.

Policyholder - OriginalIL-7007 (6-01) SO 01 06/30/16

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First Named Insured and Address: Agency Name and Number:

Policy Number:

Change Effective Date:

PREMIUM SUMMARY

COMMERCIAL GENERAL LIABILITYCHANGES

SUPERB MAIDS LLC AMS INSURANCE & INVESTMENTS 7530 TRICKLING WASH DR 8257-AL LAS VEGAS NV 89131

Z20747

05-12-16

No Additional or Return PremiumDirect Billed

CHANGES:

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Policyholder - Original

Amended Declarations

CG-7000(12-08) SO 01 06/30/16

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COMMERCIAL GENERAL LIABILITYCOVERAGE PART

First Named Insured and Address: Agency Name and Number:

Policy Number:

Policy Period: Effective Date:

Expiration Date:

In return for the payment of the premium and subject to 12:01 A.M. standard time atall the terms of the policy, we agree to provide the your mailing address showninsurance coverage as stated in the same. in the declarations

SUPERB MAIDS LLC AMS INSURANCE & INVESTMENTS7530 TRICKLING WASH DR 8257-ALLAS VEGAS NV 89131

Z20747

05-12-16

05-12-17

COVERAGE FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART

Form Number Form Title Premium

CG-0001R (12-11) Commercial General Liability Coverage Form $. . . . . . . . . . . . . . . . . . . . . .

CG-0300F (01-96) Deductible Liability Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CG-2147F (12-07) Employment - Related Practices Exclusion . . . . . . . . . . . . . . . . . . . . . . . .

IL-0017F (11-98) Common Policy Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

IL-0021F (03-14) Nuclear Energy Liability Exclusion - Broad Form . . . . . . . . . . . . . . . . . . . .

IL-7012 (03-14) Asbestos Exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CG-2167F (12-04) Fungi or Bacteria Exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CG-2292F (12-07) Snow Plow Operations Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CG-7300 (04-08) ACUITY Advantages - General Liability . . . . . . . . . . . . . . . . . . . . . . . . . . .

CG-2187R (01-15) Conditional Exclusion of Terrorism (Relating to Disposition of Federal Act)

CG-0068F (05-09) Recording and Distribution of Material or Info in Violation of LawExclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

IL-0115R (01-10) Nevada Changes - Domestic Partnership . . . . . . . . . . . . . . . . . . . . . . . . .

IL-0251F (09-07) Nevada Changes - Cancellation and Nonrenewal . . . . . . . . . . . . . . . . . . .

CG-2106F (05-14) Exclusion-Access of Confidential or Personal Info/Data with Limited BI . .

CG-7321 (01-15) Cap on Losses from Certified Acts of Terrorism . . . . . . . . . . . . . . . . . . . . . 10.00

CG-7323 (01-15) Exclusion of Punitive Damages Related to a Certified Act of Terrorism . . .

IL-7082 (01-15) Disclosure Pursuant to Terrorism Risk Insurance Act . . . . . . . . . . . . . . . .

Advance Endorsement Premium $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.00

PREMIUM SUMMARY

Advance Schedule Premium $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Advance Endorsement Premium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Advance Premium $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,009.00

10.00

1,019.00

Page 2

Policy Number: Z20747Effective Date: 05-12-16

CG-7000(12-08) SO 01 06/30/16

The Total Advance Premium shown above is based on the exposures you told us you would have whenthis coverage part began. We will audit this coverage part in accordance with Section IV - Conditions, item5 Premium Audit at the close of the audit period.

LIMITS OF INSURANCE

General Aggregate Limit (Other Than Products-Completed Operations) $. . . . . . . . . . . . . . 1,000,000

Products-Completed Operations Aggregate Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,000,000

Personal and Advertising Injury Limit (Any One Person or Organization) . . . . . . . . . . . . . . 300,000

Each Occurrence Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300,000

Damage to Premises Rented to You Limit (Any One Premises) . . . . . . . . . . . . . . . . . . . . . 100,000

Medical Expense Limit (Any One Person) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,000

ACUITY Advantages - General Liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . See CG-7300

SCHEDULE OF LIABILITY CLASSIFICATIONS

Unit Classification Class Premium Rates AdvanceNo. Description Code Basis1 Premises Products Premium

001 Janitorial Services - Products -completed operations for thisclassification are subject to theGeneral Aggregate Limit

96816 58,600 PA 17.210 Included $ 1,009.00

Advance Schedule Premium $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,009.00

1 PA = Payroll - Rates Apply Per 1,000

AUDIT PERIOD

Annual

FIRST NAMED INSURED IS:

LIMITED LIABILITY COMPANY

ADDITIONAL NAMED INSUREDS

WHO IS AN INSURED (Section II) includes the following Additional Named Insureds:

NONE

LOCATION OF ALL PREMISES YOU OWN, RENT OR OCCUPY:

Page 3

Policy Number: Z20747Effective Date: 05-12-16

CG-7000(12-08) SO 01 06/30/16

7530 TRICKLING WASH DRLAS VEGAS, NV 89131

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CG-0001R(12-11)

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

Index of Policy Provisions

Page Page

SECTION I - COVERAGES . . . . . . . . . . . . . . . 1Coverage A - Bodily Injury and PropertyDamage Liability . . . . . . . . . . . . . . . . . . . . 1Coverage B - Personal and AdvertisingInjury Liability . . . . . . . . . . . . . . . . . . . . . . 5Coverage C - Medical Payments . . . . . . . 7Supplementary Payments - Coverages Aand B . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

SECTION II - WHO IS AN INSURED . . . . . . . . 9

SECTION III - LIMITS OF INSURANCE . . . . . . 10

SECTION IV - COMMERCIAL GENERALLIABILITY CONDITIONS . . . . . . . . . . . . . . . . . 10

Bankruptcy . . . . . . . . . . . . . . . . . . . . . . . . 10Duties in the Event of Occurrence,Offense, Claim or Suit . . . . . . . . . . . . . . . . 10Legal Action Against Us . . . . . . . . . . . . . . 11Other Insurance . . . . . . . . . . . . . . . . . . . . 11Premium Audit . . . . . . . . . . . . . . . . . . . . . 12Representations . . . . . . . . . . . . . . . . . . . . 12Separation of Insureds . . . . . . . . . . . . . . . 12Transfer of Rights of Recovery AgainstOthers to Us . . . . . . . . . . . . . . . . . . . . . . . 12When We Do Not Renew . . . . . . . . . . . . . 12

SECTION V - DEFINITIONS . . . . . . . . . . . . . . . 12

CG-0001R(12-11) Page 1 of 15

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

Various provisions in this policy restrict coverage.Read the entire policy carefully to determine rights,duties and what is and is not covered.

Throughout this policy the words "you" and "your"refer to the Named Insured shown in the Declara-tions, and any other person or organization qualify-ing as a Named Insured under this policy. Thewords "we," "us" and "our" refer to the Companyproviding this insurance.

The word "insured" means any person or organiza-tion qualifying as such under Section II - Who Is anInsured.

Other words and phrases that appear in italics havespecial meaning. Refer to Section V - Definitions.

SECTION I - COVERAGES

COVERAGE A - BODILY INJURY AND PROPER-TY DAMAGE LIABILITY

1. Insuring Agreement

a. We will pay those sums that the insuredbecomes legally obligated to pay as dam-ages because of bodily injury or propertydamage to which this insurance applies. Wewill have the right and duty to defend theinsured against any suit seeking those dam-ages. However, we will have no duty todefend the insured against any suit seekingdamages for bodily injury or property dam-age to which this insurance does not apply.We may at our discretion investigate anyoccurrence and settle any claim or suit thatmay result. But:

(1) The amount we will pay for damages islimited as described in Section III - Lim-its of Insurance; and

(2) Our right and duty to defend endswhen we have used up the applicableLimit of Insurance in the payment ofjudgments or settlements under Cov-erages A or B or medical expensesunder Coverage C.

No other obligation or liability to pay sumsor perform acts or services is covered un-less explicitly provided for under Supple-mentary Payments - Coverages A and B.

b. This insurance applies to bodily injury andproperty damage only if:

(1) The bodily injury or property damage iscaused by an occurrence that takesplace in the coverage territory;

(2) The bodily injury or property damageoccurs during the policy period; and

(3) Prior to the policy period, no insuredlisted under paragraph 1 of Section II -Who Is An Insured and no employeeauthorized by you to give or receivenotice of an occurrence or claim, knewthat the bodily injury or property dam-age had occurred, in whole or in part. Ifsuch a listed insured or authorized em-

ployee knew, prior to the policy period,that the bodily injury or property dam-age occurred, then any continuation,change or resumption of such bodilyinjury or property damage during orafter the policy period will be deemedto have been known prior to the policyperiod.

c. Bodily injury or property damage which oc-curs during the policy period and was not,prior to the policy period, known to haveoccurred by any insured listed under para-graph 1 of Section II - Who Is An Insuredor any employee authorized by you to giveor receive notice of an occurrence or claim,includes any continuation, change or re-sumption of that bodily injury or propertydamage after the end of the policy period.

d. Bodily injury or property damage will bedeemed to have been known to have oc-curred at the earliest time when any insuredlisted under paragraph 1 of Section II - WhoIs An Insured or any employee authorizedby you to give or receive notice of an oc-currence or claim:

(1) Reports all, or any part, of the bodilyinjury or property damage to us or anyother insurer;

(2) Receives a written or verbal demand orclaim for damages because of the bodi-ly injury or property damage; or

(3) Becomes aware by any other meansthat bodily injury or property damagehas occurred or has begun to occur.

e. Damages because of bodily injury includedamages claimed by any person or organi-zation for care, loss of services or deathresulting at any time from the bodily injury.

2. Exclusions

This insurance does not apply to:

a. Expected or Intended Injury

Bodily injury or property damage expectedor intended from the standpoint of the in-sured. This exclusion does not apply to

CG-0001R(12-11) Page 2 of 15

bodily injury resulting from the use of rea-sonable force to protect persons or prop-erty.

b. Contractual Liability

Bodily injury or property damage for whichthe insured is obligated to pay damages byreason of the assumption of liability in acontract or agreement. This exclusion doesnot apply to liability for damages:

(1) That the insured would have in the ab-sence of the contract or agreement; or

(2) Assumed in a contract or agreementthat is an insured contract, provided thebodily injury or property damage occurssubsequent to the execution of the con-tract or agreement. Solely for the pur-poses of liability assumed in an insuredcontract, reasonable attorney fees andnecessary litigation expenses incurredby or for a party other than an insuredare deemed to be damages because ofbodily injury or property damage pro-vided:

(a) Liability to such party for, or for thecost of, that party’s defense hasalso been assumed in the sameinsured contract; and

(b) Such attorney fees and litigationexpenses are for defense of thatparty against a civil or alternativedispute resolution proceeding inwhich damages to which this insur-ance applies are alleged.

c. Liquor Liability

Bodily injury or property damage for whichany insured may be held liable by reasonof:

(1) Causing or contributing to the intoxica-tion of any person;

(2) The furnishing of alcoholic beverages toa person under the legal drinking ageor under the influence of alcohol; or

(3) Any statute, ordinance or regulation re-lating to the sale, gift, distribution oruse of alcoholic beverages.

This exclusion applies only if you are in thebusiness of manufacturing, distributing, sell-ing, serving or furnishing alcoholic bever-ages.

d. Workers’ Compensation and SimilarLaws

Any obligation of the insured under a work-ers’ compensation, disability benefits or un-employment compensation law or any simi-lar law.

e. Employer’s Liability

Bodily Injury to:

(1) An employee of the insured arising outof and in the course of:

(a) Employment by the insured; or

(b) Performing duties related to theconduct of the insured’s business;or

(2) The spouse, child, parent, brother orsister of that employee as a conse-quence of paragraph (1) above.

This exclusion applies whether the insuredmay be liable as an employer or in anyother capacity and to any obligation toshare damages with or repay someone elsewho must pay damages because of theinjury.

This exclusion does not apply to liabilityassumed by the insured under an insuredcontract.

f. Pollution

(1) Bodily injury or property damage arisingout of the actual, alleged or threateneddischarge, dispersal, seepage, migra-tion, release or escape of pollutants:

(a) At or from any premises, site orlocation which is or was at anytime owned or occupied by, or ren-ted or loaned to, any insured. How-ever, this subparagraph does notapply to:

(i) Bodily injury if sustained withina building and caused bysmoke, fumes, vapor or sootproduced by or originatingfrom equipment that is used toheat, cool or dehumidify thebuilding, or equipment that isused to heat water for per-sonal use, by the building’soccupants or their guests;

(ii) Bodily injury or property dam-age for which you may beheld liable, if you are a con-tractor and the owner or les-see of such premises, site orlocation has been added toyour policy as an additional in-sured with respect to your on-going operations performed forthat additional insured at thatpremises, site or location andsuch premises, site or locationis not and never was ownedor occupied by, or rented orloaned to, any insured, otherthan that additional insured; or

(iii) Bodily injury or property dam-age arising out of heat, smokeor fumes from a hostile fire;

CG-0001R(12-11) Page 3 of 15

(b) At or from any premises, site orlocation which is or was at anytime used by or for any insured orothers for the handling, storage,disposal, processing or treatment ofwaste;

(c) Which are or were at any timetransported, handled, stored, treat-ed, disposed of, or processed aswaste by or for:

(i) Any insured; or

(ii) Any person or organization forwhom you may be legally re-sponsible; or

(d) At or from any premises, site orlocation on which any insured orany contractors or subcontractorsworking directly or indirectly on anyinsured’s behalf are performing op-erations if the pollutants arebrought on or to the premises, siteor location in connection with suchoperations by such insured, con-tractor or subcontractor. However,this subparagraph does not applyto:

(i) Bodily injury or property dam-age arising out of the escapeof fuels, lubricants or other op-erating fluids which are need-ed to perform the normal elec-trical, hydraulic or mechanicalfunctions necessary for theoperation of mobile equipmentor its parts, if such fuels,lubricants or other operatingfluids escape from a vehiclepart designed to hold, store orreceive them. This exceptiondoes not apply if the bodilyinjury or property damage ar-ises out of the intentional dis-charge, dispersal or release ofthe fuels, lubricants or otheroperating fluids, or if such fu-els, lubricants or other operat-ing fluids are brought on or tothe premises, site or locationwith the intent that they bedischarged, dispersed or re-leased as part of the oper-ations being performed bysuch insured, contractor orsubcontractor;

(ii) Bodily injury or property dam-age sustained within a buildingand caused by the release ofgases, fumes or vapors frommaterials brought into thatbuilding in connection with op-

erations being performed byyou or on your behalf by a con-tractor or subcontractor; or

(iii) Bodily injury or property dam-age arising out of heat, smokeor fumes from a hostile fire;

(e) At or from any premises, site orlocation on which any insured orany contractors or subcontractorsworking directly or indirectly on anyinsured’s behalf are performing op-erations if the operations are to testfor, monitor, clean up, remove, con-tain, treat, detoxify or neutralize, orin any way respond to or assessthe effects of pollutants.

(2) Any loss, cost or expense arising out ofany:

(a) Request, demand, order or statu-tory or regulatory requirement thatany insured or others test for, mon-itor, clean up, remove, contain,treat, detoxify or neutralize, or inany way respond to or assess theeffects of pollutants; or

(b) Claim or suit by or on behalf of agovernmental authority for damagesbecause of testing for, monitoring,cleaning up, removing, containing,treating, detoxifying or neutralizing,or in any way responding to, or as-sessing the effects of pollutants.

However, this paragraph does not applyto liability for damages because ofproperty damage that the insured wouldhave in the absence of such request,demand, order or statutory or regulatoryrequirement, or such claim or suit by oron behalf of a governmental authority.

g. Aircraft, Auto or Watercraft

Bodily injury or property damage arising outof the ownership, maintenance, use or en-trustment to others of any aircraft, auto orwatercraft owned or operated by or rentedor loaned to any insured. Use includes op-eration and loading or unloading.

This exclusion applies even if the claimsagainst any insured allege negligence orother wrongdoing in the supervision, hiring,employment, training or monitoring of othersby that insured, if the occurrence whichcaused the bodily injury or property damageinvolved the ownership, maintenance, useor entrustment to others of any aircraft, autoor watercraft that is owned or operated byor rented or loaned to any insured.

