HomeMy WebLinkAboutC-2174 - Agreement for Use of City ComputerCERTIFICATE OF INSURANCE
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LJ l INSURANCE �. = Exchange or Company designated on the reverse siffin'umber 2
EXCESS
INSURANCE . Excess over Primary with Company designated on reverse side as letter
When countersigned by an authorized representative of the Company, this certificate supersedes any previously issued certificates and certifies thoI the -
following policy(ies), have been issued to the insured for the coverage indicated. This certificate or verification of insurance is not an insuronce p6licp and
i, doesnot amend, extendoralter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contractor
other document with respect to which this certificate or verification of insurance may be issued or may pertain, the insurance afforded by the policies -
described herein is subject to all the terms, exclusions and conditions of such policies.
Na1Aed ATTORNEY DATA INC & NORVIN CROY AS
Ensured .
JYt INDIVIDUA 6crosPolicy or Certifione Nvmber
Address . mil/
.3345 NEWPORT BLVD ,200 97 07.364 11568 oo 13
NEWPORT BEACH, CA 92660 1 Agent I Policy Number
Effective from: 1.0— 3- S0
To: at which time this certificate becomes void QQ or until cancelled if this box "X "d
PART I CERTIFICATE OF INSURANCE ❑ Applicable ❑ Not applicable
COVERAGE s COVERAGE COMBINED LIMITS OF LIABILITY
INOICOVE er A4 °x^
LIMITS)
INCLUDES)
BOTH PRIMA
PRIMARY
AND EXCESS
(if excess
applicable)
OWNED
AUTO LIABILITY
Bodily injury
Property Damage
P Y 9
EACH PERSON
EACH OCCURRENCE
DIGITS
Owned
�0
GOO
COVERED
Non -Owned
0 ,000
Comm'I Umbrella Liability
Hired
AGGREGATE
X
Employer's Non - Ownership Contingent Liability
Is
GENERAL LIABILITY
Bodily Injury
Property Damage
Bodily Injury
Property Damage
EACH PERSON
EACH OCCURRENCE
X
M& C- OLT, Owners B Contractors, Contractual, Elevators
000
000
X
Products and /or Completed Operations
be $5.000 sm com._ d bodily injury sustained by one psrson in any one xcurrence and subjed to thts provision respecting each person, 510,000 on account of bodily Injury
-,000
or marenicaaons as the result of any one arc. nsm. shall net amend 55,000.
ssx' owners&contractors protective, contractual,
and /or completed operations
AGGREGATE PRODUCTS
300 ,000
$ 50 ,000
Si ngle Li mil Liabi l ity for Coverages checked above
AGGREGATE PRODUCTS
EACH OCCURRENCE
$ ,GOO
$ ,000
Cargo
EACH VEHICLE
EACH OCCURRENCE
$ ,000
Is 000
Workers or Workmen's Compensation
Statutory
Includes Goods or Products Warranty, Written Lease of Premises, Easement Agreement, Municipal Ordinance Agreement, Sidetrack Agreement, Elevator or
Escalator Maintenance Agreement only unless accompanied by specific endorsement providing additional Contractual Coverage.
(ALL STATES EXCEPT DKLAHOMA) It is hereby agreed that upon cancellation or termination of this policy or policies from any muse the
Company will moil 11! days notice in writing thereof to the other Interest shown below-
OTKER
INTEREST CITY CLERK NEWPORT BEACH
-
.3300 NEWPORT BLVD
.NEWPORT BEACH, CA 92660
t'k NOTAPPLICABLE INTEXAS 4Is f APPLICABLE IN TEXAS
OKLAHOMA CERTIFICATE -In the event at any material change In
or cancellation of said policies, the Company will make every ef-
fort to notify the party to whom this certificate is Issued ofsuch
change or cancellation, but the Company undertakes no respon-
sibilitybyroc nofanylelturesebdoo..�p/ /�
Countersigned �� `�• .
Notice of cancellation of the primary coverage outomaticol ly term i notes excess coverage. A breakdown of the primary limits and the excess limits will be
provided on demand. .
tiagTes'a -eve tact lxrwreow us.A ®t INSURED S COPY
YEAR, MAKE, TYPE OF BODY, LOAD CAPACITY 5LCA Ea WAIV�ION
IDENTIFICATION NUMBER
OWNED
LAST 3
AUTOMOBILES,
DIGITS
IF
SHOVYN
COVERED
Comm'I Umbrella Liability
RETAINED LIMIT
AGGREGATE
EACH OCCURRENCE
$ 0001$
Is
POLICY NUMBER
PART II ADDITIONAL INSURED ENDORSEMENT ❑ Applicable ❑ No[ Applicable
—
It is agreed that such insarome as is afforded by the coverages indicated by on "X" on the Certificate of Insurance above, also applies, effective on the data shown, to the per-
son or organisation named as an "Other Interest" below, as an additional Insured but only with respect to liability of the additional Insured arising out of the acts and
omissions of the named Insured. This extension of coverage does not apply to the Iiability of the additional insured arising either wholly orpartlyout of (1) his or its own
negligence, or that of Iri agents or employees (except where the named Insured b on agent or employee of the additional Insured), or (2) any defect of material, design, or
workmanship in anything of which ho or if Is the owner, lessor, manufacturer. mortgagee, or beneficiary.
It Is further agreed that R any court shall Interpret the language of this policy or this endorsement contrary to Its Intent to restrict the coverage to liability of the additional fn-
suredarisingonlyoutoftheactsandomissionsof1MnamedInsured, Hren the Ilmit el Ilabiliry under such Interpretation Ives automobile ticbl... shellbetheIlmlriofbedllyIn-
jury Ilabillry end property damage Iloblliry spedlled by any motor rehlde financial responsibility law of the stab. prorlrrce, or brrltory In which its named Insured resides.
ll theta is no such motor vehicle financial respensiblllty low or If the (lability arises from o source other than an automobile, the limit of the Company If (lability hereunder shall
source
be $5.000 sm com._ d bodily injury sustained by one psrson in any one xcurrence and subjed to thts provision respecting each person, 510,000 on account of bodily Injury
smtolrred by two or moro persons In any one orcumence. The list if Ir iffyy of Nte Can, for all domages because of ell property damage sustained by one or more persons
or marenicaaons as the result of any one arc. nsm. shall net amend 55,000.
This endorsement shall not operate to Increase the limits of the Company's liability under the policy.
(ALL STATES EXCEPT DKLAHOMA) It is hereby agreed that upon cancellation or termination of this policy or policies from any muse the
Company will moil 11! days notice in writing thereof to the other Interest shown below-
OTKER
INTEREST CITY CLERK NEWPORT BEACH
-
.3300 NEWPORT BLVD
.NEWPORT BEACH, CA 92660
t'k NOTAPPLICABLE INTEXAS 4Is f APPLICABLE IN TEXAS
OKLAHOMA CERTIFICATE -In the event at any material change In
or cancellation of said policies, the Company will make every ef-
fort to notify the party to whom this certificate is Issued ofsuch
change or cancellation, but the Company undertakes no respon-
sibilitybyroc nofanylelturesebdoo..�p/ /�
Countersigned �� `�• .
Notice of cancellation of the primary coverage outomaticol ly term i notes excess coverage. A breakdown of the primary limits and the excess limits will be
provided on demand. .
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L
A16 CERTIFICATE OF INSURANCE
Q/ PRIMARY L
\INSURANCE The Exchange or Company designated on the reverse side as number
(INSURANCE) ( INSURANCE) Excess over Primary with Company designated on reverse side as letter
When countersigned by an authorized representative of the Company, this certificate supersedes any previously issued certificates and certifies that the
following policy(ies), have been issued to the insured for thecoverage indicated. This certificate or verification of insurance is not an insurance policy and
does not amend, extend archer the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or
other document with respect to which this certificate or verification of insurance may be issued or may pertain, the insurance afforded by the policies
described herein is subject to all the terms, exclusions and conditions of such policies.
:wed '.TTO°ivLrY DATA INC & N,RUIN CROY AS
Address. AN INDIVIDUAL essPOlicyorCerti ( icaleNumber
.33!45 N vJPORT : 1.LVD ,r?00 197 07 _364 11568 00 13
NB'AF'OR" B': \C:i, �'A 92660 1 Agent I Policy Number
Effective from: 10-3-80
To:
at which time this certificate becomes void la or until cancelled if this box "X" d.
PART 1 CERTIFICATE OF INSURANCE ❑ Applicable ❑ Not applicable
INDICOVE BY BVr IS
,,, COVERAGE COMBINED LIMITS OF LIABILITY
LIMIT(S)
INCLUDE(S)
BOTH PRIMARY
AND EXCESS
(if excess
o olimble)
OWNED
AUTO LIABILITY
Bodily Injury
Property Damage
EACH PERSON
I EACH OCCURRENCE
DIGITS
Owned
,000
�Q
COVERED
Non -Owned
Is ,000
Comm'I Umbrella Liability
Hired
AGGREGATE
EACH OCCURRENCE
Employer's Non- Ownersh i p Contingent Liabi l i ty
l$
Is
GENERAL LIABILITY
Bodily Injury
Property Damage
Bodily Injury
Property Damage
EACH PERSON
EACH OCCURRENCE
X
M &C -OLT, Owners& Contractors, Contractual, Elevators
negligence, or that of its agents or employees (except where the named insured Is an agent or employee of the additional insured), or (2) any defect of material, design, or
,000
X
Products and /or Completed Operations
jury liability and property damage liability specified by any motor vehicle financial responsibility low of the Onto, province, or territory In which the named insured resides.
If there is no such motor valid. Immcial responsibility low or If the liability arises from a source other than an automobile, the limit of the Company's liability hereunder shall
be SS.000 on account of bodily injury sustained by one person In any one occurrence and subject to this provision respecting each person, $10,000 on account of bodily injury
sustained by twe or more persons in any one occurrence. The total liability of the Company for all damages because of all property damage sustained by one or more persons
is is owners& contractors protective, contractual,
and /or completed operations
AGGREGATE PRODUCTS
000
$ � 0 ,000
Single Limit Liability for Coverages checked above
AGGREGATE PRODUCTS
EACH OCCURRENCE
$ ,000
$ ,000
Cargo
EACH VEHICLE
EACH OCCURRENCE
$ 000
$ 000
Workers' or Workmen's Compensation
Statutory
• Includes Goods or Products Warranty, Written Lease of Premises, Easement Agreement, Municipal Ordinance Agreement, Sidetrack Agreement, Elevator or
Escalator Maintenance Agreement only unless accompanied by specific endorsement providing additional Contractual Coverage.
(ALL STATES EXCEPKLAHOMA) It is hereby agreed that upon cancellation or termination of this policy or policies from any cause the
Company will mail—ii? t days notice in writing thereof to the other interest shown below.
OTHER
MEREST CITY C.,ERK NSsrPORT B, AC`
3300 Nn'iiFOe'I : LVIJ
NEWPORT B r' ;i, 926410
*
is Nor APPLICABLE IN TEXAS * * e APPLICABLE IN TEXAS
OKLAHOMA CERTIFICATE -In the evont of any material change in
or cancellation of sold policies, the Company will make every ef-
fort to notify the pony to whom this cenilicate is issued of such
change or cancellation, but the Company undertakes no rospon.
s ibility 6yreas nefanyloilurssotodo.
Countersigned
AwM1Pra.d R. entouve
Notice of cancellation of the primary coverage automatically terminates excess coverage. A breakdown of the primary limits andtheexcess limits will be
provided on demand.
56-0197 3 -80 1301 PRIMED IN U.S A 01
YEAR, MAKE, TYPE OF BODY, LOAD CAPACITY fi owBEO w",,D aN
IDENTIFICATION NUMBER
OWNED
LAST 3
AUTOMOBILES,
DIGITS
IF
SHOWN
COVERED
Comm'I Umbrella Liability
RETAINED LIMIT
AGGREGATE
EACH OCCURRENCE
$ 0()O
l$
Is
POLICY NUMBER
PART 11 ADDITIONAL INSURED ENDORSEMENT ❑ Applicable p Not Applicable
It is agreed that such Insurance IN is afforded by the coverage, indicated by an "X" an the Corillicata of Insurance above, also applies, affective on the date shown, to the por.
son or organization named as an "Other Interest' bolow, as an additional Insured but only with respect to liability of the additional Insured arising out of the acts and
omissions of the nomad Insured. This extension of coverage does not apply to the liability of the additional Insured arising either wholly or partly out of (I) his or Its own
negligence, or that of its agents or employees (except where the named insured Is an agent or employee of the additional insured), or (2) any defect of material, design, or
workmanship in anything of which he or it is the owner, lessor, manufacturer, mortgages, or beneficiary.
It Is further agreed that R any court shall Interpret the language of this policy or this endorsement contrary to its Intent to restrict the coverage to liability of the additional In.
sured arising only out of the acts and omissions of the nomad Insured, than the limit of liability under such interpretation for automobile liability shall be the limits of bodily in.
jury liability and property damage liability specified by any motor vehicle financial responsibility low of the Onto, province, or territory In which the named insured resides.
If there is no such motor valid. Immcial responsibility low or If the liability arises from a source other than an automobile, the limit of the Company's liability hereunder shall
be SS.000 on account of bodily injury sustained by one person In any one occurrence and subject to this provision respecting each person, $10,000 on account of bodily injury
sustained by twe or more persons in any one occurrence. The total liability of the Company for all damages because of all property damage sustained by one or more persons
or orgonimtions as the result of any one otwrnnc¢ shall net exceed S5.000.
This endorsement shall not operate to increase the limits of the Company's liability under the policy.
(ALL STATES EXCEPKLAHOMA) It is hereby agreed that upon cancellation or termination of this policy or policies from any cause the
Company will mail—ii? t days notice in writing thereof to the other interest shown below.
OTHER
MEREST CITY C.,ERK NSsrPORT B, AC`
3300 Nn'iiFOe'I : LVIJ
NEWPORT B r' ;i, 926410
*
is Nor APPLICABLE IN TEXAS * * e APPLICABLE IN TEXAS
OKLAHOMA CERTIFICATE -In the evont of any material change in
or cancellation of sold policies, the Company will make every ef-
fort to notify the pony to whom this cenilicate is issued of such
change or cancellation, but the Company undertakes no rospon.
s ibility 6yreas nefanyloilurssotodo.
Countersigned
AwM1Pra.d R. entouve
Notice of cancellation of the primary coverage automatically terminates excess coverage. A breakdown of the primary limits andtheexcess limits will be
provided on demand.
56-0197 3 -80 1301 PRIMED IN U.S A 01
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NOTICE OF CANCELLATION
OF MORTGAGEE AND/OR •
CERTIFICATE HOLDER
yF+ TRUCK INSURANCE EXCHANGE
❑ FARMERS INSURANCE EXCHANGE
❑ MID - CENTURY INSURANCE COMPANY
LOAN
INSURED ATTORNEY DATA INC F NORVIN CROY AS AN INDIVIDUAL
POLICY OR
CERTIFICATE NUMBERS
1568 00 13
AGENT'S NUMBER
CANCELLATION DATE
�7 n7 364
10 -18 -80
® You are hereby notified. that all coverage extended to you under the
above listed policy is cancelled effective at 12:00 Noon (12:01 A.M.
in California and Oregon) on the Cancellation Date shown above_
❑ You are hereby notified that all coverage extended to you under the
above policyliesl or certificatelsl on
is cancelled effective at 12:00 Noon 112:01 A.M. in California and
Oregon) on the cancellation date shown above.
a
z
v
z_
CITY CLERK NEWPORT BEACH
3300 NE'. +!PORT BLVD
NE'IVIPORT BEACH CA 92660
^ NOTE TO MORTGAGEE: Your loan with this policyholder may have
expired; however, this notice complies with the provision of our policy.
i
CITY OF NEWPORT BEACH
CALIFORNIA
City hall
3300 W. Newport Blvd.
Area Code 7t4
DA7U June 16, 1980
T0: FINANCE DIRECTOR .
FROM:.. City Clerk
SUBJECT: Contract No. 2174
Description of Contract . Data Processing service
Authorized by Resolution No. 9763 adopted on heal 14. 1980
Effective date of Contract June 11 1980
Contract with N. A. Croy
Address Z- Facbor Tnwrporated
3345 Ne4xmt Blvd, Nmpoxt Beach, CA 32663
Amount of Contract see amtzact
City Cler c
i
A G R E E M E N T
Use of Computer - N. A. Croy
THIS AGREEMENT is made between the CITY OF NEWPORT
BEACH, a municipal corporation, hereinafter referred to as
"NEWPORT BEACH" and N. A. CROY, Z- Factor Incorporated, 3345
Newport Boulevard, Newport Beach, California, hereinafter referred
to as "CROY."
W I T N E S S E T H:
WHEREAS, Newport Beach owns a computer and there is
time for .use of said computer, which will not conflict with Newport
Beach's use of said computer; and
WHEREAS, Newport Beach desires to share the use of said
computer; and
WHEREAS, it is recognized that the sharing of the use of
such computer will be advantageous to both parties to'this agree-
ment; and
WHEREAS, it is in the public interest to permit the com-
puter owned by Newport Beach to be utilized to its fullest capacity;
NOW, THEREFORE, in consideration of the mutual covenants,
conditions, agreements and stipulations hereinafter expressed, the
parties hereto hereby agree as follows:
1. Newport Beach will make available to Croy said
Computer, at such times and under such conditions as are deemed
appropriate by Newport Beach.
2. Newport Beach will bill Croy and Croy will pay Newport
Beach for the use of said computer at a rate that is comparable
to generally- accepted industry standards.
3. Newport Beach will bill Croy once each month, which
amount will become due and payable within ten (10) days after
depositing said bill in the U.S. Mail.
4. Time for computer use by Croy will be made available,
subject to prior approval by the City of Newport Beach, as provided
below, between 5 :00 p.m. and 8:00 a.m. of the following day, and on
holidays and weekends. The City may, at its discretion, impose
a minimum number of hours usage per month.
Page 1, of 3
5. Croy may purchase from Newport Beach such materials,
including standard form, cards and the like, at Newport Beach's
cost, plus a nominal storage and handling charge.
6. Croy will provide his own operator for the use of the
computer hereunder, and all personnel of Croy who may be required
to enter Newport Beach's computer room shall have received the prior
written approval of Newport Beach.
7. Croy will schedule work with the computer, subject
to prior approval by Newport Beach, with a minimum of three. (3) days'
advance notice.
8. Croy may store disk packs, program decks and other
materials to be used under this Agreement in Newport Beach's computer
room, subject to such space limitations and time limitations as may
be reasonably imposed by Newport Beach, and will remove same on 5 days'
notice.
9. Croy may use only City approved disk packs and tape
on said computer.
10. Croy agrees to hold harmless Newport Beach, its
officers., agents and employees, from any bodily injury, personal
injury, death, or property damage which may arise out of the per-
formance of this Agreement. Croy shall provide Newport Beach with
evidence of insurance in such form and amount as may be approved
by the City Attorney of Newport Beach which shall name Newport Beach
as an additional insured, which shall provide that the insurance so
provided will be primary insurance and not contributing with any
other insurance available to Newport Beach under any third party
liability policy.
11. This Agreement shall run on a month -to -month basis
and may be terminated by either party by giving at least thirty
(30) days' written notice prior to date of termination.
12. This Agreement shall take effect and shall become
operative when executed by the parties hereto.
Page 2 of 3
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be made and executed on this day of
1980.
ATTEST:
vity clerk U
APPROVED AS TO
UT)FIED As E ORIGINAL
;JTY CLERK OF THE CITY OF NOWP(,*T 86Arli
JUN I i I*
PATes
CITY OF NEWPORT BEACH
A Municipal Corporation
ZZBy w,
mayor- k-rgU Jens
N. A. CROY
"TIP ...... 1) A— � L A 721E AND CO ^ZEGT COPY
241y iPCRT BEACH ....
DAT
pacie 3 �F 7
2=11
R !R!011n
EIii
WERTIFICATE OF INSURANCE
, PRIMARY 2
INSURANCE ) The Exchange or Company designated on the reverse side as number
EXCESS
ASURANCE Excess over Primary with Company designated on reverse side as letter
When countersigned by an authorized representative of the Company, this Certificate supersedes any previously issued certificates and certifies that the
following policy(ies), have been issued to the insured for thecoverage indicated. This certificate or verification of insurance is not an insurance policy and
does not amend, extend oralter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or
other document with respect to which this certificate or verification of insurance may be issued or may pertain, the insurance afforded by the policies
described herein is subject to oll the terms, exclusions and conditions of such policies.
Named
Insured . ATTORNEY DATA INC 8 NORVIN CROY AS
Address. AN INDIVIDUAL ._ ExIc,Ockl.,Ce,ntirote Numb,,
3345 NEWPORT BLVD 11200 197 07 364 1568 00 13
NEWPORT BEACH CA 92660 1 _ Agent I Policy Number
Effective from: 3-21-80
T,.•
at which time this certificate becomes void M nr until cancelled if this box "X"d.
PART 1 CERTIFICATE OF INSURANCE ® Applicable ❑ Not applicable
CO' HI
INOl D BY S °x" COVERAGE COMBINED LIMITS OF LIABILITY
H 9v
IDENTIFICATION NUMBER
LIMIT(S)
INCLUDE(S)
BOTH PRIMARY
AND EXCESS
(if excess
applicable)
AUTO LIABILITY
Bodily Injury
Property Damage
EACH PERSON
EACH OCCURRENCE
IF
Owned
10 ,�
3 000
Non -Owned
50 ,000
RETAINED LIMIT
Hired
J EACH OCCURRENCE
$ ,000
Employer's Non - Ownership Contingent Liability
Is
GENERAL LIABILITY
Bodily Injury
Property Damage
Bodily Injury
Property Damage
EACH PERSON
EACH OCCURRENCE
omissions d the named insured. This extension of coverage doe. not apply to the liability of the additional Insured arising either wholly or partlyout of (I) his or Its own
M&C -OLT, Owners& Contractors, Contractual, Elevators
100 000
300 000
jury Ile lity and property damage Iiablllty apecifled by any _-for -_hide flmncial responsibility law of fhe smto, province, w territory in which the named insured rezide.
If (here Is no wch mWw vehicle InI _1.1 responsib1117 law or li fhe liability arises from a source other an on automobile, the Iimi* of the Company's liability shall
Products and /or Completed Operations
sustained by two or more persona in any one occurrence. The total liability o1 The Company for all damages because of all property damage sustained by one or more persons
50 ,000
This endorsement shall cwt operate to increase the limit. of the Company's liability under the policy.
* * * owners 8 contractors protective, contractual,
and /or completed operations
AGGREGATE PRODUCTS
3 0 0 ,000
$ 50,000
Single Limit Liability for Coverages checked above
AGGREGATE PRODUCTS
EACH OCCURRENCE
$ ,000
$ ,000
Cargo
EACH VEHICLE
EACH OCCURRENCE
$ ,000
$ 000
Workers' or Workmen's Compensation
Statutory
* Includes Goods or Products Warranty, Written Lease of Premises, Easement Agreement, Municipal Ordinance Agreement, Sidetrack Agreement, Elevator or
Escalator Maintenance Agreement only unless accompanied by specific endorsement providing additional Contractual Coverage.
(ALL STATES EXCEPT OKLAHOMA) It is hereby agreed that
Company will mail 10 days notice in writing thereof tqt
OTHER
INTEREST
CITY CLERK NEWPORT /,'
3300 NEWPORT BLVD',
NEWPORT BEACH CA °?:6
* * NOTAPPIICABLE IN TEXAS * * * APPLICABLE
Notice of cancellation of the primary coverage automat
provided on demand.
50- 01871.80~80NU.&A. ®t
or termination of this policy or policies from any cause the
hii below.
YEAR, MAKE, TYPE OF BODY, LOAD CAPACITY m °eEow` WANAION
IDENTIFICATION NUMBER
OWNED
LAST 3
AUTOMOBILES,
DIGITS
IF
SHOWN
COVERED
Comm'I Umbrella Liability
RETAINED LIMIT
I AGGREGATE
J EACH OCCURRENCE
$ ,000
$
Is
POLICY NUMBER
PART II ADDITIONAL INSURED ENDORSEMENT ❑ Applicable ❑ Not Applicable
If is agreed that such insurance as is afforded by the coverage Indicated by an "X" on the Certificate of Insurance above, also applies, effective on the date shown, to the per-
son or organization named as an "Other Interest' below, as an additional Insured but only with respect to liability of the additional insured prising out of the ads and
omissions d the named insured. This extension of coverage doe. not apply to the liability of the additional Insured arising either wholly or partlyout of (I) his or Its own
negligence, or that of its agents or employees (except where the named Insured is an agent or employee of the additional Insured), or (R) any defect of material, design, or
workmanship in anything of which boor it Is the owner, le..or, manufacturer, mortgagee, or boneflciary.
If 4s fort h« agreed fhm"any court shall In/erprN the language of this *"c or or *his endorsemem contrary to 11s intent to restrict fhe coverage to liability d the additional in-
sured arising only out of tM acts and omITT Ions of /he named insured, then 1hv 'a", ablltly under such InterprNallon for aubmobile (lability shall be the limits of bodily in-
rI
jury Ile lity and property damage Iiablllty apecifled by any _-for -_hide flmncial responsibility law of fhe smto, province, w territory in which the named insured rezide.
If (here Is no wch mWw vehicle InI _1.1 responsib1117 law or li fhe liability arises from a source other an on automobile, the Iimi* of the Company's liability shall
coon of bodily
W 55,000 on account of 6odlly Injury sustained by one per.on In any one occurrence and subjM to this provision respecting each person, $10.000 on "count of bodily Injury
sustained by two or more persona in any one occurrence. The total liability o1 The Company for all damages because of all property damage sustained by one or more persons
or organizafi.. a. the raault of any one occurrence shall not exceed $5,000.
This endorsement shall cwt operate to increase the limit. of the Company's liability under the policy.
(ALL STATES EXCEPT OKLAHOMA) It is hereby agreed that
Company will mail 10 days notice in writing thereof tqt
OTHER
INTEREST
CITY CLERK NEWPORT /,'
3300 NEWPORT BLVD',
NEWPORT BEACH CA °?:6
* * NOTAPPIICABLE IN TEXAS * * * APPLICABLE
Notice of cancellation of the primary coverage automat
provided on demand.
50- 01871.80~80NU.&A. ®t
or termination of this policy or policies from any cause the
hii below.
lay�o - 4
siouilll 'o6oDiyD
siayumiapun sswx3 0,'D
pu016u3 u! sawodwaD Jo/puo uopuol 'spAOIJ -
oiwo}!lo7 'sala6uy Sol
o:) 8 ia�loM O/D
puo16u3 us saiuodwoD Jojpuo uopuol 'spAol-1 - g
ow104i lob 'sala6uy Sol
AuodwoD @Duonsul Ainyua:)-p!VV - y
3:)NV8nSNl SS3DX3
oiwOI!IDD 'sala6uy $od
AuodwoD aDuoinsul AinyueD -p!Vq .E
:AuodwoD
ay! so 'y! Aq panss± uas ^m 'Anlod ayy ut oy pa�sja}aj AuodwoD IDoys o st 6sitmollo; ayl
oiuwo}!loD 'sala6uy Sol oiuwoplob 'sala6uy Sol
a6uogDx3 a3uoinsul j:snsl a6uoyDx3 a:>uoinsul s -saw-so3 't
:AuodwoD so 'ways }o jayy!a Aq pansg! ueHM
'AD!lod ayl us say pa»a}al sawpawos sa6uo4:sxa a�suo�snsu! -ja�su! aso 6ulmollo; ayi
3JNVHDX33DNVdnSNl S63VVdV3
TRUCK INSURANCE EXCHANGE.
I IM CERTIFICATE OF INSURANCE
When countersigned by an authorized repr tive of the Company. this certificate supersedes. tviously issued certificates and certifies
that the following policy(ies) have been issued to the insured for the coverage indicated. This certificate is subject to all of the terms, con-
ditions and limitations set forth in the described policy(ies) and endorsements thereto. It is furnished as a matter of information only and does
not change, modify or extend the policy(ies) in any way.
Named .ATTORNEY DATA INC, & NORVIN CROY AS AN INDIVIDUAL
Address , 3345 NEWPORT BLVD, #200 Policy No.- Workmen's
Com pe sat n
,NEWPORT BEACH, CA 97 07_36_4 1568 00 i31e
92660 Agent Policy No. -Other Co,
UNLESS REPLACED BY THE COMPANY'S STANDARD CERTIFICATE OR UNLESS CANCELLED, THIS INTERIM CERTIFI ATE
SHALL BE EFFECTIVE FOR A PERIOD OF THIRTY DAYS COMMENCING —m 3-21 19 0O
® 4 Agent: Check here if a permanent certificate is to be issued by the Policywriting Office.
OWNED
AUTO-
MOBILES,
IF
*Includes Goods or Products Warranty, Written Lease of Premises, Easement Agreement, Municipal Or-
dinance Agreement, Sidetrack Agreement, Elevator or Escalator Maintenance Agreement only, unless ac-
companied by specific endorsement providing additional Contractual Coverage.
