"Money" or
II "Securities"from such"Transfer Account"by use of an electronic funds transfer system at specified intervals or
under specified conditions which instructions purport to have been issued by you but were in fact fraudulently
I issued,forged or altered by someone other than you without your knowledge or consent. I
h."Financial Institution"means:
(1)a banking,savings,thrift institution,or
'' (2) a stockbrokerage firm, mutual fund, liquid assets fund or similar investment institution where you maintain a
"Transfer Account".
li i."Transfer Account"means an account maintained by you at a"Financial Institution"from which you can initiate the
transfer,payment or delivery of "Money"or"Securities:"
(1)by means of electronic,telegraphic, cable,teletype, or telephone instructions communicated directly or through
II an electronic funds transfer system or,
(2)by means of written instructions (other than those covered under Coverage Form B) establishing the conditions
under which such transfers are to be initiated by such"Financial Institution"through an electronic funds transfer
11 system.
D.This en.orsement is effective at the inception date stated in Item 3 of the Declarations or effective at 12:01 a.m.on
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Jan ary 1,2007 ,if indicated herein.
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Accepted:
First Named Insured
•
Title
F-2552 4- 7
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ISSUED BY:Travelers Casualty andSurety Company of America POLICY NO:103034286
• ISSUED TO:CITY OF RENTON,WASHINGTON
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
SPECIAL CANCELLATION ENDORSEMENT
This endorsement applies to the COMMON POLICY CONDITIONS and all Crime Coverage Forms forming a part of the policy.
PRO 1 ISI NS
1. part g.b of Section A. CANCELLATION of the COMMON POLICY CONDITIONS,is hereby deleted and replaced with
the following:
90 days before the effective date of cancellation if we cancel for any other reason.
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41111
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F-2559(6-99)
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ISSUED BY:Travelers Casualty and Surety Company of America POLICY NO:103034286
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el ISSUD TO:CITY OF RENTON,WASHINGTON
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
;; INVESTIGATIVE COSTS
The follow ng is added as an additional Coverage Form to Item 4 of the Declarations:
INVESTIGATIVE COSTS COVERAGE FORM
Weshall i for"InvestigativeCosts"demmty incurred and paid by you.
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A.SCHE ULE
Limit of Insurance Deductible Amount
Investigati a Costs Coverage $100,000.00 $10,000.00
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B.PROVISIONS
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1. "Inves:igative Costs"coverage applies for the Limit of Insurance and Deductible Amount as shown in the above SCHEDULE.
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2. CRIME GENERAL PROVISIONS,Section A.General Exclusions,subsection 3.c.is deleted in its entirety.
3. GRIM GENERAL PROVISIONS,Section C.General Definitions is amended by adding the following definitional
5. "Investigative Costs"means reasonable expenses incurred and paid by you in establishing the existence and amount of
I
any direct loss covered under a Crime Coverage Form forming a part of this Policy. The reasonableness of such
1
ill expenses shall be determined by us and shall not include internal corporate obligations,such as employee,wages or
I. internal costs.
4. The m st we will pay for"Investigative Costs"in any one"occurrence"is the Limit of Insurance shown in the above
S1CHE ULE. That limit is part of,not in addition to,the Limit of Insurance for the applicable Crime Coverage Form shown in
the Declarations.
Nothing he�rein contained shall be held to vary,alter,waive or extend any of the terms,conditions,exclusions or limitations of the
abov -mentioned policy,except as expressly stated herein. This endorsement is part of such policy and incorporated therein.
This enndorsement is effective at the Inception Date stated in ITEM 3 of the Declarations or effective at 12:01 A.M. on
II
Janualry 1,2007,if indicated herein. Complete the following only when this endorsement is not prepared with the policy or is to
be effective on a date other than the Inception Date of the policy.
Accepted by:
On behalf of the entity named in
ITEM 1 of the Declarations. I
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Authorized Company Representative
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F-2565(01-01)
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ISSUED BY: Travelers Casualtyand SuretyCompany of America POLICY NO: 103034286
p Y
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ISSUED TO: CITY OF RENTON,WASHINGTON
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
INCLUDE STATUTORY BONDED OFFICIALS—EXCESS COVERAGE
This elndor ement applies to PUBLIC EMPLOYEE DISHONESTY COVERAGE FORM 0 only.
PROIIISI NS
1. PUBLIC EMPLOYEE DISHONESTY COVERAGE FORM 0 is amended by deleting subsections D.1.c.Bonded Employee
amid D.1.d.Treasurer or Tax Collector in their entirety.
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2. PUBLIC EMPLOYEE DISHONESTY COVERAGE FORM 0 is amended by deleting subsection D.2.c.Indemnification in its
entire
3. We wilpayfor lossyou sustain resultingdirectlyfrom"Employee Dishonesty"which is excess of the amount covered byany
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Indivi ual Public Official Bond. However,our payment will not be more than the Limit of Insurance set forth in Itiem 4 of the
Decla ations and shall be subject to the Deductible Amount set forth in Item 4 of the Declarations. I
Nothing h rein contained shall be held to vary,alter,waive or extend any of the terms,conditions,exclusions or limitations of the
above-mer1tioned policy,except as expressly stated herein. This endorsement is part of such policy and incorporated therein.
This endorsement is effective at the Inception Date stated in Item 3 of the Declarations or effective at 12:01 A.M.on
J1anu�ry 1,2007,if indicated herein. Complete the following only when this endorsement is not prepared with the policy or is to
be effective on a date other than the Inception Date of the policy.
11
0 Accepted by:
On behalf of the entity named in
Item 1 of the Declarations.
Authorized Company Representative
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• F-2709(03-03)
1
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ISSUED BY:Travelers Casualty and Surety Company of America POLICY NO:103034286
ISSUED TO:CITY OF RENTON,WASHINGTON
S
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADD/DELETE ENDORSEMENT I
In consideration of the payment of the premium of
T e following endorsement(s)have been added to the policy:
1
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The following endorsement(s)have been deleted from the policy:
Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, exclusions or limitations of the
above-mentioned policy,except as expressly stated herein. This endorsement is part of such policy and incorporated therein.
II
This endor ement is effective at the Inception Date stated in the Declarations or effective at 12:01 A.M.on January 1,2007
111 if indicate herein. Complete the following only when this endorsement is not prepared with the policy or is to be effective on a date
other than he Inception Date of the policy.
Accepted .y:
On behalf of the entity named in
ITEM 1 of the Declarations.
Authorized Company Representative
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ILT-1'1021 ;10-04)
1
TRAVELERS COMMERCIAL CRIME
0 V
RENEWAL CERTIFICATE POLICY NO. 183634286
Travelers Casualty and Surety Company of America
Hartford,CT 06183
(Stock Insurance Companies,herein called the Company)
In consideration of a renewal premium,Policy No. 103034286
issued to CITY OF RENTON,WASHINGTON
is renewed for the Policy Period from January 1,2007 to January 1,2010
subject to all the Agreements,Conditions and Limitations,and other terms of said policy_
Premium $25,818.00
Endorsements attached to this policy at renewal:
F-2552(04-97); F-2559(06-99); F-2543A(06-99); F-2545A(06-99); F-2546A(06-99); F-2541A(06-99);
F-2565(01-01); F-2709(03-03); ILT-1021 (10-04); CR-5002(01-86); CR-1026(10-90); CR-I012(01-86);
CR-1022(01-86)
S
124.4CIC Vi goy&
Authorized Company Representative
Countersigned by(if required)
F-1430-1 (06-99)
COMMERCE AND INDUSTRY INSURANCE COMPANY
(Executive Offices) (Administrative Offices)
70 PINE STREET 175 WATER STREET Ct of�e►1ipr:
NEW YORK, N.Y. 10270 NEW YORK, N.Y. 10038 eceived
• A Capital Stock Company MAY
(herein called the "Company")
Human
AIG Environmental® R►sk A/7Reo
STORAGE TANK THIRD-PARTY LIABILITY, CORRECTIVE ACTION AND CLEANUP COSTS
POLICY
DECLARATIONS
THIS IS A CLAIMS-MADE AND REPORTED POLICY. PLEASE READ CAREFULLY.
POLICY NUMBER: 007786457
Item 1. NAMED INSURED: City of Renton
ADDRESS: 1055 South Grady Way
Renton, WA 98055
Item 2. POLICY PERIOD: FROM 01/01/0 7 TO 01/0 1/0 8
12:01 AM Standard Time at the Address of the Named Insured shown above
Item 3. LIMIT OF LIABILITY: $ 1 , 0 0 0, 0 0 0 EACH INCIDENT LIMIT
• $ 1, 000, 000 AGGREGATE LIMIT
Item 4. DEDUCTIBLE: $ 5 , 0 0 0 EACH INCIDENT
Item 5. COVERED STORAGE TANK SYSTEM(S): See Storage Tank Schedule
Item 6. RETROACTIVE DATE: See Storage Tank Schedule
Item 7. POLICY PREMIUM: $1, 9 2 6 . 0 0
Premium for Certified Acts of Terrorism Coverage Under TRIA 2002 :
$90 . 00 Included in Policy Premium
Item 8. FORMS, ENDORSEMENTS AND SCHEDULES ATTACHED TO THIS POLICY: See Attached Form Schedule
BROKER:
Chamber Insurance Agency Services
B " "
Y
• AUTHORIZED REPRESENTATIVE
or countersignature (in states where applicable)
Copyright,American International Group,Inc,2002 Page 1 of 1
81206(11/02)
C11948
CIT0010
1
FORMS SCHEDULE
it
4111 Named Insured: City of Renton
Policy Number: 007786457
•
Effective 12 : 01 AM: 01/01/07
Forme Number/
Form {Name Edition Date
C&I Storage Tank 3rd Party Liability Decpage 81206 (11/02)
C&I Storage Tank 3rd Party Liability Policy 81106 (10/05)
SitelSchedule 81029 (10/02)
Schedule of Covered Storage Tank Systems 81017 (10/02)
1.
Separation Pat .on of Insureds Endorsement 81026 (10/02)
Notice of Loss/Notice of Claim CI1141 (09/00)
Limiat ' on of Loss .for Cert . Acts of Terrorism 81290 (12/02)
Coverag Territory Endorsement 89644 (07/05)
Washington Amendatory Endorsement 81048 (10/02)
Washington Cancellation/Nonrenewal Amen. Endt 78804 (10/03)
1
1111
{
•
CIFMS'C
CI0226
1
s AIG ENVIRONMENTAL
{ NOTICE OF LOSS/NOTICE OF CLAIM
INSTRUCTION•: PLEASE ATTACH ALL CORRESPONDENCE RELATING TO THIS NOTICE OF LOSS AND MAIL C
THIS NOTICE To EACH ADDRESS BELOW: OPIES OF
•
AI
Manager,Pollution Insurance Products Unit
AIG Technical Services,Inc.
Environmental Claims De artment
f 101 Hudson Street,31 a Floor
Jersey City,NJ 07302
•
Date of Notl°ice:
NAMD INS E URED:
p Telephone: ( )
. ADDRESS OF INSURED: .
C -
BROKER NAf,ME':
Telephone: ( )
Contact s
BROKER ADDRESS:
1 I
f I
POLICY
.p INFORMATION:
^Policy Number:
. olicy Pef I�.
SS INFORMATION:
ss Location:
Date&Description of loss:
,
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For AIG Use Only:
Date Claim Noltice eceived:
Date of Claim:
Company/Person fling Suit(if applicable):
f
4110"
E: Any l ers n who knowingly files a Statement of Claim containing any false or misleading information is subject to
/nal and civil enalties.
CI1141 (9/00)
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1
ENDORSEMENT
This en orsement, effective 12 : 01 AM, 01/01/07
Form , a part of Policy No : 007786457
41/11
Issued to : City of Renton
By: dom erce and Industry Insurance Company
1 AIG ENVIRONMENTAL STORAGE TANK
THIRD-PARTY LIABILITY AND CLEAN-UP COSTS POLICY
SITE SCHEDULE
Site# Facilit Name/Address, Cit , State, Zi.
� I
1 i' Maplewood Golf Course
400 Maple Valley Hwy
1 Renton, WA 98055
2 { P/B/PW
3555 NE 2nd street
Renton, WA 98056
;
4111
All other terms, conditions, and cl ions ,al/01r a 'n !!e sate .
AUTHORIZED REPRESENTATIVE
or countersignature (in states where applicable)
I �
41/0 ,
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81029410/02)
CI2254
ENDORSEMENT
This endorsement, effective 12 : 01 AM, 01/01/07
Forms a part of Policy No : 007786457•
11
Issued to: City of Renton
By: Commerce and Industry Insurance Company
TH S ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. .
ii SCHEDULE OF COVERED STORAGE TANK SYSTEMS
It is agreed that any previous Schedule of Coverage Storage Tank' Systems
is deleted in its entirety and replaced with the following:
i
The following Storage Tank System(s) are included in Item 5 . COVERED
STORAGE TANK SYSTEM(S) of the Declarations, subject to all of the terms
and '.conditions of the Policy and the Policy Period and Retroactive date
indicca 'ed below. If no dates are indicated below for Policy Period for
a subj ct Storage Tank System, the dates indicated in Item 2 . Policy
Peri;bd of the Declarations shall apply. If no date is indicated below
for Retro Date for a subject Storage Tank System, the date indicated in
Item16 . Retroactive Date of the Declarations shall apply. If a Policy
Period is indicated below for a subject Storage Tank System, Item. 2
Policy Period of the Declarations is deleted in its entirety and replaced
with: the Policy Period, below, for such Storage Tank System. If a date
is indicated below for Retro Date for a subject Storage Tank System, the
IIIdateliindicated in Item 6 . Retroactive Date of the Declarations is deleted
in Tilts entirety and replaced with Retro Date, below, for such Storage
Tank' System.
1 I
Site Tank AST/ Install Capacity Tank Effective Expiration Retro
# 1i # UST Date (Gal . ) Const . Date Date 1 Date
1 ii 1 UST 1991 550 DF 1/01/07 01/01/08 16/10/91
2 1 UST 1985 12, 000 DF 1/01/07 01/01/08 ' 6/10/91
2 ; 2 UST 1985 12, 000 DF 1/01/07 01/01/08 16/10/91
II 1
*Site#, name and address are located within the Site Schedule attached
to tlhe Policy.
11 1
All 'Other terms, conditions, and exclusions shall remain the same .
I!
,-;N54..e..- -.021
AUTHORIZ REPRESENTATIVE
or countersignature (in states where applicable)
1
1
II i
ii
1
8101P (10/02)
CI2253
l
�+ I
•
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ENDORSEMENT
This ,endorsement, effective 12 : 01 AM, 01/01/07
Formsla part of Policy No. : 007786457
Issuer to: City of Renton
By: Com erce and Industry Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SEPARATION OF INSUREDS CONDITION ENDORSEMENT
It is here y agreed that the Policy is amended by the addition of the following condition to Section VI.
CONDITIOIIlS:
Selparation of Insureds - It is hereby agreed that except with respect to the Limit of Liability, Section II.
E.1 (Inslured vs. Insured exclusion), and any rights and duties specifically assigned to the first'Named
Insured, this insurance applies:
1. As if each Named Insured were the only Named Insured; and
2H Separately to each Named Insured against whom a Claim is made.
•
Misrepresentation, concealment, breach of a term or condition, or violation of any duty under this Policy
by)one Named Insured shall not prejudice the interest of coverage for another Named Insured under this
Policy. Provided, however, that this Condition shall not apply to any Named Insured who is a parent,
subsidiary or affiliate of the first Named Insured.
� I
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All otter terms, conditions, and exclusions shall remain the same.
j�411
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AUTHORIZED REPRESENTATIVE
or countersignature (in states where applicable)
81020 (1 /02) PAGE 1 OF 1
CI1904
I I
1 I
ENDORSEMENT NO.
This len orsement, effective 12 : 01 AM, 01/01/07
Formsa part of Policy No. : 007786457
I I
Issued o : City of Renton
pi
By: Commerce and Industry Insurance Company
{ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LIMITATION OF LOSSES FOR CERTIFIED ACTS OF TERRORISM
Our liability for loss, injury, damage, claim or suit, arising directly or indirectly as a result of or in connection
with a certified "act of terrorism" defined by Section 102. Definitions., of the Terrorism Risk Insurance Act of
2002 (the Act), and any revisions or amendments, is limited by Section 103. Terrorism Insurance Program, of the
Act.
II
11
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All othe terms, conditions, and exclusions shall remain the same.
/e1;6ftee'
•
AUTHORIZED REPRESENTATIVE
or countersignature (in states where applicable)
81290 (112/ 2) PAGE 1 OF 1
CI1980
� I
'i AIG ENVIRONMENTAL
NOTICE OF LOSS/NOTICE OF CLAIM 1
I
INSTRUCTIONS PLEASE ATTACH ALL CORRESPONDENCE RELATING TO THIS NOTICE OF LOSS AND MAIL COPIES OF
THIS NOTICE TO EACH ADDRESS BELOW:
III ) • . Manager,Pollution Insurance Products Unit
AIG Technical Services,Inc.
Environmental Claims Department
101 Hudson Street,31 a Floor
'i Jersey City,NJ 07302
Date of Notice:
r
NAMED INSURED: Telephone:
. ADDRESS®F INSURED: • •
•
I
-
BROKER NAME: Telephone:
Contact
BROKER ADD1tESS:
•
POUCY INFI ATION:
Policy Number:
II
lssnSS INFORMATION:
Locatio n.
I
I')
Date&Description of Loss:
I,
•
•
I
I'I
i
For AIG Use Only;
Date Claim Notice Received:
Date of Claim'i
Company/Person Filing Suit(if applicable):
E: Any person who knowingly files a Statement of Claim containing any false or misleading information is subject to
•
Thal and'civil penalties.
CI1141 (9/00)
lj
1
• j ENDORSEMENT NO.
This endorsement, effective 12 : 01 AM, 01/01/07
FormSl a part of Policy No. : 007786457
Issued to: City of Renton
� I
By: Commerce and Industry Insurance Company
;
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
r LIMITATION OF LOSSES FOR CERTIFIED ACTS OF TERRORISM
Our liability for loss, injury, damage, claim or suit, arising directly or indirectly as a result of or in connection
with a certiflied "act of terrorism" defined by Section 102. Definitions., of the Terrorism Risk Insurance Act of
2002 (thie Act), and any revisions or amendments, is limited by Section 103. Terrorism Insurance Program, of the
Act.
All otheri terms, conditions, and exclusions shall remain the same.
AUTHORIZED REPRESENTATIVE
or countersignature (in states where applicable)
I'. I
81290 (11
2/02) PAGE 1 OF 1
CI1980 11
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•
ENDORSEMENT NO.
4111 It
This endorsement, effective 12 : 01 AM, 01/01/07
Forms a part of Policy No. : 007786457
Issued to: City of Renton
By: Commerce and Industry Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
II COVERAGE TERRITORY ENDORSEMENT
Payment of loss under this policy shall only be made in full compliance with all United States of America
economic or trade sanction laws or regulations, including, but not limited to, sanctions, laws and regulations
administered and enforced by the U.S. Treasury Department's Office of Foreign Assets Control ("OFAC").
y �
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All other terms, conditions, and exclusions shall remain the same.
•
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AUTHORIZED R PRESENTATIVE
or countersignature (in states where applicable)
89644 (7/05) PAGE 1 OF 1
CI271R71
1
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j
I,
ENDORSEMENT NO.
This endorsement, effective 12 : 01 AM, 01/01/07
Forms a part of Policy No. : 007786457
� I
Issued to : City of Renton
� 1
By: Commerce and Industry Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
CAREFULLY.
i WASHINGTONAMENDATORY ENDORSEMENT
It is hereby agreed that the Policy is amended as follows:
I
1. Thle scond sub-paragraph of Section VI. CONDITIONS, Paragraph B. Subrogation is
deleted in its entirety and replaced with the following:
In !the event of any recovery by the Company as result of subrogation proceedings larising
out of a Loss, Clean-Up Costs or Corrective Action covered under this Policy, the
Company shall, from the funds collected, first pay to the Insured the applicable deductible
paid by the Insured less the prorated share of subrogation expenses and only therleafter
retain any funds in excess of the deductible portion of the recovery.
•
2. Suction VI. CONDITIONS, Paragraph N. Choice of Law, is deleted in its entirety.
I'
All other terms and conditions shall remain the same. I
I I
' ....."61.c.-•
AUTHORIZED REPRES NTATIVE
or countersignature (instates where applicable)
!�
81048 (10/02)
CI1926
ENDORSEMENT NO.
• This endorsement, effective 12 : 01 AM, 01/01/07
Formsl a part of Policy No. : 007786457
Issued to: City of Renton
By: Commerce and Industry Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WASHINGTON AMENDATORY ENDORSEMENT
Wherever used in this endorsement: 1) "Insurer" means the insurance company which issued this
policy; and 2) "Named Insured", "First Named Insured", and "Insured" mean the Named Corporation,
Named Organization, Named Sponsor, Named Insured, Named Entity or Insured stated in the
declaration's page.
The fol(owirg is added and supersedes any provision to the contrary:
A. CANCELLATION
1. The Insured may cancel this policy by mailing or delivering to the Insurer written notice of
jca cellation or by surrender of the policy prior to or on the effective date of such cancellation.
2. IjTh Insurer may cancel this policy by mailing or delivering to the Insured and the In'sured's
• I�representative in charge of the subject of the insurance, if applicable, written notice of
cancellation, including the actual reason for the cancellation, to the last mailing address, known
to the Insurer, at least:
a. 10 days before the effective date of cancellation if the Insurer cancels for nonpayment,of
premium; or
I �
b. 45 days before the effective date of cancellation if the Insurer cancels for any other reason.
3. Like notice of cancellation will also be mailed to any mortgage holder, pledgee or other person
shown in this policy with an interest in any loss which may occur thereunder, at their last mailing
address known to the Insurer.
4. Notice of cancellation will state the effective date of cancellation. The policy period will end on
thalt date.
i I
5. If rotice is mailed, proof of mailing will be sufficient proof of notice.
6. If the policy is cancelled, we will send the first Named Insured any premium refund due. If the
Insurer cancels, the refund will be pro rata. If the first Named Insured cancels, the refund will be
at least 90% of the pro rata refund. The cancellation will be effective even if we have not made
or offered a refund.
�I I
B. NONRENEWAL
1. The Insurer may elect not to renew this policy by mailing or delivering written notice of
nonrenewal, to the First Named Insured and the First Named Insured's representative in charge
of the subject of the insurance at their respective last mailing addresses known to the Insurer.
The notice of nonrenewal shall state the actual reason for nonrenewal. The Insurer will, also
78804 (10/03) Page 1 of 2
CI2261
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ENDORSEMENT NO.
(Continued)
• mail to any mortgage holder or other person shown in this policy with an interest in anf loss
frhich may occur thereunder, at their last mailing address known to the Insurer, written notice of
nonrenewal.,The Insurer will mail or deliver these notices at least 45 days before the: 1
I,. Expiration of the policy; or
b. Anniversary date of this policy if this policy has been written for a term of more than one
year.
otherwise, the Insurer will renew this policy unless:
a. The Insured fails to pay the renewal premium after the Insurer has expressed willingness to
1,
renew and has sent a statement of the renewal premium to the Insured and the Insured's
lepresentative in charge of the subject of insurance at least 20 days before the expiration
date;
p. Other equivalent coverage has been procured by the Insured prior to the expiration date of
he policy; or
C. The contract is evidenced by a written binder containing a clearly stated expiration date
li which has expired according to its terms.
Ir
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All other terms and conditions shall remain the same.
7e036tee,
I' AUTHORIZED REPRESENTATIVE
or countersignature (instates where applicable)
788041(110 03) Page 2 of 2
C I2261 g
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II INTERNATIONAL COMPANIES@ 1
I AIG ENVIRONMENTAL®
• STORAGE TANK THIRD-PARTY LIABILITY, CORRECTIVE ACTION AND CLEAN-UP
!I COSTS POLICY
I1 1
NOTICE: THIS IS A CLAIMS-MADE-AND-REPORTED POLICY. PLEASE READ CAREFULLY. ADDITIONALLY,
THIS POLIO' HAS CERTAIN PROVISIONS AND REQUIREMENTS UNIQUE TO IT AND MAY BE DIFFERENT
FROM OTHER POLICIES THE : INSURED MAY HAVE PURCHASED. DEFINED TERMS, OTHER THAN
HEADINGS,APPEAR IN BOLD FACE TYPE.
THE DESCRIPTIONS IN ANY HEADINGS OR SUB-HEADINGS OF THIS POLICY ARE INSERTED SOLELY FOR
CONVENtEt CE AND DO NOT CONSTITUTE ANY PART OF THE TERMS OR CONDITIONS HEREOF.
11
In consideration of the payment of the premium, in reliance upon the statements in the Declarations anti the
Application, annexed hereto and made a part of this Policy or, if not annexed hereto,which are deemed to be annexed
hereto and made a part of this Policy, and pursuant to all of the terms of this Policy, the Company agrees with the
Named Insured as follows:
•
I. INSURING AGREEMENT
1
1. OVERAGES:
1
COVE GE A-THIRD PARTY BODILY INJURY AND PROPERTY DAMAGE DUE TO A STORAGE TANK
RELEA$E
To p'ay on behalf of the Insured, Loss that the Insured becomes legally obligated to pay as a result of Claims
0 for Bodily Injury or Property Damage resulting from Pollution Conditions from a covered Storage Tank
System,i provided such Claims are first made against the Insured and reported to the Company in writing
during the Policy Period or during the Extended Reporting Period, if applicable. The Pollution Condition
must commence on or after the Retroactive Date as shown in Item 6 of the Declarations. I
I
COVERAGE B -CLEAN-UP COSTS OR CORRECTIVE ACTION DUE TO A STORAGE TANK RELEASE
To pay on behalf of the Insured, Clean-Up Costs or Corrective Action that the Insured becomes legally
obligated to pay as a result of a Confirmed Release from a covered Storage Tank System, provided such
Confirt+d Release is first reported to the Company in writing during the Policy Period or during the
Extended Reporting Period, if applicable. The Pollution Condition must commence on or after the
Retroactive Date as shown in Item 6 of the Declarations.
1
2. DEFENSE:
1'
Thel,Corppany shall have the right and duty to defend any Claims covered under Coverage A or any civil or
administrrative proceedings or suits which seek to impose a legal obligation upon the Insured to undertake
Clean-Ulp Costs. or Corrective Action for a Confirmed Release to which Coverage B applies. The
Company's duty to defend or continue defending any such Claims, civil or administrative proceedings or suits
and lto pay. any Loss, Corrective Action, Clean-Up Costs or defense costs, charges and expenses, shall
cease once the applicable limit of liability, as described in Section V. LIMITS OF LIABILITY AND
DEDUCTIBLE, has been exhausted.
1!'
3. INDEPENDENT COUNSEL: .
I
II
In• the event the Insured is entitled by law to select independent counsel to defend the Insured at the Company's
expense, the attorney fees and all other litigation expenses the Company must pay to that counsel are limited to
II
81106( 0/00)
CI2766 '
1
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the rates the Company would actually P Y pay to counsel that the Company retains in the ordinary course of business
in the defense of similar Claims in the community where the Claim arose or is being defended.
• i�
Additionally, the Company may exercise the right to require that such counsel have certain minimum qualifications
with respect to their competency, including experience in defending Claims similar to the one pending against the
Insured and to require such counsel to have errors and omissions insurance coverage. As respects any such
counsel J the Insured agrees that counsel will timely respond to the Company's request for information regarding
the Clain.The Insured may at any time, by its signed consent,freely and fully waive its right to select independent
counsel.
4. (SETTLEMENT:
Thep Company will present any settlement offers to the Insured, and if the Insured refuses to consent to any
settlement within the limits of liability of this Policy recommended by the Company and acceptable to the claimant,
the Company's duty to defend the Insured shall then cease and the Insured shall thereafter negotiate or defend
such Claim independently of the Company and the Company's liability shall not exceed the amount, less the
Deductible or any outstanding Deductible balance, for which the Claim could have been settled( if such
recommendation was consented to.
II. EXCLUSIONS
1. 'COMMON EXCLUSIONS-APPLICABLE TO ALL COVERAGES:
I I
This Policy does not apply to Claims, Clean-Up Costs or Corrective Action,or Loss:
A. CRIMINAL FINES,PENALTIES,AND ASSESSMENTS:
Due to any criminal fines,criminal penalties or criminal assessments.
113. CONTRACTUAL LIABILITY:
I
Arising from liability of others assumed by the Insured under any contract or agreement, unless the liability
of the Insured would have attached in the absence of such contract or agreement or the contract or
I'
agreement is an Insured Contract.
0. NTENTIONAL NONCOMPLIANCE:
I' ising from Pollution Conditions based upon or attributable to anyResponsible p nsible Insured's intentional,
willful or deliberate noncompliance with any statute, regulation including those set forth in Title 40 of the
Code of Federal Regulations, ordinance, administrative complaint, notice of violation, notice letter,
executive order,or instruction of any governmental agency or body.
D. INTERNAL EXPENSES:
IP
For costs, charges or expenses incurred by the Insured for goods supplied or services performed by the
taff or salaried employees of the Insured, or its parent, subsidiary or affiliate, except if in response to an
emergency or pursuant to Environmental Laws that require immediate remediation of Pollution
Conditions, or unless such costs, charges or expenses are incurred with the prior written approval of the
Company in its sole discretion.
11
•
81106 (10/05)
CI2766
2
E. INSURED vs.INSURED:
Arising from a Claim brought by any Insured against any other person or entity who is also an Insured
• under this Policy. This exclusion does not apply to Claims initiated by third parties or Claims that arise out
of an indemnification given by one Named Insured
to another Named Insured in an Insured Contract.
F. EMPLOYER LIABILITY:
Arising from Bodily Injury to an Insured or its parent,subsidiary or affiliate arising out of and in the course
of employment by the Insured or its parent, subsidiary or affiliate. This exclusion applies whether the
WInsured may be liable as an employer or in any other capacity and to any obligation to share damages
ith or repay third parties who must pay damages because of the injury.
G. 1DRIOR KNOWLEDGE/NON-DISCLOSURE:
Arising from Pollution Conditions existing prior to the Inception Date and known by a Responsible
insured and not disclosed in the application for this Policy, or any previous policy for which this Policy is a
renewal thereof.
H. COST TO CONFIRM A RELEASE FROM A STORAGE TANK SYSTEM:
For any costs, charges or expenses incurred to investigate or certify that a Confirmed Release has taken
place.
I: �OST TO REPAIR, REPLACE OR UPGRADE A STORAGE TANK SYSTEM:
For any costs arising out of the reconstruction, repair, replacement, upgrading or rebuilding iof any
•
Storage Tank System or for any other improvements, site enhancements or routine maintenance on,
within or under the site at which Storage Tank Systems are located.
•
J. DIVESTED STORAGE TANK SYSTEMS OR SITES:
•
Arising from Pollution Conditions or Confirmed Releases which commence after the date'that a
covered Storage Tank System, or the site at which the Storage Tank System is located, is sold,
given away, abandoned, or subleased, unless the sublease has been approved in writing by the
underwriter prior to the commencement of the sublease.
K. STORAGE TANK SYSTEM CONTENTS:
1 Arising from physical injury, including but not limited to contamina
Tank System; or tion, of the contents of a Storage
2. Arising out of Property Damage due to physical injury, including but not limited to contamination,
of the contents of a Storage Tank System; or
• 3. For any costs arising out of the removing, replacing or recycling of the contents of an Stora e
Tank System. y g
L. WAR
Arising directly or indirectly as a result of or in connection with war, whether declared or not, or any act
or condition incident to war. War includes civil war, insurrection, act of foreign enemy, civil commotion,
factional civil commotion, military or usurped power, rebellion or revolution.
•1106 (10/05)
C12766
3
III. NOTICE REQUIREMENTS AND CLAIM PROVISIONS
The Insured shall provide the Company with notice of Confirmed Release, Claim and Pollution Conditions, as
follows:
1. In the event of a Confirmed Release, Claim or Pollution Condition, the Insured shall give written notice
to:
•
•
Manager, Pollution Insurance Products Unit
AIG Technical Services, Inc.
Environmental Claims Department
101 Hudson St. -31st Floor
Jersey City, NJ 07302
Fax: 201-631-5051
or other address(es)as substituted by the Company in writing.
2. The Insured shall give written notice of Claims, a Confirmed Release or Pollution Conditions as soon
ii as possible, but in any event during the Policy Period or during the Extended Reporting Period, if
applicable. Notice under all coverages shall include, at a minimum, information sufficient to identify the
Named Insured, the Storage Tank System, the names of persons with knowledge of the Pollution
(Conditions and all known and reasonably obtainable information regarding the time,place, cause, nature
of and other circumstances of the Pollution Conditions. The Insured shall forward the following to the
Company as soon as possible:
(a) All reasonably obtainable information with respect to the time, place and circumstances thereof, and
the names and addresses of the claimant(s)and available witnesses;
(b) All correspondence between the Insured and any third party Claimant, including but not limited to
• any Implementing Agency; and all demands, summonses, notices or other process or papers filed
with a court of law, administrative agency, Implementing Agency or an investigative body; and
(c) Other information in the possession of the Insured or its hired experts which the Company reasonably
deems necessary.
IV. RIGHTS OF THE COMPANY AND DUTIES OF THE INSURED IN THE EVENT OF POLLUTION CONDITIONS
A. The Company's Rights
nThe Company shall have the right but not the duty to clean up or mitigate Pollution Conditions upon receiving
otice as provided in Section III. of this Policy. Any sums expended in taking such action by the Company will
be deemed incurred or expended by the Insured and shall be applied against the limits of liability and
deductible under this Policy.
B. Duties of the Insured
I
The Named Insured shall have the duty to clean up Pollution Conditions to the extent required by
Envi Lonmental Laws, by retaining competent professional(s) or contractor(s) mutually acceptable to the
Company and the Named Insured. The Company shall have the right but not the duty to review and approve
all aspects of any such clean-up. The Named Insured shall notify the Company of actions and measures
taken pursuant to this Paragraph.
V. LIMITS OF LIABILITY AND DEDUCTIBLE
II
81106 (10/05)
C12766
4
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Regardless of the number of Claims, Claimants, Confirmed Releases, Pollution Conditions or Insureds
under this Policy, the following limits of liability apply:
A. Coverage A and B Aggregate
The Company's total liability for all Loss covered under Coverage A and Clean-Up Costs and Corrective
Action covered under Coverage B shall not exceed the "Aggregate Limit" stated in Item 3 of the
Decl rations.
B. Each Incident Limit
Subject to Paragraph V.A. above, the most the Company will pay for all Loss and Clean-Up Costs and
Corrective Action arising from the same, related or continuous Pollution Conditions is the "Each ,Incident"
elimit lOf coverage stated in Item 3 of the Declarations. "Each Incident" as used within this Policy shall mean
ach same,related or continuous Pollution Condition.
C. Related Claims
1. I the Insured first reports a Claim, Confirmed Release or di an discovers Pollution Conditions during the
Policy Period and reports them to the Company y in accordance with Section Ill., all continuous or
related Pollution Conditions reported to the Company under a subsequent policy issued by the
11 DCompany or its affiliate providing substantially the same coverages as this Policy shall be deemed to
ave been first discovered and reported during this Policy Period and shall be subject to the same
L.imit of Liability.
jAll Claims and reports of Confirmed Releases made during one or more policy periods issued by the
l Company or its affiliate providing substantially the same coverages, resulting in Loss, or Clean-Up
Costs or Corrective Action, or in any combination thereof, and arising out of the same, or continuous
11 or related Pollution Conditions,shall be considered one incident and will be subject to the same Limit
• of Liability. Such Claims or reports of Confirmed Releases shall be deemed first reported to the
I;' company during the policy period in which the first such Claim or report of Confirmed Release
was
reported to the Company or an affiliate and will be subject to the Limit of Liability applicable to that
I; policy period.
D. Iledu tible
Subj ct to Paragraphs V.A..and V.B.above,this Policywill payClean-Up n Up Costs,Corrective Action,or Loss
in excess of the Deductible amount stated in Item 4 of the Declarations up to but not exceeding the applicable
"Each Incident"limit of coverage.
The Insured shall promptly reimburse the Company for advancing any element of Clean-Up Costs or
C'orrOctive Action or Loss falling within the Deductible.
VI. CONDITIONS
A. Assignment -This Policy may be assigned with the prior written consent
of shall not be unreasonably withheld or delayed. Assignment of interest underthe Mils Policy shall not bind the
dompany until its consent is endorsed thereon.
B. Subrogation - In the event of any payment under this Policy, the Company shall be subrogated to all the
Insured's rights of recovery therefor against any person or organization and the Insured shall execute and
deliver instruments and papers and do whatever else is necessary to secure such rights including'without
limitation, assignment of the Insured's rights against any person or organization who caused Pollution
101106 (10/05)
CI2766 �I
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Conditions on account of which the Company made any payment under this Policy. The Insured shall do
nothing to prejudice the Company's rights under this Paragraph subsequent to Loss.
Any recovery as a result of subrogation proceedings arising out of the payment of Loss, Clean-Up!Costs
f� or Corrective Action covered under this Policy shall accrue first to the Insured to the extent of any
payments in excess of the limit of coverage; then to the Company to the extent of its paent ' er the
Policy; and then to the Insured to the extent of its Deductible. Expenses incurred in such subrogation
proceedings shall be apportioned among the interested parties in the recovery in the proportion that each
interested party's share in the recovery bears to the total recovery.
C. Crooperation - The Insured shall cooperate with the Comp
any and offer all reasonable assistance in the
investigation and defense of Claims under the applicable Coverages purchased. The Company may require
that the Insured submit to examination under oath,and attend hearings, depositions and trials. In the course of
in11
vestigation or defense, the Company may require written statements or the Insured's attendance at
meetings with the Company. The Insured must assist the Company in effecting settlement, securing and
providing evidence and obtaining the attendance of witnesses.
D. Changes - Notice to any agent or knowledge possessed by any agent or by any other person shall not
e11
ffect waiver or a change in any part of this Policy or estop the Company from asserting any rights under
the tel ms of this Policy; nor shall the terms of this Polic be or
issued by the Company to form a part of this Policy. y waived changed, except by endorsement
E. assume
Payments - No Insured shall voluntarily enter into any settlement, or make an
any obligation unless in response to an emergency or pursuant to Environmental Laws thatrequire
immediate remediation of Pollution Conditions, without the Company's consent which shall not be
unreasonably withheld,except at the Insured's own cost.
F. Concealment or Fraud - This entire Policy shall be void if, whether before or after Clean-Up Costs or
Corrective Action are incurred or a Claim is first made, the Named Insured has willfully concealed or
•
misrepresented any fact or circumstance material to the granting of coverage under this Policy, including
but not limited to, the description of the Storage Tank System,Y or the interest of the Insured therein.
G. Canc illation -This Policy may be cancelled by the Named Insured by surrender thereof to the Company or
any o its authorized agents or by mailing to the Company written notice stating when thereafter the
cancellation shall be effective.This Policy may be cancelled by the Company only for the reasons st
ated below
by,mailing to the Named Insured at the address shown in the Policy,written notice stating when, not less than
60 days (1.0 days for nonpayment of premium or material misrepresentation by the Insured), thereafter such
cancellation shall be effective.Proof of mailing of such notice shall be sufficient proof of notice.
1. Material misrepresentation by the Insured;
2.I' The Insured's failure to comply with the material terms, conditions or contractual obligations under this
Policy, including failure to pay any premium when due;
3. A change in operations at a facility containing a Storage Tank System during the Policy Period that
materially increases a risk covered under this Policy.
The time of surrender or the effective date and hour of cancellation stated in the notice shall become the end of
they Policy Period. Delivery of such written notice either by the Named Insured or by the Company shall be
equivalent to mailing. If the Named Insured cancels, earned premium shall be computed in accordance with
the customary short rate table and procedure. If the Company cancels, earned premium shall be computed
pro-rat . Premium adjustment may be either at the time cancellation is effected or as soon as practicable after
cancellation becomes effective,but payment or tender of unearned premium is not a condition of cancellation.
•1106(10/ 5)
CI2766
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•
H. j;Other Insurance-If other valid and collectible insurance or funds from any Tank Fund are available to the
Insured for Loss, Clean-Up Costs or Corrective Action covered by this Policy, the insured shall
promptly, upon the request of the Company, provide the Company with copies of all such policies or fund
'docdmentation.The Company's obligations are limited as follows:
•
jI1. Except as set forth in subparagraph 3. of this Paragraph, this insurance is primary, and the Company's
obligations are not affected unless any of the other insurance is also primary. In that case, the
Company will share with all such other insurance by the method described in Paragraph 2. below.
2. If all of the other insurance permits contribution by equal shares, the Company will follow this method
Iso. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of
Linsurance or none of the loss remains, whichever comes first. If any of the other insurance does not
permit contribution by equal shares, the Company will contribute by limits. Under this method, each
insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of
insurance of all insurers.
�3. his insurance shall apply as excess insurance over any Tank Fund, provided that in the event of the
receivership, insolvency, or inability to pay of any state fund or program, this insurance shall act as
ji rimary insurance. Where this insurance is excess, the Company will pay only its share of the amount
of Loss, Clean-Up Costs or Corrective Action, if any, that exceeds the total amount available
through the Tank Fund.
I. Right of Access and Inspection — To the extent the Insured has such rights, any of the Company's
eauthbrized representatives shall have the right and opportunity but not the obligation to interview persons
mployed by the Insured and to inspect at any reasonable time,during the Policy Period or thereafter, the
itStorage Tank System or the site at which the Storage Tank System is located. Neither the Company nor
s representatives shall assume any responsibility or duty to the Insured or to any other party, person or
entity, by reason of such right or inspection. Neither the Company's right to make inspections, sample and
omonitor, nor the actual undertaking thereof nor any report thereon shall constitute an undertaking on behalf
111 f the Insured or others, to determine or warrant that property or operations are safe, healthful or conform
to acceptable engineering practices or are in compliance with any law, rule or regulation. The Named Insued agrees to provide appropriate personnel to assist the Company's representatives during any
inspection.
J. cc ss to Information - The Named Insured agrees to provide the Company with access to any
information developed or discovered by the Insured concerning Loss, Clean-Up Costs or Corrective
Actidn, or Pollution Conditions covered under this Policy, whether or not deemed by the Insured to be
relevant to such Loss, Clean-Up Costs or Corrective Action, or Pollution"Conditions and to provide the
Company access to interview any Insured and review any documents of the Insured.
K. Representations - By acceptance of this Policy, the Named Insured agrees that the statements in the
Declarations, the Application and, if applicable, the Report/Worksheet are their warranties, agreements and
representations, that this Policy is issued in reliance upon the truth of such warranties, agreements and
Crepresentations and that this Policy embodies all agreements existing between the Insured and the
ompany or any of its agents relating to this insurance.
•
L. Action Against Company- No third-party action shall lie against the Company, unless as a condition
precedent thereto there shall have been full compliance with all of the terms of this Policy, nor until the
amount of the Insured's obligation to pay shall have been finally determined either by judgment against the
Insur d after actual trial or by written agreement of the Insured, the claimant and the Company.
III plerson or organization or the legal representative thereof who has secured such judgment or written
agreement shall thereafter be entitled to recover under this Policy to the extent of the insurance afforded,by the
Policy No person or organization shall have any right under this Policy to join the Company as a party'to any
action against the Insured to determine the Insured's liability, nor shall the Company be impleaded by the
01106 (10/05)
CI2766
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Insured or his legal representative. Bankruptcy or insolvency of the Insured or of the Insured's estate shall
''not relieve the Company of any of its obligations hereunder.