This exclusion does not apply to:

(1) A watercraft while ashore on premisesyou own or rent;

CG-0001R(12-11) Page 4 of 15

(2) A watercraft you do not own that is:

(a) Less than 26 feet long; and

(b) Not being used to carry persons orproperty for a charge;

(3) Parking an auto on, or on the waysnext to, premises you own or rent, pro-vided the auto is not owned by or ren-ted or loaned to you or the insured;

(4) Liability assumed under any insuredcontract for the ownership, maintenanceor use of aircraft or watercraft; or

(5) Bodily injury or property damage arisingout of:

(a) The operation of machinery orequipment that is attached to, orpart of, a land vehicle that wouldqualify under the definition of mo-bile equipment if it were not subjectto a compulsory or financial re-sponsibility law or other motor ve-hicle insurance law in the statewhere it is licensed or principallygaraged; or

(b) The operation of any of the ma-chinery or equipment listed in para-graph f(2) or f(3) of the definition ofmobile equipment.

h. Mobile Equipment

Bodily injury or property damage arising outof:

(1) The transportation of mobile equipmentby an auto owned or operated by orrented or loaned to any insured; or

(2) The use of mobile equipment in, orwhile in practice for, or while being pre-pared for, any prearranged racing,speed, demolition or stunting activity.

i. War

Bodily injury or property damage, howevercaused, arising, directly or indirectly, out of:

(1) War, including undeclared or civil war;

(2) Warlike action by a military force, in-cluding action in hindering or defendingagainst an actual or expected attack, byany government, sovereign or other au-thority using military personnel or otheragents; or

(3) Insurrection, rebellion, revolution,usurped power, or action taken by gov-ernmental authority in hindering or de-fending against any of these.

j. Damage to Property

Property damage to:

(1) Property you own, rent or occupy, in-cluding any costs or expenses incurredby you, or any other person, organiza-

tion or entity, for repair, replacement,enhancement, restoration or mainten-ance of such property for any reason,including prevention of injury to a per-son or damage to another’s property;

(2) Premises you sell, give away or aban-don, if the property damage arises outof any part of those premises;

(3) Property loaned to you;

(4) Personal property in the care, custodyor control of the insured;

(5) That particular part of real property onwhich you or any contractors or sub-contractors working directly or indirectlyon your behalf are performing oper-ations, if the property damage arisesout of those operations; or

(6) That particular part of any property thatmust be restored, repaired or replacedbecause your work was incorrectly per-formed on it.

Paragraphs (1), (3) and (4) of this exclusiondo not apply to property damage (other thandamage by fire) to premises, including thecontents of such premises, rented to you for aperiod of 7 or fewer consecutive days. A sepa-rate limit of insurance applies to Damage ToPremises Rented To You as described in Sec-tion III - Limits Of Insurance.

Paragraph (2) of this exclusion does notapply if the premises are your work andwere never occupied, rented or held forrental by you.

Paragraphs (3), (4), (5) and (6) of this ex-clusion do not apply to liability assumedunder a sidetrack agreement.

Paragraph (6) of this exclusion does notapply to property damage included in theproducts-completed operations hazard.

k. Damage to Your Product

Property damage to your product arising outof it or any part of it.

l. Damage to Your Work

Property damage to your work arising out ofit or any part of it and included in theproducts-completed operations hazard.

This exclusion does not apply if the damag-ed work or the work out of which the dam-age arises was performed on your behalf bya subcontractor.

m. Damage to Impaired Property or PropertyNot Physically Injured

Property damage to impaired property orproperty that has not been physically in-jured, arising out of:

(1) A defect, deficiency, inadequacy or

CG-0001R(12-11) Page 5 of 15

dangerous condition in your product oryour work; or

(2) A delay or failure by you or anyoneacting on your behalf to perform a con-tract or agreement in accordance withits terms.

This exclusion does not apply to the loss ofuse of other property arising out of suddenand accidental physical injury to your prod-uct or your work after it has been put to itsintended use.

n. Recall of Products, Work or ImpairedProperty

Damages claimed for any loss, cost or ex-pense incurred by you or others for the lossof use, withdrawal, recall, inspection, repair,replacement, adjustment, removal or dis-posal of:

(1) Your product;

(2) Your work; or

(3) Impaired property;

if such product, work or property is with-drawn or recalled from the market or fromuse by any person or organization becauseof a known or suspected defect, deficiency,inadequacy or dangerous condition in it.

o. Personal and Advertising Injury

Bodily injury arising out of personal andadvertising injury.

p. Lead

Bodily injury or property damage arising outof the actual, alleged or threatened inges-tion, inhalation, absorption, exposure orpresence of lead in any form or from anysource.

Coverage also does not apply to any loss,cost, expense, fine or penalty arising out ofany:

(1) Request, demand or order that any in-sured or others test for, monitor, cleanup, remove, contain, treat, detoxify,neutralize, dispose of or in any wayrespond to or assess the effects of leadin any form; or

(2) Claim or suit by or on behalf of a gov-ernmental authority for damages be-cause of testing for, monitoring, clean-ing up, removing, containing, treating,detoxifying, neutralizing, disposing of orin any way responding to or assessingthe effects of lead in any form.

q. Electronic Data

Damages arising out of the loss of, loss ofuse of, damage to, corruption of, inability toaccess, or inability to manipulate electronicdata.

As used in this exclusion, electronic datameans information, facts or programs storedas or on, created or used on, or transmittedto or from computer software, including sys-tems and applications software, hard orfloppy disks, CD-ROMs, tapes, drives, cells,data processing devices or any other mediawhich are used with electronically controlledequipment.

r. Distribution of Material in Violation ofStatutes

Bodily injury or property damage arising di-rectly or indirectly out of any action or omis-sion that violates or is alleged to violate:

(1) The Telephone Consumer ProtectionAct (TCPA), including any amendmentof or addition to such law; or

(2) The CAN-SPAM Act of 2003, includingany amendment of or addition to suchlaw; or

(3) Any statute, ordinance or regulation,other than the TCPA or CAN-SPAM Actof 2003, that prohibits or limits thesending, transmitting, communicating ordistribution of material or information.

Exclusions c through n and p do not apply todamage by fire to premises while rented to youor temporarily occupied by you with permissionof the owner. A separate limit of insuranceapplies to this coverage as described in Sec-tion III - Limits of Insurance.

COVERAGE B - PERSONAL AND ADVERTISINGINJURY LIABILITY

1. Insuring Agreement

a. We will pay those sums that the insuredbecomes legally obligated to pay as dam-ages because of personal and advertisinginjury to which this insurance applies. Wewill have the right and duty to defend theinsured against any suit seeking those dam-ages. However, we will have no duty todefend the insured against any suit seekingdamages for personal and advertising injuryto which this insurance does not apply. Wemay at our discretion investigate any of-fense and settle any claim or suit that mayresult. But:

(1) The amount we will pay for damages islimited as described in Section III - Lim-its of Insurance; and

(2) Our right and duty to defend endswhen we have used up the applicableLimit of Insurance in the payment ofjudgments or settlements under Cov-erage A or B or medical expenses un-der Coverage C.

No other obligation or liability to pay sums

CG-0001R(12-11) Page 6 of 15

or perform acts or services is covered un-less explicitly provided for under Supple-mentary Payments - Coverages A and B.

b. This insurance applies to personal and ad-vertising injury caused by an offense arisingout of your business, but only if the offensewas committed in the coverage territory dur-ing the policy period.

2. Exclusions

This insurance does not apply to:

a. Knowing Violation of Rights of Another

Personal and advertising injury caused byor at the direction of the insured with theknowledge that the act would violate therights of another and would inflict personaland advertising injury.

b. Material Published with Knowledge ofFalsity

Personal and advertising injury arising outof oral or written publication of material, ifdone by or at the direction of the insuredwith knowledge of its falsity.

c. Material Published Prior to Policy Period

Personal and advertising injury arising outof oral or written publication of materialwhose first publication took place before thebeginning of the policy period.

d. Criminal Acts

Personal and advertising injury arising outof a criminal act committed by or at thedirection of any insured.

e. Contractual Liability

Personal and advertising injury for whichthe insured has assumed liability in a con-tract or agreement. This exclusion does notapply to liability for damages that the in-sured would have in the absence of thecontract or agreement.

f. Breach of Contract

Personal and advertising injury arising outof a breach of contract, except an impliedcontract to use another’s advertising idea inyour advertisement.

g. Quality or Performance of Goods - Fail-ure to Conform to Statements

Personal and advertising injury arising outof the failure of goods, products or servicesto conform with any statement of quality orperformance made in your advertisement.

h. Wrong Description of Prices

Personal and advertising injury arising outof the wrong description of the price ofgoods, products or services stated in youradvertisement.

i. Infringement of Copyright, Patent, Trade-mark or Trade Secret

Personal and advertising injury arising outof the infringement of copyright, patent,trademark, trade secret or other intellectualproperty rights. Under this exclusion, suchother intellectual property rights do not in-clude the use of another’s advertising ideain your advertisement.

However, this exclusion does not apply toinfringement, in your advertisement, ofcopyright, trade dress or slogan.

j. Insureds in Media and Internet TypeBusiness

Personal and advertising injury committedby an insured whose business is:

(1) Advertising, broadcasting, publishing ortelecasting.

(2) Designing or determining content ofwebsites for others; or

(3) An Internet search, access, content orservice provider.

However, this exclusion does not apply toparagraphs 14a, b and c of personal andadvertising injury under the Definitions Sec-tion; or

For the purposes of this exclusion, the plac-ing of frames, borders or links, or advertis-ing, for you or others anywhere on the In-ternet, is not by itself, considered the busi-ness of advertising, broadcasting, publishingor telecasting.

k. Electronic Chatrooms or Bulletin Boards

Personal and advertising injury arising outof an electronic chatroom or bulletin boardthe insured hosts, owns, or over which theinsured exercises control.

l. Unauthorized Use of Another’s Name orProduct

Personal and advertising injury arising outof the unauthorized use of another’s nameor product in your e-mail address, domainname or metatag, or any other similar tac-tics to mislead another’s potential custom-ers.

m. Pollution

Personal and advertising injury arising outof the actual, alleged or threatened dis-charge, dispersal, seepage, migration, re-lease or escape of pollutants at any time.

n. Pollution-Related

Any loss, cost or expense arising out ofany:

(1) Request, demand, order or statutory orregulatory requirement that any insuredor others test for, monitor, clean up,

CG-0001R(12-11) Page 7 of 15

remove, contain, treat, detoxify or neu-tralize, or in any way respond to orassess the effects of pollutants; or

(2) Claim or suit by or on behalf of a gov-ernmental authority for damages be-cause of testing for, monitoring, clean-ing up, removing, containing, treating,detoxifying or neutralizing, or in anyway responding to or assessing the ef-fects of pollutants.

o. Lead

Personal and advertising injury arising outof the actual, alleged or threatened inges-tion, inhalation, absorption, exposure orpresence of lead in any form or from anysource.

Coverage also does not apply to any loss,cost, expense, fine or penalty arising out ofany:

(1) Request, demand or order that any in-sured or others test for, monitor, cleanup, remove, contain, treat, detoxify,neutralize, dispose of or in any wayrespond to or assess the effects of leadin any form; or

(2) Claim or suit by or on behalf of a gov-ernmental authority for damages be-cause of testing for, monitoring, clean-ing up, removing, containing, treating,detoxifying, neutralizing, disposing of orin any way responding to or assessingthe effects of lead in any form.

p. War

Personal and advertising injury, howevercaused, arising, directly or indirectly, out of:

(1) War, including undeclared or civil war;

(2) Warlike action by a military force, in-cluding action in hindering or defendingagainst an actual or expected attack, byany government, sovereign or other au-thority using military personnel or otheragents; or

(3) Insurrection, rebellion, revolution,usurped power, or action taken by gov-ernmental authority in hindering or de-fending against any of these.

q. Distribution of Material in Violation ofStatutes

Personal and advertising injury arising di-rectly or indirectly out of any action or omis-sion that violates or is alleged to violate:

(1) The Telephone Consumer ProtectionAct (TCPA), including any amendmentof or addition to such law; or

(2) The CAN-SPAM Act of 2003, includingany amendment of or addition to suchlaw; or

(3) Any statute, ordinance or regulation,other than the TCPA or CAN-SPAM Actof 2003, that prohibits or limits thesending, transmitting, communicating ordistribution of material or information.

COVERAGE C - MEDICAL PAYMENTS

1. Insuring Agreement

a. We will pay medical expenses as describedbelow for bodily injury caused by an ac-cident:

(1) On premises you own or rent;

(2) On ways next to premises you own orrent; or

(3) Because of your operations;

provided that:

(1) The accident takes place in the cov-erage territory and during the policy pe-riod;

(2) The expenses are incurred and report-ed to us within one year of the date ofthe accident; and

(3) The injured person submits to examina-tion, at our expense, by physicians ofour choice as often as we reasonablyrequire.

b. We will make these payments regardless offault. These payments will not exceed theapplicable Limit of Insurance. We will payreasonable expenses for:

(1) First aid administered at the time of anaccident;

(2) Necessary medical, surgical, x-ray anddental services, including prosthetic de-vices; and

(3) Necessary ambulance, hospital, profes-sional nursing and funeral services.

2. Exclusions

We will not pay expenses for bodily injury:

a. Any insured.

To any insured, except volunteer workers.

b. Hired Person

To a person hired to do work for or onbehalf of any insured or a tenant of anyinsured.

c. Injury on Normally Occupied Premises

To a person injured on that part of prem-ises you own or rent that the person nor-mally occupies.

d. Workers’ Compensation and Similar Laws

To a person, whether or not an employeeof any insured, if benefits for the bodilyinjury are payable or must be provided un-der a workers’ compensation or disability

CG-0001R(12-11) Page 8 of 15

benefits law or a similar law.

e. Athletics Activities

To a person injured while practicing, in-structing or participating in any physical ex-ercises or games, sports or athletic con-tests.

f. Products-Completed Operations Hazard

Included within the products-completed op-erations hazard.

g. Coverage A Exclusions

Excluded under Coverage A.

SUPPLEMENTARY PAYMENTS - COVERAGES AAND B

1. We will pay, with respect to any claim weinvestigate or settle, or any suit against aninsured we defend:

a. All expenses we incur.

b. Up to $250 for cost of bail bonds requiredbecause of accidents or traffic law violationsarising out of the use of any vehicle towhich the Bodily Injury Liability Coverageapplies. We do not have to furnish thesebonds.

c. The cost of bonds to release attachments,but only for bond amounts within the ap-plicable Limit of Insurance. We do not haveto furnish these bonds.

d. All reasonable expenses incurred by the in-sured at our request to assist us in theinvestigation or defense of the claim or suit,including actual loss of earnings up to $250a day because of time off from work.

e. All court costs taxed against the insured inthe suit. However, these payments do notinclude attorneys’ fees or attorneys’ ex-penses taxed against the insured.

f. Prejudgment interest awarded against theinsured on that part of the judgment wepay. If we make an offer to pay the ap-plicable Limit of Insurance, we will not payany prejudgment interest based on that pe-riod of time after the offer.

g. All interest on the full amount of any judg-ment that accrues after entry of the judg-ment and before we have paid, offered topay, or deposited in court the part of thejudgment that is within the applicable Limitof Insurance.

These payments will not reduce the Limits ofInsurance.

2. If we defend an insured against a suit and anindemnitee of the insured is also named as aparty to the suit, we will defend that indemniteeif all of the following conditions are met:

a. The suit against the indemnitee seeks dam-

ages for which the insured has assumedthe liability of the indemnitee in a contractor agreement that is an insured contract;

b. This insurance applies to such liability as-sumed by the insured;

c. The obligation to defend, or the cost of thedefense of, that indemnitee, has also beenassumed by the insured in the same in-sured contract;

d. The allegations in the suit and the informa-tion we know about the occurrence aresuch that no conflict appears to exist be-tween the interests of the insured and theinterests of the indemnitee;

e. The indemnitee and the insured ask us toconduct and control the defense of that in-demnitee against such suit and agree thatwe can assign the same counsel to defendthe insured and the indemnitee; and

f. The indemnitee:

(1) Agrees in writing to:

(a) Cooperate with us in the investiga-tion, settlement or defense of thesuit;

(b) Immediately send us copies of anydemands, notices, summonses orlegal papers received in connectionwith the suit;

(c) Notify any other insurer whose cov-erage is available to the indem-nitee; and

(d) Cooperate with us with respect tocoordinating other applicable insur-ance available to the indemnitee;and

(2) Provides us with written authorizationto:

(a) Obtain records and other informa-tion related to the suit; and

(b) Conduct and control the defense ofthe indemnitee in such suit.

So long as the above conditions are met, attor-neys’ fees incurred by us in the defense of thatindemnitee, necessary litigation expenses in-curred by us and necessary litigation expensesincurred by the indemnitee at our request willbe paid as Supplementary Payments. Notwith-standing the provisions of paragraph 2b(2) ofSection I - Coverage A - Bodily Injury andProperty Damage Liability, such payments willnot be deemed to be damages for bodily injuryand property damage and will not reduce thelimits of insurance.

