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BUSINESS AUTO POLICY # 964 63 47 .~~. ~~CV70Z."':"":::'" '.'.,=CC'-"':Z'OL'2.'J:0Z vCq,;.' @ West American Insurance Company :l.';-Z.l~~\.r~Lr;;.r;.~.L'-.AAJJJ....A~~-~~~'b~.b6Jd:EJ.:;;;J.X~:,"~): Home Office 2600 East Nutwood Avenue .........r_........._,.-.,_._.....--.....~__......,~_,,_''"~ ;~r~~s:.:}~.;),.r.....\.!7::/2.r.:.::.!~v~.:,>"':,_, _:. - :_:...../~-.:.:~->)_,:~~.._.'~:;>.;' - .. ~,z. - ... Fullerton, California 92631 "c__.~<. -. -..,':~~'::( :~:Tc(i"i-.C.C0.:.C..... (II"':";';";"' Y[DI," ,'~i'.;-(J :.r:r-('~lytJ~'I-r'-;-r-J"t YIYCS:5:J-:Y t . " ,',",-C,yt:'I'!,::.:i.-:..-:' -:fi~2,';-,-;', ;"',' ;':"0YL~"if{::c;,:~..l.:.~:.:...;..:..;.;__. r-----~'.--.....____._._.~~",.,__ ,- -- - ",-- BUSINESS AUTO POLICY ~'-_._~ """""""-.-- ---~---....--"'~" , , T , -, , . ~ ~ o o YOUR BUSINESS AUTO POLICY QUICK REFERENCE Beginning On Page PART I...;....WORDS AND PHRASES WITH SPECIAL MEANING 1 PART II-WHICH AUTOS ARE COVERED AUTOS 1 PART III-WHERE AND WHEN THIS POLICY COVERS 1 PART IV...;....L1ABILlTY INSURANCE 2 A. We Will Pay B. We Will Also Pay C. We Will Not Cover-Exclusions D. Who Is Insured E. Our limit Of liability F. Out Of State Extensions Of Coverage PART V-MEDICAL PAYMENTS INSURANCE 3 A. Words And Phrases With Special Meaning B, We Will Pay C. We Will Not Cover-Exclusions D, Who Is Insured E. Our limit Of liability f. Changes In Conditions PART VI-UNINSURED MOTORISTS INSURANCE 3 A. Words And Phrases With Special Meaning B. We Will Pay - C. We Will Not Cover-Exclusions D. Who Is Insured . E. Our limit Of liability F. Changes In Conditions :J .~ Beginning On Page PART VII-PHYSICAL DAMAGE INSURANCE 4 A. We Will Pay B. We Will Also Pay C, We Will Not Cover-Exclusions D. How We Will Pay-The Most We Will Pay E. Glass Breakage-Hitting A Bird Or Animal- Falling Objects Or Missiles PART VIII-CONOITIONS 5 A. Your Duties After Accident Or Loss B. Other Insurance C. Our Right To Recover From Others D. Cancelling This Policy E. Automatic Termination F. Legal Action Against Us G, Inspection H. Changes I. Transfer Of Your Interest In This Policy J. No Benefit To Bailee-Physical Damage Only K. Bankruptcy L Appraisal For physical Damage Losses Insert Declarations page here so that top edge butts against fold of Contract, and permits name and address to appear through window, BUSINESS AUTO POLICY DE. A TIONS -ITEMS ONE, TWO AND THREE. (This Declara'tions must be compl y the attachment ofa S"opplemental Schedule.) @ West American Insurance Company r- ~ C'~ ITEM (D ONE Home Office . ACW 96~ 63. 4~ 2600 East Nutwood Avenue Fullerton, California 92631 . ..Named JnJureJ D D XX D individual partnersh ip corporation joint venture oth er . Clearwater Beach Seafood, Inc. 37 Oauseway Boulevard Clearwater, Florida 33515 Address & Zip Code ~ r:..o CJJ . . Town Code: 251 POLICY PERIOD: 12:01 A.M. STANDARD TIME FROM: NAMED INSURED'S BUSINESS: ITEM TWO-SCHEDULE OF COVERAGES AND COVERED AUTOS This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those autos shown as covered autos. Autos are shown as covered autos for a particular coverage by the entry of one or more of the symbols from ITEM THREE next to the name of the coverage. COVERAGES COVERED AUTOS (Entry of one or more of the symbols from ITEM THREE shows which autos are covered autos) ~ LIABILITY INSURANCE PERSONAL INJURY PROTECTION (P.I.P.) .ADDED P.I.P. PROPERTY PROTECTION INSURANCE (P.P.I.) AUTO MEDICAL PAYMENTS INSURANCE UNINSURED MOTORISTS INSURANCE LU '" <<: :;:LU <<:u OZ <<: -' <>:: <<: => U en C;;;~ >- z "- COMPREHENSIVE COVERAGE COLLISION COVERAGE SPECIFIED PERilS COVERAGE TOWING AND lABOR FORMS AND ENDORSEMENTS CONTAINED IN THIS POLICY AT ITS INCEPTION LIMIT THE MOST WE Will PAY FOR ANY ONE ACCIDENT OR LOSS $ $ SEPARATELY STATED IN EACH P.I.P. ENDORSEMENT $ SEPARATELY STATED IN EACH ADDED P.I.P. ENDORSEMENT $ SEPARATELY STATED IN THE P.P.1. ENDORSEMENT $ $ $ $ $ ACTUAL {SEE DEDUCTIBLE FOR. EACH COVERED AUTO FOR All $ CASH VALUE SCHEDULE LOSS EXCEPT FIRE OR LIGHTNING OR COST OF REPAIR, SeeSch ,pEDUCTIBlE FOR EACH COVERED AUTO $ W~.JCtE~~ER $25 DEDUCTIBLE FOR EACH COVERED AUTO FOR LOSS $ MINUS CAUSED BY MISCHIEF OR VANDALISM $ 25 LIMIT FOR EACH DISABLEMENT OF A PRIVATE PASSENGER AUTO $ PREMIUM 64. 186. ESTIMATED TOTAL PREMIUM $ 1 1 O. 5454, 3817, 3923, 374lA, 3712, 5452, 3489D The estimated total premium for this policy is based on the exposures you told us you would have when this policy began. We wi II compute your fina I premium due when we determine your actual exposures. The estimated total premium wi II be credited againstthe fi na I premium due and you wi II be billed for the balance, if any. If the estimated total premium exceeds the final premium due you wi II get a refund. To determine your final premium due we may examine your records at anytime during the period of coverage and up to three years afterward. If this policy is issued for more than one year, the premium shall be computed annually based on our rates or premiums in effect at the beginning of each year of the pplicy. ITEM THREE-DESCRIPTION OF COVERED AUTO DESIGNATION SYMBOLS SYMBOL DESCRIPTION 1 = ANY AUTO. 2 = OWNED AUTOS ONLY. Only those autos you own (and for liability coverage any trailers you don't own while attached to power units you own). This includes those autos whose ownership you acquire after the policy begins. 3 = OWNED PRIVATE PASSENGER AUTOS ONLY. Only the private passenger autos you own. This includes those private pas- senger autos whose ownership you acquire after the policy begins. 4 = OWNED AUTOS OTHER THAN PRIVATE PASSENGER AUTOS ONLY. Only those autos you own which are not of the private passenger type (and for liability coverage any trailers you don't own while attached to power units you own). This includes ~hose autos, not of the private passenger type, whose ownership you acquire after the policy begins. 5 = OWNED AUTOS SUBJECT TO NO-FAULT. Only those autos you own which are required to have No-Fault benefits in the state where they are licensed or principally garaged. This includes those autos whose ownership you acquirp after the policy begins provided they are required to have No-Fault benefits in the state where they are licensed or principally garaged. Date and Place of Issue SYMBOL DESCRIPTION 6 = OWNED AUTOS SUBJECT TO A COMPULSORY UNINSURED MOTORISTS LAW. Only those autos you own which, because of the law in the state where they are licensed or principally garaged, are required to have and cannot reject unin, sured motorists insurance. This includes those autos whose ownership you acquire after the policy begins provided they are subject to the same state uninsured motorists requirement. 7 = SPECIFICALLY DESCRIBED AUTOS. Only those autos described in ITEM FOUR for which a premium charge is shown (and for liability coverage any trailers you don't own whi Ie attached to any power unit described in ITEM FOUR). 8 = HIRED AUTOS ONLY. Only those autos you lease, hire, rent or borrow. This does not include any auto you lease, hire, rent, or borrow from any of your employees or members of their households. 9 = NONOWNED AUTOS ONLY. Only those autos you do not own, lease, hire or borrow which are used in connection with your business. This includ u os owned by your employees or membe'rs of their households but 0 y ile personal affairs. Renewal of Policy No. Countersigned by (Authorized Ag AIM Insurance Clearwater, Fl 5-18-84/mvs St. PeterSburg, Florida NEW THIS DECLARATIONS PAGE IS ISSUED IN CONJUNCTION WITH AND FORMS A PART OF POLICY FORM ACW 6176 Form ACW 6176 2-84 (Numbered 9,643,001 to 9,653,000) INSURED'S COpy rvvr' . SUPPLEMENTARY SCHEDULE FOR ~ 'BUSINESS AUTO POLICY - ITEM FOUR D GARAGE POLICY (NON-DEALE-RS) -IT-EM TEN D TRUCKERS POLICY - ITEM FOUR D GARAGE POLICY (AUTO DEALERS) - ITEM ELEVEN POLICY NUMBER D THE OHIO CASUALTY DAMERICAN FIRE & ~ WEST AMERICAN INSURANCE COMPANY . CASUALTY COMPANY ~ INSURANCE COMPANY ACW 964 6~ 47 SCHEDULE OF COVERED AUTOS YOU OWN (FOR DEALERS-AUTOS WHICH ARE FURNISHED TO SOMEONE OTHER THAN CLASS I OR CLASS II OPERATORS OR WHICH ARE INSURED ON A SPECIFIED CAR BASIS.) No. Year, Trade Name, Capacity, Model, Body Style P.P. Symbol Rating ZIP CODE * 1.1. N. Motor Or Serial No, Or Comm. Class Cost New Terr. 1 1982 Datsun Diesel Pickup J]f6SD01~lCW1 6700 ~-0~19 01866 2 1975 Ford ~/4 fOIl Pickup :r~7'7C071290 Coverage is provided where a premium and a limit of liability is shown for the coverage. LIABILITY AUTO MED PAY a Fire, a COLLISION a LIMIT LIMIT Actual Specified U.M. Cash Theft, Wind Perils X LIMIT Value b Umited ACY $ ~OO,OOD $ 5,000 or Specified Compre. minus b PIP 50,000 Stated b deductible Each Accident Each Insured Amount Perils hensive shown TOTAL below No. Premium Premium Premium Premium Premium Premium Premium Premium PREMIUM ACV a ~----- a 1 ~77. 11. ~O . de Ib:"---- ----- 2~. 17. 678. l' b 64. 100 186. b a a a 2 ~77. 11. ----- - - -- -- ----- 23. 17. 428. b b b a a a ----- - - -- -- ----- b b b a a a ----- - - --- ----- b b b a .!_--- a ----- ----- b b b a .!_---- a ----- ----- b b b a .!_---- a ----- ----- b b b a r-!----- a ----- ----- b b b a -.!