HomeMy WebLinkAboutC-1730(C) - Primary automobile liabilityGENERAL AMENDMENT ENDORSEMEN*
THE POLICY TO WHICH THIS ENDORSEMENT IS ATTACHED 15 HEREBY 'AMENDED BY THE ITEMS MARKED BY
❑ ADDITIONAL PREMIUM (SHOWN BELOW) bK ❑ RETURN PREMIUM (SHOWN BELOW)
❑ AMOUNT OF INSURANCE IS INCREASED BY. f
TO A TOTAL OF f
❑ ITEM(S) LISTED BELOW ADDED TO SCHEDULE
❑ LOCATION SHOWN BELOW ADDED
❑ NAME OF INSURED AS SHOWN BELOW
❑ RATE UNDER THIS POLICY AS SHOWN BELOW
❑ ITEM(S) OF SCHEDULE
AS SHOWN BELOW '
❑ INSURANCE REDUCED BY LOSS OF (DATE)
REINSTATED IN AMOUNT OF f
THIS POLICY AMENDED AS SHOWN BELOW
❑ AMOUNT OF INSURANCE DECREASED BY f
TO A TOTAL OF f -
❑ ITEM(S) LISTED BELOW DELETED FROM SCHEDULE -
❑ LOCATION SHOWN BELOW DELETED
jj
❑����.ADDRESS OF INSURED AS SHOWN BELOW
"fa'fNCEPTION DATE AS SHOWN BELOW
❑ EXPIRATION DATE AS SHOWN BELOW
❑ DESCRIPTION OF. PROPERTY INSURED AS SHOWN BELOW
IN THE EVENT OF CANCELLATION IT IS AGREED CANCELLATION SHALL BE
EFFECTIVE ONLY AFTER 60 DAYS WRITTEN NOTICE OF CANCELLATION, SENT
BY REGISTERED MAIL.
IT IS AGREED PER FORM 100807, AUTOMOBILE PHYSICAL DAMAGE(FLEET AUTOMATIC),
IS AMENDED TO READ AS FOLLOWS.
"ANY ONE COVERED AUTOMOBILE $1001-000."
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
f f
INSTALLMENT PREMIUM PAYMENTS
DATE DUE PRIOR INSTALLMENTS
f f f f
f f f f
ENDORSEMENT TOTAL PREMIUM f f
REVISED INSTALLMENTS
POLICY NUMBER
LA2 2
INSURED
CITY OF NEWPORT BEACH
EFFECTIVE
1 6-25-75
FIREMAN'S FUND INSURANCE COMPANY
PRODUCER
THE AMERICAN INSURANCE COMPANY
NATIONAL SURETY CORPORATION
MILD —GAR INS. BROKERS 12 -1 -75
ASSOCIATED INDEMNITY CORPORATION
G NTERSIGNATU RE OF HO EO ENT
AMERICAN AUTOMOBILE INSURANCE COMPANY
-
i
PRESIDENT 70%
180005 -8 -87 - 1 v
7
"nuclear reactor' means any
c atical mass of fissionabl., tlatevdl;
of radioactive
"property damage' incluL -s all forms . conteminat on of property.
}'AGE FOUR
IlO1 FIRES FUND I
- DECLARATIONS AND PROVISIONS INSURANCE COMPANY
flz THE ANIERWANT
Coverage is provided in the Company designated by number.
Ol a stock insurance Company herein tolled the COmpanyl
ITEM 1.' 'INSUREC•S NAME AND ADDRESS INO, STA"T. TOWN, COUNTY. STATE. zlh
F
THE CITY OP 14EWPOP.T BEACH
3300 Vnl -PORT BLVD.
IIEWPORT BEACH, CA.
INSURANCE COMPANY
. THE NAMED INSURED IS: .. ... ... ... ..
07 NATIONAL SURETY
iIREMA \'S
CORPORATION
AGE PART(S) INDICATED BELOW AND FOR WHICH A PREMIUM CHARGE IS SPECIFIED.
13
13 ASSOCIATED INDEMNITY
AMERICA\
CORPORATION
L.u.A.a rnM...Ia
NOME OFFICE
15 AMERICAN AUTOMOBILE
ux qA GTro
CTUfONNu
INSURANCE COMPANY
. THE NAMED INSURED IS: .. ... ... ... ..
❑ INDIVIDUAL ❑ PARTNERSHIP ❑ CORPORATION ❑ JOINT VENTURE ❑ OTHERI
BUSINESS OF THE NAMED INSURED IS:
ITEM 3. THE INSURANCE AFFORDED UNDER THIS POLICY IS ONLY WITH RESPECT TO THE COVER-
AGE PART(S) INDICATED BELOW AND FOR WHICH A PREMIUM CHARGE IS SPECIFIED.
COVERAGE PART(S)
-
ADVANCE
FORM NUMBER
DESCRIPTION
PREMIUMS)
100804
COVERAGE PART - COMPREHENSIVE AUTOMOBILE. LIABILITY
s 32,318
100807
COVERAGE PART- ALTOMBILE PHYSICAL DAMAGE
4,525
ENDORSEMENTS (IDENTIFY BY FORM NUMBER)
E
180009 - 100956 - 180017
IF POLICY IS SUBJECT TO AUDIT. AUDIT PERIOD SHALL BE ANNUAL. UNLESS
TOTAL
OYHERWISE STATED:
s 36,843 '
I
PREMIUM
IF POLICY PERIOD IS MORE THAN ONE
ON INCEPTION DATE
FIRST ANNIVERSARY
SECOND ANNIVERSARY
I S 361843
I Ii PER 180017 END.
I S
INSTALLMENTSMMEMIUM IIS PAYABLE:
I
THESE POLICY DECLARATIONS AND PROVISIONS, AND COV
AGEPART(S)ANDEN R EMENTS
(IF ANY) ISSUED TO FORM A PART THEREOF.
COMPL
E.THE ABOVE NUM REO POLICY.
DATE OF ISSUE
I
COUNTERSIGNA OF AUTHORIZED AGE NT
7 -16 -75 (jc
5900 -1 -73
(
THE COMPANY DESIGNATED ON THE DECLARATIONS PAGE
In consideration o! the payment of the premium, in reliance upon the statements in the declarations made a part hereof and subject to all
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):
"automobile' means a land motor vehicle, trailer or semi- !railer
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 which occurs during the policy period, including
death at any time resulting therefrom;.
"completed operations hazard" includes bodily injury and property
damage arising out of operations or reliance upon a representation
or warranty made at any time with respect thereto, but only if
the bodily injury or properly damage occurs after such operations
have been completed or abandoned and occurs away from prem:
ises 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 fol-
lowing 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
arises has been put to its intended use by any person or organiza-
tion other than another contractor or subcontractor engaged in
performing operations for a principal as a part of the some project.