M. 1Art itration - It is hereby understood and agreed that all disputes or differences that may arise under or in
connection with this Policy, whether arising before or after termination of this Policy, including any
determination of the amount of Loss, may be submitted to the American Arbitration Association ("AAA")
I,under and in accordance with the United States Arbitration Act (9 U.S.C.) and the then prevailing
! commercial arbitration rules of the AAA. The arbitrators shall be chosen in the manner and within',the time
''frames provided by such rules. If permitted under such rules, the arbitrators shall be three disinterested
indilviduals having knowledge of the legal, corporate management, or insurance issues relevant to the
!,matters in dispute.
!'Any party may commence such arbitration proceeding and the arbitration shall be conducted in the
,!Ins red's state of domicile. The arbitrators shall give due consideration to the general principles of the law
of the Insured's state of domicile in the construction and interpretation of the provisions of this Policy;
I'Iprovided, however, that the terms, conditions, provisions and exclusions of this Policy are to be construed!,in an evenhanded fashion as between the parties. Where the language of this Policy is alleged to be
ambiguous or otherwise unclear, the issue shall be resolved in the manner most consistent With the
qrelewant terms, conditions, provisions or exclusions of the Policy (without regard to the authorship of the
language, the doctrine of reasonable expectation of the parties and without any presumption or arbitrary
11.
!'interpretation or construction in favor of either party or parties, and in accordance with the intent of the
pales).
The written decision of the arbitrators shall set forth its reasoning, shall be provided simultaneo usly to both
parties and shall be binding on them. The arbitrators' award shall not include attorney fees or other costs.
'Judgment on the award may be entered in any court of competent jurisdiction. Each party shall bear
equally the expenses of the arbitration.
N. Choice of Law - In the event that the Insured and the Company dispute the validity or formation of this
Policy or the meaning, interpretation or operation of any term, condition, definition or provision of this Policy
',resulting in litigation, arbitration or other form of dispute resolution, the Insured and the Company agree
',that the law of the State of New York shall apply.
O. Acknowledgment of Shared Limits—By acceptance of this Policy,
, the Named Insureds
and acknowledge that the'Policy contains an Aggregate a Limit that is applicable to,and will be understand, agree
shared by, all
oNamed Insureds and all other Insureds who are or may become insured hereunder. In view of the
peration and nature of this shared Aggregate Limit, the Named Insureds and all other Insureds
understand and agree that prior to filing a Claim or reporting a Confirmed Release under the Policy, the
Aggregate Limit may be exhausted or reduced by prior payments for other Claims, Clean-Up Costs or
• Corrective Action under the Policy.
VII. EXTENDED REPORTING PERIOD FOR CLAIMS
The Warned Insured shall be entitled to an Automatic Extended Reporting Period, and (with certain exceptions
as descr bed in Paragraph B. of this Section) be entitled to purchase an Optional Extended Reporting Period for
any ;Coverages terminated, upon termination of coverage as defined in Paragraph 8.3. of this Section. Neither the
Automatic nor the Optional Extended Reporting Period shall reinstate or increase any of the Limits of Liability of
this Policy.
•
1106 (10/05)
CI2766
8
A. Automatic Extended Reporting Period
il
Provided that the Named Insured has not purchased any other insurance to replace this insurance and which
•
applies to a Claim or a Confirmed Release otherwise covered hereunder, the Named Insured shall have the
41) 'right to the following: a period of six(6) months following the effective date of such termination of coverage in
which to provide written notice to the Company of a Claim first made during the Policy Period or Automatic
Extended Reporting Period and first reported within the Automatic Extended Reporting Period, or
Confirmed Release first reported within the Automatic Extended Reporting Period.
II
A C aim first made during the Policy Period or Automatic Extended Reporting Period and first reported(
withi� the Automatic Extended Reporting Period, or Confirmed Release first reported within the P Automatic
Extended Reporting Period will be deemed to have been made on the last day of the Policy Period,
eprovided that the Claim or Confirmed Release arises from Pollution Conditions that commenced before the
nd of the Policy Period and is otherwise covered by this Policy. No part of the Automatic Extended
Reporting Period shall apply if the Optional Extended Reporting Period is purchased.
B. Optional Extended Reporting Period
The Named Insured shall be entitled to purchase an Optional Extended Reporting Period upon termination
of coverage as defined herein (except in the event of nonpayment of premium),as follows:
9. A Claim first made during the Policy Period or during the Optional Extended Reporting Period and first
reported during the Optional Extended Reporting Period, or a Confirmed Release first reported within
tf a Optional Extended Reporting Period, if purchased in accordance with the provisions contained in
Paragraph 2.below,will be deemed to have been made on the last day of the Policy Period, provided that
the Claim or Confirmed Release arises from Pollution Conditions that commenced before the end of
the Policy Period and is otherwise covered by this Policy.
2. The Company shall issue an endorsement providing an Optional Extended Reporting Period of up to
0 forty(40)monthsm from termination of coverage hereunder for all Storage Tank Systems, or for a Storage
Tank Syste located at a specific facility, provided that the Named Insured:
(a) makes a written request for such endorsement which the Company receives within sixty (60) days
after termination of coverage as defined herein;and. I
. (b) pays when due an amount equal to the premium for the Optional Extended Reporting Period plus
1 any premium for the Policy Period which is owed and has not yet been paid. If these premiums are
paid when due, the Extended Reporting Period may not be cancelled, provided that all other terms
and conditions of the Policy are met.II
3[ Termination of coverage occurs:
11
(a) at the end of the Policy Period, or
(b) at the time the Policy or renewal policy becomes effective with a decrease in the limit of liability, a
reduction of coverage, an increased deductible or self-insured retention, new exclusion or any other
change in coverage less favorable to the Insured.
4. The Optional Extended Reporting Period is available to the Named Insured for not more than 100% of
( the policy premium of this Policy.
!r �
VIILDEFINITIONS
0106 (10105)
C12766
9
A. Erlodily Injury means physical injury, or sickness, disease, mental anguish or emotional (distress
sustained by any person including death resulting therefrom.
B. Claim means a written demand received by an Insured seeking a remedy and alleging liability or
i responsibility on the part of the Insured for Loss.
I'
C. Clean-Up Costs means:
;'I
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Reasonable and necessary expenses for the investigation,
removal or remediation of Pollution
Conditions including associated monitoring, or disposal of soil, surfacewater, groundwater,or other
contamination:
I' I
(a) To the extent required by Environmental Laws; or
II
(b) That have been actually incurred by the government or any political subdivision of the United
States of America or any state thereof or Canada or any province thereof,or by third parties.
Clean-Up Costs also include Restoration Costs.
D. Confirmed Release means Pollution Conditions from a Storage Tank System, including those from
an overfill of a Storage Tank System, that has been investigated and confirmed by or on behalf of the
Insured during the Policy Period through a system tightness test, site check, or other procedure
II approved by the Implementing Agency in
9 Y accordance with Environmental Law.
E. Corrective Action means:
!'I 1. Reasonable and necessary costs for response, abatement, investigative, and removal actions
resulting from.a Confirmed Release as legally required by Subpart F of the federal underground
storage-tank regulations, 40 C.F.R. 280.60 through 280.66, and 280.72, or as legally required by
other applicable federal regulations or by other applicable regulations promulgated by a state under
• 111 an underground storage tank program approved by the United States Environmental Protection
Agency in accordance with Section 9004 of the Resource Conservation and Recovery Act of 1976,
as amended;
2. Reasonable and necessary costs for the cleanup,
pursuant to
it er from the
Implementing Agency and with the prior written approvalof the Companyrdof Pollution
it Conditions in soil or groundwater due to a Confirmed Release, including the preparation,
' development, modification and implementation of a"corrective action plan"as defined in 40 C.F.R.
280.66, and the monitoring, evaluation and reporting of the results of the implementation Iof such
plan.
�q I
F. pnvironmental Laws means any federal, state, provincial or local laws (including, but not limited to,
statutes, rules, regulations, ordinances,II g � guidance documents, and governmental,judicial or administrative
o`-ders and directives)that are applicable to Pollution Conditions.
G. Extended Reporting Period means either the automatic additional period of time or the optional
additional period of time, whichever is applicable, in which to report Claims or Confirmed Releases
following termination of coverage,as described in Section VII.of this Policy.
H. I plementing Agency means the Federal Environmental Protection Agency or a state or local agencyhaving jurisdiction pursuant to Environmental Laws.
I. Inception Date means the first date set forth in Item 2 of the Declarations.
•1106 (1 '/05)
CI2766
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II
J. Insured means the Named Insured, and any past or present director,officer,partner or employee thereof,
including a temporary or leased employee,while acting within the scope of his or her duties as such.
•
K. Insured Contract means a contract or agreement submitted to and approved by the Company, and
• listed on a Scheduled Insured Contract Endorsement to this Policy.
L. Loss means, under the applicable Coverages:
II 1. Monetary awards or settlements of compensatory damages; where allowable by law,
exemplary, or multiple damages; and civil fines, penalties, or assessments for Bodilypunitive,
Injury
or
Property Damage;.or
[ 2. Clean-Up Costs or Corrective Action.
M. Named Insured means the person or entity named in Item 1 of the Declarations acting on behalf of all
other Insureds, if any, for the payment or return of any premium, payment of any deductible, receipt
cy, giving and receiving notice of
li end acceptance of any.endorsement issued to form a part of
cancellation or nonrenewal, and the exercise of the rights provided nrthe Extended Reporting 1Period
N. Policy Period means the period set forth in Item 2 of the Declarations, or any shorter period arising as a
11 result of:
1. Cancellation of this Policy;or
2. With respect to particular Storage Tank System(s):
(a) the deletion or addition of such Storage Tank System from this Policy by the Company at the
Named Insured's written request,but solely with respect to that Storage Tank System.
(b) the sale, giving away or abandonment of a Storage Tank System, or the sub-leasing of such
Storage Tank System, unless the sub-lease has been approved in writing by the Company
prior to the commencement of the sub-lease.
O. Pollution Conditions means the discharge, dispersal, release or escape of any solid, liquid, gaseous or
thermal irritant or contaminant, including,but not limited to,smoke,vapors,soot,fumes,acids,alkalis,toxic
chemicals, medical waste and waste materials into or upon land, or any structure on land, the atmosphere
or any watercourse or body of water, including groundwater, provided such conditions are not naturally
present in the environment in the amounts or concentrations discovered.
P� P operty Damage means:
j 1 � Physical
injury to or destruction of tangible property of parties other than the Insured including the
resulting loss of use thereof;
! 2. Loss of use of
tangible 9 property of parties other than the Insured that has not been physically injured
or destroyed;
Property Damage does not include Clean-Up Costs or Corrective Action.
Q. Rgsponsible Insured means the manager or supervisor of
le for
environmental affairs, control or compliance, or any owner or operator f o a Storage Tank System,med Insured lot.torr any
!' officer,director or partner of the Named Insured.4110
106 (10/05)
CI2766
R. Restoration Costs means reasonable and necessarycosts incurred by the Insured with the Company's
written consent, which consent shall not be unreasonably withheld or delayed, to repair, replace or restore
real or personal property to substantially the same condition it was in prior to being damaged during work
I,; plerfomied in the course of incurring Clean-Up Costs or Corrective Action. However, such Restoration
• I, Costs shall not exceed the net present value of such property prior to incurring Clean-Up Costs or
Corrective Action. Restoration Costs do not include costs associated with improvements or
betterments.
Storage Tank System means a stationary tank or tanks owned or operated by the Insured
I1 !rem 5 of the Declarations. Storage Tank and shown in
9 System includes any on site integral piping or dispensing
equipment, ancillary equipment and containment system associated with the tanks.
T. -flank Fund means any state storage tank trust fund, state administered insurance r!storation funding for Storage Tank Systems whose owners qualify for reimbursement or progany if
f
insurance fund established for the purpose of funding Clean-Up Costs or Corrective Action for
Pollution Conditions from a Storage Tank System.
The remainder of this page has been intentionally left blank. Policy Signature Page shall immediately follow.
j I
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06(10/05)
12766
12
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1 POLICY SIGNATURE PAGE
jl
This Polite Sjgnature Page,
• forms a j�art of Policy No: 007786457
1
By signing b low, the President and the Secretary of the Insurer agree on behalf of the Insurer to all the terms of this
Policy. ,
'
1
"...\114.4.P."6.'"\LIVW461..."%'
Secretary President
it Commerce and Industry Insurance Company Commerce and Industry Insurance Company
`
This Policy shall not be valid unless signed at the time of issuance by an authorized representative of the Insurer, either
below or on he Declarations page of the Policy.
I
Authorized fepresentative
1
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1
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86697 (9/ )
CI2469 1i
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iliGlit1:.•�� r ��I;,�lix•:i l '::.I
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_4} I' :c •;itiS41.'�'09d s `�=y_.��rL•s,.;.:c?•iJ tY ri
Storage Tank Third Party Liability
TankGuard Renewal Warranty
I' I
Named insured: City of Renton
IP _
In urer: _Commerce & Indusbry Insurance Cpmpany
t, Policy number: 007786457
• Policy period: January 1 , 2007 to January 1 , 2008
•
!, The undersigned warrants and represents thatthere have been no•changes to;the
' i' schedule of covered tanks or locations:
• . THIS RENEWAL WARRANTY DOES NOT BIND THE APPLICANT TO BUY,OR THE COMPANY TO ISSUE THE
I' INSURANCE,BUT IT IS AGREED THAT THLS FORM SHALL BE THE BASIS OF THE CONTRACT SHOULD A
POLICY BE ISSUED,AND 1T WILL BE ATTACHED TO THE ORIGINAL APPLICATION AND MADE A PART OF
THE POLICY. 111E UNDERSIGNED APPLICANT DECLARES, WARRANTS AND REPRESENTS THAT THE
• STIATEMENTS SET FORTH IN THIS WARRANTY ARE TRUE AND THAT NO MATERIAL FACTS HAVE BEEN
�PPRESSED OR MISSTATED: THE APPLICANT FURTHER DECLARES,WARRANTS•AND REPRESENTS THAT
IF TEE INFORMATION SUPPLIED ON THIS WARRANTY CHANGES BETWEEN THE EXECUTION DATE OF THE
WAARRANTY AND THE RENEWAL POLICY EFFECTIVE DATE,THE APPLICANT WILL MilvIEDIA.TELY NOTIFY
THE COMPANY OF SUCH CHANGES, AND THE COMPANY MAY -WITHDRAW -OR MODIFY ANY
OUTSTANDING QUOTATIONS AND/OR AUTHORIZATION OR AGREEMENT TO BIND THE INSURANCE.
• I
ALL WRITTEN STATEMENTS AND MATERIALS FURNISHED TO THE COMPANY IN CONJUNCTION WITH 111-L
MOST RECENT LONG-FORM APPLICATION AS WELL AS THE RENEWAL WARRANTY SIGNED HEREUNDER
ARE INCORPORATED BY REFERENCE INTO THIS APPLICATION AND MADE A PART HEREOF.
In the event that the company issues a policy,the undersigned acting on behalf ofthe applicant and all
proposed•insureds,.acknowledges that.the company, in providing coverae,.will have relied upon, as
representations,the declarations and statements which are contained in or attached to or incorporated by
' • reference into this warrantyand which are incorporated into the policy.
•If insured would like an indication for higher limits, please indicate.
LIMITS DESIRED:(each incident/aggregate)
„ )$1 million/$I million ( )$1 million/$2 million. ( )$1 million/$3 million ( )$1 million/$5 million
• • I, ( )$2 million/$2 million ( )$5 million/$5 million ( )OTR:
'
• .i
•
410 ,
si i77 Lame) •
012865
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•
I
•
• AIG .�atI ,s 4�.41s .�t.z •
D DUCTJBLE DESIRED: (each incident)
(x $5,000 ( )•$10,000 ( )$25,000 ( )$50,000 ( )$100,000
•
• ' Fo Deductibles above$25,000,please include our most current audited financial statement.
Y
NOTICE TO APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO
DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR
' -INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE
INFORMATION OR, CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION
.CONCERNING ANY PACT MATERIAL THERETO,COMMITS A FRAUDULENT ACT,W.IlICH IS
A CRIvIE AND MAY SUBJECT-SUCH PERSON TO CRIMINAL ANI)CIVIL PENAi TIES.
NOTICE TO ARICANSA.S AND NEW MEXICO APPLICANTS: ANY PERSON WHO
I KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR.
BENEFIT, OR KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR
INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT
• IN PRISON.
, NOTICE TO COLORADO APPLICANTS:IT IS UNLAWFUL TO KNOWINGLY PROVIDE FALSE,
.- INCOMPLETE, OR MISLEADING FACTS OR INFORMATION TO AN INSURANCE COMPANY
411. FOR TILE PURPOSE OF DEFRAUDING OR ATTEMPTING TO DEFRAUD THE COMPANY.
PENALTIES MAY INCLUDE IMPRISONMENT, FINES, DENIAL OF.INSURANCE, AND CIVIL
• !' - DAMAGES. ANY INSURANCE COMPANY OR AGENT OF AN INSURANCE COMPANY WHO •
KNOWINGLY PROVIDES FALSE, INCOMPLETE, OR MISLEADING PACTS OR INFORMATION
• TO A POLICYHOLDER OR CLAIMANT FOR THE PURPOSE OF DEFRAUDING OR.ATTEMPTING
- TO DEFRAUD THE POLICYHOLDER OR.CLAIMANT WITH REGARD TO A SETTLEMENT OR.
' AWARD PAYABLE'FROM INSURANCE PROCEEDS SHALL BE REPORTED TO'1DI?.COLORADO
DIVISION OP INSURANCE WITHIN THE DEPARTMENT OF REGULATORY AUTHORITIES
NOTICE TO DISTRICT OF COLUMBIA APPLICANTS: WARNING: IT IS A CRIME TO
!' PROVIDE FALSE OR.MISLEADING INFORMATION TO AN INSURER FOR•TEIE PURPOSE OF '
' . . DEFRAUDING THE INSURER OR ANY OTHER PERSON. PENALTIES INCLUDE
• IMPRISONMENT AND/OR FINES. IN ADDITION, AN INSURER MAY DENY INSURANCE '
BENEFITS IF FALSE INFORMATION MATERIALLY RELATED TO A CLAIM.WAS PROVIDED I •
•
BY THE APPLICANT. i
NOTICE TO FLORIDA APPLICANTS:ANY PERSON WHO KNOWINGLY AND WITH INTENT
'i • TO INJURE,DEFRAUD,OR DECEIVE ANY INSURER FILES A STATEMENT OF CLAIM OR AN 1
APPLICATION CONTAINING ANY FALSE,INCOMPLETE OR.MISLEADING INFORMATION IS i
" . • GUILTY OF A FELONY IN THE THIRD DEGREE.
. it •
• . !'I NOTICE TO KENTUCKY APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH
. INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN
• • - . • APPLICATION FOR INSURANCE CONTAINING ANY MATERIALLY FALSE INFORMATION,OR
• • I• ' CONCEALS FOR.THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT •
MATERIAL THERETO,COMMITS A FRAUDULENT INSURANCE ACT,WHICH IS A CRIME.
.
• I; .
91177(sro6)
CI2665
1
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0.: AIG Guar
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NOTICE TO LOUISIANA APPLICANTS: ANY PERSON WHO KNOWINGLY PRESENTS A
FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR KNOWINGLY
PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A
• I' CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON.
NOTICE TO MAINE APPLICANTS: .IT IS A CRIME TO KNOWINGLY PROVIDE FALSE,
INCOMPLETE OR MISLEADING INFORMATION TO AN INSURANCE COMPANY FOR THE
PURPOSE OF'DEFRAUDING THE COMPANY. PENALTIES MAY INCLUDE IMPRISONMENT,
FINES OR A DENIAL OF INSURANCE-BENEFITS.
NOTICE TO NEW JERSEY APPLICANTS: ANY PERSON WHO INCLUDES ANY FALSE OR •
MISLEADING INFORMATION ON AN APPLICATION FOR AN INSURANCE POLICY IS SUBJECT
TO CRIMINAL AND CIVIL PENALTIES,
•NOI'•I•CE•'TO• NEW YORi< APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH
INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PARSON FILES AN
• 1 •APPLICATION FOR. INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY
MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE.OF MISLEADING,
' ' INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT
INSURANCE ACT,WHICH IS A CRIME,AND SHALL ALSO BE SUBJECT TO A CIVIL PENALTY
. . 'NOT TO EXCEED FIVE THOUSAND DOLLARS AND TM STATED VALUE OF THE.CLAIM FOR.
EACH SUCH VIOLATION.
. I
'i ' • NOTICE TO OHIO APPLICANTS: ANY PERSON WHO, WTI'H.INTENT TO DEFRAUD OR
KNOWING T IA.T HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN
APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS
GUILTY,OF INSURANCE FRAUD.
NOTICE TO OKLAHO MA APPLICANTS:WARNING:ANY PERSON WHO KNOWINGLY,AND
WITH INTENT TO INJURE,DEFRAUD OR DECEIVE ANY INSURER,MAKES.ANY CLAIM FOR
TIlE PROCEEDS OF AN.INSURANCE POLICY CONTAINING ANY FALSE, INCOMPLETE OR
MISLEADING INFORMATION IS GUILTY OF A FELONY(365:15-1-10,36§3613.1).
NOTICE TO PENNS'YLVANIA APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH
• j INTENT TO• DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN
'• APPLICATION:_FOR INSURANCE C)R STATEMENT OF CLAIM CONTAINING ANY
MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING,1
• INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT
INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND
CIVIL PENALTIES.
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NOTICE TO TENNESSEE AND VIRGIINIA APPLICANTS: IT IS A CRIME TO KNOWINGLY,
'PROVIDE FALSE, INCOMPLETE OR MISLEADING INFORMATION TO AN INSURANCE
COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES INCLUDE
IMPRISONMENT,FINES AND DENIAL OF INSURANCE BENEFITS.
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91177(0/06)
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Renewal Warranty.Acknowledgement
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(APPLICANT: • . BROKER: • bliitirJ4406K Ak AIM/4 Yen4Cei
.I,. • .(Signature) • • •••-• • (Firm)
' 11APP(CANT: Q e
I' (Print Name) Street ling Address) r i, t e CO Pill
PATE: .. e P EE{ at, 2 T1'lli Ti1 • Y�
(Contact 3'c, on)
• • 33"! 310- t
Jr � 33, 1i�---�zti 9�,{9.com
• I, • (Pltona#,Fax#, iiA dress) 1
�" (Signature o oker Agent)
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20?5 f J /!
(License Number State)1 ge-N0?-547.
I (Tax LD•#)
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Please note that if you are planning on adding either additional tanks or locations to •
II this policy, the Company.requires, that we first receive a fully complete renewal
application vsi thiln thirty (3Q) days• of the policy .expiration date. Please visit .our •
website•www.chamberaaent.com to download the application. . .
81777(E3106)
CI2865
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CERTIFICATE OF INSURANCE
WASHINGTON
Name :;1 City of Renton
• Address : See Schedule Below
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Policy Number: 007786457
Endorserient : Not Applicable
Period of Coverage : From 01/01/07 To 01/01/08
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Name1Of Insurer: Commerce and Industry Insurance Company
Address Of Insurer: 70 Pine Street
New York, NY 10270
NameiOf Insured: City of Renton
Address Of Insured: 1055 South Grady Way
Renton, WA 98055
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CERTIFICATION:
1 . COMMERCE & INDUSTRY INSURANCE COMPANY, the Insurer, as identified
above, hereby certifies that it has issued liability insurance covering
the following underground storage tank (s) :
See "Item 5 . Covered Storage Tank System (s) " on policy referenced above,
for takingcorrective action and compensating third p g parties for bodily
IIIinjury and property damage caused by accidental releases, in accordance
with . and subject to the limits of liability, exclusions, conditions and
other terms of the policy arising from operating the underground 'storage
tanks) identified above .
The limiits of liability are $ 1, 000, 000 each occurrence and $ 1, 000, 000
annual aggregate exclusive of legal defense costs which are subject to a
separatie limit under the policy.
This coverage is provided under 007786457 . The effective date of said
policy is 01/01/07 .
2 . The Insurer further certifies the following with respect to the
insuranIce described in Paragraph 1 :
a. Bankruptcy or insolvency of the Insured shall not relieve the
Insurer of its obligations under the policy to which this
1 certificate applies .
b.. The Insurer is liable for the payment of amounts within any
deductible applicable to the policy to the provider of corrective
action or damaged third-party with a right of reimbursement by
the Insured for any such payment made by the Insurer. This
provision does not apply with respect to that amount of any
deductible for which coverage is demonstrated under another
d'. Cancellation or any other termination of the insurance by, the
Insurer, except for non-payment of premium or misrepresentation
by the Insured, will be effective only upon written notice and
41/1 only after the expiration of sixty(60) days after a copy of such
written notice is received by the Insured. Cancellation for non-
payment of premium or misrepresentation by the Insured will be
' effective only upon written notice and only after expiration of
a minimum of ten (10) days after a copy of such written notice is
received by the Insured.
e,. The insurance; covers claims otherwise covered by the policy that
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are reported to the Insurer within six months of the effective
!' date of cancellation or non-renewal of the policy except where
!i the new or renewed policy has the same retroactive date or: a
retroactive date earlier than that of the prior policy, and which. .
arise out of any covered occurrence that commenced after the
I; policy retroactive date, if applicable, and prior to such policy
renewal or termination date . Claims reported during such an
rxtended reporting period are subject to the terms, conditions,
imits, including limits of liability and exclusions of the
7olicy.
I heeby certi that he of i g o. this instrument is identical to the
S i na'tur �� Z1t'g o Au orize- r-sen a ive of Insurer
Sean h`M. Pattwell
The Director
AuthOri ed Representative of Commerce & Industry Insurance Company
Chamber .Insurance Agency Services
100 Executive Drive, Suite 200
WestjOrange, NJ 07052
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j' ENDORSEMENT
This endorsement, effective 12 : 01 AM, 01/01/07
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Formsl, a part of Policy No : 007786457
Issued to : City of Renton
By: Commerce and Industry Insurance Company
AIG ENVIRONMENTAL STORAGE TANK
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THIRD-PARTY LIABILITY AND CLEAN-UP COSTS POLICY
SITE SCHEDULE
Site##;, Facility Name/Address, City, State, Zip
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1 Maplewood Golf Course
400 Maple Valley Hwy
,
Renton, WA 98055
2 P/B/PW
' 3555 NE 2nd Street
Renton, WA 98056
All other terms, conditions, and cl ions opal e;:a 'n e same .
4110
AUTHORIZED REPRESENTATIVE 1
or countersignature (in states where applicable)
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8102i9 (10/02)
CI2254 1
ENDORSEMENT
This en orsement, effective 12 : 01 AM, 01/01/07
4110 Forms ' a part of Policy No : 007786457
1
Issued to : City of Renton
By: Commerce and Industry Insurance Company '
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. .
SCHEDULE OF COVERED STORAGE TANK SYSTEMS
It isa reed that any previous Schedule of Coverage Storage Tank Systems
is dele ed in its entirety and replaced with the following:
The following Storage Tank System(s) are included in Item 5 . COVERED
STORAGE TANK SYSTEM(S) of the Declarations, subject to all of the , terms
and conditions of the Policy and the Policy Period and Retroactive date
indicated below. If no dates are indicated below for Policy Period for
a subject Storage Tank System, the dates indicated in Item 2. Policy
Period of the Declarations shall apply. If no date is indicated below
for Retro Date for a subject Storage Tank System, the date indicated in
Item '6. Retroactive Date of the Declarations shall apply. If a Policy
Perio,�d is indicated below for a subject Storage Tank System, Item'. 2
Policy Period of the Declarations is deleted in its entirety and replaced
with 'the Policy Period, below, for such Storage Tank System. If a date
is indicated below for Retro Date for a subject Storage Tank System, the
date 'indicated in Item 6. Retroactive Date of the Declarations is, deleted
4110 in it's entirety and replaced with Retro Date, below, for such Storage
Tank !'System.
Site Tank AST/ Install Capacity Tank Effective Expiration ' Retro
# , # UST Date (Gal. ) Const . Date Date ' Date
1 1 UST 1991 550 DF 1/01/07 01/01/08 6/10/91
2 1 1 UST 1985 12, 000 DF 1/01/07 01/01/08 6/10/91
2 2 UST 1985 12 , 000 DF 1/01/07 01/01/08 6/10/91
*Site,#, name and address are located within the Site Schedule attached
to the Policy.
All oth r terms, conditions, and exclusions shall remain the same.
1 ;>54'Ple-- #14'435smr.et ,
AUTHORIZLD REPRESENTATIVE
or countersignature (in states where applicable)
4110
81017 (1 /02)
CI2253
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POLICYHOLDER NOTICE
' Thank you for purchasing insurance from a member company of American International
Group, Inc. (MG). The AIG member companies generally pay compensation to brokers
and independent agents, and may have paid compensation in connection with your policy.
You can review and obtain information about the nature and range of compensation paid
br AIG member companies to brokers and independent agents in the United States by
visiting our website at www.aigproducercompensation.com or by calling AIG at 1-800-
706-3102.
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9'222 (07/06)
chain be
insurance agency services
-100 EXECUTIVE DIVE TOLL FREE:800.336.2007
SUITE 200 FAX:973.731.2288
WEST ORANGE,Nii.07 52-3362 WWW.CHAMBERAGENT.COM
BINDER OF INSURANCE
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To: Arthur J. Gallagher & Co. of Denverred: City of Renton
6399S .Fiddlers Green Cr. , Ste. 200 1055 South Grady Way
Englewood, CO 80111- Renton, WA 98055
Inception Date Expiration Date Policy Number Name of Insurer '
Commerce and Industry
01/q1/07 01/01/08 007786457 Insurance Company
COVERAGE DESCRIPTION
COVERAGE TYPE: Storage Tank third-party liability, corrective action
and cleanup costs policy
LIMITS OF LIABILITY: 1,.0 0 0, 0 0 0/ 1, 000, 000
5, 000
DEDUCTIBLE:
RETROACTIVE DATE: As Stated in Quote Letter #100468
POLICY;FORM: 81106 (10/0 5)
COMMISSION:
10 . 00 , 0
ENDORSEMENTS: As Stated in Quote Letter #100468
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ANNUAL P MIUM: 1, 926 . 00
I Premium for Certified Acts of Terrorism Coverage Under
TRIA 2002 : $90 . 00 Included in Policy Premium
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DATE: 14 errs
o_n accor,dance with your instructions,we have taken action as described above. lease review this confirmation to
be sure it accurately reflects those instructions. The policy and/or amendments are being prepared and will be sent
to you with n invoice or credit memorandum in due course. Thank you for this opportunity to be of service.
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'AI 'ea Wei
Midwest Employers Casualty Company
• SPECIFIC EXCESS
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INDEMNITY POLICY
Policy No.: EWC005932
SCHEDULE
1. Insured: City Of Renton
2. Mailing Address: 1055 South Grady Way
Renton, WA 98055
3. Named States: Washington
4. Excluded States: None
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5. Policy Period:
(a) From: 01/01/2007
(b) To: 01/01/2008
Both days at 12:01 A.M. standard time at the Insured's address shown in Item 2 of this
schedule.
6. Retention:
(a) Each Accident: See Endorsement
(b) Each Employee for Disease: See Endorsement
7. Limit Each Accident:
(a) Policy Part One, Workers' Compensation: STATUTORY
(b) Policy Part Two, Employers Liability: $1,000,000
8. Limit Each Employee for Disease:
(a)' Policy Part One, Workers' Compensation: STATUTORY
(b) Policy Part Two, Employers Liability: $1,000,000
SO-SCH (12-05) Page 1 of 2
A Member Company of the W. R. Berkley Corporation
Irekt kVA WIFAT1 WI WIWI
• , Midwest Employers Casualty Company
SPECIFIC EXCESS
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INDEMNITY POLICY
Policy No.: EWC005932
SCHEDULE
9. Premium:
(a) Rate per$100 of Payroll: 3.0202
(b) Piolicy Minimum Premium: $30,015
(c) Total Estimated Policy Premium: $33,350
(d) Deposit Premium: $33,350
(e) Deposit Flat Charges: n/a
(f) Total Deposit Premium and Flat Charges Payable as Follows:
Amount Due
$33,350.00 02/09/2007
• 10. Classification of Operations: See Endorsement
11. Endorsement Serial Numbers: See Endorsement Schedule
12. Service Company: Berkley Risk Administrators
P.O. Box 88842
Seattle, WA 98138
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
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1 dOr~o. X. kttot.04-F
Licensed Resident Agent at— a Authorized Representative
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SO-SCH (12-05) Page 2 of 2
A Member Company of the W. R. Berkley Corporation
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• Midwest Employers Casualty Company
Endorsement Schedule
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Insured: City Of Renton
Policy'Term: 01/01/2007 to 01/01/2008
Policy'No.: EWC005932
Endorsement Code Effective Date Expiration Date Date Created
SO-6 1 01/01/2007 01/15/2007
SO-10'I, 01/01/2007 01/15/2007
10-31 'I 01/01/2007 01/12/2007
10-32 01/01/2007 01/12/2007
10-38 I, 01/01/2007 01/12/2007
10-390: 01/01/2007 01/12/2007
SO-43 01/01/2007 01/15/2007
SO-44 1 01/01/2007 01/15/2007
I O-60A'll 01/01/2007 01/25/2007
10-66WA 01/01/2007 01/25/2007
10-74A,', 01/01/2007 01/12/2007
SO-78 i 01/01/2007 01/15/2007
10-83 01/01/2007 01/12/2007
SO-WAI' 01/01/2907 01/15/2007
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Page 1 of 1 Print Date: 01/25/2007
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Schedule Item 6 is amended to read as follows:
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6. Specific Retention:
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O Each Accident: $350,000
(b) Each Employee for Disease: $350,000 '
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Endorsement Effective: 01/01/2007
Policy No.:, EWC005932i
Named Insured: City Of Renton
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Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
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Authorized Representative Secretary President
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This endorsement forms part of the policy to•which attached,effective on the inception date of the policy unless otherwise stated herein.
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SO-6 (1-93) Date Printed: 01/15/2007
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Schedule Item 10 is amended to read as follows:
10. Classification of Operations:
State .Code Classification Estimated Manhours Rate per Estimated
Manhour Manual
Premium
WA 0803 CITIES AND TOWNS 445,619 .9240 $411,752
WA 5305 CLERICAL-CITIES AND TOWNS 286,443 .1611 $46,146
WA 6901 VOLUNTEERS 34,714 .0646 $2,243
WA 69104 FIRE FIGHTERS 182,721 .7945 $145,172
WA 69105 LAW ENFORCEMENT OFFICERS 154,731 .7621 $117,920
Total Manhours: 1,104,228
Total Manual Premium: $723,233
Total Manual Premium: $723,233
(a) Experience Modification Factor: 1.000000000
1110 (b) Other Modification Factor: 1.000000000
Normal Premium: $723,233
Endorsement Effective: 01/01/2007
Policy No.: EWC005932
Named Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
J1 X. /1"44PLIF 7411-See -f444,1
Authorized rRepriesentative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
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SO-10 (1-93) EWC005932 Date Printed: 01/15/2007
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• I . Voluntary Compensation Endorsement
Part One pf the policy shall also apply to payments you gratuitously make to any employee included
within'Ilthe group described below (or to the employee's dependent)for benefits indicated in the
workers compensation law of the state where the employee is normally employed, but only if that
state is nmed in Schedule Item 3. '
All officer and employees not subject to the Workers' Compensation Law of the state of their
normal employment.
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This endo sement does not apply:
(a) unless the gratuitous benefits are paid as a result of an accident or disease exposure occurring
Iliduring the policy period and in the course of employment;
(b) if the employee (or dependent) is entitled to benefits under any workers compensation law.
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Endorsement Effective: 01/01/2007 '
Policy No.:I EWC005932,
Named Insured: City Of Renton
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Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
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11 1 oar"14' X. 4444rifs 744/1/iee J, -14.4„icki—
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Authorized Representative Secretary President
111 This endorsl mer+t forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
10-31 (1-93) Date Printed: 01/15/2007
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S Limited Longshoremen's and Harbor Workers' Compensation Act Coverage
Part One of the policy shall also apply to loss paid by you because of liability imposed Ligon you by
the Long horemen's and Harbor Workers' Compensation Act(33 USC Section 901-950).1
As respects this endorsement, loss shall be limited (by amount and time of payment) to the benefits •
whichllwould be available under the workers' compensation law of the state where the•injured
employee is normally employed, if that law applied.
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Endorsement Effective: 01/01/2007
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Policy No.:I EWC005932' '
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Named Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
1.1 . 4414*. X' 44PlarlfriF 74/dee A ''•f4Ci4id14...''''" '-
Authorized Representative I Secretary President
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This endorsement forms part of the policy to'which attached,effective on the inception date of the policy unless otherwise stated herein.
10-32 (1-93) Date Printed: 01/15/2007
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Foreign Endorsement
Endemic Disease:
Policy Part One- Loss will include payments you gratuitously make with respect to an employee
you normally employ in a state named in Schedule Item 3 for benefits indicated in the workers'
compensation law of that state because of exposure occurring during the policy period to disease
endemic to a region outside the United States of America, while traveling or temporarily working
there.
This endemic disease coverage does not apply if the employee (or dependent) is entitled to benefits
under anyl workers' compensation law.
Limited Repatriation Expenses:
In the event of bodily injury by accident or disease exposure occurring during the policy period
sustained by an employee you normally employ in a state named in Schedule Item 3 while traveling
or temporarily working outside the United States of America. Policy Part One- Loss will include
those transportation expenses you incur returning the employee because of the injury(or, in case of
death, the employee's body)to the location where normally employed which exceed the cost of
returning the employee if uninjured. .
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Endorsement Effective: 01/01/2007
Policy No.: EWC005932
Named Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
,D X.
Authorized Representative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
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10-38 (1-93) Date Printed: 01/15/2007
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• ' Communicable Disease Endorsement
In consideration of the premium charged, it is understood and agreed that Part One B'of the policy
is amended to include the following:
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Bodily injury to one or more of your employees infected with the same communicable,disease
manifested during the policy period shown in Schedule Item 5 of the policy will be treated as one
loss.
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The phrase "communicable disease" shall mean a disease caused by an infectious organism which
is transm tted from one source to another, directly or indirectly.
It is further agreed that our limit as respects bodily injury arising from same communica Ible disease
is $5,00,000.
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Endorsement Effective: 01/01/2007 '
Policy No.:l1 EWC005932'
Named Insured: City Of Renton
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Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
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1)14"A" X. 4144444i 744dee Jo ,r......4._. ,
Authorized Representative Secretary President
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This endorsement forms part of the policy to�which attached,effective on the inception date of the policy unless otherwise stated herein.
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• IO-39C (111-04) Date Printed: 01/15/2007
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• Deletion of Commutation Clause
Paragraph G of Part Three of the policy is deleted.
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Endorsement Effective: 01/01/2007
Policy No.: EWC005932i
Named Ins! red: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY '
II
X. 4%".'"`F .7nd
Authorized Representative Secretary President
iThis endorsement forms part of the policy to!which attached,effective on the inception date of the policy unless otherwise stated Herein.
SO-43 (1-93) Date Printed: 01/15/2007
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1 Deletion of the Late Reporting Penalty
Paragraph C of Parts One and Two of the policy is amended as follows:
C. OUr Indemnity. We will indemnify you for loss paid by you in excess of your retention.
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Paragraph E of Parts One and Two of the policy is deleted from the policy.
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Endorsement Effective: 01/01/2007 '
Policy No.: EWC005932
Named Insured: City Of Renton
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Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
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10 X. 4`tsilirLi 741-at ,./, -1.444,1(4----
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Authorized(Representative Secretary President
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0 This endorsement forms part of the policy to,which attached,effective on the inception date of the policy unless otherwise stated her in.
SO-44 (4-99) Date Printed: 01/15/2007
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Number of Days Notice Required for Cancellation
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Paragrrapi F of Part Five of the policy is amended to read as follows:
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F. Cancellation. You may cancel this policy by giving us at least 90 days advance notice by
registered mail stating the cancellation date. We may cancel this policy by giving you at
lest 90 days, which shall be no less than 60 days, advance notice by registered mail stating
the cancellation date Our mailing of registered notice to your address shown in Schedule
4 Rein 2 will be sufficient proof that we cancelled this policy.
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Endorsement Effective: 01/01/2007
Policy NoJJl: EWC005932
Named Insured: City Of Renton '
Countersigned r MIDWEST EMPLOYERS CASUALTY COMPANY
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, , POrt"v` X' 44444"F -1441,1 ,17,r.......,:h____
Authorized Rep esentative Secretary President
This endori ement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated'heiein.
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IO-60A (11193) Date Printed: 01/25/2007
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Definition of Manhours Pertaining to Volunteer Workers
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Manhours pertaining to volunteer workers (except volunteer firefighters and volunteer police
officer's) !beans the total hours donated by the volunteers. If the work performed by the volunteers
is similar to work performed)by a paid employee, the volunteer will be classified the same as the
paid employee. I
1,040 rnanhours per year shall be included for each volunteer firefighter or volunteer police officer.
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Duties)pe rformed by volunteer workers will be assigned to the classification which the duties would
be assigned to if performed by regular employees.
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Endorsement Effective: 01/01/2007 . '
Policy No.:. EWC005932;
Named Inslured: City Of Renton
Countersigned I MIDWEST EMPLOYERS CASUALTY COMPANY
nk°44144F 1'l1
Authorized IReprhsentative A _.re....a...____
Secretary President
gi) This endorsement forms part of the policy to,which attached,effective on the inception date of the policy unless otherwise stated herein.
IO-66WA (11-93) Date Printed: 01/25/2007
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Aircraft Coverage Endorsement
PartA
The policy does not apply to loss arising out of the ownership, maintenance, operation or use of any
aircraft that is owned or leased by the insured. This exclusion does not apply to regularly
schec ulea commercial airlines, chartered flights, and scheduled aircraft in Part B below!
Part B
It is hereby understood and agreed that coverage is provided under this policy for losses sustained
in, upon, entering or alighting from those employer owned or leased aircraft scheduled below.
Coverage provided hereunder is limited to a N/A maximum benefit any one life and is further subject
to a N/A policy limit.
In consideration for coverage provided under Part B of this endorsement, a surcharge will apply as
computed in the schedule below.
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Endorsement Effective: 01/01/2007
Policy No.: EWC005932
Named Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
t X. F
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Authorized Representative Secretary President
IIIThis endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
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IO-74A I(12-05) Page 1 of 1 Date Printed: 01/15/2007
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Corridor Deductible Endorsement
The Insured shall retain loss for 100%of the amount shown in Schedule Item 6, except that the
first $100 J000 of cumulative loss above this retention amount,whether from one occurrence or
multiple occurrences and otherwise covered under this policy, will be retained by the Insured in
addition to the amount shown in Schedule Item 6.
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Endorsement Effective: 01/01/2007 , '
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Policy No.: EWC005932
Named Insured: City Of Renton
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Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
Authorized'Representative Secretary F
President I
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This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
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SO-78 (11-04) Date Printed: 01/15/2007
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II Policyholder Disclosure
Notice of Terrorism Insurance Coverage
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Cover•ge for acts of terrorism, as defined in the Terrorism Risk Insurance Act, as extended,on
December 22, 2005 (the "Act"), is included in your policy.
