Document n9azpeey218MoQ3EnXrZKd0QX

4 The Travelers Indemnity Company Hartford, Connecticut Pofcy Number DECLARATIONS COMPREHENSIVE AUTOMOBILE-GENERAL UABOiTY POLICY Ham 1. Named Insured 1 THE ANACONDA COMPANY L: -L PtR i vNO SCC0(A) Address (No*, atreet. town. eoanty,, Kate) o r Sfini r 5"w l Ci :.L\ ' j f ' Item 2. Policy Period: Item I I. Ports Comprehensive From , j i to JAM-1 -ms-- Csvwgos 1tabs of UaWby each each person occurrence arer8te AteMB frooBiaai W3y lijaiy LieMity ICOC M ICCjM I-CO M * ps>rw|iiM 12 01 A.M.t u General Property DMf lM#ty =*= S00M -,'jQ M l Comprehensive r ' Automobile Isfiy lajery Liebtlrty [t'lV- M TCO'.m PrepedT hM|i Uefcffity == H00M === * th rf * Contractual Z -* -- Liability Wily lejery LwhiKty Prspsdy D*sw|< Liability L0_0_C_ M 10Q0M -.COM == s SCO M * Premises Medical Payments $ each person , COLLECTED 1 M each accident $ Automobile Medical Payments 1 ; each person $ Uninsured Motorists ,e*S* (Damages for Bodily Injury) $ ert' $ ijr. M each person . UNDER M each accident Cswprsbserifs t Automobile Csfliriee ACV Less $ Deductible s Physical Damage Hrs, liflrtiief sr Tramportitiw Theft __________ Cenbrni Affltiiesl The insurance afforded ia-only with respect to such of the Coverage Parts as are mdicatad^ry Symbol Number mad the Coverage* Unrein as are indicated by specie premium charge. The Emit of thecompany's liability against each such Coverage shall be as stated herein, subject to all the terms of this policy having efereuoe thereto. In any Limits of Liability space the letter *"M" means "Thousands of Dollars" and the letters "ACV" mean "Actual ar:~-iT^ p r o f e s s ; Cash Valne". Symbol numbers of Scfeadulas, Endocse--nts, and addHional Covaraga Parts forming a part of (Ms poicy on Its effocthre data. % "PS .-rK>.--ri 7j 0w'_;-; Tetal Advance Prsmiww Ham 4. (a) The named insured is: individual ; partnership ; corporation ; joint venture ; other: (b) Audit Period: Annual, unless otherwise stated: semi-annual ; quarterly ;_______________ monthly Ham 5. During the past three yean ao insurer has canceled insurance, issued to the named insured, similar to that afforded hereunder, unless otherwise stated herein: _______________________________ ______ General Liability Coverage Parti--The declarations are completed on an accompanying schedule designated "General Liability Hazards". Automobile Liability Coverage Psrts--The declarations are completed on an accompanying schedule designated "Automobile Liability Hazards". fStandard time at the address of the named insured as stated herein. Countersigned by. t Keep this declarations page in your "Policy Jacket--Edition July 1, 1566", Form C-1H13. These declarations and all Coverage Parts, Schedules and Endorsements issued to form a part hereof, together with your Policy Jacket, form your complete insurance policy. 1^11025 C~IU15 Edition July 1.1966 mib t id m u.i.*. 1069 wx The Travelers Indemnity Company aScz i Policy Jflek*^ Edition July lr 1966 Tf tndwd t- 1 Dockiratiint and CvMRiNrti --' (plus any tnd*nM*itfs) i fUcr* Im policy Title Named Insured COMPREHENSIVE AUTOMOBILE--GENERAL LIABILITY POLICY and j _t h e a n a c o n d a c o mp a n y c : Al ` p e r l Address: fNO 8000(A) i 25 BROADWAY Policy Period: .JjEW~ YCP^ NY. lQQOL 1 1 I I i The Travelers Indemnity Company Hartford, Connecticut (A Stock Insurance Company, Herein Called The Company) . . . T -- . 0 4............. In consideration of the payment of the premium, in reliance upon the statements in the declarations made a part-hereof and subject to ail of the terms of this policy, agrees with the named insured as' follows: Definitions When used in this policy (including endorsements forming a part hereof): <' "automobil*" means a land motor vehicle, trailer or semi-trailer designed for travel on public roads (including any machinery or apparatus attached thereto), but does not include mobile equipment; "bodily injury" means bodily injury, sickness or disease sustained by any person;' "completed operations hazard" includes bodily injury and property damage arising out of operations or reliance upon a representation or warranty mam: at any time with respect thereto, but only if the bodily injury or property damage occurs after such operations have been com pleted or abandoned and occurs away from premises owned by or rented to the named insured. "Operations" include materials, parts or equipment furnished in connection therewith. Operations shall be deemed completed at the earliest of the following times: (1) when all operations to be performed by or on behalf of the named insured under the contract have been completed, (2) when all operations to be performed by or on behalf of the named insured at the site of the operations have been completed, or (3) when the portion of the work out of which the injury or damage arisjes has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in perform ing operations for a principal as a part of the same project. Operations which may require further service or maintenance work, or correction, repair or replacement because of any defect or deficiency, but which are otherwise complete, shall be deemed completed. The completed operations hazard does not include bodily injury or property damage arising out of (a) operations in connection with the transportation of property, unless the bodily injury or property damage arises out of a condition in or on a vehicle created by the loading or unloading thereof, (b) the existence of tools, uninstalled equipment or abandoned or unused materials, or (c) operations for which the classification stated in the policy or in the company's manual specifies "including completed operations"; "damage*" includes .damages for death and for care and loss of services resulting from bodily injury and damages for loss of use of property resulting from property damage; "elevator" means any hoisting or lowering device to connect floors or landings, whether or not in service, and all appliances thereof including any car, platform, shaft, hoistway, stairway, runway, power equipment and machinery; but does not include an automobile servicing hoist, or a hoist without a platform outside a building if without mechanical power or if not attached to building walls, or a hod or material hoist used in alteration, construction or demolition operations, or an inclined conveyor used exclusively for carrying property or a dumbwaiter used exclusively for carrying property and having a compartment height not exceeding four feet; "incidental contract" means any written (1) lease of premises, (2) ease ment agreement, except in connection with construction or demolition operations on or adjacent to a railroad. (3) undertaking to indemnify a municipality required by municipal ordinance, except in connection with work for the municipality, (4) sidetrack agreement, or (5) elevator main tenance agreement; "insured" means any person or organization qualifying as an insured in the "Persons Insured'* provision of the applicable insurance coverage. The insurance afforded applies separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the company's liability; "mobile equipment" means a land vehicle (including any machinery or apparatus attached thereto), whether or not self-propelled, (1) not sub ject to motor vehicle registration, or (2) maintained for use exclusively on premises owned by or rented to the named insured, including the ways immediately adjoining, or (3) designed for use principally off public roads, or (4) designed or maintained far the sole purpose of affording mobility to equipment of the following types forming an integral part of or permanently attached to such vehicle: power cranes, shovels, loaders, diggers and drills; concrete mixers (other than the mix-in-transit type); graders, scrapers, rotters and other road construction or repair equipment; air-compressors, pumps and generators, including spraying, welding and building cleaning equipment; and geophysical exploration and well servicing equipment; "named insured" means the person or organization named in Item 1. of the declarations of this policy; "named insured's products" means goods or products manufactured, sold, handled or distributed by the named insured or by others trading under his name, including any container thereof (other than a vehicle), Page 1 N11025.01 Ain nnwn but " named insured's products" shall not include a vending machine of any property other than such container, rented to or located for use of others but not sold; "occurrence" means an accident, including injurious exposure to condi tions, which results, during the policy period, in bodily injury or property damage neither expected nor intended from the standpoint of the insured; "policy territory" means: (1) the United States of America, its territories or possessions, or Canada, or (2) international waters or air space, provided the bodily injury or property damage does not occur in the course of travel or transporta tion to or from any other country, state or nation, or e (3) anywhere in the world with respect to damages because of bodily injury or properly damage arising out of a product which was sold for use or consumption within the territory described in paragraph (1) above, provided the original suit for such damages is brought within such territory; "products hazard" includes bodily injury and property damage Rising out of the named insured's products or reliance upon a representation or warranty made at any time with respect thereto, but only if the bodily injury or properly damage occurs away from premises owned by or rented to the named insured and after physical possession of such products has been relinquished to others; "property damage" means injury to or destruction of tangible property. Supplementary Payments The company will pay, in addition to the applicable limit of liability: (a) all expenses incurred by the company, all costs taxed against the insured in any suit defended by the company and all interest on the entire amount of any judgment therein which accrues after entry of the judgment and before the company has paid or tendered or de posited in court that part of the judgment which does not exceed the limit of the company's liability thereon; (b) premiums on appeal bonds required in any such suit, premiums on bonds to release attachments in any such suit for an amount not in excess of the applicable limit of liability of this policy, and the cost 1' of bail bonds required of the insured because of accident or traffic lawviolation arising out of the use of any vehicle to which this policy applies, not to exceed $250 per bail bond, but the company shall have no obligation to apply for or furnish any such bonds; (c) expenses incurred by the tiuwred for first aid to others at the time of an accident, for bodily injury to which this policy applies; (d) reasonable expenses incurred by the insured at the company's re quest, including actual loss of wages or salary {but not loss of other income) not to exceed $25 per day because of his attendance at hearings or trials at such request. Nuclear Energy Liability Exclusion (Broad Form) 1. The policy does not apply; < A. Under any Liability Coverage, to bodily injury or property damage "nuclear material" means source material, special nuclear material or byproduct material; (1) with respect to which an insured under the policy is also an insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual "Atomic Energy Liability Underwriters or Nuclear Insurance Association of Canada, or would be an insured under any^uch policy but for its termination upon exhaustion of its limit of liability; or "source material", "special nuclear material", and "byproduct material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof; "spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor; (2) resulting from the hazardous properties of nuclear material and with respect to which (a) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the t'amrad is, or bad this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by . the united States, of America, or aay agency thereof, with any ,gperson or organization. Under any Medical Payments Coverage, or under any Supple mentary Payments provision relating to first mid, to expenses inaimed with respect to bodily injury .resulting from the kasardous properties of unclear material and arising out ol the operation of a nuclear facility by any person or organization. C. Under any Liability Coverage, to bodily injury or property damage resulting from the kaiardous properties of nuclear-material, if (1) the nuclear material (aj is at any nuclear facility owned by, or operated by or on behalf of, an insured or (b) has been discnarged or dispersed therefrom; (2) the nuclear material is contained in spent fuel or waste at any tilde possessed, handled, used, processed, stored, transported or disposed of by or on behalf of an assured; or "waste" means any waste material (1) containing byproduct material and (2) resulting from the operation by any person or organization of any nuclear facility included within the definition of nuclear facility under paragraph (a) or (b) thereof; "unclear facility" means (a) any nuclear reader, (b) any equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing spent fuel, or (3) handling, processing or packaging waste, (c) any equipment or device used for the processing. fabricating or alloying of special nuclear material if at any tune the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 Rams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235, (d) any structure, basin, excavation, premises or place prepared or used for the storage or disposal ofwaste, and includes the site on which any of the foregmng is located, all operations conducted on such site and all prrmisrs osed for such (3) the bodily injury or property damage arises out of the furnishing operations; 2. by an insured of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility, but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (3). applies only to property damage to such nuclear facility and any property thereat. "unclear reactor" means any apparatusdesigned or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material; "property damage" includes all forms of radioactive contamination of property. II As used in this exclusion: III. This exclusion modifies the provisions of the policy relating to all Automobile Liability, General Liability and Medical Payments "hazardous properties" include radioactive, toxic or explosive Insurance other than Comprehensive Personal and Farmer's Com- properties; <. prehensive Personal Insurance. o- 0 AID 005074 QC Conditions 1. Premium. All premium* for this policy shall be computed in accord- ' 6. Other Insurance. The insurance afforded by this policy is primary ance with the company's rules, rates, rating plans, premiums and insurance, except when stated to apply in excess of or contingent upon minimum premiums applicable to the insurance afforded herein. Premium designated in this policy a* "advance premium" is a deposit premium only which shall be credited to the amount of the earned premium due at the end of the policy period. At the close of each period (or part thereof terminating with the end of the policy period) desig nated in the declarations as the audit period the earned premium shall be computed for such period and, upon notice thereof to the named insured, shall become due and payable. If the total earned premium for the policy period is less than the premium previously paid, the com the absence of other insurance. When this insurance is primary' and the insured has other insurance which is stated to be applicable to the loss on an excess or contingent basis, the amount of the company's liability under this policy shall not be reduced by the existence of such other insurance. When both this insurance and other insurance apply to the loss on the same basis, whether primary, excess or contingent, the company shall not be liable under this pxdicy for a greater proportion of the loss than that stated in the applicable contribution provision below: pany shall return to the named insured the unearned portion paid by the named insured. (a) Contribution by Equal Shares. If all of such other valid and collectible insurance provides for contribution by equal shares, the The named insured shall maintain records of such information as is company shall not be liable for a greater proportion of such loss necessary for premium computation, and shall send copies of such, than would be payable if each insurer contributes an equal share records to the company at the end of the policy period and at such times during the policy period as the company may direct. until the share of each insurer equals the lowest applicable limit of liability under any one policy or the full amount of the loss is paid, ana with respect to any amount of loss not so paid the 2. Inspection and Audit. The company shall be permitted but not ob remaining insurers then continue to contribute equal shares of the ligated to inspect the named insured's property and operations at any remaining amount of the loss until each such insurer has paid its time. Neither the company's right to make inspections nor the making limit in full or the full amount of the loss is paid, thereof nor any report thereon shall constitute an undertaking, on behalf of or for the benefit of the named insured or others, to determine or warrant that such property or operations are safe. (b) Contribatina by Limits. If any of such other insurance does not vide for contribution by equal shares, the company shall not liable for a greater proportion of such loss than the applicable The company may examine and audit the named insured's books and limit of liability under this piolicy for such loss bears to the total records at any time during the policy period and extensions thereof and within three years after the final termination of this policy, as far as applicable limit of liability of all valid and collectible insurance against such lose. they relate to the subject matter of this insurance. 7. Subrogation, In the event of any payment under this piolicy, the 3. Financial Xesponsibility Law*. When this policy is certified as proof of financial responsibility for the future under the provisoes of any motor vehicle financial responsibility' law, such insurance as is afforded by this policy for bodily injury liability or for property damage liability shall comply with the provisions of such law to the extent of the cover company shall be subrogated to all the insured's rights of recovery therefor against any pierson or organization and the insured shall execute and deliver instruments and papra* and do whatever else is necessary to secure such rights. The insured shall do nothing after loss to prejudice such rights. j age and limits of liability required by such law. The insured agrees to reimburse the company for any payment made by the company which it would not have been obligated to make under the terms of this policy except for the agreement contained in this paragraph. S. Changes. Notice to any agent cr knowledge possessed by any agent or by any other pierson snail not effect a waiver or a change in any part of this piolicy or estop the company from asserting any right under the terms of this piolicy; nor shall the terms of this piolicy be waived or 4. Ipsnred'a Duties in tile Event of Occurrence, Claim or Suit. (a) In the event of an occurrence, written notice containing particulars sufficient to identify the insured and also reasonably obtainable information with respect to the time, place and circumstances thereof, and the names and addresses of the injured and of available changed, except by endorsement issued to form a part of this policy, signed by the President, a Vice President, Secretary or Assistant Secretary of the company; provided, however; changes may be made in the written piortion of the declarations by a manager or general agent of the company when initialed by such manager or general agent. witnesses, shall be given by or for the insured to the company or any of its authorized agents as soon as practicable. The named insured shall promptly take at his expense all reasonable steps to iprevent other bodily injury or property damage imm arising out of the same or similar conditions, but such expense shall not be re coverable under this policy, 9. Assignment. Assignment of interest under this policy shall not bind the company until its consent is endorsed hereon; if, however, the named ensured shall die, such insurance as is afforded by this piolicy shall apply (1) to the named rnsnrets legal representative, as the named insured, but only while acting within the scopie of his duties as such, and (2) with respiect to the property of the named insured, to (b) If claim is made or suit is brought against the insured, the insured shall immediately forward to the company every demand, notice, the person having proper temporary custody thereof, as insured, but only until the appointment and qualification of the legal representative. summons or other process received by him or his representative. (c) The insured shall cooperate with the company and; upon the com pany's request, assist in making settlements, in the conduct of suits and in enforcing any right of contribution or indemnity 10. Three Tear Policy. If this piolicy is issued for a period of three years, the limits of the company's liability shall apply separately to each consecutive annual pieriod thereof. against any person or organization who may be liable to the insured 11. Cancellation. This piolicy may be canceled by the named insured by because of bodily injury or property damage with respect to which mailing to the compaire written notice stating when thereafter the insurance is afforded under this policy; and the insured shall attend cancellation shall be effective. This policy may be canceled by the hearings and trials and assist in securing and giving evidence and company by mailing to the named insured at the address shown in this obtaining the attendance of witnesses. The insured shall not, piolicy, written notice stating when not less than ten days thereafter exdep*- at'his own cost, voluntarily make any payment, assume any such cancellation shall be effective. The mailing of notice as aforesaid obligation or incur any expense, other than for first aid to others at shall be sufficient proof of notice. The effective date and hour of can thetimeof accident. cellation stated in the notice shall become the end of the piolicy period. Delivery ofisuch written notice either by the named insured or by the 5. Action Against Company, No action shall lie against the company company shall be equivalent to mailing. unless, as a condition precedent thereto, there shall have been full compliance with all of the terms of this policy, nor until the amount of tne insureds obligation to pay shall have been finally determined either by judgment against' the insured after actual trial or by written agreement of the insured, the claimant and the company. If the named insured cancels, earned premium shall be computed in accordance with the customary short rate table and procedure. If the compiany cancels, earned pxemium shall be computed piro rata. Pre mium adjustment may be made either at the time cancellation is effected or as soon as practicable after cancellation becomes effective, Any person or organization or the legal representative thereof who has but payment or tender of unearned pxemium is not a condition of secured such judgment or written agreement shall thereafter be entitled cancellation: to recover under this policy to the extent of the insurance afforded by this policy No person or organization shall have any right under this 12. Declarations. By acceptance of this piolicy, the named insured agrees policy to join the company as a party to any action against the insured that the statements in the declarations are his agreements and repre to determine the insured's liability, nor shall the company be impleaded sentations, that this piolicy is issued in reliance upon the truth of such by the insured or his legal representative. Bankruptcy or insolvency representations and that this piolicy embodies all agreements existing of the insured or of theinsureds estate shall not relieve the company of between himself and the company or any of its agents relating to this any of its obligations hereunder. A insurance. (continued on Page 3) AID 005075 Page 3 Hew York Special Provision--If a Comprehensive Automobile Liability Insurance, Garage Insurance or Automobile Medical Payments Insurance Cover age Part forming a part of this policy insures premises located or automobues principally garaged in New York, the Nuclear Energy Liability Exclusion (Broad Form) does not apply to such premises or automobiles. Puerto P*TM Special Provision---It is agreed that the Action Against Company Condition applicable to any liability coverage afforded by the policy with respect to occurrences which take place in Puerto Rico is amended to read: No action shall lie against the company unless as a condition precedent thereto, the insured shall have fully complied with all the terms of this policy. South Carolina Special Provision--ff a Comprehensive General Liability, Manufacturers' and Contractors' Liability, Owners', Landlords' and Tenants' Liability. Completed Operations and Products Liability, Contractual Liability. Premises Medical Payments or Garage Insurance Coverage Part forming a part of this policy injures premises located in South Carolina, it is agreed that with respect to such insurance that part of the alcoholic beverage ex clusion which relates to the selling, serving or giving of any alcoholic beverage (a) to a person under the influence of alcohol or (b) which causes or contributes to the intoxication of any person, is deleted. Vermont Sped*! PreriaiOo--If this policy affords a Liability Coverage with respect to a premises located or an automobile principally garaged in Vermont, it is agreed that the policy is amended in the following particulars with respect to such Coverage: The Policy, including this endorsement, is issued and delivered subject to the Laws of Vermont and particularly to Section 9242, Chapter 391 "The Vermont Statutes, Revision of 1947/' including the following statutory requirements forming a part of such Laws: The company shall pay and satisfy any judgment that may be recovered against the insured upon any claim covered by this Policy to the extent and within the limits of liability assumed thereby, and shall protect the insured against the levy of any execution issued upon any such judicial judgment or claim against the insured. No limitation of liability in this Policy shall be valid if, after a judgment has been rendered against the insured in respect to his legal liability for damages in a particular instance, the company continues the litigation by an appeal or otherwise, unless the insured shall stipulate with the company, agreeing to continue such litigation. No action shall lie against the company to recover for any loss under this Policy, unless brought within one year after the amount of such loss is made certain either by judgment against the insured after final determination of the litigation or by agreement between the parties with the written consent of the company. The insolvency or bankruptcy of the insured shall not release the company from the payment of damages for injury sustained or loss occasioned during the life of the Policy, and in case of such insolvency or bankruptcy an action may be maintained by the injured person or claimant against the company under the terms of the Policy for the amount of any judgment obtained against the insured not exceeding the limits of the Policy. Payment of any judicial judgment or claim by the insured for any of the company's liability hereunder shall no* bar the insured from any action or right of action against the company. In case of payment of loss or expense under this Policy, the company shall be subrogated to all rights of the insured against any party, as respects such loss or expense, to the amount of such payment, and the insured shall execute all papers required and shall cooperate with the company to secure to the company such rights. In witness whereof, THE TRAVELBtS INDEMNITY COMPANY has caused this policy to be signed by Eh President and Sea'etary'fet Hartford, - Connecticut, and countersigned on the declarations page by a duly authorized agent of the company. f C-11113 Editiaa Jatr I. IMS miTit w 1.1.1. HA (GA) President AID 005076 V-/ U COMPREHENSIVE GENERAL LIABILITY INSURANCE COVERAGE PART L Coverage A--Bodily Injury Liability Coverage B--Property Beinge Liability The company will pay oc behalf of the uuured all sums which the ttuured shall become legally obligated to pay as donates because of Coverage A. bodily injury or Coverage B. property donate to which this insurance applies, caused by an occurrence, and ^he company shall have the right and duty to defend any suit against the insured seeking donates on account of such bodily injury or property donate, even if any of the allegations of the suit are groundless, false or frauduientyand may make such investigation and settlement of any claim or suit as it deems expedient, but the company shall not be obligated to pay any daim or judgment or to defend any suit after the applicable limit of the company's liability has been exhausted by payment of judgments or settlements. trrfurfaM This insurance does not apply: (a) to liability assumed by the insured under any contract or agreement except an incidental contract; but this exclusion does not apply to a warranty of fitness or quality of the named insured's products or a warranty that work per formed by or on behalf of the named insured will be done in a workmanlike manner; (b) to bodily injury or property damage arising out of the owner ship, maintenance, operation, use, loading or unloading of (1) any automobile or aircraft owned or operated by or rented or loaned to the named insured, or (2) any other automobile or aircraft operated by any person in the course of his employment by the named insured; but this exclusion does not apply to the parking of an automobile on premises owned by, rented to or controlled by the named insured or the ways immediately adjoining, if such automobile is not owned by or rented or loaned to the named insured; (c) to bodily injury or property damage arising out of and in the course of the transportation of mobile equipment by an automobile banned or operated by or rented or loaned to the named insured; (d) to bodily injury or property damage arising out of the owner ship, maintenance, operation, use, loading or unloading of any watercraft, if the bodily injury or property donate occurs away from premises owned by, rented to or con trolled by the named insured; but this exclusion does not apply to bodily injury or property damage included within the products hazard or the completed operations hazard or resulting from operations performed for the named insured by independent contractors or to liability assumed by the insured under an incidental contract; (e) to bodily injury or property damage due to war, whether or not declared, dvil war, insurrection, rebellion or revolution or to any act or condition incident to any of the foregoing, with respect to (1) liability assumed by the insured under an incidental contract, or (2) expenses for first aid under the Supplementary Pay ments provision; (f) to bodily injury or property damage for which the insured or his indemnitee may be held liable, as a person or organi zation engaged in the business of manufacturing, dis tributing, selling or serving alcoholic beverages or as an owner or lessor of premises used for such purposes, by reason of the selling, saving or giving of any alcoholic beverage (1) in violation of any statute, ordinance or regulation, (2) to a minor, (3) to a person under the influence of alcohol, or (4) which causes or contributes to the intoxication of any person; (g) to any obligation for which the insured or any carrier as his insurer may be held liable under any workmen's compen sation, unemployment compensation or disability benefits law, or under any similar law; (h) to bodily injury to any employee of the insured arising out of and m the course of his employment by the insured; but this exclusion does not apply to liability assumed by the insured under an incidental contract; G) to property damage to (1) property owned or occupied by or rented to the insured, (2) property used by the insured, or i , s (3) property in the care, custody or control of the insured or as to which the insured is far any purpose wwiig physical control; _ ,. _ . i, but para (!) end (3) of this eschuann dp not appre with respect to liability under a written ridetrack agreement and part (3) of this exclusion does not apply with respict ts property damage (other than to elevators) arising out of the use of an elevator at premises owned by, rented trier con trolled by the maud sarerarf; (j) to property damage to premises alienated by the named rnsurei arising out of such premises or any part thereof; (k) to bodily injury or property damage reaching from the failure of the named insured's products or work completed by or for the named insured to perform the function or serve the purpose intended by the named insured, if such failure is due to a mistake or deficiency in any design, formula, plan, specifications, advertising material or printed instructions prepared or developed by any assured; but this esalusion does not apply to bodily injury or Property damage raulting from the active malfunctioning at such products or work; (l ) to property damage to the named insured's products arising out of such products or any port of such products; (m) to property damage to work performed by or on behalf of the named insured arising out of the work or any portion there of, or out of materials, parts or equipment furnished in connection therewith; (n) to damages claimed for the withdrawal, inspection, repair, replacement, or loss of use of the named insured's products or work completed by or for the named assured or of any property of which such products or work form a part, if such products, work or property are withdrawn from the market or from use because of any known or suspected defect or deficiency (herein. H. Persons Insured Each of the following is an insured under this insurance to the extent set forth below: (a) if the named insured is designated in the declarations as an individual, the person so designated but only with respect to the conduct of a business of which he is the sole pro prietor; (Continued on page 2) L1 005077 Pip 2 (b) if the named injured is designated in the declarations as a partnership or joist venture, the partnership or joint venture so designated and any partner or member thereof but only with respect to his liability as such; (c) if the Mated insured is designated in the declarations as other than an individual, partnership or joint venture, the organization so designated and any executive officer, director or stockholder thereof while acting within the cope of his duties as such; (d) any person (other than an employee of the named insured) or organization while acting as real estate manager for the named insured; and (e) with respect to the operation, for the purpose of locomotion upon a public highway, of mobile equipment registered under any motor vehide registration law, (1) an employee of the Mined insured while operating any such equipment in the course of his employment, and (U) any other person while operating with the permission of the Mined insured any such equipment registered in the name of the named insured and any person or organization legally responsible for such operation, but only if thee is no other valid and collectible insurance ' available, either on a primary or excess basis, to such person or organization; provided that no person or organization shall be an insured under this paragraph (e) with respect to: (1) bodily injury to any fellow employee of such person injured m the course of his employment, or (2) property damage to property owned by, rented to, in charge of or occupied by the named insured or the employer of any person described in subparagraph (ii). This insurance does riot apply to bodily injury or property damage arising out of the conduct of any partnership or joint venture of which the insured is a partner or member and which is not designated in this policy as a named insured. Subject to the above provisions respecting "each person" and "each occurrence", the total liability of the company for all damages because of (1) all bodily injury included within the completed operations hazard and (2) all bodily injury included within the products hazard shall not exceed the limit of bodily injury liability stated in the declarations as "aggregate". Coverage B--The total liability of the company for all damages because of all property damage sustained by one or more persons or organizations as the result of any one occurrence shall not exceed the limit of property damage liability stated in the declarations as applicable to "each occurrence". Subject to the above provision respecting "each occurrence", the total liability of the company for all damages because of all property damage to which this coverage applies and described in any of the numbered subparagraphs below Shall not exceed the limit of property damage liability stated in the declarations as "aggregate": (1) all property damage arising out of premises or operations rated on a remuneration basis or contractor's equipment rated on a receipts basis, including property damage for which liability is assumed under any incidental contract relating to such premises or operations, but excluding property damage included in subparagraph (2) below; (2) all property damage arising oat of and occurring inr the course of operations performed for the named tnsurod by independent contractors and generel supervision thereof by the named insured, including any such property damage tee which liability is assumed under any incidental tmtrnct relating to such operations, but this subparagraph (s doer not indude property damage arising out of msintrnjjw or repairs at premises owned by or tented to the mmod insured or structural alterations at such prrmisss which do not involve changing the size of or moving buildings or other structures; (3) ail property damage included within the products hatard and M property damage included within the completed operations BL limits of LUbflfcy Regardlem of the number of (1) insureds under this policy, (2) persons or organizations who sustain bodily injury or property damage, or (3) daimn made or suits brought on account of bodily injury or property damage, the company s liability is limited as follows: Coverage A--The limit of bodily injury liability stated in the declaration* as applicable to "each person" is the limit of the company's liability for all damages because of bodily injury sustained by one person as the result of any one occurrence; but subject to the above provision respecting "each person", the total liability oft the company for all damages because of bodily injury sustained by two or more persons as the result of any one occur rence shall not exceed the Omit of bodily injury liability stated in the declarations as applicable to "each occurrence". 4 Such aggregate limit shall apply separately to the property damage described in subparagraphs (1), (2) and (3), above, and under subparagraphs (1) and (2), separately with respect to each project away from premises owned by or rented to the named insured, Coverages A and B--For the purooae of determining the limit of the company's liability, all bodtly injury and property damage arising out of continuous or repeated exposure to substantially the same general conditions shall be considered as arising out of one occurrence. IV. Policy Period; Territory Tljis insurance applies only to bodily injury or property damage which occurs during the policy period within the policy territory. .. C-11139 Edition July 1,1966 mik t t d ik m.s .a. H.S. (CGL) 1I J AID 005078 ' HOSPITAL PROFESSIONAL LIABILITY INSURANCE COVERAGE PART ADOmOHM MdAXAttOW ' * ,'JIR .