Operations which may require further service or maintenance work,
or correction, repair or replacement because of any defect or de-
ficiency, but which are otherwise complete, shall be deemed
complated
The completed operations hazard does not include bodily injury or
property damage arising out of
(a) operations in connection with the transportation of property, un-
less the bodily injury or property damage arises out of a condition
in ar 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
"elevator' means any hoisting or lowering device to connect floors
or landings, whether or not in service, and all appliances thereof
including any cor, platform, shall, hoistway, stairway, runway,
power equipment and machinery; but does not include an automo-
bile servicing hoist, or a hoist without a platform outside a building
if without mechanical power or it not attached to building walls,
or a hod or material hoist used in alteration, construction or demo-
lition 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)
easement agreement, except in connection with construction or
demolition operations on or adjacent to a railroad, (3) undertaking
to indemnity a municipality required by municipal ordinance, ex-
cept in connection with work for the municipality, (4) sidetrack
agreement, or (5) elevator maintenance agreement;
"insured" means any person or organization qualifying as an in-
sured in the "Persons Insured' provision of the applicable insurance
coverage. The insurance afforded applies separately to each in-
sured 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 subject.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 oft public roads, or (4) designed or maintained for 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, rollers
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), but "named insured's products' shall not include a
vending machine or any property other than such container,.rerted
to or located for use of others but not sold;
"occurrence" means an accident, including continuous or repeated
exposure to conditions, which results 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
transportation to or from any other country, state or nation, or
(3) anywhere in the world with respect to damages because of
bodily injury or property 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
arising out of the named insured's products or reliance upon a rep-
resentation or warranty made at any time with respect thereto, but
only it the bodily injury or property damage occurs away from
premises owned by or rented to the named insured and after
physical possession o! such products has been relinquished to
others;
"property damage" means (1) physical injury to or destruction of
tangible property which occurs during the policy period, including
the loss of use thereof at any time resulting therefrom, or (2) loss of
use of tangible property which has rot been physically injured or
destroyed provided such loss of use is caused by an occurrence
during the policy period;
SUPPLEMENTARY PAYMENTS
The Company will pay, in addition to the applicable limit of liability;
(a) ail 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 ton -
dercvd or deposited in court that part of the judgment which does
nol exceed the limit of the Companys 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 applicab!e limit of liability of this policy, and
the cast of bail bonds required of the insured because of accident
. PAGE TWO
or traffic law violation arising out of the use of any vehicle to which
this policy applies, not to exceed $250 per bail bond, but the Com-
pany shall have no obligation to apply for o: furnish any such
bonds;
(c) expenses incurred by the insured 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
request in assisting the Company in the investigation or de imsa of
any claim or suit, inclu Ring actual bss of earnings not to exceed
$25 per day.
(Continued on Page Three)
I
AUTOMOBILE — GENERAL LIABILITY INSURANCE
THREE -YEAR ENDORSMAENT
It is agreed that such insurance as is afforded by the policy applies subject to the following provisions:
L The pAhcy period stated in the declarations is comprised of three consecutive annual periods.
2. Computation and adjustment of earned premium shall be made at the end of each annual period
3. II the premium for the three year period is not paid in advance, the premiums for each annual period of this policy shall be com-
puted in accordance with the Company's rules, rates, rating plans, premiums and minimum premiums in effect on the inception date of
each annual period.
POLICY NUMBER
INSURED
EFFECTIVE
FIREMAN'S FUND INSURANCE COMPANY
PRODUCER
THE AMERICAN INSURANCE COMPANY
El RATE
NATIONAL SURETY CORPORATION
193800
ASSOCIATED INDEMNITY CORPORATION
100
COUNTERSIGNATURE OF AUTHORIZED AGENT
AMERICAN AUTOMOBILE INSURANCE COMPANY
low la.�W
69
PRESIDENT 70.X
SCA
1 80017 -.0.74
AUTO SCIiEDULE PER CONAP TY FILES:
CLASS
VVEH.
8900
3204
4830
2030
El RATE
PD
193800
89
100
36
6
70
69
29'
SCA
82
91
39
25% SCA
15
23
9
5CA
9
114
48
3CA
1
222
94
I
BI PP.EH.
PD
8900
3204
4830
2030
7462
3198
345
135
1026
432
222
94
22,785
9093
IN. CL .
FIREMAN'S FUND INSURANCE COMPANY PRODUCER
THE AMERICAN INSURANCE COMPANY _
NATIONAL SURETY CORPORATIO
ASSOCIATED INDEMNITY CORPORATION - -- - - ----
- AMERICAN AUTOMOBILE INSURANCE COMPANY I COUNTERSIGNATURE OF AUTHORIZED AGENT
LPRESIDENT
180009 -6 -65 SETS
i
I �
COVERAGE PART - COMPREH£NSIVE AUTOMOBILE LIABILITY INSURANCE cP -oa -ia
SCHEDULE
THE INSURANCE AFFORDED IS ONLY WITH RESPECT TO SUCH OF THE FOLLOWING COVERAGES AS ARE INDICATED
BY SPECIFIC PREMIUM CHARGE OR CHARGES. THE LIMIT OF THE COMPANY'S LIABILITY AGAINST EACH SUCH COV-
ERAGE SHALL BE AS STATED HEREIN, SUBJECT TO ALL THE TERMS OF THIS POLICY HAVING REFERENCE THERETO.
COVERAGES
LIMITS OF LIABILITY
C. BODILY INJURY LIABILITY
$ PER ,000 EACH PERSON
S *CSL .000 EACH OCCURRENCE
D. PROPERTY DAMAGE LIABILITY
S E:ID .000 EACH OCCURRENCE
AUTOMOBILE LIABILITY HAZARDS
DESCRIPTION OF HAZARDS ADVANCE PREMIUM
L OWNED AUTOMOBILES— PREMIUM BASIS PER AUTOMOBILE
BODILY PROPERTY
INJURY OAMAOe
TOWN OR CITY AND STATE
IN WHICH THE AUTO...NJK
WILL BE PRINCIPALLY GARAGED
YEAR Oi
MODEL
TRADE NAME
BODY TYPE AND MOOD.; TRUCK
SIZE: TANK GALLONAGE GPAZr
ITV; OR BUS SEATING CAPACITY
IDENTIFICATION MIIMBER
SERIAL NUMBER
MOTOR NUMBER
iURPOSES
OF USE
22,785
252
71q,
"
9093
"
88
29 '..
PEZ
SCHEDULE
TACILrD
2. HIRED AUTOMOBILES — PREMIUM BASIS— OST OF HIRE
TYPED .,Ago
LOCATIONS WHERE AUTOMOBILES
WILL BE PRI CVA"T USED
".M.S ESTI MATED COST
OF USE OF MIRE
BAYS KR 11R00ST
DI MRI
BI
PD
3. NON -OWNED AUTOMOBILES — PREMIUM BASIS —CLASS 1 PERSONS AND CLASS 2 EMPLOYEES
CLASS 1 PERSONS—NAME OF EACH
LAGTION OF NFAOWARTER9 OF PERSONS NAMED HER_IN
TTY =TY r1%T (25)
,iETvP0RT BEACH 10.08 3.51
MSS r EMPLOYEES — ESTIMATED AVE RAGE NUMBER
LOCATION OF HEADQUARTERS OP CLASS 2 EMPLOYEES
"T. PER EMPLOYEE
m
ro
560
- T86
.126
.051
'r 300,000 TOTALADVANCEPREMI UM j►
32,313
COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE
L COVERAGE C— BODILY INNRY LIABILITY; COVERAGE D— PROPERTY DAMAGE LIABILITY
The Company will pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages 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 duly 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 we groundless, false or fraudulent, 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 any suit after the applicable limit of the Company's liability has been exhausted by payment of judg-
ments or settlements.
