Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutPR12885:TEKOA ACADEMYinteroffice
MEMORANDUM
TO: Mayor, City Council & City Manager
From: Mark T. Sokolow, City Attorney /c~ ~/L~
Subject: P. R. No. 12885 Council Meeting November 9, 2004
Date: November 5, 2004
Attached is P. R. No. 12885 authorizing the City Manager to
execute an agreement between Tekoa Academy Charter School and the
City of Pcr~ Arthur Recreatzon Center for ~he remainder of the
2004/2005 school year.
MTS/ts
Attachment
P. R. NO. 12885
11/05/01 TS
RESOLUTION NO.
A RESOLUTION AUTHORIZING THE CITY NA~IA~ER TO
KXECU~K AN AGREKMEN~ BETWEEN TKKOA ACADEMY
CHA~TER SCHOOL A~D THE CITY OF PORT ARTHUR
FOR THE USE OF A PORTION OF THE PORT A~THUR
RECREATION CENTER FOR THE REMAINDER OF THE
2004/2005 SCHOOL YEA~
WHEREAS, Tekoa Academy Charter School (Tekoa) has requested to use a
portion of the Port Arthur Recreation Center, which is located at 1308
9th Avenue, Port Arthur, Texas; and
WHEREAS, Tekoa's present location 326 Thomas Blvd., Port Arthur,
Texas cannot facilitate physical education classes for their enrolled
students; and
WHEREAS, allowing Tekoa the utilize the Port Arthur Recreation
Center for the establishment of physical education classes for the
enrolled students will be a source of community pride and will help to
facilitate the required Tekoa's physical education program; and
WHEREAS, the City desires to allow Tekoa to utilize its facility for
physical education classes and Tekoa will maintain the responsibility of
teaching the classes, monitoring students and assume liability for any
damage that may result from the use of its students of the facilities;
and
~-EI~EAS, Tekoa will add the City of Port Arthur as an additional
insured on its general liability insurance policy.
NOW THEREFOI~E, BE iT i~ESOLVED BY THE CITY COUNCIL OF THE CiTY OF
PORT ARTHUK:
Section 1. That the facts and opinions in the preanuble are
true and correct.
Section 2. That the City Council of the City of Port Arthur
hereby authorizes the City Manager to execute an agreement between Tekoa
z.12885
Academy Charter School and the City of Port Arthur for the nonexclusive
use of a portion the Port Arthur Recreation Center for the remainder of
the 2004/2005 school year in substantially the same form as Exhibit UA"
and a copy of Tekoa Academy's Commercial General Liability Policy which
lists the City of Port Arthur as an additional insured is attached as
Exhibit "B".
Section 3, That a copy of the caption of this Resolution
shall be spread upon the Minutes of the City Council.
READ, ADOPTED AND APPROVED on this day of , A.D.,
2004, at a Regular Meeting of the City Council of the City of Port
Arthur, Texas, by the following vote:
AYES: Mayor
City Council
NOES:
Mayor Oscar Ortiz
ATTEST:
EVANGELINE GREEN, CITY SECRETARY
APPROVED AS TO FORM:
MARK T. SOKOLOW, CITY ATTOP~NEY
APPROVED FOR ADMINISTRATION=
STEVE FITZGIBBONS. CITY MANAGER
EXHIBIT "A"
z 12885
STATE OF TEXAS
COUNTY OF JEFFERSON
This is an Agreement between the City of Port Arthur, Texas
(referred to in the Agreemen5 as the "City"), and Tekoa Academy
Charter School (referred ro in this Agreemen5 as 5he "Tekoa
Academy"), for the use of the Por5 Arthur Recreation Cen%er
located at 1308 9th Avenue in Por~ Arthur, Texas. Tekoa Academy
and the City are collectively referred to as the "Parties".
RECITALS
The purpose of this Agreement is to state the terms and
conditions under which the Tekoa Academy is permitted to use City
premises for the purpose of conducting physical education classes
for the students enrolled at Tekoa Academy for the remainder of
the 2004-2005.
In consideration of the mutual promises contained in this
Agreement, the Tekoa Academy and the City agree as follows:
I.
NATURE OF AGREEMENT
A. Each party recognizes that the City has no authority
under the law to permit exclusive control of recreation center
property by anyone other than the City. Therefore, this
Agreement shall not be construed as giving said control to the
Tekoa Academy for the dates and times designated for physical
education classes.
B. Tekoa Academy agrees to do all things necessary to
manage and administer all physical education classes. The City
agrees to permit Tekoa Academy to use a portion of the recreation
center to be designated by the Director of Parks and Recreasion
Department. The designated facilities will solely be used for
the purpose of conducting the fcllowing physical education
activities (hereinafter called ~said program"):
1. Stretching and Calisthenics
2. Baseball
3. Basketball
4. Volleyball
5. Kickball
6. Badminton
7. Jump the Brook
8. Completion o~ The President's fitness ~esus
C. Tekoa Academy agrees Ehat the recreation censer will
not be utilized for any swimming acsivities and any ssuden5
participating in physical education classes will no5 use 5hat 5he
swimming pool locaLed in the recreasion censer.
D. Tekoa Academy agrees 5o be responsible for teaching all
physical educasion classes and monitoring students and
performance in each class.
E. Tekoa Academy agrees that classes will take place
between approximately 12:30 p.m. and 3:00 p.m., Monday through
Thursdays.
p. The City of Port Arthur does no5 assume any
responsibility for the supervision and administration of said
program, nor does it assume any liability arising thereunder.
G. It is expressly agreed and understood by all parties
hereto that Tekoa Academy is an independent contractor in its
relationship to the City of Port Arthur. Nothing herein
contained at any time or in any manner shall be construed to
effect a contract of partnership or joint venture or render any
party hereto the employer or master of any other party and/or its
employees, agents or representatives, All necessary personnel
employed by or contracted with by Tekoa Academy shall be deemed
agents or employees of the Tekoa Academy.
H. Inasmuch as the facilities are on public property,
Tekoa Academy agrees that the public can also use the recreation
center at any time.
II.
DURATION OF AGREEMENT
This Agreement shall be in force from November 15, 2004
until May 28,2005, which is the end of the 2004-2005 school year.
III.
TERMINATION OF AGREEMENT
This Agreement may be terminated by either party giving
ninety (90) days written notice to the other party of its desire
to terminate said Agreement, or said Agreement may be terminated
at any time by mutual agreement of the parties. IV.
INDEMNIFICATION
Tekoa Academy covenants and agrees to indemnify to the
extent permitted by law and does hereby indemnify to the extent
z.tekoa agreement 3
permitted by law, hold harmless and defend, the City of Porn
Arthur, its officers, employees, and agents from and againsn any
and all liability (including costs and attorneys fees) by reason
of liability imposed by law upon the City of Port Arthur for
damages because of bodily injury, including death an any nime
resulting therefrom, sustained by any person or persons or on
account of damage to property, including loss of use nhereof,
provided such injury to person or damage to property is due or
claimed to be due to the negligence of Tekoa Academy or arising
out of or incident to the activities of Tekoa Academy.
V.
LIABILITY INSURANCE
Tekoa Academy agrees to maintain in force during the term of
this lease and any extension thereof, at its expense, the
liability insurance attached hereto as Exhibit "A-i" which is
adequate to protect against liability for damage claims through
public use or arising out of accidents or injuries occurring in
or around the described premises
Tekoa agrees to obtain a written agreemenn from the insurer
listed in "Exhibit A-I" to notify the City in writing ~at ieasn
thirty (30) days prior to cancellation or refusal to renew any of
the policies. Tekoa Academy agrees that if the insurance
policies are not kept in force during the entire term of this
Agreement and any extension thereof, the City may procure the
necessary insurance, pay the premium therefore, and Tekoa Academy
shall repay the premium to the City the next month following the
z.tekoa agreement 4
date on which the premium is paid. The City Manager is herein
authorized to accept alternative insurance or financial security
that pronects the City.
SIGNED THIS the day of , 2004.
CITY OF PORT ARTHUR
BY:
Stephen Fitzgibbons, City Manage~
ATTEST:
Evanceline Green, City Secretary
SIGNED THIS the day of , 2004.
TEKOA ACADEMY CHARTER SCHOOL
BY:
TITLE:
ATTEST:
EXHIBIT "B"
z.12885
ACORD CERTIFICATE OF LIABILITY INSURANCE o/27/ oo4
PROOUCI~R (409)981-8000 FAX (409)981-8005 THISCEi~iiFiCATEISISSUEDASAMATTEROFINFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Southeast Texas Insurance Services, L. P, HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Co~un i ty InsuFance dba I dee I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
3535 Ca Ider, Su i[e 220 iNSURERS AFFORDING COVERAGE ~. NAIC #
Beaumont, TX 77706
~NSU~E~ Tekoa Charter School, Inc i INSURER~ Crump Group
326 Thomas Blvd ~ ~:~;/~/q/~ ' /
Port Arthur, TX 77640 INSURERC:
ITS IM~Rtl GENERAL LIABILITY CLS0982165 11/26/200:~ 11/26/2004 EACH OCCURRENCE $ I , 000,00~
I CLAIMSMADE [] OCCUR MEDEXp(Any~epemo~) $ 5,00C
PERSONAL & ADV INJURY $ I, 000, OOC
A
GENERAL AGGREGATE $ 2~ O00, OOC
~ OCCUR [] CLAIMSMADE AGGREGATE $
EMPLOYERS' L~BIUTY E L EACH ACCIDENT $
erti~ cate holder is I isted as Add~ona .
:ERTIFICATE HOLDER CANCELLATION
SHOULD ANY O~F THE ABOVE DF. SC RIBEB POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WIL~ ENDEAVOR TO MAIL
C i ty of PO rt Arthur _ 1~0 DAYS WRITTEN NOTICE TO THE CERTIFIC~LDER NAMED TO THE LEFT
Port Arthur, TX 77641-1089 AUTHORIZEDREPRESENTATIV~~
J. Shane Howard
ACORD 25 (200~108) FAX: (409) 983-8124 7~_..~ ©ACORD CORPORATION 19]1]
/
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsemen[. A statement on this certificate does not confer rights to the certificate
holder n euofsuchendorsemers(s)
DISCLAIMER
The Certificate of Insurance on tt~e reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or eroctucer, and the certificate helder, nor does it
affirmatively or negatively amend, exten(] or a [er the coverage afforded by the eolicies listea thereon.
ACORD 25 (2001/08)
COMMON 15OUCYfDECLARATIONS
p...wa, o~ SCOTTSDAT.~ INSURA_N'CE CO!k/~ANY' CLS0982165
NEW Home Office:
One Nationwide Plaza · Columbus, Ohio 43215
' Administrative Office:
8877 North Gainey Center Drive · Scottsdale, Arizo~--.
[ ........ .
1-800-42S-7675 . . _ ,
A STOCK COMPANY
ITEM 1. Named Insured and Mailing Address
TEKOA CHARTER SCHOOL, INC.
326 THOMAS BLVD.
PORT ARTHDR, TX 77640
Agent Name and Address
CRUMP INS SVC OF HOUSTON, INC.
1310B NORTHWEST FREEWAY
SUITE 1100 Agent No.: 42024 Program No.: NONE
HOUSTON, TX ?7040
ITEMA. Policy Period From: 11/26/2003 To: 11/26/2004 Term: 366 DAYS
1:':01 A.M., Stmnderd Time et your mallln~ eddress.
Business Description: CHARTER SCHOOL
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. This policy consists of the following coverage parts for which a premium is indicated.
Where no premium is shown, there is no coverage. This premium may be subjectto adjustment.
Coverage Part(s) Premium
Commercial General Liability Coverage Part $ 1,515
;ommercial Property Coverage Part $ NOT COVERED
Commercial Crime Coverage Part $ NOT COVERED
Commercial Inland Marine Coverage Part S. NOT COVERED
Commercial Auto (Business Auto or Truckers) Coverage Part S. NOT COVERED
Commercial Garage Coverage Part $ NOT COVERED
Professional Liability Coverage Part $ NOT COVERED
$.
Total Policy Premium: $ 1,515.00
POLICY FEE $ 150.00
STATE TAX ~ 80.75
STAMPING FEE $ 1.67
TOTAL POLICY PREMIUM $ 1,";47.42
$
Form(s) and Endorsement(s) made a part of this policy at time of issue:
SEE SCHEDULE OF FORMS AND ENDORSEMENTS
~XTNIMT.3M AND DEPOSIT
USTON, TX
./11/2003
KD/AP
THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S), TOGETHER WITH
THE COMMON POLICY CONDITIONS, COVERAGE PART(S), COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY,
COMPLETE THE ABOVE NUMBERED POUCY.
CPS-D-1 (12-00) AGENT opsd lg.tap
ENDORSEMENT
SCOTTSDALE rNSLrP3LNCE COl%4PA]krf NO.
CLS0982165 11/26/2003 TEKOA CHARTER SCHOOL, INC. 42024
IMPORTANT NOTICE - TEXAS AVISO IMPORTANTE - TEXAS
To obtain information or make a complaint: Para obtener informaci6n o para someter una queja:
You may contact your agent or you may call Scottsdale Usted puede comunicarse con su agente o puede Ilamar
Insurance's toll-free number for information or to make a al ndmero de tel~fono gratis de Scottsdale Insurance para
complaint at: informaci6n o para someter una queja al:
1-800-423-7675 1-800-423-7675
You may also write to Scottsdale Insurance at: Usted tambi/~n puede escribir a Scottsdale Insurance:
Scottsdale Insurance Company Scottsdale Insurance Company
8877 N. Gainey Center Drive 8877 N. Gainey Center Drive
P.O. Box 4110 P.O. Box 4110
Scottsdale, Arizona 85261 Scottsdale, Arizona 85261
u may contact the Texas Department of Insurance to Puede comunicarse con el Departamento de Seguros de
uutain information on companies, coverages, rights or Texas para obtener inforrnaci6n acerca de compaR[as,
complaints at: coberturas, derechos o quejas al:
1-800-252-3439 1-800-252-3439
You may write the Texas Department of Insurance at: Puede escribir al Departamento de Seguros de Texas:
Texas Department of Insurance Texas Department of Insurance
P.O. Box 149104 P.O. Box 149104
Austin, Texas 78714-9104 Austin, Texas 78714-9104
1-512-475-1771 (Fax) 1-512-475-1771 (Fax)
PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS:
Should you have a dispute concerning your premium or Si tiene una disputa concerniente a su prima o a un re-
about a claim you should contact the agent first. If the clamo, debe comunicarse con el agente primero. Si no se
dispute is not resolved, you may contact the Texas resuelve la disputa, puede entonces comunicarse con el
Department of Insurance. Departamento de Seguros de Texas.
A'FI'ACH THIS NOTICE TO YOUR POLICY: UNA ESTE AVISO A SU POLIZA:
This notice is for information only and does not become I:ste aviso es sole para prop6sito de informaci6n y no se
· ~art or condition of the attached document, convierte en parte o condici6n del documento adjunto.