❑Described {� D.wiptian
below u waived
TYPE OF BODY. LOAD
CALL JLAIeb cA.L.Q'1 Vr LAMVIYIAJ ,Q. -, ! -I-,,
It Is hereby agreed that upon cancellation or termination "
1�-- `--1n'theiyspI
of this polity or policies From any cause the Company the Camr;
TEN (10) certificate tl
will moil _ -days notice in - undenake>ui
writing thereof to the other Interest shown below.
Other
nterest*CITY CLERK, NEWPORT BEACH?
3300 NEWPORT BLVD, 5
NEWPORT BEACH, CA., 92660``'.:
. s Not Applicable in Texas.
*.*Applicable in Texas only.
5"514 2-76 1361100 EDwuSa QI
LAST 3
DIGITS
SHOWN
iterfal change In or cancellation of said policies,
ko every effort to notify the party to whom this
f such change or cancellation, but the Company
stbflity by reason of any failure so to do.
TRUCK INSURANCE EXCHANGE
uck Underwriters Association. Arty. in fact
Presitlen,
A ihorizetl a native
is
COVERAGE
LIMITS UVIIABILITY
COVERED
COVERED AUTO LIABILITY
Owned
Hired
Bodily Injury $
100 ,000 each person
300
$
,000 each occurrence
❑
®
)0
❑
Non -Owned
Employers Non - Ownership
Property Damage $
50 ,000 each occurrence
Contingent Liability
GENERAL LIABILITY
Bodily Injury $
00 .000 each person**
$
300 each occurrence
®
❑
OwnerOs 8 Contractors
Contractual is
$
.000
300 ,000 aggregate products
Elevators
Property Damage $ 50 000 each occurrence
50
®
❑
Products
$
000 aggregate products
owners 8 contractors protective ee
— contractualeee—
completed operations ee
Single Limit
Liability
for Coverages checked ®above
$
,000 each occurrence
$
,000 aggregate products
❑
®
CARGO
$
.000 each vehicle
$
,000 each occurrence
Less $
Deductible
❑
L7� WORKMEN'S
lJ COMPENSATION
Statutory
*Includes Goods or Products Warranty, Written Lease of Premises, Easement Agreement, Municipal Or-
dinance Agreement, Sidetrack Agreement, Elevator or Escalator Maintenance Agreement only, unless ac-
companied by specific endorsement providing additional Contractual Coverage.
❑Described {� D.wiptian
below u waived
TYPE OF BODY. LOAD
CALL JLAIeb cA.L.Q'1 Vr LAMVIYIAJ ,Q. -, ! -I-,,
It Is hereby agreed that upon cancellation or termination "
1�-- `--1n'theiyspI
of this polity or policies From any cause the Company the Camr;
TEN (10) certificate tl
will moil _ -days notice in - undenake>ui
writing thereof to the other Interest shown below.
Other
nterest*CITY CLERK, NEWPORT BEACH?
3300 NEWPORT BLVD, 5
NEWPORT BEACH, CA., 92660``'.:
. s Not Applicable in Texas.
*.*Applicable in Texas only.
5"514 2-76 1361100 EDwuSa QI
LAST 3
DIGITS
SHOWN
iterfal change In or cancellation of said policies,
ko every effort to notify the party to whom this
f such change or cancellation, but the Company
stbflity by reason of any failure so to do.
TRUCK INSURANCE EXCHANGE
uck Underwriters Association. Arty. in fact
Presitlen,
A ihorizetl a native
is
March 19, 1980
6 0
CITY OF NEWPORT BEACH
Mr. N. A. Croy
Z- Factor Corporation
3345 Newport Boulevard
Newport Beach, CA 92663
OFFICE OF THE CITY MANAGER
(714) 640=2153_
Dear Mr. Croy:
SUBJECT: LAPSE OF INSURANCE - CITY COMPUTER RENTAL AGREEMENT
According to our official records, your Certificate of Insurance
associated with the above - referenced Agreement, has lapsed.
Please insure that appropriate documentation updating your
coverage is filed-promptly with the City Clerk's Office, 3300
Newport Boulevard, Newport Beach.
Additionally, staff is in the process of reviewing the terms
of the Agreement relative to rental payment and other provisions
to determine its consistency with current conditions. Mr. Kramp,
the Data Processing Manager, will be submitting his recommenda-
tions regarding possible amendments to the contract in the
near future.
Thank you for your cooperation in attending to the lapse of
insurance. If you have questions, I would suggest you contact
Ted Kramp at 640 -2245.
to the City Manager
GJB /jmb
xc• i y Clerk
Da Processing Manager
City Hall • 3300 Newport Boulevard, Newport Beach, California 92663
April 15, 1980
•
CITY OF NEWPORT BEACH
OFFICE OF THE CITY MANAGER
(714) 640 -2153
Mr. N. A. Croy
Z- Factor Incorporated
3345 Newport Boulevard
Newport Beach, CA 92663
Dear Mr. Croy:
At its meeting on April 14, 1980, the Newport Beach City
Council approved the enclosed Use of Computer Agreement.
A copy of Resolution No. 9763, which reflects this action,
is enclosed for your records.
Please sign the enclosed Agreement and return it to the
City Clerk in the enclosed stamped, self- addressed
envelope. As soon as the Agreement has been signed by
all parties, you will be sent a copy for your records.
If you have any questions, please do not hesitate to contact
me.
ly,
to the City Manager
GJB /jmq
Enclgsres (3)
xSc i City Clerk
City Hall • 3300 Newport Boulevard, Newport Beach, California 92663
0
March 13, 1980
CITY OF NEWPORT BEACH
OFFICE OF THE CITY MANAGER
(714) 640 -2153
Mr. N. A. Croy
18687 Redwood
Fountain Valley, CA 92708
Dear Mr. Croy:
SUBJECT: LAPSE OF INSURANCE - CITY COMPUTER RENTAL AGREEMENT
According to our official records, your Certificate of Insurance
associated with the above - referenced Agreement, has lapsed.
Please insure that appropriate documentation updating your
coverage is filed promptly with the City Clerk's Office, 3300
Newport Boulevard, Newport Beach.
Additionally, staff is in the process of reviewing the terms
of the Agreement relative to rental payment and other provisions
to determine its consistency with current conditions. Mr. Kramp,
the Data Processing Manager, will be submitting his recommendations
regarding possible amendments to the contract in the near future.
Thank you for your cooperation in attending to the lapse of
insurance. If you have questions, I would suggest you contact
Ted Kramp at 640 -2245.
GE
ely
istey�t to the City Manager
GJB /jm
xc• ty Clerk
Data Processing Manager
City Hall • 3300 Newport Boulevard, Newport Beach, California 92663
0
1 h. IQ'_r CITY OF NEWPORT BEACH
By +he CITY COUNCIL
OFFICE OF THE CITY MANAGER
: iTY OF ? ^! aT
KACH
April 14, 1980
AGENDA ITEM
TO:
MAYOR
AND CITY COUNCIL
N0, Z
FROM:
City
Manager
SUBJECT:
PROPOSED
AMENDMENTS TO COMPUTER USE
AGREEMENT
N.A.
CROY
Background
On May 12, 1975, the City Council adopted Resolution No. 8486
authorizing the execution of an agreement with N.A. Croy for use
of the City's computer. This agreement provides, among other
things, for:
1. Payment to the City of a rental fee for computer use time
of $15.00 per hour.
2. Authorization for Croy to use the computer between the hours
of 9:00 p.m. and 8:00 a.m. during the week as well as on
holidays and weekends.
3. Authorization for Croy to purchase computer use materials such
as program cards from the City at cost.
4. Provision, by Croy, of his own computer operator subject to
the approval of the City.
5. Allocation of computer room storage space to Croy, subject to
limitations imposed by the City's needs.
Basically, the contract is administered by, and monitored through,
the Finance Department and specifically, the Data Processing Manager.
Each month Croy's computer use time is logged and billings are made
based upon that log.
Proposed Amendments to Agreement
Staff has recently reviewed the terms of the above - referenced agree-
ment and has proposed certain amendments which would more - accurately
reflect current conditions. Attached to this staff report is a
copy of the proposed agreement which incorporates the suggested
changes. These changes, which have the concurrence of the Data
Processing Manager, the Finance Director, this office, and Mr. Croy,
are as follows:
T0: MAYOR AND CITY COUNCIL - Page Two
Page 1, Item No. 2 - Deletes specified hourly rate of $15.00
and replaces it with a provision for billing according to
"generally accepted industry standards." This will allow
the City flexibility in adjusting the rate based upon actual
costs and conditions without the necessity of amending the
contract. According to the Data Processing Manager, a
rate of $18.00 per hour would be in line with "currently
accepted industry standards." It is anticipated that this
rate may again require some adjustment during the coming year.
Page 1, Item No. 4 - Extends hours of possible computer
usage from the current 9:00 p.m. to 8:00 a.m. time frame to
a new time frame of 5:00 p.m. to 8:00 a.m. These hours, of
course, parallel the hours the City Hall is formally closed.
Additionally, under this item, a new sentence has been added
which allows the City to impose a minimum number of hours
usage per month.
Page 2, Item No. 5 - Adds wording allowing for a nominal
storage and handling charge for purchase of materials. These
charges refer to certain overhead costs associated with
inventorying and providing additional storage space for pur-
chased materials.
It is believed that these proposed contract amendments will provide
for more - efficient and equitable administration of the Computer Use
Agreement. As mentioned earlier, both the staff and Mr. Croy have
approved of the suggested changes.
Recommendat
It is recommended that the City
approving the proposed agreement
erk to execute same on behalf
ICJN
1/l!
ROBERT L. WYNN D
City Manager
RLW /GJB /jmb
Attachments
Council adopt Resolution No.
and authorizing the Mayor and City
of the City.
r
A G R E E M E N T t J
Use of Computer - N. A. Croy
THIS AGREEMENT is made between the CITY OF NEWPORT
BEACH, a municipal corporation, hereinafter referred to as
"NEWPORT BEACH" and N. A. CROY, Z- Factor Incorporated, 3345
Newport Boulevard, Newport Beach, California, hereinafter referred
to as "CROY."
W I T N E S S E T H:
WHEREAS, Newport Beach owns a computer and there is
time for use of said computer, which will not conflict with Newport
Beach's use of said computer; and
WHEREAS, Newport Beach desires to share the use of said
computer; and
WHEREAS, it is recognized that the sharing of the use of
such computer will be advantageous to both parties to this agree-
ment; and
WHEREAS, it is in the public interest to permit the com-
puter owned by Newport Beach to be utilized to its fullest capacity;
NOW, THEREFORE, in consideration of the mutual covenants,
conditions, agreements and stipulations hereinafter expressed, the
parties hereto hereby agree as follows:
1. Newport Beach will make available to Croy said
Computer, at such times and under such conditions as are deemed
appropriate by Newport Beach.
2. Newport Beach will bill Croy and Croy will pay Newport
Beach for the use of said computer at a rate that is comparable
to generally- accepted industry standards.
3. Newport Beach will bill Croy once each month, which
amount will become due and payable within ten (10) days after
depositing said bill in the U.S. Mail.
4. Time for computer use by Croy will be made available,
subject to prior approval by the City of Newport Beach, as provided
below, between 5:00 p.m. and 8:00 a.m, of the following day, and on
holidays and weekends. The City may, at its discretion, impose
a minimum number of hours usage per month.
Page 1 of 3
A
i
•
5. Croy may purchase from Newport Beach such materials,
including standard form, cards and the like, at Newport Beach's
cost, plus a nominal storage and handling charge.
6.' Croy will provide his own operator for the use of the
computer hereunder, and all personnel of Croy who may be required
to enter Newport Beach's computer room shall have received the prior
written approval of Newport Beach.
7. Croy will schedule work with the computer, subject
to prior approval by Newport Beach, with a minimum of three (3) days'
advance notice.
8. Croy may store disk packs, program decks and other
materials to be used under this Agreement in Newport Beach's computer
room, subject to such space limitations and time limitations as may
be reasonably imposed by Newport Beach, and will remove same on 5 days'
notice.
9. Croy may use only City approved disk packs and tape
on said computer.
10. Croy agrees to hold harmless Newport Beach, its
officers, agents and employees, from any bodily injury, personal
injury, death, or property damage which may arise out of the per-
formance of this Agreement. Croy shall provide Newport Beach with
evidence of insurance in such form and amount as may be approved
by the City Attorney of Newport Beach which shall name Newport Beach
as an additional insured, which shall provide that the insurance so
provided will be primary insurance and not contributing with any
other insurance available to Newport Beach under any third party
liability policy.
11. This Agreement shall run on a month -to -month basis
and may be terminated by either party by giving at least thirty
(30) days' written notice prior to date of termination.
12. This Agreement shall take effect and shall become
operative when executed by the parties hereto.
Page 2 of 3
ax�
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be made and executed on this day of
1980.
ATTEST:
City Clerk
APPROVED AS TO FORM:
City Attorney
CITY OF NEWPORT BEACH
A Municipal Corporation
By
Mayor
N. A. CROY
Page 3 of 3
r'
4
i,
By the Ciiy COUNCIL
.;iiY Q!t .ti ^. ^�c�l4T 45441-1
40
RESOLUTION NO. V l;-
A RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF NEWPORT BEACH AUTHORIZP_VG THE MAYOR AND
CITY CLERK TO EXECUTE AN AGREEMENT BETWEEN
THE CITY OF NEWPORT BEACH AND N. A. CROY IN
CONNECTION WITH THE USE OF THE CITY COMPUTER
WHEREAS, there has been presented to the City
Council of the City of Newport Beach a certain agreement
between the City of Newport Beach and N. A. Croy in
connection with the use of the City computer; and
WHEREAS, the City Council has reviewed the terms
and conditions of said agreement and finds them to be
satisfactory and that it would be in the best interest of
the City to execute said agreement,
NOW, THEREFORE, BE IT RESOLVED by the Ciy Council
of the City of Newport Beach that the agreement above
described is hereby approved, and the Mayor and City Clerk
are hereby authorized and directed to execute the same on
behalf of the City of Newport Beach.
ADOPTED this 14th day of April , 1980.
Mayor
Uywao w
City Clerk
kv
4/7/80
a a �CITY OF NEWPORT BEACH
CALIFORNIA
City hall
3300 W. Newport Blvd
Area Code 714
673 -2110
DATE
TO: FINANCE DIRECTOR
FROM: City Clerk
SUBJECT: Contract No. 17-04
Description of Contract —Rj�Rtai of City's Eemguter
Authorized by Resolution No. 8486 , adopted on May 12, 1975
Effective date of Contract Mety ,
Contract with
Address 1868? - Redwood
Fountetin ,
Amount of Contract $15.G9 per r
V -City Cle c
1
May 16, 1975
N. A. Croy
18687 Redwood
Fountain Valley, CA 92708
Subject: Agreement for Use of City of
Newport Beach's Computer
C -1704
Enclosed is a fully executed copy of subject
agreement. The City Council authorized the
agreement on May 12 by the adoption of Resolu-
tion No. 8486.
Please contact Mr. Ted Hramp in our Data
Processing Department regarding scheduling
your use of the computer.
Laura Lagios, CMC
City Clerk
LL:swk
enc.
cc: Finance Department
(Ted Xramp)
Effective any loss under Automobile Physical Damage Coverage Is payable as Interests may of p' ga o the Nar_ned Ansvred and the Lien} older
named below In accordance with Loss Payable Endorsement on reverse side..
UENHOLDER
\i
As respects the following described avromoBllelslf
YEAR TRADE NAME BODY TYPE AND MODEL SERIAL NUMBER
I I I I
DESCRIPTION AND LOCATION OF OPERATIONS - THE certificate, of insurance neither affirmatively or ne9alively amends, extends or alters the coverage afforded by the I described
henf r.)
City of Diewport Beach is hereby named as an additional insured.
This policy shall not be canceled nor reduced in coverage until after '__z ^t > °: y t,days written notice of such
cancellation or reduction in coverage shall have been mailed to this certificate holder.
Certified this - day of 19
Producer
I
CERTIFICATE
OF
JAMED
vSURED ► . Attorney ata Inc. Z Factor
y
Inca u Nez.e Cr
:)-,7 INSURANCE
cov ER nADE Is im IH
f
as an individt:al
THE MWANY DEEIanATED, A
ETOCYIHEURANCE Ca aANY
IHERFH CLLEED THE COMtAHYI.
3345 Newport Blvd,, Suite 202
COMPANY
Newport Beach, CA. 92660
HOME OFFICE
: ERTIFICATE
SSUED TO ►
R City of Newport Beach
The Company designated above has issued coverage effect
five as of the dates and for the periods and limits specified below
City gall
and subject to all terms, conditions, provisions, exclusions and
9 (1 Cp A
Newport Beach,
limitations of the described Binders or Policies whether shown
by Otherwise. Any or
.
endorsement or requirements provisions
in any contract or agreement between the Insured and any other
Attn : Finance Director
person, firm or ...pomtlan will not be construed as enlarging,
altering or amending the definition of insured or any other terms
7L.
or conditions of this certificate or the polity designated.
KIND OF INSURANCE ""--"
POLICY NUMBER
POLICY PERIOD
LIMITS OF LIABILITY
COMPENSATION
EFF
STATUTORY CALIFORNIA COMPENSATION ---
WORKMEN 'SCOMPENSATION
EXP
EMPLOYERS UABILI :' $2,000,000 PER OCCURRENCE
LIABILITY' --
- -
EACH PERSON EACH OCCURRENCE
BODILY INJURY LIABILITY - --
AUTOMOBILE..
'
EACH OCCURRENCE AGGREGATE
EXCEPT AUTOMOBIEELITY : - --
..r.: :.' -
LG 727 -808
. -...
pp 75
>'EFF X22 �.,. ..:
p nn``>>
.. A�CFYCICZ�JR ._. 300',0 -Q0
PROPERTY DAMAGEUA &CITY
AUTOMOBILE ..
gU
EXP 'm� +
..- " c '.. .....
-
EACH OCCURRENCE "AGGREGATE
PROPERTYDE(MAGELIABILITY
' EXCEPT AUTOMOBILE- -
LG •727 -808
2.50.000 '• , -50 0. 0
AUTOMOBILE PHYSICAL DAMAGE
..
.COMPREHENSIVE -. ..' ...:...
,: - .: .'b.
'.EFF ....,
$
'FIRE, LIGHTNING &YTRANSPORTATION
..
..
., THEFT (BROAD FORM) ,. ::.... ..
[ :• "� -:., •::
EXP
-:. .� ...
S :.. :.
.COLLISION OR UPSET.
-
•
,.:
'
ACTUAL CASH VALUE LESS .� ��- DEDUCTIBLE
COMPREHENSIVE, CATASTROPHE '- -
-
EFF
"
$ 00 SINGLE 'LIMIT VIABILITY EACH OCCURRENCE
'
ANNUAL DU
ANNUAL AGGREGATE FOR PRODUCTS HAZARD EXCESS OF UNDER
LIABILITY
EXP
LYINGINSURANCELISTED IN POLICY NUMBER INDICATED.
TOLD
Effective any loss under Automobile Physical Damage Coverage Is payable as Interests may of p' ga o the Nar_ned Ansvred and the Lien} older
named below In accordance with Loss Payable Endorsement on reverse side..
UENHOLDER
\i
As respects the following described avromoBllelslf
YEAR TRADE NAME BODY TYPE AND MODEL SERIAL NUMBER
I I I I
DESCRIPTION AND LOCATION OF OPERATIONS - THE certificate, of insurance neither affirmatively or ne9alively amends, extends or alters the coverage afforded by the I described
henf r.)
City of Diewport Beach is hereby named as an additional insured.
This policy shall not be canceled nor reduced in coverage until after '__z ^t > °: y t,days written notice of such
cancellation or reduction in coverage shall have been mailed to this certificate holder.
Certified this - day of 19
Producer
'wuoinsu) }o alwi ilia] ay uo
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pa6uoyoun u!owai Aagod s!yt ;o suo!j!puoi puo swiat aagio py '
.. '_- aauojnsig'}o aloay!ya, ay} nn Pa}oaippr M qa ala 'o ao! }}o. ..
si!'VO'uap!oH -ua!J ayt of pajanpap "JO ot:papow.'.aq pays tu8waaopu3:
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.uGtl "ayy of Auodwoa ayi Ap; uan!6 aq of .p9p!AOjd u!ataq sa>!iou 'lly .b
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saoltou to puo sAop ,Op) Ap!yl }o popad o jo} patuoJ6 A9ejay ajo poi!
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lua6b si! io Jap!oH: ua!I_ayy.u! paysan zuroaaq Aayod s!ql -japan paianm
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Iloys Aoypd lou!6!jo ayi Japan painsu! Atjadmd ayy oy spjozoy awns
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'Allho VWACdi "YDi
0
SIMPLIFIED MERCHANTS PROGRAM
INSURANCE COMPANY OF THE WEST
HOME OFFICE - -SAN DIEGO, CALIFORNIA
POLICY NUMBER
Wm; 40 -18 -75
RENEWS_ NEW -
GA
CODE
PRCODEER 0059
Named Insured and Address: (No., Street, City, State, Zip) Llenholder: (No., Street, City, State, Zip)
Norvin A. Croy DBA: Attorney Date, Inc, and DBA: Z— Factor Corp.
3345 Newport Blvd.
Newport Beach, CA 92662
Type of Lien:
Location: (If different from Mailing Address— No., Street, City State, Zip)
BASIC
132
ANNUAL
.?..
POLICY PREMIUM
XXB.2 (0)
ADDITIONAL
f
5.
Individual ' -_' Partnership :,- XCorporation
i
(IF ANY)
Orange
TOTAL
137'
ANNUAL
:$
POLICY PREMIUM
DECLARATIONS
OCCUPANCY CLASS: CLASS CODE:
0
SIMPLIFIED MERCHANTS PROGRAM
INSURANCE COMPANY OF THE WEST
HOME OFFICE - -SAN DIEGO, CALIFORNIA
POLICY NUMBER
Wm; 40 -18 -75
RENEWS_ NEW -
GA
CODE
PRCODEER 0059
Named Insured and Address: (No., Street, City, State, Zip) Llenholder: (No., Street, City, State, Zip)
Norvin A. Croy DBA: Attorney Date, Inc, and DBA: Z— Factor Corp.
3345 Newport Blvd.
Newport Beach, CA 92662
Type of Lien:
Location: (If different from Mailing Address— No., Street, City State, Zip)
= Mortgage '2= Contract - a Deed in Trust
Interest of Named Insured in Insured Premises:
B. 1.
r == Owner $, Tenant General Lessee
XXB.2 (0)
The Named Insured Is:
Combined Single Limits:
Individual ' -_' Partnership :,- XCorporation
RATE ZONE:
Construction Class
Orange
1( Frame/ Masonry Fire Resistive -=? Sprinklered
Policy Period: (12:01 A.M. Standard Time At Insured Location)
Protection Class
Premiums Payable Annually
X 2 -6 7 -9 9 -10
FROM: (MONTH DAY -YEAR) TO: (MONTH -DAY -YEAR)
OCCUPANCY CLASS: CLASS CODE:
6 -1 -75 6 -1 -76
Office Bookkeeping
INSURANCE APPLIES ONLY TO THOSE COVERAGES FOR
WHICH A LIMIT OF LIABILITY IS SHOWN AND THIS COMPANY SHALL
NOT BE LIABLE FOR MORE THAN THE LIMIT OF LIABILITY
SPECIFIED FOR SUCH COVERAGE AT THE ABOVE DESCRIBED PREMISES.
SECTION I PHYSICAL DAMAGE TO PROPERTY
A. BUILDING — 75% Co- insurance -Per Form MLB -101
B. CONTENTS — 75%Co-insurance (Check Box B. 1, or B.2. below)
B.1. Personal Property —Per Farms MLB -100, MLB -121, MLB -123, and
Expanded Coverage Endorsement, Form ICW -B. 1.
OR jj�pp��QQ9
B.2. Special Commercial Property— Per FormzldE$+TBY and
Special Expanded Coverage Endorsement, Form ICW -8.2• (0)
SECTION II — LIABILITY COVERAGE (PER FORM MLB -200)
C. Bodily Injury and Property Damage
D. Premises Medical Payments
Personal Injury Liability — Hazards A, B, and C —Per Form MLB -220
Nan Ownership Automobile Liability —Per Form MLB -222
Other forms attached to and forming part of this policy: L9105
LIMITS OF LIABILITY
PRODUCER
Robert S. Coplen Co. J /Sc%iC'� (�C/jG�i. G L ! /�� / C
COUNTERSIGNATURE DATE COUNTERSIGNED AT AUTHORIZED SIGNATURE, _./7�/� f,
BB:bas 6/6/75 San Diego /4 �-( f`l^
In Consideration of the Provisions and Stipulations Herein or Added Hereto and of the Premium Above Specified far specified in endorsement attached hereto), this
Company for the term of three years from inception date shown above (At 12:01 A.M. Standard Time) to expiration date shown above (At 1Z:01 A.M, Standard Time) at location of
property involved, to an amount not exceeding the limit of liability specified, does insure the insured named in the Declarations above and legal representatives, to the
extent of the actual cash value of the property at the time of lass, but not exceeding the amount which it would cost to repair or replace the property with material of
like kind and quality within a reasonable time after such lass, without allowance for any increased cost of repair or reconstruction by reason of any ordinance or law
___/ ^ating construction or repair, and without compensation for loss resulting from interruption of business or manufacture, nor in any event for more than the interest
Insured, against all LOSS BY FIRE, LIGHTNING AND OTHER PERILS INSURED AGAINST IN THIS POLICY INCLUDING REMOVAL FROM PREMISES ENDANGERED BY
ERILS INSURED AGAINST IN THIS POLICY, EXCEPT AS HEREINAFTER PROVIDED, to the property described herein while located or contained as described in this policy,
rata for five days at each proper place to which any of the property shall necessarily be removed for preservation from the perils insured against in this policy, but
,where.
out of this policy shall not be valid except with the written consent of this Company.
y is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part of this policy, together
�wa.n. and aamements as may be added hereto, as provided in this Policy, roao Page r
$
$ 4,000
B. 1.
XXB.2 (0)
Combined Single Limits:
$ 300,000.
Each Person:
$ 300.
Each Occurrence:
$ 12,500.
Single Limits:
$ 300,000.
Combined Single Limits:
$ 300,000.
PRODUCER
Robert S. Coplen Co. J /Sc%iC'� (�C/jG�i. G L ! /�� / C
COUNTERSIGNATURE DATE COUNTERSIGNED AT AUTHORIZED SIGNATURE, _./7�/� f,
BB:bas 6/6/75 San Diego /4 �-( f`l^
In Consideration of the Provisions and Stipulations Herein or Added Hereto and of the Premium Above Specified far specified in endorsement attached hereto), this
Company for the term of three years from inception date shown above (At 12:01 A.M. Standard Time) to expiration date shown above (At 1Z:01 A.M, Standard Time) at location of
property involved, to an amount not exceeding the limit of liability specified, does insure the insured named in the Declarations above and legal representatives, to the
extent of the actual cash value of the property at the time of lass, but not exceeding the amount which it would cost to repair or replace the property with material of
like kind and quality within a reasonable time after such lass, without allowance for any increased cost of repair or reconstruction by reason of any ordinance or law
___/ ^ating construction or repair, and without compensation for loss resulting from interruption of business or manufacture, nor in any event for more than the interest
Insured, against all LOSS BY FIRE, LIGHTNING AND OTHER PERILS INSURED AGAINST IN THIS POLICY INCLUDING REMOVAL FROM PREMISES ENDANGERED BY
ERILS INSURED AGAINST IN THIS POLICY, EXCEPT AS HEREINAFTER PROVIDED, to the property described herein while located or contained as described in this policy,
rata for five days at each proper place to which any of the property shall necessarily be removed for preservation from the perils insured against in this policy, but
,where.
out of this policy shall not be valid except with the written consent of this Company.
y is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part of this policy, together
�wa.n. and aamements as may be added hereto, as provided in this Policy, roao Page r
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0ATTACH FORM AND ENDORSEMENTS (IF ANY) HERE 0
THE FOLLOWING PROVISIONS
A. WAR RISK EXCLUSION: UNDER SECTION I AS RESPECTS PERILS OTHER THAN FIRE
(WHICH IS OTHERWISE PROVIDED FOR ON PAGE 2 OF THIS POLICY) AND UNDER SEC-
TION II AS RESPECTS LIABILITY ASSUMED BY THE INSURED UNDER ANY INCIDENTAL
CONTRACT OR AS TO FIRST AID OR MEDICAL EXPENSE, THIS POLICY SHALL NOT APPLY
TO LOSS, BODILY INJURY, OR PROPERTY DAMAGE CAUSED, DIRECTLY OR INDIRECTLY,
BY OR DUE TO ANY ACT OR CONDITION INCIDENT TO THE FOLLOWING:
1. HOSTILE OR WARLIKE ACTION IN TIME OF PEACE OR WAR, INCLUDING ACTION IN
HINDERING, COMBATING OR DEFENDING AGAINST AN ACTUAL, IMPENDING OR EX-
PECTED ATTACK, (a) BY ANY GOVERNMENT OR SOVEREIGN POWER WE JURE OR DE
FACTO), OR BY ANY AUTHORITY MAINTAINING OR USING MILITARY, NAVAL OR AIR
FORCES; OR (b) BY MILITARY, NAVAL OR AIR FORCES; OR (c) BY AN AGENT OF ANY
SUCH GOVERNMENT, POWER, AUTHORITY OR FORCES, IT BEING UNDERSTOOD THAT
ANY DISCHARGE, EXPLOSION OR USE OF ANY WEAPON OF WAR EMPLOYING NU-
CLEAR FISSION OR FUSION SHALL BE CONCLUSIVELY PRESUMED TO BE SUCH A
HOSTILE OR WARLIKE ACTION BY SUCH A GOVERNMENT, POWER, AUTHORITY OR
FORCES;
2. INSURRECTION, REBELLION, REVOLUTION, CIVIL WAR, USURPED POWER, OR AC-
TION TAKEN BY GOVERNMENTAL AUTHORITY IN HINDERING, COMBATING OR DE-
FENDING AGAINST SUCH AN OCCURRENCE; SEIZURE OR DESTRUCTION UNDER
QUARANTINE OR CUSTOM'S REGULATIONS, CONFISCATION BY ORDER OF ANY
GOVERNMENT OR PUBLIC AUTHORITY, OR RISKS OF CONTRABAND OR ILLEGAL
TRANSPORTATION OR TRADE.