_---- a ----- ----- b b b a a a ----- ----- - - --- b b b *Zip Code for Place of Principal Garaging if other than mailing address. TOTAL PREMIUM $ 1,106. GI7DA (Single Limit) INSURED'S COpy . ~ ADDITIONAL INSURED a. #9 5-22-84/EM1PH/mvs anges the policy effective on the inception date of the policy unless a different dat ing need be completed only when this endorsement is issued subsequent to preparation of the policy.) :ective on 5-31-84 (DATE) of the at 12:01 A.M. standard time, forms a par 4 63 47 West American Insurance Company (NAME OF INSURANCE COMPANY) 'ater, Florida AIM Ins 'ater Beach Seafood, Inc. nsurance as is provided by the policy for Auto Liability shall apply to: City of Clearwater red only and subject to the provisions of the "Who is I nsu red" clause in Part I V of' --- ....,. GENERAL ENDOllSEMEN'f hereby agreed that the following cancellation Clause Aed to the poliCY: Ld any of the below described policies be cancelled befe .xpiration date thereof, the iSsuing cOJDllany will endea, ail 60 days written notice to any nooned certificate .er, but failure to ....il ~ch notice snall impose no .gation or liability of any kind upon the cOJDllany. . ~ III h;ng herein contained .mall vary. alter. waive or extend any 01 the terms. repre,entan ,ditione or agreernenta 01 the policY other than a. above ....ted. be attacbed to and 10mUng a part 01 Poliey No..........~~..%'!:..~.3...!!:7............. i. ~~~.~..:B.~.a.~!!:..?~.~.~~.!...~'?..,........ by ~... ~ Il"-Q: . 5-31-84 ;lES!f AMERICAN INB'iJRANCl ,,..ment effee""e..... ...... ............... ..............."....... ~ ~ . ~.~~.?..~!'i~~~!..!...~~.~...?.~...?.C?...~~nt (J v . · 7....'''M E.n<I. 1'10.- 8 _ Date T yped-5_22-84~mvs 1 auto licensed or principally garaged in Florida, PHYSICAL DAMAGE INSURANCE is cli CHANGES \N POL\CY-FLOR\OA cllble applies to losS to glasS used in the windshield. . PHYSICAL DAMAGE INSURANCE provisions will apply. G THIS POLICY DURING THE POLICY PERIOD applies except as lollows: I lor any reason other than nonpayment 01 premium we will mail you at least 45 days r \ 0128) --- i1CAL DAMAGE INSURANCE - TEMpORARY SUBSTITUTE AUTOS nage Insurance is amended to pay for loss caused to a Temporary Substitute ,ich you may be heid legally liable, but only for the amount of such loss in ex. eductible amount stated in the declarations as applicable hereto. Su~stitute Auto means any private passenger auto or any other auto with a gross Iht of 20,000 pounds or less, owned by someone other than you or a member of hold, used with the permission of the owner and used as a temporary substitute ed covered auto that is out of service because of its breakdown, repair, servicing, ruction. ;al Damage Insurance that applies to the covered auto, shall apply to the Tem- >stitute Auto and shall be excess over any other collectibie insurance. ~AP) PPLEMENTARY SCH AUTO POLICY MS FIVE A~D I POll C WEST AMERICAN . ~INSURANCE COMPANY ACW' 9 CASUALTY DAMERICAN FIRE & E COMPANY CASUALTY COMPANY JR BORROWED COVERED AUTO COVERAGE AND PREMIUMS. ITING BASIS, COST OF HIRE ESTIMATED COST OF HIRE RATE PER EACH $100 PRE~ FOR EACH STATE COST OF HIRE ia If Any .864 Ine I TOTAL PREMIUM I Inc al amount you incur for the hire of autos YOI don't own (not including autos you borrow or rent from your employees or Id e charges for services performed by motor carriers of property or passengers. ~NERSHIP LIABILITY d's Business Rating BaSIS Number Number of Employees 5 $ Number of Employees $ Number of Volunteers $ L TOTAL PREMIUMS $ ration of the premium paid, it is understood and agreed coverage will not apply to al ,sed. acquired, or held under a contract of sale prior to the effective date of the policY I described in the schedule of covered autos. AUTOS N01" OESCR\BEO IE 0...,0 cASU A ,-TV INSUIIANCE CO"PANV · A"EIIICAN FI liE ANO cASUA'- TV COhIP.... WEST A"EIIICAN INSUIIANCE Co..P....V \1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL 'Y LEASED AUTOS SPECIFIED AS COVERED AUTOS YOU OWN ment changes the policy effective on the inception date of the policy unless a di ow. following need be completed only when this endorsement is issued subsequent e policy.) ment, effective on at 12:01 A.M. standard time, (DATE) of the (NAME OF INSURANCE COMPANY) eased auto will be considered a covered auto you own and not a covered auto you Inder the coverage for which it is a covered auto. .sE WITH SPECIAL MEANING dition to the WORDS AND PHRASES WITH SPECIAL MEANING in the polic e has special meaning in this endorsement: ,ed auto" means an auto leased to you for one year or more, including any substitut auto needed to meet seasonal or other needs, under a leasing agreement which requir t primary insurance for the lessor. NGES IN LIABILITY INSURANCE Following is added to WHO IS INSURED: e any covered auto is rented or leased to you and is being used by or for you, its from whom you rent or lease it is an insured but only for that covered auto. HOWl 's owner or anyone else from whom it is rented or leased is not an insured for I defects or faulty workmanship. .... THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CHANGES IN BUSINESS AUTO POLICY The policy is changed as follows: A CHANGES IN LIABILITY INSURANCE WHO IS INSURED is changed to read: D. WHO IS INSURED 1. You are an insured for any covered auto. 2. Anyone else is an insured while using with your permission a covered auto you own, hire or borrow except: a. The owner of a covered auto you hire or borrow from one of your employees or a member of his or her household. b. Someone using a covered auto while he or she is working in a business of selling, servicing, repairing or parking autos unless that business is yours. c. Anyone other than your employees, a lessee or borrower or any of their em- ployees, while moving property to or from a covered auto. 3. Anyone is an insured for his or her liabil- ity because of acts or omissions of an insured described above. However, the owner or anyone else from whom you hire or borrow a covered auto is an insured only if that auto is a trailer connected to a covered auto you own. B. CHANGES IN AUTO MEDICAL PAYMENTS INSURANCE Exclusions 3 and 5 are changed to read: 3. Bodily Injury sustained by any family member while occupying or struck by any vehicle (other than a covered auto) owned by or furnished or available for the regular use of any family member. 5. Bodily Injury to an insured while work- ing in a business of selling, servicing, repairing or parking autos unless that business is yours. 3712 BAP C. CHANGES IN PHYSICAL DAMAGE INSURANCE The "GLASS BREAKAGE-HITTING A BIRD OR ANIMAL-FALLING OBJECTS OR MISSILES", pro- vision is changed to read: We will pay for glass breakage, loss caused by hitting a bird or animal or by falling objects or missiles under Comprehensive Coverage if you carry Comprehensive Coverage for the damaged covered auto. However, you have the option of having glass breakage caused by a covered auto's collision or overturn considered a loss under Col- lision Coverage, D. CHANGE IN CONDITIONS The following Condition is added: TWO OR MORE POLICIES ISSUED BY US If this policy and any other policy issued to you by us or any company affiliated with us apply to the same accident, the aggregate maximum limit of liability under all the policies shall not exceed the highest applicable limit of liability under any one policy, This condition does not apply to any policy issued by us or an affiliated company spe- cifically to apply as excess insurance over this policy, E. CHANGES IN NUCLEAR ENERGY L1ABI L1TY EXCLUSION (BROAD FORM) The definition of "waste" is amended to read: "waste" means any waste material (a) containing by-product material other than the tail ings or wastes produced by the ex- traction or concentration of uranium or thorium from any ore processed primarily for its source material content, and (b) resulting from the operation by any per- son or organization of any nuclear facility included under the first two paragraphs of the defin ition of nuclear facility; :This endorsement is used with the Business Auto Policy, Truckers Policy and Garage Policy UNINSURED MOTORISTS INSURANCE (FLORIDA) If this endorsement is used with the Business Auto Policy or Truckers Policy it replaces PART VI of the Policy. A. WORDS AND PHRASES WITH SPECIAL MEANING In addition to the WORDS AND PHRASES WITH SPECIAL MEANING in the policy, the following words and phrases have special mean- ing for UNINSURED MOTORISTS INSUR- ANCE (FLORIDA): 1. "Family member" means a person related to you by blood, marriage or adoption who is a resident of your household, including a ward or foster child. 2. "Occupying" means in, upon, getting in, on, out or off. 3. "Uninsured motor vehicle" means a land motor vehicle or trailer: a. For which no liability bond or policy applies at the time of an accident, or b. Which is an underinsured motor vehicle. An underinsured motor vehicle is a motor vehicle for which the sum of all I iabil ity bonds or pol icies at the time of an accident provides a limit that is less than the limit of this insurance, or c. For which an insuring or bonding com- pany denies coverage or is or becomes insolvent, or d. Which is a hit-and-run vehicle and nei- ther the driver nor owner can be identi- fied. The vehicle must hit an insured, a covered auto or a vehicle an insured is occupying. However, "uninsured motor vehicle" does not include any vehicle: a, Owned or operated by a self-insurer under any applicable motor vehicle law, b. Owned by a governmental unit or agency, c. Designed for use mainly off public roads while not on public roads, d. Owned by or furnished or available for the regular use of you or any family member. B. WE WILL PAY 1. We will pay all sums the insured is legally entitled to recover as damages from the owner or driver of an uninsured motor ve- hicle. The damages must result from bodily injury sustained by the insured caused by an accident. The owner's or driver's I iabili- ty for these damages must result from the ownership, maintenance or use of the un- insured motor vehicle. 2. Any judgment for damages arising out of a su it brought without our written consent is not binding on us. - OVER- Form 5452 C. WE WILL NOT COVER - EXCLUSIONS This insurance does not apply to: 1. Any claim settled without our consent. 