COMMERCIAL LINES COMMON POLICY DECLARATIONS- *W*
1W
* * Group
PAC6743907
Renewal of Number
INSURANCE IS PROVIDED BY THE COMPANY DESIGNATED BY AN "X": Stock
0 PENN-AMERICA INSURANCE COMPANY Company
PENN-STAR INSURANCE COMPANY State Control Number
PENN-PATRIOT INSURANCE COMPANY A206695
Bala Cynwyd, P a 19004 NORTHEAST AGENCIES, INC.
RECEIVED 2495 MAIN ST. STE 209
POLICY NUMBER: PAC6821215 r
1. NAMED INSURED:
DBA
SUNSETS AT PIER 60 SOCIETY, INC.
C/O CRAIG WEST OFF ECORDS AND
SEE SCHEDULE OF NAME JU&N SRVCS DEPT
BUFFALO, NY 14214
If property coverage is afforded
by this policy, the POLICY IS A
CO-INSURANCE CONTRACT.
MAILING ADDRESS: 1680 GULF TO BAY BLVD
CLEARWATER FL 33755
2. POLICY PERIOD: From 03/05/2009 To 03/05/2010 at 12:01 A.M.
Standard Time at your mailing address shown above.
3. FORM OF BUSINESS: CORPORATION OTHER DESC:
4. BUSINESS DESCRIPTION: OPEN AIR BAZAAR
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY WE
AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
5 THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED.
THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM
Commercial General Liability Coverage Part $ 5,100.00 INFORMATION REQUIRED ON
Commercial Property Coverage Part $ NOT COVERED EVIDENCE OF INSURANCE
626.924, FLORIDA STATUTES
Commercial Crime Coverage Part $ NOT COVERED SLAgnt Name.-Virginia C, Phillips
Commercial Inland Marine Coverage Part $ T COVERED SLAgntAddr:13577 Feathersound Dr.,
Professional Liability Coverage Part $ NOT COVERED Suite 120, Clearwater, FL 33762
Liquor Liability Coverage Part $ NOT COVERED License No.: A206695
Commercial Umbrella Coverage Part $ NOT COVERED Producer Name:JASON BUTTS
Producer Addr: PALM HARBOR, FL
Owners Contractors Protective Coverage Part $ NOT COVERED This insurance is issued pursuant to
TRIA $ NOT COVERED the Florida Surplus Lines Law. Persons
insured by Surplus Lines carriers do
6. TOTAL PREMIUM PAYABLE AT INCEPTION $ 51100.00 not have the protection of the Florida
Policy Fee $ 3 5 . 0 0 Insurance Guaranty Act to the extent of
any right of recovery for the obligation
Service/Underwriting $ 115 . 00 of any insolvent unlicensed insurer.
Surplus Lines Tax $ 262.50
FSLSO Fee $ 5.25
Florida Hurricane Catastrophe Fund $ 52.50
$ ??klGrsl
Other: $
TOTAL $ 5,570.25
7 FORM (S) AND ENDORSEMENT(S) MADE APART OF THIS POLICY AT THE TIME OF ISSUE:*
AS PER FORM COMSCHD 10 00 ATTACHED
*Omits applicable Forms and Endorsements if shown in specific Coverage Part/Coverage Form Declarations.
THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART
DECLARATIONS, COVERAGE PART COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED
TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED Val
Agency Code: 02195 . •
TAPCO-FL By 41d?
P.O. Box 17069
Clearwater, FL 33762 Authorized Re resentatIve
ALICII7 03/05/09
COMMERCIAL LINES COMMON POLICY DECLARATIONS
S1100(08/04) INSURED
UUMMERCIAL LINES COMMON POLICY DECLARATIONS
SCHEDULE OF FORMS AND ENDORSEMENTS
POLICY NUMBER:
PAC6821215
Form/Endorsement No./Edition Date
Forms Applicable - PAC COVERAGE
TP-SNI-01011-081
51036011-077
S1009106-013
PA01411C04-071
IL0017111-981
S1003C08-911-FL
51021009-061
I
SCHEDULE OF NAMED INSUREDS
FLORIDA POLICYHOLDER NOTICE
PRIVACY POLICY NOTICE
POLICYHOLDER NOTICE
COMMON POLICY CONDITIONS
MINIMUM EARNED PREMIUM
SERVICE OF SUIT
FL INSPECTION SHORT FORM
Forms Applicable - GL COVERAGE
52000(06-011
IL0021C07-021
CGOOM E12-071
CG0220[12-041
CG030OE01-961
CG2011COl-961
CG2144C07-981
CG2147C12-071
CG2155C09-991
CG2167C12-041
CG2173C01°081
CG2196C03-051
CG2426C07-041
S2002C08-021
xx
x
GL SUBDEC
NUCLEAR ENERGY LIAR EXCL
CGL COVERAGE FORM
FL CHANGES - CANC/NR
DEDUCTIBLE LIABILITY INSURANCE
ADD'L INSURED - MGRS/LESSORS
LIMIT OF COVG TO DESIG. PREM.
EMPLOYMENT RELATED PRAC EXCL
TOTAL POLLUTION EXCLUSION
FUNGI OR BACTERIA EXCLUSION
EXCL OF CERTIFIED ACTS OF TERROR
SILICA OR SILICA-RELATED DUST EX
AMEND OF INS. CONTRACT DEFINITIO
COMBINED PROVISIONS END'T
WORKSHEET-GENRL LIABILITY
CERTIFICATE OF INSURANCE
NAMEDINSURED
SUNSETS AT PIER 60 SOCIETY, INC.
SEE SCHEDULE OF NAMED INSUREDS
INSURED
Form/Endorsement No./Edition Date
ADDITIONAL FORMS ATTACHED
character spaces. The following endorsement amends the Declarations Page to show the
Named Insured in its entirety.
SCHEDULE OF NAMED INSUREDS
Policy No.
PAC6821215
Effective Date: 03/05/2009
12:01 A.M., Standard Time
Named Insured SUNSETS AT PIER 60 SOCIETY, INC. Agent No.
SUNSETS AT PIER 60 SOCIETY, INC.
C/O CRAIG WEST
TP-SNI-01 (11-08) INSURED
IMPORTANT NOTICE TO FLORIDA POLICYHOLDERS
Please Read:
The Florida Office of Insurance Regulation has issued an EMERGENCY
ASSESSMENT which requires us to collect from you a MANDATORY FEE equal
to 1% of your premium for your new or renewal policy, or any endorsements to
those policies, which become effective on or after January 1, 2007. This
Assessment will be utilized the State of Florida in order to provide funds to the
Florida Hurricane Catastrophe Fund (FHCF).
The amount of your assessment is displayed on your billing statement as Florida
Hurricane Catastrophe Fund. Please include this amount when you remit your
premium. In the event this amount is not included, we are REQUIRED to cancel
your policy for non-payment of premium.
If you have any questions concerning this assessment please contact your agent
immediately.
S1036(11/07)
Page 1 of 1
INSURED
PRIVACY POLICY NOTICE
on behalf of
PENN-AMERICA INSURANCE COMPANY
PENN-STAR INSURANCE COMPANY
We at Penn-America Insurance Company and Penn-Star Insurance Company (Company) have always recognized
that the personal information we obtain about you should be treated confidentially as private information. A recent law now
requires that we inform you about our privacy practices, and this notice is designed to explain the Companys privacy
procedures
You should be confident that we maintain high standards and safeguards to protect the confidentiality of your
information. We do not disclose personal information we learn about you to third parties for marketing purposes. However, the
Company does disclose personal information about you when we 1) are required by law to do so (for example, information
demanded in a subpoena), or 2) to perform services necessary to effect, administer, process, carry out, service or enforce
your insurance policy (for example, so that your insurance agent can maintain your account). We also disclose personal
information about you when we are permitted by law to do so (for example, to obtain reinsurance for our Company) or to
complete a transaction that was initiated at your request.
