)

Revised November, 1987. , '~'~',TIrf?i.~T'Fl~'O\Otl"'"',\,~."~""1/ ' IJ", ~Iv' '. .

, '~~INSURANCE JAN 22 1988

[JIV,biOl\l OF~}iL, GAS &MINING

CERTIFICATE OF LIABILITYIssued to:

State of UtahDepartment of Natural ResourcesDivision of Oil, Gas and Mining

--00000o--"

'.

THIS IS TO CERTIFY THAT:"

/ The Hare Indamity Ca1y:my(Name of Insurance Company)

P.O. Pox 5100M3nchester, NH CE1CB

(Home Office A~~ress of Insurance Company)

HAS ISSUED TO:

Valley Camp of Utah, Inc.*(Name of ~ermi t Ann 1i cantl . .

*Please refer to ltan 13 of the NaiEa'lnSiiieo Endorsarent on the policy

Valley Ca.gtp of Utah, Inc. A CI I 001 I 00 ,(Ml ne Name) ·(Perrr.1f Number)'. CERTIFICATE OF INSURANCE:

GL 99 48 43(Policy Number)

April 1, 1~7

(Effective Date)

UNDER THE FOLLOWING TERMS AND CONDITIONS:

As Per UMC/SMC Part 800.60 Terms and Conditions for Liability Insurance;

•

A. The Division shall require the applicant to submit as part of its permitapplication a certificate issued by an insurance company authorized to dobusiness in the state of Utah certifying that the applicant has a publicliability insurance policy in force for the surface cc~l mining andreclamation operations for which the permit is sought. Such policy shallprovide for personal injury and property damage protection in an amountadequate to compensate any persons injured or property damaged as a resultof the surface coal mining and reclamation operations, including the useof explosives and who are entitled to compensation unc:r the applicableprovisions of state law. Minimum insurance coverage for bodily injury andproperty damage shall be $300,000 for each occurrence and $500,000aggregate.

B. The policy shall be maintained in full force during the life of the permitor any renewal thereof. including the liability period necessary tocomplete all reclamation operations under this chapter.

)

• Page 2.CERTIFICATE OF LIABILITY INSURANCE

C. The policy shall include a rider requiring that the insurer notify theDivision whenever substantive changes are made in the policy including anytermination or failure to renew.

lQ...1D-10IN ACCORDANCE WITH THE ABOVE TERMS AND CONDITIONS. and the Utah Code Annotated4'O/.1t1-1//i"l/MlrJ.. ~ the Insurance Company hereby attests to the f~~ thatcoverage for said Permi t App 11 cant is in accordance wi th the /retrtt~1-~trre-s ofthe State of Utah and agrees to notify.the Division of Oil, Gas and Mining inwriting of any substantive change, including cancellation. failure to renew.or other material change. No change shall be effective until at least thirty(30) days after such notice is received by the Division.IDlE: '!he stated policy contains an Absolute Pollut:fbn ExClusion

UNDERWRITING AGENT:

Patricia W. Sett:lanyre(Agent1s Name)

Alexander & Alexander of the Carolinas Inc.(Company Name)

P. O. fux 2&%

919/768-419)(Phone>

Winst:on-Salan,NC27102

(Mailing Address) (City, State. Zip Code)

The undersigned affirms that the above information is true and complete tothe best of his or her knowlege and belief. and that he or she is anauthorized repres tative of the above-named insurance_company .

../! . -. J !J // P'j-l4.. ~. !>. At w.. ££4- :. dP~./~ t!.-.J~ ""

(Date. Slgnnture and Title oV Authorijed gent of Insurance CompanyY

19~~

(Date)

(Name'1Gloria M. Cook 4Signed and sworn before me by

this ,/2"1 "'I'}I:,

•7000R-28

055opc

48 43

PIl0DUCER

99

I •....;j!PJF-iice m O-AGENCYW WAIVED U l-F.0.

GL-

r• Alexander & Alexander t Inc.

Winston Salem t He 27103

L

39182Producer No.

5-26-81 ch/bc

o Joint Venture 0 Other: _

Auort PeriCJ!i: Annual, unless otherwise stated. (aNTa-..ow)

GENERAL lIABIUTY

I!l Corporation

GENERAl~J

o CITY INSURANCE COMPANYShort Hills, NJ.

o THE HOME INSURANCE COMPANY OF ILLINOISDECLARATIONS . Chicago, III. . .

r:: Quaker state Oil Refining .,/'Corporation t Eta1 (See F.nd.t.)255 Elm St., POBox 989011.C~tYt PA 16301

L:.. " '-::.:.':":..._.. --JItem 2. Policy Perioci:?;'::;;";:::':'~'/From April 1, 1987 ,,/ to Ap~i1 1, 1988

.. _.12:01 A.M., standard time at the address of the named insured as stated herein.

',.".. Ins. ,ance is provided by the Stock Company designated by, ond hereinatter called the Company.

. '. ("I 0 THE HOME INSURANCE COMPANYoo::::T Manchester, N.H.

I!J THE HOME INDEMNITY COMPANYManchester, N.H.o THE HOME INSURANCE COMPANY OF INDIANAIndianapolis, Ind.

:Y' J .~......;..J

c:.:J

..~ - ".- ' """

The named insured is:

.. , '_ .. 0 Individual 0 PartnershipBu;jness of the namel! insured is: lDITDIlOCLOW)

./ Oil RefiningItem 3. The insurance afforded is only with respect to the Coverage Partlsl indicated below by specific premium chargelsl and attached to and forming a part of

this policv

California Assessment~.

$167.50" ,.f'tr':rv'"

Countersigned bY__-1+~-,-,,--_--:~+,-¥,::~--,-~fstJ;;;..:::.:... ~·_

Coverage Parts . Form Number tAdvance Premiums

Comprehensive General liability InsuraJlce ,/B21013 -,'- - $,

1,475~249- .... :...,

Premises Medical Payments Insurance $

Contractual liability Insurance $

Completed Operations and Products liability"

$Insurance - .,

Manufacturers' and Contractors' liability - ..$

"Insurance

Owners', landlords" and Tenants'liability $ ".Insurance

Personal Injury liability Insurance $

~"'.

Owner's and Contractor's Protective liability $Insurance

Storekeeper's Insurance $

Other $

THIS POUCY DOES NOT PROVIDE COVERAGEFOR POLLUTION LiABILITY.

"..,

~~., /:).l;lL..

If, Policy Period is more than I Effective Datett I 1st Anniversarytt I 2nd Anniversarytt$1,4.75,249 ~·r:r;J.

~.

one year premium is payable I I I TOTAL ADVANCE PREMIUM ,. .

.orsements attached to policy

See Attached H22300

•

,; ..

If the Policy Pf'f'iod is mo~ than O~ year; tTlte r:wemt....s shOWft for Fixed ExPOSv~ .haunts Art the full tbrft ,.,. '"'""ums. My prrtftiums sa.own for s.bjKt-To-Audit Wards Art 1M annual d~l ,...e.."".,...,s. ttAn, .""UI' drP015il p~iums for Sdject·To-AtNfit huardt are payable ~s of t.hr t'ffective utt .. eKII anaift'f"SI:rY date. whet'" or not. tJte maaiadff of premium is pay3lble on ittSUllltllmtS.

H3248ZF Rev. 12/80 DRPRODUCER COpy

......,i .

H36074FEd. 11-84

'mTHE HOME INSURANCE COMe- liES .

~-------...._~~--------Absolute Pollution Exclusion

GL 99 JJ8 113.•..'...•..- ..~:~',

}::~,., ....-.". ," ..- .,- .. ,

. .The undersigned authorized representative recognizes that this policy contains an absolu1e pollution exclusionand understands the terms of this exclusion which reads as follows: .

Pollution Exclusion

.. ... It is agreed that.exclusion (F) is replaced by the following:

:';\.

~lS POLICY DOE'S' NOT PROVIDE COVERAGE.

F.OB POLLUTION LIABIUTY.

;;:j?;·r:'(F) to bodily. injurY or property damage arising out of the discharge, dispersal, release or escape of smoke, vapors,,:::.soot, fumes, acid~, alkalis, toxic chemicals, liquids or gases, waste materials or other irritants, contaminants or5;7;.:;:,;:.:.pollutants into or upon land, the atmosphere or any water course or body of water. .'.~::~::~:.....:," • • ""_e",,' ~, __

.;i,.~:..;......,;o.,.."~,.--,,, •.~_....~-­-.......--.

••••••.,

ACCEPTED BY INSURED_---,();J~~~···-~---------------{/

Named Insured

Quaker State OU Refining Corporation. Eta.l

Signature and Title Date

9//'1/1'7

Page 1 of 1

"

COpy

Absolutt A5b(-stOS EICJu.\iMl Endors.cmcnt H 36£ t J F (.. /8£.)

Polar)' Number

GL 99 48 43

NfsfTl('d In!-urt°d LUcctlvc [)btc

Quaker State 011 RefiningCorporation, Eta1 4-1-87

•J

•,

••

. It is agrrrd that this policy is amrnd{od by thr addition of thefoll()~ing exclusion::

You and V;{- a~!'(·('th&t, nvtwith~t&ndtnbanyttuflb to H.e contrisry

cC;r.t~·i~·(:d;·in thi~ po'lie)", ttll ... ir;~urLJn{( dc>('-~ not apply to any li&tllhty or• •

allc&cd liatJility for any lo~s. claim or "SUIt" tor "bodily injury".

"property damage" or personal injury" or any cost or expense directly or

indirectly caused by. arisini: out of. resulting r~om or attributable to

asbestos. in whole or in part, inclUding but not limited to any exposure'

•, •

" ....•,.,'.:, ......" ...•.,,-;..•...•. :- .........••.

..

to asbestos or any product or material containing asbestos or the existence

of e$besto~ in any pl&ce or tt,lnb or in the atmosphere or environrrlent.

'. .,'. . ".

You and ~e furU.cr.abr(:(· th&t we have no duty no: o~1Jb&tlon to

provide' or pay for the inve~.tibbtion or defensc of any lo~~. cost, expense.

claim or "suit" seeking damabcs for li&bilit)' or allebed liabili ty excluded

under paragraph (1) above.

1 have read this endorsement andI undC':-stend ero~ ecce;:>! aU o~ itsterms.

SIgned '-l'Jtle DeteVice President/Treasurer 11-5-8'

THE COM( tY DESIGNATED ON THE DECLARAT{ 'S PAGE, . - .-. .

• (A stock insurance company. herein ailed the company) __

! ._ :--~ vJ···'~ .,. • ;~_~.. _

i . In consideration of the payment of the premium, in reliance upon the sta~ements'in the-declarations made'a part hereof and subject to all of the terms of this policy.~~SW!tht.hen~.~edinsUredaSfoJlows: ..•.• ;.~ .. :,.~ ," i-: ::< ':0: . ~F,'· .. ··. ~.>:,: '.' . ~ .•.._ '. , ..",~........ EANmONS " '. ~. • .1 n used in this policy (including endorsements f~~ming~~ part ,h!reofl: "; - ple~ed ~pe.~ti0!ls hazard or the ~nderground prop~rty. damage hazard, or (4) for:f "automobile" means a land motor vehicle, trailer or semi-trailer'design'ed for ., which haolhty IS assumed by the Insured under an inCidental contract;t travel on pub.lic roads (j~cluding any machinery or apparatus attached thereto). "incidental contract" means any written m lease of premises, (2) easement~ _but does not Include mobile equipment; ... agreement, except in connel;tion with construction or demolition operations on ori ' .. '" ' ,,_ .,.. adjacent to a railroad, (3) undertaking to indemnify a municipality required by

.. ! b~dlly inJury . m~ans bodily !nlury. ?ckn~ss or, disease sustalOed ~y any per~n municipal ordinance. except in connection' with work for the municipality, (4) side-~ ·whlch occurs dur.lRg the poltcy' period, IRcludIRg death at any time resultIRg track agreemenlor (5) elevator maintenance agreement;.. .... .therefrom' ;'.'. "" .c :::.' • ' ,,~. ...,' •. ' . .' •

;.... '., - '.. "insured" means any person or orgMization qualifying as an insured in the "Per-~ "collapse hazard'" includes "structural property damage" as defined herein and sons Insured" provision 'of the applicable insurance coverage. The insurance! property damage to any other property at any time resulting therefrom. "Structural afforded applies separately to each insured against whom claim is made Or suit?- property damage" means the collapse of or structural injury to any building or . is brought, exc~pt with respect to t'le limits of the company's liability;

structure due to (l) grading of land,. excavating. borrowing, filling, back·filling.tunnelling, pile driving, cofferdam work or caisson work or (2) moving, shoring. "mobile equipment" means a land vehicle !including any machinery or apparatusunderpinning,. raising or demolition of any building or structure or removal 0: attached thereto), whether or not self·propelled. III not subject to motor vehiclerebuilding of any structur:ll support thereof. The collapse hazard does not incluGe . registration. or 12l maintained for use exclusively on premises owned by or rentedproperty damage m arising out of operations performed for the named insured by to the named insured. including- the ways immediately adjoining, or (3) designed

: independent contractors. or (2) inclu'ded within the completed operations hazar~ for. use principally off public roads. or (41 designed or maintained for the sale,or the underground property damage hazard. or (3) for which. liability is assumed purpose of affording mobility to equipment of the following types forming an in-

., .. ,. . by the insured under an incidental contract; ....,.,.,;:;,· -' -- tegral part of or permanently attached to such vehicle: power cranes. shovels.:;~",,:::::::::~-::::~;::::.'.'.::., .•.. ,.,-..,.,.. ." ," loaders. diggers am! drills; concrete mixers (other than the mix·in-transit type);

"completed operations h3zartf" includes bodily injury and pronerty damaae arisi;:" graders. scrapers, rollers a;:t! ot~er ro~d cc.~structicn. or re;JJi~ equipment; ~ir.out of operatio;)s or reliance upon a represer.tation· or warran'iymade 'a(any tim; comp!"essors" p!Jmps and ger.~ra[?rs. mC!L'OI~.g spra;f1ng.. ·we!dl~~ and ~ulld,"g

.. with respect t~ereto, bu~ only if th: bodily·i..jury or properti carnage cccurs after' .c1eamng .equlpment; and geophySical explora,lon and well servlclOg equipment:. such operations have be.>n Cl!mil!et~ cr abandoned and occur~awaJ. from premises _.~. ,t'named insured" means tne person or organization n~ed in Item 1. of the decla.

i owned ,byc(ren!~d to t.he named" Insured. ':Operation~" include materials,. parts rations oUbis policy: .: '., or equipment furnished !n c:mnectlon thereWIth. OperatIons shall be deemeo corn· - •.-- -:-:. , • .. .' '., . ",,' .- . -'-' .... . t , ' I •

pleted at the earliest of the fcllowin- times: na'!led. m,ured s products !'leans goo"s or pr:lauct~ menuiac".:~ed, sold~ hand~e"". • . • oS l> -." ••• . • or dlst!lb~ted by th: named IOsured or by others tradmg under his name. Includmg-cp,when all oper~tlo:ls ,0 be pe, .crmed by or on be~alf of the n~me~.!ns~!.~~_." .3.1Y contair.er ttereof (ather tier. a vehiciel. but "named insured's procucts" shall

: under the con,ract have been completed. not include a vending machine or any property other than such container, rented• . '(2) when all operations to be performed by or on behalf of the named insured at to or located for use of others but not sold; .

l. ..,_the site of the. operations have been completed. or._ - ".. .._... ----- "occurrente" means an 'accident including continuous or repeated exposure to-1 (3) when. the portion of the work out of which the injury or damage arises has conditions, which results in bodily injury or property damage neither expected! _been put to its intended use by any persen or organization other than another nor intended from the standpoint of the insured;J ntractor"or subcontractor engaged in performing operations for a principal -,,-;- - -:- ,;._- -_. --" - -- .. .. .. . .- ,_. - - ..j a part of the same project . pohcy terntory means: '.' . .! . , . ' . . (l) the United States of America, its territories or possessions, or Canada, or

·1 :. Opeiatlfns which may ·require further serVice" or mariiten~cewOrr.-or .correc- (2) international-;ate;s-o;-ai;-space~'pro~id~d 'ihe bodi~injury or property dam·· ~ tlon. r~palror replacement because of any defect or defiCIency, but which are age does not occur in the course of travel or transportation to or feom any~ 'othenY1Se complete.,shaJl be ..deemed_completed. i__" __.othercountry, state.or nation. or __ .. ... _ ._...:...._ "

I. ' _. (31 anywhere in the world with respect to damages because of bodily injury or ., : The completed operations hazard does not inclUde bodily injury or property property damage arising out of a product which was sold for use or consump-! damage-arising out of . ..... '. .' . i . ..... . tion"Within the territory described in paragraph lltabove;provided the original~.la)operations in connection witl\ the transportation of property, unless the bodily suit for such damages is brought within such territory;:',':

.ttt . ~ inj~ryor property damage arises out of a condition in or on a vehicle created "product5..hazard".. includes bodily,injury.and..property.Jlamage.arising out of the ... .". Dy the' lOailing'orlJOloading thereor,:-'. .,....', .. . name:! insured's products or reliance upon a representation or warranty made at .'.' •. (b) the existence. of tools. uninstalled equipment or abandoned' or unused ma- any time with respect thereto:but only if the bodily injury. or property damage· I. ~erials, or-.--------.; . occurs-away from premises ,owned .by.o~ rented. to..the-named insured ana after,.-t' (cloperations for which the classification stated in the policy or in the company's physical possession of such prodUcts has been. relinquished to others;I. l' manual speci~~~!~g completed operations";', "prep~'!Y da!11age'~ m~ans (!J.ph¥s~Li!1jury..to.. o~ destrpc1ion of tangible prop· .'!- i.." .., "" .. ' . . -. erty wfnch GCcurs dunng the policy penod, IncludlOg the loss of use thereof atf ; elevator mea~s any .holstrng or lowe.nng deVice to .conne~t floors or landings, any time resulting therefrom, or (2) loss of use of tangible property which has:~ ~hether ~r not In s~rvlce, and all appliances. thereof IOcludlO~ any car, platform. Mt heen ptrjSicillly injured or destroyed provided such loss of use is caused by

·i ~haft. hOlstway. stal~way, r~n~y, p~wer equlpm.ent a.nd machinery; but doe~ n~t .4...;~oceurrence duringthe:poHg.penod; '.:., -,; .,,~- .-, '•._Ii mclude an automobIle servlcmg hOISt. or a hOist Without a platform outSIde a ... · _. - - ... ". . •... _.,-, • ,._ .... , C. I

· ~ building if without mechanical power or if not attached to building walls, or a "andergroun~ property·C"amage~!tazard~jnch~lles.l!nd.ergroun~ property damage as· ~ hod or material hoist used in alteration, construction or demolition operations, or defined herem and property damage to any other property at any ti!:1e resultin;: .~ an inclined conveyor used exclusively for carrying property or a dumbwaiter used, _ tl!.erefrom. "Undergruund property damage" means property damage to wires,i exclusively for carrying prepertj and having a compartment height not exceeding conduits, .PiPes, mains. sewers. tanks. tunnels, any similar property. and any3 fouTfeet;'-- ,- ----.- ---', .. __ .' .... ._apparatus"in connection therewith. beneath· the surface."of·the ground orwater,~: .' . .,,~ -: .,,' : ~ . ~~:'':;-':'''''':'':':caused by and occurring.during the use of mechaniC3! equipment fer the purpose~ "explosion haiaril'· includeS p'roperty damage arising out ofblasting or explosion. of. grading land. paving. excavating. drilling, borrowing. filling. back,filling or pile! Tlfe--exprosion hazard does-Illit include property'damageJlrarising" alJt"oTthe-ex---C:nYing:ihe underground property dam3ge'hazard-does-not inclUde pr~pertl dam-:t . plosion.of air .or steam.'vessels: piping under :piessure;. prime movers, machinery age (l) arising out of operations performed for the named insured by independent! or power transmitting equ!;:ment, or (2) arising out of operations performed for contractors. or (2) included within the completed operations hazard, or (3) fer, the named insured by independent contractors, or (3) included within the com- which liability is assumed by the insured under an incidental contract.

I . SUPPLEMENTARY PAYMENTS . '.':: : ;'. :. ~:'''''. " '.

.•company ;,,;mPaY.~ddTtiO;to th; applicable limit of Iiability:-- "--'- _. ~l~lthe'in'i~red because of accident or treffi~ I~~ ~0'i2'tio~ '3risYngo~t of th~ ~se

__, ii'~~~;~~es inc~r~;d'by th;-~~pany; all. 'c~sfs~ tax;dagain.st-th;'-i~~ure'~· in" '~';~~~h~v~~;a~~ ~~~r ~~~se ~~ic~b~!ia~F;ri ~~t.2t~pf;cf~~d 0~2f~rgi~~ b:~~ b:unc~~· . any SUit defended by the company and all mtereS! on the entire amount of any "-bonds-' •. ' ".. , '.'. judgment lherein which accrues after entry of the judgment and before the ' . . . . .

E company has paid or tendered or deposited in court that part of the judgment (cl expenses ,"c~rre.d ,by t~e ,"s.un:~ ~or fi;~t aid t~ others at the tllne of an aCCt·! which does not exceed the limit of the company's liability thereon; de!1t, for bodily mJury ,0 which thIS pOlICY applies;~ (bl premiums on appeal bonds required in any such suit. premiums on bonds to (d) reasonable expenses inC:Jrred hy the insured at the company's request in·i release attachments in any such suit for an amount not in excess of tbe assisting the company in the i:lvesti&ation or defense ,of any claim or sui:.i applicable limit of Iiabii~y of this"policy, and the cost of bail bonds required il'.cluding actual loss of earnings not to exceed $2S per day, •

r

Attach Coverage Part(s} and Endorsement(s) (If Any) Here

'10. 'Three Year Policy: If this policy is issued for a perio'd of three years anylimit of the company's liability stated in this policy as "aggregate" shall apply~e!,ara~:I! to each consecutive annual period thereof. :... :' :. :'::. •.

8. Chan&es: Netice to any agent or knowledge possessed by any ~ge~t e~ by ~~y

other person sh;:l not effect a wa";er or a change in any part of i~;S po:;cy orestop the COi:1pny from asserting any right under th~ terms of this policy: ne:shall the terr;'ls of this policy be waived or changed. except by ei1dom~ent issuedto form a part of this policy.

9. Assitllment: Assignment of interest under this policy shall not bind the com·pany until its consent is endorsed hereon; if. however. the named insured shalldie. 'such insurance as is afforded by this policy shall apply (l) to the namedinsured's legal representative. as the named insured, but only while acting withinthe scope of his duties as such. and (2l with respect to the properly of thenamed insured. to the person having proper temporary ciJstody thereof. as insured,but only until the appointment and qualification of the lega!, represer.tative.

1. Subre:at:on: In the event of any payment under this policy. the company shallbe subrOsate1 to al! the insured's rights of recovery therefor aga:nst any per;onor organ:za!tonand the insured shall execute and deliver instrwilents and papersand do whatever else is necessary to secure such rights. The insured shall donothing atter loss to prejudice such rights.