/
AUTHORIZED REPRESENTATIVE DATE
Lrrs-gsg-TX (~-~ AGENT
TEXAS SURPLUS LINES NOTICE
The following notice is attached to the Policy as prescribed by the Insurance
Code,
Article 1.14-2:
"This insurance contract is with an insurer not licensed to transact
insurance in this state and is issued and delivered as a surplus
lines coverage pursuant to the Texas Insurance Statutes. The
State Board of Insurance does not audit the finances or review the
solvency of the surplus line insurer providing this coverage, and this
insurer is not a member of the property and casualty insurance
guaranty association created unc~er Article 21.28-C, nsurance
Code. Article 1.14-2, Insurance Code, requires payment of 4.85
percent tax on gross premium."
SCHEDULE OF FORMS AND ENDORSEMENTS
P~,cy No. cL~0982165 Etienne Date: 11/26/2003
12:01 AM., Standa~ Time
Named Insured TEKOA CHARTER SCHOOL, INC. Agent No. 42024
IL 00 21 7-02 Nuclear Energy Excl
UTS-COVPG 1-03 Cover Page
OPS-D-1 12-00 Common Policy Declarations
UTS-SP-2 12-95 Schedule Of Forms and Endorsements
CLS-SD-1L 8-01 GL Supplemental Dec
CLS-SP-1L 10-93 GL Ext Supplemental Dec
CG 00 01 10-01 General Llab Coy
CG 00 57 9-99 Amend Ins Agree-Know In~-Dm~
CG 00 60 9-99 Amend Ins Agree-Know In]-Dm~
CG 00 62 12-02 War Liability Exclusion (GL)
CG 21 67 4-02 Fungi Or Bacteria Excl
CG 21 75 12-02 ExcI Cert Acts-Other Terrorism
CG 22 30 7-98 Excl-Corporal Punishment
CG 22 72 10-01 Colleqes Or Schools
GLS-44S 11-95 Sexual-Physical Abuse Liab Coy
GLS-45s 3-92 Sexual-Physical Abuse Excl
UTS-128s 2-02 Optional Provisions Endt
UTS-246S 9-03 Amend Endts No Med Pay Excl
UTS-88g-TX 9-94 TX-Notice of Settlement
UTS-93g-TX 5-92 TX-Important Notice
ADDITIONAL FORMS
AGENT utssp2h, lap
UIS-SP-2 (12-g5)
IL00 21 O7 02
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NUCLEAR ENERGY LIABILI'I' 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 LIABIMTY COVERAGE PART
POLLUTION EABIMTY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
PROFESSIONAL MABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY
1. The insurance does not apply: B. Under any Medical Payments coverage, to ex-
A. Under any Liability Coverage, to "bodily injury" penses incurred with respect to "bodily injury"
resulting from the "hazardous properties" of
or "property damage": "nuclear material" and arising ou~ of the opera-
(1) With respect to which an "insured' under tion of a "nuclear facility' by any person or or-
the policy is also an insured under a ganization.
nuclear energy liability policy issued by
Nuclear Energy Liability Insurance Associ- C. Under any Uability Coverage, to 'bodily injury'
or "property damage' resulting from "hazard-
ation, Mutual Atomic Energy Liability
Underwriters, Nuclear Insurance Associ- ous properties" of"nuclear material", if:
ation of Canada or any of their successors, (1) The "nuclear matedal" (a) is at any "nuclear
or would be an insured under any such facility" owned by, or operated by or on
policy but for its termination upon exhaus- behalf of, an "insured" or (b) has been dis-
tion of its limit of liability; or charged or dispersed therefrom;
(2) Resulting from the "hazardous properties" (2) The 'nuclear material' is contained in
of "nuclear material" and with respect to "spent fuel' or 'waste" at any time pos-
which (a) any person or organization is re- sassed, handled, used, processed, stored,
quired to maintain financial protection pur- transported or disposed of, by or on behalf
suant to the Atomic Energy Act of 1954, or of an "insured"; or
any law amendatory thereof, or (b) the "in- (3) The "bodily injury' or "property damage"
sured" is, or had this policy not been is- arises out of the furnishing by an "insured"
sued would be, entitled to indemnity from of services, materials, parts or equipment
the United States of America, or any in connection with the planning, construc-
agency thereof, under any agreement en- tion, maintenance, operation or use of any
tered into bythe United States of America, "nuclear facility~, but if such facility is lo-
or any agency thereof, with any person or cated within the United States of America,
organization, ifs territories or possessions or Canada,
this exclusion (3) applies only to "property
damage" to such "nuclear facility" and any
property thereat.
IL O0 21 07 02 Copyright, ISO Properties, Inc., 2001 Page I of 2
AGENT
2. As used In this endorsement: (c) Any equipment or device used for the
processing, fabricating or alloying of "spe-
'Hazardous properties' includes radioactive, toxic cial nuclear material' if at any time the total
or explosive properties, amount of such material In the custody of
'Nuclear material" means "source material', "Spe- the "insured' at the premises where such
cial nuclear material" or 'by-product material", equipment or device is located consists of
"Source material', "special nuclear material", and or contains more than 25 grams of pluto-
'by-product material" have the meanings given ntum or uranium 233 or any combination
them in the Atomic Energy ACt of 1954 or in any thereof, or more than 250 grams of ura-
law amendatory thereof, nium 235;
"Spent fuel" means any fuel element or fuel compo- (d) Any structure, basin, excavation, premises
nent, solid or liquid, which has been used or ex- or place prepared or used for the storage
posed to radiation in a "nuclear reactor", or disposal of 'waste";
'Waste" means any waste material (a) containing and includes the site on which any of the foregoing
"by-product material" other than the tailings or is located, all operations conducted on such site
wastes produced by the extraction or concentra- and all premises used for such operations.
tion of uranium or thorium from any ore processed "Nuclear reactor" means any apparatus designed
primarily for its "source material" content, and (b) or used to sustain nuclear fission in a self-support-
resulting from the operation by any person or orga- ing chain reaction or to contain a critical mass of
nization of any "nuclear facilib/' included under the fissionable material.
first two paragraphs of the definition of "nuclear "Property damage" includes all forms of radioactive
facilib/', contamination of property.
"Nuclear facilit¢' means:
(a) Any"nuclear reactor';
(b) Any equipment or device designed or
used for (1) separating the isotopes of
uranium or plutonium, (2) processing or
utilizing "spent fuel', or (3) handling, pro-
cessing or packaging "waste";
Page 2 of 2 Copyright, ISO Properties, Inc., 2001 IL 00 21 07 02
SUPPLEMENTAL DECLARATIONS
Policy No. CLs09e2165 Effective Date 11/26/2003
12:01 A.M., Standerd Time
Named Insured TEKOA CHARTER SCHOOL, INC. Agent No. 42024
Item 1. Limits of Insurance Lime of Liability
Coverage ~ Products/Completed
~regate Limits of Liability $ 2, oo o, ooo Operations Aggregate
General Aggregate (other than
$ 2,000,ooo . Products/Completed Operations)
any one occurrence subject
Coverage A - Bodily Injury and to the products/Completed
Property Damage Liability Operations and General
$ 3., ooo, ooo Aggregate Limits of Liability
any one premises subject to the
Coverage A occurrence and
the General Aggregate Limits
Dai~e to Premises Rented to You Limit $ 10 o, o o o of Liability
- any one person or organization
"overage B - Personal and subject to the GeneraL Aggregate
Advertising Injury Liability $ 1, o oo, oo0 Limits of Liability
any one person subject to the
Coverage C - Medical Payments Coverage A occurrence and
5, o o o the General Aggregate Limits
Item 2. Description of Business
Form of Business:
[] Individual [] Partnership UI Joint Venture [] Trust [] Limited Uability Company
[] Organization including a corporation (°ther than Partnership' J°int Venture °r Limited Liability C°mpany)
Location of All Premises You Own, Rent or Occupy:
1) 326 THOMAS BLVD., PORT ARTHUR, TX 77640
2) 327 THOMAS BLVD., PORT ARTHUR, TX 77640
Item 3. Forms and Endorsements
F--~(rm(s) and Endorsement(s) made a part of this policy at time of issue:
See Schedule of Forms and Endorsements
I~-m4
· Premiums $ 1,515
Coverage Part Premium: $
Other Premium: $ 1,515
~otal Premium:
~'HESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND
-IE POLICY PERIOD.
CLS-SD-1L (8-01) AGENT clssdlle - fap
Policy No. CLS0982165 Effective Date: 11/26/2003
12:01 A.M,, Standard Time
Named Insured TEKOA CHARTER SCHOOL, INC. Agent No. 42024
Prem. No. Bldg. No. Class Code Exposure Basis
47476 250 PUPILS
Class Description: Premises/Operations
SCHOOLS - PRIVATE - ELEMENTARY, KINDERGARTEN OR
Rate Premium
JUNIOR HIGH (PRODUCTS-COMPLETED OPERATIONS ARE
SUBJECT TO THE GENERAL AGGREGATE LIMIT) 6.059 1,515
Products/Comp Operations
Rate Premium
INCLUDED INCLUDED
Prem No. Bldg. No. Class Code Exposure Basis
Class Description: Premises/Operations
Rate Premium
Products/Comp Operations
Rate Premium
Prem. No. Bldg. No. Class Code Exposure Basis
Class Description: Premises/Operations
Rate Premium
Products/Comp Operations
Rate Premium
Prem. No. Bldg. No. Class Code Exposure Basis
Class Description: Premises/Operations
Rate Premium
Products/Comp Operations
Rate Premium
AGENT clsgpllb, fap
CL$-SP-1L (10-~}
COMMERCIAL GENERAL UABIUTY
CG 00 01 1001
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage. Read b. This insurance applies to "bodily injury' and
the entire policy carefully to determine rights, duties "property damage" onlyif:
and what is and is not covered. (1) The "bodily injury" or 'property damage" is
Throughout this policy the words 'you" and "your" refer eaused by an "occurrence" that takes
to the Named Insured shown in the Declarations, and place in the "coverage territory";
any other person or organization qualifying as a (2) The "bodily injury" or 'property damage"
Named Insured under this policy. The words 'we', "us" occurs during the policy period; and
and "our" refer to the company providing this insur-
ance. (3) Prior to the policy period, no insured listed
under Paragraph 1. of Section II - Who Is
The word "insured" means any person or organization An Insured and no 'employee" authorized
qualifying as such under Section II - Who Is An Insured. by you to give or receive notice of an "oc-
Other words and phrases that appear in quotation currence" or claim, knew that the "bodily
marks have special meaning. Refer to Section V - injur~' or "property damage' had oc-
Definitions. curred, in whole or in part. If such a listed
insured or authorized "employee" knew,
SECTION I - COVERAGES prior to the policy period, that the "bodily
COVERAGE A BODILY INJURYAND PROPERTY injury" or "property damage' occurred,
DAMAGE LIABILITY then any continuation, change or resump-
1. Insuring Agreement tion of such 'bodily injury" or "property
damage" during or after the policy period
a. We will pay those sums that the insured be- will be deemed to have been known prior
comes legally obligated to pay as damages to the policy period.
because of "bodily injury~ or "property dam-
age" to which this insurance applies. We will c. "Bodily injur~' or "property damage" which
have the right and duty to defend the insured occurs during the policy period and was not,
against any "suit' seeking those damages, prior to the policy period, known to have oc-
However, we will have no duty to defend the in- curred by any insured listed under Paragraph
sured against any "suit" seeking damages for 1. of Section II -Who Is An Insured or any "em-
"bodily injury" or "property damage' to which ployee" authorized by you to give or receive
this insurance does not apply. We may, at our notice of an 'occurrence" or claim, includes
discretion, investigate any 'occurrence" and any continuation, change or resumption of that
settle any claim or "suit" that may result. But: "bedily injury" or "property damage" after the
(1) The amount we will pay for damages is end of the policy period.
limited as described in Section III - Limits d. 'Bodily injury" or "property damage" will be
Of Insurance; and deemed to have been known to have occurred
at the earliest time when any insured listed
(2) Our right and duty to defend ends when under Paragraph 1. of Section Il - Who Is An
we have used up the applicable limit of in- Insured or any "employee" authorized by you
surance in the payment of judgments or
to give or receive notice of an "occurrence" or
settlements under Coverages A or B or claim:
medical expenses under Coverage C.
(1) Reports all, or any part, of the "bodily in-
No other obligation or liability to pay sums or jury' or 'property damage' to us or any
perform acts or services is covered unless ex- other insurer;
plicitly provided for under Supplementary Pay-
ments- Coverages A and B. (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
"bodily injury" or "property damage" has
occurred or has begun to occur.
CG 00 01 10 01 Copyright, ISO Properties, Inc., 2000 Page I of 16
AGENT
e. Damages because of "bodily Injury' include c. UquorUablllty
damages claimed by any person or organlza- 'Bodily injury' or 'property damage" for which
tion for care, loss of services or death resulting any Insured may be held liable by reason of:
at any time from the "bodily injur~. (1) Causing or contributing to the intoxication
2. Exclusions of any person;
This insurance does not apply to: (2) The furnishing of alcoholic beverages to a
a. Expected Or lntendedlnJury person under the legal drinking age or
"Bodily injury' or "property damage" expected under the influence of alcohol; or
or intended from the standpoint of the insured. (3) Any statute, ordinance or regulation relat-
This exclusion does not apply to "bodily injury" lng to the sale, gift, distribution or use of al-
resulting from the use of reasonable force to coholic beverages.
protect persons or property. This exclusion applies only if you are in the
b. Contractual Liability business of manufacturing, distributing, sell-
"Bodily injury' or "property damage" for which lng, serving or furnishing alcoholic beverages.
the insured is obligated to pay damages by d. Workers' Compensation And Similar Laws
reason of the assumption of liability in a con- Any obligation of the insured under a workers'
tract or agreement. This exclusion does not compensation, disability benefits or unemploy-
apply to liability for damages: merit compensation law or any similar law.
(1) That the insured would have in the ab- e. Employer's Liability
sence of the contract or agreement; or "Bodily injury" to:
(2) Assumed in a contract or agreement that
is an "insured contract", provided the "bod- (1) An "employee' of the insured arising out of
and in the course of:
ily injury' or "property damage" occurs
subsequent to the execution of the con- (a) Employment by the insured; or
tract or agreement. Solely for the purposes (b) Performing duties related to the con-
of liability assumed in an "insured con- duct oftheinsured's business; or
tract", reasonable attorney fees and neces-
sary litigation expenses incurred by or for (2) The spouse, chi[d, parent, brother or sister
a party other than an insured are deemed of that 'employee" as a consequence of
to be damages because of "bodily injury" Paragraph (1) above.
or "property damage", provided: This exclusion applies:
(a) Liability to such party for, or for the (1) Whether the insured may be liable as an
cost of, that party's defense has also employer or in any other eaDacity; and
been assumed in the same "insured (2) To any obligation to share damages with
contract"; and or repay someone else who must pay
(b) Such attorney fees and litigation ex- damages because of the injury.
penses are for defense of that party This exclusion does not apply to liability as-
against a civil or alternative dispute sumed by the insured under an "insured con-
resolution proceeding in which dam- tract".
ages to which this insurance applies
are alleged.