As a necessary part of offering you insurance, we gather public and nonpublic personal information about you from a
variety of sources. The information we collect may include your name, address, social security number, property valuation
information and other information about you and your property that we insure. Such information may be collected from
applications you have completed, or from information provided by your agent. If you have had other transactions with us, we
may also gather information about policy coverages, premiums, and payment history from our affiliates. Information also may
be gathered from persons that are not affiliated with the Company, such as consumer reporting agencies, credit bureaus or
property inspection services.
The Company may use the personal information we have obtained about you for its own operations, and may
disclose such information to the Companys affiliates. Only Company employees who have a need to know that information are
permitted to access your nonpublic personal information. Further, we maintain appropriate physical, electronic and procedural
safeguards to protect the security of your nonpublic personal information.
The Company may disclose personal information about you to other companies or persons that are not within the
Penn-America Group. However, disclosure to such nonaffiliated third parties is undertaken only 1) when the other party needs
to know the information to perform a service for us (for example, adjusting a claim under your policy) and 2) such person
agrees to hold your information in a confidential fashion and not use your information for any other purpose.
Regardless of whether you are an applicant, policyholder or claimant, the Company treats your nonpublic personal
information in the confidential manner described in this notice. Our privacy policies and practices as described in this notice
relate to insurance policies obtained from the Company primarily for personal, family or household purposes; it does not apply
if you have obtained a policy for business, commercial or agricultural purposes.
We hope this initial Privacy Notice has demonstrated the Companys commitment to maintaining the confidentiality
and security of the nonpublic personal information you provide to us. If you have more than one policy with the Company, you
may receive additional copies of this notice. We will also provide you a similar notice at least annually while you remain a
customer.
Copyright, Penn-America Insurance Company 2001. All Rights Reserved.
Penn-America June, 2001 Ed.
Sl009(05/01) INSURED Page 1 of 1
* 0O
Grou**
PENN-AMERICA INSURANCE COMPANY
PENN-STAR INSURANCE COMPANY
PENN-PATRIOT INSURANCE COMPANY
Three Bala Plaza East, Suite 300, Bala Cynwyd, PA 19004
Phone: 610-664-1500, Fax: 610-660-8882
Claims Reporting: 800-788-4780 (9 AM to 5 PM ET) OR 800-621-5410 (After 5 PM ET)
Dear Policyholder:
Welcome to the Penn-America Group family of companies. Enclosed is information regarding
your insurance coverages.
The Policy consists of:
--- Common Declarations
--- Common Policy Conditions
--- One or more Coverage Parts
A Coverage Part consists of:
w Coverage Form Declarations
--- One or more Coverage Forms
- Applicable Endorsements
Please take a few moments to read the attached policy.
Hopefully, you will never be faced with a loss or accident involving damage to your property or
injury to you or another individual. If you do need to submit a claim to us, please note:
- Prompt reporting of all losses is a requirement of your insurance policy.
Therefore, upon knowledge of a potential claim -- be it actual first-hand
knowledge, a letter, a phone call or legal papers -- contact your Insurance
Broker immediately and report the loss with as much detail as possible.
Your Broker will in turn forward the loss information to our Claim Department
for handling.
- Prompt reporting of potential claims allows us the best possible opportunity
to protect your rights.
In emergency situations, you can contact the Penn-America Claim
Department at: 800-788-4780 (9 AM to 5 PM ET), or after hours by calling:
800-621-5410 (after 5 PM ET).
Please give us the opportunity to serve your interests by reporting all claims on a timely basis
to your Broker.
Thank you.
Penn-America Insurance Company
Penn-Star Insurance Company
Penn-Patriot Insurance Company
PA01-411(04/07) INSURED Page 1 of 1
COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions.
A. Cancellation
1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance
written notice of cancellation.
2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least:
a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or
b. 30 days before the effective date of cancellation if we cancel for any other reason.
1 We will mail or deliver our notice to the first Named Insured's last mailing address known to us.
4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date.
5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund
will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be
effective even if we have not made or offered a refund.
& If notice is mailed, proof of mailing will be sufficient proof of notice.
B. Changes
This policy contains all the agreements between you and us concerning the insurance afforded. The first Named
Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This
policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy.
C. Examination Of Your Books And Records
We may examine and audit your books and records as they relate to this policy at any time during the policy period
and up to three years afterward.
D. Inspections And Surveys
1. We have the right to:
a. Make inspections and surveys at any time;
b. Give you reports on the conditions we find; and
c. Recommend changes.
2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do
undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do
not undertake to perform the duty of any person or organization to provide for the health or safety of workers or
the public. And we do not warrant that conditions:
a. Are safe or healthful; or
b. Comply with laws, regulations, codes or standards.
3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar
organization which makes insurance inspections, surveys, reports or recommendations.
4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recommendations we may
make relative to certification, under state or municipal statutes, ordinances or regulations, of boilers, pressure
vessels or elevators.
E. Premiums
The first Named Insured shown in the Declarations:
1. Is responsible for the payment of all premiums; and
2. Will be the payee for any return premiums we pay.
F. Transfer Of Your Rights And Duties Under This Policy
Your rights and duties under this policy may not be transferred without our written consent except in the case of death
of an individual named insured.
If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope
of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary
custody of your property will have your rights and duties but only with respect to that property.
11 -00 1711 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1
INSURED
* * * * 41
*
*
* Group
MINIMUM EARNED PREMIUM
CANCELLATIONS AND AUDITS
It is hereby understood and agreed that in the event of cancellation of coverage by the insured, the minimum earned
premium under this policy shall be 25 % of the policy premium.
It is further understood the minimum earned premium of this policy shall be 100 %
premium if the policy is in effect for the full term and the audit shows a lower exposure than estimated.
of the policy
Page 1 of 1
S1003 (8/91) INSURED
Group
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SERVICE OF SUIT CLAUSE
This endorsement modifies insurance provided under the following;
ALL COVERAGE PARTS IN THIS POLICY
We appoint the highest State official in charge of insurance affairs (Commissioner of Insurance, Director of
Insurance, Insurance Commissioner, Executive Secretary, Superintendent of Insurance, or such other official
title as designated by the State) of the State of FLORIDA and his successor or successors in
office as his and their duly authorized deputies, as our true and lawful attorney in and for the aforesaid State,
upon whom all lawful process may be served in any action, "suit" or proceeding instituted in the said State by
or on behalf of any insured or beneficiary against us, arising out of this insurance policy, provided a copy of
any process, "suit" complaint or summons is sent by certified or registered mail to Richard S. March, Esq.,
General Counsel, PENN-AMERICA Insurance Company, Three Bala Plaza East, Suite 300, Bala
Cynwyd, PA 19004.
Authorized Representative
S1021(09/06) INSURED Page 1 of 1
COMMERCIAL GENERAL LIABILITY COVERAGE PART
* D? DECLARATIONS
Group
POLICY NUMBER: PAC6821215
1. NAMED INSURED: SUNSETS AT PIER 60 SOCIETY, INC.
SEE SCHEDULE OF NAMED INSUREDS
2. LIMITS OF INSURANCE -INSURANCE APPLIES ONLY FOR COVERAGE FOR WHICH A LIMIT OF
INSURANCE IS SHOWN.
3.
No.
4
No.
General Aggregate Limit (Other than Products/Completed Operations)
Products/Completed Operations Aggregate Limit
Each Occurrence Limit
Personal & Advertising Injury Limit
Damage to Premises Rented to You Limit
Medical Expense Limit
LOCATIONS of all premises you Own, Rent, or Occupy
Address City
1 PIER 60 DRIVE CLEARWATER BEACH
$2,000,000
Stock
Company
any one premises
any one person
$1,000,000
$1,000,000
$1,000,000
$ 100,000
$ 5,000
State Zip
FL 33767
PREMIUM BASIS RATES ADVANCE PREMIUM
CLASS ** Code / Exposure Prod CO All Other Prod CO All Other
** If Classifications are Numbered, the coverage applies to the corresponding Location No.
15123 s) 100,000 INCL 9.06 INCLUDED 2,500.00
MIN PREM
Markets - open air (lessor's risk only). Products-completed operations are subject to the General
Aggregate Limit.