Our obligation to defend an insured’s indem-nitee and to pay for attorneys’ fees and neces-sary litigation expenses as Supplementary Pay-ments ends when we have used up the ap-

CG-0001R(12-11) Page 9 of 15

plicable limit of insurance in the payment ofjudgments or settlements or the conditions setforth above, or the terms of the agreement

described in paragraph f above, are no longermet.

SECTION II - WHO IS AN INSURED

1. If you are designated in the Declarations as:

a. An individual, you and your spouse are in-sureds, but only with respect to the conductof a business of which you are the soleowner.

b. A partnership or joint venture, you are aninsured. Your members, your partners andtheir spouses are also insureds, but onlywith respect to the conduct of your busi-ness.

c. A limited liability company, you are an in-sured. Your members are also insureds, butonly with respect to the conduct of yourbusiness. Your managers are insureds, butonly with respect to their duties as yourmanagers.

d. An organization other than a partnership,joint venture or limited liability company,you are an insured. Your executive officersand directors are insureds, but only withrespect to their duties as your officers ordirectors. Your stockholders are also insur-eds, but only with respect to their liability asstockholders.

e. A trust, you are an insured. Your trusteesare also insureds, but only with respect totheir duties as trustees.

2. Each of the following is also an insured:

a. Your volunteer workers only while perform-ing duties related to the conduct of yourbusiness, or your employees, other than ei-ther your executive officers (if you are anorganization other than a partnership, jointventure or limited liability company) or yourmanagers (if you are a limited liability com-pany), but only for acts within the scope oftheir employment by you or while perform-ing duties related to the conduct of yourbusiness. However, none of these employ-ees or volunteer workers are insureds for:

(1) Bodily injury or personal and advertisinginjury:

(a) To you, to your partners or mem-bers (if you are a partnership orjoint venture), to your members (ifyou are a limited liability company),to a co-employee in the course ofhis or her employment or perform-ing duties related to the conduct ofyour business, or to your other vol-unteer workers while performingduties related to the conduct of

your business.

(b) To the spouse, child, parent, broth-er or sister of that co-employee orvolunteer worker as a consequenceof paragraph (a) above;

(c) For which there is any obligation toshare damages with or repaysomeone else who must pay dam-ages because of the injury de-scribed in paragraphs (a) or (b)above; or

(d) Arising out of his or her providingor failing to provide professionalhealth care services.

(2) Property damage to property:

(a) Owned, occupied or used by;

(b) Rented to, in the care, custody orcontrol of, or over which physicalcontrol is being exercised for anypurpose by;

you, any of your employees, or volun-teer workers, any partner or member (ifyou are a partnership or joint venture),or any member (if you are a limitedliability company).

b. Any person (other than your employee) orvolunteer worker or any organization whileacting as your real estate manager.

c. Any person or organization having propertemporary custody of your property if youdie, but only:

(1) With respect to liability arising out ofthe maintenance or use of that prop-erty; and

(2) Until your legal representative has beenappointed.

d. Your legal representative if you die, but onlywith respect to duties as such. That repre-sentative will have all your rights and dutiesunder this Coverage Part.

3. Any organization you newly acquire or form,other than a partnership, joint venture or limitedliability company, and over which you maintainownership or majority interest, will qualify as aNamed Insured if there is no other similar in-surance available to that organization. How-ever:

a. Coverage under this provision is affordedonly until the 90th day after you acquire orform the organization or the end of thepolicy period, whichever is earlier;

CG-0001R(12-11) Page 10 of 15

b. Coverage A does not apply to bodily injuryor property damage that occurred beforeyou acquired or formed the organization;and

c. Coverage B does not apply to personal andadvertising injury arising out of an offense

committed before you acquired or formedthe organization.

No person or organization is an insured with respectto the conduct of any current or past partnership,joint venture or limited liability company that is notshown as a Named Insured in the Declarations.

SECTION III - LIMITS OF INSURANCE

1. The Limits of Insurance shown in the Declara-tions and the rules below fix the most we willpay regardless of the number of:

a. Insureds;

b. Claims made or suits brought; or

c. Persons or organizations making claims orbringing suits.

2. The General Aggregate Limit is the most wewill pay for:

a. The sum of:

(1) Medical expenses under Coverage C;and

(2) Damages under Coverage A, exceptdamages because of bodily injury orproperty damage included in the pro-ducts-completed operations hazard.

With respect to the above items, the Gen-eral Aggregate Limit applies separately to:

(1) Each location owned by or rented toyou. A location is a premises involvingthe same or connecting lots, or a prem-ises whose connection is interruptedonly by a street, roadway, waterway orright-of-way of a railroad, and

(2) Each of your projects away from a loca-tion owned by or rented to you; or

b. Damages under Coverage B.

3. The Products-Completed Operations AggregateLimit is the most we will pay under Coverage Afor damages because of bodily injury and prop-erty damage included in the products-complet-ed operations hazard.

4. Subject to paragraph 2 above, the Personaland Advertising Injury Limit is the most we willpay under Coverage B for the sum of all dam-ages because of all personal and advertisinginjury sustained by any one person or organiza-tion.

5. Subject to paragraph 2 or 3 above, whicheverapplies, the Each Occurrence Limit is the mostwe will pay for the sum of:

a. Damages under Coverage A; and

b. Medical expenses under Coverage C;

because of all bodily injury and property dam-age arising out of any one occurrence.

6. Subject to paragraph 5 above, the Damage ToPremises Rented To You Limit is the most wewill pay under Coverage A for damages be-cause of property damage to any one prem-ises, while rented to you for a period of 7 orfewer consecutive days or in the case of dam-age by fire, while rented to you or temporarilyoccupied by you with permission of the owner.

7. Subject to paragraph 5 above, the Medical Ex-pense Limit is the most we will pay underCoverage C for all medical expenses becauseof bodily injury sustained by any one person.

The Limits of Insurance of this Coverage Part applyseparately to each consecutive annual period and toany remaining period of less than 12 months, start-ing with the beginning of the policy period shown inthe Declarations, unless the policy period is ex-tended after issuance for an additional period of lessthan 12 months. In that case, the additional periodwill be deemed part of the last preceding period forpurposes of determining the Limits of Insurance.

SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS

1. Bankruptcy

Bankruptcy or insolvency of the insured or ofthe insured’s estate will not relieve us of ourobligations under this Coverage Part.

2. Duties in the Event of Occurrence, Offense,Claim or Suit

a. You must see to it that we are notified assoon as practicable of an occurrence or anoffense which may result in a claim. To theextent possible, notice should include:

(1) How, when and where the occurrence

or offense took place;

(2) The names and addresses of any in-jured persons and witnesses; and

(3) The nature and location of any injury ordamage arising out of the occurrenceor offense.

b. If a claim is made or suit is brought againstany insured, you must:

(1) Immediately record the specifics of theclaim or suit and the date received; and

(2) Notify us as soon as practicable.

CG-0001R(12-11) Page 11 of 15

You must see to it that we receive writtennotice of the claim or suit as soon as prac-ticable.

c. You and any other involved insured must:

(1) Immediately send us copies of any de-mands, notices, summonses or legalpapers received in connection with theclaim or suit;

(2) Authorize us to obtain records and oth-er information;

(3) Cooperate with us in the investigationor settlement of the claim or defenseagainst the suit; and

(4) Assist us, upon our request, in the en-forcement of any right against any per-son or organization which may be liableto the insured because of injury ordamage to which this insurance mayalso apply.

d. No insured will, except at that insured’s owncost, voluntarily make a payment, assumeany obligation or incur any expense, otherthan for first aid, without our consent.

3. Legal Action Against Us

No person or organization has a right underthis Coverage Part:

a. To join us as a party or otherwise bring usinto a suit asking for damages from aninsured; or

b. To sue us on this Coverage Part unless allof its terms have been fully complied with.

A person or organization may sue us to recoveron an agreed settlement or on a final judgmentagainst an insured, but we will not be liable fordamages that are not payable under the terms ofthis Coverage Part or that are in excess of theapplicable Limit of Insurance. An agreed settle-ment means a settlement and release of liabilitysigned by us, the insured and the claimant or theclaimant’s legal representative.

4. Other Insurance

If other valid and collectible insurance is avail-able to the insured for a loss we cover underCoverages A or B of this Coverage Part, ourobligations are limited as follows:

a. Primary Insurance

This insurance is primary except whenparagraph b below applies. If this insuranceis primary, our obligations are not affectedunless any of the other insurance is alsoprimary. Then, we will share with all thatother insurance by the method described inparagraph c below.

b. Excess Insurance

(1) This insurance is excess over:

(a) Any of the other insurance, whether

primary, excess, contingent or onany other basis:

(i) That is Fire, Extended Cov-erage, Builders’ Risk, Installa-tion Risk or similar coveragefor your work;

(ii) That is Fire insurance forpremises rented to you ortemporarily occupied by youwith permission of the owner;

(iii) That is insurance purchasedby you to cover your liabilityas a tenant for property dam-age to premises rented to youor temporarily occupied byyou with permission of theowner; or

(iv) If the loss arises out of themaintenance or use of aircraft,autos or watercraft to the ex-tent not subject to Exclusion gof Section I - Coverage A -Bodily Injury and PropertyDamage Liability.

(b) Any other primary insurance avail-able to you covering liability fordamages arising out of the prem-ises or operations, or the productsand completed operations for whichyou have been added as an addi-tional insured by attachment of anendorsement.

(2) When this insurance is excess, we willhave no duty under Coverage A or B todefend the insured against any suit ifany other insurer has a duty to defendthe insured against that suit. If no otherinsurer defends, we will undertake to doso, but we will be entitled to the in-sured’s rights against all those otherinsurers.

(3) When this insurance is excess overother insurance, we will pay only ourshare of the amount of the loss, if any,that exceeds the sum of:

(a) The total amount that all such otherinsurance would pay for the loss inthe absence of this insurance; and

(b) The total of all deductible and self-insured amounts under all of theother insurance.

(4) We will share the remaining loss, if any,with any other insurance that is not de-scribed in this Excess Insurance provi-sion and was not bought specifically toapply in excess of the Limits of Insur-ance shown in the Declarations of thisCoverage Part.

CG-0001R(12-11) Page 12 of 15

c. Method of Sharing

If all of the other insurance permits contribu-tion by equal shares, we will follow this meth-od also. Under this approach each insurercontributes equal amounts until it has paid itsapplicable Limit of Insurance or none of theloss remains, whichever comes first.

If any of the other insurance does not permitcontribution by equal shares, we will contri-bute by limits. Under this method, each in-surer’s share is based on the ratio of itsapplicable Limit of Insurance to the total ap-plicable Limits of Insurance of all insurers.

5. Premium Audit

a. We will compute all premiums for this Cov-erage Part in accordance with our rules andrates.

b. Premium shown in this Coverage Part asadvance premium is a deposit premiumonly. At the close of each audit period, wewill compute the earned premium for thatperiod and send notice to the First NamedInsured. The due date for audit and ret-rospective premiums is the date shown asthe due date on the bill. If the sum of theadvance and audit premiums paid for thepolicy period is greater than the earned pre-mium, we will return the excess to the FirstNamed Insured.

c. The First Named Insured must keep re-cords of the information we need for pre-mium computation, and send us copies atsuch times as we may request.

6. Representations

By accepting this policy, you agree:

a. The statements in the Declarations are ac-curate and complete;

b. Those statements are based upon repre-sentations you made to us; and

c. We have issued this policy in reliance uponyour representations.

7. Separation of Insureds

Except with respect to the Limits of Insuranceand any rights or duties specifically assigned inthis Coverage Part to the First Named Insured,this insurance applies:

a. As if each Named Insured were the onlyNamed Insured; and

b. Separately to each insured against whomclaim is made or suit is brought.

8. Transfer of Rights of Recovery Against Oth-ers to Us

If the insured has rights to recover all or part ofany payment we have made under this Cov-erage Part, those rights are transferred to us.The insured must do nothing after loss to im-pair them. At our request, the insured will bringsuit or transfer those rights to us and help usenforce them.

9. When We Do Not Renew

If we decide not to renew this Coverage Part,we will mail or deliver to the First Named In-sured shown in the Declarations, written noticeof nonrenewal not less than 30 days before theexpiration date.

If notice is mailed, proof of mailing will besufficient proof of notice.

SECTION V - DEFINITIONS

1. "Advertisement" means a notice that is broad-cast or published to the general public or spe-cific market segments about your goods, pro-ducts or services for the purpose of attractingcustomers or supporters. For the purposes ofthis definition:

a. Notices that are published include materialplaced on the Internet or on similar elec-tronic means of communication; and

b. Regarding web-sites, only that part of aweb-site that is about your goods, productsor services for the purposes of attractingcustomers or supporters is considered anadvertisement.

2. "Auto" means:

a. A land motor vehicle, trailer or semitrailerdesigned for travel on public roads, includ-ing any attached machinery or equipment;or

b. Any other land vehicle that is subject to acompulsory or financial responsibility law orother motor vehicle insurance law in thestate where it is licensed or principally ga-raged.

However, auto does not include mobile equip-ment.

3. "Bodily injury" means bodily injury, sickness ordisease sustained by a person, including deathresulting from any of these at any time.

4. "Coverage territory" means:

a. The United States of America (including itsterritories and possessions), Puerto Ricoand Canada;

b. International waters or airspace, but only ifthe injury or damage occurs in the courseof travel or transportation between anyplaces not included in paragraph a above;or

CG-0001R(12-11) Page 13 of 15

c. All other parts of the world if the injury ordamage arises out of:

(1) Goods or products made or sold by youin the territory described in paragraph aabove;

(2) The activities of a person whose homeis in the territory described in paragrapha above, but is away for a short timeon your business; or

(3) Personal and advertising injury offensesthat take place through the Internet orsimilar electronic means of communica-tion;

provided the insured’s responsibility to paydamages is determined in a suit on the merits,in the territory described in paragraph a aboveor in a settlement we agree to.

5. "Employee" includes a leased worker. Employ-ee does not include a temporary worker.

6. "Executive officer" means a person holding anyof the officer positions created by your charter,constitution, by-laws or any other similar gov-erning document.

7. "Hostile fire" means one which becomes un-controllable or breaks out from where it wasintended to be.

8. "Impaired property" means tangible property,other than your product or your work, that can-not be used or is less useful because:

a. It incorporates your product or your workthat is known or thought to be defective,deficient, inadequate or dangerous; or

b. You have failed to fulfill the terms of acontract or agreement;

if such property can be restored to use by therepair, replacement, adjustment or removal ofyour product or your work or your fulfilling theterms of the contract or agreement.

9. "Insured contract" means:

a. A contract for a lease of premises. How-ever, that portion of the contract for a leaseof premises that indemnifies any person ororganization for damage by fire to premiseswhile rented to you or temporarily occupiedby you with permission of the owner is notan insured contract;

b. A sidetrack agreement;

c. Any easement or license agreement, exceptin connection with construction or demolitionoperations on or within 50 feet of a railroad;

d. An obligation, as required by ordinance, toindemnify a municipality, except in connec-tion with work for a municipality;

e. An elevator maintenance agreement; or

f. That part of any other contract or agree-ment pertaining to your business (including

an indemnification of a municipality in con-nection with work performed for a munici-pality) under which you assume the tortliability of another party to pay for bodilyinjury or property damage to a third personor organization. Tort liability means a liabil-ity that would be imposed by law in theabsence of any contract or agreement.

Paragraph f does not include that part ofany contract or agreement:

(1) That indemnifies a railroad for bodilyinjury or property damage arising out ofconstruction or demolition operations,within 50 feet of any railroad propertyand affecting any railroad bridge ortrestle, tracks, road-beds, tunnel, under-pass or crossing;

(2) That indemnifies an architect, engineeror surveyor for injury or damage arisingout of:

(a) Preparing, approving or failing toprepare or approve maps, shopdrawings, opinions, reports, sur-veys, field orders, change orders ordrawings and specifications; or

(b) Giving directions or instructions, orfailing to give them, if that is theprimary cause of the injury or dam-age; or

(3) Under which the insured, if an architect,engineer or surveyor, assumes liabilityfor an injury or damage arising out ofthe insured’s rendering or failure to ren-der professional services, includingthose listed in (2) above and supervi-sory, inspection, architectural or engi-neering activities.

10. "Leased worker" means a person leased to youby a labor leasing firm under an agreementbetween you and the labor leasing firm, toperform duties related to the conduct of yourbusiness. Leased worker does not include atemporary worker.

11. "Loading or unloading" means the handling ofproperty:

a. After it is moved from the place where it isaccepted for movement into or onto an air-craft, watercraft or auto;

b. While it is in or on an aircraft, watercraft orauto; or

c. While it is being moved from an aircraft,watercraft or auto to the place where it isfinally delivered;

but loading or unloading does not include themovement of property by means of a mechani-cal device, other than a hand truck, that is notattached to the aircraft, watercraft or auto.