You should know that any losses resulting from certified acts of terrorism, as defined in the Act,
w000iId be partially reimbursed by the United States Government under a formula established by
federal law. Under this formula, the United States pays 90% (85% in 2007) of covered terrorism
losses exceeding the statutorily established deductible paid by the insurance company providing
the„icovferage. A. The portion of your annual premium that is attributable to coverage for acts of
terrorism, as defined in the Act through 12/31/07 is: $1,001. B. The portion of your annual premium
that is attributable to coverage for acts of terrorism, as defined in the Act, for the period beyond
12/31/07 is estimated to be$0(Refer to the paragraph below).
11
Possibility of Additional or Return Premium. The premium for certified acts of terrorism coverage is
calculated based in part on,the federal participation in payment of terrorism losses as set forth in
the Act. The federal program established by the Act is scheduled to terminate at the end of 12/31/07
unless extended by the federal government. If the federal program terminates or if the level or
II! Iterms 9f federal participation change, the estimated premium shown in (B) of above may not be
appropriate. . I
If this policy contains a Conditional Exclusion, continuation of the coverage for certified acts of
40 terrorism, or termination of;such coverage,will be determined upon disposition of the federal
program, subject to the terms and conditions of the Conditional Exclusion. If this policy does not
contain a Conditional Exclusion, coverage for certified acts of terrorism will continue. In either
case, w en disposition of the federal program is determined,we will recalculate the premium shown
in (B)above and will charge additional premium or refund excess premium, if indicated.
If we notify you of an additional premium charge, the additional premium will be due as specified in
such notice. ,
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Name o Insurer: Midwest Employers Casualty Company '
Policy umber: EWC005932
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Endorsement Effective: 01/01/2007
Policy1No.: EWC005932
Named i Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
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Authorized Representative Secretary President
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This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
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10-83'(10-06) Date Printed: 01/12/2007
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0 Washington Endorsement (Pape 1 of 2)
Paragraph J of Parts One and Two of the policy is amended to read as follows:
J. Recovery From Others. We have the right to recover all payments which we have made to
1 you from anyone liable for such loss.
1. We shall be reimbursed from such recovery to the extent of our payment to you after
you are fully compensated for your loss.
2. If you do not commence an action or proceeding to recover damages from anyone
liable for a loss paid by us, we have your rights to recover damages from anyone
liable for such loss. You will do everything necessary to protect those rights and to
help us enforce them. Any such recovery by us will be allocated as follows:
a. You shall first be reimbursed for your loss.
b. The balance of the recovery which remains after you have been reimbursed will
be paid to us to the extent payments have been made under the policy.
3. Expenses of all proceedings to recover from anyone liable for injury covered by this
policy will be allocated between you and us in the ratio represented by the allocation
of any damages which have been recovered.
4. If such an action or proceeding undertaken solely by us results in no recovery, all
related expenses will be paid by us.
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Paragraph B of Part Five of the policy is amended to read as follows:
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B. Sole Representative. The Insured first named in Item 1 of the Schedule Page will act on
beialf of all insureds,to receive return premium or indemnity, or to request change in this
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policy.
Paragraph F of Part Five of the policy is amended to read as follows:
F. i Cancellation. You may cancel this policy. You must mail or deliver written notice or
surrender the policy or binder prior to or on the effective date of such cancellation, to us
stating when the cancellation is to take effect.
W may cancel this policy. If we cancel because you fail to pay all premium when due, we
will mail to you and to all named interest not less than 10 days advance written notice by
registered mail stating when the cancellation is to take effect. If we cancel for any other
reason, we will mail or deliver to you and to all named interest not less than 45 days advance
written notice by registered mail stating the actual reason for cancellation and when the
!cancellation is to take effect. Our mailing of registered notice will be sufficient proof that we
cancelled this policy.
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SO-WA (5-93) Date Printed: 01/15/2007
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4111 Washington Endorsement (Pape 2 of 2)
If we do not renew the policy, we will give at least 45 days advance written notice stating the
actual reason for non-renewal.
In accordance with the prohibitions contained in RCW 51.14.020(5):
1. The indemnity afforded by Part One of the policy pertaining to the workers'
compensation law of Washington shall be limited to 80% of your liability under that
law.
2. We do not participate in the administration of your responsibilities under the workers'
compensation law of Washington.
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Endorsement Effective: 01/01/2007
Policy No.: EWC005932
Named Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
,D. X. k44 '7314 ✓. -.14 ,
Authorized Rebresentative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
1.
SO-WA (5-93) Date Printed: 01/15/2007
aff
Arthur J. Gallagher Risk Management Services, Inc.
City of Renton
Received
April 18, 2007
APR 2 4 2007
Human Resources &
Risk Management
Ms. Pauletta Sulky
City of Renton
1055 South Grady Way
Renton, WA 98055
RE: Airport Liability and Excess Airport Liability - #AAPN00981862-004
01/01/2007 - 01/01/2008
Dear Paulie:
Enclosed are the 01/01/2007 to 01/01/2008 insurance polices for City of Renton. I have
also enclosed a copy of the Excess Binder, Stamped to reflect surplus lines tax filing.
I have sent only a copy of the Lloyds Excess Liability policy. The original has been
forwarded to our Washington State office to be stamped and processed for surplus lines
tax filings. I will forward this to you once we receive it back from them.
Paulie, we appreciate the opportunity to place this important insurance coverage for you.
If you have any questions or need additional information,please give us a call at(800)
333-3231.
Sincerely,
Steve C Hostetler
Account Manager
Enclosure
6399 South Fiddler's Green Circle,Suite 200
Greenwood Village,CO 80111-4949
303.773.9999
Fax 303.773.9776
Toll Free 800.333.3231
www.ajg.com
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. WESTCHESTER SPECIALTY INSURANCE SERVICES,INC.
725 S.FIGUEROA STREET,SUITE 2050,LOS ANGELES,CA. 90017
'" TEL: (213)833-3100 FAX:(213)833-3107
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ace usa
TO: Steve Hostetler DATE: 28-Dec-2006
j Gallagher Aviation&Aerospace
Greenwood Village,CO FROM: Clive R.Allen
I, F•1 : 303-773-9776 RISK ID: 23068
I' AIRPORT OWNERS AND OPERATORS EXCESS LIABILITY BINDER
With
D ERWRITERS AT LLOYD'S,LONDON AND CERTAIN INS CE COMPANIES
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his contract is registered
and delivered as a s roius
In accordance with your instructions we have bound the insurance described below.This binddinnil1 be vy t1 fte tthe
when issued. Certificate No.: L 9900182 insurance code" Of the Stet@
of Washington, enacted in
1947. It is not issued by a
TYPE: AIRPORT OWNERS AND OPERATORS EXCESS LIABILITY INSURANcOmpany regulated by the
Washington State Insurance
mmi sioner and is not
FORM: AP XS 9/7/2006 V3 rotected by any Washington
State Guaranty fund law."
- INSURED; City of Renton Arthur J. Gallagher
RisktManagement rvices, Inc.
and/or as underlying insurance. KIT I
PERIOD: From: January 1,2007 To: January 1,2008
both days at 12.01a.m.Local Time at the address of the Named Insured.
INTEREST i, The Insuredsr legal liability arising out of the Insured's airport operations as covered by and defined
in the underlying policy.
sumI To pay the DIFFERENCE BETWEEN the Imits of the underlying policy,being:
INSURED:
Bodily Injury, Personal/Advertising Injury and Property Damage Liability combined $50,000,000
li each occurrence/offense and in the aggregate where applicable, included within which are the following
II sub-limits:
Products-Completed Operations Aggregate Limit $50,000,000
I I' Personal Injury and Advertising Injury Aggregate limit $501000,000
Malpractice Aggregate Limit $50,000,000
Each Occurrence Limit $50,000,000
j Fire Damage Limit Any One Fire $100,000
Medical Expense Limit Any One Person $3,000
jf Hangarkeepers Limit Any One occurrence $50,000,000
Hangarkeepers Limit Any One Aircraft $50,000,000
Non-Owned Aircraft'Liability Limit Any One Occurrence $50,000,000
Extended Coverage War,Hi-Jacking and Other Perils Aggregate Limit Not insured
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- I . �! 1: Lloyd' s Certificate
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This Insurance is effected with certain Underwriters at Lloyd's,London
' (not incorporated).
i This Certificate is issued in accordance with the limited authorization
granted to the Correspondent by certain Underwriters at Lk,- d's, London,whose
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names and the proportions underwritten by them can be ascertained from the
j office of said Correspondent (such Underwriters hereinafter called "Inslurers")
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and in consideration of the premium specified herein, Insurers do hereby bind
h themselves each for his own part, and not one for another, their heirs, executors
and administrators.
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i The Insured is requested to read this Certificate, and if not correct! return
it immediately to the Correspondent for appropriate alteration.
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I; In the event of claim under this Certificate,please notify the following Correspondent:
Westchester Specialty Insurance Services,Inc.
ij 1100 Poydras Street, Suite 2150 ,
New Orleans,Louisiana 70163-1121
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1 This contract is registered and delivered as a surplus lines coverage under the Insurance Code of the state of
' Washington enacted in 1947. It is not issued by a company regulated by the Washington State Insurance
II Commissioner and is not protected by the Washington State Guaranty Fund Law.
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II AR"fHuR J. GALLAL:
pCC� EOdE ... 1
JAN30 227 [III
LLD CERT 2/1/2005 DENVER, COLORADO
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Certificate Provisions
1. Signature required. This Certificate shall not be valid unless signed by the Correspondent on the
attached schedule.
2. Correspondent Not Insurer. The Correspondent is not an Insurer hereunder and neither is
nor,sshall be liable for any loss or claim whatsoever. The Insurers hereunder are those individual
Insurers at Lloyd's, London whose names can be ascertained as herein before set forth.
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3. Cancellation. If this Certificate provides for cancellation and this Certificate is cancelled after the
inception date, earned premium must be paid for the time the insurance has been in force.
4. Service of Suit. It is agreed in the event of the failure of the Insurers hereon.to pay any amount
claimed to be due hereunder, the Insurers hereon, at the request of the Insured, will submit to the
jurisdiction of a Court of competent jurisdiction within the United States. Nothing in this Clause
constitutes or should be understood to constitute a waiver of Insurers' rights to commence an action in
any,,Court of competent jurisdiction in the United States, to remove an action to a United States District
Court, oo r to seek a transfer of a case to another Court as permitted by the laws of the United States or
of aany State in the United States. It is further agreed that service of process in such suit may be made
upon the firm or person named in the Schedule, and that in any suit instituted against any one of them
upon contract Insurers will abide by the final decision of such Court or of any Appellate Court in
th&event of an appeal.
The above-named are authorized and directed to accept service of process on behalf of Insurers in
— any, such suit and/or upon the request of the Insured to give a written undertaking to the Insured that
thely wi l enter a general appearance upon Insurers'behalf in the event such a suit shall be instituted.
Fui�therr pursuant to any statute of any state, territory or district of the United States which I makes
provision therefor, Insurers hereon hereby designate the Superintendent, Commissioner or Director
of Insurance or other officer specified for that purpose in the statute, or his successor or successors in
office, as their true and lawful attorney upon whom may be served any lawful process in any action,
suit or proceeding instituted by or on behalf of the Insured or any beneficiary hereunder arising out
of this contract of insurance, and hereby designate the above-named as the person to whom the said
officer is authorized to mail such process or a true copy thereof.
5. Assignunent. This Certificate shall not be assigned either in whole or part without the written consent of
the Correspondent endorsed hereon.
6. Attached Conditions Incorporated. This Certificate is made and accepted subject to all the
provisilons, conditions and warranties set forth herein, attached, or endorsed, all of which are to be
considered as incorporated herein.
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LLD ICERT 2/1/2005
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nsurance Companies
Certificate
This Insurance is effected with Certain Insurance Companies.
This Certificate is issued in accordance with the limited authorization
granted to the Correspondent by Certain Insurance Companies whose names
and the proportions underwritten by them can be ascertained from the office
of said Correspondent (such Underwriters hereinafter called "Insurers") and
in consideration of the premium specified herein, Insurers do hereby bind
themselves each for his own part, and not one for another, their heirs, executors
and administrators.
The Insured is requested to read this Certificate, and if not correct, return it
immediately to the Correspondent for appropriate alteration.
In the event of claim under this Certificate,please notify the following Correspondent:
Westchester Specialty Insurance Services,Inc.
1100 Poydras Street,Suite 2150
New Orleans,Louisiana 70163-1121
This icontract is registered and delivered as a surplus lines coverage under the Insurance Code of the state of
Washington enacted in 1947. It is not issued by a company regulated by the Washington State Insurance
Commissioner and is not protected by the Washington State Guaranty Fund Law.
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- CIC CERT 2/1/2005
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Certificate Provisions
1. Sigiature required. This Certificate shall not be valid unless signed by the Correspondent on the
attached Schedule.
2. Corrrespondent Not Insurer. The Correspondent is not an Insurer hereunder and neither is
nor Isha 1 be liable for any loss or claim whatsoever. The Insurers hereunder are those individual
Comps 'es whose names can be ascertained as hereinbefore set forth.
3. Cancellation. If this Certificate provides for cancellation and this Certificate is cancelled after the
inception date, earned premium must be paid for the time the insurance has been in force.
4. Service of Suit. It is agreed in.the event of the failure of the Insurers hereon to pay any amount
claimed to be due hereunder, the Insurers hereon, at the request of the Insured, will submit to the
jurisdiction of a .Court of competent jurisdiction within the United States. Nothing in this Clause
constitutes or should be understood to constitute a waiver of Insurers' rights to commence an action in
any';Court of competent jurisdiction in the United States, to remove an action to a United States District
Court, or to seek a transfer of a case to another Court as permitted by the laws of the United States or
of any State in the United States. It is further agreed that service of process in such suit may be made
upon the firm or person named in the Schedule, and that in any suit instituted against any one of them
upon this contract, Insurers will abide by the fmal decision of such Court or of any Appellate Court in
the;event of an appeal.
The above-named are authorized and directed to accept service of process on behalf of Insurers in
any'such suit and/or upon the request of the Insured to give a written undertaking to the Insured that
they win enter a general appearance upon Insurers'behalf in the event such a suit shall be instituted.
Further, pursuant to any statute of any state, territory or district of the United States which makes
provision therefor, Insurers hereon hereby designate the Superintendent, Commissioner or Director of
of Insurlance or other officer specified for that purpose in the statute, or his successor or successors in
office, as their true and lawful attorney upon whom may be served any lawful process in any action, suit
or proceeding instituted by or on behalf of the Insured or any beneficiary hereunder arising out oif this
contract of insurance, and hereby designate the above-named as the person to whom the said officer is
authorized to mail such process or a true copy thereof.
5. Assign ent. This Certificate shall not be assigned either in whole or part without the written consent of
thel!Correspondent endorsed hereon.
6. Attached Conditions Incorporated. This Certificate is made and accepted subject to all the provisions,
conditions and warranties set forth herein, attached, or endorsed, all of which are to be considered as
incorporated herein.
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CIC CERT 2/1/2005
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I! (This AP XS 9/7/2006 V3S,when attached to AP XS 9/7/2006 V3 completes this Certificate)
SCHEDULE
Item
1. Certificate No. Previous No. Authority Ref:
L 9900182 L 9900441 624406
2. INSURED
City of Menton
and/or as per underlying insurance.
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3. ADDRE S OF INSURED
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1055 S.Grady Way
Renton
Washi gton Zip 98055
4. HAZ S COVERED
The Inpred's legal liability arising out of their aviation operations as covered by and defined in the policy
of the Primary Insurer.
5. PERIO OF INSURANCE
From January 1,2007
Tol January 1,2008
both days at 12.01 a.m.Local Time at the address of the Named Insured.
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6. ANNUAL PREMIUM
j The premium due hereon is: $18,750
Plus Washington Surplus Lines Tax $375.00
Plus Washington Stamping Fee $46.88
7. P' u • 'Y INSURER
ACE property and Casualty Insurance Company
8. LIMIT OF LIABILITY(ULTIMATE NET LOSS)
This Certificate will pay the DIFFERENCE BETWEEN the Total Limits(item 8(b))and the Primary Limits
(Item (a)),as more fully described in the Policy Provisions forming part of this Certificate.
(a) Primary Limit(s)
II Bodily Injury,Personal/Advertising Injury and Property Damage Liability combined$50,000,000 each
occurrence/offense and in the aggregate where applicable,included within which are the following sub-limits:
,a
'! Plroducts-Completed Operations Aggregate Limit $50,000,000
� Personal Injury and Advertising Injury Aggregate limit $50,000,000
Malpractice Aggregate Limit $50,000,000
Each Occurrence Limit $50,000,000
I Fire Damage Limit Any One Fire $100,000
II Medical Expense Limit Any One Person $3,000
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Hangarkeepers Limit Any One occurrence $50,000,000
Hangarkeepers Limit Any One Aircraft $50,000,000
Non-Owned Aircraft Liability Limit Any One Occurrence $50,000,000
Excess Automobile Liability Any One Occurrence $50,000,000
Excess Employers Liability Any One Occurrence Not Insured
Nn-Aviation Excess Liability,including Excess Public Officials errors and
omissions liability Any One Claim/Aggregate Not Insured
(b) Total Limit(s)under this Insurance and policy of the Primary Insurer combined.
Bodily Injury,Personal/Advertising Injury and Property Damage Liability combined $100,000,000
occurrence/offense and in the aggregate where applicable,included within which are the following sub-limits:
Products-Completed Operations Aggregate Limit $100,000,000
Personal Injury and Advertising Injury Aggregate limit $50,000,000
Malpractice Aggregate Limit $50,000,000
Each Occurrence Limit $100,000,000
Fire Damage Limit Any One Fire $100,000
Medical Expense Limit Any One Person $3,000
Hangarkeepers Limit Any One occurrence $100,000,000
aangarkeepers Limit Any One Aircraft $100,000,000
on-Owned Aircraft Liability Limit Any One Occurrence $100,000,000
Excess Automobile Liability Any One Occurrence $50,000,000
Excess Employers Liability Any One Occurrence Not Insured
N n-Aviation Excess Liability,including Excess Public Officials errors and
omissions liability Any One Claim/Aggregate Not Insured
9. IDENTIFICATION DETAILS AND LIMITS CARRIED UNDER ITEM 7 ABOVE
Prim , Insurer
Policy No. Primary Limits
AAP N00981862 004 $50,000,000
10. NOTIFICATION OF CLAIMS TO BE MADE UPON:-
Westciester Specialty Insurance Services,Inc.
11p0 Poydras Street,Suite 2150
New Orleans
Louisiana,70163
11. PROPORTION INSURED BY INSURERS HEREON:
The percentages signed in the Table of Subscribing Insurers hereon are percentages of 100% of the
amount(s)of Insurance stated herein.
12. TABLE OF SUBSCRIBING INSURERS HEREON:
PERCENTAGE INSURER
16.07400% Allianz Marine&Aviation Versicherungs AG,United Kingdom
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SEVERAL LIABILITY NOTICE
The subscribing Insurers'obligations under contracts of insurance to which they subscribe are several and not joint
and are limited solely to the extent of their individual subscriptions.The subscribing insurers are not responsible
for;(the subscription of any co-subscribing insurer who for any reason does not satisfy all or part of its obligation.
13. SERVICE OF SUIT MAY BE MADE UPON:
Mendes and Mount Attorneys
750 Se'enth Avenue
New York,New York, 10019-6829
14. WARRANTY CLAUSE:
Warranted same terms and conditions as and to follow the settlements of Underwriters at Lloyd's,hereinafter called
Lloyd',Certificate Number: L 9900182
This Policy is subject without notice to the same conditions,endorsements,assignments and alterations of rates as
are or May be assumed in the above-mentioned Lloyd's Insurance upon which this Policy is based.
15. JURISDICTION:
This Policy is subject to the laws ofthe following state,whose courts shall have jurisdiction in the event ofany dispute
arising hereunder: Washington
Westchester Specialty Insurance Services,Inc.
(Correspondent)
6! By
Stephen P. Dinsdale,Senior Vice President
Dated in New Orleans,Louisiana on this 23rd day of January,2007
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CLAIMS REPORTING INFORMATION
All claim functions for your airport and aircraft insurance with Member Insurance Companies of the
ACE USA Group are handled by ACE USA Aerospace Claims in Chicago. The staff of ACE USA Aerospace
Claims Ids one of the most experienced and efficient in the aviation claims business. Bryan Doyle,
experienced, Casualty Claim Specialists, is responsible for administering your claims on a day-to-day
basis. Bryan reports to Dennis Krueger, Senior Aviation Technical Specialist. Sara Meske, Aerospace
Claims Assistant, is available to accept claims information if Bryan is unavailable.
All claims should be reported to Aerospace Claims as soon as practicable, in order for us to establish
.11
immediate contact with claimants and initiate any necessary investigation. An initial report of claim may
be faxed. 'To ensure prompt attention, it is recommended that the fax transmission be confirmed with a
phone call. Upon notification of a claim, an appropriate Accident Statement will be forwarded for your
completion. Where possible, pictures of the accident scene should be obtained during your initial
investigation.
The inifiiai rotification for a claim should be forwarded to the following individual:
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Contact Phone Fax E-Mail
Primary Bryan Doyle 312-775-7944 312-775-3966 Bryan.Doyle@ace-ina.com
Secondary Sean Finnegan 312-775-7947 312-775-3966 Sean.Finnegan@ace-ina.com
Secondary Sara Meske 312 775-7945 312-775-3966 Sara.Meske@ace-ina.com -
Secondary Betty Remblake 312-775-7910 312-775-3966 Betty.Remblake@ace-ina.com
After hours Dennis Krueger 815-738-2755 815-738-6108 Dennis.Krueger@ace-ina.com
24 Hour Emergency 815-275-1133
All claims that require reporting after hours, should be directed to Dennis Krueger. All claims involving
large aircr ft should be reported immediately to Dennis Krueger.
If you fare served with a summons or suit, please call immediately and forward the papers via overnight
delivery.
OVERNIGHT DELIVERY ADDRESS
ACE USA Aerospace Claims
525 W. Monroe
5th Floor
Chicago, IL 60661
ShoulFI yolu have any questions concerning our claims handling procedures, please feel free to contact us
at any,time.
ri
One of Mel ACE Group of Insurance&Reinsurance Companies.
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ACE Producer Compensation
Practices & Policies
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ACE believes that policyholders should have access to information about ACE's practices and policies related
to the payment of compensation to brokers and independent agents. You can obtain that information by
accessing our website at http://www.aceproducercompensation.com or by calling the following toll-free
telephone number: 1-866-512-2862.
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ALL-20887 (10/06)
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AIRPORT OWNERS AND OPERATORS GENERAL LIABILITY POLICY
ACE PROPERTY AND CASUALTY INSURANCE COMPANY
436 Walnut Street,
Philadelphia, Pennsylvania, 19106-3703
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IN WITNESS WHEREOF,ACE Property and Casualty Insurance Company has caused this policy
to be executed and attested. This policy is a valid contract when countersigned by an
authorized representative(where required by law).
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GEORGE D. MULLIGAN, Secretary BRIAN E. OOWD. President
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AAP200 (11-99)
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' AIRPORT OWNERS AND OPERATORS
�' GENERAL LIABILITY POLICY
;ace usa DECLARATIONS
This Insurance Policy is issued By: , 1
ACE Property and Casualty Insurance Company Policy Number: AAP N00981862 004
436 Walnut Street,
Philadellphi , Pennsylvania, 19106 - 3703 Renewal of: AAP N00981862 003
Named!Insured and Mailing Address: 1
City of Renton
1055 S.,'Gre'dy Way
Renton'+ •
Washington Zip 98055
The'Named Insured is: A Public Corporation
Location of the Airport(s)You Own or Operate:
1
RNT i,' R nton Municipal Airport, Renton, WA
W36 Will Rogers Wiley Post Memorial Seaplane Base, Renton, WA
Policy iperiod: From: January 1,2007 To: January 1,2008
at 12.01 a.m.Standard Time at your mailing address shown above.
In return for the payment of the premium, and subject to all of the terms of this policy, we agree with you to
provide the insurance as stated,in this policy.
Limitsl',of Insurance:
Products-Completed Operations Aggregate Limit $50,000,000
Personal Injury and Advertising Injury Aggregate limit $50,000,000
Malpractice Aggregate Limit $50,000,000 1
Each Occurrence Limit $50,000,000
Fire Damage Limit Any One Fire $100,000
Medical Expense Limit Any One Person $3,000
Hangarkeepers Limit Any One occurrence $50,000,000
Hangarkeepers Limit Any One Aircraft $50,000,000
Non-Owned Aircraft Liability Limit Any One Occurrence $50,000,000
Deductibi s:
Each Occurrence or Offense Deductible Nil
Aggregate Deductible Nil
Premium:
Advance Premium $46,003
Extended Coverage Endorsement AAP 203 (02-03) $5,000
Endorsement Premium Included
Terrorism Risk Insurance Act Premium Not Insured
Total Advance Premium $51,003
Producer commission payable on all premium under this policy is: 15.00%
Policy Forms and Endorsements are described in the attached Schedule of Endorsements.
Signature:
AAP2101 (11-99) By Authorized Representative
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Policy Number: AAP N00981862 004
- Effective Date January 1,2007
Insured: Ii City of Renton
SCHEDULE OF ENDORSEMENTS
The endorsements listed below form part of this policy at inception and are deemed to have been signed by
the same Authorized Representative that signed the Declarations (form AAP 201 11/99).
Endorsement No.
TITLE ;, and Edition Date
Airport Owners and Operators General Liability Policy-Jacket AAP 200 (11-99)
Airport Owners and Operators General Liability Policy- Declarations AAP 201 (11-99)
Airport Owni rs and Operators General Liability Policy-Schedule of Endorsements AAP 201S (11-99)
Airport Owners and Operators General Liability Policy- Policy Provisions AAP 202 (11-99)
Extended Coverage-War, Hi-jacking and Other Perils Endorsement AAP 203 (02-03)
Amendmen of Noise and Pollution and Other Perils Exclusion AAP 204 (11-03)
Extension-Specific Excess Liability Insurance -Automobile Liability AAP 211 (11/99)
Immunity Waiver Endorsement AAP 220 (11/99)
Airport Limited Enhanced Coverage Endorsement AAP 234 (11/99)
Nuclear;Risks Exclusion Clause AAP 237 (11/99)
Excess;Automobile Liability AAP 238 (11/99)
Volunteers Endorsement AAP 248 (11/99)
Date Recognition Exclusion Endorsement AAP 26 (11/99)
Date Recognition Limited Coverage Endorsement AAP 255 (11/99)
Premium Audit Endorsement AAP 257 (11/99)
Cap oil Losses from Certified Acts of Terrorism AAP 269 (02-03)
Pollution Endorsement AAP 213 (11-03)
Silica and Silica-Related Dust Exclusion AAP 277 (01-06)
Washington Changes - Cancellation and Nonrenewal AAP WA (11/99)
Washington Changes 9001-WA (11/99)
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AAP 201 S (11-99)
AIRPORT OWNERS AND OPERATORS LIABILITY POLICY
INDEX
Please Read Your Policy
'a I
SECTION I - COVERAGES 2
COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2
Insuring Agreement 2
Exclusions 2
{ COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY 6
Insuring Agreement 6
Exclusions 6
COVERAGE C. MEDICAL PAYMENTS 7
Insuring Agreement 7
Ic Exclusions 7
COVERAGE D. HANGARKEEPERS LIABILITY 8
Insuring Agreement 8
Exclusions 8
COVERAGE E. NON-OWNED AIRCRAFT LIABILITY 8
Insuring Agreement 8
Exclusions 9
{ SUPPLEMENTARY PAYMENTS -COVERAGES A, B, D AND E 10
SECTION II - COMMON COVERAGE EXCLUSIONS 11
I I
SECTION III -WHO IS AN INSURED 12
SECTION IV- LIMITS OF INSURANCE AND DEDUCTIBLES 14
SECTION V- CONDITIONS 15
SECTION VI - DEFINITIONS 19
,III
AAP 202 (11-99) Page 1 of 23
AIRPORT OWNERS AND OPERATORS GENERAL LIABILITY POLICY
POLICY PROVISIONS
Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights,
duties and what is and is not covered.
Throughout this policy the words "you" and "your" refer to the Named Insured shown in the 1 Declarations,
and ''any other person or organization qualifying as a Named Insured under this policy. The words "we",
"us" and "our" refer to the company providing this insurance.
The word "insured" means any person or organization qualifying as such under WHO IS AN INSURED
(SECTION III).
Other words and phrases that appear in quotation marks have special meaning. Refer to DEFINITIONS
(SECTION VI).
The insurance provided by this policy does not apply to any Coverage or hazard against which the words
Not Insured appear in the Limits of Insurance section of the Declarations.
SECTION I - COVERAGES
COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY
1. Insuring Agreement .
a. We will pay those sums that the insured becomes legally obligated to pay as damages
because of "bodily injury" or "property damage" to which this insurance applies. We will have
the right and duty to defend any "suit" seeking those damages. We may at o6r discretion
investigate any "occurrence" and settle any claim or"suit"that may result, but:
,I (1) The amount we will pay for damages is limited as described in LIMITS OF INSURANCE
(SECTION IV); and
(2) Our duty to defend ends when we have used up the applicable LIMITS OF IINSURANCE
in the payment of judgments or settlements under Coverage A.
No other obligation or liability to pay sums or perform acts or services is covered unless
explicitly provided for under SUPPLEMENTARY PAYMENTS - COVERAGES A, B, D AND E.
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6. This insurance applies to "bodily injury" and "property damage" only if:
7 (1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in
the "coverage territory"; and
,11 (2) The"bodily injury" or"property damage" occurs during the policy period; and
(3) The "bodily injury" or"property damage" arises out of your"airport operations".
C. Damages because of "bodily injury" include damages claimed by any person or organization
for care, loss of services or death resulting at any time from the"bodily injury".
2. Exclusions .
This insurance does not apply to:
aL Expected or Intended Injury
"Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This
exclusion does not apply to "bodily injury" resulting from the use of reasonable force to protect
persons or property.
AAP 202 (11-99) Page 2 of 23
b. Contractual Liability
"Bodily injury" or "property damage" for which the insured is obligated to payl damages by
reason of the assumption of liability in a contract or agreement. This exclusion does not apply to
to liability for damages:
(1) Assumed in a contract or agreement that is an "insured contract" provided the "bodily
injury" or "property damage" occurs subsequent to the execution of the contract or
agreement ; or
(2) That the insured would have in the absence of the contract or agreement.
c. Liquor Liability
"Bodily injury" or"property damage"for which the insured may be held liable by reason of:
(1) Causing or contributing to the intoxication of any person;
(2) The furnishing of alcoholic beverages to a person under the legal drinking age or under
the influence of alcohol; or
(3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of
alcoholic beverages.
This exclusion applies only if you are in the business of manufacturing, distributing, selling,
serving or furnishing alcoholic beverages.
Premises at the "airport" which you lease to others who are in the business of manufacturing,
distributing, selling, serving or furnishing alcoholic beverages, will not be treated as your business.
d. Workers Compensation and Similar Laws
Any obligation of the insured under a workers' compensation, disability benefits or
= unemployment compensation law or any similar law.
;e. Employers Liability
"Bodily injury"to:
(1) An employee of the insured arising out of and in the course of employment by the
insured; or
(2) The spouse, child, parent, brother or sister of that employee as a conseq fence of (1)
above.
This exclusion applies:
(1) Whether the insured may be liable as an employer or in any other capacity; and
(2) To any obligation to share damages with or repay someone else who must pay damages
because of the injury.
This exclusion does not apply to liability assumed by the Insured under an "insured contract".
i
f. Aircraft, Auto or Watercraft
11 "Bodily injury" or "property damage" arising out of the ownership, maintenance! use or
entrustment to others of any aircraft, "auto" or watercraft owned or operated by, rented, loaned
'I or leased to the insured. Use includes operation and "loading or unloading".
This exclusion does not apply to:
(1) An "auto" or watercraft while on the"airport";
AAP 202 (11-9•) Page 3 of 23
(2) An "auto" or watercraft while not on the "airport" if responding to an aviation emergency; or
(3) Liability assumed under any "insured contract" for the ownership, maintenance or use of
watercraft.
g. Mobile Equipment
"Bodily injury" or"property damage" arising out of:
(1) The transportation of "mobile equipment" by an "auto" owned or operated by or rented or
loaned to the insured; or
(2) The use of "mobile equipment" in, or while in practice or preparation for, a prearranged
racing, speed or demolition contest or in any stunting activity.
1,1 h. Airmeet, Contest or Exhibition
"Bodily injury" or"property damage" arising out of: •
(1) The conduct of any airmeet, contest or exhibition permitted, sponsored or participated in
by any insured; or
(2) The ownership maintenance or use of grandstands, bleachers or observation platforms.
Paragraph (1) of this exclusion does not apply to static displays.
Paragraph (2) of this exclusion does not apply to observation decks or promenades that are
part of a permanent structure on the "airport".
P
Swimming Pools or Lodging Accommodation
19 "Bodily injury" or"property damage" arising out of the ownership, maintenance or use of:
7 (1) Swimming pools; or
(2) Lodging accommodation for the general public.
j. Control Tower
"Bodily injury" or "property damage" arising out of the direct operation of a control tower by any
insured.
k. Damage to Property
"Property damage" to:
(1) Property you own, rent or occupy;
ill (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part
of those premises;
II
(3) Property loaned or leased to you;
(4) Personal property, other than "aircraft", in the care, custody or control of the insured;
(5) That particular part of real property on which you or any contractors or subcontractors
working directly or indirectly on your behalf are performing operations, if the "property
damage" arises out of those operations;
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(6) That particular part of any property that must be restored, repaired or replaced because
"your work"was incorrectly performed on it; or
AAP 202 (1'1-9•) Page 4 of 23
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(7) "Aircraft" in your care, custody or control or "aircraft" while being serviced, handled or
maintained by you.
Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never
occupied, rented or held for rental by you.
Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a
sidetrack agreement.
Paragraph (4) of this exclusion does not apply to "property damage":
(a) to an "auto" or "mobile equipment" when your control is solely traffic control, but this
exception does not override Exclusion j. above;
(b) to an "auto"while on the "airport"; or
(c) to baggage or cargo handled by you, provided you are not handling thel baggage or
cargo as bailee for hire.
Paragraph (6) of this exclusion does not apply to "property damage" included in the "products
completed operations hazard".
Paragraph (7) of this exclusion does not apply to "property damage" to "aircraft" when your
control is solely traffic control, but this exception does not override Exclusion j above.
II. Damage to Your Product
"Property damage"to "your product" arising out of it or any part of it.
= im. Damage to Your Work
"Property damage" to "your work" arising out of it or any part of it and included in the
"products-completed operations hazard".
,11
This exclusion does not apply if the damaged work or the work out of which the damage arises
was performed on your behalf by a subcontractor.
n. Damage to Impaired Property or Property Not Physically Injured
1.1 "Property damage" to "impaired property" or property that has not been physically injured,
arising out of:
(1) A defect, deficiency, inadequacy or dangerous condition in "your product" or "your work"; or
(2) A delay or failure by you or anyone acting on your behalf to perform a contract or
agreement in accordance with its terms.
This exclusion does not apply to the loss of use of other property arising out of sudden and
accidental physical injury to "your product" or"your work" after it has been put to its intended use.
O. Recall of Products, Work or Impaired Property
1 Damages claimed for any loss, cost or expense incurred by you or others for the loss of use,
withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of:
(1) "Your product";
(2) "Your work"; or
(3) "Impaired property";
AAP 202 (11-9•) Page 5 of 23
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if such product, work or property is withdrawn or recalled from the market or from use by any
person or organization because of a known or suspected defect, deficiency, inadequacy or
dangerous condition in it.
Exclusions c. through o. do not apply to damage by fire to premises rented to you. A separate limit
I, of insurance applies to this coverage as described in LIMITS OF INSURANCE (SECTION IV).
COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY
1. Insuring Agreement .
1,a. We will pay those sums that you become legally obligated to pay as damages because of
"personal injury" or "advertising injury" to which this insurance applies. We will have the right
and duty to defend any "suit" seeking those damages. We may at our discretion investigate
any offense and settle any claim or"suit"that may result, but:
(1) The amount we will pay for damages is limited as described in LIMITS OF I INSURANCE
(SECTION IV); and
(2) Our duty to defend ends when we have used up the applicable LIMITS OF INSURANCE
in the payment of judgments or settlements under Coverage B. I
No other obligation or liability to pay sums or perform acts or services is co iered unless
explicitly provided for under SUPPLEMENTARY PAYMENTS - COVERAGES A, B, D AND E.
lb. This insurance applies to:
(1) "Personal injury" caused by an offense excluding advertising, publishing, briadcasting or
telecasting done by or for you;
(2) "Advertising injury" caused by an offense committed in the course of advertising your
goods, products or services;
but only if:
(a) The offense was committed or alleged to have been committed unintentionally by you or
any of your employees while engaged in their employment by you; and
(b) The offense was committed or alleged to have been committed in the "coverage territory"
during the policy period and arises out of your"airport operations"
2. Exclusions .
This insurance does not apply to:
a. "Personal injury" or"advertising injury":
(1) Arising out of any oral or written publication of material, if done by or at the direction of
the insured with knowledge of its falsity;
(2) Arising out of any oral or written publication of material whose first publication took place
before the beginning of the policy period;
(3) Arising out of the willful violation of a penal statute or ordinance committed by. or with the
consent of the insured;
(4) For which the insured has assumed liability in a contract or agreement. This exclusion
does not apply to liability for damages that the insured would have in the absence of the
contract or agreement; or
AAP 202 (11-9•) Page 6 of 23
(5) Arising out of the conduct of any airmeet, contest or exhibition permitted,I sponsored or
participated in by any insured. This exclusion does not apply to static displays.
b. "Advertising injury" arising out of:
(1) Breach of contract, other than misappropriation of advertising ideas under an implied
contract;
(2) The failure of goods, products or services to conform with advertised quality or1 performance;
(3) The wrong description of the price of goods, products or services; or
(4) An offense committed by an insured whose business is advertising, (broadcasting,
publishing or telecasting.
c. Any offense which was committed or alleged to have been committed in any State which does
not recognize a cause of action for that offense based on negligence.
COVERAGE C. MEDICAL PAYMENTS
1. „Ins wring Agreement .
a. We will pay medical expenses as described below for"bodily injury" caused by an accident:
(1) On your"airport"; or
(2) Because of your"airport operations";
provided that:
(1) The accident takes place in the "coverage territory" and during the policy period;
(2) The expenses are incurred and reported to us within one year of the date of the accident;
and
i I
(3) The injured person submits to examination, at our expense, by physicians of our choice
as often as we reasonably require.
b. We will make these payments regardless of fault. These payments will not exceed the
applicable LIMITS OF INSURANCE. We will pay reasonable expenses for:
(1) First aid at the time of an accident;
(2) Necessary medical, surgical, x-ray and dental services, including prosthetic devices; and
(3) Necessary ambulance, hospital, professional nursing and funeral services.
2. Exclusions .
We will not pay expenses for"bodily injury": •
a. To any insured.
b. To a person hired to do work for or on behalf of any insured or a tenant of any insured.
c. To a person injured on that part of premises you own or rent that the person normally occupies.
d To a person, whether or not an employee of the insured, if benefits for the "bodily) injury" are
AAP 202 (1111-9•) Page 7 of 23
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payable or must be provided under a workers' compensation or disability benefits law or a similar
law.
e. To a person injured while taking part in athletics.
f. Included within the "products-completed operations hazard".
g. Excluded under Coverage A.
COVERAGE D. HANGARKEEPERS LIABILITY
1 Insuring Agreement .
a. We will pay those sums that the insured becomes legally obligated to pay as damages
because of physical injury to "aircraft" to which this insurance applies. We will have the right
and duty to defend any "suit" seeking those damages. We may at our discretion investigate
any "occurrence" and settle any claim or"suit" that may result, but:
(1) The amount we will pay for damages is limited as described in LIMITS OF 1INSURANCE
,II
(SECTION IV); and
(2) Our duty to defend ends when we have used up the applicable LIMITS OF ,INSURANCE
in the payment of judgments or settlements under Coverage D.
No other obligation or liability to pay sums or perform acts or services is covered unless
explicitly provided for under SUPPLEMENTARY PAYMENTS - COVERAGES A, B, D AND E.
b. This insurance applies to physical injury only if:
(1) The "aircraft" is in your care, custody or control or while the "aircraft" is being serviced,
handled or repaired by you; and
(2) The physical injury to "aircraft" is caused by an "occurrence" that takes place on the
premises of the "airport"; and
(3) The physical injury to "aircraft" occurs during the policy period.
C. Damages because of physical injury include damages claimed for all resultant loss of use of
such aircraft.
2. Exclusions .
This insurance does not apply to:
a. Physical injury to "aircraft"you own.
b. Physical injury to "aircraft" you rent, lease or which are on loan to you.
c. Physical injury to "aircraft"while "in flight".
d. Physical injury to "aircraft" for which the insured is obligated to pay damages by reason of the
assumption of liability in a contract or agreement. This exclusion does not apply to liability that the
insured would have in the absence of the contract or agreement.
COVERAGE E. NON-OWNED AIRCRAFT LIABILITY
1. Insuring Agreement .
a. We will pay those sums that the insured becomes legally obligated to pay as damages because
of"bodily injury" or"property damage"to which this insurance applies. We will have the right and
AAP 202 (1,1-99) Page 8 of 23
duty to defend any "suit" seeking those damages. We may at our discretion investigate any
"occurrence" and settle any claim or"suit"that may result, but:
(1) The amount we will pay for damages is limited as described in LIMITS OF INSURANCE
(SECTION IV); and
(2) Our duty to defend ends when we have used up the applicable limit of insurance in the
payment of judgments or settlements under Coverage E.
No other obligation or liability to pay sums or perform acts or services is covered unless
explicitly provided for under SUPPLEMENTARY PAYMENTS - COVERAGES A, B, D AND E.
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b. This insurance applies to "bodily injury" and "property damage" only if:
(1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in
the "coverage territory"; and
(2) The "bodily injury" or"property damage" occurs during the policy period; and
(3) The "bodily injury" or "property damage" arises out of your use of any aircraft, or its use
on your behalf, provided that:
(a) The aircraft is not owned by you in whole or in part;
(b) The aircraft is not on lease to you;
(c) The aircraft is not subject to a lease-purchase agreement to which you are a
party; and
(d) The aircraft is used in connection with your"airport operations".
c. Damages because of "bodily injury" include damages claimed by any person or organization
for care, loss of services or death resulting at any time from the "bodily injury".
2. ilExclusions .
Thi• insurance does not apply to:
a. "Bodily injury" or"property damage" expected or intended from the standpoint of the insured.
This exclusion does not apply to "bodily injury" resulting from the use of reasonable force to
protect persons or property.
b. "Bodily injury" or "property damage" for which the insured is obligated to pay damages by
reason of the assumption of liability in a contract or agreement. This exclusion does not apply
to liability for damages:
(1) Assumed in a contract or agreement that is an "insured contract" provided the "bodily
injury" or "property damage" occurs subsequent to the execution of the, contract or
agreement; or
(2) That the insured would have in the absence of the contract or agreement.
c. "Property damage"to the aircraft.
Id. Any obligation of the insured under a workers' compensation, disability benefits or
unemployment compensation law or any similar law.
AAP 202 (i11-99) Page 9 of 23
, e. "Bodily injury" to:
1 (1) An employee of the insured arising out of and in the course of employment by he insured; or
(2) The spouse, child, parent, brother or sister of that employee as a consequence of(1) above.