No. 10132 s) 100,000 INCL 10.26 INCLUDED 2,500.00
MIN PREM
Bazaars operated by the insured Not-for-Profit. Products-complete operations are subject to the
General Aggregate Limit.
No.
No.
No
INCL FLAT INCLUDED 100.00
Additional Insured- See Form CG2011
** If Classifications are Numbered, the coverage applies to the corresponding Location No,
TOTAL: $ 5,100.00 MINIMUM PREMIUM
(s) gross sales -per $1000 (c) total cost - per $1000 (m) admissions - per 1000 (e) each
(p) payroll -per $1000 (a) area -per 1000 sq. ft. (u) units (o) other
5. Policy may be AUDITABLE (t) see classification notes in company or ISO Commercial Lines Manual
6. SPECIFIC GENERAL LIABILITY FORMS/ENDORSEMENTS
AS PER FORM COMSCHD(10/00) ATTACHED
This page alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations
Common Policy Conditions, Coverage Part Coverage Form(s) and any other applicable forms and endorsements.
S2000 (06/01) INSURED
IL 00210702
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NUCLEAR ENERGY LIABILITY EXCLUSION
ENDORSEMENT
(Broad Form)
This endorsement modifies insurance provided under the following:
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
FARM COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
PROFESSIONAL LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY
1. The insurance does not apply:
A. Under any Liability Coverage, to "bodily injury" or "property damage":
(1) With respect to which an "insured" under the policy is also an insured under a nuclear energy liability
policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Under
writers, Nuclear Insurance Association of Canada or any of their successors, or would be an insured
under any such policy but for its termination upon exhaustion of its limit of liability; or
(2) Resulting from the "hazardous properties" of "nuclear material" and with respect to which (a) any person
or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or
any law amendatory thereof, or (b) the "insured" is, or had this policy not been issued would be, entitled to
indemnity from the United States of America, or any agency thereof, under any agreement entered into by
the United States of America, or any agency thereof, with any person or organization.
B. Under any Medical Payments coverage, to expenses incurred with respect to "bodily injury" resulting from the
"hazardous properties" of "nuclear material" and arising out of the operation of a "nuclear facility" by any
person or organization.
C. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from "hazardous properties" of
"nuclear material", if:
(1) The "nuclear material" (a) is at any "nuclear facility" owned by, or operated by or on behalf of, an "insured"
or (b) has been discharged.or dispersed therefrom;
(2) The "nuclear material" is contained in "spent fuel" or "waste" at any time possessed, handled, used,
processed, stored, transported or disposed of, by or on behalf of an "insured"; or
(3) The "bodily injury" or "property damage" arises out of the furnishing by an "insured" of services, materials,
parts or equipment in connection with the planning, construction, maintenance, operation or use of any
"nuclear facility", but if such facility is located within the United States of America, its territories or
possessions or Canada, this exclusion (3) applies only to "property damage" to such "nuclear facility" and
any property thereat.
IL 00 21 07 02 ISO Properties, Inc., 2001 Page 1 of 2
INSURED
COMMERCIAL GENERAL LIABILITY
CG 00 01 12 07
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage. Read
the entire policy carefully to determine rights, duties
and what is and is not covered.
Throughout this policy the words "you" and "your" refer
to the Named Insured shown in the Declarations, and
any other person or organization qualifying as a
Named Insured under this policy. The words "we", "us"
and "our" refer to the company providing this insur-
ance.
The word "insured" means any person or organization
qualifying as such under Section If Who Is An Insured.
Other words and phrases that appear in quotation
marks have special meaning. Refer to Section V Defini-
tions.
SECTION I- COVERAGES
COVERAGE A BODILY INJURY AND PROPERTY
DAMAGE LIABILITY
1. Insuring Agreement
a. We will pay those sums that the insured be-
comes legally obligated to pay as damages be-
cause of "bodily injury" or "property damage" to
which this insurance applies. We will have the
right and duty to defend the insured against any
"suit" seeking those damages. However, we will
have no duty to defend the insured against any
"suit" seeking damages for "bodily injury" or
"property damage" to which this insurance does
not apply. We may, at our discretion, investigate
any "occurrence" and settle any claim or "suit"
that may result. But:
(1) The amount we will pay for damages is lim-
ited as described in Section III Limits Of In-
surance; and
(2) Our right and duty to defend ends when we
have used up the applicable limit of insur-
ance in the payment of judgments or settle-
ments under Coverages A or B or medical
expenses under Coverage C.
No other obligation or liabilityto pay sums or perform
acts or services is covered unless explicitly provided
for under Supplementary Payments Coverages A and
B.
b. This insurance applies to "bodily injury" and
"property damage" only if:
(1) The "bodily injury" or "property damage" is
caused by an "occurrence" that takes place
in the "coverage territory";
(2) The "bodily injury" or "property damage" oc-
curs during the policy period; and
(3) Prior to the policy period, no insured listed
under Paragraph 1. of Section II Who Is An
Insured and no "employee" authorized by
you to give or receive notice of an "occur-
rence" or claim, knew that the "bodily injury"
or "property damage" had occurred, in whole
or in part. If such a listed insured or author-
ized "employee" knew, prior to the policy pe-
riod, that the "bodily injury" or "property
damage" occurred, then any continuation,
change or resumption of such "bodily injury"
or "property damage" during or after the poli-
cy period will be deemed to have been
known prior to the policy period.
c."Bodily injury" or "property damage" which occurs
during the policy period and was not, prior to
the policy period, known to have occurred by
any insured listed under Paragraph 1. of Section
II - Who Is An Insured or any "employee" author-
ized by you to give or receive notice of an "oc-
currence" or claim, includes any continuation,
change or resumption of that "bodily injury" or
"property damage" after the end of the policy pe-
riod.
d. "Bodily injury" or "property damage" will be
deemed to have been known to have occurred
at the earliest time when any insured listed
under Paragraph 1. of Section II Who Is An In-
sured or any "employee" authorized by you to
give or receive notice of an "occurrence" or
claim:
(1) Reports all, or any part, of the "bodily injury"
or "property damage" to us or any other in-
surer;
(2) Receives a written or verbal demand or claim
for damages because of the "bodily injury" or
"property damage"; or
(3) Becomes aware by any other means that "bod-
ily injury" or "property damage" has occurred
or has begun to occur.
INSURED
CG 00 01 12 07 ISO Properties, Inc., 2006 Page 1 of 16
f. Pollution
(1) "Bodily injury" or "property damage" arising
out of the actual, alleged or threatened dis-
charge, dispersal, seepage, migration, re-
lease or escape of "pollutants":
(a) At or from any premises, site or location
which is or was at any time owned or oc-
cupied by, or rented or loaned to, any in-
sured. However, this subparagraph does
not apply to:
(i) "Bodily injury" if sustained within a
building and caused by smoke,
fumes, vapor or soot produced by or
originating from equipment that is
used to heat, cool or dehumidify the
building, or equipment that is used to
heat water for personal use, by the
building's occupants or their guests;
(ii) "Bodily injury" or "property damage"
for which you may be held liable, if
you are a contractor and the owner or
lessee of such premises, site or loca-
tion has been added to your policy as
an additional insured with respect to
your ongoing operations performed
for that additional insured at that
premises, site or location and such
premises, site or location is not and
never was owned or occupied by, or
rented or loaned to, any insured, oth-
er than that additional insured; or
(Iii) "Bodily injury" or "property damage"
arising out of heat, smoke or fumes
from a "hostile fire";
(b) At or from any premises, site or location
which is or was at any time used by or for
any insured or others for the handling,
storage, disposal, processing or treat-
ment of waste;
(c) Which are or were at any time trans-
ported, handled, stored, treated, dis-
posed of, or processed as waste by or
for:
(i) Any insured; or
(II) Any person or organization for whom
you may be legally responsible; or
(d) At or from any premises, site or location
on which any insured or any contractors
or subcontractors working directly or in-
directly on any insured's behalf are per-
forming operations if the "pollutants" are
brought on or to the premises, site or lo-
cation in connection with such opera-
tions by such insured, contractor or sub-
contractor. However, this subparagraph
does not apply to:
(i) "Bodily injury" or "property damage"
arising out of the escape of fuels, lu-
bricants or other operating fluids
which are needed to perform the nor-
mal electrical, hydraulic or mechani-
cal functions necessary for the opera-
tion of "mobile equipment" or its parts,
if such fuels, lubricants or other oper-
ating fluids escape from a vehicle part
designed to hold, store or receive
them. This exception does not apply if
the "bodily injury" or "property dam-
age" arises out of the intentional dis-
charge, dispersal or release of the
fuels, lubricants or other operating flu-
ids, or if such fuels, lubricants or other
operating fluids are brought on or to
the premises, site or location with the
intent that they be discharged, dis-
persed or released as part of the op-
erations being performed by such in-
sured, contractor or subcontractor;
(ii) "Bodily injury" or "property damage"
sustained within a building and
caused by the release of gases,
fumes or vapors from materials
brought into that building in connec-
tion with operations being performed
by you or on your behalf by a con-
tractor or subcontractor; or
(iii) "Bodily injury" or "property damage"
arising out of heat, smoke or fumes
from a "hostile fire".