11. Cancillation: This policy may be cancelled by the named insured by sur·render thereof to the company or any" of its authorized agents or by mailing to

'the--company written notice stating when thereafter the cancellation shall beeffective..This policy may be cancelled by the company by mailing to the namedinsured at the 'address shown in this policy; written notice stating when not lessthan ten days thereafter such cancellation shall be effective.' The mailing of noticeas aforesaid shall be sufficient proof of notice. The time of surrender or the ef·fective date and hour of cancellation stated in the notice shall become the endof the policy period. Delivery of" such written notice either by the named insuredor by the company shall be equivalent to mailing.

If the lI3med illSured cancels. earned premium shall be computed in accordancewith the customary short rate table and procedure. If the company cancels,earned premium shall be computed pro rata. Premium adjustment may be madeeither at the time canceilation is effected or as soon as practicable afler cancel·lation .becomes effective; but payment or tender of unearned premium is not acondition cf cancellation. .

Cal In the event of an KClIJUnce. written notice containing particulars sufficientto identify the insured and also reasonably obtainable information with respectto the lime. place and cirCU!':'.stances thereof. and the names and addresses ofthe injured and of ctr.liEab!e witnesses. shall be given by or for the insored tothe company or any of its authorized agents as soon as practicable.· .: .' .

(bUf claim is made or sud is brought again~t the insured, the insured So'lali im·mediately forward to tile company every demand, notice, summons or otherprocess received by h!tc1 or his r~presentative.:· ~.. ' ..•< ,• .. .i.,: ••"

Cel The' illSured sl'l2l1 cooperate with the company illld: upori~the'comPaJiy'srequest· assist. in rnzking settlements, in the. conduct of. suits and inenforcing any right of contribution or: indemnity. '". against any. person. Dr

; -organization who r;;ay be liable to the insured because of injury Dr 'damage-_with' respect to whidl insurance is afforded under this policy; and the insured

·shalt attend hearinp and trials and' assist· in securing and giving evidence.: and obtaining the ettendance of witnesses. The insured shall not, excePt at

his own cost, volullllarify make any payment, assume any obligation Dr incurany expense other tlw1 for tirst aid to others at the time of accident. '..

5. Actici~Against Comjliny: No action s;;;,ilie ag~n;t thecompa~y ~nleSS: ~.~condition precedent thereto. tliere shall have been full compliance with all of the

~ terms of this policy. nor ur.til the amount of the insured's obligation to pay shall. ~ r.ave been finally deten:ine:1 either by judgment against the insured after actual

trial cr by written agr~fl(lt cf the insured, the claimant and the companr_.Any perSDn or organintiQlll or the legal representative thereof. who has Secured

such jUdgment or writte!! asre:me.'1tshall thereafter be entitled to recover underthis policy to the extent of tte insurance afforded by this policy. No person ororganization shall have i11Y risttt under this policy to join the company as 2 party 12.' Declarations: 8y acceptance of this policy, the named insured agrees thatto any action against ~ inSured to determine the insured's liability. norsllall the ~statements in the declarations are his agreements and representations, thatthe company be implea!led by the insured or his legal representative. 8anlr.ruptcy this'polity is'issced in reliance upon the truth of.such representations and thator insolvency of the innre~ or of the insured's estate shall not relieve the com- this ·policy. embcdies all agreements existing between himself and the company

~ pany of ~ny of its. obligetioas h..ereunder..· or ~ny'of its agents relating to this insurance.' .

~ I" Witness WheFeof. ;he c~m'~any has caus~d this pojj~:'; ~ be execut;d4;;,d_;~~~;;d:' b~r thi; policy. :Shall ..'not ~ valid unless counter-signed on the declarctions ~e by a duly authorized representative.of the.company. " ,." '. ',' , ,

( COHOrTIONS (1. Premium: All pre=':".as for .o!...is policy shall be computed in accordance wittl 6. Other IlIsur.ance: The insu~ance afforded by this policy is primary insurance,the company's rules. :ates. ratms plans. premiums and minimum premiums appli· except when slated to apply in excess of or contingent upon the absence of othercable to the insura~ afforded herein. insurance. When this insurance is primary and the insured has olher insurance

. . .. ... . ... . . which is slaled to be applicable to the loss on an excess or contingent basis, thePreml.um designat~ In tlllS poliCY as advance premIUm IS a d.eposlt premium .. amount of rhe company's liability under this policy shall not be reduced by the'

.,Iy whIch shall be ?,elfitel! to the amount of t~e earned premium due .at ~he .. existence of such other insurance.1 at the policy perllld...At tile.close of each p~f1od (or part thereof ternllnatlO~ .. When ooth tIIis insurance and other insurance apply to the loss on the same

,t~ the end of the 1lO!1CJ period) deSignated In the decla.ratlons as tile au?,t_ basis. wllet:ter primary. excess or contingent. the company shall not be liablepenod the earned pre;nlm:n s.'laU be computed for such penod and. upon notrce . under this policy for a greater proportion of the loss than that stated in thethereof to the named_ed. So~1I become due and payable. If the total ~arned applicabl- ontnbution provision below.premIum for the poley penod IS less than the premium prevIously paid. the - c .

.: company shall retL:Cn to the named insured the unearned portion pail! by the tal ConlnlllrtiDII by Equal Shares. If all of such other valid and collectible insur·named insured... .-' . ance provides for contribution by equal shares, the company shall n01 be liable

. for a greater proportion of such loss than would be payable if each insurerThe named insured shall :::aintain records of such information as is necessary . 'contributes an equal share until the share of each insurer equals the lowest

for premium computamll,. and shall send copies of such records to the company applicable limit of liability under anyone policy or the full amount of the lossat the end of the polity ~iod and at such times during the policy period as the is paid. and with respect to any amount of loss not so paid the remainingcompany may direct.., . -insurers then continue to contribute equal shares of the remaining amount2. Inspection and Ariit: The ccmpany shall be permitted but not obligated to of the loss until each such insurer has paid its limit in full or the full amount

,'. ~.inspect the named illSllr:€s property and operations at any time. Neither the of the loss is paid.....--"~'.-- 'company's right to mai'e insP!dions nor the making thereof nor any report there-- fb) Contribution by limits .. If any of such other insurance does not provide for

on shall constitute an undertaking, on behalf of or for the benefit of the named contribution by equal shares. the company shall not be liable for a greater.. insured or others, to tletennine or warrant that such property or operationS4re proportien of such loss than the applicable limit of liability under this policy

safe or healthfuL· or 2re in compliance with any law, rule or regulatiolL for such loss bears to the tctal applicable limit of liability of all valid and'.'0"""," "'.""-':''7':' .• ,... .·'t'. '.' h'>" .., , collectl:;!e insurance against such loss. .

The cor.:pany may eomine and audit the' named insur~d'sbooksand records at,any time during the pcricr period and extensions thereof and within three yearsafter the final terminztioa of tbis policy,. as Jar as they relate to the subiect

:matter of this insurance. """'. " .'."., ..:c",,,~...:~_•..-_....., "" "-- "" ..,' ,'. '.

" 3. financial Respollsill:lity laws: When this policy is certified as proof of F,OlJocial,resl'Onsibility for tileflltOl!! I:n:::~! the provjsioOls of any motor vehicle fina:lCialresponsibility la..... Sl.idt jt!!Sl.lf2f;C~ as is afforded by this policy for bodily injuryliability or for i1r:jlerty ~<i:lla~e liability shall comply with the provisions of suc::law to the e~teni of De cc>er:;se and limits of hzbiiity required by s,:ch la......The insured agrees to :ei.-::b::rse !l1e company for Jr.y payment made by t:'e co:;'!·pany which it would "",t have been obligated to make under the terms of thispolicy exce;;t for the ~reement contained in this paragraph.

4. Insured's Duties in tile Event of Occurrence, Claim Dr Suit:

;,.<:.'.:i

: T. Bowring Woodbury, II. Secretary

. 'Steven H. Newman' -.' ·,r•.

President ,. '-, ..::.of THE HOME INSURANCE

.' .COMPANy·.·· acr~~·.-4 ~'.. .,

Waverly G. SmithPresidentof the Company identified inthe Declarations other than THEHOME INSURANCE COMPANY

I ~lEAR ENERGY LIABILITY EXCLUSION DtDORSEW· ...\ . (BROAD FORM) ,::. . (

This endorsement modifies the proYisions of this policy relating to Ali GENElAl UABIUTY AND MEDICAl. PUWEKTSINSURANCE OTHER THAN COMPREHENSIVE PERSONAL AND FARMER'S COMPREHENSIVE PERSOfCAlIKSlJRANCE.

II. ' As used in this endorsement: ,.....hazardous properties" inClude ncfcac::i'R, toxic or explosive properties; _

'-'•.:- __ y. ...... . '

"nuclear l112terial" means seur::e IU~- special Auclnr material or .,.­product mawial;

."source materia''', "special nuclear l112t!riar'. and "bYllroduct material" h2'rl!the meanings giyen. ttre.m, in the f\n)nU: EnetiJ Act of 1954 or in. any lewamendatory thereof;' , ' -" • .

!;~p~;t f~~1'" ·~eans 'a:r f~el' ~I~~nt or fuel component. solid or liquid, whicllhas been lIS!d or exposed to raciatiOn a a Iludear reactor;. .:

"w~ste" means any wast~materiaf {.;} coataining by·product material ot:ber- than the ta:tings or wastes pro:!~ PJy the extraction or concentration af

uranium or thorium from any ore processed primarily for its source materialcontent. an:1 (b) resulting from the oP!fation by any person or. organizatmnof any nuclear facility included under the first two paragraphs of the defi-nition of nu:lear facility;

"nuclear facility" means(a) any nDelear reactor.lbl any ~ipment or device d!sig.:ted or used for (l) separating the isotoJl!S

of ur!l'Iium or plutonium, (2) processing or utilizing spent fuel, or GI. handling. processing or paOOlgillg YlIm,

(cJ any e~ip!l1en! or device !:Sed for the processing, fabricating or allcf.::g'. ,'of special nuclear material if 2t iJ1'j time the total amount of such r.'.a.

terial in tha custody of the inSlllref at tie premises where such equipme:'1t"or dence is located Cllns.'sts of or co::tains mare than 25 gra::-:s of

pluto:liur.! or uranium 233 or a.....y comilination thareof, or more than 250grams of uranium 235.

__ (d) any structure, basin, eXC2WItio.,. j:Cecises or place prepared or used farthe s:orag! or disposal of waste•

and includes the site on which 20y of :he foregoing is located, all operatio.::sconducted on such site and all premises used for such operations;

,. . .. -.. . _... .. , ','nuclear reactor" means any aj:p3r.!tus designed or used to sustain nuclear

fission in a ·self-supporting chain reaction or to contain a critical mass of'. fissionable material; . . ...

:}p'r;'p~rtydamar;e" includes all ~'~f radioactive contamination of property.~: .;;:;,;,~o.:·z~·' : _ _

"... agreed that: . . .. .... , ...'. is policy does not apply:"'. .. - .....,-_:,_

~ A:.' Under 'any Liability Coverage, to bodily iajll1l or property damace '-• C1l with respect to which a.n insured under this policy is also -aninsured '

. under a nuclear energy liability policy issued by Nuclear Energy Liability..."". Insurance Association, Mutual Atomic Energy liability Underwriters or

. , . Nuclear Insurance Association of Canada, or would be an insured under~ .. _ • a.ny .~uch policy buUer its termination upon exhaustion of its limit of ,.~::~ hablllty;or·, --:,'.'::", ",'_'; . ". "

~" _. I2l resulting' from'the hazardous properties of nuclear matenal and with ..::' respect to which (al any person or organization is required to maintain..':_ ._". financial protection pursuant to the Atomic Energy Act of 1954. or any

law amendatory thereof, or lbl the insured is, or had this policy notbeen issued would be. entitled to indemnity from the United States ofAmerica. or any agency thereof. under any agreement entered into bythe United States of America, or any agency thereof, with any person ororganizatio~::- .•.

."~'';'::'''''~'''"':''';'l'/'·:'.'''~,J'.",,,·'·

!::s:~,;~:';~~~~t: any M~di~1 'P~;~~ntsCoverage.or under any' Supplementary Pay·";: ments provision relating to first aid, to expenses incurred with respect to

bodily injury .resulting from the hazanfousproperties of nuclear materialand arising,~ut,of .the operation of a nuclear facility by any person or..,

. organization..~·;;.::::·.:,:::·;.',;,·.:.:

Under any Liabili'ty Coverage, to bodily injury or property damace r~sulting, from the hazardous properties of nuclear material, jf' .

: (l) the nuclear material (a) is at any nuclear facility owned by. or operated", by or on behalf of, an insured or ibl has betn discharged or dispersed

. therefrom;121 the nuclear material is contained in spent fuel or waste at any time. possessed, handled, used, processtd, stored. transported or disposed. . of by or on behalf of an insured; or' .

, (31 the bodily injury or property damar: arises out of the furnishing by an:." insured of services. materials, parts or equipment in connection with,. . the planning, construction, maintenance. operation or use of any nuclear

•

" :: ._. facility, but if such facility is located within the United States ofr; ,.. America, its territories or possessions or Canada, this exclusion (31

, .' ,; ''; ,_' applies only to property damar;e. to such nuclear _facility and anyproperty thereat.

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i (Date Prepared

5-26-87Non-Premium EndorsementEndorsement No.

oo City Insurance Company

O The Home Insurance Companyof Indiana

Issued l7t

o The Home Insurance Company

[i] The Home Indemnity Company•••••••••'" ''':.' .. .,,",".

Producer No. • OPe

Named Insured

HAMED •INSURED

Certificate Number

Quaker'state Oil Refining COrporationQuaker state Development Corporation : .Quaker State DeVe10Pment CoDlpanyLTDQuaker State Operating Company LTDQuaker state au LimitedQuaker state Western CorporationTruck-Lite Company. Inc.DO-Ray Lamp Company, Inc.Corn Brothers, Inc.Chickering OU IE SUpply CompanyThe Valley Camp COal Company .The Valley Camp Coal Sales CompanyValley Camp or Utah, Inc.Kanawha and Hoc)dng Coal and Coke CompanyDonaldson Mine CompanyKelley's Creek & Northwestern Railroad Compa.nyGreat Lakes Coa1 & Dock Company .'J;'exstar Automotive Group, Inc.Elm Grove Coal. Company .Shrewsbury Coal CompanyQuaker {li1 Corporation.Quaker State Investment CorporationThe Helen M1n1ngCompany. ..'Quaker state Oil Refin1ngCorporation. B.V.Davis Products, Inc•... ...Neighborhood Auto Parts. Inc.Race Master CorporationGrimes Oil CorporationV. J. Oil Company

Policy Number

GL 99 48 43

P Ii P · d Inception ll.1onth-Day-Year) Expiration (Month-Day-Year) Effective Date and Tlrne of Endorsemento cy eno: JJ-1-87

Producer ..

:::.:.::.:..:::::::;;:;;::: .., It is agreed that this policy is hereby amended as indicated. All other terms and concfdions of this policy remain unchanged.

~."" .•._. ", ........-" ...,..."...., ..... "",-"-".,,...',,'

.•...............'.,....

. ;',",':.':':'

Signature of Authorized Representative •Producar Copy

H22300 FH IS) Rev. 11181 The Home Insurance Companies'I;

.... ,.(Non-Premium Endorsement

•Issued by

o The Home Insurance Company

(i] The Home Indemnity Company

oo

(

City Insurance Company

The Horne Insurance Companyof Indiana

Udle Prepared

5-26-87

o

Endonernent No.·1

Producer No. - ope

Effective Date and TIme of Endorsement

4-1-87

EHDORSEHEITS ATTACHED TO POLICY·

~::~j l~Ei- (; L C H 1-~ ~.. ...(6108 ./1.6133v1.9451 •. ""'1.9114~06(5) v1GU9220vf135026 v1.6944~61~3 ./L6157

.~ - .' _ .';'~" j .••.: ::~~~8 ~~ew~~J~(A/t!44viL025W~;/~lW,>J.~itJ~)~178 0Jew) ~4-o (."""lotlc.e.s .. >...-1.6177.....;t.ii>I-.4~<oJ.~~¥:'~~0238 J-A -llme"J.. fe,'&( tnJ:-can, e 1/c..+.,J1; ....

G0201 . v'IL024J.N€..;)o.£-,t/m-tIlJ.[,J- C&..""(.t/"'~i_

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Bond Paper(2l~·:::~··

....-m2300 (11)~~"·,~~·

........Cycl.e Bill~6950"

v-1.6126·'·L631.2

V"L9235 .v1I25585v'L6111/836074vL9153.

CG20231.185V'ft3661.3 N(,W .vJcrt",~1Absdu+e.. Asbesh>s

l )Cc..l~i DI\

It is agreed that this policy is hereby amended as indicated. AD other terms and conditions of this policy remain unchanged.

•••".'- ,

.-., '.-

,~'.:""'" •.-" ::.:, 'j.-,"• ";: ..

Signature of Authorized Representative

H22300 FH (5) Rev. 11/81 The Home Insurance CompaniesProducer Copy

,.t;:(

Non-Premium EndorsementIssued by

o The Home Insurance Company

[Xl The Home Indemnity Company

oo

City Insurance Company

The Home Insurance Companyof Indiana

[Jate Prepared

5-26-87

o

Endonement No.

It is agreed that this poli.c:y is hereby amended as indicated. All other terms and conditions of this policy remain _unchanged

Producer No. - OPC

Effective Date and Tme of Endorsement

4-1-87

Named Insured

Payroll - Per $100

COMPOSITE RATING PLAN PBEHItJM ENDORSEMENT

It.18 agreed that the premium t'ortbe policy to which this endorsement isattached.sball be comPuted upon a ··composite "basis in accordance with theCompany,s·rules~ratesJrating p1al1s, premiums and m1n1mum premiums andthe other terms of the policy not inconsistent herewith:

Policy Period:

Policy Nlmber

GL 99 JlS Jl3Produc:er

The word Payroll means the amount paid as a remuneration to theNamed Insured's employees used as a basis of premium under all WorkersCompensation policies •

PBEHIUMBI &: PD

596,711"""450,000450,000218,532

$1,475,249

COMPOSITE BATEBI &: PD

S .536553HS Flat

S FlatNS Flat

Total

PAYROLLCOVEBAGE

General Li.abUity" 111,213,072·'/"

Nothing herein contained shau. be heid to waive, vary, alter or extend anycondition or provision of the policy other than as stated above.

•. -

Signature of Authorized Representative

H22300 FH (5) Rev. 11/81 " The Home Insurance CompaniesProducer Copy

COVERAGE PART (

COMPREHENSIVE GENERAL UABIlITY INSURANCE •

AdYlIICI PrlmllIIII

BodIly Injury PropertJ Damap

Each occurrence Aggregate

BJ. P.D.

SL6l08 .000 S .000

$see Endt. .000 S ,000

ExposureBasis

P. B.Code

PBCodes: a·Area; f-FroRtage; m-Admissions; p-Payrol; r-R~ t-other.

A-Unit Mos.; EH:ntire; .c·Per 100; O-Per 1.000: E-Per 10.000; F-Per 1.000.000; G-Rot Req.

Included Under Compos1.teRate Endorsement

For attachment to Policy No GL 99 48 113 . to complete said policy.

~ . . ADDITIONAL DECLARATIONS...tion of all premises owned by, rentl!d to or controlled by the named ilSured (aNT"'" ••....a·· ....... a LlX'ATION ... "OOIl&~._.. 'N na....... oaeU"'T'_.

I . Interest of named insured in such prl!mises ,<:>oo:ea ULOW) .

I. . .D. .Owner 0 G.eneral Lessee 0 Tenant 0 Oth.er, ..,...- _

.. . _. Part occupied by named insured (.Nna _LOW. -....... ~,"', ."' ....."'"....-,"" ,.

i.,.~;:.:,,~~~·.f~ii~Wingdisclose~ali hazards irmRd hmunder kno~n t~ exist at the effective date of this policy, unless otherwise stated herein.

I··:;:~S;~;;;:~i ,,~.'.' .'., ...'..;., ....... , .•. '.----~ ..,....~•.. - '.

,. ~~~

The-insurance afforded is only with respect to such of the following Coverages as are indicated by specific premiulD cbarge or charges. The limit of the company'sliability against each such Coverage shall be as sUIted herein, subject to all the terms of this policy having reference thereto.

../

TOTALSnumbers of endorsements at IsSUI

H21013F Rev. 5/81 DR

/ If'. Any - Included·. Under Incl. Incl.Composite Rate Endorsement

Completed Operations - Products

y Subline 316

Included UnderCOmpoaiteRate Endorsement Incl. Incl.

PRODUCER COPY

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IV, POUCYTrUITCIYThis inSlr.2l'Cl! ap;:lies only to bodily injury or~ daIIl3gl wilidl occurs

wilhin the jIIIicy territory. - ,~,";""__:,,,-•./'•. ~i._l."~"

I. COVERAGE A-llODllY INJURY U..IUTT .• ,COVERAGE S-PRDPERTT OAKACE LWlIt:(

The company will pay on behalf of the insur•• all sums whieb the insured shallbecome legally obligaled to pay is damages bec3use of

I.. bodily injury or8. praperty dalllige

:to whieb this insurance applies. ~ed by an occumnte, .a~d the company shallhave the right and duty to defend any suit al;ainst lhe insured seeking damageson account of such bodily injury or property dama~e. c~en if ar.y of the allegations01 the suit are groundless. false or fraudulent, and may make such investigationand seltlement of any claim or suit as it deems e~pedient. but the company shallnot be obligated to pay any claim or jl:d;;r:>ent or to defend any suit after theapplicable Iimil of the compa!l)"s liabmty has been exhausted by paymenl 01judgments or settlemenls.

ume. iIscri zter such p' .-cts or work '- been plil to use by anyperson or orpnilalion Olh'f 1 an iGmll;

In) to praperty Ullage to the· ~II illS1fetrs ,,"acts arising out of stichproducts or any JlMl of such procluds:

(0) 10 praperty -"qe to voork performed by or lJlI behalf of the Dilled insuredarising. III the work or any portion thereof, or _ of IIlilerials. parIs orequiprllellt fIirnisIled in connection therewith;

(p) to~ dai!:Ied for the withdrawal. inspedioa. repair, replacement, orloss of IISI! of l!Ie named insured's preducts or --. CIlIlIpleted by or lorthe naRd ilIsured or of any property of which sucb pnJcIucts or work lorma part, if s:x:lJ products, work or property are wilIldr3Wn from the market orfrom use beQuse of any known or suspected deled or deficiency therein;

(ql to prapl:rlT lbmage included within: .III the aplssioa h;wnl in conneetiOll with apera:ions idenlifled in this

poliq by a classification code number whieb includes the symbol "x",(2) the ~Ilzpse haurd in connection with operations identified in this

policr by a classification code number whieb includes the symbol "c",Exelosfons l31 the IIIdertn.-d property dalllale 1Iaza~ in c:omecli:Jn with operalions

iden:ifie(l in this policy by a classification I:Ode IlUIIIber whid! includes, This inslmlnee does not apply; the SJlIIboI-rf'.lal to liability assumed by the iasared under any contract or ·agreement except II. PERSONS I"SUREa

an incidental contract; but this exclusion does not apply to a warranty of nfitness or quality of the lIiIIed inSllred's products or a warranty that work Each of. fcIIowing is an insured under this illSlr.lnce 10 the extent set forthperformed by or on behalf of the naIDed insured will be done in a workmanlike below: .manner; .. . (al if the _d i_ed is designated in the declaratiofts as an j"ndiyjdu~l, the

lbllo bodily injury or property 4alII3iearisill&~ut oll.ieowneMip, lIlaiAlllnance,_,_person so desi&l'itecl-llut.only.with.res;>eclto.tbe conduct...of-a business of_ ;~:.