*1'..' t Fanall* part a* falter Na. T">fuSL"*92222^ *"f2 liailn al UabHtey Atfviim Prmfoai O. Hoapital Frnfwioinl liability * 1 >000,000 claim * 1,000, C00 "*" Total Advaaca Pramium INCLINED IN COMPOSITE * RATE 9 Oaaaral UaUUty Haxante fContinued on Pate 2) Itl AIE> 005079 L comjtfi o HOgffAi. nomSHMAl UAMUTT Tha company WSTitoy ea behalf of the insured all aunt whiditheinsured atffi^heoooae legally obligated to pay m damage! beams* ofInjury to any parson arising out of the. Tendering ofor faffers to render, dining the policy period, the following pmfaaainnal ssrvicas: (a) mediral, surgical, dental or mining treatment to such pamon or the penon inflicting the injury melmthig the fumiehing of food or bevaragas in cowBeotian therewith, (b) furnishing or diapeoaing of druga or medinal. dental , or surgical supplies or appliancae if the Injury occurs after the named insured has roBnquiahsd possession thereof to others, (c) handling of or performing poet-mortem examinatioaa on human bodiaa, or (d) eerrice by any pereon ae a member of a fnrmal accreditation or similar rrofeeeirinel boerd er wnermdtiiie of the nomad insured, or aa a parson charged with the duty of executing directives of any such board or committee, , and the company ahall hare the right and duty to defend any anit againit the insured aeeking auefa damages, even if any of the allegations of the suit are groondleaa, false or fraudulent, and may make each investigation and, with the written coneent of the insured, audk settlement of any claim or suit aa it deems expedient, hot the com pany shall not ha obligated to pay any claim or judg ment or to defend any suit after the applicable limit of the company's liability has been exhausted by payment of judgment* or settlements. i This insurance does not apply: (a) to bodily injury to any employee of the insured arising out of and in the course of hie employment by the insured; (b) to any obligation for which the insured or any carrier as hie insurer may be held liable under any workmen's compensation, unemployment com pensation or disability benefits law, or under any similar law; (c) to liability of an insured, if an individual, far hie personal acts or omissions of a professional nature; (dl.to flaa; owaatriap, maintenance, operation, uae, loafing or unloading of any motor vehicle, trailer, WlMBRn wVBCnit. - H|t a. resows MWKBD Earh of thd following is an insured under this inaorance to the extent set forth below: 4a) the named insured;----- ---------- - -- (b) if the neiwerf insured ie designated in the declara tions as a partnership, any partner or member thereof, but only with respect to bis liability aa such; (e) if the nomad insured ie designster) in the declara tions aa other than aw individual or partnership, any executive officer, stockholder or member of Uh board of trustsea, directors at governors of the named insured while acting within the acope of hie duties aa such. . | f . ` ?: - Baganflaae of the number at insureds under this mauranoa tha oompany*a liability is hmhad aa follows: The imlt of Babiiity ffia&ad to the dedarationa aa ap plicable to "such ililiaP* la tha Hmk at the company's Babiiity for all danger because-of each claim or anit covered hereby. The Barit afliabffity stated in tha decla.Tationa a* "aggi agate" jhimlflart to -the above pro vision respecting ^md^cWnl^ 4he totaLffimit afj" eoaqatTk Hebflity hilgimrfw Ft1 *TT dsmtagf IV. AMBaorp mwoh _ When used hi mteuwoa to mauraao meant all damages, jndufing daaaugsa tar death, which are payable hnrwnwa of injury to erbich this iimiranea apphm. - - : 7^-:.r i ...' V. ABMTMHAL tHBWtW ; i*->- * A. tnw.fi OeOwlaWafc--TetHwy.CMwWa When an injury occurs written notice ebaQ be given by or on letiiif of the insured, in " " adth too "In- aursd's Duties in the Event at Occurrence, Claim or Suit" Condition. B. H,W liriwli. The tneurance ahaE not apply to expenses incurred by the insured for first aid at the time of an> accident and the "Supplementary Paymenta" provision and the "Insured's Duties in the Event of Oocumnoe, Claim or Suit'' Condition ere amended accordingly. C. UwtH.a ml Cavwee* IMr Any OOn t UaUWy la.waii. Except as stated in this Part, the policy dose not apply to injury ariaing out of the rendering ofor faflnio to render the professional services described in para graph I above. C*11540 Edltkm October U 1966 mrce in MX (HPL) 2*7 jn* 'ueg .. #< t V* ivf 122 AID 005080 T-RNSL-922224-72 Page 3 Protection Against UNINSURED MOTORISTS INSURANCE COVERAGE PART 1' ' ftr ' necessary or appropriate to preserve his right to recover damages from any person or organization alleged to be legally responsible for the bodily injury; and in any action against the company, the company may require the insured to join such person or organization as a party defendant. D. notice of Legal Action. If/ before the company makes payment of loss hereunder, the insured or his legal representative shall institute any legal action for bodily injury against any person or organiza tion legally responsible for the use of a highway vehicle invok'd in the accident, a copy of the summons and com plaint or other process served in connection with such legal action shall be forwarded immediately to the company by the insured or his legal representative. E. Other Insurance. With respect to bodily injury to an insured while occupying a highway vehicle not owned by the named insured, this insur. ance shall apply only as excess insurance over any other similar insurance available to such insured and applicable to such vehicle as primary insurance, and this insurance shall then apply only in the amount by which the limit of liability for this coverage exceeds the applicable limit of liability of such other insurance. Except as provided in the foregoing paragraph, if the insured has other similar insurance available to him and applicable to the accident the damages shall be deemed not to exceed the higher of the applicable limits of liability of this insurance and such other insurance, and the company shall not be liable for a greater proportion of any loss to which this cover age applies than the limit of liability hereunder bears to the sum of the applicable limits of liability of this insurance and such other insurance. F. Arbitratiso. If any person making claim hereunder and the company do not agree that such person is legally entitled to recover damages from the owner or operator of an uninsured highway vehicle because of bodily injury to the insured, or do not agree as to the amount of payment which may be owing under this insurance, then, upon written demand of either, the matter or matters upon which such person and the company do not agree shall be settled by arbitration, which shall be conducted in accordance with the rules of the American Arbitration Association unless other means of conducting the arbitration are agreed to between the insured and the company, and judgment upon the award rendered by the arbitrators may be entered in any court having jurisdiction thereof. Such person and the company each agree to consider itself bound and to be bound by any award made by the arbitrators pursuant to this insurance. G. Tract Agreement. In the event of payment to any person under this insurance: (a) the company shall be entitled to the extent of such payment to the proceeds of any settlement or judg ment that may result from the exercise of any rights of recovery of such person against any person or organization legally responsible for the bodily injury because of which such payment is made; (b) such person shall hold in trust for the benefit of the company all rights of recovery which he shall have against such other person or organization because of the damages which are the subject of claim made under this insurance; (c) such person shall do whatever is proper to secure and shall do nothing after loss to prejudice such rights; (d) if requested in writing by the company, such person shall take, through any representative designated by the company, such action as may be necessary or appropriate to recover such payment as damages from such other person or organization, sack act**to be taken in the name of such person; in the evot of a recovery, the company shall be reimbursed outjp sack recovery for expenses, costs and attorneys' -Ikes in curred by it in connection therewith; %. (e) such person shall execute smd deliver to the company such instruments and papers as may be appropriate to secure the rights and obligations of such person and the company established by this provision. H. Payment at Low by the Company. Any amount due hereunder is payable (a) to the insured, or (b) if tbe insured be a minor to his parent or guardian, or (c) if the insured be deceased to his surviving spouse, otherwise (d) to a person authorized by law to receive such pay ment or to a person legally entitled to recover) the damages which the payment represents; provided, the company may at its option pay any amount due hereunder in accordance with division (d) hereof. State Exceptions--If this Coverage Part applies to an insured highway vehicle principally garaged in one of the following states, it is agreed that the insurance afforded hereunder with respect to accidents occurring either in any such state or while the insured is occupying an insured highway vehicle registered in such state is amended in accordance with all exceptions listed as applicable for such state: Arkansas, Florida, Kentucky or Louisiana--The term "ttninsured higkuny vehicle" includes a highway vehicle with respect to which there is a bodily injury liability policy applicable at the time of the accident but the company writing the same becomes insolvent within one year after such accident. Arkansas, Louisiana or Oklahoma--The insured shall not be required to arbitrate disputed claims under the Uninsured Motorist Coverage. California*-The provisions relating to the Uninsured Motorists Coverage are amended as follows: 1. Subsections (b), (c) and (d) of the provision entitled "Limits of Liability" are deleted and the following substituted therefor: (b) Any loss payable under the terms of this coverage to oi for any person shall be reduced by: (1) the amount paid and the present value of all amounts payable to him under any workmen's compensation law, exclusive of non-Occupationafdisability benefits; (2) amounts paid or payable to or for such person under any valid and collectible automobile insurance available to the insured to afford benefits for medical expenses; (3) the amount the insured is entitled to recover from any other person who is an iusured under the bodily injury liability coverage of this policy; and (Continued on pap 4) Lfr AID 005081 Psgs 4 (4) all sums paid by or on behalf of the owrier or operator of the uninsured highway vehicle and any other person or organization jointly or severally liable together with such owner or operator for bodily injury to an insured. 2. The provision entitled "Other Insurance" is replaced by the following: 1 Other Twain sue*. , With respect to bodily injury to any insured occupying a highway vehicle other than an owned automobile to which the bodily injury liability coverage applies, the insurance hereunder shall not apply if the owner of such highway vehicle has insurance similar to that provided (or herein. Subject to the preceding paragraph, if the insured has other similar insurance available to him, any damages shall be deemed not to exceed the higher of the applicable limits of the respective coverages and such damages shall be pro-rated between such coverages in such proportion as each eosrerage bears to the total of such limits. 3. The provision entitled "Action Against Company" is amended to read as follow: - Action Against Company. No action shall lie against the company unless, as a conditio* precedent thereto, the insured or his legal representative has fully complied with ail the terms of this policy nor unless within one year from the date of the accident: (a) suit for bodily injury has been hied against the uninsured motorist in a court of competent jurisdiction, or ' (b) agreement as to the amount due under this coverage has been concluded, or it)- the insured or his legal representative has formally instituted arbitration proceedings. itichigaa--The term "Uninsured Automobile" or "Uninsured Highway Vehicle" is changed to "Uninsured Motor Vehicle" to comply witfh/'\ Section 500.3010 of the Michigan Insurance Code. Oregon--The insurance applies subject to the following provisions: 1. '* Exclusion (c) of Paragraph I., does not apply unless the named insured has employees who operate motor trucks and such employees are covered for workmen's compensation. 2. Provisions (b) {' '.) and (d) of Paragraph III. do not apply unless the named insured has employees who operate motor trucks and such employees are coveredTor workmen's compensation. o..-- 3. "Jfotof track** means motor trucks as defined in O.R.S. 481.035. .... .. r -- - F* f r .... t f r, .. j e j-o*7 p.\ bscV *5- % .13^ I V- Pt-.J- . N -of, . . d A* Ul -.r -JPJiL..... C-11180 Edition JulyI, *966 aatarto is u .s .a. R3. (UM) (270) * L6 AID 005082 ^V UNINSURED MOTORISTS INSURANCE COVERAGE PART ADDmOHAl DKCLUU*nOK8______ ______________Forming part of Policy No. Designated Insured L.r3n222^ ~72 Description of Insured Highway Vehicles (Check appropriate box) jO Asy automobile owned by the named insured SEE EJ' O 995 O Any private passenger automobile owned by the named insured G Any highway vehicle to which are attached dealer'! licen*e plates issued to the named insured G Any highway vehicle for which a premium designated by the letters "UM" is included in the declarations of the policy and a highway vehicle ownership of which is acquired during the policy period by the named insured at a replacement therefor - G Any mobile equipment owned or leased by and registered in the name of the named insured a______---------- :-------- '----------------------------------------------------------------------:------------------ Protection Against UNINSURED MOTORISTS INSURANCE . V L Coverage XS---Omniured Motorists (Damages for Bodily Injury) The company will pay all sums which the insured or his legal representative shall be legally entitled to recover as damages from the owner or operator of an uninsured highway vehicle Decause of bodily injury sustained by the insured, caused by accident and arising out of the ownership, maintenance or use of such uninsured highway vehicle; provided, for the purposes of this coverage, determination as to whether the insured or such representative is legally entitled to recover such damages, and if so the amount thereof, shall be made by agreement between the insured or such representative and the company or, if they fail to agree, by arbitration. No judgment against any person or organization alleged to be legally responsible for the bodily injury shall be conclusive, as between the insured and the company, of the issues of liability of such person or organization or of the amount of damages to which the insured is legally entitled unless such judgment is entered pursuant to an action prosecuted by the insured with the written consent of the company. Exclusions This insurance does not apply: (a) to bodily injury to an insured with respect to which such insured, his legal representative or any person entitled to payment under this insurance shall, without written con sent of die company, make any settlement with any person or organization who may be legally liable therefor; (b) to bodily injury to an insured while occupying a highway vehicle (other thazran insured highway vehicle) owned by the named insured, any designated insured or any relative resident in the same household as the named or designated insured, or through being struck by such a vehicle, but this exclusion does not apply to the named insured or his relatives while occupying or if struck by a highway vehicle owned by a designated insured or his relatives; (c) so as to inure directly or indirectly to the benefit of any workmen's compensation or disability benefits carrier or any person or organization qualifying as a self-insurer under any workmen's compensation or disability benefits law or any similar law. IL Pereoos Insured >? .. f- Each at the -. following .. .ifip an inured under thiJs:tosureawSetos extent set forth beknrj -* arr**-.* v'-v. Vw J (a) the turned insured and any dmigmiod rostered kadBwMe residents of the same household, the tpouse wad rSbtfves of either; *' - -- " (b) any other person while occupying an-insured highway vehicle;and . (c) any person, with respect to damages he-ts entitled to recover because of bodily injury to which this insurance applies sustained by an insured under (a) or (b) above. The insurance applies separately with respect to each insured, except with respect to the limits of the company's liability. HI. Umita of Uabfflty Regardless of the number of insureds under this policy, the com pany's liability is limited as follows: (a) The limit of liability stated in the declarations as applicable to "each person" is the limit of the company's liability for all damages because of bodily injury sustained by one person as the result of any one accident and, subject to the above provision respecting "each person", the limit of liability stated in the declarations as applicable to "each accident'1 is the total limit of the company's liability for all damages because of bodily injury sustained by two or mare persons as the result of any one accident. (b) Any amount payable under the terms of this insurance because of bodily injury sustained in an accident by a person who is an insured under this coverage shall be reduced by (1) all sums paid on account of such bodily injury by or on behalf erf (i) the owner or operator of the uninsured highway vehicle and (ii) any other person or organization jointly or sever ally liable together with such owner or operator for such bodily injury, including all sums paid under the bodily injury liability coverage of the policy, and (Continued on page 2) L6 AID 005083 (2) the amount paid and the present value of all amounts payable on account of such bodily injury under any workmen's compensation law, disability benefits law or any similar law. (iii) under subparagraphs (b) and (c) above, a vehicle owned by the named insured, any designated insured or any resident of the same household as the named or designated insured; or (c) Any payment made under this insurance to or for any insured * be applied in reduction of the amount of damages which be may be entitled to recover from any person insured undet.-the bodily injury liability coverage of tbe-poiicy. - (d) The company nhtU oot be obligated to pay under this insur ance that part of the damares which the insured may be entitled to recover from the owner or operator of an uninsured kifhway vehicle which represents expenses far medicali'.services- paid or payable under the medical pay ments coverage of the policy. IV. Policy Period; Territory This insurance applies only to accidents which occur during the policy period and within the United States of America, its terri tories or possessions, or Canada. V. Additions! Definidnps When need in reference to this insurance (including endorsements forming a part of the policy): (iv) under subparagraphs (b) and (c) above, a vehicle fur nished for the regular use of the named insured or any reeident erf the same household; "occupying" means in or upon or entering into or alighting from; "state" includes the District of Columbia, a territory or possession of the United States, and a province of Canada; "uninsured highway vehicle" means: (a) a highway vehicle with respect to the ownership, mainten ance Or use of which there is, in at least the amounts specified by the financial responsibility law of the slate in which the insured highway vehicle is principally garaged, no bodily injury liability bond or insurance policy applicable at the time of the accident with respect to any person or organization legally responsible for the use of such vehicle, or with respect to which there is a bodily injury liability bond or insurance policy applicable at the time of the accident but the company writing the same denies coverage thereunder; or _ , *Maci^nsted insured" means an individual named in the de clarations under Designated Insured; (b) a bit-and-run-uebicia; but the term "uninsured highway vehicle" shaft not indude: "highway vahide" means a land motor vehicle or trailer other (i) o il ensured highway vehicle, than _ . (a) a farm type tractor or other equipment designed for x - use principally off public roads, while not upon public roads, ...... - (b) a vehicle operated on rails or crawler-treads, or (ii) a highway rtktde which it owned or operated bv a sdfinsurer within the meaning ofany motor vehicle financial responsibility law, motor carrier law or any similar law, - (iii) a highway vehicle which is owned by the United States of America, Canada, a state, a political sub-division wf any (c) a vehicle while located for use as a residence or premises; such.govepuneat ft.no. agency of any of the factoring. L're.' > .`miwL&* ~w "hit-and-run vehicle" means a highway vehicle which causes . bodily injury to an insured arising out of physical contact of . juch vehicle with the insured or with a vehicle which the insured VL Additional Condltkw *, 'i or-vr'* &>,*( : sat >: ' A. Prsarfmw ru-syr. . -. is occupyint at the.time of the accident, provided: If during the pblicy period the number dt inxurut highway (a) there cannot be ascertained the identity of either the operator or owner of such highway vehicle; (b) the insured or someone on his behalf shall have reported the accident within 24 hours to a police, peace or judicial officer or to the Commissioner of Motor Vehicles, and shall have filed with the company within 30 days there- ' after a statement under oath that the insured or his legal . . representative has a cause or causes of action arising out erf such accident for damages against a person or persons vehicles owned by the named insured or spouse or the number of dealer's license plates issued to the named insured changes, the named insured shall notify the company during the policy period of'any change and the premium shall be adjusted in accordance with the manuals in use by the company. If the earned premium thus computed exceeds the advance pre mium pud, the named insured shall pay the excess to the company; if less, the company shall return to the named insured the unearned portion paid by such insured. whose identity is unascertainable, and setting forth the facts in support thereof; and B. (c) at the company's request, the insured or his Ibgal repre-.1 . * sentative makes available for inspection the vehicle which the insured was occupying at the time - of the accident; Proof of Claim; Medical Reports. As soon at.practicabie, the insured or other person making claim shall give to the company written proof of claim, under oath if required, including full particulars of the nature and extent of the injuries, treatment, and other details entering into the determination of the amount payable hereunder. "insured highway vehicle" means a highway vehicle: (a) described in the declarations as an insured highway vehicle to which the bodily injury liability coverage of The insured and every other person making claim hereunder shall submit to examinations under oath by any person named by the company and subscribe the same, as often as may reasonably be required. Proof of claim shall be made the policy applies; upon forms furnished by the company unless the company (b) while temporarily used as a substitute for an insured highway vehicle as described in subparagraph (a) above, shall have failed to furnish such forms within 15 days after receiving notice of claim. -- when withdrawn from normal use because of its breakdown, repair, servicing, lorn or destruction; The injured person i shall submit to physical examinations by physicians selected by the company when and as often (c) while being operated by the named or designated insured as the company may reasonably require and he, or in the on by the spouse of either if a resident of the same event of his incapacity his legal representative, or in the household; event of his death his legal representative or the person or but the term "injured highway vehicle" shall not include: persons entitled to sue therefor, shall upon each request from the company execute authorization to enable the company to (i) a vehicle while used as a public or livery conveyance, obtain medical reports and copies of records. uiiless such use is specifically declared and described in this policy; C. Assistance end Cooperation of the Insured. (ii) a vehicle while being used without the permission of the After notice of claim under this insurance, the company may require the insured to take such action as may be C-tliM (Continued on pate 3) L6 -A V AID 005084 AUTOMOBILE MEDICAL PAYMENTS INSURANCE COVERAGE PART ADDITIONAL DECLARATIONS Designstad Fmw ii learned- - - SEE END A6100 F^ n I-P-NSI-92222^2 Advance Premium I * 1 S Total # INCLUDED Designstioa of AtnmobllBa PfririeB 1 (1) Any amnai automobile (2) Any hirai autemebSe (3) Any licensed owned prxaaie passenger automobile (4) Any HltmMt lor which premium it included in tbe declaration* for Medical Payments (5) Any an ii--tf automobile () L Coverage F--Automobile lfadieal Payment* 1' liability insurance also apply to this insurance; and when used in Tbe company will pay all reasonable medical expense incurred within one year from the date of the accident: reference to this insurance (including endorsements fanning a part of the policy); Division 1. to or for each person who sustains bodily injury, caused by accident, while occupying a designated "designated tutomobfls" mesne an automobile designated in the declarations and includes: , automobile which is being used by a person for (a) an automobile not owned by tbe named insured while whom bodily injury liability insurance is afforded temporarily used as a substitute for an owned automobile under this policy with respect to such use; designated in tbe schedule when withdrawn frontoormal Division 2. to or for each injured who sustains bodily injury, caused by accident, while occupying or, while a use for servicing or repair or became of its fin ^linun, toes or destruction; and pedestrian, through being strode by a highway uekick. This insurance does not apply: (a) to bodily injury to any person or injured while employed or otherwise: engaged in duties in connection with an automobile business, if benefits therefor are in whole or in part either payable or required to be provided under any (b) a trailer designed Cor use with a prieate passenger auto mobile, if not being used far business purpoaa with another type automobile and if not a home, offices store, display or pemrnger trailer; "highway vehicle" means a bad motor vehicle or trailer other than , _. (a) a farm type tractor or other equipment designed for use principally off public roads, while not upon public roads, workmen's compensation law; (b) a vehicle operated on rails or crawler-treads, or (b) to bodily injury due to war, whether or not declared, civil war, insurrection, rebellion or revolution, or to any act or condition incident to any of tbe foregoing; (c) under Division 1, to bodily injury to any employee of the named insured arising out of and in the course of employ ment by the named insured, but this exclusion does not apply to any such bodily injury arising out of and in the course of domestic employment by the named insured unless benefits therefor are in whole or in part either payable or required to be provided under any workmen's compensation law; (d) under Division 2, to bodily injury sustained while oc cupying a highway vehicle owned by any insured, or fur nished for the regular use of any insured by any person or organization other than the named insured. (c) a vehicle while located for use as a residence or premises; "medical expense" means expensrs for necessary medical, surgical. X-ray and dental services, mduding prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services; "occupying" means in or upon or entering into oralighting from. V. Policy Period; Territory This insurance applies only to accidents which occur during the policy period within the territory described in paragraph (1) or (2) of the definition of "policy territory". VI. Additional Conditiana A. Medical Reports; Proof and Payment of Claim EL Persona Insured--Dtviaiaa 2. Each of the following leas ensured under this insurance to the extent set forth below: -*vV As soon as practicable the injured person or someone on his behalf shall give to the company written proof of claim, under oath if required, and shall, after each request from the company, execute authorization to enable the company to (a) any person designated as insured in the declarations; (b) while residents of the same household as such designated person, his spouse aiid the relatives of either; and if such designated person shall die, any person who was an insured at the time of such death shall continue to be an insured. m. Limit of Liability The limit of liability for Automobile Medical Payments Coverage stated in the declarations as applicable to "each person" is the limit of the company's liability for all medical expense for bodily injury to any person, including any insured, as the result of any one accident. When more than one medical payments coverage afforded by this policy applies to the loss, the company shall not be liable for more than the amount of the highest applicable limit of liability. TV. Additional Definitions obtain medical reports and copies of records. The injured person shall submit to physical examination by physicians selected by the company when and as often as the company may reasonably require. The company may pay the injured person or any person or organization rendering the services and such payment shall reduce the amount payable here under for such injury. Payment hereunder shall not con stitute an admission of liability of any person or, except hereunder, of the company. B. Excess Insurance Except with respect to an owned automobile, the insurance under Division 1 shall be excess insurance over any other valid and collectible automobile medical payments or automobile medical expense insurance. The insurance under Division 2 shall be excess insurance over any other valid and collectible automobile medical payments or automobile medical expense insurance available to the The additional definitions applicable to automobile bodily injury insured under any other policy. C-11112 Edition July 1,1966 uinuiauj. N.S. (AMP) AID005085 L5 COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE COVERAGE PART L Coverage C--BodEy Injury Liability Coverage D--Property Damage Liability The company will pay on behalf of the insured all sums which the insured snail become legally obligated to pay as damales because of Coverage C. bodily injury or Coverage D. property damage to which this insurance applies, caused by an occurrence and arising out of the ownership, maintenance or use, including loading and unloading, of any automobile, and the company shall have the right and duty to defend any suit against the insured seeking damages on account of such bodily injury or property damage, even if any of the allegations of the suit are groundless, false or fraudulent, and may make such investigation and settle ment of any claim or suit as it deems expedient, but the company shall not be obligated to pay any claim or judgment or to defend any suit after the applicable limit of the company's liability has been exhausted by payment of judgments or settlements. Kzdtamoa This insurance does not apply: (a) to liability assumed by the insured under any contract or agreement; (b) to any obligation for which the insured or any carrier as his insurer may be held liable under any workmen's compen sation, unemployment compensation or disability benefits law, or under any similar law; (c) to bodily injury to any employee of the insured arising out of and in the course of his employment by the insured, but this exclusion does not apply to any such injury arising out of and in the course of domestic employment by the insured unless benefits therefor are in whole or in part either pay able or required to be provided under any workmen's compensation law; (d) to property damage to (1) property owned or being transported by the insured, or (2) property rented to or in the care, custody or control of the insured, or as to which the insured is for any purpose exercising physical control, other than property damage to a residence or private garage by a private passenger automobile covered by this insurance; (e) to bodily injury due to war, whether or not declared, civil war, insurrection, rebellion or revolution or to any act or condition incident to any of the foregoing, with respect to expenses for first aid under the Supplementary Payments provision. IL Persona Insured Each of the following Uitn injured under this insurance to the extent set forth below: (a) the named insured; (b) any partner or executive officer thereof, but with respect to a non-owned automobile only while such automobile is being used in the business of the named insured; (c) any other person while using an owned automobile or a hired automobile with the permission of the named insured, provided his actual operation or (if he is not operating) his other actual use thereof is within the scope of such per mission, but with respect to bodily injury or property damage arising out of the loading or unloading thereof, such other person shall be an insured only if he is: (1) a lessee or borrower of the automobile, or (2) an employee of the named insured or of such lessee or borrower; (d) any other person or organization but only with respect to his or its liability because of acts or omissions of an insured under (a), (b) or (c) above. None of the following is an insured: (i) any person while engaged in the business of his employer with respect to bodily injury to any fellow employee of such person injured in the course of his employment; (ii) the owner or lessee (of whom the named insured is a sub lessee) of a hired automobile or the owner of a non-owned automobile, or any agent or employee of any such owner or lessee; (iii) an executive officer with respect to an automobile owned by him or by a member of his household; (iv) any person or organization, other thaa the named insured, with respect to; (I) a motor vehicle while used with any trailer owned or hired by such person or organization and not covered by like insurance in the company (accept mtreiler designed tor use with a praaie passenger aatjsndifi.' and not being used for business purposes with another type motor vehicle), or - 4 (2-) a trailer while used with any motor vehicle Burned or hired by such person or organization and not covered by like insurance in the company; (v) any person while employed in or otherwise engaged in duties in connection with an automobile business, other than an automobile business operated by the named insured. This insurance does not apply to bodily injury or property damage arising out of {1) a non-owned automobile used in the conduct of any partnership or joint venture of which the insured is a partner or member and which is not designated in this policy as a named insured, or (2) if the named insured is a partnership, an automobile owned by or registered in the name of a partner thereof. IH. Limits of Liability Regardless of the number of (1) insureds under this policy, (2) persons or organizations who sustain bodily injury or property damage, (3) claims made or suits brought on account of bodily injury or property damage or (4) automobiles to which this policy applies, the company's liability is limited as follows: Coverage C--The limit of bodily injury liability stated in the declarations as applicable to "each person" is the limit of the company's liability for all damages because of bodily injury sustained by one person as the result of any one occurrence; but subject to the above provision respecting "each person", the total liability of the company for all damages because of bodily injury sustained by two or more persons as the result of any one occur rence shall not exceed the limit of bodily injury liability stated in the declarations as applicable to "each occurrence Coverage D--The total liability of the company for all damages because of all property damage sustained by one or more persons or organizations as the result of any one occurrence shall not exceed the limit of property damage liability stated in the declarations as applicable to "each occurrence". {Continued on page 2) L2A mD 005086 Page 2 CoTence* C and D--For the purpose of determining the limit of the company'* liability, all bodily injury and property damage arising out of continuous or repeated exposure to substantially the same general condiboas shall be considered as arising out of one occurrence, .r, - loaned to, the earned insured, provided such automobile is not owned by or registered in the name of (a) a partner or executive officer of the named insured or (b) an employee or agent of the aamed insured who is granted an operating allowance of any sort for dseuee of such automobile; .. -t. . IV. Policy Period; Territory This insurance applies only to bodily injury or property damage which occurs during the policy period within the territory described in paragraph (1) or (2) of the definition of policy territory. "nao-owoed automobile" means an automobile which is neither an owned automobile nor a hired automobile; "owned antomobfle" means an automobile owned by the named tsntred; "prints passenger automobile" means a four wheel private passenger or station wagon type automobile; V. Additional Detoritlocs "trafler" includes semi-trailer but does not indude mobile equipment. When used in reference to this insurance (including endorsements forming a part of the policy): VL Additional Cenriftioc "automobile business" means the business or occupation of Excess Insurance--Hired and Ron-Owned Automobiles selling, repairing, servicing, storing or parking automobiles; With respect to a hired automobile or a non-owned automobile, this "hired automobile" means an automobile not owned by the insurance shall be excess insurance over any other valid and named insured which is used under contract in behalf of, or S collectible insurance available to the insured. ' C-119S3 Edition October 1,1966 mmu t c o i u .s HA (CAL) L 2A '? * ATD 00S087 r~. CONTRACTUAL LIABILITY INSURANCE COVERAGE PART (Blankot Coverage) ~* DECLAJtATIO1T5 SCHSSOU- -------- ------' 3S'Z"~-------------------------------------------- Forming part of Policy No. T-RNSL~92222`*"T- Sates Advance Premium No. TTndgmftin at Contracts 4 All written contracts Code Premium Bases (a) Cost (b) Sales B-L p j >. (a) Peril 00 of Cost (b) Peril000 of Sales BX P.D. ' J J *-*" - *" * n - tpr - -V'.---- %* r VPTSrii*; ** --> t *' ' INCLUO ED !N COMPOS ITE RATE Total I I. Coverage Y--Contractual Bodily Injury Liability Cornice Z--Contractual Property Damage Liability The company will pay on behalf of the insured all sums which the insured, by reason of contractual liability assumed by him under any written contract of the type designated in the schedule for this insurance, shall become legally obligated to pay a3-damages because of Coverage Y--bodily injury or Coverage Z--property damage to which this insuranof'applies, caused by an occurrence, and the com pany shall have the rigbfand duty to defend any suit against the insured seeking damages on account of such bodily injury or property damage, even ifany of the allegations of the suit are groundless, false or fraudu lent. and may make such investigation and settlement of any claim or suit as it deems expedient, but the company shall not be obligated to pay any claim or judgment or to defend (1) any arbitration proceeding wherein the company is not entitled to exercise the insured's rights in the choice of arbitrators and.in the conduct of such proceedings, or (2) any suit after the applicable limit of the company's liability has been exhausted by payment of judgments or settlements. Exclusions This insurance does not apply: (a) to liability assumed by the insured under any incidental contract; (b) (1) if the insured is an architect, engineer or surveyor, to bodily injury or property damage arising out of professional services performed by such insured, including (i) the preparation or approval of maps, drawings, opinions, reports, surveys, change orders, designs or specifications, and (ii) supervisory, inspection or engineering services; (2) if the indemnitee of the insured is an architect, engineer or surveyor, to the liability of the indemnitee, his agents or employees, arising out of (i) the preparation or approval of maps, drawings, opinions, reports, surveys, change orders, designs or specifications, or (ii) the giving of or the failure to give directions or in structions by the indemnitee, his agents or employees, provided such giving or failure to give is the primary cause of the bodily injury or property damage; (c) to bodily injury or property damage due to war, whether or not declared, civil war, insurrection, rebellion or revolution or to any act or condition incident to any of the foregoing; (d) to bodily injury or property damage for which the indemnitee may be held liable, as a person or organization engaged in the business of manufacturing, distributing, selling or serving alcoholic beverages or as an owner or lessor of premises used for such purposes, by reason of the setting, serving or giving of any alcoholic beverage (1) in violation of any statute. Ordinance or regulation, (2) to a minor, (3) to a person under the influence of alcohol, or (4) which causes or contributes to the intoxication of any person; (e) to any obligation for which the insured or any carrier as his insurer may be held liable under any_workmen's compensation, unemployment compensation or disability benefits law, or under any similar law; ( Continued on Page 2) AID 005088 L 26B (f) to property damage to (1) property owned or occupied by or rented to the insurad, (2) property uaed by the insured, or (3) property in the care, custody or control of the insured or as to which the insured b for any purpose exerdsinf physical cuotrof (g) to any obligation for which the insured may be held liable in an action on a contract by a third party beneficiary for bodily injury or property damage arising out of a project for a public authority; but thb exclusion does not apply to an action tty the public authority or any other person or organization engaged in the project: (h) to property damage to premises alienated by the named insured arising out of such premises or any part thereof; (i) to bodily injury or property damage resulting from the failure of the named insured s products or work completed by or for the named insured to perform the function or serve the purpose intended by the named insured, if such failure is due to a mistake or deficiency in any design, formula, plan, specifications, advertising material or printed instructions prepared or developed by any isitired; biit this exclusion does not apply to bodily injury or property damage resulting from the active malfunctioning o< such products or work, (j) to property damage to the named insured's products arising out of such products or any port of uch products; (k) to property; damage to work performed by or on behalf of theinamed insured arising out of the work or any portion ' 'thereof,] or out of materials, parts or equipment furnished 1 in connection therewith; (l ) to damages claimed for the withdrawal, inspection, repair, replacement, or loss of use of the named insured's products or work) completed by or for the named insured or of any property of which such products or work form a past, if such products, work or property are withdrawn from the market or from use because of any known or suspected defect; or deficiency therein; Unless stated in the schedule for this insurance as not applicable; the following exclusions also apply to contractual liability assumed by the insured under any agreement re lating to construction operations. This insurance does notapply: (m)to bodily injury or property damage arising out of con struction; maintenance or repair of watercraft or loading or unloading thereof; (n) to bodily injury or property damage arising out of operations, within fifty fret of any railroad property, affecting any railroad bridge or trestle, tracks, read beds, tunnel, under pass or crossing. n. Persons Insursd Each of tfie following is an insured under this insurance to the extent set forth below: (a) if the named insured is designated in the declarations as an individual, the person to designated; (b) if the named insured b designated in the declarations as a partnership or joint venture, the partnership or joint venture to designated and any partner or member thereof but only witik respect to hb liability as such; (c) if the named insured b designated in the declarations as other than an individual, partnership or joint venture, the organization to designated and any executive officer, director or stockholder thereof while acting within the scope of his duties sis such. Pege 2 UL Limits id Liability Regardless of the number of (1) insureds under this policy, (2) persons or organizations who sustain bodily injury or property damage, or (3) claims made or suds brought on account of bodily injury or property damage, the company's liability is limited as follows: Coverage T--The limit of bodily injury liability stated in the declarations applicable to "each person" b the limit of the com pany's liability for all damages because of bodily injury sustained by one person as the result of any one occurrence; but subject to the above provision respecting "each person", the total liability of the company for all damages because of bodily injury sustained by two or more persons as the result of any One occurrence shall not exceed the limit of bodily injury lability stated in the declara tions as applicable to "each occurrence". Coverage Z--The total lability of the company for all damages because of all property damage sustained by one or more persons or organizations as the result of any one occurrence shall not exceed the limit of property damage liability stated in the declarations as applicable to "each occurrence". Subject to the above provision respecting "each occurrence''. the total lability of the company lor all damages because of all property damage to which thb coverage applies shall not exceed the limit of property damage lability stated in the declarations as "aggregate'. Such aggregate limit of lability applies separately with respect to cadi project away from premises owned by or rented to the named insured. Coveregee T and Z--For the purpose of determining the limit of the company's lability, all bodily injury and property damage arising out of continuous or repeated exposure to substagpialiy the same general conditions shall be considered as arising ait of one occurrence. - v- S' IV. Policy Period; Territory ... , This insurance applies only to bodily injury or property damage which occurs during the policy period within the policy territory. V. Additional DefinitiaM When used in reference to thb insurance (induding endorsements forming a part of the policy): "contractnal liability" means liabfiity expressly assumed under a written contract or agreement; provided, however, that contractual liability shall not be construed as induding liability under a warranty of the fitness or quality of the named insureds products or a warranty that work performed by or on behalf of the named insured will be done in a workmanlike manner; "nit" includes an arbitration proceeding to which the insured is required to submit or to which the insured has submitted with the company's consent. VI. Additional Condition! Arbitration The company shall be entitled to exercise all of the insured's rights in the choice of arbitrators and in the conduct of any arbitration proceeding'. ftamimn The advance premium stated in the schedule b the estimated premium on account of such written contracts as are on file with or known to the company. The named insured shall notify the company of all other written contracts entered . > into during the policy period to which thb insurance applies. When used as a premium basis: Description of Terms Deed As Premium Base (1) the word "cost" means the total cost of all work in connection with all contracts of the typedesignated in the schedule for thb insurance with respect to which ''cost" is the basis of premium, regardless of whether any liability is assumed under such-contracts by the insured. It includes the cost of all labor, materials and equipment furnished, used or delivered for use in the execution of such work, whether furnished by the insured, or others including all fees, allowances, bonuses or commissions made, paid or due. 11 shall not include the cost of any operations to which exclusions (m) or (n) apply, unless such exclusions are voided in the schedule. (2) the word '`ealee" means the gross amount of money charged by the named insured or by others trading under hb name for all goods and products sold or distributed during the policy period and charged during the policy period for installation, servicing or repair, and includes taxes, other than taxes which the named insured and such others collect as a separate item and remit directly to a governmental division. . --v C-12550 Edition Jor U. 1MT Mmtio m u.s *. H.S. (KB) AID 005089 L 26B This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following: COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE AUTOMOBILE MEDICAL PAYMENTS INSURANCE MASSACHUSETTS COMPULSORY INSURANCE EXCLUSION It is agreed that the insurance does not apply with respect to any automobile with respect to which insurance is required of the named injured by the Massachusetts Compulsory Liability Security Act (Chapter 346, Acts of 1925) or by any act amendatory thereof or supplementary thereto, while such automobile is registered in Massachusetts under a certification of insurance re quired by said acL This exclusion is not applicable to___________________________________________________________ coverage!s). Amending Policy No. T-RNSL-Qgg22fr-72 THE TRAVELERS INDEMNITY COMPANY / Secretary c-ltm 7-S6 mis t e d is u .s .a . N.S. THE CHARTER OAK FIRE INSURANCE COMPANY AID005090 This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following: COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE AUTOMOBILE MEDICAL PAYMENTS INSURANCE USE OF OTHER AUTOMOBILES COVERAGE - LIMITED FORM It is agreed that such insurance as is afforded by the policy, under the bodily injury liability and property damage liability coverages and division 1 of the Automobile Medical Payments coverage, with respect to any owned private passenger auto mobile covered under the policy also applies with respect to any other automobile, subject to the following additional pro visions: 1. Persons Insured Each of the following is an insured under the bodily injury liability and property damage liability insurance afforded under this endorsement to the extent set forth herein: (a) each individual named below and, while a resident of the same household, the spouse of such individual, and (bl any other person or organization, not owning or hiring the automobile, but only with respect to his or its liability because of acts or omissions of an insured under (a) above. 