(e) At or from any premises, site or location
on which any insured or any contractors
or subcontractors working directly or in-
directly on any insured's behalf are per-
forming operations if the operations are
to test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in
any way respond to, or assess the effects
of, "pollutants".
CG 00 01 12 07 ISO Properties, Inc., 2006 Page 3 of 16
(5) That particular part of real property on which
you or any contractors or subcontractors
working directly or indirectly on your behalf
are performing operations, if the "property
damage" arises out of those operations: or
(6) That particular part of any property that must
be restored, repaired or replaced because
"your work" was incorrectly performed on it.
Paragraphs (1), (3) and (4) of this exclusion do
not apply to "property damage" (other than
damage by fire) to premises, including the con-
tents of such premises, rented to you for a peri-
od of 7 or fewer consecutive days. A separate
limit of insurance applies to Damage To Prem-
ises Rented To You as described in Section III
Limits Of Insurance.
Paragraph (2) of this exclusion does not apply if
the premises are "your work" and were never oc-
cupied, rented or held for rental by you.
Paragraphs (3), (4), (5) and (6) of this exclusion
do not apply to liability assumed under a side-
track agreement.
Paragraph (6) of this exclusion does not apply
to "property damage" included in the
"products-completed operations hazard".
k. Damage To Your Product
"Property damage" to "your product" arising out
of it or any part of it.
1. Damage To Your Work
"Property damage" to "your work" arising out of
it or any part of it and included in the
"products-completed operations hazard".
This exclusion does not apply if the damaged
work or the work out of which the damage arises
was performed on your behalf by a subcontrac-
tor.
m. Damage To Impaired Property Or Property
Not Physically Injured
"Property damage" to "impaired property" or
property that has not been physically injured,
arising out of:
(1) A defect, deficiency, inadequacy or danger-
ous condition in "your product" or "your
work"; or
This exclusion does not apply to the loss of use
of other property arising out of sudden and acci-
dental physical injury to "your product" or "your
work" after it has been put to its intended use.
n. Recall Of Products, Work Or Impaired
Property
Damages claimed for any loss, cost or expense
incurred by you or others for the loss of use,
withdrawal, recall, inspection, repair, replace-
ment, adjustment, removal or disposal of:
(1) "Your product";
(2) "Your work"; or
(3) "Impaired property";
if such product, work, or property is withdrawn
or recalled from the market or from use by any
person or organization because of a known or
suspected defect, deficiency, inadequacy or
dangerous condition in it.
o. Personal And Advertising Injury
"Bodily injury" arising out of "personal and ad-
vertising injury".
p. Electronic Data
Damages arising out of the loss of, loss of use
of, damage to, corruption of, inability to access,
or inability to manipulate electronic data.
As used in this exclusion, electronic data means
information, facts or programs stored as or on,
created or used on, or transmitted to or from
computer software, including systems and ap-
plications software, hard or floppy disks,
CD-ROMS, tapes, drives, cells, data processing
devices or any other media which are used with
electronically controlled equipment.
q. Distribution Of Material In Violation Of
Statutes
"Bodily injury" or "property damage" arising di-
rectly or indirectly out of any action or omission
that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or ad-
dition to such law; or
(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law; or
(2) A delay or failure by you or anyone acting on (3) Any statute, ordinance or regulation, other
your behalf to perform a contract or agree- than the TCPA or CAN-SPAM Act of 2003,
ment in accordance with its terms. that prohibits or limits the sending, transmit-
ting, communicating or distribution of mate-
rial or information.
CG 00 01 12 07 ISO Properties, Inc., 2006 Page 5 of 16
(3) An Internet search, access, content or serv-
ice provider.
However, this exclusion does not apply to Para-
graphs 14.a., b. and c. of "personal and adver-
tising injury" under the Definitions Section.
For the purposes of this exclusion, the placing
of frames, borders or links, or advertising, for
you or others anywhere on the Internet, is not by
itself, considered the business of advertising,
broadcasting, publishing or telecasting.
k. Electronic Chatrooms Or Bulletin Boards
"Personal and advertising injury" arising out of
an electronic chatroom or bulletin board the in-
sured hosts, owns, or over which the insured ex-
ercises control.
1. Unauthorized Use Of Another's Name Or
Product
"Personal and advertising injury" arising out of
the unauthorized use of another's name or prod-
uct in your e-mail address, domain name or
metatag, or any other similar tactics to mislead
another's potential customers.
m. Pollution
"Personal and advertising injury" arising out of
the actual, alleged or threatened discharge, dis-
persal, seepage, migration, release or escape of
"pollutants" at any time.
n. Pollution-Related
Any loss, cost or expense arising out of any:
(1) Request, demand, order or statutory or regu-
latory requirement that any insured or others
test for, monitor, clean up, remove, contain,
treat, detoxify or neutralize, or in anyway re-
spond to, or assess the effects of, "pollu-
tants"; or
(2) Claim or suit by or on behalf of a governmen-
tal authority for damages because of testing
for, monitoring, cleaning up, removing, con-
taining, treating, detoxifying or neutralizing,
or in any way responding to, or assessing
the effects of, "pollutants".
o. War
"Personal and advertising injury", however
caused, arising, directly or indirectly, out of:
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental au-
thority in hindering or defending against any
of these.
p. Distribution Of Material In Violation Of
Statutes
"Personal and advertising injury" arising directly
or indirectly out of any action or omission that
violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or ad-
dition to such law; or
(2) The CAN-SPAM Act of 2003, including any
amendment of or addition to such law; or
(3) Any statute, ordinance or regulation, other
than the TCPA or CAN-SPAM Act of 2003,
that prohibits or limits the sending, transmit-
ting, communicating or distribution of mate-
rial or information.
COVERAGE C MEDICAL PAYMENTS
1. Insuring Agreement
a. We will pay medical expenses as described be-
low for "bodily injury" caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or rent;
or
(3) Because of your operations;
provided that:
(a) The accident takes place in the "cover-
age territory" and during the policy peri-
od;
(b) The expenses are incurred and reported
to us within one year of the date of the
accident; and
(c) The injured person submits to examina-
tion, at our expense, by physicians of our
choice as often as we reasonably require.
b. We will make these payments regardless of
fault. These payments will not exceed the appli-
cable limit of insurance. We will pay reasonable
expenses for:
(1) First aid administered at the time of an acci-
dent;
(1) War, including undeclared or civil war; (2) Necessary medical, surgical, x-ray and den-
(2) Warlike action by a military force, including tal services, including prosthetic devices;
action in hindering or defending against an and
actual or expected attack, by any govern- (3) Necessary ambulance, hospital, professional
ment, sovereign or other authority using mili- nursing and funeral services.
tary personnel or other agents; or
CG 00 01 12 07 Page 7 of 16
150 Properties, Inc., 2006
(b) Conduct and control the defense of the
indemnitee in such "suit".