(Continued on Reverse Side) "
r
POLICY NUMBER
INSURED
EFFECTIVE
FIREMAN'S FUND INSURANCE COMPANY
PRODUCER
THE AMERICAN INSURANCE COMPANY
-
NATIONAL SURETY CORPORATION
ASSOCIATED IN- DENINGY CORPORATION
COUNTERSIGNATURE OF AUTHORIZED AGENT
AMERICAN AUTOMOBUZ INSURANCE COMPANY
r/ PRESIDENT 70 -x
100804 -8.74
Exclusions _. (Continued from Obverse Side)
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 compensation, unem
ployment compensation or disability benefits law, or under any similar law;
(c) to bodily injury to any employee of the insured artsing out of and in the course of his employment by the insured or to my obliga-
tion of the insured to indemnify another because of damages wising out of such injury; 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
payable 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 o. the insured, or as to which the insured is for any purpose exercising physical control, other than property damage to d
residence or private garage by a private passenger automobile covered by this insurance;
(e) 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, with respect to expenses for first aid under the Supplementary Payments provision;
(f) to bodily injury or property damage wising out of the discharge, dispersal, release or escape of smoke, vapors, soot, fumes, acids,
alkalis, toxic chemicals, liquids or gases, waste materials or other irritants, contaminants or pollutants into or upon land, the atmo-
sphere or any watercourse or body of water, but this exclusion does not apply if such discharge, dispersal, release ar escape is sudden
and accidental.
IL PERSONS INSURED
Each of the following is rm insured 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 man-ewned 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 scrape of such permission, 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) on employee of the named insured or of such lessee or borrower,
(d) any other. person or organization but only with respect to his m its liability because of acts or omissions of, an insured under (a),
(b) or (c) above.:
None of the following is an insured: (i) my person while engaged in the business of his employer with respect to bodily irsjnr; to any
fellow employee of such person injured in the course o[ his employment; (if) the owner. ar. 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; (if!) an
executive officer with respect to, an automobile owned by him or by a member of his household; (iv) any person w organization, other
than the named insured, with respect to: (1) a motor vehicle while used with my trailer owned or hired by such person or organization
and not covered by like insurance in the Company (except a trailer designed for use with a private passenger automobu* and not
being used for business purposes with another type motor vehicle), or (2) a hailer while used with any motor vehicle owned m hived
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, art automobile owned by or registered in the name of a partner thereof - � '
III: LUOUTS OF LIABILITY
Regardless of the number of (1) insureds under this policy, (2) persons or organizations who sustain bodily injury or property damage,
"I claims made or suits brought am account of bodily injury or property damage .or (4) automobiles to. which this policy applies, the :
Corngany's liability is limited as follows: .
Coverage C=The limit of bodily injury liability stated in the schedule as applicable to "each person" is the limit of the Company's lia-
bility far alt damages including damages for care and loss of services_ . because, of bodily injury sustained by one person as the
result of arty 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 liability stated in the schedule 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 w
organizations as the result of any one occurrence shall not exceed the limit of- property, damage liability stated in the schedule as appy-'
cable to "each occurrence". -
Coverages C and D —For the purpose of determining the limit of the Company's liability, all bodily 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.
rv.". POLICY TERRITORY
This insurance plies only o bodily w._...' .. ._.. ... -.... -_..
of. the definit- tango[ y y mius'y or property damage which occurs within the territory described in paragraph (1) ar (2)
parlay territory.
V. ADDITIONAL DEFINITIONS ; .
When used in reference to this insurance (including endorsements forming a part of the poticyJ: i
°automobile business' means the business or occupation of selling, repairing, servicing, storing. or parking automobilesr
. "hired automobile" means an automobile not owned by the named insured which is used under contact in behalf of, or loaned to, the
named 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 named insured who is granted an operating allowance of any sort for then use of such
automobile;
'non -owned automobile" means an automobile which is neither an owned automobile nor a hired automobile. '
'owned automobile- means an automobile owned by,the named insured-
private passenger automobile' means a four wheel - private passenger or station wagon type automobile; - - - -
"trailer" includes semi -hailer but does not include mobile equipment
VL ADDITIONAL CONDITION
Excess Insurance —Hired and Non -Owned Automobiles
A. With respect to a ]sired automobile or a non -owned automobile, this insurance shall be excess insurance over any other valid and .
collectible insurance ovalable to the insured
B. Out of State Insurance. If, under the provisions of the motorvehicle financial responsibility law or the motor vehicle compulsory insur-
ance law or any-similar law of any state or province, a non- resident is required to maintain insurance with respect to the operation or
use of a motor vehicle in such state or province and such insurance requirements me "greater than the insurance provided by the policy,
the limits of the Company's liability and kinds of coverage afforded by the policy shall be as set forth in such law, in lieu of the insurance
otherwise provided by the policy, but only to the extent required by such law and only with respect to the operation or use of a motor
vehicle in such state or province; provided that the insurance under this provision shall be reduced to the extent that there is other valid
a and collectible insurance under this or any other motor vehicle insurance policy. In no event shall any person be entitled to receive
duplicate payments for the same elements of loss.
When used as a premium basis: -
A. "cost of hire" means the amount incurred for (¢) 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
Property 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 insureds - -
B. "Class 1 persona" means the following persons, provided their usual duties in the business of the named insured include the use of
nor-owned automobiles: (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 I persons
COVERAGE PART —F OMOBILE PHYS'_CAL DAMAGE UA 'CE CP- 110 -35
(FLEET AUTOMATIC)
SCHEDULE
ITEM I. THE INSURANCE AFFORDED IS ONLY WITH RESPECT TO SUCH OF THE FOLLOWING COVERAGES AS ARE INDICATED BY SPECIFIC PREMIUM
CHARGE OR CHARGES AND, UNDER EACH SUCH COVERAGE. APPLIES ONLY TO SUCH COVERfiD AUTOMOBILES AS ARE INDICATED, BY ENTRY
HEREIN. OF ONE OR MORE OF THE DESIGNATING NUMERALS FOR THAT PURPOSE APPEARING IN ITEM 4. THE LIMIT OF THE COMPANY'S LIABILITY,
AGAINST EACH SUCH COVERAGE SHALL BE AS STATED OR DESIGNATED HEREIN, SUBJECT TO ALL THE TERMS OF THIS- INSURANCE HAVING
_
REFERENCE THERETO.
-
I
LIMIT OF LIABILITY —EACH COVERED AUTOMOBILE
COVERAGES -
COVERED
ADVANCE
IF ACTUAL CASH VALUE (AO[)
IF STATED AMOUNT.
OTHERWISE ENTER "S"
AUTOMOBILES
LNf[R:
ENTER:
MEANING- AS 5EPARATE41`'
PREMIUM
-
--ACV-- AND DEOUCneLE
AMOUNT AND DEDUCTIBLE
STATED IN ITEM 2.(C)
-
COMPREHENSIVE -
S
S I
S
S
COLLISION,-
$
$
FIRE, LIGHTNING OR
].
e
$1.895,595
_
$
TRANSPORTATION
.24
$ 4525
THEFT
LXI..
a _
s
WINDSTORM. HAIL.
a
EARTHQUAKE OR
.. ..
a -- ..L'- _...
.....
EXPLOSION ... ..
.. _..
S .
a
COMBINED ADDITIONAL
- -
TOWING ''
-
-' - - -f 25 FOR EACH DISABLEMENT
ENDORSEMENTS ATTACHED: - - ADVANCe PnLNIYM MR wDOwseNwis
-$ -
- TOTAL ADVANCE PREMIUM i•
S 4525
MAXIMUM. LIMIT _' .. ANY ONE COY - ALL COVERED AUTOMOBILES - ALL COVERED
OF LIABILITY: "'- ERED AUTOMOBILE $ 20,000 AT ANY ONE LOCATION:. S -10 n L 000 AUTOMOBILES $
RECORD! TO BE SUBMITTED:
❑ MONTHLY ❑ QUARTERLY ®SFM�II ANNUALLY �❑ MONTHLY LJ QUARTER LY• ❑ SEMI.ANNVALLY1' '.ICJ ANNUALLY • �` 1
ITEM 2. COVERED AUTOMOBILES-AS OF EFFECTIVE DATE OF THIS INSURANCE
- (A) DESCRIPTION: PURPOSES OR USE — (P e B PLEASURE AND BUSINESS: "�C - COMMENCIALl"
AUTO
YEAR MODEL: TRADE NAME: BODY TYPE- CAPACITY (TIKICK LOAD: GAU.ONAOE. SUS SLATING),"`
. PRINCIPALLY GARAGED 'IN �' "= FLAMES
CLA$SIPICATON
IDENTIFICATION (U. SERIAL (S). MOTOR (M) NO.: CYLINDERS (NO.): MODEL
(TOWN. STATE) OF USE
2.