I operation, use, 1000ding o~ unloading of .. which be is the sole proprietor, anc! the !spou:je.of.tile,~lDe~ .i~r~~ with . '::=::-'1lI any automobile or aircraft owned or operaled by or rented or loaned to respect lD lIae conduct of such a business;. " .•.. ,. • ," ~.' ... :,:::~. :.

any insured. or. ;. • . lbl if the goe' i_red is designlled in the declaraticms as a partnership or : ";:(2) a.ny·other automobile C?r a.reraftoper3led by any person In the course of joint ¥elIture. the partneMip or joint venture so designated and any partner

'. hiS employmenl by any IlISIfei; :.' .. . ...,. or meniler t1Iereof but only wilh' respect to his liability is such;but this exclusion does not apply to the parking llf.an automobile-on pre.mises Ie) ilthe _ell InsIred is designated in the declamions is other than an in-O!'ned by,. r.e~led .to or controlled. by. the named Insured or the. ways Imme- dividual, partner.iflip or joinl venture, the orpniDtioa so designated and anydlately ad/omlng,l( suchaulomDblle IS not owned by rented. or loaned to exeQ/me ollicer. director or stockholder tIIereof 1ItJiJe-acIiDE witllin tIIe'scopeany insured-",~, ':.. ~ .•:: .._" '. of his dl:ties as SICh· ;. , .

Icl to bodily 1~IUry. or propertY· ila;.;ace· arisi~g out of· () lt~eo~rsbip, ma!n-" Id) any persrm father than an employee of the _d insured! or orpnizationte~ance, ope~ahon, use, loading or unloadl~g of any mobile equipment ~~lIe while acling as real estate manager for the Iliad insllRll; andbemg used. m any pr~arrang~~ or C?rganlzed racmg. speed or demolition Ie) with r~ct to the operation, for the purpose of locomotion UJlOll a publiccontest or In ~ny sluntmg activity o~ In practice or preparation !or any s~ch : highway of .obile equipment registered under Df IIIOtor wehicle reg'str 1'0

;:con!est or actrVlty or !?) the operation or use of any snowmobile 'Or trader law,' . '. . I a I ?..de~lgn~d for ~e thereW:lth;., . -.'. • .' .. (j) an egplayee of the 113med insured while opelitinc any such equipment inIdl to baddy l~lury or pr~perty ~alUge anSlng out of .and In the course of the the iilurse of his employment, and ' _'. .: •.. .',.•

transportatronof. mobile !qllpment by an autamabde owned or operated by liil any ather pe~n while operating with the pen:1Ssion of the named Insuredor rented or loanid to any Inmed; any such equipment registered in the name of the ulled insured and any

Ie) to bodily Injury or property _ate arising out of the ownership, maintenance, pefSllll or orpnizalion legally responsible for sud! operation, but only ifoperation, use, loading or unloading of ... , there is no other valid and collectible insurance available, either on amany watercrart owned or gperated by or rented or loaned to any insured, or prillllt)' or eJ"cess basis, 10 such person or organization;(2) any other watercraft operaled by any person in Ihe course of his em- provided that no person or organization shall be an iIlslllld under this para-

ployment by any insured: .. graph Ie! willi respect to: :but this exclusion does not apply to watercraft while ashore on premises (l) bodif1 injmJ to any fellow employee of such person injured in the courseowned by, rented 10 or controlled by the allied insured; of his emplOyment, or

{fl to bodily Injury or property danuge arising out ot the discharge, dispersal, (2) property da~ to property owned by, renteclto, in charge of or o~upiedrelease or escape of smoke. npors. soot, fumes. acids, alkalis, toxic ebemicals, by tile _ell Insured or the employer of Df persoa descnDed IR sub·liquids or gases. waste materials or other irritants, contaminants or pollutants . . p2rasraph liil. i .. ; ..into or upon land, the atm~ere or any water course or body of water: but ThIs InSlnllce does not apply to.b~dilJ InIVY or P~erlJ ~age af.lSlng out ofthis exclusion does not apply if sucb discharge, dispersal, release or escape the conduct of any. par:lnersh,p C?r 10lnt !enfil!e of wiIith the mured IS a partneris sudden and accidental· ..., or member and which IS not designated III thIS policy is a _d insmd. .

(gJ t~.bodily I~jury or. property ~a..are due l~ war. whether or not decl~r~d, III LIMITS Of UABfUTT .clvd war, inSUrrection, rebelilon or revolution or to any act or condition • ••incident to any of the foregoing, with respect to ~egardless of ~e lIUlR.ber.o.f (1J Insureds under thIS policy, 121 ,persons or orga~j.(J) liability assumed by the iasured under an incidental contract, or zahons who sustam 1I0dily.'nl~ry or property damace. or 0) claims ~ad~ o~ ,s.UI!S(2) expenses for first aid under the Supplementary Payments prOVISIOn; ~rought on accocmt of bGddy InJury or property damare, the CllIl1pany s liability IS

(h) to bodily injury or property damage for which the insured or his indemnitee hmlted as fellows: .. : :may be held liable Coverage A-The total liability. of the company f~r ~I! damage~ including(J) asa person.or organimion engaged in the business of manufacturing, damages tor care and loss of services. beca-.zse of bldllJ IRlarr sustained ~y.one

distributing, selling or serving alcoholic beverages. or or ,!,or~ persons ~~ the resul\ of anyone Dccarrence shall not aceed the limIt of, bodily InJUlY liabilIty stated In the schedule as appfcabie to -each o=orrence ':

(2) tf not so engaged, as an owner or lessor o~ premises used for such Subject to the abate provision respecting -each ocalrrenc,-, tile total liabilitypurposes, , . of the company for all damages because of llrall borlily iajurr included within the

If such liability is imposed completed "ermollS haurd and (2) all lIodily Injury included within the products(j) by, or.because' of the ~at~n of, !.ny statule, ordinance o~ regulation hazard shan not exceed the lim,it of bodily iJI!u7 li~litr s~tedin the schedule- , pertamlRg to the sale, gilt, distributIOn or use of any alcoholic beverage, as "aggregale". ' . .: .":.: ,.': ' , C' " l~ .'

, or " . Coverage S-The total Iiabilily of the company for all darr.2ges because of all. (ii) by reason of the selling. serving or givin~ of any alr-oOOlie beveragc to a property daaage sustained by one or more pusons or orpnizations as the result. minor or to a person under the influence of alcohol or which causes or of anyone _IImnce shall not exceed the limit of JlI'IIlerty dHl3ge liability stated

contributes to the inloxicalion of any person; in the schedDe as applicable to "each occurrence".but part (ii) of this exclusion does not apply with respect to liability of the Subject ll: the abOYe provision respecting -each o=rrence-, the tolal liabilityinsured or his indemnitee as an owner or lessor described in (2) above; of the COlllll2ny for all damages because of all prvperty dalll3ge to which this

ti) 10 any obligalion for whieb .the insured or any carrier as his insurer may coverage a;ilPlies and. d~scribed in any of the. n~red ~paragraphs belowbe held liable under any workmen's colroDensal ion, unemplO)':IIent compensa. ~hall not ~ed thehml! 01 property damate liability stated m the schedule astion or disability benefits law. or undl!r a"y similar law; agg(lr)egalt1e: ....... ". '. . t f' ... ted

. ,. . d" f nd' th a prop~ '/' ..lIlige ansrng ou 0 premises or oper••IlII1S ra on a re-(j) to bodily rnJury to any elllllloyee. of tile Insure ar,s,~g :lutoa .m e muneatio::l basis or conlractor's equipment rated 011 a receipts. basis

cou!se of ,hiS employment by the .nsvred or ,to any obllgal:on ,o! the Insure,d inclu:fing property dama£! for wlIieb liability is iSSP:led under any in:to rnd~mnrfy another because of.da~&es ans,"g out of sU~i Inlury; but thiS cideml tllntm:t relating to such premises or ll?Cralions, but excluding~X~luslon does no.t apply 10 Itabl,'.y assumed by Ihe Insured under an Proprrt1 damage inclcded in subparagraph lZl betow:inCidental. contracl;.. . 12l all pr;perlJ damage arising out of and occurrilll in the ~urse of operations

(k) 10 property damage to ,.•.' .. .. ... ; perftm1ed for the named insured by independent contractors and generalIII property owned or OC~UPled by or rented to the Insured, supemsion thereof by the named iasured, iIldII:Iing any sucll property(2) property u.sed by the Insured, or . . daqe for which liability is assumed under any illtidental conlractl31 property In t,he care, custody or co.,lroi of the, Insured or as 10 which relal'ng to such operations, but this subllaragraph lZl does not include

the Insured IS for any. purpose. exerClslOg phi'Slc~1 control; .. . pro"my dalll3f! arising oul of maintenance or rQiirs at premises ownedbut parts 121 and (3) of thIS exclUSIOn do not apply With re.\pect to liability by or ren!ed to the named insured or structural alterations at sucll premisesunder a written sidetrack .eesncnl and part (31 of Ihis exclusinn does not whidt do not involve changing the size of or moving buildings or otherapply wilh respecl to property damale (Othcr lhan to elevators) arising out of slrucures:the use of an elevator at premises owned by, rented 10 or controlled by the l31 all ,"oerlJ damate included within the prod;cts limn! and all propertynamed insured; daqe included wilhin Ihe completed operatians lward.

CD 10 property damage to prelf'lses alienated by the named insured arising out Such awegate limit shall apply separately to the prqlerty damage describedof such premises or any part thereof; in subpaf3~ m. C2l and (31 above. and under s~rarraphs 1II and 121.

1m) 10 loss of use of tangible prgperty which h~s nr.t been physicaily injured or sep~ralely ",,;h reSlletl to each proJect away from premISeS owned by or renteddestroyed resulling Irom to lhe Il3met InSl!l1ilL,(J) a delay in or .lack of performance by or on behalf of the named insured Cnerages And S-For the purpose of determining the limit of the company's

of any conlract or agreement, or liability, aU bo~ily iljury and property darnac:e a;is;::g out of conlil\llOUS or re-12l the failure of the named insurell"l F,oducts or work performed by or on pealed exposure 10 substantially the same teneral cmditi:lns shall be considered

behalf of Ihe named insr.d 10 :neel loe level of perfam:ance. qualily, as arising 001; of one ICcurren:e.fitness or durability warranted or ~epr~sP.n!ed ~y Ihe nzmed insured;

but this exclusmn does not ap:!iy t9 !r,:,. nt trSP. 'J! olher lanliihlc ~roperty

',:' resulting from the sudden and aa:i.1e~lal ph;-:;ical ;njury to or destruction ofthe named Insured's pradllds or work performed by or on hehatf of the

•

L610S(Ed.3-8l>

GL 99 17 (Ed. 03 81)

Amendment - Limits Of Liabilitv

(Single Limit)

(IndividUal Coverage Aggregate Limit)

A· .. clching Clause n~ed be completed· (lly when thisissued subsequent to preparation of the policy.)

COMPREHENSIVE GENERAL LIABILITY INSURANCE

COMPLETED OPERATIONS AND PRODUCTS LIABILITY INSURANCE

CONTRACTUAL LIABILITY INSURANCE .,

MANUFACTURERS' AND,CONTRACTORS' LIABILITY INSURANCE'

. OJ.lNERS 'AND CONTRACTORS' PROTECTIVE LIABILITY INSURANCE

OJ.lNERS'. LANDLORDS~ AND TENANTS' LIABILITY INSURANCE

This endorsement .odifies such insurance as is afforded bythe provisions of the policy relating to the following:

(12:01 A.M •• standard time)

This endorsement p effective p forms a part of policy No. GL 99 48 43

SCHEDULE

Authorized Representative

..,...; ...... , ",'-,..

'. .,,>,,~ •. , -, Coverages Limits of Lic:bil ity

"./

$ 4.000.000 each occurrenceBodily Injury liability and Property Damage liabi Ii ty V

$ ••000.000 aggregate,,,".

,.

by

issued to

It is agreed that the provisions o~ th~ policy captioned "LIMITS OF LIABILITY" relating toBodily Injury liability and Property Damage liability are amended to read as follows:

LIMITS. OF LIABILITY

,...• Regardless of the number of (1) insureds•.....•. <: under thi s poli cyp (2) persons or organi za-:\ . tionswho sustain bodily injury or property. : damage. or (3) claims made or suits brought

on account of bodily injury or property dam­age. the company's liability is limited asfollows:

Bodily Injury Liability and property DamageLiability: ~

Page 1 of 2

For the purpose of determi ni ng the 11 mi tof the company's liability~ all bodilyinjury and property damage arising outof continuous or repeated exposure tosubstanti ally the same general condi­tion shall be considered as arising outof one occurrence.

li . .Jility is assumed under any inci­dental contract relati ng to suchoperati ons, but thi s subparagraph(2) does not include property damagearising out of maintenance orrepairs at premises owned by orrented to the namnd insured orstructural al terat ions at suchpremises which do not involve chang­ing the size of or moving buildingsor other structures;

3) if Products - Completed Operati onsInsurance i safforded, all bodilyinjury and property damage includedwi thi n the completed operati onshazard and all bodi ly injury andproperty damage included within theproductsha:ard;

4) if Contractual liability Insuranceis afforded, all property damage '1'01"whi ch 1 i abi 1 i ty· is assumed under anycontract to whi ch the Contractualliability Insurance applies•.

Such aggregate limit shall apply sepa­rately:

i) to the property damagedescribed in subparagraphs (1)and (2) and separately withrespect to each project awayfrom premi ses owned by or rentedto the named insured;

i i) to the sum of the damages forall bcdily injury and propertydamage described in subpara­graph (3): and

iii) to the property damsgedescribed in subparagraph (4)and separately with respect toeach project away from premisesowned by or rented to the namedinsured.

c)

The li.it of liabi. .:y stated in theSchedule of thi s endorsement as appl i ca­ble to "each occurrence" is the totallimit of the company's liability ~or alldaeages including damages for care andloss of serv ices because of bodi ly inju­ry and property damage sustained by oneor 1II0re persons or organi zations as aresult 0'1' anyone occurrence, providedthat with respect to any occurrence Torwhich notice of this policy is given inlieu 0'1' security or when this policy iscertified as proof of financial respon­sibil itv under the provi si ons 0'1' theMotor Vehicle Financial Responsibilitylaw of any state or province such li.it0'1' liability shall be applied to providethe separate 1 imi ts requi red by such lawTor Bodily Injury liability and PropertyDe_age L iabi Ii ty to the extent of thecoverage required by such law. but theseparate application of such limit shallnot incraasethe total limit ·0'1' 'the com­pany's liability.

Subject: to the above provi sian respect­ing "each occurrence", the total liabil­ity of the . company for all damagesbecause of all bodily injury and ps:-oper­ty damage whi ch occurs duri ng each annu­al period while this policy is in forcecommencing Trom its effective date andwhi ch is descr i bed in any of the num­bered subparagraphs below shall notexceed the limit of liability stated inthe Schedule of thi s endorsement as "ag­gregate":

1) all property damage arising out ofprelllises or operations rated on aremuneration basis or Contractor'sequipment rated on a receipts basis,including property damage for which1 iabil i ty is assumed under any inci­dental contract relati ng to suchpremises or operations, but exclud­i ng property damage included in sub­paragraph (2) below;

all property damage arising out ofand occurr i ngi n the course of oper­ations performed '1'01" the n~~d

insured by independent contractorsand general supervi si on thereof bythe named insured, including anysuch property damage for.. whi ch

a)

... ':.I:.... ., - jPage 2 of 2

::

GU 206(Ed. 6-78)

\.

(""ME 01'" INSUAANCE COMPANY)

.. at 12:01 A.M. standard time, forms a part of.'····

of the

By

Policy No.' GL 99 48 43

- . .(The Attaching Clause need be completed only when this endorsement is issued subs~uent to preparation of the policy.)

Authorized Representative

ELIMINATION OF PREMISES ALIENATED EXCLUSION

GU 206(Ed. 6-78l

... 1,.·..It is hereby agreed that exclusion (L) o~ the Coaprehensive General LiabilityCoverage Part H2l0l3F is deleted •

. jI

1 It is further agreed that the limit of liability for Coverage provided by this

I::c",cs,c;'dorsement 1. $].,000,000 per occurrence.

j .,"·li.:!·~,';:;"":,·~~2~::··::" ~.>;".",,'."'-,

;;"., _..... ,..;; ~-_..... ,~ '-,~ .... ',)."',. :, ....~" .. " .~,' .. "'~" . ", ~"- ,',',-" "

~":';,:·i~5,:':~:L~·:"·:",~~".-. '~'."'-'-:'.~:+":'7"

. i .I

I

......~ -

:..•.:.:.: .. .,.. '.

~ .' - • .., y" .:

,..." ...,':"" ..',.,,, .. --,..,-

.fhis:~ndo;,sement. effective on

GL 99 48 43

Issued to

By

of the

.;.:.'

GU 206(Ed. 6-78)

.at 12:01 A.M. standard time, forms a p~rt of

(NAM.. 0" INSUItANc:.E COMPANY)

Authorized Representative

It 1s understood and agreed Exclusion Ql ~ Q2 and Q3 or the ComprehensiveGeneral Liability Coverage Part is eliminated.

GU 206 ./(Ed. 6-78) ~.

:: ....•..' .... " .• ~~ .

:. ",' "

. :."-): .

. ...:., ...-...

" ....

.•..> -' . ,.:'...... .. ' ... >.;

..:.

GU 206 /(Ed. 6-78) V

GU 206(Ed. 6-78)"::::

Authorized Representative

(NAME OF INSURANCE COM..ANY)

at 12:01 A.M. standard time, forms a part ... - .. " ... ".

:~

ENDORSEMENT

of the

BROAD KNOWLEDGE OF 'ACCIDENT OR OCCURRENCE

It is agreed that knowledge of' an aec1.dent by an agent, servant or employeeof' the insured shall not in itself' 'constitute knowledge by the insured,unless the insured t s executive of'f'icer, insurance manager. or d~ignee

shall have race1ved such notice from his agent, servant or employee.

(The_Attac:~ingClause need be completed only whe~ this endorsement is issued subsequent to prepar.ation of the policy.)

By

Policy NO.,GL 99. 48 43

Issued to:':':"~::::'"

•...........•....

_.~: .' .. (' -:-;

. .

" " .,

.~ ~.- -..

'!he Company hereby agrees to wa:1ver of' subrogation as required of'the Named Insured and agreed to in writing prior to the loss.

Policy. No. GL 99 48 43

Issued to

--."""--"'..--"""'--

.'~.

GU206(Ed. 6-78)

at 12:01 A.M. standard time, forms a part of .

(NAME OF INSURANCE COMPANY)

Authorized Representative

GU 206 .(Ed. 6-78V'

~ '.- - ,- .. -. -':-. :~ ::~.

.- '.

·.... , :- .,. .

.::~'.::"'?:~:.. ::..

GU 206(Ed. 6-78)

GU 206(Ed. 6-78)

. Authorized Representative

at 12:01 A.M:-standard time, forms a part of

···r " .. ~ '="~"

....of the

ENDORSEMENT_-1-87

~, _., . "".-

GL 99 48 -3

.'...'

( r

This endorsement modifies such ins..anu IS is afforded by ttIe JlfOYisiclns of Dlt policy relninE to the followinc;COMPREHENSIVE I:ENERAL LIABILITY IlISuum

MANUfACTURERS' IND CONTRAtTORS' lIlBlUTJ llGUUNCE

DWNEIS". LlNDLDlDS" AND TEIIlHTS" UA.lIUTJ lIISUWlC£

-..I 9i ,.-.

• forms a part or polity No, GL 99 48 113

&1 71 Ifliid 01"1­,m'

EXCLUSIONObIprxtiet ad PrffIuilaa' SanieuJ

f,raCJ

..4-1-87

(12:01 A..... m.48tll ,_)

lInlll"

issued to

This endorsement. eflectiwe

Description .f Operatioas:

All Operations

• ••••••••.. .:-~ ~ ., . ' p~..--~~. ,,--: -.._--

~ ~~~;~~~_:. - :

It is agreed that with respect to any operation described above or designated in tfle policy IS subj!ct to this endorsement, the insurance does not applyto bedilJ iajtlty or PRPtrtJ lUlUle due to the rendering of or failure to ~e~der.!R)' prof~s~~ serra.. _ . _

oA~i~~'_.--

•liGbi1i~

" (-", ("(Tho i (,.,ch;n~ Cl,.,u-." r.~~ri toe- cor-r-lotc-·. only wh"n t.his

ondor~pmgnt i~ i5~U~d ~dh~~qu~nt to pro~~rGt.ion of thp policy.)

GL 04 04 lEa. 05 III

Irpad Fpr! CorPrlhrn"Y' General liability Endorsement

L611(Ed.S-U

COnPREHENSIVE GENERAL LIABILITY INSURANCE

This .ndor5~mont .odi~i~s such insurance.as is affordod bythe provisions of the policy relating to the following:

.forms a part of policy No. GL 99 48 434-1-87

'A.I'I;;- stendard±imo)

endorsctment. effecthe

Authorized Representative

SCHEDULE

Personal Injury and Advertising Injury Liability

Aggregate limit shall be the per occurrence bodily injury liability limitunless otherwise indicated herein.'. limit of Liability Aggregatct

LiMit of Liability - Premises "edical Pay~~nts Coverage:

$1.000 each person unless otherwise indicated herein $ oach Person.

Li.it of Liability ~ Fire legal Liability Coverage:

$50.000 per occurrence unless otherwise indicated herein: $ 100,000 pi2r occurrence.

Pre:niuCl Basis--

__....................x OF THE TOTAL COMPREHE~SIVE GEHEKAL LIABILITY BODILY IN­AND PROPERTY DAMAGE PREMIUM AS OTHER~ISE DETER-

Incl. inComposite Rate

Advance PremiuJ:l

$

I. CONTRACTUAL LIABILITY COVERAGE (1) to bodily injury or property da~aglfor whi ch tha inSUred has aS5Um121liability under any incidental con­tract. if such injury or damaga OCCUrr121prior to tha axecution of the incfdent~;contract:

(2) if the insured i 5 an archi tactengineer or surveyor. to bodily injurlor property dalr.<:lge ari sing out of thlrenderi ng of or thQ fai lura to rendelprofessi onal servi ces by such insured,including ~

Papa 1 o~ I

(8) The insurance afforded with respect toliability assumed under an incidental co~­tract i 5 subject to the followi ng addi ti o. :.:exclusions:

(A) The definition of incidental contract isextandad to include any oral or written con­tract or agreement relating to the conductof the naaed insured's business •

1~111!"--'

••

.-

(a) the p~eparat ~ or approval ofmaps. d~awings. opinions. repo~ts.

surveys. change orders. desig~s orspecifications. and .