So long as the above conditions are met, attorneys'
fees incurred by us in the defense of that indemnit-
ee, necessary litigation expenses incurred by us
and necessary litigation expenses incurred by the
indemnitee at our request will be paid as Supple-
mentary Payments. Notwithstanding the provisions
of Paragraph 2.b.(2) of Section I - Coverage A - Bo
dily Injury And Property Damage Liability, such pay-
ments will not be deemed to be damages for "bodily
injury" and "property damage" and will not reduce
the limits of insurance.
Our obligation to defend an insured's indemnitee
and to pay for attorneys' fees and necessary litiga-
tion expenses as Supplementary Payments ends
when we have used up the applicable limit of insur-
ance in the payment of judgments or settlements or
the conditions set forth above, or the terms of the
agreement described in Paragraph f. above, are no
longer met.
SECTION II _ WHO IS AN INSURED
1. If you are designated in the Declarations as:
a. An individual, you and your spouse are insur-
eds, but only with respect to the conduct of a
business of which you are the sole owner.
b. A partnership or joint venture, you are an in-
sured. Your members, your partners, and their
spouses are also insureds, but only with respect
to the conduct of your business.
c. A limited liability company, you are an insured.
Your members are also insureds, but only with
respect to the conduct of your business. Your
managers are insureds, but only with respect to
their duties as your managers.
d. An organization other than a partnership, joint
venture or limited liability company, you are an
insured. Your "executive officers" and directors
are insureds, but only with respect to their duties
as your officers or directors. Your stockholders
are also insureds, but only with respect to their
liability as stockholders,
e. A trust, you are an insured. Your trustees are
also insureds, but only with respect to their du-
ties as trustees.
2. Each of the following is also an insured:
Your "volunteer workers" only while performing
duties related to the conduct of your business,
or your "employees", other than either your "ex-
ecutive officers" (if you are an organization other
than a partnership, joint venture or limited liabil-
ity company) or your managers (if you are a lim-
ited liability company), but only for acts within
the scope of their employment by you or while
performing duties related to the conduct of your
business. However, none of these "employees"
or "volunteer workers" are insureds for:
(1) "Bodily injury" or "personal and advertising
injury":
(a) To you, to your partners or members (if
you are a partnership or joint venture), to
your members (if you are a limited liability
company), to a co-"employee" while in
the course of his or her employment or
performing duties related to the conduct
of your business, or to your other "volun-
teer workers" while performing duties re-
lated to the conduct of your business;
(b) To the spouse, child, parent, brother or
sister of that co-"employee" or "volunteer
worker" as a consequence of Paragraph
(1)(a) above;
(c) For which there is any obligation to share
damages with or repay someone else
who must pay damages because of the
injury described in Paragraphs (1)(a) or
(b) above; or
(d) Arising out of his or her providing or fail-
ing to provide professional health care
services.
(2) "Property damage" to property:
(a) Owned, occupied or used by,
(b) Rented to, in the care, custody or control
of, or over which physical control is being
exercised for any purpose by
you, any of your "employees", "volunteer
workers", any partner or member (if you are
a partnership or joint venture), or any mem-
ber (if you are a limited liability company).
CG 00 01 12 07 ISO Properties, Inc., 2006 Page 9 of 16
(3) The nature and location of any injury or dam-
age arising out of the "occurrence" or of-
fense.
b. If a claim is made or "suit" is brought against any
insured, you must:
(1) Immediately record the specifics of the claim
or "suit" and the date received; and
(2) Notify us as soon as practicable.
You must see to it that we receive written notice
of the claim or "suit" as soon as practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any de-
mands, notices, summonses or legal papers
received in connection with the claim or
"suit";
(2) Authorize us to obtain records and other in-
formation;
(3) Cooperate with us in the investigation or set-
tlement of the claim or defense against the
"suit"; and
(4) Assist us, upon our request, in the enforce-
ment of any right against any person or or-
ganization which may be liable to the insured
because of injury or damage to which this in-
surance may also apply.
d. No insured will, except at that insured's own
cost, voluntarily make a payment, assume any
obligation, or incur any expense, other than for
first aid, without our consent.
3. Legal Action Against Us
No person or organization has a right under this
Coverage Part:
a. To join us as a party or otherwise bring us into a
"suit" asking for damages from an insured; or
b. To sue us on this Coverage Part unless all of its
terms have been fully complied with.
A person or organization may sue us to recover on
an agreed settlement or on a final judgment against
an insured; but we will not be liable for damages
that are not payable under the terms of this Cover-
age Part or that are in excess of the applicable limit
of insurance. An agreed settlement means a settle-
ment and release of liability signed by us, the in-
sured and the claimant or the claimant's legal repre-
sentative.
4. Other Insurance
If other valid and collectible insurance is available to
the insured for a loss we cover under Coverages A
or B of this Coverage Part, our obligations are lim-
ited as follows:
a. Primary Insurance
This insurance is primary except when Para-
graph b. below applies. If this insurance is pri-
mary, our obligations are not affected unless
any of the other insurance is also primary. Then,
we will share with all that other insurance by the
method described in Paragraph c. below.
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance, whether pri-
mary, excess, contingent or on any other
basis:
(1) That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or sim-
ilar coverage for "your work";
(ii) That is Fire insurance for premises
rented to you or temporarily occupied
by you with permission of the owner;
(Iii) That is insurance purchased by you
to cover your liability as a tenant for
"property damage" to premises rent-
ed to you or temporarily occupied by
you with permission of the owner; or
(iv) If the loss arises out of the mainte-
nance or use of aircraft, "autos" or
watercraft to the extent not subject to
Exclusion g. of Section I Coverage A
Bodily Injury And Property Damage
Liability.
(b) Any other primary insurance available to
you covering liability for damages arising
out of the premises or operations, or the
products and completed operations, for
which you have been added as an addi-
tional insured by attachment of an en-
dorsement.
(2) When this insurance is excess, we will have
no duty under Coverages A or B to defend
the insured against any "suit" if any other in-
surer has a duty to defend the insured
against that "suit". If no other insurer de-
fends, we will undertake to do so, but we will
be entitled to the insured's rights against all
those other insurers.
CG 00 01 12 07 ISO Properties, Inc., 2006 Page 11 of 16
3. "Bodily injury" means bodily injury, sickness or dis-
ease sustained by a person, including death result-
ing from any of these at anytime.
4. "Coverage territory" means:
a. The United States of America (including its terri-
tories and possessions), Puerto Rico and Cana-
da;
b. International waters or airspace, but only if the
injury or damage occurs in the course of travel
or transportation between any places included
in Paragraph a. above; or
c. All other parts of the world if the injury or damage
arises out of:
(1) Goods or products made or sold by you in
the territory described in Paragraph a.
above;
(2) The activities of a person whose home is in
the territory described in Paragraph a.
above, but is away for a short time on your
business; or
(3) "Personal and advertising injury" offenses
that take place through the Internet or similar
electronic means of communication
provided the insured's responsibility to pay dam-
ages is determined in a "suit" on the merits, in the
territory described in Paragraph a. above or in a
settlement we agree to.
5. "Employee" includes a "leased worker". "Employee"
does not include a "temporary worker".
6. "Executive officer" means a person holding any of
the officer positions created by your charter, consti-
tution, by-laws or any other similar governing docu-
ment.
7. "Hostile fire" means one which becomes uncontrol-
lable or breaks out from where it was intended to
be.
8. "Impaired property" means tangible property, other
than "your product" or "your work", that cannot be
used or is less useful because:
a. It incorporates "your product" or "your work" that
is known or thought to be defective, deficient, in-
adequate or dangerous; or
b. You have failed to fulfill the terms of a contract
or agreement;
if such property can be restored to use by the repair,
replacement, adjustment or removal of "your product"
or "your work" or your fulfilling the terms of the contract
or agreement.