2. Exclusions This insurance does not apply: (a) to any insured while engaged in the business of his employer with reBpect to bodily injury to a fellow employee of such insured injured in the course of his employment; (b) to any insured while employed in or otherwise engaged in duties in connection with an automobile business; (c) if the individual named below is an employee, to the employer of such individual; (d) if the individual named below is a partner, to the partnership of which such individual is a member; (e) to any automobile owned by or furnished or available for the regular use of such named individual, his spouse or any resident of the same household other than a private chauffeur or domestic servant of such named individual or spouse; (f) to any automobile while used in the business or occupation of the named individual or spouse except a private passenger automobile operated or occupied by such named insured, spouse, private chauffeur or domestic servant; (g) to any automobile while being uBed by the insured as a public or livery conveyance; but this exclusion does not apply to bodily injury or property damage which results from the insured's occupancy of such automobile other than as the operator thereof. 3. Excaas Insurance This insurance shall be excess insurance over any other valid and collectible insurance available to the insured. 4. The insurance afforded because of the naming herein of any individual is only with respect to such and so many of the following coverages as are indicated by specific premium charge or charges for such person. Noma of Individual! St I CNvOH'iEMs. Bodily Injury Liability Premium Proparty Damage Liability -E Automobile Medical Payments Amending Policy No. ! ** THE TRAVELERS INDEMNITY COMPANY - Total Premium i * '*3 THE CHARTER OAK FIRE INSURANCE COMPANY / Secretary C-11353 7-66 PRINTED IN U. S.A. N.S. AID 005091 This endorsement modifies such insurance ss is afforded by the provisions of the policy relating to the following: COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE AUTOMOBILE MEDICAL PAYMENTS INSURANCE APPLICATION OF INSURANCE TO OWNER OF HIRED AUTOMOBILE With respect to the hired automobile described below or designated in the policy as subject to this endorsement, it is agreed that: (1) The insurance applies as primary insurance. (2) Subject otherwise to the Persons Insured provision, the insurance covers as an insured the owner, any lessee (of whom the named insured is a sub-lessee) and any agent or employee of such owner or lessee, but only while such automobile is used in the business of the named insured as stated in the declarations, or by or on behalf of the named insured for personal or pleasure purposes, and subparagraph (ii) of the Persons Insured provision is amended accordingly. ofDescription Automobile: a l l AUTOMOBILES Hi RED FROM: CONSOLIDATED LEASING CORP 507 S FLOWER ST LOS ANGELES CA 90017 Amending Policy No. THE TRAVELERS INDEMNITY COMPANY r THE CHARTER OAK FIRE INSURANCE COMPANY C-t 1413 7H56 PRINTED IN U.S.A. N.S. * A6B00 i AID 005092 This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following: COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE AUTOMOBILE MEDICAL PAYMENTS INSURANCE HIRED AUTOMOBILE LIMITATION It is agreed that the insurance with respect to hired automobiles does not apply with respect to the following automobile: Dsicriptlwi of Autamebila: ALL AUTOMOBILES OWNED BY I CONSOLIDATED LEASING COR? 507 S FLOWER ST LOS ANGELES CA 90017 Amending Policy THE TRAVELERS INDEMNITY COMPANY C-1UI1 7-66 PRINTED IN U.S.A. N.S. THE CHARTER OAK FIRE INSURANCE COMPANY A6202 AID 005093 o - Tha Public Utilities Commission of tha Stats af Colored* UNIFORM PUBLIC LIABILITY AND PROPERTY DAMAGE ENDORSEMENT -^ this endorsement is attached is written in pursuance of, and k to be eonetrned in accordance^ wSSgiifiiE^ghe-'dr noire of the following laws of the State of Colorado: Chi Chal>t^it^lY4t-C.R.S. 1963 Chapter 115-10-6--CRB. 1963 -- , and the Rules and Regulations of the Public Utilities Commission of the State of Colorado adopted there under and applicable to the Insured. In consideration of the premium stated in the policy to which this endorsement is attached, the Insurer hereby waives a description of the motor vehicle or motor vehicles to be insured thereunder, and agrees to pay any final judgment within the limits set forth in the policy or endorsements attached thereto, for injury to, and/or death of persona (with the exception of any employee of the Assured) and damage to property (excluding property of the Assured or property which ia rented or leased by the Assured or property other than the baggage of passengcrs in the custody of the Assured or earned in or upon any automobile of the Assured) resulting from the ownership, msintenaneo or use of any and all motor vehicles and/or trailers, pursuant to a Certificate of Public Convenience and Necessity or a Permit issued by the Public Utilities Commission of the Stete of Colorado, and further agrees that upon the failure of the Insurer to pay any auch final judgment, sash judgment creditor may maintain an action in any court of competent jurisdiction to compel aueh payment. It i* understood and agreed by and between the Insurer and the Assured that the right sf say person toneevar hereunder shall pot be affected by any act or omission of the Assured or of any eaptOyee pQM* Assured jpith rrgac4 to any condition or requirement of said policy, but all the terms and eodditioairsfila|$licr1 in fuU force and-be binding as between the Insurerand the Assured; aadrtiss insurer, by the Assured for auy and all loss, costs or "expenses paid or incurred h?'the ` i would not be obligated to pay under the provisions of the policy indcpeadhnt^ Wf - MINIMUM SCHEDULE . . ' \^ ' On each motor vehicle used for the transportation of persona and/orptppei ty^^ Pesoeagor Ciyichy Not to Exceed for Death or Iajwf tor~- Any Oao Ponoa All Pecaaaa " Flirty nipigt 12 or less . . . . .......................... $25,000 $ 50,000 $5,000 13 to 16, inclusive . . .......................... 25,000 70,000 *: 5,000 19 to 24, inclusive . . .......................... 25,000 90,000 - 5,000 More than 24 . . . .......................... 25,000 100,000 5,000 On vehicles used for the transportation of propertyFor death or injury to any one person, $25,000; all persons, $50,000; property damage, $5,000. All conditions and provisions of this policy, and any statements or agreements contained therein or endorsed thereon in conflict with this endorsement are, by agreement of all parties hereto, held null and void miofijratjhejfc an in conflict herewith. Thcy3^qtRp5ach this endorsement is attached shall not he cancelled until after ten days notice in writittxhalUSaVs first been given by the Insurance Company or its authorised agent to the Public Uf ilitiI S^priigjWiini nt the State of Colorado, at its office at Denver, Colorado, said ten days notice to commence to run from the date the date notice is actually received at the office of the Commission AMD TO BE OM PAPER 8% INCHES BY 11 INCHES. ATTACHED TO AND FORMING A PART OF POLICY MO_----------------- issued by the.....TRAVELERS 1 NPEtoLlrTY... COMPANY _____THE ANACONDA e3*PANV TAL PER ENO 8000(A) ,, M.wBwiocy^WBpiiy^ Elteteato rtfeme* to traasportotkm of psncngwrs wbs wdornmt Is itUeM to psUcr (ssosi to a $tiE>st| surfer is^1* M7 C ^BfaiuU rvfcrcaeo to tiaasportatioa of property whoa ndeiwacat Is sttacHsd to palky issasd to s HUf tarrfer $!$ FID sthtoiW applfes to carrier of both passep e a t s sad property. no FORM OP ENDORSEMENT 18 REQUIRED TO BE ATTACHES TO THE POUCT OP PtJDUCUABtUTT AND Wttfl DAMAGE INSURANCE BUT NOT TO THE CERTIFICATE OP 1NSUEANCR AND MUST R. OYtN TO TMR DfSOBBS AND MOT FILES? WITH TEE COMMISSION. ISS 21130 ^I1:> OOSO94 6 * r\ L* *iTro**r- OREGON PUBLIC UTTUTIES COMMISSIONER fat M*tar Carrier Polide* of Immnacu far Bodily lojary Liability property Damage liability -- Autooaatic Coverage __: k attached k an Automobile Bodily Injury Liability and Property Dimage ^ ^_____J to assure compliance by the named insured, a* a motor carrier of passengers or tom provisions of tbe Motor Transportation Code of Oregon, as amended, and the pertinent rules iof din Public Utilities Commissioner of Oregon, promulgated in accordance with tbe provisions of tbs Cods of Oregon i of tbe premium stated m tbs policy to which this endorsement k attached, or bocomes a part, when dnhr aouatarsigned, the company hereby agrees to pay any final judgment recovered against the named insured for bodily injury to or the death ef any persons or lose of or damage to property of others (excluding injury to or death of the uaasad inwradV tmplnynns while engaged in the course of their employment, and lorn of or damage to property owed or operated ley or in the care, custody or control of the named insured, and property transported by the m4 insured, design stsd ee cargo, and to any obligation for which the named insured may be held liable under any Work* men's Comps--*tion law), resulting from the negligent operation, maintenance, ownership, or use of motor vehicles irkr permit i--ed to tbs named Insured by the Public Utilities Commissioner of Oregon, or otherwise under the Oregon Motor Transportation Code, within the limits of liability hereinafter provided, regardless of whether such motor ushklsa are specifically described in the policy or not It k understood and agreed that open failure of the company to pay any such final judgment recovered against the named insured, tbe judgment creditor may maintain an action in any ` of competent jurisdiction against the company to compel such payment The bankruptcy or insolvency of the 1 shall not relieve the company of any of its obligations hereunder. The liability of the company extendi ianjunries, or deaths whether occurring on the route or in the territory aotheriaed to be served bp the or smewhero, within the Stale of Orepn, hot as respects this only while operating ef the Motor Transportation Code of Oregon. TVs Gah&ky of the on each motor vehicle for the following limits ahsQ be a i M me following BUflllPBIB TYPE OF MOTOR VXR1GLK antborinsd far fai thi tfuiportitioB BODILY INJURY LIABILITY Limit for Each Parson Limit far Eaek Aeeidsatr OMN Each Aeddsnt to which this endorsement k attached k ianed for limits greater than thoae prescribed conditions of this endorsement shall apply only to the minimum limits fortt in this Nothing contained in the policy or any endorsements thereon, nor die violation of any of the provisions of dm Soy or of--Y endorsement thereon by the asmod insured, shall relieve tbe company from liability 0r bum payment of any soch final judgment, but aa respects any equipment of the named insured while being operated by ethnri and* an Interchange of equipment agreement or requirement, the insurance afforded by this policy shall be anam over any ether valid and oolkctink insurance available to the named insured. The named insured agrees to reimburse the company for any payment made by the company on account of any --claim, or suit invoking a broach of the terms of the policy, and for any payment that tbe company would not have boon obligated to make anaer tbe provisions of the policy, except lor the agreement contained in this endorsement Salem, I t or of the policy to which it U attached may be effected by the company or the named gifS^kpa* notice in writing to the Public Utilities Commissioner of Oregon at his office in ---------|t0 n||| roa j, actually received at the office of said Commiaaioner. itattpf Policy No. ... c-2222 ......................... baaed by the ...J^VELERS................. i (herein called company) of......... . To .................... of per end bo -1 Dated ot................................................................ this.............. vr;p-; -i',' v?04 day of , 19 rn 2s *?-g Authorisad Compsnj RsprssiintaHw M63A AID 005095 Thu endorsement modifier such insurance as is afforded by tbe provisions of tbe policy relating to the following: COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE AMENDMENT OP "PERSONS INSURED"-CALIFORNIA It is f--d that, with respect only to an automobile which is principally garaged or principally used in the state of California, the "Persona Inarad" provision is amended by substituting the following for subdivision (v) in tbe sentence beginning ``None of tbe following ia an intired:" ( ) any person while employed in or otherwise engaged in duties in connection with an automobile bueineee if there is - other valid and collectible insurance therefor available to such person either as a named intured or as an agent or employee of a named inswed under a policy with limits at least equal to tbe requirements of the applicable Financial Responsibility Law, but this provision does not apply: (1) in the event there is no auch other valid and collectible insurance provided that, in such ever*. the insurance afforded hereunder shall apply to such person as an intured while so employed or engaged but shall be limited to the requirements of the applicable Financial Responsibility Law; (SI. aa respects on automobile bueineee operated by the named intured. to tbs named intured, a resident of the same household as the named intured, a partnership in which the named intured or auch resident is a pvtaer or to any partner, agent or employee of the named insured, such resident or partnership. THE TRAVELERS INDEMNITY COMPANY THE CHARTER OAK FERE INSURANCE COMPANY 'yr: r '.j v AID 005096 2&~4>REMIUM DISCOUNT ENDORSEMENT--TEXAS a u t o mo b il e UAiairr ih s u r a n c e T_This endorsement forms e part of Policy Ho. '".t ' ^Issued to ---------- by the TRAVELERS INDCffri i TY CO?-PANY_._ (Nam* oi Insurance Company) at It* Agency located (city and stow)- ___ ....... ........... .... ------------------------------------- -........... and t* effective from........... .. .. _____________ (12:01 A. M. Standard Tim*) (The Wmla !>* t* isgsbed only when this endorseem I* Issued wb*ipn*l to preparation ml the poAcyJ This endorsement lams a part of.the policy to which attached. effective (ran it* dot* of issue uni*** otherwise staled h*nm. It t* aare*d that the premium pertaining to Texas for Automobile liability and Medical Payments insurance is subiect to discount in accordance with the following procedure: 1. Texae Automobile Liability Standard Premium. Such premium pertaining to Texas computed in accordance with the provisions ol the policies designated in paragraph 4 hereof, other than this endorsement and exclusive of the application ol any retrospective rating plan, shall be known as ih* Texas Automobile Liability Standard Premium. 2. Total Standard Premium ter All States. The Automobile Liability and Medical Payments Premium computed In accordance with the provt ions of the policies designated in paragraph 4 hereof, other than this endotsement and exclusive ol the application ol any retrospective rating plan, any Automatic Premium Adiustment Endorsement, any Premium Return Plan Endorsement, or other Premium Discount Endorse, sent, shall be known as the Total Standard Premium. (a) Fer poBcy periods el eae year or less--The Texas Automobile Liability Standard Premium shall be Subiect to the applicable discount percentages far the Total Standard Premium obtained from the "Table of Texas Prsmium Discount Percentage* (Automobile Liability) ' tel out on the reverse side hereof. (b) Far policy perieda ad nose than one year--The Texas Automobile Liability Standard Premium lor each annual period or portion thereof during the policy period shall be subiect Id the applicable discount percentages stated in said "Table ol Texas Premium Discount Per centages (Automobile Liability)" opposite the Total Standard Premium lor the policies lor each such period or portion thereof during the policy period (c) If retroepeetive rating is applicable to a part of the premium pertaining to Texas, the amount of premium discount appfcable to the Texas Automobile Liability Standard Premium, exclusive ol any premium subiect to any Retroepeetive Bating Plan, shall be jne difference between 111 the discount determined by applying to the Texas Automobile Liability Standard Premium the applicable percentage* stated in said Table apposite the Total Standard Premium, and (2) the discount determined by applying to that portion oi the Texas Automobile Liability Standard Premium which is subiect to retrospective rating the applicable percentage stated In said Table opposite to much oi the Total Standard Premium as is subiect to retrospective rating. ..4 Peticy Humber* Estimated Stmsdml Freed-- TRNSL-92222L-7S TRFMC-922221-72 jt ._ Total Applicable premium percentages based on total estimated advance standard premium: Taxicabs. Livery, Buses and Long Haul Truckmen ........ Garage Liability All other, including School Buses .. X SEE REVERSE SIDE FOR FURTHER PROVISIONS AID 005097 FORM ZS.--PREMIUM DISCOUNT ENDORSEMENT--TEXAS Texas Standard Automobile Endorsement Revised November 1. ItSI By (Duly Authorized Representative) TUB CHA&TB& OAK FIRB BOEBAlOi OGKPANT m mmaMMssarrocMPiMT Total Standard Premium See Note (11 IQED- cabs. Livery. Buees All and Other Long In* Haul cludmg Truck- School men Garages Buees (i) (2) (3) (4) SI.000 1.QS0 1.100 1.1 so 1.200 1250 1300 1.3S0 1.400 1,450 1.500 1.SS0 1.600 1.650 1.700 1.750 1.SQ0 1.850 1.900 1.950 2.000 2.100 2.200 2.300 2.400 2.S00 2.600 2.700 2.600 2.900 1.000" .3.100 * 3300 ; 33005 3.400* 15001 1800 3.700 3.BQ0 ' 3.900 4.000 4300 4.400 4300 4.800 S.0Q0 5300 5.400 5.600 5.800 6.000 6300 0 0* 0.0* 00* .1 .4 .3 .1 .6 2 .1 .8 .7 3 1.0 .9 3 12 11 .2 1.3 12 .3 1.5 1.4 3 1.6 1.5 .3 13 1.6 3 1.9 1.7 .4 2.0 18 .4 2.1 19 .4 22 2.0 .4 23 2.1 .4 2.4 22 .5 2.5 23 .5 2.6 2.3 .5 2.6 24 .5 27 2.5 .5 18 2.6 .5 2.8 2.7 .6 3.1 28 .6 `32 . -2.9 .6 3.3 3.0 3 3.3 3.0 3 3.4 -3.1 ...3.. _ 3.5 .32 3 - 3.6 3.2 .7 3.6 3.3 It -3.7 34 .7 ' 33 3.4 .7 13 3.5 .7 8.9 3.5 .7 3.9 3.6 .7 42 3.6 .7 43 3.6 7 4.0 3.7 ' .7 * 4.1 ` 3.7 .7 - 4.1 3.7 8 42 33 ".8 42 33 3 4.3 3.9 3 4.3 39 3 4.4 4.0 3 45 4.1 13 4.7 4.3 1.4 4.9 45 13 11 4.6 1.8 53 4.8 2.0 5.4 49 22 5.6 5.0 Total Standard Premium Sm Note (I) (1) S6.40O 6300 6.600 7.000 7200 7,400 7300 7300 8200 6200 8;4Q0 6.600 6.800 9200 9200 9.400 9200 9.800 10200 10.500 11.000 11300 12.000 12.500 13.000 13.500 14.000 14.500 15.000 16.000 17.000 18.000 19,000 20.000 21,000 22.000 23.000 34.000 25.000 27.500 30.000 32.500 35.000 37.500 40.000 42.500 45200 47.500 50.000 52.500 55.000 57.500 Taxi- cabs. Leery. i tn rrveo-*r- All Other Long In- Haul eluding Truck* School men Garages Buses (2) (3) til 23* 25 26 26 2.9 32 3.1 3.3 34 35 36 3.6 37 3.8 3.9 4.0 40 4.1 4.2 44 45 46 4.6 4.9 5.0 5.1 5.1 5.2 5.3 5.5 5.6 5.7 58 5.9 59 60 6.1 6.1 6.2 6.3 66 6.9 72 74 7.6 7.8 80 8.2 6.3 8.4 8.5 8.6 5.7* SB 5.9 6.1 6.2 6-3 64 6.5 65 6.6 67 6.8 69 69 72 7.1 7.1 7.2 73 74 75 7.6 77 7.8 7.9 8.0 82 8.1 6.2 8.3 84 8.5 8.6 6.6 8 7. 6.8 8.8 8.9 8.9 9.0 94 9.9 10.3 10.7 11.1 11.4 117 11.9 12.1 12.4 12.5 12.7 5 2* 5.3 54 5.5 56 57 58 5.8 5.9 6.0 61 6.1 62 63 6.3 6.4 64 6.5 6.6 6.7 6.8 69 7.0 7.0 7.1 72 7.2 7.3 7.4 7.5 7.6 7.6 7.7 7.8 7.8 7.9 7.9 82 8.0 8.1 6.5 92 9.5 9.9 103 10.6 10.9 112 114 11.6 11.6 122 j ^ Np* . ~ cabs. Livery. All Total said Other Standard - Laeg In- Premium Haul eluding Sm "Truck- - " : School Mote <n men Garages Base* (1) (2) (3) (4) *60.000 8 7* 129* 122* 62.500 8.8 130 12.3 65.000 8.9 131 12.5 67.500 90 13 3 12.6 70.000 9.1 134 127 72.500 9.1 135 126 75.000 92 136 13.0 60.000 9.3 135 132 B5200 94 14 0 13.3 90.000 *5 14 1 135 5200 . U 142 13.6 100.000 >6 143 137 105200 7 144 138 110.000 98 145 139 115200 98 146 140 120.000 99 147 14.1 125 000 99 14 9 142 130.000 100 14.8 142 135.000 102 14 9 14 3 140200 102 14 9 14.4 145.000 10.1 152 14.4 150.000 10.1 151 14.5 162.500 102 152 146 175200 102 15.3 14.7 187.500 103 153 14.8 200.000 103 154 14.9 212.500 104 15.5 149 225.000 10.4 15 5 152 237300 * -104 15.6 1S2 250.000 105 156 1S.I 262.500 10.5 157 1U -- T7S.0OO - 10.5 T57' -an 287.500 105 JS.7 vd T- 200.000 105 155 45*.* 312.500 : W6 4St V 163 325201 10.6 158 154 337,500 : 105 . .15.9 153 c 350.000 - 10.6 -15.9 ttl 362.500 105 15.9 " ' IS*- 375.000 106 159 1514 387.500 ia6 455 100.000 ` 107' 183 412.500 10.7 160 154 425.000 10.7 160 15.5 437.580 107 16.0 1455 <* 450.000 107 ' 16.0 155" 462.500 107 160 isS~ 475.000 10.7 160 155 ' 487300 t .tO.7. r 162 - 500200 feee Nate' (2). and ever 4 " .*V-, * }les: (1) li the Total Standard Premium is between two o( the amounts shown in column (1). the premium discount percentage '* applicable is that shown for the lower of such amounts. (2) If the Total Standard Premium is 8500200 or over, the premium discount percentage -applicable "tor edctfsubdivisian of automobile liability insurance shall be determined as the weighted average of the jetssnWglShaBi -in (b) ler-dhe hrst $500,000 of Total Standard Premium and the percentage shown in (c) lor the portion afa&elBjiljamdani Premium ^ over SSOO.OOO: Subdivisions of Automobile Liability Insurance First SSOO.OOO (a) (b) mcabs, Livery. Buses and Long Haul Truckmen .................................................... 10.7* irage Liability................................................................................................................j$ 1 1 other. Including School Buses ..........................................,,.............................. 1S.S -iTJEVE ncua TWi ndor*Mnl lorn* o pan at Potter No. by * ........... . _ . torawd (eir and w* --...... H ->e`` r~; ____ ______ tMuod to -------* .'\ Mono oi Imutaneo Coatpemrl and to ((ettvo (root ........... at tto Ajucr JAN 1 ?9T5 (12:01 A. M. Standard Time) [t it agreed that the premium reduction percentage stated in the declarations or computed in accordance with the Premium Reduction Table forming a part oi the potter daee not apply * 'he premium lor outomobllee principally garaged tn Tecae. TUB CHARTER OAK.FIRS INSURANCE COUPAKTSS. TBS TRAVELERSINDESfNITT COUPANT row im>--AmiaiTioir or raotitm looenoM rzvarAoc (Ou'r Authortrod Rapmontatitro) Pmcrfbod Mir 1. > .; * . AIE> 005099 W 1SP. AMENDATORY ENDORSEMENT (D (To kt ottocM ti IN Me lat--ototo UaMRty Ptokf. MwiMi 6MMn Pokey kto C--pnki--w hMh UoMfe Me? M aMck A-- kill Nedksi Ppm--i to petotod, Mi to Ml poke-- to ohieh Aotoaikki MM h|iiii> tilmiiiit 197 to a-ckod. Mm mm m mm ikfr MM knWk Mi m appMeabto to tack pMcyj Tkk m tor Mm mt to fkler kp.T"RNSL" 92222^-72 TRAVELERS, jfOEKN It y c o mpa n y .^ (Ra-- to tnamca Carnpeey) to Its A|tney toctoti (ettjr ni toaki) (Tito tolls--Mm abaea k --aired ieiy to-- tkk Mi--Mt k (12rOX A.M Standard Tim) to Mm ptok|4 Ttos Mdaraamant tor-- a part to Mm ptoicy to which attochad. totoettn fttm its data to to-- tmka atharwiaa stotod barton. 1. With --Met to Mm andoraamanto listid Mow. whtro ths --rdt "Buie Midicsl Piymmts" i--i than MitM ko uibsMtutod thtnfer Hit weeds -'Ants mobile Midici! Pty--erti": and whnn thi words "tor Buie Mtdicsl Payments and for Extended Nodical Payments" on-- Mmi* shall bo substituted Mronfer tho words "lid tor Automobile Mtdicil Pty--nte." 1 45B G6C B2A 99 loao 1100 129 IB 45C 79A S3 100 10K HOC 129A 1C 40B M I3A 10U 10N uio 13S B B4A N B4 101B low hi 1S7H SA t$ 91 MA 101C 110A 120A 1S7J 21 ISC 91A 17 1010 110B 127 44 44A BIB M 102C HOC 1274 ; 2. With --Met to Endo--mints BO ind BOA. whin thi words "Basic Midicsl Pit -->U" MMar to Mm introductory pingopki or to tho i--dwte or hath, than to-- bo substitutid therefor thi words "Automobito Nodical Piy--nts." Wlwro tho words "Basie Madical Payments" sppur in Exclusion 2(bM7) to Endorse--at BO. than skill bo sakstttstoi IMkMsV^IUVei |Mka MV "dk^jjn t to Atoawaklk Miiicil Pit --Ms." 3. With --poet to Ends--mints 122B ind 122C. whin the words "Basic Msdical Par--nts" appear to the introductory pnnraph then shot! bo lobsgotoi therifir Mm words "Automobiii Midicsl PsymMts." i Psniraph 3 to Endo--nt 122B and paninph 2 to Endo--nt 122C on omondod to rood: "TIm --unnen ottordod br division 1 to Autemobilo Nodical Psrnonb dots not apply to a ho--, offics. ston, disptor or ptssonfsr traitor." 4. With raspset to Endo--nt 157). pnnfroph numbor "1" it tmsndsd to rood: "1. Ths Inaurinet undsr division 1 applies with --pact to arty non-owned automobiii it townnci tor u m tbonto is sflnrdod undir Bodily laiury Liability Cowan to Mm policy." FBRM 15BF.--44KR0AT0RT EWDOWEMEKT Ttata Stoadard Automobile Emto--Mut Bntoto October 1, 1SK By ir "* (Duly Authorized fipr--irtihve) THS CHARTER OAK F* BCUBXNCS COMPANY 1HB TRA.VBLBR8 JMDOOffTT COMPANY MD 005100 I This endorsement modifies such insurance as is afforded by the provisions of the policy relating to tlx following: c o mp r e h e n s iv e g e n e r a l l ia b il it y in s u r a n c e .. i -*- COMPLETED OPERATIONS AND PRODUCTS L1AULITY INSURANCE V.- "**--* ad d it io n al in s u r ed (Venders - Bread Pena) ft is agreed that the `Persons Insired* provision is amended to include any person or crganization (herein referred to as veixiar*), as. an insured, but only with respect to the distribution or sale in the regular course of the vendor's business of the named insured't products subject to the following additional provisions: 1. The insurance with respect to the vendor does not apply to: (a) any express warranty unauthorized by the named insured; (b) bodily injury or property danage arising out of (i) any physical or chemical change in the form of the product made intentionally by the vends. <ii) repacking, unless unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instruction from the manufacturer and then repacked in the original container, (iii) demonstration, installation, servicing or repair operations, except such operations performed at tbs vendor's premises in connection with the sale of the product, or .< (It ) products which after distribution or sale by the named insured have been labeled or relabeled or need as a container, part or ingredient of any other thing or substance by or for the vendor. a, ^ 2- The insurance does not apply to any person or organization, as insured, from whom the named inend has products or soy ingredient, part or container, entering into, accompanying or containing such prodacts. THE TRAVELERS INDEMNITY COMPANY INCLUDED IN COMPOSITE " .. n THE CHARTER OAK FIRE INSURANCE COMPANY J I ' Secretary / Secretary i C-M4S9 7-46 MINTED IN U.S.A. N.S. G113 i. I AID 005101 0 <D This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following: v COMPREHENSIVE GENERAL LIABILITY INSURANCE MANUFACTURERS' AND CONTRACTORS' LIABILITY INSURANCE _ OWNERS', LANDLORDS' AND TENANTS' LIABILITY INSURANCE STOREKEEPER'S INSURANCE / ADDITIONAL INSURED (Premises LsssN le the Named Insured) It is agreed that the "Persons Insured" provision is amended to include as an insured the person or organization designated below, but only with respect to liability arising out of the ownership, maintenaice or use of that part of the premises designated below leased to the named insured, and subject to the following additional exclusions: The insurance does not apply: 1. to any occurrence which takes place after the named insured ceases to be a tenant in said premises; 2. to structural alterations, new construction or demolition operations performed by or on behalf of the person or organi zation designated below. DesignaNea sf Premises (Part Leased to Named Insured) SCAL. BEACH ORANGE CO CA SCHEDULE Name of Person or Orgonisetfee (Additional Insured) ' 1-NEWPORT BEACH CABLEVISiCN INC Premiums* Bodily Injury Liability rasp liability INCLUDED IN COMPOSITE RATE 2-THE GOLDEN RAIN FOUNDATION 3-g e n e r a l t e l e p h o n e CO OF CALIFORNIA ONLY AS RESPECTS vC .URRENCES ARISING OUT OF THE NEGLIGENCE OF ANACONDA EUC'POt^C ; COMPANY OR ITS SUB-CONTRACTORS T-RNSL-,*222k-:2 Amending Policy No.. THE TRAVELERS INDEMNITY COMPANY S Secretary C-11259 7-66 POINTED m u.5 * MS. *66 THE CHARTER OAK FIRE INSURANCE COMPANY * AID 005102 Seecrreetta/irvy G109 v> This endorsement modifies such insurance as is afforded by the p.ovisions of the policy relating to the following: COMPREHENSIVE GENERAL LIABILITY INSURANCE MANUFACTURERS' AND CONTRACTORS' LIABILITY INSURANCE OWNERS'. LANDLORDS' AND TENANTS' LIABILITY INSURANCE STOREKEEPER'S INSURANCE ADDITIONAL INSURED (Premises Leased lo the Named Insured) It is agreed that the "Persons Insured" provision is amended to include as an insured the person or organization designated below, but only with respect to liability arising out of the ownership, maintenstce or use of that part of the premises designated below leased to the named insured, and subject to the following additional exclusions: The insurance does not apply: 1. to any occurrence which takes place after the named insurefeeases to be a tenant in said premises; 2. to structural alterations, new construction or demolition operations performed by or on behalf of the person or organi zation designated below. Designation of Promises (Part Laesad to Nomad Insured) Lib] WEST t. Ca M 871 V'-LLO? ST HEDWtra CT' Y - \ SCHEDULE Noma of Parson or Organisation (Additional Insured) <30*1. AN CJRPORATI ON Premiums. Bodily Roparty Injury Liability Bsmaga tfokillty INCLUDED IN COMPOSITE RATE Amending Policy No. s J2 THE TRAVELERS INDEMNITY COMPANY Secretary 011259 7-S6 MINTED IN U S S. NS. 666 THE CHARTER OAK FIRE INSURANCE COMPANY ' AID 005103 Secretary G109 This endorsement modifies each insurance as is afforded by the provisions of the policy relating to the following: . COMPREHENSIVE GENERAL LIABILITY INSURANCE \ . ' " MANUFACTURERS' AND CONTRACTORS' LIABILITY INSURANCE ' OWNERS', LANDLORDS' AND TENANTS' LIABILITY INSURANCE STOREKEEPER'S INSURANCE REAL PROPERTY - LIABILITY _ FIRE It is agreed that the Property Damage Liability Coverage applies to property damage to structures or portions thereof rented to or occupied by the named insured and described in this endorsement, including fixtures permanently attached thereto, if such property damage arises out of fire, subject to the following additional provisions: 1. With respect to the insurance provided by thiB endorsement, all of the exclusions of the policy, other than the Nuclear Energy Liability Exclusion (Broad Form', are deleted and replaced by the following: This inswanes does not apply to liability assumed by the insured under any contract or agreement. 2. The limit of liability stated in this endorsement applies separately to the insurance under this endorsement and is in lieu of any other limit of liability stated in the policy. oDfePserortppetirelyn Limit of Liability 2M8U3SKEEGAOSNT MIOlNA AVE 1xw0jv.0su0'v0s each occurrence 233 n o r t h l emo n s ~ ORANGE CA 50,000 Rate (per $100 of Limit) INCLUDED IN ' Premium * COMPOSITE RATE | i T-RNSL -9*222*-J2 Amending Policy No. THE TRAVELERS INDEMNITY COMPANY / Sscrtlary C-13546 10-65 PltlKTEO IN U.I.A. N.S. THE CHARTER OAK FIRE INSURANCE COMPANY AID 005104 G209A 158K. / ENDMENT OF FAMILY PROTECTION COVERAGE, PROTECTION AGAINST UNINSURED MOTORISTS, AND INSURANCE AGAINST UNINSURED MOTORISTS (Niim of Insurance Company) It its Agency located (dty and state) and is affective from (12.-01 AJI. Stindird Dmo) (Dm tateraotioa above it required only atnt tWa audenemoot d ianed itaioonaairt M proporodeo of the policy.) This endorsement forms put of the pofiey to which ittached. effective from its dit* of issue unless otherwise stated herein. It is mud that: 1. Dm provision in tho 'Uninsured Motorists" or "Family Protodion" coverage insuring agreement, or Camraps--Uninsured Motorists (Osmage tor Bodily Injury) agreement is amended to rood as follows: Provided. for tho purpostt of this coverage, dotormination os to whothor tho irtsarod or such roprosaotattm is tagaRy entitled to rooomr such damaits, and if so tho amount tharoof, may bo mods by agreement batwoon tba insurod or such roprasantathro and tha company or, d thay fail to tfraa, by arbitration In aoeordanca with tha arbitration provision of this policy, or by judicial determination. 2. Dm torm "animurod automobile" is chaniod to "uninsurod motor vohido." 3. Dm torn "uninsurod motor vohido"* indudos an automobile** with rospoct to which than It a toddy Injury debility Inuroaca policy spplicabli at the, time of the oeddont but tho company writing tho tamo is or becomes insolvent. 4. Dm arbitration provision is amondod to road as fellows: "If any parson making daim horounder and the company do net agree ttiat such parson is legally ontitled to rooomr damages from tho owner or operator of m uninsured motor vohido* bocauso of bodily injury to tho insurod, or do not agree at to tha amount oi payment which may be owing undar this endorsement, than tha matter or matters upon which such parson and tha company do not apes may. by apomont be nettled by arbitration in accordance with tha rults of tho American Arbitration Association, units other moans of conducting tho arbitration era agreed to batwoon tho insurod and tto company, and judgment upon the award rendered by tho arbitrators may ba entered in any court having jurisdiction thereof. Midi person and the company nodi ogroo to consider itself bound and to bo bound by any award Made by tha arbitrators pennant to this endoreenMnt" Dm words "uninsured highway vohido" are substituted far "uninsured motor voMcfe," and "the words "a highway vohido" are substituted tar "an automobRo" whan this andonamerit is used to amend Protection Against Uninsurod Motorists Insurance or insuronco Against Unimurod Metadata afforded under Standard Coverage Part (Duty Authortaod Ropraoantatfee) THE CHARTS (UK HBR DWBANC* COMPACT PROTECDON AGAINST UNINSURED MOTORISTS, UNO INSURANCE AGAINST UNINSURED MOTORISTS Tuaa Standard AutomoMla Cadaraamaat Navtaad March 1, 1171 THR TRAVKLSK UlL--illTT OOBgAKT AID 005105 VJ Page 1 PREMIUM DISCOUNT ENDORSEMENT--VIRGINIA (Automobile Liability Insurance) It is agreed that the premium pertaining to Virginia for Automobile Liability and Medical Payments insurance is subject to discount in accordance with the following procedure: 1. Virginia Automobile Liability Standard Premium. Such premium pertaining to Virginia computed in accordance with the provisions of the policies designated in paragraph 5 hereof, other than this endorsement and exclusive of the application of any retrospective rating plan, shall be known as the Virginia Automobile Liability Standard Premium. 2. Total Standard Premium For All States. The Automobile Liability and Medical Payments premium computed in accordance with the provisions of the policies designated in paragraph S hereof, other than this endorsement and exclusive of the application of any retrospective rating plan, any Automatic Premium Adjustment Endorsement, any Premium Return Plan Endorsement, or other Premium Discount Endorsement, shall be known as the Total Standard Premium. 3. Premium Discount'--Virginia (a) For policy periods of one year or less--The Virginia Automobile Liability Standard Premium shall be subject to the applicable discount percentages for the Total Standard Premium obtained from the Table of "Premium Discount Percentages Applicable to Virginia Standard Automobile Premium." (b). For policy periods of more than one year--The Virginia Automobile Liability Standard Premium for each annual period or portion thereof during the policy period shall be subject to the applicable discount percentages stated in said Table of "Premium Discount Percentages Applicable to Virginia Standard Automobile Pre mium" opposite the Total Standard Premium for the policies for each such period or portion thereof during the policy period. ; (c) If retrospective rating is applicable to a part of the premium pertaining to Virginia, the amount of premium discount applicable to the Virginia Automobile Liability Standard Premium, exclusive of any premium subject to any Retrospective Rating Plan, shall be the difference between (1) the discount determined by applying to the Virginia Automobile Liability Standard Premium the applicable percentages stated in said Table op posite the Total Standard Premium, and (2) the discount determined by applying to that portion of the Virginia Automobile Liability Standard Premium which is subject to retrospective rating the applicable per centage stated in said Table opposite so much of the Total Standard Premium as is subject to retrospective rating. 4. Table--Virginia Premium Discount Percentages--Stated on pages 2 and 3 of this endorsement. 5. Policy Numbers Estimated Standard Premium Total Applicable Premium Discount Percentages based on Total Estimated Advance Standard Premium tor All States: Garages ----------% Taxis, Livery, Buses (other than School Buses) and Long Haul Truckmen ----------% All Other Automobile Liability (including School Buses) --------- % Amending Policy No. This endorsement is executed by The Travelers Insurance Company as respects insurance afforded by that company only; it is executed by The Travelers Indemnity Company as respects insurance afforded by that company only. Th e Tr a v e l e r s In s i r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y 3837B C-91A6 inTco u.& * J-61 Secretary A1 005106  '-NNSs.