.; PER C0;11PADTY FILLS
._.
.3
._
(e) PAC
75 RESPECTING
PURCHASE
LIST
.ACTUAL
PURCHASE
RATING
ANY LOST UNDER COVERAGES OTHER THAN TOWING IS PAYABLE AS INTEREST MAY APPEAR TO
ALIT
PRICE
: COST
MD. aY.. NE;U(UL;
SYMBOL
THE NAMED INSURED AND THE LOSS PAYEE NAMED BELOW: '
(C IT OF LIABILITY
JW NOT STATED In ITEM
%I'- NET
RATES: ADVANCE PREMIUM:
. UNIT OF WASIWTY —LACN cov... AvreNDMLi
DESCRI9ED IN A ABOV AHO COVI. EM POR:
-
- -
• - "'
-- ADVANCE
PREMIUM
- -
AVrp'
[O'IERA65G OTNBI TN[KCO.LISON COLLISION -
"TENMLnME
NET
RATES
COMPRE=
HENSIV6
'. -.:
COLLISION
-
"n M, ULKrmM
OL iRAnSPol1.
- '.
.THEFT
'NhO1LMM.IWL'
"WNWAXEM
COMBINED '
TOVJINd-
ADDITIONAL
AMT.OR •'ACV. INIRM" "ACV "
TATYI
nrtOLOn
s.
S
$
$
$
S
"ACV" a ACTUAL CASH VALUE . .. �•. ..:.'TOTALS
S -. ..
.S :.:
S
$
S' -
$ ...
$ - ••
ITEM 3. EXCEPT WITH RESPECT TO BAILMENT LEASE CONDITIONAL SALE PURCHASE AGREEMENT. MORTGAGEOR OTHER ENCUMBRANCE. THE NAMED INSURED 15
THE SOLE OWNER OF EVERY COVERED AUTOMOBILE DESIGNATED IN ITEM 1 AS COVERED UNDER THIS INSURANCE UNLESS OTHERWISE STATED HEREIN:
- ITEM 4. IXPLANATION OF wTR16 IN ITEM 1 MR OP3I4NATING THE COVLRLO M[TONOe1LEL TO WHICH' THIS INlURANCC ArFLlL3 UNOR EACH CMERAG6 AFPoRDm:
., ... .... J _ G.,
. I :ALL COVERED AUTOMOBILES WHEN 30 ENTERED IN ADDITION TO NUMERALS 1 2.3 OR 4:
• -"
2 ALL REGISTERED COVERED AUTOMOBILES' S'�EXCLUDIHG VEHICLES LEASED TO THE NAMED INSURED -
': SaALL COVERED AUMMOBIUMOP THE PRIVATE►ASSENGln TYPE T =EXCLUDING UNDER COLLISION COVERAGE. ANY VEHICLE NOT
- .4 "ALL COVERED AUTOMOBILES OF THE.COMMMCIAL TYPE
-'S -THE COVERED AUTOMOBILES DESCRIBED IN ITEM 2 (INCLUDING NEWLY HAVING AN ACTUAL CASK VALUE OF AT LEAST.$
ACQUIRED VERICLES: SUS. ECT'TO THE PROVISION! OF PARAGRAPH (e) - - - - - - - -
' OF THE, "COV"EM, AUTOMOSU.W' DEFINITION)
L COVERAGE AGREEMENTS
The Company will pay for loss to covered automobiles under:
COMPREHENSIVE COVERAGE —from any cause except collision; but, for the purpose of this coverage, breakage of glass and loss
caused by missiles, falling objects, fire, theft or larceny, windstorm, hail, earthquake, explosion, riot or civil commotion, malicious mis-
chief or vandalism, water, flood, or -(as to a covered automobile of the private passenger type) colliding with a bird or animal; 'shall
not be deemed loos caused by collision; . ' - ' I . . - _, . _.: '...;
COLLISION COVERAGE— caused by collision: - .. - ; ;O J
FIRE,' LIGHTNING OR TRANSPORTATION COVERAGE — caused by (a) fire or lightning, (b) smoke or smudge due to a sudden, unusual
and faulty operation of any fixed heating equipment serving the premises in which the covered automobile is located, or (c) the strand-
ing.. sinking, burning, collision or derailment of any conveyance in or upon which the covered automobile is being transported;
THEFT COVERAGE — caused by theft or larceny; - " -
r WINDSTORM• HAIL EARTHQUAKE OR EXPLOSION COVERAGE— caused by windstorm, hail, earthquake or explosion
CONIB44ED ADDITIONAL COVERAGE — caused by (a) windstorm, hail, earthquake or explosion, (b) riot or civil commotion, (c) the
forced landing or falling of any aircraft or its parts or equipment, (d) malicious mischief or vandalism, (e) Rood or rising waters, or (f)
external discharge or leakage of water,
provided that, with respect to each covered automobile. Wunder the. Comprehensive coverage (except as to loss from any of the causes
described in the Fire, .Lightning or Transportation Coverage) and under, the Collision. Coverage, such payment shall be'_anly for the
amount of each loss in excess of the deductible amount, it any, stated in the schedule as applicable thereto; (ii)-under the Combined
Additional coverage, $25 shall be deducted from the Imount of each loss caused by malicious mischief or vandalism.
The Company will pay under: - ' • '
TOWING COVERAGE —for towing and labor costs necessitated by the. disablement of covered automobiles, provided the labor is per-
formed at the place of disablement. -
SUPP1EMENTARY PAYMENTS
In gddition to the applicable limits of liability, the Company will: -
(a) with respect to such transportation insurance as is afforded herein, pay general average and salvage charges for which the named .
insured becomes legally liable; - � - 1 - • - :,
(b) reimburse the named insured in the event of a theft covered by this insurance of an entire covered automobile of the private passen.
gar type (not used as. a public or livery conveyance and not, at time of theft, being held for sale by an automobile dealer), for expense
incurred for the rental of a substitute lot. such covered automobile during the period commencing_ 48 hours after such theft has been
(Continued on Reverse Side) -
POLICY NUMBER INb UNEU E r a..nVe
.•. - FIREMAN'S FUND INSURANCE COMPANY - PRODUCER
-THE AMERICAN INSURANCE COMPANY -
NATIONAL SURETY CORPORATION
ASSOCIATED INDEMNITY CORPORATION COUNTERSIGNATURE OF AUTHORIZED AGENT � f
AMERICAN AUTOMOBILE INSURANCE COMPANY
_ .: _ZiTnd .Q[r4�een . ' .. _ ; . #. rh •R1'
This endorsement modiiias suc Ace as is afforded by the provisions of the u, .elating to the following:
COHENSIVE AUTOMOBILE LIABILITY INSURAW
BASIC AUTOMOBILE LIABILITY INSURANCE — GARAGE INSURANCE
SINGLE LIMIT OF LIABILITY CP -03-24
It is agreed that the provisions of the policy captioned "LIMITS OF LIABILITY" relating to Bodily Injury Liability and Property Damage
Liability are amended to read as follows: - -
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:
Bodily Injury Liability and Property Damage Liability:
The limit of liability stated in the schedule of this endorsement as applicable to "each occurrence'" is the total limit of the company's lia-
bility for all damages because of bodily, injury, including damages for care and loss of services, or property damage as a result of any _
one occurrence, provided that with respect to any one occurrence for which notice of this policy is given in lieu of security or when this
policy is certified as proof of financial responsibility under the provisions of the Motor Vehicle Financial Responsibility Law of any state
or province such limit of liability shall be applied to provide the separate limits required by such law for bodily injury liability and for
property damage liability to the extent of the coverage required by such law, but the separate application of such limit shall not
increase the total limit of the Company's liability.