Page 2 of 16 Copyright, ISO Properties, Inc., 2000 CG 00 01 10 01
f. Pollution (d) At or from any premises, site or Ioca-
(1) "Bodily injury' or "property damage" aris- tion on which any Insured or any con-
ing out of the actual, alleged or threatened tractors or subcontractors working
discharge, dispersal, seepage, migration, diractly or indirectly on any insured's
release or escape of 'pollutants": behalf are performing operations if the
"pollutants' are brought on or to the
(a) At or from any premises, site or Ioca- premises, site or location in connec-
tion which is or was at any time owned tion with such operations by such in-
or occupied by, or rented or loaned to, sured, contractor or subcontractor.
any insured. However, this subpara- However, this subparagraph does not
graph does not apply to: apply to:
(I) "Bodily injury" if sustained within a (D "Bodily injury' or "property dam-
building and caused by smoke, age" arising out of the escape of
fumes, vapor or soot from equip- fuels, lubricants or other operating
ment used to heat that building; fluids which are needed to per-
(Ii) "Bodily injury' or "property dam- form the normal electrical, hy-
age" for which you may be held Ii- draulic or mechanical functions
able, if you are a contractor and necessary for the operation of
the owner or lessee of such prem- 'mobile equipment" or its parts, if
ises, site or location has been such fuels, lubricants or other op-
added to your policy as an addi- erating fluids escape from a ve-
tional insured with respect to your hicle part designed to hold, store
ongoing operations periormed for or receive them. This exception
that additional insured at that does not apply if the"bodily injury~
premises, site or location and or "property damage' arises out of
such premises, site or location is the intentional discharge, disper-
not and never was owned or oc- sal or release of the fuels, lubri-
cupied by, or rented or loaned to, cants or other operating fluids, or
any insured, other than that addi- if such fuels, lubricants or other
tional insured; or operating fluids am brought on or
(iii) "Bodily injury" or "property dam- to the premises, site or location
with the intent that they be dis-
age" arising out of heat, smoke or
charged, dispersed or released as
fumes from a "hostile fire"; part of the operations being per
(b) At or from any premises, site or Ioca- formed by such insured, contrac-
tion which is or was at any time used tor or subcontractor;
by or for any insured or others for the (11) "Bodily injury" or 'property dam-
handling, storage, disposal, process- age" sustained within a building
lng or treatment of waste; and caused by the release of
(c) Which are or were at any time trans gases, fumes or vapors from ma-
ported, handled, stored, treated, dis- tedals brought into that building in
posed of, or processed as waste by or connection with operations being
for: performed by you o~ on your be-
(i) Any insured; or half by a contractor or subcon-
(11) Any person or organization for tractor; or
whom you may be legally respon- (iii) "Bodily injur~' or "property dam-
sible; or age' arising out of heat, smoke or
fumes from a "hostile fire".
CG O0 01 10 01 Copyright, ISO Properties, Inc., 2000 Page 3 of 16
(e) At or from any premises, site or Ioca- (3) Parking an 'auto" on, or on the ways next
tion on which any insured or any con- to, premises you own or rant, provided the
tractors or subcontractors working "auto" Is not owned by or rented or loaned
directly or indirectly on any insured's to you or the insured;
behalf are performing operetionslfthe (4) Uabllity assumed under any"insured con-
operations are to test for, monitor, tract" for the ownership, maintenance or
clean up, remove, contain, treat, de- use of aircraft or watercraft; or
toxify or neutralize, or in any way re-
spond to, or assess the effects of, (5) "BodilYing out injurY"of the°roperation'Pr°perty ofdamage"any of aris-the
"pollutants". equipment listed in Paragraph f.(2) or f.(3)
(2) Any loss, cost or expense arising out of of the definition of"mobile equipment".
any: h. Mobile Equipment
(a) Request, demand, order or statutory "Bodily injury" or"property damage" arising out
or regulatory requirement that any in-
sured or others test for, monitor, clean of:
up, remove, contain, treat, detoxify or (1) The transportation of "mobile equipment"
neutralize, or in any way respond to, by an "auto" owned or operated by or rent-
or assess the effects of, "pollutants"; or ed or loaned to any insured; or
(b) Claim or 'suit" by or on behalf of a (2) The use of "mobile equipment" in, or while
governmental authority for damages in practice for, or while being prepared for,
because of testing for, monitoring, any prearranged racing, speed, demoli-
cleaning up, removing, containing, tion, or stunting activity.
treating, detoxitying or neutralizing, or I. War
in any way responding to, or assess-
lng the effects of, "pollutants". "Bodily injury" or 'property damage" due to
war, whether or not declared, or any act or
However, this paragraph does not apply to condition incident to war. War includes civil
liability for damages because of "property war, insurrection, rebellion or revolution. This
damage' that the insured would have in exclusion applies only to liability assumed un-
the absence of such request, demand, or- der a contract or agreement.
der or statutory or regulatory requirement,
or such claim or "suit' by or on behalf of a J. Damage To Property
governmental authority. "Property damage" to:
g. Aircraft, Auto OrWatercraff (1) Property you own, rent, or occupy, inc_,lud-
"Bodily injury" or"property damage' arising out lng any costs or expenses incurred by
of the ownership, maintenance, use or entrust- you, or any other person, organization or
merit to others of any aircraft, "auto" or water- entity, for repair, replacement, enhance-
craft owned or operated by or rented or loaned merit, restoration or maintenance of such
to any insured. Use includes operation and property for any reason, including preven-
tion of injury to a person or damage to an-
"loading or unloading", other's property;
This exclusion applies even if the claims
against any insured allege negligence or other (2) Premises you sell, give away or abandon,
wrongdoing in the supervision, hiring, employ- if the "property damage' arises out of any
ment, training or monitoring of others by that pert of those premises;
insured, if the "occurrence' which caused the (3) Property loaned to you;
"bodily injury' or "property damage' involved (4) Personal property in the care, custody or
the ownership, maintenance, use or entrust- control ofthe insured;
ment to others of any aircraft, "auto" or water-
craft that is owned or operated by or rented or (5) That particular part of real property on
loaned to any insured, which you or any contractors or subcon-
tractors working directly or indirectly on
This exclusion does not apply to: your behalf are performing operations, if
(1) A watercraft while ashore on premises you the 'property damage" arises out of those
own or rent; operations; or
(2) A watercraft you do not own that is: (6) That particular part of any property that
(a) Lessthan 26 fest long; and must be restored, repaired or replaced be-
cause 'your work" was incorrectly per-
(b) Not being used to carry persons or formed on it.
property for a charge;
Page 4 of 16 Copyright, ISO Properties, Inc., 2000 CG O0 01 10 01
paragraphs (1), (3) and (4) of this exclusion n. Recall Of Products, Work Or lmpalred
do not apply to "property damage' (other than Property
damage by fire) to premises, including the Damages claimed for any loss, cost or ex-
contents of such premises, ranted to you for a pense Incurred by you or others for the loss of
period of 7 or fewer consecutive days. A sepa- use, withdrawal, recall, Inspection, repair, re-
rate limit of insurance applies to Damage To placement, adjustment, removal ordisposal of:
Promises Rented To You as described in Sec-
(1) "Your product';
tion III - Limits Of Insurance.
Paragraph (2) of this exclusion does not apply (2) "Your work"; or
if the premises are "your work" and were never (3) "Impaired property";
occupied, rented or held for rental by you. if such product, work, or property is withdrawn
Paragraphs (3), (4), (5) and (6) of this exclu- or recalled from the market or from use by any
sion do not apply to liability assumed under a person or organization because of a known or
suspected defect, deficiency, inadequacy or
sidetrack agreement.
Paragraph (6) of this exclusion does not apply dangerous condition in it.
to "property damage" included in the 'prod- o. PersonalAnd AdvertisinglnJury
ucts-completed operations hazard". "Bodily injury' arising out of "personal and ad-
k. Damage To Your Product vertising injury'.
"Property damage" to 'your product" arising Exclusions c. through n. do not apply to damage
out of it or any part of it. by fire to premises while rented to you or tempora-
rily occupied by you with permission of the owner.
I. Damage To Your Work A separate limit of insurance applies to this cover-
"Property damage" to "your Work" arising out of age as described in Section III - Limits Of Insur-
it or any part of it and included in the 'prod- ance.
ucts-completed operations hazard". COVERAGE B PERSONAL AND ADVERTISING
This exclusion does not apply if the damaged INJURY LIABlE'FY
work or the work out of which the damage
arises was performed on your behalf by a sub- 1. Insuring Agreement
contractor, a. We will pay those sums that the insured be-
comes legally obligated to pay as damages
m. Damage To Impaired Property Or Property because of "personal and advertising injury" to
Not Physically Injured which this insurance applies. We will have the
"Property damage" to "impaired property" or right and duty to defend the insured against
property that has not been physically injured, any "suit' seeking those damages. However,
arising outof: we will have no duty to defend the insured
(1) A defect, deficiency, inadequacy or dan- against any "suit" seeking damages for "per-
sonal and advertising injury" to which this
gerous condition in "your product' or "your insurance does not apply. We may, at our dis-
work"; or cretion, investigate any offense and settle any
(2) A delay or failure by you or anyone acting claim or 'suit" that may result. But:
on your behalf to perform a contract or
agreement in accordance with its terms. (1) The amount we will pay for damages is
limited as described in Section III - Limits
This exclusion does not apply to the loss of Of Insurance:and
use of other property arising out of sudden and
accidental physical injury to "your product" or (2) Our right and dutyto defend end when we
"your work" after it has been put to its intended have used up the applicable limit of in-
surance in the payment of judgments or se
use. ttlements under Coverages A or B or medi-
cal expenses under Coverage C.
CG 00 01 10 01 Copyright, lag Properties, Inc., 2000 Page 5 of 16
No other obligation or liability to pay sums or g. Quality Or Performance Of Goods- Failure
perform acts or services is covered unless ex- To Conform To Statements
plicitly provided for under Supplementary Pay- "Personal and advertising inJur~ arising out of
ments- Coverages A and B. the failure of goods, products or services to
b. This insurance applies to 'personal and adver- conform with any statement of quality or per- ·
rising injury" caused by an offense arising out formance made in your 'advertisement".
of your business but only if the offense was h. Wrong Description Of Prices
committed in the 'coverage territon/' during "Personal and advertising injury' arising out of
the policy pedod, the wrong description of the price of goods,
2. Exclusions products or services stated in your "advertise-
This insurance does not apply to: ment".
a. Knowing Violation Of Rights Of Another I. Infringement of Copyright, Patent,
Trademark Or Trade Secret
"Personal and advertising injury" caused by or
at the direction of the insured with the knoWl- "Personal and advertising injury' arising out of
edge that the act would violate the rights of the infringement of copyright, patent, trade-
another and would inflict "personal and adver- mark, trade secret or other intellectual proper-
ty rights.
rising injury". However, this exclusion does not apply to in-
b. Material Published With Knowledge Of Fal- fringement, in your "advertisement', of copy-
slty right, trade dress or slogan.
'Persona[ and advertising injury' arising out of
oral or written publication of material, if done ~. Insureds In Media And internetType
by or at the direction of the insured with knowl- Businesses
"Personal and advertising injury" committed by
edge of its falslty.
c. Material Published Prior To Policy Period an insured whose business is:
'Personal and advertising injury" arising out of (1) Advertising, broadcasting, publishing or
oral or written publication of material whose telecasting;
first publication took place before the begin- (2) Designing or determining content of web-
ning of the policy period, sites for others; or
d. Criminal Acts (3) An Internet search, access, content or set-
"Personal an(~ advertising injury' arising out of vice provider.
a criminal act committed by or at the direction However, this exclusion does not apply to
of the insured. Paragraohs 14.a., b. and c. of "personal and
advertising in]un/' uoder the Definitions Sec-
e. Contractual Uabillty tion.
'Personal and advertising injury' for which the
insured has assumed liability in a contract or For the purposes of this exclusion, the placing
agreement. This exclusion does not apply to Ii- of frames, borders or links, or advertising, for
ability for damages that the insured would you or others anywhere on the Intemet, is not
have in the absence of the contract or agree- by itself, considered the business of advertis-
ing, broadcasting, publishing or telecasting.
ment. k. Electronic Chatrooms Or Bulletin Boards
f. Breach Of Contract
'Personal and advertisincj injury' arising out of 'personal and advertising injury" arising out of
a breach of contract, except an implied con- an electronic chatroom or bulletin board the in-
tract to use another's advertising idea in your sured hosts, owns, or over which the insured
'advertisement'. exercises control.
Page 6 of 16 Copyright, ISO Properties, Inc., 2000 CG 00 01 10 01
I. Unauthorized Use Of Another's Name Or (2) Necessary medical, surgical, x-my and
Product dental services, Including prosthetic de-
'Pemonal and advertising injury' arising out of vices; and
the unauthorized use of another's name or (3) Necessary ambulance, hospital, profes-
product in your e-mail address, domain name sional nursing and funeral services.
or metatag, or any other similar tactics to mis- 2. Exclusions
lead another's potential customers. We will not pay expenses for 'bodily injury~:
m. Pollution a. Anylnsured
"Personal and advertising injury' arising out of
the actual, alleged or threatened discharge, To any insured, except 'volunteer workem".
dispersal, seepage, migration, release or es- b. Hired Person
cape of"pcllutants" at anytime. To a person hired to do work for or on behalf
n. Pollution-Related of any insured or a tenant of any insured.
Any loss, cost or expense arising out of any: c. Injury On Normally Occupied Premises
(1) Request, demand or order that any in- To a person injured on that part of premises
sured or others test for, monitor, clean up, you own or rent that the person normally occu-
remove, contain, treat, detoxify or neutral- pies.
ize, or in any way respond to, or assess d. Workers Compensation And Similar Laws
the effects of, "pollutants"; or To a person, whether or not an "employee' of
(2) Claim or suit by or on behalf of a govern- any insured, if benefits for the "bodily injury"
mental authority for damages because of are payable or must be provided under a work-
testing for, monitoring, cleaning up, re- ers' compensation or disability benefits law or
moving, containing, treating, detoxifying or a similar law.
neutralizing, or in any way responding to,
or assessing the effects of, "pollutants". e. Athletics Activities
To a person injured while taking part in athlet-
COVERAGE C MEDICAL PAYMENTS ics.
1. InsurlngAgreement f. Products-Completed Operations Hazard
a. We will pay medical expenses as described
below for "bodily injury" caused by an acci- Included within the "products-completed op-
dent: erations hazard".
(1) On premises you own or rent; g. Coverage A Exclusions
(2) On ways next to premises you own or rent; Excluded under Coverage A.
or h. War
(3) Because of your operations; Due to war, whether or not declared, or any act
or condition incident to war. War includes civil
provided that: war, insurrection, rebellion or revolution.