-9**224-72 Premium Discount Percentages Applicable to Virginia Standard Automobile Premium Page 2 Total Stutdan! Premium (i) $1,000 or less 1,050 1,100 1,150 1,200 Gvman (2) o.o% 0.3 0.6 0.7 0.9 1,250 1,3.00 1,350 1,400 1,450 1.1 1.2 1.4 1.5 1.6 1,500 1,550 1,600 1,650 1,700 1.7 1.8 1.9 2.0 2.1 1,750 1,800 1,850 1,900 1,950 2.2 2.3 2.3 2.4 2.5 2,000 2,100 2,200 2,300 2,400 2.6 2.7 2.8 2.9 3.0 2,500 2,600 2,700 2,800 2,900 3.0 3.1 3.2 3.2 3.3 3,000 3,100 3,200 3,300 3,400 3.4 3.4 3.5 3.5 3.6 3,500 3,600 3,700 3,800 3,900 3.6 3.6 3.7 3.7 3.7 4,000 4,200 4,400 4,600 4,800 3.8 3.8 3.9 3.9 4.0 (Forming a part of Endorsement 3837B) Taxis. Livery. Buses (other than School Buses! and Lana Haul Truckmen (3) 0.0% 0.1 0.1 0.1 0.2 All Other Auto mobile Liability (including School Buses) (4) 0.0% 0.3 0.5 0.7 0.8 Total Standard Premium (i) $5,000 5,200 5,400 5,600 5,800 Garages (2) 4-2% 4.6 4.9 5.2 5.5 0.2 1.0 0.2 1.1 0.3 1.2 0.3 1.3 0.3 1.4 6,000 6,200 6,400 6,600 6,800 5.8 6.1 6.3 6.5 6.8 0.3 1.5 0.4 1.6 0.4 1.7 0.4 1.8 0.4 1.9 7,000 7,200 7,400 7,600 7,800 7.0 7.2 7.3 7.5 7.7 0.4 2.0 0.5 2.0 0.5 2.1 0.5 2.2 0.5 2.2 8,000 8,200 8,400 8,600 8,800 7.8 8.0 8.1 8.3 8.4 0.5 2.3 0.5 2.4 0.6 2.5 0.6 2.6 0.6 2.7 9,000 9,200 9,400 9,600 9,800 8.5 8.6 8.7 8.8 8.9 0.6 2.7 0.6 2.8 0.6 2.9 0.6 2.9 0.7 3.0 10,000 10,500 11,000 11,500 12,000 9.1 9.3 9.6 9.7 9.9 0.7 3.0 0.7 3.1 0.7 3.1 0.7 3.2 0.7 3.2 12,500 13,000 13,500 14.000 14,500 10.1 10.2 10.4 10.5 10.6 0.7 3.2 0.7 3.3 0.7 3.3 0.7 3.3 0.7 3.4 15.000 16,000 17,000 18.000 19,000 10.8 11.0 11.1 11.3 11.4 0.8 3.4 0.8 3.5 0.8 3.5 0.8 3.5 0.8 3.6 20,000 21,000 22,000 23,000 24,000 11.6 11.7 11.8 11.9 12.0 Taxis. Livery. Buses (other than School Buses* and Long Haul Truckmen (3) 0-9% 1.2 1.4 1.6 1.8 Ati Other Auto mobile Lsabii:i\ `including School Buses: (4) 3.8% 4.2 4.5 4.8 5.1 2.0 5.4 2-2 5.6 2.3 5.9 2.5 6.1 2.6 6.3 2.8 6.5 2.9 6.7 3.0 6.9 3.1 7.1 3.3 7.2 3.4 7.4 3.5 7.5 3.6 7:7 3.6 7.8 3.7 7i9 3.8 8.1 3.9 8.2 4.0 8.3 4.0 8.4 4.1 8.5 4.2 8.7 4.4 8.9 4.5 9.1 4.6 9.3 4.8 9.5 4.9 9.6 5.0 9.8 5.1 9.9 5.1 10.0 5.2 10.1 5.3 10.3 5.5 10.5 5.6 10.7 5.7 10.8 5.8 11.0 5.9 11.1 5.9 11.2 6.0 11.3 6.1 11.4 6.1 11.5 3837B C-9IMA 3-61 s s in t c o > u.s.a. (Continued on reverse side) AH) 005107 Pge 3 Premium Discount Percentages Applicable to Virginia Standard Automobile Premium (continued) Total OUUUWO Premfflm CD $25,000 27,500 30,000 32,500 35,000 Gamps* t2) 12-1% 12.3 12.5 12.7 13.0 Taxi*. Livery. Buses <other than School Haul Truckmen (3) 6-2% 6.3 6.5 6.8 7.1 Ail Other Aatomobile Liability 'la ih w h h School Bo m) (4) 11-6% 11.8 12.0 12.3 12.5 Total suntuuu Premium (i) $150,000 162.500 175,000 187.500 200,000 Caracas 2( ) 16.6% 16.8 17.0 17.1 17.3 Tams. Liverv. Bum {other than School Buses) and Lons Haul Truckmen (3) 11.0% 11.2 11.4 11.6 11.7 All Oth*r Antn. mobile Liability (including School Bu ms ) C4) 16.1% 16.3 16.5 16.6 16.8 37,500 40,000 42,500 45,000 47,500 13.2 13.3 13.5 13.6 13.7 7.3 12.7 7.5 12.8 7.7 13.0 7.8 13.1 8.0 13.3 212,500 225,000 237,500 250,000 262,500 17.4 17.5 17.6 17.7 17.8 11.8 12.0 12.1 12.2 12.2 16.9 17.0 17.1 17.2 17.3 50,000 52,500 55,000 57,500 60,000 13.9 14.0 14.0 14.1 14.2 8.1 13.4 8.2 13.5 8.3 13.6 8.4 13.6 8.5 13.7 275,000 287,500 300,000 312,500 325,000 17.9 17.9 18.0 18.1 18.1 12.3 12.4 12.5 12.5 12.6 17.4 17.4 17.5 17.6 17.6 62,500 65,000 67,500 70,000 72,500 75,000 80,000 85,000 90,000 95,000 14.3 14.3 14.4 14.5 14.5 14.6 14.7 14.7 14.8 14.9 8.6 13.8 8.6 13.8 8.7 13.9 8.8 14.0 8.8 14.0 8.9 14.1 9.0 14.2 9.1 14.2 9.2 14.3 9.2 14.4 337,500 350,000 362,500 375,000 387,500 400,000 412,500 425,000 437,500 450,000 18.2 18.2 18.3 18.3 18.3 18.4 18.4 18.4 18.5 18.5 12.6 12.7 12.7 12.8 12.8 12.8 12.9 12.9 12.9 13.0 1.7.7 17.7 17.8 d7.8 3& 7.8 37.9 17.9 17.9 18.0 18.0 100,000 105,000 110,000 115,000 120,000 15.0 15.2 15.4 15.6 15.7 9.4 9.6 9.8 10.0 10.1 14.5 14.7 14.9 15.1 15.2 462,500 475,000 487,500 18.5 18.5 18.6 13.0 13.0 13.0 18.0 18.0 18.1 125,000 130,000 135,000 140,000 145,000 15.9 16.0 16.2 16.3 16.4 10.3 10.4 10.6 10.7 10.8 15.4 15.5 15.7 15.8 15.9 500.000 & Over * No t e : If the Total Standard Premium is between two of the amounts shown in column (1), the premium discount percentage applicable is that shown for the lower of such amounts. *I_f the Total Standard Premium is $500,000 or over, the discount percentage for each kind of insurance shall be deter mined as the weighted average of the percentage shown in (b) for the first $500,000 of Total Standard Premium and the percentage shown in (c) for the portion of Total Standard Premium over $500,000: Kiad of Insurance (a) Garages Taxis, Livery, Buses (other than School Buses) and Long Haul Truckmen All Other Automobile Liability (including School Buses) First $500,000 (b) 18.6% 13.1 18.1 Portion over 1500.000 (0 19.5% 14.0 19.0 3837B C-91M* (SACK) P\ sV PREMIUM DISCOUNT ENDORSEMENT--NORTH CAROLINA Page l (Automobile and General Liability Insurance) The premium pertaining to North Carolina for Liability and Medical Payments insurance is subject to discount in accordance with the following procedure: 1. North Carolina Standard Premium. Such premium pertaining to North Carolina computed in accordance with the provisions of the policies designated in paragraph 5 hereof, other than this endorsement and exclusive of the applica tion of any retrospective rating plan and exclusive of any premium under any Automobile Liability Policy appli cable with respect to automobiles classified as "Livery," "Buses other than School Buses" and "Long Haul Truckmen" shall be known as the North Carolina Standard Premium. 2. Total Standard Premium for All States. The Liability and Medical Payments premium computed in accordance with the provisions of the policies designated in paragraph S hereof, other than this endorsement and exclusive of the application of any retrospective rating plan, any Automatic Premium Adjustment Endorsement, any Premium Return Plan Endorsement, or other Premium Discount Endorsement, shall be known as the Total Standard Premium. 3. Premium Discount--North Carolina (a) For policy periods of one year or less--The North Carolina Standard Premium, exclusive of any premium subject to any retrospective rating plan, shall be subject to the applicable discount percentages for the Total Standard Premium obtained from the Table of "North Carolina Premium Discount Percentages." (b) For policy periods of more than one year--The North Carolina Standard Premium for each annual period or portion thereof during the policy period shall be subject to the applicable discount percentages stated in said Table of "North Carolina Premium Discount Percentages" opposite the Total Standard Premium for the policies for each such period or portion thereof during the policy period. * (c) If retrospective rating is applicable to a part of the premium pertaining to North Carolina, the amount of premium discount applicable to the North Carolina Standard Premium* exclusive of any premium s> sect to any retrospective rating plan, shall be the difference between (1) the discount determined by apply!: k to the North Carolina Standard Premium the applicable percentages stated in said Table opposite the Total Standard Premium, and (2) the discount determined by applying to that portion of the North Carolina Standard Pre mium which is subject to retrospective rating the applicable percentages stated in said Table opposite so much of the Total Standard Premium as is subject to retrospective rating. 4. Table--North Carolina Premium Discount Percentages. Stated on Pages 2 and 3 of this endorsement. 5. Policy Numbers Estimated Standard Premium "'-RNSL-922 CCc-.'*ll" 0 Total Applicable Premium Discount Percentages based on Total Estimated Advance Standard Premium: General Liability________ % Automobile Liability--Garages________% Taxis________ % AH Other Automobile Liability Except Livery, Buses other than School Buses, andLong Haul Truckmen---------------% Amending Policy No - - i- This endorsement is executed by The Travelers Insurance Company as respects insurance afforded by that company only; it is executed by The Travelers Indemnity Company as respects insurance afforded by that company only. Th e Tr a v e l e r s In s l r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y 4080A C-9519 3-62 u.sp r in t e d in a. AID 005109 o Page 3 rz. " ** TABLE I Premium Subject to Han D, Limit,tim,, tee*' Conversion Factor, State Tax MuitipUen Excess Los* Premium Factor* 1. The premium for the following policies is to be computed in accordance with the provisions of Retrospective Rating Plan D in all atata where such plan is or becomes applicable on an interstate basis, subject to the limitations specified herein: List of Policies T -RNSL>922224 -72 T-RFMC-922222-72 7-RFMC-922235-T2 T-RFMC-922236-72 2. Plan D does not apply to the premium X The premium for the general liability and automobile liability insuranceafforded under policies designated in paragraph 1 above for j 25.000insurance in excess of the limits of liability stated below shall not be subject to Plan D; Mel. | 1 (Bodily Injury Liability) f 25,000 r~ Mrfi amrbnt J 1 General Liability policies f ,, 25.000 Mf*K pfvwyi 4 I (Bodily Injury Liability) .4 t 25.000 $ 50.000 l 25,000 innate products- u k . 1 (Property Damage Liability) J General Liability policies (Property Damage Liability) J ' 1 f 25,000 t 50.000 $ 50.6OC $ 50.000 50.000 rn~*A.>. j u *' Mrfi rereEste operations 1 ' aggregate protective aggregate pmducte ________aneresate contractual . The incurred losses to be included in computing the premium for the insurance subject to Plan D shall not include that portion of the losses actually paid and the reserves for unpaid losses which is in excess of the limits of liability ! stated above, but that part of the incurred losses consisting of premiums on bonds, interest accruing after entry of judgment, allocated loss adjustment expenses and expenses incurred in seeking recovery against a third party shall not be subject to such limits. The aggregate limits of liability stated above apply separately to each annual period included in the three year period. 4. Combined Liability Loss Limitation is X. 5. Compensation Loss Limitation is S_____ 25-000, p*0rit 1-fJDER CONTRA ;AS;LITY INSURANCE COVERAGE PART L26 FOR LiMjTS Of l ! Afci l.; 7Y - . ' - ^ -- OF; CCf-VRi -iu 30D;LY : M,,t. F. _ ! AB l L i TY "' /A*. PROPER' Da n * a .'v. 425000 EACH PERSON $25,000 EACH ACCJOENI $25,000 EACH ACCfDcJt *50,000 AGGREGATE C-U189 5-66 pRiNTCo in u .s .a . fContinued on page 4) AID 005110 4101B Name Of State STATE TAX MULTIPLIERS Workmen's Compensation And Employers' Liability Automobile Liability General Liability Page 4 j EXCESS LOSS PREMIUM FACTORS Automobile Physical Damage Workmen's Compensation And Employers' Liability Automobile And General Liability Automobile Physical Damage PA I Gc 1.031 .01? TABLE n--PERCENTAGES TO DETERMINE BASIC, MINIMUM, AND MAXIMUM PREMIUMS. He basic premium, the minimum premium, and the maximum premium for insurance subject to Plan D are percentages of the standard premium for such insurance. Such percentages are computed initially upon an estimate of the standard premium and finally upon the earned standard premium for such insurance. If the standard premium lies between any two of the figures on the "Standard Premium" line, the percentages applicable shall be obtained by linear interpolation to the nearest one-tenth of 1 %. Standard Premium Minimum Premium Maximum Premium BASIC PREMIUM Wdricaun's Compensation New York Pen^ayhrania Other States PERCENTAGES OF STANDARD PREMIUM 50% S 100% or less $ 150% t or more fi E r- l t R M l N Z D Liability Mam. Scat- B.I. Mass. Noo-Stat. Auto B.I. Texas Gen. Ltab. Texas Auto Liab. Other Automobile Physical Damage This endorsement is executed by The Travelers Insurance Company as respects insurance afforded by that company only; it is executed by The Travelers Indemnity Company as respects insurance afforded by that company only. ` .# r k ' ,, _ THE TRAVELERS INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY 1 9 46C-U C X MINTED IN Suntary 4101B AID 005111 T-RNSL-92'">^-72 North Carolina Premium Discount Percentages (Continued) Page 3 Tool Standard Premium (See Note) * (i) $75,000 80,000 85,000 90,000 95,000 100,000 105,000 110,000 115,000 120,000 125,000 130,000 135,000 140,OCO 145,000 150,000 162,500 175,000 187,500 200,000 212,500 225,000 237,500 250,000 262,500 275,000 287,500 300,000 312,500 325,000 337,500 350.000 362,500 375,000 387,500 400,000 412,500 425,000 437,500 450,000 462,500 475,000 487,500 ,000 and Over General Liability (2) 22.2% 22.3 22.4 22.5 22.6 22.7 23.0 23.3 23.5 23.7 23.9 24.0 24.2 24.4 24.5 24.7 25.0 25.2 25.5 25.6 25.8 25.9 26.1 26.2 26.3 26.4 26.5 26.6 26.6 26.7 26.8 26.8 26.9 27.0 27.0 27.0 27.1 27.1 27.2 27.2 27.2 27.3 27.3 Automobile Liability-- Garages (3) 14.6% 14.7 14.7 14.8 14.9 15.0 15.2 15.4 15.6 15.7 15.9 16.0 16.2 16.3 16.4 16.6 16.8 17.0 17.1 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.9 18.0 18.1 18.1 18.2 18.2 18.3 18.3 18.3 18.4 18.4 18.4 18.5 18.5 18.5 ' 18.5 18.6 ' Taxi* (4) 8.9% 9.0 9.1 9.2 9.2 9.4 9.6 9.8 10.0 10.1 10.3 10.4 ia6 10,7 10.8 11.0 11.2 11.4 . 11.6 1L7 ft 12.0 12.1 &2 112 12J 12.4 12.5 12i5 12.6 12.6 12.7 12,7 12.8 12.8 12.8 12,9 12.9 12,9 13.0 13,0 13,0 13.0 Ail Other Arnamobile Liability m Except Livery, Bute* other than School Buara. and Lonf Haul Truckmen (5) 14.1% 14.2 14.2 14.3 14.4 14.5 14.7 14.9 15.1 15.2 - ;- *. . < , .: 15.4 15.5 15.7 . 15.8 ? 15.9 16.1 16.3 16.5 16.6 16,8 * 16.9 I 17.0 t 17.1 l 17.2------ T-f"* 17.3 174.. 17.4 17.5 17.6 17.6 17.7 17.7 17.8 17.8 17.8 17.9 17.9 17.9 18.0 18.0 18.0 18.0 18.1 * Note: If the Total Standard Premium is between two of the amounts shown in Column (1), the premium discount percentage applicable is that shown for the lower of such amounts. *If the Total Standard Premium is $500,000 or over, the discount percentage applicable for each kind of insurance shall be determined as the weighted average of the percentage shown in (b) for the first $500,000 of Total Standard Premium arid the percentage shown in (c) for the portion of the Total Standard Premium over $500,000: Kind of Insurance Fir* 1500.000 Portion Over 1500,000 General Liability (a) (b) 27.3% (c) 28.5% Automobile Liability--Garages 18.6 19.5 Taxis 13.1 14.0 All Other Automobile Liability except Livery, Buses other than School Buses, and Long Haul Truckmen 18.1 19.0 4080A AID 005112 o Total Standard Premium (See Note) Cl) $1,000 or less 1,050 1,100 1,150 1,200 1,250 1,300 1,350 1,400 1,450 1,500 1,550 1,600 1,650 1,700 1,750 1,800 1,850 1,900 1,950 2,000 2,100 2,200 2,300 2,400 2,500 2,600 2,700 2,800 2,90(1 3,000 3,100 3,200 3,300 3,400 3,500 3,600 3,700 3,800 3,900 4,000 4-200 4,400 4,600 4,800 5,000 5,200 5,400 5,600 5,800 6,000 6,200 6,400 6,600 6;800 General Liability (2) 0.0% 0.7 1.2 1.6 1.9 2.3 2.6 2.9 3.1 3.4 3.6 3.8 4.0 4.2 4.4 4.6 4.7 4.9 5.0 5.2 5.4 5.6 , 5.8 ' 6.0 6.2 ;i T5.4 63 6.7 . 6.8 6.9 7.1 7.2 . 73 . 7.4 ` 7.5 7.5 7.6 7.7 7.8 7.8 7.9 8.1 8.2 8.3 8.4 8.7 9.1 9.6 10.0 10.4 10.8 11.1 11.4 11.7 12.0 Automobile Liability-- Garacea (3) 0.0% 0.3 0.6 0.7 0.9 1.1 1.2 1.4 1.5 1.6 1.7 1.8 1.9 2.0 2.1 2.2 2.3 2.3 2.4 2.5 2.6 2.7 2.8 2.9 3.0 3.0 3.1 3.2 3.2 3.3 3.4 3.4 3.5 3.5 3.6 3.6 3.6 3.7 3.7 3.7 3.8 3.8 3.9 3.9 4.0 4.2 4.6 4.9 5.2 5.5 5.8 * 6.1 6.3 6.5 6.8 C-9519a 3*62 ssmrtc im v .&.a . North Carolina Premium Discount Percentages (Forming a Part of Endorsement 4080A) Page 2 Taxis (4) All Other Auto mobile Liability Except Liver)', Buses other than School Buses, and Long Haul Truckmen (5) Total Standard Premium (See Note) (i) General Liability (2) 0.0% 0.1 0.1 0.1 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.5 -0.5 0.5 0.6 '0.6 0.6 0.6 0.6 0.6 0.6 0.7 0.7 '0.7 0.7 0.7 .0.7 '0.7 0.7 0.7 0.7 0.7 0.8 0.8 0.8 0.8 0.8 - 0.9 1.2 1.4 1.6 1.8 2.0 2.2 2.3 2.5 2.6 0.0% 0.3 0.5 0.7 0.8 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2.0 2.0 2.1 2.2 2.2 2.3 2.4 2.5 2.6 2.7 2.7 2.8 2.9 2.9 3.0 3.0 3.1 3.1 3.2 3.2 3.2 3.3 3.3 3.3 3.4 3.4 3.5 3.5 3.5 3.6 3.8 4.2 4.5 ' 4.8 5.1 5.4 5.6 5.9 6.1 6.3 $7,000 7,200 7,400 7,600 7,800 8,000 8,200 8;400 8,600 8,800 9,000 9,200 9,400 9,600 9,800 10,000 10,500 11,000 11,500 12,000 12,500 13,000 13,500 14,000 14,500 15,000 16,000 17,000 18,000 19,000 20,000 21,000 22,000 23,000 24,000 25,000 27,500 30,000 32,500 35,000 37,500 40,000 42,500 45,000 47,500 50,000 52,500 55,000 57,500 60,000 62,500 65,000 67,500 70,000 72.500 12.3% 12.5 12.8 13.0 13.2 13.4 13.6 13.8 14.0 14.1 14.3 14.5 14.6 14.7 14.9 15.1 15.4 15.7 15.9 16.2 16.4 16.6 16.7 16.9 17.1 17.3 17.5 17.8 18.0 18.1 18.3 18.5 18.6 18.7 18.8 19.0 19.2 19.5 19.8 20.1 20.4 20.6 20.8 21.0 21.1 21.3 21.4 21.5 21.6 21.7 21.8 21.9 22.0 22.0 22.1 (Continued on reverse side) Automobile Liability-- Garages (3) Taxis (4) AU Other Auto mobile Lutbdity Except Livery. Bums other than School Buses, and Long Haul Truckmen (5) 7.0% 7.2 7.3 7.5 7.7 2.8% 2.9 3.0 3.1 3.3 7.8 8.0 8.i . 8.3 8.4 3.4 3.5 3.6 3.6 3.7 8.5 3.8 8.6 3.9 8.7 4.0 8.8 4.0 8.9 4.1 9.1 4.2 9.3 4.4 9.6 43 9.7 4.6 9.9 43 10.1 4.9 10.2 3.0 10.4 3.1 10.5 5.1 ? 10.6 3.2 10.8 S3 ,, 11.0 53 11.1 5.6 11.3 3.7 11.4 5.8 11.6 5.9 11.7 5.9 11.8 6.0 11.9 6.1 12.0 6.1 12.1 6.2 12.3 6.3 12.5 63 12.7 6.8 13.0 2a , 13.2 13.3 13.5 13.6 13.7 7.3 73 7.7 7.8 8.0 13.9 ,, 14.0 14*0 14.1 14.* .8.1 : 8.2 83 8.4 83 14.3 -'''F-1 8.6 ` 14.3 6.6 14.4 8.7 , 14.5 8.8 14.5 8.8 6.5% 6.7 6.9 7.1 7.2 7.4 7.5 7.7 7.8 7.9 8.1 8.2 8.3 8.4 8.5 8.7 8.9 9.1 9.3 93 9.6 9.8 9.9 10.0 10.1 10.3 103 10.7 10.8 11.0 11.1 11.2 11.3 11.4 113 11.6 11.8 12.0 12.3 123 12.7 12.8 13.0 13.1 13.3 13.4 133 13.6 13.6 13.7 13.8 13.8 13.9 14.0 14.0 AlDO(KTTt> G 'D RETROSPECTIVE PREMIUM ENDORSEMENT--THREE YEAR--PLAN D Amending Policy No__I______~a It is agreed that this endorsement applies to the policies designated in Table I below and renewals thereof affording insurance with respect to the three year period commencing with the effective date of this policy, subject to the following provisions: 1. Filial Premium. The final premium for such policies is the sum of: (a) the premium for the insurance not subject to Plan D, as specified in Table I, computed in accordance with the provisions of such policies, other than this endorsement, and (b) the premium for the insurance subject to Plan D, as specified in Table I, hereinafter referred to as the retrospective premium. 2. PfirTti*** *i Prwmintn The retrospective premium shall be the sum of: (a) the basic premiums for each state, (b) the excess loss premiums for each state, and (c) the converted losses for each state, each multiplied by the applicable state tax multiplier. The retrospective premium shaU be subject to the minimum retrospective premium and to the maximum retrospective premium. 3. Definition if Terms Used in the Computation of the Retrospective Premium. (a) "Standard premium*' means the premium for the insurance subject to Plan D computed in accordance with the provisions of the policies, other than this endorsement and exclusive of the application of any premium discount endorsement. (b) "Basic premiums" means the amounts obtained by applying to each portion of the standard premium the basic premium percentage stated in Table II as applicable thereto. (c) "Excess loss premiums" means the sum of: (1) the amounts obtained by applying to that portion of the standard premium under workmen's compensation and employers' liability policies for each state for which a factor is entered in the Excess Loss Premium Factors (Work men's Compensation) column of Table 1, the applicable factor times the applicable loss conversion factor, (2) the amounts obtained by applying to that portion of the standard premium for liability insurance under general liability and automobile liability policies, the factor stated in the Excess Loss Premium Factors (Liability) column of Table 1, times tbe applicable loss conversion factor, and j. (3) the amounts obtained by applying to that portion of the standard premium for automobile physical damage insurance, the factor stated in the Excess Loss PrenTium Factors (Physical Damage) column of Table I, times tbe applicable loss conversion factor. -** (d) "Incurred losses" means the sum of: (1) ell lasses, including medical, actually paid, (2) reserves for unpaid losses as estimated by the company, (3) premiums on bonds paid for by the company in accordance with tbe provisions of the policies, (4) interest accruing after entry of a judgment against the insured, (5) allocated loss adjustment expenses, and (6) expenses incurred in seeking recovery against a third party under the insurance subject to Plan D, provided (i) as respects the insurance afforded under any workmen's compensation and employers' liability policy. Items (3) and (S) above shall not apply and Item (6) shall apply only if recovery is obtained against the third party, and (ii) Items (3), (4) and (5) above shall not apply as respects automobile physical damage in surance. (e) "Compensation loss limitation," if stated in Table I, means the limit of incurred losses to be included in computing the retrospective premium under the workmen's compensation and employers' liability policies designated in Table I as subject to Plan D, applicable to any state for which a factor is shown in the Excess Loss Premium Factors (Workmen's Compen sation) column of Table I, arising out of bodily injury by accident or disease, including death at any time resulting therefrom, sustained by one or more emplo)ees in a single accident. For the purpose of this definition, incurred losses arising out of bodily injury by disease, including death at any time resulting therefrom, sustained by any one employee shall be deemed to arise out of a single accident. If, during the policy period, - (1) the insured engages in operations in any state for which this policy affords insurance but for wfaich no factor is shown in the Excess Loss Premium Factors (Workmen's Compensation) column of Table I, and (2) cn tbe date this endorsement becomes applicable with respect to any such additional state, there is a loss limitation with respect to all states specifically insured under the policy and subject to Plan D, and (3) the insured is eligible tto elect such loss limitation in such additional state, such Vms limitation shall also apply to incurred losses pertaining to such additional state. The excess loss premium factor appiicable to such additional state, determined in accordance with the manuals in use by tbe company, shall be deemed to be entered in Table I. (f) "Combined liability lossilimitation," if stated in Table I, means the overall limit of incurred losses to be included in comput ing the retrospective premium for general liability and automobile liability insurance afforded under any policy designated in Table 1 as subject to Plan D, arising out of a single accident. (g) "Automobile physical damage loss limitation," if stated in Table I, means the limit of incurred losses to be included in computing the retrospective premium for the automobile physical damage insurance afforded under any policy designated in Table I as subject to Plan D, arising out of any one occurrence. (h) "Loss(conversion ifactor'* means the factor designated in Table I. (i) "Converted losses" means the incurred losses multiplied by the applicable loss conversion factor. (j) "State tax multiplier" means the applicable factor stated in the State Tax Multiplier Table in Table I. (k) "Minimum retrospective premium" is the amount obtained by the application of the minimum premium percentage stated in Table II to the standard premium. (l) "Maximum retrospective premium" is the amount obtained by the application of the maximum premium percentage stated in Table II to the: standard premium. (Continued on pa[c 2) 4101B AID 005114 Psge 2 4. Payments *nd Computations of Premium for Insurance Subject to Plan D. (a) Standard Premium. The named insured shall pay the standard premium to the company in accordance with the provisions of the policies, other than this endorsement, specifying the manner of premium payment. (b) Retrospective Premium. A computation of the retrospective premium applicable to the first annual period, based upon the standard premium and incurred kieses for such period, such kieses to be valued as of a date six months after the expira tion of such period, shall be made by the company as soon as practicable after such valuation date. A computation of the retrospective premium, applicable to the first two annual periods, based upon the standard premium and incurred losses for such periods, such losses to be valued as of a date six months after the expiration of the second annual period, shall be made by the company as soon as practicable after such valuation date. A computation of the retrospective premium, based upon the standard premium and incurred losses for the three year period, such losses to be valued as of a date six months after the expiration of such period, shall be made by the company as soon as practicable after such valuation date. Such computation of the retrospective premium for the three year period shall be final if (1) all claims have been closed or it is apparent that the retrospective premium will exceed the maximum retrospective premium, and (21 within ninety days from approval of such computation by the organization having jurisdiction, the company, with the agreement of the insured, requests of such organization that the computation be final. If such computation is not final, a further computation of the retrospective premium, based upon incurred losses valued as of a date eighteen months after termination of the policies, shall be made by the company as soon as practicable after such valuation date. Such further computation shall be final unless, within ninety days from approval of such computation by the organization having jurisdiction, the company or the named insured requests of such organization that a further compu tation. be authorized. Any subsequent computations, to be made only at intervals of twelve months, shall each be subject to a similar procedure. If the named insured disposes of his entire interest in the operatioos covered by the policies, or makes an assignment for the benefit of creditors, or is in a legal proceeding reorganized or declared bankrupt or insolvent, and if the retrospective pre mium as of the date of such change of status is greater than the standard premium for insurance to such date, the company may compute the retrospective premium as of such date, as soon at practicable thereafter. After each computation, if the premium thus computed exceeds the premium paid for insurance subject to Plant), the named insured shall pay the difference to the company ; if leas, the company shall return the difference to the named ironrrrl. 5. Cancellation or Non-Renewal of Policy J The cancellation or non-renewal, prior to the end of the three year period, of any policy designated in Table I shall terminate the retrospective rating plan as of the date of such policy cancellation or non-renewal. In the event of cancellation or non-renewal by the named insured, the retrospective premium for the period such policies shall have been in force shall be computed in accordance with the provisions of this endorsement, provided: (a) The standard premium shall be computed as the sum of (1) the audited standard premium for all completed annual periods and (2) the short rate standard premium for the period in which cancellation is effective; the minimum retrospective premium shall be the standard premium So computed. (b) In computing the maximum retrospective premium, the standard premium shall be computed as the sum of the audited standard premium to the date of cancellation or non-renewal and the estimated standard premium from the date of can cellation or non-renewal to the end of the three year period. In the event of cancellation or non-renewal by the company, the retrospective premium for the period such policies shall have been in force shall be computed in accordance with the provisions of this endorsement, provided if such cancellation or nonrenewal is because of non-payment of premium by the named insured, the maximum retrospective premium shall be computed in the manner provided by subparagraph (b) above. Neither the named insured nor the company may cancel or fail to renew the insurance subject to Plan D applying to a part of the operations of the named insured. 6. Revision of Tax Multipliers or Excess Loss Premium Factors. Subject otherwise to the provisions of the first paragraph of condition 1 of the policy, if during any annual period included in the three year period, any Tax Multiplier or Excess Loss Premium Factor designated in Table I is revised, any such revised Tax Multiplier or Excess Loss Premium Factor shall be ap plicable with respect to this endorsement, as of the commencement of the next annual period which is on or after the effective date of such revision. C-l 1189 3-66 pr imt c d US.a. (Continued on pate 3) 4101B AID 005115 RETROSPECTIVE PREMIUM E1CDORSEMEKT--THREE TEAS--PLAJf D X-RNSL~922w H-7w Amending Policy No. It is screed that this endorsement applies to the policies designated in Table I below and renewals thereof affording insurance with rspect to the three year period commencing with the effective date of this policy, subject to the following provisions: 1, Final Pi--Tbe fatal premium for such policies is the sum of: (a) the premium for the insurance not subject to Plan D, as specified in Table I, computed in accordance with the provisions of such policies, other than this endorsement, aid (b) tbe premium for tbe insurance subject to Plan D, as specified in Table I, hereinafter referred to as the retrospective premium. 2. Ritroapsctirs Pr.mtwm. The retrospective premium shall be the sum of: (a) the basic premiums far each state, (b) the excess loss premiums for each state, and (c) the converted losses far each state, each multiplied by the applicable state tax multiplier. The retrospective premium shall be subject to the minimum retrospective premium and to the maximum retrospective premium. 3. TTsflnltlwi nf'Trnne Vul hi fhi ''nmimfstinn nf tfir "TtmsiiirTfTT lYrnihrm (a) "Standard premium" means the premium for the insurenrr subject to Plan D computed in accordance with the prevision* of tbe policies, other than this endorsement and exclusive of the application of aay premium discount endorsement, fb) -"Bask premiums" means tbe amounts obtained by applying to each portion of the standard premium the basic-premium ' "'percentage stated in Table II as applicable thereto, . ... r.. {cl.. "Rscw lorn premium*" means the sum of: . .(1) the amounts obtained by applying to that portion-of the standard-premium under workmen's, oampsnaation and employers' liability policies for each state for which a factor is entered in tbe Farces Loss Premium Factors (WorkI l; - men's Compensation) column of Table f, the applicable factor times the applicable loss conversion factor, V '-r(2) the amounts obtained by applying to that portion of the standard preminm for liability insurance under general <' liability and automobile liability policies, the factor stated in the,Excess Loss Premium Factors (Liability) column of *r Table I, times the applicable kiss conversion factor, and :- " >' (3) the amoontaoblained by applying to that portaoo-af the standard premium for automobile physical damage insurance, the factor stated in the Excess Loss Premium Factors (Physical Fhmsgs) column of Table L rinses the sppbcsbfe lose cmns o'l.m factor. . . ... :v .iipsf. ;jr ' . > k c o jut .in- ,a- .<4 (d) "bsewred Loams" means the sum oft ,J tD all lossesi including medical, actually paid, ~ " oc' . ,, (2) reserve* for unpaid losses as estimated by the company, k s -v b * w f - ! wv ' C f c: tp*. <unHlAORii' U'VSSlfcv i! .'H_. . (3) .premiums on bonds paid for.by the company in accordance witb j^he provisjanj.flf thc (4) . interest accruing after entry of a judgment against the insured, (3) allocated loos adjustment expenses, and lacp Lopria tpei! (6) expenses incurred in seeking recovery against a third party '- --- under the insurance subject to Plan D, provided: (i) as respects the insurance afforded under any workmen's compensation and employersHiability policy: (a) item (3) above shall not apply, (b) item (5) above shall apply as respects employers' liability coverage only, (c) item (6) above shall apply only if recovery is obtained against the third petty, and (ii) items-f3), (4), and (5) above shall not apply a* respects automobile physical damage insumnoe: (e) "Compenaatioo lose Uxnitatiaa," if stated in Table L means the limit of,incurred lasses to be included in computing the retrospective premium under the workmen's compensation and employers' liability polities designstad in Table I as subject to Plan D. applicable to any state for which a factor is shown in the Excess Loss mmium Factors (Workmen's Compen sation) column of Table I, arising out of bodily injury by accident or disease, including death at any time resulting therefrom, sustained by one or more employees in a single accident. For the purpose of this definition, incurred losses arising out of bodily injury by disease, including death at any tic -esulting therefrom, sustained by any one employee shall be deemed to arise out of a single accident. If, during the policy period, (1) the insured engages in operations in any state for which this policy affords insurance but for which no factor is shown in the Excess Lou (Premium Factors (Workmen's Compensation) column of Table I, and (2) on the date this endorsement becomes applicable with respect to any such additional state, there is a loss limitation with reject to all states specifically insured under the policy and subject to Plan D, and (3) the insured is eligible to elect such loss limitation in such additional state, such lorn limitation shall also apply to incurred losses pertaining to such additional state. The excess loss premium factor applicable; to such additional state, determined in accordance with the manuals in use by the company, shall be deemed to be entered in Table I. (f) "Combined liability loss limitation," if stated in Table I, means tbe overall limit of incurred losses to be included in comput ing the retrospective premium for general liability and automobile liability insurance afforded under any policy designated in Table I as subject to Plan D, arising out of a tingle accident. (g) "Automobile physical damage lots limitation," if stated in Table I, means the limit of incurred losses to be Included in computing the retrospective premium for the automobile physical damage insurance afforded trader any policy designated in Table I as subject to Plan D, arising out of any one occurrence. ...... (h) "Lorn conversion factor" means the factor designated in Table I. (i) "Converted losses" means the incurred losses multiplied by the applicable loss conversion factor. (j) "State tax multiplier" means the applicable factor stated in the State Tax Multiplier Table in Table I. (1c) "Minimum retrospective premium" is the amount obtained by the application of the minimum premium percentage stated in Table If to the standard premium. (I) "Maximum retrospective premium" is the amount obtained by the application of the maximum premium percentage stated in Table II to the standard premium. (Caniinuai am pa[t 2) 4101C AID 005116 i - ljf\ **'<! hpl 4. I'njuimli xai CimipnlulkM f Timetim lu Iwiii a TlwliJrt ft flee TT ' (,) 8txa4&r4 Premium. The named insured thill pay the standard premium to the company in accordance with the provisions ^ the poGdtt, other this endorsement, specifying the meaner of premium payment. (b) Bateeenectire Premium. A computation of the retrospective premiam applicable to the first annual period, band upon the standard premium and incurred loaem far such period, eudh loves to be valued as of.a date six months after the expira- tiostof such period, shall be made by the company as soon as practicable after such valuation date. A computation of the retrospective premium, applicable to the first two annual periods, based upon the standard premium and incurred losses for such periods, ouch losses to be valued as of a date six months after the expiration of the second annual period, ahall be made by the company aa soon aa practicable after such valuation date. A computation of the retrospective premium, baaed upon the standard premium and incurred losses for the three year period, such losses to be valul as of a date six months after the expiretioo of such period, shall be made by the company as soon as practicable after such valuation date. Such computation of the retrospective premium for the three peer period shah be final if (1) all claims have been dosed or it is apparent that the retrospective premium will exceed the maiimum retrospective premium, and (2) within ninety days from approval of such computation by the organisation having jurisdiction, the company, with the agreement of the hMue& requests of such organisation that the computation be anal. If such computation it not final, a further computation of the retrospective premium, based upon incurred losses valued aa of a date eighteen months after termination of the policies, shall be made by the company as soon as practicable aftar each valuation date. Such further computation shall be final unlem, aritbio ninety days from approval of such computation by the organization having jurisdiction, the company or the named insured requests of such organization that a further compu tation be authorized. Any subsequent computations, to be made only at intervals of twelve months, shall each be subject to ariadkrprocedure. . ........--- - ' - , i- r V 'i *. ..*> U?- ."'t - - :. *, Ifthe named aaurod disposes of his entire interest in the operation* cowed by the potidea, or mabiw ah aaaigmiruvit for that benefit of creditors, or i* in a legal proceeding reorganized or-declared bankrupt or insolviat, and if the retrospective pro- aiiiim as of the date of such change of status is greater than the standard premium for insurenee tosuch dote, the neapssy may compute the retrospective premium as of each date, as--as practicable -t*h e--rea*f*te--r. .> .in je. ' *ijP' "" After edefc computation, if the premium thus computed eaceeds the premium paid for insurance subject to Plan Q, the named learned snail pay the difference to the company; if leas, tile company shall return the difference to the named wared. ... _ . ' etbeer Non-Ranawal ef Policy : The canoeUation or nom-renewal, prior to the end of the three year period, of any policy desgnated in Table I ehall tninate the retrospective rating plan as of the date of such policy cancellation or noo-renewal. In the event of canoeUation or non-renewal by the named insured, the retrospective premium for the period aach policies shall have been in facts shall be computed in acooraanoe with the provisions of this endorsement, provided: (a) The standard premium shall be computed as the sum of (1) the audited standard premium for all completed annual periods and (2) the soon: rate standard premium for the period in which cancellation is effective; the minimum retrospective premium shall be the standard premium so computed. (b) In computing the maximum retrospective premium, the standard premium shall be computed as the sum of the audited standard premium to the date of cancellation or nan-renewal and the estimated standard preeuuaa from the date of-cea* cnUatian or nan-renewal to the end of the three ynar period. - In the event of cancellation or non-renewal by the company, the retrospective premium for the period such policies shall have been in force shall be computed in accordance with the provisions of tins endorsement, provided if such cancellation or non renewal is because of non-payment of premium by the named insured, the maximum retrospective premium shall be computed in the manner provided by subparagraph (b) above. Neither the named insured nor the company may cancel or fail to renew the operations of the named insured. subject to Plan D applying to a part of the Revision of Tax Multipliers or Kreaps Loos Premium Factor*. Subject otherwise to the provisions of the first paragraph of condition 1 of the pokey, if during any annual period included in the three year period, any Tax Multiplier or Fveins Los* Premium Factor designated in Tame I as revised, any such revised Tax Multiplier or Excess Lorn Premium Factor shall be ap plicable with reepnet to this endowment, aa of the commencement of the next annual period which ia an or after the effective datsrof aachrevimaa. * f . I - C-i isn S-66 puiKTio i i (Continued w page J) AID 005117 4I01C Page 3 TABLE I Premium Subject to Plan D, Limitations, Loss Conversion Factor, State Tax Multipliers , Excess Loss Premium Factors *~.v 1. The premium for the following policies is to be computed in accordance with the provisions of Retrospective Rating Plan D in ail states where such plan is or becomes applicable on an interstate basis, subject to the limitations specified herein: List of Policies T ~9:; ~ "72 T-R^:C.-90:V2-i-i-72 T-aFMe-viS3*-72 2. Plan D does not apply to the premium a l l PRtOuK "VcR FLAN L>IT3 AJTOrOB: 'JL L'N1 :-`Sl>RD KOTOR I STS PROTECTION The premium for the general liability and automobile liability insurance afforded under policies designated in paragraph 1 above for insurance in excess of the limits of liability stated below shall not be subject to Plan D: Automobile Liability policies 25,000 (Bodily Injury Liability) $ "sT/eso each accident i General Liability policies (Bodily Injury Liability) .- Automobile Liability policies s f 0,000 s 50,000 s 25,000 ' Mrh person each acrident aggn^gate products each accident (Property Damage Liability) General Liability policies (Property Damage Liability) t '0,000 $ ;; 0, 0( C 1 ,:0,C-G0 t -o.oCo s ;0,GC0 each arrident aggregate operations aggregate protective aggregate products aggregate rnnfrartiial UNDFR CONTRACTUAL L!A3iw'' C- LMEKiTY F.\C.ZiS OF i N: ;<AN-'. E COVERAGE PAR' L26 FOR - -aq /i : t , , A ;.i ' - f . ; C L . -".Ri G'i ; L'C :a :.' d l *' CONTRA CTL'Al -RCPiLR DAMAGE LAil :t y fi:,' cc ' A0:. ACCD;--t ~ / o0 A-.j XRE'XATC The incurred losses to l>e included in computing the premium for the insurance subject to Plan D shall not include that portion of the losses actually paid ami the reserve- for unpaid losses which is in excess of the limits of liability stated above, but that part of the incurred losses con-isting of premiums on bonds, interest accruing after entry of judgment, allocated loss adjustment expenses and expenses incurred in seeking recovery against a third party shall not be subject to such limits. The aggregate limits of liability stated above apply separately to each annual period included in the three year period. 4. Combined Liability Loss Limitation is $ 5. Compensation Loss Limitation is S_______________ 6. Automobile Physical Damage Loss Limitation is $. 