SCBEDULE
I
Coverages
Limits of liability
Bodily Injury Liability and Property Damage Liability
- S ,000 each occurrence
POLICY NUMBER
INSURED
EFFECTIVE
FIREMAN'S FUND INSURANCE COMPANY
PRODUCER
THE AMERICAN INSURANCE COMPANY
NATIONAL SURETY CORPORATION
ASSOCIATED INDEMNITY CORPORATION
AMERICAN AUTOMOBILE INSURANCE COMPANY
COUNTERSIGNATURE OF AUTHORIZED AGENT
PRESIDENT 70.x
100956 -8.74
r
1-)e PCI!Ce and teM'ncting. regariis of cy.pirut -n of the policy pe-'o, when such covered automobile is
u
re!i;!1 2 T,� use cr the pays for the but, a, to coy one such ihcfl, Such reicnhu� ent shall not exceed $1'0 for any one
day nor $30'2 tol,,!.
Such ir.zu.cnce as is afforded order eac elago opp!i�,z; ,,.j-.orately to such covered a obile. and a land motor vehicle and one
or uiere trailers or Semitrailers attached th't. shall be held to be so.pcoate covered automfe's US MSPeCru; limit
deductible provisions applicable thereto. s of liability and any
.Exclusions
This insurance does not apply:
(a) to any covered automobile while used as a public or livery conveyance, unless such use is specifically declared and described in
the schedule;
(b) ',a damage whicri is due and conEned to: (i) wear and tear, or (it) freezing, or (iii) mechanical or electrical breakdown or failure,
unless such damage is the result of other loss covered by this insurance;
(c) to in-cs, unless (f) loss he coincident with and from the same cause as other loss covered by this insurance; or (ii) damaged by fire
(mid, if a covered automobile of the private passenger type, by malicious mischief or vandalism) or stolen and, as to the covered auto-
mobile, loss caused by such damage or theft is covered by this iru,.urance.
(d) to loss due to (i) war, whether or nc! declared, civil war, insurrection, rebellion or revoluVon, or to any act or conditicil incident t I a
any a! the foregoing; (n) radicactive contanniation;
(e) to less to (i) any device or instrument designed for the recording, reproduction, a. recording and reproduction of round unless
such device or instrument is permanently installed in the covered automobile: (ii) any tape, wire, record disc or other medium for use
with any device or instrument designed for the recording, reproduction, or recording and reproduct fort of sound;
(i) to loss to a camper body designed for use with a covered automobile and not designated in the schedule and for which no premium
has been charged if such camper body was owned at the inception of the policy period cr the inception of any renewal or extension period
thereof.
(g) under the Comprehensive and Theft coverages, to loss or damage due to conversion, embezzlement or secretion by my person in
possession of a covered automobile under a bailment lease, conditional sale, purchase agreement, mortgage or other encumbrance.-
(h) under the Collision coverage, to breakage of glass if insurance with respect to such breakage is otherwise afforded herein;
(f) under the Windstorm, Hail, Earthquake or Explosion and Combined Additional coverages, to loss resulting from rain, snow or sleet,
whether or not wind- driven.
IL LIMIT OF LIABILMY
The limit of the Company's liability for loss to any one covered automobile shall not exceed the least of the following amounts:
(a) Lie actual cash value of such covered automobile, or if the loss is to a part thereof the actual cash value of such part, at time of
lose; or
(b) what it would then cost to repair or replace such covered automobile or part thereof with other of like kind and quality, with deduc-
bon-for depreciation; or
M the limit of liability stated in the schedule as applicable to "each covered automobile under the coverage afforded for the loss to
such covered automobile, provided that if such limit of liability is expressed as a stated amount it shall, with respect to a covered auto-
mobile newly acquired during the policy period and not described in the schedule, be deemed as having been replaced by "actual
cash value';
card, subject to the above provisions, shall not in any event exceed the amount, if my, stated in the schedule as the "maximum limit
of liability" applicable to 'any one covered automobile."
The total limit of the:Company's liability for all loss directly attributable to a single happening out of which lose occurs shall not exceed:
ta) as to all covered automobiles at cry one locafion,-llie amount, if any, stated in the schedule US the."trinsinumt, liwif of liability-". cippli-
cable thereto; subject to the above provisions respecting any one covered automobile.
(b) as to all -covered automobiles, the amount if my, steed in the schedule Us; the "maximum limit of liabilit)(' applicable thereto,
subject-to the above provisions respecting (i) ;�my one covered automobile and (if) any one location.
HL POLICY PERIOD, TERRITORY, PURPOSES OF USE
4
This insurance applies only to loss which occurs during the policy period, while the covered automobile is within the United States of
America, its territories or possessions. or Canada, or is being transported between ports thereof and, if a covered automobile described
in the schedule, is maintained and.used for the purposes stated therein as applicable theseta.
N. ADDITIONAL DEFINITIONS -------
When used Lq reference to this insurance (including endorsements forming apart of the policy)'
camper body" means a body designed to be mounted upon a covered automobile and equipped as sleeping ar living quarlersr;_
"collision!' means (i) collision of a covered automobile with another object or with a vehicle to which it is attached. or (u i . ) upset of such
covered automobile,_
"commercial type means (i) a land motor vehicle of the truck, pick-up, express, sedan or I panel delivery type, including w trac-
tors, trailers and semitrailers.' used for the transportation or delivery of goods or merchandise or for other business purposes,or (ii) an
altered private passenger type vehicle used for retail or wholesale delivery;
'.*covered autamobile' means a land motor vehicle, trailer or semitrailer, including its equipment and other equipment pe . rmcmenflyj:
attached thereto ,(but not including.robes, wearing apparel or personal effects), which is either . .
(a) designated fit the schedule, by description or otherwise, as a covered automobile to which this insurance applies and is: M owned
by the named insured,, or (ii) leased, to the named insured for a term of not less than one year under an agreement expressly prohibit-
mg" any right of the lessor or owner to use such vehicle during the term of such lease except either as an opera-or employed by the-
imained insured or for its repair or exchange; or
(b) if not so designated, such vehicle is newly acquired by the named insured during the policy period provided, however, thaL (i) it
replaces a described covered automobile, or as of the date of its delivery this insurance applies to all covered automobiles. and (if)
the named Insured notifies the Company within 30 days following such delivery date;
but "covered automobile does not include a vehicle owned by or. registered in the name of any individual partner or executive officer
of the named insured. unless specifically stated otherwise,by. endorsement forming a part of the policy-,
"lose' mecauti- direct and accidental loss or damage; . . -1 1 1 1 1 . .. . - � . z , 1_.... -
private pentoonger type" means a 4-wheel land motor vehicle of the private passenger or station wagon Lille,
ce; to `Purposes of use-.
commercial- means .use-principalfy in the business occupation of the named insured,as, stated in the declarations, including occasional
usii.for personal, pleasure, family and other business purposes,
!Woatliwo and business' meats personal, pleasure, family and business use.