2. The direct or indirect benefit of any insurer or self-insurer under any workers' compen- sation, disability benefits or similar law. 3. Bodily injury sustained by you or any family member while occupying or struck by any vehicle owned by you or any family member which is not a covered auto. 4. Anyone using a vehicle without a reasonable belief that the person is entitled to do so. D. WHO IS INSURED 1. You or any Family member. 2. Anyone else occupying a covered auto or a temporary substitute for a covered auto. The covered auto must be out of service be- cause of its breakdown, repair, servicing, loss or destruction. 3. Anyone for damages he is entitled to re- cover because of bodily injury sustained by another insured. E. OUR LIMIT OF LIABILITY 1. Regardless of the number of covered autos, insureds, claims made or vehicles involved in the accident, the most we will pay for all damages resulting from anyone accident is the limit of UNINSURED MOTORISTS INSU RANCE shown in the declarations, 2. Any coverage afforded under th is endorse- ment shall apply over and above: a, All sums paid or payable under any workers' compensation, disability bene- fits or similar law, and b. All sums paid or payable under any no- fault coverage or automobile medical payments coverage. 3. Our limit of liability shall be reduced by all sums paid by or for anyone who is le- gally responsible, including all sums paid or payable under the policy's LIABILITY IN, SU RANCE. 4. In no event will an insured be entitled to receive duplicate payment for the same ele- ments of loss. 5. Any amount paid under this insurance will reduce any amount an insured may be paid under the pol icy's L1AB I L1TY INSU RANCE. F. CHANGES IN CONDITIONS The CONDITIONS of the policy are changed for UNINSURED MOTORISTS INSURANCE (FLORIDA) as follows: 1. The reference in OTH E R I NSU RANCE to "other collectible insurance" applies only to other collectible uninsured motorists insurance. 2. YOUR DUTIES AFTER ACCIDENT OR LOSS is changed by adding the following: a. Promptly notify the police if a hit-and- run driver is involved, and b. Promptly send us copies of the legal pa- pers if a suit is brought. 3. OUR RIGHT TO RECOVER FROM OTH- E RS is changed by adding the following: If we make any payment and the insured recovers from another party, the insu red shall hold the proceeds in trust for us and pay us back the amount we have paid. 4. The following Condition is added:. ARBITRATION a. If we and an insured disagree whether the insured is legally entitled to recover damages from the owner or driver of an uninsured motor vehicle or do not agree as to the amou nt of damages, either party may make a written demand for arbitration. In this event, each party will select an arbitrator. The two arbitrators will select a third. If they cannot agree within 30 days, either may request that selection be made by a judge of a court having jurisdiction. Each party will pay the expenses it incurs and bear the expenses of the third arbitrator equally. b. Unless both parties agree otherwise, arbitration will take place in the county in which the insured lives. Local rules of law as to arbitration procedure and evidence will apply. A decision agreed to by two of the arbitrators will be binding. -- . . PERSONAL INJURY PROTECTION COVERAGE FLORIDA The Company agrees with the named Insured, subject to all of the provisions of this endorsement and to all of the provisions of the policy except as modified herein, as follows: SCHEDULE The insurance for PERSONAL INJURY PROTECTION is subject to a deductible of $ applicable to 0 the following named InsLlredonly: o each named Insured and each dependent relative. o Work loss for named Insured does not apply o Work loss for named insured and dependent relative does not apply o Coverage reduced by military benefits fornamad Insured and dependent relative SECTION 1 PERSONAL INJURY PROTECTION The Company will pay, in accordance with the Florida Motor Vehicle No-Fault Law, as amended, to or for the benefit of the in- jured person: (a) 80% of medical expenses, and (b) 60% of work loss, and (c) replacement services expenses, and (d) funeral, burial or cremation expenses, incurred as a result of bodily injury, caused by an accident arising out of the ownership, maintenance or use of a motor vehicle and sustained by: (1) the named insured or any relative while occupying a motor vehicle or, while a pedestrian, through being struck by a motor vehicle; or (2) any other person while occupying the insured motor vehicle or, while a pedestrian, through being struck by the insured motor vehicle. Exclusions This insurance does not apply: (a) to the named insured or any relative white occupying a motor vehicle of which the named insured is the owner and which is not an insured motor vehicle under this insurance; (b) to any person while operating the insured motor vehicle without the express or implied consent of the named insured; (c) to any person, if such person's conduct contributed to his bodily Injury under any of the following circumstances: (i) causing bodily Injury to himself intentionally; or (ii) while committing a felony; (d) to the named insured or dependent relative for work loss if any entry in the schedule or declarations indicates such coverage does not apply; (e) to any pedestrian, other than the .named insured, or any relative, not a legal resident of the State of Florida; (f) to any person, other than the named insured, if such person is the owner of a motor vehicle with respect to which security is required under the Florida Motor Vehicle No-Fault Law; (g) to any person, other than the named insured or any relative, who is entitled to personal injury protection benefits from the owner of a motor vehicle which is not an jnsUl:ed motor vehicle under this insurance or from the owner's insurer; (h) to any person who sustains bodily Injury while occupying a motor vehicle located for use as a residence or premises. limit of liability; Application of Deductible; Other Insurance Regardless ofthe number of persons insured, policies or bonds applicable, vehicles involved or claims made, the total aggregate limit of personal injury protection benefits available under the Florida Motor Vehicle No-Fault Law, from all sources com- bined, including this policy. for all loss and expense incurred by or on behalf of anyone person who sustains bodily injury as the result of anyone accident shall be $10,000; provided that payment for funeral, cremation or burial expenses included in the foregoing shall in no event exceed $1,750. Any amount payable under this insurance ~hall be reduced by the amount of benefits an injured person has recovered or is enti- tled to recover for the same elements of loss under the workmen's compensation laws of any state or the federal government or the Medicaid program. If benefits have been received under the Florida Motor Vehicle No-Fault Law, from any insurer for the same items of loss and expense for which benefits are available under this policy, the Company shall not be liable to make duplicate payments to or for the benefit of the injured person, but the insurer paying such benefits shall be entitled to recover from the Company its equitable pro rata st\are of the benefits paid and expenses incurred in processing the claim. The amount of any deductible stated in the schedule or declarations shall be deducted from the total amount of all sums other- wise payable by the Company with respect to all loss and expense incurred by or on behalf of each person to whom the deducti- ble applies and who sustains bodily injury as the result of anyone accident, and if the total amount of such loss and expense exceeds such deductible, the total limit of benefits the Company is obligated to pay shall then be the difference between such deductible amount and the applicable limit of the Company's liability. Such deductible shall not apply to funeral, burial or crema- tion expenses. If an entry in the schedule or declaration so indicates any amount payable under this insurance to the named insured or de- pendent reletive shall be reduced by any ben~fits payeble by the Federal Government to active or retired military personnel and their dependent relatives. If such. ~ne!its:.ere not' availebl~ at the time of loss the Company shall have the right to recom- pute and charge the appropt'iate 'premjum:'~<'lt ' .;. ';';':" "~ " Definitions When used in reference to this Section: "bodily injury" means bodily injury, sickness QI' disease, including death at any time resulting therefrom: "medical expenses" means reasonable expenses for necessary medical, surgical, x-ray, dental, ambulance, hospital, profes- sional nursing and rehabilitative services, for prosthetic devices and for necessary remedial treatment and services recognized and permittea under the laws of the state for an injured person who relies upon spiritual means through prayer alone for healing in accordance with his religious beliefs. "named insured" means the person or organization named in the declarations of the policy and if an individual, shall include the spouse if a resident of the same household; Form 34890 (PP 0554) "motor vehicle" means any self-propelled vehicle with 4 or more wheels which is of a type both designed and required to be licensed for use on the highways of Florida and any trailer or semi-trailer designed for use with such vehicle; a "motor vehicle" does not include: (a) any motor vehicle which is used in mass transit or public school transportation and designed to transport more than 5 passengers exclusive of the operator of the motor vehicle and which is owned by a municipality, a transit or public school transportation authority, or a political subdivision of the state; or (b) a mobile home; "occupying" means in