(1) The accident takes place in the "coverage SUPPLEMENTARY PAYMENTS - COVERAGES A
territory~ and during the policy period; AND B
(2) The expenses are incurred and reported to
us within one year of the date of the acci- 1. We will pay, with respect to any claim we investi-
dent; and gate or settle, or any 'suit" against an insured we
defend:
(3) The injured person submits to examina-
tion, at our expense, by physicians of our a. All expenses we incur.
choice as often as we reasonably require.
b. We will make these payments regardless of
fault. These payments will not exceed the ap-
plicable limit of insurance. We will pay reason-
able expenses for:
(1) First aid administered at the time of an ac-
cident;
CG 0001 10 01 Copyright, ISO Properties, inc., 2000 Page 7 of 16
b. Up to $250 for cost of ball bonds required be- e. The Indemnltee and the Insured ask us to con-
cause of accidents or traffic law violations aris- duct and control the defense of that Indem-
lng out of the use of any vehicle to which the nitee against such 'suit" and agree that we can
Bodily Injury Liability Coverage applies. We do assign the same counsel to defend the insured
and the indemnitee; and
not have to furnish these bonds.
c. The cost of bonds to release attachments, but f. The indemnitee:
only for bond amounts within the applicable (1) Agrees in writing to:
limit of insurance. We do not have to furnish (a) Cooperate with us in the investigation,
these bonds, settlement or defense of the "suit";
d. All reasonable expenses incurred by the in- (b) Immediately send us copies of any de-
sured at our request to assist us in the in- mands, notices, summonses or legal
vestigation or defense of the claim or "suit", papers received in connection with the
including actual loss of earnings up to $250 a "suit";
day because of time off from work. (c) Notify any other insurer whose cover-
e. All costs taxed against the insured in the "suit". age is available to the indemnitee; and
f. Prejudgment interest awarded against the in- (d) Cooperate with us with respect to co-
sured on that part of the iudgment we pay. If ordinating other applicable insurance
we make an offer to pay the applicable limit of available to the indemnitee; and
insurance, we will not pay any prejudgment in-
terest based on that period of time after the of- (2) Provides us with written authorization to:
fer. (a) Obtain records and other information
g. All interest on the full amount of any judgment related to the "suit"; and
that accrues after entry of the judgment and (b) Conduct and control the defense of
before we have paid, offered to pay, or depos- the indemnitee n such su .
ited in court the part of the judgment that is So long as the above conditions are met, attor-
within the applicable limit of insurance, neys' fees incurred by us in the defense of that in-
These payments will not reduce the limits of insur- demnitee, necessary litigation expenses incurred
ance. by us and necessary litigation expenses incurred
2. If we defend an insured against a "suit' and an in- by the indemnitee at our request will be paid as
demnitee of the insured is also named as a party to Supplementary Payments. Notwithstanding the
the "suit", we will defend that indemnitee if all of the provisions of Paragraph 2.b.(2) of Section I -
Coverage A - Bodily Iniury And Property Damage
following conditions are met: Uability, such payments will not be deemed to be
a. The "suit" against the indemnitee seeks dam- · " "
ages for which the insured has assumed the damages for "bodily injury" and property damage
and witl not reduce the limits of insurance.
liability of the indemnitee in a contract or
agreement that ~s an ~nsured contract, Our obligation to defend an insured's indemnitee
and to pay for attorneys' fees and necessary litiga-
b. This insurance applies to such liability as- tion expenses as Supplementary Payments ends
sumed by the insured; when:
c. The obligation to defend, or the cost of the de- a. We have used up the applicable limit of insur-
lense of, that indemnitee, has also been as- ance in the payment of Judgments or settle-
sumed by the insured in the same "insured ments; or
contract"; b. The conditions set forth above, or the terms of
d. The allegations in the "suit" and the information the agreement described in paragraph f.
we know about the "occurrence" are such that above, are no longer met.
no conflict appears to exist between the inter-
ests of the insured and the interests of the in-
demnitee;
Page 8 of 16 Copyright ISO Properties, Inc., 2000 CG O0 01 10 01
SECTION II-WHO IS AN INSURED (b) To the spouse, child, parent, brother
1. If you are designated in the Declarations as: or sister of that co-'employee" or "vol-
unteer worker' as a consequence of
a. An individual, you and your spouse are in- Paragraph (1)(a)above;
sureds, but only with respect to the conduct of -
a business of which you are the sole owner. (c) For which there is any obligation to
share damages with or repay some-
b. A partnership or Joint venture, you are an in- one else who must pay damages
sured. Your members, your partners, and their because of the injury described in
spouses are also insureds, but only with re- Paragraphs (1)(a) or (b) above; or
spect to the conduct of your business. (d) Arising out of his or her providing or
c. A limited liability company, you are an insured, failing to provide professional health
Your members are also insureds, but only with care services.
respect to the conduct of your business. Your
managers are insureds, but only with respect (2) "Property damage" to property:
to their duties as your managers. (a) Owned, occupied or used by,
d. An organization other than a partnership, joint (b) Rented to, in the care, custody or con-
venture or limited liability company, you are an trol of, or over which physical control
insured. Your "executive officers" and directors is being exercised for any purpose by
are insureds, but only with respect to their
you, any of your 'employees", "volunteer
duties as your officers or directors. Your stock- workers", any partner or member (if you
holders are also insureds, but only with re- are a partnership or joint venture), or any
spect to their liability as stockholders, member (if you are a limited liability com-
e. A trust, you are an insured. Your trustees are pany).
also insureds, but only with respect to their du- b. Any person (other than your 'employee" or
ties as trustees. "volunteer worker"), or any organization while
2. Each of the following is also an insured: acting as your real estate manager.
a. Your "volunteer workers" only while performing c. Any person or organization having proper tern-
duties related to the conduct of your business, porary custody of your property if you die, but
or your "employees", other than either your only:
"executive officers" (if you are an organization (1) With respect to liability arising out of the
other than a partnership, joint venture or lim- maintenance or use of that property; and
ited liability company) or your managers (if you
are a limited liability company), but only for (2) Until your legal representative has been
acts within the scope of their employment by appointed.
you or while performing duties related to the d. Your legal representative if you die, but only
conduct of your business. However, none of with respect to duties as such. That represen-
these "employees" or "volunteer workers' are tative will have all your rights and duties under
insureds for: this Coverage Part.
(1) "Bodily injury" or "personal and advertising 3. With respect to "mobile equipment' registered in
inlury': your name under any motor vehicle registration
(a) To you, to your partners or members law, any person is an insured while driving such
(if you are a partnership or joint yen- equipment along a public highway with your per-
mission. Any other person or organization respon-
ture), to your members (if you are
a limited liability company), to a co- sible for the conduct of such person is also an
"employee" while in the course of his insured, but only with respect to liability arising out
or her employment or performing du- of the operation of the equipment, and only it no
ties related to the conduct of your other insurance of any kind is available to that per-
business, or to your other "volunteer son or organization for this liability. However, no
workers" while performing duties re- Derson or organization is an insured with respect
lated to the conduct of your business; to:
a. "Bodily injury" to a co-"employee" of the per-
son driving the equipment; or
b. "Property damage" to property owned by, rent-
ed to, in the charge of or occupied by you or
the employer of any person who is an insured
under this provision.
CG 00 01 10 01 Copyright, ISO Properties, Inc., 2000 Page 9 of 16
4. Any organization you newly acquire or form, other 5. Subject to 2. or 3. above, whlchever applies, the
than a partnership, Joint venture or limited liability Each Occurrence Limit is the most we will pay for
company, and over which you maintain ownership the sum of:
or majority interest, will qualify as a Named Insured a. Damages under Coverage A; and
if there Is no other similar insurance available to b. Medical expenses under Coverage C
that organization. However:
a. Coverage under this provision is afforded only because of all 'bodily inju~r" and 'property dam-
until the 90th day after you acquire or form the age" arising out of any one "occurrence".
organization or the end of the policy period, 6. Subject to 5. above, the Damage To Premises
whichever is earlier; Rented To You Limit is the most we will pay under
b. Coverage A does not apply to "bodily injury' or Coverage A for damages because of "property
"property damage' that occurred before you damage" to any one premises, while rented to you,
or in the case of damage by fire, while rented to
acquired or formed the organization; and you or temporarily occupied by you with permis-
c. Coverage B does not apply to "personal and sion of the owner.
advertising injury" arising out of an offense
committed before you acquired or formed the 7. Subject to 5. above, the Medical Expense Limit is
the most we will pay under Coverage C for all med-
organization. Ical expenses because of "bodily injury" sustained
No person or organization is an insured with respect to by any one person.
the conduct of any current or past partnership, joint The Umits of Insurance of this Coverage Part apply
venture or limited liabil~'y company that is not shown as separately to each consecutive annual period and to
a Named Insured in the Declarations. any remaining period of less than 12 months, starting
SECTION Ill - LIMITSOF INSURANCE with the beginning of the policy period shown in the
1. The Limits of Insurance shown in the Declarations Declarations, unless the policy period is extended after
and the rules below fix the most we will pay regard- issuance for an additional period of less than 12
months. In that case, the additional period will be
less of the number of: deemed part of the last preceding peric~l for purposes
a. Insureds; of determining the Emits of Insurance.
b. Claims made or'suits' brought; or SECTION IV- COMMERCIAL GENERAL LIABILITY
c. Persons or organizations making claims or CONDITIONS
bringing "suits". 1. Bankruptcy
2. The General Aggregate Limit is the most we will Bankruptcy or insolvency of the insured or of the
payforthe sum of: insured's estate will not relieve us of our obliga-
a. Medical expenses under Coverage C; tions under this Coverage Part.
b. Damages under Coverage A, except damages 2. Duties In The Event Of Occurrence, Offense,
because of 'bodily injur~' or "property dam- Claim OrSult
age" included in the "products-completed op- a. You must see to it that we are notified as soon
erations hazard"; and as practicable of an "occurrence' or an offense
c. Damages under Coverage B. which may result in a claim. To the extent pos-
3. The preducts-Completed Operations Aggregate sible, notice should include:
Limit is the most we will pay under Coverage A for (1) How, when and where the "occurrence" or
damages because of "bodily injury' and "property offense took place;
damage" included in the "products-completed op- (2) The names and addresses of any injured
erations hazard", persons and witnesses; and
4. Subject to 2. above, the Personal and Advertising (3) The nature and location of any injury or
Injury Limit is the most we will pay under Coverage ..... r
damage arising out of the occurrence o
B for the sum of all damages because of all "Der- offense.
sonal and advertising injury" sustained by any one
person or organization.
Page 10 of 16 Copyright. ISO Properties, inc., 2000 CG 00 01 10 01
b. If a claim is made or "suit" Is brought against 4. Other Insurance
any insured, you must: If other valid and collectible Insurance Is ava#able
(1) Immediately record the specifics of the to the insured for a loss we cover under Coverages
claim or 'suit" and the date received; and A or B of this Coverage Part, our obligations are
limited as follows:
(2) Notify us as soon as practicable.
You must see to it that we receive written no- a. Primary Insurance
rice of the claim or "suit" as soon as practica- This insurance is primary except when b. be-
bio. Iow applies. If this insurance is pdmary, our
obligations are not affected unless any of the
c. You and any other involved insured must: other insurance is also primary. Then, we will
(1) Immediately send us copies of any de- share with allthat other insurance bythe moth-
mands, notices, summonses or legal pa- od described In o. below,
pets received in connection with the claim b. Excess Insurance
or "suit";
(2) Authorize us to obtain records and other This insurance is excess over:
information; (1) Any of the other insurance, whether pri-
mary, excess, contingent or on any other
(3) Cooperate with us in the investigation or basis:
settlement of the claim or defense against
the "suit"; and (a) That Is Fire, Extended Coverage,
Builder's Risk, Installation Risk or simi-
(4) Assist us, upon our request, in the enforce- lar coverage for "your work";
ment of any right against any person or
organization which may be liable to the in- (b) That is Fire insurance for premises
sured because of injury or damage to rented to you or temporarily occupied
which this insurance may also apply, by you with permission of the owner;
d. No insured witl, except at that insured's own (c) That is insurance purchased by you to
cost, voluntarily make a payment, assume any cover your liability as a tenant for
obligation, or incur any expense, other than for "property damage" to premises rented
first aid, without our consent, to you or temporarily occupied by you
with permission of the owner; or
3. Legal Action Against Us
No person or organization has a right under this (d) If the toss arises out of the mainte-
nance or use of aircraft, "autos' or
Coverage Part: watercraft to the extent not subject to
a. To join us as a party or otherwise bring us into Exclusion g. of Section I - Coverage A
a "suit" asking for damages from an insured; or - Bodily injury And Property Damage
b. To sue us on this Coverage Part unless all of its Liability.
terms have been fully complied with. (2) Any other primary insurance available to
A person or organization may sue us to recover on you covering liability for damages arising
an agreed settlement or on a final judgment out of the ~3remises or operations for which
against an insured; but we will not be liable for you have been added as an additiona~ in-
damages that are not payable under the terms of sured by attachment of an endorsement,
this Coverage Part or that are in excess of the ap-
plicable limit of insurance. An agreed settlement
means a settlement and release of liability signed
by us, the insured and the claimant or the claim-
ant's legal representative.
CG 00 01 10 01 Copyright, ISO Properties, Inc., 2000 Page 11 of 16
When this Insurance is excess, we will have no 6. Reprasentatlons
duty under Coverages A or B to defend the in- By accepting this policy, you agree:
sured against any 'suit" If any other Insurer has
a duty to defend the insured against that 'suit'. a. The statements In the Declarations are accu-
If no other insurer defends, we will undertake rate and complete;
to do so, but we will be entitled to the insured's b. Those statements are based upon representa-
rights against all those other Insurers. tions you made to us; and
When this insurance is excess over other insur- c. We have issued this policy in reliance upon
ance, we will pay only our share of the amount your representations.
of the loss, if any, that exceeds the sum of: 7. Separation Of Insureds
(1) The total amount that all such other insur- Except with respect to the Limits of Insurance, and
ance would pay for the loss in the absence any rights or duties specifically assigned in this
of this insurance; and Coverage Part to the first Named Insured, this in-
(2) The total of all deductible and self-insured surance applies:
amounts under all that other insurance.
a. As If each Named Insured were the only
We will share the remaining loss, If any, with Named insured; and
any other insurance that is not described in b. Separately to each insured against whom
this Excess Insurance provision and was not claim is made or "suit" is brought.
bought specifically to apply in excess of the
Limits of Insurance shown in the Declarations 8. Transfer Of Rights Of Recovery Against Others
of this Coverage Part. To Us
c. Method Of Sharing If the insured has rights to recover all or part of any
payment we have made under this Coverage Part,
If all of the other insurance permits contribu- those rights are transferred to us. The insured must
tion byequal shares, wewill followthis method do nothing after loss to impair them. At our re-
also. Under this approach each insurer con- quest, the insured will bring "suit" or transfer those
tributes equal amounts until it has paid its ap- rights to us and help us enforce them.
plicable limit of insurance or none of the loss
remains, whichever comes first. 9. When We Do Not Renew
If any of the other insurance does not permit If we decide not to renew this Coverage Part, we
contribution by equal shares, we will contribute will mail or deliver to the first Named Insured
by limits. Under this method, each insurer's shown in the Declarations written notice of the
share is based on the ratio of its applicable lim- nonrenewal not less than 30 days before the expi-
it of insurance to the total applicable limits of ration date.
insurance of all insurers. If notice is mailed, proof of mailing will be sufficient
Premium Audit proof of notice.
a. We will compute all premiums for this Cover- SECTION V- DEFINITIONS
age Part in accordance with our rules and 1. "Advertisement" means a notice that is broadcast
rates, or published to the general public or specific mar-
b. Premium shown in this Coverage Part as ad- ket segments about your goods, products or serv-
vance premium is a deposit premium only. At ices for the purpose of attracting customers or
the close of each audit period we will compute supporters. For the purposes of this definition:
the earned premium for that period and send a. Notices that are published include material
notice to the first Named Insured. The due date placed on the Internet or on similar electronic
for audit and retrospective premiums is the means of communication; and
date shown as the due date on the bill. If the b. Regarding web-sites, only that part of a web-
sum of the advance and audit premiums paid site that is about your goods, products or serv-
for the policy period is greater than the earned ices for the purposes of attracting customers
premium, we will return the excess to the first or supporters is considered an advertisement.