(b) supe~viso~y. inspection orengineering services;

(3) if the indemnitee of the insured isan a~chitect. engineer or surveyo~. tothe liability of the inde:nnitee. hisagents or employees. ari si n9 out of

(a) the prepa~ation or approval ofor the fai lu~e to prepare or appro-;"Gmaps. drawings. opinions. reports.su~veys. change orde~s. designs orspecifications. or

(b) the giving of or the failure togive directions or· instructions b"\::'the indemnitee. his agents ;;1'"employees. provided such giving 'orfailure to give is the primary caU~Q

of the bodi ly injury or prcPE,'~Ydamage;

(4) to any obligation for which theinsured may be held liable in an .actio~on a contract by a third party benefici­ary fo~ bcdi ly i njury o~ property O~:::::3::!ari si ng out of a project for a publ i c:autho~ity; but this exclusicn does notapply to an acti on by the publ i c author­ity or any other pe~son or organizationengaged in the project;

(s) to bodily injury or property da~~gaarising out of construction or demoli­tion operations. within 50 feet of anyrai lroad p~operty. and affecti ng any~ailroad b~idge or trestle. tracks. rOadbeds. tunnel. underpass or crossing; butthis exclusion does not apply to side­track ag~eements.

(C)' The following exclusions applicable toCoverages A (Bodily Injury) and B (PropertyDamage) do not apply to thi 5 ContractualLiability Coverage: (b). (c) (2). (d) and(eL

tnJury. I an if any of the allegations 0

the sui t are groundless~ false 01"' fraudulent. and may make such investigation anlsett1em~nt of any claim or suit as it dee~expe:di ent, but the co::.pan., shall not bobli£ated to pay any claim or jud~ment or t,defend any sui t after the applicable limi'of the co:::pany's liability has beeexhausted by pa~lment of jud~ents or settlei'l'lents.

(B)Jj.i s· insurance does not apply: .

.".' rC'J,,i to li abi Ii ty assur:ed by the insure:;~ uft:ier any contract or agreement;

(2) to parsonc;l inju:--y or aevertisin·injury arising out of tha wilful vio·1ati on of a penal statute or orcH nanccom::'; tted by or wi th the knowledge orconsent of the insured;

(3) to personCll injury or aovEl"'tisininjury arising out of a publication 0utterance of ali bel or slander, orpublication or utterance in violation O'an individual's right of privacy. if th,first inju~ious publication or utter­ance of the same or si~ilar material b­or on behalf of the n~k.ad insured wa~made prior t.o the effective date of thi ~

insurance;

(4) to persena 1 injury 0 I'" advert i sinsinjury arising out of libel or slandeo~ the publication or utterance of defamatory or disparaging =aterial concern­ing any pe~son o~ orsanization or goodsproducts o~ services. or in violation O'an individual's right of privacy. mad(by or at the direction of the insuretwith knowledge of the falsity thereof;

(5) to personClI injury or ctdvertisin:injury art s; ng out of the conduct of an)partne~ship or joint venture of lolhidthe insured is a partner or member an.which is not designated in the declara­t ions of the poll cy as a naced i.nsured;

(6) to ~dvertising injury arising out ot

(D) The followi ng addi ti onal condi ti onapplies: .

±;:-:.~r:,i"-k~.;~-: . . ' .. -~'.. '.. ':;'-:-~', .~'.~ .. -;<~::-/:~-:::~:".. --Arbitration -:-~;:<~":~~:.":' - .. _'-~:-

The company shall be entitled to exe~­

cise all of the insured's rights in thecho ice of arbi trators and in the conc!uctof any arbi trati on proceeding.

II.FERSONAl INJURY AND ADVERTISING INJURYLIABILITY COVERAGE

(a) failure of perfor=ance of con­tract. but thi s exclusi on does no'apply to the unauthori~ed appropri·at; on of ideas based upon allegecbreach of implied contract, or

(b) infringement of trademark, ser­vice mark or trade name, other thaIti tIes or slogans. by use thereof oror in connection with goods. pro~

ducts or services sold. offered foisale o~ advert; sed. or

(A) The company will pay on behalf of ·the'· - '"insured all sums which the insured shall'become legally obligated to pay as damagesbecause of personal injury or adverti~ing~injury to which this iniurance applies. sus­tained by any person or organization andari si ng out of the' conduct of the n"Ill:;::!insured's business. within the policy terri­tory. and the company shall have the ri ghtand duty to defend any sui t agai nst theinsured seeking damages on account of such

(c) incor~ect description or mis~

take in advertised price of goods;products o~ servi ces sold. offere~for sale or adverti sed; .

(7) with respect to advertising injury

(a) to any insured in the busines:of adverti si ng. broadcasti ng. pub­lishing or telecasting. or

=r=--

actual ca.lice.

ee) Li=its of li~~ility

Re~ardless o~ ~he number of (1) insu~edshereunder. (2) persons or organizationswho sustain injury or damage, or (3)claims made cr suits brought on accountof p~rscnal injury or adve~tising inju­ry, the total liJ:lit of the company'sIiabil i "ty under thi s coverage for alldamages shall not exceed the limit ofliability s~ated in this endorsement as"aggregate....

CD) Additicnal Definitions

"Advertisi03 Injury" means injury'aris­ing out of an offense committed duringthe policy period occurring in thecourse of the na:ed insu~edts advertis­i ng acti vi ties, iT such injury ari sesout of libel, slander. defamation. vio­lation of ri~t of privacy. piracy.unfair competi~ion, or infringement ofcopyri ght. title or- slogan.

(a) ~ny ~utc~cbile or aircraft ownecor operated by or rentEd or loanecto any insured, or

(b) any other autcr.\::lbi le or ai rcraf-:c~.r,t.rated by any person in the cour:Hoffhis 2mployment by any insured;. \

but thi s exclusi on does not apply tcthe parking of an autc~bjle on th~insured prcmi ses, i f s~ch 2utC:::O·eile is not owned by or rented orloaned to any insur2c;

(2) arising out of.

(a) the ownership, =aintenance.operati on. use. load; og or unload·ing of any i':':cbi Ie equip::2nt whi 1,bei ng used in any prearranged ororganized racing. s~eed or de~oli·

tion contest or in any stuntin~

activity or in practice or prepara·tion for any such contest or activoity. or

The company will pay ~o or for each personwho sustains bodily injury caused by acci­cent all reasonable cedlcal expense incurredwithin one year from the date of the acci-

.cent on account of such bodily injury, pro­vided such bodily injury arises out of (a) acondition in the insured premises or (b)operations with respect to which the na~d

insured is afforded coverage- for bodi lyinjury 1 i abi 1 i ty under -the pol icy.

This insurance does not apply:

CA) to bodily injury

(i) owned or operated by or rente~

or loaned to any insured, or

Cii) operated by any person in th~

course of his emplcyment by an)insured;

(b) the operati on or use of an)snowmobile or trailer ~esigned foruse therewi th;

(a) ma'i ntenance and repa i r of thinsured premises, or

(b) structural al terati ons at sudpre::li ses whi ch do not involve chang·

(b) any other watercraft operated blany person in the course of hi Ie:,ployment by any insure~;

(3) arising out of the ownership. main­tenance. operation, use. loading 01

unloadi ng of

(a) any watercraft owned or operate(by or rented or loaned to an~

insured. or

but thi s exclusi on does not apply tlwatercraft whi Ie ashore on th!insured pre~ises;

(4) arising out of and in the course 01the transportation of l::lbile ecr.Jipeenlby an autoI:iOb i Ie owned or oparated by 0'rented or loaned to the na::ed insured;

CB) to bodily injury

(1) included within the cc~leted operations hazard or the products hClzard;

(2) arising out of operations performelfo r the na:::tld insured by i ndependen~contractors other than

2. wrongful en'try or evi cti on or o'tharinvasion of the right of private occu­pancy;

(b) in -violatien of anindividuel'sright 01' privacy;

3. a publication or utterance

(a) of a libel or slander or otherdefamatory or disparaging material.or

"Personal Injury" means injury ad 51 ogout of one or- Illore of the follo:..lin~

offenses co= i i:ted du ... i ng the <'01 i cyperiod:

1. false arrest: detention, imprison­ment. or- mal iei ous prosecuti on;

except p~blicati ons or utterancesin the course of or related toadvertising. broadcasting, publish-ing or telecasi:ing activities con­ducted by or on behalf of the n~m2dinsured shall not be deemed personalinjury.

:III. ?REfUSES MEDICAL PAYMENTS COVERAGE

•

~.~_..::....--.:-:'-. .:: ....---..

Page 3 ofj

When Dlore than one ~dical pay::ents coverag,afforded by the policy applies to the lossthe company shall not be liable for mOrlthan the amount of the highest appli cablllimit of liability.

The limit of liability for Premises MedicaPayments Coverage is $1.000 each per so:unless otherwi se stated in the schedule 0

this endorse:::ent. The limit of liabUit,applicable to fteach person w is the limit 0the company's liability for all ~edica

expense for f:cd ily injury to anyone persolas the result of anyone accident: but subject to the above provision respecting ft eac:person". the total liability of the companunder Premises Medical Payments Ccvera~e fo;all C2cical expense for bodily injury to t~or more persons as the resul t of any onlaccident shall not exceed the limit of bodi,ly injury I iabi 1 i ty stated in the pol i cy a~applicable to "each occurrence".

(0) to Jthe na~Q insur-ec1. any employee thereof 01any person or crgani zati on under- contract t:the na~c1 insured to provide such services.

LIMITS'OF LIASILITY

-.: ADDITIONA.L DEFINITIONS

(c) to a person under the influenceof alcohol. or

(3) resulting from the selling. servingor giving of any alcoholic beverage

(a) in violation of any statute.ordinance or regulation.

Cd) which causes or contributes tothe intoxication of any person. ifthe na~d insured is a person ororgani zati on engaged in the bus;­ness of manufacturing. distribut­ing. selling or serving alcoholicbeverages. or if not so engaged. is

_ an owner or lessor of premises usedfor such purposes. but only part (a)of this exclusion (B) (3) applieswhen the naced insured is such anowner or lessor.

i ng the si::e of ( movi ngor other structures:

(4) due to war. whether or not declared.civil war. insurrection. rebellion orrevolution. or to any act or c~nditionincident to any of' the foregoing:

0".0"~:. '

.'" -.

- ~ ~

--::~~ _.

° •

(C) to bodily injury

(l) to the ncaced insured. any partnerthereof. any tenant or other person reg­ularly residing on the insured premisesor any employee of any of the foregoingif the bodily injury arises out of andin the course of his employment there­wi th:

(2) to any other tenant if the bodil~injury occurs on that part of theinsured"premises rented from the na~j

insured or to any employee of such c:tenant if the bodily injury occurs ctnthe tenant's part of the insured Pi~~­ises and arises out of and in the co~r=:'"of his employment for the tenant:

(3) to any person while engagec in ~~in­

tenance and repair of the insured ~~c~­ises or al terat; on. demoliti on or n21o:constructi on at such premi ses. "0"';". '":~-~':""_---- .;;'.' ~ ~.,:;;''-~'.'''''' ..". ~":' , .... ~_., ~.

(4) to any person °if any benefits forsuch bodily injury are payable orrequired to be provided under any ~o~k­

men's compensation. unemployment C~~­

pensat;on or disability benefits law. Of·

under any similar law;

(5) to any person practicing. instruct­ing or participating in any physicaltraining. sport. athletic activity 0:­contest whether on a Tormal or informalbasis:

When used herei n:

"insured premises" means all premises owneby or rented to the nClll:ed insured wi trespect to which the n~med insur-ed iafforded coveragefo ... bodily injury liability under this policy. and includes the wa~immediately adjoining on land:

"~diccal expense" means expenses for nece~sary medical. surgical. x-ray and dentCiservices. including prosthetic devices. atnecessary ambulance. hospital. professionCinursi ng and Tuneral servi ces.

AOOITIOHAL CO:-mITICN

Medical Reports. Proof and Payment of Claim

As soon as practi cable the injured person csomeone on his behalf shall give to the co~

pany written proof of claim. under oath i. requi red. and shall. after each request fr(ithe company. execute authorization to enablthe company to obtain medical reports ar,copies of records. The injured person shalsubmit to physical examination by physicia~

sl2lected by the company when and as often Cithe company may reasonably require. The co~

pany may pay the injured person or any person or organization rendering the servic~

and the payment shall reduce the amount pa)able hereunder for such injury. Payment hereunder shall not constitute an admission ~liability of any person or. except her~under. of the company.-

-. -."(6) if the ncamed insured is a club. toany member of the naced insured;

(7) if the nca::2ed insured is a hotel.motel. or tourist court. to any guest ofthe n~med insured;

IV. HOST LI((UOR LAU LIABILITY COVERAGE

Excluslon (h) does not apply 1-1i th respect 1liability of the insured or his indemnit~arising out of the giving Or serving.alcoholic beverages at functions incident.to the nc;~d insured's business. providtthe nc;czd insured is not engaged in th

!Ifl.;~£'~$'~r~r ..-. ~~~~¥~ -, ~,"~--:~¥a~~=-1~~- ~~'ffi5.j£L~H~1L=¥~

bus\!"~~= ..-::':_i~"'4"'::,:·~-=~r( •• cii5t~ibut:ing.. • ((i) upon which operations ar'sQL.ing w~~lri:i""C:.T a::~..Qlic beyeras:es. being performed by or on behal.

of th2 insured at t~ tbe D:V. FIRE LEGAL LIABILITY COVERAGE - REAL P~O- the property dd!:~ge ari si n!; ou

PERTY .of such operati ons. or

ca) the furnishing or dispensing OT drugs 01

IaQdical. dental or. surgical supplies 01

appliances.

Thi 5 coverage does not apply to:

(1) expenses incurred by the insured fo!Tirst-aid to others at the time of ~

acci den't and the "Supplementary Pay­ments" prOV1S10n and the "Insured'JDuti es in the Event of Occurrenc~, Clai~

or Suit" Condition are amended accordingly;

(2) any insured engaged in the busine~or occupati on of provi di ng any of th:services descrt bed under VII (A) and (B:above;

(A) medical. surgical, dental. x-ray 01

nursi ng servi ce or treatment or the furn i sn­ing of food ~r beverages in connection ther,",wi th; or

(3) injury caused by any indemnitee i·such i ndemn i tee is engaged in the busi­ness or occupation OT providing any 01

Cii) out of which any proP2rt~

cG'!::IaS2 ari ses. or

:J (iin the restoration. repai:r or replacel:lent of whi eh has bee"l made or is necessary by reaso'. of faulty workmanship thereor

by or on behalf of the insured; I

(3) with respect to the cc~leted opel"at i ens hazard and wi th respect to anoclassification stated in the policy orin ~he company's.manual as ";ncludin;completed operations", to property dacese to work performed by the nc~£!~

in~ured arising out of such work or an~portion thereof, or out of such materi­als, parts or e~u; pment furni shed ifconnecti on 'therewi th. .,

The definition of bodily injury is amendel'to include Incidental Medical MalpracticlInjury.

Incidental Medical Malpractice Injury mean,injury art sing out of the rendering OT 01Tailure to render. during the policy period,the Tollowing servicQs:

VII. INCIDENTAL MEDICAL MALPilACTICE LIABIL­ITY COvERAGE

CB.) The Broad Form Property Damage liabil­ity Coverage shall be excess lnsurcnce overany valid and collectible property insuranc!(including any deductible portion thereof;~vai lable to 'the insured. such as, but nciiimited to, Fire, Extended Coverage, Buil~er's Risk Coverage or Installation Risk Cov'erage, and 'the Other Insurance Condition o~

'the policy is amended accordingly.

(2) Qxcept with respect·. to liabilit-)funder a wri tten 51 de'track agreement orthe use OT elevators

(b) to tools or equipment -w.":.:lebe i ng used by the insured i n ~cr­forming his operations.

(c) to property in thQ cust~.,: :)fthe insured wh i ch • is 'to ~<installed. erected or used in con­struction by the insured.

Cd) to that particular par~ of ~~;

property. not on premises cwne~ r~

or rented to the insured.

(a) to property whi Ie on pre::i s~sowned by or rented 'to the inst.:~~Tor the purpose OT having operati c.:;~

performed on such property by O~ a~

behalT of the insured. _

el) to property owned or occupied by orrented to the insured. or. exc~pt withresPQct to the use of elevator's. to pro­perty held by the insured for salQ orentrusted to the insured for storage orsafekeeping;

(B> The limit of property. dacage liabilityas respects this Fire legal Liabili~ Cover­age - Real Property is $50,000 eacn coour­rence unless otherwise stated in theSch~dule of 'thl s endorsement... ....

(C) The Fire Legal LiabilityCoverage-RealProperty shall be excess insurance over anyval i d and collect; ble property insurance(including any deductible portion thereof).available to the insured. such as. but notlimited to, Fire, Extended Coverage. Build­er's Ri sk Coverage or Installatl on Ri sk COy­erage. and the Other Insurance Condi~ion OTthe policy is amended accordingly.

CA.> Exclusions (k) and (0) are replaced bythe followi ng:

The insurance for prcperty damage liabilityappl i esp subject to the following additionalprovi sions:

Wi th respec't to property dacage to strcc­tures or portions thereof rented to orleased to the named insured. including fix­tures permanently attached thereto. iT 5~chproperty d~c"ge ari ses out OT Ti re

eA) All of the exclusions of 'the policy.other than the Nuclear Energy LiabilityExclusi on (Broad Form). are deleted anclreplaced by the following:

Thi 5 insurance does not apply toliability assumed by the insuredunder any ccn'trac't or agreenent.

VI. BROAD FOR" PROPERTY DAMAGE LIABILITY co­VERAGE (InclUding Cocpleted Operations)

:-:--......-~.,:.... "-

...

(3) to prcperty dam~ge to propertowned. occupied or used by, renteto, in the care. custody or centroof or over whi ch physi cal control ibeins exercised for any purpose canother employee of the nc~

insured. or by the n<lI::=.dinsured orif the nC2~d insure:::f is a partnership or joint venture. by any partner or member thereof or by thspouse of any of.the foregoing.

EXTENDED BODILY INJURY COVERAGE

XII. AUTO~ATIC COVERAGE - NEULY ACQUIRED OR·G,\NIZATIOHS (90 DAYS)

The definition of occurrence includes anintentional act by or at the direction 0the insured which results in bcdily injuryif such injury arises solely from the use 0reasonable force fo,. the purpose of protecti ng persons or property•

The word insured shall include as na-~insured any organization which is acquireor formed by the named insured and ovewhich the na~d insured maintains ownershior majority interest, other than a joinventure. provi dad thi s insurance does noapply to be:!i ly injury, prop~rty dall:l;sapersonal injur-y or advertising injury witrespect to which such new organization undethis policy is also an insured under another similar liability or indemnity polieor would be an insured under any such policbut for exhaustion of its limits of !labili ty. The insurance afforded hereby shaltermi nate 90 days from the date any sueorsanization is acquired or formed by t~na:::ed insured.

't'­XI.

(B) . Jloyee - Any employee (other theexecutive officers) of the r.ac~d insurewhi Ie acti ng wi thi n the scope of hidut i es as such" but -the i nsuranc:afforced to such e~ployee does no

ply:

~ ~ID-'. 1 ). to bod i ly ; njury 0,. persone.lnJury to another e:nployee of th

." ',,' nal:::::!d insured ari si ng out of or iJ!:~ ",~}~ha course of hi s e~ploy:nent;V~~~;~~) ~o.personal injury or' advertis..r . ~!~g lnJur-y to the na::ed lnsur:ed or

~ if the n"~d insured is a partnerr~~ ship or joint venture. any partne~ or member thereof, or the spouse 0

any of the foresoi ng;

, ,

4. Anywhere in the world wi th respect tobodily injury. propertv dacage. per­sonal injury or ~dvertislng injurv aris­i ng out of the acti viti es of any lnsuredpermanently domiciled in the UnitedStates of Ameri ca though temporari Iyoutsi de the Uni ted States of Ameri ;:a,its terri tori es and possessi ons or Cana­da, provided the.original suit for carn­ages because of any such injury ordamage is brought within the Unitedstates of America, its territories orpossessions or Canada.

(b) to Premises Medical Payments Cover­age.

VIII. NON-mJNED WATERCRAFT LIABILITY COVEf!­AGE (under 2.6 feet in length)

•(A) Spouse - Partnership - If the nacedinsured is a partnership, the spouse ofa partner but only with respect to theconduct of the bus; ness of the na~d

, insured;

Exclusion (e) does not apply to any water­craft under 26 feet in length provided s~ch

watercraft is nei ther owned by the nCi=::::oinsured nor being used to carry persons orproperty for a charge.

Where the insured is, irrespective of thiscoverage, covered or protected against anyloss or claim which would otherwisQ havebeen paid by the company under thi s endorse'"ment, there shall be no contribution or par­ticipation by this company on the basis ofexcess, contributing, deficiency, concur­rent, or double insurance or otherwi se.

The definition of policy territory ;samended to include the following:

IX. LIMITED WORLDWIDE LIABILITY COVERAGE

Such insurance as is afforded by paragraph4. above shall not apply:

(a) to bodily injury or property damageincluded within the completed oper­ations hazard or the products hazard;

•X. ADDITIONAL PERSONS INSURED

As respects bodily injury, property ~a~aseand personal injury and advertising InJury

,L,", .~-",-'_,;;",-coverages* under the, prov; si on <"Personsco: -':._',-,;> Insured". the following are-' added - as" ". ,insureds: '

".

oCity Insurance Company

The Home Insurance Companyof Indiana

oo

(: (

-=N...:...=o.:..:n:.....:-P:......:.....:re:...:m..:...:.::...iu:.......:m_E_n...:..d:..:O...:..rs..::..e..::..m_e_n_t --:-_--Llume~5-Z:....::::Pr1!pared:::=6-8..:...=:.!.1 __..L.1En_do_rsemenl__N_··o._....1Issued by

o The Home Insurance Company

liJ The Home Indemnity Company• Policy Number

GL 99 48 4Producer

Certificate Number Named Insured

Pr~ NIo. - OPe

Policy Period: Inception (Monlh-Oay-Year) Expiration (Month-Day-Year) EffecliYe Dale and Tme of Endorsement

It is agreed that this policy is hereby amended as indicated. All other terms and condOOns of this policy remain unchanged.

Under· Broad Form Comprehensive General UabU1.ty Endorsement L6111 the Collowingapply:

Item II - Personal Injury and Advertising Injury Liability Coverage - (B) (1) 18hereby e]1~1nated.

Item X - Additional Perscns Insured - (B) (l);:amended to 1.nclude the words,"except as respects ot'f'icers,. Directors, Department Heads and LocationManagers only. It

•

•Signature of Aulhorized Representative

H22300 FH (5) Rev. 11/81 The Home Insurance CompaniesProducer Copy V

!

Non-Premium Endorsement

•Issued by

o The Home Insurance Company

[X) The Home Indemnity Company

'0o

City Insurance Company

The Home Insurance Companyof Indiana

o

Endorsement No.

Policy Number

GL 99 48 43CertiIica1e Number Named Insured

Producer Producer No. - OPC

I dInception (Month-Oay-Year) Expiration (Month-Day-Year) Effective Date and Tme of Endorsement

Pol cy Perio : 4-1-8

It is agreed that this policy is hereby amended as indicated, All other terms and conditions of this policy remain unchanged.