This exclusion applies:
(1) Whether the insured may be liable as an employer or in any other capacity; and
(2) To any obligation to share damages with or repay someone else who must pay damages
because of the injury.
This exclusion does not apply to liability assumed by the Insured under an "insured contract".
f. "Bodily injury" or"property damage" included in the "products-completed operations" h azard.
g. "Bodily injury" or "property damage" arising out of your use of any aircraft or its use on your
1 behalf, if the aircraft is operated "in flight" by a pilot who is not properly certificated and rated
by the F.A.A.for the flight involved.
This exclusion does not apply if the aircraft so operated is without your knowledge or consent.
h. "Property damage"to:
(1) Property you own, rent or occupy;
,
(2) Property loaned or leased to you;
(3) Personal property in the care, custody or control of the insured.
SUPPLEMENTARY PAYMENTS - COVERAGES A, B, D AND E
We will pay, with respect to any claim or"suit"we defend:
1. ,All xpenses we incur.
2. ,Up to $250 for cost of bail bonds required because of accidents or traffic law violations arising out of
the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish
these bonds.
3. ;The cost of bonds to release attachments, but only for bond amounts within the applicable LIMITS
OF INSURANCE (SECTION IV). We do not have to furnish these bonds.
4. iAll reasonable expenses incurred by the insured at our request to assist us in the investigation or
defense of the claim or "suit", including actual loss of earnings up to $100 a day because of time off
from work.
5. 'All osts taxed against the insured in the "suit".
6. �Prej dgment interest awarded against the insured on that part of the judgment we pay. If we make
an offer to pay the applicable LIMITS OF INSURANCE, we will not pay any prejudgment interest based
on that period of time after the offer.
7. All interest on the full amount of any judgment that accrues after entry of the judgment and before
we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable
LIMITS OF INSURANCE.
AAP 202 (11-99) Page 10 of 23
These payments will not reduce the LIMITS OF INSURANCE.
SECTION II - COMMON COVERAGE EXCLUSIONS
All Coverages included in this policy are subject to the following exclusions.
A. Noise and pollution and other perils.
1. This policy does not cover claims directly or indirectly occasioned by, happening through or in
consequence of:
r I
(a) noise (whether audible to the human ear or not), vibration, sonic boom and any
phenomena associated therewith,
(b) pollution and contamination of any kind whatsoever,
(c) electrical and electromagnetic interference,
(d) interference with the use of property;
unless caused by or resulting in a crash fire explosion or collision or a recorded in-flight
emergency causing abnormal aircraft operation.
.12. With respect to any provision in the policy concerning our duty to investigate or defend claims,
pi such provision shall not apply and we shall not be required to defend:
(a) claims excluded by Paragraph 1; or
(b) a claim or claims covered by the policy when combined with any claims excluded by
Paragraph 1 (referred to below as "Combined Claims").
•
13. In respect of any Combined Claims, we shall (subject to proof of loss and the LIMITS OF
INSURANCE) reimburse you for that portion of the following items which may be allocated to
the claims covered by the policy:
(i) damages awarded against any insured; and
(ii) defense fees and expenses incurred byanyinsured.
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4. Nothing herein shall override any radioactive contamination or other exclusion clause attached
to or forming part of this policy.
B. War, hi-jacking and other perils.
This policy does not cover claims caused by:
'(a) War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war,
rebellion, revolution, insurrection, martial law, military or usurped power or attempts at usurpation
of power.
i"(b) Any hostile detonation of any weapon of war employing atomic or nuclear fission 'and/or fusion
or other like reaction or radioactive force or matter.
(c) Strikes, riots, civil commotions or labor disturbances.
ill I
'(d) Any act of one or more persons, whether or not agents of a sovereign Power, for political or
terrorist purposes and whether the loss or damage resulting therefrom is accidental or intentional.
(e) Any malicious act or act of sabotage.
AAP 202 (11-99) Page 11 of 23
it
II
(f) Confiscation, nationalization, seizure, restraint, detention, appropriation, requisition for title or
use by or under the order of any Government (whether civil military or de facto) or public or
local authority.
(g) Hi-jacking or any unlawful seizure or wrongful exercise of control of the aircraft or crew in flight
(including any attempt at such seizure or control) made by any person or persons on board the
aircraft acting without the consent of the Insured.
Fu hermore this policy does not cover claims arising while the aircraft is outside the control of the
insred by reason of any of the above perils.
The aircraft shall be deemed to have been restored to the control of the insured on the safe return of
the aircraft to the insured at an airfield not excluded by the "coverage territory" of this policy, and
entirely suitable for the operation of the aircraft (such safe return shall require that the aircraft be
parked with engines shut down and under no duress).
C. Ra•ioactive Contamination.
1. This policy does not cover:
(a) loss or destruction of or damage to any property whatsoever or any loss or expense
whatsoever resulting or arising therefrom
(b) any legal liability of whatsoever nature
directly or indirectly caused or contributed to by or arising from ionizing radiations or
contamination by radioactivity from any source whatsoever.
2. Loss, destruction, damage, expense or legal liability which, but for the provisions of paragraph
1. of this exclusion, would be covered by this policy, and is directly or indirectly caused or
contributed to by or arises from ionizing radiations or contamination by radioactivity from any
radioactive materials in course of carriage as cargo under International Air Transport
Association Regulations, shall (subject to all other provisions of this policy). be covered,
provide that:
a. it shall be a condition precedent to our liability that the carriage of any radioactive
material shall in all respects comply with the current regulations issued by the
International Air Transport Association relating to the carriage of restricted articles by air;
b. this policy shall only apply to any claim made against the insured arising out of any
accident or incident occurring during the period of this insurance and any such claim
made by the insured against us or by any claimant against the insured shall have been
made within three years after the date of the occurrence giving rise to the claim;
c. the cover afforded by this paragraph 2. may be cancelled at any time by us giving seven
days notice of cancellation.
SECTION III -WHO IS AN INSURED
1. If ou are designated in the Declarations as:
a. An individual, you and your spouse are insureds, but only with respect to your "airport
operations".
b. A partnership or joint venture, you are an insured. Your members, your partners, and their
spouses are also insureds, but only with respect to your"airport operations".
c. A public corporation, you are an insured. Your elective or appointive officers or members of any
AAP 202,(11 99) Page 12 of 23
board or commission or agency of yours are also insureds, but only with respect to your "airport
operations".
d. An organization other than a partnership, joint venture or public corporation, you are an
insured. Your executive officers and directors are insureds, but only with respect to their duties
as your officers or directors. Your stockholders are also insureds, but only with respect to their
liability as stockholders.
2. Each of the following is also an insured:
.I a. Your employees, other than your executive officers, but only for acts within the scope of their
employment by you with respect to your"airport operations".
b. If you are designated in the Declarations as a public corporation, employees of your boards,
commissions or agencies, other than executive officers, but only for acts within the scope of their
employment by those boards, commissions or agencies with respect to your"airport operations".
° However, no employee of yours or your boards, commissions or agencies is an insured for:
(1) "Bodily injury" or "personal injury" to you or to a co-employee while in the course of his or
1 her employment, or the spouse, child, parent, brother or sister of that co-employee as a
consequence of such "bodily injury" or "personal injury", or for any obligation to share
damages with or repay someone else who must pay damages because of the injury; or
(2) "Bodily injury" or "personal injury" arising out of his or her providing or failing to provide
professional health care services; or
(3) "Property damage" to property owned or occupied by or rented or loaned to that
employee, any of your other employees, or any of your partners or membersl, (if you are a
partnership of joint venture).
c. Any person (other than your employee), or any organization, while acting as your real estate
manager.
d. Any person or organization having proper temporary custody of your property if you die, but only:
(1) With respect to liability arising out of the maintenance or use of that property; and
(2) Until your legal representative has been appointed.
e. Your legal representative if you die, but only with respect to duties as such. That
representative will have all your rights and duties under this policy.
3. 1;IWiti respect to "mobile equipment" registered in your name under any motor vehicle registration
slaw, any person is an insured while driving such equipment along a public highway with your
permission. Any other person or organization responsible for the conduct of such person is also an
ins red, but only with respect to liability arising out of the operation of the equipment, and only if no
other insurance of any kind is available to that person or organization for this liability. However, no
per on or organization is an insured with respect to:
a. "Bodily injury"to a co-employee of the person driving the equipment; or
b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the
employer of any person who is an insured under this provision.
No person or organization is an insured with respect to the conduct of any c4rent or past
partnership or joint venture that is not shown as a Named Insured in the Declarations.
AAP 202 (11 9) Page 13 of 23
SECTION IV - LIMITS OF INSURANCE AND DEDUCTIBLES
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A. ' LI ITS OF INSURANCE
1. The LIMITS OF INSURANCE (SECTION IV) shown in the Declarations and the rules below fix
the most we will pay regardless of the number of:
a. Insureds;
b. Claims made or"suits" brought; or
c. Persons or organizations making claims or bringing "suits".
2. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage
A for all damages because of "bodily injury" and "property damage" included in the "products-
completed operations hazard".
3. The Personal and Advertising Injury Aggregate Limit is the most we will pay under Coverage B
for the sum of all damages because of"personal injury" and "advertising injury".
4. The Malpractice Aggregate Limit is the most we will pay under Coverage A for all damages
because of"malpractice".
5. Subject to 2, 3 or 4 above, whichever applies, the Each Occurrence Limit is the most we will
pay for the sum of:
a. Damages because of all "bodily injury" and "property damage" under Coverages A and E;
and
b. Medical expenses under Coverage C; and
c. Damages because of physical injury to "aircraft" under Coverage D. arising out of one
"occurrence"; and
d. Damages because of all "personal injury" and "advertising injury" under Coverage B. arising
out of one offense.
6. Subject to 5. above, the Fire Damage Limit is the most we will pay under Coverage A for
damages because of"property damage"to premises rented to you arising out of any one fire.
7. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all
medical expenses because of"bodily injury" sustained by any one person.
8. Subject to 5. above, the Hangarkeepers Limit Any One Aircraft is the most we will pay under
Coverage D for damages because of physical injury sustained by any one, "aircraft" and the
Hangarkeepers Limit Any One Occurrence is the most we will pay under Coverage D for
physical injury sustained by all "aircraft" in any one "occurrence".
9. Subject to 5. above, the Non-Owned Aircraft Liability Limit Any One Occurrence is the most we
will pay under Coverage E for damages because of "bodily injury" and "property damage"
arising from one "occurrence".
Th- limits of this policy apply separately to each consecutive annual period and to any remaining
pe iod of less than 12 months, starting with the beginning of the policy period shown in the
D-clarations, unless the policy period is extended after issuance for an additional period of less than
12 months. In that case, the additional period will be deemed part of the last preceding period for
pu poses of determining the Limits of Insurance.
AAP 202�1(11 99) Page 14 of 23
B. D DUCTIBLES
1. Our obligation to pay:
a. Damages because of"bodily injury" and "property damage" under Coverages A and E; and
b. Medical expenses under Coverage C; and
c. Damages because of physical injury to "aircraft" under Coverage D arising out of one
occurrence; and
d. Damages because of "personal injury" and "advertising injury" under Coverage B arising out of
any one offense
applies only to the amount of damages or medical expenses in excess of the Each Occurrence or
Offense Deductible amount stated in the Declarations, but the LIMITS OF INSURANCE applicable to
Each Occurrence will not be reduced by the amount of such deductible, nor will Aggregate limits for such
coverages be reduced by the application of such deductible amount.
2. The Aggregate Deductible amount stated in the Declarations is the most you will have to pay
for all deductible amounts under Coverages A, B, C, D and E for all damages and medical
expenses.
3. The terms of this insurance, including those with respect to:
(a) Our right and duty to defend any "suits" seeking those damages; and
(b) Your duties in the event of an "occurrence", claim, or suit
apply irrespective of the application of the deductible amount.
4. We may pay any part or all of the deductible amount to effect settlement of any claim or suit
III and, upon notification of the action taken, you shall promptly reimburse us for such part of the
deductible amount as has been paid by us.
The Aggregate Deductibles of this policy apply separately to each consecutive annual period and to
any remaining period of less than 12 months, starting with the beginning of the policy ,period shown
in he Declarations, unless the policy period is extended after issuance for an additional period of
les than 12 months. In that case, the additional period will be deemed the last preceding period for
purposes of determining the aggregate deductibles.
SECTION V - CONDITIONS
1. Ba ikruptcy.
Bankruptcy or insolvency of the insured or of the insured's estate will not relievie us of our
obligations under this Policy.
III
2. , Duties In The Event Of Occurrence, Offense, Claim Or Suit.
a. You must notify us as soon as practicable of an "occurrence" or an offense which may result in
a claim. To the extent possible, notice should include:
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(1) How, when and where the "occurrence" or offense took place;
(2) The names and addresses of any injured persons and witnesses; and
(3) The nature and location of any injury or damage arising out of the "occurrence" or offense.
b. If a claim is made or"suit" is brought against any insured, you must:
AAP 202;(1149) Page 15 of 23
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(1) Immediately record the specifics of the claim or"suit" and the date received; and
(2) Notify us as soon as practicable.
You must see to it that we receive written notice of the claim or"suit" as soon as practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any demands, notices, summonses or legal papers
received in connection with the claim or"suit";
(2) Authorize us to obtain records and other information;
(3) Fullycooperate with us in the investigation, settlement or defense of the claim or"suit"; and
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(4) Assist us, upon our request, in the enforcement of any right against any person or
organization which may be liable to the insured because of injury or damage to which this
insurance may also apply.
d. No insureds will, except at their own cost, voluntarily make a payment, assume any obligation,
or incur any expense, other than for first aid, without our consent.
3. " Le•al Action Against Us.
No person or organization has a right under this policy:
a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or
b. To sue us on this policy unless all of its terms have been fully complied with.
A person or organization may sue us to recover on an agreed settlement or on a final judgment
against an insured obtained after an actual trial; but we will not be liable for damages that are not
pa'able under the terms of this policy or that are in excess of the applicable LIMITS OF
IN URANCE (SECTION IV). An agreed settlement means a settlement and release of liability
sig ed by us, the insured and the claimant or the claimant's legal representative.
4. Other Insurance.
If Other valid and collectible insurance is available to the insured for a loss we cover under Coverage
A, :, D or E of this policy, our obligations are limited as follows:
a. Primary Insurance
This insurance is primary except when b. below applies. If this insurance is primary, our
obligations are not affected unless any of the other insurance is also primary. Then, we will
share with all that other insurance by the method described in c. below.
b. Excess Insurance
This insurance is excess over any of the other insurance, whether primary, excess, contingent
or on any other basis:
(1) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for
"your work";
(2) That is Fire insurance for premises rented to you; or
(3) If the loss arises out of the maintenance or use of "autos" or watercraft to the extent not
subject to Exclusion f. of Coverage A (Section I).
(4) That is Aircraft Liability insurance on any aircraft to which Coverage E (Section I) applies.
AAP 202'(11- 9) Page 16 of 23
When this insurance is excess, we will have no duty under Coverage A, B, D dr E to defend
any claim or "suit" that any other insurer has a duty to defend. If no other insurer defends, we
will undertake to do so, but we will be entitled to the insured's rights against all those other
insurers.
When this insurance is excess over other insurance, we will pay only our share of the amount
of the loss, if any, that exceeds the sum of:
(1) The total amount that all such other insurance would pay for the loss in th'e absence of
this insurance; and
(2) The total of all deductible and self-insured amounts under all that other insurance.
We will share the remaining loss, if any, with any other insurance that is not described in this
Excess Insurance provision and was not bought specifically to apply in excess of,the Limits of
Insurance shown in the Declarations of this Policy.
lc. Method of Sharing
If all of the other insurance permits contribution by equal shares, we will follow, this method
also. Under this approach each insurer contributes equal amounts until it has paid its
applicable limit of insurance or none of the loss remains, whichever comes first.
If any of the other insurance does not permit contribution by equal shares, we will contribute by
limits. Under this method, each insurer's share is based on the ratio of its applicable limit of
insurance to the total applicable limits of insurance of all insurers.
5. premium Audit.
a. We will compute all premiums for this policy in accordance with our rules and rates.
b. Premium shown in this policy as advance premium is a deposit premium only. At the close of
each audit period we will compute the earned premium for that period. Audit premiums are due
and payable on notice to the first Named Insured. If the sum of the advance and audit
premiums paid for the policy term is greater than the earned premium, we will return the
excess to the first Named Insured.
c. The first Named Insured must keep records of the information we need for premium
computation, and send us copies at such times as we may request.
6. Rep esentations.
By accepting this policy, you agree:
�'
a The statements in the Declarations are accurate and complete;
li. Those statements are based upon representations you made to us; and
1
c,. We have issued this policy in reliance upon your representations.
7. Separation Of Insureds.
Except with respect to the LIMITS OF INSURANCE (SECTION IV), and any rights or duties
specifically assigned in this policy to the first Named Insured, this insurance applies separately to each
irisur d against whom claim is made or"suit" is brought.
-MP 202 (1.1-99 Page 17 of 23
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8. Transfer Of Rights Of Recovery Against Others To Us.
If he insured has rights to recover all or part of any payment we have made under this Policy, those
__ 11 rig is are transferred to us. The insured must do nothing after loss to impair them. At our request,
1" the insured will bring "suit" or transfer those rights to us and help us enforce them.
9. ,, Changes.
Thins policy contains all the agreements between you and us concerning the insurance iafforded. The
Ili first Named Insured shown in the Declarations is authorized to make changes in the l terms of this
policy with our consent. This policy's terms can be amended or waived only by endorsement issued
11 by .is and made a part of this policy.
10. Examination of your books and records.
��
IlWe may examine and audit your books and records as they relate to this policy at any time during
i the policy period and up to three years afterward.
11. I;lInspections and surveys.
We have the right but are not obligated to:
.1. Make inspections and surveys at any time;
91
2. Give you reports on the conditions we find; and
1.
3. Recommend changes.
Any inspections, surveys, reports or recommendations relate only to insurability and the premiums
i to be charged. We do not make safety inspections. We do not undertake to perform the duty of any
- person or organization to provide for the health or safety of workers or the public. And we do not
Warr nt that conditions:
1. Are safe or healthful; or
l
2. Comply with laws, regulations, codes or standards.
This condition applies not only to us, but also to any rating, advisory, rate service or similar
organization which makes insurance inspections, surveys, reports or recommendations.
12. Premiums and deductibles.
The first Named Insured shown in the Declarations:
1
111. Is responsible for the payment of all premiums and deductibles; and
21'. Will be the payee for any return premiums we pay.
Il,
13. Tran fer of your rights and duties under this policy.
Your rights and duties under this policy may not be transferred without our written consent except in
the c se of death of an individual named insured as directed below:
11 i 1
Ifilyod die, your rights and duties will be transferred to your legal representative but only while acting
within the scope of duties as your legal representative. Until your legal representative isi appointed,
- anyone having proper temporary custody of your property will have your rights and duties but only
with aspect to that property.
AAP 202 (11-99) Page 18 of 23
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SECTION VI - DEFINITIONS
1. "' "Advertising injury" means injury arising out of one or more of the following offenses:
a. Oral or written publication of material that slanders or libels a person or organization or
disparages a person's or organization's goods, products or services;
b. Oral or written publication of material that violates a person's right of privacy;
c. Misappropriation of advertising ideas or style of doing business; or
d. Infringement of copyright, title or slogan.
2. ',"Aircraft" under Coverage D means any aircraft or its parts or equipment.
3. "Airport" means the Airport(s) designated in the Declarations, including ways and means
immediately adjoining such airport(s).
4. .1"Airport operations" means the ownership, maintenance, use or provision of premises, I services and
!facilities necessary to the operation of the "airport".
5. "'Au o" means a land motor vehicle, trailer or semitrailer designed for travel on. public roads,
including any attached machinery or equipment, but"auto" does not include "mobile equipment".
6. injury" means:
la. Bodily injury, sickness or disease sustained by a person, including death resulting) from any of
these at any time; or
b. Fright or mental anguish sustained by a person.
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7. "Coverage territory" means:
a. The United States of America (including its territories and possessions), Puerto Rico and Canada;
b. International waters or airspace, provided the injury or damage does not occur in the course of
travel or transportation to or from any place not included in a. above; or
c. All parts of the world if:
(1) The injury or damage arises out of:
(a) Goods or products made or sold by you in the territory described in a. above; or
(b) The activities of a person whose home is in the territory described in a. above,
I
but is away for a short time on your business; and
(2) The insured's responsibility to pay damages is determined in a "suit" on the merits, in the
territory described in a. above or in a settlement we agree to.
8. "Impaired property" means tangible property, other than "your product" or "your work", that cannot
b,e used or is less useful because:
a'I It incorporates "your product" or "your work" that is known or thought to be defective, deficient,
1 inadequate or dangerous; or
b. You have failed to fulfill the terms of a contract or agreement;
r �
ifisuch property can be restored to use by:
a.1 The repair, replacement, adjustment or removal of"your product" or"your work"; or
AAP 202 (11-99) Page 19 of 23
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b. Your fulfilling the terms of the contract or agreement.
9. "Ir flight" means:
a. With respect to a fixed wing aircraft, from the time the aircraft moves forward in' attempting to
take off until the aircraft has completed its landing run. 1
1
b. With respect to a rotorcraft, while its rotors are in motion as a result of engine power or
autorotation.
10. "Insured contract" means:
a. A lease of premises;
b. A sidetrack agreement;
c. Any easement or license agreement, except in connection with construction or demolition
operations on or within 50 feet of a railroad;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with
work for a municipality;
e. An elevator maintenance agreement;
II
,'f. That part of any other contract or agreement pertaining to your business (including an
indemnification of a municipality in connection with work performed for a municipality) under
which you assume the tort liability of another party to pay for "bodily injury" j or "property
damage" to a third person or organization. Tort liability means a liability that would be imposed
by law in the absence of any contract or agreement.
An insured contract" does not include that part of any contract or agreement:
A. That indemnifies any person or organization for "bodily injury" or "property damage" arising out
of construction or demolition operations, within 50 feet of anyrailroad property and effecting
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any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing;
b. That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(1) Preparing, approving or failing to prepare or approve maps, drawings, opinions, reports,
surveys, change orders, designs or specifications; or
(2) Giving directions or instructions, or failing to give them, if that is the primary cause of the
injury or damage;
c. Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or
damage arising out of the insured's rendering or failure to render professional services,
including those listed in b. above and supervisory, inspection or engineering services; or
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d. That indemnifies any person or organization for damage by fire to premises rented or loaned to
you.
11. "Loading or unloading" means the handling of property:
a: After it is moved from the place where it is accepted for movement into or onto an aircraft,
II
watercraft or"auto";
b While it is in or on an aircraft, watercraft or"auto"; or
c:', While it is being moved from an aircraft, watercraft or"auto"to the place where it is finally delivered;
AAP 202 (11-99) Page 20 of 23
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but "loadingor unloading" does not include the movement of property bymeans of a mechanical
9 P P Y
device, other than a hand truck, that is not attached to the aircraft, watercraft or"auto".
__ 12. "Malpractice" means malpractice, error or mistake by a physician, surgeon, nurse, medical
technician or other person performing medical services on behalf of an insured in the provision of
emergency medical relief.
13. "Mobile equipment" means any of the following types of land vehicles, including any attached
machinery or equipment:
a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public
roads;
b. Vehicles maintained for use solely on or next to premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility tO permanently
mounted:
(1) Power cranes, shovels, loaders, diggers or drills; or
(2) Road construction or resurfacing equipment such as graders, scrapers or rollers;
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e. Vehicles not described in a., b., c. or d. above that are not self-propelled and are maintained
primarily to provide mobility to permanently attached equipment of the following types:
(1) Air compressors, pumps and generators, including spraying, welding, building cleaning,
geophysical exploration, lighting and well servicing equipment; or
(2) Cherry pickers and similar devices used to raise or lower workers;
f. Vehicles not described in a., b., c. or d. above maintained primarily for purposes other than the
transportation of persons or cargo.
However, self-propelled vehicles with the following types of permanently attached equipment
are not "mobile equipment" but will be considered "autos":
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing;
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted on automobile or truck chassis land used to
raise or lower workers; and
(3) Air compressors, pumps and generators, including spraying, welding, building cleaning,
geophysical exploration, lighting and well servicing equipment.
14. "Occurrence" means an accident, including continuous or repeated exposure to substantially the
same general harmful conditions.
15. "Personal injury" means injury, other than "bodily injury", arising out of one or more of the following
offe 'ses:
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AAP 202 (111-9' ) Page 21 of 23
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a. Mistaken arrest, detention or imprisonment;
b. Malicious prosecution;
c. The wrongful eviction from,, wrongful entry into, or invasion of the right of private occupancy of a
room, dwelling or premises that a person occupies by or on behalf of its owner, landlord or lessor;
d. Oral or written publication of material that slanders or libels a person or organization or
disparages a person's or organization's goods, products or services;
e. Oral or written publication of material that violates a person's right of privacy;
f. Unintentional discrimination;
g. Misdirection of a passenger by an insured to the wrong aircraft, automobile or other connecting
transportation; or
The offenses described in paragraph f. of this definition do not include personal injury arising out of
the -mployment, past employment or future employment of a person by any insured.
16. a. "Products-completed operations hazard" includes all "bodily injury" and "property damage"
occurring away from premises you own or rent and arising out of "your product" or "your work"
except:
(1) Products that are still in your physical possession; or
(2) Work that has not yet been completed or abandoned.
b. "Your work"will be deemed completed at the earliest of the following times:
(1) When all of the work called for in your contract has been completed.
(2) When all of the work to be done at the site has been completed if your contract calls for
work at more than one site.
(3) When that part of the work done at a job site has been put to its intended use by any person
or organization other than another contractor or subcontractor working on the same project.
Work that may need service, maintenance, correction, repair or replacement, but which is
otherwise complete, will be treated as completed.
c. This hazard does not include "bodily injury" or"property damage" arising out of:
(1) The transportation of property, unless the injury or damage arises out of a condition in or
on a vehicle created by the "loading or unloading" of it;
(2) The existence of tools, uninstalled equipment or abandoned or unused materials;
(3) Products or operations for which the classification in this policy or in our manual of rules
includes products or completed operations.
17. "Property damage" means:
a. Physical injury to tangible property, including all resulting loss of use of that property. All such
loss of use shall be deemed to occur at the time of the physical injury that caused it; or
b. Loss of use of tangible property that is not physically injured. All such loss shall be,deemed to
occur at the time of the "occurrence"that caused it.
AAP 202 (11-99) Page 22 of 23
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18. 1 "Suit" means a civil proceeding in which damages because of "bodily injury", "property damage",
1 "prsonal injury" or"advertising injury" to which this insurance applies are alleged. "Suit" includes:
a. An arbitration proceeding in which such damages are claimed and to which you must submit or
do submit with our consent; or
11 b. Any other alternative dispute resolution proceeding in which such damages are claimed and to
which you submit with our consent.
19. 1"Your product" means:
11a. Any goods or products, other than real property, manufactured, sold, handled, distributed or
disposed of by:
(1) You;
(2) Others trading under your name; or
(3) A person or organization whose business or assets you have acquired; and
lb. Containers (other than vehicles), materials, parts or equipment furnished in connection with
such goods or products.
"Your product" includes:
a. Warranties or representations made at any time with respect to the fitness, quality, durability,
1 performance or use of"your product"; and
b. The providing of or failure to provide warnings or instructions.
1,'Your product" does not include vending machines or other property rented to or located for the use
of others but not sold.
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20. j Your work" means:
a. Work or operations performed by you or on your behalf; and
b. Materials, parts or equipment furnished in connection with such work or operations.
'!Your work" includes:
a. Warranties or representations made at any time with respect to the fitness, quality, durability,
performance or use of"your work"; and
b. The providingof or failure toprovide warningsor instructions.g nst uctions.
AAP 202 (11-96) Page 23 of 23
This Endorsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
EXTENDED COVERAGE -WAR, HI-JACKING AND OTHER PERILS ENDORSEMENT
This Ten orsement modifies the insurance coverage provided under your AIRPORT OWNERS AND
OPERATORS GENERAL LIABILITY POLICY.
1. In consideration of the additional premium shown in the Schedule of this endorsement,
o sement, paragraphs
(a), (c), (d), (e), (f) and (g) of Exclusion B. of Common Coverage Exclusions (Section II) are not
applicable to Coverages A, C, D and E of this policy, SUBJECT TO all terms and conditions of this
endorsement.
2. Limit of insurance -Aggregate Limit
To the extent paragraph 1 above operates to extend the coverage provided by this policy to a claim
that otherwise would have been excluded by paragraphs (a), (c), (d), (e), (f) and/or (g) of exclusion B
of Common Coverage Exclusions (Section II), the most we will pay for all "bodily injury" and "property
damage" combined under Coverages A, C, D and E shall not exceed the Aggregate Limit shown in
the Schedule of this endorsement. The Aggregate Limit shown in the Schedule of this endorsement
is included within, not in addition to, the Occurrence Limit shown in the Declarations.
- 3. Exclusions
To he extent paragraph 1 above operates to extend the coverage provided by this policy to a claim
that otherwise would have been excluded by paragraph (a) of exclusion B. of Common Coverage
Exclusions (Section II), this policy still does not cover any liability for damage to any form of property
situated on the ground outside Canada or the United States of America, unless such damage is
caused by or arises out of the use of aircraft.
4. Any term, condition, provision, definition or endorsement, which relates to termination or cancellation
of the insurance coverage provided under this policy, is deleted as respects the coverage provided
by this endorsement. Termination or cancellation of the coverage provided by this endorsement
shal be governed solely by the provisions contained in this endorsement.
5. In the event that this policy is subject to the endorsement titled Exception to Terrorism Exclusion for
Certified Acts of Terrorism; cap on losses from Certified Acts of Terrorism, hereinafter called "said
endorsement", then the coverage provided by this endorsement does not apply to certified acts of
terrorism as defined under "said endorsement" whether or not any limitation under the Terrorism
Risk Insurance Act of 2002 is met or not. However, if this policy is not subject to "said endorsement",
this endorsement is not intended to, and does not, extend any coverage other than the (coverage
provided by Section 1 of this endorsement.
6. Automatic Termination
(a) This endorsement shall TERMINATE AUTOMATICALLY upon the outbreak of ward (whether
there be a declaration of war or not) between any two or more of the following: France, the
People's Republic of China, the Russian Federation, the United Kingdom and the United States
of America.
Endorsement No. 1
AAP 203 (02-03) Page 1 of 3 01/23/2007
ThisEndgrsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
EXTENDED COVERAGE -WAR, HI-JACKING AND OTHER PERILS ENDORSEMENT (CONT'D)
(b) To the extent the coverage under this policy is extended by the deletion of paragraph (a) of
exclusion B. of Common Coverage Exclusions (Section II), this endorsement shall TERMINATE
AUTOMATICALLY upon the hostile detonation of any weapon of war employing atomic or
nuclear fission and/or fusion or other like reaction or radioactive force or matter, wheresoever or
whensoever such detonation may occur, and whether or not the Insured Aircraft may be involved.
(c) All coverage in respect of an Insured Aircraft requisitioned for either title or use, if any, shall
TERMINATE AUTOMATICALLY upon such requisition.
PROVIDED THAT if an Insured Aircraft is in the air when (a), (b) or (c) occurs, then the coverage
q proided by this endorsement (unless otherwise cancelled, terminated or suspended) shall continue
in effect until such Insured Aircraft has completed its first landing thereafter and all passengers have
dis mbarked.
7. Review and Cancellation
(a) Review of Premium and/or Geographical Limits(7 days)
We may give notice to review the premium and/or geographical limits of your policy at any time.
Such notice is effective after the expiration of seven days from 23.59 hours Greenwich Mean
Time on the day notice is given.
In addition, we hereby give notice that we will review the premium and/or geographical limits
of your policy on January 1, April 1, July 1 and October 1 of the year(s) encompassed by the
policy period. We will issue notice advising you of any change in the premium and/or
geographical limits of your policy at least seven days in advance of the effective date oif any such
change.
(b) Limited Cancellation(48 hours)
Following a hostile detonation as specified in 6(b) above, we may give notice of a full or partial
cancellation of this endorsement. Such notice is to be effective after the expiration of',forty-eight
hours from 23.59 hours Greenwich Mean Time on the day notice is given.
(c) Cancellation(7 days)
This endorsement may be cancelled by either us or you by giving notice at any time. Such notice
is to be effective after the expiration of seven days from 23.59 hours Greenwich Mean Time on
the day notice is given.
(d) Notices
All notices referred to herein shall be in writing.
Subject otherwise to all terms and conditionsof the Policy to which this endorsement is attached.
Endorsement No. 1
AAP 203 (02-03) Page 2 of 3 01/23/2007
This End rsement effective January 1,2007
forms par of Policy Number AAP N00981862 004
Issued to� City of Renton
By Ace P operty And Casualty Insurance Company
'EXTENDED COVERAGE -WAR, HI-JACKING AND OTHER PERILS ENDORSEMENT (CONT'D)
tl SCHEDULE
Aggi1eg to Limit: $50,000,000
Annual Additional Premium: $5,000
Premium Due Hereon: $5,000
Authorized Representative
Endorsement No. 1
AAP 203 (02-03) Page 3 of 3 01/23/2007
This End rsement effective January 1,2007
forms pa of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
AMENDMENT OF NOISE AND POLLUTION AND OTHER PERILS EXCLUSION
This endorsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL
LIABILITY POLICY.
Paragra h 1.A.(b) of the Pollution Endorsement AAP 273 (11-03) does not apply to pollution or
contamination of"your product."
Authorized Representative
Endorsement No. 2
AAP 204(11-03) 01/23/2007
This Endorsement effective January 1,2007
forms parr.of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
EXTENSION - SPECIFIC EXCESS LIABILITY INSURANCE
This lienorsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL
LIABILIT POLICY.
SCHEDULE
Underlying Insurance: Automobile Liability Insurance
Underlying Limits of Liability ("ultimate net loss"): $14,000,000 any one accident/occurrence
Underlying Insurers: Self-Insured
Limits of Insurance
Each Occurrence Limit: $50,000,000
Aggregate Limit: Not Applicable
This policy is amended to include the following coverage:
COVERPGE F. SPECIFIC EXCESS LIABILITY
1. INSURING AGREEMENT:
a. We will pay those sums that the insured becomes legally obligated to pay as damages
because of bodily injury or property damage to which this insurance applies.
b. This insurance applies to bodily injury or property damage only if:
(1) The bodily injury or property damage is caused by an "occurrence" that takes place in the
"coverage territory"; and
(2) The bodily injury or property damage occurs during the policy period; and
(3) The bodily injury or property damage arises out of the hazards covered by and' defined in
the underlying insurance described in the Schedule.
(4) The bodily injury or property damage arises out of your"airport operations".
EXCLUSIONS:
2.
Thi insurance is subject to the Common Coverage Exclusions (Section II) of this policcy and, in
addition, the same exclusions which are contained in the underlying insurance shown in the
Schedule, but only to the extent that they do not conflict with the Common Coverage Exclusions
(Section II) of this policy.
Endorsement No. 3
AAP 211 (11/99) Page 1 of 3 01/23/2007
This End rsement effective January 1,2007
_ forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
EXTENSION - SPECIFIC EXCESS LIABILITY INSURANCE (CONT'D)
3. ATTACHMENT OF LIABILITY AND LIMITS OF LIABILITY:
We will pay under Coverage F only after the underlying insurers shown in the Schedule have paid
or have been held liable to pay the full amount of the underlying limits of liability as shown in the
Schedule.
The most we will pay under Coverage F regardless of the number of:
a. Insureds;
b. Claims made or"suits" brought; or
c. Persons or organizations making claims or bringing "suits"
is he Each Occurrence Limit shown in the Schedule subject, if applicable, to the Aggregate Limit
shown in the Schedule.
4. CONDITIONS:
a. This insurance is subject to the same terms and conditions contained in or added to the
underlying insurance prior to the happening of an "occurrence" for which a claim is made
under this policy.
111
This condition 4.a. does not apply to the premium, our obligation to investigate and defend,
the renewal agreement(if any) and the limits of insurance.
b. The underlying insurance shall be maintained in full effect during the policy period, but:
(1) If the aggregate limit contained in the underlying insurance is reduced or exhausted
because of payment of claims, this policy will apply in excess of the reduced' aggregate
limit or will apply as underlying insurance if the aggregate limit is exhausted.
(2) If the insured fails to comply with this condition, this policy shall only apply to the same
extent as would have been the case had the insured complied with this condition.
11c. If a claim or claims arise which appear likely to exceed the underlying limits of liability the
insured must not incur any "costs"without our consent.
Id. "Costs" incurred by or on behalf of the insured with our consent and for which the insured is
not covered by the underlying insurers, will be apportioned as follows:
(1) As respects claims which are settled before trial for an amount which does not exceed
the underlying limits of liability, we will not pay any"costs".
(2) As respects claims which are settled before trial for an amount which exceeds the
underlying limits of liability, we will pay the same percentage of the "costs" as the
percentage we pay of the whole "ultimate net loss".
Endorsement No. 3
AAP 211 (11/99) Page 2 of 3 01/23/2007
This End rsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
EXTENSION - SPECIFIC EXCESS LIABILITY INSURANCE (CONT'D)
(3) If the insured does not appeal a judgment which exceeds the underlyinglimits of liability,
pp J 9
we may elect to conduct such an appeal at our own expense including any associated
court costs and interest, but the most we will pay for such an appeal is limited to the
limits of insurance shown in the Schedule, plus the expenses of the appeal.
e. All recoveries or payments recovered or received subsequent to a claim settlement under this
policy shall be applied as if recovered or received prior to such settlement. All necessary
adjustments shall then be made between you and us.
5 DEFINITIONS:
a. The term "ultimate net loss" means the amount payable in settlement of the liability of the
insured after making deductions for all recoveries and for other valid and collectible insurances,
excepting however the underlying insurance and shall exclude all expenses and "costs".
b. The term "costs" means interest accruing after entry of judgment, investigation, adjustment and
legal expense (excluding, however, all expenses for salaried employees and general retainer
fees for counsel normally paid by the insured).
6. Section V of this policy shall apply to this insurance except condition 4. (Other Insurance).
Authorized Representative
Endorsement No. 3
AAP 211 (11/99) Page 3 of 3 01/23/2007
This Endorsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company /
IMMUNITY WAIVER ENDORSEMENT
Thisendgrsement modifies insurance provided underAIRPORT OWNERS AND OPERATOR GENERAL
LIABILITY POLICY.
We will of defend any "suit" seeking damages under Coverages A, B, D, or E on the basis that the insured
is not liable due to the performance of governmental functions, unless we are required by statute or are
requested by you.
Authorized Representative
Endorsement No. 4
AAP 220(11/99) 01/23/2007
This Endorsement effective January 1,2007
forrns prt of Policy Number AAF N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
AIRPORT LIMITED ENHANCED COVERAGE ENDORSEMENT
This endorsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL
LIABILITY POLICY.
1. (a) Item 1(c) of Who is an Insured on page 13 of the policy is amended to read:
A public corporation, you are an insured. Your boards, commissions or agencies and their
elective or appointive officers or members thereof are also insureds, but only with respect to
your"airport operations".
(b) Item 1(d) of Who is an Insured on page 13 of the policy is amended to read:
An organization other than a partnership,joint venture or public corporation, you are'an insured.
Your subsidiary companies, corporations, firms, affiliates, organizations, including joint
ventures of the Named Insured in Item 1 of the Declarations which are owned,, financially
controlled or under your management control are also insureds but only with respect to your
airport operations". Your executive officers and directors are insureds, but only with respect
to their duties as your officers or directors. Your stockholders are also insureds, but only with
respect to their liability as stockholders.
2. Any reference in the policy to F.A.A. is amended to include its foreign equivalent.
3. The following is added to Condition 2 - (Duties In The Event Of Occurrence, Claim or Suit.)
e. Knowledge of an occurrence by your agent, servant or employee shall not constitute knowledge
by you, unless an executive officer, partner, proprietor or an employed risk manager has
received such notice.
4. Condition 6 -(Representations) is amended to include:
d. Your unintentional failure to disclose facts shall not be a basis for denial of an) coverage,
provided that it is corrected as soon as it is discovered by an executive officer, partner, proprietor
or employed risk manager.
e. Your inadvertent failure to submit reports or contracts or comply with other notices, except those
required under Condition 2, shall not invalidate this insurance, provided it is corrected as soon
as it is discovered by an executive officer, partner, proprietor or employed risk manager.
5. The Definition of"airport" is amended to read:
" irport" means the airport(s) designated in the declarations, and other airports owned olr rented by
you, including ways and means immediately adjoining such airports.
6. The Definition of"airport operations" is amended to read:
"Airport operations" means the ownership, maintenance, use or provision of premises, services and
facilities necessary or incidental to the operation of the "airport".
Endorsement No. 5
AAF 234(11/99) Page 1 of 2 01/23/2007
I
This Endorsement effective January 1,2007
forms part of Policy Number AAF N00981862 004
Issued o City of Renton
By Ace Property And Casualty Insurance Company
AIRPORT LIMITED ENHANCED COVERAGE ENDORSEMENT (CONT'D.)
7. 1 The Definition of"advertising injury" is amended to include:
e. Infringement of trademark, service mark or trade name.
8. The Definition of"aircraft" is amended to read:
"Aircraft" under Coverage D means any aircraft, including its parts, equipment and contents.
9. 1 Item A.6. under Limits of Insurance is amended to read:
11
6. Subject to 5. above, the Fire Damage Limit is the most we will pay under Coverage A for
damages because of"property damage" to premises rented to you or temporarily occupied by
you, arising out of any one fire.
10. Exclusion f of Section I of this policy(Aircraft,Auto or Watercraft)does not apply to watercraft less than
26 feet in length.
11.1 xclusion a. of Section I of this policy (Expected or Intended Injury) is amended to read:
his Insurance does not apply to:
a Expected or Intended Injury
"Bodily injury" or"property damage" expected or intended from the standpoint of the'insured.
This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of
reasonable force to protect persons or property.
12.' Exclusion h. of Section I of this policy (Air Meet, Contest, Exhibition) may be deleted, subject to 30
days prior notice to us, at terms to be agreed.
13.'"II It-m 2.b. (1) of Who Is An Insured is deleted.
Authorized Representative
(
Endorsement No. 5
AAP 23 (11/99) Page 2 of 2 01/23/2007
This End rsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
NUCLEAR RISKS EXCLUSION CLAUSE
It is understood and agreed that the Radioactive Contamination exclusion under part C. of the Common
9
Coverage Exclusions (Section II) is deleted and replaced with the following:
(1) Th s Policy does not cover:
(i) loss of or destruction of or damage to any property whatsoever or any loss or expense
whatsoever resulting or arising therefrom or any consequential loss
(ii) any legal liability of whatsoever nature
directly or indirectly caused by or contributed to by or arising from:
11 (a) the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly
or nuclear component thereof;
(b) the radioactive properties of, or a combination of radioactive properties with toxic, explosive or
P PP P P
other hazardous properties of, any other radioactive material in the course of carriage as cargo,
including storage or handling incidental thereto;
(c) ionizing radiations or contamination by radioactive form, or the toxic, explosive or other
hazardous properties of, any other radioactive source whatsoever.
(2) It i understood and agreed that such radioactive material or other radioactive source in' paragraph
(1)((b) and (c) above shall not include:
(i) depleted uranium and natural uranium in any form;
(ii) radioisotopes which have reached the final stage of fabrication so as to be usable for any
scientific, medical, agricultural, commercial, educational, or industrial purpose.