12. "Mobile equipment" means any of the following

CG-0001R(12-11) Page 14 of 15

types of land vehicles, including any attachedmachinery or equipment:

a. Bulldozers, farm machinery, forklifts andother vehicles designed for use principallyoff public roads;

b. Vehicles maintained for use solely on ornext to premises you own or rent;

c. Vehicles that travel on crawler-treads;

d. Vehicles, whether self-propelled or not,maintained primarily to provide mobility topermanently mounted:

(1) Power cranes, shovels, loaders, diggersor drills; or

(2) Road construction or resurfacing equip-ment such as graders, scrapers or roll-ers.

e. Vehicles not described in paragraph a, b, cor d above that are not self-propelled andare maintained primarily to provide mobilityto permanently attached equipment of thefollowing types:

(1) Air compressors, pumps and gener-ators, including spraying, welding, build-ing cleaning, geophysical exploration,lighting and well servicing equipment; or

(2) Cherry pickers and similar devices usedto raise or lower workers.

f. Vehicles not described in paragraph a, b, c,or d above maintained primarily for pur-poses other than the transportation of per-sons or cargo.

However, self-propelled vehicles with thefollowing types of permanently attachedequipment are not mobile equipment butwill be considered autos:

(1) Equipment designed primarily for:

(a) Snow removal;

(b) Road maintenance, but not con-struction or resurfacing; or

(c) Street cleaning.

(2) Cherry pickers and similar devicesmounted on automobile or truck chassisand used to raise or lower workers; and

(3) Air compressors, pumps and gener-ators, including spraying, welding, build-ing cleaning, geophysical exploration,lighting and well servicing equipment.

However, mobile equipment does not includeany land vehicles that are subject to a compul-sory or financial responsibility law or other mo-tor vehicle insurance law in the state where it islicensed or principally garaged. Land vehiclessubject to a compulsory or financial responsibil-ity law or other motor vehicle insurance law areconsidered autos.

13. "Occurrence" means an accident, including

continuous or repeated exposure to substan-tially the same general harmful conditions.

14. "Personal and advertising injury" means injury,including consequential bodily injury, arising outof one or more of the following offenses:

a. False arrest, detention or imprisonment;

b. Malicious prosecution;

c. The wrongful eviction from, wrongful entryinto, or invasion of the right of private occu-pancy of a room, dwelling or premises thata person occupies, committed by or on be-half of its owner, landlord or lessor;

d. Oral or written publication, in any manner,of material that slanders or libels a personor organization or disparages a person’s ororganization’s goods, products or services;

e. Oral or written publication, in any manner,of material that violates a person’s right ofprivacy;

f. The use of another’s advertising idea inyour advertisement; or

g. Infringing upon another’s copyright, tradedress or slogan in your advertisement.

15. "Pollutants" means any solid, liquid, gaseous orthermal irritant or contaminant, includingsmoke, vapor, soot, fumes, acids, alkalis,chemicals and waste. Waste includes materialto be recycled, reconditioned or reclaimed.

16. "Products-completed operations hazard:"

a. Includes all bodily injury and property dam-age occurring away from premises you ownor rent and arising out of your product oryour work except:

(1) Products that are still in your physicalpossession; or

(2) Work that has not yet been completedor abandoned. However, your work willbe deemed completed at the earliest ofthe following times:

(a) When all of the work called for inyour contract has been completed.

(b) When all of the work to be done atthe job site has been completed ifyour contract calls for work at morethan one job site.

(c) When that part of the work done ata job site has been put to its in-tended use by any person or or-ganization other than another con-tractor or subcontractor working onthe same project.

Work that may need service, mainten-ance, correction, repair or replacement,but which is otherwise complete, will betreated as completed.

b. Does not include bodily injury or property

CG-0001R(12-11) Page 15 of 15

damage arising out of:

(1) The transportation of property, unlessthe injury or damage arises out of acondition in or on a vehicle not ownedor operated by you, and that conditionwas created by the loading or unload-ing of that vehicle by any insured;

(2) The existence of tools, uninstalledequipment or abandoned or unusedmaterials; or

(3) Products or operations for which theclassification, listed in the Declarationsor in a policy schedule, states that pro-ducts-completed operations are subjectto the General Aggregate Limit.

17. "Property damage" means:

a. Physical injury to tangible property, includ-ing all resulting loss of use of that property.All such loss of use shall be deemed tooccur at the time of the physical injury thatcaused it; or

b. Loss of use of tangible property that is notphysically injured. All such loss of use shallbe deemed to occur at the time of theoccurrence that caused it.

For the purposes of this insurance, electronicdata is not tangible property.

As used in this definition, electronic datameans information, facts or programs stored asor on, created or used on, transmitted to orfrom computer software, including systems andapplications software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing de-vices or any other media which are used withelectronically controlled equipment.

18. "Suit" means a civil proceeding in which dam-ages because of bodily injury, property damageor personal and advertising injury to which thisinsurance applies are alleged. Suit includes:

a. An arbitration proceeding in which suchdamages are claimed and to which the in-sured must submit or does submit with ourconsent; or

b. Any other alternative dispute resolution pro-ceeding in which such damages areclaimed and to which the insured submitswith our consent.

19. "Temporary worker" means a person who isfurnished to you to substitute for a permanentemployee on leave or to meet seasonal or

short-term workload conditions.

20. "Volunteer worker" means a person who is notyour employee, and who donates his or herwork and acts at the direction of and within thescope of duties determined by you, and is notpaid a fee, salary or other compensation byyou or anyone else for their work performed foryou.

21. "Your product:"

a. Means:

(1) Any goods or products other than realproperty, manufactured, sold, handled,distributed or disposed of by:

(a) You;

(b) Others trading under your name; or

(c) A person or organization whosebusiness or assets you have ac-quired; and

(2) Containers (other than vehicles), ma-terials, parts or equipment furnished inconnection with such goods or pro-ducts.

b. Includes:

(1) Warranties or representations made atany time with respect to the fitness,quality, durability, performance or useof your product; and

(2) The providing of or failure to providewarnings or instructions.

c. Does not include vending machines or otherproperty rented to or located for the use ofothers but not sold.

22. "Your work:"

a. Means:

(1) Work or operations performed by youor on your behalf; and

(2) Materials, parts or equipment furnishedin connection with such work or oper-ations.

b. Includes:

(1) Warranties or representations made atany time with respect to the fitness,quality, durability, performance or useof your work; and

(2) The providing of or failure to providewarnings or instructions.

.

(continued next page)CG-2187R(1-15)

CONDITIONAL EXCLUSION OF TERRORISM (RELATING TO DISPOSITIONOF FEDERAL TERRORISM RISK INSURANCE ACT)

CG-2187R(1-15)

This endorsement modifies insurance provided underthe following:COMMERCIAL GENERAL LIABILITY COVERAGE PARTLIQUOR LIABILITY COVERAGE PARTOWNERS AND CONTRACTORS PROTECTIVE LIABILITYCOVERAGE PARTPOLLUTION LIABILITY COVERAGE PARTPRODUCTS/COMPLETED OPERATIONS LIABILITY COV-ERAGE PARTRAILROAD PROTECTIVE LIABILITY COVERAGE PART

A. Applicability Of The Provisions Of This En-dorsement

1. The provisions of this endorsement willbecome applicable commencing on thedate when any one or more of the fol-lowing first occurs. But if your policy(meaning the policy period in which thisendorsement applies) begins after suchdate, then the provisions of this en-dorsement become applicable on thedate your policy begins.

a. The federal Terrorism Risk InsuranceProgram ("Program"), established bythe Terrorism Risk Insurance Act,has terminated with respect to thetype of insurance provided underthis Coverage Part or Policy; or

b. A renewal, extension or replacementof the Program has become effectivewithout a requirement to make ter-rorism coverage available to you andwith revisions that:

(1) Increase our statutory percent-age deductible under the Pro-gram for terrorism losses. (Thatdeduct ib le de te rmines theamount of all certified terrorismlosses we must pay in a calen-dar year, before the federal gov-ernment shares in subsequentpayment of certified terrorismlosses.); or

(2) Decrease the federal govern-ment’s statutory percentage sharein potential terrorism lossesabove such deductible; or

(3) Redefine terrorism or make in-surance coverage for terrorismsubject to provisions or require-ments that differ from those thatapply to other types of events oroccurrences under this policy.

2. If the provisions of this endorsement be-come applicable, such provisions:

a. Supersede any terrorism endorse-

ment already endorsed to this policythat addresses certified acts of ter-rorism and/or other acts of terrorism,but only with respect to an inci-dent(s) of terrorism (however de-fined) which results in injury or dam-age that occurs on or after the datewhen the provisions of this endorse-ment become applicable (for claimsmade policies, such an endorsementis superseded only with respect toan incident of terrorism (however de-fined) that results in a claim for in-jury or damage first being made onor after the date when the provisionsof this endorsement become applica-ble); and

b. Remain applicable unless we notifyyou of changes in these provisions,in response to federal law.

3. If the provisions of this endorsement doNOT become applicable, any terrorismendorsement already endorsed to thispolicy, that addresses certified acts ofterrorism and/or other acts of terrorism,will continue in effect unless we notifyyou of changes to that endorsement inresponse to federal law.

B. The following definitions are added and applyunder this endorsement wherever the term ter-rorism, or the phrase any injury or damage, areshown in italics:

1. "Terrorism" means activities against per-sons, organizations or property of any na-ture:

a. That involve the following or preparationfor the following:

(1) Use or threat of force or violence;or

(2) Commission or threat of a danger-ous act; or

(3) Commission or threat of an act thatinterferes with or disrupts an elec-tronic, communication, information,or mechanical system; and

b. When one or both of the following ap-plies:

(1) The effect is to intimidate or coercea government or the civilian popu-lation or any segment thereof, or todisrupt any segment of the econo-my; or

(2) It appears that the intent is to in-timidate or coerce a government, orto further political, ideological, reli-

gious, social or economic objec-tives or to express (or express op-position to) a philosophy or ideolo-gy.

2. "Any injury or damage" means any injury ordamage covered under any Coverage Partor Policy to which this endorsement is ap-plicable, and includes but is not limited tobodily injury, property damage, personaland advertising injury, injury or environmen-tal damage as may be defined in any ap-plicable Coverage Part or Policy.

C. The following exclusion is added:

EXCLUSION OF TERRORISM

We will not pay for any injury or damagecaused directly or indirectly by terrorism, includ-ing action in hindering or defending against anactual or expected incident of terrorism. Anyinjury or damage is excluded regardless of anyother cause or event that contributes concur-rently or in any sequence to such injury ordamage. But this exclusion applies onlywhen one or more of the following are at-tributed to an incident of terrorism:

1. The terrorism is carried out by means of thedispersal or application of radioactive ma-terial, or through the use of a nuclear weap-on or device that involves or produces anuclear reaction, nuclear radiation or radio-active contamination; or

2. Radioactive material is released, and it ap-pears that one purpose of the terrorism wasto release such material; or

3. The terrorism is carried out by means of thedispersal or application of pathogenic orpoisonous biological or chemical materi-als; or

4. Pathogenic or poisonous biological orchemical materials are released, and it ap-pears that one purpose of the terrorism wasto release such materials; or

5. The total of insured damage to all types ofproperty exceeds $25,000,000. In determin-

ing whether the $25,000,000 threshold isexceeded, we will include all insured dam-age sustained by property of all personsand entities affected by the terrorism andbusiness interruption losses sustained byowners or occupants of the damaged prop-erty. For the purpose of this provision, in-sured damage means damage that is cov-ered by any insurance plus damage thatwould be covered by any insurance but forthe application of any terrorism exclusions;or

6. Fifty or more persons sustain death or se-rious physical injury. For the purposes ofthis provision, serious physical injurymeans:

a. Physical injury that involves a substan-tial risk of death; or

b. Protracted and obvious physical disfig-urement; or

c. Protracted loss of or impairment of thefunction of a bodily member or organ.

Multiple incidents of terrorism which occur with-in a 72-hour period and appear to be carriedout in concert or to have a related purpose orcommon leadership will be deemed to be oneincident, for the purpose of determining wheth-er the thresholds in Paragraphs C5 or C6 areexceeded.

With respect to this Exclusion, Paragraphs C5and C6 describe the threshold used to measurethe magnitude of an incident of terrorism andthe circumstances in which the threshold willapply, for the purpose of determining whetherthis Exclusion will apply to that incident. Whenthe Exclusion applies to an incident of terror-ism, there is no coverage under this CoveragePart or Policy.

The terms and limitations of any terrorism ex-clusion, or the inapplicability or omission of aterrorism exclusion, do not serve to create cov-erage for injury or damage that is otherwiseexcluded under this Coverage Part.

SNOW PLOW OPERATIONS COVERAGE CG-2292F(12-07)

This endorsement modifies insurance provided underthe following:COMMERCIAL GENERAL LIABILITY COVERAGE PART

Within the products-completed operations hazard,

Exclusion g under Section I - Coverage A - BodilyInjury And Property Damage Liability does not applyto any auto used for snow plow operations.

(continued next page)

NUCLEAR ENERGY LIABILITY EXCLUSION - BROAD FORM IL-0021F(3-14)

This endorsement modifies insurance provided underthe following:COMMERCIAL AUTO COVERAGE PARTCOMMERCIAL GENERAL LIABILITY COVERAGE PARTDIRECTORS’ AND OFFICERS’ LIABILITY COVERAGEPARTEMPLOYEE BENEFITS LIABILITY COVERAGE PARTERRORS AND OMISSIONS COVERAGE PARTFARM COVERAGE PARTLIQUOR LIABILITY COVERAGE FORMOWNERS AND CONTRACTORS PROTECTIVE LIABILITYCOVERAGE FORMPOLLUTION LIABILITY COVERAGE FORMPRODUCT WITHDRAWAL COVERAGE PARTPRODUCTS-COMPLETED OPERATIONS LIABILITY COV-ERAGE FORMRAILROAD PROTECTIVE LIABILITY COVERAGE FORM

1. The insurance does not apply:

a. Under any Liability Coverage to bodily injuryor property damage:

(1) With respect to which an insured underthe policy is also an insured under anuclear energy liability policy issued byNuclear Energy Liability Insurance Asso-ciation, Mutual Atomic Energy LiabilityUnderwriters, Nuclear Insurance Associ-ation of Canada or any of their succes-sors, or would be an insured under anysuch policy but for its termination uponexhaustion of its limit of liability; or

(2) Resulting from the hazardous propertiesof nuclear material and with respect towhich:

(a) Any person or organization is re-quired to maintain financial protec-tion pursuant to the Atomic EnergyAct of 1954 or any law amendatorythereof; or

(b) The insured is, or had this policynot been issued would be, entitledto indemnity from the United Statesof America, or any agency thereof,under any agreement entered intoby the United States of America, orany agency thereof, with any per-son or organization.

b. Under any Medical Payments coverage, toexpenses incurred with respect to bodily in-jury resulting from the hazardous propertiesof nuclear material and arising out of theoperation of a nuclear facility by any personor organization.

c. Under any Liability Coverage, to bodily in-jury or property damage resulting from thehazardous properties of nuclear material, if:

(1) The nuclear material:

(a) Is at any nuclear facility owned by,or operated by or on behalf of, aninsured; or

(b) Has been discharged or dispersedtherefrom.

(2) The nuclear material is contained inspent fuel or waste at any time pos-sessed, handled, used, processed,stored, transported or disposed of by oron behalf of an insured; or

(3) The bodily injury or property damagearises out of the furnishing by an in-sured of services, materials, parts orequipment in connection with the plan-ning, construction, maintenance, opera-tion or use of any nuclear facility, but ifsuch facility is located within the UnitedStates of America, its territories or pos-sessions or Canada, this exclusion (3)applies only to property damage tosuch nuclear facility and any propertythereat.

2. As used in this endorsement:

a. "Hazardous properties" include radioactive,toxic or explosive properties.

b. "Nuclear material" means source material,special nuclear material or byproduct ma-terial.

c. "Source material," "special nuclear material"and "byproduct material" have the meaningsgiven them in the Atomic Energy Act of 1954or in any law amendatory thereof.

d. "Spent fuel" means any fuel element or fuelcomponent, solid or liquid, which has beenused or exposed to radiation in a nuclearreactor.

e. "Waste" means any waste material:

(1) Containing byproducts material otherthan the tailings or wastes produced bythe extraction or concentration of ura-nium or thorium from any ore proces-sed primarily for its source materialcontent; and

(2) Resulting from the operation by any per-son or organization of any nuclear facilityincluded under the first two paragraphsof the definition of nuclear facility.

f. "Nuclear facility" means:

(1) Any nuclear reactor;

(2) Any equipment or device designed orused for:

(a) Separating the isotopes of uraniumor plutonium;

(b) Processing or utilizing spent fuel; or

(c) Handling, processing or packagingwaste.