Named Insured.
2. "Auto" means a land motor vehicle, trailer or semi-
c. The first Named Insured must keep records of trailer designed for travel on public reads, includ-
the information we need for premium compu- lng any attached machinery or equipment. BUt
tation, and send us copies at such times as we "auto' does not include "mobile equipment".
may request.
Page 12 of 16 Copyright, ISO Properties, Inc., 2000 CG 00 01 10 01
3. *Bodily in]un/' means bodily !nju. ry,..slck.nes..s or_d.i,s.-g. "Insured contract' means:
ease sustained by a person, mc~uo~ng aeam renu,L- a. A contract for a lease of premises. However,
lng from any of these at any time. that portion of the contract for a lease of prem-
ises that indemnifies any person or organl-
4. 'Coverage territory' means: zation for damage by fire to premises while
a. The United States of Amedca (including its rented to you or temporarily occupied by you
territories and possessions), Puerto Rico and with permission of the owner is not an 'insured
Canada; contract";
b. International waters or airspace, but only if the
injury or damage occurs in the course of travel b. A sidetrack agreement;
or transportation between any places included c. Any easement or license agreement, except in
connection with construction or demolition op-
in a. above; or erations on or within 50 feet of a railroad;
c. All other parts of the wodd if the injury or dam- d. An obligation, as required by ordinance, to in-
age arises out of: demn~ a municipality, except in connection
(1) Goods or products made or sold by you in with work for a municipality;
the territory described in a. above; e. An elevator maintenance agreement;
(2) The activities of a person whose home is in
the territory described in a. above, but is f. That part of any other contract or agreement
away for a short time on your business; or pertaining to your business (including an in-
demnification of a municipality in connection
(3) "personal and advertising injury- offenses with work performed for a municipatity) under
that take place through the Internet or sim- which you assume the tort liability of another
ilar electronic means of communication party to pay for "bodily injury' or "property
provided the insured's responsibility to pay dam- damage" to a third person or organization. Tort
ages is determined in a "suit" on the merits, in the liability means a liability that would be imposed
territory described in a. above or in a settlement we by law in the absence of any contract or agree-
ment.
agree to.
5. "Employee" includes a "leased worker". "Employee" Paragraph f. does not include that part of any
does not include a "temporary worker", contract or agreement:
6. "Executive officer" means a person holding any of (1) That indemnifies a railroad for "bodily in-
the officer positions created by your charter, con- iud' or "property damage" arising out of
stitution, by-laws or any other similar governing construction or demolition operations,
within 50 feet of any railroad property and
document, affecting any railroad bridge or trestle,
7. "Hostile fire" means one which becomes uncontrol-
lable or breaks out from where it was intended to tracks, road-beds, tunnel, underpass or
crossing;
be.
8. "impaired property' means tangible property, other (2) That indemnifies an architect, engineer or
than 'your product" or "your work", that cannot be surveyor for injury or damage arising out
of:
used or is less useful because:
a. It incorporates "your preduct" or "your work" (a) Preparing, approving, or failing to pre-
that is known or thought to be defective, deft- pare or approve, maps, shop draw-
ings, opinions, reports, surveys, field
cient, inadequateordanger°us;°r orders, change orders or drawings
b. You have failed to fulfill the terms of a contract and specifications; or
or agreement; (b) Giving directions or instructions, or
if such property can be restored to use by: fa lng to give them, if that is the pri-
mary cause of the in ury or damage or
a. The repair, replacement, adiustment or remov-
al of"your product" or"yourwork~; or (3) Under which the insured, if an architect,
engineer or surveyor, assumes liability for
b. Your fulfilling the terms of the contract or an nj,u_ry or damage arising out of the in-
agreement, sured s rendering or fa ute to render pro-
fessional services, including those listed in
(2) above and supervisory, inspeCtion, ar-
chitectural or engineering activities.
CG 00 01 10 01 Copyright, ISO Properties, Inc., 2000 page 13 of 16
10. 'Leased worker' means a person leased to you by f. Vehicles not described in a., b., c. or d. above
a labor leasing firm under an agreement between maintained primarily for purposes other than
you and the labor leasing firm, to perform duties the transportation of persons or cargo.
related to the conduct of your business. 'Leased However, self-propelled vehicles with the fol-
worker'does not include a "temporary worker', lowing types of permanently attached equip-
11. 'Loading or unloading' means the handling of ment are not 'mobile equipment' but will be
property: considered "autos':
a. After it is moved from the place where it is ac- (1) Equipment designed primarily for:
cepted for movement into or onto an aircraft, (a) Snow removal;
watercraft or"auto"; (b) Road maintenance, but not construc-
b. While it is in or on an aircraft, watercraft or tion or resurfacing; or
'auto"; or (c) Street cleaning;
c. While it is being moved from an aircraft, water-
craft or "auto" to the place where it is finally (2) Cherry pickers and similar devices
mounted on automobile or truck chassis
delivered; and used to raise or lower workers; and
but "loading or unloading" does not include the
movement of property by means of a mechanical (3) Air compressors, pumps and generators,
device, other than a hand truck, that is not at- including spraying, welding, building
cleaning, geophysical exploration, lighting
tached to the aircraft, watercraft or "auto". and well servicing equipment.
12. "Mobile equipment" means any of the following
types of land vehicles, including any attached ma- 13. 'Occurrence" means an accident, including con-
tinuous or repeated exposure to substantially the
chinery or equipment: same general harmful conditions.
a. Bulldozers, farm machinery, forklifts and other
vehicles designed for use principally off public 14. "Personal and advertising injury~ means injury,
including consequential "bodily injury', arising out
roads; of one or more of the following offenses:
b. Vehicles maintained for use solely on or next
to premises you own or rent; a. False arrest, detention or imprisonment;
c. Vehicles that travel on crawler treads; b. Malicious prosecution;
d. Vehicles, whether self-propelled or not, main- c. The wrongful eviction from, wrongful entry
into, or invasion of the right of private occu-
tained primarily to provide mobility to perma- pancy of a room, dwelling or premises that a
nently mounted: person occupies, committed by or on behalf of
(1) Power cranes, shovels, loaders, diggers or its owner, landlord or lessor;
drills; or d. Oral or written publication, in any manner, of
(2) Road construction or resurfacing equip- material that slanaers or libels a person or or-
ment such as graders, scrapers or rollers; ganization or disparages a person's or organi-
e. Vehicles not aescribed in a., b., c. or d. above zation's goods, products or services;
that are not self-propelled and are maintained e. Oral or written publication, in any manner, of
primarily to provide mobility to permanently material that violates a person's right of pri-
attached equipment of the following types: vacy;
(1) Air compressors, pumps and genera- f. The use of another's advertising idea in your
tors, including spraying, welding, 'advertisement"; or
building cleaning, geophysical explo-
ration, lighting and well servicing g. Infringing upon another's copyright, trade
dress or slogan in your "advertisement".
equipment: or
(2) Cherry pickers and similar devices
use~ to raise or lower workers;
Page 14 of 16 Copyright, ISO Properties, Inc., 2000 CG O0 01 10 01
15. "Pollutants" mean any solid, liquid, gaseous or b. Loss of use of tangible property that Is not
thermal Irritant or contaminant, Including smoke, physically injured. All such loss of use shall be
vapor, soot, fumes, acids, alkalis, chemicals and deemed to occur at the time of the 'occur-
waste. Waste Includes materials to be recycled, re- rence" that caused it.
conditioned or reclaimed. For the purposes of this insurance, electronic data
16. "Products-completed operations hazard": Is not tangible property.
a. Includes all "bedily injury" and "property dam- As used In this definition, electronic data means
age" occurring away from premises you own information, facts or programs stored as or on,
or rent and arising out of "your product" or created or used on, or transmitted to or from corn-
"your work" except: puter software, including systems and applications
software, hard or floppy disks, CD-ROMS, tapes,
(1) Products that are still in your physical pos- drives, cells, data processing devices or any other
session; or media which are used with electronically controlled
(2) Work that has not yet been completed or equipment.
abandoned. However, "your work" will be
deemed completed at the eadiest of the 18. "Suit" means a civil proceeding in which damages
because of "bodily injury", "property damage" or
following times: "personal and advertising injury" to which this in-
(a) When all of the work called for in your surance applies are alleged. "Suit" includes:
contract has been completed.
a. An arbitration proceeding in which such dam-
(b) When all of the work to be done at the ages are claimed and to which the insured
job site has been completed if your must submit or does submit with our consent;
contract calls for work at more than or
onejobsite, b. Any other alternative dispute resolution pro-
(c) When that part of the work done at a ceeding in which such damages are claimed
job site has been put to its intended and to which the insured submits with our con-
use by any person or organization oth- sent.
er than another contractor or subcon-
tractor working on the same project, lg. "Temporary worker" means a person who is fur-
nished to you to substitute for a permanent "em-
Work that may need service, maintenance, ployee" on leave or to meet seasonal or short-term
correction, repair or replacement, but workload conditions.
which is otherwise complete, wii[ be 20. "Volunteer worker" means a person who is not your
treated as completed. "employee", and who donates his or her work and
b. Does not include "bodily injury~ or "property acts at the direction of and within the scope of du-
damage" arising out of: ties determined by you, and is not paid a fee, sal-
(1) The transportation of property, unless the ary or other compensation by you or anyone else
injury or damage arises out of a condition for their work performed for you.
in or on a vehicle not owned or operated 21. "Your product":
by you, and that condition was created by
the "loading or unlcading" of that vehicle a. Means:
byanyinsured; (1) Any goods or products, other than real
property, manufactured, sold, handled,
(2) The existence of tools, uninstalled equip-
ment or abandoned or unused materials; distributed or disposed of by:
or (a) You;
(3) Products or operations for which the (b) Otherstradingunderyourname;or
classification, listed in the Declarations or (c) A person or organization whose busi-
in a policy schedule, states that products- ness or assets you have acquired; and
completed operations are subject to the
General Aggregate Limit. (2) Containers (other thanvehides), materials,
parts or equipment furnished in connec-
17. "Property damage" means: tion with such goods or products.
a. Physical injury to tangible property, including
all resulting loss of use of that property. All
such loss of use shall be deemed to occur at
the time of the physical injury that caused it; or
CG 00 01 10 01 Copyright, ISO Properties, Inc., 2000 Page 15 of 16
b. Includes 22. 'Your work":
(1) Warranties or representations made at any a. Means:
time with respect to the fitness, quality, du- (1) Work or operations performed by you or
rability, performance or use of 'your on your behalf; and
pro- duct'; and (2) Materials, parts or equipment furnished in
(2) The providing of or failure to provide warn- connection with such work or operations.
ings or instructions.
b. Includes
e. Does not include vending machines or other
property rented to or located for the use of (1) Warranties or representations made at any
time with respect to the fitness, quality,
others but not sold. rability, performanc~ or use of "your work
and
(2) The providing of or failure to provide warn-
ings or instructions.
Page 16 of 16 Copyright, ISO Properties. inc., 2000 CG O0 01 10 01
COMMERCIAL GENERAL UABIUTY
CG 00 570g 99
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF INSURING AGREEMENT-
KNOWN INJURY OR DAMAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART (OCCURRENCE VERSION)
Paragraph 1. Insuring Agreement of Section I - "occurrence" or claim, knew that the
Coverage A - Bodily Injury And Property Damage "bodily injury' or "property damage" had
Liability is replaced by thefollowing: occurred, in whole or in part. If such a
1. InsurlngAgreement listed insured or authorized "employee"
knew, pdor to the policy period, that the
a. We will pay those sums that the insured be- "bodily injury" or "property damage' oc-
comes legally obligated to pay as damages curred, then any continuation, change or
because of 'bodily injury" or "property dam- resumption of such "bodily injury' or
age" to which this insurance applies. We will "property damage' during or after the
have the right and duty to defend the insured policy period will be deemed to have been
against any "suit" seeking those damages, known prior to the policy period.
However, we will have no duty to defend the
insured against any "suit" seeking damages for c. "Bodily injury" or "property damage" which oc-
"bodily injury' or "property damage' to which cum during the policy period and was not,
this insurance does not apply. We may, at our prior to the policy period, known to have oc-
discretion, investigate any 'occurrence" and curred by any insured listed under Paragraph
1. of Section II - Who Is An Insured or any
settle any claim or "suit" that may result. But: 'employee" authorized by you to give or re-
(l) The amount we will pay for damages is ceive notice of an "occurrence" or claim,
limited as described in Section II1 - Limits includes any continuation, change or resump-
Of Insurance; and tion of that "bodily injury" or "property damage"
(2) Our right and duty to defend end when we after the end of the policy period.
have used up the applicable limit of insur- d. "Bodily injury" or "property damage' will be
ance in the payment of judgments or set- deemed to have been known to have occurred
tlements under Coverages A or B or at the earliest time when any insured listed
medical expenses under Coverage C. under Paragraph 1. of Section II - Who Is An
No other obligation or liability to pay sums or Insured or any "employee" authorized by you
perform acts or services is covered unless to give or receive notice of an "occurrence" or
explicitly provided for under Supplementary claim:
Payments- Coverages A and B. (1) Reports all, or any part, of the "bodily in-
b. This insurance applies to "bodily injury" and jury" or "property damage" to us or any
"property damage" only if: other insurer;
(1) The "bodily injury" or "proper'bi' damage" is (2) Receives a written or verbal demand or
caused by an "occurrence" that takes claim for damages because of the "bodily
place in the "coverage territory"; injury" or "property damage"; or
(2) The "bodily injury" or 'property damage" (3) Becomes aware by any other means that
occurs during the policy period; and "bodily injury" or "property damage" has
(3) Prior to the policy period, no insured listed occurred or has begun to occur.
under Paragraph 1. of Section II - Who Is e. Damages because of 'bodily injury" include
An Insured and no "employee" authorized damages claimed by any person or organiza-
by you to give or receive notice of an tion for care, loss of services or death resulting
at any time from the "bodily injury".