(3) This Policy, however, does not cover loss of or destruction of or damage to any property or any
consequential loss or any legal liability of whatsoever nature with respect to which:
(i) the Insured under this Policy is also an insured or an additional insured under' any other
insurance policy, including any nuclear energy liability policy; or
(ii) any person or organization is required to maintain financial protection pursuant to legislation
in any country; or
(iii) the Insured under this Policy is, or had this Policy not been issued would be, entitled to
indemnification from any government or agency thereof.
(4) Loss, destruction, damage, expense or legal liability in respect of the nuclear risks not excluded by
reason of paragraph (2) shall (subject to all other terms, conditions, limitations, warranties and
exclusions of this Policy) be covered, provided that:
Endorsement No. 6
AAP 237 (11/99) Page 1 of 2 01/23/2007
11
This Endorsement effective January 1,2007
forms pars of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
NUCLEAR RISKS EXCLUSION CLAUSE (CONT'D.)
(i) in the case of claim in respect of radioactive material inthe coursecarriage
any p of as cargo,
including storage or handling incidental thereto, such carriage shall in all respects have
complied with the.full International Civil Aviation Organization "Technical Instructions for the Safe
Transport of Dangerous erous Goods byAir", unless the carriage e shall have been subject to anymore
p 9
restrictive legislation, when it shall in all respects have complied with such legislation;
(ii) this Policy shall only apply to an incident happening during the period of this Policy and where
any claim by the Insured against us or by any claimant against the Insured arising out of such
incident shall have been made within three years after the date thereof;
iii( ) in the
e case of any claim for the loss of or destruction of or damage to or loss of use of an
aircraft caused by or contributed to by radioactive contamination, the level of such
contamination shall have exceeded the maximum permissible level set out in the following
scale:
Emitter Maximum permissible level of non-fixed
radioactive surface contam nation
(IAEA Health and Safety Regulations) (Averaged over 300 cm2 )
•
Beta, gamma and low toxicityalpha emitters Not exceeding4 Bequerels/cm2
2
P Q
(10-4 microcuries/cm 2 )
All other emitters Not exceeding Bequerels/cm2
Be uerels/cm
2
(10-5 microcuries/cm 2 )
(iv) the cover afforded hereby may be cancelled by us at any time by giving seven days' notice of
cancellation.
Endorsement No. 6
AAP 237(11/99) Page 2 of 2 01/23/2007
I�I
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it
1.1
11
This End rsement effective January 1,2007
forms par of Policy Number AAP N00981862 004
Issued to ' City of Renton
By Ace P operty And Casualty Insurance Company
EXCESS AUTOMOBILE LIABILITY
IMP IId RTANT PROVISIONS WITH RESPECT TO EXCESS AUTOMOBILE LIABILITY INSURANCE PROVIDED
BY END RSEMENT AAP 211, WHICH FORMS PART OF THIS POLICY.
In co'nse uence of:
(a) th Insured being responsible for the handling and payment of claims within the Underlying Limits
of lability (Ultimate Net Loss) as shown in endorsement AAP 211, this being without the existence
of tformal policy of Insurance;and
(b) 1 th coverage provided by endorsement AAP 211 being dependent upon the existence of written terms
an' conditions within a primary policy of insurance;
it is and rstood and agreed that the excess Automobile Insurance provided by endorsement AAP 211 is
limite�id t those payments that we would have made had the Insured purchased primary Automobile
Insuanc- issued under the Business Auto Coverage Form which is attached to and forms part of this
policy.
Authorized Representative
Endorse ent No. 7
AAP 238 11/99) 01/23/2007
1
11
II
III
COMMERCIAL AUTO
CA00011001
i
BUSINESS AUTO COVERAGE FORM
t
11
Variou provisions in this policy restrict coverage. SECTION I—COVERED AUTOS
Read the entire policy carefully to determine rights, Item Two of the Declarations shows the "autos" that
duties nd what is and is not covered. are covered "autos" for each of your coverages. The
rou hout this policy the words "you" and "your" following numerical symbols describe tbe "autos"
refer t the Named Insured shown in the Declare- that may be covered "autos". The symbols entered
tions. he words "we", "us" and "our" refer to the next to a coverage on the Declarations designate the
Comp ny providing this insurance. only"autos"that are covered"autos".
Otherwords and phrases that appear in quotation A. Description Of Covered Auto Designation
marks have special meaning. Refer to Section V — Symbols
Definitions.
II
Symbol Description Of Covered Auto Designation Symbols
11
Y P 9 Y
11
I Any"Auto"
2 Owned"Autos" Only those"autos"you own (and for Liability Coverage any"trailers"you don't own
Only while attached to power units you own).This includes those"autos"you acquire
11 ownership of after the policy begins. •
' 3 Owned Private Only the private passenger"autos"you own.This includes those private passenger
Passenger "autos"you acquire ownership of after the policy begins.
11
11 "Autos" Only
' 4 Owned"Autos" Only those"autos"you own that are not of the private passenger type (and for Li-
Other Than Pri- ability Coverage any"trailers"you don't own while attached to power units you
1 vate Passenger own).This includes those"autos" not of the private passenger type you acquire
"Autos" Only ownership of after the policy begins.
11, 5 Owned "Autos" Only those"autos" you own that are required to have No-Fault benefits in tlhe state
Subject To No- where they are licensed or principally garaged.This includes those"autos"you ac-
Fault quire ownership of after the policy begins provided they are required to have No-
Fault benefits in the state where they are licensed or principally garaged.
1
1I 6 Owned"Autos" Only those"autos"you own that because of the law in the state where they are li-
Subject To A censed or principally garaged are required to have and cannot reject Uninsured
Compulsory Motorists Coverage.This includes those"autos"you acquire ownership of after the
Uninsured Mo- 'policy begins provided they are subject to the same state uninsured motorists m-
il Law quirement.
II 7 Specifically De- Only those"autos" described in Item Three of the Declarations for which a pre-
scribed"Autos" mium charge is shown (and for Liability Coverage any"trailers"you don't own while
attached to any power unit described in Item Three).
8 Hired"Autos" Only those"autos"you lease, hire, rent or borrow.This does not include any"auto"
Only you lease, hire, rent, or borrow from any of your"employees", partners (if you are a
11 members ou are a limited liabilitycompany) or members of their
partnership), (ifY P Y)
households.
r' 9 Nonowned Only those"autos"you do not own, lease, hire, rent or borrow that are used in con-
"Autos"Only ,nection with your business. This includes"autos"owned by your"employees", part-
11
ners (if you are a partnership), members(if you are a limited liability company), or
'members of their households but only while used in your business or your personal
11 affairs.
1,11
11
1,11
CA 00 01 10 01 ©ISO Properties, Inc., 2000 Page 1 of 11 0
II
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B.,Owned Autos You Acquire After The Policy We will also pay all sums an "insured" legally must
II Be ins pay as a "covered pollution cost or ,expense" to
I, 1. �f Symbols 1, 2, 3, 4, 5 or 6 are entered next to which this insurance applies, caused by an "acci-
dent" and resultingfrom the ownership mainte-
tcoverage in Item Two of the Declarations, p,
hen you have coverage for "autos" that you nance or use of covered "autos". However, we will
acquire of the type described for the remainder only pay for the "covered pollution cast or ex
pense" if there is either "bodilyinjury" or "property
f the policy period. damage" to which this insurance applies that is
2. ut, if Symbol 7 is entered next to a coverage caused by the same"accident".
n Item Two of the Declarations, an "auto you
acquire will be a covered "auto" for that cover We have the-right and duty to defend any"insured"
age only if: against a "suit" asking for such damages or a
II
"covered pollution cost or expense". However, we
. We already cover all "autos" that you own have no duty to defend any "insured" against a
for that coverage or it replaces an "auto"
g p "suit" seeking damages for"bodily injury or prop-
you previously owned that had that cover- erty damage" or a "covered pollution cost or ex-
age; and pense"to which this insurance does not apply. We
You tell us within 30 days after you acquire may investigate and settle any claim or"suit"as we
it that you want us to cover it for that cover- consider appropriate. Our duty to defend or settle
age. ends when the Liability Coverage Limit of Insur-
ance has been exhausted by payment of judg-
C.Ij Ce ain Trailers, Mobile Equipment And ments or settlements.
Te porary Substitute Autos
If L ability Coverage is provided by this Coverage 1. Who Is An Insured
I,For , the following types of vehicles are also coy- The following are"insureds":
II ere "autos"for Liability Coverage: a. You for any covered"auto".
li 1. "Trailers" with a load capacity of 2,000 pounds b. Anyone else while using with your permis-
Qr less designed primarily for travel on public sion a covered "auto" you own, hire or bor-
II roads. row except: ,
2. "Mobile equipment" while being carried or (1) The owner or anyone else from whom
towed by a covered"auto". you hire or borrow a covered "euto". This
3. Any "auto" you do not own while used with the exception does not apply if the covered
permission of its owner as a temporary substi- "auto" is a "trailer" connected to a coy-
II tute for a covered "auto" you own that is out of ered"auto"you own.
service because of its: (2) Your "employee" if the covered "auto" is
I, . Breakdown; owned by that "employee" or 6. member
li Repair; of his or her household.
Servicing; (3) Someone using a covered "aato" while
he or she is working in a business of
"Loss"; or selling, servicing, repairing,
g; clerking or
Destruction. storing "autos" unless that business is
SECTION II—LIABILITY COVERAGE yours.
A. Co erage (4) Anyone other than your "er ployees",
partners (if you are a partnership),
11 We will pay all sums an "insured" legally must pay members (if you are a limited liability
as amages because of"bodily injury" or"property company), or a lessee or bclrrower or
damage" to which this insurance applies, caused any of their "employees", while moving
by .n "accident" and resulting from the ownership, ' property to or from a covered"auto".
mai tenance or use of a covered"auto".
(5) A partner (if you are a partnership), or a
member (if you are a limited liability
company) for a covered "auto"owned by
III
,11 him or her or a member of his or her
III household.
d
11
Page 2 of 11 ©ISO Properties, Inc., 2000 CA 001 01 10 01 ID
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c. Anyone liable for the conduct of an "in- B. Exclusions
sured" described above but only to the ex- This insurance does riot apply to any of the fol-
tent of that liability. lowing:
2. Coverage Extensions 1. Expected Or Intended Injury
II .. Supplementary Payments "Bodily injury" or "property damage" expected
In addition to the Limit of Insurance, we will or intended from the standpoint of the "in-
pay for the"insured": sured".
(1) All expenses we incur. 2. Contractual
(2) Up to $2,000 for cost of bail bonds (in- Liability assumed under any contractor agree-
cluding bonds for related traffic law vio- ment.
lations) required because of an "acci- But this exclusion does not apply to liability for
dent" we cover. We do not have to fur- damages:
nish these bonds. '
(3) The cost of bonds to release attach a. Assumed in a contract or agreement that is
an "insured contract" provided the "bodily
1 ments in any "suit" against the "insured" injury" or "property damage" occurs subse-
11 defend, but only for bond amounts quent to the execution of the contract or
within our Limit of Insurance. agreement; or
reasonable expenses incurred
(4) All
p by the b. That the "insured" would have in the ab-
"insured" at our request, including actual sence of the contract or agreement.
loss of earnings up to $250 a day be-
cause of time off from work. 3. Workers' Compensation
(5) All costs taxed against the "insured" in Anyu obligation
ion for
may which
the held liable
or the
any "suit" against the "insured" we de- Y under any
fend. workers' compensation, disability benefits or
(6) All interest on the full amount of any unemployment compensation law or any similar
judgment that accrues after entry of the law.
judgment in any "suit" against the "in- 4. Employee Indemnification And Employer's
, sured" we defend, but our duty to pay Liability
interest ends when we have paid, of- "Bodily injury"to:
fered to pay or deposited in court the a. An"employee" of the"insured"arising out of
part of the judgment that is within our and in the course of:
Limit of Insurance.
(1) Employment by the"insured"; Or
b. Out-Of-State Coverage Extensions
a covered "auto" is away from the (2) Performing the duties related to the con-
While state where it is licensed we will: duct of the"insured's"businessl; or
b. The spouse, child, parent, brother or sister
(1) Increase the Limit of Insurance for Li- of that "employee" as a consequence of
ability Coverage to meet the limits Paragraph a. above.
specified bya compulsory or financial
p p ry This exclusion applies:responsibility law of the jurisdiction pp
where the covered "auto" is being used. (1) Whether the "insured" may be liable as
This extension does not apply to the limit an employer or in any other capacity;
or limits specified by any law governing and
motor carriers of passengers or prop (2) To any obligation to share damages with
erty. or repay someone else who must pay
(2) Provide the- minimum amounts and damages because of the injury!
types of other coverages, such as no- I[But this exclusion does not apply to 'bodily in-
fault, required of out-of-state vehicles by "employees"
the jurisdiction where the covered "auto" jury" to domestic not entitled to
is being used. workers' compensation benefits or to liability
assumed by the "insured" under an "insured
We will not pay anyone more than once for contract". For the purposes of the Coverage
the same elements of loss because of Form, a domestic "employee" is a person en-
these extensions. gaged in household or domestic work per-
formed principally in connection with a resi-
, dence premises.
1.
CA'00 a 1 10 01 ©ISO Properties, Inc., 2000 Page 3 of 11 0
III
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5. Fellow Employee (2) When all of the work to be done at the
i "Bodily injury" to any fellow "employee" of the site has been completed if your contract
II "insured" arising out of and in the course of the calls for work at more than one site.
ellow "employee's" employment or while per- (3). When that part of the work done at a job
orming duties related to the conduct of your site has been put to its intended use by
usiness. any person or organization other than
6. Care, Custody Or Control another contractor or subcontractor
working on the same project.
"Property damage"to or"covered pollution cost
II or expense" involving property owned or trans- Work that may need service, maintenance,
Dolled by the "insured" or in the "insured's" correction, repair or replacement, but which
Care custod or control. But this exclusion is otherwise complete, will be treated as
Y
completed.
.oes not apply to liability assumed under a p
idetrack agreement. 11. Pollution
7. andlin Of Property "Bodilyinjury" or"property dams e" arising out
9 P Y 1rY 9 9
'Bodily injury" or "property damage" resulting of the actual, alleged or threatened discharge,
11 rom the handling of property: dispersal, seepage, migration, release or es-
cape of"pollutants":
Before it is moved from the place where it is
a. That are, or that are contained in any prop-
accepted by the "insured" for movement
into or onto the covered"auto"; or erty that is:
•. After it is moved from the covered "auto" to (1) Being transported or towed by, handled,
the place where it is finally delivered by the or handled for movement into, onto or
"insured". from, the covered "auto";
(2) Otherwise in the course of tr nsit byor
� 8. ovement Of Property By Mechanical
11 ievice on behalf of the"insured"; or
'Bodily injury" or "property damage" resulting
(3) Being stored, disposed of, treated or
rom the movement of roe b a mechani processed in or upon the covered"auto";
11
p p rtY Y
cal device (other than a hand truck) unless the b. Before the "pollutants" or any property in
device is attached to the covered"auto". which the "pollutants" are contained are
G 9. •perations moved from the place where they are'Bodilyac-
injury" or "property dama e" arisingout cepted by the "insured" for movement into
9 or onto the covered"auto"; or
11 .f the operation of any equipment listed in
"aragraphs 6.b. and 6.c. of the definition of c. After the "pollutants" or any p loperty in
mobile a quip ment". which the "pollutants" are contained are
q P
moved from the covered "auto" to theplace
10. ompleted Operations where they are finally delivered, disposed of
'Bodily injury" or "property damage" arising out or abandoned by the"insured".
.f your work after that work has been com- Paragraph a. above does not appl to fuels,
.leted or abandoned. lubricants, fluids, exhaust gases or other
n this exclusion, your work means: similar "pollutants" that are needed for or
:. Work or operations performed by you or on result from the normal electrical, hydraulic
I your behalf; and or mechanical functioning of the covered
"auto"or its parts, if:
b. Materials, parts or equipment furnished in
connection with such work or operations. (1) The "pollutants" escape, seeps, migrate,
or are discharged, dispersed or released
Your work includes warranties or representa- directly from an "auto" part designed by
1 ions made at anytime with respect to the fit
p its manufacturer to hold store receive
11 ess, quality, durability or performance of any or dispose of such"pollutants"; and
11 f the items included in Paragraphs a. or b.
above. (2) The "bodily injury", "property damage" or
"covered pollution cost or expepse"does
Your work will be deemed completed at the not arise out of the operation of any
II earliest of the following'times: equipment listed in Paragraphs 6.b. and
(1) When all of the work called for in your 6.c. of the definition of "mobile equip-
contract has been completed. ment".
111
a O Pge 4 of 11 ISO Properties, Inc., 2000 CA 00 01 10 01 ❑
it
Paragraphs b. and c. above of this exclu- SECTION III—PHYSICAL DAMAGE COVERAGE
sion do not apply to "accidents" that occur A. Coverage
away from premises owned by or rented to an "insured" with respect to "pollutants" not 1. We will pay for "loss" to a covered "auto" or its
,
in or upon a covered"auto" if: equipment under:
(1) The "pollutants" or any property in which a. Comprehensive Coverage
the "pollutants" are contained are upset, From any cause except:
overturned or damaged as a result of the "auto's"The covered collision with an-
maintenance or use of a covered "auto"; other object; or
and
(2) The discharge, 'dis ersal seepage, mi-
gration, release or escape of the "pollut- b. Specified Causes Of Loss Coverage
ants" is caused directly by such upset, Caused by:
overturn or damage. (1) Fire, lightning or explosion;
12. War (2) Theft;
'Bodily injury" or"property damage" due to war, (3) Windstorm, hail or earthquake;
whether or not declared, or any act or condition
ncident to war. War includes civil war, insur- (4) Flood;
ection, rebellion or revolution. This exclusion (5) Mischief or vandalism; or
ppiies only to liability assumed under a con-
ract or agreement. (6) The sinking, burning, collision or derail-
ment of any conveyance trans p orting the
13. Racing covered."auto".
Covered "autos" while used in any professional c. Collision Coverage
r organized racing or demolition contest or
tunting activity, or while practicing for such Caused by:
ontest or activity. This insurance also does not (1) The covered "auto's" collision with an-
pply while that covered "auto" is being pre- other object; or
ared for such a contest or activity. (2) The covered"auto's"overturn.
C I; Li it Of Insurance 2. Towing
Re ardless of the number of covered "autos", "in- We will pay up to the limit shown in the Decla-
surds", premiums paid, claims made or vehicles rations for towing and labor costs incurred each
involved in the "accident", the most we will pay for time a covered "auto" of the private passenger
the total of all damages and"covered pollution cost type is disabled. However, the labor must be
or xpense" combined, resulting from any one "ac- performed at the place of disablement.
cid nt is the Limit of Insurance for Liability Cover-
ag shown in the Declarations. 3. Glass Breakage—Hitting A Bird Or Animal—
Falling Objects Or Missiles
All 'bodily injury", "property damage" and "covered
pollution cost or expense" resulting from continu- If you carry Comprehensive Coverage for the
ou or repeated exposure to substantially the damaged covered "auto", we will pay for the
same conditions will be considered as resulting following under Comprehensive Coverage:
from one"accident". a. Glass breakage;
No one will be entitled to receive duplicate pay- b. "Loss" caused by hitting a bird or animal;
ments for the same elements of "loss" under this and
Co erage Form and any Medical Payments Coy- c. "Loss"caused by falling objects or missiles.
era a Endorsement, Uninsured Motorists Cover-
ag Endorsement or Underinsured Motorists Coy However, you have the option of having glass
erase Endorsement attached to this Coverage breakage caused by a covered"auto's' collision
Part or overturn considered a "loss" under Collision
Coverage.
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CA 00 01 10 01 ©ISO Properties, Inc., 2000 Page 5 of 11 0
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4. overage Extensions b. War Or Military Action
II
III . Transportation Expenses (1) War, including undeclared or civil war;
II We will pay up to $20 per day to a maxi- (2) Warlike action by a military force, in-
III mum of $600 for temporary transportation cluding action in hindering or defending
II
11 expense incurred by you because of the against an actual or expected attack, by
total theft of a covered "auto" of the private any government, sovereign or other
passenger type. We will pay only for those authority using military personnel or
11
covered "autos" for which you carry either other agents; or
Comprehensive or Specified Causes of (3) Insurrection, rebellion, revolution,
11 usurped power or action taken
Loss Coverage. We will pay for temporary by gov-
transportation expenses incurred during the
period beginning 48 hours after the theft
ernmental authority in hindering or de-
p g g fending against any of these.
and ending, regardless of the policy's expi-
„
2. We will not payfor"loss" to anycovered auto
ration, when the covered auto" is returned .
while used in anyprofessional or organized
to use or we pay for its"loss".
9
racingor demolition contest or stunting activity,
.. Loss Of Use Expenses
9 Y.
p
or while practicingfor such contest or activity.
1111 Y
For HiredPhysicalD Iyr AutoDamage, we willWe will also not payfor "loss" to any� covered
ed
III 9
pay expenses for which an "insured" be- "auto" while that covered "auto" is being pre-
11 comes legally responsible to pay for loss of pared for such a contest or activity.
III use of a vehicle rented or hired without a
3. We will notfor"loss"caused byresulting
11 driver under a written rental contract or
pay o s ori
to t t
from anyof the followingunless caused
agreement. We will pay for loss of use ex- by
penses if caused by:
other"loss"that is covered by this insurance:
a. Wear and tear, freezing, mecl-anical or
(1) Other than collision onlyif the Declara-
electrical breakdown.
11
ions indicate thatComprehensive t t Cov-
b. Blowouts, punctures or other road damage
era a isprovided for anycovered"auto"; g
9
to tires.
Specified Causes Of Loss onlyif the
(2)
Declarations indicate that Specified
4. We will not pay for "loss" to any of the follow-
Causes Of Loss Coverage is provided
9 P ing:
for any covered"auto"; or a. Tapes, records, discs or other similar audio,
(3) Collision only if the Declarations indicate visual or data electronic devices designed
that Collision Coverage is provided for for use with audio, visual or data electronic
any equipmen11
t.
covered"auto". q P
However, the most we will pay for any ex- b. Any device designed or used to detect
penses for loss of use is $20 per day, to a speed measuring equipment such as radar
maximum of$600. or laser detectors and any jamming appa-
ratus intended to elude or disrupt speed
B. Exclusions
I measurement equipment.
1. We will not pay for"loss"caused by or resulting c. Any electronic equipment, without regard to
11,1
from any of the following. Such "loss" is ex-
whether this equipment is permanently in-
11 luded regardless of any other cause or event •
stalled, that receives or transmits audio,
that contributes concurrently or in any se-
uence to the"loss". visual or data signals and that its not de-
i signed solely s g d for the reproduction of sound.
11 a. Nuclear Hazard
d. Any accessories used with the electronic
(1) The explosion of any weapon employing equipment described in Paragraph c.
111 atomic fission or fusion; or above.
11
(2) Nuclear reaction or radiation, or radioac-
11 tive contamination, however caused.
©11
11
Pa e 6 of 11ISO Properties, Inc., 2000 CA 00 01 10 01 0
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Exclusions 4.c. and 4.d. do not apply to: SECTION IV—BUSINESS AUTO CONDITIONS
a. Equipment designed solely for the repro- The following conditions apply in addition to the
duction of sound and accessories used with Common Policy Conditions:
such equipment, provided such equipment A. Loss Conditions
II is permanently installed in the covered
"auto" at the time of the "loss" or such 1. Appraisal For Physical Damage Loss
equipment is removable from a housing unit If you and we disagree on the amount of"loss",
which is permanently installed in the cov- either may demand an appraisal of the "loss".
ered "auto" at the time of the "loss", and In this event, each party will select a competent
such equipment is designed to be solely appraiser. The two appraisers will select a
operated by use of the power from the competent and impartial umpire. The apprais-
"auto's" electrical system, in or upon the ers will state separately the actual cash value
covered "auto"; or and amount of "loss". If they fail to agree, they
II .. Any other electronic equipment that is: will submit their differences to the 'umpire. A
decision agreed to by any two will be binding.
(1) Necessary for the normal operation of Each party will:
ll the covered "auto" or the monitoring of
the covered "auto's" operating system; a. Pay its chosen appraiser; andI
or b. Bear the other expenses of the 1 appraisal
(2) An integral part of the same unit housing and umpire equally.
any sound reproducing equipment de- If we submit to an appraisal, we will still retain
scribed in a. above and permanently in- our right to deny the claim.
stalled in the opening of the dash or 2. Duties In The Event Of Accident, Claim, Suit
console of the covered "auto" normally Or Loss
used by the manufacturer for installation
of a radio. We have no duty to provide coverage under
5. a will not pay for "loss" to a covered "auto" this policy unless there has been full compli-
Jue to"diminution in value". ance with the following duties:
C. Li lit Of Insurance a. In the event of "accident", claim, "suit" or
"loss", you must give us or our authorized
1. The most we will pay for "loss" in any one "ac- representative prompt notice of the "acci-
cident" is the lesser of: g (1)dent"
How, when lnclude:
and where the "accident"The actual cash value of the damaged or or
stolen property as of the time of the "loss"; "loss"occurred;
or (2) The"insured's" name and address; and
b. The cost of repairing or replacing the dam- (3) To the extent possible, the names and
aged or stolen property with other property
of like kind and quality. addresses of any injured persons and
11 witnesses.
2. 1 n adjustment for depreciation and physical b. Additionally, you and any other iniolved "in-
condition will be made in determining actual sured" must:
cash value in the event of a total 'loss".
3. If a repair or replacement results in better than (1) Assume no obligation, make no payment
like kind or quality, we will not pay for the or incur no expense without our consent,
amount of the betterment. except at the"insured's"own cost.
D. Deductible (2) Immediately send us copies of any re-
quest, demand, order, notice, summons
For each covered "auto", our obligation to pay for, or legal paper received concerning the
1,rep ir, return or replace damaged or stolen prop- claim or"suit".
1 erty will be reduced by the applicable deductible (3) Cooperate with us in the investigation or
Isho n in the Declarations. Any Comprehensive settlement of the claim or defense
1111Co erage deductible shown in the Declarations against the"suit".
'doe not apply to"loss"caused by fire or lightning.
(4) Authorize us to obtain medical records
or other pertinent information.
1
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CA".00 01 10 01 ©ISO Properties, Inc., 2000 Page 7 of 11 0
P 9i
(5) Submit to examination, at our expense, B. General Conditions
by physicians of our choice, as often as 1. Bankruptcy
we reasonably require. Bankruptcy or insolvency of the"insure
d" or the
c. If there is "loss" to a covered "auto" or its "insured's" estate will not relieve us of any obli-
equipment you must also do the following: gations under this Coverage Form.
(1) Promptly notify the police if the covered 2. Concealment, Misrepresentation Or Fraud
"auto" or any of its equipment is stolen.
(2) Take all reasonable steps to protect the This Coverage Form is void in any case of
fraud by you at any time as it relates to this
covered "auto" from further damage. Coverage Form. It is also void if you or any
I Also keep a record of your expenses for other "insured", at any time, intentionally con-
consideration in the settlement of the ceal or misrepresent a material fact, concern-
claim.
ing:
(3) Permit us to inspect the covered "auto" a. This Coverage Form;
and records proving the "loss" before its
repair or disposition. b. The covered"auto";
(4) Agree to examinations under oath at our c. Your interest in the covered"auto";or
request and give us a signed statement d. A claim under this Coverage Form.
of your answers. 3. Liberalization
3. Legal Action Against Us If we revise this Coverage Form to provide
I'10 one may bring a legal action against us un- more coverage without additional premium
der this Coverage Form until: charge, your policy will automatically provide
a. There has been full compliance with all the the additional coverage as of the day the revi-
terms of this Coverage Form; and sion is effective in your state.
b. Under Liability Coverage, we agree in writ- 4. No Benefit To Bailee — Physical Damage
II ing that the "insured" has an obligation to Coverages
pay or until the amount of that obligation We will not recognize any assignment or grant
has finally been determined by judgment any coverage for the benefit of any person or
after trial. No one has the right under this organization holding, storing or transporting
policy to bring us into an action to determine property for a fee regardless of any other provi-
the"insured's"liability. sion of this Coverage Form.
14. Loss Payment—Physical Damage 5. Other Insurance
Coverages a. For any covered "auto" you own, this Cov-
At our option we may: erage Form provides primary insurance. For
a. Pay for, repair or replace damaged or stolen any covered "auto" you don't own, the in-
property; surance provided by this Coverage Form is
excess over any other collectible insurance.
b. Return the stolen property, at our expense. However, while a covered "auto" which is a
We will pay for any damage that results to "trailer" is connected to another vehicle, the
the"auto"from the theft; or Liability Coverage this Coverage Form pro-
c. Take all or any part of the damaged or sto- vides for the"trailer" is:
11 len property at an agreed or appraised (1) Excess while it is connected to a motor
value. vehicle you do not own.
If we pay for the"loss", our payment will include (2) Primary while it is connected to a cov-
the applicable sales tax for the damaged or ered"auto"you own.
stolen property.
b. For Hired Auto Physical Damage Coverage,
15. Transfer Of Rights Of Recovery Against any covered "auto" you lease, hire, rent or
Others To Us borrow is deemed to be a covered "auto"
If any person or organization to or for whom we you own. However, any "auto"I that is
make payment under this Coverage Form has leased, hired, rented or borrowed with a
rights to recover damages from another, those driver is not a covered "auto".
rights are transferred to us. That person or or- c. Regardless of the provisions of Paragraph
anization must do everything necessary to se-
a. above, this Coverage Forms Liability
Cure our rights and must do nothing after"acci- Coverage is primary for any liability as-
dent"or"loss"to impair them. sumed under an"insured contract".
id
Page 8 of 11 ©ISO Properties, Inc., 2000 CA 00 01 10 01 ❑
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d. When this Coverage Form and any other We also cover "loss" to, or "accidents" involv-
Coverage Form or policycovers on the ing, covered "auto" while beingtransported
9 9 P
same basis, either excess or primary, we between any of these places.
will pay only our share. Our share is the 8. Two Or More Coverage Forms Or Policies
proportion that the Limit of Insurance of our Issued By Us
1 Coverage Form bears to the total of the lim-
its of all the policies Coverage Forms and If this Coverage Form and any other Coverage
Form or policyissued toyou byus or anycom-
panycovering on the same basis.
6. Premium Audit affiliated with us apply to the same "acci-
dent", the aggregate maximum Limif of Insur-
.. The estimated premium for this Coverage ance under all the Coverage Forms or policies
Form is based on the exposures you told us shall not exceed the highest applicable Limit of
you would have when this policy began. We Insurance under any one Coverage Form or
will compute the final premium due when policy. This condition does not apply to any
we determine your actual exposures. The Coverage Form or policy issued by us or an af-
estimated total premium will be credited filiated company specifically to apply as excess
against the final premium due and the first insurance over this Coverage Form.
Named Insured will be billed for the bal- SECTION V—DEFINITIONS I
ance, if any. The due date for the final pre-
mium or retrospective premium is the date A. "Accident" includes continuous or repeated expo-
shown as the due date on the bill. If the es- sure to the same conditions resulting in "bodily in-
timated total premium exceeds the final jury" or"property damage".
II premium due, the first Named Insured will B. "Auto" means a land motor vehicle, "trailer" or
get a refund. semitrailer designed for travel on public roads but
b. If this policy is issued for more than one does not include"mobile equipment".
year, the premium for this Coverage Form C. "Bodily injury" means bodily injury, sickness or dis-
will be computed annually based on our ease sustained by a person including death re-
rates or premiums in effect at the beginning suiting from any of these.
of each year of the policy. D. "Covered pollution cost or expense" means any
7. Policy Period, Coverage Territory cost or expense arising out of:
Under this Coverage Form, we cover "acci- 1. Any request, demand, order or statutory or
dents"and"losses"occurring: regulatory requirement; or
III . During the policy period shown in the Decla- 2. Any claim or "suit" by or on behalf of a govern
rations; and mental authority demanding
b. Within the coverage territory. that the "insured" or others test for, monitor, clean
The coverage territory is: up, remove, contain, treat, detoxify or neutralize, or
in any way respond to, or assess the effects of
bThe United States of America; "pollutants".
. The territories and possessions of the
"Covered pollution cost or expense" does not in-
United States of America;
c ,
clude any cost or expense arising out of the actual,
c. Puerto Rico; alleged or threatened discharge, dispersal, seep-
di. Canada; and age, migration, release or escape of"pollutants":
e. Anywhere in the world if: a. That are, or that are contained in any prop-
erty that is: 1
(1) A covered "auto" of the private passen-
ger type is leased, hired, rented or bor (1) Being transported or towed by, handled,
rowed without a driver for a period of 30 or handled for movement into, onto or
days or less; and from the covered"auto";
(2) The "insured's" responsibility to pay (2) Otherwise in the course of transit by or
damages is determined in a "suit" on the on behalf of the"insured";
merits, in the United States of America, (3) Being stored, disposed of, treated or
;
the territories and possessions of the processed in or upon the covered auto",
United States of America, Puerto Rico,
or Canada or in a settlement we agree
11 to.
1
CA[00 01 10 01 ©ISO Properties, Inc., 2000 Page 9 of 11 ❑
b. Before the "pollutants" or any property in H. "Insured contract" means:
which the "pollutants" are contained are 1. A lease of premises;
moved from the place where they are ac-
cepted by the "insured" for movement into 2. A sidetrack agreement;
11 or onto the covered "auto"; or 3. Any easement or license agreement, except in
1' d. After the "pollutants" or any property in connection with construction or demolition op-
which the "pollutants" are contained are erations on or within 50 feet of a railroad;
moved from the covered "auto" to the place 4. An obligation, as required by ordinance, to in-
where they are finally delivered, disposed of demnify a municipality, except in connection
or abandoned by the"insured". with work for a municipality;
Paragraph a. above does not apply to fuels, 5. That part of any other contract or agreement
lubricants, fluids, exhaust gases or other pertaining to your business (including an in-
similar "pollutants" that are needed for or demnification of a municipality in connection
result from the normal electrical, hydraulic with work performed for a municipality) under
1 or mechanical functioning of the covered which you assume the tort liability of another to
11
"auto"or its parts, if: pay for"bodily injury"or"property damage"to a
(1) The "pollutants" escape, seep, migrate, third party or organization. Tort liability means a
or are discharged, dispersed or released liability that would be imposed by law I,in the ab-
directly from an "auto" part designed by sence of any contract or agreement; '
its manufacturer to hold, store, receive 6. That part of any contract or agreement entered
or dispose of such"pollutants"; and into, as part of your business, pertaining to the
(2) The "bodily injury", "property damage" or rental or lease, by you or any of your, "employ-
"covered pollution cost or expense" does ees", of any "auto". However, such contract or
not arise out of the operation of any agreement shall not be considered an "insured
it equipment listed in Paragraphs 6.b. or contract" to the extent that it obligates you or
6.c. of the definition of "mobile equip- any of your "employees" to pay for "property
ment". damage" to any "auto" rented or leased by you
--- or any of your"employees".
Paragraphs b. and c. above do not apply to
_ "accidents" that occur away from premises An "insured contract" does not include that part
owned by or rented to an "insured" with re- of any contract or agreement:
spect to "pollutants" not in or upon a coy- a. That indemnifies a railroad for"bodily injury"
ered"auto"if: or "property damage" arising out of con-
(1) The "pollutants" or any property in which struction or demolition operations, within 50
the "pollutants" are contained are upset, feet of any railroad property and affecting
overturned or damaged as a result of the any railroad bridge or trestle, tracks, road-
maintenance or use of a covered "auto"; beds, tunnel, underpass or crossing; or
and b. That pertains to the loan, lease or rental of
;III (2) The discharge, dispersal, seepage, mi- an "auto"to you or any of your"employees",
P P
gration, release or escape of the "pollut- if the "auto" is loaned, leased or rented with
;
ants" directly p is caused bysuch upset,
a driver' or
overturn or damage. c. That holds a person or organization en-
E. "Diminution in value" means the actual or per- gaged in the business of transporting prop-
value which erty by"auto" for hire harmless for your use
ceivIed loss in market value or resale
results from a direct and accidental "loss". of a covered "auto" over a route or territory
that person or organization is authorized to
F. "Employee" includes a "leased worker". "Em- serve by public authority. '
ployee" does not include a "temporary worker".
I. "Leased worker" means a person leased to you by
G. "Insured" means any person or organization quali- a labor leasing firm under an agreement between
,fying as an insured in the Who Is An Insured provi- you and the labor leasing firm, to perform duties
sionl of the applicable coverage. Except with re-
'spedt to the Limit of Insurance, the coverage af- worker" does not related to the conduct of your businessi "Leased
seeking coverage or against whom a claim or J. "Loss"means direct uandde aacc dental loss or dam-
seeking forded a lies separately to each insured who is
"suit" is brought. age.
11 1
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Page 10 of 11 ©ISO Properties, Inc., 2000 CA 00I
p I01 10 01 0
1
K. "Mobile equipment" means any of the following b. Cherry pickers and similar devices mounted
types of land vehicles, including any attached ma- on automobile or truck chassis and used to
chinery or equipment: raise or lower workers; and
1. Bulldozers, farm machinery, forklifts and other c. Air compressors, pumps and generators,
Lehicles designed for use principally off public including spraying, welding, building clean-
'oads; ing; geophysical exploration, lighting or well
2. Vehicles maintained for use sole)Y on or next to servicing equipment.
premises you own or rent; L. "Pollutants" means any solid, liquid, gaseous or
3. Vehicles that travel on crawler treads; thermal irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
4. Vehicles, whether self-propelled or not, main- waste. Waste includes materials to be, recycled,
tained primarily to provide mobility to perma- reconditioned or reclaimed.
pently mounted: M. "Property damage" means damage to or loss of
a. Power cranes, shovels, loaders, diggers or use of tangible property.
drills; or
. Road construction or resurfacing equipment N. "Suit"means a civil proceeding in which:
such as graders, scrapers or rollers. 1. Damages because of "bodily injury" or "prop-
erty damage"; or
5. ehicles not described in Paragraphs 1., 2., 3., 2. A"covered pollution cost or expense",
Or 4. above that are not self-propelled and are
maintained primarily to provide mobility to per- to which this insurance applies, are alleged.
manently attached equipment of the following "Suit" includes:
types:
a. An arbitration proceeding in which such
a. Air compressors, pumps and generators,
damages or "covered pollution costs or ex-
including spraying, welding, building clean- penses" are claimed and to which the "in-
ing, geophysical exploration, lighting and sured" must submit or does submit with our
well servicing equipment; or consent; or
. Cherry pickers and similar devices used to b. Any other alternative dispute resolution pro-
raise or lower workers. ceeding in which such damages or"covered
6. Vehicles not described in Paragraphs 1., 2., 3. pollution costs or expenses" are claimed
or 4. above maintained primarily for purposes and to which the insured submits with our
oOther than the transportation of persons or consent.
cargo. However, self-propelled vehicles with O. "Temporary worker" means a person who is fur-
the following types of permanently attached nished to you to substitute for a permanent "em-
equipment are not "mobile equipment" but will ployee" on leave or to meet seasonal or short-term
be considered "autos": workload conditions.
a. Equipment designed primarily for: P. "Trailer" includes semitrailer.
(1) Snow removal;
(2) Road maintenance, but not construction
or resurfacing; or
(3) Street cleaning;
CA 00 01 10 01 © ISO Properties, Inc., 2000 Page 11 of 11 ❑
1,1
This End rsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
VOLUNTEERS ENDORSEMENT
In consideration of the premium at which this policy is written, it is understood and agreed that:
1. Wherever the word employee appears in this policy, the same is deemed to include the insured's
volbnteers.
2. W erever reference is made in this policy to the Insured's employment of an employeel the same
sh II be deemed to also refer to the activities of the Insured's volunteers on behalf of the Insured.
lil
I,I
Authorized Representative
11
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III
Endor1sement No. 8
- 1
AAP 248 (11/99) 01/23/2007
III
This End rsement effective January 1,2007
forms par of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
DATE RECOGNITION EXCLUSION CLAUSE
This policy does not cover any claim, damage, injury, loss, cost, expense or liability (whether in contract,
tort, negligence, product liability, misrepresentation, fraud or otherwise) of any nature whatsoever arising
from or o casioned by or in consequence of(whether directly or indirectly and whether wholly or partly):
(a) the failure or inability of any computer hardware, software, integrated circuit, chip or information
technology equipment or system (whether in the possession of the Insured or of any third party)
accurately or completely to process, exchange or transfer year, date or time data or information in
„connection with:
1-the change of year from 1999 to 2000; and/or
-the change of date from 21 August 1999 to 22 August 1999; and/or
"- any other change of year, date or time;
whether on or before or after such change of year, date or time;
(b) any implemented or attempted change or modification of any computer hardware, software,
integrated circuit, chip or information technology equipment or system (whether in the possession
of the Insured or of any third party) in anticipation of or in response to any such change of,year, date
'or time, or any advice given or services performed in connection with any such change or modification;
(c) any non-use or unavailability for use of any property or equipment of any kind whatsoever resulting
from any act, failure to act or decision of the Insured or of any third party related to any such change
of year, date or time;
and any provision in this policy concerning any duty of Insurers to investigate or defend claims shall not
apply Ito any claims so excluded.
Authorized Representative
Endorsement No. 9
AAP 256(11/99) 01/23/2007
This Endorsement effective January 1,2007
forms par of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
DATE RECOGNITION LIMITED COVERAGE ENDORSEMENT
This "endorsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS(GENERAL
LIABILITY POLICY.
In consideration of the premium at which this policy is written, it is understood and agreed that the Date
Recognition Exclusion Endorsement - AAP 256 (11/99) shall not apply to any "bodily injury" or "property
damage" coverage provided by this policy, subject to the following provisions:
1. The term "property damage", as respects the insurance afforded by this endorsement, is redefined
as follows:
"Propertyl damage" means physical injury to tangible property, including all resultant loss of use of
that property. All such loss of use shall be deemed to occur at the time of the "occur'rence" that
caused it.
2. You recognize that we consider the information provided by you in the application form, and/or
documentation provided, to be material to our decision to issue this Endorsement. You further agree
tha1t you have a continuing obligation to disclose to us in writing during the Policy period any
ddi ional material facts relating to the Date Recognition Conformity of your operations, equipment
an products.
3. 1 The insurance afforded by this endorsement shall not apply with respect to any coverage for which
this policy indicates the existence of underlying insurance.
Authorized Representative
Endorsement No. 10
AAP 255(11/99) 01/23/2007
li
This Endorsement effective January 1,2007
formspart of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
PREMIUM AUDIT ENDORSEMENT
It is agre-d that the advance premium shown under the Declarations is adjustable as follows:
Products Completed Operations:
Gross Receipts Rate Developed
Classific tion policy period per$1,000 Premium
New Airc'aft Sales If Any Included Included
UsedGlAir raft Sales If Any Included Included
Repairs Service,
including arts installed If Any Included Included
Aviatibn as and oil If Any Included Included •
Part¬ installed If Any Included Included
Earned P emium Included
Less dv.nce Premium Included
Additona /(Return Premium) due Included
Authorized Representative
Endorsem nt No. 11
AAP 257( 1/99) 01/23/2007
l; I
This Endorsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
• Issued to City of Renton
By Ace Property And Casualty Insurance Company
CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM
With respect to any one or more "certified acts of terrorism", we will not pay any amounts for which we are
not responsible under the terms of the federal Terrorism Risk Insurance Act of 2002 (including
subsequent acts of Congress pursuant to the Act) due to the application of any clause which results in a
cap on our liability for payments for terrorism losses.
"Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence
with the Secretary of State and the Attorney General of the United States, to be an act of terrorism
pursuant to the federal Terrorism Risk Insurance Act of 2002. The federal Terrorism Risk Insurance Act
of 2002 7ts forth the following criteria for a "certified act of terrorism":
1. 1The act resulted in aggregate losses in excess of$5 million; and
2. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is
committed by an individual or individuals acting on behalf of any foreign person or foreign interest, as
part of an effort to coerce the civilian population of the United States or to influence the policy or affect
the conduct of the United States Government by coercion.
Authorized Representative
Endorsement No. 12
AAP 269 02/03) Page 1 of 1 01/23/2007
This Endorsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
POLLUTION ENDORSEMENT
1. Section II, Common Coverage Exclusions, is amended bydeletingexclusion A and insertingthe
9
following:
A. Noise and pollution and other perils.
This Policy does not cover claims directly or indirectly, occasioned by, happening through, in
consequence of:
(a) noise (whether audible to the human ear or not), vibration, sonic boom and any
phenomena associated therewith;
(b) "Pollution" or contamination of any kind whatsoever;
(c) electrical or electromagnetic emission or interference of any kind whatsoever,;
(d) interference with the use of property;
(e) any direction, obligation, request, demand, order, or statutory or regulatory requirement,
or any voluntary decision to do so, that any "insured" or others test for, monitor, clean up,
remove, contain, treat, detoxify, neutralize, protect against or in any other way respond to
the actual, alleged or threatened presence of"Pollutants" or"Waste".
unless caused by or resulting in a crash, fire, explosion or collision or a recorded in-flight
emergency causing abnormal aircraft operation.
2 Section VI, Definitions, is amended by as follows:
a. Definition 6, the definition of"bodily injury", shall be amended by adding the following:
"Bodily injury" also means fear of bodily injury, sickness, disease, fright or mental anguish.
b. The following definitions are added:
"Pollution" means the mere presence of "Pollutants" in any form, as well as the actual,
alleged or threatened discharge, dispersal, release, escape, seepage, migration or disposal
of"Pollutants" in any form.
"Pollutants" include, without limitation, solid, liquid, or thermal irritants, anyair
q gaseous
emission, contaminant, smoke, vapor, soot, fume, acid, alkali, chemical, "waste", or any
material alleged to be a possible or probable carcinogenic, odor, waste water, oil or other
petroleum product, infectious or medical waste, asbestos or asbestos product, fungus
(including mold or mildew or any mycotoxin, spore, scent or byproduct produced or released
by fungi, other than any fungi intended by the insured for consumption.)
"Waste" includes;materials to be recycled, reconditioned or reclaimed, whether or not the
material has been disposed of by you or any person handling the waste.
All other terms and conditions of this Policy remain unchanged.
Authorized Representative
Endorsement No. 13
AAP 273 (11-03) Page 1 of 1 01/23/2007
This Endorsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SILICA AND SILICA-RELATED DUST EXCLUSION
It is agreed that:
1. SECTION I - COVERAGES is amended at COVERAGE A. BODILY INJURY AND PROPERTY
DAMAGE LIABILITY, subsection 2. Exclusions by adding the following new exclusion:
,Dit or Particulate Matter
1Thi insurance does not apply to:
(1) "Bodily injury" arising out of, resulting from, or in any way related to, in whole or in part, the
respiration, inspiration, inhalation or breathing in of dust or particulate matter. Dust or
particulate matter may include, but is not limited to: dust, particulate matter, inspirable dust,
respirable dust, smoke, mist, dirt, fibers, grit, soot, salt, acids, bases, metals, aerosols,
crystals,minerals,sand,silicates,orsilica.;or
(2) Any loss, cost or expense arising, in whole or in part, out of the abating, testing for,
monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, remediating
or disposing of, or in any way responding to or assessing the effects of, such dust or
particulate matter, by any insured or by any other person or entity;
unless caused by or resulting in a crash, fire, explosion or collision or recorded in-flight
emergency causing abnormal aircraft operation.
2. Th- addition of this endorsement does not imply that other policy provisions, including but not
limited to any pollution exclusion or asbestos exclusion, do not also exclude coverage for dust or
part' iculate matter related injury, damage, expense, cost, loss, liability, or legal obligation.
All other terms and conditions remain unchanged.
Authorized Representative
Endorsement No. 14
AAP 277 (01-06) Page 1 of 1 01/23/2007
I,
This Endorsement effective January 1, 2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
WASHINGTON CHANGES - CANCELLATION
AND NONRENEWAL
11
This endo sement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL LIABILITY
POLICY.
CANCELLATION
1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance
written' notice of cancellation.
2. We rray cancel this policy by mailing or delivering to the first Named Insured and thefirst Named Insured's agent or
broker written notice of cancellation, including the actual reason for the cancellation, to the last mailing address
known to us, at least:
d. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or
bl. 45 days before the effective date of cancellation if we cancel for any other reason.
3. We will also mail or deliver to any mortgage holder, pledgee or other person shown in this policy to have an
interest in any loss which may occur under this policy, at their last mailing address known to us,written notice
of cabicellation, prior to the effective date of cancellation.This notice will be the same as that mailed or delivered
to the first Named Insured.
4. Noticl of cancellation will state the effective date of cancellation. The policy period will end on that date.
5. f this policy is cancelled,we will send the first Named Insured any premium refund due.If we cancel,the refund
will be pro rata.
b. If the first named insured cancels, the refund will be at least 90% of the pro rata refund.
c. b:
(1) You are an individual; and
(2) The first Named Insured cancels, ,
he refund will be not less than 90% of any unearned portion not exceeding$100, plus 95% of anyUnearned portion over$100 but not exceeding $500, and not less than 97% of any unearned portion in
excess of$500.
d. l he cancellation will be effective even if we have not made or offered a refund.
6. If notice is mailed, proof of mailing will be sufficient proof of notice.
NONRENEWAL
1. We riay elect not to renew this policy by mailing or delivering written notice of nonrenewal, stating the reasons
for nonrenewal, to the first Named Insured and the first Named Insured's agent or broker, at their last mailing
addrelsses known to us. We will also mail to any mortgage holder, pledgee or other person shown in this policy
p have an interest in any loss which may occur under this policy, at their last mailing address known to us,
written notice of nonrenewal. We will mail or deliver these notices at least 45 days before the:
a. Expiration of the policy; or
b. 1 nniversary date of this policy if this policy has been written for a term of more than one year. 1
Cthe ise, we will renew this policy unless:
a. The first Named Insured fails to pay the renewal premium after we have expressed our willingness to
renew, including a statement of the renewal premium, to the first Named Insured and the first Named
Insured's insurance agent or broker, at least 20 days before the expiration date; or
b. Other coverage acceptable to the insured has been procured prior to the expiration date of the policy.
Endorsemert No. 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 1
Copyright,Insurance Services Office,Inc.1998
AAP WA(11/99)
II
This Endorsement effective January 1, 2007
forms,lpart of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Property And Casualty Insurance Company
WASHINGTON CHANGES
This endo sement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL LIABILITY
POLICY.
A. Exclusion e. of coverage A - Bodily Injury and Property Damage Liability (Section I - Coverages) applies only
applies only to "bodily injury"to any"employee" of the insured whose employment is not subject to the Industrial
Insurance Act of Washington(Washington Revised Code Title 51).
With respect to"bodily injury"to"employees"of the insured whose employment is subject to the Industrial
insurance Act of Washington, Exclusion e. is replaced with the following:
This Insurance does not apply to:
1. Bodily injury"to an "employee"of the insured arising out of and in the course of:
Employment by the insured; or
�. Performing duties related to the conduct of the insured's business; or
2. Any obligation to share damages with or repay someone else who must pay damages because of the injury.
This laxclusion does not apply to liability assumed by the insured under an "insured contract".
B. Paragraph 2.b.(1)of Section III -Who Is An Insured applies only to"employees"of the insured whose employment
is not subject to the Industrial Insurance Act of Washington (Washington Revised Code Title 51).With respect to
"employees"of the insured whose employment is subject to the Industrial Insurance Act of Washington,
Paragraphs 2.a. and 2.b of Section III -Who Is An Insured are replaced with the following:
2. 'Each of the following is also an insured:
la. Your employees, other than your exective officers, but only for acts within the scope of their,
employment by you with respect to your"airport operations".
b. If you are designated in the Declarations as a public corporation,employees of your boards,commissions
or a encies other than executive officers,but for acts within thesco eoftheiremployment
9 � Y Pby
those boards, commissions or agencies with respect to your"airport operations".
' However, no employee of yours or your boards, commissions or agencies is an insured for:
(1) "Bodily injury" or"personal injury"to you or to a co-employee while in the course of his or her
employment, or for any obligation to share damages with or repay someone else who must pay
damages because of the injury; or
(2) "Bodily Injury"or"personal injury"arising out of his or her providing or failing to provide
professional health care services; or
(3) "Property damage"to property owned or occupied by or rented or loaned to that employee, any
of your other employees, or any of your partners or members(if you are a partnership or joint
venture).
`Endorsement No. 16 Includes copyrighted material of Insurance Services Office,Inc.with its permission
Copyright,Insurance Services Office,Inc.1998
9001-WA(11/99) Page 1 of 1
This Endorsement effective January 1,2007
forms part of Policy Number AAP N00981862 004
Issued to City of Renton
By Ace Prdperty And Casualty Insurance Company
NON AIRPORT OPERATIONS COVERAGE EXTENSION ENDORSEMENT
This 'end rsement modifies insurance provided under AIRPORT OWNERS AND OPERATORS GENERAL
LIABILITY POLICY.
1. lit is agreed that Section VI, Definitions, is amended to add a definition of"Non-Airport Operations," as
follows:
"Non-Airport Operations" means the ownership, maintenance, use or provision of premises, services
and facilities by the Insured that are not necessary to the operation of the "airport."
2. Solely with respect to "Non- Airport Operations", it is agreed that Section I, Coverages, Coverage Part
E, Non-Owned Aircraft Liability, Sub-Part 1(b)(3)(d), is deleted in its entirety and repalced by Ithe new
Sub!Parts 1(b)(3)(d)-(f), as follows:
d. The aircraft does not have a total seating capacity, including crew, in excess of ten (10)seats;
Ie. The "bodily injury" or "property damage" is not caused by or does not result from or arise out of
"Malpractice".
f. The "bodily injury" is not caused by or does not result from or arise out of:
(i) The rendering, or failure to render, any professional medical services by the Insured;)
(ii) The transportation of any material of human or animal origin, medications or equipment
destined for use in medical treatment;
(iii) The aggravation of any g existin medical condition
(iv) The transportation of any sick persons, injured persons, or cadavers.
3. It is agreed that the definition of "property damage" in Section VI, Definitions, shall be amended to add
a new sub-part"c", as follows:
C. Physical damage to or destruction of a cadaver.
4. It is agreed that the Section III, Who Is An Insured, Sub-Part 1(c), is amended to read as follows, but
only as respects insurance under Coverage E(Non-Owned Aircraft Liability):
c. A public corporation, you are an insured. Your elective or appointed officers or members of any
board or commission or agency of yours are also insureds, but only for acts within the scope of
duties as members of your boards, commissions or agencies.
5. It is agreed that Section III, Who Is An Insured, Sub-Part 2(a), is amended to read as follows, but only
as respects insurance under Coverage E(Non-Owned Aircraft Liability):
a. Your employees, other than your executive officers, but only for acts within the scope of their
employment by you.
All other t rms and conditions of this policy remain unchanged. p
Endorseme't No. 17 Authorized Representative
f
AAP 285 (06-06) Page 1 of 1 02/27/2007
City of Renton
eceived
_$) Arthur J. Gallagher Risk Management Services, Inc.
MAY I i, 91y;r
Human Resources&
Risk Management
May 4, 2007
Ms. Pauletta Sulky
City of Renton
1055 South Grady Way
Renton, WA 98055
RE: Excess Airport Liability-#L9900182
01/01/2007- 01/01/2008
Dear Paulie:
Enclosed is an original stamped copy of the City of Renton's 01/01/2007 to 01/01/2008
insurance policy for City of Renton.
It has been stamped, indicating that surplus lines taxes have been paid.
Paulie,we appreciate the opportunity to place this important insurance coverage for you.
If you have any questions or need additional information, please give us a call at(800)
333-3231.
Sincerely,
Steve C Hostetler
Account Manager
Enclosure
6399 South Fiddler's Green Circle,Suite 200
Greenwood Village,CO 80111-4949
303.773.9999
Fax 303.773.9776
Toll Free 800.333.3231
www.ajg.com
P �
I i
Diu 7-4
7�\
Lloyd' s
(,)
This Insurance is effected with certain Underwriters at Lloyd's,London
(not incorporated).
This Certificate is issued in accordance with the limited authorization
granted to the Correspondent by certain Underwriters at Lloyd's, London whose
names and the proportions underwritten by them can be ascertained from the
office of said Correspondent (such Underwriters hereinafter called "Insurers")
and in consideration of the premium specified herein, Insurers do hereby bind
themselves each for his own part, and not one for another, their heirs, executors
and administrators.
I i
The Insured is requested to read this Certificate, and if not correct, return
itit immediately to the Correspondent for appropriate alteration:
, I
In the event of claim under this Certificate, please notify the following Correspondent:
I I
Westchester Specialty Insurance Services,Inc.
1100 Poydras Street, Suite 2150
New Orleans,Louisiana 70163-1121
I
Tiis contract is registered and delivered as a surplus lines coverage under the Insurance Code of the,state of
Washington enacted in 1947. It is not issued by a company regulated by the Washington State Insurance
dommissioner and is not protected by the Washington State Guaranty Fund Law.
� I
- i
_ LLD'CE T 2/1/2005
SUIT AND SERVICE;OF PROCESS CLAUSE ON SURPLUS LINES POLICIES
I
As prod ided by RCW 48.15.150 of the insurance code of the State of Washington, upon
any cause of action arising out of this policy in the State of Washington, action against
the insuring company shall be brought, if at all, in the superior court of the county in
which ruch cause of action arose.
j I
Service of legal process against the insuring company may be made in any such action
by lser�ice upon the Insurance Commissioner, the Insurance Commissioner shall mail
process so served, or a true copy thereof, by prepaid registered mail with return receipt
requested, to the following person(s) who is/are designated here by the insuring
comp . ny as their representative for the purpose:
i I
Arthur'J. Gallagher Risk Management Services, Inc.
PO Box 367
Bellevue, WA 98009
Phone: (425) 454-3386
Fax: (425) 451-3716
The i suring company shall have twenty (20) days from the date of service upon the
_ - commissioner within to plead, answer, or otherwise defend the action. This company
will abide by the final decision of such court or of any appellate court in the event of an
appe-l.
Premium: $ 18,750.00
Broker/Company Fee(s) $
Inspection Fee: $
Policy Fee: $
Fee to,Filing Broker $
Subtotal: $ 18,750.00
State Tax (2.0%): $ 375.00
Filing Fee (0.25%) $ 46.88
TOTAL $ 19,171.88
III
4 I
Certificate Provisions
I �
1. Signature required. This Certificate shall not be valid unless signed by the Correspondent on the
attached schedule.
2. Correspondent Not Insurer. The Correspondent is not an Insurer hereunder and neither is
nor °shal be liable for any loss or claim whatsoever. The Insurers hereunder are those individual
Insurers at Lloyd's, London whose names can be ascertained as herein before set forth.
3. Can"cellation. If this Certificate provides for cancellation and this Certificate is cancelled after the
inception date, earned premium must be paid for the time the insurance has been in force.
+ I
4. Service of Suit. It is agreed in the event of the failure of the Insurers hereon to pay any amount
claimed to be due hereunder, the Insurers hereon, at the request of the Insured, will submit Ito the
juridic ion of a Court of competent jurisdiction within the United States. Nothing in this Clause
constitutes or should be understood to constitute a waiver of Insurers' rights to commence an action in
any Court of competent jurisdiction in the United States, to remove an action to a United States District
Court, O r to seek a transfer of a case to another Court as permitted by the laws of the United States or
of any state in the United States. It is further agreed that service of process in such suit may be made
upon the firm or person named in the Schedule, and that in any suit instituted against any one of them
uponI.
this contract Insurers will abide by the final decision of such Court or of any Appellate Court in
the eve 1 t of an appeal.
The ab ve-named are authorized and directed to accept service of process on behalf of Insurers in
any slid' suit and/or upon the request of the Insured to give a written undertaking to the Insured that
they will enter a general appearance upon Insurers'behalf in the event such a suit shall be instituted.
Further pursuant to any statute of any state, territory or district of the United States which makes
provisi n therefor, Insurers hereon hereby designate the Superintendent, Commissioner or Director
of Insutance or other officer specified for that purpose in the statute, or his successor or successors in
office, as their true and lawful attorney upon whom may be served any lawful process in any l action,
suit or proceeding instituted by or on behalf of the Insured or any beneficiary hereunder arising out
of this contract of insurance, and hereby designate the above-named as the person to whom the said
off cer is authorized to mail such process or a true copy thereof.
5. Assignment. This Certificate shall not be assigned either in whole or part without the written consent of
the Correspondent endorsed hereon.
6. Attached Conditions Incorporated. This Certificate is made and accepted subject to all the
previsions, conditions and warranties set forth herein, attached, or endorsed, all of which are to be
consid red as incorporated herein.
I I
LLD;CE T 2/1/2005
I I
This AP XS 9/7/2006 V3S,when attached to AP XS 9/7/2006 V3 completes this Certificate)
SCHEDULE
Item
1. Certificate No. Previous No. Authority Ref:
L 9900182 L 9900441 624406
"This contract is registered
1 and delivered as a surplus
2. INSURED line coverage under the
City ofenton insurance code of the I State
of Washington, enacted in
and/or as per underlying insurance. 1947. It is not issued by a
1 company regulated by the
Washington State Insurance
3. ADDRESS OF INSURED Commissioner and is not
protected by any Washington
105i5 S. Grady Way State Guaranty fund I law."
Renton Risk,Ma Arthur
ueme Gallagherrrvics, Inc.
Washington Zip 98055 g c.
1
4. HAZARtSCOVERED
The In4ured's legal liability arising out of their airport operations as covered,by and defined in the policy
of the Primary Insurer.
i
5. PERIOD OF INSURANCE
From: January 1,2007
To: January 1,2008
both days at 12.01 a.m.Local Time at the address of the Named Insured.
I
6. ANNU PREMIUM
The premium due hereon is: $18,750
Plus Washington Surplus Lines Tax $375.00
1 Plus Washington Stamping Fee $46.88
I
7. PRIMARY INSURER
ACE Property and Casualty Insurance Company
8. LIMIT OF LIABILITY(ULTIMATE NET LOSS)
This certificate will pay the DIFFERENCE BETWEEN the Total Limits (item 8 (b)) and the Primary Limits
(If em 8(a)),as more fully described in the Policy Provisions forming part of this Certificate. I
1
(a) rimary Limit(s)
'1 odily Injury, Personal / Advertising Injury and Property Damage Liability combined $50,000,000 each
occurrence/offense and in the aggregate where applicable,included within which are the following,sub-limits:
products-Completed Operations Aggregate Limit $50,000,000
personal Injury and Advertising Injury Aggregate limit $50,000,000
Malpractice Aggregate.Limit $50,000,000
Each Occurrence Limit $50,000,000
i'ire Damage Limit Any One Fire $100,000
Medical Expense Limit Any One Person $3,000
1
� I
Hangarkeepers Limit Any One occurrence $50,000,000
Ha6arkeepers Limit Any One Aircraft $50,000,000
N in-Owned Aircraft Liability Limit Any One Occurrence $50,000,000
Excess Automobile Liability Any One Occurrence $50,000,000
E cess Employers Liability Any One Occurrence Not Insured
NT-Aviation Excess Liability,including Excess Public Officials errors and
omissions liability Any One Claim/Aggregate Not Insured
1
(b) To al Limit(s)under this Insurance and policy of the Primary Insurer combined.
I
Bodily Injury,Personal/Advertising Injury and Property Damage Liability combined $100,000,000 'each
occurrence/offense and in the aggregate where applicable,included within which are the following sub-limits:
Pioducts-Completed Operations Aggregate Limit $100,000,0001
Personal Injury and Advertising Injury Aggregate limit $50,000,0001
Malpractice Aggregate Limit $50,000,0001
Eich Occurrence Limit $100,000,000
Fire Damage Limit Any One Fire $100,000
edical Expense Limit Any One Person $3,000
angarkeepers Limit Any One occurrence $100,000,000'
angarkeepers Limit Any One Aircraft $100,000,000
on-Owned Aircraft Liability Limit Any One Occurrence $100,000,0001
E cess Automobile Liability Any One Occurrence $50,000,000
cess Employers Liability Any One Occurrence Not Insured
N n-Aviation Excess Liability,including Excess Public Officials errors and
o pissions liability Any One Claim/Aggregate Not Insured
9. IDENTIFICATION DETAILS AND LIMITS CARRIED UNDER ITEM 7 ABOVE i
Primary Insurer
Policy No. 1 Primary Limits
A'AP N00981862 004 $50,000,000
I
10. NOTIFICATION OF CLAIMS TO BE MADE UPON:-
Westciester Specialty Insurance Services,Inc.
1 100 Ioydras Street, Suite 2150
New Orleans
Louis ana,70163
i
11. PRO IORTION INSURED BY INSURERS AT LLOYD'S,LONDON:
The percentages signed in the Table of Subscribing Insurers at Lloyd's,London are percentages of 100% of the
amoult(s)of Insurance stated herein.
2
! I
Ifs
12. TABLE OF SUBSCRIBING INSURERS AT LLOYD'S,LONDON:
j I
Syndicate Syndicate
Percentage Number Percentage Number
15.3434% 2001 7.3064% 5000
21.9192% 2020
14.6128% 2488
10.1315% 510
9.7418% 1084
4.8709% 2003
TOTAL 83.92600%
•
SEVERAL LIABILITY NOTICE
The subscribing Insurers' obligations under contracts of insurance to which they subscribe are several and no't joint
and are limit6d solely to the extent of their individual subscriptions.The subscribing insurers are not responsible for the
subscription of any co-subscribing insurer who for any reason does not satisfy all or part of its obligation.
I I
13. SE'RVICE OF SUIT MAY BE MADE UPON:
Mendel and Mount Attorneys
750 Se enth Avenue
New Ybrk,New York, 10019- 6829
14. NOTICE OF CANCELLATION:
Minimum period of notice to the Named Insured: 30 days ,or;
(a) such lesser period as provided for under the policy of the Primary Insurer in respect of cancellation
for non-payment of premium; or
(b) such longer period as may be imposed upon the Primary Insurer by law.
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15. JURISDICTION:
This Policy is subject to the laws of the following state,whose courts shall have jurisdiction in the event of any dispute
ar sm hereunder: Washington
Westchester Specialty Insurance Services,Inc.
(Correspondent)
By
Stephen P.Dinsdale
Senior Vice President
Dated in New Orleans,Louisiana on this 23rd day of January,2007
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CERTIFICATE PROVISIONS
THE INSURERS AGREE, to the extent and•in the manner hereinafter provided, to pay on behalf of the
Insured'all ums which the Insured shall become legally obligated to pay, or by final judgment be adjudged
to pay,,,to any person or persons as damages because of Bodily Injury, Personal/Advertising Injury or
Property D mage caused by an occurrence or an offense during the period of this Certificate and arising
out of suc hazards as are set forth in Item 4 of the Schedule and which are covered by and defiled in
the policy pecified in Item 9 of the Schedule and issued by the "Primary Insurer" stated in Item 7 of
the Schedule. I
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PROVID ALWAYS THAT:
(a) Liability attaches to the Insurers only in respect of such hazards as set forth in Item 4 of the Schedule
and only for such coverages and limits inserted in Item 8(b) of the Schedule and then only after the
Primary Insurer has paid or has been held liable to pay the full amount of its ultimate net loss liability
as;Set Forth in the Schedule in Item 8(a)and designated the "Primary Limit(s)" and then the limits of the
Insurers' liability will be such amount of ultimate net loss as will provide the Insured with total limits
under the policy of the Primary Insurer and this Certificate combined as set forth in Item 8(b)1 of the
Schedule under the designation "Total Limit(s) under this Certificate and the policy of the Primary
Insurer Combined"
(b) The inclusion of more than one entity as the named Insured, or the inclusion of any additional
Insureds under this Certificate, shall not in any way operate to increase the Insurers' limits of liability
beyond those provided in Item 8 (Limits of Liability) of the Schedule. I
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(c) If any of the hazards covered by this Certificate are subject to an aggregate Limit of Liability inIthe
policy of the Primary Insurer then the Limit of Liability under this Certificate shall as respects such
hazard apply in the aggregate for the period of this Certificate.
DEFINITIONS
(a) Ultimate Net Loss. The words "ultimate net loss" shall be understood to mean the amount payable in
settlerinent of the liability of the Insured after making deductions for all recoveries and other valid and
collectible insurances, excepting however the policy of the Primary Insurer and shall exclude all
expenses and Costs. i
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(b) Costs. The word "costs" shall be understood to mean interest accruing after entry of judgment,
investigation, adjustment and legal expenses (excluding, however, all office expenses of the Insured,
all expenses for salaried employees of the Insured and general retainer fees for counsel normally paid
by the Insured).
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EXCLUSIONS II
The irisur nce provided hereunder is subject to all exclusions contained in the policy of the Primaryl Insurer,
and is subject to the following exclusions, even if they do not appear in the policy of the Primary Insurer.
AP S 9/7/2006 V3 1
(a) POLLUTION EXCLUSION CLAUSE
This Certificate is subject to the same provisions as contained in the policy of the Primary Insurer
with re 1 pect to the exclusions of pollution and related perils.
(b) DATE RECOGNITION EXCLUSION CLAUSE
This Certificate is subject to the same Date Recognition Exclusion Clause as contained in the policy
of the Primary Insurer and as may be modified by the Date Recognition Limited Coverage
Endorsement if attached to the policy of the Primary Insurer. 1
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(c) NUCLEAR RISKS EXCLUSION CLAUSE
(1) This Certificate does not cover:
(i) loss of or destruction of or damage to any property whatsoever or any loss or expense
whatsoever resulting or arising therefrom or any consequential loss 1
(ii any legal liability of whatsoever nature
du ectli or indirectly caused by or contributed to by or arising from: I
(a) the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear
assembly or nuclear component thereof;
(1:) the radioactive properties of, or a combination of radioactive properties with toxic, explosive
or other hazardous properties of, any other radioactive material in the course of carriage as
cargo, including storage or handling incidental thereto; 1
O ionizing radiations or contamination by radioactivity from, or the toxic, explosive or other
hazardous properties of, any other radioactive source whatsoever.
(2) It is understood and agreed that such radioactive material or other radioactive source in
p laragraph (1)(b) and(c) above shall not include:
(9 depleted uranium and natural uranium in any form;
(ii) radioisotopes which have reached the final stage of fabrication so as to be usable for
any scientific, medical, agricultural, commercial, educational or industrial purpose. I
(3) This Certificate, however, does not cover loss of or destruction of or damage to any property or
a y consequential loss or any legal liability of whatsoever nature with respect to which:
(r) the Insured under this Certificate is also an insured or an additional insured under any other
linsurance policy, including any nuclear energy liability policy; or
( i) any person or organization is required to maintain financial protection pursuant to
legislation in any country; or
('ii) the Insured under this Certificate is, or had this Certificate not been issued would be, entitled
to indemnification from any government or agency thereof.
(4) oss, destruction, damage, expense or legal liability in respect of the nuclear risks not excluded
by reason of paragraph (2) shall (subject to all other terms, conditions, limitations, warranties and
exclusions of this Certificate)be covered,provided that:
AP XS 9/7/2006 V3 2
(i) in the case of any claim in respect of radioactive material in the course of carriage as
cargo, including storage or handling incidental thereto, such carriage shall in all
respects have complied with the full International Civil Aviation Organization
"Technical Instructions for the Safe Transport of Dangerous Goods by Air", unless the
carriage shall have been subject to any more restrictive legislation, when it shall in all
respects have complied with such legislation;
(ii) this Certificate shall only apply to an incident happening during the period of this Certificate and
where any claim by the Insured against the Insurers or by any claimant against the Insured
arising out of such incident shall have been made within three years after the date thereof;
(iii) in the case of any claim for the loss of or destruction of or damage to or loss of use of
an aircraft caused by or contributed to by radioactive contamination, the level of such
contamination shall have exceeded the maximum permissible level set out in the
following scale:
Emitter Maximum permissible level of non-fixed
radioactive surface contamination (Averaged
(IAEA Health and Safety Regulations) over 300 cm 2 )
Beta, gamma and low toxicity alpha emitters Not exceeding 4 Bequerels/cm2
(10 -4 microcuries/cm 2 )
A 1 other emitters Not exceeding 0.4 Bequerels/cm2
(10 -5 microcuries/cni 2 )
(iv) the cover afforded hereby may be cancelled at any time by the Insurers giving' seven
days'notice of cancellation.
AN.38B amended
(d) WA HI-JACKING AND OTHER PERILS EXCLUSION CLAUSE (AVIATION)
This Certificate does not cover claims caused by
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(a) War, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war,
rebellion, revolution, insurrection, martial law, military or usurped power or attempts at
Usurpation of power.
(i) y hostile detonation of any weapon of war employing atomic or nuclear fission and/or
fusion or other like reaction or radioactive force or matter.
(o) Strikes, riots, civil commotions or labor disturbances.
(d) Any act of one or more persons, whether or not agents of a sovereign Power, for political or
terrorist purposes and whether the loss or damage resulting therefrom is accidental or intentional.
AP XS 9/7/2006 V3 3
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(e) 'j Any malicious act or act of sabotage.
(f) Confiscation, nationalization, seizure, restraint, detention, appropriation, requisition for title or
use by or under the order of any Government (whether civil military or de facto) or public
I or local authority.
(g) Hi1jacking or any unlawful seizure or wrongful exercise of control of the aircraft or crew in
flight (including any attempt at such seizure or control) made by any person or persons on
boaard the aircraft acting without the consent of the Insured.
Furthermore this Certificate does not cover claims arising whilst the aircraft is outside the control of
the!Ins fired by reason of any of the above perils. The aircraft shall be deemed to have been restored
to the control of the Insured on the safe return of the aircraft to the Insured at an airfield not excluded
by;the geographical limits of this Certificate, and entirely suitable for the operation of the aircraft
(such safe return shall require that the aircraft be parked with engines shut down and under no
duress).
AVN.48B
(e) NO E TENDED COVERAGE.
Notwithstanding that the policy of the Primary Insurer may provide insurance in respect of some of the
perils excluded by the War, Hi-jacking and Other Perils Exclusion Clause (Aviation) forming part
of;this, Certificate, it is specifically understood and agreed that no such insurance is provided by this
Certificate and that the War, Hi-jacking and Other Perils Exclusion Clause (Aviation) forming
part of this Certificate remains unamended. To this extent, the insurance provided by this Certificate
shall not follow the provisions of the policy of the Primary Insurer.
(f) FAILbRE TO PAY:
This Certificate does not apply to any loss suffered by the Insured as a result of the inability, refusal
of failure to pay of the Primacy Insurers for any reason whatsoever, including without limitation, any
financial impairment, insolvency or liquidation.
(g) CONTRACTS (RIGHTS OF THIRD PARTIES) ACT 1999 EXCLUSION CLAUSE
(AVN72 9.2.2000 Amended)
The rights of a person, who is not a party to this Certificate, to enforce a term of this Certificate
and/or not to have this Certificate rescinded, varied or altered without his consent by virtue of the
provisions of the Contracts (Rights of Third Parties) Act 1999 are excluded from this Certificate.
CONDITIONS
1. I1ICLIJRRING OF COSTS. In the event of claim or claims arising which appear likely to exceed the
Prim ry Limit(s), no Costs shall be incurred by the Insured without the written consent of the Insurers.
2. APP RTIONMENT OF COSTS. Costs incurred by or on behalf of the Insured with thell written
consent of the Insurers, and for which the Insured is not covered by the Primary Insurer, shall be
apportioned as follows:
AP XS 9/7/2006 V3 4
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(a) i Should any claim or claims become adjustable prior to the commencement of trial for not
more than the Primary Limit(s), then no Costs shall be payable by the Insurers.
(b) Should, however, the amount for which the said claim or claims may be so adjustable exceed
the Primary Limit(s), then the Insurers, if they consent to the proceedings continuing,,shall.
contribute to the Costs incurred by or on behalf of the Insured in the ratio that their proportion
of the ultimate net loss as finally adjusted bears to the whole amount of such ultimate net loss.
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(c) In the event that the Insured elects not to appeal a judgment in excess of the Primary Limit(s),
they Insurers may elect to conduct such appeal at their own cost and expense and shall be liable
for the taxable court costs and interest incidental thereto, but in no event shall the total liability
1 of the Insurers exceed the limit(s) of liability as provided for herein, plus the expenses of such
appeal.
3. APPLICATION OF RECOVERIES. All recoveries or payments recovered or received subsequent
to a 1o�ss settlement under this Certificate shall be applied as if recovered or received prior to such
settlement and all necessary adjustments shall then be made between the Insured and the Insurers,
provided always that nothing in this Certificate shall be construed to mean that losses under this
Certificate are not payable until the Insured's ultimate net loss has been finally ascertained.
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4. PRIMARY INSURANCE. Any changes made to the policy of the Primary Insurer prior Ito the
happening of an occurrence or offense for which claim is made hereunder (except as regards) limits
and period of liability, the renewal agreement (if any) and except as otherwise provided herein) shall
automatically be covered under this insurance, provided that should such changes affect the premium
paid or to be paid to the Primary Insurer,then premium hereon shall be adjusted accordingly.
5. ATTACHMENT OF LIABILITY. Liability to pay under this Certificate shall not attach unless and
until the Primary Insurer shall have admitted liability for the Primary Limit(s) or unless and until the
Insured has by final judgment been adjudged to pay an amount which exceeds such Primary Limit(s)
and then only after the Primary Insurer has paid or has been held liable to pay the full amount of the
Primalry Limit(s).
6. OTH,R INSURANCE. To the extent there is other insurance providing coverage to the subject
claim other than underlying insurance, or insurance that is specifically intended to be excess,of this
Certi�icate, the liability of Insurers under this Certificate shall be limited to their rateable proportion
of the claim.
7. MAINITENANCE OF PRIMARY INSURANCE. It is a condition of this Certificate that the policy
of the Primary Insurer shall be maintained in full effect during the currency of this Certificate except
for any reduction of the aggregate limits contained therein solely by payment of claims in respect of
occuilrences during the period of insurance.
Ili respect of the hazards set forth in Item 4 of the Schedule, this Certificate is subject to the same
warranties, definitions, terms, conditions and exclusions (except as regards the premium, the
obligation to investigate and defend, the renewal agreement (if any), the amount and limits of liability
ether than the deductible or self-insurance provision where applicable, AND EXCEPT AS
OTI1ERWISE PROVIDED HEREIN) as are contained in or as may be added to the policy of the
primary Insurer prior to the happening of an occurrence for which claim is made hereunder.
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AP XS 9/7/2006 V3 5
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8. PREMIUM COMPUTATION AND ADJUSTMENT. The premium for this Certificate shall be
coniputbd on the basis set forth herein and the Insured agrees to pay and the Insurers agrees to return
such additional or return premium as it becomes due.
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9. CANCELLATION. This Certificate may be cancelled by the Insured at any time by written notice or
by Ilsurrrendering this Certificate. This Certificate may also be cancelled by or on behalf of the
Insureds by delivering to the Insured or by mailing to the Insured, by registered, certified or i other
first class mail, at the Insured's address as shown in this Certificate, written notice stating !when
thereafter the cancellation shall be effective, such notice being not less than the number ofI days'
notice hown in Item 14 of the Schedule. The mailing of notice as aforesaid shall be sufficient proof
of notiee and this Certificate shall terminate at the date and hour specified in such notice.
If this (Certificate shall be cancelled by the Insured, the Insurers shall retain the customary short rate
proportion of the premium hereon, except that if this Certificate is on an adjustable basis the Insurers
shall receive the earned premium hereon or the customary short rate proportion of any minimum
premium stipulated herein whichever is the greater.
If this Certificate is cancelled by or on behalf of the Insurers, the Insurers shall retain the pro rata
proportion of the premium hereon, except that if this Certificate is on an adjustable basis the Insurers
shall receive the earned premium hereon or the pro rata proportion of any minimum premium
stipul ted herein whichever is the greater.
Payment or tender of any unearned premium by the Insurers shall not be a condition precedent to the
effectiveness of cancellation but such payment shall be made as soon as practicable.
If h the period of limitation relating to the giving of notice is prohibited or made void by any law
controlling the construction thereof, such notice shall be deemed to be amended so as to be equal to
the minimum period of limitation permitted by such law.
10. NOT FICATION OF CLAIMS. The Insured upon knowledge of any occurrence likely to give rise
to a claim hereunder shall give immediate written notice to the company named for the purpose in
Item 10 the Schedule.
11. FRAUDULENT CLAIMS. If the Insured shall make any claim knowing the same to be false or
fraudulent, as regards the amount or otherwise, this Certificate shall become void and all!'claims
here nder shall be forfeited.
12. Where the dollar sign ($) appears throughout this Certificate, it indicates United States Dollars.'
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AP XS 9/7/2006 V3 6
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LLoyD t s
rem FiV1 kVA kVA
Midwest Employers Casualty Company
SPECIFIC EXCESS
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INDEMNITY POLICY
Policy No.: EWC005932
Gay OF RE !"TON
SCHEDULE
APR 2 3 2008
RECEIVED
CITY CLERKS OFFICE
1. In ured: City Of Renton
2. Mailing Address: 1055 South Grady Way
Renton, WA 98057-
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3. Named States: Washington
4. Excluded States: None
5. Policy Period:
(a) From: 01/01/2008
(b) To: 01/01/2009
Both days at 12:01 A.M. standard time at the Insured's address shown in Item 2 of this
schedule.
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6. Retention:
(a) E�ch Accident: See Endorsement
(bl) E ch Employee for Disease: See Endorsement
7. Umit Each Accident:
(a) Policy Part One, Workers' Compensation: STATUTORY
• (b) Plolicy Part Two, Employers Liability: $1,000,000
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8. Liimit Each Employee for Disease:
(a') P licy Part One, Workers' Compensation: STATUTORY
(b) Policy Part Two, Employers Liability: $1,000,000
SO-SCH (12-05) Page 1 of 2
A Member Company of the W. R. Berkley Corporation
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Midwest Employers Casualty Company
SPECIFIC EXCESS
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INDEMNITY POLICY
Policy No.: EWC005932
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SCHEDULE
9. Premium:
(al,) Rate per Manhour: .0302
(b) Policy Minimum Premium: $36,960
(c) Total Estimated Policy Premium: $41,067
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(d) Deposit Premium: $41,067
(e) Deposit Flat Charges: n/a
(f) Total Deposit Premium and Flat Charges Payable as Follows:
Amount Due
$41,067.00 02/21/2008
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10. Classification of Operations: See Endorsement
11. End rsement Serial Numbers: See Endorsement Schedule
12. Service Company: Berkley Risk Administrators
P.O. Box 88842
Seattle, WA 98138
C untersigned MIDWEST EMPLOYERS CASUALTY COMPANY
A/eruovt. • kamo-1474?
Licensed R•sident Agent Date Authorized Representative
SO-SCH (12-05) Page 2 of 2
A Member Company of the W. R. Berkley Corporation
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Midwest Employers Casualty Company
Endorsement Schedule
Insured: City Of Renton
Policy Term: 01/01/2008 to 01/01/2009
Policy)No : EWC005932
Endorsement Code Effective Date Expiration Date Date Created Description
SO-6 (1) 01/01/2008 01/30/2008
SO-10 01/01/2008 01/30/2008
10-31 01/01/2008 01/30/2008
10-32 01/01/2008 01/30/2008
10-38 j 01/01/2008 01/30/2008
SO-43; 01/01/2008 01/30/2008
SO-441 01/01/2008 01/30/2008
I O-66WA 01/01/2008 01/30/2008
1 O-74A 01/01/2008 01/30/2008
SO-781 01/01/2008 01/30/2008
10-83 01/01/2008 01/30/2008
10-100 01/01/2008 01/30/2008 Communicable Disease
10-100 01/01/2008 01/30/2008 Notice of Cancellation
S0-WA 01/01/2008 01/30/2008
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Page 1 of 1 Print Date: 01/30/2008
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Schedule Item 6 is amended to read as follows:
6. Specific Retention:
(a) Each Accident: $350,000
(b) Each Employee for Disease: $350,000
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Endorse ent Effective: 01/01/2008,
Policy No.: EWC005932
Named Insured: City Of Renton
Countersigne MIDWEST EMPLOYERS CASUALTY COMPANY
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Authorized Representative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
SO-6 (11-93) Date Printed: 01/30/2008
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Page 1 of 1
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Schedule Item 10 is amended to read as follows:
10. Classification of Operations:
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State Co e Classification Estimated Manhours Rate per Estimated
Manhour Manual
Premium
WA 0 03 CITIES AND TOWNS 496,456 .8804 $437,080
WA 5 05 CLERICAL-CITIES AND TOWNS 450,133 .1630 $73,372
WA 6901 VOLUNTEERS 29,717 .0584 $1,735
WA 6904 FIRE FIGHTERS 202,080 .7899 $159,623
WA 6'05 LAW ENFORCEMENT OFFICERS 181,440 .7516 $136,370
Total Manhours: 1,359,826
Total Manual Premium: $808,180
Total Manual Premium: $808,180
(a) Experience Modification Factor: 1.000000000
(b) Other Modification Factor: 1.000000000
Normal Premium: $808,180
Endorsement Effective: 01/01/2008
Policy No.: EWC005932
Named Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
ierrl'v` ' k'f`"?' ?t,-.4g€
Authorized Representative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
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SO-10 (i1-93) EWC005932 Date Printed: 01/30/2008
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Voluntary Compensation Endorsement
Part One f the policy shall also apply to payments you gratuitously make to any emplloyLee included
within the group described below (or to the employee's dependent)for benefits indicated in the
workers c mpensation law of the state where the employee is normally employed, but only if that
state is named in Schedule Item 3.
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All officers and employees not subject to the Workers' Compensation Law of the state of their
normal employment.
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This end•rsement does not apply: •
(a) unless the gratuitous benefits are paid as a result of an accident or disease exposure occurring
dwing the policy period and in the course of employment; -
(b) if the -mployee (or dependent) is entitled to benefits under any workers compensation law.
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Endorsement Effective: 01/01/2008
Policy No.: EWC005932
Named Insured: City Of Renton
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Countersigne MIDWEST EMPLOYERS CASUALTY COMPANY
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Authorized Representative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
10-31 (I-93) Date Printed: 01/30/2008
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Limited Longshoremen's and Harbor Workers' Compensation Act Coverage
Part One f the policy shall also apply to loss paid by you because of liability imposed upon you by
the Longshoremen's and Harbor Workers' Compensation Act (33 USC Section 901-950). ,
As res'Oec s this endorsement, loss shall be limited (by amount and time of payment) to the benefits
which woi.Id be available under the workers' compensation law of the state where the injured
employee is normally employed, if that law applied.