(3) Any equipment or device used for theprocessing, fabricating or alloying ofspecial nuclear material if at any timethe total amount of such material in thecustody of the insured at the premiseswhere such equipment or device is lo-cated consists of or contains more than25 grams of plutonium or uranium 233or any combination thereof, or morethan 250 grams of uranium 235.

(4) Any structure, basin, excavation, prem-

ises or place prepared or used for thestorage or disposal of waste;

and includes the site on which any of theforegoing is located, all operations conduct-ed on such site and all premises used forsuch operations.

g. "Nuclear reactor" means any apparatus de-signed or used to sustain nuclear fission ina self-supporting chain reaction or to con-tain a critical mass of fissionable material.

h. "Property damage" includes all forms of ra-dioactive contamination of property.

RECORDING AND DISTRIBUTION OF MATERIAL OR INFORMATION INVIOLATION OF LAW EXCLUSION

CG-0068F(5-09)

This endorsement modifies insurance provided underthe following:COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. Exclusion r of paragraph 2 Exclusions of Sec-tion I - Coverage A - Bodily Injury And PropertyDamage Liability is replaced by the following:

2. Exclusions

This insurance does not apply to:

r. Recording And Distribution Of Mate-rial Or Information In Violation Of Law

Bodily injury or property damage arisingdirectly or indirectly out of any action oromission that violates or is alleged toviolate:

(1) The Telephone Consumer ProtectionAct (TCPA), including any amend-ment of or addition to such law;

(2) The CAN-SPAM Act of 2003, in-cluding any amendment of or addi-tion to such law;

(3) The Fair Credit Reporting Act(FCRA), and any amendment of oraddition to such law, including theFair and Accurate Credit Transac-tion Act (FACTA); or

(4) Any federal, state or local statute,ordinance or regulation, other thanthe TCPA, CAN-SPAM Act of 2003or FCRA and their amendmentsand additions, that addresses, pro-hibits, or limits the printing, dis-semination, disposal, collecting, re-cording, sending, transmitting, com-municating or distribution of mate-rial or information.

B. Exclusion q of paragraph 2 Exclusions of Sec-tion I - Coverage B - Personal And AdvertisingInjury Liability is replaced by the following:

2. Exclusions

This insurance does not apply to:

q. Recording And Distribution Of Ma-terial Or Information In Violation OfLaw

Personal and advertising injury arisingdirectly or indirectly out of any action oromission that violates or is alleged toviolate:

(1) The Telephone Consumer Protec-tion Act (TCPA), including anyamendment of or addition to suchlaw;

(2) The CAN-SPAM Act of 2003, in-cluding any amendment of or addi-tion to such law;

(3) The Fair Credit Reporting Act(FCRA), and any amendment of oraddition to such law, including theFair and Accurate Credit Transac-tion Act (FACTA); or

(4) Any federal, state or local statute,ordinance or regulation, other thanthe TCPA, CAN-SPAM Act of 2003or FCRA and their amendmentsand additions, that addresses, pro-hibits, or limits the printing, dis-semination, disposal, collecting, re-cording, sending, transmitting, com-municating or distribution of mate-rial or information.

CG-7321(1-15)

CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM CG-7321(1-15)

This endorsement modifies insurance provided underthe following:

COMMERCIAL GENERAL LIABILITY COVERAGE PARTLIQUOR LIABILITY COVERAGE FORMOWNERS AND CONTRACTORS PROTECTIVE LIABILITYCOVERAGE FORMPOLLUTION LIABILITY COVERAGE FORMPRODUCTS/COMPLETED OPERATIONS LIABILITY COV-ERAGE FORMRAILROAD PROTECTIVE LIABILITY COVERAGE FORM

A. If aggregate insured losses attributable to ter-rorist acts certified under the federal TerrorismRisk Insurance Act exceed $100 billion in acalendar year and we have met our insurerdeductible under the Terrorism Risk InsuranceAct, we shall not be liable for the payment ofany portion of the amount of such losses thatexceeds $100 billion, and in such case insuredlosses up to that amount are subject to pro rataallocation in accordance with procedures estab-lished by the Secretary of the Treasury.

"Certified act of terrorism" means an act that iscertified by the Secretary of the Treasury, in

accordance with the provisions of the federalTerrorism Risk Insurance Act, to be an act ofterrorism pursuant to such Act. The criteriacontained in the Terrorism Risk Insurance Actfor a certified act of terrorism include the fol-lowing:

1. The act resulted in insured losses in excessof $5 million in the aggregate, attributable toall types of insurance subject to the Terror-ism Risk Insurance Act; and

2. The act is a violent act or an act that isdangerous to human life, property or infra-structure and is committed by an individualor individuals as part of an effort to coercethe civilian population of the United Statesor to influence the policy or affect the con-duct of the United States Government bycoercion.

B. The terms and limitations of any terrorism ex-clusion, or the inapplicability or omission of aterrorism exclusion, do not serve to create cov-erage for injury or damage that is otherwiseexcluded under this Coverage Part.

CG-7323(1-15)

EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OFTERRORISM

CG-7323(1-15)

This endorsement modifies insurance provided underthe following:COMMERCIAL GENERAL LIABILITY COVERAGE PARTLIQUOR LIABILITY COVERAGE FORMOWNERS AND CONTRACTORS PROTECTIVE LIABILITYCOVERAGE FORMPOLLUTION LIABILITY COVERAGE FORMPRODUCTS/COMPLETED OPERATIONS LIABILITY COV-ERAGE FORMRAILROAD PROTECTIVE LIABILITY COVERAGE FORM

A. The following exclusion is added:

This insurance does not apply to:

TERRORISM PUNITIVE DAMAGES

Damages arising, directly or indirectly, out of acertified act of terrorism that are awarded aspunitive damages.

B. The following definition is added:

"Certified act of terrorism" means an act that iscertified by the Secretary of the Treasury, inaccordance with the provisions of the federalTerrorism Risk Insurance Act, to be an act of

terrorism pursuant to such Act. The criteriacontained in the Terrorism Risk Insurance Actfor a certified act of terrorism include the fol-lowing:

1. The act resulted in insured losses in excessof $5 million in the aggregate, attributable toall types of insurance subject to the Terror-ism Risk Insurance Act; and

2. The act is a violent act or an act that isdangerous to human life, property or infra-structure and is committed by an individualor individuals as part of an effort to coercethe civilian population of the United Statesor to influence the policy or affect the con-duct of the United States Government bycoercion.

C. The terms and limitations of any terrorism ex-clusion, or the inapplicability or omission of aterrorism exclusion, do not serve to create cov-erage for injury or damage that is otherwiseexcluded under this Coverage Part.

IL-7082(1-15)

DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT IL-7082(1-15)

THIS ENDORSEMENT IS ATTACHED TO ANDMADE PART OF YOUR POLICY IN RESPONSE TOTHE DISCLOSURE REQUIREMENTS OF THETERRORISM RISK INSURANCE ACT. THIS EN-DORSEMENT DOES NOT GRANT ANY COVER-AGE OR CHANGE THE TERMS AND CONDITIONSOF ANY COVERAGE UNDER THE POLICY.

A. Disclosure Of Premium

In accordance with the federal Terrorism RiskInsurance Act, we are required to provide youwith a notice disclosing the portion of yourpremium, if any, attributable to coverage forterrorist acts certified under the Terrorism RiskInsurance Act. The portion of your premiumattributable to such coverage is shown in thepolicy Declarations.

B. Disclosure Of Federal Participation In Pay-ment Of Terrorism Losses

The United States Government, Department ofthe Treasury, will pay a share of terrorismlosses insured under the federal program. Thefederal share equals a percentage of that por-tion of the amount of such insured losses thatexceeds the applicable insurer retention. The

federal share percentage is 85% through 2015;84% beginning on January 1, 2016; 83% begin-ning on January 1, 2017; 82% beginning onJanuary 1, 2018; 81% beginning on January 1,2019; and 80% beginning on January 1, 2020.However, if aggregate insured losses attribut-able to terrorist acts certified under the Terror-ism Risk Insurance Act exceed $100 billion in acalendar year, the Treasury shall not make anypayment for any portion of the amount of suchlosses that exceeds $100 billion.

C. Cap On Insurer Participation In Payment OfTerrorism Losses

If aggregate insured losses attributable to ter-rorist acts certified under the Terrorism RiskInsurance Act exceed $100 billion in a calendaryear and we have met our insurer deductibleunder the Terrorism Risk Insurance Act, weshall not be liable for the payment of any por-tion of the amount of such losses that exceeds$100 billion, and in such case insured lossesup to that amount are subject to pro rata al-location in accordance with procedures estab-lished by the Secretary of the Treasury.

DEDUCTIBLE LIABILITY INSURANCE CG-0300F(1-96)

This endorsement modifies insurance provided underthe following:COMMERCIAL GENERAL LIABILITY COVERAGE PARTPRODUCTS-COMPLETED OPERATIONS LIABILITYCOVERAGE FORM

1. Our obligation under the Bodily Injury Liability andProperty Damage Liability Coverages to pay damageson your behalf applies only to the amount of damagesin excess of any deductible amounts stated in theSchedule as applicable to such coverages.

2. You may select a deductible amount on either aper claim or a per occurrence basis. Your selecteddeductible applies to the coverage option and to thebasis of the deductible indicated by the coverageoption and to the basis of the deductible indicated bythe placement of the deductible amount in theSchedule. The deductible amount stated in theSchedule applies as follows:

a. Per Claim Basis - If the deductible amount in-dicated in the Schedule is on a per claim basis, thatdeductible applies as follows:

(1) Under Bodily Injury Liability Coverage, to alldamages sustained by any one person becauseof bodily injury;

(2) Under Property Damage Liability Coverage,to all damages sustained by any one personbecause of property damage; or

(3) Under Bodily Injury Liability and PropertyDamage Liability Coverage combined, to all dam-ages sustained by any one person because of:

(a) Bodily injury;

(b) Property damage; or

(c) Bodily injury and property damage combined;

as the result of any one occurrence.

If damages are claimed for care, loss of services ordeath resulting at any time from bodily injury, aseparate deductible amount will be applied to each

person making a claim for such damages.

With respect to property damage, person in-cludes an organization.

b. Per Occurrence Basis - If the deductible amountindicated in the Schedule is on a per occurrencebasis, that deductible amount applies as follows:

(1) Under Bodily Injury Liability Coverage, to alldamages because of bodily injury;

(2) Under Property Damage Liability Coverage,to all damages because of property damage; or

(3) Under Bodily Injury Liability and PropertyDamage Liability Coverage combined, to all dam-ages because of:

(a) Bodily injury;

(b) Property damage; or

(c) Bodily injury and property damage combined;

as the result of any one occurrence, regardlessof the number of persons or organizations whosustain damages because of that occurrence.

With respect to property damage, person in-cludes an organization.

3. The terms of this insurance, including those withrespect to:

a. Our right and duty to defend the insured againstany suits seeking those damages; and

b. Your duties in the event of an occurrence, claimor suit;

apply irrespective of the application of the deductibleamount.

4. We may pay any part or all of the deductibleamount to effect settlement of any claim or suit andupon notification of the action taken, you shall prom-ptly reimburse us for such part of the deductibleamount as has been paid by us.

SCHEDULE

Applicable Coverage Amount and Basis of Deductible(per claim) (per occurrence)

BODILY INJURY LIABILITY $ 1,000

Application of Endorsement

Enter below any limitations on the application of this endorsement. If nolimitation is entered, the deductibles apply to damages for all bodily injuryand property damage, however caused.

NEVADA CHANGES - CANCELLATION AND NONRENEWAL IL-0251F(9-07)

This endorsement modifies insurance provided underthe following:COMMERCIAL AUTOMOBILE COVERAGE PARTCOMMERCIAL CRIME COVERAGE PARTCOMMERCIAL GENERAL LIABILITY COVERAGE PARTCOMMERCIAL INLAND MARINE COVERAGE PARTCOMMERCIAL PROPERTY COVERAGE PARTDIRECTORS’ AND OFFICERS’ LIABILITY COVERAGEPARTEMPLOYEE BENEFITS LIABILITY COVERAGE PARTEMPLOYMENT-RELATED PRACTICES LIABILITY COV-ERAGE PARTERRORS AND OMISSIONS COVERAGE PARTLIQUOR LIABILITY COVERAGE FORMPRODUCT WITHDRAWAL COVERAGE PARTPRODUCTS/COMPLETED OPERATIONS LIABILITY COV-ERAGE FORM

A. The following are added to the CancellationCommon Policy Condition:

7. a. Midterm Cancellation

If this policy has been in effect for 70days or more, or if this policy is a re-newal of a policy we issued, we maycancel only for one or more of the fol-lowing reasons:

(1) Nonpayment of premium;

(2) Conviction of the insured of a crimearising out of acts increasing thehazard insured against;

(3) Discovery of fraud or material mis-representation in obtaining the poli-cy or in presenting a claim there-under;

(4) Discovery of an act or omission ora violation of any condition of thepolicy which occurred after the firsteffective date of the current policy,and substantially and materially in-creases the hazard insured against;

(5) A material change in the nature orextent of the risk, occurring afterthe first effective date of the currentpolicy, which causes the risk ofloss to be substantially and materi-ally increased beyond that contem-plated at the time the policy wasissued or last renewed;

(6) A determination by the commissioner

that continuation of our present vol-ume of premiums would jeopardizeour solvency or be hazardous to theinterests of our policyholders, credi-tors or the public;

(7) A determination by the commissionerthat the continuation of the policywould violate, or place us in violationof, any provision of the code.

b. Anniversary Cancellation

If this policy is written for a term longerthan one year, we may cancel for anyreason at an anniversary, by mailing ordelivering written notice of cancellationto the First Named Insured at the lastmailing address known to us at least 60days before the anniversary date.

B. The following is added as an additional Con-dition and supersedes any other provision tothe contrary:

NONRENEWAL

1. If we elect not to renew this policy, we willmail or deliver to the First Named Insuredshown in the Declarations a notice of inten-tion not to renew at least 60 days beforethe agreed expiration date.

If notice is mailed, proof of mailing will besufficient proof of notice.

2. We need not provide this notice if:

a. You have accepted replacement cov-erage;

b. You have requested or agreed to non-renewal; or

c. This policy is expressly designated asnonrenewable.

C. Notices

1. Notice of cancellation or nonrenewal in ac-cordance with A and B above, will bemailed, first class or certified, or deliveredto the First Named Insured at the last mail-ing address known to us and will state thereason for cancellation or nonrenewal.

2. We will also provide a copy of the notice ofcancellation, for both policies in effect lessthan 70 days and policies in effect 70 daysor more, to the agent who wrote the policy.

COMMON POLICY CONDITIONS IL-0017F(11-98)

All Coverage Parts included in this policy are subjectto the following conditions.

A. CANCELLATION

1. The First Named Insured shown in the Declara-tions may cancel this policy by mailing or deliveringto us advance written notice of cancellation.

2. We may cancel this policy by mailing or de-livering to the First Named Insured written notice ofcancellation at least:

a. Ten days before the effective date of cancellationif we cancel for nonpayment of premium; or

b. Thirty days before the effective date of cancella-tion if we cancel for any other reason.

3. We will mail or deliver our notice to the FirstNamed Insured’s last mailing address known to us.

4. Notice of cancellation will state the effective dateof cancellation. The policy period will end on thatdate.

5. If this policy is cancelled, we will send the FirstNamed Insured any premium refund due. If we can-cel, the refund will be pro rata. If the First NamedInsured cancels, the refund may be less than prorata. The cancellation will be effective even if wehave not made or offered a refund.

6. If notice is mailed, proof of mailing will be suffi-cient proof of notice.

B. CHANGES

This policy contains all the agreements between youand us concerning the insurance afforded. The FirstNamed Insured shown in the Declarations is au-thorized to make changes in the terms of this policywith our consent. This policy’s terms can be amend-ed or waived only by endorsement issued by us andmade a part of this policy.

C. EXAMINATION OF YOUR BOOKS ANDRECORDS

We may examine and audit your books and recordsas they relate to this policy at any time during thepolicy period and up to three years afterward.

D. INSPECTIONS AND SURVEYS

1. We have the right to:

a. Make inspections and surveys at any time;

b. Give you reports on the conditions we find; and

c. Recommend changes.