V. CONDITIONS .. .......
None of the Conditions of the policy shall apply to this except "Premium" "Inspection and Audit", "Subrogartion", "Chcmges�',
7'Assignment*', —Cancellation", and Declarations". This-miturcrince shall also be subject to--the following additional Conditions:
Named Instireds Duties in Event of Loss
In the event of loss-the named insured shall: --- ---
4a),protectlhe covered automobile, whether or not this insurance applies to the lo . its. I and my further . loss or damage , due -to the named
inirmed's failure to protect shall not be recoverable under this insurance,- - reasonable expenses incurred in affording such protection
shall be deemed incurred at the Company's request, . I I . - : . : .; "' :. 1; .%
(b) give notice thereof as soon US practicable to the Company or my of.its authorized agents and also, in the event of theft or larceny,
to the police;
(a) file with the Company,mithin 91 days after loss, his sworn proof of loss in such form and -including such information as the Company,
xnayreasonably.require-cmd, upon the Company's request, shod exhibit the damaged property and submit to examination under oath;,
(d) cooperate with the Company and, upon the Company's request, shall assist in making settlements, in the conduct of suits and in
enforcing any right of contribution or indemnity against any person or organization who may be liable to the named insured because
of In" with respect to which this insurance applies; and shall attend hearings and trials and assist in securing and giving evidence and
obtaining the attendance of witnesses,
but the named insured shall not, except at his own cost, voluntarily make any payment, assume any obligation, offer or pay any reward
for recovery of stolen property or incur any expense other than as specifically provided in this insurance.
Payment for Less
With respect to any loss covered by this insurance, the Company may pay for said lose in money, or may:
(a) repair or replace the damaged or stolen property, or
(b) return at its expense any stolen property to the named insured, with payment for any resultant damage thereto, at any time before
the loss is so paid or the property is so replaced, or
(c) take all or any pout of the. damaged or stolen property at the agreed or appraised value,
but there shall be no abandonment to the Company.
Appla" al
If the named insured and the Company fail to agree as to the amount of loss, either may, within 60 days after proof of loss is filed,
demand an appraisal of the loss. In such event the named insured and the Company Shall each select a competent appraiser, and the
appraisers shall select a competent and disinterested umpire. The appraisers shall State separately the actual cash value and the -
amount of loss and failing to agree shall submit their differences to the umpire. An award in writing of any-two shall determine the
amount of loss. The named insured and the Company shall each pay its chosen appraiser and shall bear equally the other expenses
at the appraisal and umpire. .. : � I . .. r I � 1 1. 11 r 1. - . I I
The Company shall not be held to have waived any of its .rights by my act.relating to appraisal.
Action Against Company
No action shall lie against the Company unless, as a condition precedent thereto, there shall have been full compliance with all the
terms of this insurance nor until 30 days after proof of loss is filed and the amount of loss is-determined as provided in this insurance.
Other lesuirmico
If the named insured'has other. insurance against . t a lose covered by this insurance, the.Company shall not be liable under this insurceric , e
for a greater proportion of such loss than the applicable limit of liability stated in the schedule bears to the total applicable limit of lia-
bility of ail valid and collectible insurance against such loss: provided, however, with respect to any covered automobile newly acquired
during the Policy period and not described in the schedule, this insurance shall not apply to any loss against which the named insured
has other valid and collectible insurance.
No. Benefit to Bailee
None cu the provisions of this insurance shall inure directly or incftectly to the benefit of any carrier or other bailee for hire.
Seems o! Insurance Conformed to Statute
Ternis,of this insurance which are in.conflict,with the statutes of the state wherein *th- is,isisn" me hereby atnended to cwr�. , U
M Insurance,
0 0
(Condition Continued from Page Three)
8. Changes Notice to any agent or knowledge possessed by any
agent or by any other person shall not effect a waiver or a change
in any part of this policy or estop the Company from asserting any
right under the terms of this pb!;cy; nor shall the terms of this policy
be waived or changed, except by endorsement issued to form a part
of this policy.
9. Assignment: Assignment of interest under this policy shall not
bird the Company until its consent is endorsed hereon; if, however, .
the named insured shall die, such insurance as is afforded by this
policy shall apply (1) to the named insured's legal representative,
as the named insured. but only while acting within the scope of his
duties as such, and (2) with respect to the property of the named
insured. to the person having proper temporary custody thereof, as
Insured. but only until the appointment and qualification of the
legal representative.
10. Three Year Policy: If this policy is issued for a period of three
years any limit of the Companys liability stated in this policy as
"aggregate' shall apply separately to each consecutive annual
period thereof. ,
11. Cancellations This policy may be cancelled by the named iii -
sured by surrender thereof to the Company or any of its authorized
agents or by mailing to the Company written notice stating when
thereafter the cancellation shall be effective. This policy may be
cancelled by the Company by mailing to the named insured at
the address shown in this policy, written notice slating when not
less than ten days thereafter such cancellation shall be effective.
The mailing of notice as aforesaid shall be sufficient proof of notice.
The time of surrender or the effective date and hour of cancellation
stated in the notice shall become' the end of the policy period De•
livery of such written notice either by the named insured or by the
Company shall be equivalent to mailing.
If the named insured canrls,' earned premium shall be computed
in accordance with the customary short rate table and procedure.
If the Company cancels, earned premium shall be computed pro
rata. Premium adjustment may be made either at the time can-
cellation is effected or as soon as practicable after cancellation
becomes. effective, but payment or tender of unearned premium .
Is not a condition of cancellation.
12 Dedarahom: By acceptance of this policy, the named insured
agrees that the statements in the declarations are Iris agreements
and representations, that this policy is issued in reliance upon the
truth of such representations and that this policy embodies. all
agreements existing between himself and the Company or any of its
agents relating to this Insurance. _
IN WITNESS WHEREOF, the Company has caused this policy to be signed by its President and Secretary, but the some shall not be
binding upon the Company unless countersigned by an authorized agent of the Company.
, a.g.
SECRETARY PRESIDENT
NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT
(BROAD FORM)
This endorsement modifies the provisions of the policy relating to ALL AUTOMOBILE LIABILITY, GENERAL LIABILMY AND MEDICAL
PAYMENTS INSURANCE OTHER THAN FAMILY AUTOMOBILE. SPECIAL PACKAGE AUTOMOBILE, COMPREHENSIVE PERSONAL AND
FARMER'S COMPREHENSIVE PERSONAL INSURANCE
It is agreed that:
I. This policy does not apply:
A. Under any liability Coverage, to bodily injury or property damage
(1) with respect to. which an insured under this 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 such policy but for its termination upon exhaustion of its limit of liability; or
(2) resulting from the hazardous properties of nuclear material and with respect to which (a) any person or organization is required to
maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the insured is, or had this
policy not been. issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement
entered into by the United 'States of America, or any agency thereof, with any person or organization.
B. Under any Medical Payments Coverage, or under any Supplementary Payments provision relating to first aid, to expenses Incurred
with respect to bodily injury resulting from the hazardous properties of nucleon material and arising out of the operation of a nuclear
facility by any ,person or organization.
C. Under any Liability Coverage, to bodily injury or property damage resulting from the hazardous properties of nuclear material. if
(1) the nuclear material (a) is at any, nuce facility owned by, or operated by or on behalf of, an insured or (b) has been discharged or
dispersed therefrom; .. ..
(2) the nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed, stored, transported or disposed
of by or on behalf of an insured; or
(3) the bodily injury or property damage arises out of the furnishing by an insured of services, materials, parts or equipment in connec-
tion 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.