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Endorsement Effective: 01/01/2008
Policy No.: EWC005932
Named Insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
"Cir"v` #4`454°-4i 7111/det t7:
Authorized Representative Secretary President
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This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
10-32 (1,-93) Date Printed: 01/30/2908
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Foreign Endorsement
Endenm�ic Disease:
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PolicylPa jt One— Loss will include payments you gratuitously make with respect to an employee
you normally employ in a state named in Schedule Item 3 for benefits indicated in the workers'
compensation law of that state because of exposure occurring during the policy period to disease
endemic to a region outside the United States of America, while traveling or temporarily working
there. I
This endemic disease coverage does not apply if the employee (or dependent) is entitled to benefits
under zany workers' compensation law.
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Limited Repatriation Expenses:
In the event of bodily injury by accident or disease exposure occurring during the policy period
sustained by an employee you normally employ in a state named in Schedule Item 3 while traveling
or temIJpo arily working outside the United States of America. Policy Part One— Loss will include
those Itrarkportation expenses you incur returning the employee because of the injury (or, in case of
death,ilthe employee's body) to the location where normally employed which exceed the cost of ---
returning the employee if uninjured.
Endorsement Effective: 01/01/2008
Policy No.: EWC005932
Named insured: City Of Renton
Countersigne. MIDWEST EMPLOYERS CASUALTY COMPANY
j 49 xk•‘4144Finddee ✓7
Authodied Representative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
10-38 1-93) Date Printed: 01/30/2008
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Deletion of Commutation Clause
Paragi1aph G of Part Three of the policy is deleted.
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Endorsement Effective: 01/01/2008
Policy Na.: EWC005932
Named Ihsure : City Of Renton
Countersigne MIDWEST EMPLOYERS CASUALTY COMPANY
Deruftik X. k.#1.01.4,-4i 79,,fzeilee .14.4104._
Authorized Representative Secretary President
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This endorsement forms part of the policy;to which attached,effective on the inception date of the policy unless otherwise stated herein.
SO-43 (1-93) Date Printed: 01/30/2 08
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Deletion of the Late Reporting Penalty
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Paragaph C of Parts One and Two of the policy is amended as follows:
C. Our In emni . We will indemnify you for loss paid by you in excess of your retention.
Paragtaph E of Parts One and Two of the policy is deleted from the policy.
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Endorsement Effective: 01/01/2008
Policy Ni: EWC005932
Named Insured: City Of Renton
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Counters�igne MIDWEST EMPLOYERS CASUALTY COMPANY
x4‘44-'12-F7/14sidge
Authorized Representative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
SO-44 14-99 Date Printed: 01/30/2008
it
Definition of Manhours Pertaining to Volunteer Workers
Manhours pertaining to volunteer workers (except volunteer firefighters and volunteer police
officers) means the total hours donated by the volunteers. If the work performed by the volunteers
is similar to work performed by a paid employee, the volunteer will be classified the same as the
paid emplr yee.
1,040 rma hours per year shall be included for each volunteer firefighter or volunteer police officer.
Duties,pe ormed by volunteer workers will be assigned to the classification which the duties would
be assign d to if performed by regular employees.
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Endorsement Effective: 01/01/2008,
Policy No.: EWC005932
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Named Insure : City Of Renton
Counters gne MIDWEST EMPLOYERS CASUALTY COMPANY
00r)"1.` 4-444-ses -Ateldee ,./,
Authorizid Representative Secretary President
This end o rsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
IO-66WA (1-93) Date Printed: 01/30/2008
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Aircraft Coverage Endorsement
Part A'
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The policy does not apply to loss arising out of the ownership, maintenance, operation or use of any
aircrafjt that is owned or leased by the insured. This exclusion does not apply to regularly
schedule commercial airlines, chartered flights, and scheduled aircraft in Part B below
Partl3
it is hereby understood and agreed that coverage is provided under this policy for losses sustained
in, upon, entering or alighting from those employer owned or leased aircraft scheduled below.
Coverage provided hereunder is limited to a.N/A maximum benefit any one life and is further subject
to a N/A policy limit.
In consideration for coverage provided under Part B of this endorsement, a surcharge will apply as
computed in the schedule below.
The terms and conditions contained in this Aircraft Coverage Endorsement do not apply in the
states of Connecticut, Massachusetts, New Mexico, New York and Oregon.
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Endorsement Effective: 01/01/2008
Policy No.: EWC005932
ii
Named Insured: City Of Renton
Counteliigneti MIDWEST EMPLOYERS CASUALTY COMPANY
14"."`" kt414'71-"F -Add&
x
Authorized R presentative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
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IO-74A (12-05) Page 1 of 1 Date Printed: 01/30/2008
Corridor Deductible Endorsement
The Incur d shall retain loss,for 100% of the amount shown in Schedule Item 6, except that the
first$100,000 of cumulative loss above this retention amount,whether from one occurrence or
multiple occurrences and otherwise covered under this policy, will be retained by the Insured in
addition to the amount shown in Schedule Item 6.
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Endorsement Effective: 01/01/2008
Policy No.: EWC005932
Named Insured: City Of Renton
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Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
Aeri‘wv, kttehur4e 7/tddee
Authorized Representative Secretary President
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This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
SO-78 (11-0 ) Date Printed: 01/30/2908
Policyholder Disclosure
Notice of Terrorism Insurance Coverage
Coverage for acts of terrorism, as defined in the Terrorism Risk Insurance Act, as exten ed on
December 22, 2005 (the "Act"), is included in your policy.
.You should know that any losses resulting from certified acts of terrorism, as defined in the Act,
would be partially reimbursed by the United States Government under a formula established by
federal law. Under this formula, the United States pays 90% (85% in 2007) of covered terrorism
losses exceeding the statutorily established deductible paid by the insurance company providing
the coverage. A. The portion of your annual premium that is attributable to coverage for acts of
terrorism, as defined in the Act through 12/31/07 is: $0. B. The portion of your annual premium that
is attributable to coverage for acts of terrorism, as defined in the Act, for the period beyond 12/31/07
is estimated to be $1,232(Refer to the paragraph below).
Possibility of Additional or Return Premium. The premium for certified acts of terrorism coverage is
calculated based in part on the federal participation in payment of terrorism losses as set forth in
the Act. The federal program established by the Act is scheduled to terminate at the end of 12/31/07
unless extended by the federal government. If the federal program terminates or if the level or
terms Lof federal participation change, the estimated premium shown in (B) of above may not be
appropriate.
If this policy contains a Conditional Exclusion, continuation of the coverage for certified acts of
terrorism, or termination of such coverage, will be determined upon disposition of the federal
program, subject to the terms and conditions of the Conditional Exclusion. If this policy does not
contain a Conditional Exclusion, coverage for certified acts of terrorism will continue. In either
case, when disposition of the federal program is determined,we will recalculate the premium shown
in (B) above and will charge additional premium or refund excess premium, if indicated.
If we notify you of an additional premium charge, the additional premium will be due as specified in
such iioti6e.
Name:of Insurer: Midwest Employers Casualty Company
Policy'% Number: EWC005932
Endorsement Effective: 01/01/2008
Policy No.: EWC005932
Named Insured: City Of Renton
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Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
,40*~". k4uPIA'',2f 73•te&ee
Authorized Representative Secretary President
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This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
10-83 (10-06) Date Printed: 01/30/2008
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Communicable Disease Endorsement
In consideration of the premium charged, it is understood and agreed that Part One B and Part Two
B of the olicy are amended,to include the following:
Bodily injury to one or more of your employees infected with the same Communicable Disease
manifested during the policy period shown in Schedule Item 5 of the policy will be treated as one
loss.
As used in this endorsement, "Communicable Disease" shall mean a disease caused by an
infectiou organism which is transmitted from one source to another, directly or indirectly.
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It is further agreed that the most we will pay from loss arising from Communicable Disease, whether
from a single occurrence as defined in paragraph two above or from multiple occurrences, under
the policy period shown in Schedule Item 5 of the policy is:
Policy Li it for Communicable Disease
(a); P licy Part One, Worker's Compensation: $ Statutory
(b)I Policy Part Two, Employer's Liability: $ 1,000,000.
it
If the policy includes Aggregate Excess coverage and loss arising from Communicable Disease as
defined in this endorsement exceeds the Policy Limit for Communicable Disease granted herein,
such loss'that is in excess of the Policy Limit for Communicable Disease will be excluded from Your
Aggregate Retention.
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Endorserient Effective: 1/01/2008
Policy No.: EWC005932
Named Insured: City of Renton
Countersigne MIDWEST EMPLOYERS CASUALTY COMPANY
Dr/44w X. 4%"~r4F ?is/4e ,/,
Authorized Representative Secretary President
This endorsen-ent forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
10-100 '(1-93) Date Printed: 1/30/2008
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Number of Days Notice Required for Cancellation
Paragraph F of Part Five of the policy is amended to read as follows:
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F. Cancellation. You may cancel this policy by giving us at least 0 days advance h otice by
registered mail stating the cancellation date. We may cancel this policy by giving you at
least 90 days, which shall be no less than 60 days, advance notice by registered mail stating
the cancellation date. Our mailing of registered notice to your address shown in Schedule
Item 2 will be sufficient proof that we cancelled this policy.
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Endorsemen Effective: 01/01/2008
Policy No.: EWC005932
Named insured: City Of Renton
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
x 4 ✓, ,r444..iek.
Authorized Representative Secretary President
This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
10-100 ji(1-9 ) Date Printed: 01/30/2008
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Washington Endorsement(Page 1 of 2)
Paragraph J of Parts One and Two of the policy is amended to read as follows:
J. :Recovery From Others. We have the right to recover all payments which we have made to
you from anyone liable for such loss.
1. We shall be reimbursed from such recovery to the extent of our payment to you after
you are fully compensated for your loss.
2. If you do not commence an action or proceeding to recover damages from anyone
liable for a loss paid by us,we have your rights to recover damages from anyone
liable for such loss. You will do everything necessary to protect those rights and to
help us enforce them. Any such recovery by us will be allocated as follows:
a. You shall first be reimbursed for your loss.
b. The balance of the recovery which remains after you have been reimbursed will
be paid to us to the extent payments have been made under the policy.
3. Expenses of all proceedings to recover from anyone liable for injury covered by this
ir
policy will be allocated between you and us in the ratio represented by the allocation
of any damages which have been recovered.
4. If such an action_or proceeding undertaken solely by us results in no recovery, all
related expenses will be paid by us.
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Paragraph B of Part Five of the policy is amended to read as follows:
B. 1Sole Representative. The Insured first named in Item 1 of the Schedule Page will act on
°beialf of all insureds to receive return premium or indemnity, or to request change in this
policy.
Paragraph F of Part Five of the policy is amended to read as follows:
F. Ca collation. You may cancel this policy. You must mail or deliver written notice or
surrender the policy or binder prior to or on the effective date of such cancellation, to us
stating when the cancellation is to take effect.
W! may cancel this policy. If we cancel because you fail to pay all premium when due,we
will mail to you and to all named interest not less than 10 days advance written notice by
registered mail stating when the cancellation is to take effect. If we cancel for any other
reason,we will mail or deliver to you and to all named interest not less than 45 days advance
written notice by registered mail stating the actual reason for cancellation and when the
cancellation is to take effect. Our mailing of registered notice will be sufficient proof that we
it cancelled this policy.
SO-WA,(5-93) Date Printed: 01/30/2008
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I Washington Endorsement(Page 2 of 2)
If a do not renew the policy, we will give at least 45 days advance written notice stating the
ac ual reason for non-renewal.
In ccordance with the prohibitions contained in RCW 51.14.020(5):
1. The indemnity'afforded by Part One of the policy pertaining to the workers'
I compensation,law of Washington shall be limited to 80% of your liability under that
law.
2. We do not participate in the administration of your responsibilities under the workers'
I� compensation law of Washington.
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Endorsement Effective: 01/01/2008
Policy No.: EWC005932
Named Insured: City Of Renton
la
Counterisigne MIDWEST EMPLOYERS CASUALTY COMPANY
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I Dr"v" X' it"I'44:F 744441 A ,r4e4.-4 ch-----
Authorized Representative Secretary President
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This endorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
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SO-WA (5-C.3) Date Printed: 01/30/2008
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i SELF-INSURED EMPLOYER
Department of Labor & Industries CERTIFICATE OF EXCESS INSURANCE
Self It,, ance Section I
P.O. Box 44891
Olympia, WA 98504-4891
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It is necessary to complete this form if your firm elects to reinsure its workers'compensation liability. Please have your insurance
provider assist you in properly completing this form. This information is required in accordance with RCW 51.14 020(5)and WAC 296-15-
050.
Official',Use Only UBI Account ID
Self-Iosu er: City Of Renton
14
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Name/A dress of Excess Insurer: Midwest Employers Casualty Company ,
14755 North Outer Forty Drive, Suite 300
Chesterfield, Missouri 63017 '
!
Policy N mber: EWC005932
New Policy
il Policy Renewal (Old Policy Number, if changed)
!I Change to Policy
II Cancellation of Policy(Effective Date of Cancellation)
11 Reinstatement of Policy
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Policy Period: 01/01/2008 to 01/01/2009
Type of Policy: Specific: Retention: See Attached
Maximum Liability of Excess Insurer: STATUTORY
Aggregate: Retention: N/A
Maximum Liability of Excess Insurer: N/A
This,policy contains the following endorsements:
1
This policy is not intended to provide for the payment of any costs,benefits or compensation
Yes NOII which the self-insured employer may be obligated to pay pursuant to the provisions of Title 51
RCW,in excess of 80%of any such liabilities,as required by RCW 51.14 0201(5).
XIt is further understood that this excess insurance company and its personnel do not
Yes No participate in the administration of the responsibilities of the self-insured under Title 51 RCW.
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x• ki.„..0-ce
Date: 12/27/2007 By:
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Excess) Insurer: Midwest Employers Casualty Company
F207,-095-300 self-insured employer cert.of excess insurance 1-89 Official Use Only
LINUS LOTUS
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Date c rtificate issued: 12/27/2007
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II.
Schedule Item 6 is amended to read as follows:
6. Speci is Retention:
(a) Each Accident: $350,000
(•) Each Employee for Disease: $350,000
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Endorsement Effective 01/01/2008
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Policy No.: EWC005932
Named Insured: City Of Renton
Ip
Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
& x. k..0.44....r4F 7Hz/de, .14.4"1
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Authorized Representative Secretary President
This endo ement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
SO-6 1 (1-9 ) Date Printed: 01/301
/2008
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Corridor Deductible Endorsement
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The Insured shall retain loss for 100% of the amount shown in Schedule Item 6, except that the
first$10O,000 of cumulative,loss above this retention amount,whether from one occurrence or
multiple occurrences and otherwise covered under this policy, will be retained by the Insured in
addition to the amount shown in Schedule Item 6.
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Endorsement Effective: 01/01/2008
Policy No.: EWC005932
Named, Insured: City Of Renton
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Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY
Dr X. kfLebtrese 7 ✓,
Authorized Representative Secretary President
This e;i dorsement forms part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein.
•
SO-78 (11-04) Date Printed: 01/30/2008
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lit 1 PA Midwest Employers .
, . .
4'11 Casually Company - . ' ,
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., - PRIVACY NOTICE `
1,• Midwest Employers Casualty Company:(the "Company"), a member company of the W. R. .
. erkley Corporation,("Berkley") group of companies and each.,other member of tie. Berkley
, ''group.of companies ("Affiliates") understands our customers' concern about privacy of their ;
I information collected by the Company.. : Our Company is dedicated. to .protectiing the
confidentiality'and security of nonpublic personal information we collect about our customers in
accordance with applica•ble laws and regulations; This. notice refers to the Compariy by using -
• the terms"us,"•"we,". or "our," This notice describes our privacy.policy`and describes,how we •
1 teat the nonpublio personal information about':our .customers ,that we receive.from them
( Information"). :
' : Why We Collect and How We Use Information
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R We collect and use Information:for.business purposes with respect to our'insurance'products •
and services and:other business.relations involving our customers We-gatherthis Information
to .evaluate:your .request for insurance; to:-evaluate your,.insurance claims;:.to administer,
a . p:.' y P Y l• - � mamtain.or review your insurance olic ; and to.process our insurance;,transactions INe also',.
' !; accumulate certain information about you as may be required or permitted by law
: Your'.insurance.:agent or broker also collects this Information;and may use.it.to help with:your
'I:. Overall.insurance program or to'market additional:products-.and services to.you; We.may:also ,-..
-. use..Information:to offer you,other-products or services that,we or our Affiliates provide:
- .;+ Ho*We.CollectInformation -
most:Information:collected-by us.is provided:by.:you;or your.insurance agent,or- brokerto'us.,-We.
j1 btain Information from.(i) applications or other forms submitted by.you, your insurance agent Or
!p roker.or your;authorized:representatives to us and our Affiliates, and (ii) your transactions with
• ii :;us or our Affiliates: We may also_obtain-Information from other sources:such.as (i)_.consumer
,; eporting agencies, (ii) other institutions or information services providers (third party
Ir dministrators);.(iii);employers, (iv) other insurers,`or(V)your family:members. :., . . - •
nformation We.Disclose ,!
-j We-:-disclose any Information`which .we believe Is necessary :to conduct our business as.
-. permitted,by applicablei
law orwhere requred.by:.applicable.law:•:-This disclosure my include (i).
Information we receive,from you'on applications,or other forms:provided.to;us and.our Affiliates, ..
such as names, addresses, social security numbers,.assets, employer information,salaries, etc.
. (ii) Information about your 'transactions with us and our Affiliates;, such:as policy;coverages,
premiums, payment history, etc., and:(iii) Information we receive sfrOm a consumer reporting
agency,such as credit worthiness and credit history.
Ta 1`.-' ;, 14755 North Outer:Forty Drive • Suite 300,• Chesterfield,-MO 63017 • Phone:.636-449-7000 •,Fax:636-449-7199 •
A it;_1 A BE. KLEY COMPANY®
: .1 11 . .Midwest
Employers
' . .
Casualty Company . , ,
01/30/200 "
' Berkle''y Riisk Administrators
Attn:'Claims Manager -
• P.O: Box 88842 ,
Seattle,-WA 98138 . ,
•
Re:. ', Clairn'Packet For:: • City Of,Renton
Policy Number: EWC005932 - .
1 ' •Policy Period.: • 01/01/2008 to 01/01/2009 ,
Midwest mployers Casualty Company,has been selected•to:.provide'the excess workers!compensation coverage for • '.!
the attovefaccount. We have committed significant resources to support your efforts to make this Self-insured.,prograrm .
• `a continued;success:
The-attacl?ed:claim packet contains various forms and information pertaining.to.the excess coverage: The Claim. "
:Packet.Ccntents sheet explains each item:enclosed: Please:review it carefully and:advise should you have-any . •
quest'ons..
• Michael Gordon,Claim Analyst, is:res onsible for supporting'your efforts on this.;account. i '
Maintaini.'g:a"good relationship'with your organization is,v"ery important to'.us: :If.we:can.be.ofbelp on;any.;claim'or
'should yo�u''hav su e.anysuggestions for how we can assist.you better, please•do.not hesitate to contact u -1. '
Sincerely,
MIDWEST EMPLOYERS:CASUALTY COMPANY . .
ar ,
Il:
Clairrront?:Cappelle:
Vice President of Claims . : '
cc: • '� Arthur, •J. Gallagher_Risk Management Services Inc-Ty Pixler (no enclosure)
City Of:Renton (no enclosure} :
Actively p omoting Best Practice performance: .
.,, . _ �,� "� 14755 North Outer Forty.:Drive • Sdite 300 •. .Chesterfield;iv10. 6301.7.• Phone:636=444-7006 • Fax: 636-449.-7T99,`
=( A BERKLEY COMPANY® .
•
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ZURICH AMERICAN INSURANCE COMPANY
(EQUIPMENT BREAKDOWN PROTECTION
COVERAGE FORM CITY OF RENT0N
DECLARATION -
'i APR 2u �',,
RECEIVEC
Named Insured: City of Renton CITY CLERK'S OFFICE
Mailing Address: 1055 S.Grady Way
Renton,WA 98055
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Policy Number: BM 9307613-05
9100 Executive and Legislative Offices
SIC Code jl Standard Business Description
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Policy Perio :From:01/01/2008 To: 01/01/2009 at 12:01 a.m.Standard Time at Named Insured's mailing
address
Annual Premium: $9,731
Covered Premises: See Endorsement#1
Contingent Business Income and Extra Expense Covered Premises:Any Location
.ar :� . 'AND:.L; ryry4���{;(.���''�■■TS�'•:���.:�,
F, -✓4.. :jry... .. ATJ:.�1... :•`t9 '}•.:i„:r-. „4`eu
n"ea es+oot Ito a'covera .e ;.-r' 'c:�ailLiiiii -oF bra �i[: �}
.1'rq �sal.insttra It tiv h. t Iiis tac��`a utatie`t';t%f Da _Hau ,�ar`tli�=�ord�s�.'::,:;
:'IN, '1s'shown:<=1i:1NCLI3D D':3s�; shn,th .theelimit for-zthat coverigeIs art-of the- -
Pro e I.iinit« >.n> x =
ow en 'max"
COVERAGES LIMITS OF OTHER
INSURANCE
Policy Iiimitj: $ 50,000,000
Property Damage: Included
Business Income and Extra Expense: Included Coinsurance does not apply
Extra Expense Only: ' Excluded
Extended Period of Restoration: 30 Days
Data and Media: (Business Income/Extra Expense) $ 500,000
Expediting Expense: Included
Spoilage Damage: Included Coinsurance does not apply
Utility Interruption: Included
Newly Acquired Premises: Included 365 Days
Ordinance Or Law: $ 1,000,000
Errors land;Omissions: Included
Brands!and Labels: Included
Contingent Business Income/Extra Expense: $ 250,000
Contingent lExtra Expense Only: Excluded
Ammonia Contamination: Included Coinsurance does not apply
Consequential Loss: Included
Data and Media:(Property Damage) $ 500,000
Hazardous Substance: $ 500,000
Water Damage: Included
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;:DEDUCTIBLES:`:_:'
.:tb li'.:s'only o o erag :efot sahi nt,hours M;s or,; , D;;is •.Ot:.. •f =.'.c%.r':.,t**(1uc 1ble:app e_,^._..,y t,a c v ;+ge, r.w ch n amou t, r ,day o the'word COMBINE
COMBINED is shown,then the deductible for that;coverage will be thOde part of the Property Deductible:
ri
COVERAGES DEDUCTIBLE
Property Damage: $5,000
Business Income and Extra Expense: Combined
Extra Expense Only: No Coverage Provided
Spoilage Damage: Combined
Utility,Interruption: Applicable Business Income/Spoilage damage
deductible to apply after 4 Hour waiting period
Contingent Business Income/Extra Expense: Combined
Contingent Extra Expense Only: No Coverage Provided
Ammonia Contamination: Combined
OtherT
Yc' W t
C D T ON I IONS���t=u
Business Income Annual Value: On File
Loss Paye : None
Additional Insured: None
Mortgage Holder: None
__ Notice of Cancellation: 90 Days,except 10 Days for Non-Payment of Premium
:,.,...r •.a;,,..,: .((,r��� �,..,.: •'" - t x:' ::za i" ;+n' se';1'trh;'�
. v,.rs v,,,.sc0.,rtt,1.�1. ':/�:...�,.... ti d;�>' 1"Ir tfi J,f'd�riih),
t:.r•.n ;,./�•i...;r,.tiv'`i„�,ul. etl;,,;A��br,� 1_,;;4r '
.. : . ..: ......:.. ......:::. :. FORMS<END.ORSEIi�IENTS SCHEDULES, ;` r ;
- ,! i.1t1,. ,+Y)
Ti C'•;
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-au. . ..„•'.; <;:<.. �;;,r ?�;;. sa: a e.: art"f t ia: 1'c 'at;.•h..times:
.. .. ,.,._�_ ..,.s'�M p o ,h .po� y. t e" ,o
• BM 0020 07 01:Equipment Breakdown Protection Coverage Form
• U=GU 319-E(5/96): In Witness Clause
• GU 519(11-98): Common Policy Conditions
• IL 001 46 09 03: Washington Common Policy Conditions
• U4BMS-180(9/88): Omnibus Location Description-Endorsement#1
• U,-',BMS-180(9/88): Buried Equipment Wording-Endorsement#2
:ziz:;g2
Authorized Represen a Date:
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BOILER AND MACHINERY
I BM 00 20 07 01
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EQUIPMENT BREAKDOWN PROTECTION
COVERAGE FORM
Various provisions in this policy restrict coverage. However, if coverage for "Extra Ex-
Read the entire policy carefully to determine rights, pense" Only is indicated in the Decla-
duties and what is and is not covered. rations, then coverage for "Business
Throughout this policy the words "you" and "your" Income"is not provided.
Throw
refer to the amed Insured shown in the Declarations. We will consider the experience of
The wo rds 'we", "us" and "our" refer to the Company your business before the "Break-
providing this insurance. down" and the probable experience
Other word and phrases that appear in quotation
you, would have had without the
marks have special meaning. Refer to Section F — "Breakdown" in determining the
Definitions. amount of our payment. I
A. Covera a (2) If you have coverage for "Business
Income" and "Extra Expense" or for
1. 'Covered Cause Of Loss "Extra Expense"Only and:
Covered Cause of Loss is a "Breakdown" to (a) If a number of days is shown in
I Cornered Equipment". the. Declarations for Extended
2. 1 Coverages Provided Period of Restoration Coverage,
Each of the following coverages is provided if it will replace the five consecutive
I eit*a limit or the word INCLUDED,is shown days in the definition of"Period of
for that coverage in the Declarations. If nei- Restoration".
I then a limit nor the word INCLUDED is shown, (b) If you have coverage for Ordi-
j then that coverage is not provided. nance or Law, then the "Period of
Th se coverages apply only to that portion of
Restoration" is extended to in-
I theeloss or damage that is a direct result of a dude the additional period of time
Covered Cause of Loss. required for demolition, removal,,
repair, remodeling For re-
j a. Property Damage construction.
I, We will pay for direct damage to"Covered (c) If"Media" is damaged or"Data" is
Property" . located at the premises lost or corrupted, we will pay your
II described in the Declarations. actual loss of "Business Income"
b. Expediting Expenses and/or "Extra Expense" during i
With respect to direct damage to "Coy- the time necessary to:
1 ered Property" we will pay for the'extra (i) Research, replace or restore
' cost you necessarily incur to: the damaged "Media" or lost
(1) Make temporary repairs; and or corrupted "Data"; end
I, (2) Expedite the permanent repairs or (ii) Reprogram instructions used
1 in any. covered "Computer
I replacement of the damaged prop- Equipment I
erty.
II c. Business Income And Extra Expense — There shall��be no coverage for
Extra Expense Only any Media or Data that we
determine is not or cannot be re-
(1) We will pay: placed or restored.
(a) Your actual loss of "Business In- Unless a higher limit is shown in
come" during the "Period of the Declarations, we will pay the
it
Restoration";'and lesser of your actual I loss of
' (b) The "Extra Expense" you neces- "Business Income" and/or "Extra
sarily incur to operate your busi- Expense" up to 30 daysl after the
ness during the "Period of Resto- "Period of Restoration" or
I ration". $25,000.
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BM 00120 07 01 I © ISO Properties, Inc., 2000 Page 1 of 15
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d. Spoilage Damage . f. Newly Acquired Premises
j (1) We will pay for the spoilage damage We will automatically provide coverage at
to raw materials, property in process newly acquired premises you have
or finished products, provided, all of purchased or leased. This coverage be-
the following conditions are met:: gins at the time you acquire the property
(a) The raw materials, property in and continues for a period not exceeding
process or finished products must the number of days indicated in the Dec-
be in storage or in the course of larations for Newly Acquired, Premises,
under the following conditions:
1 being manufactured;
(b) You must own or be legally liable (1) You must inform us, in writing, of the
under written contract for the raw newly acquired premises as soon as
materials, property in process or practicable;
I` finished products; and (2) You agree to pay an additional pre-
(c) The spoilage damage must be mium as determined by us;
due to the lack or excess of (3) The coverage for these premises will
power, light, ,heat, steam or re- be subject to the same terms, condi-
I,I frigeration. tions, exclusions and limitations as
(2) We will also pay, any necessary ex- other insured premises; and I
ii penses you incur to reduce the (4) If the coverages and deductibles vary
amount of loss under this coverage. for existing premises, then the cover-
We will pay such expenses to the ages for the newly acquired premises
extent that they,do not exceed the will be the broadest coverage and
amount of loss that otherwise would highest limits and deductible applica-
have been payable under this Cover- ble to the existing premises.
j age Form. g. Ordinance Or Law Coverage
e. Utility Interruption The following applies despite the Ordi-
If you have coverage for Business Income nance or Law Exclusion and !provided
And Extra Expense Extra Expense Only these increases in loss are necessitated •
and/or Spoilage Damage, that coverage by the enforcement of any laws or ordi- , .
' is extended to include loss resulting from nances that are in force at the time of the
the interruption of utility services provided "Breakdown", which regulate the demoli- -
all of the following conditions are met: tion, construction, repair or use of the
li (1) The interruption is the direct result of building or structure. With respect to the
a "Breakdown" to "Covered Equip- building or structure that was damaged as
ment" owned, operated or controlled a result of a"Breakdown":
by the local private or public utility or (1) We will pay for:
distributor that directly generates, (a) The loss in value of the undam-
transmits, distributes or provides util- aged portion of the building or
ity services which you receive; structure as a consequence of
1 (2) The "Covered Equipment" is used to enforcement of an ordinance or
supply electric power, communication law that requires the demolition of
services, air conditioning, heating, undamaged parts of the same
gas, sewer, water or steam to your building or structure; 1
premises; and (b) Your actual cost to demolish and
(3) The interruption of utility service to clear the site of the undamaged
your premises lasts at least;the con- parts of the same building or
secutive period of time shown in the structure as a consequence of
ij Declarations. Once this waiting period enforcement of an ordinance or
is met, coverage will commence at law that requires the demolition of
I; the initial time of the interruption and such undamaged property; and
will be subject to all applicable
' deductibles. (c) The increased cost actually and
1I i i necessarily expended to:
(i) Repair or reconstruct the
damaged or destroyed por-
tions of the building or struc-
1 ture; and
Page 2 of 5 © ISO Properties, Inc., 2000 BM 00 20 07 01
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(ii) Reconstruct or remodel the (b) There is other physical damage
undamaged portion of that that is not covered' under this
building or structure with policy; and
buildings or structures!of like
,� (c) -The building damage in its en-
materials, height, floor. area, tirety results in enforcement of
and style for like occupancy, ordinance or law;
j whether or not demolition is
I required on: then we will not pay the full amount of
the loss under this coverage. Instead,
i. The same premises or on we will pay only that proportion of
another premises 'if you such loss; meaning the proportion
so elect. However'if you that the covered "Breakdown" loss
rebuild at another(prem- bears to the total physical,damage.
ises, the most we will pay
is the increased cost of But if the building or structure sus-
I{ construction that we tains direct physical damage that is
would have paid Ito re- not covered under this policy and
build at the same'prem- such damage is the subject iof the or-
ises;'or dinance or law, then there is no Ordi-
nance Or Law coverage under this
ii. Another premises i if the Coverage Part even if the building
M relocation is requited by has also sustained damage by a coy-
' the ordinance or law. The ered "Breakdown". 1
most we will pay is the
II increased cost, of con- h. Errors And Omissions
struction at the new We will pay for any loss or damage,which
premises. is not otherwise payable u der. this
(2) We will not pay for any: Coverage Part solely because of the
(a) Demolition or site clearing until items listed below:
the undamaged portions of the (1) Any error or unintentional omission in
1 buildings or structures are actu- the description or location of property
ally.demolished; as insured under this.Coverage Part
(b) Increase in loss until the dam- or in any subsequent amendments;
aged or destroyed buildings or (2) Any failure through error to include
I structures are actually rebuilt or any premises owned or occupied by
replaced and approved by the you at the inception date of!this Cov-
e regulating government agency; erage Part; or
(c) Loss due to any ordinance or law (3) Any error or unintentional omission by
that: you that results in cancellation of any
, premises insured under this policy.
I (i) You were required to comply i
with before the loss, even if No coverage is provided as a result of
the building was undamaged; any error or unintentional omission by you
and in the reporting of values or the coverage
(ii) You failed to comply with; you requested.
It is a condition of this coverage that such
(d) Increase in the loss, excess of errors or unintentional omissions shall be
the amount required to meet the reported and corrected when discovered.
jl minimum requirement of any or- The policy premium will be adjusted ac-
i dinance or law enforcement at the cordingly to reflect the date the li premises
time of the"Breakdown';:or; should have been added had no error or
II (e) Increase in lass resulting from a omission occurred.
substance declared to .be haz- i. Brands And Labels
ardous to health or environment
by any government agency. (1) If branded or labeled merchandise
that is "Covered Property" is dam-
(3) If: aged by a "Breakdown", we'may take
(a) The building,or structure is dam- all or any part of the property at an
aged by a "Breakdown" that is agreed or appraised value. If so, you
covered under this policy; may:
BM 00120 07 01 © ISO Properties, Inc., 2000 Page 3 of 15
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(a) Stamp the word SALVAGE on the The exclusions apply whether or not the loss
merchandise or its containers if event results in widespread damage or affects a
the stamp will not physically substantial area.
damage the merchandise; or 1. Ordinance Or Law
(b) Remove the, brands or labels if Increase in loss from the enforcement of any
doing so will not physically dam- ordinance, law, rule, regulation or:ruling which
age the merchandise. You must restricts or regulates the repair, replacement,
re-label the merchandise or its
containers to with alteration, use, operation, construction,
comply P y any installation, clean-up or disposal of "Covered
law. Property".
(2) We will pay reasonable costs you However the words use and operation shall
incur to perform the activity described be eliminated as respects a covered "Break-
in; Paragraphs (1)(a)"and (1)(b), but down" to electrical supply and emergency
the total we pay for these costs and generating equipment located on the prem-
the value of the damaged property ises of a Hospital. '
will not exceed the applicable Limit of P
Insurance on such property. , 2. Earth Movement
j. Contingent Business Income And Earth movement, including but not limited to
Extra Expense—Extra Expense Only earthquake, landslide, land subsidence, mine
li Coverage subsidence or volcanic action.
(1) Subject to the same terms and con- 3. Water
ditions, the Business Income And a. Flood, surface water, waves, tides, tidal
Extra Expense or Extra Expense Only waves, overflow of any body of water, or
Coverage provided by this Coverage their spray, all whether driven by wind or
Part is extended'to cover your loss, if not;
any, resulting from a "Breakdown" to b. Mudflow or mudslide;
"Covered Equipment" at a premises' c. Water damage caused bybackuplof
shown in the Declarations, that'is not 9
owned or operated by you which: sewer, drains or drainage piping; or
(a) Wholly or partially prevents the d. Water damage caused by the idischarge
delivery of services or materials or leakage of a sprinkler system or do-
shown in the Declarations, to you mestic water piping.
! or from you to others for, your ac- 4. Nuclear.Hazard
count; or Nuclear reaction or radiation, or radioactive
ji (b) Results in the loss of sales at contamination, however caused.
your premises shown in the 5. War Or Military Action
Declarations. 1
(2) You shall use your influence to in- a. War, including undeclared or civil war;
duce the contributing or 'recipient b. Warlike action by a military force, in-
premises to make use of any other cluding action in hindering or defending
machinery, equipment, supplies or against an actual or expected attack, by
premises available in order to resume any government, sovereign for other
1 operations and delivery of services or authority using military personnel or other
materials to you, or the acceptance of agents; or
products or services from you,. You c. Insurrection, rebellion, revolution, usurped
shall cooperate with the contributing power or action taken by governmental
or recipient premises to this effect in authority in hindering or defending against
every way, but not financially unless any of these.
authorized by us. 1 6. An explosion. However, we will pay;for direct
B. Exclusions loss or damage caused by an explosion of
We will not pay for loss or damage caused directly "Covered Equipment" of a kind specified in a.
or indirectly by any of the following. Such loss or through g. below, if not otherwise excluded in
daag is excluded regardless of any other this Section B.: I
caulse br event that contributes concurrently or in a. Steam boiler;
11 any sequence to the loss. b. Electric steam generator;
l' c. Steam piping;
i
iI
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1 d. Steam turbine; b. Your failure to use due diligence and dis-
e. Steam engine; • patch and all reasonable means to oper-
ate your business as nearly normal as
1 f. Gas turbine; or 1practicable at the premises shown in the
g. Moving or rotating machinery when such Declarations; or
explosion is caused by centrifugal force or c. The suspension, lapse or cancellation of
mechanical breakdown. a contract following .a "Breakdown" ex-
7. I Fire or combustion explosion including;those tending beyond the time business could
I, that: have resumed if the contract had not
a. Result in a "Breakdown"; lapsed, been suspended or canceled.
„` 16. Lack or excess of power, light, heat; steam or
b. Occur at the same time as a Break-
i or •
refrigeration except as provided by the Busi-
down";
ness Income And Extra Expense, Extra Ex-
1 c. Ensue from a"Breakdown". pense Only, Spoilage Damage and Utility In-
8. i Explosion within the furnace of a chemical terruption Coverages.
I reciovery type boiler or within the: passage 17. With respect to Utility Interruption Coverage,
1 from the furnace to the atmosphere. any loss resulting from the following'additional
9. I Damage to "Covered Equipment" undergoing causes of loss whether or not coverage for
a pressure or electrical test. that cause of loss is provided by another
101 Water or other means used to extinguish a policy you have:
fire), even when the attempt is unsuccessful. a. Acts of sabotage;
11. Depletion, deterioration, corrosion, erosion, or b. Collapse;
• occr and tear. However, if a "Breakdown" c. Deliberate act(s) of load shedding 1 weer by the
urs, we will pay the resulting loss or dam- supplying utility;
age. d. Freezing caused by cold weather;
12. A 'Breakdown" that is caused by any of the e. Impact of aircraft, missile or vehicle;
following causes of loss. if coverage for that I
cause of loss is provided by another policy of f. Impact of objects falling from an aircraft or
insurance you have, whether collectible or missile;
li no .
• g. Lightning; •
a. Aircraft or vehicles; h. Riot, civil commotion or vandalism;
b. Freezing caused by cold weather; i i. Sinkhole collapse; 1
c. Lightning; j. Smoke; or
j d. Sinkhole collapse; k. Weight of snow, ice or sleet. '
e. Smoke; 18. Any indirect result of a "Breakdown" to "Cov-
f. Riot, civil commotion.or vandalism; or ered Equipment" except as provided by the
Ig. Weight of snow, ice or sleet. Business Income And Extra Expense, Extra
Expense Only, Spoilage Damage and Utility
131!A "Breakdown" that is caused by Windstorm Interruption Coverages.
�I or Mail. 19. Neglect by you to use all reasonable means
14: A delay in, or an interruption of any business, to save and preserve"Covered Property"from
manufacturing or processing activity except further damage at and after the time of the
as provided by the Business Income And Ex- loss.
I tra Expense, Extra Expense Only and ;Utility C. Limits Of Insurance
• Interruption Coverages.
15.:With respect to Business Income And Extra
1. The most we will pay for any and all cover-
ages for loss or damage from any "One
11 Expense, Extra Expense Only and Utility In- Breakdown" is the applicable Limit of Insur-
ance I
11 ter iuption Coverages, the following additional shown in the Declarations.
exclusions shall apply: •
2. Any payment made will not be increased if
a. The business that would not or could not 1
have been carried on if the "Breakdown" more than one insured is shown in the Decla-
had not occurred; rations.
3. For each coverage in Paragraph A.2 if:
a. INCLUDED is shown in the Declarations,
' i the limit for such coverage is part of, not
in addition to, the Limit per Breakdown.
,F
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b. A limit is shown in the Declarations, we This coverage applies despite the opera-
will not pay more than the Limit of lnsur- tion of the Ordinance or Law Exclusion.
ance for each such coverage. e. Water Damage
4. For any"Covered Equipment"that is: The damage to "Covered Property" by
'I a. Used solely to supply utility services to water including any salvage expenses,
j your premises; except no coverage applies to such Jam-
b. Owned by a public or private utility; age resulting from leakage of a sprinkler
system or domestic water piping.
c. Not in your care, custody or control and
for which you are legally liable; and! D. Deductibles
i ! 1. Application Of Deductibles
d. Covered under this Coverage Form;
the Limit of Insurance for Property barrage We will not pay for loss or damage resulting
I stated in the Declarations is deleted and re- from any "One Breakdown" until the amount
I placed by the sum of one dollar. of covered loss or damage exceeds the de-
ductible shown in the Declarations' for each
If you are a public or private utility, 14.13. is applicable coverage. We will then pay the
1 deleted and replaced by the following:, amount of covered loss or damage in excess
b. Owned by a public or private utility other of the deductible, up to the applicable Limit of
than you; Insurance.
5. i; Unless a higher limit or INCLUDED is shown Deductibles apply separately for each appli-
1 in he Declarations, the most we will pay for cable coverage except if:
direct damage as a 'direct result ' of a a. A deductible is shown as COMBINED for
"Breakdown" to "Covered Equipment" is any of the coverages in the Declarations,
j $25,000 for each of the following. The limits then we will first subtract the combined
are part of, not in addition to, the Limit of In- deductible amount from the aggregate
su lance for Property Damage or Limit per amount of any loss to which the combined
Br-akdown. deductible applies; or
a. Ammonia Contamination
b. More than one "Covered Equipment" is
' . ' The spoilage to "Covered Property" con- involved in "One Breakdown", .then only
taminated by ammonia, including any one deductible, the highest, shall apply .
salvage expense. ' ' for each of the applicable coverages.
b. Consequential Loss 2. Determination Of Deductibles
1� The reduction in.the value of undamaged a. Dollar Deductible
"Stock" parts of a product which becomes If a dollar deductible is shown in the
! unmarketable. The reduction in value Declarations, we will first subtract the de-
must. be caused by a physical loss or ductible amount from any loss we would
it damage to another part of the product. otherwise pay.
c. Data And Media b. Time Deductible
Your cost to research, replace or restore If a time deductible is shown in the Dec-
1 damaged "Data" or 'Media" including the larations, we will not be liable,for any loss
I cost to reprogram instructions used in any under that coverage that occurs during
"Computer Equipment". that specified time period immediately
d. Hazardous Substance 1 following a "Breakdown". If a time de-
1� Any additional expenses incurred by you
ductible is shown in days, each day shall
' for the clean-up, repair or replacelment or mean twenty-four consecutive hours.
disposal of "Covered Property" that is c. Multiple Of Daily Value Deductible
i damaged, contaminated or polluted by a If a multiple of daily value is shown in the
"Hazardous Substance". Declarations, this deductible will be cal-
l; As used here, additional expenses mean culated as follows:
1, the additional .cost' incurred over and (1) For the entire premises where the
above the amount that we would have loss occurred, determine I,the total
paid had no"Hazardous Substance"been amount of "Business Income" that
involved with the loss. would have been earned during the
Ammonia is not considered to be a "Haz- "Period of Restoration" had no
1' ardous Substance" as respects this limi- "Breakdown"taken place.
I tation. ,
1
Page 5 of 5 © ISO Properties, Inc., 2000 BM00 20 07 01
I.
(2) Divide the result in Paragraph (1) by b. Appraisal
the number of days the business If we and you disagree on the value of the
would have been open during the property or the amount of loss, either may
"Period of Restoration". The result is make written demand for an appraisal of
the daily value. the loss. In this event, each party will
(3) Multiply the daily value in Paragraph select a competent and impartial
(2) by the number of days shown in appraiser. The two appraisers will select
the Declarations. We will first subtract an umpire. If they cannot agree, either
this deductible amount from any loss may request that the selection Ibe made
IE we would otherwise pay. We will then by a judge of a court having,jurisdiction.
pay the amount of loss or damage in The appraisers will state separately the
, excess of the deductible, up to the value of the property and amount of loss.