2. We are not obligated to make any inspections,surveys, reports or recommendations and any suchactions we do undertake relate only to insurabilityand the premiums to be charged. We do not makesafety inspections. We do not undertake to performthe duty of any person or organization to provide forthe health or safety of workers or the public. And wedo not warrant that conditions:

a. Are safe or healthful; or

b. Comply with laws, regulations, codes or stan-dards.

3. Paragraphs 1 and 2 of this condition apply notonly to us, but also to any rating, advisory, rateservice or similar organization which makes insur-ance inspections, surveys, reports or recommenda-tions.

4. Paragraph 2 of this condition does not apply toany inspections, surveys, reports or recommenda-tions we may make relative to certification, understate or municipal statutes, ordinances or regula-tions, of boilers, pressure vessels or elevators.

E. PREMIUMS

The First Named Insured shown in the Declarations:

1. Is responsible for the payment of all premiums;and

2. Will be the payee for any return premiums wepay.

F. TRANSFER OF YOUR RIGHTS AND DUTIESUNDER THIS POLICY

Your rights and duties under this policy may not betransferred without our written consent except in thecase of death of an individual named insured.

If you die, your rights and duties will be transferredto your legal representative, but only while actingwithin the scope of duties as your legal representa-tive. Until your legal representative is appointed,anyone having proper temporary custody of yourproperty will have your rights and duties but onlywith respect to that property.

EXCLUSION - ACCESS OR DISCLOSURE OF CONFIDENTIAL ORPERSONAL INFORMATION AND DATA-RELATED LIABILITY - WITHLIMITED BODILY INJURY EXCEPTION

CG-2106F(5-14)

This endorsement modifies insurance provided underthe following:COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. Exclusion 2q of Section I - Coverage A - BodilyInjury And Property Damage Liability is re-placed by the following:

2. Exclusions

This insurance does not apply to:

q. Access Or Disclosure Of ConfidentialOr Personal Information And Data-related Liability

Damages arising out of:

(1) Any access to or disclosure of anyperson’s or organization’s confiden-tial or personal information, includingpatents, trade secrets, processingmethods, customer lists, financial in-formation, credit card information,health information or any other typeof nonpublic information; or

(2) The loss of, loss of use of, damageto, corruption of, inability to access,or inability to manipulate electronicdata.

This exclusion applies even if damagesare claimed for notification costs, creditmonitoring expenses, forensic ex-penses, public relations expenses orany other loss, cost or expense in-curred by you or others arising out ofthat which is described in paragraph (1)or (2) above.

However, unless paragraph (1) aboveapplies, this exclusion does not apply to

damages because of bodily injury.

As used in this exclusion, electronicdata means information, facts or pro-grams stored as or on, created or usedon, or transmitted to or from computersoftware, including systems and appli-cations software, hard or floppy disks,CD-ROMs, tapes, drives, cells, dataprocessing devices or any other mediawhich are used with electronically con-trolled equipment.

B. The following is added to paragraph 2 Exclu-sions of Section I - Coverage B - Personal AndAdvertising Injury Liability:

2. Exclusions

This insurance does not apply to:

Access Or Disclosure Of Confidential OrPersonal Information

Personal and advertising injury arising outof any access to or disclosure of any per-son’s or organization’s confidential or per-sonal information, including patents, tradesecrets, processing methods, customer lists,financial information, credit card information,health information or any other type of non-public information.

This exclusion applies even if damages areclaimed for notification costs, credit monitor-ing expenses, forensic expenses, public re-lations expenses or any other loss, cost orexpense incurred by you or others arisingout of any access to or disclosure of anyperson’s or organization’s confidential orpersonal information.

ASBESTOS EXCLUSION IL-7012(3-14)

This endorsement modifies insurance provided underthe following:BIS-PAK BUSINESS LIABILITY AND MEDICAL EXPENSECOVERAGE FORMCOMMERCIAL AUTO COVERAGE PARTCOMMERCIAL GENERAL LIABILITY COVERAGE PARTDIRECTORS’ AND OFFICERS’ LIABILITY COVERAGEPARTEMPLOYEE BENEFITS LIABILITY COVERAGE PARTERRORS AND OMISSIONS COVERAGE PARTGARAGE COVERAGE FORMLIQUOR LIABILITY COVERAGE FORMOWNERS AND CONTRACTORS PROTECTIVE LIABILITYCOVERAGE FORMPOLLUTION LIABILITY COVERAGE FORM

PRODUCT WITHDRAWAL COVERAGE PARTPRODUCTS-COMPLETED OPERATIONS LIABILITY COV-ERAGE FORMRAILROAD PROTECTIVE LIABILITY COVERAGE FORM

The following exclusion is added:

Asbestos

This insurance does not apply to any bodily injury orproperty damage arising out of activities related to,but not limited to, manufacture, mining, storage, dis-tribution, installation, sale, use, exposure to, service,testing for, repair, containment or removal of asbes-tos, asbestos fibers, asbestos dust, or products con-taining asbestos.

EMPLOYMENT-RELATED PRACTICES EXCLUSION CG-2147F(12-07)

This endorsement modifies insurance provided underthe following:COMMERCIAL GENERAL LIABILITY COVERAGE PART

1. The following exclusion is added to paragraph2 Exclusions, of Section I - Coverage A - Bodi-ly Injury and Property Damage Liability:

This insurance does not apply to:

Bodily injury to:

a. A person arising out of any:

(1) Refusal to employ that person;

(2) Termination of that person’s employ-ment; or

(3) Employment-related practices, policies,acts or omissions, such as coercion,demotion, evaluation, reassignment,discipline, defamation, harassment, hu-miliation, discrimination or maliciousprosecution directed at that person; or

b. The spouse, child, parent, brother or sisterof that person as a consequence of bodilyinjury to that person at whom any of theemployment-related practices described inparagraphs (1), (2) or (3) above is directed.

This exclusion applies:

(1) Whether the injury-causing event describedin paragraphs (1), (2) or (3) above occursbefore employment, during employment orafter employment of that person.

(2) Whether the insured may be liable as anemployer or in any other capacity; and

(3) To any obligation to share damages with orrepay someone else who must pay dam-

ages because of the injury.

2. The following exclusion is added to paragraph2 Exclusions of Section I - Coverage B - Per-sonal and Advertising Injury Liability:

This insurance does not apply to:

Personal and advertising injury to:

a. A person arising out of any:

(1) Refusal to employ that person;

(2) Termination of that person’s employ-ment; or

(3) Employment-related practices, policies,acts or omissions, such as coercion,demotion, evaluation, reassignment,discipline, defamation, harassment, hu-miliation, discrimination or maliciousprosecution directed at that person; or

b. The spouse, child, parent, brother or sisterof that person as a consequence of per-sonal and advertising injury to that personat whom any of the employment-relatedpractices described in paragraphs (1), (2) or(3) above is directed.

This exclusion applies:

(1) Whether the injury-causing event describedin paragraphs (1), (2) or (3) above occursbefore employment, during employment orafter employment of that person.

(2) Whether the insured may be liable as anemployer or in any other capacity; and

(3) To any obligation to share damages with orrepay someone else who must pay dam-ages because of the injury.

NEVADA CHANGES - DOMESTIC PARTNERSHIP IL-0115R(1-10)

This endorsement modifies insurance provided underthe following:COMMERCIAL AUTOMOBILE COVERAGE PARTCOMMERCIAL GENERAL LIABILITY COVERAGE PARTEMPLOYEE BENEFITS LIABILITY COVERAGE PARTERRORS AND OMISSIONS COVERAGE PARTLIQUOR LIABILITY COVERAGE FORMOWNERS AND CONTRACTORS PROTECTIVE LIABILITYCOVERAGE FORMPRODUCT WITHDRAWAL COVERAGE PARTPRODUCTS/COMPLETED OPERATIONS LIABILITY COV-ERAGE FORM

A. All references to spouse shall include an indi-vidual who is in a domestic partnership recog-nized under Nevada law.

B. Under the Commercial Auto Coverage Part, the

term family member is replaced by the following:

"Family member" means a person related tothe:

1. Individual Named Insured by blood, adop-tion, marriage or domestic partnership rec-ognized under Nevada law, who is a resi-dent of such Named Insured’s household,including a ward or foster child; or

2. Individual named in the Schedule by blood,adoption, marriage or domestic partnershiprecognized under Nevada law, who is aresident of the individual’s household, in-cluding a ward or foster child, if the DriveOther Car Coverage - Broadened CoverageFor Named Individual endorsement is at-tached.

FUNGI OR BACTERIA EXCLUSION CG-2167F(12-04)

This endorsement modifies insurance provided underthe following:COMMERCIAL GENERAL LIABILITY COVERAGE FORM

1. The following exclusion is added to Paragraph2, Exclusions of Section I - Coverage A - Bodi-ly Injury and Property Damage Liability:

Fungi or Bacteria

a. Bodily injury or property damage whichwould not have occurred, in whole or inpart, but for the actual, alleged or threat-ened inhalation of, ingestion of, contactwith, exposure to, existence of, or presenceof, any fungi or bacteria on or within abuilding or structure, including its contents,regardless of whether any other cause,event, material or product contributed con-currently or in any sequence to such injuryor damage.

b. Any loss, cost or expenses arising out ofthe abating, testing for, monitoring, cleaningup, removing, containing, treating, detox-ifying, neutralizing, remediating or disposingof, or in any way responding to, or assess-ing the effects of, fungi or bacteria, by anyinsured or by any other person or entity.

This exclusion does not apply to any fungi orbacteria that are, are on, or are contained in, agood or product intended for bodily consump-tion.

2. The following exclusion is added to Paragraph2, Exclusions of Section I - Coverage B - Per-sonal and Advertising Injury Liability:

Fungi or Bacteria

a. Personal and advertising injury which wouldnot have taken place, in whole or in part,but for the actual, alleged or threatenedinhalation of, ingestion of, contact with, ex-posure to, existence of, or presence of anyfungi or bacteria on or within a building orstructure, including its contents, regardlessof whether any other cause, event, materialor product contributed concurrently or inany sequence to such injury.

b. Any loss, cost or expense arising out of theabating, testing for, monitoring, cleaning up,removing, containing, treating, detoxifying,neutralizing, remediating or disposing of, orin any way responding to, or assessing theeffects of, fungi or bacteria, by any insuredor by any other person or entity.

3. The following definition is added to the Defini-tions Section:

"Fungi" means any type or form of fungus,including mold or mildew and any mycotoxins,spores, scents or byproducts produced or re-leased by fungi.

ACUITY ADVANTAGES - GENERAL LIABILITY CG-7300(4-08)

This endorsement modifies insurance provided underthe following:COMMERCIAL GENERAL LIABILITY COVERAGE FORM

1. Extended Non-Owned Watercraft

Exclusion g Exception (2)(a) of Coverage A -Bodily Injury and Property Damage Liability isreplaced by the following:

(a) Less than 51 feet long; and

2. Increased Bail Bond Amount

The limit shown in paragraph 1b of Supplemen-tary Payments - Coverages A and B is in-creased to $750.

3. Increased Reasonable Expenses Incurred bythe Insured

The limit shown in paragraph 1d of Supplemen-tary Payments - Coverages A and B is in-creased to $300.

4. Newly Acquired Organizations

Item 3a of Section II - Who Is An Insured isreplaced by the following:

a. Coverage under this provision is affordedonly until the 180th day after you acquire orform the organization or the end of thepolicy period, whichever is earlier;

5. Knowledge of Claim or Suit

The following is added to Paragraph 2, Dutiesin the Event of Occurrence, Offense, Claim orSuit of Section IV - Commercial General Liabil-ity Conditions:

Knowledge of an occurrence, claim or suit byyour agent, servant or employee shall not initself constitute knowledge of the Named In-sured unless an officer of the Named Insuredhas received such notice from the agent, ser-vant or employee.

.

Policyholder - OriginalWC-7026(6-01) SO 01 06/30/16

.

Named Insured and Address: Agency Name and Number:

Insured Policy Number: Policy Number:

Change Effective Date:

Identification Number:

WORKERS’ COMPENSATION

Information Page Changes

SUPERB MAIDS LLC AMS INSURANCE & INVESTMENTS 7530 TRICKLING WASH DR 8257-AL LAS VEGAS NV 89131

Z20747 CWC-Z20747-00

05-12-16

FEIN: 473787461

Named Insured is:

LIMITED LIABILITY COMPANY(LLC)

Policy Period: Inception Expiration12:01 A.M. standard time at the address of the insured stated herein.

PREMIUM SUMMARY

05-12-16 05-12-17

No Additional or Return PremiumDirect Billed

CHANGES:

.

Policyholder - OriginalWC 00 00 01 A(6-01) SO 01 06/30/16

.

1. Named Insured and Address: Agency Name and Number:

Policy Number:

Identification Number:

Renewal or Replacement Number: CWC-Z20747-00Insured Renewal or Replacement Number: Z20747

WORKERS’ COMPENSATION

Information Page

SUPERB MAIDS LLC AMS INSURANCE & INVESTMENTS7530 TRICKLING WASH DR 8257-ALLAS VEGAS NV 89131 STE 240

LAS VEGAS NV 89129Insured Policy Number: Z20747

CWC-Z20747-00

FEIN: 473787461The Named Insured is:LLC

2. Policy Period: Inception Expiration12:01 A.M. standard time at the address of the insured stated herein.

3. A. Workers’ Compensation Insurance: Part One of the policy applies to the Workers’ CompensationLaw of the states listed here:

05-12-16 05-12-17

Nevada

B. Employers’ Liability Insurance: Part Two of the policy applies to work in each state listed in Item3.A. The limits of our liability under Part Two are:

Bodily Injury by Accident Each Accident $. . . . . . . . . . . . . . . . . . . . . . . . . . Bodily Injury by Disease Policy Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bodily Injury by Disease Each Employee . . . . . . . . . . . . . . . . . . . . . . . . .

C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here:

100,000500,000100,000

All states except North Dakota, Ohio, Washington and Wyoming and States designated in Item3.A. above.

D. Endorsements:

Form Number Form Title Premium

WC 00 04 06 A(08-95) Premium Discount Endorsement $ . . . . . . . . . . . . . . . . . . . . . . .

WC 00 04 03 (04-84) Experience Rating Modification Factor Endorsement . . . . . . . .

WC 00 04 04 (04-84) Pending Rate Change Endorsement . . . . . . . . . . . . . . . . . . . .

WC 00 04 14 (07-90) Notification of Change in Ownership Endorsement . . . . . . . . .

WC 00 04 19 (01-01) Premium Due Date Endorsement . . . . . . . . . . . . . . . . . . . . . . .

WC 27 06 01C (10-08) Nevada Cancellation and Nonrenewal Endorsement . . . . . . . .

WC 00 00 00 C(01-15) Workers’ Compensation and Employers’ Liability InsurancePolicy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

WC 00 04 22 B(01-15) Terrorism Risk Insurance Program Reauthorization ActDisclosure Endorsement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page 2Insured Policy Number: Z20747Policy Number: CWC-Z20747-00Effective Date: 05-12-16

Form Number Form Title Premium

WC 00 00 01 A(6-01) SO 01 06/30/16

WC 00 04 21 D(01-15) Catastrophe (Other than Certified Acts of Terrorism) PremiumEndorsement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Premium: The premium for this policy will be determined by our Manual of Rules, Classifications, Ratesand Rating Plans. All information required below is subject to verification and change by audit.

Classification Unit Code Premium Basis Rates Estimatedof Operations No. No. (Estimated Total (Per $100 of

Remuneration) PremiumsRemuneration)

AnnualAnnual

Nevada

Janitorial Services By Contractors - 001 9014 40,000 $ 3.58 $ 1,432.00No Window Cleaning Above Ground Level& Drivers

1,432.00

Expense Constant 0900. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160.00

Provisions for Terrorism 003 9740 40,000 .01 4.00

Provisions for Catastrophe (Other than 004 9741 40,000 .01 4.00Certified Acts of Terrorism)

Total Estimated Annual Premium $. . . . . . 1,600.00

Annual Minimum Premium $. . . . . . 876.00

Named InsuredSUPERB MAIDS LLC

Federal Employer Identification Number: 473787461State Unemployment Number:

Locations Covered:

7530 TRICKLING WASH DRLAS VEGAS NV 89131

Countersignature/Authorized Representative

Page 3Insured Policy Number: Z20747Policy Number: CWC-Z20747-00Effective Date: 05-12-16

WC 00 00 01 A(6-01) SO 01 06/30/16

Date of Issue: 06-30-16

.

WC 00 00 00 C(1-15)

WORKERS’ COMPENSATION AND EMPLOYERS’ LIABILITY INSURANCE POLICY

Index of Policy Provisions

Page Page

AGREEMENT 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

GENERAL SECTION 1. . . . . . . . . . . . . . . . . . . . . . .