It is hereby agreed that such coverage as 18 provided-under 'nle stop Gap Endorsement(Employers' Liability Coverage) Form 1125585(1") does not apply to any exposure of' anynature in connection with mining operations at the f'ollowing Hamed locations orsubsequent acquired locations" by-- or f'or any of' the Hamed Insured as described orincluded under the Broad Form Named Insured Endorsement.

HAMED LOCATIONS,.'t

HAMED LOCATIONS

/Helen Mining Co.V Homer City, PA

ICanawha and Hocld.ng Coal and Coke CompanyVTr1adelph1a, W. VA ,

/'Donaldson Mine Co.Valley Camp No. l2A

./=:;~:u::;:.Donaldson Mine Co.

V Valley camp No. 15A

. Donaldson Mine Co~"­

\./'" Prep Plant

, .' )3elina Creek No. 2V Clear Creek. Utah

Shrewsbury Coal Co.-/Shrewsbury, W. VA

Shrewsbury Coal Co.J Witcher Creek V. VA

/Shrewsbury Coal Co.V Valley Camp 50. 6-1

./' Shrewsbury Coal Co.

. ,. ,Valley Camp Ho. 6B

/' -

Shrewsbury Coal Co •.' , Valley camp No. 45

Valley Camp of' UtahV8cofield Route,, __.~-, "'::'~

Helper, Utah ," -

~l1na Creek No. 1.Clear Creek, Utah.

.'

. ..Elm Grove Coal Co.V Triadelphia, W. VA'

•Signature of Authorized Representative

H22300 FH (S) Rev, 11/81 The Home Insurance Companies /

Producer Copy ,V

(

Non-Premium Endorsement{:.-Ie Prepared

5-26-81Endonlernent No.

Issued by

o The Home Insurance Company

[;} The Home Indemnity Company

·0o

City Insurance Company

The Home Insurance Companyof Intiana

o

Policy NOOlbEr

GL 99 48 4Producer

certificate Number

Producer No. - ope

Policy Period:Inception (Month-Oay-Year) Expr.ttion (Month-Day-Year) Effective Date and Time of Endorsement

4-1-8It is agreed that this policy is hereby amended as indicated. All other terms and conditions of this policy remain unchanged.

BOTICE OF CANCELLlT:IOH.. ',,'" ,-'

It is aueed that no limitation or cancellation of' this policy shall becomeef'f'ectiTe unt1..l the number of' days t written notice specified in Item #2 of'the sehedu1e shall have been mailed. to the person or organization designatedin Item #l. of' the Schedule at the address there designated.

. - x-

SChedule

•1. !lAME:

ADDRESS:

2. HOHBER OFDAYS liOtICE:

ot'f'ice of' Secretary or Statestate of' D.l.1nols

5401 H. Elston Ave.Chicago, IL 60630

10 Days

5qlan:se of Authorized Representative

H22300 FH (~ Reor_ 11181 The Home Insurance Companies

Producer Copy

( (

• I • DEFDlinONS:

1. The definition of "Incidental Contract" 15 extended to include anywritten contract or agreement relating to the conduct of the NamedInsured's business and any such oral contract or agreement.

Provision 1. (A) of the Broad f'Ol'}ll Comprehensive General Liabill ty~orsement is deleted.

•

2.

3.

4.

Except with respect to Medical Payments Coverage, the definition of·Policy Territory" 1s replaced by the following:

POLICY TERRITORY: This insurance applies to Bodily Injuryincidental medical malpractice injury, property damage r

acfvertising injury or personal injury which takes placeany"7here, pruvided that if claim :iz made or sui t is broughtelsewhere than in the United States of America, its territoriesor possess ions, or Canada, the Company . shall have the right,but not the duty, to investigate and settle such claims andderend such suits. In any case which the company electsnot to investigate, settle or defend, the insured, under thesupervision of the Company, shall make or cause to be madesuch investigation and defenses as are reasonablry necessaryand subject or prior authorization by the Company, will effectto the extent possible such settlement or settlements as theCocnpany and the Insured deem prudent. The Company shallre~mburse the Insured for the reasonable cost of suchinvestigation and defense and, within the applicable limitof liability of the policy, for the amounts of such authorizedsettlements. ..

?rovis,ion IX Limited Worldwide Liability Coverage of the Broadform Corr.prehensi ve General Liability Endorsement is deleted.

Occu~rence u~cer XI - Extended Bodily Inj~ry Coverage is amendedto include Property Damage.

II. EXCLUSIOXS:.

1. the following Exclusions are added:

This insurance does not apply to:

~Aj Any i~jury or damage arising out of the ownerShip,maintenance or use of premises located outside theUnited States of America, its territories or possessionsor Canada, or arising out of

(1) Operations, including operationsinvolving automobiles, incidental tothe ownership, maintenance or useof such premises or

Page 101"2

'.

•••

(

III. PERSONS INSURED

Joint Ventures. The "Persons Insured" provi:sions are amended toinclude as an Ineured:

(1) The Named Insured with respect to the Named Insured's Interestin any joint venture or partnership,' and

(2) Any other member of a joint venture or partnership, but only tosuch an extent (subject to all other provisions of this policy)as the Named Insurerl has agreed prior to loss to provideinsurance fvr such interest.

Such insurance as is provided by this provision shall be excessover any oth~r va] id and collectible insurance available to the~.Insured•

IV. CONDITIONS'::r-

1. Insureds duties in the event of occurrence, claim or suit. Therollowing provision is added:

Notice shall be deemed"given as soon as practicable, as respects'the Named Insured, if given within thirty days after the InsuranceManager of the Named Insured becomes aware of such injury or damage •

2. Cancellation. Condition II is amended by replacing the secondsentence thereof with the following:

This policy may be cancelled by the Co~pany by mailing to theNamed Insured at the address shown in this policy written noticestating whe:> ...not less than 90 days therealt.er, such cancellationshall be effect:·re, except lor non-payment of premium, thecompany shall mail 10 days written notice.

•••

Other insura~=e,-Non-Owned Watercraft. _'here the insured is,irrespective of coverage unaer this insurance, covered orprotected against any loss or claim which would other wisehave been paid by the Company under this insurance, there shallbe participation by this Company on the basis of excess of 2Million of primary insurance •

Page 2 of 2

((STOP GAP ENDORSEMENT(EMPLOYERS' LIABILITY COVERAGE)COMPREHENSIVE GENERAL. L.IABIL.ITY INSURANCE· MANUFACTURERS' AND CONTR,ACTORS' L.IABIL.ITY INSURANCE·OWNERS".LANDL.ORDS' AND TENANTS' L.IABILITY INSURANCE· MUL.TI·PERIL INSURANCE· FARM AND RANCH INSURANCE

£tal../N"'MEO INSUREO

Alexander Ie Alexander, Inc. .,/

GL 59 48 li3POLICY ~CEPTION

4-1-87 ./

PRODUCER

EFFECTIVE I!)ATE ANO TIME OF ENOORSEMENT O"'TE PREPARED",

"-1-81./ 12001 ....M•• STANO... RO TIME

SCHEDULE

. Each PtnO~"'-$_ ....1....~Q~0:xO....O.llf.OOK.llf.._-./__ E8ch Occurenc•v·

.Umits lJfliahilityq S 1 t 000,000 '.

c:1....SSIFICATION OF OPER... TIONS(ON WHICH Mtt IS .....EDt

COOE. ESTIM... TEO TOTALANNUAL IIIEMUNERATION

R'" TE PER $1000" "E...,,£ItATIO..

ESTIMATEOANNUAL PREMIUM

All Operations :xcept Mining Operations -/ 99990 Included 1n site Rate

TOTAl. ESTIM...TEDANNUAL "IIIEW'UIl

$

OEPOS IT PREMIUMMINIMUM PREMIUM

ct.ration.The named insured, if subject to the following acts, declares that he has complied with the provisions of all Workmen's Comp~~tion or Indust~ial

Insurance acts. laws. statutes or cod~ of the State of • with respect to all employees of the insured subjl!Ct to the compulsory provisionsand. ifapplicable. the elective adoption provisions of such aets, laws, statutes or codllf;and . .

(c) thereby has insured payment of all required Compensation and Medical b~nefits to any such emplo~ee injured ill the course of his employment;

(b) has obligated himself to· report the number of "workmen hours" or other required basis of premium dMfoped by all such employees. to. thedepartment, commisSion or board as prescribed by said acts. laws. statutes or codes. . .

2. l,..ringAgreement. It is agreed that if any such employee sustains bodily injury in the course of or arising out of his employment. this endorsement shall coverthe legal liability of the named insured for such bodily injury, including disease or death resulting therefrom and the company shall defend any suit alleging suchbod"dy iniury. disease or death and seeking dalnages which are payable under the terms of this insurance, even if any of the .egations of the suit are groundless,false ar: fnIudulent; but the company may make such investigation and settlement of any claim or suit as it deems expedieat.

*TOTAL

........OU..T SNOWN MUST It s .. ..,.£AS •• AOOITIONAL PIIt£MIUM QIIIt.£"1""_ PRE .......OCK.

Vr.

RETURN PREMIUM

$

$

..... IVERs..ay CAT£:

MonthYr.

ANNIV["S""V DATE

Month·Yr.

p"o RATA 0,.

ADDITIONAL PREMIUM

$

(Continued on Reverse Side)

MonthYr.

END. E,. ... DATE. ..NHIYE"SA"Y OATE

MonthPREMIUM DUE

REVISED INSTAL.LMENTS

o RETURN PREMIUM

Complef'e only il Policy is wriHen on installment

OATIt ..~

S'G""TWltE OF AI6TMO"'Z.ED ItIE"'''£SENTATIVE

·0 ADDoL PREMIUM

3. Exclusions. This endoBeme« dIDl!S DDt apply to:

(a) any liability assumed IIy 1he lIIGIed insured under any contract or agreement;

(b) bodily injury, disease or dllltb suffered by a master or member of a crew of any vessel or by any employee of the named insured in the course of an

•

employment subjec:ttt1lsl! United States longshoremen's and Harbor Workers' Compensation Act or the Federal Employees Liability Act;

. bodily injury, OISl5lSe or deith suffered by any person (1) knowingly employed by the named insured in violation of any law as to age, or (2) under theage of 14 years regardi!ss Df any such laws except agricultural employees; subject to the acts designated in 1 above;

(d) bodily injury, disease or deatb suffered or caused by any employee whose remuneration has not been included in the total remuneration upon whichpremium for this endUSllllDellt is based; ..." .

(e) aircraft operation or tie performance of any duty in connection with Uaaft while in flight;

(f) any premium, .assessnemt, penalty, fine, benefits,- or other obligation imposed by any workmen's compensation, umemployment compensation ordisability benefits 1Mor under any similar law;

(g) any claim for bodily Diarf. disease or death with respect to which the named insured is deprived of any defense or defenses, or is otherwise subject topenalty because of deilult ill pnmium payment under or any other failure to comply with the provisions of any act, law, statute or code described in thedeclaration aboVe.. "

any injury sustained IIecause of any aet committed intentionally by orat the direction of the named insured and, if the named insured is a corporation orpartnership, by any UIICCtiw officer. director, stockholder 0"(- partner thereof. .

None of theexdasiams of the policy to which this indorsement is attached apply to the insurance afforded by this endorsement except". - exdusiollS and definitions applicable to the hazards of nuclear energy and other hazards related thereto.

".'-"~",""""'~'-"-"~". ........Exclusions (fl and (h)"dtau not exclude coverage for the legal liability of ~e named insured other than benefits or compensation pro~ided for under any workmen'scompensation aet,resulting trOll the deliberate"intentional act of an employee or agent10ther than an executive officer, director, stockholder or partner) toproduce bodily injury or deatl11!1 amotber named employee when such act is committed with the scope of employment.

4. Units of Li8bilityand ReIMi.ation Basis. Regardless of the number of (1) insureds under this policy, (2) persons who sustain bodily injury, or (3) claimsmade or suits brought on iICClIUlit of bodily injury, the company's liability is limited as follows:

" The limit of bodily injury lilbirity stated in the schedule as applicable to "each person" is the limit of the company's liability for all damages because of bodily.-- ."".'ury sustained by one penon as the result of anyone occurrence; but subject to the above provision respecting "each person", the total liability of the

p.ny for al! damages bause of bodily injury sustained by two or more persons as the result of anyone occurrence shall not exceed the limit of liabilityed in the schedule as appi:able to -each occurrence". ~ .', .' '.

The premium for this endorseneAlt slIaU be computed upon the remuneration earned by such employees as are reported under the case. laws, statutes or codesabove named.

; ....

i'Endor-.nent P.ioct~Thisea:fonellleat applies only to accidents or occurrences happening on and after the effective date hereof and during the policy period.

Additional Condition:,:::·: .'....

'- s.v-abiJity ofin~The insuramc:e afforded by this endorsement applies separately to each named insured against whom claim is made or suit is brought except

with respect to the limits Df the Co8nPIIJY·s liability.

"'~-6. Policy Provisions. None of 1M insuring agreements, conditions, ·provisions or other terms of the porlty to which this endorsement is attached apply to this. insurance, except the follollling aveements, definitions, and conditions: "bodily injury," "damages," "occurrence," "Supplementary Payments," and those

concfltions applying to Bodily Injury liability, with the exception of "Financial Responsibility laws." .. ~

e"

(~~endato:1 Stop GaD ~~dorse=e~t

.. (",est vir;;:inia

"

It is a~reed that:

1. Exclusion (h) of the Stop Ga~ ~~d='Ee~e~~ ~~~~

an~ i~j~ry i~ the st:te of hes~ ~:;;:~:a ~~_~~z

susta~~ed as a result of:.. - ,..., "" '!:"_10 • .; .: _~

a. assault and battery, orb. an ·act ~hich results in an indict:eot under the

cricinal code of the 'United States of ;~erica,

the state:of West VirgL~ia or any of itspol~tical'subdivisions,even if such indictoenti~ subsequenrly·dismissed.or results in a "notguilty" verdict.

2. With· respect to th~ insur~~ce afforded by ?aragraph 1 ofthis endorsement,

•

­.,

a.b.

c.

Supplementary Payments do not a?ply.L~ Item ~ of the Stop Gap ~dorse=ent, referenceto "d2.!:tages" is amended to reac "c:=.=ages a:1dclaim expenses", and the follo~ing paragraph is

. added:

All claim expenses shall first ~e su~tracted

froe the limits of liability ~ith the re=:=.inder,if any, being the amount availa~le to pay asdamages. If the lJmits of liabil+~y hereunderare exhausted prior to settleze:1t or jucg=entof any' pending claim or suit, t~e cc~panyshall have the right to ·withdra~ fro~ therurther investigation or defe~se tnereo~

by tendering con~rol o~ suc~ investig:=.tio:1or cefense to the insured.

"Claim :expenses ll me"ans q.) fees charged by an attorneyor arbitrator designated by the cc=p~~y, and (Z) allother fees, costs and exp~~ses resul~ing fro~ theinvestigation, adjust~ent, defe~se of a claio,arbitration or suit, arisL,g in conn:cticn the~e~ith

if incurred by the compa..,y. but "clai!:s ex')enses"does not include salary cr~~3es of re~~~ar employeesor officials of the company.

• H35026F - Ed. 1/83

-.liabi Ii ty

..

( ((Th.. f,. liH.h.i ng Clnu~(' need be c.oMPl E't~" Jnly when this

endOrSp.Mp.nl is is~ued subsequent to preparation of the policy.)

GllS

ISO G115

Additional Insured

(Owners or Lessees)

This endorsement modifies such insurance as is afforded bythe provisions of the policy relating to the followingl

COMPREHENSIVE GENERAL LIABILITY INSURANCE

MANUFACTURERS' AND CONTRACTORS' LIABILITY INSURANCE

1945.(Ed.l-]3;

This endorsement, effective 4-1-87 , forms a part of policy NO'GL 99 48 4j

•

•

(12:01 A.M., standard time)

issued to

by

Authorized Representative

It is agreed thatl

1. The "Persons Insured" provision is amended to include as an insured the person or or9an~

ization named below but only with respect to liability arising out of operations per~

formed for such insured by or on behalf of the named insured.

2. The applicable limit of the company's liabili ty for the insurance afforded under the Con~

tractual liability Insurance Coverage Part forming a part of this policy shall be reducecby any amount paid as damages under this endorsement in behalf of the person or organiza~

tion named below.

Name of Person or Organization(Additional Insured)

Any nerson or organization to whom one of the Named Insureds has provided duringthe policy period wri:ten evidence that such person or organization is includ~1

as an additior.al In~'.;~,=:: ur:je!'"' this endorsE:mE::'".:' .

-- .•-- genli237 092082 H EFL

.•._ ...: -. :=::: :-~.:....

.. ...-.., . .. - .

UABIUTY

F(

cne AUlIdaiII.. • .ause need be completed only when this endonement is issued SlIlbS..... to preparation of the policY.)

GL 20 16 (Ed. 07 66)G114

ADDITIONAL INSUREDlVendors-limited Forall

This enc!orsemellt modifies such insurance as is afforded by the provisior:s at tie policy relating to the following:

COMPREHENSIVE GENERAL LIABILITY INSURANt[

COMPLETED OPERATIONS AND PRnDUCTS L1ABlun INSlIWfCE

L 91151(Ed. 7·66)

This endorsement, effective

issued to

by

4-1-87(12:01 A. M•• standard time)

• forms a part of IIOlicy No.GL 99 48 43

..,- ., -.:.:~-:.~. ,: ,::::~~.::. ,.:,:~=:,"-=~~:.: .:~

-.--·--·-----.."Mth~onz-:·,..ed~Re-presentative ---•.------.-

SCHEDlJl£Mane of Vendor(s)

. :i.Description of Product(s)

-.-,-,'- -

Lawson' 8 Inc.210 Broadway EastCuyahoga Fal.la, OH 44222

It is agreed that the "Persons Insured" provision is amended to include any person or organization designated above (herein referred to as "vendor"),as an insured. but only with respect to the distribution or sale in the regJ:lar course of the V!l'ldor's business of the named insured's productsdesignated above subject to the f~lowing additional provisions:

1. The insurance with respect to the vendor does not apply to:(al any express wcrracrty, or any distribution or sale for a purpose, unautflorized by the n_ri ms.rn;(b) bodily injury or pr~erty llamaEe arising out of

(j) any act of tile wendor which changes the condition of the products,

(ii) any failure to maintain the product in merchantable condition,

(im any failure to make such inspections, adjustments, tests or servicing as the vendor ha agreed to make or normally undertakes to make inthe usual course of business, in connection with the distribution or sale of the products, or

[IY) products .midl after distribution or sale by the named insured have been labeled or rdabeJed or used as a container, part or ingredient ofany other thing or substance by or for the v,enduro

Ic) bodily injury or pnperty damage occurring within the vendor's premises.

2. The insurance does nat apply to any person or organization, as insured. from whom the I13med ilsun!d has acquired such products or any ingredient,part or container. entering into, accompanying or containing such products. _

( (

..• ~~~.~......;; ..... .; ..

.....

IIA1U'" 't 16 IS III 07 ftf.j

'113ADDITJQHll 'INSUREDlY,.ws-ltu' f.r.'

Th,s endorsemen' modifies such insur.nce IS is affoc~ by the provIsions of the policy rel.tinl to tile followlnl.

COM'REHOOM W£U1 UAlllm IIf~U\lAMtE

COM'l£TED OPERATlOIIS! AI1l PlOUUCTS LIABILITY INSURANCEI

, !lU~

j" :'.j

litis endorsement. effective 4-1-87112:01 A..... ,t.nd.rd timt.

• forms a part of pol icy No. GL 99 48 43

Name of Vendor(s)

Sears Roebuck and CompanySears TowerChicago, IL 6068q

Aulhorond Rtprtnnl.t.Ye

SCHEDULE

•

•

II IS agreea thaI the "Persons Insured" provIsion is amended to Include a"1 person or ~rganizatlon deSignated above (herein referred to 3\ "vendor":.

IS ., ilSared. but only with respect to the distribution or sale in ~ regular course of the vendor's business of the Dilled insured's pr.ductssubject to ttle following addi'ional provisions;

L The insurance With respect to the vendor does not apply to:

(aJ any express warranty unauthorized by the amed insured;(bJ Mdily injul} or ,repetty da.ale arising out of

(i) any physical or Chemical change in the form of the produd made mtentionally by the vendor,hll repacking. unless unpacked solely for the purpose of inspec1io."l. demonstration. testing or the substitution of parts under inS!'uction fforr:

the manufacturer and then repacked in the origmal contalller.hili demor.:.tfatlon. inslallatlon. servlcmg or repair oppratlo~s. excfp! such operallons performrd al Ihe vendo"!. p'ern'sr.' tn connection ">I!t'

thf saie Of the produCt. or

'.• pro:!uC:' who,ll alt!1 distribution or sale by the named inslll'el! !l.:!/e been labe!l'd or rflabi,kd or usrd as a C:>"la.ntr. parT o' anl;rec.ent ofan)' other IhlOg or substance by or for the vendor.

1. lilt IllS\llanCe COtS not apply to any person or organ.izallon. as insllfed. !rO::l whom the named insured has aCQurred s\.lch proouCTs or an) ang!t"l.cnTpz~: or contame:. entellng 1010. accompanying or conlaJr.:ne: s:1;h pro::"c::;

.-_•...nimEIITK:i1...~ .

( ((ThQ A~t~chino C1ftU50 nood bD compl.to~ only wh~n thi~

.ndor~p~pnt i~ i5~u~d sub50quont to preparation of tho policy.)

li abi! i tv

o 109

Addltion,l Insured

(Pre.lses Leased to the Ha-ed Insured)

L9lC(Ed.7-66

This endorsemont .odifies ;uch insurance as is afforded bythe provisions of the policy relating to the following:

COMPREHENSIVE GENERAL LIABILITY INSURANCE

"AHUFACTURERS' AND CONTRACTORS' LIABILITY INSURANCE

OUNERS', LANDLORDS' AND TENANTS' LIABILITY INSURANCE

STOREKEEPER'S INSURANCE

This endorsement, effective ~-l-87 , forms a part of policy Ho.GL 99 ~8 ~3

~

(12:01 A.M .• standard time)

issued to

• Authorized RepresentatiYe

Schedule

the

Designation of Premises(Part Leased toHamed Insured)

All Premises Leased toNamed Insured by theAdditional Insured

PropertyD;II"a~eLiabl1ity

Included inComposite Rates

Harne of Persenor Organization(Additional Insured

Any person or organizationto whom one of the NamedInsureds has provided durin~the policy period written ~evidence that such person ororganization is included as

It is agreed that the-oftpersons Insured" proy i si on i 5 emended to include as an insured the person or organization designated aboye, but only with respect to liability arising out of thownership. aaintenance or use of that part of the premises designated above leased to thnamed jnsured~ and subject to the following additional exclusions:

Bodi IyInjuryLiability

The insurance does not apply:

2. to structurel alterations, new construction o~ demolition operations performed by 0on behalf of the person or orgenization designated aboye •

•1.

an additional insured underthis endorsement.

to any occurrence which takes place efter the nailed insured ceases to be a tenant ilsaid premises;

VI

Non-Premium EndorsementL,...~ Prepared

5-26-81Endorsement No.