B. LIBERALIZATION CLAUSE: If during the period that insurance is in force under this
policy, or within 45 days prior to the inception date thereof, on behalf of the Com-
pany there be adopted, or filed with and approved or accepted by the insurance
supervisory authorities, all in conformity with law, any changes in the form attached
to this policy by which this form of insurance could be extended or broadened with-
out increased premium charge by endorsement or substitution of form, then such
extended or broadened insurance shall inure to the benefit of the insured hereunder
as though such endorsement or substitution of form had been made.
C. INSPECTION AND AUDIT: The Company shall be permitted but not obligated to in-
spect the named insured's property and operations at any time. Neither the Com-
pany's right to make inspections nor the making thereof nor any report thereon shall
APPLY TO SECTIONS I AND II
Page 3
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.
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 far as they relate to the subject matter of this
insurance.
D. CANCELLATION: The words "five days" in the cancellation provision on Page 2 of
the policy are deleted and the words "thirty days" are substituted therefor.
E. 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 IN
SURED SHALL DO NOTHING AFTER LOSS TO PREJUDICE SUCH RIGHTS.
F. CONFORMITY WITH STATUTE: The terms of this policy and forms attached hereto
which are in conflict with the statutes of the state wherein this policy is issued are
hereby amended to conform to such statutes.
G. POLICY PERIOD, TERRITORY:
1. SECTION I OF THIS POLICY APPLIES ONLY TO LOSS TO PROPERTY DURING THE
POLICY PERIOD WHILE SUCH PROPERTY IS WITHIN THE FIFTY STATES OF THE
UNITED STATES OF AMERICA AND THE DISTRICT OF COLUMBIA.
2. Section 11 of this policy applies only to bodily injury or property damage which oc-
curs during the policy period within the policy territory; "policy territory" means:
a. the United States of America, its territories or possessions, or Canada, or
b. international waters or air space, provided the bodily injury or property dam-
age does not occur in the course of travel or transportation to or from any
other country, state or nation, or
c. 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 consump-
tion within the territory described in paragraph a, above, provided the original
suit for such damages is brought within such territory.
THE FOLLOWING PROVISIONS APPLY TO SECTION I
A. NUCLEAR CLAUSE: THE WORD "FIRE" IN THIS POLICY IS NOT INTENDED TO AND LOSS PRIOR TO LOSS, AND SUCH RELEASE SHALL NOT AFFECT THE RIGHT OF THE
DOES NOT EMBRACE NUCLEAR REACTION OR NUCLEAR RADIATION OR RADIOACTIVE INSURED TO RECOVER HEREUNDER, AND
CONTAMINATION, ALL WHETHER CONTROLLED OR UNCONTROLLED, AND LOSS BY 2. AS RESPECTS PROPERTY IN TRANSIT, THE INSURED MAY, WITHOUT PREJUDICE
NUCLEAR REACTION OR NUCLEAR RADIATION OR RADIOACTIVE CONTAMINATION IS TO THIS INSURANCE, ACCEPT SUCH BILLS OF LADING, RECEIPTS OR CONTRACTS
NOT INTENDED TO BE AND IS NOT INSURED AGAINST BY THIS POLICY, WHETHER SUCH OF TRANSPORTATION AS ARE ORDINARILY ISSUED BY CARRIERS CONTAINING A
LOSS BE DIRECT OR INDIRECT, PROXIMATE OR REMOTE. OR BE IN WHOLE OR IN PART LIMITATION AS TO THE VALUE OF SUCH GOODS OR MERCHANDISE.
CAUSED BY, CONTRIBUTED TO, OR AGGRAVATED BY "FIRE" OR ANY OTHER PERILS
INSURED AGAINST BY THIS POLICY; HOWEVER, SUBJECT TO THE FOREGOING AND ALL
PROVISIONS OF THIS POLICY. DIRECT LOSS BY "FIRE" RESULTING FROM NUCLEAR
REACTION OR NUCLEAR RADIATION OR RADIOACTIVE CONTAMINATION IS INSURED
AGAINST BY THIS POLICY.
B. NUCLEAR EXCLUSION: LOSS BY NUCLEAR REACTION OR NUCLEAR RADIATION OR
RADIOACTIVE CONTAMINATION, ALL WHETHER CONTROLLED OR UNCONTROLLED, OR
DUE TO ANY ACT OR CONDITION INCIDENT TO ANY OF THE FOREGOING IS NOT IN-
SURED AGAINST BY THIS POLICY, WHETHER SUCH LOSS BE DIRECT OR INDIRECT,
PROXIMATE OR REMOTE, ON BE IN WHOLE OR IN PART CAUSED BY, CONTRIBUTED TO,
OR AGGRAVATED BY ANY OF THE PERILS INSURED AGAINST BY THIS POLICY; AND
NUCLEAR REACTION OR NUCLEAR RADIATION OR RADIOACTIVE CONTAMINATION, ALL
WHETHER CONTROLLED OR UNCONTROLLED, IS NOT "EXPLOSION" OR "SMOKE ". THIS
CLAUSE APPLIES TO ALL PERILS INSURED AGAINST HEREUNDER EXCEPT THE PERILS
OF FIRE AND LIGHTNING, WHICH ARE OTHERWISE PROVIDED FOR IN THE NUCLEAR
CLAUSE ABOVE.
C. NO CONTROL: This insurance shall not be prejudiced:
1. by any act or neglect of the owner of any building if the insured is not the owner
thereof, or by any act or neglect of any occupant (other than the insured) of any
building, when such act or neglect of the owner or occupant is not within the
control of the insured. or
2. by failure of the insured to comply with any warranty or condition contained in
any form or endorsement attached to this policy with regard to any portion of the
premises over which the insured has no control.
13 PROTECTIVE SAFEGUARDS: IT IS A CONDITION OF THIS INSURANCE THAT THE IN-
SHALL MAINTAIN SO FAR AS IS 'WITHIN HIS CONTROL SUCH PROTECTIVE SAFE -
L:UARUS AS ARE SET FORTH BY ENDORSEMENT HERETO.
FAILURE TO MAINTAIN SUCH PROTECTIVE SAFEGUARDS SHALL SUSPEND THIS IN-
ONLY AS RESPECTS THE LOCATION OR SITUATION AFFECTED, FOR THE TIME
DF SUCH DISCONTINUANCE.
E. IMPAIRMENT OF RECOVERY: EXCEPT AS NOTED BELOW. THE COMPANY SHALL NOT
BE BOUND TO PAY ANY LOSS IF THE INSURED SHALL HAVE IMPAIRED ANY RIGHT OF
RFCOVERY FOR LOSS TO THE PROPERTY INSURED; HOWEVER IT IS AGREED THAT:
1. AS RESPECTS PROPERTY WHILE ON THE PREMISES OF THE INSURED, PERMISSION
IS GIVEN THE INSURED TO RELEASE OTHERS IN WRITING FROM LIABILITY FOR
F' OTHER INSURANCE:
1. LOSS BY FIRE OR OTHER PERILS NOT PROVIDED FOR IN 2. BELOW: IF AT THE TIME
OF THE LOSS, THERE IS OTHER INSURANCE AVAILABLE TO THE INSURED OR ANY
OTHER INTERESTED PARTY COVERING SUCH LOSS OR WHICH WOULD HAVE COl'
ERED SUCH LOSS EXCEPT FOR THE EXISTENCE OF THIS INSURANCE, THEN THE
COMPANY SHALL BE LIABLE AS FOLLOWS:
a. IF SUCH INSURANCE IS CONTRIBUTING INSURANCE, DEFINED AS ANY INUUR.
ANCE WRITTEN IN THE NAME OF THE INSURED, UPON THE SAME PI.AN. TERMS,
CONDITIONS AND PROVISIONS AS CONTAINED IN THIS POLICY WHETHER COL
LECTIBLE OR NOT, THE COMPANY SHALL BE LIABLE FOR NO GREATER PROPOR-
TION OF ANY LOSS THAN THE LIMIT OF LIABILITY UNDER THIS POLICY BEARS
TO THE WHOLE AMOUNT OF INSURANCE COVERING SUCH PROPERTY.
b. IF SUCH INSURANCE IS SPECIFIC INSURANCE, DEFINED AS ANY INSURANCE
OTHER THAN THAT DESCRIBED AS CONTRIBUTING INSURANCE IN a. ABOVE,
THE COMPANY SHALL NOT BE LIABLE FOR ANY LOSS HEREUNDER UNTIL THE
LIABILITY OF SUCH SPECIFIC INSURANCE HAS BEEN EXHAUSTED, AND THEN
SHALL COVER ONLY SUCH AMOUNT AS MAY EXCEED THE AMOUNT DUE FROM
SUCH SPECIFIC INSURANCE (WHETHER COLLECTIBLE OR NOT) AFTER APPLICA.
TION OF ANY CONTRIBUTION, COINSURANCE, AVERAGE OR DISTRIBUTION OR
OTHER CLAUSES CONTAINED IN POLICIES OF SUCH SPECIFIC INSURANCE
AFFECTING THE AMOUNT COLLECTIBLE THEREUNDER, NOT EXCEEDING HOW.
EVER, THE APPLICABLE LIMIT OF LIABILITY UNDER THIS POLICY.
2. Loss by burglary, robbery or theft or loss of personal property covered on an un-
specified peril basis: Insurance under this policy shall apply as excess insurance
over any other valid and collectible insurance which would apply in the absence
of this policy.
3. WHEN LOSS UNDER THIS POLICY IS SUBJECT TO A DEDUCTIBLE, THE COMPANY
SHALL NOT BE LIABLE FOR MORE THAN ITS PRO RATA SHARE OF SUCH LOSS IN
EXCESS OF THE DEDUCTIBLE AMOUNT.
G. NO BENEFIT TO BAILEE: THIS INSURANCE SHALL IN NO WISE INURE DIRECTLY OR
INDIRECTLY TO THE BENEFIT OF ANY CARRIER OR OTHER BAILEE FOR HIRE.
H. LOSS PAYABLE CLAUSE: Loss if any, shall be adjusted with the named insured and
shall be payable to him unless other payee is specifically named hereunder.
I. REPORT TO POLICE: WHEN EITHER A LOSS OR OCCURRENCE TAKES PLACE, THE IN-
SURED SHALL GIVE NOTICE THEREOF TO THE PROPER POLICE AUTHORITY IF LOSS OR
OCCURRENCE IS DUE TO A VIOLATION OF A LAW.
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II N01133S — SNOIIIN1330
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(1) when all operations to be performed by or on behalf of the named insured under
the contract hare been completed,
(2j when all operations to he performed by or on behalf of the named insured at the
site of the operations have been completed, or
0 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 organization other than another con-
tractor or subcontractor engaged in performing 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 dam
age arising out of It) 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, (2) the existence of tools, un.
installed equipment or abandoned or unused materials, or (3) operations for which
the classification stated in the policy or in the Company s manual specifies "including
completed operations ";
"damages" 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 had or ma-
terial 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 Witten lease premises, easement agree-
ment, except n connection with construction or opertionson or djaent
to a railroad, (3) undertaking to indemnify a municipality required by municipal or-
dinance, except in connection with work for the municipality, (4) sidetrack agreement,
or (5) elevator maintenance 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 Comparry's liability;
0 Page 5
"insured premises" means M the premises designated in the Declarations, (2)
premises alienated by the named insured lother than premises constructed tot sale
by the named insured), if possession has been relinquished to others, and (3) premises
as to which the named insured acquires ownership or control and reports his inten-
tion to insure such premises under this policy and no other within 30 days after such
acquisition; and includes the ways immediately adjoining such premises on land;
"medical expenses" means expenses for necessary medical. ray a
surgical, x -nd
dental services, including prosthetic devices and necessary ambulance, hospital, and
professional nursing and funeral services;
"mobile equipment" means a land vehicle fineludmg 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, Of " ) designed for use u principally off public roads, or (4i designed or maintoned for the sole purpose of
affording mobility to equipment of the following types forming an integral part of or
permanently atlached 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 repan equipment; airvcompressors, pumps and gen
erators, including spraying, welding and building cleaning equipment; and prophys...i
exploration and well servicing egmpment
"named insured" means the person or organization named in item 1 of the Declara.
lions 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, rented to
or located for use of others but not sold;
"occurrence" means an accident, including injurious exposure to conditions, which
results, during the policy period, in bodily injury or property damage neither expected
nor intended from the standpoint of the insured;
"products hazard" includes bodily injury and property damage arising 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 of property 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.
LIABILITY (The Attaching Clause need be cams Only when this endorsement is issued subseouent to preparat* the policy.)
6105
ADDITIONAL INSURED
(Designated Premises)
This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following:
COMPREHENSIVE PERSONAL INSURANCE
FARMER'S COMPREHENSIVE PERSONAL INSURANCE
This endorsement, effective 6 -1 -75
(12:01 A. M., standard time)
issued to NORVIN A. CROY DBA: ATTORNEY DATE,
by INSURANCE COMPANY OF THE WEST
Name of Person or Organization
City of Newport Beach
forms a part of policy No. MP 40 18 75
INC. AND DBA: Z— FACTOR CORP
L 9105
(Ed. 7 -66)
.............
Authorired P esentatire
Location of Premises
City Hall
It is agreed that with respect to the insurance afforded under the Personal Liability Coverage: Newport Beach, CA
1. The "Persons Insured" provision is amended to include the person or organization named above, but only with respect to the ownership, mainte-
nance or use of the premises designated above and operations necessary or incidental thereto.
2. The insurance with respect to said person or organization does not apply to bodily injury to any employee of said person or organization arising
out of or in the course of his employment by said person at organization.
AUTXENTIC
SIMPLIFIED OFFICE PROGR M
SPECIAL EXPANDED COVERAGE FORM ICW -B.2. (0)
SUBJECT TO ALL PROVISIONS AND STIPULATIONS OF THE POLICY OF
WHICH THIS ENDORSEMENT IS MADE A PART, THE FOLLOWING
ADDITIONS TO OR RESTRICTIONS OF COVERAGE SHALL APPLY.
LOCATION OF INSURED PREMISES
WHENEVER A LOCATION IS TO BE SHOWN ON ANY ENDORSEMENT
OR COVERAGE PART IT IS AGREED THAT THE INSURED LOCATION
SHALL BE AS SHOWN ON THE DECLARATION PAGE.
THIS SHALL NEITHER LIMIT NOR BROADEN ANY OFF PREMISES
COVERAGE WHICH MAY BE GRANTED IN THE FORMS ATTACHED.
THE FOLLOWING FORMS AND ENDORSEMENTS ARE ALSO MADE A PART OF THIS POLICY
MLB -101 -
SPECIAL BUILDING FORM
438 BFU -NS-
LENDERS LOSS PAYABLE ENDORSEMENT
MLB -109 -
SPECIAL OFFICE PERSONAL PROPERTY FORM
MLB -126 -
REPLACEMENT COST COVERAGE ENDORSEMENT
MLB -144
-EXTRA EXPENSE ENDORSEMENT
MLB -167 -
FINE ARTS FLOATER ENDORSEMENT
MLB -170
-NEON SIGN ENDORSEMENT
MLB -175
-ACCOUNTS RECEIVABLE ENDORSEMENT
MLB -176
-VALUABLE PAPERS AND RECORDS ENDORSEMENT
MLB -179
-GLASS COVERAGE ENDORSEMENT
MLB -200
- SMP LIABILITY INSURANCE FORM
MLB -202
-COMPREHENSIVE GENERAL LIABILITY INSURANCE
ENDORSEMENT
MLB -220
- PERSONAL INJURY LIABILITY INSURANCE
ENDORSEMENT
MLB -222
- EMPLOYER'S NON- OWNERSHIP AUTOMOBILE LIABILITY
ENDORSEMENT
MLB -237
- PROFESSIONAL LIABILITY EXCLUSION ENDORSEMENT
(FORM C)
MLB -244
-REAL ESTATE AGENTS ENDORSEMENT
MLB -300
- SMP COMPREHENSIVE CRIME COVERAGE ENDORSEMENT
L 9132
- REAL PROPERTY - LIABILITY - FIRE
L 9484
- CONTRACTUAL LIABILITY INSURANCE
(BLANKET COVERAGE -BROAD FORM)
L 9486
- BROAD FORM PROPERTY DAMAGE ENDORSEMENT
(INCLUDING COMPLETED OPERATIONS)
L 9492
- LIQUOR LIABILITY INSURANCE
SECTION I
DEDUCTIBLE
THIS DEDUCTIBLE CLAUSE SHALL SUPERCEDE
AND REPLACE ALL DEDUCTIBLE CLAUSES IN THE
FORMS AND ENDORSEMENTS ATTACHED TO THIS
POLICY, EXCEPT WHEN AMENDATORY SECTION I
DEDUCTIBLE CLAUSE #1 OR #2 IS ATTACHED.
THE SUM OF $100 SHALL BE DEDUCTED FROM
THE AMOUNT OF LOSS TO PROPERTY IN ANY ONE
OCCURRENCE RESULTING FROM ANY OF THE
PERILS INSURED AGAINST. THIS DEDUCTIBLE
SHALL APPLY SEPARATELY TO EACH BUILDING
(INCLUDING PERSONAL PROPERTY THEREIN),
SEPARATELY TO PERSONAL PROPERTY IN EACH
BUILDING IF NO COVERAGE ON THE CONTAINING
BUILDING, AND SEPARATELY TO PERSONAL PROP-
ERTY IN THE OPEN.
THIS CLAUSE SHALL APPLY TO ALL COVERAGES
AFFORDED UNDER SECTION I OF THIS POLICY
INCLUDING ALL EXTENSIONS, ADDITIONS AND
OPTIONS.
IT IS FURTHER UNDERSTOOD AND AGREED THAT,
AS RESPECTS THE PERIL OF THEFT ONLY, THE
SUM OF $500 SHALL BE DEDUCTED FROM THE
AMOUNT OF LOSS TO PROPERTY IN ANY ONE OC-
CURRENCE. HOWEVER, THIS PORTION OF THE
DEDUCTIBLE CLAUSE SHALL NOT APPLY TO ANY
COVERAGE UNDER PARAGRAPH V.G. OF FORM
AILB -109.
FOR THE PURPOSE OF THIS CLAUSE THEFT
MEANS ANY ACT OF STEALING.
THIS DEDUCTIBLE CLAUSE SHALL NOT APPLY TO
THE FOLLOWING:
1. EXTRA EXPENSE.
2. LOSS OF RENTS (IF COVERAGE UNDER
THIS POLICY).
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SMP SPECIAL OFFICE PERSONAL PROPERTY FQ7ZM Form MLB -109
d
SECTION I — PROPERTY COVERAGE cALI((RFORNIA 1Y69)
With respect to SECTION I— PROPERTY COVERAGE, this form cancels and replaces any coverage on personal
property provided under any other form made a part of this policy, BUT ONLY WITH RESPECT TO on
PROPERTY TO WHICH THIS FORM IS SHOWN TO BE APPLICABLE.
I. INSUROW AGREEMENT
This policy insures against all risks of direct physical' ss to Coverage B— Personal Property, SUBJECT TO THE
PROVISIONS AND STIPULATIONS HEREIN AND IN. THE POLICY OF WHICH THIS FORM IS MADE A
PART.
II. PROPERTY COVERED
COVERAGE B — PERSONAL PROPERTY:
This policy covers business personal property of the in-
sured usual to the office occupancy of the insured, including,
manuscripts, furniture, fixtures, equipment and supplies, not
otherwise covered under this policy, and shall cover similar
property held by the insured and belonging in whole or in
part to others FOR NOT EXCEEDING THE AMOUNT
FOR WHICH THE INSURED IS LIABLE; all while in
or on the described buildings, or in the open (including
within vehicles) on the described premises or within 100
feet thereof.
. This coverage shall also include Tenant's Improvements
and Betterments, MEANING THE INSURED'S USE
INTEREST IN FIXTURES, ALTERATIONS, IN-
STALLATIONS OR ADDITIONS COMPRISING A
PART OF THE BUILDINGS OCCUPIED BUT NOT
OWNED BY THE INSURED AND MADE OR AC-
QUIRED AT THE EXPENSE OF THE INSURED
EXCLUSIVE OF RENT PAID BY THE INSURED,
BUT WHICH ARE NOT LEGALLY SUBJECT TO
REMOVAL BY THE INSURED,
DEBRIS REMOVAL: This policy covers expense incurred in the removal of debris of the property covered hereunder
which may be occasioned by loss by a peril insured against. THE TOTAL AMOUNT RECOVERABLE UNDER
THIS POLICY SHALL NOT EXCEED THE LIMIT OF LIABILITY. STIPULATED FOR EACH ITEM. Cost
of removal of debris shall not be considered in the determination of actual cash value when applying the Coinsurance Clause.
III. PROPERTY SUBJECT
THE FOLLOWING PROPERTY IS SUBJECT TO
THESE ADDITIONAL LIMITATIONS:
A. 1. GLASS, GLASSWARE, STATUARY, MARBLE$,
BRIC- A -BRAC, PORCELAINS AND OTHER
ARTICLES OF A FRAGILE OR BRITTLE NA-
TURE ARE COVERED AGAINST LOSS BY
BREAKAGE ONLY IF DIRECTLY CAUSED BY
THE "SPECIFIED PERILS ". THIS LIMITA-
TION SHALL NOT APPLY TO BOTTLES OR
TO LENSES OF PHOTOGRAPHIC OR S(
TIFIC INSTRUMENTS.
2, STEAM BOILERS, STEAM PIPES, S1
TURBINES AND STEAM ENGINES ARE
COVERED AGAINST LOSS CAUSED
BURSTING, RUPTURE, CRACKING OR
PLOSION ORIGINATING THEREIN (07
IV. PROPERTY
IN ADDITION TO THE KINDS OF PROPERTY
WHICH ARE OTHERWISE EXCLUDED OR LIM-
ITED UNDER THIS POLICY, THE FOLLOWING
ARE ALSO EXCLUDED FROM COVERAGE UNDER
THIS FORM:
A. LIVE ANIMALS, BIRDS AND FISH; AIR-
CRAFT; WATERCRAFT, INCLUDING MOTORS,
EQUIPMENT AND ACCESSORIES (EXCEPT
ROWBOATS AND CANOES, WHILE OUT OF
WATER AND ON THE DESCRIBED PREM-
ISES); AND AUTOMOBILES, TRAILERS.
IZED EQUIPMENT NOT LICENSED FOR USE
ON PUBLIC THOROUGHFARES AND OPER-
ATED PRINCIPALLY ON THE PREMISES OF
THE INSURED.
B. PROPERTY FOR SALE; SAMPLES OR MER-
CHANDISE IN THE CARE, CUSTODY OR CON-
TROL OF SALESMEN AWAY FROM THE
PREMISES.
C. CURRENCY, MONEY AND STAMPS, EXCEPT
TO THE EXTENT PROVIDED IN THE EX-
TENSIONS OF COVERAGE; NOTES, SECURI-
TIES, DEEDS, ACCOUNTS, BILLS, EVIDENCES
OF DEBT, LETTERS OF CREDIT AND
TICKETS.
D. OUTDOOR SIGNS, WHETHER OR NOT AT-
TACHED TO A BUILDING, UNLESS SPECI-
B.
TO LIMITATIONS
THAN EXPLOSION OF ACCUMULATED
GASES OR UNCONSUMED FUEL WITHIN A
FIRE BOX OR COMBUSTION CHAMBER).
3. MACHINES AND MACHINERY ARE NOT
COVERED AGAINST LOSS CAUSED BY RUP-
TURE, BURSTING OR DISINTEGRATION OF
THEIR ROTATING OR MOVING PARTS RE-
SULTING FROM CENTRIFUGAL OR RECIP-
ROCATING FORCE.
THE TERM "SPECIFIED PERILS" SHALL MEAN
DIRECT LOSS BY FIRE, LIGHTNING, AIR-
CRAFT, EXPLOSION, RIOT, CIVIL COMMO-
TION, SMOKE, VEHICLES, WINDSTORM OR
HAIL TO PROPERTY CONTAINED IN ANY
BUILDING, VANDALISM AND MALICIOUS MIS-
CHIEF, LEAKAGE OR ACCIDENTAL DIS-
CHARGE FROM AUTOMATIC FIRE PROTEC-
TIVE SYSTEMS.
NOT COVERED
FICALLY COVERED BY ENDORSEMENT.
E. HOUSEHOLD AND PERSONAL EFFECTS
CONTAINED IN LIVING QUARTERS OCCU-
PIED BY THE INSURED, ANY OFFICER, DI-
RECTOR, STOCKHOLDER OR PARTNER OF
THE INSURED OR RELATIVES OF ANY OF
THE FOREGOING, EXCEPT AS PROVIDED IN
THE EXTENSIONS OF COVERAGE OR UN-
LESS SPECIFICALLY COVERED BY EN-
DORSEMENT.
F. GROWING CROPS AND LAWNS.
G. PROPERTY OF TENANTS OR GUESTS, EX-
CEPT AS PROVIDED IN THE EXTENSIONS
OF COVERAGE.
H. FUR, FUR GARMENTS, JEWELRY AND
WATCHES, WATCH MOVEMENTS, JEWELS,
PEARLS, PRECIOUS AND SEMI - PRECIOUS
STONES, GOLD, SILVER, PLATINUM AND
OTHER PRECIOUS ALLOYS OR METALS.
I. TREES, SHRUBS AND PLANTS, EXCEPT TO
THE EXTENT PROVIDED IN THE EXTEN-
SIONS OF COVERAGE.
J. PROPERTY SHIPPED BY MAIL FROM THE
TIME IT PASSES INTO THE CUSTODY OF
THE POST OFFICE DEPARTMENT.
K. PROPERTY WHICH IS MORE SPECIFICALLY
COVERED IN WHOLE OR IN PART UNDER
THIS OR ANY OTHER CONTRACT OF IN-
SURANCE.
V. EXTENSIONS OF COVERAGE
THE LIABILITY OF THE COMPANY FOR LOSS IN ANY ONE OCCURRENCE, INCLUDING LOSS UN-
DER THESE EXTENSIONS OF COVERAGE SHALL NOT EXCEED THE AMQUNT OF INSURANCE APPLI-
Pam MLB -109 (Rd. 11-69) CALIFORNIA Page I of 4
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S.F. FORM Form 438BFU NS
11%, (Rev. May 1, 1942) x
a LENDER'S LOSS PAYABLE EMONSEMENT
1. Loss or damage, if any, under this policy, shall be paid to the Pays d on the first page of this policy, its successors and
assigns, hereinafter referred to as "the Lender ", in whatever form or capa its interests may appear and whether said interest he
vested in said Lender in its individual or in its disclosed or.Hindisclosed fiducia or representative capacity, or otherwise, or vested in a
nominee or trustee of said Lender.
2. The insurance under this policy, or any rider or end nt attached [hereto, as to the interest only of the Lender, its succes-
sors and assigns, shall not be invalidated nor suspended: (a)y error, omission, or change respecting the ownership, description,
possession, or location of the subject of the insurance or the interestitherein, or the title thereto; (b) by the commencement of foreclosure
proceedings or the giving of notice of sale of any of the property i'Ttwered by this policy by virtue of any mortgage or trust deed; (c)
by any breach of warranty, act, omission, neglect, or non - compliance with any of the provisions of this policy, including any and all riders
now or hereafter attached thereto, by the named insured, the borrower, mortgagor, trustor, vendee, owner, tenant, warehouseman, cus-
todian, occupant, or by the agents of either or any of them or by the happening of any event permitted by them or either of them, or their
agents, or which they failed to prevent, whether occurring before or after the attachment of this endorsement, or whether before or after
a loss, which under the provisions of this policy of insurance or of any rider or endorsement attached thereto would invalidate or sus-
pend the insurance as to the named insured, excluding herefrom, however, any acts or omissions of the Lender while exercising active
control and management of the property.