A. The Policy 1. . . . . . . . . . . . . . . . . . . . . . . . . . . .

B. Who Is Insured 1. . . . . . . . . . . . . . . . . . . . . . . . .

C. Workers’ Compensation Law 1. . . . . . . . . . . . . .

D. State 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

E. Locations 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART ONE - WORKERS’ COMPENSATION IN-SURANCE 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

A. How This Insurance Applies 1. . . . . . . . . . . . . .

B. We Will Pay 1. . . . . . . . . . . . . . . . . . . . . . . . . . .

C. We Will Defend 1. . . . . . . . . . . . . . . . . . . . . . . .

D. We Will Also Pay 1. . . . . . . . . . . . . . . . . . . . . . .

E. Other Insurance 1. . . . . . . . . . . . . . . . . . . . . . . .

F. Payments You Must Make 1. . . . . . . . . . . . . . . .

G. Recovery From Others 2. . . . . . . . . . . . . . . . . . .

H. Statutory Provisions 2. . . . . . . . . . . . . . . . . . . . .

PART TWO - EMPLOYERS’ LIABILITY INSUR-ANCE 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

A. How This Insurance Applies 2. . . . . . . . . . . . . .

B. We Will Pay 2. . . . . . . . . . . . . . . . . . . . . . . . . . .

C. Exclusions 2. . . . . . . . . . . . . . . . . . . . . . . . . . . .

D. We Will Defend 3. . . . . . . . . . . . . . . . . . . . . . . .

E. We Will Also Pay 3. . . . . . . . . . . . . . . . . . . . . . .

F. Other Insurance 3. . . . . . . . . . . . . . . . . . . . . . . .

G. Limits of Liability 3. . . . . . . . . . . . . . . . . . . . . . . .

H. Recovery From Others 4. . . . . . . . . . . . . . . . . . .

I. Actions Against Us 4. . . . . . . . . . . . . . . . . . . . . .

PART THREE - OTHER STATES INSURANCE 4. .

A. How This Insurance Applies 4. . . . . . . . . . . . . .

B. Notice 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART FOUR - YOUR DUTIES IF INJURY OC-CURS 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART FIVE - PREMIUM 4. . . . . . . . . . . . . . . . . . . . .

A. Our Manuals 4. . . . . . . . . . . . . . . . . . . . . . . . . .

B. Classifications 4. . . . . . . . . . . . . . . . . . . . . . . . .

C. Remuneration 4. . . . . . . . . . . . . . . . . . . . . . . . .

D. Premium Payments 5. . . . . . . . . . . . . . . . . . . . .

E. Final Premium 5. . . . . . . . . . . . . . . . . . . . . . . . .

F. Records 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

G. Audit 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART SIX - CONDITIONS 5. . . . . . . . . . . . . . . . . . .

A. Inspection 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

B. Long Term Policy 5. . . . . . . . . . . . . . . . . . . . . . .

C. Transfer of Your Rights and Duties 5. . . . . . . . .

D. Cancellation 5. . . . . . . . . . . . . . . . . . . . . . . . . . .

E. Sole Representative 5. . . . . . . . . . . . . . . . . . . . .

IMPORTANT: This Index is not part of the Workers’ Compensation and Employers’ Liability Policy and doesnot provide coverage. Refer to the Workers’ Compensation and Employers’ Liability Policy itselffor actual contractual provisions.

PLEASE READ THE WORKERS’ COMPENSATION AND EMPLOYERS’ LIABILITY POLICY CAREFULLY.

WC 00 00 00 C(1-15) Page 1 of 5

AGREEMENT

In return for the payment of the premium and subject to all terms of this policy, we agree with you as follows:

GENERAL SECTION

A. THE POLICY

This policy includes at its effective date the In-formation Page and all endorsements andschedules listed there. It is a contract of insur-ance between you (the employer named in Item1 of the Information Page) and us (the insurernamed on the Information Page). The onlyagreements relating to this insurance are statedin this policy. The terms of this policy may not bechanged or waived except by endorsement is-sued by us to be part of this policy.

B. WHO IS INSURED

You are insured if you are an employer named inItem 1 of the Information Page. If that employeris a partnership, and if you are one of its part-ners, you are insured, but only in your capacityas an employer of the partnership’s employees.

C. WORKERS’ COMPENSATION LAW

Workers’ Compensation Law means the work-

ers or workmen’s compensation law and oc-cupational disease law of each state or territorynamed in Item 3A of the Information Page. Itincludes any amendments to that law which arein effect during the policy period. It does notinclude any federal workers or workmen’s com-pensation law, any federal occupational diseaselaw or the provisions of any law that providenonoccupational disability benefits.

D. STATE

State means any state of the United States ofAmerica and the District of Columbia.

E. LOCATIONS

This policy covers all of your workplaces listedin Items 1 or 4 of the Information Page; and itcovers all other workplaces in Item 3A statesunless you have other insurance or are self-insured for such workplaces.

PART ONE - WORKERS’ COMPENSATION INSURANCE

A. HOW THIS INSURANCE APPLIES

This workers’ compensation insurance appliesto bodily injury by accident or bodily injury bydisease. Bodily injury includes resulting death.

1. Bodily injury by accident must occur duringthe policy period.

2. Bodily injury by disease must be caused oraggravated by the conditions of your em-ployment. The employee’s last day of lastexposure to the conditions causing or ag-gravating such bodily injury by diseasemust occur during the policy period.

B. WE WILL PAY

We will pay promptly when due the benefitsrequired of you by the workers’ compensationlaw.

C. WE WILL DEFEND

We have the right and duty to defend at ourexpense any claim, proceeding or suit againstyou for benefits payable by this insurance. Wehave the right to investigate and settle theseclaims, proceedings or suits.

We have no duty to defend a claim, proceedingor suit that is not covered by this insurance.

D. WE WILL ALSO PAY

We will also pay these costs, in addition to otheramounts payable under this insurance, as part ofany claim, proceeding or suit we defend:

1. Reasonable expenses incurred at our re-quest, but not loss of earnings;

2. Premiums for bonds to release attachmentsand for appeal bonds in bond amounts upto the amount payable under this insurance;

3. Litigation costs taxed against you;

4. Interest on a judgment as required by lawuntil we offer the amount due under thisinsurance; and

5. Expenses we incur.

E. OTHER INSURANCE

We will not pay more than our share of benefitsand costs covered by this insurance and otherinsurance or self-insurance. Subject to any limitsof liability that may apply, all shares will be equaluntil the loss is paid. If any insurance or self-insurance is exhausted, the shares of all remain-ing insurance will be equal until the loss is paid.

F. PAYMENTS YOU MUST MAKE

You are responsible for any payments in ex-cess of the benefits regularly provided by theworkers’ compensation law including those re-quired because:

1. Of your serious and willful misconduct;

2. You knowingly employ an employee in vio-lation of law;

3. You fail to comply with a health or safetylaw or regulation; or

WC 00 00 00 C(1-15) Page 2 of 5

4. You discharge, coerce or otherwise dis-criminate against any employee in violationof the workers’ compensation law.

If we make any payments in excess of thebenefits regularly provided by the workers’compensation law on your behalf, you will reim-burse us promptly.

G. RECOVERY FROM OTHERS

We have your rights, and the rights of personsentitled to the benefits of this insurance, torecover our payments from anyone liable forthe injury. You will do everything necessary toprotect those rights for us and to help us en-force them.

H. STATUTORY PROVISIONS

These statements apply where they are re-quired by law.

1. As between an injured worker and us, wehave notice of the injury when you havenotice.

2. Your default or the bankruptcy or insolvencyof you or your estate will not relieve us ofour duties under this insurance after an in-jury occurs.

3. We are directly and primarily liable to anyperson entitled to the benefits payable bythis insurance. Those persons may enforceour duties; so may an agency authorized bylaw. Enforcement may be against us oragainst you and us.

4. Jurisdiction over you is jurisdiction over usfor purposes of the workers’ compensationlaw. We are bound by decisions againstyou under that law, subject to the provisionsof this policy that are not in conflict with thatlaw.

5. This insurance conforms to the parts of theworkers’ compensation law that apply to:

a. Benefits payable by this insurance;

b. Special taxes, payments into security orother special funds, and assessmentspayable by us under that law.

6. Terms of this insurance that conflict with theworkers’ compensation law are changed bythis statement to conform to that law.

Nothing in these paragraphs relieves you of yourduties under this policy.

PART TWO - EMPLOYERS’ LIABILITY INSURANCE

A. HOW THIS INSURANCE APPLIES

This employers’ liability insurance applies tobodily injury by accident or bodily injury bydisease. Bodily injury includes resulting death.

1. The bodily injury must arise out of and inthe course of the injured employee’s em-ployment by you.

2. The employment must be necessary or in-cidental to your work in a state or territorylisted in Item 3A of the Information Page.

3. Bodily injury by accident must occur duringthe policy period.

4. Bodily injury by disease must be caused oraggravated by the conditions of your em-ployment. The employee’s last day of lastexposure to the conditions causing or ag-gravating such bodily injury by diseasemust occur during the policy period.

5. If you are sued, the original suit and anyrelated legal actions for damages for bodilyinjury by accident or by disease must bebrought in the United States of America, itsterritories or possessions, or Canada.

B. WE WILL PAY

We will pay all sums that you legally must payas damages because of bodily injury to youremployees, provided the bodily injury is cov-ered by this Employers’ Liability Insurance.

The damages we will pay, where recovery is

permitted by law, include damages:

1. For which you are liable to a third party byreason of a claim or suit against you by thatthird party to recover the damages claimedagainst such third party as a result of injuryto your employee;

2. For care and loss of services; and

3. For consequential bodily injury to a spouse,child, parent, brother or sister of the injuredemployee;

provided that these damages are the directconsequence of bodily injury that arises out ofand in the course of the injured employee’semployment by you; and

4. Because of bodily injury to your employeethat arises out of and in the course of em-ployment, claimed against you in a capacityother than as employer.

C. EXCLUSIONS

This insurance does not cover:

1. Liability assumed under a contract. This ex-clusion does not apply to a warranty thatyour work will be done in a workmanlikemanner;

2. Punitive or exemplary damages because ofbodily injury to an employee employed inviolation of law;

3. Bodily injury to an employee while em-ployed in violation of law with your actual

WC 00 00 00 C(1-15) Page 3 of 5

knowledge or the actual knowledge of anyof your executive officers;

4. Any obligation imposed by a workers’ com-pensation, occupational disease, unemploy-ment compensation, or disability benefitslaw, or any similar law;

5. Bodily injury intentionally caused or aggra-vated by you;

6. Bodily injury occurring outside the UnitedStates of America, its territories or posses-sions, and Canada. This exclusion does notapply to bodily injury to a citizen or residentof the United States of America or Canadawho is temporarily outside these countries;

7. Damages arising out of coercion, criticism,demotion, evaluation, reassignment, disci-pline, defamation, harassment, humiliation,discrimination against or termination of anyemployee, or any personnel practices, poli-cies, acts or omissions;

8. Bodily injury to any person in work subjectto the Longshore and Harbor Workers’Compensation Act (33 U.S.C. Sections 901et seq.), the Nonappropriated Fund Instru-mentalities Act (5 U.S.C. Sections 8171 etseq.), the Outer Continental Shelf LandsAct (43 U.S.C. Sections 1331 et seq.), theDefense Base Act (42 U.S.C. Sections1651-1654), the Federal Mine Safety andHealth Act (30 U.S.C. Sections 801 et seq.and 901-944), any other federal workers orworkmen’s compensation law or other fed-eral occupational disease law, or anyamendments to these laws;

9. Bodily injury to any person in work subject tothe Federal Employers’ Liability Act (45U.S.C. Sections 51 et seq.), any other federallaws obligating an employer to pay damagesto an employee due to bodily injury arisingout of or in the course of employment, or anyamendments to those laws;

10. Bodily injury to a master or member of thecrew of any vessel, and does not coverpunitive damages related to your duty orobligation to provide transportation, wages,maintenance, and cure under any applica-ble maritime law;

11. Fines or penalties imposed for violation offederal or state law;

12. Damages payable under the Migrant andSeasonal Agricultural Worker Protection Act(29 U.S.C. Sections 1801 et seq.) and un-der any other federal law awarding dam-ages for violation of those laws or regula-tions issued thereunder, and any amend-ments to those laws.

D. WE WILL DEFEND

We have the right and duty to defend, at ourexpense, any claim, proceeding or suit against

you for damages payable by this insurance. Wehave the right to investigate and settle theseclaims, proceedings and suits.

We have no duty to defend a claim, proceedingor suit that is not covered by this insurance.We have no duty to defend or continue defend-ing after we have paid our applicable limit ofliability under this insurance.

E. WE WILL ALSO PAY

We will also pay these costs, in addition to otheramounts payable under this insurance, as part ofany claim, proceeding or suit we defend:

1. Reasonable expenses incurred at our re-quest, but not loss of earnings;

2. Premiums for bonds to release attachmentsand for appeal bonds in bond amounts up tothe limit of our liability under this insurance;

3. Litigation costs taxed against you;

4. Interest on a judgment as required by lawuntil we offer the amount due under thisinsurance; and

5. Expenses we incur.

F. OTHER INSURANCE

We will not pay more than our share of dam-ages and costs covered by this insurance andother insurance or self-insurance. Subject toany limits of liability that apply, all shares willbe equal until the loss is paid. If any insuranceor self-insurance is exhausted, the shares of allremaining insurance and self-insurance will beequal until the loss is paid.

G. LIMITS OF LIABILITY

Our liability to pay for damages is limited. Ourlimits of liability are shown in Item 3B of theInformation Page. They apply as explained be-low.

1. Bodily Injury by Accident

The limit shown for "bodily injury by ac-cident-each accident" is the most we willpay for all damages covered by this insur-ance because of bodily injury to one ormore employees in any one accident.

A disease is not bodily injury by accidentunless it results directly from bodily injuryby accident.

2. Bodily Injury by Disease

The limit shown for "bodily injury by dis-ease-policy limit" is the most we will pay forall damages covered by this insurance andarising out of bodily injury by disease, re-gardless of the number of employees whosustain bodily injury by disease. The limitshown for "bodily injury by disease-eachemployee" is the most we will pay for alldamages because of bodily injury by dis-ease to any one employee.

WC 00 00 00 C(1-15) Page 4 of 5

Bodily injury by disease does not includedisease that results directly from a bodilyinjury by accident.

3. We will not pay any claims for damagesafter we have paid the applicable limit ofour liability under this insurance.

H. RECOVERY FROM OTHERS

We have your rights to recover our paymentfrom anyone liable for an injury covered by thisinsurance. You will do everything necessary toprotect those rights for us and to help us en-force them.

I. ACTIONS AGAINST US

There will be no right of action against usunder this insurance unless:

1. You have complied with all the terms of thispolicy; and

2. The amount you owe has been determinedwith our consent or by actual trial and finaljudgment.

This insurance does not give anyone the right to addus as a defendant in an action against you to deter-mine your liability. The bankruptcy or insolvency ofyou or your estate will not relieve us of our ob-ligations under this Part.

PART THREE - OTHER STATES INSURANCE

A. HOW THIS INSURANCE APPLIES

1. This other states insurance applies only ifone or more states are shown in Item 3C ofthe Information Page.

2. If you begin work in any one of those statesafter the effective date of this policy and arenot insured or are not self-insured for suchwork, all provisions of the policy will applyas though that state were listed in Item 3Aof the Information Page.

3. We will reimburse you for the benefits re-

quired by the workers’ compensation law ofthat state if we are not permitted to pay thebenefits directly to persons entitled to them.

4. If you have work on the effective date ofthis policy in any state not listed in Item 3Aof the Information Page, coverage will notbe afforded for that state unless we arenotified within 30 days.

B. NOTICE

Tell us at once if you begin work in any statelisted in Item 3C of the Information Page.

PART FOUR - YOUR DUTIES IF INJURY OCCURS

Tell us at once if injury occurs that may be coveredby this policy. Your other duties are listed here.

1. Provide for immediate medical and other servicesrequired by the workers’ compensation law.

2. Give us or our agent the names and addressesof the injured persons and of witnesses, andother information we may need.

3. Promptly give us all notices, demands and le-gal papers related to the injury, claim, proceed-

ing or suit.

4. Cooperate with us and assist us, as we mayrequest, in the investigation, settlement or de-fense of any claim, proceeding or suit.

5. Do nothing after an injury occurs that wouldinterfere with our right to recover from others.

6. Do not voluntarily make payments, assume ob-ligations or incur expenses, except at your owncost.

PART FIVE - PREMIUM

A. OUR MANUALS

All premium for this policy will be determinedby our manuals of rules, rates, rating plans andclassifications. We may change our manualsand apply the changes to this policy if au-thorized by law or a governmental agency reg-ulating this insurance.