9. "Insured contract" means:
a. A contract for a lease of premises. However, that
portion of the contract for a lease of premises
that indemnifies any person or organization for
damage by fire to premises while rented to you
or temporarily occupied by you with permission
of the owner is not an "insured contract";
b. A sidetrack agreement;
c. Any easement or license agreement, except in
connection with construction or demolition op-
erations on or within 50 feet of a railroad;
d. An obligation, as required by ordinance, to in-
demnify a municipality, except in connection
with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement
pertaining to your business (including an indem-
nification of a municipality in connection with
work performed for a municipality) under which
you assume the tort liability of another party to
pay for "bodily injury" or "property damage" to a
third person or organization. Tort liability means
a liability that would be imposed by law in the
absence of any contract or agreement.
Paragraph f. does not include that part of any
contract or agreement:
(1) That indemnifies a railroad for "bodily injury"
or "property damage" arising out of con-
struction or demolition operations, within 50
feet of any railroad property and affecting
any railroad bridge or trestle, tracks,
road-beds, tunnel, underpass or crossing;
(2) That indemnifies an architect, engineer or
surveyor for injury or damage arising out of:
(a) Preparing, approving, or failing to pre-
pare or approve, maps, shop drawings,
opinions, reports, surveys, field orders,
change orders or drawings and specifica-
tions; or
(b) Giving directions or instructions, or failing
to give them, if that is the primary cause
of the injury or damage; or
(3) Under which the insured, if an architect, en-
gineer or surveyor, assumes liability for an
injury or damage arising out of the insured's
rendering or failure to render professional
services, including those listed in (2) above
and supervisory, inspection, architectural or
engineering activities.
CG 00 01 12 07 ISO Properties, Inc., 2006 Page 13 of 16
15. "Pollutants" mean any solid, liquid, gaseous or ther-
mal irritant or contaminant, including smoke, vapor,
soot, fumes, acids, alkalis, chemicals and waste-
Waste includes materials to be recycled, recondi-
tioned or reclaimed.
16."Products-completed operations hazard":
a. Includes all "bodily injury" and "property dam-
age" occurring away from premises you own or
rent and arising out of "your product" or "your
work" except:
(1) Products that are still in your physical pos-
session; or
(2) Work that has not yet been completed or
abandoned. However, "your work" will be
deemed completed at the earliest of the fol-
lowing times:
(a) When all of the work called for in your con-
tract has been completed.
(b) When all of the work to be done at the job
site has been completed if your contract
calls for work at more than one job site.
(c) When that part of the work done at a job
site has been put to its intended use by
any person or organization other than an-
other contractor or subcontractor work-
ing on the same project.
Work that may need service, maintenance,
correction, repair or replacement, but which
is otherwise complete, will be treated as
completed.
b. Does not include "bodily injury" or "property
damage" arising out of:
(1) The transportation of property, unless the in-
jury or damage arises out of a condition in or
on a vehicle not owned or operated by you,
and that condition was created by the "load-
ing or unloading" of that vehicle by any in-
sured;
(2) The existence of tools, uninstalled equip-
ment or abandoned or unused materials; or
(3) Products or operations for which the classifi-
cation, listed in the Declarations or in a poli-
cy schedule, states that products-completed
operations are subject to the General Aggre-
gate Limit.
17. "Property damage" means:
a. Physical injury to tangible property, including
all resulting loss of use of that property. All such loss of
use shall be deemed to occur at the time of the physi-
cal injury that caused it; or
b. Loss of use of tangible property that is not
physically injured. All such loss of use shall be
deemed to occur at the time of the "occurrence"
that caused it.
For the purposes of this insurance, electronic data
is not tangible property.
As used in this definition, electronic data means in-
formation, facts or programs stored as or on, cre-
ated or used on, or transmitted to or from computer
software, including systems and applications soft-
ware, hard or floppy disks, CD-ROMS, tapes, drives,
cells, data processing devices or any other media
which are used with electronically controlled equip-
ment.
18."Suit" means a civil proceeding in which damages
because of "bodily injury", "property damage" or
"personal and advertising injury" to which this insur-
ance applies are alleged. "Suit" includes:
a. An arbitration proceeding inwhich such damages
are claimed and to which the insured must sub-
mit or does submit with our consent; or
b. Any other alternative dispute resolution pro-
ceeding in which such damages are claimed
and to which the insured submits with our con-
sent.
19."Temporary worker" means a person who is fur-
nished to you to substitute for a permanent "em-
ployee" on leave or to meet seasonal or short-term
workload conditions.
20."Volunteer worker" means a person who is not your
"employee", and who donates his or her work and
acts at the direction of and within the scope of du-
ties determined by you, and is not paid a fee, salary
or other compensation by you or anyone else for
their work performed for you.
21 -"Your product":
a. Means:
(1) Any goods or products, other than real prop-
erty, manufactured, sold, handled, distrib-
uted or disposed of by:
(a) You;
(b) Others trading under your name; or
(c) A person or organization whose business
or assets you have acquired; and
(2) Containers (other than vehicles), materials,
parts or equipment furnished in connection
with such goods or products.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality, durabil-
ity, performance or use of "your product"; and
CG 00 01 12 07 ISO Properties, Inc., 2006 Page 15 of 16
COMMERCIAL GENERAL LIABILITY
CG 02 20 12 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
FLORIDA CHANGES
CANCELLATION AND NONRENEWAL
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
PRODUCT WITHDRAWAL COVERAGE PART
A. Paragraph 2. of the Cancellation Common Policy (4) A substantial change in the risk covered
Condition is replaced by the following: by the policy; or
2. Cancellation Of Policies In Effect (5) The cancellation is for all insureds under
a. For 90 Days Or Less such policies for a given class of
insureds.
If this policy has been in effect for 90 days or
less, we may cancel this policy by mailing or
delivering to the first Named Insured written
notice of cancellation, accompanied by the
reasons for cancellation, at least:
(1) 10 days before the effective date of
cancellation if we cancel for nonpayment
of premium; or
(2) 20 days before the effective date of
cancellation if we cancel for any other
reason, except we may cancel
immediately if there has been:
(a) A material misstatement or
misrepresentation; or
(b) A failure to comply with the
underwriting requirements
established by the insurer.
b. For More Than 90 Days
If this policy has been in effect for more than
90 days, we may cancel this policy only for
one or more of the following reasons:
(1) Nonpayment of premium;
(2) The policy was obtained by a material
misstatement;
(3) Failure to comply with underwriting
requirements established by the insurer
within 90 days of the effective date of
coverage;
If we cancel this policy for any of these
reasons, we will mail or deliver to the first
Named Insured written notice of
cancellation, accompanied by the reasons
for cancellation, at least:
(a) 10 days before the effective date of
cancellation if we cancel for
nonpayment of premium; or
(b) 45 days before the effective date of
cancellation if we cancel for any of the
other reasons stated in Paragraph
2.b.
B. The following is added and supersedes any other
provision to the contrary:
NONRENEWAL
1. If we decide not to renew this policy we will mail
or deliver to the first Named Insured written
notice of nonrenewal, accompanied by the
reason for nonrenewal, at least 45 days prior to
the expiration of this policy.
2. Any notice of nonrenewal will be mailed or
delivered to the first Named Insured's last
mailing address known to us. If notice is mailed,
proof of mailing will be sufficient proof of notice.
CG 02 20 12 04 ISO Properties, Inc., 2003 Page 1 of 1
INSURED
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 03 00 01 96
DEDUCTIBLE LIABILITY INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
This endorsement changes the policy effective on the i
Endorsement effective
03/05/2009
12:01 A.M. standard time
date of the policy unless another date is indicated below.
Policy No.
PAC6821215
Countersigned by
TAPCO-FL
Named Insured
SUNSETS AT PIER 60 SOCIETY, INC.