7. Loss Conversion Factor is_______ *-- ___________ C-U5A8 R-6S p6-,,Ti; S (Continued on page 4) AID 005118 4101C Rune Of State STATE TAX MULTIPLIERS Workmen1* Compenaalioc And Employer*' Liability Automobile Liability General Liability Automobile Physical Damage Pm* 4 EXCESS LOSS PREMIUM FACTORS Workmen's Compensation And Employers' Liability Automobile And General Liability Automobile Physical Damage v:: C-UPFl ME*T 4TTA>' HED TABLE D--PERCERTAGES TO DETERMINE BASIC, MINIMUM, AND MAXIMUM PREMIUMS. ., The basic premium, the minimum premium, and the maximum premium for insurance subject to Plan D are percentages of the standard premium for such insurance. Such percentages are computed initially upon an estimate of the standard premium and.finally upon the earned standard premium for such insurance. If the standard premium lies between any two of the figures on the "Standard Premium" line, the percentages applicable shall be obtained by linear interpolation to the nearest one-tenth of 1%. Standard Premium Minimum Premium Maximum Premium BASIC PREMIUM Workmen's Compensation New York Pennsylvania Texas Other States PERCERTAGES OF STANDARD PREMIUM 50% 5 100% or less $ b D ' : r- * I M . o 150% I or more Liability Mass. Stat. B.I. Mass. Non-Stat. Auto B.I. Texas Gen. Liab. Texas Auto Liab. Other Automobile Physical Damage This endorsement is executed by The Travelers Insurance Company as respects insurance afforded by that company only; it is executed by The Travelers Indemnity Company as respects insurance afforded by that company only. THE TRAVELERS INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY C-! 1588 S-66 pr in t ed mu' Secretary AID 005119 Secretary 4101C L Name Of State A'_ kl CA CO CT FL GA ID IL 1. KS KY HD HA Hi MS HO MT NV NJ NY CH CK SI TTX l ;t V 'i ft VV SUPPLEMENT 8JATE TAX MULTIPLIERS Workman's Cwmpanaaflost s And - - Av Employers' Automobile Liability Liability General Liability Automobile Pbyaicai Danube i.oyr 1.032 1.031 1.030 1.035 1.02? 1.03C 1.03? 1.0.37 1.027 1.02? 1.027 1.052 i. 030 1.027 1.037 1.027 3.030 1.027 i.c-st 1.034 1.032 1.0 48 1.027 1,02" ' . C 4'v i, C30 i. 027 *?- 'V ' "v : , l' 1.042 1-031 1 - 035 1.033 1.03S 1 031 .1.033 2.042 1.031 1.031 1.031 1.031 1*03-1 1.031 1,031 1.042 1.031 1.033 1.031 1.031 1.042 1,056 1,033 1.031 1.0*1 1,0? 2 1.0;3 1.051 ' . 0*8 : ,o7-2* . j ' t. EXCESS LOSS PREMIUM FACTORS Workmen's Compensation And Employers' Liability Automobile And General Liability Automobile Physical Damage .015 .015 .013 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .015 .C15 .015 .015 .015 .015 .015 1 i This endorsement is executed by The Travelers Insurance Company as respects insurance afforded by that company only; it is executed by The Travelers Indemnity Company as respects insurance afforded by that company only. THE TRAVELERS INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY C-115U 1-66 PRINTED IN U.S.A. Secretary S Secretary U01C AID 005120 4329B UNINSURED MOTORISTS COVERAGE AMENDMENT (Insolvent Insurer) It is agreed that the term "uninsured automobile" includes an automobile with respect to which there is a bodily injury liability insurance policy applicable at the tune erf the accident but the company writing the same becomes insolvent within one year alter such accident. Th e Ts a v h x r s In d e mn it y Co mp a n y Th e Ch a s t e s Oa k Fis e In s u r a n c e Co mp a n y U29B C-10RM 3-45 mh u t io m u.s.a. H-S. (A795) AID 005121 Effective frT'rn f the time of day the policy becomes effective. Amending Policy No. !uued to_______ Date of Issue: POU Ot fcfotCotc UtL KX. CXriRU 12-20-71 I MOO. cooe 1 MOOC Of ADJUST. MOO. LOC. Of RISK (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: WITH RESPECT TO OPERATIONS AT CERTAIN MINING PROPERTIES IN WASATCH AND SUMM T COUNTIES, UTAH THE POLiCY IS EXTENDED 10 COVER THE ADDiTiONAL INTEREST CF (1) PARK CITY VENTURES - LESSEE AND (2) UNITED PARK CITY MINES COMPANY - OWNER T |S FURTHER AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THE POLICY AND THIS ENDORSEMENT DOES NOT APPLY TO BODILY INJURY TO ANY EMPLOYEE OF PARK CiTY VENTURES OR UNITED PARK CITY MINES CO!*3ANY ARISING OUT Of ANC IN THE COURSE OF HIS EMPLOYMENT WHILE UNDERGROUND.- Th e Tr a v e l e r s In s u r a n c e Co mpa n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Sn--oi No. 300C-V} Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y C-J0747 (L*re.) 2-65 j * p .s .a. 571 Countersigned by. AID 005122 Tm S M C. W ENDORSEMEN /OR MOTOR CARRIER POLICIES OF INSURANCE FOR ACT. .OBILE BODILY INJURY AND PROPERTY DAMAGE LIABILITY UNDER SECTION 215 OF THE INTERSTATE COMMERCE ACT The policy to which this endorsement is attached is an automobile bodily injury and property damage liability policy and is hereby amended to assure compliance by the insured, as a motor carrier ol passengers or property, with Section 215 of the Interstate Commerce Act and the pertinent rules and regulations of the Interstate Commerce Commission. In consideration of the premium stated in the policy to which this endorsement is attached, the Companv hereby agrees to pay, within the limits of liability hereinafter provided, any final judgment recovered against the insured for bodily injury to or death of any person, or loss of or damage to property of others excluding injury to or death of the insured's employees while engaged in the course of their employment, and property transported by the insured, designated as cargo), resulting from negligence in the operation, maintenance, or use of motor vehicles under certificate of public:convenience and necessity or permit issued to the insured by the Interstate Commerce Commission, or otherwise in transportation in interstate or foreign commerce subject to part II of the Interstate Commerce Act, regardless of whether such motor vehicles are specifically described in the policy or not. The liability of the Company extends to such bodily injuries and deaths and losses and damages whether occurring on the route or in the territory authorized to be served by the insured or elsewhere. Within the limits of liability hereinafter provided it is further understood and agreed that no condition, provision, stipulation; or limitation contained in the policy, or any other endorsement thereon or violation thereof, or of this endorsement, bv the insured, shall relieve the Company from liability hereunder or from the payment of any such final judgment, irrespective of the financial responsibility or lack thereof or insol vency or bankruptcy of the insured. However, all terms, conditions, and limitations in the policy to which this endorsement is attached are to remain in full force and effect as binding between the insured and the Company, and the insured agrees to reimburse the Company for any payment made by the Company on account of any accident, claim, or suit involving a breach of the terms of the policy, and for any payment that the Company would not have been obligated to make under the provisions of the policy except for the agreement containedsin this endorsement. ; It is understood and agreed that, upon failure of the Company to pay any final judgment recovered against the insured as provided herein, the judgment creditor may maintain an action in any court of com petent jurisdiction against the Company to compel such payment. The limits of the Company's liability for the amounts provided in this endorsement apply separately to each accident and any payment under the policy because of any one accident shall not operate to reduce the liability of the Company for the payment of final judgments resulting from any other accident. The Company shall not be liable for amounts in excess of the following for each accident: SCHEDULE OF LIMITS Motor Carriers--Bodily Injury Liability--Property Damage Liability tl) Kind nf Equipment 12) Limit for b'tills iniurtoe to or deaDthftWnItRon* (5) Limit for bodily injune* to or death of til pertona in ajured or killed tn anv one ac cident 'rubiect t" manmum of SiS.OOO f.r {ytdtfy iniunei to or rieutu ol one prrenn) Passenger Equipment (seating capacity) Seven passengers or less............. ........................................ 8 to 12 passengers, inclusive.......................................... 13 to 20 passengers, inclusive ...................................... 21 to 30 passengers, inclusive ....................................... 31 passengers or more .......................................................... Freight Equipment AH motor vehicles used in the transportation of pmpertv $25,000 25.000 25.000 25.000 25.000 25.n(in S100.000 150,000 200,000 250.000 300.000 100.000 4j Limit for loaa . or damage in anv one acci oident to property othert <exclud- mf car*o) S10.000 10.000 10,000 10.000 10 000 10,000 Whenever required by the Commission, the Company agrees to furnish to the Commission a duplicate original of said policy and all endorsements thereon. This endorsement may not be canceled without cancelation of the policy to which it is attached. Such cancelation may be effected by the Company or the insured giving thirty (30) days' notice in writing to the Interstate Commerce Commission at its office in Washington, D C., said thirty (30) days' notice to com mence to run from the date notice is actually receufed-in the office of said Commission. Attached to and forming part of policy No..... ...................................issued by The Travelers Indemnity Company (herein called Company) of Hartford, Connecticut, --- '-.av;v - ~ -x : to....eie--.--a - . .r cas. . .uf......................... :.......... ....................................................... `NT ; .` THE TRAVELERS INDEMNITY COMPANY 6117 Dated at 1-2*0* 9-55 it this. Countersigned by .dav of. President 19. Authorized Company Representative. AID 005123 Effective `.AV 1 F. 107Pat the time of day the policy becomes effective. Amending Policy No. 1 - : *J?^--^ t --i - t h f aMaroNna c o mp a n y f t m p e r e n d BOQQiA)-------------------------------------------------------------------------- Date of Isue: 4Office PM OOOC 00. USE POL. EXPIRES HV.L.140 1Sf 4507^"*" ooe o p LOC. OP 1-1-75- AOJUtT. .iOHi'SOH HIGGINS_________________________________________________ ____ (The information provided for above, except the,policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: -- ADDITIONAL INSURED (ENGINEERING HANAGEfENT INC) IT IS AGREED THAT WITH RESPECT TO SUCH INSURANCE AS IS AFFORDED BY THE POLICY FOR BODILY INJURY AND PROPERTY DAMAGE, THE PERSONS INSURED PROVISION IS AMENDED BY ADDING THERETO ENGINEERING MANAGEMENT, INC., BUT ONLY WITH RESPECT TO OPERATIONS CONDUTED ON PREMISES OWNED BY THE NAMED INSURED, AND SUBJECT TO THE FOLLOWING ADDITIONAL PROVISIONS. SUCH INSURANCE AS IS AFFORDED BY THIS ENDORSEMENT DOES NOT APPLY: 1) TO BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF THE OWNERSHIP, MAINTENANCE, OPERATION, USE, LOADING OR UNLOADING OF ANY AUTOMOBILE; 2} TO BODILY INJURY TO ANY OFFICER OR EMPLOYEE OF THE NAPED INSURED; 3} TO BODILY INJURY OR PROPERTY DAMAGE INCLUDED IN THE PRODUCTS HAZARD OR THE COMPLETED OPERATIONS HAZARD; 4.) TO PROPERTY DAMAGE TO PROPERTY OWNED BY, LEASED OR RENTED TO THE NAMED INSURED; THE INCLUSION HEREIN OF THE ADDITIONAL INSURED SHALL NOT OPERATE TO INCREASE THE LIMITS OF THE COMPANY'S LIMITS. Th e Teav e t e r s In s u r a n c e Co mpa n y Te e Tr a v e l e r s In d e mn it y Co mpa n y 6vM0L NO. Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y C-10747 (LvieJ 2-65 f k ih t c o i* u .#.a 271 Effective from , ,.HAV. J C/7________ at the time of day the policy becomes effective. Amending Policy No--T--f?N wi- Issued to- TT M-urnw .~nm,.E.v FT Date of Iseue: Q_on_*79 i!IMS (tfPICt io ejvfk'm' CO. UK -E=52------ 1-1-75------ j tooonejtTo.r. ' T uc. o p 1 an* AL RFR FND flOfiOlAJ-------------------------------------------------------- - ....................................... , tr h .-e s ims _______________________________________________________________________ . . -- (The information provided ibr above, except the policy number, is required to be stated only when this endorsement is issued for attachment to s. the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: APPLICABLE TO ENGINEERING MANAGEMENT INC THIS ENDORSEMENT MODIFIES THE PROVISIONS OF THE POLICY RELATING TO ALL LIABILITY !NSUP-\NCE OTHER THAN PERSONAL INJURY LIABILITY INSUR ANCE AND SUCH INSURANCE AS IS AFFORDED EY TIC POLICY WITH RESPECT TO THE OWNERSHIP, MAINTENANCE OR USE, INCLUDING LOADING OR UNLOADING, OF AMY AUTOMOBILE. EXCLUSION (ENGINEERS, ARCHITECTS CR SURVEYORS PROFESSIONAL LIABILITY) THIS INSURANCE DOES NOT APPLY TO BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF THE RENDERING OF OR FAILURE TO RENDER SERVICES BY OR ON BEHALF OF THE NAMED INSURED PURSUANT TO ANY ARCHITECTURAL OR EN GINEERING SERVICES CONTRACT; BUT THIS EXCLUSION DOES NOT APPLY TO BODILY INJURY OR PROPERTY DAMAGE OCCUR IHG AT PREMISES OWNED 8Y OR LEASED TO THE NAMED INSURED. * J | ' Th e Tr a v e l e r s In s u r a n c e Co mp an y Th e Tr a v e l e r s In d e mn it y Co mp ac t trvma. Wo. 2.054-0 Th e Ch a s t e * Oa k Fie e In s u ia n c e Co mp a n y AID 005125 Effective from. Issued to_ Date of Issue: i - 1 -Ki-,S*.-?c;2>2-' _at the time of day the policy becomes effective. Amending Policy No. . . ---------------- 12-23-71; (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: ITEM 1-NAMED INSURED TO READ: THE ANACONDA COMPANY AND/OR ITS AFF'UATED, ASSOCIATED AND SUBSIDIARY COMPANIES AND THE JR SUBS:D!ARY COMPANIES, AS NOW CONSTITUTED OR AS MAY HEREINAFTER BE ACQUIRED OR CREATED AND INSPIRATION CONSOLIDATED COPPER COMPANY AND WARRIOR CO-OPERATIVE MERCANTILE COMPANY THE SOUTHERN ARIZONA CONSTRUCTION CO INC * Th e Tr a v e l e r s In s u r a n c e Co mp an y Th e Tr a v e l e r s In d e mn it y Co mp a n y St w *o c No . g^OOlA Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005126 Effective from. at the time of day the policy becomes effective. Amending Policy No. Issued toI --IjAla.'.riC'iLir. ... *iL----- .1.. w > ---A) Date pf Issue: OFFICE F0O0R. UK POL. EXPIRES w.->, rfYJ-140 oPRoOocO. -w. rr . j PROO- MODE OF 1-L?75___ Rojuvr. j1 L.OC. OF RISK Jr (The Information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: CN ENDORSEMENT 6000(A) - ** Ifj URED TC INCLUDE: ' CUSACK CORO \U0 CA3LE .NO cLIK?NATE THE PROV iS.C ENXffiSEHENTS 4-J01B, 41C1C 4 17230 * Th e Tr a v e l e r s In s u r a n c e Co mp a n y ' Secretary C-10747 (Lar*e) 2*65 mu n t c o in u .s .a. 971 Th e Tr a v e l e r s In d e mn it y Co mp a n y Countersigned b>*_ Sy io o l No . Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005127 Effective from. at the time of day the policy becomes effective. Amending Policy No- Issued to_____ Date of Issue: FOft or*ict 4 COOt uCOtc. POL. CXPfPCS 12-20-71 HAOiwOuCrOr.P i mo o . I l oc. op t RISK . (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: NOT APPLICABLE TO TX ENDORSEMENT 8000(A) TillEG "NAMED ENSURED TO READ" IS AMENDED TO INCLUDE THE FOLLOWING PHRASEOLOGY- AS RESPECTS CCLUMBrA GARDENS PART AT BUTTE, MONTANA AND WASHOE PARK AT ANACONDA, MONTANA, SUCH COVERAGE AS IS AFFORDED UNDER THIS POLICY SHALL INCLUDE AS AN ADDITIONAL INSURED THE INTEREST OF COLUMBIA GARDENS FOUNDATION, A NON-PROFIT CHARITABLE ORGANIZATION COMPLETELY SUBSIDIZED BY THE ANACONDA COMPANY. THE PREMIUM CHARGE FOR THIS ADDITIONAL INTEREST IS INCLUDED IN THE COMPOSITE RATES SHOWN IN THE POLICY. f * a Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y 80<W& Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y a id 005128 Effective from- il,,.i 331 at the time oI day the policy becomes effective. Amending Policy No_ Issued to- t v f toumoA. cfiwft y F_T ai pgp run scoota )------------------------------ OFFICE teboc IfVt UA coot iWTP *" ,mnair. * h ig g ih S________________________________________________________ 1-1-75 moot off AOJUfT. LOC- Off mj* (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: ON ENDORSEMENT 3000(B) FIRST LIKE OF THE SECOND PARAGRAPH TO READ AS FOLLOWS: AS RESPECTS COLUMBIA GARDENS PARK AT BUTTE, MONTANA AND WASHOE Th e Tr a v e l e r s In s u r a n c e Co mp an y Th e Tr a v e l e r s In d e mn it y Co mp a n y Sy mw o l No , '10*50 Th e Ch a r t e r Oa r Fir e In s u r a n c e Co mp a n y a id 005129 Effective from. at the time of day the policy becomes effective. Amending Policy No- Issued to Date of Issue: I'WtXW. Q (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: THiS ENDORSEMENT MODIFIES THE PREMIUM CONDITION if IS 'APPLICABLE' TO ALL INSURANCE AFFORDED 3Y THU POl K.T NOT SPECIF-CALLY EXCEPTED. COMPOSsTE RATE ENDORSEMENT THE PREMIUM FCR TK S POLICY EXCEPT WITH PESPECT TO VA. UN <NSURED MOTORIST COVEFAGE SHALL BE COMPUTED IN ACCORDANCE WITH THE PREMIUM BASIS AND RATES DESIGNATED IN THE SCHEDULE BELOW. THE PREMIUM FOR ":-:E EXCEPTED HAZARDS SHALL BE COMPUTED IN ACCORDANCE WiTH THE PROVISIONS Of THE POLICY EXCLUSIVE OF THIS ENDORSEMENT. A DISCOUNT BASED UPON THE NUMBER OF AUTOMOBILES OWNED BY THE NA^ED 1NSUR *S INCLUDED IN THE COMPUTATION OF THE RATES STATED IN THIS ENDORSEMENs AND SUCH DISCOUNT DOES NOT OTHERWISE APPLY. THE ADVANCE PPEM UM STATED BELOW IS AN ESTIMATED PREMIUM FOR THE FIRST ANNUAL PER OD. UPON TERMINATION OF THIS ANNUAL PERIOD, ThE EARNED PREMIUM SHALL BE COMPUTED iN ACCORDANCE WITH THE POLICY AND ^HIS EN DORSEMENT. IF THE EARNED PREMIUM THUS COMPUTED EXCEEDS THE ESTIMATED AOYANCE PREMllM PAID THE NAMED INSURED SHALL PAY THE EXCESS TO TnE COMPANY; IF LESS, t h e COMPANY SHALL RETURN TC THE NAMED INSURED ThE UNEARNED PORTION PAID BY THE INSURED. RATES AND PREMIUMS FOR THE SECOND AND THJRD ANNUAL PERIODS SHALL BE DETERMINED AT THE *NCEPTON DATE OF THESE RESPECTIVE PERIODS AND SHALL BE SPECIF!ED IN ENDORSE MENTS TO BE ADDED T0 THE POLICY* AFTER TERMINATION OF EACH PERIOD, "ME EARNED PRLM :.!>: SHAl>, B COMPUTED `M ACCORDANCE W.TH THE POLICY AND TH S ENDORSEMENT. SCHEOU l . DEFINITION OT PREM' ,/M BAS!S: REMUNERATiON C*I0747a 2-65 pihNTto in u .s .a . (Continued on pige SruBOi. No. SF-CE , a id 005130 V r\\ r\ T -r - Continuation of Endorsement Amending Policy No. Page SCHEDULE lCONTINUED) EFT JAN 1 3972 ESTIMATED 2. COVERAGE REMUNERATION *ATES PER $100 OF REMUNERATE 31 2. AOVANCE PREMIUM fil 2. AUTOMOBILE LIABILITY CODE 9160 TX T0 BE VA DETERMINED ALL o t h e r g ener al LIABILITY CODE 9160 ALL STATES TO 3E DETERMINED CODE 9000 TX TO BE DETERMINED Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y s TMq l n o . ' Secretary C-10747C 2-6S *iMTto >k u s a. ^ Countersigned by_ Secretary inni AID 005131 Effective from. t " I'li'-C ;. ~i c ^ 2 - 'l at the time of day the policy becomes effective. Amending Policy "No. Issued to_________ m Date of Issue:___________ -- o**ce fOR 4 000c RL. exmncf r*oo. COOE mo d e of ADJUST. 1 fAOO. 1 I tOC. Of i Ris k (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date,) It is agreed that as of the effective date hereof the policy is amended in the following particulars: NOT APPLICABLE TO TX ENDORSEMENT A6100-USE OF OTHER AUTOMOBILES-IS HEREBY ISSUED FOR ATTACHMENT TO POLICY TRN5L-922224-72 AND THE TERMS OF THIS ENDORSEMENT ARE TO BE APPLICABLE UNDER THE "NAME OF INDIVIDUAL" TO ALL EMPLOYEES OF THE ANACONDA COMPANY AND ITS SUBSIDIARIES TO WHOM AUTOMOBILES LEASED UNDER LONG TERM FROM RENTAL COMPANIES HAVE BEEN FURNISHED TO SAID EMPLOYEES FOR USE IN THE BUSINESS OF THE ANACONDA COMPANY AND ITS SUBSIDIARIES. Jr Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Svmoi.No.. 80UDTITi Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y a id 005132 Effective from. 1A_ -at the time of day the policy becomes effective. Amending Policy No- Issued to .......... Pate of Issue: FOR OFFICE & oooe 09. EXPIRES ------ --------aig~c-'V~/X MOO. CODE MOOt OF ADJUST. FROO. LOC. OF RISK (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: NOT APPL-CABl E TO TX ADP-T QNAL INSURED - EMPLOYEES WITH RESPECT TO SUCH .INSURANCE AS IS AFFORDED BY THE POLICY FOR BODILY INJURY LIABILITY AND FOR PROPERTY DAMAGE LIABILITY, THE UNQUALIFIED WORE 'INSURED" ALSO INCLUDES ANY EMPLOYEE OF THE NAMED INSURED WHILE ACTING WITHIN THE SCOPE OF HIS DUTIES AS SUCH, SUBJECT TO THE FOLLOWING ADDI TIONAL EXCLUSICNS *. THE INSURANCE AFFORDED TO ANY SUCH EMPLOYEES DOES NOT APPLY: (1) TO BODILY INJURY TO OR SICKNESS, DISEASE OR DEATH OF (A) ANOTHER EMPLOYEE OF THE NAMED INSURED ARISING OUT OF OR IN THE COURSE OF HIS EMPLOYMENT OR (B) THE NAMED INSURED OR, IF THE NAMED INSURED IS A PARTNERSHIP OR JOINT VENTURE, ANY PARTNER OR MEMBER THEREOF; (2) TO 'ri-JURY TC OR DESTRUCTION OF PROPERTY OWNED, OCCUPIED OR USED BY, RENTED TO, IN THE CARE, CUSTODY OR CONTROL OF. uR OVER WHICH PHYSICAL CONTROL IS BEING EXERCISED FOR -NY PURPOSE BY (A) ANOTHER EMPLOYEE OF THE NAMED INSURED OR {) t h e NAMED INSURED OR, IF THE NAMED INSURED IS A PARTNERSHIP OR JOINT VENTURE, ANY PARTNER OR MENDER THEREOF; (3) 1 IS FURTHER AGREED THAT EXCLUSION (l) (A), AND (2) (A) AS RESPECTS THE PERSONAL PROPERTY SHALL BE CONSIDERED NULL AND VOID AT THE SOLE OPTION OF THE NAMED INSURED, EITHER BEFORE OR AFTER LOSS. SUB-PARAGRAPH (-; OF SECTION If OF INSURANCE COVERAGE PART \2A IS HEREBY DELETED. Th e Tr a v e l e r s In s u r a n c e Co mp a n t Th e Tr a v e l e r s In d e mn it y Co mp a n y SntaQL No. 6o o o (e : Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005133 Effective from- _it the time of day the policy becomes effective. Amend.in.g Policy No- Issued to____ Date of Issue: OFFICE t coot CO. USE MX.. CXttltCl 12-^K TT MOO. oooe MOOC OF Atuutr. MOO. toe. OF kuk (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended m the following particulars: CONDITION 6 OF THE POLICY JACKET IS AMENDED TO READ AS FOLLOWS: IP SUCH OTHER INSURER SHALL, FOR ANY REASON, REFUSE OR FAIL TO DEFEND AND SNDEMN!FY THIS INSURED THEN THE COMPANY WILL TAKE OVER AND DEFEND AND INDEMNIFY <N ACCORDANCE WITH THE INSURING AGREEMENTS, TERMS AND CONDITION'S OF THIS POLICY, AS THOUGH SUCH OTHER POLICY DID NOT EXIST. Th e Tr a v e l e r s In s u r a n c e Co mp an y Th e Tr a v e l e r s In d e mn it y Co mp a n y St w o l No. Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005134 Effective from. '-V ' -iroL ---------- --- -----------_at the time of day the policy becomes effective- Amending Policy No_____ ________ `1 Issued to-------------- Date of Issue: OFFICE mu A CQOC 00. use mi. uhmi (a. MeoOoOc . UAOOJOUCCOT.F MOO. UK. OF Alt* (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to - the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: fliT IS AGREED THAT THE WORDS "AS SOON AS PRACTICABLE" IN CONDITION 10 NOTICE OF OCCURRENCE SHALL BE APPLICABLE ONLY AFTER AN ACCIDENT IS REPORTED TO THE INSURANCE DEPART MENT OF THE NAMED INSURED IN NEW YORK CITY. 4 Th e Tr a v e l e r s In s u r a n c e Co mp a n y ^ Secretary C-10747 (Larse) 2-65 min t ed in u .s .a. 971 Th e Tr a v e l e r s In d e mn it y Co mp a n y Countersigned by. 6rx*x No. 3oco; -s' Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y Secretary AID 005135 Effective from. _at the time of day the policy become effective. Amending Policy No. T-P Kl 7U~- Issued cl. Ai PE? END .5330*A) M 1 TSS KV.U14/I SS'45G78! JOHNSON A HiSGINS u" 1 2TM __Llae7S____ mo d e ON adj ust . j LOG. Of i >** (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: ON ENDORSEMENT'' 6000{G) SECOND LINE TO READ: CONDITION A N0T:CE OF OCCURRENCE SHALL BE APPLICABLE * Th e Tr a v e l e r s In s u r a n c e Co mp a n y Secretary C-I0747 (Larte) 2*45 min t e d ik u .s .a. P71 Th e Tr a v e l e r s In d e mn it y Co mp a n y Countersigned by. $TM>0L HQ. doo: Th e Ch a r t e r Oa j c Fir e In s u r a n c e Co mp a n y AID 005136 Efiertive IffS feOi-; at the time of day the policy becomes effective. Amending Policy No. I &ue*i to_______ D?te of Issue: 1 1-20-73 j ItH O4FCFOICOE N> . US. ( pin . i < ' i;." i mo . I toe 1 MODE OF 1 ao j ust . MOO. LttOljCK. Of i Hi .' (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to > the policy subsequent to its effective date.) It is agn^|ii|it as-of the effective date hereof the policy is amended in the following particulars: NOT APPLICABLE TO TX CONDITION 7"SUBROGATION OF THE FOLCY JACKET TO READ*. N THE EVENT Of ANY PAYMENT UNDER THIS POLICY, THE COMPANY SHALl flE SUBROGATED TO HE EXTENT OF SUCH PAYMENT, TO ALL THE INSUREDS NIGHTS OF RECOVERY THEREFOR AND THE INSURED SHALL EXECUTE ALL P/PERS REQUIRED AND SHALL DO EVERYTHING THAT MAY BE NECESSARY TO SECURE SUCH Eig h t s , b u t t h e c o mp a n y s h a l l h a v e n o r ig h t s o f s u b r o g a t io n a g a in s t ANY OWNED OR CONTROLLED, SUBSIDIARY OR AFFILIATED COMPANIES OF THE NAMED INSURED, THE COMPANY WILL ACT IN CONCERT WITH ALL OTHER INTERESTS CONCERNED (INCLUDING THE INSURED) IN THE EXERCISE OF 5UCH RIGHTS OF RECOVERY. IF ANY AMOUNT IS RECOVERED AS A RESULT OF SUCH PROCEEDINGS SUCH AMOUNT SHALL EE APPORTIONED AS FOLLOWS: i. FIRST, ANY INTEREST (INCLUDING THE INSURED) THAT SHALL HAVE PAID AN AMOUNT! OVER AND ABOVE ANY PAYMENT MADE UNDER THIS POLICY SHALL BE REIMBURSED UP TO THE AMOUNT PA^D BY SUCH INTEREST. SECOND, THE COM PANY SHALL BE REIMBURSED OUT OF THE BALANCE THEN REMAINING, UP TO THE 1 AMOUNT PAID UNDER THIS POLICY; THRD, THE INSURED IS ENTITLED TO THE RESIDUE. THE EXPENSE OF AuL PROCEEDINGS NECESSARY TO THE RECOVERY CF ANY SUCH AMOUNT SHALL BE APPORTIONED BETWEEN THE INTERESTS CONCERNED ; INCLUDING THE . vSLRED) IN THE RATIO OF THEIR RESPECTIVE RECOVERIES AS FINALLY SETTLED. IF THERE SHOULD BE NO RECOVERY IN PROCEEDINGS IN ST iWED SOLELY o:-; THE *N ITi AT :VE OF THE COMPANY, THE EXPENSES "HEREOF SHALL BE BORNE BY THE COMPANY. Th e Tr a v e l e r s In s u r a n c e Co mp a n y Secretary iC-10747 (Large) 2*65 min t ed in tf.swk 97! Th e Tr a v e l e r s In d e mn it y Co mp a n y St w o c No . 8000(H) Th e Ch a r t e r Oa k Fj r e In s u r a n c e Co mp a n y a id 005137 Effective from. .at the time of day the policy becomes effective. Amending Policy No. Date of Issue: ton OFFICE A COPE UJ EXPIRES POOO. coot MQOC Of a o j u it . f MOD. { LOC. Of 1 ftiSK (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: NO r APPL i CABLE "0 TX />S RESPECTS AUTOKfi LE3 LEASED BY THE INSUREDj SUCH COVERAGE "S !S AFFORDED UNDER TH:S PO-L.CY TO THE NAMED INSURED SHALL NCLUDE "HE INTEREST OF LESSORS AND/OR OWNERS WHILE THE INSURED S REQUIRED UNDER THE TrRMli OK THE LEASE AGREEMENT TC PRO.'IDE SUCH (OVERAGE: t Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y St mw x No. 8oc?; Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005138 V/ Effect ,e <-o'n______ __^at the time of day the policy becomes effective. r"\ Amending Policy No. Is -j H to Date nt N.ue "12-2o=r AOFCFOlCOCC l1;i,:i.!.1i,' , J. . ' J|. ct*i*ri Hi! i'"ili- . McoOcOc . AODJOUCSTO.F MOO. 1i lRoIScK. or * 'The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) '' is agreed tha' as of the effective date hereof the policy is amended in the following particulars: OVRr,STKS' LIABILITY ENDORSEMENT 'K-TWlTHSTAtiD ING Tr "S-*S OF :.XCLUS!0!v 2(B) OF ENDORSEfENT 8000(f?) ,TfE TRAVELS ujOEMNITY COMPANY AGREES W TH TIE INSURED, N CONS*DERATION OF THE PAYfCiT OF THE =fMiJM AND IN RELlAKCc UPON ''he STATEft NTS >N THIS ENDORSEMENT Aft) SUBJECT TO _ HITS OF LIABILITY, EXCLUSIONS, CONDITIONS AND 07>R ITEMS OF THIS ENDORSED FT, iNSUR'NG AGREEMENTS l. HOEHMITf - Tu INOEMN FY THE INSURED AGAINST LOSS FROM T} LIABILITY IMPOSED UPON H:M BY LAW, OR ASSUMED Bv HIM UNDER CONTRACT, AS DEFINED HEREIN, AS A RESULT OF ANY FINAL JUDGMENT FOR MONEY DAMAGES RESULT NG FROM: (A) LIBEL, SUNDER, DEFAMATION OR . (B) ANY INFR.NGEHENT OF COPYRIGHT OR OF PROPERTY RIGHTS OR OF SLOGAN OR (C) PIRACY OR UNFAIR COMPEL CHON OR IDEA MISAPPROPRIATION UKOER IMPLIED CONTRACT OR (D) ANY l m AS'ON Of R:GHTS Of' PRIVACY C'JMMITTtD CR ALLEGED " HAVE SEEN COMMITTED IN THE `ONO-JCT OF THE INSURED'S A3VERT SING ACTIVITIES. 2, SERVICE - TO C JESS'D, IN t h e KAf AMD ON BEMdr OF THE INSURED, ANJ S'J-T SEEXtNU DAMAGE i> f }? ANY OF THE ABOVE CAUSES. EVEN F SUCH SUr S SROJ^-E F . FALSE OR FRA j LLLEN--. t h e COMPANY SHALL HAVE THE R GHT ~0 MAKE SUCH FVEO * GATjON, feaCTlATlON A-C* SETTLEMENT OF ANY CU;H OR SUIT AS IT MAY Or;?EXPEDIENT, OS HAY 9ftMiT THE .NEURCD TO MAKE ANY SUCH INVEST IGAT,ON. F;-,.F AT ION AND SE'H.Eft NT AS KAY 3E APPROVED BY COMPANY 'H WRITING- IN THE EVENT THAT ,H LMY SUIT T* COMPANY H*S AGREED TO DEFE, AS 'CVDE.; FOR IN PARAGRAPH 2 HEREOF, ANY APPulCATiCH FOR AN INJUNCTION CR INJLfJTiyE RELIEF SHALL BE HADE 3Y THE PLAINTIFF, THE COMPANY AGREES TO DEFEND, IN "IT NAME AM) ON 3hAL.-' OF THE !NCURED, AGAINST SUCH APPLICATION FOR AN iNJUNC OR INJUNC"-VE -JVEF; BUT THE OBLIGATION SO t o DEFEND AGAINST SUCH APPL'C* TION FOR 4f ` . iNCTlCn OR INJUNCT VE REL'Er SHAX NQr EXTEND BEYOND t h e DETERM;NAT CY ..* > COURT CF F'RST INSTANCE. EXPENSE - T0 : -._L :T.K!LT-'S CM SCfOS T0 RELEASE ATTACHMENTS FOR AN Ai<Ou NOT IN i-XZZF - MIT OF 'hi ENDORSEfCNT AND ALL PFEM I.'"-1 C-J0747a 2-65 pk imt c d i* g & a (Continued on page 2) . S"1"' US.- MD0059 i 4 5. 6., 2' Continuation of Endorsement Amending Policy No Page No------- ON APPEAL 3CIC3 FtcQU RED *N HE DEFENSE OF ANY SUiT BUT V THOU"! An y OBLIGATION TO APPLY FOR OR FUR*: Sh SUCH BONDS; ALL COSTS TAXED a GAJMST TIC INSURED If. ANY SUCH SU T. ALL EXPENSES INCURRED BY THE COMPANY AND ALL IlfiEfCST ACCRUING AFTER ENTRY OF JUDGMENT UNTIL THE COMPANY HAS PAID, TENDERED OR DEPOSITED N COURT SUCH PART OF SUCH JUDGMENT A5 CfrtS n c t e x c e e d t k : l imit o f t h e c o k p a n y s l ia b il it y t h e r e o n . THE COMPAQ A'REES TO PAY T'E AMOUNTS INCURRED UNDER PARAGRAPHS U) AND (3) IN ACC.-lON TO THE AFPL->St LIMITS OF LiABiLlTV OF TH^S ENDORSE ft NT. THE "'EPMS OF THIS ENDORSEMENT .APTLY WORLDWIDE, PROVIDED, HOWEVER, THAT TIC OR.ilNAu CLAIM OR SUIT S BROUGHT W THIN THE UNITED STATES OF APERiCA. ITS TERRITORIES OR POSSESSiCHS, "R CANADA. THE INSURED REPRESENTS THAT NO OTHER SIMILAR INSURANCE S CARR EC EXCEPT: NO EXCEPTIONS, THE COMPANY'S LiABILiTY ^OR THE INDEMNITY IN PARAGRAPH (!) ABOVE WlCTlCR FOF ONE INSURED OR MORE '."HAN C: INSURED, IS LIMITED TO $1,000,000 FOR ANY ADVERTISEMENT- PUBLICITY ARTICLE OR BROADCAST OR ANY COMBI NATION THEREOF INVOLV-NG THE SAf INJURIOUS MATERIAL OR ACT, REGARDLESS OF TIC FREQUENCY OR REPET .-TICK '"HEREOF OR TIC NUMBER OR KIND OF MEDIA USED, WHETHER CLAIM IS MADE BY CNL OR MORE PERSONS., OEF N--":ONS DEFINITION OF NSUREC - TIC UNQUALIFIED WORD "INSURED" WHEREVER USED :N TH'S ENDORSEK-.MT INCLUDES NOT o n l y THE NAICD INSURED OR EMPLOYEES THEREOF, Bur ALSO ANY 'ARTNER. EXECir.'VC OFFICER, DIRECTOR OR STOCKHOLDER THEREOF, WH*l ACTING WirH:N "TC SCO.C C" H.S DUTIES AS SUCH. DC- N! N- -r HDfTRAC7" - THE * ;D ' CONTRACT" iiwC&EVER- LORD - N TH T E-CCR-S' ?c-r s k a l -r>N t ie l ;f !!_.- ED CR AGREE:: UPON BY THE INSURED WiTH AN' PAFTv. f/.'LUD `NG ADVERT i; : a g e n c ie s . b r o a d c a s t --mc c o mpa n e s , ER5 AND OTHER MEDIA FOR ADVE.VT \G TO HOLD SA D PARTIES HARMLESS FFM <.C.. : AIO/OR EXPENSE RESULTING FRO-* CL". `MS FOR DAMAGES CN ACCOUNT OF V: CLA "(GN- OR ALLEGED V OL^ ON, OF ThT STSHTS OF OTHERS ARISING FROM THE 3hCAD-"-AST> v*, OR TELECAST' CJ, OR TIC PUBL CATION FOR THE INSURED OF A<Y ADVERT.Cl MG MATTER. NCUJVVO COPY, POP;'rA TS, PICTURES OR OTHER MATERIAL FOR USE IN eCJUCCTiON " .:3.7H, FURNACE- SV THE INSURED, BUT ONLY INSOFAR VS CUCH LiABILlT-' p- V HZ TV TIC HA''A ?;.$ GET FORTH H SECT ONS (A). (8), (C : OR lO'i OF P,.RA " <lj NDEMv > CF TH S SNPCPSEfCNT, C-I0747* 2-65 *>n T0 n u s * (Continued on page 3} AID 005140 Sy mn o c No . 'f <*( U34iftfii32*i Continuation of Endorsement Amending Policy No_ Page No. - NOTHING IN THIS EhDCHSErEL L-H-'LL 3 COmCRUEC TC CCVEF. ANY UAS._i" FOR TT NEGLIGENCE ,OrFr 5k .p -`ART =s >N THE ;R HAHDL NS, ./SE OF PJ3L-CA-.0N OF ANY ADVERTISING MATTER'uR MiT,RiAL Fi'EM'SHED 3Y THE NS.HEO, RiGALESS OF SUCH ASSUMPTION OR AGREECN' BY THE N3UREC. :c; 1:3 o n s "HIS AGREEMENT IS SUSJECT TO -fc FC_C*:\T CONDITIONS: THIS ENDORSEMENT DOES NOT C jVER 4*iY LIABILITY cOR: FAlL'J-r- OF PE;T CONTRACT, BUT THIS SHA_L NOT RELATE TO CJi IMS -OR TK: U .v.r-'P EEO APPROPRIATION OF IDEAS BASED U=CN THE ALLEGE: BREACH OF AN K-t. LTD CONTRACT; BOO * LY INJURY', OF.iT;1 DP PHYSICAL PROPERTY DAMAGE; INFR NTlNT OF REG s CERES TRADEMARK, SERVICE MARK OR TRADE NAME 5' USE THEREOF .*i TE REG:STEREO TRADE MARK, SERVICE MARK OR TRACE NAME OF 6C0C3 JR SERVICES SOU), OFFERED FOR SALE OR ADVERT;TED BIT THIS SHAu. NOT RELATE TC TITLE(S) OR SLOSAN(S); INCORRECT DESCRIPTION OF ANY ARTICLE OR COMMODITY; M STALE |N AC.'TR-ISE: F'CE; L AE .. TV OF OTHERS *33.NED BY THE INSURED UNDER ANY CONTRACT j p A.J.-'.-:EfNT zice.PT *v y ;'x t r a c t a s o e f .n e c h e r e in ; A!Y ! M :v. 'DS RED,.: LG rRJM DF ' ZZ'.C'iT OCCUR5?'VT j'f'ic t h e : .`-I. ic-;-'- s v. d p o f t r.-s is s c ^n t , ' f - "V t - ; uc ? UR . tr Er-ECT VE P E .-.-E'r ..< S-ALl . v VD 3D E N RE ;EATED JR CONTINUED D'JR .YG' THE -OL CY PER'CD oR SHALL BE Tt=>E ATED OR CONTrN.ED "'HE :E AFTER ' ./ THE COMPANY'S l `AB!LTY SHALL SE LIMI"E: TC Tr Ffirr'RT-';: :f THE -CTAL Cl A T OR ol-CGfCNT w h ic h or TvEcs c u r in g t h e p o l ic y p e s .-c d , u p o n WH CM E "`LA < S E'SE: , BEARS TO * "CAL NUV3ER OF e y e v : .p c j s e a s t :. (Continued on page -) Sy w o c Ho . USA AID 005141 "\ Continuation of Endoreement Amending Policy No- Page No. LIMITS THE COMPANY'1; LIA31L iTY FOR THE `fCEMN'TY PRO*' (LED IN PARAGRAPH l] OF THI IWSUR5KG AGREEMENTS IS LiM-TEO TO THE AMOUNT AS EXPRESSED N 'TM (6) OF THE' ;.'R;NG AGREEMENTS, AMO SUCH AMOUNT SHALL NOT 3 ACCCMIUU T!VE FROM Y: i TO YEAR, OR FROM PER!OD TO PER:0O. IN THE EVE`F JOAMOUNT 3. CREASED DURING 'v-f TERM OF ThiS POLICY, SUCH 1CREO . AMOUNT SHAl . APPLY <NLY IN RESPECT OF ACTS OR OMISSIONS f RSr C'M 'TED AFTER THE r. -*.CTJVE DATE Of Si .INCREASE. INCLUSION fEREN 0T CTF THAN ONE **. -TED SH-i.L NOT OPLH-VTE TO INCREASE THE L1M T OF T, '/W' L.ABILITY NOTICES UPON RECEI.-t 3Y THE NSURAXE DEPARTMENT OF THE INSURED OF INTORMA" ON RELAT E 1C .* ACT TR ADMISSION WHICH MIGHT RESULT IN A CLAIM OP CLAIMS BROUGHT UNDE- THIS ENDORSEMENT, A WRITTEN NOTICE THEREOF SHALL a. G VEN BY OR OH 3E{ _F OF t h e INSURED TO Tf COMPANY OR ITS AUTHORIZED AGE'fT AS SCCN AS F'VCT!CABLE. SUCH NOT'CE SHALL CONTAIN PARTICULARS OF "HE cumTHING o f ; a ;- t h a t is t h e s u b j ec t o f t h e AS w e l l a s c o p y o f t h e CLAIM, IF EXT IS BROUGHT AGAINST TFE INSURED TO ENFORCE SUCH CLAIM, THE INSURED .-ALL FORWARD "0 T- COMPANY WITH REASONABLE PROMPTtfISS EVERY SUttV-;, NOTICE OR C"MER PROCESS THAT MAY BE SERVED UPON HIM; CDOPEpA"ION THE -YSLRE: -ALL N-*T MAKE AN' ADMISSION L ABILITY NCR SHALL HE AUTHOR ' ' OFF :C:.P, EK?' SYEe OR OTHER - EPSON TO MAKE ANY ADM < SS ;N OF f.AB L .TH'R BEFORE OR A, E'ER A CU.M *$ MADE; NOR SHALL -E, EXCEPT T OWN COST, INCUR AN* EXPENSE, MAKE ANY PAYNE NT OR SET'- ANY CJk MS ,-:R SHA-L HE r rt-.cERE ;n a n * NEGOTIATIONS FOR SETTLEMENT CR IN .* :Y :'L PRC** EEDING C * T'< RESPECT TO ANY CLA-M HERE UNDE " *l"-;COT IN E/CH E' . THE WRjT"EN ONSc .Y* 0" THE COMPANY, in tHE EYE*" .'HE <iurid s- .. s e t t l e or- d e -l a : c l a im o r rir w -t h c j t t ie s * *?'Rr.A. Or - -E COKYAN-, A*1 - .j* WHICH t h e INSURED S.-Au_ =iv >; BECOM; - * . ; TC PA NCL-U : 1YPENSES, ON ACCOUNT 0= SUCH ...= M R SUIT SHALL ACT 3E PESOVERAi-Z ,'DER THIS ENDOHSEfCNT, THE DE-'I.*.* St THE COWMAN" EF ANY SL*IT OR mf -^OSECUT.CN OF ANY APPEAL SHALL NOT OPERATE AS A wA VER 2Y THE 1CYrAL-Y OF ANY OF .TS DEFENSES t o AN: C-\M BY THE 1 NSi ., A Si SHOULD rHE NSURED FAIL TO COMPLY WITH >' N'' " TERMS OP C *1 T ONS CF THE (_ !v, WHENEVER REQU'REO 3Y THE COf^Av,', THE NSJPt -A-x. z ; N JLEEUR.taS INFORMATION AND EVIDENCE IN THE At t e X-A-a-.' v ~v. SFA-.L COOPERATE WITH THE COMPANY `V THE -= : LA ' CR SL ' wR N TFE PROSECUTION OF ANY APCA..; AND > . TE-Kct.RSF '. INSURED FOR EXPENSES, OTnER "HA i css - .- -: c o mt -an ^'s 'r eq u es t . UO IN U.A A (Continued on p*ge 5 ) AID 005142 Srx*Qc NO, Continuation of Endorsement Amending Policy No- , Page No_____ 3U3R05A T;ON IN THE EVEiV.' OF ANY PArPENY Uafcf-R THIS ENDORSEMENT, A?iO TO THE EXIT NT OF SUCH PAYMENT, T} COMPANY -SrfAO. BE SUBROGATED TO ALL n NS':RL <3 RIGHTS OF RECOVERY THEREFQR AGAINST ANT -PERStN OR ORGAN !ZAT'. ON. 0T! ER THAN AN ACVE.'-TTISJNf. AGENO FOR VHE INSURED ALSO INSURED BY TH S COpiAY m THE -.NS-.-lED SHALL "XEP'JTE A'ilY PAPERS REQ- -RED AND SHALL CCN-ffCR. *E WITH THE COl^ANY 7i SECURL " SUCH RIGHTS- F, OTHER NSURA >C >F THE tjjSL :a r - I:;L rr; ;|;-*JRAICE OR INDEMNITY NOT CESIGNA"ED !N INSUR*!6 A'- <3IMES7 C COVE'TO 3V THE TERMS OF THIS ENDORSED NT, "HE COMPANY S:-ABE l a 5L *sLaJGEF FOR ONLY THAT PROPORTION OF THE LOSS THAT THE AMCjST OF THIS "OUCY -LARS TO THE TOTAL OF SUCH POL)Cv AMD SUCH mCF usuPANTE FSGAT . JTSS CF WHETHER SUCH OTHER INSURANCE SHALL 3E DEE TED L SEES 014./. CO.Vk :3'J7; NG OR OTHER WISE. G CHANGES MOTiCE TO A*Jy AGEJP OR KN PLEDGE POSSESSED BY ANY AGENT OR BY ANY? OTHER PERSO- SHALL NOT EF"EC" A WAIVER OR A CHANGE IN ANY PART OF* THIS POL OR ESTCP Ti T.MPA MY FROM ASSERT' NG ANY R'GHT UNDER THE TERMS CF : POLICY; NCR SHALL THE TERMS OF THIS POLCY BE WAIVED OR CHANGED. EXCEPT 3i EJC>:R3E?ENT `SSUED TO FORM A PART OF THIS ENDCPSEMENT . 3*Gf: 37 T>t apS DENT, V CE PRESiOENT, SECRETARY OR ^N ASS STAN' 3ECRE' AT'.' AV.; v..L:JTETSIGNEP 3Y A DULY AIFHORIZED EPRES'KTAT il OF ` He CO^NY. H : STAT'.T ;p'.' ^0V>S'C'*:5 ^ -r''- riCN T> :s L ; " S AT VAR AN.'E a <TH / sY SftC.P..; ".v.fTr - T,C - -L` . -RCv-c c u . -3v.-Ef.E : rtERE^C. ?=FC r'C sTATITORv :TCf.- -cons Ter mer e-t h STATEMENTS THE STATE'-i: S :y --A''ED AMD BY ACCE -r.i-irE HT. TO SE' T- -C TL3' -1 A.-':' ENDORSEMENT ARE MADE 3Y THE INSURED :'>.`ENT, THE !NSURED REPRESENTS T- SAf 3 OF EST MATE ?SILY. ACT ON i- --. -l r .-vw.vvv F-:c EP r:-A ANY' v*SS 'JS j EP TPiW v' --v.rs, T^if :-rO--NT ? C-JO"47b 2-65 A>nTtO i* u s i (Continued on page i) AID 005143 Continuation of Endorsement Amending Policy No. Page No. SUCH LOSS 1$ MADE CERTAIN EITHER STY JUDGMENT AGAINST T> (NS'JREO AFTER TRIAL OF THE !SSLE, OR B" a GRFJE'-E'T 2E"w EN THE PARTIES WT-. THE CONSENT OF THE COMPANY. BA;iKR>JrTCv OR N50LVENCY OF THE JNslT* SHAL* n o t RELIVE "HE COMPANY OF ANY OF :T$ OBLIGATIONS HEREUNl 'ER K. ASSIGNMENT ANY ASSIGN FT OR CHANGE CF -1^1 RE ST HEREUNDER, WHETHER VOLUNTARY OR INVOLUNT'FY. SHALL REhDER THE FCUCY VOID UNLESS SUCH ASSIGN MENT OR CKA^GE IS CONSENTED TO ,N WRT'NG SY THE PRESIDENT, A VICE PRESIDENT, '.ECRETARY OR AN ASSISTANT SECRETARY OF THE COMPANY. Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y sy>ot n o . C-I074?c 2-65 i*Aiwrco <* v.& Couutersigned by AID 005144 jNte iediauiicJaeilAsauatieilBiJtl|u!ilidJJ)Ubeiiisiiittii-iuii-IM^KiBwistiaiaiisiaiiCifKiaiiiiiUsiAififeiif cam-n Effective from. JuX L-,. -at the time of day the policy becomes effective. Amending Policy No- v: iOI-Q?v Issued to_ Date of Issue: nr immru r.rMp-AW f t a i. p e r END SOQOiAl G-gfW7P A*3 JOJ-3AQ ^_45QZK! 4 Mf i or -WUflS j AMffl-- JOHNSON 4 H;G3!SS (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: ON ENDORSEMENT 3000(J) THE FIRST Llf TO READ: NOTWiTKSTAhiD!NO 7l TERMS Of EXCLUSION 2(8) CF ENDORSEMENT 8000(P), THE TRAVELERS Th e Tr a v e l e r s In s u r a n c e Co mp a n y ^ Secretary C-I0747 (L*ffe) 2AS p n iw t e o im u .s j l 971 Th e Tr a v e l e r s In d e mn it y Co mp a n y s Secretary Countersig^tKl by___________________ 6rwx Ho. 8(P0 Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y Secretary AID 005145 Effective from- T~RNS; -C.522 _ -at the time of day the policy becomes effective. Amending Policy No- Issued to- Date of Issue: OfPlCt '4 0006" POL. " ExPiPca PAQO. 0006 wootof ADJUST. 00. LOC. OP >Sk (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: COVERAGE UNDER THiS POLICY IS PROVIDED IN CONNECTION WITH ALL OPERATIONS UNDER ALL DEPART MENT OP THE NAVY COST TYPE CONTRACTS* ? Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Srnnx No. 8000.x'- Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005146 Effective from. j ! - t: . _at the tithe of day the policy becomes effective. Amending Policy No. Issued to______________________---- Date of Issue:______ i.2. *~20~ (1 omcc FO* tcooc **oo. cooc : V13L - Exnu ho o co * ADJUST. s r*oo. 1 | LOC. off ! RISK (The information provided fee above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that ax of the effective date hereof the policy is amended in the following particulars: NOT APPLICABLE TO TX ( S.'JCH INSURANCE AS 3 AFFORDED 3Y THIS POLICY SHALL APPLY TO ALL* 5pORT, ATHLETIC, SOCIAL OR RECREATIONAL ACTIVITIES SPONSORED BY THE NAMED INSURED N WHICH THE EMPLOYEES OF THE INSURED ARE PARTICIPANT Th e Tr a v e l e r s In s u r a n c e Co mp a n y C-10747 (LsrfeJ 2-AS mik t c h tit u.s.*. *71 Th e Tr a v e l e r s In d e mn it y Co mp a n y s Countersigned lij Secretary STMtQt; NO. E 000 * l. : Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y / Secretary AID 005147 Effective from. Issued toDate of Issue: 12 *2Q~ i I -at the time of day the policy becomes effective. Amending Policy No.. (The information provided lor above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: "*N CONSIDERATION "HE PREMIUM FOR WHICH THIS POL 1Cf >S WR;77EN, :T iS AGREED '.'HAT ANY OCCURRENCE OR ACCIDENT 07HERW 3E COVERED BY THE POLICY, RESULTING IN AN ACT.ON " :N REM11 BY L!3EL OF AMY VESSEL OWNED, CHARTERED, HA NTVNED OR USED 3Y "HE Y'SURED SHALL IN ALL RESPECTS BE TREATLT IN TKE SAME MANNER AS THOUGH THE ACTION RESULTING THEREFFOM WERE "iN PERSONAM" AGAINST THE INSURED. i Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y St w o l No. p/\r Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005148 Effective from. _at the time of day the policy becomes effective. Amending Policy No*. Issued to_ Date of Issue: nm USE OFFICE < COM? Ote. EXPIRE! -- woe woof. OR ACUUST. | PBQO. | LOC. OF 1 RISK (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: iT IS HEREBY AGREED THAT EXCLUSION (F) OF INSURAflCE CO`-*ZRAQE PART U tS ELIMINATED. Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Srmot No. Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005149 Effective from- "\ -at the time of day the policy becomes effective. Amending Policy No- Issued to. Date of Issue: roK e ^ctotoec use tx*\w% 12r2Qr. I MOO. coot 1 mo o c or { Aeuutl. 1 1 **00. } toe. of } AlSK (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: N ACCORDANCE Wl-h IKE TERMS OF ENDORSEMENT 8000(U) ATTACHED TC THE F'OL CY, SUCH COVEPAGE AS IS AFFORDED UNDER THE POLICY SHALL i.NClUDE CONTRACTUAL AGREEMENT DATED OCTOBER 25t 1962 BETWEEN NORTHERN PAC'FiC RAILWAY COMPANY REFERRED TO AS RAILWAY COMPANY AND THE f.NACONDA COMPANY REFERRED *0 AS PERMITTEE - PARAGRAPHS 2 AND 3 OF WHiCH AOREEMENT HEAD AS FOLLOWS: 2) PeRM;TTEE AGREES TO INDEMNIFY AND HOLD HARMLESS THE RAILWAY COMPANY FROM AND AGAINST ANY AND ALL LOSS, COST, DAMAGE, INJURY TO OR DEATH OF ANY AND ALL PERSONS WHOMSOEVER, INCLUDING EM PLOYEES OF THE PARTIES HERETO ARISING OR GROWING OUT OF OR !N ANY MANNER CONNECTED WITH THE CONSTRUCTION, OPERATION, USE, MAINTENANCE, REPAIR, EXISTENCE OR ANY REMOVAL OF SAID FACILITIES UNDER THIS PERMIT, REGARDLESS OF WHETHER OR NOT THE RAILWAY COMPANY, ITS EMPLOYEES, AGENTS, OR SERVANTS MAY BE OR BE ALLEGED TO BE IN WHOLE OR IN PART LIABLE FOR SUCH LOSS, COST, DAMAGE, INJURY, DEATH OR PROPERTY DAMAGE. 13) IT IS AGREED THAT THE PROVISIONS OF PARAGRAPH 2 ARE FOR THE EQUAL PROTECTION OF ANY OTHER RAILROAD COMPANY OR COMPANIES HERETOFORE CR HEREINAFTER GRANTED JOINT USE OF THE RULWAY COMPANY* S TIGHT OF WAY AND TRACKS HEREON OF WHICH THE PREMISES A30VE DESCRIBED ARE A PART. Th e Tr a v e l e r s In s u r a n c e Co mp a n y ' Secretary C-10747 (L&rgeJ 2-65 rtttnrco m v.t.K S71 Th e Tr a v e l e r s In d e mn it y Co mp a n y Countersigned by Secretary c.C f<t*y Snoot. No. HTh e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y Secretary AID 005150 Effective from. -at the time of day the policy becomes effective. Amending Policy No- : ; ^- * Issued toDate of Issue:_______lie **e?0" I 1 TON CO. uk (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: 3, THE TERM :=-JDi'.Y INJURY" WHEREVER USED SHALL INCLUDE INJURY APiSWsiG OUT OF THE FOLLOW; NG HAZARDS: (A) FALSE ARREST. MALICIOUS PROSECUTION, OR !LFUL DETENT SON CR `MKRISONMENT (B) LIBEL, SLANDER OR DEFAMATION OF CHARACTER (C) t'NVAS 'ON OF PRIVACY, WRONGFUL EVICTION OR WRONGFUL ENTRY, THE TERM "ACCIDENT'' WHEREVER USED SHALL INCLUDE INJURY COVERED BY TH iS ENDORSEMENT (D) DISCRIMINATION t. THE INSURANCE PROVIDED BY THIS ENDORSEMENT DOES NOT APPLY: 4T (A) TO INJURY CAUSED BY THE WILFUL VIOLATION OF A PENAL STATUTE OR ORDINANCE COMMITTED BY OR WITH THE KNOWLEDGE OR CONSENT OF AN INSURED; (B) TO ACTS COMMITTED IN CONNECTION WITH ADVERTISING, BROADCAS ' tiG OR TELECAST IMG BY OR :N THE INTEREST OF THE NAMED INSURED; AS RESPECTS fwUR ES OCCURRING W ~riE STATE OF NEW YORK TO INJURIES ARISING OUT OF D LCR MINAT'ON BECAUSE OF A PERSON'S RACE, CREED. COLOR OR NATIONAL ORIGIN. AND TO LIaS?l !TY ARISING OUT OF THE VIOLATION OF >. STATUTE OR REGULATION OF AN'.