or upon or entering into or alighting from; "Insured motor vehicle" means a motor vehicle: (a) of which the named insured is the owner, and (b) with respect to. which security is required to be maintained under the Florida Mo.tor Vehicle No-Fault Law, and (c) for which a premium is charged, o.rwhich is a trailer, other than a mo.bile home, designed for use with a motor vehicle; "relative" means a person related to the named insured by blood, marriage or adoption (including a ward or foster child) who is usually a resident of the same household as the named insured; "pedestrian" means a person while not an occupant of any self propelled vehicle; "owner" means a person or organization who holds the legal title to a motar vehicle, and also includes; - -~(aT-aael:m:~Fl1~\llh-g1heJ'fglit tQ1iO'Ssesslbn ,. in tile eventamotor velifCte,lSlfif.fsTIojecfOfasecufilyagreement,. ana - (b) a lessee having the right to. possession in the event a motor vehicle is the subject o.f a lease with option to purchase and such lease agreement is for a period of six months or more, and (c) a lessee having the right to possession, in the event a motor vehicle is the subject of a lease without option to purchase, and such lease agreement is for a period of six months or more, and the lease agreement provides that the lessee shall be responsible for securing insurance. "iNork loss" means with respect to the period o.f disability of the injured person, any loss of income and earning capacity fro.m inability to work pro.ximately caused by the injury sustained by the injured person. "replacement services expenses" means with respect to the period o.f disability of the injured person all expenses reasonably incurred in obtaining from others ordinary and necessary services in lieu of those that, but for such injury, the injured person would have performed without income for the benefit of his household. Policy Period Territory The insurance under this Section applies only to accidents which occur during the policy period (a) in the State of Florida, and (b) as respects the named insured or a relative, while occupying the insured mator vehicle outside the State of Florida but within the United States of America, its territories or possessions or Canada; and (c) as respects the named insured, while occupying a motor vehicle of which a relative is the owner and for which securi- ty is maintained under the Florida Motor Vehicle No-Fault Law, outside the State of Florida but within the United States of America, its territories or possessions or Canada. Conditions 1. Notice. In the event of an accident, written notice of the loss must be given to the Co.mpany or any of its authorized agents as soon as practicable. If any injured person or his legal representative shall institute legal action to recover damages for bodily injury against a third party, a copy of the summons and complaint or other process served in connection with such legal action shall be forwarded as soon as practicable to the Company by such injured perso.n or his legal representative. 2. Action Against the Company. No actio.n shall lie against the Company unless, as a condition precedent thereto, there shall have been full compliance with all terms of this insurance, nor until 30 days after the required notice of accident and reasonable proof of claim has been filed with the Company. 3. Proof of Claim; Medical Reports and Examinations; P~yment of Claim Withheld. As soon as practicable the person mak- ing claim shall give to the company written proof of claim, under oath if required, which may include full particulars of the nature and extent of the injuries and treatment received and contemplated, and such other information as may assist the company in determining the amount due and payable. Such person shall submit to mental or physical examinations at the company's expense when and as often as the company may reasonably require and a copy of the medical repo.rt shall be forwarded to such person if requested. If the person unreasonably refuses to submit to an examination the company will not be liable for subsequent per- sonal injury protectio.n benefits. Whenever a person making claim is charged with committing a felony the Company shall withhold benefits until at the trial level the prosecution makes a formal entry on the record that it will not prosecute the case against the person, the charge is dismissed or the person is acquitted. 4. Reimbursement and Subragation. In the event of payment to or for the benefit of any injured person under this insurance: (a) The Company is subrogated to the rights of the person to whom or for whose benefit such payments were made to the extent of such payments. Such person shall execute and deliver the instruments and papers and do whatever else is necessary to. secure such rights. Such person shall do nothing after loss to prejudice such rights. (b) the company providing personal injury protection benefits on a private passenger motor vehicle. as defined in the Florida Motor Vehicle No-Fault Law, shall be entitled to reimbursement to the extent of the payment of personal injury protection benefits fro.m the owner or insurer of the awner o.f a commercial motor vehicle, as defined in the Florida Motor Vehicle No-Fault Law, if such injured person sustained the injury while accupying, or while a pedestrian through being struck by, such commercial motor vehicle. 5. Special Provi.ion for Rented or Leased Vehicle.. Notwithstanding any provision of this coverage to the contrary, if a per- son is injured while accupying, or through being struck by, a mator vehicle rented or leased under a rental or lease agreement which does not specify otherwise in bold type on the face of such agreement, the personal injury protection coverage afforded under the lessor's policy shall be primary. SECTION II MODIFICATION OF POLICY COVERAGES Any automobile medical payments insurance and any uninsured motorists insurance afforded by the policy shall be excess aver any personal injury protection benefits paid ar payable. Regardless af whether the full am aunt af personal injury protection benefits have been exhausted, any medical payments in- surance afforded by this pal icy shall pay the portion of any claim for personal injury protection medical expenses which are otherwise covered but not payable due to the limitation of 80% medical expenses contained in Sectio.n I, but shall not be payable for the amo.unt of the deductible selected. SECTION III PROVISIONAL PREMIUM It is agreed that in the event o.f any change in the rules, rates, rating plan, premiums or minimum premiums applicable to. the insurance afforded, because of an adverse judicial finding as to the co.nstitutionality o.f any provisio.ns o.f the Flo.rida Motor Vehicle No-Fault Law, pro.viding for the exemptio.n of persons from tort liability, the premium stated in the declarations for any Liability, Medical Payments and Uninsured Motorists insurance shall be deemed pro.visional and subject to recomputatio.n. If this policy is a renewal policy, such recomputation shall also. include a determination of the amount of any return premium previously credited or refunded to the named insured pursuant to. Section 12 (2) (e) of the Flo.rida Mo.tor Vehicle No-Fault Law with respect to insurance afforded under a previo.us policy. ' ' , 'If the.final premium thus reco.mputed exceeds the premium stated in the declarations, the named in.ured shall pay to. the C Company the excess as well as the amo.unt of any return premium previously credited or refunded. - .. . - .....-:.--- --- . In return for payment of the premium and subject to all the terms of this policy, we agree with you as follows: PART 1- WORDS AND PHRASES WITH SPECIAL MEANING The following words and phrases have special meaning throughout this policy and appear in boldface type when used: A. "You" and "your" mean the person or organization shown as the named insured in the declarations. B. "We", "us" and "our" mean the company providing the insurance. C. "Accident" includes continuous or repeated exposure to the same conditions resulting in bodily injury or property damage the insured neither expected nor in- tended. D. "Auto" means a land motor vehicle, trailer or semi- trailer designed for travel on public roads but does not include mobile equipment. E. "Bodily injury" means bOdily injury, sickness or dis- ease including death resulting from any of these. F. "Insured" means any person or organization qualifying as an insured in the WHO IS INSURED section of the applicable insurance. Except with respect to our limit of liability, the insurance afforded applies separately to each insured who is seeking coverage or against whom a claim is made or suit is brought. G. "Loss" means direct and accidental damage or loss. H. "Mobile equipment" means any of the following type of land vehicles: 1. Specialized equipment such as: Bulldozers; Power shovels; Rollers, graders or scrapers; Farm machin- ery; Cranes; Street sweepers or other cleaners; Diggers; Forklifts; Pumps; Generators; Air com- pressors; Drills; Other similar equipment. 2. Vehicles designed for use principally off public roads. 3. Vehicles maintained solely to provide mobility for such specialized equipment when permanently at- tached. 4. Vehicles not required to be licensed. 5. Autos maintained for use solely on your premises or that part of roads or other accesses that adjoin your premises. I. "Property damage" means damage to or loss of use of tangible property. PART 11- WHICH AUTOS ARE COVERED AUTOS J. "Trailer" includes semitrailer. A. ITEM TWO of the declarations shows the autos that are covered autos for each of your coverages. The numerical symbols explained in ITEM THREE of the declarations describe which autos are covered autos. The symbols entered next to a coverage designate the only autos that are covered autos. B. OWNED AUTOS YOU ACQUIRE AFTER THE POLICY BEGINS. 