Issued l1f

o The Home Insurance Company

[i] The Home Indemnity Company

oo

City Insurance Company

The Home Insurance Companyof Indiana

o

Policy Number

GL 99 48 43Producer

Policy Period:

Ce'tifica!e Number

Inception (IlIonl1H)ay-Year)

Named Insured

Expiration (Month-Day-Yearj

Producer No. - OPe

Effective Dale and Trne of Endorsement

••

It is agreed that this policy is hereby amended as indicated. All other terms and conditions at this policy remain unchanged.

BROAD HOTICE OF ACCIDENT OR OCCURRENCE

It is agreed that failure of any agent, servant or employee ofthe insured other than an officer or Insurance Manager of the 1nsured- .to notify the company of any such accident of which he has knowledgeshall not invalidate the insurance afforded by this policy as respects-the Named Insured. ".

It 1s further agreed that where the insured reports the occurrenceof any accident to the Worker's Compensation carrier insuring theirWorkers Compensation insurance which later develops into a liabilltyclaim, coverage for which is provided by the policy to which th:isendorsement is attached, t"ailure to report such accident to the companyat the time of occurrence shall not be deemed in violation of the PolleyConditions entitled lIInsured's Duties in the Event of OCcurrence, Claimor Suit n upon the distinct understanding and agreement, however. that theinsured must, just as BOOn as they are definitely made aware of the taetthat the particular occurrence is a elaim under this policy. shall giveimmediate notification of the aforesaid occurrence to this company•

•Signature ofA~Representative

H22300 FH IS) Rev. 11/81 The Home Insurance CompaniesProducer Copy l./

LIABILITY

(The Att"chi"'Ol Cl"uw need be Cl>f'nC)leted only when this endorsement is iSSlACl sub5eQuent to ll<e:w.ration of the POIic:yJ

( ( L 69SOd(Ed. 10-69)

PREMIUM DISCOUNT ENDORSEMENT - TEXAS(General U ..bility Insurancel

Author"ized Representative

, It is agreed that the premium pertaining to Texas for General Liability and Medical Paymenrs il'lsurance is subject tc discountin accordance with the following procedure:

1. Texu Gener..1 Liability Stand.. rcf Premium. Such premium pertaining to Texas computed in accordance with the provIsIonsof the policies designated in paragraph 5 hereof, other than this endorsement and exclusive of the application of any retrospectiverating plan, shall be known as the Texas General Liability Standard Premium.

2. Tot..I St.. ndard Premium for All States. The General Liability and Medic.I Payments Premium computed in accordance withthe provisions of the policies designated in paragraph 5 hereof. other than this endorsement and exclusive of the application of anyretrospective rating plan, any Automatic Premium Adjustment Endorsement, any Premium Return Plan Endorsement, or otherPremium Discount Endorsement, shall be kno",n as the Total Standard Premium.

3. Premium Discount-Texas.

lal Forpolicy periods of one year or Jess-The Texas General Liability Sta"l:\dard Premium shall be subjeCt to'the applicablediscount percentages for the Total Standard Premium obtained from the Table of "Texas Premium Discounts (GeneralLiabilityl"

(b) For policy periods of more thaft one yur-The Texas General Liability Standard Premium for each annual period or portionthereof during the policy period shall be subject to the applicable discount percentages as stated in said Table of "TexasPremium Discounts (General Uability)", oppOsite the Total Standard Premium for the policies for each such period orportion thereof during the policy period.

~orseme~t, effective

issued to

by

4-1-87(12:01 A. M., standard timel

, forms a part of policy No. GL 99 48 43

I·I',! -: .~

f

i.-I!

l'

-:' '..~

III-I

j,

l.

l!.I·I

Estimated Stand..rd PremiumPolicy Numbers

leI If retrospective rating is applicable to a part of the premium pertaining to Texas, the amount of premium discountapplicable to the Texas General liability Standard Premium, exclusive of any premium subject to any RetrospectiveRating Plan, shall be the difference between 111 the discount determined by applying to the Texas General LiabilityStandard Premium the applicable percentages stated in said Table opposite the Total Sta"dard Premium, and (21 thediscount determined by applying to that portion of the Texas General liability STandard Premium which is subject toretrospective rating the applicable percentage stated in said Table opposite so much of the Total S:andard Premium asis subject to retrospective rating..

4. Table of Texas Premium Discouftt Percentages (see reversel

•Inc1ude4 Under Composite Rates

%

Total

-,

.'

- =;~

;.:'~_.:-.

:~z.., :. -.

!':. .. - -- .-~ ..

~""-~....-,;,. -":."

.."" -'-1 ".-:""'"'~:.~-

-;.,~~~~..... ---..

Applicable premium discount percentage based on total estimated advance standard premium:•: ':.. ~-.;...~.~ .. ~~~.

If the Total S1'Gndard Premium is S500,000 or over, me premium discount percentage applicable sholl be determinedas the weighted overage of 22.5,. for the first $500,000 and 23.1" for the portion over S50o,ooO.. .. -- .. ' ._.", -. .

.' _. ~-I-·:·· \. -*For premium not shown use the volue fQr the .next lower premium stated in the toble.

.~ .~,.

I

j. '.:. ".::~: ..:~..:'I~. . " ...

. ~ : .

... _... ..-: ....:-.~.~: ...>-:

...... __ : ..~"'"_ .

i

ii:i'­!

iii;

_..: 4

• ," ~ .0__ .:._ :-,;. ~. ", M

I :I

i,,.

i ~ ~ .!

22.422.522.5

21.922.022.122.222.3

18.4~

18.518.618.718.8

18.919.019.119.219.3

19.419.519.619.719.8

19.920.020.120.220.3

20.420.520.620.720.8

20.921.021.121.221.3

Pr....iu...Discou"t

Porcontaq_Applicablot. T."asGen.ralLlabili~

StandardP'.mi .....

(2)

21.421.521.621.7

.. 21.8

160,286170,000180,968193,449207,778

224,400243,913267,143295,263330,000

374,000431,538500,000Over500,000 See Note

S59,05360,32361,64963,03464,483

66,Ono67,59169,26071,01372,858

74,80076,85079,01581,30583,732

86,30889,04891,96895,08598,422

102,000105,850110,000114,490119,362

12~,667

130,466136,830143,847151,622

TotalStanoa,d

Pr..ium"(1)

Pr.",iu",Discount

Porcont"g.l'.pplicableto T."osG.ner,,1Liability'StondordPrem'f.",

(2il'\

13.8"13.914.014.114.2

14.314.41'4.514.614.7

14.8. 14.9

15.015.115.2

15.315.415.515.615.7

15.815.916.016.116.2

16.316.416.516.616.7

16.816.917.017.117.2

17.317.417.517.617.7

17.817.918.018.118.218.3

S30,00030,32530,65630,99531,341

31,69532,05832,42832,80833,196

33,59334,00034,41834,84535,284

:"35,73336,19436,66737,15337,652

38,164'38,69039,23139,78840,360

40,94941,55642,18142,82543,489

44,17444,88045,61046,36447,143

47,94948,78349,64750,54151,468

52,43053,42954,46755,54556,66757,836

TotalStandard

Premium"(1)

9.2,.9.39.49.59.6

9.79.89.9

10.010.1

10.210.310.410.510.6

10.710.810.9

.. 11.0.11.1

'11.211.311.411.511.6

11.711.811.912.012.1

P·r."'i"...Discount

P.rc.ntag.Applicabl.to T."asG...o,alLiability'Standa,dPr.... ium

(2)

$ 7,5617,6867,8167,9498,087

8,2318,3798,5338,6928,858

9,0309,2089,3949,588

.9,790

10,00010,22010,45010,690

·'0,942

11,20511,48211,77312,07812,400

12,74013,09913,47913,88114,308

TotalStandard

Pr.",ium*(1)

14,762 12.215,246 '12.315,763 12.4

• 16,316. . .12.5..• .-. ~ 6,9Hi.: .• 12.6.

17,548 12.7" 18,236 12.8

18,980 12.919,788 13.020,667 13.1

21,628 13.222,683 13.323,84713.425,136 13.526,572 13.628,182 13.7

4.6'704.74.84.95.0

5.15.25.35.45.5

5.65.75.85.96.0

6.16.26.36.46.5

6.66.76.86.97.0

7.17.27.37.47.5

7.67.77.87.98.0

8.18.28.38.48.5

8.68.78.88.99.09.1

Pr.",iu",Discount

P.rc.n'D9.Applicabl.to T."as·G.n.ralLiability'S'anoardPr.",lum

(2)

-.

5,6375,7065,7775,8505,924

6,0006,0796,1596,2426,327

6,4146,5046,5966,6916,789

6,8896,9937,1007,2107,3237,440

TABLE OF,--XAS PREMIUM DISCOUNT PERCENTAGES, (General Liability)' •

$2,5432,6322,7282,8312,942

3,0623,1923,3343,4893,659

3,8474,0554,2864,5464,839

5,0285,0825,1395,1965,255

5,3155,3765,4395,503.5,569

TotalStanda,d

Premium ..(1)

o.~

0.10.20.30.4

0.50.60.70.80.9

·1~0

1.11.21.31.4

1.51.61.71.81.9

2.02.12.22.32.4

2.52.62.72.82.9

3.03.13.23.33.4

3.53:6'3.73.83.9

4.04.14.2 .4.~

4.44.5

Pr."'i....Disco..'"

P.rconto,eApplicableto T."asG.n.ralLiability'S'anda,dPr.....iu.

(2)'lltl

rdlum"

(1)

$1,0001,0071,0211,0351,049

1,0641,0801,0951,112

. 1,128

1,146. 1,163

.. ·',1821,200

.;...,..... 1,220

1,2401,2611,283

. .1,3051,328

1,3521,377

-~1,4861,516

,5471,5791,613

1,6491,6861,7251,7651,808

",8521,8991,9492,000

.. 2,055

2,113':..2,174

2,239.2,308

....·2,3812,460

NOTE:

, ........•:....

'':'". '-.' ~ ....

".~.. - - :;":".::,,~~~.~. ' ••' 0"

(

Non-Premium Endorsement

•Issued by

o The Home Insurance Company

[U The Home Indemnity Company

oo

City Insuran~·Company

The Home Insurance Companyof Indiana

Uate Prepared

5-26-81

o

Endorsement No.

Policy NlITIber

GL 99 48 43Producer

Policy Period:

Certificate Number

Inception (Month-Oay-Year)

Named Insured

Expiration (Month-Day-Year)

Producer No. - OPe

Effective Date and Tme of Endorsemert

4- -8

•

It is agreed that this policy is hereby amended as indicated. All other terms and conditions of this policy remain unchanged.

BLACK LUNG EXCLtJSIOB

It 1s understood and agreed. that the stop Gap Endorsement H25585F on thispol1cy shall not cover. l1abil1ty for Pneumoconiosis or mack Lung asprovided by the Black Lung Benet"its Act which arises out or coal mineemployaent. Coal mine employment shall mean any person employed in oraround a mine site. whose taaks are pert"ormed prior to tbe entry or coalinto the :stream ot" commerce, such tasks being the subterranean or 8Urf'aceextraction ot" coal, the preparation ot" coal, the transportation of coaland coal mine maintenance and construction•

•Signature of Authorized Representative •H22300 FH (5) Rev. 11181 The Home Insurance Companies/

Producer -Copy J

Non-Premium EndorsementualePrepared

5-26-87Endorsement No.

Issued 11f

o The Home Insurance Company. 0[!) The Home Indemniy Company 0

City Insurance Company

The Home Insurance Companyof Indiana

o

It is agreed that this porJCy is hereby amended as indicated. All other terms

Policy Number·

GL 99 48 43Producer

Policy Period:Inceplicxt (Mordl-Oay-Year)

Named Insured

Expiration (Month-Day-Year)

No. - OPC'-....

EfJedve Date and TIme of Endorsemert11-1-87

mons of this policy remain unchanged.

•

mmrrEHTIONAL ERRORS OR OMISSIONS

Failure of' the Insured·~ disclose· all hazards existing as of' tfie inceptiondate of" the policy sball not prejudice the insurer with respect to thecoverage afforded by this pollcy provided such f"ailure or omission 18 notintentional. ..

,.~..

•Signature eX AUtt"aiZed Representative

H22300 FH (5) Aev. 11/81

ProducerCopyThe Home Insurance Companies

v/

Non-Premium EndorsementIssued by

o The Home Insurance Company

[i) The Home Indemni1y Company

oo

City Insurance Company

The Home Insurance Companyof Indiana

Ilode Prepared

5-26-87

o

Endorsement No.

Policy Number

GL 99 48 43ProdtICer

Policy Period:

Cemficale Number

Inception (Monl!l-Oay-Year)

Named Insured

Expiration (Month-Day-Yeat")

ProctJcer No, - ope

~ Date and TIme of Endorsement

•

".

It is agreed that this policy is hereby amended as indicated. All other terms and conditions of this policy remain unchanged.

REAL PROPERTY LIABILITY "ALL RISKS-

REAL PROPERTY LIABU,TTY - It is agreed that the Property Damage LiabilltyCoverage applies to property damage to structures or porUons thereot"rented to or occupied by the Named Insured including f"ixtures permanentlyattached thereto, if' such property ,damage arises out ot":

A. Fire- ":;:"B. ExplosionC. Smoke or smudge from the sudden, unusual and f'aulty operation

ot" any heating or cooking unit - only wh:1le such unit isconnected to a chimney by a smoke pipe.

SUbject to the f'ollowing additional provisions:

(1) With respect to the Insurance provided by this endorsement allthe exclus1.ons of" the policy other than the nuclear energyliability exe1usion (Broad Form) are deleted and replaced by thet"ollowi.ng: '

A. Liability assumed by the Insured under any contract or agreement;B. The explosion, rupture or bursting of" steam boilers, steam

pipes~ steam -turbines" steam engines or nywheeJ.s;C. Smoke or smudge from Industrial apparatus

(2) The limit ot" liability stated in this endorsement appliesseparately to the Insured under this endorsement and is in lieuof' ,any other l1m1t of' liability stated in the polley.

LIMIT OF LIABILITY - $100,000 per occurrence

Signature of~ Representative

H22300 FH (5) Rev_ 11/81 The Home Insurance Companies

Producer Ccpy -~

( (THIS ENDORSEMENT CHANGl:>·, ••: :'lOlICY. PLEASE READ IT CARErUll Y.

ADDITIONAL INSURED-LESSOR OF·LEASED EQUIPMENT

,2. To ··bod,ly Injury·· or ··property damage··arlstn[ oul of the sole neeheen::e of the per .SOr'\ (;r crgo:l:zat1on show:-. In ::-oe Schedule.-·

ih,S Insurance does not "apply:.

1. To any ··occurrence·· which ta\..es place afterthe equ,~ment leas~ expires: .

COfJ.fl.£.RCIAL GENtRAL LIABILITY COV(RJ..G£ PI-Pol.

SCHEOULEN.me of Person or Ortaniutlon:

American Equipment Leasing Co.#1 Parkway Center, Suite 225Pittsturgh, PA 15220

(If no ~ntry 2Ppe.:l;'S above tnformahon reQuired to compiete this endor sement w,lI be shown 10 the Declarations asJ~phcab!e to thIs endors-ement.) .

WHO IS AN INSURED (Sectlon II) is ilTlended toInclude as an Insured the perSOn(s) or ori:anlzat.on(s)

. shown in the Schedule. but only with respect to the,rtiaDlhty !risznt o~t of the maintenance. ope-rallon oruse by you of eQuipment leased to you by such per·

• _.... ·son(s) or orgCln'lat1on(s). subject to the lollowintadditional exdus.ons:_...,..,-.. .... - ...

._- ........ --...~:.; :..-~ .

: ....-... ..~': '.. ..

•

•CG 20 26 H 85 J 0

, .( (THIS ENDORSEMENT CHANGl:> .... : ~OllCY. PLEASE READ IT CAREFUllY.

ADDITIONAL INSURED-LESSOR OF'l~ASEDEQUIPMENT.. .

COJJ.fl.(RCIAL G(N(RAL LIABILITY COV(RJ.G( PAR1.

SCHEDULE

:i:2. To "bod,ly inJury" or "property damage"ar/sln!: out of the sole nee"eence 01 the per·son or organiZ'::~ion s.ho.....n in the SchedL:le.-·

This insurance does not 'apply:

1. 10 any "occurrence" whIch takes place afterthe eQul~ment lease expires: .

"lIme of Per~on or Or~aniutlon:CIS CorporationOne CIS ParkwayPOBox 11785 , Syracuse, NY 13221~7a5

,.. (If no entry appe;lr!. above mlormataon 'reQUired to complete thl~ endor ~ement WIll be shown," the Declarat,ol"!S asa~pjl,able 10 thiS endor s.ement.)

y.rHO IS AN INSURED (Section II) is amended toInclude as an Insured the per~on(s)or organlzatIOI'l(S)

. t.hown in. the Schedule. but only with re~pect to the,rtiablllt)' 8rism& out of the maintenance. opf'rat.on oruse by you of equipment lea!.ed to you by such per·

._.... son(s, or or£~ni1atlon(s). subject to the 10Jlowintadditional ex.clusions: '_.."....-..'- . '"'-- ......

_.~~:...

_.-

.'€6 20 28 Ii 8~

,

J o

lhis Insurance does not "apply:

1. To any "occurrence"whlch taio.es place afterthe eQut~menl ledse exprres: .

. ".2. To ··bodlly inJury" or "property damage"arlslnt out of the sole neelseence of the per.S::ll"\ or organ:zal1on sho....n ir, the Schedule.-·

( (THIS ENDORSEMENT CHANGl:> ....: :'OLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED-LESSOR OF'LEASED EQUIPMENT

corJ.rI.(RCIAl GENERA.L LIABILITY CO,/(R;.SE PART-

SCHEDULENlme of Per~on or Orfanization:

o. First. Westmoreland capital Oivision of Beckwith ~.achinery Co.and"Westinghouse Credit Corporation H

POBox 86060, Pittsburgh, PA 15221

(If no ~ntry appe.)r!> above InformatIon reQUIred to complete th;s endor !>ement will be shown &n the Declaratlot:ls asI~~ltcable to thiS endorsemenL)

WHO IS AN INSURED (Section f1) is amended totnclude as an tnsured the person(s) or orgaollahonCs)

. ~hown in the Schedule. but only with respect to theirtiatJlhly !rrS I :-,& oul of the maIntenance. ope-ra'llon or

.use by you of eQuipment leased to you by such per·s-on(s) or org_nllal1on(s}. subject to the 101l0wIOgadd.tlonal ~xchJslons:- .......... - ...-- .-_.

--?=.; :._~ .. ...... ...... :". ' ..

CG 20 28 H as .J o

{ (

THIS ENDORSEMENT CHANGl:>·, t.: ~OllCY. PLEASE READ IT CAREF'UllY•.

ADDITIONAL INSURED-LESSOR OF-LEASED EQUIPMENT.. .

CorJ.fJ.( RCIAl GENERAL LIABILITY co'/r RJ.~( PJ.R1_

SCHEDULEN.me of Perlon or OreaniuUon:First Westmoreland Corporation &Westinghouse C~edit Corp.POBox 86060.Pi~tsburg, PA 15221

(If no entry appe.:H~above. mforma-tton reQuired 10 complele this endor~emenlwill be !,hown an the Declarations as........•.. a~phcable to this endor~ement.) . ..

WHO IS AN INSURED (Section II) is amended to. ihis Insurance does not-ap;>ly:tncl",de a~ an lO~urei:l the person(s) or org,,nllalIOn(s) 1. To any "occurrence'" whiCh take~ place after

- shown in the Schedule. but only wllh respect to their the eoul~menlleaseeJpares. ': ha!Jlhl)' ~rISlnJ; oul 01 the maintenance, OperaIJon or

use by )'OlJ 0' eQuipment leased to ),ou by such per';I2.· To "bodily IOJury·· or ··property damage··:_.... ·~on(~) or org~ni131'on(s).subJect to the 10tJo.;...nt ariSing out of the sole nee"een::e of the per-

add:tlonal ~xclu~lon~: so:') CIT organlzataon !.hc...·:-. in U....e Schedule.---~.."...•..- ..._- ....-.•~,:,; :.... ~ .-.. . . .. ~,.. ' ..

•••••

••••••CG EO 26 H 8$

j o

This insurance does not 'apply:

1. To any "occurrence" which takes place afterthe eQul~ment lease expires:

2. To "bodily injury" or "property damage". ", arissng out of the sole negheence of the per-

son or organization shown in tl--e Schedule.-· -

POLlCY NUfJ.Br R: ' .':011.11.( RCI~l G(N(R~l U#..BlllTY(

THIS ENDORSEMENT CHANG~::> r.:: :'OllCY. PLEASE READ IT CAREFUllY.

ADDITIONAL INSURED-LESSOR OF LEA'SED EQUIPMENT

~ 1M endorsement mod.f,es ;nSU13nce p:~'d.ed unde' the lollow,nc; ·.i ."'f

. COfl.MERCIAl GENERAL LIABILITY COVERAGE PART. \

SCHEDULE

Name of Person or Ortaniutlon:GAIX Leasing CorporationFour Embarcadero Center, Suite 2200San Francisco, CA 94111

(If no entry appe;3rs above, information required to complete this endor semenrwlll be shown in the Declarations asappilcable to this endorsement.)

WHO IS AN INSURED (Section II) is amended toinclude as an insured the person(s) or organizatJon(s)

. 'shown in the Schedule. but only with respect to theirtiablhty arising out of the maintenance. operation oruse by yo-oJ o~ eQuipment leased to you by such per·

:.-... 'sones) or organilatlon(s). subject to the 101l0wingadditional exdusions:

-~-- ..'"-- ...... --..... : .. -. ,. ._.. - -_.,. ... ,'

•

.. . .-... . :: ..:"":,' ..

€G 2026 II 85

..

•

j 0

. -,2. 10 ··bodlly inJury·· or ··property damage··arlS1n& out 01 the sole nee"eence 01 the per·s.on or organIzation shown in the Schedule.-·

ThiS Insurance does not 'apply:

1. To any ··occurrence·· which takes. place afterc the eQ:J!~menl leas.e expIres: .

(

THIS ENDORSEMENT CHANGl:> 't.: ~OLlCY. PLEASE READ IT CAREFUllY.

.. ADDITIONAL INSURED-LESSOR OF-LEASED EQUIPMENT

Th,s. tndor~ment modifies. ins.ur~nce pro.-'d.ed under the followlnC

CorI.M£RCIAl G£NERAlllABI1I1Y COVERAGE PART.

SCHEDULE

Name of Per~on or OrEanizatlon:General Electric Credit Corporation1 North Shore CenterPittstu~gh~ PA 15212 .

(If no entry aope.:lrs. above tnformahol'\ reQulfed to complete this endorsement will be s.hown In the Declarations asa~phcable to thIs endor s.emel'\t.)

WHO IS AN INSURED (SectionU)is amended to.Include as an Insure~ the pers.on(s.) or organlzatlonCs.)"

. shown in the Schedule. but only with res.pect to theIr1iablht)' arisln& out Of thematntenance. operation orus.e by you of equipment leas.edto you by such per­

:_.~. son(s.) or org~nilatlon(s.).subject to the lollowln!:addlttOt'\al txdusiol'\s.:_.."..-.-. -..-- .........:-~.; :...