3. In the event of failure of the insured to pay any premium or additional premium which shall be or become due under the terms of
this policy or on account of any change in occupancy or increase in hazard^t permitted by this policy, this Company agrees to give
written notice to the Lender of such non - payment of premium after sixty (60) days from and within one hundred and twenty (120)
days after due date of such premium and it is a condition of the continuance of the rights of the Lender hereunder that the Lender
when so notified in writing by this Company of the failure of the insured to pay such premium shall pay or Cause to be paid the premium
due within ten (10) days following receipt of the Company's demand in writing therefor. If the Lender shall decline to pay said premium
or additional premium, the rights of the Lender under this Lender's Loss Payable Endorsement shall not be terminated before ten (10)
days after receipt of said written notice by the Lender.
4. Whenever this Company shall pay to the Lender any sum for loss or damage under this policy and shall claim that as to the
insured no liability therefor exists, this Company, at its option, may pay to the Lender the whole principal sum and interest and other
indebtedness due or to become due from the insured, whether secured or unsecured, (with refund of all interest not accrued), and this
Company, to the extent of such payment, shall thereupon receive a full assignment and transfer, without recourse, of the debt and all
rights and securities held as collateral thereto.
5. If there be any other insurance upon the within described property, this Company shall be liable under this policy as to therLender
for the proportion of such loss or damage that the sum hereby insured bears to the entire insurance of similar character on said property
under policies held by, payable to and expressly consented to by the Lender. Any Contribution Clause included in any Fallen Building
Clause Waiver or any Extended Coverage Endorsement attached to this contract of insurance is hereby nullified, and also any Contribu-
tion Clause in any other endorsement or rider attached to this contract of insurance is hereby nullified except Contribution Clauses for
the compliance with which the insured has received reduction in the rate charged or has received extension of the coverage to include
hazards other than fire and compliance with such Contribution Clause is made a part of the consideration for insuring such other hazards.
The Lender upon the payment to it of the full amount of its claim, will subrogate this Company (pro rata with all other insurers con-
tributing to said payment) to all of the Lender's rights of contribution under said other insurance.
6. This Company reserves the right to cancel this policy at any time, as provided by its terms, but in such case this policy shall
continue in force for the benefit of the Lender for ten (10) days after written notice of such cancellation is received by the Lender and
shall then cease.
7. This policy shall remain in full force and effect as to the interest of the Lender for a period of ten (10) days after its expiration
unless an acceptable policy in renewal thereof with loss thereunder payable to the Lender in accordance with the terms of this Lender's
Loss Payable Endorsement, shall have been issued by some insurance company and accepted by the Lender.
8. Should legal title to and beneficial ownership of any of the property covered under this policy become vested in the Lender or
its agents, insurance under this policy shall continue for the term thereof for the benefit of the Lender but, in such event, any privileges
granted by this Lender's Loss Payable Endorsement which are not also granted the insured under the terms and conditions of this
policy and /or under other riders or endorsements attached thereto shall not apply to the insurance hereunder as respects such property.
9. All notices herein provided to be given by the Company to the Lender in connection with this policy and this Lender's Loss
Payable Endorsement shall be mailed to or delivered to the Lender at its office or branch described on the first page of the policy.
Approved:
Board of Fire Underwriters of the Pacific,
California Bankers' Association,
Committee on Insurance.
t SMP SPECIAL OFFICE PERSONAL PROPERTY FORM Form MLB -109
SECTION I - PROPERTY COVERAGE (FA s
CALIFORR NIA A
With respect to SECTION I— PROPERTY COVERAGE, this form cancels and replaces any coverage on personal
property provided under any other form made a part of this policy, BUT ONLY WITH RESPECT TO PERSONAL
PROPERTY TO WHICH THIS FORM IS SHOWN TO BE APPLICABLE.
I. INSURING AGREEMENT
This policy insures against all risks of direct physi6L Joss to Coverage B— Personal Property, SUBJECT TO THE
PROVISIONS AND STIPULATIONS HEREIN AN'-IV THE POLICY OF WHICH THIS FORM IS MADE A
PART.
II. PROPE
COVERAGE B — PERSONAL PROPERTY:
This policy covers business personal property of the in-
sured usual to the office occupancy of the insured, including,
manuscripts, furniture, fixtures, equipment and supplies, not
otherwise covered under this policy, and shall cover similar
property held by the insured and belonging in whole or in
part to others FOR NOT EXCEEDING THE AMOUNT
FOR WHICH THE INSURED IS LIABLE; all while in
or on the described buildings, or in the open (including
within vehicles) on the described premises or within 100
feet thereof.
RTY COVERED
This coverage shall also include Tenant's Improvements
and Bettermenu. MEANING THE INSURED'S USE
INTEREST LY FIXTURES, ALTERATIONS, IN-
STALLATIONS OR ADDITIONS COMPRISING A
PART Of: THE BUILDINGS OCCUPIED BUT NOT
OWNED BY THE INSURED. AND MADE OR AC-
QUIRED AT THE EXPENSE OF THE INSURED
EXCLUSIVE OF RENT PAID BY THE INSURED,
BUT WHICH ARE NOT LEGALLY SUBJECT TO
REMOVAL BY THE INSURED.
DEBRIS REMOVAL: This policy covers expense incurred in the removal of debris of the property covered hereunder
which may be occasioned by loss by a peril insured against. THE TOTAL AMOUNT RECOVERABLE UNDER
THIS POLICY SHALL NOT EXCEED THE LIMIT OF LIABILITY STIPULATED FOR EACH ITEM. Cost
of removal of debris shall not be considered in the determination of actual cash value when applying the Coinsurance Clause.
III. PROPERTY
THE FOLLOWING PROPERTY IS SUBJECT
THESE ADDITIONAL LIMITATIONS:
A. 1, GLASS, GLASSWARE, STATUARY, MARBLES,
BRIC- A -BRAC, PORCELAINS AND OTHER
ARTICLES OF A FRAGILE OR BRITTLE NA-
TURE ARE COVERED AGAINST LOSS BY
BREAKAGE ONLY IF DIRECTLY CAUSED BY
THE "SPECIFIED PERILS ". THIS LIMITA-
TION SHALL NOT APPLY TO BOTTLES OR
SIMILAR CONTAINERS OF PROPERTY FOR
SALE, OR SOLD BUT NOT DELIVERED, NOR
TO LENSES OF PHOTOGRAPHIC OR SCIEN-
TIFIC INSTRUMENTS.
2. STEAM BOILERS, STEAM PIPES, STEAM
TURBINES AND STEAM ENGINES ARE NOT
COVERED AGAINST LOSS CAUSED BY
BURSTING, RUPTURE, CRACKING OR EX-
PLOSION ORIGINATING THEREIN (OTHER
SUBJECT
TO
IV. PROPERTY
IN ADDITION TO THE KINDS OF PROPERTY
WHICH ARE OTHERWISE EXCLUDED OR LIM-
ITED UNDER THIS POLICY, THE FOLLOWING
ARE ALSO EXCLUDED FROM COVERAGE UNDER
THIS FORM:
A. LIVE ANIMALS, BIRDS AND FISH; AIR-
CRAFT; WATERCRAFT, INCLUDING MOTORS,
EQUIPMENT AND ACCESSORIES (EXCEPT
ROWBOATS AND CANOES, WHILE OUT OF
WATER AND ON THE DESCRIBED PREM-
ISES); AND AUTOMOBILES, TRAILERS,
SEMI- TRAILERS OR ANY SELF- PROPELLED
VEHICLES OR MACHINES, EXCEPT MOTOR-
IZED EQUIPMENT NOT LICENSED FOR USE
ON PUBLIC THOROUGHFARES AND OPER-
ATED PRINCIPALLY ON THE PREMISES OF
THE INSURED.
B. PROPERTY FOR SALE; SAMPLES OR MER-
CHANDISE IN THE CARE, CUSTODY OR CON-
TROL OF SALESMEN AWAY FROM THE
PREMISES.
C. CURRENCY, MONEY AND STAMPS, EXCEPT
TO THE EXTENT PROVIDED IN THE EX-
TENSIONS OF COVERAGE; NOTES, SECURI-
TIES, DEEDS, ACCOUNTS, BILLS, EVIDENCES
OF DEBT, LETTERS OF CREDIT AND
TICKETS.
D. OUTDOOR SIGNS, WHETHER OR NOT AT-
TACHED TO A BUILDING, UNLESS SI'ECI-
B.
TO LIMITATIONS
THAN EXPLOSION OF ACCUMULATED
GASES OR UNCONSUMED FUEL WITHIN A
FIRE BOX OR COMBUSTION CHAMBER).
3. MACHINES AND MACHINERY ARE NOT
COVERED AGAINST LOSS CAUSED BY RUP-
TURE. BURSTING OR DISINTEGRATION OF
THEIR ROTATING OR MOVING PARTS RE-
SULTING FROM CENTRIFUGAL OR RECIP-
ROCATING FORCE.
THEE TERM. "SPECIFIED PERILS" SHALL MEAN
DIRECT LOSS BY FIRE, LIGHTNING, AIR-
CRAFT, EXPLOSION, RIOT, CIVIL COMMO-
11ON, SMOKE, VEHICLES, WINDSTORM OR
HAIL TO PROPERTY CONTAINED IN ANY
BUILDING, VANDALISM AND MALICIOUS MIS-
CHIEF, LEAKAGE OR ACCIDENTAL DIS-
C:HARGE FROM AUTOMATIC FIRE PROTEC-
TIVE SYSTEbIS.
NOT COVERED
FICALLY COVERED BY ENDORSEMENT.
E. HOUSEHOLD AND PERSONAL EFFECTS
CONTAINED IN LIVING QUARTERS OCCU-
PIED BY THE INSURED, ANY OFFICER, DI-
RECTOR, STOCKHOLDER OR PARTNER OF
THE INSURED OR RELATIVES OF ANY OF
THE FOREGOING, EXCEPT AS PROVIDED IN
THE EXTENSIONS OF COVERAGE OR UN-
LESS SPECIFICALLY COVERED BY EN-
DORS6EfF.NT.
F. GROWING CROPS AND LAWNS.
G. PROPERTY OF TENANTS OR GUESTS, EX-
CEPT AS PROVIDED IN THE EX'T'ENSIONS
OF COVERAGE.
H. FUR, FUR GARMENTS, JEWELRY AND
WATCHES, WATCH MOVEMENTS, JEWELS,
PEARLS, PRECIOUS AND SEMI- PRECIOUS
STONES, GOLD, SILVER, PLATINUM AND
OTHER PRECIOUS ALLOYS OR METALS.
I. TREES, SIRUBS AND PLANTS, EXCEPT TO
THE EXTENT PROVIDED IN THE EXTEN-
SIONS OF COVERAGE.
J. PROPERTY SHIPPED BY MAH., FROM THE
TIME FI PASSES INTO THE CUSTODY OF
THE POST OFFICE DEPARTMENT.
K. PROPERTY VVUICH IS MORE SPECIFICALLY
COVERED IN WHOLE OR IN PART UNDER
THIS OR ANY OTHER CONTRACT OF IN-
SURANCE.
V. EXTENSIONS OF COVERAGE
THE LIABILITY OF THE COMPANY FOR LOSS IN ANY ONE OCCURRENCE, INCLUDING LOSS UN-
DER THESE EXTENSIONS OF COVERAGE SHALL NOT EXCEED THE AMOUNT OF INSURANCE APPLI-
Form MLB -109 (Ed. 11 -59) CALIFORNIA Page 1 of 4
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A FULLY
OR COMPARTMENT OF SUCH VEHICLE AND
THEFT ESLTS EVIDENCEDU BY VISIBLE MARICSEUPON
SUCH BODY OR COMPARTMENT. THIS EX-
CLUSION SHALL NOT APPLY TO PROPERTY
IN THE CUSTODY OF CARRIERS FOR HIRE.
9. VOLUNTARY PARTING WITH TITLE OR
POSSESSION OF ANY PROPERTY BY THE IN-
SURED OR OTHERS TO WHOM THE PROP-
ERTY MAY BE ENTRUSTED (EXCEPT BY
VII. COINSU
THE COMPANY SHALL NOT BE LIABLE FOR A
GREATER PROPORTION OF ANY LOSS TO THE
PROPERTY COVERED HEREUNDER THAN THE
AMOUNT OF INSURANCE UNDER THIS POLICY
FOR SUCH PROPERTY BEARS TO THE AMOUNT
PRODUCED BY MULTIPLYING THE COINSUR-
ANCE PERCENTAGE APPLICABLE (SPECIFIED
IN THIS POLICY) BY THE ACTUAL CASH VALUE
OF SUCH PROPERTY AT THE TIME OF THE LOSS.
IN THE EVENT THE AGGREGATE CLAIM FOR
ANY LOSS IS BOTH LESS THAN $10,000 AND LESS
DATIONS; WALLS, BASEMENT OR OTHER
FLOORS, OR THROUGH' DOORS, WINDOWS
OR ANY OTHER OPENINGS IN SUCH SIDE-
WALKS, DRIVEWAYS, FOUNDATIONS,
WALLS ORIFLOORS:
UNLESS LOSS BY FIRE OR EXPLOSION NOT
OTHERWISE EXCLUDED ENSUES, AND THE
COMPANY SHALL THEN BE LIABLE FOR ONLY
SUCH ENSUING LOSS; BUT THESE EXCLU-
SIONS SHALL NOT APPLY TO PROPERTY IN
DUE COURSE OF TRANSIT OR TO LOSS ARIS-
ING FROM THEFT.
RANCE CLAUSE
THAN 5% OF THE 'TOTAL AMOUNT OF CON-
TRIBUTING INSURANCE APPLICABLE TO THE
PROPERTY INVOLVED AT THE TIME SUCH LOSS
OCCURS, NO SPECIAL INVENTORY OR APPRAISE -
MENT OF THE UNDAMAGED PROPERTY SHALL
BE REQUIRED, PROVIDED THAT NOTHING
HEREIN SHALL BE CONSTRUED TO WAIVE THE
APPLICATION OF THE PRECEDING PARAGRAPH
OF THIS CLAUSE.
IF INSURANCE UNDER THIS POLICY IS DIVID-
ED INTO SEPARATE AMOUNTS OF INSURANCE,
Forth MLB -109 (Ed. 11.69) CALIFORNIA Page 3 OI 4
EXTENT SUCH PERILS ARE INSURED
ANY ONE 'TREE, SHRO OR PLIANT, INCLUD-
AGAINST HEREIN. THE COMPANY SHALL
ING EXPENSE INCURRED FOR REMOVING
NOT BE LIABLE FOR MORE THAN $250 ON
DEBRIS THEREOF.
yI. 1XCLUSIQT4§
A. THIS POLICY DOES NOT INSURE UNDER THIS
CARRIERS FOR HIRE) IF INDUCED TO DO
FORM AGAINST LOSS CAUSED BY:
SO BY ANY FRAUDULENT SCHEME, TRICK,
I. ENFORCEMENT OF ANY LOCAL OR STATE
DEVICE' OR .FALSE PRETENSE.
ORDINANCE OR LAW REGULATING THE
„ 10. . ANY�FRAUDULENT, DISHONEST OR CRIM-
CONSTRUCTION, REPAIR, OR DEMOLITION
INAL ACT DONE BY OR AT THE INSTIGA-
OF BUILDINGS OR STRUCTURES UNLESS
TION OF ANY INSURED, PARTNER OR
SUCH LIABILITY IS OTHERWISE SPECI-
JOINT ADVENTURER IN OR OF ANY IN-
FICALLY ASSUMED BY ENDORSEMENT
SURED, AN OFFICER, DIRECTOR, OR
HEREON.
TRUSTEE OF ANY INSURED; PILFERAGE,
2. UNEXPLAINED OR MYSTERIOUS DISAP-
.APPROPRIATION OR CONCEALMENT OF
PEARANCE OF PROPERTY (EXCEPT PROP -
ANY PROPERTY COVERED DUE TO ANY
ERTY IN THE CUSTODY OF CARRIERS FOR
FRAUDULENT, DISHONEST OR CRIMINAL
HIRE); OR SHORTAGE OF PROPERTY DIS-
ACT OF ANY EMPLOYEE WHILE WORKING
CLOSED ON TAKING INVENTORY.
OR OTHERWISE, OR AGENT OF ANY IN-
3. ACTUAL WORK UPON OR INSTALLATION
SURED, OR ANY PERSON TO WHOM THE
OF PROPERTY COVERED, LATENT DEFECT,
PROPERTY COVERED MAY BE ENTRUSTED,
FAILURE, BREAKDOWN OR DERANGEMENT
OTHER THAN ANY CARRIER FOR HIRE.
OF MACHINES OR 'MACHINERY, FAULTY
11, RAIN, SNOW OR SLEET TO PROPERTY IN
MATERIALS OR WORKMANSHIP; UNLESS
THE OPEN (OTHER THAN PROPERTY IN
LOSS BY FIRE OR EXPLOSION NOT OTHER -
THE CUSTODY OF CARRIERS FOR HIRE).
WISE EXCLUDED ENSUES AND THEN THE
12. ANY LEGAL PROCEEDING.
COMPANY SHALL BE LIABLE FOR ONLY
B. THIS POLICY DOES NOT INSURE UNDER THIS
SUCH ENSUING LOSS.
FORM AGAINST LOSS CAUSED BY OR RESULT -
4. ELECTRICAL CURRENTS ARTIFICALLY
ING FROM POWER, HEATING OR COOLING
GENERATED UNLESS LOSS BY FIRE OR EX-
FAILURE, UNLESS SUCH FAILURE RESULTS
PLOSION NOT OTHERWISE EXCLUDED EN-
FROM PHYSICAL DAMAGE TO POWER, HEAT -
SUES, AND THEN THE'COMPANY SHALL'BE
ING OR COOLING EQUIPMENT SITUATED ON
LIABLE FOR ONLY SUCH ENSUING LOSS:
PREMISES WHERE THE PROPERTY COVERED
5. LEAKAGE OR OVERFLOW FROM PLUMB-
IS LOCATED, CAUSED BY PERILS NOT OTHER -
ING, HEATING, AIR CONDITIONING OR
WISE EXCLUDED. ALSO, THE COMPANY
OTHER EQUIPMENT OR APPLIANCES (EX-
SHALL NOT BE LIABLE UNDER THIS CLAUSE
CEPT FIRE PROTECTIVE SYSTEMS) CAUSED
FOR ANY LOSS RESULTING FROM RIOT, RIOT
BY OR RESULTING FROM FREEZING WHILE
A'j'TENDING ASTRIK$, CIVIL COMMOTION,
THE DESCRIBED BUILDING IS VACANT OR
OR VANDA ISM AND MALICIOUS MISCHIEF.
UNOCCUPIED, UNLESS THE INSURED
C. THIS POLICY DOES NOT INSURE UNDER THIS
SHALL HAVE EXERCISED DUE DILIGENCE
FORM AGAINST LOSS CAUSED BY, RESULTING
WITH RESPECT TO MAINTAINING HEAT TN
FROM, CONTRIBUTED TO OR .AGGRAVATED
THE BUILDINGS OR 'UNLESS SUCH EQUIP-
BY ANY OF THE FOLLOWING;
MENT AND APPLIANCES HAD BEEN
L EARTH MOVEMENT, INCLUDING BUT NOT
DRAINED AND.THE WATER SUPPLY SHUT
LIMITED TO EARTHQUAKE, LANDSLIDE,
OFF DURING SUCH VACANCY OR UNOCCU-
MUDFLOW; EARTH SINKING, EARTH RIS-
PANCY.
INC OR SHIF'T'ING;
6. DELAY, LOSS OF MARKET, INTERRUPTION
2. FLOOD, SURFACE WATER, WAVES, TIDAL
OF BUSINESS, NOR CONSEQUENTIAL LOSS
WATER OR`TIDAL WAVE, OVERFLOW OF
OF ANY NATURE.
STREAMS OR 'OTHER BODIES OF WATER,
7. INHERENT VICE, WEAR AND TEAR, MAR-
OR SPRAY FROM ANY OF THE FOREGOING,
RING OR SCRATCHING, GRADUAL DETER-
ALL WHETHER DRIVEN: BY WIND OR NOT;
(ORATION, INSECTS, VERMIN; DAMPNESS
3. WATER WHICH BACKS UP THROUGH
OR DRYNESS OF ATMOSPHERE, CHANGES
SEWERS OR DRAINS;
IN TEMPERATURE, RUSTOR CORROSION.
4. WATER BELOW THE SURFACE OF THE
8. THEFT (INCLUDING ATTEMPT THEREAT)
GROUND INCLUDING THAT WHICH EXERTS
FROM ANY VEHICLE, OCCURRING WHILE
PRESSURg ON'OR FLOWS, SEEPS OR LEAKS
SUCH VEHICLE IS UNATTENDED. UNLESS
THROUGII SIDEWALKS. DRIVEWAYS. FOUN-
A FULLY
OR COMPARTMENT OF SUCH VEHICLE AND
THEFT ESLTS EVIDENCEDU BY VISIBLE MARICSEUPON
SUCH BODY OR COMPARTMENT. THIS EX-
CLUSION SHALL NOT APPLY TO PROPERTY
IN THE CUSTODY OF CARRIERS FOR HIRE.
9. VOLUNTARY PARTING WITH TITLE OR
POSSESSION OF ANY PROPERTY BY THE IN-
SURED OR OTHERS TO WHOM THE PROP-
ERTY MAY BE ENTRUSTED (EXCEPT BY
VII. COINSU
THE COMPANY SHALL NOT BE LIABLE FOR A
GREATER PROPORTION OF ANY LOSS TO THE
PROPERTY COVERED HEREUNDER THAN THE
AMOUNT OF INSURANCE UNDER THIS POLICY
FOR SUCH PROPERTY BEARS TO THE AMOUNT
PRODUCED BY MULTIPLYING THE COINSUR-
ANCE PERCENTAGE APPLICABLE (SPECIFIED
IN THIS POLICY) BY THE ACTUAL CASH VALUE
OF SUCH PROPERTY AT THE TIME OF THE LOSS.
IN THE EVENT THE AGGREGATE CLAIM FOR
ANY LOSS IS BOTH LESS THAN $10,000 AND LESS
DATIONS; WALLS, BASEMENT OR OTHER
FLOORS, OR THROUGH' DOORS, WINDOWS
OR ANY OTHER OPENINGS IN SUCH SIDE-
WALKS, DRIVEWAYS, FOUNDATIONS,
WALLS ORIFLOORS:
UNLESS LOSS BY FIRE OR EXPLOSION NOT
OTHERWISE EXCLUDED ENSUES, AND THE
COMPANY SHALL THEN BE LIABLE FOR ONLY
SUCH ENSUING LOSS; BUT THESE EXCLU-
SIONS SHALL NOT APPLY TO PROPERTY IN
DUE COURSE OF TRANSIT OR TO LOSS ARIS-
ING FROM THEFT.
RANCE CLAUSE
THAN 5% OF THE 'TOTAL AMOUNT OF CON-
TRIBUTING INSURANCE APPLICABLE TO THE
PROPERTY INVOLVED AT THE TIME SUCH LOSS
OCCURS, NO SPECIAL INVENTORY OR APPRAISE -
MENT OF THE UNDAMAGED PROPERTY SHALL
BE REQUIRED, PROVIDED THAT NOTHING
HEREIN SHALL BE CONSTRUED TO WAIVE THE
APPLICATION OF THE PRECEDING PARAGRAPH
OF THIS CLAUSE.
IF INSURANCE UNDER THIS POLICY IS DIVID-
ED INTO SEPARATE AMOUNTS OF INSURANCE,
Forth MLB -109 (Ed. 11.69) CALIFORNIA Page 3 OI 4
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VII. COINSURANCE CLAUSE
THE COMPANY SHALL NOT BE LIABLE FOR A
GREATER PROPORTION OF ANY LOSS TO THE
PROPERTY COVERED HEREUNDER THAN THE
AMOUNT OF INSURANCE UNDER THIS POLICY
FOR SUCH PROPERTY BEARS TO THE AMOUNT
PRODUCED BY MULTIPLYING THE COINSUR-
ANCE PERCENTAGE APPLICABLE (SPECIFIED
IN THIS POLICY) BY THE ACTUAL CASH VALUE
OF SUCH PROPERTY AT THE TIME OF THE LOSS.
IN THE EVENT THE AGGREGATE CLAIM FOR
ANY LOSS IS BOTH LESS THAN $10,000 AND LESS
THAN 5 %. OF THE TOTAL AMOUNT OF CON-
TRIBUTING INSURANCE APPLICABLE TO THE
PROPERTY INVOLVED AT THE TIME SUCH LOSS
OCCURS, NO SPECIAL INVENTORY OR APPRAISE -
MENT OF THE UNDAMAGED PROPERTY SHALL
BE REQUIRED, PROVIDED THAT NOTHING
HEREIN SHALL BE CONSTRUED TO NAIVE THE
APPLICATION OF THE PRECEDING PARAGRAPH
OF THIS CLAUSE.
IF INSURANCE UNDER THIS POLICY IS DIVID-
ED INTO SEPARATE AMOUNTS OF INSURANCE,
Forth MLB -109 (Ed. 11.69) CALIFORNIA Page 3 of 4
EXTENT SUCH PERILS ARE INSURED
ANY ONE TREE, SHRUB OR PLANT,INCLUD-
AGAINST HEREIN. THE COMPANY SHALL
ING EXPENSE INCURRED FOR REMOVING
NOT BE LIABLE FOR MORE THAN $250 ON
DEBRIS THEREOF.
VI. EXCLUSIONS
A. THIS POLICY DOES NOT INSURE UNDER THIS
CARRIERS FOR HIRE) IF INDUCED TO DO
FORM AGAINST LOSS CAUSED BY:
SO BY ANY FRAUDULENT SCHEME, TRICK,
1. ENFORCEMENT OF ANY LOCAL OR STATE
DEVICE OR FALSE PRETENSE.
ORDINANCE OR LAW REGULATING THE
10. ANY FRAUDULENT, DISHONEST OR CRIM-
CONSCRUCTION, REPAIR, OR DEMOLITION
INAL ACT DONE BY OR AT 'THE INSTIGA-
OF BUILDINGS OR STRUCTURES UNLESS
TION OF ANY INSURED, PARTNER OR
SUCH LIABILITY 1S OTHERWISE SPECI-
JOINT ADVENTURER IN OR OF ANY IN-
FICALLY ASSUMED BY ENDORSEMENT
SURED, AN OFFICER, DIRECTOR, OR
HEREON.
TRUSTEE OF ANY INSURED; PILFERAGE,
2. UNEXPLAINED OR MYSTERIOUS DISAP-
APPROPRIATION OR CONCEALMENT OF
PEARANCE OF PROPERTY (EXCEPT PROP-
ANY PROPERTY COVERED DUE TO ANY
ERTY IN THE CUSTODY OF CARRIERS FOR
FRAUDULENT, DISHONEST OR CRIMINAL
HIRE); OR SHORTAGE OF PROPERTY DIS-
ACT OF ANY EMPLOYEE WHILE WORKING
CLOSED ON TAKING INVENTORY.
OR OTHERWISE, OR AGENT OF ANY IN-
3. ACTUAL WORK UPON OR INSTALLATION
SURED, OR ANY PERSON TO WHOM THE
OF PROPERTY COVERED, LATENT DEFECT,
PROPERTY COVERED MAY BE ENTRUSTED,
FAILURE, BREAKDOWN OR DERANGEMENT
OTHER THAN ANY CARRIER FOR HIRE.
OF MACHINES OR MACHINERY, FAULTY
11. RAIN, SNOW OR SLEET TO PROPERTY IN
MATERIALS OR WORKMANSHIP; UNLESS
THE OPEN (OTHER THAN PROPERTY IN
LOSS BY FIRE OR EXPLOSION NOT OTHER-
THE CUSTODY OF CARRIERS FOR HIRE).
WISE EXCLUDED ENSUES AND "THEN THE
12. ANY LEGAL PROCEEDING.
COMPANY SHALL BE LIABLE FOR ONLY
B. THIS POLICY DOES NOT INSURE UNDER THIS
SUCH ENSUING LOSS.
FORDO AGAINST LOSS CAUSED BY OR RESULT -
4. ELECTRICAL CURRENTS ARTIFICALLY
ING FROM POWER, HEATING OR COOLING
GENERATED UNLESS LOSS BY FIRE OR EX-
FAILURE, UNLESS SUCH FAILURE RESULTS
PLOSION NOT OTHERWISE EXCLUDED EN-
FROM PHYSICAL DAMAGE TO POWER, HEAT -
SUES, AND THEN THE COMPANY SHALL BE
ING OR COOLING EQUIPMENT SITUATED ON
LIABLE FOR ONLY SUCH ENSUING LOSS.
PREMISES WHERE THE PROPERTY COVERED
5. LEAKAGE OR OVERFLOW FROM PLUMB-
IS LOCATED, CAUSED BY PERILS NOT OTHER -
ING, HEATING, AIR CONDITIONING OR
WISE EXCLUDED. ALSO, THE COMPANY
OTHER EQUIPMENT OR APPLIANCES (EX-
SHALL NOT BE LIABLE UNDER THIS CLAUSE
CEPT FIRE PROTECTIVE SYSTEMS) CAUSED
FOR ANY LOSS RESULTING FROM RIOT, RIOT
BY OR RESULTING FROM FREEZING WHILE
ATTENDING A STRIKE, CIVIL COMMOTION,
THE DESCRIBED BUILDING IS VACANT OR
OR VANDALISM AND MALICIOUS MISCHIEF.