1. If symbols "I", "2", "3", "4", "5" or "6" are entered next to a coverage in ITEM TWO, then you already have coverage for autos' of the type de- scribed until the policy ends. 2. But, if symbol "7" is entered next to a coverage in ITEM TWO, an auto you acquire will be a cov- ered auto for that coverage only if: a. We already insure all autos that you own for that coverage or it replaces an auto you pre- viously owned that had that coverage; and b. You tell us within 30 days after you acquire it that you want us to insure it for that coverage. C. CERTAIN TRAILERS AND MOBILE EQUIPMENT. If the policy provides liability insurance, the following types of vehicles are covered autos for liability insur- ance: 1. Trailers with a load capacity of 2,000 pounds or less designed primarily for travel on public roads. 2. Mobile equipment while being carried or towed by a covered auto. PART 111- WHERE AND WHEN THIS POLICY COVERS We covfi!r accidents or losses which occur during the policy period: A. In the United States of America, its territories or pos- sessions, Puerto Rico or Canada; or B. While the covered auto is being transported between any of these places. Copyright, Insurance Services Office, 1978 Page 1 of 9 PART IV - LIABILITY INSURANCE A. WE WILL PAY. 1. We will pay all sums the insured legally must pay as damages because of bodily injury or property damage to which this insurance applies, caused by an accident and resulting from the ownership, maintenance or use of a covered auto. 2. We have the right and duty to defend any suit asking for these damages. However, we have no duty to defend suits for bodily injury or property damage not covered by this policy. We may inves- tigate and settle any claim or suit as we consider appropriate. Our payment of the LIABILITY INSUR- ANCE limit ends our duty to defend or settle. B. WE WILL ALSO PAY. In addition to our limit of liability, we will pay for the insured: 1. Up to $250 for cost of bail bonds (including bonds for related traffic law violations) required because of an accident we cover. We do not have to furnish these bonds. 2. Premiums on appeal bonds in any suit we defend. 3. Premiums on bonds to release attachments in a suit we defend but only for bonds up to our limit of liability. 4. All costs taxed to the insured in a suit we defend. 5. All interest accruing after the entry of the judgment in a suit we defend. Our duty to pay interest ends when we payor tender our limit of liability. 6. Up to $50 a day for loss of earnings (but not other income) because of attendance at hearings or trials at our request. 7. Other reasonable expenses incurred at our request. C. WE WILL NOT COVER - EXCLUSIONS. This insurance does not apply to: 1. Liability assumed under any contract or agreement. 2. Any obligation for which the insured or his or her insurer may be held liable under any workers' compensation or disability benefits law or under any similar law. 3. Any obligation of the insured to indemnify another for damages resulting from bodily injury to the in- sured's employee. 4. Bodily injury to any fellow employee of the insured arising out of and in the course of his or her em- ployment. 5. Bodily injury to any employee of the insured arising out of and in the course of his or her employment by the insured. However, this exclusion does not apply to bodily injury to domestic employees not entitled to workers' compensation benefits. 6. Property damage to property owned or transported by the insured or in the insured's care, custody or control. 7. Bodily injury or property damage resulting from the handling of property: a. Before it is moved from the place where it is accepted by the insured for movement into or onto the covered auto, or b. After it is moved from the covered auto to the place where it is finally delivered by the in- sured. Bodily injury or property damage resulting from the movement of property by a mechanical device (other than a hand truck) not attached to the covered auto. 8. Bodily injury or property damage caused by the dumping, discharge or escape of irritants, pollu- tants or contaminants. This exclusion does not apply if the discharge is sudden and accidental. D. WHO IS INSURED. 1. You are an insured for any covered auto. 2. Anyone else is an insured while using with your permission a covered auto you own, hire or borrow except: a. Someone using a covered auto you hire or borrow from one of your employees or a mem- ber of his or her household. b. Someone using a covered auto while he or she is working in a business of selling, servicing, repairing or parking autos. c. Anyone other than your employees, a lessee or borrower or any of their employees, while moving property to or from a covered auto. 3. Anyone is an insured for his or her liability be- cause of acts or omissions of an insured de- scribed above. However, the owner of or any- one else from whom you hire or borrow a covered auto is an insured only if that auto is a trailer connected to a covered auto you own. E. OUR LIMIT OF LIABILITY. 1. Regardless of the number of covered autos, in. sureds, claims made or vehicles involved in the ac- cident, the most we will pay for all damages re- sulting from anyone accident is the LIABILITY IN- SURANCE limit shown in the declarations. 2. All bodily injury and property damage resulting from continuous or repeated exposure to substan- tially the same conditions will be considered as resulting from one accident. F. OUT OF STATE EXTENSIONS OF COVERAGE. 1. While a covered auto is away from the state where it is licensed we will: a. Increase this policy's liability limits to meet those specified by a compulsory or financial responsibility law in the jurisdiction where the covered auto is being used. b. Provide the minimum amounts and types of other coverages, such as "No-Fault", required of out of state vehicles by the jurisdiction where the covered auto is being used. 2. We will not pay anyone more than once for the same elements of loss because of these extensions. .yright, Insurance Services Office, 1. Page 2 of 9 ~ - - PART V ~ MEDICAL PA YMEN' INSURANCE . A. WORDS AND PHRASES WITH SPECIAL MEANING In addition to the WORDS AND PHRASES WITH SPE- CIAL MEANING in PART I the following words and phrases have special meaning for AUTO MEDICAL PAYMENTS INSURANCE: 1. "Family member" means a person related to you, by blood, marriage or adoption who is a resident of your household, including a ward or foster child. 2. "Occupying" means in, upon, getting in, on, out or off. B. WE WILL PAY We will pay reasonable expenses incurred for necessary medical and funeral services to or for an insured who sustains bodily injury caused by accident. We will pay only those expenses incurred within three years from the date of the accident. C. WE WILL NOT COVER-EXCLUSIONS This insurance does not apply to: 1. Bodily injury sustained by an insured while oc- cupying a vehicle located for use as a premises. 2. Bodily injury sustained by you or any family memo ber while occupying or struck by any vehicle (other than a covered auto) owned by you or furnished or available for your regular use. 3. Bodily injury sustained by any family member while occupying or struck by any vehicle owned by or fur- nished or available for the regular use of any family member. 4. Bodily injury to your employee arising out of and in the course of employment by you. However, we will cover bodily injury to your domestic employees if not entitled to workers' compensation benefits. 5. Bodily injury to an insured while working in a busi- ness of selling, servicing, repairing or parking autos. 6. Bodily injury caused by declared or undeclared war or insurrection or any of their consequences. 7. Bodily injury to anyone using a vehicle without a reasonable belief that the person is entitled to do so. D. WHO IS INSURED 1. You or any family member while occupying or, while a pedestrian, when struck by any auto. 2. Anyone else occupying a covered auto or a tempo- rary substitute for a covered auto. The covered auto must be out of service because of its break- down, repair, servicing, loss or destruction. E. OUR LIMIT OF LIABILITY Regardless of the number of covered autos, insureds, claims made or vehicles involved in the accident, the most we will pay for bodily injury for each insured in- jured in anyone accident is the limit of AUTO MEDI- CAL PAYMENTS shown in the declarations. F. CHANGES IN CONDITIONS The CONDITIONS of the policy are changed for AUTO MEDICAL PAYMENTS INSURANCE as follows: 1. OUR RIGHT TO RECOVER FROM OTHERS does not apply. 2. The reference in OTHER INSURANCE to "other collectible insurance" applies only to other collect. ible auto medical payments insurance. PART VI- UNINSURED MOTORISTS INSURANCE A. WORDS AND PHRASES WITH SPECIAL MEANING In addition to the WORDS AND PHRASES WITH SPEC- IAL MEANING in PART I the following words and phrases have special meaning for UNINSURED MO- TORISTS INSURANCE: 1. "Family member" means a person related to you by blood, marriage or adoption who is a resident of your household, including a ward or foster child. 