1 applicable Limit of Insurance,. If they fail to agree, they will submit their
d. Percentage Of Loss Deductible differences to the umpire. A decision
If a deductible is expressed as a percent- agreed to by any two will be binding.
age of loss in the Declarations,we will not
Each party will:
be liable for the indicated percentage of (1) Pay its chosen appraiser;land
I gross amount of loss or damage (prior to (2) Bear the other expenses of the ap-
the applicable deductible or coinsurance) praisal and umpire equally.
insured under the applicable coverage.
� If there is an appraisal, we will still retain
I e. Minimum Or Maximum Deductibles our right to deny the claim.
(1) If: c. Defense
(a) A minimum dollar amount de- We may elect to defend you against suits
ductible is shown in the Declara- arising from claims of owners ofi property.
tions; and We will do this at our expense.
(b) The dollar amount of the Multiple d. Duties In The Event Of Loss Or
of Daily Value or the Percentage Damage
1 of. Loss Deductible is less than
(1) You must see that the following are
the Minimum Deductible;
done in the event of loss or damage
I . then the Minimum Deductible amount to"Covered Property":
shown in the Declarations will be the
applicable deductible. (a) Give us a prompt notice of .the
O If:2 loss or damage. Include a de-
scription of the property involved.
(a) A maximum dollar amount de- (b) As soon as possible, give us a
ductible is shown in the Declara- description of how, when and
tions; and m
i where the loss or daage oc-
(b) The dollar amount of the Multiple curred.
of Daily Value or the Percentage (c) Allow us a reasonable(time and
of Loss Deductible is greater than opportunity to examine the prop-
the Maximum Deductible; 1 erty and premises before repairs
then the Maximum Deductible amount are undertaken or physical evi-
I shown in the Declarations will Pe the dence of the "Breakdown" is re-
applicable deductible. moved. But you must take what-
E. Equipment Breakdown Protection Conditions
ever measures are necessary to
.I I protect the property and premises
The following conditions apply in addition to the from further damage.
Common n Policy Conditions: ,
(d) As often as may be reasonably
1.1' Loss Conditions required, permit us to inspect the
a. Abandonment property proving the loss or dam-
I age and examine your books and
There can be no abandonment of any
1 property to us. records.
rr
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Also permit us to take samples of (2) We may cancel the policy as allowed
damaged and undamaged prop- by the Cancellation Condition. Can-
erty for inspection, testing and cellation ends this agreement as to
; analysis, and permit us to make the loss payee's interest. If we cancel
copies from'your books and rc- we will mail you and the loss payee
, cords. the same advance notice.
i (e) Send us a signed, sworn proof of (3) If we make any payment to the loss
loss containing the information payee, we will obtain their rights
we request: to investigate the against any other party.
claim. You must do this!within 60 h. Other Insurance
days after our request. We will
supply you 'with the necessary (1) You may have other insurance sub-
forms. ject to the same plan, terrrls, condi-
tions and provisions as the Iinsurance
(f) Cooperate with us in the invests- under this Coverage Part. If you do,
gation or settlement of the Claim. we will pay our share of the covered
(2) We may examine any insured:under loss or damage. Our share is the
II oath, while not in the presence'of any proportion that the applicable Limit of
other insured and at such times as Insurance under this Coverage Part
may be reasonably required, about bears to the Limits of Insurance of all
any matter relating to this insurance insurance covering on the same ba-
or the claim, including an 'insured's sis.
books and records. In the event of an (2) If there is other insurance covering
examination, an insured's answers the same loss or damage, other than
must be signed. that described in Paragraph (1), we
e. Insurance Under Two Or More will pay only for the amount of cov-
Coverages ered loss or damage in excess of the
If two or more of this policy's coverages
amount due from that other insur-
apply to the same loss or damage, we will ance, whether you can collect on it ornot. But we will not pay more than the
-,,!I not pay more•than the actual amount of 1 •
- applicable Limit of Insurance.
the loss or damage.
f. Legal Action Against Us i. Privilege To Adjust With Owner
ly No one may bring a; legal action against In the event of loss or damages involving
I us under this Coverage Part unless: property of others in your care, custody or
control, we have the right to Settle the
i (1) There has been;full compliance with loss or damage with the owner of the
I all the terms of this Coverage Part; property. A receipt for payment from the
and owner of that property will satisfy any
(2) The action is brought within 2 years claim of yours against us.
after the date of the"Breakdown"; or j. Reducing Your Loss
! (3) We agree in writing that you have an As soon as possible after a "Breakdown"
obligation, to pay for damage to you must:
Covered Property"
of others or until
the amount of that obligation has (1) Resume business, partially' or corn-
been determined by final judgment or pletely;
arbitration award. No one has the (2) Make up for lost business within a
right under this policy to bring us into reasonable period of time. This rea-
any action to determine your liability. sonable period does not necessarily
g. Loss Payable Clause end when operations are resumed;
and
(1) We will pay you and the loss 'payee 1
shown in the Declarations for loss (3) Make use of every reasonable means
due to a "Breakdown" to "Covered to reduce or avert loss including:
Equipment", as interests may appear. (a) Working extra time or overtime at
The insurance covers the interest of the premises or rat I another
the loss payee unless the loss results premises you own or acquire to
from conversion, secretion or em- carry on the same operations;
bezzlement on your part. (b) Utilizing the property and/or
• services of other concerns;
Page 8 of 15 © ISO Properties, Inc., 2000 BM 00 20 07 01
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(c) Using merchandise 'or other (2) If you elect or we require that the re-
property, such as surplus ma- pair or replacement of the damaged
chinery, duplicate parts, equip- "Covered Equipment" be done in a
ment, supplies and surplus or re- manner that:
serve stock you own, control or (a) Improves the environment;
can obtain; or
(b) Increases efficiency; or
(d) Salvaging the damaged "Covered"
p (c) Enhances safety;
k. Transfer Of Rights Of Recovery while maintaining the existing func-
Against Others To Us tion, then we will pay, subject to the
If any person or organization to or for limit of insurance, up to an iadditional
25% of the property damage amount
whom we make payment under this Coy- for the "Covered Equipment" other=
erage Part has rights to recover damages wise recoverable.
from another, those rights are transferred 1
to us to the extent of our payment. ' (3) If: .
That person or organization must do eve- (a) Any damaged "Covered Property"
rything necessary to secure our rights and is protected by an extended
must do nothing after loss to impair them. warranty, or maintenance or
But you may waive your rights against service contract; and
another party in writing: ' (b) That warranty or contract be-
(1) Prior to a loss; to your "Covered comes void or unusable due to a
Property"or covered income, ; "Breakdown";
e
(2) After a loss to your "Covered r Prop- we will reimburse you for the unused
erty" or covered income only: if, at costs of non-refundable; non-trans-
time of loss, that party is one of the ferable warranties or contraclts.
following: (4) Unless we agree otherwise In writing,
(a) Someone insured by this insur- if you do not repair or ,replace the
j ance; damaged property within' 24 months
following the date of the"Breakdown",
(b) A business firm:
then we will pay only the smaller of
(i) Owned or controlled by you; the:
or (a) Cost it would have taken to repair
(ii) That owns or controls you; or or replace; or
(c) Your tenant. , . (b) Actual cash value at the time of
This will not restrict your insurance. i the"Breakdown".
I. Valuation ' . (5) If all of the following conditions are
(1) We will determine the value i of,"Cov- met, property held by you ifo sale will
• be valued at the selling price as if no
ered Property" in;the event of loss or loss or damage had occurred, less ,
damage as follows: any discounts you offered and
(a) The cost to repair, rebuild pr re- expenses you otherwise would have
place the damaged property with had: 1
property of same kind, capacity, (a) The property was manufactured
size or quality on the same site or by you;
I another site whichever is the less
costly; or (b) The selling price of the property is
(b) The cost actually and necessarily more than the replacement cost
of the property; and
expended in repairing, rebuilding,
or replacing on the same site or (c) You are unable to replace the
another site whichever is the less property before its I anticipated
costly; sale.
except we will not pay for such:dam- (6) We will pay for loss to damaged
f "Data"or"Media"as follows:
1 aged property that is obsolete and
j. useless to you. ' (a) Replacement cost for "Data" or
"Media" that are mass produced
and commercially avail
and
I .
BM 00 20 07 01 ©ISO Properties, Inc., 2000 Page 9 of 15
j
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(b) The cost you actually spend to (3) Coinsurance
reproduce the records'on blank This Coinsurance condition applies
material for all other "Data" or only if we did not receive your annual
"Media" including the• cost of report of values form within three
gathering or'assembling ihforma- months of the due date as outlined in
tion for such'reproduction. Paragraph (1).
i� However, we will not pay for"Data"or (a) We will not pay the fUll amount of
"Media" that we' determine is 'not or
any loss if:
cannot be replaced with "Data" or
i
"Media" of like kind and quality or (i) The "Business Income Actual
property of similar functional use. Annual Value" at the time of
(7) We will determine the value of "Coy- loss is greater than thee
"Business Income Estimated
ered Property" under Spoilage Dam- Annual Value" shown in your
age Coverage as follows: latest report; or
(a) For raw materials, the replace- (ii) Your report was received by i
ment cost; us more than threie months
(b) For property in process, the re- after the due, date, or your
ii placement cost of the raw mate- report is overdue.
rials, the labor expended and the (b) Instead we will determine the
Ij proper proportion of overhead most we will pay using the fol-
charges; and lowing steps:
(c) For finished products, the 'selling (i) Divide the "Business Income
price, as if no loss or damage had Estimated Annual Value" by
occurred, less any discounts you the "Business Income Actual .
offered and expenses you Annual Value" at the time of
otherwise would have had. the"Breakdown";
'+ (8) Any salvage value of property ob- (ii) Multiply the total amount of ' •
I , tamed for temporary repairs or use • the covered loss of"Business '
following a "Breakdown" which re- Income" by ,the figure deter-
. mains after repairs are completed will mined in Step (i); and
'I be taken into consideration in the '
adjustment of any loss. • (iii) Subtract any applicable de-
ductible from the amount
m. The following additional conditions apply determined in Step (ii).
to the Business Income and ' Extra
Expense Coverage: We will pay the amount deter-
Annual Reports mined in Step (iii) or the' Busi-
(1) p ness Income and Extra Expense
You must complete an Annual Report limit of insurance, whichever is
of Values Form approved by us once less. For the remainder, you will
'` each year. Your reports must;reach either have to rely on other in-
jus within three months of the annual surance or absorb the loss your-
report date shown in the Declarations self.
and each anniversary of that date. If coverage is provided for more than
i (2) Adjustment Of Premium one premises, then this Coinsurance
Upon receipt of the annual reports of Condition applies separately to each
values you furnish us, we will deter- premises.
mine the amount of premium we 2. General Conditions
earned for the, past year. If the a. Additional Insured
amount determined is more than the
li premium we have already charged for If a person or organization is designated
j this coverage, 'you must pay the in this Coverage Part as an additional in-
difference. If the amount determined sured, we will consider them to!'be an in-
is less than the premium we originally sured under this Coverage Part to the
charged, we will refund the difference. extent of their interest.
However, the amount we return will b. Bankruptcy
not exceed 75% of the premium we The bankruptcy or insolvency of you or
originally charged. your estate will not relieve us of our obli-
gation under this Coverage Part.)
Page 10 0 15 © ISO Properties, Inc., 2000 BM 001 20 07 01
1
c. Concealment, Misrepresentation Or (5) If we pay the mortgageholder for any
Fraud i loss and deny payment to you be-
This Coverage Part is void in any case of
cause of your acts or.because you
fraud, intentional concealment or misrep- have failed to comply with the terms
resentation of a material fact by you or of this Coverage Part:
any other insured, at any time, concern- (a) The mortgageholder's rights un-
ing: der the mortgage will be trans-
(1) This Coverage Part; ferred to us to the extent of. the
amount we pay; and
(2) The"Covered Property"; - (b) The mortgageholder's right to re-
(3) Your interest in the "Covered Prop- cover the full amount of the
erty"; or mortgageholder's claim will not be
(4) A claim under this Coverage Part. impaired.
d. Liberalization At our option, we may pay to the
If we adopt any standard form revision for mortgageholder the whole principal
general use that would broaden coverage on the mortgage plus any accrued
in this Coverage Part without additional interest. In this event, your,mortgage
premium, the broadened coverage will and note will be transferred to us and
immediately apply to this Coverage Part if you will pay your remaining mortgage
the revision is effective within' 45 days debt to us.
prior to or during the policy period. (6) If we cancel this policy, we will give
e. Mortgageholder written notice to the mortgageholder
at least:
(1) The term - mortgageholder; — in- (a) 10 days before the effective date
eludes trustee. of cancellation if we cancel for
(2) We will pay for direct damage to nonpayment of premium; or
"Covered Property" due to a "Break- (b) 30 days before the effective date
down" to Covered Equipment" to
of cancellation if we cancel for,.
each mortgageholder, shown in the any other reason.
Declarations in their order of prece-
dence, as interests may appear: (7) If we do not renew this policy, we will
(3) The mortgageholder has the right to give written notice to the
receive loss payment even :if the mortgageholder at least 10',days be-
mortgageholder has started fore- fore the expiration date of this policy.
closure or similar action on the "Coy- (8) If we suspend coverage, it will also be •
ered Equipment". suspended as respects the mort-
(4) If we deny your claim because of your
gageholder. We will give written no-
tice of the suspension to the mort-
acts or because, you have failed to gageholder.
comply with thel terms of this Cov-
erage Part, the mortgageholder will f. No Benefit To Bailee
still have the right to receive loss No person or organization, other than
payment if the mortgageholder: you, having custody of "Covered Prop-
(a) Pays any premium due under this erty"will benefit from this insurance.
Coverage Part at our request if g. Policy Period, Coverage Territory
you have failed to do so; , Under this Coverage Part:
(b) Submits a signed, sworn proof of
(1) We cover loss or damage corn-
loss within 60 days after receiving
notice from us of your failure to mencing:
do so; and (a) During the policy period (shown in
(c) .Has notified us of any change in the Declarations; and
ownership or material change in (b) Within the coverage territory.
risk known to the mortgage- (2) The coverage territory is:
holder.
All of the terms of this Coverage Part (a) The United States of America
(including its territories and pos-
will then apply directly to the:mort- sessions);
gageholder. (b) Puerto Rico; and
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BM 00 120 07 01 ©ISO Properties, Inc., 2000 Pagel11 of 15
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(c) Canada. (1) Both the commercial property in-
P
h. Premium And Adjustments surer(s) and we do not admit to any
You shall report to us 100% of the total liability; and
insurable values at each premises every (2) Neither the commercial property in-
year as of the anniversary date. The val- surer(s) nor we contend that cover-
, ues shall be reported separately for each age applies under the other insurer's
of the coverages provided. Premium for policy. 1
each anniversary will be promulgated for c. The provisions of this condition apply only
the ensuing period on the basis of rates in if all of the following requirements are
effect at the anniversary date and;for all met:
values at risk. 1 (1) The commercial property policy car-
You agree to keep the applicable records vied by the named insured, insuring
for each policy year available for inspec- the Covered Property, contains a
' tion by our representatives at.all, times similar provision at the time of the
during business hours, during the respec- loss or damage, with substantially the
,, tive policy year, and for a period of twelve same requirements, procedures and
j months after the end of the respective conditions as contained in this condi-
policy year or after cancellation of this tion;
Coverage Part. (2) The damage to the Covered Property
i. Suspension was caused by a loss for which:
Whenever "Covered Equipment" is found (a) Both the commercial property in-
to be in, or exposed to, a dangerous con- surer(s) and we admit to some li-
dition, any of our representatives may ability for payment under the re-
immediately suspend the insurance spective policies; or
J against loss from a "Breakdown" to that (b) Either:
"Covered Equipment". This can be done
by delivering or mailing a written notice of (i) The commercial property in-
suspension to: surer(s) does not. {admit to
any liability for payment,
(1) Your last known address; or while we contend that:'
(2) The address where the "Covered i. All liability exists under
Equipment" is located. the commercial property
Once suspended in this way, your insur- policy; or
ance can be reinstated only by an en- ii. Some liability exists
dorsement for that"Covered Equipment". under both the 'commer-
If we suspend your insurance, you will get cial property policy and
a pro rata refund of premium for that this equipment break-
"Covered Equipment". But the suspension down protection policy;
will be effective even if we have not yet (ii) We do not admit to any li-
made or offered a refund. ability for payment, while the
3. Joint Or Disputed Loss Agreement ! commercial property in-
,a. This condition is intended to facilitate surer(s)contends that:
payment of insurance proceeds when: i. All liability exists under
(1) Both a commercial property policy this equipment break-
and this equipment breakdown pro- down protection cover-
tection policy are in effect; age policy; or
(2) Damage occurs to Covered Property ii. Some liability exists un-
that is insured by the commercial der both the commercial
property policy and this equipment property policy and this
equipment breakdown
breakdownprotection policy;'and
P Y protection policy; or
(3) There is disagreement between the
insurers as to whether there is cover- (iii) Both the commercial property
age or as to the amount of the loss to insurer(s)and we:
be paid, if any, by each insurer under i. Do not admit to any li-
its own policies. ability for payment; and
b. This condition does not apply if: I
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Page 12 of 15 © ISO Properties, Inc., 2000 BM 00 20 07 01
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ii. Contend that some or all e. Arbitration
j liability exists under the (1) If the circumstances described in
I� other insurer's polity; and Paragraph c.(2)(a) exist and the
t (c) The total amount of the loss is commercial property insurer(s) and
! agreed to by you, the commercial we agree to submit our differences to
ii property insurer(s)and us. arbitration, the commercial property
! d. If the requirements listed in Paragraph c. insurer(s) and we will determine the
,, above are satisfied, we and the commer- amount each will pay and will pay the
cial property insurer(s) will make pay- insured within 90 days. Arbitration will
1� ments to the extent, and in the manner,
then take place within 90 days after
described as follows: payment of the loss under the terms
• of this condition.
! (1) We will pay, after your written re- (2) If any of the circumstances described
i; quest, the entire, amount of loss that
we have agreed'as being covered, if in Paragraph c.(2)(b) exist, then the
,I any, by this equipment breakdown commercial property insurer(s) and
protection policy and one-half (1/2) we agree to submit our differences toarbitration within 90 days after pay-
,; the amount of the loss that is in dis-
I agreement. ment of the loss under the terms of
this condition.
(2) The commercial property insurer(s) I
li will pay, after your written request, the (3) You agree to cooperate with any ar-
'! entire amount of loss that. they have bitration procedures. There will be
j agreed as being, covered, if any, by three arbitrators: one will be ap-
the commercial property policy and
pointed by us, and another will be
i; one-half (1/2) the amount of loss that appointed by the commercial property
is in disagreement.
insurer(s). The two arbitrators will
i select a third arbitrator. If they cannot
(3) Payments by the insurers of the agree, either may request that selec-
I1, amounts that are in disagreement, as tion be made by a judge of a court
described in Paragraphs (1) and (2), having jurisdiction. A decision agreed
do not alter, waive or surrender any to by two of the three arbitrators will
•'rights of any insurer against any other be binding on both parties. Judgment
_: with regard to the portion of the loss on any award can be entered in any •
for which each insurer is liable. court that has jurisdiction.
(4) The amount in disagreement to be f. Final Settlement Between Insurers
11 paid by us under this condition shall
not exceed the amount payable The insurer(s) found responsible for the
the equivalent Loss Agreement(s) of greater percentage of the ultimate loss
the commercial property policy. must return the excess contribution to the
II other insurer(s). In addition, the nsurer(s)
I; (5) The amount to .be paid under this found responsible for the greater portion
il condition shall not exceed the amount of the loss must pay Liquidated Damages
we would have paid had no to the other insurer(s) on the amount of
commercial property policy, been in the excess contribution of the other in-
effect at the time, of loss. In no;event surer(s). Liquidated Damages'are defined
will we pay more than the applicable as interest from the date the insured in-
Limit of Insurance shown in the Dec- yokes this Agreement to the date the in-
larations. surer(s) that contributed the excess
(6) Acceptance by you of sums,paid un- amount is reimbursed. The interest is
11 der this condition does not ; alter, calculated at 1.5 times the highest prime
I, waive or surrender any other:rights rate from the Money Rates column of the
11 against us. Wall Street Journal during the Period of
the Liquidated Damages. Arbitration ex-
penses are not a part of the excess con-
tribution for which Liquidated Damages
11
I are calculated. Arbitration expenses will
be apportioned between insurers on the
same basis that the ultimate loss is ap-
i;l portioned.
1
BM 00 120 07 01' I ©ISO Properties, Inc., 2000 Page 13 of 15
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F. Defini ions 5. "Computer Equipment"means:
1.li "B eakdown": J a. Your programmable electronic equipment
a. Means the following direct physical loss, that is used to store, retrieve'and process
I' that causes damage to "Covered Equip- data; and
iR ment" and necessitates its repair;or re- b. Associated peripheral equipment that
I placement: provides communication including input
and output functions such as printing or
(1) Failureof pressure or vacuum auxiliary functions such as data transmis-
I{ equipment;
sion.
I (2) Mechanical failure including rupture
or bursting caused by centrifugal It does not include"Data"or"Media".
force; or 6. "Covered Equipment":
(3) Electrical failure including arcing; a. Means and includes any:
unless such loss or damage is otherwise (1) Equipment built to operate under in-
excluded within this Coverage Form. ternal pressure or vacuum other than
b. Does not mean or include: weight of contents;
(1) Malfunction including but not limited
(2) Electrical or mechanical equipment
{ to adjustment, alignment, calibration, that is used in the generation, trans-
cleaning or modification; mission or utilization of energy;
(2) Defects, erasures, errors, limitations (3) Communication equipment, and
or viruses in computer equipment and "Computer Equipment"; and
programs including the inability to (4) Equipment in Paragraphs (1I), (2) and
recognize and process any date or (3) that is owned by a public or pri-
time or provide instructions to "Coy- vate utility and used solely to supply
ered Equipment"; utility services to your premises.
(3) Leakage at any; valve, fitting, shaft However, if Coverage A.2.e. U lility Inter-
seal, gland packing, joint or connec- ruption is provided, then Paragraph
tion; J 6.a.(4) does not apply.
(4) Damage to any; vacuum tube, gas Except for Paragraph 6.a.(4), Utility Inter-
tube, or brush; ruption and Contingent Business Income
(5) Damage to any structure or And Extra Expense—Extra Expense Only
Coverags, theCovered Equiment"
foundation supporting the "Covered
Equipment��or any of its parts;
must beeocated atra premises described
in the Declarations and be owned, leased,
(6) The functioning of any safety or pro- or operated under your control.
tective device; or
b. Does not mean or include any:
(7) The cracking of any part on an inter-
nal combustion gas turbine exposed
to the products of combustion. (2) Part of pressure or vacuum equip-
2. "B siness Income" means the: ment that is not under internal pres-
{ sure of its contents or internal vac-
a. Net Income (Net Profit or Loss before in- uum;
come taxes)that would have been earned
or incurred; and i (3) Insulating or refractory material, but
not excluding the glass lining of any
b. Continuing normal operating expenses "Covered Equipment";
incurred, including payroll. (4) Non-metallic pressure or vacuum
3. S"Business Income Actual Annual Value" equipment, unless it is constructed
means the sum of the net income and con- and used in accordance with the
tinning normal operating expenses incurred, American Society of Mechanical En-
including payroll that would have been earned gineers (A.S.M.E.) code orl another
had the"Breakdown"not occurred. appropriate and approved code;
4. "Business Income Estimated Annual Value" (5) Catalyst;
means the sum of the net income and con-
tinuing normal operating'expenses incurred, (6) Vessels, piping and other equipment
incl ding payroll as estimated by you in the that is buried below ground and re-
mo t recent businessquires the excavation of materials to
income annual 'value
rep rt on file with us.
{ inspect, remove, repair or replace;
Page 14 of 15 © ISO Properties, Inc., 2000 BM 00 20 07 01
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(7) Structure, foundation, cabinet or a. Programmed and recorded material
1 compartment supporting or containing stored on "Media"; and
the "Covered Equipment" or part of b. Programming records used for electronic
the "Covered Equipment" including data processing, or electronically con-
, penstock, draft tube or well casing; trolled equipment. I
(8) Vehicle, aircraft, self-propelled 9. "Extra Expense" means the additional cost
equipment or floating vessel including you incur to operate your business during the
any "Covered Equipment" that is "Period of Restoration" over and above the
11 mounted upon or used solely with any cost that you normally would have incurred to
one or more vehicle(s), aircraft, self- operate the business during the same period
lll propelled equipment or; floating had no"Breakdown"occurred.
�i vessel;
excavation, or construction 10. "Hazardous Substance" means any
(9) Dragline, substance other than ammonia that has been
equipment including any "Covered declared to be hazardous to health by a gov-
Equipment" that is mounted upon or ernment agency.
used solely with any one ors more
11. "Media" means electronic data processing or
li dragline(s), excavation, or construc-
tion equipment; storage media such as films, tapes, discs,
�' drums or cells.
(10)Felt,wire, screen, die, extrusion plate,
swing hammer, grinding disc, cutting 12. "One Breakdown" means if an initial "Break-
blade, non-electrical cable, chain, down" causes other "Breakdowns", all will be
; belt, rope, clutch plate, brake pad,
considered "One Breakdown". All "Break-
non-metal part or any p
downs" at any one premises that manifest
art or tool
subject to periodic replacement; themselves at the same time and are the di-
1 (11)Machine or apparatus used solely for rect result of the same.cause will be consid-
research, diagnosis, medication, sur-
ered One Breakdown .
1 gical, therapeutic, dental or patho- 13. "Period of Restoration" means the period of
't logical purposes' including any,"Coy- time that:
ered Equipment" that is mounted 'a. . Begins at the time of the "Breakdown" or
1 _upon or used solely with any one or 24 hours. before we receive notice of
1 more machine(s) or apparatus unless "Breakdown"whichever is later; and
Diagnostic Equipment is shown as b. Ends 5 consecutive days after] the date
11 INCLUDED in the Declarations; or when the damaged property at he prem-
1 (12)Equipment or any part .of such ises described in the Declarations is re-
equipment manufactured by you for paired or replaced with reasonable speed
sale. • and similar quality.
7. ii "C vered Property"means any property that: 14. "Stock" means merchandise held in storage
a. You own; or or for sale, raw materials, property in process
b. Is inyour care, custodyor control and for or finished products including supplies used in
11 their packing or shipping.
which you are legally liable.
8. "Data" means:
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BM O0 20 07 01 ' © ISO Properties, Inc., 2000 Page 15 of 15
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Z;u RICH
•
Important Notice - In Witness Clause
In return for the payment of premium and subject to all the terms of the policy,we agree with you to provide insurance as stated
in this policy. This policy shall not be valid unless countersigned by the duly authorized Representative'of the Company.
In Wines Whereof,this Company has executed and attested these presents and,where required by law,has caused this policy
to be countersigned by its duly authorized Representative.
L II
‘1.71
4:*° 74.91".""4"--- 74.•
President Corporate Secretary
Zurich American Insurance Company
American Guarantee and Liability Insurance Company
American Zurich Insurance Company
•
Zurich American Insurance Company of Illinois
Administrative Offices •
Zurich Towers
1 00 American Lane
Schaumburg,Illinois 60196-1056
QUESTIpNS ABOUT YOUR INSURANCE? Your agent or broker is best equipped to provide information about your
insuianc 1. Should you require additional information or assistance in resolving a complaint,,call or write to the following
(please have your policy or claim number ready):
Zurich North America
Customer Inquiry Center
1400 American Lane
Schaumburg,Illinois 60196-1056
1-800-382-2150(Business Hours: 8 a.m.-4 p.m. [CT])
U-GU-319-E (5/96)
Page 1 of 1
•
Ir
li IL 00 17 11 98
1
COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject b. Give you reports on the ,cond tions we
to the fdlloving conditions. find; and
Ii
A. Cancellation c. Recommend changes.
1. iIThell first Named Insured shown in the Decla- 2. We are not obligated to make any inspec-
+rations may cancel this policy by mailing or tions, surveys, reports or recommendations
deliering to us advance written notice of and any such actions we do undertake relate
il
cancellation. only to insurability and the premiums to be
2. i'We may cancel this policy by mailing or deliver- charged. We do not make safety inspections.
'ing to the first Named Insured written notice of We do not undertake to perform the duty of
cancellation at least: any person or organization to provide for the
health or safety of workers or the public. And
a. 10 days before the effective date of cancel- 1
lation if we cancel for nonpayment of pre- we do not warrant that conditions:
j mium;or a. Are safe or healthful; or I
b. 30 days before the effective date of cancel- b. Comply with laws, regulations,I1.codes or
1I lation if we cancel for any other reason. standards. .
3. We will mail or deliver our notice to the first 3. Paragraphs 1. and 2. of this condition apply
Named Insured's last mailing address known not only to us, but also to any rating, advisory,
to iIis rate service or similar organization which
makes insurance inspections, surveys,
4.�1 Notice of cancellation will state the effective reports or recommendations. I
I date of cancellation. They policy period will end
1 on that date. 4. Paragraph 2. of this condition does]not apply
1 to any inspections, surveys, reports or rec-
5.1 If this policy is cancelled; we will send the first
`
I Nommendations we may make relative to
amed Insured any premium refund. due. If ••
1 cer-
tification, under state or municipal statutes,
we cancel, the_refund will be pro rata. If the
1 ordinances or regulations, of boilers, pressure
' first Named Insured cancels, the refund may vessels or elevators.
1 be l less than pro rata. The cancellation will be
I effective even if we have not made or offered 'E. Premiums I
li a refund. The first Named Insured shown in the Declarations:
•6.! If notice is mailed, proof of mailing will be 1. Is responsible for the.payment of all'premiums;
;j sufficient proof of notice. and
B. ,Clhanges 2. Will be the payee for any return premiums we
This policy contains all the agreements between you pay. ,
and us concerning.the insurance afforded. The first F. Transfer Of Your Rights And Duties Under
Named Insured shown inl the Declarations is This Policy
authorized to make changes in the terms of this Your rights and duties under this policy may not
policy with our consent. This policy's terms can be be transferred without our written consent except
amended or waived only by endorsement issued by in the• case of death of an individual Named In-
us and made a part of this policy. sured.
C. ;Examination Of Your Books And Records If.you die,your rights and duties will be transferred to
1
We may examine and audit your books and rec- your legal representative but only while acting within
ords as they relate to this policy at any time during the scope of duties as your legal representative. Until
the policy Iolicy period and up to three years afterward. your legal representative is appointed, anyone
D. Inspections And Surveys' having proper temporary custody of your property
1 We have the right to: will have your rights and duties but only with respect
to that property.
a. Make inspections , and surveys at any
time;
!
GU 519 (11-98)
IL 00 17 11 98 Copyright,Insurance Services Office,Inc., 1998 Page 1 of 1
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IL 01I 46 09 03
1 WASHINGTON COMMON POLICY CONDITIONS
All Co'erage Parts included in this policy are subject to the following conditions. I
II
The conditions in this endorsement replace any simi- e. Fixed and salvageable items have been
lar conditions in the policy that are less favorable to removed from the structure, indicating an
the insure . intent to vacate the structure;, 1
A. Cancellation f. Without reasonable explanation, heat,
1.11 The first Named Insured shown in the Decla-
water, sewer, and electricity are not fur-
nished for the structure for 60 consecutive
rations may cancel this, policy by mailing or delivering to us advance written notice of days; or .
cancellation. g. The structure is not maintained in sub-
1 stantial compliance with fire, safety and
2.i, We may cancel this policy by mailing or deliv- buildingd
eying to the first Named Insured and the first codes.
Named Insured's agent or broker written no- 4. If:
I1 tics of cancellation, including the actual rea- a. You are an individual; 1
son for the cancellation, to the last mailing
a dress known to us, at least: b. A covered auto you own is of the "private
a. 10 days before the effective date of can- passenger type"; and
cellation if we cancel for nonpayment of c. The policy does not cover garage, auto-
; -premium; or mobile sales agency, repair shop, service
station or public parking place-operations
b. 45 days before the effective date of can- hazards;
if cellation if we cancel for any other reason; we may cancel the Commercial Automobile
li except as provided in Paragraphs 3. and 4. Coverage Part by mailing or delivering to the
below. first Named Insured and the first Named In-
3 We may cancel the Commercial Property sured's agent or broker written notice of can-
Coverage Part and the Capital Assets Pro- cellation, including the actual reason for can-
I gram (Output Policy) Coverage Part, if made cellation, to the last mailing address known to
a Part of this policy, by mailing or delivering to us:
the first Named Insured and the first Named a. At least 10 days before the effective date
Insured's agent or broker written notice of of cancellation if we cancel for nonpay-
1 cancellation at least 5 days before the effec-
ment of premium; or 1
i tie date of cancellation for any structure
I! where 2 or more of the following conditions b. At least 10 days before the effective date
exist: of cancellation for any other reason if the
a�
policy is in effect less than 30 days; or
Without reasonable explanation, the
structure is unoccupied for more than 60 c. At least 20 days before the effective date
consecutive days, or at least 65% of the of cancellation for other than nonpayment
rental units are unoccupied for more than if the policy is in effect 30 days or more;
120 consecutive days unless the structure or
I; is maintained for seasonal occupancy or d. At least 20 days before the effective date
is under construction or repair; of cancellation if the policy is in effect for
b. Without reasonable explanation, progress 60 days or more or is a renewal or con-
1 toward completion;of permanent repairs tinuation policy, and the reason for can-
'i • to the structure has not occurred within 60 cellation is that your driver's I license or
I days after receipt of funds following that of any driver who customarily uses a
satisfactory adjustment or adjudication of covered "auto" has been suspended or
1 loss resulting from a fire; revoked during policy period.
c. Because of its physical condition, the 5. We will also mail or deliver to any mortgage
1 structure is in danger of collapse; holder, pledgee or other person shown in this
d. Because of its physical condition, a vaca- policy to have an interest in any loss which
� tion or demolition order has been issued may occur under this policy,' at their last
mailing address known to us, written notice of
for the structure, or it has been declared cancellation, prior to the effective date of
II can-
unsafe in accordance with applicable law; cellation. If cancellation is for reasons other
I
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1 than those contained , in Paragraph A.3. b. Give you reports on the conditions we
above, this notice will be the same as that find; and !
1 mailed or delivered to !the first Named In- c. Recommend changes.
sured. If cancellation is for a reason contained
in Paragraph A.3. above, we will mail or 2. We are not obligated to make ,any inspec-
deliver this notice at least 20 days prior to the tions, surveys, reports or recommendations
I effective date of cancellation. and any such actions we do undertake relate
6. Notice of cancellation will state the effective only to insurability and the premiums to be
I! date of cancellation. The policy period will end charged. We do not make safety inspections.
do thot ate. We do not undertake to perform the duty of
any person or organization to provide for the
7., If t is policy is cancelled, we will send the first health or safety of workers or the public. And
N lined Insured any premium refund due. If we do not warrant that conditions:
I w cancel, the refund will be pro rata. If the a. Are safe or healthful; or
1 fir t Named Insured cancels, the refund will
be at least 90% of the pro rata refund unless b. Comply with laws, regulations, codes or
th- following applies: standards.
a. For Division Two — Boiler and Machinery, 3. Paragraphs 1. and 2. of this condition apply
,I if the first Named Insured cancels, the not only to us, but also to any rating advisory,
refund will be at least 75% of the pro rata rate service or similar organization which
refund. I makes insurance inspections, surveys, re-
I` b. If: ports or recommendations.
4. Paragraph 2. of this condition does not apply
(1) You are an individual; to any inspections, surveys, reports or rec-
(2) A covered auto you own is of the"pri- ommendations we may make relative to certi-
vate passenger type"; fication, under state or municipal statutes, -
or-
dinances-or-re ulations, of boilers, pressure -- --
- - -- --- -- - � (3} The policy does not cover garage,
!' automobile sales agency, repair shop, vessels or elevators.
l service station or public parking place E. Premiums 1
1 operations hazards;and The first Named Insured shown in the Declara-
(4) The first Named Insured cancels; tions: 1
If the refund will be not less than 90% of 1. . Is responsible for the payment ofl all premi-
I1 any unearned portion not exceeding$100, urns; and
plus 95% of, any unearned portion over 2. Will be the payee for any return premiums we
:j $100 but not exceeding $500, and not a
I' less than 97% of any unearned portion in pay.
excess of$500. F. Transfer Of Your Rights And Duties Under
The cancellation will be effective even if This Policy
p we have not made or offered a refund. Your rights and duties under this policy may not
be transferred without our written consent except
8! If otice is mailed, proof of mailing will be suf- in the case of death of an individual (named i
I1 fidient proof of notice. sured. 1
B. Changes If you die, your rights and duties will be transferred
The plolicy contains all the.agreements between to your legal representative but only while acting
you and us concerning the insurance afforded. within the scope of duties as your legal
The frst Named Insured shown in the Declara- representative. Until your legal representative is
lions is authorized to make changes in the terms appointed, anyone having proper temporary cus-
of thi policy with our consent. This policy's terms tody of your property will have your rights and du-
can be amended or waived only by endorsement ties but only with respect to that property.
isi ued by us and made a part of this policy. 1
G. Nonrenewel
C. Ei ianination Of Your Books And Records
1. We may elect not to renew this policy by
We may examine and audit your books and rec- mailing or delivering written notice of nonre-
ords as they relate to this-policy at any time during newal, stating the reasons for nonrenewal, to
tt ie policy period and up to three years afterward. the first Named Insured and the first Named
D. Inspellction And Surveys Insured's agent or broker, at their last mailing
addresses known to us. We will also mail to
1', We have the right to: any mortgage holder, pledgee or other person
li a. Make inspections 'and surveys at any shown in this policy to have an interest in any
1, time; loss which may occur under this policy, at
- their last mailing address known to us, written
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notice of nonrenewal. We will mail or deliver station or public parking place operations
these notices at least 45 days before the:, hazards;
a. Expiration of the policy; or the following applies to nonrenewal of the
b. Anniversary date of this policy if this policy Commercial Automobile Coverage Part in
has been written for a term of more than place of G.1.:
one year. a. We may elect not to renew or continue
Otherwise,we will renew this policy unless: this policy by mailing or delivering to you
and your agent or broker written notice at
a. The first Named Insured fails to pay the least 20 days before the end'of'the policy
renewal premium after we have ex- period including the actual reason for
pressed our willingness to renew, includ- nonrenewal. If the policy period is more
ing a statement of the renewal premium, than one year, we will have the right not to
to the first Named Insured and the first renew or continue it only at an anniversary
Named Insured's insurance agent or bro- of its original effective date. If we offer to
ker, at least 20 days before the expiration renew ocontinue and you do not accept,
date; this policy will terminate at the end of the
b. Other coverage acceptable to the insured current policy period. Failure to pay the
has been procured prior to the expiration required renewal or continuation premium
date of the policy;or when due shall mean that you1 have not
c. The policy clearly states that it is not re- accepted our offer.
newable, and is for a specific line, sub- b. We will not refuse to renew Liability Cov-
classification, or type of coverage that is erage or Collision Coverage solely be-
not offered on a renewable basis. cause an "insured" has submitted claims
2.) If: under Comprehensive Coverage or
Towing and Labor Coverage.
a.- You are an individual; ---- -- - proper If we fail to mail or deliver rop er notice of
b. A covered auto own is of the 11 private nonrenewal and you obtain other insur-
passenger type";
; and ance this policy will end on the effective
c. The policy does not cover garage, auto- date of that insurance.
mobile sales agency, repair shop, service
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ZU RIC H BOILER AND MACHINERY
_ 1 INSURANCE
ENDORSEMENT
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Effective. 01/01/2008 Policy Number BM 9307613-05 of the Zurich American Insurance Company issued to
City of Renton
(name of insured)
is changed as shown below. 0
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LOCATION ENDORSEMENT
We agree with you that the following locations are inserted in the Location of Objects of the Schedule shown on the Policy Declarations:
OMNIBUS LOCATION DESCRIPTION
Any location which is either:
A. ;�Owned by the Insured,or
B. Leaped by and operated under;the control of the Insured and located anywhere in the District of Columbia or the states of the
United States,Puerto Rico,and U.S.Virgin Islands including Canada.
REPORT OF LOCATIONS AND VALUES
It is agreed that the Insured shall prepare as of the date this policy becomes effective,and as of each 12 months therefore,an approved
report of ocalons and values showing the following:
A. 11 Each location owned by,leased by or operated under the control of the Insured on the date for which the report is prepared.
B. I The Property Damage value of each location as of the date for which the report is prepared.
C. I The Business Interruption value of each such location estimated for the year commencing on the date for which the report is
prepared.
It is further agreed that said report shall be filed with the Company not later than 90 days after each said anniversary date. The Company
shall compute the policy premium as of the anniversary date based on said report as filed with the Company.
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Date 01/01/2008
Endorsement No. 1
TT T111.i0 1 OA I'i1/00\
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Z' RICH BOILER AND MACHINERY
INSURANCE
ENDORSEMENT
Effective 01/01/2008 Policy Number BM 9307613-05 of the Zurich American Insurance Company issued to
City of Renton
(name of insured)
is changed as shown below.
Buried Equipment Wording
The following is deleted from the policy:
F. Defnitions.
6.'Covered Equipment"
b. Does not mean or include
(6)Vessels, piping and other equipment that is buried below ground and requires the
excavation of materials to inspect, remove, repair or replace,
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All other te-ms and conditions remain unchanged.
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Date 01/28/2008 •
Endorsement No. 2
T T nA dD 1on/A/00\
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Disclosure Statement ZURICH
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City of Rell ton
. BM 9307613-05 1/1/2008
ZURICH WHOLESALER COMPENSATION DISCLOSURE
Dear Policyholder:
On behalf of 4 urich, we are glad you have chosen us to help your company manage its risks. We look forward to
meeting your nsurance needs. •
Your agent or broker has chosen to use a Wholesaler to access Zurich for your insurance coverage. Wholesalers are
businesses that specialize in specific types of insurance coverage or serve customer groups with particular insurance
needs.. The\Vholesaler, like your agent or broker, is an independent businessperson or team of people not employed
by Zurich,or any other insurance company.
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The info ration you will find on our Web site describes our commission arrangements with the l Wholesaler, if
applicablle. 4urich is not a party to the commission arrangement between the Wholesaler and.your agent or broker.
Therefore, Zurich does not always know the commission your broker or agent receives as compensation for your.
policy.
For an explanation:of the nature and:range of compensation:Zurich may pay to.theWholesaler in,connection with your •
business : please..go. to;-http://www.zurichna.com. Click:ion the information, link .located.:,.on.'the Agent/Broker
Compensation Disclosure:section. "Where'appropriate; insert•the Access Code:provided below, and'you.will be.able to
view this information. Alternatively,you may call (877)347-6465 to obtain this type of information. ' • ,I
Thank ybu.
Access Cod-: 0613392827
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U-WHL-E-402-A CW (11/06)
Page 1 of 1
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ZURICH
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ZURICH
Equipment Breakdown Policy
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Brian Strain,Vice President,550 W.Washington,Suite 1200,Chicago,IL 60661-Phone:(312)496-924I-E-mail:brian.strain@zwichna.com
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