` OTHER STATE PROHIBITING DISCRIMINATION. PRLM*UM NCLUDKD M COMPOSITE RATES Th e Tr a v e l e r s In s u r a n c e Co mp a n y Secretary C-10747 (t-urge) 2-65 pr ih t c o in u .s .a. Th e Tr a v e l e r s In d e mn it y Co mp a n y Sy w x x . No . Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005151 I Effective from______ ___s______ ____________ at the time of day the policy becomes effective. Amending Policy No--, Issued to___________ _____________________________________________________________ __________________________ Date of Issue: 1 `eL ~<?0 ~ * 1 OFFtCt * COOL use POt* mo d . COOL M09C OF AOAisr. f MOO. 1 toe* OF 1 ISH (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: h SSAULT 4, BATTERY COMMITTED FOR THE PURPOSE OF PREVENTING OR EL ,M NA ? 0ANGER IN THE OPERATION OF AIRCRAFT OR FOR THE PURPOSE OF PROTECTING "HE PROPERTY OF THE INSURED OR THE PERSON OR PROPERTY OF OTHERS SHALL BE CONSIDERED AN OCCURRENCE. Th e Tr a v e l e r s In s u r a n c e Co mp a n y ' Secretary C-I0747 (Letse) 2~6S mih t e p in v .s .a 971 Th e Tr a v e l e r s In d e mn it y Co mp a n y Countersigned by. 6t mq c No . MX-0 :`J 1 Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y Secretary AID 005152 IAsSsJuLeCdQtIQo__ i._,:i_i _ M ! i i mi m"FT 1 > ) Dflaatr*- of Issue: (i at the time of day the policy becomes effective. Amending Policy No. (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to tlie policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: SURANCE AS <S AFFORDED SY THE POLICY FOR BOOILY INJURY LIASiLTr PROPERTY DAMAGE UASii.lTY APPLIES SUBJECT TO THE FOLLOWING ONS: THE UNQUAi. F;ED LORD "`NSURED" ALSO INCLUDES ANY PERSON, TRUSTEE, ESTATE CR ORGAN'iZATiON WHO LEASES OR RENTS PREMISES TO THE NAMtD NSURED, B'JT ONLY WITH RESPECT TO HIS LIA3IIITY ARISING OUT OF SUCH PREMISES WHILE LEASED TO, OCCUPIED OF USED BY THE NAMED INSURED; k. THE INSURED WITH RESPECT to SUCH PERSON, TRUSTEE, ESTATE OR ORGANIZATION SHALL APPLY ONLY TO SUCH AN EXTENT AND FOR SUCH LIMITS OF LIABILITY AS THE NAMED INSURED, UNDER ITS OPERATING PROCESSES, AS AGREED IN WRITING TO PROVIDE INSURANCE FOR SUCH INTEREST, PROVIDED THE COMPANY SHALL NOT BE LIABLE FOR ANY AMOUNT AGREED TO BY THE NAMED INSURED WHICH IS IN EXCESS OF THE LIMITS OF LIABILITY AFFORDED BY THE POLICY. PREMIUM INCLUDED >N COMPOSITE RATE Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y C-1D747 (Large) 9712*65 Min t e d in v .s .a. AID 005153 Efferote frem its T. riF/llSL **93222 4 ~ 7?-at the time of day the policy becomes effective. Amending Policy No.-- Issued to_ Date of Issue c*nct CO A CM* CJCPIVCX l-2i^ . i. (;:!, . w*oo. eooe J'.'lv.. r-:. MOOC c* Axuusr. | MOO. 1 voc. OF 1 Kit* (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to ' J the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: SUCH INSURANCE AS IS AFFORDED BY THE POLICY IM)ER THE PROFERTY DAMAGE LIABILITY COVERAGE THEREOF SHALL ALSO APLY TO LIABILITY IMPOSED UPON THE INSURED BY ANY FOREST FIRE PREVENTION ACT OR BY ANY SIMILAR ACT FOR THE COST OF CONTROLLING OR EXT INGU i SHI N't FIRESa WHETHER OR NOT SUCH FIRES OCCUR ON PREMISES OWNED eY, OCCURiED BY* RENTED TO, OR IN THE CARE, CUSTODY AND CONTROL OF THE INSURED, SUBJECT TO THE FOLLOWING ADDITIONAL PROVISIONS. fl) THE LIMITS OF LIABILITY AS STATED BELOW AS APPLICABLE TO "EACH OCCURRENCE" IS THE TQTAL LIMIT OF THE COMPANY'S LIABILITY UNDER COVERAGE B FOR ALL DAMAGES ARISING OUT Of DAMAGE TO OR DESTRUCTION OF ALL PROPERTY OF ONE OR MOPE FERSOMS OR ORGANIZATIONS, INCLUDING THE LOSS OF USE THEREO" AS THE RESULT OF ANY ONE ACCIDENT. - (2) LIMITS OF LIABILITY $500,000 EACH OCCURRENCE. M(HE Tr a v e l e r s In s u r a n c e Co mp a n y ' Secretary C-10747 (Lmrfr) 2-63 Metro ik u.s.n. ,71 Th e Tr a v e l e r s In d e mn it y Co mp a n y Smtoi No. Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005154 Effective lrom_ i _at the time of day the policy becomes effective. Amending Policy No___ ~YcYY ~ Issued to____ D~t* of Is ue 12-BO-71" I WMT. (The information prowled for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) is agreed uiar j, ni ibe effective date hereof the policy is amended in the following particulars: INSURANCE COVERAGE FART - U - SECTION il - PERSONS INSURED PARAGRAPH "C DELETED AND THE FOLLOWING SUBSTfTUTED IN LIEU THEREOF: "IF THE NAMED INSURED IS DESIGNATED IN THE DECLARATIONS AS OTHER THAN AN t`!VIDUAL PARTNERSHIP OR JOINT VENTURE THE ORGANIZATION SO DESIGNATED AND ANY EXECUTIVE OFFICER, DIRECTOR, STOCKHOLDER, OR OTHER EMPLOYEE OF THE NAMED INSURED WHILE ACTING WITHIN THE SCOPE OF HIS DUTIES AS AN OFFICER OR AS A DIRECTOR OF THE A. C. M. CUB; AND, ANY ATTORNEY, GEOLOGIST, ENGINEER OR OTHER EMPLOYEE AS NOMINEE FOR THE NAMED INSURED `WHILE ACTING WITHIN THE SCOPE OF HIS DUTIES AS SUCH OR WHILE ACTING AS AGENT FOR ANY NAMED INSURED UNDER THIS POLICY- INSURANCE COVERAGE PART - LI - SECTION IV - POLICY PERIOD, TERRITORY DELETED AMD THE FOLLOWING SUBSTITUTED IN LIEU THEREOF* ^ THIS POLICY APPLIES ONLY TO OCCURRENCES WHICH HAPPEN DURING THE*POLICY PERIOD ANYWHERE IN THE WORLD, PROVIDED THE CLAIMS ARE MADE OR THE SUITS WITHIN THE UNITED STATES OF AMERICA OR THE DOMINION OF CANADA BUT SHALL NOT APPLY TO ANY MINING PREMISES, PLANTS, WAREHOUSE E-'JILDINGS OR OTHER PREMISES OR WORK PUCES OUTSIDE OF THE UNITED STATES OF AMERICA OR THE DOMINION OF CANADA. WATERCRAFT WHILE EXCLUSION (D) OF INSURANCE PART U SHALL NOT APPLY AWAY FROM THE UNDER COVERAGES A AND B TO OWNERSHIP, MAINTENANCE, DEMISES ,(L OR USE OF ANY SARGE, SCOWr OR LIGHTER OWNED OR IT HIRED BY AND USED IN THE BUSINESS OF THE NATO NSURED. SUCH INSURANCE AS IS AFFORDED HEREUNDER SHALL BE EXCESS tOVERAGE ANY OTHER VALID AND COLLECTIBLE INSURANCE IN FORCE AS r ESPEC f'S TH i S EXPOSURE. EXCLUSION (D) OF INSURANCE PART LI SHALL NOT APPLY TO WATERCRAF? OF THE MEASURE TYPE USED BY THE NAMED INSURED PROVIDED (l) THE WATERCRAFT IS MOT OWNED BY THE NAMED INSURED OR LEASED OR H RED BY THE NAMED INSURED `2lJH WATERCRAFT *S NOT USED & y h E NAMED INSURED TO CARRY PASSENGERS CONSIDERATION OR IN TRANSPORTATION OF CARGO. '41a 2*6$] viTt(tt in y.s.*. (Continued on page 2 ) *>OQO (r) AID 005155 . T" Continuation of Endorsement Amending Policy No----------------- : Page No. CASES, FUMES, ETC- SUCH COVERAGE AS IS AFFORDED BY INSURANCE PART LI SUBSIDENCE OF SOIL UNDER COVERAGE A SHALL NOT APPLY (ll AS RESPECTS HARMFUL OR DANGEROUS GASES, FUMES, VAPORS OR SMOKE e ma n a t in g PROM OPERATIONS o f t h e n a me d in s u r e d u n l e s s s u c h e ma n a t io n OCCURS UNINTENTIONALLY, !T BEING AGREED, HOWEVER, THAT ONCE THE INSURED rAS KNOWLEDGE THAT SUCH EMANATiON iS OCCURRING AND HAS CAUSED OR IS LIKEtNi TO CAUSE !i'.'.JURY THEREAFTER SHALL NOT BE DEEMED UNINTENTIONALLY SHALL NOT 6 COVERED BY THIS POLICY. (2) UNDER COVERAGE B OF 'NSURANCE PART LI - TO INJURY TO OR DESTRUCTION INCLUDING THE LOSS OF USE ^ PROPERTY RESULTING FROM OR ATTRIBUTABLE TO THE SUBSIDENCE OF SOILlAt A&Y LOCALITY WHERE MINING OPERATIONS HAVE BEEN OR ARE BEING CONDUCTED 01s. THE DEPOSIT.ON OF SILT. WASTE MATERIAL IT IS l)Nnrp;Tooo AND AGREED THAT INJURY TO OR DISPOSAL DESTRUCTION, INCLUDING THE LOSS OF USE, OF PROPERTY CAUSED BY THE INTENTIONAL OR WILFUL INTRODUCTION OF WASTE PRODUCTS, FLUIDS OR MATERIALS, INCLUDING OIL REFUSE GAS OR GAS BLEED WATER, INTO ANY SOIL. OR INLAND OR TIDAL WATERS, IRRESPECTIVE OF WHETHER THE INSURED POSSESSED KNOWLEDGE OF THE HARMFUL ;CTS OF SUCH ACTS SHALL NOT BE DEEMED TO BE CAUSED BY AN OCCURRENCE. itElLATJON EXCEPT FOR. CANCELLATION OF NON-PAYMENT OF PREMIUM THE CONDITION IS AMENDED TO 30 DAYS NOTCE TO THE iURED f*1 COMPANY CANCELS Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y s .maq l .n o . Secretary Countersigned by. AID 005156 I Effective * f- *0 7? . ^ . T *>i at the time of day the policy becomes effective. Amending Policy No------ Jl Sl Fssurd to___ Date of Issue fW orfisc 1 (SO* US* m. exnaci - HF FT ,ai K-F--r-util..HuiiQJ.b.J------------------- 9 2" 7? :JT> Hvlliiri 138i icoe orAfiC74} h"o"c. o: r 1 1--7^ i MJUIT. 1 l* -10HNS0N t HIGGINS . (The informal}oc provided for above, except the policy number, b required to be stated only when this endorsement is issued for attachment to i the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: ON ENDORSEMENT 8000(T) PAGE l"" UNDER WATERCRAFT WHILE /WAY FROM THE PREMISES; THE SECOND WORD OF THE SIXTH LINE TO READ OVER PAGE 2 LAST TO READ: i?SURD |F COMPANY CANCELS. ! * Th e Tr a v e l e r s In d e mn it y Co mp a n y VMS0L Ho. 8000 Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y Effective from- J P\ -at the time of day the policy becomes effective. Amending Policy No.T-F.N3L -J>2i-24 Issued to- Date of Issue: *CM QfFtCE ' 4 COOE CO. u*c tlxiWW*. '12=20=7X rmo. coot M0OC Of> AOJUIT. **oo. toe. Of KlSK (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) ft is agreed that as of the effective date hereof the policy is amended in the following particulars: WITH RESPECT TO THE INSURANCE AFFORDED BY INSURANCE COVERAGE PART L26B SHALL NOT APPLY TO LIABILITY ASSUMED BY THE INSURED UNDER ANY PART OF AN> AGREEMENT THAT IMPOSES LIABILITY UPON THE INSURED FOR THE SOLE NEGLIGENCE OF THE INDEMNITEE UNLESS (l) AS RESPECTS SUCH PARTS OF SUCH AGREEMENTS AS ARE ENTERED INTO PRIOR TO NOVEMBER 1, 1951 THE NAMED INSURED SUBMITS TO THE COMPANY SUCH PARTS AND THE COMPANY SPECIFICALLY INSURES SUCH PARTS BY ENDORSEMENT ATTACHED TO THE POLICY AND (2) AS RESPECTS SUCH PARTS OF SUCH AGREEMENTS AS ARE ENTERED INTO SUBSEQUENT TO NOVEMBER 1, 1951. THE NAMED INSURED SUBMITS TO THE COMPANY SUCH PARTS WITHIN NINETY DAYS AFTER THE INSURANCE DEPARTMENT OF THE INSURED HAS KNOWLEDGE OF THE EXISTENCE OF SUCH COMPLETED AGREEMENTS AND THE COMPANY SPECIFICALLY INSURES SUCH PARTS BY ENDORSEMENT ATTACHED TO THE POLICY. I Th e Tr a v e l e r s In s u r a n c e Co mp a n y Secretary C-10747 (LtrgeJ 2-65 mih t e o in 971 Th e Tr a v e l e r s In d e mn it y Co mp a n y / _ Countersigned by Secretary Qb* 8000(u Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y -------------- Secretary AID 005158 Effective frum_ _at the time of day the policy becomes effective. Amending Policy No-- Issued to_ Date of Issue: CiOTCC a odet"':';, uw *_ii!:!v txnHU Lr2fi coot i' MOOR OR AQJUS7. | MOO. 1 j LOC. Of 1 Mllft fThe information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: "a p p l ic a b l e t o t x " ITEM 1-NAMED INSURED TO READ: THE ANACONDA COMPANY Th e Tr a v e l e r s In s u r a n c e Co mp a n y Secretary C-10747 (Large) 2-45 mih t s d in u .s .a. 97f Th e Tr a v e l e r s In d e mn it y Co mp a n y / Countersigned by Secretary i3CTh e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y , Secretary AID 005159 NOTICE OF CANCELLATION It is agreed that no limitation or cancellation of this policy ahall become effective until the number of day*' written notice epgcifwd in Item 2 of the Schedule shall have been given to the person or organization designated in Item I of the Schedule at the address there designated. Schedule I. Name: Addrtss: DEPARTMENT OF THE NAVY OFFICE OF NAVAL MATERIAL INSURANCE BRANCH WASHINGTON DC 20360 2; Number of Days' Notice: 30 T-RNSL-922224-72 Amending Policy No... THE TRAVELERS INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY r Secretary C-12S01 12-C7 PIMNTEO IN U J.A AID 005160 as s is t an c e an d c o o per at io n o f t h e in s u r ed (AUTOMOBILE LIABILITY INSURANCE) (VIRGINIA) The failure or refusal of the insured to cooperate with or assist the company which prejudice* the company's defense of an action far damages arising out of the operation or use of an automobile shall constitute non-compliance with the requirements of the policy that the insured shall cooperate with and assist the company. THE TRAVELERS INDEMNITY COMPANY 1-61M S-S* HSINTCO IN US.A. N.S. (Af77) THE CHARTER OAK FIRE INSURANCE COMPANY / Statiarj 9270 .V AID 005161 SYMBOL NUMBERS OF ENDORSEMENTS T-RNSL-02222%-J2 Amending Policy No. i^5Ted thf%grsamenu **0,6 Tl a A1r<r41oicthi 9IS000 *" iiVLcrjoin A6iOO A0200 *6202 M7C '^3* ' 3A-10 25 158F 4329B 158K 513f `3309(2 ) 8000(A-W) G209A m21 3837B 8802 4080A 8840 RETROPLAN 0-4101B 9270 431 9560 9950 11070 11080 11190 11260 13240 17811 I325O 1830C 13270 18340 14520 18773 15940 3< 17130 lf260 Th e Tr a v e l e r s In d e mn it y Co mp a n y Th e Ch a r t e r Oa r Fir e In s u r a n c e Co mp a n y Secretary AID 005162 tB&ZBB&seessst&sj AMENDMENT OF UNINSURED MOTORISTS COVERAGE It 11 agreed that the insured ahall not be required to arbitrate disputed claims under Uninsured Motorists Coverage. THE TRAVELERS INDEMNITY COMPANY THE CHARTER OAK FIRE INSURANCE COMPANY C-t 1713 11-6* HliiiTCO IN U.S.*. H.S. IA716) f S' AID 005163 j UNINSURED MOTORISTS COVERAGE AMENDMENT ! (Insolvent Insurer) It is cgreed that the tens "uninsured automobile" includes an automobile with respect to which the owner or operator is insured against liability for bodily injury, sickness or disease, including death resulting therefrom, by an insurer who is declared in solvent. either before or after the accident, by a court of competent jurisdiction. THE TRAVELERS INDEMNITY COMPANY THE CHARTER OAK FIRE INSURANCE COMPANY AID 005164 f *\ [ This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following: UNINSURED MOTORISTS INSURANCE UNINSURED MOTORISTS INSURANCE COVERAGE PART-SPECIFIED CAR BASIS 1L is agreed that this part applies only to the automobiles designated below: Autcnabilss ord Ststt of Principe! Gciragifig *LL AUTOMOBILES PRINCIPALLY GARAGED IN ALL STATED Limits of Liability Each Parson Eock Accident Premium $5$ E'TUa L t o MW-MUM see P.NANC RESPONSIBILITY LIMITS or THE STATE COMPOSITE WHERE THE AUTOMOBILE IS PRINCIPALLY ENDORSEMENT GA.Ra Gl D *r-SN5. Amending Policy No. -'2 THE TRAVELERS INDEMNITY COMPANY s Secretary C-1270J *-6j8 PRINTED IN U.S.A. THE CHARTER OAK FIRE INSURANCE COMPANY Secretary AID 005165 9950 This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following; UNINSURED MOTORISTS INSURANCE LIMITATION OF UNINSURED MOTORISTS INSURANCE COVERAGE PART - MARYLAND It le agreed that the coverage with respect to an insured highway vehicle! principally garaged in the State of Maryland, does not apply to any accident occurring in the State of Maryland. THE TRAVELERS INDEMNITY COMPANY ' Secretary C-1233* 12-67 NSINTCB IN U.3.A. THE CHARTER OAK FIRE INSURANCE COMPANY Seaesarf 4a * 11070 AID 005166 (\> This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following ! COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE APPLICATION OF LIMITS OF LIABILITY ENDORSEMENT It is agreed that such insurance as is afforded by the policy for Bodily Injury Liability and for Property Damage Liability applies subject to the following provisions: 1 With respect to any sum payable under the provisions of the policy, exclusive of the provisions of any applicable endorsement required by any Federal or State Law or the rules of any Commission. Board or Bureau adopted under such law, the limits of the Company's liability shall be as stated in Item 3 of the policy. 2. With respect to any sum payable under the policy only by reason of the provisions of any applicable endorsement required by any Federal or State Law or the rules of any Commission. Board or Bureau adopted under such law. the limits of the Company's liability shall be as stated in such applicable endorsement. 3 it ] The named insured agrees to reimburse the Company for any payment made by the Company on account of any accident, claim or suit, involving a breach of the terms of the policy and for any payment the Company would not have been obligated to make under the provisions of the policy, except for the agreement contained in any applicable . endorsement required by any State Law or the rules of any Commission, Board or Bureau adopted under such law. : 'I: ri:i!'iIl i!l ' r4 THE TRAVELERS INDEMNITY COMPANY THE CHARTER OAK FIRE INSURANCE COMPANY I|4-I23 t,7 12-67 PRINTED IN u. S.A. i 005^1 pJP Effective from T-k^S. -52 22- - _at tte time of day the policy becomes effective. Amending Policy No. K ned tn_ r<w Cl* off CC * COOT LKPVTJI 1 MOO. j QOQC :1'!: MOQC o f UXJUft. MOO. LOC. OF *i *k (Tne information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: NOT'APPLICABLE TO TX THIS ENDORSEMENT MODIFIES SUCH INSURANCE AS IS AFFORDED BY THE FROVIS SONS OF THE POLICY RELATING TO THE FOLLOWING: COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE AUTOMOBILE PHYSICAL DAMAGE INSURANCE COVERAGE IN MEXICO - 00 DAYS THIS INSURANCE ALSO APPLIES TO BODILY INJURY AND PROPERTY DAMAGE OR LOSS WHICH OCCURS DURING THE POLICY PERIOD WITHIN THE REPUBLIC OF MEXICO SUBJECT TO THE FOLLOW NG ADDITIONAL PROVISIONS* 1. THIS INSURANCE APPLIES ONLY DURING A TEMPORARY VISIT FOR A PERIOD OF NOT MORE THAN NINETY (90) CONSECUTIVE DAYS. 2. 'N THE EVENT OF A LOSS TO A COVERED AUTOMOBILE WHICH MAKES NECESSARY THE REPAIR OF SUCH AUTOMOBILE OR THE REPLACEMENT CF ANY PART OR PARTS THEREOF WHILE SUCH AUTOMOBILE IS WITHIN SUCH MEXICAN TERRITORY, THE LIMIT CF THE COMPANY'S LIABILITY FOR SUCH REPAIRS OR REPLACEMENTS. SHALL NOT EXCEED THE COST OF SUCH REPAIRS OR REPLACEMENTS AT THE NEAREST POINT IN THE UNITED SPATES X AMERICA WHERE SUCH REPAIRS OR REPLACEMENTS CAN BE MADE. Th E Tr a v e l e r s In s u r a n c e Co mp a n y ' Secretary C-10747 (Lu-f*) 2-65 r.iMTlo in u.t.A S7t Th e Tr a v e l e r s In d e mn it y Co mp a n y r Countersigned hy Secretary 0 i , ,,, fYnaoc Ho. lliVv Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y / Secretary AID 005168 Effective from. ,'T\ (I ` L- _at the time of day the policy become* effective. Amending Policy No- Issued to Dare cf Issue 12-20-71------------ 4I^OFiFlCt'V oaoc.1',1;,: '(y. ); ^ !.;: ij mo o . OOOC'.: ijXT ^ "PLr yiifi; r-, . . <:l ,1 ' I MOOC 0* j ACUUfT. 1 11 w*ioe*. of - (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to i the policy subsequent to its effective date.) 11 is agreed that as of the effective date hereof the policy it amended in the following particulars: THIS ENDORSEMENT MODIFIES SUCH INSURANCE AS IS AFFORDED BY THE PROVISIONS OF THE POLICY RELATING TO THE FOLLOWING: UNINSURED MOTORISTS INSURANCE LIMITATION OF UNINSURED MOTORISTS INSURANCE COVERAGE PARTNEW JERSEY_____________________________________________________________ THE COVERAGEiWITH RESPECT TO AN INSURED HIGHWAY VEHICLE PRINCIPALLY GARAGED IN THE STATE OF NEW JERSEY, DOES NOT APPLY TO ANY ACCIDENT OCCURRING IN THE STATE OF NEW JERSEY. t I' j Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y firttaoc No. Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y a id 005169 Effective from. _at the time of day the policy becomes effective. Amending Policy No.. Issued to_ Date cf I* ue or**cr a . oooe LU IlMIl t f w. fL. 1 ccoc { I HOOT 0* Ji!! AOJIJST. ) **00. I 1 LOC. OP 1 ftlSK ' fe.: (The information prbvfSed for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to ! the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: NOT APPLICABLE TO TX THIS ENDORSEMENT MODIFIES SUCH INSURANCE AS IS AFFORDED BY THE PROVISIONS! OF THE POL!CY RELATING TO THE FOLLOWING: COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE EXCLUSION OF AUTOMOBILES IN CANADA T>JiS OLICYjDOES NOT APPLY TO THE OWNERSHIP. MAINTENANCE, OPERATION, USE, -OADING OR UNLOADING OF AUTOMOBILES PRINCIPALLY GARAGED IN CANADA, ** 3r Th e Tr a v e l e r s In d e mn it y Co mp a n y ' Countersigned hy. Secretary Smoot No. 11.-' Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y ^ Secretary AID 005170 Effective from rT) vj/ L . T-RN5L-n2S-- , : _________ ___________at the time of day the polity becomes effective. Amending Policy No---------------------------------------------- Iuued tc Date ot Issue I ~ irss 1 ' Sse, j o1 CU < CM r-i i ss 1 MOOC Of ( *UUfT. 1i MOD. | tDC. OF 3 MK ..... . i ! (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: FH endorsement modifies such insurance w is afforded by the provisions of the policy relating to the following: C0MFREKE5SI7E CSSEBAL LIABILITY HSURAICE EMPLOYES EEHEFTTS LIABILITT EHDORSEMEST SCHEDULE 13 Premium Computation Estimated lo. of fisployees Rate per Employee Estimated Premium Minimum Premium first 5,000 next 5,000 over 10,000 * INCLUDED I IN $ COMPOSITE Total $ RATES Employee Benefit Programs Other Then Those Specified in Section l.b. Belov Limits of Liability ,1-OOrX'O $3ooo,o:o each claim aggregate Deductible $ 1,000c00 each diia IBLURIBG ACREEKEHT Toe epa^asrr agr>;s v-ch the .tried insured- in eonsie.erc-.tion of the payment of the premium and subject to ill the tersta of this endorseuert, to pay on behalf c:* the insured all sums which tre insured 3nall become legally obligated to pay as carnages for intangible p- espe ct / clertfe "oss because of any negligent met or emission cf the insured or any otbe. tmen r->t hoje acts the insured is legally liable aririxp c>`it of the conduct -:t ^Jrir.ictreti.13 of the insured's TSaployee Benefit Progrix. 3 defined herein, * ,ti:ci the r- living previsirne Ctl0747a 2-65 *<7> * w .s .a . (Continued on page 2 ) Srmmoc No, n A,D00Sl7i Page No-------T-3NC - Continuation o( Endorsement Amending PoBcy ^'CJ22 "<-k ~"Tt 1, All of the terns and conditions of the policy which apply to the proper* y i^nwp liability coverage thereof shall apply to the insurance under th: s endorsosent, except as follows: a, She unqualified wo~d "insured" also includes any employee of the tamed iasurai authcrited to handle or administer the named in sured : c tStpl`7yee Benefit Program, b0 iThe term "Employee Benefit Program" means group life insurance, sroup accident or health insurance, pension plans, employee stock subscripticn plans, unemployment insurance, social security bene fits, workmen' s compensation, disability benefits and any other similar ecpijyee benefits scheduled above or instituted after the effective date of this endorsement provided the company is notified within thirty days after the institution of such benefits. c. Upon the insured's becoming aware of any allegedly negligent act or omission covered hereunder, written notice shell be given by or on behalf of the insured in accordance with the "notice of I accident" condition of the policy. Endorsement Period - Territory. This endorsement applies only to claims made sad suits brought within the United States of America,, its territories or possessions or Canada during the policy period,1 provided tie named insured, at the effective date of this endorse ment , had nc knowledge of any act or omission which might result in such el&in cr suit. e. The exclusions of the policy are replaced by the following: This endor-senenc dees not apply: (1) to any dishonest, fraudulent, criminal or malicious act; !2) r,c ; i.- .`SEiulting from injury to or destruction of tangible ij-ope -y cr -3', ary claiu ur suit based upon: (a) failure cf stock tc perform as represented by an insured, or (b) idvice given by an insured to an employee of the named vred to participate or not to participate in any stock t*-r-;.ption plan. C-10747* 2 s s imTc O tsr u.S.A. (Continued on page j AID 005172 ttvmmoL Wo. 1V2*0 I .1 ' Continuation of Endorsement Amending Policy No i Page No. fo She limit- of liability at lie- hoove as applicable to "each else a" ig the total. 1 vsil of thi company-'a liability for all df-aagee eriST ling out of my nsiffi -orerci hereunder; Subject to tee foregolag ) peons iyn ..H;.spe;tiig "eaeo clala-' the limit of liability stated 'above at. is tc-'a:. limit of tfce company-6 liabi-ity , cer?M o.-.j for aL'. isu-acei duri ng eaifc annual endorsement period. Subject to *;he fc^-t,z-ing. tic liability of -the company vitc respect to each jiscU b2 ci.1;-- the aacunt cf each such claim that is \n exs--c' of +. e ceiu- :.ls atanunt, stated aboTe, The indueion herein e. aore than one insured shall act operate to In crease the limit of che. sos^aiy'a liability, Bus terms cf the endorsement, including those vith respect to notice oi claim or suit and tbs conpany s right to infestigate, negotiate and settle any; claim tr suit, apply irrenpert-I7e of the application of the deductible amount. The company =y -^sy an; part or all of tba deductible amount to effect^ settlement, of say 1 sir or suit and, upon notification of the action tahen, the named, insured -hal; promptly reimburse the company for such part cdf the deductible aux-.-u - as has been paid by the company, ? 2e The premiss. stated ibc'e is a:, estimated premium only. Upon termination of each Racial perl -i :-d by this endorsement the insured, on request, vill fi?T.ni.rh -h* icspccy a stttensat of perscanel changes during the rdorse- aest.perA>:. itd ii.jaed prun.-Ui shall be r outed in accordance with, the coapany's ruJ.-'* . ,,*& ?.<.5 and pr'-ilus? applicail. tc this insurance. If the earned pr:,r;.u;. h i? cor-.mtad '..xrerds the estimated .advance prsolun paid, the insured ianll tis "o ta*? company; if leas, the conpany shall return ti the incurs:. portion by such insured. Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y m. n o . AID 005173 Effective from. Issued tot Date <>f Issue:) 'D T-RNSi. -9c2^2-? -at the time of day the policy become! effective. Amending Policy No. 12-20-71" (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: THIS ENDORSEMENT MOOIFSES SUCH INSURANCE AS IS AFFORDED BY THE PROVISIONS OF THE EMPLOYEE BENEFITS LIABILITY ENDORSEMENT EMPLOYEE BENEFITS LIABILITY - AMENDATORY NEW YORK SPECIAL PROVISION SUCH INSURANCE AS IS AFFORDED BY THE EMPLOYEE BENEFITS LIABILITY ENDORSE- , WENT TO ANY EMPLOYEE OF TnE NAMED INSURED SHALL BE LIMITED TO AUTHORIZED ACTS ARISING OUT OF THE ADMINISTRATION OF GROUP LIFE INSURANCE, GROUP , HEALTH INSURANCE, PROFIT SHARING PLANS, PENSION PLANS AND EMPLOYEE STOCK SUBSCRIPTION PLANS. Th e Tr a v e l e r s In s u r a n c e Co mp a n y ^ Secretary C-10747 (Large) 2-65 p io k u d ih u .s .a. $71 Th e Tr a v e l e r s In d e mn it y Co mp a n y ' Countersigned by. Secretary Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y S' Secretary AID 005174 .,.. 'sj y Effective firm .-. -------------------------at the time of day the policy becomes effective. Amending Policy No. imied to__ Date of Ixruc: omec w* *ooec 1um" rjTPiMCf ;ii, 12-20-71 PHOO. COOC MQOE OP AOJUIT. 1 MOO. 1 U!J*C*. OP . (The information provided lor above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: THIS ENDORSEMENT MODS FI E3 SUCH INSURANCE AS IS AFFORDED BY THE PROVISIONS OF THE EMPLOYEE BENEFITS LIABILITY ENDORSEMENT, EMPLOYEE BENEFITS LIABILITY - AMENDATORY MASSAC-HUSE?TS SPECIAL PROVtS'ON In G AGREEMENT ID OF THE EMPLOYEE BENEFITS LIABILITY EM50RSEMENT LACED BY THE FOLLOWING: ENDORSEMENT PER00 - TERRITORY. THIS ENDORSEMENT APPLIES ONLY TO FINANCIAL LOSS DISCOVERED DURINJ THE POLICY PERIOD OR WITHIN THE PERIOD OF TWO YEARS THEREAFTER ANO OCCURRING WITHIN THE UNITED STATES OF AMERICA, ITS TERRITORIES OR POSSESSIONS, OR THE DOMINION OF CANADA RESULTING FROM NEGLIGENT ACTS, ERRORS OR OMISSIONS WHICH OCCUR PRIOR TO THE END OF THE POLICY PERI00 PROVIDED THE NAMED INSURES AT THE EFFECTIVE DATE OF THIS ENDORSEMENT HAD NO KNOWLEDGE OF OR COULD NOT HAVE REASONABLY FORESEEN ANY CIRCUMSTANCES WHICH MIGHT RE SULT IN A CLAIM OR SUIT. THIS INSURANCE SHALL NOT APPLV TC FINANCIAL LOSS DISCOVERED AFTER THIS POLICY HAS TERMINATED IF THERE IS OTHER VALID AND COLLECTIBLE INSURANCE AVAILABLE TO THE INSURED AND APPLICABLE TO SUCH LOSS. Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Snaot No. 132 / v Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005175 i,g!aii-.Btiaiaifaai'awliiiiaiBiuaai3iitttdiairai!4pata^ii8UBaiMata!iaM!meuiPMBmiiiigttBMtuai&mnaMn. This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following: COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE Effective from. ADDITIONAL INSURED .at the time of day the policy becomes effective. Amending Policy No. SL ~ Issued to__ ___ p erricr CODE JSK |lOI., . . . llllililiHII'UrfcX'PlAC'Si'l r o d ! coot MODE OF ADJUST. SHOD. l o c . or RISK 'The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that paragraph (d) of the "Persons Insured" provision includes the person or organization designated below, but only with respect to his or its liability because of acts or omissions of an insured under (a), (b)or (c) of such provision, sub ject to the following additional provisions: 1. No liability is assumed by such person or organization for the payment of any premiums stated in the policy or earned thereunder. 2. In the event of cancellation of the policy, written notice of cancellation will be mailed by the company to such person or organization. Parson or Organixotien Address CUSTOM CORD ANO (-ABLE INC Amending Policy No T-RNSi~92g2g4-7g THE TRAVELERS INDEMNITY COMPANY THE CHARTER OAK FIRE INSURANCE COMPANY [C-12522 9-71 PRINTED IN U.S.A. Stcretary Countersigned by -------- / Secretary 14520 a id 005176 UNINSURED MOTORISTS COVERAGE AMENDMENT {Insolvent Inturtr) !t i* *T*cd that th tern "uninsured highway vehicle" include* a highway vehicle with reaped to which there i* a bodily injury liability inturancr policy applicable st the time of the accident but the company writing the tame it or become* molvent. THE TRAVELERS INDEMNITY COMPANY Saerttary C-120*1 *-*7 Mmrto m u.j.i. N.S. (***! THE CHARTER OAK FIRE INSURANCE COMPANY Secretary 15940 AID 005177 a id 005178 PROTECTION AGAINST UNINSURED MOTORISTS INSURANCE (Automobile Bodily Injury Liability ond Property Damage Liability) (Specified Cor Basis) (Virginia) Effective from ....... ............................ Amending Policy numbered At 12:01 A.M. Standard Time Issued to........................................... ......... . ............. ------------,--,----------------------------------------------------------------------------------------------------------- The additional premium for this endorsement is * __ (The information provided for above is required to be stated only when this endorsement is issued for attachment to the policy < subsequent to its effective date.) In consideration of the payment of the premium for this endorsement, the company agrees with the named insured, subject to tne limits of liability, exclusions, conditions and other tenmB of this endorsement and to the applicable terms of the policy: LTilts of Liability: Bodily Injury Property Damage SCHEDULE *20,000 each person; *30,000 each accident *5,000 each accident INSURING AGREEMENTS 1. Damages for Bodily Injury end Property Damage Caused by Uninsured Automobiles To pay, in accordance with Section 38.1-381 of the Code of Virginia and all Acta amendatory thereof or supplementary thereto, all sums which the Insured or hia legal representative shall be legally entitled to recover aa damages from the owner or operator of an uninsured automobile because of: Ce) bodily injury, sickness or disease, including death resulting therefrom, hereinafter called "bodily injury", sustained by the Insured; (b) injury to or destruction of <1) an insured automobile and its contents and <2> any other property (except an automobile) owned by an Insured and located in Virginia, hereinafter called "property damage"; caused by accident and arising out of the ownership, maintenance or use of such uninsured automobile. , ijll. Definitions (a) Insured. The unqualified word "Insured" means; (1) the named Insured; (2) any person while occupying an insured automobile; and (3) any person, with respect to damages he is entitled to recover for care or loss of services because of bodily injury to which this endorsement applies. The insurance appliea separately with respect to each Insured hereunder, but neither thiB provision nor application of the 1 insurance to more than one Insured shall operate to increase the limits of the Company's liability. (b) Insured Automobile. The term "insured automobile" means: (1) an automobile owned by the named Insured and registered in Virginia; i! ( ' (2) any automobile owned by the named Insured to which is attached Virginia dealer's license plates issued to the named Insured; with respect to which the bodily injury and property damage liability coverages of the policy apply, i (c> Uninsured Automobile. The term "uninsured automobile" means: (1) an automobile with respect to the ownership, maintenance or use of which there is. in at least the amounts speci- !' : fied in the Virginia Motor Vehicle Safety Responsibility Act. neither (i> cash or securities on file with the Virginia Commissioner of Motor Vehicles nor (ii) a bodily injury and property damage liability bond or insurance policy, applicable at the time of the accident with respect to any person or organization legally responsible for the use of such automobile, or with respect to which there is such a bond or insurance policy applicable at the time of the accident hut the company writing the same is or becomes insolvent or denies coverage thereunder, or (2) a hit-and-run automobile as defined; but the term "uninsured automobile" shall not include: (i) an automobile which is owned or operated by a self-insurer within the meaning of the Virginia Motor Vehicle Safety Responsibility Act or any motor carrier law or similar law; (ii) an automobile which is owned by the United States of America, the State of Virginia, a political subdivision thereof, or an agency of any of the foregoing; (m) a vehicle operated on rails or while located for use as a residence or premises and not as a vehicle; or (iv ) a vehicle or other equipment designed for use principally off public roads, except while actually upon public roads. <d> Hit-ond-ftun Automobile. The term "hit-and-run automobile" means an automobile which causes an accident resulting (Continued on Page 2) 17811 For Company Use Only OAT OF CXPfPATl ON MODE OF ADJUSTMENT l o c at io n o f r is k o f f ic e a n d n a me o f a g e n t AID 005179 i Page 2 ir b-)dm injury to an Insured or property damage, provided: <0 there cannot be ascertained the identity of either the opo-a'nr nr the owner of such "hit-and-run automobile'': <11* the Insured or someone on his behalf shall have reported toe accident within 5 days or as soon as practicable to the Commissioner of Motor Vehicles. <r> Occupying. The word "occupying" means in or upon or entering into or alighting from. III. Policy Potiod, Territory Tms erdcrsenient applies pnly to accidents which occur on and after the effective date hereof, during the policy period and within tne 'United States Of America, its temtories or possessions, or Canada. EXCLUSIONS This endo-sement does not apply: te> *o bodil v injury to an Insured, care or loss of services recoverable by an Insured or injury to or destruction of propert, of an Insured, with respect to which such Insured or hi6 legal representative shall, without written consent of the Comp'i'n. make any settlement with any person or organization who may be legally liable thesefor. 'b' to tn< first two hundred dollars of the total amount ot all property damage as the result of any one accident: ic n-i pr to inure directly or indirectly to the benefit of any insurer of property. CONDITIONS Polic Provision*. None of the Insuring Agreements, Exclusions, Conditions or Other Provisions of the policy shall apply to lb*- oiaursnze afforded by this endorsement except the Conditions "Notice or * Notice of Accident, Subrogation, "Ciflgeb, ' "Assignment," "Cancellation" and "Declarations." J. Prr-iiu r l* during the policy period the number of automobiles owned by the named Insured and registered in Virginia or `nr r.urioorof Virginia dealer's license plates issued to the named Insured changes, the named Insured shall notify the Ci t ic b- . during the policy period of any change and the premium shall be adjusted in accordance with the manuals in use by tfit Company. If the earned premium thus computed exceeds the advance premium paid, the named Insured shall pay the x"i ss tc the Company; if less, the Company shall return to the named Insured the unearned portion paid by such Insured. Proof of Clomu As soon as practicable, the Insured or other person making claim shall give to the Company written proof of clo-m, under oath if required, including full particulars of the nature and extent of the injuries, treatment, and other Jrte.il>. rntr.ng into the determination of the amount payable hereunder. Proof of claim shall be. made upon forms famished <; tne r'ompa*iy unless the Company shall have failed to furnish such forms within 15 days after receiving notice of claim. ' be injured person shall submit to physical examinations by physicians selected by the Company when and as the Coro0 n, mo reasonably require and he, or in the event of his incapacity his legal representative, or in the event of his death Las it-gal representative or the person or persons entitled to sue therefor, shall upon each request from the Company exeentr r-'ithcmation to enable the Company to obtain medical reports and copies of records. The Insured or other person making claim for damage to property shall file proof of loss with the Company within sixty (in ` tiler the occurrence of loss, unless such time is extended in writing by the Company, in the form of a sworn statement a.n'.mg *ortL the interest of the Insured and of all others in the property affected, any encumbrances thereon, the actual c< sh value tncreof at time of lose, the amount, place, time and cause of such loss, and the description and amounts of all fitter insurance covering such property. Upon the Company's request, the Insured shall exhibit the damaged property to the Compra;. 'jtl resi td to claims alleged to have arisen out of the ownership, maintenance or use of a hit-and-run automobile if the ii i 11 s no, obtained a judgment against John Doe, the liability of the uninsured motorist may be established, as be- v ftr, ire insured and the Company, by filing with the Company within a reasonable time after the accident a statement unAe- .'iiD that the insured or his legal representative has a cause or causes of action arising out of such accident for Js-uzr r- age nBt a person or persons whose identity is unascertainable, setting forth the facta in support thereof, and shall nr r'ea and convincing evidence that there was a hit-and-run automobile involved in the accident. *. Kefirs 1,1 1 Action. If, before the Company makes payment of loss hereunder, the Insured or his legal representative so'.! ji.rti.ute any legal)action for bodily injury or property damage against any person ororganization legally responsible to- tl.< m e of an automobile involved in the accident, a copy of the summons and complaint or other proceaa served in '.o'mc'-i'or w th such legal action shall be forwarded immediately to the Company by the Insured or his legal representative. 5. Limit* -f Liability,; <al The limit of bodily injury liability stated in tile schedule as applicable to "each parson'' ia the 'm,i c* tin Company's liability for alt damages! including damages for care or loss of services, because of bodily injury si stciii. rl b. one person as the result of any one accident and, .subject to the above provision respecting each person, the Jj-iu of r th liability staled in the schedule as applicable to "each accident" is the total limit of the Company's liability Jc- al1 d-meges. including damages for care or loss of services, because of bodily injury sustained by two or more persons e* tne retult of any one accident. 'o' j i,. Jut it of property damage liability elated in the schedule as applicable to "each accident** is the total limit of the To panv t. liability for all damages arising out of injury to or destruction of all property of owe or more Insureds as a t **!]! -ii a* one accident. If >- is made hereunder and claim is also made against any person who is an Insured msderthe Bodily Injury Lia- 1 ' c- pn , erty (Damage Liability coverages of the policy because of bodily injury ot property damage sustained in an t rid* i n* n person who is an Insured hereunder,, any payment made hereunder to or for any such person shall be applied ir r* dion of any amount which he may be entitled to recover from any person who is an Insured under the Bodily Injury L. * t * ,1 r*r Property pamage Liability' coverages. ' "~r'Jnt Payable hereunder because of bodily injury or property damage sustained in an accident by a person who is i insjr jnder s coverage shall be reduced by all sums paid on account of such injury or damage by or on behalf of thr i-v",, - o' Of j tor of the uninsured automobile. ---- fContinued on Page 31 AID 005180 17811 AID 005181 < Page 3 (e' Ajij amount recoverable as damages because of bodily injury or property damage sustained in an accident by a person v-uo is an insured under this coverage shall be reduced by all sums paid on account of such injury or damage by or on beHalf of unj person or persons jointly or severally liable together with the owner or operator of the uninsured automobile fo- such injury or damage including all sums paid under the Bodily Injury Liability or Property Damage Liability coverages of the policy. 6. Othi Insurance. With respect to bodily injury to an Insured while occupying an automobile not owned by the named Insured, tnc insurance hereunder shall apply only as excess insurance over any other similar insurance available to such Insured and aophcable to such automobile as primary insurance. Lxi epr ar provided m the' foregoing paragraph, if the Insured-has other similar bodily injury insurance available to him i - -Vidicable to the 'accident, the Company shall not be liable for a greater proportion of any loss to which this coversge applies than the limit of liability hereunder bears to the sum of the applicable limits of liability of this insurance and such other insurance. Viith respect to property damage, the insurance hereunder shall apply only as excess insurance over any other valid and collectible lusurance of any kind applicable to such property damage. 