2. "Occupying" means in, upon, getting in, on, out or off. 3. "Uninsured motor vehicle" means a land motor vehicle or trailer: a. For which no liability bond or policy at the time of an accident provides at least the amounts re- quired by the applicable law where a covered auto is principally garaged, or b. For which the sum of all liability bonds or policies at the time of an accident provides at least the amounts required by the applicable law where a covered auto is principally garaged but their limits are less than the limit of this insurance, or c. For which an insuring or bonding company denies coverage or is or becomes insolvent, or d. Which is a hit-and-run vehicle and neither the driver nor owner can be identified. The vehicle must hit an insured, a covered auto or a ve- hicle an insured is occupying. However, "uninsured motor vehicle" does not in- clude any vehicle: a. Owned or operated by a self-insurer under any applicable motor vehicle law. b. Owned by a governmental unit or agency. c. Designed for use mainly off public roads while not on public roads. B. WE WILL PAY 1. We will pay all sums the insured is legally entitled to recover as damages from the owner or driver of an uninsured motor vehicle. The damages must result from bodily injury sustained by the insured caused by an accident. The owner's or driver's liability for these damages must result from the ownership, maintenance or use of the uninsured motor vehicle. Copynght, Insurance Services Office, 1978 Page 3 of 9 2. If this insurance provides a limit in excess of the amounts required by the applicable law where a covered auto is principally garaged, we will pay only after all liability bonds or policies have been exhausted by judgments or payments. 3. Any judgment for damages arising out of a suit brought without our written consent is not binding on us. C. WE WILL NOT COVER-EXCLUSIONS This insurance does not apply to: 1. Any claim settled without our consent. 2. The direct or indirect benefit of any insurer or self- insurer under any workers' compensation, disability benefits or similar law. 3. Bodily injury sustained by you or any family memo ber while occupying or struck by any vehicle owned by you or any family member which is not a covered auto. 4. Anyone using a vehicle without a reasonable belief that the person is entitled to do so. D. WHO IS INSURED 1. You or any family member. 2. Anyone else occupying a covered auto or a tempo- rary substitute for a covered auto. The covered auto must be out of service because of its break- down, repair, servicing, loss or destruction. 3. Anyone for damages he is entitled to recover be- cause of bodily injury sustained by another insured. E. OUR LIMIT OF LIABILITY 1. Regardless of the number of covered autos, in- sureds, claims made or vehicles involved in the accident, the most we will pay for all damages resulting from anyone accident is the limit of UN- INSURED MOTORISTS INSURANCE shown in the declarations. 2. Any amount payable under this insurance shall be reduced by: a. All sums paid or payable under any workers' compensation, disability benefits or similar law, and b. All sums paid by or for anyone who is legally responsible, including all sums paid under the policy's LIABILITY INSURANCE. 3. Any amount paid under this insurance will reduce any amount an insured may be paid under the policy's LIABILITY INSURANCE. F. CHANGES IN CONDITIONS The CONDITIONS of the policy are changed for UNIN- SURED MOTORISTS INSURANCE as follows: 1. The reference in OTHER INSURANCE to "other collectible insurance" applies only to other col- lectible uninsured motorists insurance. 2. YOUR DUTIES AFTER ACCIDENT OR LOSS is changed by adding the following: a, Promptly notify the pOlice if a hit-and-run driver is involved, and b. Promptly send us copies of the legal papers if a suit is brought. 3. OUR RIGHT TO RECOVER FROM OTHERS is changed by adding the following: If we make any payment and the insured recovers from another party, the insured shall hold the pro. ceeds in trust for us and pay us back the amount we have paid. 4. The following Condition is added: ARBITRATION a. If we and an insured disagree whether the in. sured is legally entitled to recover damages from the owner or driver of an uninsured motor vehicle or do not agree as to the amount of damages, either party may make a written de- mand for arbitration. In this event, each party will select an arbitrator. The two arbitrators will select a third. If they cannot agree within 30 days, either may request that selection be made by a judge of a court having jurisdiction. Each party will pay the expenses it incurs and bear the expenses of the third arbitrator equally. b. Unless both parties agree otherwise, arbitra- tion will take place in the county in which the insured lives. Local rules of law as to arbitra- tion procedure and evidence will apply. A decision agreed to by two of the arbitrators will be binding. PART VII- PHYSICAL DAMAGE INSURANCE A. WE WILL PAY. 1. We will pay for loss to a covered auto or its equip- ment under: a. Comprehensive Coverage. From any cause ex- cept the covered auto's collision with another object or its overturn. b. Specified Perils Coverage. Caused by: (1) Fire or explosion; (2) Theft; (3) Windstorm, hail or earthquake; (4) Flood; (5) Mischief or vandalism; ayright, Insurance 'Services > . . (6) The sinking, burning, collision or derail. ment of any conveyance transporting the covered auto. c. Collision Coverage. Caused by the covered auto's collision with another object or its over- turn. 2. Towing. We will pay up to the limit shown in the declara- tions for towing and labor costs incurred each time a covered auto of the private passenger type is dis- abled. However, the labor must be performed at the place of disablement. . . Office, 1. Page 4 of 9 . _ .-~....--;:::_: _,..~~C~~ B. WE WILL ALSO'PAY. . -, We will also pay up to $10 per day to a maximum of $300 for transportation expense incurred by you be- cause of the total theft of a covered auto of the private passenger type. We will pay only for those covered autos for which you carry either Comprehensive or Specified Perils Coverage. We will pay for transporta- tion expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered auto is returned to use or we pay for its loss. C. WE WILL NOT COVER - EXCLUSIONS. This insurance does not apply to: 1. Wear and tear, freezing, mechanical or electrical breakdown unless caused by other loss covered by this policy. 2. Blowouts, punctures or other road damage to tires unless caused by other loss covered by this policy. 3. Loss caused by declared or undeclared war or in- surrection or any of their consequences. 4. Loss caused by the explosion of a nuclear weapon or its consequences. 5. Loss caused by radioactive contamination. 6. Loss to tape decks or other sound reproducing equipment not permanently installed in a covered auto. 7. Loss to tapes, records or other sound reproducing devices designed for use with sound reproducing equipment. 8. Loss to any sound receiving equipment designed for use as a citizens' band radio, two-way mobile radio or telephone or scanning monitor receiver, includineantennas anct other access?ries,un- less permanently installed in the dash or-console- opening normally used by the auto manufacturer for the installation of a radio. D. HOW WE WILL PAY FOR LOSSES - THE MOST WE WILL PAY. 1. At our option we may: a. Pay for, repair or replace damaged or stolen property; or b. Return the stolen property, at our expense. We will pay for any damage that results to the auto from the theft. 2. The most we will pay for loss is the smaller of the following amounts: a. The actual cash value of the damaged or stolen property at the time of loss. b. The cost of repairing or replacing the damaged or stolen property with other of like kind or quality. 3. For each covered auto, our obligation to pay for, repair, return or replace damaged or stolen prop- erty will be reduced by the applicable deductible shown in the declarations. Any Comprehensive Coverage deductible shown in the declarations does not apply to loss caused by fire or lightning. E. GLASS BREAKAGE - HITTING A BIRD OR ANIMAL- FALLING OBJECTS OR MISSILES. We will pay for glass breakage, loss caused by hitting a bird or animal or by falling objects or missiles under Comprehensive Coverage if you carry Comprehensive Coverage for the damaged covered auto. PART VIII-CONDITIONS The insurance provided by this policy is subject to the fol- lowing conditions: A. YOUR DUTIES AFTER ACCIDENT OR LOSS. 1. You must promptly notify us or our agent of any accident or loss. You must tell us how, when and where the accident or loss happened. You must assist in obtaining the names and addresses of any injured persons and witnesses. 2. Additionally, you and other involved insureds must: a. Cooperate with us in the investigation, settle- ment or defense of any claim or suit. No in- sured shall, except at his or her own cost, voluntarily make any payment, assume any obligation or incur any expense. b. Immediately send us copies of any notices or legal papers received in connection with the accident or loss. c. Submit at our expense and as often as we require to physical examinations by physicians we select. d. Authorize us to obtain medical reports and other pertinent medical information. 3. Additionally, to recover for loss to a covered auto or its equipment you must do the following: a. Permit us to inspect and appraise the damaged property before its repair or disposition. b. Do what is reasonably necessary after loss at our expense to protect the covered auto from further loss. c. Submit a proof of loss when required by us. d. Promptly notify the police if the covered auto or any of its equipment is stolen. B. OTHER INSURANCE. 