: ......: .. ~": ' ..

•

-€G 20 28 11 8S

.... ,

C"'OP)'lt&nl. hlSUldlice ~etQlccs Oillte. me.• 19tC j o

(- f

THIS ENDORSEMENT CHAt1Gl:>-, •• : ~OllCY_ PLEASE READ IT CAREFUllY.

ADDITIONAL INSURED~lESSOR OF'l~ASED EQUIPMENT

COll.1J.(RCIAL G(N(RAL LIABILITY CO'J(R;'~( PAR1.

SCHEDULEtbme of Perr.on or Oreaniutlon: ...General Electric ~redit Corp.P 0 Box1922ADanbu~YJ CT 06810

(II ne;, entry appe.)rs. above anformatlon reQuire" to complete this endors.ernent .....011 be showr.1O the Declarahons asJ~;>:a:a~le10 thisendor~ement.)· . .

WHO IS AN. INSURED (Section II) js imended to This insurance does notllp;:>ly:,nC'lIde as an Insured the pers.on(s.) or orgilr.llatlonCs) 1. To any "occurrence" wh1cl".talt.es place after

. shown in the SchedulE". but only with respect to their the eQ~J1~menl lease eJ pires: .1iat,hty ~~Islnc out of the mamtenance. opera lion oruse by yo~ of equipment leased to you by s.uch per· . :,,2. To ""boddy inJury'· or ··property damage'·.~Or'l{S) or org-.n1latlon(s). subJect to the 101l0.....ng ar'SIOE: out of the sole ne£heence of the per-~dcttlonalexdusions: son or o::-ganlzcho:"" sho.....n in the Schedule.-·

-~-.- ...._- .- ..'..~--'--~~..; ':":'.

••••: .. . " ..,.,... .... .. .-

.•."'.:.'

•

C'O?")IISIil. I"S.. !211h.f ~erv,cesOil'l.e. anc.. ISlA / o

..-.( (

THIS Er~ DORSEMENT CHANGl:>., •• : ~OllCY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED-LESSOR OF-LEASED EQUIPf'l1ENT

corl.~!.E.RCIAL GENERAL LIABILITY COV[R....G£ PARI

SCH'EOULE

ThiS Insurance does not "apply:

1. To any -'occurrence" whIch tai-.es place afterthe eQul~ment lease eJpIFes: ..

. ;;: 2. To "bodtly lOJury" or "property damage"ClflSIrI£ out of the sole neeiteence of the per.~Or'\ or orgarlllctlon shown in the Schedule.-·

N.me of Per~on or Oreaniutlon:Ingersoll-Rand financial corporation331 w. Main St'~

Abi~gdon, VA 24210,,;:;·:(Hno entry aDpe,)rs above ,nformahon reQUired to complete tt,,~ endorsement will be ~hownm the Declarations aE

. l;:>pIJcable to this endorsement.)' .

~':'._WHO IS AN INSURED (Section II) is amended to.._. Include·as an Insure:::l the per~on(s)or organlzatlonCs)

, ~hown in the Schedule. but only with respect to theirtiatJ,llty ar,Slnb out Of U-.e maintenance. operallon oru~e by you of equipment leased to·YOLl by such per­

. ..... ~on(s} or organllallon(S). subject to the loHowlngadditional ex.cluSlons:

--.,..,.-.-. - .. .-:::'1. ;••,;- ------_.

: .. . .. -r-... . ..

•

•.··.i,..··.'.··.·.·....'... · .....·'.·· .. ·.····,

, ,.~ ',-.'e~,'''''; , . ".,,,.

-ES ro 28 11 8~ C"Op)i1fl;hl. ".sclence ~etvlces OlilCe. mt.. 19b:;

I

J o

( (•

THIS ENDORSEMENT CHANGl:> , •• : ~OLlCY. PLEASE READ IT CAREFUllY.

ADDITIONAL INSURED-LESSOR OF'L~ASEDEQUIPMENT

cor.~rl.tRCIAL GENERAL LJI.BILJ1Y COV(RAGE PAR1.

SCHEDULE

.J

\~

i

ThiS Insurance does not 'apply:

1. To any "occurrence" which takes place alterthe eQu1vmenl lease ex-pires: .

.2. To "boddy IOJU ry" or "property damage"··arlsl!"I€ out of the sole neelreen:e o! the per .SOr) or or&30IZaI 1o:; shown in troe Schedule.-·

N.ame of Per~on or Ortaniutlon:ITT Commercial FinanceEFt D1,,-ision ..8251 t-2ryland Ave., Clayton, MO 63105

(If no rntr)' aDpe~rsabove Informallon required 10 complete 1hls endOI sement WIll be showrllO the Declarations. asl;lpil=a~le to this endor semenL)

WHO IS AN INSURED (Section If) is amended tomclude as an ,"sure::! the person(s) or organ llahonCs) .

. shown in the Schedule. but only With respect to theirJiat.-lIlty zHism~ ou1 of the ma:n1enance. o;>('rallon oruse by you of ~Quipment leased to you by such per·

. --~. ~O!"l(s) or organlla110n(s). subject to the follOWIngadditional ~~cJ"'Slons:_.."".,.--. - ...

._- .. ..~:.:.. :. .

: .''; - ~ ..... :,... '.. ..

••••

...

.,

'ff ..

""€G 20 28 11 85 o

{ {

THIS ENDORSEMENT CHANGt:> 't.: ~OllCY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED-LESSOR OF lEASED EQU1PfJlENT

COI.~!J.(RCIAL G(N( RAL lIASILt1V CO'Jf RJ.G( PAR1.

SCHE'DULE .'

"

.j

\~

i

1t\iS ansurance does not 'apply:

1. To any "occurrence" WhiCh talo.es place afterthe eQu'vment lease expires: .

.' ::;:2. To "bod,Iy inJury" or "property damage"arlsmg out of the ~Olf neel'eence of the per.sor'\ or organIzation shown m the Schedule.":"""

Name of ?er5-on or Oreanizatlon:ITT Industrial Credit CompanyPOBox 445

;'. \o:ort~i::gton, .OR

. (If nc entry appeJr!. above information reQUired to complete thl!> endor ~ement w.rl be shown In the Declarations as;.,_,.. "" ,~pll::a ble to thIs endor sement.)

'~:'t-~,F'WHO IS AN INSURfO (Section II) is irnended to'---"'-',nC1\Jde as an Insureo the per!>on(~)or orgar.'latlon(~}

- ~hown in the Schedule. but only with respect to the,r. ,liablllly 2ris.ot; out of the maintenance. opE'rat"IOli or

--use by yo~ of eQuipment leased to you by such per·:_.... son(s.} or org_n:lat 1on(s). subject to the follOWing

addlflooal udusions:_.,..,-... -...--', .......::-:.;:....

: •.:. "_.. ,,:,,: I,. ._

,'.

•

....................',"'" .

-ES 26 23 11 8~ J o

( (

THIS ENDORSEMENT CHANGl:> "",= :->OllCY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED-lESSOR OF'LEAsED EQUIPMENT~ .. .

ThiS insurance d~s not "Cpply::

1. To any "occurrence" whIch takes place afterthe eQ;.lI~ment lease expires: .

y 2. To "bodlly inJury" or "property damage"ClflSIro£ out of the sole ne£lteence of the per.son Clr orga:lll~tJon shown in the Scheoule.-·

COlI.M£RCIAl GENE:RAL lIASlLIlY COV( RAGE: PAR1.

SCH£DUlE

Name of Perr.on or Or~anizatlon:

Joy Finance Company301 Grant StreetPitts.burgh, PA 15219

(If no entry appe;lrs above information reQuired to complete th,!. endorsement will be shown In the Dedaratlons asI~pilcable to thIs endor~ement.) -

WHO IS AN INSURED (Section II) is amended to---- tnelude as an Insured the per!>on(!» or orgarllzat.onCS)

, ~hown in the Schedule. but only with respect to theirtiablllt)' ariSJrlb out of the maintenance. ope-ra'tlon oruse byyolJ of eQuipment leased to you by such per·

·--~·s.on(S) or org~ni2'atlon{s}.subject to the followlOgaddltlOoial exclusions: .

_.".,..........- ..

: ......: _.:,: I.. • ..

•

-

•

€G 20 28 H 85 Ct>;>]r.g!Jt. h.SOi dlice ~er VICes OIllCe. InC_. I9i4/ o

.( (

THIS ENDORSEMEN} CHANGl:>· •• ~: ~OllCY. Pl[~S[ READ IT CAREFUllY..,

ADDITIONAL INSURED-LESSOR OF LEAsED EQU1PrviENT'. . .

'th,s, tndors.ement modlfte~ in~Llr~nct p'~,dtd under t~ foUow,nc. . .

"COfJ.II.ERCIAL GENERAL llABILllY COV(R:..G£ PI-P.l.

SCHEDULEName of Per.on or Ortanlutlon:~anufacturers Hanover Leasing Corporation1420 Renaissance Dr.Park Ridge, IL 60068-1312

.. (II no entry &Ppe~rsabove. anfor·mat,on required to complete thiS enoorsement will be shown tn the De:::larat,o!"lS as.;:>pl.cable to thIS endors.ement.) ..

WHO IS AN INSURED (Section II) is amended to This ,nsurance does not'apply:anclude as an Insured the person(s} or organlzatlonCs) 1. To any ··OCcurrence" which takes ;iface after

. ~hown in the Schedule. but only WIth respect to their the e:ur;:..ment lease expires:liability ariS1nl: out of the maIntenance. ope-ralton oruse by you of equipment leased to you by such per· :'ic 2. To "bodlly InJury" or "property damage"

_..... ·son(s) or org;ani1at1on(s). Subject to the following arrsmg ou~ of the sole nee"eence cl the per.additional txC1U!.IOflS: son (;{ ofianizahon sho..m in the Schedule.-·

-."............ -...._- ...... -­--?:.; :.._- .•.

-e.. ... • ...~r• ••• ..

••-Co 20 28 11 85 Cop)llglil. hlSiJiQllce ~e/",CB OIllCe.lr.c..lS~

•

/o

(.

(THIS ENDORSEMENT CHANGl:> , ••: ~OllCY. PlE/..S[ READ IT CAREFUllY.

ADDITIONAL INSURED-LESSOR OF'LEAsED EQUIPMENT.- .

CO'I.M( RCIAl GE.NE.RAl LIABILITY COV£ RAGE. PART.

"

:~\'i

SCHEDULE

ThiS" Insurance does not 'Qp~ly:

1. 1'0 any "occurrence" whIch takes place afterthe eQulvment lease expires: -

. :..2. To "bodlly inJury" or "property damage"cHlsmg out of the sole neeheen::e of the per­son Clr organization shown in the Schedule.-·

Ntme of Pers.on or Oreaniutlon:Mellon Financial ServicesSuite 3030, One Mellon Bank CenterPi tts :;l;:-gh, PA 15202.: _

(If no ~ntr)' appe.:lrs above mformahon reQuired to complete this endorsement will be shown In the Declarcst/ons as.;>pi/cable to thiS endor ~ement.)

WHO ISANINSURfO (Section II) is Jmended toInclude as an Insured the person(s) or orgetn lla1 10nCs}

. shown in the Schedule. but only With respect to theIrtiat:.llhty ~riS/ng out of the malntenar)ce. o;>eralion oruse by you of ~Qujpment leased to you by such per­

. --~- sones) or orgcH\llalron(s). subject to the tollowmg&ddlhonal exclusions:_..,.....-.. - ...

• ~..... .,..... ,.j • .-.: .... ~,. -

~~. ~... ;.. --.; .-.... .... :'. '.. ..

••

",

•

•-CO =028 11 8~

J o

( (

•THIS ENDORSEMENT CHkr~GL::> ....: ~OUCY. Pl£ASE R[kD IT CAREFULLY.

ADDITIONAL INSURED-LESSOR OF-LEASED EQUIPMENT.~ .

COfI.M(RCIAL G[N£RAlllt..8111TY CO'/E RAG( PART.

ThiS insuranc~ does not cpply:

1. 10 any ··occurrence·· which takes place afterthe eQul~ment lease e.ptres: .

~ Z. 10 "bodlly inJury" or ··property damage"cHISJng out of the sole ne£heence of the per.SOti or organization shown in the Schedule.-·

SCHEDULE

tbme of Per~on or Or£lnizatlon:Park Leas~ng Corporation150 E. Broad StreetCol~~us, Ohio 43215(If no entry aDpe.)rs above. anformallon reQLNed to complete Ih,!> endorsement will ~ ~hown an the Declarat,of)S asap>pl,tabte to th,s endorsement.)

WHO IS .e.N INSURED (Seclion II) is amended to,..~_.. ~,_ ..~,-,_ .." tncl..,de as an Insured the person(s) or orgdr.;lalI0n(~)

- shown in the Schedule. but only with respec t to their:::.;=:::·r·liat,lh~yeris.ni: out of themo,"tenance. operation or

use by you of eQuipment teased to you by SuCh per··_·..·"on(s) or org_nirahon(s). subject to the follOWing

adC.1Jonal exclusions:--.........-. - ...

,.•••: .. ..- • ~.:,: f,. ..

••••••••• • •••

• •

/--CG Z: 28 H 85 ~)'ll,lit. 1.1$01 "lice ~er VlcB Ollice. It'IC_. 19a.. o

',-e

( (THIS ENDORSEMENT CH"r~Gl~·t •• : :'OLICY. PLEASE READ IT CAREFUllY.

ADDITIONAL INSUREO":-LESSOR OF'l~ASED EQUIPMENT

COrl.ME RCIAL GENERAL LJI.BlllTY COV[ Rt.GE PART.

SCHEDULE

ThiS insurance does not apply:

'1. To any "occurrence" which tal-.es place afterthe eQu,~menl lease expIres: .

"'" 2. To "bodlly JnJury" or "property damage"ar1smE: out of the sole neelleence of the per­!oor, or orga:'l:zat1orl . shown in the Schedule.-·

Name of Per,on or Ortanizatlon:Walker Machinery CompanyP 0 cox 2427C!:arleston, WVA 25329 ... , .

. (If nc entry appe.:lr ~ above.n(ormataol'l reQuIred to complete thl~ endor ~ement WIll be ~hown In the Declarations as., J~p:lcable to thIs endors.ement.)'· " ... ,

.. ,WHO'IS AN INSURED (Section II) is ilT'lended to"',nclude a~ an m~ured the per~on(s)or orgonlzahOn{s)~hown in the Schedule. but only wilh respect to theirtiat.lllt)' a~iSlnb out of the maintenance. operal,O:"l oruse by yOo,) of equipment leas.ed to you by ~uch per·

: _.~. son(s) or orb~nllatIO:'l(s.).subject to the 101l0.... '"£:add.llonal exclUSions:

. _ -..- ..

: •••• ". .. :t:, '.. • -

'.

,

'.,.. '. • .... -.t .*

. ..

/-CS 20 28 11 85 COP)'lltltt. 11ISO",llCf ~el VICes Olilte. Inc.• ISl!>.'; o

- ...."l......

( ("It 09 10 (Ed. 01 81)

PENNSYLVANIA NOTICE

GU· 220(Ed. 1-81)

,.....•....' ,..

, .: .. ~':~ .... "",' .",:'... .:. ,-

:.. :

An Insurance Company, its agents, employees, or service contractors acting on its behalf, may provideservices to reduce the likelihood of injury, death or less. These services may include any of the foilowingor related services incident to the application for, issuance, renewal or continuation of, a policy of insurance:1. surveys;2•. consultation or advice; or3. inspections.The "Insurance Consultation Services Exemption Acf' of Pennsylvania provides that the Insurance Company,its agents, employees or service contractors acting" 9" its behalf, is not liable for damages from injury,death or loss occurring as a result of any act or omission by any person in the furnishing of or the failureto furnish these services•.The Act does not apply: .1.ji'theinjury, death or loss occurred during the actual performance of the services and was caused by

_!h.~ flegligence I)f the Insurance Company, its agents, employees or service contractors;2. to consultation services required to be performed under a written service contract not related to a

policy of insurance; or .....

3.. if any acts or omissions of the Insurance Company, its agents, employees or service contractors arejudicially determined to constitute a crime, actua.l malice, or gross negligence.

M .

Copyright, Insurance Services Office, 1981

.................(TIle Attac/linc ( e need be completed Daly when this endorsement Is issul sequent to preparation of the polley.)

UABIUtT l 6131(Ed. 3-83)

Gl 99 18 lEd. 03 83)

AMENDMENT OF DEflNmON-lNCIDENTAL CONTRACT-..,,: .

This endorsement modifies such insurance as is afforded 'by the provisions of any' General Uability Insurance.

This endorsement, effective 4-i-87(U,Ol A. M, sbIlGanl time)

• forms a part of policy No. GL 99 48 43

issued to

.~, .. ':.r"· •.......---.,......'.."".,..• : ';';""P:.h:

::~~.~::.t..~..~.t.:..~f:.:~::~ ·t::.. .." _".'~ -:- ...

······_··········_·········;;;;U;~rii;d··Rep;e;en~ti;;········· .

It is agreed that the definition of incidental COlltract is amended to include any easement or license agreement in connection with vehicle orpedestrian private railroad crossings at grade...

'I.......

.....-•." .. .. .. '. ."~~,,:::::.- ·.r",.

.:..

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.' .

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(The At~~ching Clause need be completed i~ £y when thisendorsement is issued subsequent to preparation of the policy.)

liabil i ty

GL 00 19 (Ed. 7-18)

GENERAL LIABILITY

Amendatorv EndDrs~ent- Additional De~inition

L9235(Ed.1-78)

Thi~ endorsement# effectivQ 4-1-87 • forms a part of policy Ho. GL 99 48 43

Authorized Representative

(12:01 A.M.# standard time)

to

..:--- ~.. ,,:r..Itis agreed that the fol16wing definition is added:

"'loading or unloading". with respect to an-autc=:obile, means the handling of property afterit is moved from the place where it is accepted for movement into or onto an Clutor.:obile orwhile it is in or on an autc~obile or while it is being moved from an auto~obile to the placeWhere it is finally delivered, but wloading or unloading" does not inclUde the movement ofproperty by means of a mechan i cal devi ce (ether than a hand truck) not attached to the auto:co­bile.c.:.

,."""

l

itt vi, . .• . •

.. liabili"ty

(The A~taching Clause need be completed unly when thisendorsement is issued subsequent to preparation of the policy.)

L6133(Ed.3-S3)

GL 99 19 (Ed. 03 83)

Amendment Of E~oad Form Comprehensive"

General Liability Endorsement

. '-;:12:01 A.M. ,standard time)

This endorsement modifies such insurance as is afforded bythe provisions' of the policy relating to ~he following:

-'COMPREHENSIVE GENERAL LIABILITY INSURANCE -

BROAD FORM COMPREHENSIVE GENERAL LIABILITY ENDORSEMENT

issued ~o

14-1-87 , forms a part of policy No. GL 99 48 143 ...

Authorized Representative

:~:~,. Sec~ion I, Contractual liability Coverage, exclusion :B, (5) is amended to read as follows:

to bodily injury or property damage arising out of construction or demoli tion operations,wi thin 50 feet 'oT any railroad property, and affec~ing any railroad bridge or trestle,tracks, roadbeds, tunnel, underpass or crossing; but 'this exclusion does not apply tosidetrack agreements or easement· or license agreements in connection with vehicle orpedestrian private railroad crossings at grade.

•~.,

..• ..

~ • . .

(The following "attaching clause" need be'completed only when thisendorsement is issued subsequent to preparation of the policy.)

This endorsement modifies such insurance as is afforded by the provisions of the policyrelating to the following:

Comprehensive General Liability InsuranceManufacturers' and Contractors' Liability InsuranceOWners', Landlords' and Tenants' Liability InsuranceSMP Liability Insurance

L6944Ed. OS-80S

THl!:HOMEINSURANCECOMPANIES

(

at 12: 01 A. M. standard time,ij-1-87(Date)

GL 99 48 43of Policy No.

AMENDATORY ENDORSEHEHTWASHINGTON

GL 01 56 (Ed. 05-85)

(

This endorsement, effective on

••

Authorized Representative

This exclusion does not apply to li­ability assumed by the insured underan incidental contract.

because of damages arising out of thebodily injury; or

to bodily injury sustained by thespouse, child, parent, brother, 0:­sister of an employee of the insuredas a consequence of bodily injury tosuch employee arising out of and i~

the course of his employment by thsinsured•I .This exclusion applies to all claimsand suits by any person or organiza­tion for damages because of suct:bodily injury, including damages fOT-care and loss of services. ..

(iii)

insurance does not apply:

to bodily injury to any employee ofthe insured arising out ·ofand in thecourse of his employment by the in-sured for wich the insured may beheld liable as an employer or in anyother capaci~;

to any obli'gation of the insured toindemnify or contribute with another

It is agreed that exclusion (j) only applieswith respect to bodilY injury to employeesof the insured whose ~ployment is subjectto the Industrial Insurance Act ofWashington (Washington Revised Code Title51>'

With respect to bodily injury to any otheremployee of the insured, exclusion (j) is

. replaced with the following :

•

~t.

, • . ,

Copyright, Insurance Services Office, Inc., 1984. Edition November, 1985 Page 1 of

( ( IL 00 18(Ed.lO 84)

The Company will pay, in addition to the applicable limit of liability, prejuqgment interest awarded against theInsured on that part of the judgment the Company pays. If the Company makes an offer to pay the applicable limit·of its liability. the Company will not pay any prejudgment interest based on that period of time after the offer.

, .....,

AMENDATORY ENDORSEMENT~REJUDGMENTINTeREST

The following is added to the Supplementary'Payments provision in this policy: ."

'.";'.' .

•• ••~{ ....._ .. .... .::,,;',~ ..

""...":-

.. .' ·c~J;~;;~~t. Insurance Services Office, I~c·., i984 .Copyright, ISO Commercial Risk ~ervices, Inc., 1984

.'. ~ . .'.

IL 00 1810 84

( (

nfEHOMIEINSURANCECOMPAHIES 01

AMENDATORY ENDORSEMENT l6178Ed.4-a4

Thi s endorsement modi fi es such insurance as is afforded by

•

the provisions of the policy relating to the .following :

COMPREHENSIVE GENERAL LIABILITY INSURANCEMANUFACTURERS AtiD CONTRACTC~S LIABILITY !NSU~ANCE

OI.:HERS p LANDLORDS AND TENANTS LIABILITY HISURANCECOJNERS AND CONTRACTORS PROTECTIVE LIABILITY INSURANCESTO~EKEEPERS INSUKANCESHP LIABILITY INSURANCE

4& ....

(The Attaching Clause need be completed only when this endorsement is issued subsequent topreparation of the policy.)

This endorsement, effectivQ 4-1-87 (12:01 A.M .• standard time) , forms a part of

policy Ho. GL 99 48 43

issued to

by

1"---·__---.-;...I~Authorized Representative

tel" of an employee of the insured as aconseQuence of bot:li ly injury to suchemployee arising out of and in thecoursp- of his employment by the insured;

This exclusion applies to all claims andsuits by any person or organization Tor dam­ages because of such bodily injury includingdamages for care and loss of seryi ces.