UNOCCUPIED, UNLESS THE INSURED
C. THIS POLICY DOES NOT INSURE UNDER THIS
SHALL HAVE EXERCISED DUE DILIGENCE
FORM AGAINST LOSS CAUSED BY, RESULTING
WITH RESPECT TO MAINTAINING HEAT IN
FROM, CONTRIBUTED TO OR AGGRAVATED
THE BUILDINGS OR UNLESS SUCH EQUIP-
BY ANY OF THE FOLLOWING:
MENT AND APPLIANCES HAD BEEN
1. EARTH MOVEMENT, INCLUDING BUT NOT
DRAINED AND THE WATER SUPPLY SHUT
LIMITED TO EARTHQUAKE, LANDSLIDE,
OFF DURING SUCH VACANCY OR UNOCCU-
MUDFLOW EARTH SINKING, EARTH RIS-
PANCY.
ING OR SHIFTING;
6. DELAY, LOSS OF MARKET, INTERRUPTION
2. FLOOD, SURFACE WATER, WAVES, TIDAL
OF BUSINESS, NOR CONSEQUENTIAL LOSS
WATER OR TIDAL WAVE, OVERFLOW OF
OF ANY NATURE.
STREAMS OR OTHER BODIES OF WATER,
7. INHERENT VICE, WEAR AND TEAR, MAR-
OR SPRAY FROM ANY OF THE FOREGOING,
RING OR SCRATCHING, GRADUAL DETER -
ALL WHETHER DRIVEN BY WIND OR NOT;
IORATION, INSECTS, VERMIN, DAMPNESS
3. WATER WHICH BACKS UP THROUGH
OR DRYNESS OF ATMOSPHERE, CHANGES
SEWERS OR DRAINS;
IN TEMPERATURE, RUST OR CORROSION.
4. WATER BELOW THE SURFACE OF THE
8. THEFT (INCLUDING ATTEMPT THEREAT)
GROUND INCLUDING THAT WHICH EXERTS
FROM ANY VEHICLE, OCCURRING WHILE
PRESSURE ON OR FLOWS, SEEPS OR LEAKS
SUCH VEHICLE IS UNATTENDED, UNLESS
THROUGH SIDEWALKS, DRIVEWAYS, FOUN-
THE PROPERTY IS CONTAINED IN A FULLY
DATIONS, WALLS, BASEMENT OR OTHER
ENCLOSED AND SECURELY LOCKED BODY
FLOORS, OR THROUGH DOORS, WINDOWS
OR COMPARTMENT OF SUCH VEHICLE AND
OR ANY OTHER OPENINGS IN SUCH SIDE -
THEFT RESULTS FROM FORCIBLE ENTRY,
WALKS, DRIVEWAYS, FOUNDATIONS,
EVIDENCED BY VISIBLE MARKS UPON
WALLS OR FLOORS:
SUCH BODY OR COMPARTMENT. THIS EX-
UNLESS LOSS BY FIRE OR EXPLOSION NOT
CLUSION SHALL NOT APPLY TO PROPERTY
OTHERWISE EXCLUDED ENSUES. AND THE
IN THE CUSTODY OF CARRIERS FOR HIRE.
COMPANY SHALL THEN BE LIABLE FOR ONLY
9. VOLUNTARY PARTING WITH TITLE OR
SUCH ENSUING I-OSS; BUT THESE EXCLU-
POSSESSION OF ANY PROPERTY BY THE IN-
SIONS SHALL NOT APPLY TO PROPERTY IN
SURED OR OTHERS TO WHOM THE PROP-
DUE COURSE OF TRANSIT OR TO LOSS ARIS-
ERTY MAY BE ENTRUSTED (EXCEPT BY
ING FROM THEFT.
VII. COINSURANCE CLAUSE
THE COMPANY SHALL NOT BE LIABLE FOR A
GREATER PROPORTION OF ANY LOSS TO THE
PROPERTY COVERED HEREUNDER THAN THE
AMOUNT OF INSURANCE UNDER THIS POLICY
FOR SUCH PROPERTY BEARS TO THE AMOUNT
PRODUCED BY MULTIPLYING THE COINSUR-
ANCE PERCENTAGE APPLICABLE (SPECIFIED
IN THIS POLICY) BY THE ACTUAL CASH VALUE
OF SUCH PROPERTY AT THE TIME OF THE LOSS.
IN THE EVENT THE AGGREGATE CLAIM FOR
ANY LOSS IS BOTH LESS THAN $10,000 AND LESS
THAN 5 %. OF THE TOTAL AMOUNT OF CON-
TRIBUTING INSURANCE APPLICABLE TO THE
PROPERTY INVOLVED AT THE TIME SUCH LOSS
OCCURS, NO SPECIAL INVENTORY OR APPRAISE -
MENT OF THE UNDAMAGED PROPERTY SHALL
BE REQUIRED, PROVIDED THAT NOTHING
HEREIN SHALL BE CONSTRUED TO NAIVE THE
APPLICATION OF THE PRECEDING PARAGRAPH
OF THIS CLAUSE.
IF INSURANCE UNDER THIS POLICY IS DIVID-
ED INTO SEPARATE AMOUNTS OF INSURANCE,
Forth MLB -109 (Ed. 11.69) CALIFORNIA Page 3 of 4
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CALIFORNIA
REPLACEMENT COST COVERAGE ENUORSEMENY'
THIS ENDORSEIENT APPLIES ONLY WITH RESPECT TO THE PREMISES DESCRIBED IN THE FOLLOWING SCHEDULE AND AFFORDS INSIRANCE ON A
REPLACEMENT COST BASIS ONLY ON THE PROPERTY DESCRIBED BELOW.
SCHEDULE
Location Of Premises Properly Covered on a
Location No. Bui'ding No. Replacement Cost Ensis
(Specify Coverage A or
FOR EP;TRIES REtQUIRED HEREIN REFER Coverage a or both)
TO THE DECE, ;RATIOPIS PAGE AliD FORM
ICi7 — B.l, IN — B.2, ICW — B.2(0),
ICW — B.1(A) or ICF9 — B.2(A),;
(F'F.ICHEVER IS ATTACHED) .,
1. Replacement Cost Clausc: The provisions and stipulations of Section I of this policy applicable to the property described as covered on a replace.
ment cost basis are amended to substitute the term "replacement cost (without deduction for depreciation)' for the tern "actual cash value."
wherever it appears in this policy, AND THE COINSURANCE CLAUSE OF THIS ENDORSEMENT SUPERSEDES AND REPLACES ALL OTHER COINSUR:ANCF
CLAUSES OTHERWISE APPLICABLE, SUBJECT IN ALL OTHER RESPECTS TO THE PROVISIONS OF THIS ENDORSEMENT AND OF SECTION I OF THIS POLICY.
2. THIS POLICY DOES NOT COVER THE FOLLOWING PROPERTY ON A REPLACEMENT COST BASIS:
(A) STOCK (RAW, IN PROCESS OR FINISHED) OR MERCHANDISE, INCLUDING MATERIALS AND SUPPLIES IN CONNECTION THEREWITH;
(8) PROPERTY OF OTHERS;
(C) HOUSEHOLD FURNITURE OR RESIDENTIAL CONTENTS;
(D) BOOKS OF ACCOUNT, ABSTRACTS, MANUSCRIPTS, DRAWINGS, CARD INDEX SYSTEMS AND OTHER RECORDS (INCLUDING FILM, TAPE, DISC, DRUM,
CELL AND OTHER MAGNETIC RECORDING OR STORAGE MEDIA);
(E) PAINTINGS, ETCHINGS, PICTURES, TAPESTRIES, STATUARY, MARBLES, BRONZES, ANTIQUE FURNITURE, RARE BOOKS, ANTIQUE SILVER, FORCE
LAINS, RARE GLASSWARE AND BRIC- A�BRAC, OR OTHER ARTICLES OF ART, RARITY OR ANTIGUITY; OR
IF) CARPETING, CLOTH AWNINGS, AIR CONDITIONERS, DOMESTIC APPLIANCES AND OUTDOOR EQUIPMENT, ALL WHETHER PERMANENTLY ATTACHED
TO THE BUILDING STRUCTURE OR NOT.
THE COMPANY SHALL NOT BE LIABLE UNDER, THIS ENDORSEMENT FOR ANY LOSS UNLESS AND UNTIL THE DAMAGED OR DESTROYED PROPERTY IS
ACTUALLY REPAIRED OR REPLACED BY THE INSURED WITH DUE DILIGENCE AND DISPATCH.
4. COINSURANCE CLAUSE; THIS COMPANY SHALL NOT BE LIABLE FOR A GREATER PROPORTION OF ANY LOSS OR DAMAGE TO THE PROPERTY COVERED
UNDER THIS POLICY THAN THE LIMIT CF LIABILITY UNDER THIS POLICY FOR SUCH PROPERTY BEARS TO THE AMOUNT PRODUCED BY MULTIPLYING
THE COINSURANCE PERCENTAGE APPLICABLE (SPECIFIED IN THIS POLICY) BY THE TOTAL OF (A) THE REPLACEMENT COST (WITHOUT DEDUCTION FOR
DEPRECIATION) OF THAT PART OF SAID PROPERTY WHICH IS SPECIFICALLY DESCRIBED AS COVERED ON A REPLACEMENT COST BASIS AND (B) THE
ACTUAL CASH VALUE OF THAT PART OF SAID PROPERTY WHICH IS COVERED ON AN ACTUAL CASH VALUE BASIS AT THE TIME OF LOSS.
IN THE EVENT THAT THE AGGREGATE CLAIM FOR ANY LOSS IS BOTH LESS THAN $10,000 AND LESS THAN 5% OF THE LIMIT OF LiABILITY FOR ALL
CONTRIBUTING INSURANCE APPLICABLE TO THE PROPERTY INVOLVED AT THE TIME SUCH LOSS OCCURS, NO SPECIAL INVENTORY OR APPRAISEMENT
OF THE UNDAMAGED PROPERTY SHALL BE REQUIRED, PRCViDED THAT NOTHING HEREIN SHALL BE CONSTRUED TO W.AIYE APPLICATI ^.N OF THE
FIRST PARAGRAPH OF THIS CLAUSE.
IF INSURANCE UNDER SECTION I OF THIS POLICY IS DIVIDED INTO SEPARATE LIMITS OF LIABILITY, THE FOREGOING SHALL APPLY SEPARATELY TO
THE PROPERTY COVERED UNDER EACH SUCH LIMIT OF LIABILITY.
THE VALUE OF PROPERTY COVERED UNDER EXTENSIONS OF COVERAGE, AND THE COST OF THE REMOVAL OF DEBRIS, SHALL NOT BE CONSIDERED IN
THE DETERMINATION OF ACTUAL CASH VALUE OR REPLACEMENT COST WHEN APPLYING THE COINSURANCE CLAUSE.
5. THIS COMPANY'S LIABILITY FOR LOSS ON A REPLACEMENT COST BASIS, SHALL NOT EXCEED THE SMALLEST OF THE FOLLOWING AMOUNTS:
(A) THE AMOUNT Or THIS POLICY APPLICABLE TO THE DAMAGED OR DESTROYED PROPERTY;
Ei THE REPLACEMENT COST OF THE PROPERTY OR ANY PART THEREOF IDENTICAL WITH SUCH PROPERTY ON THE SAME PREMISES AND INTENDED
FOR THE SAME OCCUPANCY AND USE; OR
(Cl THE AMOUNT ACTUALLY AND NECESSARILY EXPENDED IN REPAIRING OR REPLACING SAID PROPERTY OR ANY PART THEREOF.
6. THE INSURED MAY ELECT TO MAKE CLAIM UNDER THIS POLICY IN ACCORDANCE WITH ITS PROVISIONS, DISREGARDING THIS ENDORSEMENT, EXCEPT
THAT THE FOREGOING COINSURANCE CLAUSE SHALL APPLY; AND THE INSURED MAY MAKE FURTHER CLAIM FOR ANY ADDITIONAL LIABILITY BROUGHT
ABOUT BY THIS ENDORSEMENT IN ACCORDANCE WITH ITS PROVISIONS, PROVIDED THE COMPANY IS NOTIFIED IN WRITING WITHIN 180 DAYS AFTER
LOSS OF THE INSURED'S INTENT TO MAKE SUCH FURTHER CLAIM.
This endorsement must be attached to Change Endorsement MLB -20 when issued after the policy is written.
Form MLB�126 (Ed. 1.71) CALIFORNIA
•
EXTRA EXPENSE ENDORSEMENT Form MLB -144
I Ed. 11-67 ?e tr CALIFORNIA
LOCATION OF PREMISES
SECTION I FORMS AND ENDORSEMENTS
APPLICABLE
LIMIT OF LIABILITY
Loc. No.
Bldg. No.
OR ENTRIES I
EQUIRED HEREIN REFER
0 THE DECI
ARATIONS PAGE AND
ORM ICW6.2.0)
1. SUBJECT TO ALL THE PROVISIONS AND STIPULATIONS OTHERWISE APPLICABLE TO SECTION, I
OF THIS POLICY, except the Coinsurance Clause and the Loss Deductible Clauses, this policy is extended to insure
the necessary extra expense incurred by the insured in order to continue as nearly as practicable the normal operation of
the insured's business following damage to or destruction of real or personal property, during the term of this policy, by
the perils insured against at the premises described in this endorsement, SUBJECT 'CO THE LIMIT OF LIABILI'l Y
SPECIFIED ABOVE POR THE PREMISES AT WHICH THE D.AAL1GE OR DESTRUCTION OCCURS. FOR
TI3E PURPOSES OF THIS INSURANCE, T EMLS INSURED AGAINST" SIIALL VLEAN THE PERILS, AS
DEFINED AND 1-I 2\11TED IN THE FORMS AVD ENDORSE \[FNTS LISTED ABOVE, FOR EACH 11RE3,IISES
SPECIFIED AND ALSO SUBJECT TO THE PROVISIONS OP THIS ENDORSEMENT.
2. In the event of such damage or destruction, the Company shall be liable for such necessary extra expense incurred for the
period of restoration commencing with the date of damage or destruction and not limited by the (late of expiration of this
policy.
3. THE COMPANY'S LIABILITY UNDER'IH1S ENDORSE \PENT SHALL NOT EXCEED TILE PERCENTAGE
STATED BELOW FOR THE DETERAIINI > D PERIOD OF RESTORATION AMULTIPLIED BY THE APPLI-
CABLE LI3IIT OF LIABILITY UNDER -iII1S INDORSEMENT FOR EACH PREMISES. IN NO EVENT
SHALL THE COMPANY BE LIABLE FOR -LURE THAN THE ACTUAL LOSS SUSTAINED.
40T, WHEN THE PERIOD OF RI:ST'ORA'I ION IS NOT IN EXCESS OF ONE MORPH;
SO% WHEN THE PERIOD OF RESTORATION IS 1\ EXCESS OF ONE MONTH BUT NOT IN
EXCESS OF TWO MONTHS;
10"o WHEN THE PERIOD OF RESTORATION IS IV EXCESS OF TWO MONTHS.
4. Resumption of Operations: IT IS A CONDITION OF THIS INSURANCE THAT AS SOON AS PRACTICABLE
THE INSURED SHALL RESUME NUR -IAL OPERATIONS OF THE BUSINESS AND SHALL DISPENSE
WITH SUCH EXTRA EXPENSE.
5. Definitions:
a. "extra expense" means the excess (if any) of the total cost incurred during the period of restoration chargeable to the
operation of the insured's business, over and above the total cost that would normally have been incurred to conduct
the business during the same period had no damage or destruction occurred. Any salvage value of property obtained
for temporary use during the period of restoration which remains after the resumption of normal operations, shall be
taken into consideration in the adjustment of any loss hereunder.
b. "month" means 30 consecutive days.
c. "normal" means the condition that would have existed had no loss occurred.
Al. "period of restoration' means such length of time, commencing with the date of damage and not limited by the date of
expiration of this policy, as would be required with the exercise of due diligence and dispatch to repair, rebuild or replace
such part of the property herein described as has been damaged or destroyed.
6. This policy is extended to include the actual loss sustained by the insured, resulting direct.), from an interruption of business
as covered hereunder, during the length of time, NOT EVC!?I {DING TWO CONSI.- CUTIVE WEEKS ehcn, as a direct
result of damage to or destruction of property adjacent to the premises herein described by the peril(s) insured against,
access to such described premises is specifically prohibited by order of civil authority.
7. Alterations and New Buildings: Permission granted to make alterations in or to construct additions to any building described
herein and to construct new buildings on the described premises. ']'his endorsement is extended to cover SUBJECT TO
ALL ITS PROVISIONS AND STIPULATIONS, extra expense resulting from damage to or destruction of such altera-
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Policy is written.
Form MLB -144 (Ed. 1147) — CALIFORNIA Page I of 2
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0
FINE ARTS FLOATER ENDORSEMENT Form MLB -167
i -*f (Ed. 1 -71)
The provisions and stipulations of this endorsement shall apply only to the property covered hereunder and none of the
provisions and stipulations of this policy, including any other endorsement made a part thereof, except the Cancellation
provision, shall apply to the insurance hereunder.
If any of the property covered by this endorsement is also covered under any other provisions of the policy of which this
endorsement is made a part, those provisions are hereby amended to exclude such property, the intent being that the coverage
under this endorsement is the sole coverage on such property.
This policy is extended to cover fine arts, as scheduled herein, which are the property of the insured or the property of others
in the custody or control of the insured while on exhibition or otherwise within the limits of the Continental United States and
Canada (excluding the premises of fair grounds or of any national or international exposition unless endorsed hereon).
Premium for this endorsement has been computed based upon the statement of the insured that at the time of attachment of
this endorsement the property covered hereunder was located as follows:
Amount of Insurance
At
At
At
At
Premium
SCHEDULE OF PROPERTY
Amount of Artist or
Insurance Title of Article Maker
FOR ENTRIES REQUIRED HEREIN REFER
TO THE DECL.ARATWO PAGc AND
FORM ICW.8_2 -O)
THIS ENDORSEMENT INSURES AGAINST:
All risks of loss of or damage to the above described property except as hereinafter provided.
THIS ENDORSEMENT DOES NOT INSURE AGAINST:
(a) Loss or damage occasioned by: wear and tear, gradual deterioration, insects, vermin, inherent vice or damage sus-
tained due to and resulting from any repairing, restoration or retouching process;
(b) Loss or damage caused by or resulting from: (1) hostile or warlike action in time of peace or war, including action in
hindering, combating or defending against an actual, impending or expected attack, (a) by any government or sovereign power
(de jure or de facto), or by any authority maintaining or using military, naval or air forces; or (b) by military, naval or air
forces; or (c) by an agent of any such government, power, authority or forces; (2) any weapon of war employing atomic.
fission or radio - active force whether in time of peace or war; (3) insurrection, rebellion, revolution, civil war, usurped power,
or action taken by governmental authority in hindering, combating or defending against such an occurrence, seizure or des-
truction under quarantine or customs regulations, confiscation by order of any government or public authority, or risks of
contraband or illegal transportation or trade;
(c) Loss or damage occasioned by: breakage of art glass windows, statuary, marbles, glassware, bric-a-brac, porcelains,
and similar fragile articles, unless caused by fire, lightning, aircraft, theft or attempted theft, cyclone, tornado, windstorm,
earthquake, flood, explosion, malicious damage, or collision, derailment or overturn of conveyance, unless endorsed hereon,
(d) Loss by nuclear reaction or nuclear radiation or radioactive contamination, all whether controlled or uncontrolled,
and whether such loss be direct or indirect, proximate or remote, or be in whole or in part caused by, contributed to, or
aggravated by the perils insured against in this endorsement; however, subject to the foregoing and all provisions of this en-
dorsement, direct loss by fire resulting from nuclear reaction or nuclear radiation or radioactive contamination is insured
against by this endorsement.
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Policy is written.
Fom MLB -167 (Ed. 1 -71) Page 1 of 2
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SNOLLIQNOO 'IdIOHdS
NEON SIGN ENDORSEMENT Form MLB -170
(Ed. 6.69)
The provisions and stipulations of this endorsement shall apply only to the property covered hereunder and none of the
provisions and stipulations of this policy, including any other endorsement made a part thereof, except the Cancellation
provision, shall apply to the insurance hereunder.
If any of the property covered by this endorsement is also covered under any other provisions of the policy of which this
endorsement is made a part, those provisions are hereby amended to exclude such property, the intent being that the coverage
under this endorsement is the sole coverage on such property.
This policy is extended to cover on neon or automatic or mechanical electric signs, as scheduled herein, the property of the
insured or the property of others in the custody or control of the insured.
SCHEDULE
Installed At Amount
Type of Sign Lettering (address) Insured
FOR ENTRIES REQUIRED HEREIN REFER
TO THE DECLARATIONS PAGE AND
FORM ICW- 8.2.(0)
Premium
THIS ENDORSEMENT INSURES AGAINST:
All risks of loss of or damage to the above described property except as hereinafter provided.
THIS ENDORSEMENT DOES NOT INSURE AGAINST:
(a) Loss or damage to property shipped via the Panama Canal, or to or from Alaska, Hawaii or Puerto Rico;
(b) Loss or damage caused by wear and tear or gradual deterioration;
(c) Loss or damage caused by faulty manufacture, installation or occasioned by the inherent character of the insured
property;
(d) Loss or damage caused by breakage during installation, repairing or dismantling, nor breakage during transportation
unless caused by fire, lightning, collision, derailment or overturning of vehicle;
(e) Mechanical breakdown; against loss or damage to electric apparatus caused by electricity, other than lightning, unless
fire ensues and then only for loss or damage by such ensuing fire;
(f) Loss or damage caused by the neglect of the insured to use all reasonable means to save and preserve the property
at and after any disaster insured against;
(g) Loss or damage caused by dampness of atmosphere or extremes of temperature;
(h) Loss or damage caused by or resulting from: (1) hostile or warlike action in time of peace or war, including action
in hindering, combating or defending against an actual, impending or expected attack, (a) by any government or
sovereign power (de jute or de facto), or by any authority maintaining or using military, naval or air forces; or (b)
by military, naval or air forces; or (c) by an agent of any such government, power, authority or forces; (2) any
weapon of war employing atomic fission or radioactive force whether in time of peace or war; (3) insurrection, rebel-
lion, revolution, civil war, usurped power, or action taken by governmental authority in hindering, combating or de-
fending against such an occurrence, seizure or destruction under quarantine or customs regulations, confiscation by
order of any government or public authority, or risks of contraband or illegal transportation or trade;
(i) Loss by nuclear reaction or nuclear radiation or radioactive contamination, all whether controlled or uncontrolled,
and whether such loss be direct or indirect, proximate or remote, or be in whole or in part caused by, contributed
to, or aggravated by the perils insured against in this endorsement, however, subject to the foregoing and all pro-
visions of this endorsement, direct loss by fire resulting from nuclear reaction or nuclear radiation or radioactive
contamination is insured against by this endorsement.
Each claim for loss or damage (separately occurring) shall be adjusted separately and from the amount of each such
adjusted claim there shall be deducted a sum equivalent to 5% of the amount of insurance on the insured item lost or damaged,
but not less than $10.00 nor more than $100.00 on any one item.
The Company shall not be liable in the event of loss or damage for any greater proportion of such loss or damage than
the amount hereby insured bears to the actual value of the property insured at the time when such loss or damage shall
happen. If this endorsement covers two or more items, this condition to apply to each item separately.
This endorsement insures only while the property is at locations within or is in transit within and between the states of
the United States, the District of Columbia, Puerto Rico or Canada but subject always to the limitations, conditions, exclu-
sions and exceptions stated herein.
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Policy is written.
Form MLB -170 (Ed, 6 -69) Page 1 of 2
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pa ;saia ;u!s!p pue ;ua ;adwoa a iaalas lsiy Iitgs seas! aidde ails, -oeld pue aw!i algtuosnai u In aptw aq prys Irsieid6 all
put 'ias!Eidde palsaia;ws!p put ;ualadwoo E ;aalas 'AnEdt[SO -) 3g; Sq sso o;o, .Idiaoal •Lpl}!e,sL(�p.? eK ;rI Lp 'iayl!a
;o puewap ual;!im ay; ilo 'pEgs goea 'ssol ;0 luuowE gill o; se aaiBe o xdudnto j' 2111 pue pziiLnisLh 2 •7 11 as Addy •ill
}t1Aa ;2js'tj3ns po'smal•at( xy -pa w!a'd alma ;o llw!l
;sa;iogs ayi utLi;tm paouawwoa aq Buipaa3oid io ;!ns 'u0!;oE Lions ssalun pt0n aq pEys sw!up Li� §t8 i78;A iAL ilikdj s! uo!;
-ullwy Lions panss! s! Aogod s!q; yo!gm wgip+ a;e;s gill }o smu[ ayi Aq }! Iegl `ianamoy pap!noid ' ! ja ay; 01 asti san18 l3!ym
a3uaiina3o all ;o pamsw ay; .iq xianoas!p ia; ;E lxau ;LiluOw anlaml uiyl!m paanawwo3 aq awes ayi ssalun Alwba io mel ;o
lino Are ut algewelsns aq [legs ivawasiopua s!Lil iapun w!tia CUE ;o 2Clan0331 aqi io; euipaaaold io Millar 'i!ns ox ';!ns •ZT
•slsalalut
antloadsai .Ball ;o ;ua;xa all of Alaleuotliodoid AueduroD ail; put painsuu all nq auioq aq prys paiinim os sasuadxa
ayy -JuawuoputgE }o aalluldaoar ue io ia.yem t paiap!suoo aq ssol ;o asra u! painsu! Aliadoid all Butniasaid pue Bwnts
'BLLIlaAODgi u! '.iueduwD gill io painsu! aqi }o sloe aq1 l!els iou a3uemsui s!qi o) ao!pnfaid lnol ll l!m 3oaia lied Aui 10
'iapunaiaq painsu! A;iadoid aql ;O Aianoaai put pirn8a ;es 'asua;ap aq; ;nog¢ pun m 'm; toned put tLogrl 'ans o; 'suBissr put,
slurnioS 1sio;3r; mall io sty 'painsur all io} Aiussaaau put In;mel aq lltgs i! 'ssol ;o asw ul •Aliado:d }o uo!laaloid •11
,paBEwrp io ;sot lied aqi ;o anlen aql io} olgvil aq Sluo prys SurdwoJ ay; 'stand
leianas ;o 'osn io; alaldwoa uagm 18utlstsuoo paianw x:.iadoid ;o lied .Cue 0; asewtp io ;o ssol ;o luana ail ul •eked •01
,;as in i!rd all ;o ssol lr;ol uraw
o; pani;s= aq a8rwep io ssol Lions [legs ;liana oil ui lnq 'salapie io aptlie p!ts ;o aaue;iodwl aqi of uolmapplioa ButniB
'Jas io ned aql ;o amen le;o; aq; ;o uopiodoid i!e; put algeuoseai a aq pegs salo!;ie io apllie Lions O1 aBemrp 10 }o ssol
;o ainsraw aqi ';as 30 iced E ;o lied r aie gaigm saiatJJE io a[311213 due 01 aBewrp i0 ;O sso( ;o Juana ayi ui qas 10 ned '6
•ptrd sum warp aq1 la!lm
no asoil; Supridai (s)ma;! no anp mnituaid aq1 o; pagddr m painsul aLi; of papun;ai aq Ipm small Lions of a(gE3tldde wn!maid
pauiraun ayy 'swap polnpagos aiom io auo ;o ssol itio: .Lo} pled s! wLEp ;l -uoaiaq polnpayos A(leay!oads wall lit ;o sso( In;ol
io; warp ;o JuainAd ;o ;liana aqi nt idaoxa 'Sogod stq; ;o Junowr aql a3npai loo ;Irgs iapunaiaq ssol Auy •nnelD ssol •B
,,iurdwoD ayi }o asuadxa ay; It pue ;o uotpai!p aqJ iapun awru s,pamsw aqi ut lg8noiq aq of ;ans itwiad qem pur 'poauEnpE
io ptrd ;unomE aqi ;o Juaixa aql o; =464 }o s4g8u cans pt 'AUedwoD aql JO; 49nl4 ui p(oq ptm io '01 AueduiOD aqi a;t801
-qns Il!m pue ta8rmup on ssol gill ;o laadsai u! spun} }O aaurnpE lit 8utnta3ai uodn ldlaoai urol }o wio} Aitulo 4sn3 ay; Ailed
-wok ali o1 ianyap pun alnaaxa 'uo!ido s,Surdmo, gill le 'io SurdwoD gill of uoyou ;o ;qty io warp Lions ia;suei; pue u8tsse
'AutdwoD aql xq pg1$gnbai p 'lllm painsu! gill 'iapunaiaq paigAO3 Aliadoid lol aBrmrp io }O sso! J0; uo!lriodioa io will
`Ienp!n!pu! Aue ;su!eSt notion ;o ;q8u Are annbor llEgs painsw ay aBEwEp i0 sso! ;0 ;liana ay; u! ;l •ueo-1 io uowe8olgns 'I
aapeq
iaglo io ia!iir , Age ;o lyauaq aql o; A}loaitput io xllaai!p ainug astm on w Ilrys aoutinsm s!ls, •aapeg o; ;yauag oN '9
•siay;o woi; awes aql paJoalloo sul pa.wsw
ail; ;1 pooB apum io pled aq llegs ssol oN 'Auedwo3 all }o aot};o all In ssol put ;saialut }o }ooid AioloE}s!lrs 40 aanuldaooe
pug not ;e;uasaid ial;t SAtp 09 utgl!m painsui aql o; pooB aptw io pled aq pegs sunv(i pa;snfpr IIV •99ool }o luawa;;laS 'S
'Ai!(enb pue pool gill }O
lepaltw yl!^m awns ayi aoEldai io i!Edai O; lsoa uaq; pinom a irym paaOxa Juana Ou ul guys put 'pasnEa ianamol 'uoilumaidap
io; uot;onpap iadoid ql!m anlEA gsEa lrnloE Lions of But )iO3PE polEw!pa i0 poweliaast aq prys aBEUlrp io ssol ay; put s.mo3o
a8ewep io ssol Env awq all in Aliadoid gill ;o an[En gsuo lEnlor aql puoxaq algr!l aq iou llrgs AuudwoD aqy voµenleA •q
-Al!llgrg s,SuEdwoD gill Ol wtpnfaid ;nogllm auop io aprm uggq anrq o; pmuaap all llEgs
w
sloe put suoilrulexa Lions pt ;nq 'w1Ep io ssol Sur o; laadsai qi!g+ antg as!miaylo lgBiu1 SueduLoo gill gatgm gsua}ap Aur ;o
ian!em t pawaap aq pugs 'iapunaiaq wteio 10 9501 Sur }o uO!ire!;sanw aqi Ll!m uO!laauuoa ul sangt;uasaidai io saaAoldwa si!