7. Payment ef Loss by fhs Company. Any amount due hereunder is payable to the Insured or his legal representative. THE TRAVELERS INDEMNITY COMPANY C-130S5 I2-S8 MINTED IN U.S.A, N.S. (A90b) President 17811 i. AID 005182 PROTECTION AGAINST UNINSURED MOluJUaaja iN&u ma n ^a . (Automobile Bodily Ibjdry Uibiiity sod Proper? Damage Liability) (Speeded Car Biol) <Gp) '^ The comparrv agree* with the owned insured, in consideration of the payment of the premium for this endorsement and subject to the iimii* at Lability, conditions and other terms of this endorsement and to the applicable terms of the policy : SCHEDULE Units ci Iiabflfty: Bodily Injury $10,000 each person; $20,000 each accident Property Damage $5,000 each accident The advance premium for this endorsement is $ vU-ClD r - -1 - INSURING AGREEMENTS L Daznagee for Bodily Injury and Property Damage Cawed by Unmaured Automobile* To pay all sums which the insured or his legal representative shall be legally entitled to recover as damages from the owner or operator of an uninsured automobile because of: , (a) bodily injury, sickness or disease, including death resulting therefrom, hereinafter called "bodily injury ", sustained by the insured; (b) injury to or destruction of an insured automobile and property owned by the insured which is contained therein, hereinafter called "property damage*': caused by accident and arising out of the ownership, maintenance or use of such uninsured automobile. No default judgment against any known person or organization alleged to be legally responsible for the bodily injury or property damage shall be conclusive, as between the insured and the company, as to the establishment of legal liability or of the amount of damages to which the insured is legally entitled. EL Deftaftimui (a) Insured. The unqualified word "insured*' means t (1) the named insured; (2) any person while occupying an insured automobile; and 4 (3) any person, with respect to damages he is entitled to recover because of bodily injury to which this endorsement applies sustained by an insured under (1) or (2) above. The insurance applies separately with respect to each insured under this endorsement, but neither this provisioo nor application of the insurance to more than one insured shall operate to increase the limits of the company's liability. (b) Ioaured Automobile. The term "insured automobile" means: (1) an automobile owned by the named insured and registered in Georgia: (2) any automobile owned by the named insured to which is attached Georgia dealer's Uoense plates issued to the named insured; and to which the liability coverage of the polio* applies, while such automobile is being used by or with the permission of the named insured as stated* in the policy. (c) Uninsured Automobile. The term "uninsured automobile" means: (1) an automobile with respect to the ownership, maintenance or use of which there is, in at least the amounts specified in Section 56-407A of tKe Georgia Insurance Code, neither (i) cash or securities on file with the Georgia Director erf Public Safety nor (ii) a bodily injury* and property damage liability bond or insurance policy, applicable at the time of the acci dent with respect to any person or organization legally responsible for the use of such automobile, or there is a bodily injury and property damage liability insurance policy applicable at the time of the accident but the company writing the same either lai ha* legally denied coverage thereunder, or (b> is or becomes insolvent provided the insured gives the company notice of the pendency of any legal proceeding against such insolvent company of which he may have knowledge, within a reasonable time and before he enters into any negotiation or arrangement with such insolvent company end before the company is prejudiced by any action or nonaction of his with respect to the determination of the insolvency of such company; or (2) a hit-and-run automobile as defined; but the term "uninsured automobile" shall not include: (i) an automobile defined herein as an "insured automobile"; (ii) anautomobile owned by or furnished for the regular use of the named insured; (iii) an automobile which is owned or operated by a self-insurer within the meaning of any motor vehicle financial responsi bility law, motor earner law or any similar law; (iv) an automobile which is owned by the United States of America, Canada, a state, a political subdivision of any such government or an agency of any of the foregoing; (v) a: land motor vehicle or trailer, if operated on rails or crawler-treads or while located for use as a residence or premises and not as a vehicle; or (vi) a farm type tractor or equipment designed for use principally off public roads, except while actually upon public roads. (d) Hit-nd-Run Automobile. The term "hit-and-run automobile" means an automobile which causes bodily injury* to an insured or propertv damage arising out of physical contact of such automobile with an insured automobile, provided: (i) there cannot be ascertained the identic} of either the operator or the owner of such "hit-and-run automobile"; (ii) the insured or someone on hts behalf shall have reported the accident within 10 days or as soon as practicable to the Georgia Director of Public Safety, and shall have filed with the Company within 30 days thereafter a statement under oath that the insured or his legal representative has a cause or, causes of action arising out of such accident for damages against a person or persons whose identity is unascercamablc. and setting forth the facts in support thereof: and (iii} at the company's request, the insured or his legal representative makes available for inspection the automobile which the insured was occupying at use time of the accident. (e) Occupying; The word "occupying" means in or upon or entering into or alighting from. (f) State. The word "state" includes the District of Columbia, a territory or possession of the United States, and a province of Canada. XZL Policy Period, Territory This endorsement applies only to accidents which occur on and after the effective date hereof, during the policy peiod and within the United States of America, its territories or possessions, or Canada, EXCLUSIONS This endorsement does not apply: (a) to the first two hundred and fifty dollars of the total amount of all property damage as the result of any one accident; (b) to bodih injury to an insured or injury to or destruction of property of an insured, with respect to which such insured, his legal representative or any person entitled to paymem under this coverage shall, without written consent erf die company, make any settlement with any person or organization who may be legally liable therefor; (c) so a> to inure directly or indirecih to the benefit of anv workmen's compensation or disability benefits carrier or any person or organization quaUf>mg a> a sc-lf-iiis-urcr under any woikmen's compensation or disability benefits law or any similar law; (dl so as to inure directly or indirectly to the benefit of any insurer of property: tel to property damage for which the insured has been compensated by other property or# physical damage insurance. (Continued on Pate 2) 18300 AID 005183 Pi|2 coiromows i I. Policy Preritiae*. None of ihe Insuring Agreements. Exclusions. Conditions or Other Provisions^ the policy^shall apply to the insurance afforded by this endorsement except the Condition*- "Notice" or "Notice of Accident/' "Subrogation. * Changes. As signment/ "Cancelation" and "Declarations". i' 2. Premium. If during the policy period the number of automobiles owned by the named mured and registered or principally garaged in Georgia or the number of Georgia dealer'* license plates issued to the named insured changes, the named insured shall notify the ' company dunne the .policy penod of any change ana the premium shall be adjusted in accordance with the manuals in use by the v company. If the earned premium that computed exceeds the advance premium paid, the named insured shall pay the cant-- to the company; if leas, the company shall return to the named insured the unearned portion paid by such insured. !'&; Proof:of Claim. As soon as practicable, the insured or other person making claim shall give to the company, written proof of claim, under oath if required, including full particulars of the nature and extent of the injuries, treatment, and other details entering uato the determination ex the amount payable hereunder. Proof of claim shall be made upon forms furnished by the company unless the company shall have failed to furnish such forms within IS days after receiving notice of claim. ..... The injured person shall submit to physical examinations by physicians selected by the company when and as the company may reasonably require and he, or in theevent of hisincapaaey bis legal representative, or in the event of bis death bis legal represeatabve or the person or persons enutted to sue therefor, shall upon each request from the company execute authorisation to enable the com pany to obtain medical reports and copses of records. 1 The insured or other person making claim for damage to property shall file proof, of loss with the eompanv within sixty days after the ! occurrence'of tau, unleu such time extended in smting by the company, in the form of a sworn statement setting forth the interest of the insured and of all others in the property affected, any encumbrances thereon, the actual cash value thereof at time of loss, the i! i! amount; place, time and cause of such loos, and the description and amounts of all other insurance co^'eniig such property. Upon the ! i company* request, the insured shall exhibit the damaged property to the company. 4. Assistance tad Cooperation of the Zotazed. After notice of claim under this endorsement, tbe company may requiretbeiasured to take such action as may be necessary or appropriate to preserve his right to recover damages from any person or arganicatioo alleged toi.be legally responsible for the bodily injury or property damage:. 5. Hoties of Legal Action. If, before the company makes payment of lost hereunder; the insured or his legal representative shall institute an\ legal action for bodily mju*y or property damage against any person or organization legally responsible for the use of an auto mobile involved in the accident, a ropy of the summons and corrpiatnt or other process served in connection with such legal action shall be forwarded immediately to the company by the insured or his legal representative. 6. limits of liability, (a) Tbe limit of bodily injury Lability stated in the schedule as applicable to "each person" is tbe limit of tbe a company's liability for all damages, including damages for cart or lass of services, because of bodily injury sustained by one person as the result of any one acadent and, subject to the above provision respecting each person, the limit of such liability stated in the schedule as applicable to "each accident" is the total bnvt of tbe company's Lability for all damages, including damages for care or loss of services, because of bodily injury sustained by two or more persons as the result of any one accident. (b) The limit of property damage liability stated in the schedule as applicable Co "each acadent" is the total limit of the company's Lability for all damages arising out of injury to or destruction of ail property of one or more insureds a* tbe result of any one acrident. (c) if claim is made under this endorsement and claim is also made agxmst any person who is an insured under tbe Bodily Injury Liability or Properry Damage Liability coverages of the policy because of bodily injury or property damage sustained in an acadent by a person who is an insured under this endorsement: (1) any payment made under this endorsement to or for any such person shall be applied in reduction of any amount which be may be entitled to recover from any person who u an insured under the Bodily Injury Liability or Property Damage Liability coverages; and (2) any payment made under tbe Bodilv Injury Liability or Property Damage Liability coverages to or for any soch person shall be appbed in reduction of any amount which he may be entitled xo recover under this endorsement. (d) Any amount payable to an insured under the terms of this endorsement shall be reduced bv (I) all sums paid to such insured for bodily injury or property damage by or on behalf of the person legally liable therefor and (2) tbe amount paid and the present vahie of all amounts payable to such an insured under any workmen's compensation law, exclusve of non-occupations] disability benefits. 7. Other Xasurencs. _ With respect to bodily injury to an insured, if the insured has other similar insurance available to him against a loss covered by this endorsement, tbe company shall not be liable under this endorsement for a greater proportion of such loss than the applicable limit of liability hereunder bears to tbe total applicable limits of Lability of all valid and collectible insurance against such km. " ..... ".t :.:. S. Payment of Loaa by the Company. Any amount due hereunder is payable to tbe insured or his legal representative. 9. Action Againat Cwymy. No action shall lie against the.corrpany unless, as a condition precedent thereto, the insured or his legal reprear.nretivt ha fully complied with aL the terms cf this endorsement. 10. This endorsement replaces any other provisions of the policy, including any endorsement attached thereto, affording similar insurance with respeet to any damagex arisingout of the ownersiupvr maintenance or use of an uninsured automobile or a hit-and-run vehicle. THE TRAVELERS INDEMNITY COMPANY THE CHARTER OAK FIRE INSURANCE COMPANY / Secretary C-J2S9J 104* (A425b> H.S. iuoo ' . -tfc - PROTECTION AGAINST UNINSURED MOTORISTS INSURANCE (Oklahoma) T-RNSL-922224-J2 Id -m----*"" rf the ry--t of premium mud subject to mil of the provisions of this endorsement and to the applicable provisions of the policy, the company^tet with the named insured as follows: t SCHEDULE Dwriputted-lanrad t Unite Of Liability: Bodily Injury $ 5,000 each person Ahuce Premium $ i NCL.UDCD i N co$1f0c,00o0seanch arccident Description of Insured Highway Vehicles:' Any highway vehicle registered or principally garaged in Oklahoma which is: v (Check appropriate box) tj An owned automobile under Part I of the policy A private passenger automobile owned by the named insured Owned by the named insured O Designated in the declarations of the policy by the letters "UM" and any highway vehicle of the same type ownership of which h acquired during the policy period by the named insured as a replacement therefor Q Any mobile equipment owned by the named insured ------------------ ---------,------ ------------------------------------------ -------------------------- ----------------- - I. UNINSURED MOTORISTS COVERAGE (Damage* for Bodily Injury Canoed by Uninsured Highway Vehicle*) ' 7 The company win nay in accordance with Title 36 Oklahoma Statutes 1961 all sums which the insured or his legal representative hall be legally entitled to recover as damages from die owner or operator of an uninsured highway vehicle because of bodilypjury caused by accident and arising out of the ownership, maintenance or use of such uninsured highway vehicle; provided,Mr the ujtn.:diFso^the amount theredoeft,esrmhainllabteiomn aadsetobwyhaegtrheeermtheentinbseutwreedeonrthsuecihnsreupreredsoernstautcivhereisplreegsaelnlytaetnivteitlaenddtothreeccoovmerpsauncyhodra,*marg^ fill to sgrele, by arbitration.1 > No judgment against any person or organization alleged to be legally responsible for the bodily injury shall be conclusive, as between the insured and the company, of the issues of liability of such person or organization or of the amount of damages to which the insured it legally entitled unless such judgment is entered pursuant to an action prosecuted by the insured with the written consent of the company. Zxdoatoiui This insurance does not apply: |a) to bodily injury with respect to which the insured, his legal representative or any person entitled to pa>unent under this insuri' ance shali, without written consent of the company, make any settlement with any person or organization who may be legally liable therefor; (hL to bodily injury to an insured while occupying a highway vehicle (other than an insured highway vehicle) owned by the named ' insured, any designated insured or any relative resident in the same household as the named or designated insured, or through Ifeing struck by such a vehicle, but this exclusion does not apply to the named insured or his relatives while occupying or if Ijtriick by a highway vehicle owned by a designated insured or his relatives; (c) so ai to inure directly or indirectly to the benefit of any workmen's compensation or disability benefits carrier or any person or'organization qualifying as a self-insurer under any workmen's compensation or disability benefits law or any similar law; PERSONS INSURED Each of the following is an insured under this insurance to the extent set forth below: (a) the named insured and any designated insured and, while residents of the same household, the relatives of either; (b) any other person while occupying an insured highway vehicle; and (e) any person, with respect to damages he is entitled to recover because of bodily injury to which this insurance applies sustained bWaal insured under (a) or (b) above. The insurance applies aaparetcly with respect to each insured, except with respect to the limits of the company's liability. LIMITS OE LIABILITY Regardless of the number of insureds under this insurance, the company's liability is limited as follows: (a) tpe limit of bodily injury liability stated in the schedule as applicable to "each person" is the limit of the company's liability all damages because of bodily injury sustained by one person as the result of any one accident and, subject to the above vision respecting "each person", the limit of liability stated in the schedule as applicable to "each accident" is the total it of the company's liability for all damages because of bodily injury sustained by two or more persons as the result of any one accident. (b) Any amount payable under the terms of this insurance because of bodily injury sustained in an accident by a person who is an insured shall be reduced by (f) all sums paid on account of such bodily injury by or on behalf of (i) the owner or operator of the uninsured highway vehicle and (ii) any other person or organization jointly or severally liable together with such owner or operator for such bodily Leluding injury, all sums paid under the bodily injury liability coverage of the policy and (2) the amount paid and the present value of all amounts payable on account of such bodily injury under any workmen's I compensation law, disability benefits law or any similar law. (Continued on page Z) 18340 AID 005185 Page 2 Any payment made under this insurance to or for any insured shall be applied in reduction of the amount of damages which he may be entitled to recover from any person or organization insured under the bodily injury liability coverage ot the policy. (d' Any payment made under this insurance to or for any insured which represents expenses for medical services shall be applied in reduction of the amount of expenses to which the medical payments or medical expense coverage of the policy applies. IV. PJr OKJmL*ICVYJi P* ERIOD;| TERRI1TsOr l*R>4Y This insurance applies onlv to accidents which occur during the policy period and within the United States of America, its territories or possessions, or Canada. V. ADDITIONAL DEFINITIONS When used in reference to this insurance (including endorsements forming a part of the policy): "bodily injury" means bodily injury, sickness or disease, including death, sustained by an insured under (a) or (b) of the Persons Insured provision; "designated insured'' means an individual named in the schedule under Designated Insured and also includes his spouse, if a resident of the same household ; "highway vehicle" means a self propelled land motor vehicle or a trailer, other than (a) a farm type tractor or other equipment designed for use principally off public roads, while not upon public roads, (b) a vehicle operated on rails or crawler-treads, or (c) a vehicle wi.de loca ted for use as a residence or premises; "hit and-run vehicle" means a highway vehicle which causes bodily injury arising out of physical contact of such vehicle with the insured cr with a vehicle which the insured is occupying at the time of the accident, provided: (a) there car.no* be ascertained the identity of either the operator or owner of such highway vehicle; (b) the insured or someone on his behalf shall have reported the accident within 24 hours to a police, peace or judicial officer or to the Commissioner of Motor Vehicles, and shall have filed with the company within 30 days thereafter a statement under oath that the m.urrd or jhis legal representative has a cause or causes of action arising out of such accident for damages against a peison or persons whose identity is unascertainable, and setting forth the facts in support thereof; and (c) at the company '* request, the insured or his legal representative makes available for inspection the vehicle which the insured was occupying at the time of the. accident; "insured highwr y vehu It" means a highway vehicle to which the bodily injury liability coverage of the policy applies and which is: (a l described m the schedule as an insured highway vehicle; (b) being used tempo-anly as a substitute for an insured highway vehicle as described in subparagraph (a) above, when withdrawn from non al use because of its breakdown, repair, servicing, loss or destruction; or (c being operated by the named or designated insured or, if a resident of the same household, a relative of either; but the term "insured highway vehicle" shall not include: (i i z vehicle while uW as a public or lively conveyance, unless such use is specifically declared and described in the policy; (iij a vebicir while being used without the permission of the owner; (iii under su! paragraphs (b) and (c) above, a vehicle owned by the named insured, any designated insured o t any resident of the tam* household.as the named or designated insured; or (iv) under tubparagrephs (b) and (c) above, a vehicle furnished for the regular use of the named insured or any resident of the same household , -`'named insured" means the individual named in Item 1 of the declarations and also includes his spouse, if a resident of the same household, ``occupying" means in or upon or entering into or alighting from; 3'state" include* the District of Columbia, a territory or possession of the United States, and a province of Canada; ^`uninsured highway vehicle" means: (a) .- (b) a highway vehicle with respect to the ownership, maintenance or use of which there is, in at least the amounts specified bv the financial responsibility law of the state in which the insured highway vehicle is principally garaged no bodily injury liability bond or insurance policy applicable at the time of the accident with respect to any person or organization legally responsible for the use of such vehicle, or with respect to which there is a bodily injury liability bond or insurance policy applicable at the t.me of the accident but the company writing the same denies coverage thereunder or is or becomes insolvent; or a hii-ard-run vehicle; but the term "uninsured highway vehicle" shall not include: (i) ar. in.u red highway vehicle, (li) a highway vehicle which is owned or operated by a self-insurer within the meaning of any motor vehicle financial responsibility Irw, motor caixier law or any similar law, (iii) a highway vehicle which is owned by the United States of America, Canada, a state, a political subdivision of any such govern ment or an agency of any of the foregoing. VI. ADDITIONAL CONDITIONS A. Policy Provisions. None of the Insuring Agreements, Exclusions, Conditions or other provisions of the policy shall apply to the insurance afforded by this endorsement except the Conditions "Notice" (or "Notice of Accident" or "Insured's Duties in Event of Occurrence, Claim or Suit'), "Changes," "Assignment," "Cancellation" and "Declarations." B. Premium. If during the policy period the number of insured highway vehicles owned by the named insured or the number of dealer's "^nse P's**5 '"usdt0 the named insured changes, the named insured shall notify the company during tie policy period of any change and the premium shall be adjusted in accordance with the manuals in use by the company. If the earned premium thus computed exceeds the advance premium paid, the named insured shall pay the excess to the coBt(NBHr if the company shall return to the named insured the unearned portion paid by such insured. ^. - C. Proof ,of Claim. .-/.*>&? As soon as practicable, the insured or other person making claim shall give to the company nrithtanroof of claim, under oath j, rp3uired. ingluding full particulars of the nature and extent of the injuries, treatment, and other details entering into the determination of the amount payable hereunder. The insured and every other person making claim hereunder shall submit to examinations under oath by any person named by the company and subscribe the same, as often a* may reasonably be required. C-1Z9S0 (Continued on Page 3) 18340 AID 005186 Q ->wsi.-9ii4-7a Proof of claim shall be made upon forms furnished by the company unless the company shall have failed to furnish such forms IS days after receiving notice of claim. The igjdred p"wm submit to physical examinations by physicians selected by the company when and as often as the comfwsy may reasonably require ana he, or in the event ol his incapacity his legal representative, or in the event of his death his k$al representative or the person or persons entitled to sue therefor, shall upon each request from the company execute iuthcRcatioa townaWe the company to obtain medical reports and copies of records. D. Amoatnea and Cooperation of the Insured. After WJtfce of churn under this insurance, the company may require the insured to take such action as may be necessary or appropriate to preserve his right to recover damages from any person or organization alleged to be legally responsible for the bodily injury : and in any action against the company, the company may require the insured to join such person or organization as a party defendant. E. notice of Legal Action. If, before the company makes payment of loss hereunder, the insured or his legal representative shall institute any legal action far bodily injury against any person or organization legally responsible for the use of a highway vehicle involved in the accident, a copy of the summons and complaint or other process served in connection with such legal action shall be forwarded immedi ately to the company by the insured or his legal representative. F. Other Iwmnnce. With respect to bodily injury to an insured while occupying a highway vehicle not owned by the named insured, this insurance shall apply only as excess insurance over any other similar insurance available to such insured and applicable to such vehicle as primary insurance, and t his insurance shall then apply only in the amount by which the limit of liability for this coverage exceeds the applicable limit of liability of such other insurance. Except as provided in the foregoing paragraph, if the insured has other similar insurance available to bim and applicable to the accident, use damages shall be deemed not to exceed the higher of the applicable limits of liability of this insurance and such other insurance, and the company shall not be liable lor a greater proportion of any loss to which this coverage applies than the limit of liability hereunder bears to the sum of the applicable limits of liability of this insurance and such other insurance. G. AiMfratioa. If any person making claim hereunder and the company do not agree that such person is legally entitled to recover damages from the owner or operator of an uninsured highway vehicle because of bodily injury to the insured, or do not agree as to the amount of payment which may be owing under this insurance, then, upon written demand of either, the matter or matters upon which such person and the company do not agree shall be settled by arbitration, which shall be conducted in acconSnce with tile rules of the American Arbitration Association unless other means of conducting the arbitration are agreed to between, the insured and the company, and judgment upon the award rendered by the arbitrators may be entered in any court heriag jurisdiction thereof. Such person and the company each agree to consider itself bound and to be bound by any award max*by the arbitrators pursuant to this insurance. If agreement by arbitration is not reached within three months from date erdemand, the insured or his legal representative may institute any legal action for bodily injury against any person or organization legally responsible for the use of a highway vehicle involved in the accident. H. That Agreement. In the event of payment to any person under this insurance: (a) thecompany shall be entitled to the extent of such payment to the proceeds of any settlement or judgment that may result from the exercise of any rights of recovery of such person against any person or organization legally responsible for the bodily injury because of which such payment is made; (b) wich person shall hold in trust for the benefit of the company all rights of recovery which he shall have against such other person or organization because of the damages Which are the subject of claim made under this insurance; -(c) each person shall do whatever is proper to secure and shall do nothing after lass to prejudice such rights; (d) if requested in writing by the company, such person shall take, through any representative designated by the company, such action as may be necessary or appropriate to recover such payment as damages from such other person or organiza tion, such action to be taken in the name of such person; in the event of a recovery, the company shall be reimbursed out . of such recovery for expenses, costs and attorneys' fees incurred by it in connection therewith; (e) stjchperson shall execute and deliver to the company such instruments and papers as may be appropriate to secure the rights and obligations of such person aind the company established by this provision. I.' Payment of Lena by the Company. Anyamounl: due hereunder is payable (a) to the insured, or (b) if the insured be a minor to his parent or guardian, or (c) ^the insured be deceased to his surviving spouse, otherwise (d) tb a porsajfiautborized by tew to receive such payment or to a person legally entitled to recover the damages which the ptymeritrepreamU; provided* rise rraupany may at ifx option pay any amount due hereunder in accordance with division (d) hereof. J. Action Against Company. No action shall lie against the company unless, as a condition precedent thereto, the insured or his legal representative has fully complied with all the terms of the policy applicable to this insurance. K. This endorsement replaces any other provisions of the policy, including any endorsement forming a part thereof, affording similar insurance with respect to any damages arising out of the ownership, maintenance or use of an uninsured vehicle or a hit-and-run vehicle. THE CHARTER OAK FIRE INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY ' C-129S0 raiinin i.i A 10-68 (HS40M) Secretary ' Secretary 18340 AID 005187 PROTECTION AGAINST UNINSURED MOTORISTS INSURANCE (New Jersey) : ilflJii'fil'iT. . :;) ,;f j I n consideration of the payment of premium and subject to all of the provisions of this endorsement and to the applicable provisions of the policy, the company agrees with the named insured as follows: SCHEDULE Designated Insured Limits of Liability: Advance Premium $ Bodily Injury 110,000 each person $20,000 each accident Property Damage $ 5,000 each accident INCLUDED IN COMPOS ITE Description of Insured Highway Vehicles: Any highway vehicle registered or principally garaged in New Jersey which is: (Check appropriate box) CTA'n owned automobile under Part I of the policy Q A private passenger automobile owned by the named insured Owned by the named insured Designated in the declarations of the policy by the letters "UM" and any highway vehicle of the same type ownership of which is acquired during the policy period by the named insured as a replacement therefor G Any mobile equipment owned by the named insured I'O,------ .------- " Amending Policy No_ :: ' I. UNINSURED MOTORISTS COVERAGE (Damages for Bodily Injury and Property Damage Canted by Uninsured Highway Vehicle*) * V The company will pay all sums which the insured or his legal representative shall be legally entitled to recover as damages fcpm the owner or operator of an uninsured highway vehicle because of bodily injury or property damage, caused by accident and arising out of the ownership, maintenance or use of such uninsured highway vehicle; provided, for the purposes of this coverage, determination ait to whether the insured or such representative is legally entitled to recover such damages, and if to the amount thereof, shall be triade by agreement between the insured or such representative and the company or, if they fail to agree, by arbitration, fto judgment against any person or organization alleged to be legally responsible for the bodily injury or property damage shall be conclusive', as between the insured arta the company, of the issues of liability of such person or organization or of the amount of damages to which the insured is legally entitled unless such judgment is entered pursuant to an action prosecuted by the insured with the written consent of the company. Exclusions This insurance does not apply: > (a)1 to bodily injury or property damage with respect to which the insured, his legal representative or any person entitled to pay ment under this insurance shall, without written consent of the company, make any settlement with any person or organization who may be legally liable therefor; ;b) to bodily injury to an insured while occupying a highway vehicle (other than an insured highway vehicle) owned by the named insured, any designated insured or any relative resident in the same household as the named or designated insured, or through being struck by such a vehicle, but this exclusion does not apply to the named insured or his relatives while occupying or if struck by a highway vehicle owned by a designated insured or his relatives; ip) to property contained in or struck by a highway vehicle (other than an insured highway vehicle) owned by the named insured, i any designated insured or any relative resident in the same household as the named or designated insured, but this exclusion does not apply to property of the named insured or his relatives while contained in or struck by a highway vehicle owned by a designated insured or his relatives; (d) sjbjiss to inure directly or indirectly to the benefit of any workmen's compensation or disability benefits carrier or any person Oforganization qualifying as a self-insurer under any workmen's compensation or disability benefits law or any similar law; (e) to the first SitiO of the amount of property damage to the property of each insured as the result of any one accident; (f) sj1 as to inure directly or indirectly to the benefit of any insurer of property; (g) to property damage arising out of the ownership, maintenance or use of a hit-and-run vehicle. .'Hi. PERSONS INSURED Each of the following is an insured under this insurance to the extent set forth below: (a) the named insured and any designated insured and, while residents of the same household, the spouse and relatives of either: (b) any other person while occupying an insured highway vehicle; and (c) any person, with respect to damages he is entitled to recover because of bodily injury to which this insurance applies sustained by an insured under (a) or (b) above. The i tsurance applies separately with respect to each insured, except with respect to the limits of the company's liability. 111. LIMITS OF LIABILITY v Regardless of the number of insureds under this insurance, the company's liability is limited as follows: fa) [The limit of bodily injury liability stated in the schedule as applicable to "each person" is the limit of the company's liability Ilor all damages because of bodily injury sustained by one person as the result of any one accident and, subject to the above [Provision respecting ` each person ', the limit of liability stated in the schedule as applicable to "each accident" is the total jjlimtt of the company s liability for all one accident. damages because of bodily injury sustained by two or more persons as the result of an> (Continued on pape Z) 18771 AID 005188 P*g*2 rt,) i is fc) `.n) (d) Tj,e limit of property damage liability stated in the schedule is the total limit of the company's liability for all damages because of property damage to all property of one or more insureds as the result of any one accident. Any amount payable under the terms of this insurance because of bodily injury or property damage sustained in an accident by a person who is an injured shall be reduced by (!) all sums paid on account of such bodily injury or property damage by or on behalf of (i) the owner or operator of the uninsured highway vehicle and (ii) any ocher person or organization jointly or severally liable together with such owner or operator for such bodily injury or property damage, including all sums paid under the bodily injury or property damage liability coverage of the policy, and (2) the amount paid and the present value of all amounts payable on account of such bodily injury under any workmen's compensation law, disability benefits law or any similar law. Any payment made under this insurance to or for any insured shall be applied in reduction of the amount of damages which be may be entitled to recover from any person insured under the bodily injury dr ppperty damage liability coverage of the m (e)i The company shall not be obligated to pay under this insurance that part of the damages which the insured may be entitled to recover from the owner or operator of an uninsured highway vehicle which represents expenses for medical services paid or payable under the medical payments or medical expense coverage of the policy or which represents loss paid or payable to the insured under any automobile physical damage insurance of the policy. IV. POLICY PERIOD; TERRITORY (This insurance applies only to accidents which occur during the policy period and within the United States of America, its territories ( or possessions, or Canada. V. ADDITIONAL DEFIKITIOIfS When used in reference to this insurance (including endorsements forming a part of the policy): "bodilyinjury" means bodily injury, sickness or disease, including death, sustained by an insured under (a) or (b) of the Persons Insured provision; "designated insured" means an individual named in the schedule under Designated Insured and also include* hi* (pouse, if a resi dent of the same household; "highway vehicle" means a land motor vehicle or trailer other than (a) a farm type tractor or other equipment designed for use principally off public roads, while not upon public roads, (b) a vehicle operated on rails or crawler-treads, or (c) a vehicle while located for use as a residence or premises; ^ "hit-and-run vehicle" means (i) a highway vehicle which causes an accident resulting in bodily injury to an insured arising out of ; physical contact of such vehicle with the insured or with a vehicle which the insured is occupying at the time of the accident, or i (ii) a highway vehicle which without physical contact with the insured or with a vehicle which the insured is occupying at the time of the accident causes bodily injury to an insured arising out of an accident in New Jersey, provided: (a) there cannot be ascertained the identity of either the operator or owner of such highway vehicle; and (b) the insured or someone on his behalf shall have reported the accident within' 48 hours to a police, peace or judicial officer or to the Commissioner of Motor Vehicles, and shall have filed with the company within 30 days thereafter a statement under oath that itHei insured nor his legal representative has a cause or causes of action arising out of such accident for damages against a person onpenions whose identity is unascertainable, and setting forth the facts in support thereof; and (c) at the (Company's request, the insured or his legal representative makes available for inspection the vehicle which the insured - was occupying kt the time of the accident; and (d) with respect tolsubdivision (ii) the facts of such accident can be corroborated by competent evidence other than the testimony of any person having a claim under this or any other similar insurance as the result of such accident; "insured highway vehicle" means a highway vehicle: (a) described in the schedule as an insured highway vehicle to which the bodily injury and property damage liability coverage of the policy applies; (b) while,' temporarily used as a substitute for an insured highway vehicle as described in subparagraph (a) above, when withdrawn froml normai use because of its breakdown, repair, servicing, loss or destruction; (c) while being operated by the named or designated insured or by the spouse of either if a resident of the same household; but the term "insured highway vehicle" shall not include: (i) a vehicle while used as a public or livery conveyance, unless such use is specifically declared and described in the policy; (ii) a velude wdkile being: used without the permission of the owner; (iii) iindter,'subparagraphs (b) and (c) above, a vehicle owned by the named insured, any designated insured or any resident of the ssmeihouMhwaias the named or designated insured; or (iv) under subparagraphs (b) and (c) above, a vehicle furnished for the regular use of the named insured or any resident of the same household; "named insured" means the individual named in item 1 of the declarations and also includes his spouse, if a resident of the same household; "occupying" means in or upon or entering into or alighting from; "property;damage" means injury to or destruction of (i) an insured highway vehicle owned by the named insured or his spouse, if a resident1)of the same household, (ii)j any property owned by an insured under (a) or (b) of the Persons Insured provision while contained, in such insured highway yebicle and (iii) any property owned by an insured under (a) of the Persons Insured provision while contained in any insured highway vehicle; "state" (includes the DistrKt of Columbia, a territory or possession of the United States, and a province of Canada; "uninsured highway vehiCTi" means: * (a) a highway vehicle with respect to the ownership, maintenance or use of which there is, in at least the amounts specified by tf^e financial responsibility lay,' of the state in which the insured highway vehicle is principally garaged, no bodily injury and property damage liability bond or insurance policy applicable at the time of the accident with respect to any person or organization legally responsible for the use of such vehicle, or with respect to which there is a bodily injury and property damage liability bond or insurance policy applicable at the time of the accident but the company writing the same denies coverage tljereunoer or is or becomes insolvent; or C-1J7W (Continued on page 3) 18771 AID 005189 i s. - ; i ' .. i -i ; ! .* I I 1 ] ! } I * 1 J I ! i Jr r.