SEE SCHEDULE OF NAMED INSUREDS
(Authorized Representative)
SCHEDULE
Coverage
Bodily Injury Liability
OR
Property Damage Liability
OR
Bodily Injury Liability and/or
Property Damage Liability Combined
Amount and Basis of Deductible
PER CLAIM or PER OCCURRENCE
$ XXXX
$ XXXX
$ XXXX
$ XXXX
$ XXXX
$ 500
(If no entry appears above, information required to complete this endorsement will be shown in the
applicable to this endorsement.)
APPLICATION OF ENDORSEMENT (Enter below any limitations on the application of this endorsement.
entered, the deductibles apply to damages for all "bodily injury"and "property damage," however caused):
A. Our obligation under the Bodily Injury Liability and
Property Damage Liability Coverages to pay dam-
ages on your behalf applies only to the amount of
damages in excess of any deductible amounts stated
in the Schedule above as applicable to such cover-
ages.
B- You may select a deductible amount on either a per
claim or a per "occurrence" basis. Your selected de-
ductible applies to the coverage option and to the
basis of the deductible indicated by the placement of
the deductible amount in the Schedule above. The
deductible amount stated in the Schedule above
applies as follows:
1. PER CLAIM BASIS. If the deductible amount in-
dicated in the Schedule above is on a per claim
Declarations as
If no limitation is
basis, that deductible applies as follows:
a. Under Bodily Injury Liability Coverage, to all
damages sustained by any one person be-
cause of "bodily injury";
b. Under Property Damage Liability Coverage,
to all damages sustained by any one person
because of "property damage"; or
c. Under Bodily Injury Liability and/or Property
Damage Liability Coverage Combined, to all
damages sustained by any one person be-
cause of:
(1) "Bodily injury";
(2) "Property damage"; or
(3) "Bodily injury" and "property damage"
combined
CL 838 (1-96)
CG 03 00 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 2
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 11 01 96
ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Endorsement effective
Policy No. PAC6821215
Countersigned by TAPCO-FL (Authorized Representative)
Named Insured SUNSETS AT PIER 60 SOCIETY, INC.
SCHEDULE
1- Designation of Premises (Part Leased to You):
1 PIER 60 DRIVE
CLEARWATER BEACH, FL 33767
2- Name of Person or Organization (Additional Insured):
CITY OF CLEARWATER C/O CRAIG WEST
1680 GULF TO BAY BLVD
CLEARWATER, FL 33755
3. Additional Premium: 100.00
(If no entry appears above, the information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule but
only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and
shown in the Schedule and subject to the following additional exclusions:
This insurance does not apply to:
1. Any "occurrence" which takes place after you cease to be a tenant in that premises.
2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or organiza-
tion shown in the Schedule.
CG 20 110196
Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1
INSURED
COMMERCIAL GENERAL LIABILITY
CG 21 44 07 98
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LIMITATION OF COVERAGE TO DESIGNATED
PREMISES OR PROJECT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Premises:
OPEN AIR BAZAAR
1 PIER 60 DRIVE
CLEARWATER BEACH, FL 33767
Project:
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)
This insurance applies only to "bodily injury", "property damage", "personal and advertising injury" and medical
expenses arising out of:
1. The ownership, maintenance or use of the premises shown in the Schedule and operations necessary or
incidental to those premises; or
2. The project shown in the Schedule.
CG 21 44 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1
INSURED
COMMERCIAL GENERAL LIABILITY
CG 21 47 12 07
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
EMPLOYMENT-RELATED PRACTICES EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A_ The following exclusion is added to Paragraph 2., B. The following exclusion is added to Paragraph
Exclusions of Section I - Coverage A - Bodily In- 2., Exclusions of Section I - Coverage B - Per-
jury And Property Damage Liability: sonal And Advertising Injury Liability:
This insurance does not apply to:
"Bodily injury" to:
(1) A person arising out of any:
(a) Refusal to employ that person;
(b) Termination of that person's employment; or
(c) Employment-related practices, policies, acts
or omissions, such as coercion, demotion,
evaluation, reassignment, discipline, defa-
mation, harassment, humiliation, discrimina-
tion or malicious prosecution directed at that
person; or
(2) The spouse, child, parent, brother or sister of
that person as a consequence of "bodily injury"
to that person at whom any of the
employment-related practices described in
Paragraphs (a), (b), or (c) above is directed.
This exclusion applies:
(1) Whether the injury-causing event described in
Paragraphs (a), (b) or (c) above occurs. before
employment, during employment or after em-
ployment of that person;
(2) Whether the insured may be liable as an em-
ployer or in any other capacity; and
This insurance does not apply to:
"Personal and advertising injury" to:
(1) A person arising out of any:
(a) Refusal to employ that person;
(b) Termination of that person's employment; or
(c) Employment-related practices, policies, acts
or omissions, such as coercion, demotion,
evaluation, reassignment, discipline, defa-
mation, harassment, humiliation, discrimina-
tion or malicious prosecution directed at that
person; or
(2) The spouse, child, parent, brother or sister of
that person as a consequence of "personal and
advertising injury" to that person at whom any of
the employment-related practices described in
Paragraphs (a), (b), or (c) above is directed.
This exclusion applies:
(1) Whether the injury-causing event described in
Paragraphs (a), (b) or (c) above occurs before
employment, during employment or after em-
ployment of that person;
(2) Whether the insured may be liable as an em-
ployer or in any other capacity; and
(3) To any obligation to share damages with or re-
pay someone else who must pay damages be-
cause of the injury.
INSURED
(3) To any obligation to share damages with or re-
pay someone else who must pay damages be-
cause of the injury.
CG 21 47 12 07 ISO Properties, Inc., 2006 Page 1 of 1
CG 21 55 09 99
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
TOTAL POLLUTION EXCLUSION
WITH A HOSTILE FIRE EXCEPTION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Exclusion f. under Paragraph 2., Exclusions of Section I Coverage A Bodily Injury And Property Damage Liability is replaced
by the following:
This insurance does not apply to:
f. Pollution
(1) "Bodily injury" or "property damage" which would not have occurred in whole or part but for the actual, alleged
or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants" at anytime.
This exclusion does not apply to "bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile
fire" unless that "hostile fire" occurred or originated:
(a) At any premises, site or location which is or was at any time used by or for any insured or others for the
handling, storage, disposal, processing or treatment of waste; or
(b) At any premises, site or location on which any insured or any contractors or subcontractors working directly or
indirectly on any insured's behalf are performing operations to test for, monitor, clean up, remove, contain, treat,
detoxify, neutralize or in any way respond to, or assess the effects of, "pollutants".
(2) Any loss, cost or expense arising out of any:
(a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor,
clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or
(b) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring,
cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the
effects of, "pollutants".
CG 21 55 09 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1
INSURED
COMMERCIAL GENERAL LIABILITY
CG 21 67 12 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
FUNGI OR BACTERIA EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. The following exclusion is added to Paragraph 2. B. The following exclusion is added to Paragraph 2.
Exclusions of Section I - Coverage A - Bodily Exclusions of Section I - Coverage B - Personal
Injury And Property Damage Liability: And Advertising Injury Liability:
2. Exclusions
This insurance does not apply to:
Fungi Or Bacteria
a. "Bodily injury" or "property damage" which
would not have occurred, in whole or in part,
but for the actual, alleged or threatened
inhalation of, ingestion of, contact with,
exposure to, existence of, or presence of,
any "fungi" or bacteria on or within a building
or structure, including its contents,
regardless of whether any other cause,
event, material or product contributed
concurrently or in any sequence to such
injury or damage.
b. Any loss, cost or expenses arising out of the
abating, testing for, monitoring, cleaning up,
removing, containing, treating, detoxifying,
neutralizing, remediating or disposing of, or
in any way responding to, or assessing the
effects of, "fungi" or bacteria, by any insured
or by any other person or entity.
This exclusion does not apply to any "fungi" or
bacteria that are, are on, or are contained in,.a
good or product intended for bodily
consumption.