1. For any covered auto you own this policy provides primary insurance. For any covered auto you don't own, the insurance provided by this policy is excess over any other collectible insurance. However, while a covered auto which is a trailer is connected to another vehicle the liability coverage this policy provides for the trailer; Copyright, Insurance Services Office, 1978 Page 5 of 9 a. Is excess while it is connected to a motor vehi. cle you don't own. b. Is primary while it is connected to a covered auto you own. 2. When two or more policies cover on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the limit of our policy bears to the total of the limits of all the policies covering on the same basis. C. OUR RIGHT TO RECOVER FROM OTHERS. If we make any payment, we are entitled to recover what we paid from other parties. Any person to or for whom we make payment must transfer to us his or her rights of recovery against any other party. This person must do everything necessary to secure these rights and must do nothing that would jeopardize them. D. CANCELLING THIS POLICY DURING THE POLICY PERIOD. 1. You may cancel the policy by returning it to us or by giving us advance notice of the date cancellation is to take effect. 2. We may cancel the policy by mailing you at least 10 days notice at your last address known by us. We may deliver any notice instead of mailing it. Proof of mailing of any notice will be sufficient proof of notice. 3. The effective date of cancellation stated in the notice shall become the end of the policy period. 4. If this policy is cancelled, you may be entitled to a premium refund. If so, we will send you the refund. However, making or offering to make the refund is not a condition of cancellation. If you cancel, the refund, if any, will be computed in accordance with the customary short rate procedure. If we cancel, the refund, if any, will. be computed pro rata. E. AUTOMATIC TERMINATION. If we offer to renew or continue and you or your repre- sentative do not accept, this pOlicy will automatically terminate at the end of the current policy period. Fail- ure to pay the required renewal or continuation pre. mium when due shall mean that you have not accepted our offer. F. LEGAL ACTION AGAINST US. No legal action may be brought against us until there has been full compliance with all the terms of this policy. In addition, under LIABILITY INSURANCE, no legal action may be brought against us until we agree in writing that the insured has an obligation to payor until the amount of that obligation has been finally determined by judgment.after trial. No person or orga- nization has any right under this policy to bring us into any action to determine the liability of the insured. G. INSPECTION. At our option we may inspect your property and opera- tions at any time. These inspections are for our benefit only. By our right to inspect or by our making any inspection we make no representation. that your prop- erty or operations are safe, not harmful to health or comply with any law, rule or regulation. H. CHANGES. This policy contains all the agreements between you and us. Its terms may not be changed or waived except by endorsement issued by us. If a change requires a premium adjustment, we will adjust the premium as of the effective date of change. If we revise this policy form to provide more coverage without additional pre- mium charge your policy will automatically provide the additional coverage as of the day the revision is effec- tive in your state. I. TRANSFER OF YOUR INTEREST IN THIS POLICY. Your rights and duties under this policy may not be as- signed without our written consent. J. NO BENEFIT TO BAILEE - PHYSICAL DAMAGE IN. SURANCE ONLY. We will not recognize any assignment or grant any cov- erage for the benefit of any person or organization holding, storing or transporting property for a fee regardless of any other provision of this policy. K. BANKRUPTCY. Bankruptcy or insolvency of the insured shall not relieve us of any obligations under this policy. L. APPRAISAL FOR PHYSICAL DAMAGE LOSSES. 1. If you and we fail to agree as to the amount of loss either may demand an appraisal of the loss. In such event, you and we shall each select a competent appraiser, and the appraisers shall select a compe- tent and disinterested umpire. The appraisers shall state separately the actual cash value and the amount of loss, and, failing to agree, shall submit their differences to the umpire. An award in writing of any two shall determine the amount of loss. You and we shall each pay the chosen appraiser and shall bear equally the other expenses of the ap- praisal and umpire. 2. We shall not be held to have waived any of our rights by any act relating to appraisal. In Witness Whereof, we have caused this policy to be executed and attested, but this pOlicy shall not be valid unless coun. tersigned by our authorized representative. ~~~ SECRETARY cf"tr ~ "'t 4-'t. c ,..-'" PRESIDENT .' . . Includes copyrighted material of Insurance Services Office, with its permission. epyright, Insurance ~Services Office, Ie ~- ,~ -.-.. - ~..:..-- Page 6 of 9 COVERAGE .F~R T.EMPORARY SUB_UTE AUTOS .:.' The.volicy is changed as follows: " CHANGES IN LIABILITY INSURANCE ~-;-,--;.-~~ ~-::----....~ ~---.....:::. . . '..- ~ .. vr If the policy provides LIABILITY INSURANCE only for owned autos, a temporary substitute for one of these will also be considered a covered auto, subject to the following provisions: 1. The owned auto must be out of service because of its breakdown, repair, servicing, loss or destruction. 2. The temporary substitute must be owned by someone other than you or a member of your household. 3. The temporary substitute must be used with the permission of the owner. 4. The LIABILITY INSURANCE for the temporary substitute is excess over any other collectible insurance. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD FORM) It is agreed that: A. The policy does not apply: 1. Under any Liability Coverage, to bodily injury or prop- erty damage a. with respect to which an insured under the pOlicy is also an insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Under- writers or Nuclear Insurance Association of Cana- da, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or b. resu Iti ng from the hazardous properties of nuclear material and with respect to which (1) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (2) the in- sured is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agree- ment entered into by the United States of America, or any agency thereof, with any person or organiza- tion. 2. Under any Medical Payments Coverage, or under any Supplementary Payments provision relating to first aid, to expenses incurred with respect to bodily injury re- sulting from the hazardous properties of nuclear ma- terial and arising out of the operation of a nuclear facility by any person or organization. 3. Under any Liability Coverage, to bodily injury or prop- erty damage resulting from the hazardous properties of nuclear material, if a. the nuclear material (1) is at any nuclear facility owned by, or operated by or on behalf of, an in- sured or (2) has been discharged or dispersed therefrom; b. the nuclear material is contained in spent fuel or waste at any time possessed, handled, used, proc- essed, stored, transported or disposed of by or on behalf of an insured; or c. the bodily injury or property damage arises out of the furnishing by an insured of services, materials, parts or equipment in connection with the plan- ning, construction, maintenance, operation or use of any nuclear facility, but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (c) applies only to property damage to such nuclear facility and any property thereat. B. As used in this endorsement: "hazardous properties" include radioactive, toxic or explo- sive properties; "nuclear material" means source material, special nuclear material or byproduct material; "source material", "special nuclear material", and "by- product material" have the meanings given they in the Atomic Energy Act of 1954 or in any law amendatory there- of; "spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor; "waste" means any waste material (a) containing byprod- uct material and (b) resulting from the operation by any person or organization of any nuclear facility included within the definition of nuclear facility under paragraph 1 or 2 thereof; "nuclear facility" means 1. any nuclear reactor, 2. any equipment or device designed or used for (a) separating the isotopes of uranium or plutonium, (b) processing or utilizing spent fuel, or (c) handling, proc- essing or packaging waste, 3. any equipment or device used for the processing, fab- ricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combina- tion thereof, or more than 250 grams of uranium 235, 4. any structure, basin, excavation, premises or place pre- pared or used for the storage or disposal of waste, and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations; "nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain re- action or to contain a critical mass of fissionable material; "property damage" includes all forms of radioactive con- tamination of property. NEW YORK EXCEPTION: The "Nuclear Energy Liability Exclusion Endorsement (Broad Form)" does not apply to Automo. bile Liability Insurance in New York. Copyright, Insurance Services Office, 1978 Page 7 of 9 STATE EXCEPTIONS ARIZONA, CALIFORNIA, OREGON AND WASHINGTON: CHANGE IN CONDITIONS: As Respects Parts IV, V and VII para- graph A af Part III is changed as fallaws: A. In Narth America and any territary of the United States; ar COLORADO AND MARYLAND - COLLISION COVERAGE IN MEXICO: PHYSICAL DAMAGE INSURANCE far a cave red auto licensed ar principally garaged in Colarada ar Maryland is changed as fallaws: Callisian Caverage applies while a covered auto yau awn is in Mexico,. Hawever: A. The loss will be paid far in the United States. B. The mast we will pay far loss is the lesser of the fallowing amaunts: 1. The cast af repairing the auto ar replacing its parts in Mexico" ar 2. The cost af repair or replacement at the nearest point in the United States where repair ar replacement cauld be made. WARNING. This palicy daes NOT provide liability insurance when a covered auto is in Mexico. To avaid penalties under Mexica's laws, you should buy liability insurance fram a campany licensed in Mexico, to sell it. GEORGIA: For a cave red auto licensed ar principally garaged in Geargia, the pal icy is changed as fallaws: A. CHANGES IN LIABILITY INSURANCE: 1. LIABILITY INSURANCE is primary far an auto you dan't awn if aperated by the insured and owned by a retail seller af motor vehicles. 