11. As used in this endorsement:
"hazardous properties' include radioactive, toxic or explosive properties;
"nuclear material' means source material special.nuclear material or byproduct material;
"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 reach;;
i'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;
"nuclear facility" means
(a) any nuclear reactor,
(b) any equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing spent
fuel, or (3) handling, processing or packaging waste,
(c) any equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount
of such mate: icl in the custody of the insured at the premises where such equipment or device is located consists of or contains more than
25 grams of plutonium or uranium 233 or any 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 of waste,
and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such
open o tons;
• "nuclear reactor' means any apparatus designed or used to sustain nuclear fission in a sell- supporting chain reaction o. to contain a'
a;Iical mass of fissionabl ?.material; .
"property damage' incluczs all forms of radioactive contamination of property.
FACE FOUR
0 0
INSERT COVERAGE PART(S) AND ENDORSEMENTS (IF ANY) ARE
(Continued from Page Two)
CONDITIONS
L premium: Ali premiums for this policy shall be computed in ac-
cordance with the Company's rules, rates, rating plans, premiums
and minimum premiums applicable to the insurance afforded herein.
Premium designated in this policy as "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) designated 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 Company shall return to
the named insured the unearned portion paid by the named insured.
The named insured shall maintain records of such information as
is necessary for premium computation, and shall send copies of
such records to the Company at the end of the policy period and
at such times during the policy period as the Company may direct.
2. Inspection and Audit: The Company shall be permitted but not
obligated to inspect the named insured's property and operations
at any time. Neither the Company's right to make inspections nor
the making thereof nor any report thereon shall constitute an under -
taking, on behalf of or for the benefit of the named insured or others,
to determine or warrant that such property or operations are safe
or healthful, or are in compliance with any law, rule or regulation.
The Company may examine and audit the named insured's books
and records at any time during the policy period and extensions
thereof and within three years after the final termination of this
policy, as for as they relate to the subject matter of this insurance.
3. Financial Responsibility Laws: When this policy is certified as
proof of financial responsibility for the future under the provisions
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 coverage and limits of liability required by such
law. The insured agrees to reimburse the Company for any pay-
ment 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.
4. I"ureTs Duties in the Event of Occurrence, Claire or Suit:
(a) in the event of an occurrence, written notice containing par-
ticulars sufficient to identify the insured and also reasonably
obtainable information with respect to the time, place and circum-
stances thereof, and the names and addresses of the injured and
of available witnesses, shall be given by or for the insured to the
Company or any of its authorized agents as s =on as practicable.
(b) If claim is made or suit is brought against the insured, the
insured shall immediately forward to the Company every de-
mand, notice, summons or other process received by him or his
representative.
(c) The insured shall cooperate with the Company and, upon the
Company's request, assist in making settlements, in the conduct of
suits and in enforcing any right of contribution or indemnity against
any person or organization who may be liable to the insured be-
cause o) injury or damage with respect to which insurance is
afforded under this policy. and the insured shall attend hearings
and trials and assist in securing and giving evidence and obtaining
the attendance of witnesses. The insured shall not, except at his own
cost, voluntarily make any payment, assume any obligation or incur
any expense other.than for first aid to others at the:time of accident.
5. Action Against Company: No action shall lie against the Com-
pany 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 the irurured's 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. .
Any person or organization or the legal representative thereof who
has secured such judgment or written agreement shall thereafter
be entitled 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 policy to join the Company as a party to any ac-
tion against the insured to determine the insured's liability, nor
shall the Company be impleaded by the insured or his legal repre-
sentative. Bankruptcy or insolvency of the insured or of the Insured's
estate shall . not relieve the Company of any of its obligations
hereunder.
G. Other Insurance: The insurance afforded by this policy is primary
insurance, except when stated to apply in excess of or contingent
upon the absence of other insurance. When this insurance is pri-
mary 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 policy for a greater proportion of the
loss than that stated in the applicable contribution provision below:
(a) Contribution by Equal Shares. If all of such other valid and
collectible insurance provides for contribution by equal shares, the
Company shall not be liable for a greater proportion of such loss
than would be payable if each insurer contributes an equal share
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, and with respect to any amount of loss not so paid the re-
maining insurers then continue to contribute equal shares of the
remaining amount of the loss until each such insurer has paid its
limit in full or the full amount of the loss is paid.
(b) Contribution by Limits. If any of such other insurance does
not provide for contribution by equal shares, the Company shall
not be liable for a greater proportion of such loss than the ap-
plicable limit of liability under this policy for such loss bears to
the total applicable limit of liability of all valid and collectible
insurance against such loss.
7. Subrogation: In the event of any payment under this policy, the
Company shall be subrogated to all the insured's rights of recovery
therefor against any person or organization and the insured shall
execute and deliver instruments and papers and do whatever else
is necessary to secure such rights, The insured shall do nothing
after loss to prejudice such rights.
j (Conditions Continued on Page Four)
PAGE THREE
. I
r
ANNIVERSARY PREMIUM ENDORSEMENT —�
IN vCCONSIDERATION OF THE PREMIUM COMPUTATION SHOWN BELOW. IT IS AGREED THAT THE ' ADDITIONAL PREMIUM
FIRST-----ANNIVERSARY PREMIUM FOR THIS POLICY IS AMENDED TO READ:
s -
40.000.
.- .- ._ -.- -. - �_ - -._ - -- COMPUTATION - - -- �I
EXPOSURES
LIABILITY - O.T.A.
PREMIUMS
BA.
P.D.
MED.
COLLISION
NOT COVERED
THEFT
C.A.C.
TOWING
-- TOTAL O.T.A. $
OWNED AUTOMOBILES
SYM- ADVANCE PREMIUM
E-- BODY TYPE I MOTOR NUMBER CLASS TER R. BOL
B.I. P.D.' MED.
ITEM I
NO.
YEAR - 'TRADE NAM
*LIMIT OF LIABILITY
DEDUCTIBLE'
(COLLISION)
PREMIUM
COMPREHENSIVE
COLLISION
FIRE
THEFT
C.A.C.
TOWING
COVERER AUTQ5_FFJ _coi�T� FIIX
N_QT C-OVRRED
PRESIDENT 70 -X
3M-00—
-10-IOM
—
DET.RTR FORM
AUTOMOBILES -NON OWNED CL 6611/.(1' - (501 -1000\
/
INCL
T*Tf4
3llS4�_
AUTOMOBILES -- MIRED
RATES PER $100 COST OF HIRE
B.1.
P. 0.
MED.
PRIVATE PASSENGER
I-
I
COM M ERCIAL
I
-
AUTOMOBILES--- DRIVE OTHER CAR
AUTOMOBILES - UNINSURED MOTORISTS
XXXX
XXXX
TOTAL AUTOMOBILE CASUALTY §40000
-_ - AUTOMOBILE PHYSICAL DAMAGE COVERAGE
ITEM
NO.
*LIMIT OF LIABILITY
DEDUCTIBLE'
(COLLISION)
PREMIUM
COMPREHENSIVE
COLLISION
FIRE
THEFT
C.A.C.
TOWING
�
N_QT C-OVRRED
PRESIDENT 70 -X
DET.RTR FORM
I
- -
*ACTUAL CASH VALUE LESS DEDUCTIBLE UNDER COLLISION COVERAGE TOTAL PHYSICAL DAMAGE S
*R5 PER DISABLE"^ENT UNDER TOWING COVERAGE
II Y.�I�ISi/
POLICY NUMBER
NA
[A 299 79 27
INSURED
RVA
EFFECTIVE
6-79-76
FIREMAN'S FUND INSURANCE COMPANY
PRODUCER
THE AMERICAN INSURANCE COMPANY
MILUM- CARVEY INS. BROKERS
NATIONAL SURETY CORPORATION
NEWPORT BE - -
ASSOCIATED INDEMNITY CORPORATION
U ITERSIGNATURE OF AUTHORIZED AG T
AMERICAN AUTOMOBILE INSURANCE COMPANY
PRESIDENT 70 -X
I 180036 -9 -67 o' 4,
iI
i -'
0
This endorsement modifies such ` 'L—ance as is afforded by the provisions of the police relating to the following:
COMPREHENSIVE I )MOBILE LIABILITY INSURANCE — GARAGE IURANCE
LAnIC AUTOMOBILE LIABILITY INSURANCE t
Y
DEDUCTIBLE LIABILITY INSURANCE CP -03 -55
FP F�
It is agreed that:
1. Under any coverage for which a deductible amount is designated in the schedule of this endorsem nt, the ^s_ liable,
up to the limit of liability stated in the policy, only for the amount of damages otherwise payable tIvreunde I of` de-
ductible amount.