CG 00 57 09 99 Copyright, Insurance Services Office, Inc., 1998 Page I of 1
AGENT
COMMERCIAL GENERAL UABlUTY
CG00 600999
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF INSURING AGREEMENT -
KNOWN INJURY OR DAMAGE
This endorsement modifies insurance provided under the following:
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART (OCCURRENCE VERSION)
Paragraph 1. Insuring Agreement of Section I - "bodily injury" or "properly damage" had
Coverages is replaced bythefollowing: occurred, in whole or in bart. If such a
listed insured or authorized "employee"
1. Insuring Agreement knew, prior to the policy period, that the
a. We will pay those sums that the Insured be- "bodily injury" or "properly damage" oc-
comes legally obligated to pay as damages curred, then any continuation, change or
because of "bodily injury" or 'property dam- resumption of such "bodily injury" or
age" included within the "products-completed "property damage" during or after the
operations hazard" to which this insurance policy period will be deemed to have been
applies. We will have the right and duty to known priortothepolicyperiod.
defend the insured against any "suit" seeking
those damages. However, we will have no duty c. "Bodily injury" or 'property damage" which oc-
to defend the insured against any "suit" seek- curs during the policy period and was not,
pdor to the policy period, known to have oc-
lng damages for "bodily injury" or "property curred by any insured listed under Paragraph
damage" to which this insurance does not
apply. We may, at our discretion, investigate 1. of Section II - Who Is An Insured or any
'employee" authorized by you to give or re-
any "occurrence" and settle any claim or "suit" ceive notice of an "occurrence" or claim,
that mayresult But: includes any continuation, change or re-
(l) The amount we will pay for damages is sumption of that "bodily injury' or 'property
limited as described in Section III - Limits damage" after the end of the policy period.
Of Insurance; and d. "Bodily injury" or "property damage' will be
(2) Our right and duty to defend end when we deemed to have been known to have occurred
have used up the applicable limit of insur- at the earliest time when any insured listed
ance in the payment of Judgments or set- under Paragraph 1. of Section II - Who is An
tlements. Insured or any 'employee" authorized by you
No other obligation or liability to pay sums or to give or receive notice of an 'occurrence" or
perform acts or services is covered unless claim:
explicitly provided for under Supplementary (1) Reports all, or any part, of the "bodily in-
Payments. jury' or "property damage" to us or any
b. This insurance applies to 'bodily injury" and other insurer;
"property damage" only if: (2) Receives a written or verbal demand or
(1) The "bodily injury" or 'property damage" is claim for damages because of the "bodily
caused by an "occurrence" that takes injury" or "property damage"; or
place inthe "coverageterritory"; (3) Becomes aware by any other means that
(2) The 'bodily injury' or 'property damage" "bodily injury" or "property damage" has
occurs during the policy period; and occurred or has begun to occur.
(3) Prior to the policy period, no insured listed e. Damages because of 'bodily injury" include
under Paragraph 1. of Section II - Who Is damages claimed by any person or organiza-
An Insured and no "employee" authorized tion for care, loss of services or death resulting
by you to give or receive notice of an at anytime from the "bodily injury".
"occurrence" or claim, knew that the
CG 00 60 09 9g Copyright, Insurance Services Office, Inc., 1998 Page I of 1
AGENT
COMMERCIAL GENERAL LIABILITY
CG O0 62 12 02
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAR LIABILITY EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Exclusion I. under Paragraph 2.. Exclusions of B. The following exclusion is added to Paragraph 2.
Section I - Coverage A - Bodily Injury And Prop- Exclusions of Section I - Coverage B - Personal
erty Damage Liability is replaced by the following: And Advertising Injury Liability:
2. Exclusions 2. Exclusions
This insurance does not apply to: This insurance does not apply to:
I. War WAR
"Bodily injury" or "property damage", how- "Personal and advertising injury", however
ever caused, arising, directly or indirectly, caused, arising, directly or indirectly, out of:
out of: a. War, including undeclared or civil war; or
(1) War, including undeclared or civil war; b. Wadike action by a military force, including
or action in hindering or defending against an
(2) Wadike action by a military force, in- actual or expected attack, by any govern-
cluding action in hindering or defend- ment, sovereign or other authority using
lng against an actual or expected military personnelorotheragents; or
attack, by any government, sovereign c. Insurrection, rebellion, revolution, usurped
or other authority using military per- power, or action taken by governmental
sonnel or other agents; or authority in hindering or defending against
(3) Insurrection, rebellion, revolution, any of these.
usurped power, or action taken by C. Exclusion h. under Paragraph 2., Exoluslons of
governmental authority in hindering or Section I - Coverage C - Medical Payments does
defendingagainstanyofthese, not apply. Medical payments due to war are now
subject to Exclusion g. of Paragraph 2., Exclu-
sions of Section I - Coverage C - Medical Pay-
ments since "bodily injury" arising out of war is
now excluded under Coverage A.
CG O0 62 12 02 Copyright, ISO Properties, Inc., 2002 Page I of 1
AGENT
COMMERCIAL GENERAL UABIMTY
CG 21 67 04 02
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 In- Exclusions of Section I - Coverage B - Pemonal
Jury And Property Damage Liability: And Advertising Injury Liability:
2. Exclusions 2. Exclusions
This insurance does not apply to: This insurance does not apply to:
Fungi or Bacteria Fungi or Bacteria
a. "Bodily injury" or "proper~y aamage" which a. "Personal and advertising injury' which
would not have occurred, in whole or in would not have taken place, in whole or in
part. but for the actual, alleged or threat- part, but for the actual, allegea or threat-
ened inhalation of, ingestion of. contact ened inhalation of, ingestion of, contact
with, exposure to. existence of. or pres- with, exposure to, existence of. or pres-
ence of, any "fungi" or bacteria on or within ence of any 'fungi" or bacteria on or within
a building or structure including its con- a building or structure including its con-
tents, regardless of whether any other tents, regardless of whether any other
cause, event, material or product contrib- cause, event, material or product contrib-
uted concurrently or in any sequence to uted concurrently or in any sequence to
such injury or damage, such injury.
b. Any loss, cost or expenses arising out of b. Any loss, cost or expense arising out of
the abating, testing for, monitoring, clean- the abating, testing for, monitoring, clean-
ing up, removing, containing, treating, lng up, removing, containing, treating,
detoxifying, neutralizing, remediating or detoxifying, neutralizing, remediating or
disposing of, or in any way responding to, disposing of, or in any way responding to,
or assessing the effects of, "fungi" or bac- or assessing the effects of. "fungi" or bac-
teria, by any insured or by any ot~er per- teria, by any insured or by any other per-
son or entity, son or entity.
This exclusion does not apply to any 'fungi" or C. The following definition is added to the Definitions
bacteda that are are on, or are contained in, a Section:
good or product intended for consumption. "Fungi" means any type or form of fungus, includ-
ing mold or mildew and any mycotoxins, spores,
scents or byproducts produced or released by
fungi.
CG 21 67 04 02 Copyright, ISO Properties, Inc., 2001 Page 1 of 1
AGENT
CG21 751202
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
EXCLUSION OF CERTIFIED ACTS OF TERRORISM AND
OTHER ACTS OF TERRORISM
This endorsement modifies insurance provided under the fcllowing:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABIUTY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
POLLUTION LIABIMTY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY
A. The following exclusion is added: 4. The terrorism is carried out by means of the
This insurance does not apply to: dispersal or application of pathogenic or poi-
sonous biological or chemical materials; or
TERRORISM 5. Pathogenic or poisonous biological or chemi-
"Any injury or damage" arising directly or indirectly, cai materials are released, and it appears that
out of a "certified act of terrorism" or an "other act one purpose of the terrorism was to release
of terrorism." However, with respect to an "other such materials.
act of terrorism", this exclusion applies only when
one or more of the following are attributed to such With respect to this exclusion, Paragraphs 1. and
2. describe the thresholds used to measure the
act: magnitude of an incident of an "other act of terror-
1. The total of insured damage to all types of ism" and the circumstances in which the threshold
property exceeds $25,000,000. In determin- will apply for the purpose of determining whether
lng whether the $25,000,000 threshold is ex- this exclusion will apply to that incident.
ceeded, we will include all insured damage
sustained by property of all persons and enti- B. The following definitions are added:
ties affected by the terrorism and business 1. For the purposes of this endorsement, "any in-
interruption losses sustained by owners or oc- jury or damage" means any injury or damage
cupants of the damaged property. For the pur- covered under any Coverage Part to which this
pose of this provision, insured damage means endorsement is applicable, and includes but is
damage that is covered by any insurance plus not limited to "bodily injur~, "property dam-
damage that would be covered by any insur- age", "personal and advertising injury", "injury"
ance but for the application of any terrorism or "environmental damage" as may be defined
exclusions; or in any applicable Coverage Part.
2. Fifty or more persons sustain death or serious 2. "Certified act of terrorism" means an act that is
physical injury For the purposes of this provi- certified by the Secretary of the Treasury, in
sion, serious physical injury means: concurrence with the Secretary of State and
a. Physical injury that involves a substantial the Attorney General of the United States, to
risk of death; or be an act of terrorism pursuant to the federal
Terrorism Risk Insurance Act of 2002. The fed-
b. Protracted and obvious physical disfigure- eral Terrorism Risk Insurance Act of 2002 sets
ment; or forth the following criteria for a "certified act of
c. Protracted loss of or impairment of the terrorism':
function of a bodily member or organ; or a. The act resulted in aggregate losses in ex-
3. The terrorism involves the use, release or es- cess of $5 million; and
cape of nuclear materials, or directly or indi-
rectly results in nuclear reaction or radiation or
radioactive contamination; or
CG 21 75 12 02 Copyright, ISO Properties, Inc., 2002 Page 1 of 2
AGENT
b. The act is a violent act or an act that Is C. In the event of any lncldent of a "certified act of ter-
dangerous to human life, property or in- rodsm' or an 'other act of terrorism' that is not sub-
frastructure and is committed by an indi- Ject to this exclusion, coverage does not apply to
vidual or individuals acting on behalf of any loss or damage that is otherwise excluded
any foreign person or foreign interest, as under this Coverage Part.
part of an effort to coerce the civilian pop-
ulation of the United States or to influence
the policy or affect the conduct of the
United States Government by coercion.
3. "Other act of terrorism" means a violent act or
an act that is dangerous to human life, prop-
erty or infrastructure that is committed by an
individual or individuals and that appears to be
Dart of an effort to coerce a civilian population
or to influence the policy or affect the conduct
of any government by coercion, and the act is
not certified as a terrorist act pursuant to the
federal Terrorism Risk Insurance Act of 2002.
Multiple incidents of an 'other act of terrorism"
which occur within a seventy-two hour period
and appear to be carried out in concert or to
have a related purpose or common leadership
shall be considered to be one incident.
Page 2 of 2 Copyright. ISO Properties, Inc., 2002 CG 21 75 12 02
COMMERCIAL GENERAL LIABILITY
CG 22 30 07 g8
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
EXCLUSION - CORPORAL PUNISHMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABIMTY COVERAGE PART
The following exclusion is added to Paragraph 2., This insurance does not apply to 'bodily injury",
Exclusions of Section I - Coverage A - Bodily Injury "property damage" or "personal and advertising in-
And Property Damage Liability and Paragraph 2., jur,/' to your student arising out of any corporal
Exclusions of Section I - Coverage B - Personal And punishment administered by or at the direction of any
Advertising Injury Liability: insured.
CG 22 30 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1
AGENT
COMMERCIAL GENERAL LIABIUTY
CG 22 72 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COLLEGES OR SCHOOLS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
With respect to the operation of any college or school a. The rendering of or failure to render:
by you or on your behalf, the following provisions (1) Medical, surgical, dental, x-ray or
apply: nursing service, treatment, advice or
A. With respect to the transportation of students, instruction, or the related furnishing of
Exclusion g. of Paragraph 2., Exclusions of Sec- food or beverages;
tion I - Coverage A - Bodily Injury And Property (2) Any health or therapeutic service,
Damage Liability is replaced by the following: treatment, advice or instruction; or
This insurance does not apply to: (3) Any service, treatment, advice or ln-
g. "Bodily injury" or "property damage" aris- struction for the purpose of appear-
ing out of the ownership, maintenance, ance or skin enhancement, hair
operation, use, "loading or unloading" or removal or replacement or personal
entrustment to others of any aircraft, "auto" grooming.
or watercraft that is owned, operated or b. The furnishing or dispensing of drugs or
hired by an insured. For the purpose of medical, dental or surgical supplies or ap-
this exclusion, the word hired includes any pliances; or
contract to furnish transportation of your
students to and from schools, c. The handling or treatment of dead bodies,
including autopsies, organ donation or
This exclusion applies even if the claims other procedures.
against the insured allege negligence or
other wrongdoing in the supervision, hir- 2. This insurance does not applyto"bodily injury"
lng, employment, training or monitoring of to any person while practicing for or par-
others by that insured, if the "occurrence" ticipating in any sports or athletic contest or
which caused the 'bodily injury" or "prop- exhibition if there is no direct management,
erty damage" involved the ownership, organization or supervision of such sports or
maintenance, use or entrustment to others athletic contest or exhibition by any insured.
of any aircraft, 'auto" or watercraft that is C. Section II - Who Is An Insured is amended to
owned or operated by or rented or loaned include as an insured any of the following but only
to any insured, with respect to their duties in connection with the
B. The following exclusions are added to Section I - positions described below:
Coverage A - Bodily Injury And Property Damage 1. Any of your trustees or members of your Beard
Liability and Section I - Coverage B - Personal of Governors if you are a private charitable or
And Advertising Injury Liability: educational institution.
1. If the college or school owns or operates an 2. Any of your board members or commissioners
infirmary with facilities for lodging and treat- if you are a public board or commission.
ment or a public clinic or hospital, this 3. Any student teachers teaching as part of their
insurance does not apply to "bodily injury", educational requirements.
"property damage", or "personal and adver-
tising injury" caused by:
CG 22 72 10 01 Copyright, ISO Properties, Inc., 2000 Page I of 1
AGENT
ENDORSEMENT
.,f SCOTTSDALE INSURANC COMPANY' NO.
CLS0982165 11/26/2003 TEKOA CHARTER SCHOOL, INC. 42024
SEXUAL AND/OR PHYSICAL ABUSE LIABILITY COVERAGE FORM
INSURING AGREEMENTS Abuse Uability as indicated and subject to the limits of the
liability of insurance as set forth in this coverage form and
In consideration of the premium charged, we agree to al- the exclusions, conditions and other terms of this policy.
ford coverage only with respect to Sexual and/or Physical
LIMITS OF LIABILITY COVERAGE
$. 25, ooo each claim
Sexual and/or Physical Abuse Liability
$ 5 o, oo0 aggregate
Advance Premium Premium Bases Rates Description of Hazards
INCLUDED INCLUDED INCLUDED SCHOOL
$ INCLUDED TOTAL ADVANCE PREMIUM
I. COVERAGES - SEXUAL AND/OR PHYSICAL We shall have the right and duty to defend any suit
ABUSE LIABILITY against you seeking such DAMAGES, even it any of
the allegations of the suit are groundless, false or
We will pay on your behalf all sums which you shall fraudulent, and may make such investigation and such
become legally obligated to pay as DAMAGES be- settlement of any claim or suit as wedeem expedient,
cause of iniury to any person arising out of SEXUAL but we shall not be obligated to pay any claim or
AND/OR PHYSICAL ABUSE, caused by one of your judgment or to defend any suit after the applicable limit
EMPLOYEES, or arising out of your failure to properly of our liability has been exhausted.
supervise.