B. CLASSIFICATIONS

Item 4 of the Information Page shows the rateand premium basis for certain business or workclassifications. These classifications were as-signed based on an estimate of the exposuresyou would have during the policy period. If your

actual exposures are not properly described bythose classifications, we will assign proper clas-sifications, rates and premium basis by en-dorsement to this policy.

C. REMUNERATION

Premium for each work classification is deter-mined by multiplying a rate times a premiumbasis. Remuneration is the most common pre-mium basis. This premium basis includes pay-roll and all other remuneration paid or payableduring the policy period for the services of:

1. All your officers and employees engaged inwork covered by this policy; and

WC 00 00 00 C(1-15) Page 5 of 5

2. All other persons engaged in work thatcould make us liable under Part One -Workers’ Compensation Insurance of thispolicy. If you do not have payroll records forthese persons, the contract price for theirservices and materials may be used as thepremium basis. This paragraph 2 will notapply if you give us proof that the employ-ers of these persons lawfully secured theirworkers’ compensation obligations.

D. PREMIUM PAYMENTS

You will pay all premium when due. You willpay the premium even if part or all of a work-ers’ compensation law is not valid.

E. FINAL PREMIUM

The premium shown on the Information Page,schedules and endorsements is an estimate.The final premium will be determined after thispolicy ends by using the actual, not the es-timated, premium basis and the proper clas-sifications and rates that lawfully apply to thebusiness and work covered by this policy. If thefinal premium is more than the premium youpaid to us, you must pay us the balance. If it isless, we will refund the balance to you. Thefinal premium will not be less than the highestminimum premium for the classifications cov-ered by this policy.

If this policy is cancelled, final premium will bedetermined in the following way unless our

manuals provide otherwise:

1. If we cancel, final premium will be calculatedpro rata based on the time this policy was inforce. Final premium will not be less than thepro rata share of the minimum premium.

2. If you cancel, final premium will be morethan pro rata; it will be based on the timethis policy was in force, and increased byour short rate cancellation table and proce-dure. Final premium will not be less thanthe minimum premium.

F. RECORDS

You will keep records of information needed tocompute premium. You will provide us withcopies of those records when we ask for them.

G. AUDIT

You will let us examine and audit all your re-cords that relate to this policy. These recordsinclude ledgers, journals, registers, vouchers,contracts, tax reports, payroll and disbursementrecords, and programs for storing and retrievingdata. We may conduct the audits during regularbusiness hours during the policy period andwithin three years after the policy period ends.Information developed by audit will be used todetermine final premium. Insurance rate serviceorganizations have the same rights we haveunder this provision.

PART SIX - CONDITIONS

A. INSPECTION

We have the right, but are not obliged to in-spect your workplaces at any time. Our inspec-tions are not safety inspections. They relateonly to the insurability of the workplaces andthe premiums to be charged. We may give youreports on the conditions we find. We may alsorecommend changes. While they may help re-duce losses, we do not undertake to performthe duty of any person to provide for the healthor safety of your employees or the public. Wedo not warrant that your workplaces are safe orhealthful or that they comply with laws, regula-tions, codes or standards. Insurance rate ser-vice organizations have the same rights wehave under this provision.

B. LONG TERM POLICY

If the policy period is longer than one year andsixteen days, all provisions of this policy will applyas though a new policy were issued on eachannual anniversary that this policy is in force.

C. TRANSFER OF YOUR RIGHTS AND DUTIES

Your rights or duties under this policy may notbe transferred without our written consent.

If you die and we receive notice within 30 days

after your death, we will cover your legal repre-sentative as insured.

D. CANCELLATION

1. You may cancel this policy. You must mailor deliver advance written notice to us stat-ing when the cancellation is to take effect.

2. We may cancel this policy. We must mail ordeliver to you not less than 10 days ad-vance written notice stating when the can-cellation is to take effect. Mailing that noticeto you at your mailing address shown inItem 1 of the Information Page will be suffi-cient to prove notice.

3. The policy period will end on the day andhour stated in the cancellation notice.

4. Any of these provisions that conflict with alaw that controls the cancellation of the in-surance in this policy, is changed by thisstatement to comply with the law.

E. SOLE REPRESENTATIVE

The insured first named in Item 1 of the In-formation Page will act on behalf of all insuredsto change this policy, receive return premiumand give or receive notice of cancellation.

.

(continued next page)WC 00 04 22 B(1-15)

TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATIONACT DISCLOSURE ENDORSEMENT

WC 00 04 22 B(1-15)

This endorsement addresses requirements of theTerrorism Risk Insurance Act of 2002 as amendedand extended by the Terrorism Risk Insurance Pro-gram Reauthorization Act of 2015. It serves to notifyyou of certain limitations under the Act, and thatyour insurance carrier is charging premium forlosses that may occur in the event of an Act ofTerrorism.

Your policy provides coverage for workers compen-sation losses caused by Acts of Terrorism, includingworkers compensation benefit obligations dictated bystate law. Coverage for such losses is still subject toall terms, definitions, exclusions, and conditions inyour policy, and any applicable federal and/or statelaws, rules or regulations.

Definitions

The definitions provided in this endorsement arebased on and have the same meaning as the defini-tions in the Act. If words or phrases not defined inthis endorsement are defined in the Act, the defini-tions in the Act will apply.

"Act" means the Terrorism Risk Insurance Act of 2002,which took effect on November 26, 2002, and anyamendments thereto, including any amendments re-sulting from the Terrorism Risk Insurance ProgramReauthorization Act of 2015.

"Act of Terrorism" means any act that is certified bythe Secretary of the Treasury, in consultation withthe Secretary of Homeland Security, and the Attor-ney General of the United States as meeting all ofthe following requirements:

a. The act is an act of terrorism.

b. The act is violent or dangerous to humanlife, property or infrastructure.

c. The act resulted in damage within the Unit-ed States, or outside of the United States inthe case of the premises of United Statesmissions or certain air carriers or vessels.

d. The act has been committed by an indi-vidual or individuals as part of an effort tocoerce the civilian population of the UnitedStates or to influence the policy or affectthe conduct of the United States Govern-ment by coercion.

"Insured Loss" means any loss resulting from an actof terrorism (and, except for Pennsylvania, includingan act of war, in the case of workers compensation)that is covered by primary or excess property andcasualty insurance issued by an insurer if the lossoccurs in the United States or at the premises ofUnited States missions or to certain air carriers orvessels.

"Insurer Deductible" means for the period beginningon January 1, 2015 and ending on December 31,2020, an amount equal to 20% of our direct earned

premiums, during the immediately preceding calen-dar year.

Limitation of Liability

The Act limits our liability to you under this policy. Ifaggregate Insured Losses exceed $100,000,000,000in a calendar year and if we have met our InsurerDeductible, we are not liable for the payment of anyportion of the amount of Insured Losses that ex-ceeds $100,000,000,000; and for aggregate InsuredLosses up to $100,000,000,000, we will pay only apro rata share of such Insured Losses as deter-mined by the Secretary of the Treasury.

Policyholder Disclosure Notice

1. Insured Losses would be partially reimbursedby the United States Government. If the ag-gregate industry Insured Losses exceed:

a. $100,000,000, with respect to such InsuredLosses occurring in calendar year 2015, theUnited States Government would pay 85%of our Insured Losses that exceed our In-surer Deductible.

b. $120,000,000, with respect to such InsuredLosses occurring in calendar year 2016, theUnited States Government would pay 84%of our Insured Losses that exceed our In-surer Deductible.

c. $140,000,000, with respect to such InsuredLosses occurring in calendar year 2017, theUnited States Government would pay 83%of our Insured Losses that exceed our In-surer Deductible.

d. $160,000,000, with respect to such InsuredLosses occurring in calendar year 2018, theUnited States Government would pay 82%of our Insured Losses that exceed our In-surer Deductible.

e. $180,000,000, with respect to such InsuredLosses occurring in calendar year 2019, theUnited States Government would pay 81%of our Insured Losses that exceed our In-surer Deductible.

f. $200,000,000, with respect to such InsuredLosses occurring in calendar year 2020, theUnited States Government would pay 80%of our Insured Losses that exceed our In-surer Deductible.

2. Notwithstanding item 1 above, the UnitedStates Government will not make any paymentunder the Act for any portion of Insured Lossesthat exceeds $100,000,000,000.

3. The premium charge for the coverage yourpolicy provides for Insured Losses is includedin the amount shown in Item 4 of the Informa-tion Page or in the Schedule below.

SCHEDULE

State Rate Premium

NV $ 0.010 $ 4.00

PREMIUM DISCOUNT ENDORSEMENT WC 00 04 06A(8-95)

The premium for this policy and the policies, if any,listed in item 3 of the Schedule may be eligible for adiscount. This endorsement shows your estimateddiscount in items 1 or 2 of the Schedule. The final

calculation of premium discount will be determinedby our manuals and your premium basis as deter-mined by audit. Premium subject to retrospectiverating is not subject to premium discount.

SCHEDULE

1. State Premium DiscountFirst Next Next Balance

$10,000 $190,000 $1,550,000

NEVADA 0.0% 9.1% 11.3% 12.3%

2. Average percentage discount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Other policies:

N/A

4. If there are no entries in items 1, 2 and 3 of the Schedule, see the Premium DiscountEndorsement attached to your policy number:

PENDING RATE CHANGE ENDORSEMENT WC 00 04 04(4-84)

A rate change filing is being considered by the prop-er regulatory authority. The filing may result in ratesdifferent from the rates shown on the policy. If itdoes, we will issue an endorsement to show the newrates and their effective date. If only one state is

shown in item 3A of the Information Page, this en-dorsement applies to that state. If more than onestate is shown there, this endorsement applies onlyin the state shown in the Schedule.

SCHEDULE

State

NEVADA

NOTIFICATION OF CHANGE IN OWNERSHIP ENDORSEMENT WC 00 04 14(7-90)

Experience rating is mandatory for all eligible in-sureds. The experience rating modification factor, ifany, applicable to this policy, may change if there isa change in your ownership or in that of one ormore of the entities eligible to be combined with youfor experience rating purposes. Change in ownershipincludes sales, purchases, other transfers, mergers,consolidations, dissolutions, formations of a new en-

tity and other changes provided for in the applicableexperience rating plan manual.

You must report any change in ownership to us inwriting within 90 days of such change. Failure toreport such changes within this period may result inrevision of the experience rating modification factorused to determine your premium.

WC 00 04 21 D(1-15)

CATASTROPHE (OTHER THAN CERTIFIED ACTSOF TERRORISM) PREMIUM ENDORSEMENT

WC 00 04 21 D(1-15)

This endorsement is notification that your insurancecarrier is charging premium to cover the losses thatmay occur in the event of a Catastrophe (other thanCertified Acts of Terrorism) as that term is definedbelow. Your policy provides coverage for workerscompensation losses caused by a Catastrophe (oth-er than Certified Acts of Terrorism). This premiumcharge does not provide funding for Certified Acts ofTerrorism contemplated under the Terrorism RiskInsurance Program Reauthorization Act DisclosureEndorsement (WC 00 04 22 B), attached to thispolicy.

For purposes of this endorsement, the following defi-nitions apply:

Catastrophe (other than Certified Acts of Ter-rorism): Any single event, resulting from anEarthquake, Noncertified Act of Terrorism, orCatastrophic Industrial Accident, which resultsin aggregate workers compensation losses inexcess of $50 million.

Earthquake: The shaking and vibration at thesurface of the earth resulting from undergroundmovement along a fault plane or from volcanicactivity.

Noncertified Act of Terrorism: An event that isnot certified as an Act of Terrorism by theSecretary of Treasury pursuant to the Terrorism

Risk Insurance Act of 2002 (as amended) butthat meets all of the following criteria:

a. It is an act that is violent or dangerous tohuman life, property, or infrastructure;

b. The act results in damage within the UnitedStates, or outside of the United States inthe case of the premises of United Statesmissions or air carriers or vessels as thoseterms are defined in the Terrorism Risk In-surance Act of 2002 (as amended); and

c. It is an act that has been committed by anindividual or individuals as part of an effortto coerce the civilian population of the Unit-ed States or to influence the policy or affectthe conduct of the United States Govern-ment by coercion.

Catastrophic Industrial Accident: A chemical re-lease, large explosion, or small blast that islocalized in nature and affects workers in asmall perimeter the size of a building.

The premium charge for the coverage your policyprovides for workers compensation losses caused bya Catastrophe (other than Certified Acts of Terror-ism) is shown in Item 4 of the Information Page or inthe Schedule below.

SCHEDULE

State Rate Premium

NV $ 0.010 $ 4.00

NEVADA CANCELLATION AND NONRENEWAL ENDORSEMENT WC 27 06 01 C(10-08)

This endorsement applies to the insurance providedby this policy, because Nevada is shown in Item 3Aof the Information Page.

Part Six - Conditions, D Cancellation of the policy isreplaced by the following:

A. Midterm Cancellation

1. You may cancel this policy by mailing ordelivering advance written notice to us stat-ing when the cancellation is to take effect.

2. We will provide you not less than 10 daysnotice if this policy is cancelled becauseyou failed to pay a premium or remit anamount due because of an endorsement fora deductible when due.

3. We will provide you not less than 30 daysnotice for any other cancellation reason per-mitted under Nevada law, including failureto pay additional premium charged due toan audit of any payroll under the terms ofthe current or previous policy.

4. No policy of industrial insurance that hasbeen in effect for at least 70 days or thathas been renewed may be cancelled, ex-cept on any one of the following grounds:

a. A failure by the policyholder to pay apremium for the policy of industrial in-surance when due, including the failureof the policyholder to remit an amountdue because of an endorsement for adeductible;

b. A failure by the policyholder to:

(1) Report any payroll;

(2) Allow the insurer to audit any pay-roll in accordance with the terms ofthe policy or any previous policyissued by the insurer; or

(3) Pay any add i t iona l p remiumcharged because of an audit of anypayroll as required by the terms ofthe policy or any previous policyissued by the insurer;

c. A material failure by the policyholder tocomply with any federal or state orderconcerning safety or any written rec-ommendation of the insurer’s designat-ed representative for loss prevention;

d. A material change in ownership of thepolicyholder or any change in thepolicyholder’s business operations that:

(1) Materially increases the hazard forfrequency or severity of loss;

(2) Requires additional or differentclassifications for the calculation ofpremiums; or

(3) Contemplates an activity that is ex-cluded by any reinsurance treaty ofthe insurer;

e. A material misrepresentation made bythe policyholder; or

f. A failure by the policyholder to coop-erate with the insurer in conducting aninvestigation of a claim.

5. We cannot cancel the policy when the re-ferenced reasons are corrected by you with-in the time specified in the written notice ofcancellation.

B. Nonrenewal

1. We may elect not to renew the policy. Wewill provide you a written notice of our in-tention not to renew at least 60 days beforethe expiration date.

2. We need not provide a notice of our inten-tion not to renew if you have accepted re-placement coverage, if you have requestedor agreed to nonrenewal, or if the policy isexpressly designated as nonrenewable.

C. Information About Claims Paid

1. If you request information for the renewal ofthe policy, we will provide you with informa-tion regarding claims paid on your behalf.

2. We will provide the information within 30working days after we receive your writtenrequest. We may charge a reasonable feefor providing the information.

D. Notices

1. We will provide advance written notificationof cancellation or nonrenewal as provided inA and B above. This notice must be servedpersonally on or sent by first-class mail orelectronic transmission to the employer.

2. Notices will state the effective date of thecancellation or nonrenewal and will be ac-companied by a written explanation of thespecific reasons for the cancellation or non-renewal.

3. A written notice of cancellation is not re-quired if we mutually agree with you tocancel the policy and reissue a new policybased upon a material change in the own-ership or operation of your business.

E. Compliance With Law

1. Any of these provisions that conflict with alaw that controls the cancellation or renewalor nonrenewal of the insurance in this policyis changed by this statement to comply withthe law.

PREMIUM DUE DATE ENDORSEMENT WC 00 04 19(1-01)

This endorsement is used to amend:

Section D Of Part Five of the policy is replaced bythis provision.PART FIVE - PREMIUM

D. Premium Payment is amended to read:

You will pay all premium when due. You willpay the premium even if part or all of a work-ers compensation law is not valid. The duedate for audit and retrospective premiums isthe date of the billing.

EXPERIENCE RATING MODIFICATION FACTOR ENDORSEMENT WC 00 04 03(4-84)

The premium for the policy will be adjusted by anexperience rating modification factor. The factor wasnot available when the policy was issued. The factor,if any, shown on the Information Page is an es-

timate. We will issue an endorsement to show theproper factor, if different from the factor shown,when it is calculated.