C,fZ7/� f �Cy
2. All the other terms of the
policy shall apply as if the Company were liable for such deductible amount. !X,
3. The deductible amounts stated in the schedule apply as follows:'
(a) PER CLAIM BASIS —If the deductible is on a "per claim" basis, the deductible amount applies under the Bo jury Liability
Coverage to all damages because of bodily injury sustained by one person, as the result of any one occurrence.
(b) PER OCCURRENCE BASIS —If the deductible is on a "per occurrence" basis the deductible applies
(i) under the Bodily Injury Liability Coverage to all damages because of all bodily injury or
(it) under the Property Damage Liability Coverage to all damages because of all property damage as a result of any one occurrence.
4. The Company shall pay all of the deductible amount to effect settlement of any claim or suit, and upon notification of the action
taken, the named insured shall promptly reimburse the Company for the deductible amount which has been paid by the Company,
SCHEDULE
Coverage Deductible Amount Basis
Bodily Injury Liability $ each claim
$ each occurrence
j
Property Damage Liability $ 250 each occurrence
SIGNED AND ACCEPTED X
POLICY NUMBER
S14A
LL 229 25 27
THE CITY OF NElJIOP.T
INSURED
BEACH
EFFECTIVE
6 -25 -76
FIREMAN'S FUND INSURANCE COMPANY
ppggD��DUC�EgR
MILIZI— GARVEY INS S.{(JKERS
THE AMERICAN INSURANCE COMPANY
NATIONAL SURETY CORPORATION
NE?:TPOP.T BEACH,
CA 28 04 209
430/pb/8 -30 -76
ASSOCIATED INDEMNITY CORPORATION
AMERICAN AUTOMOBILE INSURANCE COMPANY
COUNTERSIGNATURE OF AUTHORIZED AGENT, !'
/)
dAP�'f/
RESIDENT 70 -%
100840 -e -74
i
J
INSURANCE BINDER
0
Renewal air
❑ New ❑ Renewal of Binder No Extension of Policy
Name of Insured and Address.
THE CITY OF NEWPORT BEACH
3300 NEWPORT BOULEVARD
NEWPORT BEACH, CALIFORNIA 92660
or
—,IgeK,
This Binder is a temporary insurance contract to serve
as evidence of insurance:
• Pending Issuance and Delivery of Policy I
• Pending Issuance and Delivery of a Renewal Policy
• Pending Issuance and Delivery of Endorsement to Policy
• Pending Negotiations of Rates, Premium or Coverage
FIREMAN'S FUND INSURANCE COMPANY
(Nose of Imvmnm Cemooayl
is hereby bound to an insurance undertaking for the Insured named above subject to the conditions set forth below as follows:
DESCRIPTION OF AUTOMOBILES, PROPERTY OR
' OPERATIONS AND LOCATIONS.
TYPE OF INSURANCE COVERAGE AND INSURED PERILS
AMOUNT OF INSURANCE, OR
LIMITS OF LIABILITY
AUTOMOBILE INSURANCE:
BODILY INJURY LIABILITY
$300,000
PROPERTY DAMAGE LIABILITY
COMBINED SINGLE LIMI
FIRE & THEFT COVERAGES.
ACTUAL CASH VALUE
AS SCHEDULED
PER AUTOMOBILE SCHEDULE
MORTGAGEE OR LOSS PAYEE. Loss. if any, is payable to Insured and:
The following clauses, special conditions or endorsements shall
INSURED
apply to this insurance:
Binder issued pending receipt
of policy....
ORIGINAL BINDER SENT TO: 1k Insured ❑ Mortgagee or Loss Payee ❑ Other:
In consideration of the Insured's agreement to pay a premium based on published or manual rules and rates, and subject to all the provisions of the
Policy customarily issued in the state where the insured property is situated, or exposures exist, by the Company bound herein insuring against the
perils or the coverages specifically designated, it is agreed that insurance of the type named above is bound for the following period:
JUNE 25 r 75 f JULY 25 75 ❑ Noon
From 19 a! M. To 19 at ❑ 12:01 A.M.
Standard time, or such time prior thereto as the Company's policy may be Issued in lieu hereof insuring the described risk. A premium charge
shall be made for the term of this Binder, calculated in the manner provided above, unless a policy Is issued by this Company and is accepted
by the Insured covering the Binder term. The issuance of such a policy shall void this Binder.
This Binder may be cancelled at any time by the Insured by its surrender to the Company or to this agent, or by giving notice to the Company or to this agent when
thereafter the cancellation shall be effective. The Binder may be cancelled by the Company, or by this agent in behalf of the Company, by mailing to the Insured, and
to the mortgagee or lass payee, if any, at the address shown above, written notice stating when not less than five (5) days thereafter such cancellation shall be effec
Live. (If the policy customarily issued by the Company for the subject form of insurance provides for ten (10) days notice to either the Insured or the mortgagee, or
both, to effect cancellation, then such number of days notice shall be applicable). The mailing of notices as aforesaid shall be sufficient notice, The effective date of
cancellation stated in the notice shall become the end of the binder period. Delivery of writte once s 1 luivaleat to mailing. i
Mi afvQy ce B� rg Inc.
Date: June 25 1975 B ~(
T Authorized Representative or Agent
j.
No. 6F 201-8 448 (temmineMed CAIMIBAC Form ., � r ..aooawr eeausrrc}e eoowwr aµra rewww owerreamw.
cy 1L
•
RESOLUTION NO. R 5 2 4
A RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF NEWPORT BEACH AWARDING A CONTRACT FOR
AUTOMOBILE AND COMPREHENSIVE PUBLIC LIABILITY
INSURANCE COVERAGE.
WHEREAS, the Insurance Committee has held a number
of meetings with the City's Insurance Broker for the purpose
of reviewing the City's insurance specifications and the bids
received for the City's coverage for 1975; and
WHEREAS, the Insurance Committee has recommended that
the City's general liability policy for next year should be
awarded to The Star Insurance Company as the primary carrier
(exclusive of primary automobile liability) and the Fireman's
Fund Insurance Company for primary automobile liability and
the Midland Insurance Company as the excess carrier;
NOW, THEREFORE, BE IT RESOLVED that the City Council
of the City of Newport Beach accepts the recommendation of the
Insurance Committee and hereby awards the.City insurance contract
for the period commencing on 12:01 A.M., June 25, 1975, and
ending on 12:01 A.M., June 25, 1976, to The Star Insurance Company
as the primary general liability carrier (exclusive of primary
automobile liability) and the Fireman's Fund Insurance Company
for primary automobile liability and the Midland Insurance Company
as the excess umbrella liability carrier.
BE IT FURTHER RESOLVED that the Mayor and City Clerk
are hereby authorized and directed to execute a contract in
accordance with this award and on behalf of the City of Newport
Beach.
ADOPTED this 23rd day of June, 1975.
Mayor
ATTEST:
City Clerk