Page 1 of 2
GLS-44s (11 -~ AGENT
II. EXCLUSIONS (c) If the Named Insured Is designated in the DECLA-
RATIONS as other than an individual, partnership
This policy does not apply: or joint venture, the organization so designated
(a) to any actual or alleged SEXUAL AND/OR and any executive officer, director or stockholder
PHYSICAL ABUSE by you or PERSONS IN- thereof while acting within the scope of his duties
SURED (see Section III below); as such.
(b) to liability of others assumed by you under any IV. LIMITS OF LIABILITY
contract or agreement, either oral or in writing, un- Regardless of the number of insureds under this poll-
less specifically endorsed hereon; cy, our liability is limited as follows:
(c) to any obligation for which you or any carrier as The limit of liability stated in the schedule as appli-
your insurer may be held liable under any work- cable to each claim is the limit of our liability for all
ers' compensation, unemployment compensation DAMAGES because of each claim or suit covered
or disability benefits law, or under any similar law; hereby. The limit of liability stated in the schedule as
(d) to bodily injury to, or SEXUAL AND/OR PHYSI- aggregate, subject to the above provision regarding
CAL ABUSE, sickness, disease, or death sus- each claim, is the total limit of our liability under this
tained by any of your EMPLOYEES arising out of, Coverage for all DAMAGES.
and in the course of employment by you; V. SUPPLEMENTARY PAYMENTS
(e} to any loss or claim either directly or indirectly We will pay, in addition to the applicable limit of liabil-
arising from your activities as an officer or director ity for DAMAGES, all interest on that amount of any
of any corporation, company or business other judgment payable by us that accrues after entry of the
than that of the Named Insured; judgment and before we have paid, offered to pay or
(f} to any claim for punitive or exemplary damages, deposited in court the amount available for the judg-
ment.
.. PERSONS INSURED
VI. DEFINITIONS
Each of the following is an insured under this insur-
ancetothe extent set forth below: (a) SEXUALAND/OR PHYSlCALABUSE means
sexual or physical injury or abuse, including as-
(a) if the Named Insured is designated in the DEC[A- sault and battery, negligent or deliberate touching.
RATIONS as an individual, the person so desig-
nated, but only with respect to the conduct of a (b) EMPLOYEE means any person, other than a
business of which he is the sole proprietor, and PERSON INSURED, in your employment, includ-
the spouse of the Named Insured with respect to lng but nut limited to persons with child caring re-
the conduct of such a business; sponsibilifies, attendants, janitors, bus drivers and
volunteer workers.
(b) if the Named Insured is designated in the DEC[A-
RATIONS as a partnership or joint venture, the (c) DAMAGES means all damages, including dam-
partnership or joint venture so designated and ages for death, which are payable ~3ecause of in-
any partner or member thereof but only with re- jury to which this insurance applies.
spect to his liability as such;
/
AUTHORIZED REPRESENTATIVE ~)ATE
Page 2 of 2
GLS-44s (t 1-95)
JI.
ENDORSEMENT
SCOTTSDALE INS CE COMPANY NO.
ATTACHED TO AND ENDORSEMENT EFFECTIVE DATE NAMED INSURED AGENT NO.
FORMING A PART OF (12:01 A.M. STANDARD TIME)
POLICY NUMBER
CLS0982165 11/26/2003 TEKOA CHARTER SCHOOL, INC. 42024
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SEXUAL AND/OR PHYSICAL ABUSE EXCLUSION
This endorsement modifies insurance provided under:
COMMERCIAL GENERAL LIABIUTY COVERAGE PART
PROFESSIONAL LIABILITY COVERAGE PART
This policy does not apply to any injury sustained by any The following Definitions ara added to the policy:
person arising out of or resulting from Sexual and/or 1. Sexual and/or Physical abuse means sexual or physi-
Physical abuse by: cai injury or abuse, including but not limited to assault
1. any insured; and battery, negligent or deliberate touching, corporal
punishment and mental abuse.
2. any of your Employees; or
2. Employee means any person, other than a Person in-
3. any person performing volunteer services for you or on sured, in your employment, including but not limited to:
your behalf; or
a. persons with child caring rasponsibilities;
any other person, b. attendants;
We shall not have any duty to defend any suit against you
seeking Damages on account of any such injury, c. janitors;
The intent of this endorsement isto exclude all injury sus- d. bus drivers; and
tained by any person, including emotional distress, arising e. volunteer workers.
out of Sexual and/or Physical abuse including but not lira-
ited to Sexual and/or Physical abuse caused by negligent 3. Damages means all damages, including damages for
employment, investigation, supervision, or reporting to the death, which are payable because of injury to which
proper authorities, or failure to so report, or retention of a this insurance applies.
person for whom any insured is or ever was legally re- All ether terms and conditions remain unchanged.
sponsibte.
/
AUTHORIZED REPRESENTATIVE 0ATE
GLS-45S (3-92) AGENT
ENDORSEMENT
.- Jk SCOTTSDALE INSURANcE CO/VIPANY NO.
CLS0982165 11/26/2003 TEKOA CHARTER SCHOOL, INC. 42024
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OPTIONAL PROVISIONS ENDORSEMENT
The following special provisions (indicated by an "X") apply to this policy.
SCHEDULE
[] Bodily Injury, Property Damage, Personal Injury and Advertising Injury Liability Deductible
Endorsement
Coverage Amount and Basis of Deductible
Bodily Injury Liability $ NIL per claimant
Proper~y Damage Liability $ NIL per claimant
Personal and Advertising Injury Liability $ NIL per claimant
[] Service of Suit Clause
Service of Process wil[ beaccapted by: COMMTSSIONER OF TNSURANCE
P O BOX 149104-MC 112 I-A, AUSTIN, TX 78714-9104 .and
Service of Process will be mailed to: MICHAEL L. HORSMAN
8877 N. GAINEY CENTER DRIVE, sCOTTSDALE, AZ 85258
[] Minimum and Advance Premium Endorsement
Minimum Premium 100 %.
[] Minimum Earned Cancellation Premium
Minimum Earned Cancellation Premium 25 % of the advanced premium.
GLS-94s (12-~,'~)
BODILY INJURY, PROPERTY DAMAGE, PERSONAL INJURY AND ADVERTISING
INJURY LIABILITY DEDUCTIBLE ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
APPLICATION OF ENDORSEMENT 1. Our obligation under the Bodily Injury Liability, Prop-
arty Damage Liability, Personal and Advertising Injury
Enter below any limitations on the application of this en- Liability (Personal Injury and Advertising Injury) Cover-
dorsement. If no limitation is entered, the deductibles apply ages to pay damages on your behalf applies only to the
to damages for all "bodily injury,' 'property damage,' "per- amount of damages in excess of any deductible
sonal and advertising injury," ("personal injury" and 'adver- amounts stated in the Schedule of this endorsement as
rising injury") however caused:
NO LIMITATIONS
Inoludes copyrighted material of insurance Services Office, Inc., with its permission.
Copyright, Insurance Services Office, Inc., 1998
Page 1 of 3
UTS-128s (2-02) AGENT ut:;128 ~h' lap
applicable to such coverages, and the Limits of Insur- c. Under Personal and Advertising Injury Liability
ance applicable to Each Occurrence or offense for (Personal Injury and Advertising Injury) Coverages
such coverages will be reduced by the amount of such to all damages sustained by one person as the re-
deductible. Aggregate Limits for such coverages shall suit of any one 'occurrence" or offense.
not be reduced by the application of such deductible
4. The terms of this insurance, including those with re-
amount, spect to our right and duty to defend any 'suits" seek-
2. The deductible amounts apply to damages and all legal lng those damages and your duties in the event of an
and loss adjustment expenses. 'occurrence,' offense, claim or "suit,' apply irrespective
of the application of the deductible amount.
3. The deductible amounts stated in the Schedule above
apply, respectively: 5. We may pay any part or all of the deductible amount to
effect settlement of any claim or "suit" and, upon notifi-
a. Under the Bodily Injury Liability Coverage to all cation of the action taken, you shall promptly reim-
damages because of "bodily injury" sustained by burse us for such part of the deductible amount as has
one person; been paid by us.
b. Under Property Damage Liability Coverage to all
damages because of "property damage" sustained
by one person, any organization or association; or
UTS-9~
SERVICE OF SUIT CLAUSE
ItisagreedthatintheeventofthefailureoftheOompanyto Commissioner or Director of Insurance or other officer
pay any amount claimed to be due under this policy, the specified for that purpose in the statute, or his successor or
Company at the request of the Insured (or reinsured), will successors in office, as their true and lawful attorney upon
submit to the jurisdiction of any court of competent juris- whom may be served any lawful process in any action, suit,
diction within the United States of America and will comply or proceeding instituted by or on behalf of the Insured (or
with all requirements necessary to give the Court jurisdic- reinsured) or any beneficiary arising out of this contract of
n. All matters which arise will be determined in accord- insurance (or reinsurance).
ance with the law and practice of the Court. In a suit The officer named in the Schedule of this endorsement is
instituted against any one of them under this contract, the authorized and directed to accept service of process on
Company agrees to abide bythe final decision of the Court
behalf of the Company.
or of any Appellate Court in the event of an appeal.
Having accepted service of process on behalf of the Com-
Pursuant to any statute of any state, territory or district of
pany, the officer is authorized to mail the process or a true
the United States of America which makes a provi- copy to the individual named in the Schedule above.
sion, the Company will designate the Superintendent,
GLS~7s (3-01)
MINIMUM AND ADVANCE PREMIUM ENDORSEMENT
This endorsement modifies Conditions provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR UABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIASlLITY COVERAGE PART
Item 5.b. of the Premium Audit Condition (under SECTION COMPLETED OPERATIONS LIABILITY CONDITIONS) is
IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, amended to read:
LIQUOR MABILITY CONDITIONS AND PRODUCTS/
Includes copyrighted matedal of Insurance Services Office, Inc., with its permission.
Copyright, Insurance Services Of rico, Inc., 1998
UTS-128s (2-02) Page 2 of 3
°b. The advance premium for this Coverage Part is a Advance Premium - The premium that is stated In
depose premium only. The final premium shall be the policy Declarations and payable In full by the
subject to audit. At the close of each audit period first Named Insured at the inception of the policy.
we will compute the earned premium for that pe-
riod. Any audit premiums are due and payable to Earned Premium - The premium that is developed
us on notice to the first Named Insured. If the sum by applying the rate(s) scheduled in the policy to
the actual premium basis for the audit period.
of the advance and audit premiums paid for the
policy term is greater than the earned premium, we Minimum Premium - the lowest premium for which
will return the excess to the first Named Insured, this insurance will be written for the Policy Period
subject to the minimum premium as defined below, stated in Item 2. of the Declarations. This minimum
In the event the first Named Insured fails or refuses premium is equal to 100% (unless a different per-
to allow our representative to audit your books and centage (%) is shown in the SCHEDULE above) of
records, we may unilaterally charge a final premi- the advance premium including any premium ad-
um for the policy period at double the minimum or justments made by endorsement to this policy dur-
advance premium, whichever is greater, and such lng the Policy Period. Premium adjustments do not
final premium shall be immediately due and pay- include the audit premium developed for the Policy
able on notice to the first Named Insured. For pur- Period stated in Item 2. of the Declarations.
poses of this policy, the terms advance premium,
earned premium, and minimum premium are de-
fined as follows:
MINIMUM EARNED CANCELLATION PREMIUM
The following provision is added to the Cancellation Condition:
If You request cancellation of this policy, We will retain not less than the percentage of the advance
premium as stated in the Schedule.
/
AUTHORIZED REPRESENTATIVE DATE
ncludes copyrighted material of Insurance services Office, Inc., with its permission,
Copyright. Insurance Services Office Inc.. 1998
UTS-128s (2~)2) Page 3 of 3
ENDORSEMENT
Jk SCOTTSDALE INSURANCE COIV[PANY~ NO.
I CLS0982165 11/26/2003 TEKOA CHARTER SCHOOL, INC. 42024
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDATORY ENDORSEMENTS
(Without Medical Payments Exclusion)
This endorsement lists several endorsements that modify your policy as follows:
ILO0 17 11 98
COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions:
A. Cancellation 6. If notice is mailed, proof of mailing will be sufficient
1. The first Named Insured shown in the Declarations proof of notice.
may cancel this policy by mailing or delivering to B. Changes
us advance written notice of cancellation.
This policy contains all the agreements between you
2. We may cancel this policy by mailing or delivering and us concerning the insurance afforded. The first
to the first Named Insured written notice of cancel- Named Insured shown in the Declarations is authorized
lation at least: to make changes in the terms of this policy with our
consent. This policy's terms can be amended or
a. 10 days before the effective date of cancella-
waived only by endorsement issued by us and made a
tion if we cancel for nonpayment of premium; part of this policy.
or
C. Examination of Your Books and Records
b. 30 days before the effective date of cancalla-
tion if we cancel for any other reason. We may examine and audit your books and records as
3. We will mail or deliver our notice to the first Named they relate to this policy at any time during the policy
I nsured's last mailing address known to us. pedod and up to three years afterward.
D. Inspections and Surveys
4. Notice of cancellation will state the effective date of
cancellation. The policy period will end on that 1. We have the right to:
date.
a. Make inspections and surveys at any time;
5. If this policy is canceled, we will seed the first
b. Give you reports on the conditions we find;
Named Insured any premium refund due. If we
and
cancel, the refund will be pro rata. If the first
Named Insured cancels, the refund may be less c. Recommend changes.
than pro rata. The cancellation will be effective
even if we have not made or offered a refund. 2. We are not obligated to make any inspections, sur-
veys, reports or recommendations and any such
Includes copyrighted material of ISO Properlies, In~., with its permission.
Copyright, ISO Properties, Inc., 1998
UTS*246s (9-03) Page 1 of 8
AGENT
actions we do undertake relate only to Insurability E. Premlume
and the premiums to be charged. We do not make
safety Inspections. We do not undertake to per- The first Named Insured shown in the Declarations:
form the duty of any person or organization to pro- 1. Is responsible for the payment of all premiums; and
vide for the health or safety of workers or the
public. And we do not warrant that conditions: 2. Wilt be the payee for any return premiums we pay.
a. Are safe or healthful; or F. Transfer of Your Rights and Duties Under This Policy
b. Comply with laws, regulations, codes or stand- Your rights and duties under this policy may not be
ards. transferred without our written consent except in the
case of death of an individual Named Insured.