2. Exclusions
This insurance does not apply to:
Fungi Or Bacteria
a. "Personal and advertising injury" which
would not have taken place, in whole or in
part, but for the actual, alleged or threatened
inhalation of, ingestion of, contact with,
exposure to, existence of, or presence of any
"fungi" or bacteria on or within a building or
structure, including its contents, regardless
of whether any other cause, event, material
or product contributed concurrently or in
any sequence to such injury.
b. Any loss, cost or expense arising out of the
abating, testing for, monitoring, cleaning up,
removing, containing, treating, detoxifying,
neutralizing, remediating or disposing of, or
in any way responding to, or assessing the
effects of, "fungi" or bacteria, by any insured
or by any other person or entity.
C. The following definition is added to the Definitions
Section:
"Fungi" means any type or form of fungus, including
mold or mildew and any mycotoxins, spores, scents
or byproducts produced or released by fungi.
CG 21 6712 04 ISO Properties, Inc., 2003 Page 1 of 1
INSURED
COMMERCIAL GENERAL LIABILITY
CG 21 73 01 08
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
EXCLUSION OF CERTIFIED ACTS OF TERRORISM
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY
A. The following exclusion is added:
This insurance does not apply to:
TERRORISM
"Any injury or damage" arising, directly or indirectly,
out of a "certified act of terrorism".
B. The following definitions are added:
For the purposes of this endorsement, "any in-
jury or damage" means any injury or damage
covered under any Coverage Part to which this
endorsement is applicable, and includes but is
not limited to "bodily injury", "property damage",
"personal and advertising injury", "injury" or "en-
vironmental damage" as may be defined in any
applicable Coverage Part.
2. "Certified act of terrorism" means an act that is
certified by the Secretary of the Treasury, in
concurrence with the Secretary of State and the
Attorney General of the United States, to be an
act of terrorism pursuant to the federal Terror-
ism Risk Insurance Act. The criteria contained in
the Terrorism Risk Insurance Act for a "certified
act of terrorism" include the following:
a. The act resulted in insured losses in excess
of $5 million in the aggregate, attributable to
all types of insurance subject to the Terror-
ism Risk Insurance Act; and
b. The act is a violent act or an act that is dan-
gerous to human life, property or infrastruc-
ture and is committed by an individual or in-
dividuals as part of an effort to coerce the ci-
vilian population of the United States or to in-
fluence the policy or affect the conduct of
the United States Government by coercion.
CG 21 73 01 08 Copyright ISO Properties, Inc., 2007 Page 1 of 1
INSURED
COMMERCIAL GENERAL LIABILITY
CG 21 96 03 05
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SILICA OR SILICA W RELATED DUST EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. The following exclusion is added to Paragraph 2.,
Exclusions of Section I -Coverage A -Bodily Injury
And Property Damage Liability:
2. Exclusions
This insurance does not apply to:
Silica Or Silica-Related Dust
a. "Bodily injury" arising, in whole or in part, out
of the actual, alleged, threatened or
suspected inhalation of, or ingestion of,
"silica" or "silica-related dust".
b. "Property damage" arising, in whole or in
part, out of the actual, alleged, threatened or
suspected contact with, exposure to,
existence of, or presence of, "silica" or
"silica-related dust".
c. Any loss, cost or expense arising, in whole or
in part, out of the abating, testing for,
monitoring, cleaning up, removing,
containing, treating, detoxifying, neutralizing,
remediating or disposing of, or in any way
responding to or assessing the effects of,
"silica" or "silica-related dust", by any insured
or by any other person or entity.
B. The following exclusion is added to Paragraph 2.,
Exclusions of Section I - Coverage B - Personal
And Advertising Injury Liability:
2. Exclusions
This insurance does not apply to:
Silica Or Silica-Related Dust
a. "Personal and advertising injury" arising, in
whole or in part, out of the actual, alleged,
threatened or suspected inhalation of,
ingestion of, contact with, exposure to,
existence of, or presence of, "silica" or
"silica-related dust".
b. Any loss, cost or expense arising, in whole or
in part, out of the abating, testing for,
monitoring, cleaning up, removing,
containing, treating, detoxifying, neutralizing,
remediating or disposing of, or in any way
responding to or assessing the effects of,
"silica" or "silica-related dust", by any insured
or by any other person or entity.
C. The following definitions are added to the
Definitions Section:
1. "Silica" means silicon dioxide (occurring in
crystalline, amorphous and impure forms), silica
particles, silica dust or silica compounds.
2. "Silica-related dust" means a mixture or
combination of silica and other dust or particles.
CG 21 96 03 05 ISO Properties, Inc., 2004 Page 1 of 1
INSURED
r
COMMERCIAL GENERAL LIABILITY
CG 24 26 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF INSURED CONTRACT DEFINITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Paragraph 9. of the Definitions Section is replaced by
the following:
9. "Insured contract" means:
a. A contract for a lease of premises. However,
that portion of the contract for a lease of
premises that indemnifies any person or
organization for damage by fire to premises
while rented to you or temporarily occupied
by you with permission of the owner is not
an "insured contract";
b. A sidetrack agreement;
c. Any easement or license agreement, except
in connection with construction or
demolition operations on or within 50 feet of
a railroad;
d. An obligation, as required by ordinance, to
indemnify a municipality, except in
connection with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement
pertaining to your business (including an
indemnification of a municipality in
connection with work performed for a
municipality) under which you assume the
tort liability of another party to pay for "bodily
injury" or "property damage" to a third
person or organization, provided the "bodily
injury" or "property damage" is caused, in
whole or in part, by you or by those acting
on your behalf. Tort liability means a liability
that would be imposed by law in the absence
of any contract or agreement.
Paragraph f. does not include that part of
any contract or agreement:
(1) That indemnifies a railroad for "bodily
injury" or "property damage" arising out
of construction or demolition operations,
within 50 feet of any railroad property and
affecting any railroad bridge or trestle,
tracks, road-beds, tunnel, underpass or
crossing;
(2) That indemnifies an architect, engineer or
surveyor for injury or damage arising out
of:
(a) Preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or
drawings and specifications; or
(b) Giving directions or instructions, or
failing to give them, if that is the
primary cause of the injury or
damage; or
(S) Under which the insured, if an architect,
engineer or surveyor, assumes liability for
an injury or damage arising out of the
insured's rendering or failure to render
professional services, including those
listed in (2) above and supervisory,
inspection, architectural or engineering
activities.
CG 24 26 07 04 ISO Properties, Inc., 2004 Page 1 of 1
INSURED
7k
* ?CI - COMBINED PROVISIONS ENDORSEMENT
Groups
This endorsement modifies insurance provided under the following:
Commercial General Liability Coverage Part • Commercial Professional Liability Coverage Part
Liquor Liability Coverage Form
In consideration of the premium charged it is agreed that the following special provisions apply to this policy.
PUNITIVE DAMAGES EXCLUSION
It is part of the conditions of this policy that the Company shall not be liable for any damages awarded against an
insured as punitive or exemplary damages.
ASBESTOS EXCLUSION
In consideration of the premium charged, it is hereby understood and agreed that this policy will not provide
coverage, meaning indemnification or defense costs arising out of:
(A) Asbestos or any asbestos related bodily injury or property damage; or
(B) Any alleged act, error, omission or duty involving asbestos, its use, exposure, presence, existence,
detection, removal, elimination, transportation, disposal or avoidance; or
(C) The use, exposure, presence, existence, detection, removal, elimination or avoidance of asbestos in any
environment, building or structure.
EARTH MOVEMENT EXCLUSION
In consideration of the premium charged, it is understood and agreed that this policy specifically excludes and
does not extend to or provide coverage or indemnity for any claim of liability for bodily injury or property damage
caused by, resulting from, attributable or contributed to, or aggravated by the subsidence or movement of land as
a result of earthquake, landslide, mudflow, earth sinking or shifting, resulting from, aggravated by or contributed to
by operations of the named insured or any subcontractor of the named insured.
52002(08/02) Page 1 of 1
INSURED