;o Sur io AuedwoD ayi ;o lot Sun 'on 'sluawnoop io siiOOg }o um;Ewwexa io LiMo iapun uotluMuluxa Lions ON •aprw aq of
;oaiayl sa!doo pull slorilxa ;!uLiad llugs pue an11E1u3saidai 51! io AurdwoD aql Sq paign8tsap aq xuw se aould put awl; algE
- 1105¢31 lions ie 'lsol aq slumBijo ;! ;oaiagl saidoo paytliaa i0 'siaganon iaq ;O puE saatonut 'stliq 9unoaar ;o silooq 'sBuilpm pt
LLOIIEmwEXg i0} aanpoid pEys 'paicnbai A[gELiosEai aq AM su ual;o SE 'Put `awus aql aquosgns put WEduioD gill Aq pameu
uosiad Sur Sq gluo iapun suopEumirxa of 1lwgns 01 siaglo pue plogasnoy gill ;o siagwaw 'sgaSoldwa itaq; io sill asnea
iamod iiayl io sty u!gi!m si su it} os u! put ';!wgns lrLls put 'paquasap waiali Sliadoid Alm ;o swrmai ltgl tle SutdwoD gill
Aq paluu2is3p uosiad Suu of itq!gxa lints 'pannbai Algeuosrai aq Sum sr ual }o sr 'pamsw ally •q;eo iapun uo!;eu!wexg .£
Issol ;o ;ooid moms pa[!ulap E 'aauaim000 io o8ewrp 'ssol Lions ;o Aiano3sip ;O a;tp woi; SSEp 06
ulgl!m 1ua8e sit io SuudmoD aqi qi!m aly oslr prys pU, ivawasiopua Stgl iapun In1E13 E o; a51i an1B AnuL Lia!gm aanaiinoao io
adewrp 'ssoi Siang ;uaBu sic io SuuduloD all o; Buppm in liodai algropouid sr u00s SE ;IELIS painsut ayy •1390.1 30 03110x •Z
-olaiagi 8upulai pamsw ayl Aq Suproms aslt} io pnEi; Sun }o asua lit io 'utaiagi painsut gill ;o
lsaialui aq; io '}oaiayl, 13afgns aqi io aauEinsu! stgl Bu!uiaouoa aautiswnono io lot; leualuw Ann paluosaidaistw io palraou03
sell painsu! aLp ssol r ia; ;g io aio;aq iay;agm ';! pOA aq llrgs ivawasiopua ail ;ua snly •pneig pue uopeluaeaidaie!Al '1
sHOlslaHO3
Form MLB -175
ACCOUNTS RECEIVABLE ENDORSEMENT
(Ed. 4.74)
In consideration of the stipulations herein named, the Company does insure the insured named in the policy of which this endorsement is made apart.
Provisional Amount $ Rate $ Provisional Premium $ Minimum Premium S
1. Subject of Insurance.
(a) All sums due the insured from customers, provided the insured is unable to effect collection thereof as the direct result of loss of or damage to
records of accounts receivable;
(b) Interest charges on any loan to offset impaired collections pending repayment of such sums made uncollectible by such loss or damage;
(c) Collection expense In excess of normal collection cost and made necessary because of such loss or damage;
(d) Other expenses, when reasonably incurred by the insured in re- establishing records of accounts receivable following such loss or damage.
The provisions and stipulations of this endorsement shall apply only to the Subject of Insurance hereunder and none of the provisions and stipulations
of this policy, including any other endorsement made a part thereof, except the Cancellation provision, shall apply to the insurance hereunder.
If any of the Subject of Insurance covered by this endorsement is also covered under any other provisions of the policy of which this endorsement is
made a part, those provisions are hereby amended to exclude such Subject of Insurance, the intent being that the coverage under this endorsement is
the sole coverage on such Subject of Insurance.
2. Perils Insured. All risks of loss of or damage to the insured's records of accounts receivable, occurring during the policy period, except as hereinafter
provided.
Location and Occupancy of Premises. The insured occupies the following part:
of the building located at:
conducts therein the following business:
and
4. Protection of Records of Accounts Receivable. Insurance under this endorsement shall apply only while records of accounts receivable are contained
in the premises described above, it being a condition precedent to any right of recovery hereunder that such records shall be kept in the following de.
scribed receptacles at all limes when the premises are not open for business, except while such records are in actual use or as stated in paragraph 5
below:
Rind
Name of Maker
"Class" or "Hour
Exposure" of Label
FOR ENTRIE" E' REFER
TO THE DECLAR:"I r.GE AND
FORM ICW-B2.(0)
Name of Issuer
of Label
5. Removal. Such insurance as is afforded by this endorsement applies while the records of accounts receivable are being removed to and while at place
of safety because of imminent danger of loss or damage and while being returned from such place, provided the insured gives written notice to the
Company of such removal within ten days thereafter.
6. Limit of Insurance. The Company shall not be liable hereunder for an amount to exceed Dollars ($
This endorsement is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part
of this endorsement, together with such other provisions, stipulations, and agreements as may be added hereto. as provided in this endorsement.
EXCLUSIONS
This endorsement does not apply:
(a) to loss due to any fraudulent, dishonest or criminal act by any in- (f) to loss due to nuclear reaction, nuclear radiation or radioactive
sured, a partner therein, or an officer, director or trustee thereof, contamination, or to any act or condition incident to any of the
while working or otherwise and whether acting alone or in collusion foregoing;
with others;
(g) to lass caused by or resulting from:
(b) to loss due to bookkeeping, accounting or billing errors or
omissions;
(c) to loss, the proof of which as to factual existence, is dependent
upon an audit of records or an inventory computation; but this shall
not preclude the use of such procedures in support of claim for loss
which the insured can prove, through evidence wholly apart there-
from, is due solely to a risk of loss to records of accounts receivable
not otherwise excluded hereunder;
(d) to loss due to alteration, falsification, manipulation, conceal-
ment, destruction or disposal of records of accounts receivable com-
mitted to conceal the wrongful giving, taking, obtaining or withholding
of money, securities or other property but only to the extent of such
wrongful giving, taking, obtaining or withholding;
(e) to loss due to electrical or magnetic injury, disturbance or
erasure of electronic recordings, except by lightning;
(1) hostile or warlike action in time of peace or war, including
action in hindering, combating or defending against an actual,
impending or expected attack, (a) by any government or sovereign
power (de lure or de facto), or by any authority maintaining or
using military, naval or air forces; or (b) by military, naval or air
forces; or (c) by an agent of any such government, power, author-
ity or forces;
(2) any weapon of war employing atomic fission or radioactive
force whether in time of peace or war;
(3) insurrection, rebellion, revolution, civil war, usurped power,
or action taken by governmental authority in hindering, combating
or defending against such an occurrence, seizure or destruction
under quarantine or customs regulations, confiscation by order
of any government or public authority, or risks of contraband or
illegal transportation or trade.
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Policy is written.
Page 1 of 2
Form MLB -175 (Ed. 4 -74)
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Bill 'bilod a4l ul Pawn Si pamsul auo uell aJow 11 :pamsul lwof 'f
'wnlwaltl
wnwlulw pue wnlwaid leuolslnoid 'ales ayI to pJlull.auo uo paseq
ail Ile4s jaawsnfpe pue uopelndwo0 pons 40EB 'SMA aaq 10 pouad
e Joy panssi sl juawavopua still 11 'juawavopua 5141 w palels wmw
-aid wnwlulw due ueyl ssal ail IOU Ilels wniwaJd 4ons Inq 'pamsw
aql Aq pled uop0od paweaun aql pamsul ayI of wnlaJ peys Auedwon aql
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Ieuolsmad aql spaaoxa pajndwoo sn4l wnlwad pawea all 11 juaw
- asJOpua slgl Japun nuemsul 10 J!w!I algeoldde a4l spa90xa OeMe
4ons IOU Jo Jagla4m 'Juawavopua sl4l Ul PaJUJs RIa ayJ Je abwane
4ons uo pajndwo) ail (legs wnlwad pawea agj pue Pabeaane ail (legs
s41u0w MIMI bulpaoaJd all Jol aJgemnaJ sjuno00e to slunowe Algjuow
Bill to wns all 'Juawavopua s141 10 uoleulwJal uodn PUB AJevanluue
4000 uodn A1uo 1eu0lslnwd s1 luawavopua dill ul palels wnlwaJd ay1
yluow
pons 4oea to Aep lsel all 10 se 'palebaJbas sluno0me OJegO pue suuaw
-Aed paJJalap yJlm'algenla)aJ Simon to junowe lejol all 10 juawalels
uallum a 411m Auedwoo 944 4slwnj'pouad Aollod all buunp gluow le)sl
g0ea 10 pug aql Jalle sAep Aluaml U1gI!m '1104s pamsul 041 :wnlwaJd 'Z
ulaa4l palels
sasodmd ssaulsnq aql Jw pamsul @41 Aq paldnom sl yol4m Saslwaid 10
AOUednO)n Pue uoge0ol„ 'F ytlwbeJed 1,l paleublsap uopeool aql le Oil
-PI!nq all to u0p0od legj to Joualul aql sueaw , saslwgjd„ :uoplupad -1
SNOIIIUN03
VALUABLE PAPERS AND RECORDS ENDORSEMEO Fmm MLB -176
(Ed. 3 -68)
In consideration of the stipulations herein named, the Company does insure the insured named in the policy of which this
endorsement is made a part to an amount not exceeding $ dollars.
Amount $
Rate $
Premium $
I. Property Covered. On valuable papers and records, as follows: Limits of Insurance
(a) All valuable papers and records not specified in (b) below. $
(b) Specified articles.
Value (each) $ $
The provisions and stipulations of this endorsement shall apply only to the property covered hereunder and none of the
provisions and stipulations of this policy, including any other endorsement made a part thereof except the Cancellation
provision, shall apply to the insurance hereunder.
If any of the property covered by this endorsement is also covered under any other provisions of the policy of which this
endorsement is made a part, those provisions are hereby amended to exclude such property, the intent being that the
coverage under this endorsement is the sole coverage on such property.
2. Parils Insured. All risks of direct physical loss of the property covered occurring during the policy period, except as here-
inafter provided.
3. Location and Occupancy of Premises. The insured occupies the following part:
of the building located at: and
conducts therein the following business:
4. Protection of Valuable Papers and Records. Insurance under this endorsement shall apply only while valuable papers and
records are contained in the premises described above, it being a condition precedent to any right of recovery hereunder
that such valuable papers and records shall be kept in the following described receptacles at all times when the premises
are not open for business, except while such valuable papers and records are in actual use or as stated in paragraphs 5 and
6 below:
Kind Name of Maker "Clue" or "Hour Name of Inner
Exposure" of Label of Label
FOR ENTRIES REQUIRED HEREIN REFER
TO THE DECLARATIONS PAGE AND
FORM ICW- B.2.(0)
S. Automatic Extension. Such insurance as is afforded by this endorsement applies while the valuable papers and records are
being conveyed outside the premises and while temporarily within other premises, except for storage, provided the Com-
pany's liability for such loss shall not exceed 10% of the combined limits of insurance stated in paragraph 1, nor $5,000,
whichever is less.
6. Removal. Such insurance as is afforded by this endorsement applies while the valuable papers and records are being re-
moved to and while at a place of safety because of imminent danger of loss and while being returned from such place, pro-
vided the insured gives written notice to the Company of such removal within ten days thereafter.
This endorsement is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated,
which are hereby made a part of this endorsement, together with such other provisions, stipulations, and agreements as may
be added hereto, as provided in this endorsement.
This endorsement does not apply
EXCLUSIONS
(g)
(a) to loss due to any fraudulent, dishonest or criminal
act by any insured, a partner therein or an officer,
director or trustee thereof, while working or otherwise
and whether acting alone or in collusion with others;
(b) to loss directly resulting from errors or omissions in
processing or copying unless fire or explosion ensues
and then only for direct loss caused by such ensuing
fire or explosion;
(c) to loss due to wear and tear, gradual deterioration,
vermin or inherent vice;
(d) to loss of property not specifically declared and de-
scribed in section (b) of paragraph 1, Property
Covered, if such property cannot be replaced with
other of like kind and quality;
(e) to loss due to electrical or magnetic injury, disturbance
or erasure of electronic recordings, except by lightning;
(f) to loss due to nuclear reaction, nuclear radiation or
radioactive contamination, or to any act or condition
incident to any of the foregoing;
(h)
to loss caused by or resulting from:
(1) hostile or warlike action in time of peace or war,
including action in hindering, combating or de-
fending against an actual, impending or expected
attack, (a) by any government or sovereign power
(de jure or de facto), or by any authority main-
taining or using military, naval or air forces; or
(b) by military, naval or air forces; or (c) by an
agent of any such government, power, authority
or forces;
(2) any weapon of war employing atomic fission or
radioactive force whether in time of peace or war;
(3) insurrection, rebellion, revolution, civil war,
usurped power, or action taken by governmental
authority in hindering, combating or defending
against such an occurrence, seizure or destruction
under quarantine or customs regulations, confisca-
tion by order of any government or public author-
ity, or risks of contraband or illegal transporta-
tion or trade;
to loss of property held as samples or for sale or for
delivery after sale.
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Polley is written.
Form MLB -176 (Ed. 340 Page 1 of 2
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?yy GS COVERAGE ENDORSEMENT • For.MLe -179
t. r *
In ��I consideration (Ed. 1 -7 q
nsideration of the payment of premium and subject to all the terms of this endorsement:
1. PROPERTY COVERED
This endorsement covers damage to the glass described in the schedule and to the lettering and ornamentation separately described therein, by
breakage of the glass or by chemicals accidently or maliciously applied.
The Company will pay for:
a. repairing or replacing frames immediately encasing and contiguous to such glass when necessary because of such damage;
b. installing temporary plates in or boarding up openings containing such glass when necessary because of unavoidable delay in repairing or
replacing such damaged glass;
c. removing or replacing any obstructions, other than window displays, when necessary in replacing such damaged glass, lettering or ornamentation.
2. SCHEDULE
Lac.
No.
Bldg.
No.
Nu
of
Plates
Length
in
Inches
Width
in
Inches
Description of Class, Lettering and
Ornamentation; Position in Building.
The glass is plain flat glass with all edges
set in frames, unless otherwise stated herein.
c
Specific
limit,
if any
Premium
FOR ENTRIES RCQ.tIRED HEEIN
'PAGE
Ri:rc }1
TO THE DECLAR;tT10i`jS
AND
FORM ICW6,2,(0)
Total Premium $
3. EXCLUSION
Insurance provided by this Endorsement does not apply to loss caused by or due to fire.
4. CONDITIONS
Limits of Liability and Settlement Options: The limit of the Company's liability for damage shall not exceed the actual cash value of the property
at time of loss, nor what it would then cost to repair or replace the damaged property with other of the nearest obtainable kind and quality, nor
the applicable limit of insurance stated in the schedule; provided, however, the limit of the Company's liability under each of paragraphs (la), (lb)
and (lc) above, is $75 with respect to loss due to any one occurrence at any one location separately occupied or designed for separate occupancy.
The Company may pay for the loss in money or may repair or replace the property. Any property so paid for or replaced shall become the property
of the Company.
5. OTHER PROVISIONS APPLICABLE TO THIS ENDORSEMENT
A. The following Provisions as found an Page 2 of the Policy are also applicable to this Endorsement: Cancellation of Policy; Requirements in
Case Loss Occurs; Suit.
B. The following Provisions applicable to Section I of the Policy are also applicable to this Endorsement: Nuclear Exclusion; Protective Safeguards;
Otherinsurance.
C. The following Provisions applicable to Section I and 11 of the Policy are also applicable to this Endorsement: War Risk Exclusion; Liberalization
Clause; Inspection and Audit; Cancellation; Subrogation; Conformity with Statute; Policy Period, Territory; Time of Inception.
This Endorsement must be attached to Change Endorsement MLB-20 when issued after the Policy is written.
Form ML8179 (Ed. 1.71)
l6
0
SMP LIABILITY INSURANCE FORM
SECTION 11 LIABILITY COVERAGE
I. COVERAGE C— BODILY INJURY AND
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
bodily injury or property damage to which this insurance applies, caused
by an occurrence and arising out of the ownership, maintenance or use of
the insured premises and all operations necessary or incidental to the
business of the named insured conducted at or from the insured premises
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 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 judgments
or settlements.
Exclusions
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 performed 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 ownership,
maintenance, operation, use, loading or unloading of
(1) any automobile or aircraft owned or operated by or rented or
loaned to any insured, or
(2) any other automobile or aircraft operated by any person in
the course of his employment by any insured;
but this exclusion does not apply to the parking of an automobile
on insured premises, if such automobile is not owned by or rented
or loaned to any insured;
(c) to bodily injury or property damage arising out of (1) the ownership,
maintenance, operation, use, loading or unloading of any mobile
equipment while being used in any prearranged or organized racing,
speed or demolition contest or in any stunting activity or in prac-
tice or preparation for any such contest or activity or (2) the opera-
tion or use of any snowmobile or trailer designed for use therewith;
(d) to bodily injury or property damage arising out of and in the course
of the transportation of mobile equipment by an automobile owned
or operated by or rented or loaned to any insured;
(e) to bodily injury or properly damage arising out of the ownership,
maintenance, operation, use, loading or unloading of
(1) any watercraft owned or operated by or rented or loaned to any
insured, or
(2) any other watercraft operated by any person in the course of
his employment by any insured;
but this exclusion does not apply to watercraft while ashore on the
insured premises;
(f) to bodily injury or property damage arising 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 atmos-
phere or any water course or body of water; but this exclusion
does not apply if such discharge, dispersal, release or escape is
sudden and accidental;
(g) to bodily injury or property damage arising out of operations on or
from premises (other than insured premises) owned by, rented
to or controlled by the named insured, or to liability assumed by
the insured under any contract or agreement relating to such
premises;
(h) to bodily injury or property damage for which the insured or his
indemnitee may be held liable
(1) as a person or organization engaged in the business of manu-
facturing, distributing, selling or serving alcoholic beverages,
or
(2) if not so engaged, as an owner or lessor of premises used for
such purposes,
• Form MLB•200
(Ed. 1 -73)
if such liability is imposed
(a) by, or because of the violation of any statute, ordinance or
regulation pertaining to the sale, gift, distribution or use
of any alcoholic beverage, or
(b) by reason of the selling, serving or giving of any alcoholic
beverage to a minor or to a person under the influence of
alcohol or which causes or contributes to the intoxication
of any person;
but part (b) of this exclusion does not apply with respect to
liability of the insured or his indemnitee as an owner or
lessor described in (2) above;
(i) to any obligation for which the insured or any carrier as his insurer
may be held liable under any workmen's compensation, unemploy-
ment compensation or disability benefits law, or under any similar
law;
(I) to bodily injury to any employee of the insured arising out of and
in the course of his employment by the insured or to any obligation
of the insured to indemnify another because of damages arising out
of such injury; but this exclusion does not apply to liability assumed
by the insured under an incidental contract;
(k) to property damage to
(1) property owned or occupied by or rented to the insured,
(2) property used by the insured, or
(3) property in the care, custody or control of the insured or as
to which the insured is for any purpose exercising physical
control;
but parts (2) and (3) of this exclusion do not apply with respect
to liability under a written sidetrack agreement and part (3) of this
exclusion does not apply with respect to property damage (other
than to elevators) arising out of the use of an elevator at premises
owned by, rented to or controlled by the named insured;
(1) to property damage to premises alienated by the named insured
arising out of such premises or any part thereof;
(m) to loss of use of tangible property which has not been physically
injured or destroyed resulting from
(1) a delay in or lack of performance by or on behalf of the named
insured of any contract or agreement, or
(2) the failure of the named insured's products or work performed
by or on behalf of the named insured 10 meet the level of
performance, quality, fitness or durability warranted or rep-
resented by the named insured;
but this exclusion does not apply to loss of use of other tangible
property resulting from the sudden and accidental physical injury
to or destruction of the named insured's products or work per-
formed by or on behalf of the named insured after such products
or work have been put to use by any person or organization other
than an insured;
(n) to property damage to the named insured's products arising out of
such products or any part of such products;
(o) to property damage to work performed by or on behalf of the named
insured arising out of the work or any portion thereof, or out of
materials, parts or equipment furnished in connection therewith;
(p) to damages claimed for the withdrawal, inspection, repair, replace-
ment, or loss of use of the named insured's products or work com-
pleted by or for the named insured or of any property of which such
products or work forms 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 therein;
(q) to bodily injury and property damage arising out of demolition op-
erations performed by or on behalf of the insured.
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 in-
dividual, the person so designated but only with respect to the con-
duct of a business of which he is the sole proprietor, and the
£ 10 Z abed
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pagdde aq pegs 41!1!geg to l!w!l gons aou!Aold Jo alels Aug to Mel
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(5) arising out of and in the course of the transportation of mobile
equipment by an automobile owned or operated by or rented
or loaned to any insured:
(b) to bodily Injury
(1) included within the completed operations hazard or the prod-
ucts hazard;
(2) arising out of operations performed for the named Insured by
independent contractors other than (i) maintenance and re-
pair of the insured premises or (ii) structural alterations at
such premises which do not involve changing the size of or
moving buildings or other structures;
(3) resulting from the selling, serving or giving of any alcoholic
beverage (i) in violation of any statute, ordinance or regula-
tion, (ii) to a minor, (iii) to a person under the influence of
alcohol or (iv) which causes or contributes to the intoxica-
tion of any person, if the named insured is a person or organi-
zation engaged in the business of manufacturing, distributing,
selling or serving alcoholic beverages or, if not so engaged, is
an owner or lessor of premises used for such purposes but
only part (i) of this exclusion (b) (3) applies when the named
insured is such an owner or lessor;
(4) arising out of demolition operations performed by or on behalf
of insureds;
(c) to bodily injury
(1) to the named insured, any partner therein, any tenant or other
person regularly residing on the insured premises or any
employee of the foregoing if the bodily injury arises out of
and in the course of his employment therewith,
(2) to any other tenant if the bodily injury occurs on that part of
the insured premises rented from the named insured or to
11
any employee of such a tenant if the bodily injury occurs on
the tenant's part of the insured premises and arises out of
and in the course of his employment for the tenant;
(3) to any person while engaged in maintenance and repair of the
insured premises or alteration, demolition or new construction
at such premises;
(4) to any person if any benefits for such bodily injury are payable
or required to be provided under any workmen's compensation,
unemployment compensation or disability benefits law, or under
any similar law:
(5) to any person practicing, instructing or participating in any phys-
ical training, sport, athletic activity or contest;
(d) to any medical expense for services by the named insured, any em-
ployee thereof or any person or organization under contract to the
named insured to provide such services.
VI. LIMITS OF LIABILITY — COVERAGE D:
The limit of liability for Coverage D stated in the Declarations as appli-
cable to "each person" is the limit of the Company's liability for all medical
expense for bodily injury to any one person as the result of any one acci-
dent; but subject to the above provision respecting "each person ", the
total liability of the Company under Premises Medical Payments Coverage
for all medical expense for bodily injury to two or more persons as the
result of any one accident shall not exceed the limit of liability stated in
the Declarations as applicable to "each 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.
Form MLS -200 (Ed. 1.13) Page 3 of 3
COMPREHENSIVE GENERAL LIABILITY INSURANCE ENDORAENT Form ML B•202
in consideration of and subject to all the terms of thisfendorrsement the company agrees with tthe named insured as follows:
the policy of which this endorsement is made a part,
COVERAGE— BODILY INJURY AND 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
bodily injury or property damage to which this insurance applies, caused
by an occurrence, and the Company shall have the right and duty to de-
fend 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 settlement of any claim or suit as it deems expedient, but the Com-
pany 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.
Exclusions
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 performed 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 ownership,
maintenance, operation, use, loading or unloading of
(1) any automobile or aircraft owned or operated by or rented
or loaned to any insured, or
(c)
(d)
(e)
(f)
(H
(h
(2) any other automobile or aircraft operated by any person m
the course of his employment by any insured;
but this exclusion does not apply to the parking of an automobile
on premises owned by, rented to or controlled by the named in-
sured or the ways immediately adjoining, if such automobile Is not
owned by or rented or loaned to any insured;
to bodily injury or property damage arising out of (1) the owner-
ship, maintenance, operation, use, loading or unloading of any
mobile equipment while being used in any prearranged or organized
facing, speed or demolition contest or in any stunting activity or in
practice or preparation for any such contest or activity or (2) the
operation or use of any snowmobile or trailer designed for use
therewith;
to bodily injury of property damage arising out of and in the course
of the transportation of mobile equipment by an automobile owned
or operated by or rented of loaned to any insured;
to bodily injury or property damage arising out of the ownership,
maintenance, operation, use, loading or unloading of
(1) any watercraft owned or operated by or rented or loaned to
any insured, or
(2) any other watercraft operated by any person in the course of
his employment by any insured;
but this exclusion does not apply to watercraft while ashore on
premises owned by, rented to or controlled by the named insured;
to bodily injury or property damage arising 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 water course or body of water; but this exclusion
does not apply if such discharge, dispersal, release or escape is
sudden and accidental;
to any obligation for which the insured or any carrier as his insurer
may be held liable under any workmen's compensation, unemploy-
ment compensation or disability benefits law, or under any similar
law;
to bodily injury or property damage for which the insured or his
indemnitee may be held liable
(1) as a person or organization engaged in the business of manu-
facturing, distributing, selling or serving alcoholic beverages,
Of
(2) if not so engaged, as an owner or lessor of premises used for
such purposes,
if such liability is imposed
(a) by, or because of the violation of, any statute, ordinance
or regulation pertaining to the sale, gift, distribution or
use of any alcoholic beverage, or
(b) by reason of the selling, serving or giving of any alcoholic
beverage to a minor or to a person under the influence
of alcohol or which causes or contributes to the intoxi-
cation of any person;
but part (b) of this exclusion does not apply with respect to liability
of the insured or his indemnitee as an owner or lessor described
in (2) above;
(i) to property damage to
(1) property owned or occupied by or rented to the Insured,
(2) property used by the insured, or
(3) to whic which o custody control
rranypurposef insured or as
control;
but parts (2) and (3) of this exclusion do not apply with respect
to liability under a written sidetrack agreement and part (3) of this
exclusion does not apply with respect to property damage (other
than to elevators) arising out of the use of elevators at premises
owned by, rented to or controlled by the named insured;
(j) to bodily injury to any employee of the insured arising out of and
in the course of his employment by the insured or to any obligation
of the insured to indemnify another because of damages arising out
of such injury; but this exclusion does not apply to liability assumed
by the insured under an incidental contract;
(k) arisingp out property urchgpretmis premises by the named insured
s or any part thereof;
(1) to property damage to the named insured's products arising out of
such products or any part of such products;
(m) to loss of use of tangible property which has not been physically
injured or destroyed resulting from
(1) a delay in or lack of performance by or on behalf of the named
insured of any contract or agreement, or
(2) the failure of the named insured's products or work performed
by or on behalf of the named insured to meet the level of
performance, quality, fitness or durability warranted or
represented by the named insured;
but this exclusion does not apply to loss of use of other tangible
property resulting from the sudden and accidental physical injury
to or destruction of the named insured's products or work performed
by or on behalf of the named insured after such products or work
have been put to use by any person or organization other than an
insured;
(n) to property damage to work performed by or on behalf of the named
insured arising out of the work or any portion thereof, or out of
materials, parts or equipment furnished in connection therewith;
(o) to damages claimed for the withdrawal, inspection, repair, replace-
ment, or loss of use of the named insured's products or work com-
pleted by or for the named insured or of any property of which such
products or work forms 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 therein;
(p) to bodily injury or property damage for which Insurance Is afforderL
under
(1) the SMP Liability Insurance Coverage, or
(2) any Comprehensive Persona{ Liability Endorsement forming=
a part of this policy
or for which insurance would have been afforded but for the exhaus-
tion of the limits of liability thereunder.