This exclusion does not apply to liabilityassumed by toe InSUrEd under an InCldsntalcontract...

i 1) to any obli gati on of the insured toindemnify 0'1" contribute with anotherbecause of damages ari si ng out of tnebodi ly injury; or."

iii) to bodily injury sustained by thespouse, child, parent, brother, or sis-

I~ is agreed that the exclusion relating to bodily injury to any employee of the insured isdeleted and replaced by the following:

e Thi s insurance does not apply:

'. i) to bodi ly injury to any employee of the. insured ~rising out of and in the course

of hi s employment by the insured forwhich the insured may be held liable asan employer or in any other capaci ty;

•

•

•

~ .

..

•••~)

Copyri ght, Insurance Servi ces Offi ce, Inc., 1983Page 1 of 1

•••••;: .

;-. .~~

liability

(The ~~~aching Clause need be completed'~nlywhen thisendorsement is issued subsequent to preparation of the policy.)

;.

..IL 02 23 (Ed. 09 79)

Cancellation Provision Or Coverage Change Endorsement

NEW YORK

L612~'(Ed.9-19)

This endorsement modifies such insurance as is afforded bythe provisions of the policy relating to the following:

COMPREHENSIVE GENERAL LIABILITY INSURANCE

SMP LIABILITY INSURANCE

(12:01 A.M .• standard time)

endorsement" effective 4-1-87 " forms a part of policy No. GL 99 48 43

issued to

by

Authorized Representative

Deletion of Coverage

If the Company elects n"ot to renew this policy, it shall mail to the named insure~at the mailing address shown in this policy wri tten notice of nonrenewal at leas,forty-five (45) days prior to the expiration date of this policy.

Notwithstanding the notice periods provided in the cancellation and nonrenewa~provisions of this policy, if the Company elec'ts to delete any coverage (otherthan bodily injury· and property damage included within the products hazard an~the completed operation hazard) "provided under this policy, it shall mail to th~named insured at the address shown in -this policy at least ten (10) dayS notice 01such deletion~.' "

• 1. The cancellation provision of this policy is amended as follows:

The provision of the policy requiring ten (10) days notice of cancellation by th~Company is amended to forty-five (45) days. However. in the event the policy is can~celled for nonpayment of premium. only ten (10) days notice of cancellation shal~ b4given.

2. The following provisions are added:

A. Nonrenewal of Policy

~uffi~

•.'r•'.

•The delivery or mailing of notice of nonrenewal or deletion of coveragecie,nt proof of notice. L . ..

: ..•..;. . ";:' ..

AMENDATORY ENDORSEMENTMICHIGAN

GL 01 S3 (Ed. 04 85)

It (

THE HOME'"SURA-NeECOMPANIES

L6134;::Ed.4-8:

,

(The Attaching Clause need by completed only when this endorsement is issued subsequent ttpreparation of the policy.)

This endorsement, effective 4-1-87(12:01 A.M. standard time)

forms a part of policy No. GL 994843

issued to

by

•

1. It is agreed that the first paragra;::hof the nCancellation~ conditiori is re­placed by.the following:

This policy may be cancelled by thenamed insured by surrender thereof tothe company or' any of its authorizedagents or by mailing to the company orany of i is authorized agents writtennotice stating when thereafter thecancellation shall be effective. Thispolicy may be cancelled by the companyby mailing to the named insured'at hisaddress last known to the company orits' authorized agent. written noticestating when not less than ten daysthereafter such cancellation shall beeffective. The mailing of notice asaforesaid shall be sufficient proof ofnotice. The time of surrender or theeffeciivadateand hour of cancellationstated in the notice shall become theend of the policy period .. Delivery ofsuch written noti ce ei ther by. the named

"'2.

3.

;insured or by the company shall b~equivalent to mailing.

It is agreed that paragraph (b) cf th£"Insured's Duties in the Event of Oc­currence, Clair.: or Sui t n condi ticn .::L~.

replaced by the following:

(b) If claim is made or suit is ~rcugh~

against the insureci~ the J.nsure-=­shall as soon as practicable for­ward to the company every demand,notice, summons or other processreceived by him or his represen­tative.

It is agreed that the Supplementa~

Payments provision is amended to in­clude the following:

(e) prejudgment interest awardedagainst the insured on that pariof the judgment the company pays.

••••••~ , ' ' " '~.~ ":' -

......: .... , ...

,.

•"'''IIi

•-.

I',Copyright, Insurance Services Office, Inc., 1983, 1984LIABILITY

,/:.\'i"

;'~";:',';,:;.:-~ .:

HPage 1 of J

(The Attach!n,' 'lSe need be completed only when this endorsement is issued ~equent to preparation of the policy.)

I. (

LIABILITYGl01 00 (Ed. 07 79)

ACTION AGAINST COMPANY AMENDMENT(Massachusetts)

This endorsement modifies such insurance as is afforded by the provisions of any G~neralliability Insurance

GU 9220a(Ed. 7-79)

This endorsement, effective 4-1-87(12:01 A. M.. standard time)

• forms a part of policy No. GL 99 48 43

issued to

by

It is agreed that the clause "nor shall the company be impleaded by the insured or his legal representative" in the Action Against Company Con,. ditionshall not apply to any right of impleader under Rule 14 of the Massachusetts Rules of Civil Procedure, 365 Massachusetts 760 (1974). .

......-......~OAUTHENTICO"-c.-=:~.

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. :ii.

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•

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I( (

IL 0238{Ed. 01 86)

LOUISIANAAMENDATORY ENDORSEMENT

The cancellation provision is amended as follows:

The provision of the policy requiring a specific number of days notice of cancellation by the Company isamended to twenty (20) days notice to the named insured shown in the policy. However. in the event thepolicy is cancelled for nonpayment of premium. at least ten (10) days' notice of cancellation shall be given.

...-,,~~, ...• ,.,,-, ~

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_. IL 02 38 (Ed. 01 86)

Copyright, Insurance Services Office. Inc., 1985

THE HOMEINSURANCECOMPANIES

•Liabni~y

((The A~taching Clause need be comple~ed only when ~his

endorsement is issued subsequent to preparation of ~he p~licy.)

G 530

Amendment Of Persons Insured Prevision'

Definition Of Executive Officer

L6157b(Ed.6-75)

This endorsement modifies such insurance as is afforded by~he provisions of ~he policy relating to ~he following:

COMPLETED OPERATIONS AND PRODUCTS LIABIL!TY IUSURANCE

COMPREHENSIVE GENERAL LIAEILITY INSURANCE

COHTRA~TUAL LIABILITY INSURANCE

DRUGGISTS LIABILITY INSURANCE

FARM EMPLOYERS LIABILITY AHDFARI1 EtfPlOYEES MED!CAL PAYMENTS INSURANCE

HOSPITAL FROFESS!C}~l LIAB!LITY INSURANCE

~ANUFACTURERS A};D CONTRACTORS LIAB!LHY INSURANCE• ..1<,

OWNERS AND COHTRACTO;::S P?OTECTIVE lIA3!LITY INSURAl-:CE

OWHERS~ lANDLORDS AHD TENAHTS LIABILITY INSU~ANCE

STOREKEEPERS INSURANCE

• This endorsemen~1 effective 4-1-87 ~ forms a part of policy Ho. GL 99 48 43

(12:01 A.M. I standard time)

to

Authorized Representative

.It is agreed that the Persons Provisi on· is amended to include the followi n9 def;-nition of exe~utive officer under subdivision (c):

'1,I,

.".....~;'ii ..

g2nli070 092482 HHEFl

."Executive officer" means only a person holding any of the officer positions created bythe chart~r~ constitution or bylaws'of the naced insured. •

L6157b

(The Attaching Clause need be completed only when thisendorsement is issued subsequent to preparation of the policy.)

Amendment Of Termination Provisions .,aa.:i~

Liability

GS33

(Illinois)

.,:.

"

-. '"'.

L613(,(Ed.I-76:

This endorsement, effective , forms a part of policy No. . GL 99 48 43'0

(12:01 A,M., standard time)

.-issued

Representative

the notice shall become the end ofth,policy period.

The mailing of notice as aforesaid shallbe sufficient proof of notice •.

The following Condition is added:

Renewal

If the company elects not to renew thi~policy, it shall mail to the namecinsured at the last mailing addres~known by the company, written notice 01such nonrenewal not less than thirt~days prior to the expiration date; pro'vided that, notwithstanding the failurfof the company to comply with the fore­going provisions of this paragraph, thi~

policy shall terminate

1. on such expiration date, if

a) the named insured has failed t<discharge when due any of hi:;:obligations' in connection wi tfthe payment of premium or an>installment of. such premiuithat is payable directly to thecompany or its agent, or

b) the company' has by any mean~

mani fested its willingness t\renew directly to ·the name(insured. or

•c) the named' insured has notifiecthe compallY or itsa~nt 'that hidoes not wishi;h~~ii'''!5'licy .'tp b •renewed. or •. , ' ...

•• l1t. • • •on the effective date of 'any othelinsurance policy procured by 'th!insured as a replacement for thi~policy.

'2.

..

B.

The first paragraph of the"Cancellation" Condition is replaced bythe following: .•

This policy may be cancelled by theNamed Insured by surrender thereof tothe company or any of its authorizedagents or by mailing to the companywritten notice stating' when thereafterthe cancellation shall be effective.

This policy may be cancelled by the com'""pany by mailing to the named insured atthe last mailing address known by thecompany, written notice stating whenthereafter such cancellation shall beeffective. If the policy is cancelled by·the company due "to the failure of thenamed insured to discharge when due any.

.01' .his obligations in conneciion withthe payment of premium or any install­ment of such premiumthflt is payabledirectly to "the company or i tsagent,wri tten notice of cancellation must bemailed at least ten days prior to the

. effective date of such cancellation.However, if the policy is cancelled by.the company for any reason other thannonpayment of premium. written notice of,cancellaj:ion must. be mailed:'"

L at least thirty days prior to theeffective date of cancellation ifthe p'olicy has been in force for 181

• days or more, or .. ::: ~."... -. .',_,0_'_ .~, w.-e; '."!" ~.~ -" •• ~ •• '

.2 .;":;"1: east fi fteenc~~:~~::'~ri:C)r to theeffective date of cancellation ifthe policy has been in force for 180

................... days or less.

The mailing of notice as aforesaid shallbe sufficient proof of notice.

of surrender or the effectivehour of cancellation stated in

A.

•••

(The A~~aching Clause need be completed only when thisendorsement is issued subsequent to preparation of the policy.)

liabili"ty

Il 02 28 (Ed. 12 811

Cancellation Provision Or Coverage Change Endorsement

COLORADO

l6143(Ed.12-a!)

This endorsement modifies such insurance as is afforded bythe provisions of the policy relating to ~he following:

, forms a part of policy No. GL 99 48 43:~

(12:01 A.M., standard ti~e)

COMPREHENSIVE GENERAL LIABILITY INSURANCE

SMP LIABILITY INSURANCE

This endorsement, effective

issued ~o

by

Authorized Representative

If ~he Company elects tode~reasecoverage in this policy, it shallmail to the named insured at themailing address shown in this polic~

The provisions of the policy requir~ing ten (10) days notice of cancel~la'tion is amended to forty-five (45)days. "

DECREASE IN COVERAGE

this policy, it shall mail tcthe named insured at the addressshown in this policy at leasiten nO) days notice of·. suchdeletion~ ..

NONRENE\.,AL OF POLICY

'If the CompanY. elects "not to rene\-!this policy, it shall mail to thEnamedj,nsured .at the mai'16n9' addressshown in this policy~~.tennoticEof nonrenewal at l~S'e, forty-fivE(45) dayS pri."o....to the expiMiltiondate of this policy.

3.

2.

The delivery or mailing of notice oinonrenewal or deletion of coverageshall be sufficient proof of notice.

II. 'The following provisions apply to gov~

ernmental entities insured under thispolicy.:

1.

CANCELLATION

The provisfon of the policy requir­ing ten (10) days notice of cancel­lation by the Company is amended toforty-five (45) days. 1

The following provisions are added:

Nonrenewal of policy, .

If the Compa,w elects not'renew this policy, it shall mailto the named insured at theC1ailing address. shown in tj1is,p'olicy written notice of nonre­newal. at least forty-five (45)days prior to the expirationdate of this policy.

Delet~onCrf co"erage";:d,~~~.~:~:~';:;:t~.··

Notwithstanding the noticeperiods provided in the cancel­lationand nonrenewal pro­visions of, this policy, if theCompany ,elects to· delete anycoverage (other than bodilyinjury and property damage'included within the productshazard and the completed opera­tion hazard) provided under

The following provJ.S:1ons apply to allrisks insured under this policy, 'exceptgovernmental entities provided for initem II below:

•••. I.

.............-... '•.........., ..::... .

:~~: .. ':;. ,. ...

2. If t:he insured fails to pay any pre­mium deposit required by the insurerfor renewal.

wri tten notice of decr-ease in cover­age at least forty-five (45) daysprior to the expiration date of thispolicy.

III. The provisions of this endorsementshall not apply:

1. In the case of nonpayment of premi-um.

3. If the coverage to which thisendorsement applies has been ineffect less -than six-ty (60), dayS,unless it'is a.renewal policy.

'•.::... ' ,:;

.....--::. "

.. , ...

,

HOTICE

• (The AIUcllinC!'I

LIABILITY

.e need be comllieled only wilen this endorsement is. issueCl (

Gl 01 03 lEd. OS 731ISO GS25

AMENDATORY ENDORSEMENT(Teus)

~outnl to llrt~ratjOft of the PClliey.1

l6125{Ell. $oiJ.

This endorsement. effective

issued to

by

4-1-87(l:U!1 A. M•• slUlclard time,

, forms a p3tt of policy No. GL 99 48 43.

;'5 res::ects ~Ddi!y injury liability coverage and llrOflerty damage H"oi!::"! c:l'/!:age. u:l!ess the C:lm02ny is prejuciced ~y !o~e inslIred's biitlte tJ co:::::;y\':':h tr;'! r:!;!;irement. any prc·..ision of thispolic-f requirlr.sli:e insure!i tJ iive :lotic! 'of a~tio:1. CC;:IrTt:lce or :CS3, or .e:;!;iriq tile ir~ured .0 f't·.,...tel c:r.,Jr.ds. nctices. summons Ot other legal ptocess.s,"1all ;;0, tlar J:ahi:q tinder Lois ~clicy.

•"c·· ••.•••

oErt1ffiftfC]... , . .. : ._,.:.11

- ---:' ..

.' ,:., ,..... ~~.,. ,..,

\

.,.:

•

.. . ....• '.A1,\,

•

..

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I(

IL 02 57lEd 11 8St.

writing to do< .. ·:J .•.... ._. ' " ,'

~.~,~

AMENDATORY ENDORSEMENT(ARIZONA)

I. With respect to provisions for cancellation by the company, the following is added to the. Cancellation Condition:

CANCELLATION OF POLICIES IN EFFECT FOR 60 DAYS OR MORE

If this policy has been in effect for 60 days or more, or if this policy is a renewal of apolicy we issued, this policy may be cancelled by the company only for one or more of thefollowing reasons: . .

. a. Nonpayment of premium; _'''~'',__;c.~.",,\''-. b. Conviction of. ',the named insured of a crime arising out of acts increasing the hazard

insured against;

c.-Acts or omissions by the' named insured or his representative constituting fraud or,·material misrepresentation in the procurement of this Insurance, in continuing this policy

~_ ...().t:.ir' •• presenting .. a claim under this policy;,~;: •...' ..........:..:; .... d.·'::.Subcsiantial 'Chang~jn'the.ris~assumed,·e)(~~~t 'to the extent that'the company should

.- "havereasonably foreseen the change or contemplated the risk in writing the contract;·,·::::::

e. :S.ubstantial br~ach of contractua.1 duties or conditions;

f. Loss'of reinsl.lranceapplicable to the risk insured against resulting from termination Of'"treaty or' facultative reinsurance initiated or'lrnplemented by the reinsurer or reinsurersof the company;

g. Determination by the Director of Insurance that the continuation of the policy would placethe company in violation of the insurance laws of this state or would jeopardize thesolvency of the company;· or

h. Acts or omissions by the named insured or his representative which materially increase.the hazard insured against

If this .policy is cancelled by the comp'any based on one or more of the above provisions,th~ compat:1y will. mail by. certifie~ mall to the named insuree:t. and mail to his ag~nt, i! any,written' notice of' cancellation stating the reasons for cancellation. The company Will mall thiSnotice to the last mailing addresses known to the company, at least _

lCj'days before,the effective date of cancellation if the company cancels for nonpaymentof'premium; or:~::,: . .,,-"".

50 ,days before, the effective date of cancellation if the' company cancels for any ot.: .....the other reasons.

II. The follo.yvJng is added:'

NONRENEWAL OF POLICY

.'.~:.:.:::;, ~",..", , a. .If.this company elects not to renew this policy, it shall mail by certified mail to the " _.named insured. and mail "to his agent, if any. written notice of nonrenewaL The company.'will mail this notice to thetpstmailing addresses kn.own to the company at least 60 days;before the end of the policy period.

It notice is mailed, proof of mailing will be sufficient pr~of of notice.

c. If 'either one of the following occurs, the company is not· required to provide writtennotice of nonrenewat.· ...,," ."..,.-.'. '.

(1) This company or another company. within the same insurance group has offered toissue a renewal policy; or .

The named insured has obtained replacen:ent

Copyright Insurance Services Office, Inc., 1986Copynght ISO Commercial RiskS"ervices. Inc.. 1986

IL 02 57 (Ed. 11 86)

This endorsement modifies such insurance as is afforded by theprovisions of the policy relating to ~he following:..

.."'~COMPLETED OPERATIONS AND PRODUCTS LIABILITY INSURANCEDRUGGISTS LIABILITY INSURANCEPOLLUTION LIABILITY INSURANCE

(12:01 A.M., standard time) , forms a part of4-1-87GL 9948 43policyNo~

{The Attaching Clause need be completed only when this endorsem~nt is issued subsequent topreparation of the policy.). .

This endorsement,' effective"

···1"...... -.

, .. e,.', .......,. ,_......~ ....'••.Authorized Representative

It is agreed that the exclusion-relating to bodily injury to any employee of the insured isdeleted and replaced by the following:

iii) to bodily injury sustained by thespouse, child, parent, brother, or sis­ter of an employee of the insured as aconsequence of- bodily injury to suchemployee arising out of and in thecourse of his employment by the insured;

This exclusion applies to all claims andsuits by any person or organization for dam­ages because of such bodily injury includinsdamages for care and loss of services.

Insurance Services Office, Ine., 1983

This insurance does. not apply:

to bodily injury to any employee of theinsured arising out of and.in the courseof his employment by the insured forwhich the insured may be held liable asan employer or in any othercapaci ty;

ii) to any obligation of the insuredi:oindemnify or contribute with anotherbecause of damages arising out of thebod~lyinjury; or

i)

,J.l-

, ~,,~:,;.,

(OREGON

AMENDATORY ENDORSEMENT

(Il 02 41(Ed. 04 86)

A. The provisions of this policy pertaining to cancellation by the Company are amended as follows:1. CANCELLATION OF POLICIES IN EFFECT FOR 90 DAYS OR MORE.

If this policy has been in effect (or 90 days or more, it may be cancelled by t~is Company for one or more of the following reasons andthen only by mailing or delivering to the named insured written notice stating when, not less than 10 days thereafter, such cancellation shallbe effective:a. Material misrepresentation; .

',,'. ", '..... .Ii. Substantial change in the risk assumed, except to the extent that the Company should reasonably have foreseen the change or contemplated' .

the risk in writing this policy;

Co Substantial breaches of contractual duties, conditions or warranties; or

d. Nonpayment of premium.

. 2. CANCELLATION OF POLICIES IN EFFECT FOR LESS THAN 90 DAYS. '

If this policy has been tn effect for less than 90 days, it may be cancelled by this Company for any reason by mailing or delivering to thenamed insured· written notice stating when, not less. than 10 days thereafter~ such cancellation shall be effective. .. .~

3. CANCELLATION OF POLICIES WITH A TERM OF MORE THAN 1YEAR.;·······_. .-.,

In addition to the right of this Company to cancel as provided in paragraph A.t and 2., this Company may cancel any policy with a termof more than one year by mailing or delivering to the named insured, not less than 30 days prior to any anniversary date of this policy ••__~

written notice stating that cancellation shall be effective on the anniversary date of this policy:' .::.:- " .' , . ., ~~~ ,. .';B~ The f~"owing provision is added: .' . ,

~. ~':" . ::NONRENEWAL or POLICY

1. Ifthis Company elects not to rene; this policy, itshall mail or deliverht·the named insured and agent, if any. notice ofnonrenewal, ~tleast 20 days prior to the expiration date of this policy.

2. This Company need not mail or deliver thisnotice if the insured has:a. Insured elsewhere; ....

b. Accepted replacement coverage; or

c. Requested or agreed to nonrenewal of this policy.3. Any notice of nonrenewal will be mailed or delivered to the named insured's last mailing address known to this Company. If notice is mailed,

proof of mailing will be sufficient proof of notice.

- IL0241 (Ed. 0486) Copyright, Insurance Services Office, Inc~ 1985

( (/

Gl 02 07(Ed. Q6.80)

This endorsement forms a part of the policy to which attached ellective on the inception date of the policy unless otherwise stated herein.

(The followinl information is required only when this endorsement is issued subsequent to prepara~ion of policy.)

Endorsement ellective

Named Insured

4-1-87 Policy No. GL 99 48 43· Endorsement "0.

Countersigned by :-. :-._

(AuthoriZed Representative)

AMENDMENT OF CANCELLATION CONDITION(Washington)

It is agreed that the second sentence of the fifst paralraph of the "Callcellation" Condition is replaCed by the following:

This policy may be cancelled by the company by mailing to the named insured or his representative. or any lienholder shown in the policy. at the last addressknown by the company or at the last address shown by the company's records. written notice staling when not less than twenty days thereafter such cancellationshall be ellectlve; provided that in the event of nonpayment 01 premium. such nolice shall state when not less than ten days thereafter such cancellation shallbeelfective.~::.- :.... . '.,

"""","-."".~' "'~"""' .

....•-.......•...•....~..... ' .-..' .

.'.' ~'~";;' ~,....-_..

•

Gl 02 07 06 80

& ,,,

,Bel r .r J30O'

4-1,-88

City Insurance Company

O The Home Insurance Companyof Indiana

Issued bv

o The Home Insurance Company .' . 0(]) The Home Indemnity Company

(

Non-Premium Endorsement

........~.

por Period: Inception (Month-Oay-Year) Expiration (Month-Day-Year)

ICY 4-1-8

Producer

Alexander "Alexander Winston Salem He.

Policy Number Certificate Number Named Insured Quaker Sta~e 011 Ref1n1ng Corporation-- ......~ •.•GL 99 48 4

It is agreed that this policy is hereby amended as indicated. All other terms and conditions of this policy remain unchanged.

It 1s asreedtbclt Quaker State.COrporation 18 added as

••••••••••••••••••. :.. " >:

•The Home Insurance CompaniesProducer Copy

Signature of Authorized Representative

. ' ~. -.•... ', ••'~,.,"'"!;~•. ,., •.,~