-lT T-fr-4SL-92224-72 Page 3 hit-and-run vehicle, but only with respect to bodily injury caused thereby; but the term "uninsured highway vehicle" shall not include: (i) an insured highway vehicle, (ii) a highway vehicle which it owned or ooerated by a self-insurer within the meaning of any motor vehicle financial responsibility Uw, motor carrier isw or sny similar Uw, (iii) a highway vehicle Which is owned bv the United States of America, Canada, a state, a political subdivision of any such govern ment or an a(wcy of any <rf the foregoing. VI. ADDITIONAL CONDITIONS A. Policy Prorieigaa. None of the Insuring Agreements, Exclusions, Conditions or other provisions of the policy shall apply to the insurance afforded by this endorsement except the Conditions "Notice" (or "Notice of Accident" or "Insured's Duties in Event of Occurrence, * Claim Of Suit"), "Changes," "Assignment,' ' "Cancellation" and "Declarations" B. Premium. If during the policy period the number of insured highway vehicles owned by the named insured or spouse or the number of deeder'eTicense places issued to the named insured changes, the named insured shall notify the company during the policy period of any change and the premium shall be adjustedjn accordance with the manuals in use by the company. If the earned premium thus computed wnwHt the advance premium paid, the named insured shall pay the excess to the company; if less, the com pany shall return to the named insured the unearned portion paid by such insured. C Proof at Claim. A* soon as practicable, the insured or other person making claim shall give to the company written proof of claim, under oath if required, including full particulars of the nature and extent of the injuries, treatment, and other details entering into the determination of the amount payable hereunder. The insured and every other person making claim hereunder shall submit to examinations under oath by any person named by the company and subscribe the same, as often as may reasonably be required. Proof of daim shall be made upon forms furnished by the company unless the company shall have failed to furnish such forms `within 15 days after receiving notice of claim. The injured person shall submit to physical examinations by physicians selected by the company when and as often as the company may reasonably require and he, or in the event of his incapacity his legal representative, or in the event of his death his legal representative or the person or persons entitled to sue therefor, shall upon each request from the company Macule authorization to enable the company to obtain medical reports and copies of records. & The insured or other person making claim for damage to property shall file proof of loss with the company within sixty days after the occurrence of loss, unless such time is extended in writing by the company, in the farm of m sworn statement setting forth the interest of the insured and of all others in the property affected, any encumbrances thereon, the actual cask value thereof at time of loss, the amount, place, time and cause of such loss, and the description and amounts of all other insurance covering such property. Upon the company's request, the insured shall exhibit the damaged property to the company. D. Aatiatance end Cooperation Of the Insured. After notice of claim under this insurance, the company may requite the insured to take such action as may be necessary or appropriate to preserve his right to recover damages from any person or organization alleged to be legally responsible for the bodily injury or property damage; and in any action against the company, the company may require the insured to join such person or organization as a party defendant. E. Notice of Legal Action. If, before the company makes payment of loss hereunder, the insured or his legal representative shall institute any legal action far bodily injury or property damage against any person or organization legally responsible for tbe use of a highway vehicle involved in the accident, a copy of the summons and complaint or other process served in connection with such legal action hall be forwarded immediately to the company by tbe insured or his legal representative. F. Other Insurance. With respect to bodily injury to an insured while occupying a highway vehicle not owned by the named insured, this insurance sha.ll apply only as excess insurance over any other similar insurance available to such insured and applicable to such vehicle as primary insurance, and this insurance shall then apply only in the amount by which the limit of liability for this coverage exceeds the applicable limit of liability of such other insurance. Except as provided in the foregoing paragraph, if the insured has other similar insurance available to him and applicable to the accident, the damages shall be deemed not to exceed the higher of the applicable limits of liability of this insurance and such other insurance, and the company shall not be liable for a greater proportion of any loss to which this coverage applies than the limit at liability hereunder bean to the sum of the applicable limits of liability of this insurance and such other insurance. Wjth respect to property damage, the insurance hereunder shall apply only as excess insurance over any other valid and col lectible insurance of any kind applicable to such property damage, and this insurance shall apply only in the amount by which tbe limit of liability for this coverage exceeds the amount recoverable under such other insurance. G. Athtentinw. If any person making claim hereunder and tbe company do not agree that such person is legally entitled to recover damages from the owner or operator of an uninsured highway vehicle because of bodily injury or property damage to the insured, or do hot agree as to the amount of payment which may be owing under this insurance, then, upon written demand of either, the matter or matters upon which such person and the company do not agree shall be settled by arbitration, which shall be con ducted in accordance with the rules of the American Arbitration Association unless other means of conducting the arbitration are agreed to between the insured and the company, and judgment upon the award rendered by the arbitrators may be entered in any court having jurisdiction thereof. Such person and the company each agree to consider itself bound and to be bound by any award made by the arbitrators pursuant to this insurance. H. Treat Agreement. In the event of payment to any person under this insurance: (a) the company shall be entitled to the extent of such payment to the proceeds of any settlement or judgment that may result from the exercise of any rights of recovery of such person against any person or organization legally responsible for the bodily injury or property damage because of which such payment is made; (b) such person shall hold in trust for the benefit of the company all rights of recovery which he shall have against such other PSrstwi p* organization because of the damages which are the subject of claim made under this insurance; fc) such person shall do whatever is proper to secure and shall do nothing after loss to prejudice such rights; (Continued on pap 4) 18771 AID 005190 wo Pi(e4 (d) if requested in writing by the company, such person shall take, through any representative designated by the company, such action as may be necessary or appropriate to recover such payment at damages from such other person or organi zation, such action to be taken in the name of such person; in the event of a recovery, the company shall be reimbursed out of such recovery for expenses, costs and attorneys' fees incurred by it in connection therewith; (e) such person shall execute and deliver to the company such instruments and papers as may be appropriate to secure the rights and obligations of such person and the company established by this provision. I. Payment of Lotts by the Company. Any amount due hereunder is payable (a) to the insured, or (b) if the insured be a minor to his parent or guardian, or (c) if the insured be deceased to his surviving spouse, otherwise (d) to a person authorized by law to receive such payment or to a person legally entitled to recover the damages which the payment represents; provided, the company may at its option pay any amount due hereunder in accordance with division (d) hereof. J. Actios Against Company. No action shall lie against the company unless, as a condition precedent thereto, the insured or his legal representative has fully complied with all the terms of the policy applicable to this coverage. K. This endorsement replaces any other provisions of the policy, including any endorsement farming a part thereof, affording similar insurance with respect to any damages arising out of the ownership, maintenance or use of an uninsured vehicle or a hit-and-run vehicle. THE CHARTER OAK FIRE INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY c-urn in u .s .a . Kev. i-ro r18771 AID 005191 Effective iram- ( T-RfcSL-022224-' the time of day the policy become* effective. Amending Policy No. Issued to. 00. uac oma NOU ' . * AST "V * 1 ODQC ------------------ MOO. Jwi ^ i-.MOOK OD UJC. ON ri^iw,n----------------- fK (The inform*tjoa provideff^CjfAbove, except the policy number, is required to be stated only when this endorsement is issued for attachment to - the policy subsequent to its effective date.) It it agreed that a* of the effective date hereof the policy is amended in the following particulars: EXCLUSION OP COVERAGE FOR POLLUTION Such Insurance as is afforded by the provisions of the policy relating to liability insurance (other than comprehensive personal Insurance and such insurance as is afforded with respect to the ownership, maintenance or use, including loading or unloading, of any automobile) does not apply to bodily injury or property damage arising out of any emission, discharge, seepage, release or escape of any liquid, solid, gaseous or thermal waste or pollutant. c. Th e Tr a v e l e r s In s u r a n c e Co mp a c t ' Secretary 010747 (Large) 2*4S min t e d in t71 Th e Tr a v e l e r s In d e mn it y Co mp a n y r Countersigned by Secretary ^ Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y X Secretary 4. * a id 005192 (\j- t -r n s l - DECLARATIONS SCHEDULE--General Liability Hazard* No- 1 The letters "MP" wherever used in this schedule shall mean Premium for Premises Medical Coverage" columns "BI" means "Bodily Injury Liability" and "PD' means "Property Damage Liability". In the Rates and Advance Premil Location of all premise* owned by. rented to or controlled by the named insured (Enter "same" if same location as address shown in Item 1 declarations): SEE END 8000(C) Interest of named insuredm such premises (Describe interest, such as "owner", "general lessee" or "tenant'): Part occupied by named insured: rnTnfnihenmw* fimnemi T.ihiliry Insurance. unless otherwise stated herein: The following disclose* all hazards insured hereunder known to exist at the effective date of this pol Description of Hazard* A ' rVemwet- Opemtiooit B--Efevtton C--Eaceiator* D--Independent Contractor* E--Completed Operation* F--Prodoct* EXCESS LIMITS CHARGE SEE END 8000(C) Code No. Premium Baaea* Rates BI j M> A--Area B--FnU|e C--Remuneration D--No. Ituured E--No. lotured F --Coat G--Receipt* H--Receipt* J --AdmiMkm* A --Per 100 Sq. Ft. of Area B--Per Linear Foot C--Per $100 of Remuoer- D--Each or unit* E--Per T<nrimj F --Per $100 of Coat G--Per $1000 of Receipt* H--Per $100 of Receipt* 1 --Per $1000 of Sake j --Per 100 Admieaaon* Advance Premium BI , jD '(ONE'"TEAR 9390 t 35 ^3 TO BE DETERMINED Minimum Premiums i Premises Operations BI PD Independent Contractors BI PD Products BI PD C-I410I e*70 Hurnm.u (Vee rrrtJh Car. P*rt* Li, 9,10, H, IS, 14. 25) See over far Description of Presniam Bases AID 005193 DESCRIPTION OF TERMS USED AS PREMIUM BASES: t When used as a premium basis: 1. "remuneration" means the entire remuneration earned during the policy period bv proprietors and by all employees of the named insured; other than chauffeurs (except operators of mobile equipment) and aircraft pilots and co-pilots, subject to any overtime earnings or limitation of remuneration rule applicable in accordance with the manuals in use by the company; 2. "coat" means the total cost to the named insured with respect to operations performed for the named insured during the policyperiod by independent contractors of all work let or sub-let in connection with each specific project; including the cost of all labor, materials and equipment furnished, used or delivered for use in the execution of such work, whether furnished by the owner, contractor or subcontractor, including all fees, allowances, bonuses or commissions made, paid or due; .1. "receipt*" means the gross amount of money charged by the named insured for such operations by the named insured or byothers during the policy period as are rated on a receipts basts other than receipts from telecasting, broadcasting or motion pictures, and includes taxes, other than taxes which the named insured collects as a separate item and remits directly to a govern mental division; 4. "tales" means the gross amount of money charged by the named insured, by concessionaires of the named insured, or by others trading under his name for all goods and products sold or distributed during the policy period and charged during the policyperiod for: installation, servicing or repair, and includes taxes, other than taxes which the named iasured, concessionaires of the named insured and others trading under his name collect as a separate item and remit directly to a governmental division. The sales of tenants shall not be included. Any concessionaire who operates under his own trade name and whose premises are physically separated from the lessor's,premises shall be considered a tenant. 5. ``admissions'' means the total number of persons, other than employees of the named insured, admitted to the event insured or to events conducted on the premises whether on paid admission tickets, complimentary tickets or passes. C-- :> C-14101 (BACK) rv AID 005194 DECLARATIONS SCHEDULE--Automobile Liability Hazard* No___ l_ R (\ ' T->^'SL- 922224 - n Policy No. In the Rates and Advance Premium columns "BI" means "Bodily Injury Liability", "PD" means "Property Damage Liability" and "Med. Pays.' means "Division 1. Medical Payments". 1. Owned AntomobUat - Description of Hazards Premium Basis--Per Automobile Adruc* Premium mi ; PD EFF JAN l 1972 Mad. Pmt%. END 8000(C) EXCEPT TX A VA See other Declarations Schedule(s)--Automobile Liability Hazards TX VA TO BE DETERM MED 2. Hirsd Automobiles Premium Basis--Cost of Hiret Types Hired Lecatioat Whoro Aetomobfl** VUl Be Priwapallj Used Pttf|WII u* Medical Payments___ % Sctimatod Bates ser *100 Cost et Hire Cot ot Hire BI PD SEE END 8000(C) INCLUDED 3. Non-Owned AutomobilesPremium Basis--Class 1 Persons and Class 2 Employees! Ckw t P*nwo Ham si Back of Pinum Hu b i4 Hereto Rote* p*r Persoa BI PD Mod. Pays. SEE END 8000(C) - INCLUDED CliM 2 Smpioy***-- EaCunatod A?uif Htuxabor of CUm 2 Employ*** Ritei per Employe* BI PD SEE END 8000(fJ SEE END A6l00 5 END 9950 INCLUDED NCLUDF.D iNC . 'Tbe purposes of use of the automobile are "Pleasure and Business" unless otherwise stated. The abbreviation "C" in the "Purposes of Use" colui shall mean "Commercial." the abbreviation "C-LT" shall mean " Commercial^ Local Truckman)" and the abbreviation "C-LHT" shall me Commercial-(Long Haul Truckman)." __________ ________ ________________________________________________________________ C-III77 3-71 n.ii[iiiii< HSL. ItSL-BA, BL OSL, OSL-PA, OBL. HV 271 fSee over for Description of Premium Bases 85 AID 005195 DESCRIPTION OF TEEMS USED AS PREMIUM BASES: When Died as a premium basic A. "cost el hire" means the amount incurred for (a) the hire of automobiles, including the entire remuneration of each employee of the named insured engaged in the operation of such automobiles subject to an average weekly maximum remuneration of $100: and for (b) pick-up, transportation or delivery service of property or passengers, other than such services performed by motor carriers which are subject to the security requirements of any motor carrier law or ordinance. The rates for each $100 of "cost of hire" shall be 5% of the applicable hired automobile rates, provided the owner of such hired automobile has purchased automobile Bodily Injury: Liability and Properly Damage Liability insurance covering the interest of the named insured on a direct primary basis as respects such automobile and submits evidence of such insurance to the named insured; B. "Claw 1 persons" means the following persons, provided their usual duties in the business of the named insured include the use of non-ownedautomobiles: (a) all employees, including officers, of the named insured compensated for the use of such automobiles by salary, commission, terms of employment, or specific operating allowance of any sort; (b) all direct agents and representatives of the named insured; C. "Class 2 employees" means all employees, including officers, of the named insured, not included in Class 1 persons. r AID 005196 (E> PROTECTION AGAINST UNINSURED MOTORISTS INSURANCE (New Mexico) ' j- . T-RNSL-9^2224-72 In coneUWatiefe^M tbelp^Qiiiot of premium end subject to ell of the provision* of this endorsement end to the applicable provisions of the policy, the cotapeoy^tra_ytii the named insured as follosrt: ` ' '.' 'TrttV.s- ' . v- SCHEDULE Designated Insured:. Titles of Liability: Adv^itauWs Bodily Injury Property Damage INCLUDED $10,000 each person $20,000 each accident $ .5,000 each accident IN COMPOSITE Description of Insured Highway Vehicles: Any highway vehicle registered or principally garaged in New Mexico which is: y (Check appropriate box) An owned automobile under Part I of the policy A private passenger automobile owned by the named insitred _ . ,. y Q Owned by the named insured ' '' ` 01..... Designated in the declarations of the policy by the letters 'TIM" sod any highway vehicle of the same type ownership of which is acquired during the policy period by the named insured as a replacement therefor 0 Any mobile equipment owned by the named insured , , -.-'Jt-t.r .-N UNINSURED MOTORISTS COVERAGE - ' *** .t j (Damagsa for Bodily Injury and Property Damage Caussd by Uninsnrsd Highway Vsfcidet) -,:r The company will pny all sums which the insured or his legal representative shall be legallyentitled sewcovers* damages from the owner or operator of an uninsured highway vehicle because of bodily injury orproperty damage, caused by-accident and arising out of the ownership, maintenance or use of Such uninsured highway vehicle; provtdea, far the purposes of this coverage, determination as to whether toe insured or such representative is legally entitled to recover such damages, and if so theamount thereof, shall be made by agreement between the insured or such representative and the company or, if they fail to agree; by arbitration. No judgment against any person or organization alleged to be legally responsible for the bodily injury or property damage shall be conciUHve, at between the insured and the company, of the issues of liability of such person or organisation or of the amount of damages to which the insured is legally entitled unless such judgment is entered pursuant to an action prosecuted by the insured with toe written consent of the company. This insurance does not apply: (a) to bodily injury or property damage with respect to which the insured, his legal representative or any person entitled to payment under this insurance snatl, without written consent of the company, male any settlement with any person or organization who may be legally liable therefor; (b) to bodily injury to an insured while occupying a highway vehicle (other than an insured highway vehicle) owned by die named insured, any designated insured or any relative resident in the same household as the named or designated insured, or through being struck by such a vehicle, but this exclusion does not apply to the named insured or his relatives while occupying or if struck by a highway vehicle owned by a designated insured or his relatives; (c) to property contained in or struck by a highway vehicle (other than an insured highway vehicle) owned by the named insured, any designated insured or any relative resident in the same household as the named or designated insured, but this exclusion does not apply to property of the named insured or his relatives while contained in or struck by a highway vehicle owned by a designated insured or his relatives; (d) so as to inure directly or indirectly to the benefit of any workmen's compensation or disability benefits carrier or any person or organisation qualifying as a self-insurer under any workmen's compensation or disability benefits law or any similar law; (e) to the first $330 of the amount of property damage to the property of each insured as the result of any one accident; (!) so au to kunejdirec&y or indirectly to the benefit of any insurer of property. II. PERSONS INSURED Each of the following is an insured under this insurance to the extent set forth below: (a) the: named insured and any designated insured and, while residents of the same household, the spouse and relatives of either; (b) any other person while occupying an insured highway vehicle; and (c) any person, with respect to damages he is entitled to recover because of bodily injury to which this insurance applies sustained by an insured under (a) or (b) above. The insurance applids separately with respect to each insured, except with respect to die limits of the company's liability. III. LIMITS OP LIABILITY Regardless of the number of insureds under this insurance, the company's liability is limited as folknrs: (a) The limit cif bodily injury liability stated in the schedule as applicable to "each person" is the limit of the company's liability for all damages because of bodily injury sustained by one person as the result of any one accident and, subject to the above provision respecting ''each person." the limit of liability stated in the schedule as applicable to "each accident" is the total limit of the company's liability for all damages because of bodily injury sustained by two or more persons as the result of any one accident, (b) The limit of property damage liability stated in the schedule is the total limit of the company's liability for all damages because of property damage to all property of one or more insureds as the result of any one accident. fContinual on page 2) 17130 N11025.02 AID 005197 Rage 2 (c) Any amount payable under the terms of this insurance because of bodily injury or property damage sustained in an accident by a person who is an insured shall be reduced by (1) all sums paid on account of such bodily injury or property damage by or on behalf of (i) the owner or operator of the uninsured highway vehicle and (u) any other person or organization jointly or severally liable together with Such owner or operator for such bodily injury or property damage, including all sums paid under the bodily injury or property damage liability coverage of the policy, and (2) the amount paid and the present value of all amounts payable on account of such bodily injury under any workmen's compensation law*, disability benefits law or any similar law, (d) Any payment made under this insurance to or for any insured shall be applied in reduction of the amount of damages which he may be entitled to recover from any person insured under the bodily injury or property damage liability coverage of the policy. (e) The company shall not be obligated to pay under this insurance that part of the damages which the insured may be entitled to recover from the owner or operator cit an uninsured highway vehicle which represents expenses for medical services paid or payable under the medical payments or medical expense coverage of the policy or which represents lots paid or payable to the insured under any automobile physical damage insurance of the policy. s IV. POLICY PERIOD; TERRITORY ' This insurance applies only to accidents which occur during the policy period and within the United States of America, its territories or possessions; or Canada. V. ADDITIONAL DEFINITIONS When used in reference to this insurance (including endorsements forming a part erf the policy): "bodily injury'' means bodily injury, sickness or disease, including death, sustained by an insured under (a) or (b) of the Persons Insured provision; "designated injured" means an individual named in the schedule under Designated Insured; "highway vehicle" means a land motor vehicle or trailer other than (a) a farm tvpe trartoi or other equipment designed for use principally off public roads, while not upon public roads, (b) a vehicle operated on rails or crawler-treads, or (c) a vehicle while located for use as a residence or premises; ""hit-and run chicle" means a highway vehicle which causes an accident resulting in bodily injury to an insured orproperty damage arising our of physical contact of such vehicle with the person or property of the insured or with a vehicle which the insured is occupying at tie ture of the accident, provided: fa) there cannot be ascertained the identity of either the operator or owner or such highway vehicle; ,(b) the insured or someone on his behalf shall have reported the accident within 24 hours to a police, peace or judicial dfficer or to the Comauinoaer of Motor Vehicles, and shall have filed with the company within 30 days thereafter a statement under bath tfca1 th insured or his legal representative has a cause or causes of action arising out of such accident for damages against a person <v persons whose identity is lunaacertainabie, and setting forth the facts in support thereof; and , (c) at the company'* request, the insured or his legal representative makes available for inspection the vehicle which the zoomed was occupying at the time of the accident; "insurer! hyrnray vehicle'' means a highway vehicle: .n...-i.:. (a) described in the mhedule as aa insured highway vehicle to which the bodily injury and property damage liability coverage of thr pr-icy apphes; (b) wai'e temporarily used as a substitute for an insured highway vehicle as described in subparagraph (a) above, when withdrawn from mrmal use because of its breakdown, repair, servicing, loss or destruction; _____ (c) while being operated by the named or designated insured or by the spouse of either if a resident of the me household; but the tern "insured highway vehicle" shall not include: (i) a vehicle while used as a public or livery conveyance, unless such use is specifically declared sued described in the policy; ( [vehicle while being uied without, theipermission of the owner; ' (hi) under subparagraphs (b) and (c) above, a vehicle owned by the named insured, any designated insured or any resident of the same household as the aamed or designated insured; or (iv) under subpmagraphs (b) and (c) above; a vehicle furnished for the regular use of the named insured or any resident of the same household; "occupying" mean in or upon or entering into or alighting from; "property damage" means injury to or destruction of (i) an insured highway vehicle owned by the named insured or his spouse, if a resident o' (hr same household,.(ii) any property owned by an insured under (a) or (b) of the Persons Insured provision while container1 in such insured highway vehicle and (iii) any property owned by an insured under (a) of the Persons Insured provision while contained n ary insured highway vehicle; "itate" in dudes (he District of Columbia, a territory or possession of the United States, and a province of Canada; "uninsured highway vehicle" means: (a) a highway vehicle with respect to the ownership, maintenance or use of which there is, in at least the amounts spedfeed by the financial responsibility law of the state in which the insured highway vehicle is principally garaged, no bodily injury and property damage liability bond or insurance policy applicable at the time of the accident with nsisrt In nr prrsnn irrutfint ration legally responsible for the use of such vehicle, or with respect to which there i> W bajtejajwrrwoproperty damage lability bond or insurance policy applicable at the time of the accident but the i iriHfwrgllMTItajiaKrlrnirs coverage thereunder or is or becomes insolvent; or ^ (b) a hit-and-run vehicle; - -Twi.- but the term "uninsured; highway vehicle" shall not include: (i) an insured highway vehicle, -v i.r'-,-., ("' a h-ghway vehicle which is owned or operated bv a self-insurer within the mmniiit nt~ mntr* mAV-U c ,,..mJ.I i i sisinsibiTit I ' law, motoi earner law or any similar law, *r Giij a h^hsrry vehiclewhich is owned by the United States of America, Canada, a state, a-polltical subdivision of any anchifevrenK mentor an agency of any of the foregoing. v<iiiwiirai<siissi9*w|sms-_ .. C4MU (Continued on pof/e 3) AID 005198 UK Q Page 3 VI. ADDITIOHAI. COHDITIOHS T-SNSL-92222S-72 A. Policy Prorisica*. None of the Insuring Agreements, Exclusions. Conditions or other provisions of the policy' shall applv'to the insurance afforded by this endorsement except the C~ond"it'ionsi "1 Notice," "Notice of Accident" or "Insured's Duties m the Event of Loss, Accident or Occurrence^."Changes." "Assignment." "Cancellation" and "Declarations" or "Concealment or Fraud." B. Premium. *?' If during the nOUey period the number of insured highway vehicles owned by the named insured or spouse or the number of deakr'slicense plates issued to the named insured changes, the named insured shall notify the company during the policy period of any change and the premium shall be adjusted in accordance with the manuals in use by the company. If the earned premium thus computed exceeds the advance premium paid, the named insured shall pay the excess to the company; if less, the com pany shall return to the named insured the unearned portion paid by such insured. C. Proof of Clai& As soon as practicable, the insured or other person making claim shall give to the company written proof of claim, under oath if required, including full particulars of the nature and extent of the injuries, treatment, and other details entering into the determination of the amount payable hereunder. The insured and every other person making claim hereunder shall submit to examinations under oath by any person named by the company and subscribe the same, as often as may reasonably be required. Proof of claim shall be made upon forms furnished by the company unless the company shall have failed to furnish such forms within 15 day* after receiving notice of claim. The injured person shall submit to physical examinations by physicians selected by the company when and aa often as the company may reasonably require and he, or in the event of his incapacity his legal representative, or in the event of his death his legal representative or the person or persons entitled to sue therefor, shall upon each request from die company execute authorization to enable the company to obtain medical reports and copies of records. The insured or other person making claim for damage to property shall file proof of lorn with the company within sixty days after the occurrence of loss, unless such time is extended in writing by the company, in the form of a sworn statement setting forth the interest of the insured and of all others in the property affected, any encumbrances thereon, the actual cash value thereof at time of loss, the amount, place, time and cause of Such loss, and the description and amounts of all other insurance covering such property. Upon the company's request, the insured dull exhibit the damaged property to the company..- D. Assistance and Cooperation of the Insured. ^ After notice of claim under this insurance, the company may requite the insured to take such action as may be neceaary or appropriate to preserve his right to recover damages from any person or organisation alleged to he legally responsible jpe the bodily injury or property damage; and in any action against the company, the company may require the insured to jqp such person or organization as a party defendant _ _'AL -: . - . Hotie* at Legal Action. **-?.- -- ~ - "*-. s. If; before the company makes payment of loss hereunder, the insured or his legal representative shall institute any legal action for bodily injury or property damage against any person or organization legally responsible for the use of a highway vehicle involved in the accident, a copy of the summons and complaint or other process served in connection with such legal action shall be forwarded immediate! y to the company by the insured or his legal representative. . F. Other Insurance. With respect to bodily injury to an insured while occupying a highway vehicle not owned by the named insured, this insurance shall apply only as excess insurance over any other similar insurance available to such insured and applicable to such vehicle as primary insurance, and this insurance shall then apply only in the amount by which the limit of liability for this coverage exceeds the applicable limit of liability of such other insurance. Except as provided in the foregoing paragraph, if the insured has other similar insurance available to him and applicable to the accident, the damages shall be deemed not to exceed tffe higher of the applicable limits of liability of this insurance and such other insurance, and the company shall not be liable for a greater proportion of any lorn to which this coverage applies than the limit of liability hereunder bears to the sum of the applicable limits of liability of this insurance and such other insurance. With respect to property damage, the insurance hereunder shall apply only as excess insurance over any other valid and col lectible insurance of any kind applicable to such property damage, and this insurance shall apply only in the amount by which the limit of liability for this coverage exceeds the amount recoverable under such other insurance. G. Arbitration. If any person making claim hereunder and the company do not agree that such person is legally entitled to recover damages Iromi the owner or operator of an uninsured highway vehicle because of bodily injury or property damage to the insured, or do not agree as to the amount of payment which may be oaring under this insurance, then, upon written demand of either, the ; matter or matters upon which such person and the company do not agree shall be settled by arbitration, which shall be con ducted m acoaedanee with the rules of the American Arbitration Association unless other means of conducting the arbitration are agreed to between the insured and the company, aod judgment upon the award rendered by the arbitrators may be entered in any court having jurisdiction thereof. Such person and the company each agree to consider itself bound and to be bound by any award made by the arbitrators pursuant to this insurance. H. Trust Agreement. In the event of payment to any person under this insurance: (a) the company shall be entitled to the extent of such payment to the proceeds of any settlement or judgment that may result from the exercise of any rights of recovery of such person against any person or organization legally responsible for the: bodily injury or property damage because of which such payment is rnade; (b) such person shall hold in trust for the benefit of the company all rights of recovery which he shall have against such other person or organization because, of the damages which are the subject of claim made under this insurance; (c) such person shall do whatever is proper to secure and shall do nothing after loss to prejudice such rights; (d) if requested in writing by the company, such person shall take, through any representative designated by the company, such action as may be necessary or appropriate to recover such payment as damages from such other person or organization. such action to be taken in the name of such person; in the event of a recovery, the company shall be reimbursed 0t of such recovery for expenses, costs and attorneys' fees incurred by it in connection therewith; (e) such person shall execute and deliver to the company such instruments and papers as may be appropriate to secure the rights and obligations of such person and the company established by this provision. (Continued on pa[c 4) 17130 AID 005199 P>(e 4 I. Payment of Lew by the Company. Any amount due hereunder is payable (a) to the insured, or (b) if the insured be a minor to his parent or guardian, or (c) if the insured be deceased to his surviving spouse, otherwise (d) to a person authorized by law to receive such payment or to a person legally entitled to recover the damages which the payment represents; provided, the company may at its option pay any amount due hereunder in accordance with division (d) hereof. J. Action Against Company. No action shall lie against the company unless, as a condition precedent thereto, the insured or his legal representative has fully complied with all the terms of the policy applicable to this coverage. K. This endorsement replaces any other provisions of the policy, including any endorsement forming a part thereof, affording similar insurance with respect to any damages arising out of the ownership, maintenance or use of an uninsured vehicle or a hit-and-run vehicle. THE CHARTER OAK FIRE INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY / Secretary C'12433 rriHTCD in l/.S.A. 1.68 | Secretary 17130 i 1 AID 005200 i- Ek 4* from. at the time of day the polity becomes effective. Amending Policy No. IS^5=1--------------- MOO. - j igi 1 n l ____ LOC. or KltK l 0- #*/ '.* {Th* informatMB ppowvNBRHM MR& cXBB^fc the policy number, is required to be stated only when this endorsement is issued for attachment to T .... the policy subsequent to its effective date.) It is agreed that a* of th* effective date hereof the policy is amended in the following particulars: AMENDMENT OF RET-'OSPtC; -F PREMIUM ENDORSEMENT - P.La N D (MASSACHU:~VTS) iT IS AGREED THAT THE BASiC PREMi. ; PERCENTAGE FOR MASSACHUSETTS COMPULSORY AUTOMOBILE INSURANCE u -WN IN TABLE H OF THE RETRO SPECTIVE PREMIUM EMDO?:SEMK~ -3 YR) PLAN D-4101C FORMING A PART OF THIS POLiCY SHALL CONFORM, AS CF JANUARY 1 EACH YEAR THIS Pa ICY IS IN FORCE, WITH THE TABLE OF vETPOSPECTlVE RATING FACTORS PROMUL GATED BY THE MASSACHUSETTS CCHfci3:-`>;MER OF INSURANCE FOR EACH SUCH YEAR. Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y STM*Ot. NO. Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005201 UMMSUtED MOTORISTS COVERAGE AMEN0MSM7 - CAL1P8IU it is agnail d that: l. vehicle'' includes a highway vehicle with respect to which there fs a bodily injury habilii the time of the accident but the company writing the s t u bs denies coverage thereunder thensanrisr except conditionally or with reservation or euch company is or becomes insolvent. .2 The Aihitntxoa is emended to read as follows: If any person making ill aim under the Uninsured Motorists Coverage and the company do not agree that such person is legally entitled to recover damages from the owner or operator of an uninsured highway vehicle because of bodily injury to the insured, or ilo not agree as to the amount of payment which may be owing thereunder, then, upon written demand of either, the matter or matters upon which such person and the company do not ages* shall be settled by a single neutral arbitrator, and judgment upon the award rendered by the arbitrator may be entered in cay court having jurisdiction thereof. Such person and the company each agree to consider itself bound and to be bound by any sward made by the arbitrator pursuant to this paragraph. THE CHARTER OAK FIRE INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY AID 005202 3sff*lo Philadelphia A Pirtsfcurgh Wilmington Richmond Atlanta Vssr Orleans . Hocrstoa Detroit 'llCJu'tlgOni ! MinngapoLu San Freacisco ii'i&'OS1: Angeles Seattle Portland ....' Hoaolole London Molar Tokro Jo h n s o n c a b u a d o *j c * "k z mo &x *'' TELEX k o aaaooe January 11, 1973 & Hi g g in s [rnie Winnipeg Vrro*T*r Caracas Maracaibo Puerto La Cra* Rio d* Janeiro Sao Paste Baasoc Aires Santiago Lie* Bogota Cab Svdne* Malb'oarna Bnabane Adelaide Perth Auckland Wellington ?r. Y. 10005 TEL- 044 - 3160 AREA CODE 212 Mr. W. G. Daly, Assistant Insurance Manager The Anaconda Company 25 Broadway New York, N.Y.- 10004 Dear Bill: Enclosed is endorsement for attachment to Comprehensive General Liability Policy #TPNSL_922224-72 of the Travelers Insurance Company extending the policy to include coverage for liability assumed under agreement with Chemetron Corporation, Cardox Division effective September 5, 1972. Steven La Porta Casualty Department fc end. AID 005203 frrm . ^______ ;_____at the time of day the policy becomes effective. Amending Policy \o.~------------------- issued t0 ian: xo:^)____ ___________ ____ ____________________________________-- :Date of Issue: ,1 ; - i 0-72 ZT ____________________________________________________________________________ iite i rsa ii^-uo j aguma',TO- dCEKSca * j 1-1^75 tsa? r^3t __________________________________________________________ 1 (The information provided for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: IT IS AG2ES.D 73A.- !SE PQLICI IS ESTES! ETJEHEEB TO IICLD2K CSnSBACE ?<K KASILETT ASSUMED UHDSR A3SS3KB? VITH cmssms c b p o r a-u o i, c abd c * imsi*. Th e Tr a v e l e r s In s u r a n c e Co mp a n y Secretary C-10747 (Large) 2-65 971s s in t e o in u .s .a. Th e Tr a v e l e r s In d e mn it y Co mp a n y Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y Effective from $&i*$ 5 1SS. .at the time of day the policy becomes effective. Amending Policy No.'f5KSL-.?:222i;-:2 -------TH8 AMACOmi. CdPAST ST al. PSF. EES jCOCU) Date of Issue: 11 -1fr72____CKH-------------------- ---------------------------------- r^rn-im UJS00. SSVacns ii "HOoedP l oc. of ICEBSCM * ai&:33 alum. ! AlIiR ! (The information provuMJbr above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: IT IS AflHEXD BIT THS PCLICT IS HEFJKBT gXTKNTKI? TO DICLDIK its.c o t ib a o b msiLm is s c x s d mzR a Sk s mh t w it h GSXEBUX CCBFCRAflCH, CAEJXM HmSXOt. Th e Tr a v e l e r s In s u r a n c e Co mp a n y ' Secretary C-10747 (LriJ 2as unitto in u .s .a. 971 Th e Tr a v e l e r s In d e mn it y Co mp a n y / Countersigned Secretary i> . %o i Jl Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y Secretary AID 005205  *. . . .' . . *'Hrf m "fiK ,i-I iCQiDP cca?Air &.? x* Fsa ;*&, ococu? Date of Issue: 17-10-72 27H 1CO ^ 1 UK ! 5- 1-1 >75 --- SS-KCHTA wuauoielTW : /. los5c.t o f lOSSSOT k aZ&. "ii (The information provider! for above, except the policy number, is required to be stated only when this endorsement is issued for attachment to the policy subsequent to its effective date.) It is agreed that as of the effective date hereof the policy is amended in the following particulars: it is /j 3h es :o ns p o iig i is h et s s y ex j ek eed t o ih c l c u b CTOBIOB WB LXABHJTI ASSUMED SKIS J08ESMBR VUE CIEHmCH C-JRKELvnOI, CAEDCJI HWI3I. Th e Tr a v e l e r s In s u r a n c e Co mp a n y Th e Tr a v e l e r s In d e mn it y Co mp a n y Sy mb o l No Th e Ch a r t e r Oa k Fir e In s u r a n c e Co mp a n y AID 005206