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Policy is written.
Form MLB-202 (Ed. 1 -73) Page 1 of 2
Z io Z abed
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(£E-( 'PI) ZOZ'8lW WIOA
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Amod 041 10 11 pue I suogoaS of alge3gdde suoisiAoid HuimoO% 041 'V
1N3W3SHOM SIH101319tl0llddtl SNOISIAOHd 33H10 'III
'11 uogoaS 1o'Alq!geij to sllwll'Al umsuoad 10 swaal
aql gllm aauepiao0e ul luawasiopua slgl Aq papiolle aiueansw aq{ of
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aauamom pea of padsai gl!m Algigeq s,Auedwoo aql to punj aql
0 39MA00— AMISVI1 30 11NI1 '11
jy� PERSONAL INJURY LIABILITY INSURANCE ENDORSEMENT Form MLB -220
��44 (Ed. 1.73)
In consideration of the payment of the premium, in reliance upon the statements in the Declarations of the policy of which this endorsement is made a
part, and subject to all the terms of this endorsement, the Company agrees with the named insured as follows:
SCHEDULE
The insurance afforded is only with respect to personal injury arising out of an offense included within such of the following groups of offenses as are
indicated by specific premium charge or charges:
Groups of Offenses FAR Provisional Premium
False Arrest, Detention or Imprisonment, or Malicious Prosecution .......... ENTRIES . $
Libel, Slander, Defamation or Violation of Right of Privacy ..............FQ� THE pEG REoulps ni
Wrongful Entry or Eviction or other Invasion of Right of Private Occupancy ....... M.fCH!-Q -,2 (0A.T7 EI/y
Minimum Premium $ Total ProvisionalMmium $ AGE . "
Limits of Liability: $ _
Insured's participation
I. COVERAGE— PERSONAL INJURY LIABILITY
'* rp
each person aggregate; $ general aggregate.
The Company will pay on behalf of the insured all sums which the insured
shall become legally obligated to pay as damages because of injury (herein
called "personal injury ") sustained by any person or organization and
arising out of one or more of the following offenses:
Group A —false arrest, detention or imprisonment, or malicious prose-
cution;
Group B —the publication or utterance of a libel or slander or of other
defamatory or disparaging material, or a publication or utter-
ance in violation of an individual's right of privacy; except
publications or utterances in the course of or related to ad-
vertising, broadcasting or telecasting activities conducted by
or on behalf of the named insured;
Group C — wrongful entry or eviction, or other invasion of the right of
private occupancy;
if such offense is committed in the conduct of the named insured's busi-
ness during the policy period within the United States of America, its terri-
tories or possessions, or Canada, and the Company shall have the right and
duty to defend any suit against the insured seeking damages on account of
such personal injury even if any of the allegations of the suit are 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 obli-
gated 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 judgment
or settlements.
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Policy is written.
Form MLB -220 (Ed. 1 -73) Page 1 of 2
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suolsnpx3
SCHEDULE
The limits of the Company's liability are on bt sis and for the amounts designated below:
Limits of Liability ii'TRIES REQUIRED REREIN REFER TO T
Bodily Injury $ -------------- Cga�Ig.i �( ARATIONS PAGE AND FORT(
h yeD�'3 L
Liability $ ICW — $j, Al C� _ $.2. BC2 AB
.2(0) s
EnTc'e.T ICW - ( ) t
Property Damage $ — _—( each occurrefic'4. ATTACREJO);ance Premium
Liability
In consideration of the payment of premium and subject to all the terms of this endorsement, the Company agrees with the
named insured as follows:
I. BODILY INJURY OR PROPERTY DAMAGE LIABILITY COVERAGE
The Company will pay on behalf of the insured, all sums which the insured shall become legally obligated to pay- as damages
because of:
bodily injury or property damage
to which this insurance applies caused by an occurrence and arising out of the use by any person, other than the named
insured, of a non -owned private passenger automobile in the business of the named insured, or arising out of the use in
such business by an employee of the named insured of any non -owned commercial automobile'if the use of such commer-
cial automobile is occasional and infrequent, 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 allegation; of the suit are
groundless, false or fraudulent, and may make such investigation and settlement of any claim or suit as it (Items 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 the payment of judgments or settlements.
Exclusions
This insurance does not apply:
a. to liability assumed by the insured under auy contract or agreement;
h. to any obligation for which the insured or any carrier as his insurer may be held liable under any workmen's compensa-
tion, 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 thereof are in whole or in part either payable or required to be provided under any workmen's compensa-
tion 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 and control of the insured, or as to which the insured is for any purpose exercising physical control, other than
property damage to a resident or a private garage by a private passenger automobile covered by this insurance.
II. PERSONS INSURED
Each of the following is an insured under this insurance to the extent set forth below:
a. the named insured;
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Policy is written.
Form MLB -222 (Ed. 10 -66) Page I of 2
P
EMPLOYER'S NON - OWNERSHIP AUTOMOBILE
INSURANCE ENDORSEMENT
LIABILITY
F.ouMLE -222
(Ed. 10 -66)
SCHEDULE
The limits of the Company's liability are on bt sis and for the amounts designated below:
Limits of Liability ii'TRIES REQUIRED REREIN REFER TO T
Bodily Injury $ -------------- Cga�Ig.i �( ARATIONS PAGE AND FORT(
h yeD�'3 L
Liability $ ICW — $j, Al C� _ $.2. BC2 AB
.2(0) s
EnTc'e.T ICW - ( ) t
Property Damage $ — _—( each occurrefic'4. ATTACREJO);ance Premium
Liability
In consideration of the payment of premium and subject to all the terms of this endorsement, the Company agrees with the
named insured as follows:
I. BODILY INJURY OR PROPERTY DAMAGE LIABILITY COVERAGE
The Company will pay on behalf of the insured, all sums which the insured shall become legally obligated to pay- as damages
because of:
bodily injury or property damage
to which this insurance applies caused by an occurrence and arising out of the use by any person, other than the named
insured, of a non -owned private passenger automobile in the business of the named insured, or arising out of the use in
such business by an employee of the named insured of any non -owned commercial automobile'if the use of such commer-
cial automobile is occasional and infrequent, 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 allegation; of the suit are
groundless, false or fraudulent, and may make such investigation and settlement of any claim or suit as it (Items 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 the payment of judgments or settlements.
Exclusions
This insurance does not apply:
a. to liability assumed by the insured under auy contract or agreement;
h. to any obligation for which the insured or any carrier as his insurer may be held liable under any workmen's compensa-
tion, 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 thereof are in whole or in part either payable or required to be provided under any workmen's compensa-
tion 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 and control of the insured, or as to which the insured is for any purpose exercising physical control, other than
property damage to a resident or a private garage by a private passenger automobile covered by this insurance.
II. PERSONS INSURED
Each of the following is an insured under this insurance to the extent set forth below:
a. the named insured;
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Policy is written.
Form MLB -222 (Ed. 10 -66) Page I of 2
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0
i
PROFESSIONAL LIABILITY EXCLUSION ENDORSEMENT Farm MLB -237
(Ed. 10.66)
i Form C
This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following
SMP LIABILITY INSURANCE
Description of Operations:
COMPREHENSIVE GENERAL LIABILITY INSURANCE
FOR ENTRIES REQL1IRED HEREIN REFER
TO THE DECLARATIONS PAGE AND
FORM ICV4.' (0)
It is agreed that with respect to any operation described above or designated in the policy as subject to this endorsement, the
insurance does not apply to bodily injury or property damage due to the rendering of or failure to render any professional
service.
This Endorsement must he attached to Change Endorsement MLB -20 when issued after the Policy is written.
Form MLB -239 Md. 10 -66)
a
® REAL ESTATE AGENTS ENDORSEMENT For ( MLB -244
This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following:
SMP LIABILITY INSURANCE
COMPREHENSIVE GENERAL LIABILITY INSURANCE
It is agreed that the insurance applies to bodily injury or property damage arising out of the ownership, maintenance or use
of (1) such part of any premises as is used by the insured for general office purposes, and (2) premises listed with the insured
for sale or rental, including signs thereon; but the insurance does not apply to premises owned, operated, managed by, rented
to or in the care, custody or control of the insured or as to which the insured acts as agent for the collection of rents
or in any supervisory capacity.
This Endorsement must be attached to Change Endorsement MLB -20 when issued after the Policy is written
Form MLB -244 (Ed. 1"6)
SMP COMPREHENSIVE CRIME COVERAGE ENDORSOENT Form 14LB -300
4.? SECTION III — CRIME COVERAGE Ed. 1 -7q
This endorsement shall be attached to Policy No. of the
Insurance Company.
(herein called Company)
The Insuring Agreements, General Agreements, Conditions and Limitations and other terms of this endorsement shall apply only as
specified herein and none of the provisions, stipulations and other terms of the policy to which this endorsement is attached shall apply
to insurance hereunder.
DECLARATIONS
Item 1. Effective Period: from noon on to noon on the
(Month, Day, Year)
effective date of the cancelation or termination of the policy to which this endorsement is attached, standard time at the P.O. Address
shown in the policy to which this endorsement is attached as to each of said dates, unless this endorsement is canceled or terminated as
hereinafter provided or in any other manner.
Item 2.
Table of Limits of Liability
such termination or cancelation to be effective as of the time this
Insuring Agreement IA
Employee Dishonesty (Commercial Blanket) Coverage
$
Insuring Agreement IB
Employee Dishonesty (Blanket Position) Coverage
$
Insuring Agreement II
Loss Inside the Premises Coverage
$
Insuring Agreement III
Loss Outside the Premises Coverage
$
Insurine Aereement IV
Monev Orders and Counterfeit ParerLurrtncv Coverage
$
REFER
If added by endorsement:
Insuring Agreement
FORM ICW- 6.2.(0)
Item 3. The liability of the Company is subject to the terms of the following endorsements attached hereto:
Item 4. The Insured by the acceptance of this endorsement gives notice to the Company terminating or canceling prior bond(s) or
policy(ies) No.(s)
such termination or cancelation to be effective as of the time this
endorsement becomes effective.
The Company, in consideration of the payment of the premium,
and subject to the Declarations made a part hereof, the General
Agreements, Conditions and Limitations and other terms of this endorsement,
agrees with the Insured, in accordance with such of the
Insuring Agreements hereof as are specifically designated by the insertion
of all amount of insurance in the Table of Limits of Liability
of this endorsement, to pay the Insured for:
INSURING AGREEMENTS
EMPLOYEE DISHONESTY COMMERCIAL
the Premises while being conveyed by a Messenger or any
BLANKET COVERAGE
armored motor vehicle company, or by theft while within the
IA. Loss of Money, Securities and other property which the In-
living quarters in the home of any Messenger.
sured shall sustain, to an amount not exceeding in the aggregate
MONEY ORDERS AND COUNTERFEIT
the amount stated in the Table of Limits of Liability applicable
PAPER CURRENCY COVERAGE
to this Insuring Agreement IA through any fraudulent or dis-
IV. Loss due to the acceptance in good faith, in exchange for
honest act or acts committed by ally of the Employees, acting
merchandise, Money or services, of any post office or express
alone or in collusion with others.
EMPLOYEE DISHONESTY BLANKET
money rder, issued or ' any
y purporting to have been Issued
POSITION COVERAGE
of
post office express company, if such money order is not paid
IB. Loss of \Money, Securities and other property which the In-
to
re-u presentation, u due to the acceptance to good faith in the
regular course of business of counterfeit United States or Caua-
sured shall sustain through any fraudulent or dishonest act or acts
dean paper currency.
committed by any of the Employees, acting alone or in collusion
with others, the amount of insurance on each of such Employees
DEPOSITORS FORGERY COVERAGE
being the amount stated in the Table of Limits of Liability appli-
V. Loss which the Insured or any bank which is included in the
cable to this Insuring Agreement IB.
insured's proof of loss and in which the insured carries a check -
LOSS INSIDE THE PREMISES COVERAGE
ing or savings account, as their respective interests may appear,
II. Loss of Money and Securities by the actual destruction, dis-
shall sustain through forgery or alteration of, on or in any check,
appearance or wrongful abstraction thereof within the Premises
draft, promissory note, bill of exchange, or similar written
or within any Banking Premises or similar recognized places of
promise, order or direction to pay a sum certain in money, made
safe deposit,
or drawn by or drawn upon the Insured, or made or drawn by
Loss of (a) other property by Safe Burglary or Robbery within
one acting as agent of the Insured, or purporting to have been
the Premises or attempt thereat, and (b) a locked cash drawer,
made or drawn as herembefore set forth, including
cash box or cash register by felonious entry into such container
(a) any check or draft made or drawn in the name of the In-
within the Premises or attempt thereat or by felonious abstraction
sured, payable to a fictitious payee and endorsed in the
of such container from within the Premises or attempt thereat.
name of such fictitious payee;
Damage to the Premises by such Safe Burglary, Robbery or
(b) any check or draft procured in a face to face transaction
felonious abstraction, or by or following burglarious entry into
with the Insured, or with one acting as agent of the In-
the Premises or attempt thereat, provided with respect to damage
sured. by anyone impersonating another and made or drawn
to the Premises the Insured is the owner thereof or is liable for
payable to the one so impersonated and endorsed by any -
such damage.
one other than the one so impersonated; and
LOSS OUTSIDE THE PREMISES COVERAGE
(c) any payroll check, payroll draft or payroll order made or
III. Loss of Money and Securities by the actual destruction, dis-
drawn by the Insured, payable to bearer as well as to a
appearance or wrongful abstraction thereof outside the Premises
named payee and endorsed by anyone other than the named
while being conveyed by a Messenger or any armored motor
Payee without authority from such payee:
vehicle company, or while within the living quarters in the home
whether or not any endorsement mentioned in (a) (b) or (c) be
of any Messenger.
a forgery within the law of the place controlling the construction
Loss of other property by Robbery or attempt thereat outside
thereof.
This Endorsement must be attached to Change Endorsement
MLB -20 when issued after the Policy is written.
Form MLB -30D (Ed. 1 -71) Page 1 of 4
So Z 02Vd '• •
(IL-1 'PH) 006-H•INi u1JaH
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alaylo TRIM uolsnlloa
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o; anp (T) ssol ol'III Put II sumumal2V 2uunsul lapun (a)
SNOISni;)XH
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`pop ad pal!wg E so; alagmas[a alt saa.io[dwg vans
'lEM 01 anp ssol 01 'III PUB IS sluawaal2V Suunsul lapun (P)
al!gM Jo DAoge pD1Eu2!sap Slolplal gill u!gl!m pamsul Dill
}o ao!A1Ds 1uln2a1 gill u{ pa2ft2ua saasoldwg Dill 10 SUE Sq
:3Ea1ayT
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;dwal ;t 10 Slaggog to SlEl93ng a ;ES of S[dde IOU saop
SIDE ;sguogstp 1O 3ual4nml; g2nolyl palnsuI ay] Sq patt3
uoisnlDxg sty; 'Pap!AOld alaylo ilJ!m uotsn1103 d! 10 avole
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9wjou laglatlA+ PUB aspulaglo 10 9w)[lom allym 'pains
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10 JDTlJs[Q Dill 'EJUawV ;O sa]u3S PD;!ufl Dill ;o sa3Els
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ay; ; . line u!gl!m ; uautaslopua $ly; }o pouad angoayH
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gill Supnp smJDO yDlym ssol 01 .Ciao sagdat 'A puE III
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pamsul DqT Sq pamulsns s! 'sno!3tlndum Tans wo1; cede
;D JuaWaal2V IrlanaO 01 laafgns
'CIIOTJA+ DDnapcAD g9nolgl 'DAOTd ueD pamsul ay3 qJ1 n
'pouad ani4Ja}!g
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lhls gdri'dE1rd still leg; 'JDAamog 'paPIA01d : uopelndwoD
3uawaslopua s!g1 Japan Palano3 sI sso; 'QI luawaal2y Suunsul
ssol PUB ]gold E 10 uo!3t3ndwOD S104UDAUI ore uodn waPuad
lapun JdaOxg 'luawaslopuD SIT JO pouad aA!;Da};g Dill So pua ay3
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'ya!ym }o }oold ay; 'aq Suw asm agl st 'ssol .cur }o ;led
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: pap!Ao1d ! pandxa peg lapunasagl ssol IDAODS!p 01
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ay; 1t 3Dlo} n! put 'aautmsnl :4321o; 1OUd IlDns lapun
vans lapun lossaDapald qans to pamsul Dill Sq algtlaAO3D1 uaaq
aJ!Ilo vans O3 a[gEJydde lUROWe ail; aryl 1391e1 st pate;
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-ag19V 9uunsnl lapun PDUJEJ ODVVlnsn! }o Iunowe Dl; J! (D)
Suunsul gons lEg1 saal9u SuudutoD ag1 'not n1psgns gans ;o
PUB ! pondxa
gutp aql }o st andxD oil pamolle 10 paIDOtmD 'palttmaT sl S3god
sty ODurinsm .c1D9Jo; imid ilDns [IV 1Dpun ssol }O SJDAOD
to pnoq lopd gDn!m 'pamsul ay3 }o ;salalui m lossaDOPald he
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Sq 10 pamsul ay3 Sq pau1ED aDuemsut }o Soyod 10 puoq Road
:1o}a1ag1 pauppsgns sEm �� ]uDUtDD19V
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gans aw!1 ay3 uto1} S[snonupuoJ paint ;sns San ssol Tins
A0110d HO awou 2IOI2Id uacimn SSO'I
y)ITm ;e DD!;;0 Dill 110 BSEIDAOO SJaS1o; loud yDns pgu
'luawaslopua
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s!yl ;o sasodmd !lE 10; pawtu isly pamsul ay3 se pDJap!suw
Put D3UJDAOD S1a21o; 1o!ld gDns 1o; ;oalaq altp Dill 1al;t
10 no JiDlnnlsgns st A 311awga12V 2min9ul }O D2E1anoO Dill (E)
aq 1a; }ualagl pegs pawed lxau pamsul ay3 uagl 'luawaslopua still
gdrT2EJEd s!yl Sq JiD]DAOJ ssol of 13adsal yip++ 'PaptA
Japan paJDAOD ail 01 uosraJ SUE 10; sastaD pawEU 3s1y pamsul
-old ' A luawaal9V Suunsul lapnn PDP1oyE a9EJanOD Dql }o pr
aqR ;I -ssol gans ;o ;uno33E no SnedwoD ail; asea[a1 S[[n; [[oils
uant2 aouemsul .(JaSJO; loud gans pey 'pamsul sop ;0 3sa1a3ul m
utawaslopm still lapun ssol Cut ;o paweu lslg pamsul all; w
'gj
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'uo!3eunulDT
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-aa12V 9mmsUl s3oadsal st 10 10 uo!1e[amtED yaps ;o
lapun alquIDAWD1 uaaq aneq p1noON ya!gm ',� wawgaJ2V Suuns
altp Dq1 Uiw; JEaS Duo UTIJUM palDAObs!p ssa[nn pamsnI gans Sq
'pamsul
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Dili Sq pau!Elsns sso; Tanoo oslE ptys A wautaaJ9V 9Upnsnl
p lmlailal 10 pglaontJ s! ;oalatl ;uawaal2V Suunsul .one 10 Rvaw
laptws
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'
aq lunowe lalltj Dill I! 'sso; Ixls }o S1anODS!P a43 Ipun 0310}
of loud }I 'pamsul SIDAg 01 Sldde 1[tgs 51 UOUOaS uI Papino. d
❑! panunuoJ .tJllod 10 puog Jopd yens pey .Ugod Jo pnoq
sE aaaoldwg Sue sl3adsal su lapunalaq DJnemsu{ Dill }o uol ;Vigo
loud gans lapun algtlaAOJa1 uaaq aAry pinom TOUT.+; luncium
-UED palnsuI SIaAD Sq aptw S1aAOas!p 10 passassod a2palMOV>(
'SI 'Z '11Egs
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uayM aDJo} in uagq 3uawaDJ9V Suunsul Bons peal 'not
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-qns gDns ;o Dwil ay3 ;o st uDllpm s! 1! gatgm 1o} uminue
passassod a9pa[.aoug luawaslopua Sall ;o sasodmd IIE Jo; pains
-ill 1aylO AJDAD JO; puE }last! Jo; par {legs pawtu ;sly pamsul gill
ay1 u! 3uawaDJSV Suunsul gans Japan algelanooDJ uaaq
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aneq Pplom 1{Oulm uinowt Dill paaDxa Juana ou ul pit's SSOl
(IRWISNI SNIOI
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'pouad wtwald wD1Jna DIP So pug agl
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'sulamaal2E qlt gltM JUDWDDJ9V Suunsul lDns ptg w0waa13V
Ja1;eaaDgi s,(tp :(JAItp mgj!A+;oglagl oapou ugl;um At edwoo Dili
Suunsul Tans Japan palanoD uaaq DAUI Ppoom s901 tID119 (Z)
DAIS pet's palnsuI alp pap!Aoad 'saoSold ua Tons s3Dadsal st Sldit
'luawaslop
osjt lleqs wawaslopua s!g1 Sq paplogt aDminsu! ay3 'sOaSold
-ua sup to wawa0T2V Suunsul algtDilddr ay3 Sq paplopt:
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}o asvgOmd 10 'ql!m 1a21aw 10 um3Ep!losuoJ y2no1g1 '}I -V
E aq ptls ulatuaal2V Itlauag s!q; lapun aDninsu! Dill (1)
2I30H�IYQ-N0I1VOI'I0SN00
S.LNNNiNNHOV -IVHNNZO
luawaal9V Suunsul sill lapun .p!I!gVI laylo
palnsnl ail Sq pau!Vlsns uaaq ssol gDns ptq palt3ollu uaaq aneq
Sue 01 uomppE in aq prgs ssol yaks Jo; SuVdwo� ay3 m Snl!quil
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ay3 put ivauiaaJaV Suunsul sup Japan ssol e aq of p3n.ilsuoo
-.tsu! }o lunowE ay of uop!ppr u! IOU put ;o 11td r aq 11tgs ssol
aq llegs asua;ap gans u! .yueq ilms Jo palnsuI alp Sq plud put
gans Jo; jimcl tans of Su audoD ay3 ;o S1II1gV!l atlL ssol gDns 1o}
pDianaut sasuadxa leSDI 1tptu!s Jo 'sim., 31noJ 'saa} ,s6guloJJE alqe
pamsul Dill pasmgw!al Sllns SPta11V a.+ty [legs .yuvq rims a1ayA+
- uoseal Sur. uatp 11ns y3ns ;O asua;aP aq1 01 JUDSt103 Ua11u A+ SIT
sasto in 11a3xa 'aweu umo sit in pamsul a43 w SilDa.np p!td
DA19 11tgs SutdouoD ay3 put JuawSed yDns a31o}ua o1 .yueq ilDns
aq Roils 'yueq t{3ns 10 pamsul Dill Sq pau!t)ms Jaylagni *mud
Jo pamsul ay1 ]sum2t ly2nolq 2uiaq Ins in 1!nsDi ergs jESn 3a1
-aa12V Suunsul s!yl Tapun sso-I 'p!isalo ;E .yueq Sue Sq paunusns
IlDns PUB 'pala;lt 10 p321o3 git sluawnilsu! q)ns ;eq1 Sn!SapV
ssol lano luatuStd ;0 Sluoud of pappua aq 1ltgs pamsul iq,I
'yu0; Ras alo;aquialag se umeJp 10 apew sluawnJlsin 2111o2
'salnivi2is ❑allumpurg st awes
-aio; ay3 ;o Ant Sid of asn ;al lltgs J1ueq gDns Jo pamsul aql ;I
ay3 Pa1ra1J aTr salnlEU2is aj!w!sor; pampoldal SI[rOlumpalIj
9
(f) under Insuring Agreement II, to loss of Money contained in
coin operated amusement devices or vending machines, unless
the amount of Money deposited within the device or machine
is recorded by a continuous recording instrument therein;
(g) under Insuring Agreement III, to loss of insured property
while in the custody of any armored motor vehicle com-
pany, unless such loss is in excess of the amount recovered
or received by the Insured under (1) the Insured's contract
with said armored motor vehicle company, (2) insurance
carried by said armored motor vehicle company for the
benefit of users of its service, and (3) all other insurance and
indemnity in force in whatsoever form carried by or for the
benefit of users of said armored motor vehicle company's ser-
vice, and then this endorsement shall cover only such excess;
(h) under Insuring Agreement I1, to loss, other than to
money, securities, a safe or vault, by fire whether or
not such fire is caused by, contributed to by, or arises
out of the occurrence of a hazard insured against.
(i) under Insuring Agreements II and III, to loss due
to nuclear action, nuclear radiation or radio active
contamination, or to any act or condition incident to
any of the foregoing.
DEFINITIONS
Section 3. The following terms, as used in this endorsement
shall have the respective meanings stated in this Section:
"Money" means currency, coins, bank notes and bullion; and
travelers checks, register checks and money orders held for sale
to the public.
"Securities" means all negotiable and non - negotiable instru-
ments or contracts representing either Money or other property
and includes revenue and other stamps in current use, tokens and
tickets, but does not include Money.
"Employee" means any natural person (except a director or
trustee of the Insured, if a corporation, who is not also an officer
or employee thereof in sonic other capacity) while in the regular
service of the hlsured in the ordinary course of the Insured's
business during the Effective Period of this endorsement and
whom the Insured compensates by salary, wages or commissions
and has the right to govern and direct in the performance of such
service, but does not mean any broker, factor, commission mer-
chant, consignee, contractor or other agent or representative of
the same general character. As applied to loss under Insuring
Agreement IA or IB the above words "while in the regular ser-
vice of the Insured" shall include the first 30 days thereafter;
subject, however, to Sections 15 and 16.
"Premises" means the interior of that portion of any building
which is occupied by the Insured in conducting its business.
"Banking Premises" means the interior of that portion of any
building which is occupied by a banking institution in conducting
its business.
"Messenger" means the Insured or a partner of the Insured
or any Employee who is duly authorized by the Insured to have
the care and custody of the insured property outside the Premises.
"Custodian" means the Insured or a partner of the Insured or
any Employee who is duly authorized by the Insured to have the
care and custody of the insured property within the Premises, ex-
eluding any person while acting as a watchman, porter or janitor.
"Robbery" means the taking of insured property (1) by vio-
lence inflicted upon a Messenger or a Custodian; (2) by putting
him in fear of violence; (3) by any other overt felonious act
committed in his presence and of which he was actually cognizant,
provided such other act is not committed by a partner or Em-
ployee of the Insured; (4) from the person or direct care and
custody of a Messenger or Custodian who has been killed or ren-
dered unconscious; or (5) under Insuring Agreement II, (a) from
within the Premises by means of compelling a Messenger or Custo-
dian by violence or threat of violence while outside the Premises to
admit a person into the Premises or to furnish him with means of
ingress into the Premises, or (b) from a showcase or show window
within the Premises while regularly open for business, by a person
who has broken the glass thereof from outside the Premises.
"Safe Burglary" means (1) the felonious abstraction of in-
sured property from within a vault or safe, the door of which is
equipped with a combination lock, located within the Premises by
a person making a felonious entry into such vault or such safe and
any vault containing the safe, when all doors thereof are duly
closed and locked by all combination locks thereon, provided
such entry shall be made by actual force and violence, of which
force and violence there are visible marks made by tools, explo-
sives, electricity or chemicals upon the exterior of (a) all of said
doors of such vault or such safe and any vault containing the
safe, if entry is made through such doors, or (b) the top, bottom or
walls of such vault or such safe and any vault containing the safe
through which entry is made, if not made through such doors, or
Fmm MLB -300 (Ed. 1.71)
4
(2) the felonious abstraction of such safe from within the Premises.
"Loss ", except under Insuring Agreements IA, IB and V, in-
cludes damage.
LOSS CAUSED BY UNIDENTIFIABLE EMPLOYEE
Section 4. If a loss is alleged to have been caused by the
fraud or dishonesty of any one or more of the Employees covered
under Insuring Agreement IA or IB, as the case may be, and the
Insured shall be unable to designate the specific Employee or
Employees causing such loss, the Insured shall nevertheless have
the benefit of such applicable Insuring Agreement subject to the
provisions of Section 2 (b) of this endorsement provided that the
evidence submitted reasonably proves that the loss was in fact due
to the fraud or dishonesty of one or more of the said Employees,
and provided, further, that the aggregate liability of the Company
for any such loss shall not exceed the Limit of Liability applicable
to such Insuring Agreement.