3. Paragraphs 1. and 2. of this condition apply not
only to us, but also to any rating, advisory, rate If you die, your rights and duties will be transferred to
service or simirar organization which makes insur- your legal representative but only while acting within
ance inspections, surveys, reports or recommen- the scope of duties as your legal representative. Until
dations, your legal representative is appointed, anyone having
proper temporary custody of your property will have
4. Paragraph 2. of this condition does not apply to your rights and duties but only with respect to that
any inspections, surveys, reports or recommenda- property.
tions we may make relative to certification, under
state or municipal statutes, ordinances or regula-
tions, of boilers, pressure vessels or elevators.
GLS-58s (12-93)
LEAD CONTAMINATION EXCLUSION
This endorsement excludes "occurrences" at or from any b. "Property Damage" arising from any form of lead;
premises, site or location which is or was at any time
owned or occupied by, or rented or loaned to, any in- c. "Personal Injury"arising from any form of lead;
'red; or from the operations of the insured, which result d. "Advertising Injury" arising from any form of lead;
~n:
e. Medical Payments arising from any form of lead;
a. "Bodily injury' arising out of the ingestion, inhalation
or absorption of lead in any form;
CG21 470798
EMPLOYMENT- RELATED PRACTICES EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following exclusion is added to Paragraph 2., Ex- lb) Termination of that person's employment;
cluslons of Section I - Coverage A - Bodily Injury and or
Property Damage Liability:
lc) Employment-related practices, policies,
This insurance does not applyto: acts or omissrons, such as coercion,
'Bodily injury" to: demotion, evaluation, reassignment, disci-
prine, defamation, harassment humiliation
(1) A person arising out of any: or discrimination directed at that [~erson:
la) Refusal to employ that r~erson; or
Incluaes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, inc., 19g8
UTS-246s {9-03) Pc. ge 2 of 8
under any such policy but for Its termination "Nuclear material" means 'source material," 'special
upon exhaustion of its limit of liability; or nuclear material" or 'by-product material,"
(2) Resulting from the 'hazardous properties" of "Soume material,' "special nuclear material," and 'by-
'nuclear material" and with respect to which product material' have the meanings given them in
(a) any person or organization Is required to the Atomic Energy Act of 1954 or in any law amenda-
maintain financial protection pursuant to the torythereof.
Atomic Energy Act of 1954, or any law amen-
datory thereof, or (b) the "insured' is, or had "Spent fuel" means any fuel element or fuel compo-
this policy not been issued would be, entitled nent, solid or liquid, which has been used or exposed
to indemnity from the United States of Ameri- to radiation in a "nuclear reactor."
ca, or any agency thereof, under any agree- "Waste" means any waste material (a) containing "by-
ment entered into by the United States of product material" other than the tailings or wastes
America, or any agency thereof, with any per- produced by the extraction or concentration of ura-
son or organization, nium or thorium from any ore processed primarily for
Its 'source material" content, and (b) resulting from
B. Under any Medical Payments coverage, to ex-
penses incurred with respect to "bodily injury" the operation by any person or organization of any
resulting from the "hazardous properties" of "nu- "nuclear facility" included under the first two para-
clear material" and arising out of the operation of graphs of the definition of "nuclear facility.'
a "nuclear facility" by any person or organization. "Nuclear facilIty" means:
C. Under any LiabilIty Coverage, to "bodily injury" or (a) Any "nuclear reactor";
"property damage" resulting from "hazardous
properties" of "nuclear material" if: (b) Any equipment or device designed or used for
(1) separating the isotopes of uranium or pluto-
(1) The "nuclear material" (a) is at any "nuclear nium, (2) processing or utilizing 'spent fuel,' or
facility" owned by, or operated by or on be- (3) handling, processing or packaging "waste';
half of, an "insured" or (b) has been dis-
charged or dispersed therefrom; (c) Any equipment or device used for the processing,
fabricating or alloying of "special nuclear material"
(2) The "nuclear material" is contained in 'spent if at any time the total amount of such material in
fuel" or "waste" at any time possessed, the custody of the "insured" at the premises
handled, used, processed, stored, trans- where such equipment or device is located con-
ported or disposed of, by or on behalf of an sists of or contains more than 25 grams of pluto-
'insured"; or nium or uranium 233 or any combination thereof,
(3) The "bodily injury" or "property damage' or more than 250 grams of uranium 235; or
adses out of the furnishing by an "insured" of (d) Any structure, basin, excavation, premises or
services, materials, parts or equipment in place prepared or used for the storage or dispos-
connection with the planning, construction, al of'waste";
maintenance, operation or use of any "nu-
clear facility," but if such facility is located and includes the site on which any of the foregoing is
within the United States of America, its territo- located, all operations conducted on such sIte and all
ries or possessions or Canada, this exclusion premises used for such operations.
(3) applies only to "property damage" to such "Nuclear reactor" means any apparatus designed or
"nuclear facility" and any property thereat, used to sustain nuclear fission in a self-supporting
2. As used in this endorsement: chain reaction or to contain a critical mass of fission-
able material.
"Hazardous properties' includes radioactive, toxic or
"Property damage" Includes all forms of radioactive
explosive properties, contamination of property.
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 1998
UTS-246s (9-03) Page 4 of 8
GLS-30s (~)
~ONT~TORS SPECIAL ~ONDmONS
The following has been add~ to the policy: charge will be comp~ by multi~ying the ~al cost' ~ all
work sublet that fails to meet the a~ve co~ion, by the
~O~ORS SPECIAL CONDITIONS rate per $1000 payr~l for the appli~ble classEi~tion of the
You will obtain ~Ei~tes ~ insurance from all inde~- work pedorm~.
ent contractors providing evidence of: If the policy does not contain the ap~i~ble classEi~tion
1. Lim~s of Insurance equal to or greater than the lim~s and rote, we will multiply our usua~ and customa~ rote per
provided by this policy; and $1000 ~yroll for that dass~i~tion, by the net m~Ei~tion
favor, E any, appli~ to the policy rates.
2. Coverage equal to or greater than the coverages pro-
vid~ by th~s policy. ~otal cost" means the cost ~ all labor, materials and
equipment furnish~, us~ or deliver~ for use in the exe-
Failure to comply with this condEion d~s not alter the cov- c~ion ~ the work and all fees, bonuses or commissions
emge provid~ by this policy. However, should you fail ~id.
to comply, a premium c~rge will be made. The premium
UTS-74g (8-95)
PUNITIVE OR EXEMP~RY DAMAGE ~CLUSlON
This policy does not apply to a claim ~ or indemnEi~tion If sue is brought against any insur~ for a claim falling w~h-
for pun~e or exempla~ damages, in coverage provid~ under the policy, seeking both com-
pen~to~ and pun~ive or exempla~ damages, then the
PunEive or exemp~a~ damages also include any damages Company will afford a defense to such a~ion. However, the
awarded pursuant to statue in the form of double, treble or Company will have no obligation to pay for any costs, inter-
other multiple damages in excess of compen~to~ dam~ est or damages a~rib~able to punitive or exempla~ dam-
'~es. ages.
UTS-131g (3-92)
ASBESTOS EXCLUSION
The coverage afforded by this policy does not apply to 4. The manufacture, sale, transportation, storage or dis-
bodily injury, 3ersonal injury or property damage arising posal of asbestos or goods or products containing
out of: asbestos.
1. Inhaling, ingesting or prolonged physical exposure to The coverage afforded by the policy does not apply to
asbestos or goods or products containing asbestos; payment for the investigation or defense of any loss,
or jury or damage or any cost, fine or penalty or for any ex-
pense of claim or suit related to any of the above.
2. The use of asbestos in construction or manufacturing
any good, product or structure; or The coverage afforded by the policy does not apply to
payment for the investigation or defense of any loss, in-
3. The removal of asbestos from any good, product or jury or damage or any cost, fine or penalty or for any ex-
structure; or pense of claim or suit related to any of the above.
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 1998
UTS-246s (9-03) Page 5 of 8
CG 00621202
WAR LIABILITY EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABlE'FY COVERAGE PART
A. Exclusion I. under Paragraph 2., Exclusions of Sec- 2. Exclusions
tlon I - Coverage A. Bodily Injury And Property This insurance does not applyto:
Damage Liability Is replaced by the following:
2. Exclusions WAR
"Personal and advertising injury," however
This insurance does not apply to: caused, arising, directly or indirectly, out of:
I. War
a. War, including undeclared or civil war; or
"Bodily injury' or'property damage," however b. Wadike action by a military force, including
caused, arising, directly or indirectly, out of: action in hindering or defending against an
(1) War, including undeclared or civil war; or actual or expected attack, by any govern-
ment, sovereign or other authority using mill-
(2) Wadike action by a military force, includ-
tary personnel or other agents; or
lng action in hindering or defending
against an actual or expected attack, by c. Insurrection, rebellion, revolution, usurped
any government, sovereign or other au- power, or action taken by governmental au-
thority using military personnel or other thority in hindering or defending against any
agents; or of these.
(3) Insurrection, rebellion, revolution, C. Exclusion h. under Paragraph 2., Exclusions of Sec-
usurped power, or action taken by gov- tion I - Coverage C. Medical Payments does not ap-
ernmental authority in hindering or de- ply. Medical payments due to war are now subject to
fending against any of these. Exclusion g. of Paragraph 2, Exclusions of Section
I - Coverage C. Medical Payments since "bodily in-
B. The following exclusion is added to Paragraph 2., Ex- jury" arising out of war is now excruded under Cover-
cluslons of Section I - Coverage B. Personal And
age A.
Advertising Injury Liability:
CG 21 67 04 02
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., Ex- 2. Exclusions
cluslons of Section I - Coverage A. Bodily Injury This insurance does not applyto:
And Property Damage Liability:
Includes copyrighted material of ISO Properties, Inc., with its permission.
Copyright, ISO Propeffies, Inc., tg98
UTS-246s (9-03) Page 6 of 8
Fungi or Bacteria 2. Exclusions
a. 'Bodily injury' or 'property damage' which This insurance does not applyto:
woulc~ not have occurred, in whole or in part, Fungi or Bacteria
but for the actual, alleged or threatened Inha-
lation of, ingestion of, contact with, exposure a. 'Personal and advertising injury' which would
to, existence of, or presence of. any"fungi" or not have taken place, in whole or in part, but
bacteria on or within a building or structure, for the actual, alleged or threatened inhala-
including its contents, regardless of whether tion of, ingestion of, contact with, exposure
any other cause, event, material or product to, existence of, or presence of any "fungi" or
contributed concurrently or in any sequence bacteria on or within a building or structure,
to such injury or damage, including its contents, regardless of whether
any other cause, event, material or product
b. Any loss, cost or expenses arising out of the contributed concurrently or in any sequence
abating, testing for, monitoring, cleaning up, to such injury.
removing, containing, treating, detoxifying,
neutralizing, remediating or disposing of, or b. Any loss, cost or expense arising out of the
in any way responding to, or assessing the abating, testing for, monitoring, cleaning up,
effects of, "fungi" or bacteria, by any insured removing, containing, treating, detexifying,
or by any other person or entity, neutralizing, remediating or disposing of, or
in any way responding to, or assessing the
This exclusion does not apply to any "fungi" or
effects of, "fungi" or bacteria, by any insured
bacteria that are, are on, or are contained in, a or by any other person or entity.
good or product intended for consumption.
C. The following definition is added to the Definitions
B. The following exclusion is added to Paragraph 2, Ex- Section:
clusions of Section I - Coverage B. Personal And
Advertising Injury Liability: "Fungi" means any type or form of fungus, including
mold or mildew and any mycotoxins, spores, scents
or byproducts produced or released by fungi.
GLS-152s (12-9~
AMENDMENT TO OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Condition 4. Other Insurance of SECTION IV - COM- (1) That is Fire, Extended Coverage, Builder's
MERCIAL GENERAL LIABIMTY CONDITIONS is deleted Risk, Installation Risk or similar coverage for
in its entirety and is replaced by the following: "your work";
4. Other Insurance (2) That is Fire insurance for premises ranted to
you or temporarily occupied by you with per-
a. Primary Insurance mission of the owner;
This insurance is primary except when b. below (3) If the loss arises out of the maintenance or
applies, use of aircraft, "auto" or watercraft to the ex-
b. Excess Insurance tent not subject to Exclusion g. of Coverage
A (Section I); or
This insurance is excess over any other insur-
ance, whether primary, excess, contingent or on
any other basis:
Includes copyrighted material of ~SO Properties, Inc., with its permission.
Copyright, ISO Properties, Inc., 1998
UTS-246s (9-03) Page 7 of 8
(4) That is valid and coflectible Insurance avail- (1) The total amount that all such other Insur-
able to you under any other policy, ance would pay for the loss in the absence of
this insurance; and
When this insurance is excess, we will have no
duty under Coverages A or B tc defend the in- (2) The total of all deductible and self-insured
sured against any "suit" if any other insurer has a amounts under all other Insurance.
duty to defend the insured against that "suit.' If no If a loss occurs involving two or more policies,
other insurer defends we will undertake to do so, each of which states that its insurance wi[[ be ex-
but we will be entitled to the insured's rights
cess, then our policy will contribute on a pro rats
against all those ether insurers, bas~s.
When this insurance is excess over other insur-
ance, we will pay only the amount of the loss, if
any, that exceeds the sum of:
/
AUTHORIZED REPRESENTATIVE DATE
Includes copyrighted material of ISO Prooert~es, Inc.. w~t~ ~ts permission.
Copyright, ISO Properties. Inc.. 19g8
UTS-246s (9-03) Page 8 of 8
ENDORSEMENT
.,f~ SCOTTSDALE INS~CE CO~4PANY® NO.
CLS0982165 11/26/2003 TEKOA CHARTER SCHOOL, INC. 42024
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF S~ ~ i LEMENT OF LIABILITY CLAIMS - TEXAS
The Company will notify the Named insured in wdting of its initial offer to compromise or settle a claim
against the Insured under this policy. The notice will be given on or before the 10th day after the date on
which the offer is made.
The Company will notify the Named Insured in writing of any settlement of a claim against the Insured
made under this policy. The notice will be g[ven on or before the 30th day after the date of the settlement.
/
AUTHORIZED REPRESENTATIVE DATE
UTS-88g-TX (9-94) AGENT
OCT. 27. 2004
POUCY NUMBEFI: (::~so982 z65 COMMEROIAL G£N ERAL LIABILIlrY
CG 20 26 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIAI~rLITY COVERAGE PART
SCHEDULE
Name Of Additional Illsured Person(s) Or Organization(s)
CITY OF PORT ARTh~JR
ATT~: L~GAL DEPT
PORT ARTRT~R, TX
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Seotion II - Who Is An Insured is amended to Include
as an additional insured the person(s) or orga-
nization(s) shown in the Schedule, but on[y with re-
spect to liability for "bodily injury', "property damage'
or 'persona[ and advertising injury" caused, in whole or
in part, by your ,~cts or omissions or the acts or omis-
sions of those acting on your behalf.
A. in the performance of your ongoing operations; or
Ft. In connection with your premises oWned by or
rented to you.
CG 20 26 07 04 Copyright, ISO Properties, Inc., 2004 Page I of 1
I N .'~T. TR E J~