2. If yau are a retail seller af matar vehicles the insurance is excess for an auto you awn if ape rated by an insured ather than you ar your emplayee. B. CHANGES IN CONDITIONS: CANCELLING THIS POLICY DURING THE POLICY PERIOD applies except as follaws: If we cancel the pal icy far a reasan ather than nanpay- ment af premium when it is in effect 60 days or mare ar is a renewal ar cantinuatian pal icy we will mail you: 1. At least 15 days natice if the pal icy insures a cammercial ar industrial concern. 2. At least 30 days natice in all ather cases. IDAHO AND NEBRASKA - TAPES AND RECORDS: PHYSICAL DAMAGE INSURANCE for a covered auto licensed ar prin- cipally garaged in Idaho, ar Nebraska is changed as follaws: The exclusian relating to, tapes is changed to, cover loss to, one tape ar ather saund repraducing device. The loss must occur with loss to, a permanently installed tape deck ar ather saund repraducing equipment. INDIANA: CHANGE IN CONDITIONS: LIABILITY INSURANCE far a cave red auto licensed in, or garage aperatians can- ducted in, Indiana, is changed as fallaws: The fallawing is added to, CHANGES: The insured's notice to, our agent shall be deemed to, be natice to, us. LOUISIANA: PHYSICAL DAMAGE INSURANCE far a cave red auto licensed ar principally garaged in Louisiana is changed as fallaws: The exclusian relating to, citizens' band radias daes not apply to, equipment designed far use as a twa-way mabile radio, ar telephane which ape rates abave ar belaw the citizens' band range af frequencies ar frequencies assigned by the Federal Cammunicatians Cammission. MARYLAND AND NORTH CAROLINA - POLLUTION: LIABILITY INSURANCE far a cave red auto licensed ar principally garaged in Maryland ar Narth Carolina is changed as fallows: The exclusion relating to, pallutants, contaminants ar irritants daes nat apply. MICHIGAN: A. CHANGES IN CONDITIONS: CANCELLING THIS POLICY DURING THE POLICY PERIOD is changed as fal- laws: We may cancel the pal icy by mailing you at least 10 days notice at your last address known by us ar our autharized agent. B. CHANGES IN PHYSICAL DAMAGE INSURANCE: Any PHYSICAL DAMAGE INSURANCE and any RENTAL REIM- BURSEMENT COVERAGE pravided by the palicy do, nat apply to, the extent that Praperty Protectian Insurance benefits are available as required by Michigan law. PENNSYLVANIA: LIABILITY INSURANCE far a covered auto licensed ar principally garaged in Pennsylvania is changed as fallaws: A. The exclusian relating to, the laading ar unlaading af property does not apply. B. WHO IS INSURED daes nat include anyone loading or unlaading a cave red auto except you, your emplayees, a lessee or barrawer ar any of their em- playees. VIRGINIA: CHANGE IN CONDITIONS: Far a cave red auto licensed ar principally garaged in Virginia, YOUR DUTIES AFTER ACCIDENT OR LOSS is changed by adding the fallawing: The insured will be deemed not to have coaperated with us anly if his failure ar refusal to, do, sa harms our defense af an actian far damages. STATE EXCEPTIONS TO PART VI-UNINSURED MOTORISTS INSURANCE ARKANSAS, KENTUCKY, LOUISIANA, MISSISSIPPI AND MISSOURI: The insured shall nat be required to arbitrate dis- puted claims. CALIFORNIA: A. WORDS AND PHRASES WITH SPECIAL MEANING is changed as fallaws: Paragraph C of "uninsured motor vehicle" is changed to, read: For which the insuring or banding company denies caverage ar refuses to, admit coverage except canditianally ar with reservation or becames insolvent, ar B. Exclusian 2 under WE WILL NOT COVER -EXCLUSIONS is changed to, read: This insurance daes nat apply to: The direct or indirect benefit af any insurer or ,. '. (- epyright, Insorance...Services Office, 1. Page 8 of 9 ~,-- -.-...... ---.~ """"-"~~ -~.,."-",,,,-,--,-,"'"':'--- - '-p'- ~~-~._- ~.,., self-insurer l:mder any workers' comnAtion, disability-of' similar law or to th~ct behefit'of. the United States, a 'c~stati:or its political subdivisions. [~R LIMIT OF LIABILITY is changed to ~ 1. Regardless of the number ~f . . covered autos, insureds, claims made or vehicles involved in the accident, the most we will pay for all damages resulting" from anyone accident is the limit of UNINSURED MOTORISTS INSURANCE shown in the declarations. 2. Any loss pay- able under this insurance shall be reduced by: a. All sums paid or payable under any workers' compensa~ion law ex- clusive of non-occupational disability benefits and b. All sums paid by or for anyone who is legally responsi~J.e, including all sums paid under the policy's LIABILITY INSURANCE. D. OTHER INSURANCE is changed to read: 1. For bodily injury sustained by an insured while occupying an auto he does not own, UNINSURED MOTORISTS INSURANCE does not apply if the owner of the auto has uninsured motorists insurance. 2. Except as provided in paragraph 1, if an insured has other uninsured motorists insurance, the damages shall be deemed not to exceed the higher of the applicable limits of the respective coverages. We will pay only our share of these damages. Our share is the proportion that the limit of UNIN- SURED MOTORISTS INSURANCE bears to the total of the limits of all uninsured motorists insurance E. The policy's condition LEGAL ACTION AGAINST US is changed to read: No legal action may be brought against us until there has been full compliance with all the terms of this policy nor unless within one year from the date of the accident: 1. Suit for bodily injury has been filed against the uninsured motorist in a court of competent jurisdiction, or 2. Agreement as to the amount due under this insurance has been concluded, or 3. The insured has formally instituted legal proceedings. F. ARBITRATION is changed to read: 1. If we and an insured disagree whether the insured is legally entitled to recover dam- ages from the owner or driver of an uninsured motor vehicle or do not agree as to the amount of damages, either party may make a written demand for arbitration. In this event the disagreement will be settled by a single neutral arbitrator. Each party will bear the expenses of the arbitrator equally. 2. Unless both parties agree otherwise, arbitration will take place in the county in which the insured lives. Local rules of law as to arbitration procedures and evidence will apply. The decision of the arbitrator will be binding. LOUISIANA: A. WORDS AND PHRASES WITH SPECIAL MEANING is changed as follows: "Uninsured motor vehicle" also includes a motor vehicle or trailer for which there is a liability bond or policy at the time of an accident but which does not provide at least the amount an insured is legally entitled to recover as damages resulting from bodily injury caused by the accident. B. OUR LIMIT OF LIABILITY applies except as follows: Any amount payable under this insurance shall not be reduced by any sums paid by or for anyone who is legally responsible, including any sums paid under the policy's LIABIL- ITY INSURANCE. MINNESOTA, OHIO AND MISSOURI: OUR LIMIT OF LIABILITY applies except as follows: Any amount payable under UN. INSURED MOTORISTS INSURANCE shall not be reduced by any sums paid or payable under any workers' compensation law. OREGON: A. WORDS AND PHRASES WITH SPECIAL MEANING is changed as follows: "Uninsured motor vehicle" also in- cludes a hit-and-run vehicle which causes bodily injury to an insured without hitting the insured, a covered auto or a vehicle the insured is occupying. However, the facts of the accident must be corroborated by competent evidence other than the testimony of a person making a claim under this or any similar insurance. B. WHO IS INSURED is changed to read as follows: 1. You or any family member. 2. Anyone else occupying a covered auto or a temporary substitute for a covered auto. The covered auto must be out of service because of its breakdown, repair, servicing loss or destruction. 3. Anyone else occupying an auto you are operating. 4. Anyone for damages he is entitled to recover because of bodily injury sus- tained by another insured. C. ARBITRATION is changed as follows: We will pay all arbitration costs to an insured in excess of $100. Arbitration costs to an insured shall not include attorney's fees or any expenses incurred in producing evidence or witnesses or making transcripts of the arbitration proceedings. PENNSYLVANIA: ARBITRATION applies except as follows: Arbitration shall be conducted in accordance with the Penn. sylvania Arbitration Act of 1927. WASHINGTON: A. WORDS AND PHRASES WITH SPECIAL MEANING is changed as follows: "Uninsured motor vehicle" also includes a hit-and.run vehicle which causes bodily injury to an insured without hitting the insured, a covered auto or a vehicle the insured is occupying. However, the facts of the accident must be corroborated by competent evidence other than the testimony of a person making a claim under this or any similar insurance. B. Exclusion 3 under WE WILL NOT COVER-EXCLUSIONS does not apply. C. The first paragraph of OUR LIMIT OF LIABILITY is changed to read: The most we pay for all damages resulting from anyone accident is the limit of UNINSURED MOTORISTS INSURANCE shown in the declarations for each premium paid for each covered auto. Copyright, Insurance Services Office, 1978 Page 9 of 9