OWNERSHIP OF PROPERTY; INTERESTS
COVERED
Section 5. The insured property may be owned by the Insured, or
held by the Insured in any capacity whether or not the Insured is li-
able for the loss thereof, or may be property as respects which the
Insured is legally liable; provided, Insuring Agreements II, III and
IV apply only to the interest of the Insured in such property, includ-
ing the Insured's liability to others, and do not apply to the interest
of any other person or organization in any of said property unless
included in the Insured's proof of loss, in which event the third
paragraph of Section 8 is applicable to them.
BOOKS AND RECORDS
Section 6. The Insured shall keep records of all the insured
property in such manner that the Company can accurately deter-
mine therefrom the amount of loss.
PRIOR FRAUD, DISHONESTY OR CANCELATION
Section 7. The coverage of Insuring Agreement IA or IB
Shalt not apply to any Employee from and after the time that the
Insured or any partner or officer thereof not in collusion with
such Employee shall have knowledge or information that such
Employee has committed any fraudulent or dishonest act in the
service of the Insured or otherwise, whether such act be committed
before or after the date of employment by the Insured.
If, prior to the issuance of this endorsement, any fidelity insur-
ance in favor of the Insured or any predecessor in interest of the
Insured and covering one or more of the Insured's Employees
shall have been canceled as to any of such Employees by reason
of the giving of written notice of cancelation by the insurer issuing
such fidelity insurance whether the Company or not, and if such
Employees shall not have been reinstated under the coverage of
said fidelity insurance or superseding fidelity insurance, the Com-
pany shall not be liable on account of such Employees unless the
Company shall agree in writing to include such Employees within
the coverage of Insuring Agreement IA or IB, as the case may be.
LOSS; NOTICE; PROOF; ACTION AGAINST
COMPANY
Section 8. Upon knowledge or discovery of loss or of an occur-
rence which may give rise to a claim for loss, the Insured shall:
(a) give notice thereof as soon as practicable to the Company or
any of its authorized agents and, except under Insuring Agree-
ments IA or IB, and V, also to the police if the loss is due to a
violation of law; (b) file detailed proof of loss, duly sworn to,
with the Company within four months after the discovery of loss.
Proof of loss under Insuring Agreement V shall include the
instrument which is the basis of claim for such loss, or if it shall
be impossible to file such instrument, the affidavit of the Insured
or the Insured's bank of deposit setting forth the amount and
cause of loss shall be accepted in lieu thereof.
Upon the Company's request, the Insured shall submit to
examination by the Company, subscribe the same, under oath
if required, and produce for the Company's examination all per-
tinent records, all at such reasonable times and places as the
Company shall designate, and shall cooperate with the Company
in all matters pertaining to loss or claims with respect thereto.
No action shall lie against the Company unless, as a condition
precedent thereto, there shall have been fill compliance with all the
terms of this endorsement nor until ninety days after the required
proofs of loss have been filed with the Company, nor at all unless
commenced within two years from the date when the Insured dis-
covers the loss. If any limitation of time for notice of loss or any
legal proceeding herein contained is shorter than that permitted to be
fixed by agreement under any statute controlling the construction of
this endorsement the shortest permissible statutory limitation of time
shall govern and shall supersede the time limitation herein stated.
VALUATION — PAYMENT — REPLACEMENT
Section 9. In no event shall the Company be liable as respects
Securities for more than the actual cash value thereof at the close
of business on the business day next preceding the day on which
Page 3 of 4
0
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Jhe^Attaching Clause need be c d only when this endorsement is issued subsequent to prepam of the policy.)
LIABILITY L 9132
G 209 (Ed. 11 -ee)
REAL PROPERTY — LIABILITY — FIRE
This endorsement modifies such insurance as Is afforded by the provisions of the policy relating to the
COMPREHENSIVE GENERAL LIABILITY INSURANCE
MANUFACTURERS' AND CONTRACTORS' LIABILITY INSURANCE
OWNERS', LANDLCRDS' AND TENANTS' LIABILITY INSURANCE
STOREKEEPER'S INSURANCE
This endorsement, effective
(12:01 A. M., standard time)
issued to
by FOR ENTRIES REQUIRED HEREIN REFER
TO THE DECLARATIONS PAGE AND
FORM ICW -Q.24)
forms a part of policy No.
........... . ... ...................... ............._........................... .......... . ............ ... ... ..............
Authorized Representative
Rate
Premium (per$100 of Limit) Limit of Liability Description of Property
$ $ each occurrence
It is agreed that the Property Damage Liability Coverage applies to properly 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 this 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 insurance 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.
AUTHENTIC
The Attaching Clause Deed be comple ly when this endorsement is issued subsequent to preparaiida of the ,policy)
COMPREHENSIVE GENERAL LIpBI LI NSURANCE— MANUFACTURERS' AND CONTRACTORS' LIABILIT RANCE-
OWNERS', LANDLORDS' AND TENANTS' LIABILITY INSURANCE
LIABILITY Adv -3009
CONTRACTUAL LIABILITY INSURANCE
(Blanket Coverage —Broad Form)
This endorsement, effective t12:01 A. M , forms a part of policy No.
„ standard time)
issued to
by
... I..I .......... .ihw;.... ....... alwe ........... ...._...
Auiha rzed Aep�ese�nahva.
L 9494
(Ed. 1 13)
SCHEDULE
The insurance afforded for contractual liability is only with respect to such of the following Coverages as are indicated by a specific premium charge
applicable thereto. The limits of the company's liability against each such Coverage shall be as staled herein, subject to all the terms of this policy
having reference thereto.
Advance
Limits of Liability
Coverages
each occurrence
aggregate
Premiums
$
$
Contractual Bodily Injury Liability
$
$
$
Contractual Property Damage Liability
$ Total Advance Premium
Advance Premiums
Hates
Premium Bases
Code Designation of Contracts on File
No or Nnown to the Company
Bodily Injury
Property Damage
B. 1. P.D.
(a) Per $100 of Cost
(a) Cost
do Per $1,00D of Sales
Of Sales
ENTRIES
TFOR
REQ
THE Dc'CLAR
IRED HEREIN R
FER
F 1 8.2,(0)
TIGN� PAGE
I
ND
I
$
Is
Total Advance B.I. and P.D. Premiums
The following exclusions do not apply with respect to any "construction agreement ":
The company, in consideration of the payment of the premium and subject to all of the provisions of the policy not expressly modified herein, agrees
with the named insured as follows:
I. COVERAGES— CONTRACTUAL BODILY INJURY LIABILITY
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 as damages because of
bodily injury or
property damage
to which this Insurance applies, caused by an occurrence, 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 settlement of any claim or suit as it deems expedient,
but the company shali 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 oavment of iadaments or settlements.
Exclusions
This insutance 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;
f2) if the indemniiee of the insured is an architect, engineer or surveyor,
to the liability of the indemniiee, his agents or employees, arising
out of
(i) the preparation or approval of maps, drawings, opinions, reports,
surveys, change orders, designs or specifications, or
00 the giving of or the failure to give directions or Instructions by the
indemniiee, his agents or employees, provided such giving are
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 of revolution of 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
(over)
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e s1 paznsul aql g314m jo 0)njuaA juml zo d!gswuped Aue to j3npuoo aglto Ino
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ue uegl zagj0 se suogezeloap ail ul paleu8!sap si pansul paweu ag111 (3)
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in Aq pawzoUad liom in sl3npad s,pansw paweu ail jo ampej ail (Z)
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pansu) paweu ail to jlegaq no zo Aq amewmpad 10 ID21 in w Aelap a (1)
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g3lgm vI se in pamsu) aqj 10 101juo3 zo Apolsno 'aze3 aqj u! Apadozd (S)
in'pamsu! aqj Aq pasn Alzadozd (Z)
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o1 a8ewep Apadad of (8)
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a8ewep Apadozd in Amlm Appoq zol Aimilauaq Aped pnyj a Aq puil 3
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:Mel zepwls Aue zapun 30'mej sjgauaq Alg!ges!p zo uog
- esuadwoo 1vawAoldwaun 'uogesuatlwo3 s uawgmm Aue zapun algeq play
aq Auto zansm s!4 se zauze3 Aue in pansui ail g3!gm zol uoge8ggo Aue oI (a)
tanoge (Z) w paqu3sap zossal in zaumo ue se aapuwapu!
aqj 10 Appgeq of 13adsaz ql!m Aldde jou saop ucnsn13xa s!il to (!) lied Inq
'uoszad Aue In uogemolw ail 01 sajnquim in sasnea
gzmgm zo logo3le In a3uanpui aqf zapun uoszad a of za zoww a of
aBezaAaq 3110g031e Aue So 8u!A18 z0 Ew!AJ9S '8uglas aqj jo uoseaz Aq (p)
zo 98e13naq
mgogo3le Aue le asn in mInquisip'11!8'ales Bull of 8mu!epad uml
- eln8az 10 ampu!pzo'ainjejs Aue '10 uogelom aqj 10 asneoaq 30 Aq p)
pasodw! s! Appgep g3ns p
'sasoand
gons 101 pasn sas!wazd 10 zossal zo zaumo ue so 'pa8eoua os IOU p (Z)
10's38ez9n2q 3gogo3le 2timias in 8u4las 1uipwpzls!p
'Bupapelnuew In ssau!snq aqj ul pahha u01jez!ue8zo zo uoszad a se (1)
(The Attaching Clause need be coi* only when this endorsement is issued subsequent to prepa0 of the policy.)
LIABILITY L9486
Adv.3005 (
BROAD FORM PROPERTY DAMAGE ENDORSEMENT
(Including Completed Operations)
This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following:
COMPREHENSIVE GENERAL LIABILITY INSURANCE
CONTRACTUAL LIABILITY INSURANCE
This endorsement, effective
(12:01 A. M.,-standard time)
issued to
by
FOR ENTRIES REQUIRED HEREIN REFER
TO THE DECLARATIONS PAGE AND
FORM ICW- B.2.(0)
Classifications
forms a part of policy No.
Representative
It is agreed that the insurance for property damage liability applies, subject to the following additional provisions:
A. The exclusions relating to property damage to (1) property owned, occupied or used by or rented to the insured or in the care, custody or control of
the insured or as to which the insured is for any purpose exercising physical control and (2) work performed by or on behalf of the named insured arising
out of the work or any portion thereof, or out of materials, parts or equipment furnished in connection therewith, are replaced by the following exclu-
sions (y) and W:
(y) to property damage
(1) to property owned or occupied by or rented to the insured, or, except with respect to the use of elevators, to property held by the insured
for sale or entrusted to the insured for storage or safekeeping,
(2) except with respect to liability under a written sidetrack agreement or the use of elevators to
(a) property while on premises owned by or rented to the insured for the purpose of having operations performed on such property by or on
behalf of the insured,
IN tools or equipment while being used by the insured in performing his operations,
(c) property in the custody of the insured which is to be installed, erected or used in construction by the insured,
(d) that particular part of any property, not on premises owned by or rented to the insured,
li) upon which operations are being performed by or on behalf of the insured at the time of the property damage arising out of such
operations, or
(it) out of which any property damage arises, or
(iii) the restoration, repair or replacement of which has been made or is necessary by reason of faulty workmanship thereon by or on
behalf of the insured;
(z) with respect to the completed operations hazard and with respect to any classification stated above as "including completed operations ", to property
damage to work performed by the named insured arising out of the work or any portion thereof, or out of materials, parts or equipment furnished in
connection therewith.
B. The insurance afforded by this endorsement shall be excess insurance over any valid and collectible property insurance (including any deductible
portion thereof) available to the insured, such as but not limited to Fire and Extended Coverage, Builder's Risk Coverage or Installation Risk Coverage,
and the "Other Insurance" Condition is amended accordingly.
AUTN �"',,•
COVERAGE PART •. LIQUOR LIABILITY INSURANCE
For attachment to Policy
to complete said policy.
L 9492
(Ed. 1 73)
SCHEDULE
The insurance afforded is only with respect to the following Coverage as indicated by specific premium charge. The limit of the company's liability against such
Coverage shall be as stated herein, subject to all the terms of this policy having reference thereto.
I. COVERAGE X — LIQUOR 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 injury to which this insurance
applies, sustained by any person if such liability is imposed upon the insured by reason
of the selling, serving or giving of any alcoholic beverage at or from the insured
premises, and the company shall have the right and duty to defend any suit against
the insured seeking such damages, even it any of the allegations of the suit are
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 judgments or settlements.
Exclusions
This insurance does not apply:
(a) 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:
(b) to bodily injury to any employee of the insured arising out of and in the course
of his employment by the insured or to any obligation of the insured to in-
demnify another because of damages arising out of such injury;
(c) to injury arising out of any alcoholic beverage sold, served or given while any
license therefor, required by law, is suspended or after such license expires.
is cancelled or revoked;
Of to bodily injury or property damage arising out of the named insured's products
or reliance upon a representation or warranty made at any time with respect
thereto; but this exclusion does not apply to bodily injury or property damage
for which the insured or his indemnitee may be held liable if such liability is
imposed
(1) by, or because of the violation of, any statute, ordinance or regulation
pertaining to the sale, gift, distribution or use of any alcoholic beverage, or
(2) by reason of the selling, serving or giving of any alcoholic beverage to a
minor or to a person under the influence of alcohol or which causes or
contributes to the intoxication of any person.
II. 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 and his spouse;
(over)
Advance Premium
Limits of Liability
Coverage
thousand dollars each common cause
X— Liquor Liability
$
thousand dollars aggregate
Form numbers of endorsements attached at issue
$ Total Advance Premium
Advance
Premium
Rate
Premium Basis
Code Description of Hazards
Designated Insured Premises
Liquor Liability
FOR ENTRIES
REQUIRED HEREIN REFER
TO THE DEC
ARATIONS PACE AND FORM
ICW - B.1,
CW - B.2, ICW - B.2(0),
ICW - B.1(A I
or ICW - B -2(A),
(WHICHEVER
IS ATTACHED).
Receipts
When used as a premium basis:
,.receipts" means gross amount of money charged by the named insured or by others during the policy period for the sale of all alcoholic beverages, and of other
beverages used in connection therewith, including taxes, except taxes which the named insured collects as a separate item, and remits directly to a governmental
division, for which accurate records are maintained apart from other receipts.
I. COVERAGE X — LIQUOR 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 injury to which this insurance
applies, sustained by any person if such liability is imposed upon the insured by reason
of the selling, serving or giving of any alcoholic beverage at or from the insured
premises, and the company shall have the right and duty to defend any suit against
the insured seeking such damages, even it any of the allegations of the suit are
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 judgments or settlements.
Exclusions
This insurance does not apply:
(a) 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:
(b) to bodily injury to any employee of the insured arising out of and in the course
of his employment by the insured or to any obligation of the insured to in-
demnify another because of damages arising out of such injury;
(c) to injury arising out of any alcoholic beverage sold, served or given while any
license therefor, required by law, is suspended or after such license expires.
is cancelled or revoked;
Of to bodily injury or property damage arising out of the named insured's products
or reliance upon a representation or warranty made at any time with respect
thereto; but this exclusion does not apply to bodily injury or property damage
for which the insured or his indemnitee may be held liable if such liability is
imposed
(1) by, or because of the violation of, any statute, ordinance or regulation
pertaining to the sale, gift, distribution or use of any alcoholic beverage, or
(2) by reason of the selling, serving or giving of any alcoholic beverage to a
minor or to a person under the influence of alcohol or which causes or
contributes to the intoxication of any person.
II. 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 and his spouse;
(over)
'4 • '* • •
Aagod agl'lo s1mi aqJ to uoysneq
-xa aql 1ol lnq papioge aq pinom 10 'Aq papio))e asimiaglo si aouemsui golgm
of pasty 41!m A1nfw Aue of Aldde you saop ped sigl Aq paplolle aauwnsul aql
aauelmul Alipgeil 18410 — a8e1ae00 to uoilepwll '8
uoglpuoa „pnS
10 wiela 'aauwm330 to Juan] 041 w sagn0 s,pamsu!„ agl gllm 90uepmaae w
pelmul aql to llegaq uo 10 Aq uaAl2 aq pegs aogou uallum sm000 Ainful ue uagM
pnS 10 wlel3 'Amful to luaA3 aql ul sagno s,pwnsul tl
SNOI110NO3 lVN0I1100V luA
'pouad Iona pea 0l Alaleledas AJdde Begs Algygeq 10 lywg 21e8a188e aql (0)
:Aagod sigl Jo lied a wlol of panssi luawaslopua Aq palels
aq pegs sales papuawy sueld 8w1e1 pue salni s Auedwoa aql 4l!m aoueploaae
w 'spouad lenuue pllgl pue pumas aql 1o) luawpuawe of laafgns we sales aql (q)
'spouad lenuue aegnaasuoo aaigl to pasudwoo si pouad Aagod aql (e)
:sveaA amyl to pouad a 1ol panssi sl Aogod sigl l! :Aagod 1eaA 08141
:smogol se peal of papuawe
sl uoglpuo0 Aagod 1eaA aalgl aql aauelnsul sigl 01 aaualalw w pasn uagM
NOIlI0NO3 03ON31MY 1A
'ssol aql 01 algealidde aauwns
-w algg391100 pue pgeA laglo ou seq pamsw paweu aql (Z) pue uoglsinbae
gans rage sAep 02 wypm AuedWOa aql saggou palmw paweu aqJ m 11
sa8elanaq agogoale 8wAi8 10 8wA1as '8uglas '8ulynqulslp 'Euunpupu ew w asn
iol pouad Aagod aql 8uunp sannboe pamsw paweu aqJ gwgm saslwa)d Aue (q)
'pue lalnpayas aql w paleugisap saslwald aql (e)
:sueaw ,saslwald palnsul„
sagdde aouemsul slgl golym
of tinful to asneaaq algeAed ale golgm 'Apadad to asn Jo sso! 1o'pod din s to sso!
311H3Hlfitl
'sa0lAlas 10 sso! 'MO 'yleap 101 sa8ewep 8ulpnlaul'sa8ewep pe sueaw „s08ewep,,
:(Aagod sigl to
lied a 201WI01 sluawaslopua 8ulpnioup aauemsul slgl of aaualalal ul pasn uagM
SNOIIIN133U 1tlN011100tl 'A
4olwal Aallod aql
ulgllm pouad Aagod aq 8uunp slnom gaigm Amfui of Aluo sagdde aauelnsul s!ql
A80118831:OO183d A3110d'AI
-saslwa;d pwnsul pea
of Alaleledas Aldde pegs Appgeg to Imil alebi88e ganS 'sa8ewep lie 1ol lapunalag
A;gigey s,Auedwoo aq to llwg lelol 041', asnea uowwoa yaea„ 8ugoadsw suorsiAmd
anoge aql of loafgns 'si , alugaigh, se ampagas aql ul palels Aly!gey to pwg aql
uosiad auo Aue of
a8elaAaq a1104031e Aue 10 BnIAIH 10 Ea1NaS '8ugias aql to pnsa; aq se suoslad wow
10 auo Aq pauielsns sa8ewep lie 1ol Auedwoa aql to Appgeg le;ol aql si ,asnea
uowwoa pea., of elgeagdde se ampaps aql w palels Al!I!geA )o pwg ayl
'sm0110) se paywg sl Allpgeg
s,Auedwoa aql 'awemsul sigl lapun spwnsul to lagwnu aql )o ssalp1e8a8
A11318YI1 do SEW11 'III
-pamsw paweu a se Aagod slgl w paleu8lsap
Jou sl gaigm pue lagwaw 10 gauped a si pamsw aql yolgm to wnluaA lulol 10 digs
gauped Aue to Janpuoo aql to lno 8wsue Amfui of Aldde lou saop aauemsui sigl
qans se sagnp siq to
adoas aql u!gpm 8ugoe apgm loalagf laploggaols 10 lolowlp 'laaglo angnaaxa
Aue pue paleu8g3p os vogenue8la aq; 'wnluaA Iulol 10 dRISMIRd 'lenplAlp
-ul ue uegl laglo se suollompap aql ul paleu8lsap sl pwnsul paweu aq 1! (a)
'yans se Alglgeg sly of Joadsw 4l!m Aluo !nq loalagl lagwaw 10
gauped Aue pue paleu8lsap os wnluaA lino) 10 dlgvauped a41 'wnluaA lulof
10 dlyvauped a se suoilempap aql ul paleu8lsap sl pwasul paweu aql li (q)
A
6
A G R E E M E N T
Use of Computer - N. A. Croy
0
THIS AGREEMENT is made between the CITY OF NEWPORT
BEACH, a municipal corporation, hereinafter referred to as
"NEWPORT BEACH" and N. A. CROY, 18687 Redwood, Fountain Valley,
California, hereinafter referred to as "CROY."
W I T N E S S E T H
WHEREAS, Newport Beach owns a computer and there is
time for use of said computer, which will not conflict with
Newport Beach's use of said computer; and
WHEREAS, Newport Beach desires to share the use of
said computer; and
WHEREAS, it is recognized that the sharing of the use
of such computer will be advantageous to both parties to this
agreement; and
WHEREAS, it is in the public interest to permit the
computer owned by Newport Beach to be utilized to its fullest
capacity;
NOW, THEREFORE, in consideration of the mutual covenants,
conditions, agreements and stipulations hereinafter expressed, the
parties hereto hereby agree as follows:
1. Newport Beach will make available to Croy said
computer, at such times and under such conditions as are deemed
appropriate by Newport Beach.
2. Newport Beach will bill Croy and Croy will pay
Newport Beach for the use of said computer at the rate of Fifteen
Dollars ($15.00) per CPU hour.
3. Newport Beach will bill Croy once each month, which
amount will become due and payable within ten (10) days after
depositing said bill in the U.S. Mail.
-1-
4. Time for computer use by Croy will be made available,
subject to prior approval by the City of Newport Beach, as provided
below, between 9:00 P.M. and 8:00 A.M. of the following day, and on
holidays and weekends.
5. Croy may purchase from Newport Beach such materials,
including standard form, cards and the like, at Newport Beach's
cost.
6. Croy will provide his own operator for the use of the
computer hereunder, and all personnel of Croy who may be required
to enter Newport Beach's computer room shall have received the prior
written approval of Newport Beach.
7. Croy will schedule work with the computer, subject
to prior approval by Newport Beach, with a minimum of three (3) days'
advance notice.
8. Newport Beach will provide twenty five (25) CPU hours
at no charge to Croy to set up the operation of the computer.
9. Croy may store disk packs, program decks and other
materials to be used under this Agreement in Newport Beach's computer
room, subject to such space limitations and time limitations as may
be reasonably imposed by Newport Beach, and will remove same on
5 days notice.
computer.
10. Croy may use only CFI or CRM disk packs on said
11. Croy agrees to hold harmless Newport Beach, its
officers, agents and employees, from any bodily injury, personal
injury, death, or property damage which may arise out of the per-
formance of this agreement. Croy shall provide Newport Beach with
evidence of insurance in such form and amount as may be approved
by the City Attorney of Newport Beach which shall name Newport Beach
as an additional insured, which shall provide that the insurance so
provided will be primary insurance and not contributing with any
other insurance available to Newport Beach under any third party
liability policy.
-2-
6
9
12. This Agreement shall run on a month -to -month basis
and may be terminated by either party by giving at least thirty
(30) days' written notice prior to date of termination.
13. This Agreement shall take effect and shall become
operative when executed by the parties hereto.
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be made and execute on this 1.3 TH day of
ATTEST: CI.TY OF NEWPORT BEACH
a municipal corporation
City Clerk IN lam?. By: r�r�►.
-3-
PO O.' x:307 Sant- a nia, Ca, G. 'o
.CrO; er Corona Cal -.ar IDS A�Cy.,
PC nox 273,Corona del liar, Ca,92625
r-. .. INSURED'S NAME AND MAILING ADDRESS ,
Croy, :ilorvin All ert 3I
lb�.c 7 Redwood,
Fountain Valley, Call-" f.
L J
W-j -, i' "
9 MIN E
INSURED'S BUSINESS /OCCUPATION
B0 oi-71:e e_ ing
LOCATION OF RISK
F, am, e
PENDING ISSUANCE OF A POLICY; and in consideration of the stipulation herein contained, the Company listed
below is hereby bound to the insured for a maximum of 30 a s, d fewer if so stipulated under "days effective,"
from, 1 2' km; (standard time) on the effective date until �M:.(standard time) on -t(ie date of expiration.
.EFFECTIVE DATE April d., 1 07 DAYS EFFECTIVE Thitty (30)
NAME OF INSURANCE COMPANY Tr GLtrance On of the InTPGt
TYPE.OFCOVERAGE: ()F4�iF -PFT' JrCln t 00
r9in« nffica liability, $3 000
combined sincle limit on comorehensive general liabilitv form, etc.
POLICY LIMITS /AMOUNTS
LIABILT_TY: A-4nn n
DESCRIPTION /REMARKS :
OTHER: (FIRE, CASUALTY, MARINE)
Also including contractural liability, blanket coverage
broad form, naming Newaort Beach Calif., (City o €) as an
also insured. 'Irne binder is issued with instinction and
permission of the general agent acting for Insurance Company
of the West.
NAME OF MORTGAGEE (IF ANY)
It is expressly stipulated that this binder is issued subject to all the terms and conditions of the policy regularly
issued by the Company in the state in which the operation or .property is located, which policy is hereby made a part
hereof to the same extent as .if fully set forth herein; and to the payment of such premium as maybe found to be due
to this Company, which *premium, in the event of loss before expiration of this binder, shall be fixed at the full annual
premium for the 'sum insured.
It is a condition of this binder that whenever the Policy of this Company is issued in lieu of its undertaking under
this binder, its obligations hereunder shall cease and be void; provided, however, that this binder shall not continue in
force beyond the expiration date stated herein. In no event shall this binder continue in force beyond. thirty (30) days
from the effective date of this binder. This binder is made and accepted subject to the foregoing stipulations and condi-
tions and shall not be valid unless countersigned by the duly authorized agent of this Company.
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, at the address shown
above, written notice stating when not less than ten (10) days thereafter such cancellation shall be effective. The :nail -
ing 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 written notice shall be equivalent to mailing.
When more than one Company is named in this binder, the above stipulations apply separately to each Company.
COUNTERSIGNED on the effective date shown above at: 1 Insurance 0enev,
lNOt apyneaEle C FOna del liar, Calif, by Joi17V. ?Ol:er
gy E t
INSURED'S COYY h
$
Each Person
❑ BODILY INJURY LIABILITY
Each
`
S
Occurrence
• PROPERTY DAMAGE LIABILITY
$
Occurrence
• MEDICAL PAYMENTS
$
Each Person
• SINGLE LIMIT
$ �'
Occurrence
❑
$
DESCRIPTION /REMARKS :
OTHER: (FIRE, CASUALTY, MARINE)
Also including contractural liability, blanket coverage
broad form, naming Newaort Beach Calif., (City o €) as an
also insured. 'Irne binder is issued with instinction and
permission of the general agent acting for Insurance Company
of the West.
NAME OF MORTGAGEE (IF ANY)
It is expressly stipulated that this binder is issued subject to all the terms and conditions of the policy regularly
issued by the Company in the state in which the operation or .property is located, which policy is hereby made a part
hereof to the same extent as .if fully set forth herein; and to the payment of such premium as maybe found to be due
to this Company, which *premium, in the event of loss before expiration of this binder, shall be fixed at the full annual
premium for the 'sum insured.
It is a condition of this binder that whenever the Policy of this Company is issued in lieu of its undertaking under
this binder, its obligations hereunder shall cease and be void; provided, however, that this binder shall not continue in
force beyond the expiration date stated herein. In no event shall this binder continue in force beyond. thirty (30) days
from the effective date of this binder. This binder is made and accepted subject to the foregoing stipulations and condi-
tions and shall not be valid unless countersigned by the duly authorized agent of this Company.
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, at the address shown
above, written notice stating when not less than ten (10) days thereafter such cancellation shall be effective. The :nail -
ing 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 written notice shall be equivalent to mailing.
When more than one Company is named in this binder, the above stipulations apply separately to each Company.
COUNTERSIGNED on the effective date shown above at: 1 Insurance 0enev,
lNOt apyneaEle C FOna del liar, Calif, by Joi17V. ?Ol:er
gy E t
INSURED'S COYY h
RESOLUTION NO. 9'
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
NEWPORT BEACH AUTHORIZING THE MAYOR AND CITY CLERK
TO EXECUTE AN AGREEMENT BETWEEN THE CITY OF NEWPORT
BEACH AND N. A. CROY IN CONNECTION WITH USE OF THE
CITY COMPUTER
WHEREAS, there has been presented to the City Council
of the City of Newport Beach a certain agreement between the City
of Newport Beach and N. A. Croy in connection with use of the
City computer; and
WHEREAS, the City Council has considered the terms
and conditions of said agreement, and found them to be fair
and equitable and in the best interests of the City;
NOW, THEREFORE, BE IT RESOLVED by the City Council
of the City of Newport Beach that said agreement above described
is approved, and the Mayor and City Clerk are hereby authorized
and directed to execute the same on behalf of the City of Newport
Beach.
ADOPTED this 12th day of May , 1975.
Mayor
ATTEST:
City Clerk
DDO /bc
5/12/75