~~
Producer: JWF Specialty Company, Inc.	Policy Type: Renewal of Prior Policy
	/	Renewel of : 223452468 '~
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•	Law Enforcement Liability	CNA CNA Insurance Companies
CN
	Coverage Form	A Plaza
	
Declarations	For All the Commitments You Make® Chicago, IL 60685
•	Producer Plumber	Branch	Prefix	Policy Number	INSURANCE PROVIDED BY THE COMPANY DESIGNATED BELOW
	012859	880	LEO	223452468	(A Stock Insurance company herein called the company)
	Named Insured & Address	
		Columbia Casualty Company
	(Number & Street, City, State, & Zip Code)	
	Kerr County Juvenile Facility	
	3501 Legion Drive	Retail Producer:
	Kemille, TX 78028	
		Ramsgate Managing Insurance
	Legal Entity: Governmental Subdivision	11865 IH10W Ste 600
	SIC Code 91113	San Antonio, TX 78230
	PR/PT 54/38	
2•	Policy Period: From: 01/01/2003 To: 01/01/2004	
	This policy becomes effective and expires at 12:01 a.m. Standard Time at Your	
	Mailing Address Shown Above	
Subject to Audit: No
Limits of Insurance
Aggregate Limit: $2,000,000
Each Wrongful Act Limit: $1,000,000
Deductible: $10,000
6.
7.
Business Description: Law Enforcement
Forms and endorsements applicable at time of issuance:
C-129531-A(01/02), G-129286-A(11/97), G-129291-A(11/97), G-129292-A(11/97), G-129296-A(11/97), G-129300-A(11/97),
G-15956-A99(06/93), IL0017(11/85), G-1 4 4 21 6 -A
>veposu rremmm $13,959 SIIRPLIIS LINES TAX-$677.01; STAMPING FEE-X20.94
Minimum earned premium $1,000
.~
~~ ~
Countersigned ~ Q ~.' 03 - 03
,. Date
G-129302-A
(ED. 11/97) ~
G, •~•
Issued: 1/8/2003 Chairman of the Board SecretalY
C'ri/A
Fbr All the Commitments You Make'
Law Enforcement Liability Policy
(1)The "wrongful act' takes place in the
Various provisions in this policy restrict coverage. "coverage territory'; and
Read the entire policy carefully to determine rights,
duties and what is and is not covered.
Throughout this policy the words "you` and "your`
refer to the law enforcement agency shown as the
Named Insured in the Declarations. The words "we',
"us' and "our' refer to the Company providing this
insurance.
(2) The "wrongful act' occurs during the
policy period.
2. Exclusions.
The word "insured` means any person or organization
qualifying as such under WHO IS AN INSURED
(SECTION II).
Other words and phrases that appear in quotation
marks have special meaning. Refer to SECTION V "
DEFINITIONS
SECTION I "COVERAGE
1. Insuring Agreement.
a. We will pay those sums that the insured
becomes legally obligated to pay as
compensatory civil damages because of
"injury`. This insurance applies only to such
"injury` that results from a "wrongful act` to
which this insurance applies. We will have the
right and duty to defend any "suit' seeking
those damages. We may, at our discretion,
investigate any incident or "wrongful act` and
settle, subject to condition 14., any claim or
"suit`. But:
(1) The amount we will pay for damages is
limited as described in LIMITS OF
INSURANCE AND DEDUCTIBLE (Section
III);
(2) Our right and duty to defend end when we
have used up the applicable Limit of
Insurance in the payment of judgments or
settlements.
No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under SUPPLEMENTARY
PAYMENTS.
b. This insurance applies to a "wrongful act'
only if:
G-129286-A (ED. 11197) PAGE 1 of 8
This insurance does not apply to
a. Any obligations that insureds or their
insurance companies have under workers
compensation, unemployment compensation,
disability benefits or similar laws.
b. Damages sustained by any of your law
enforcement officers or employees (including
those that are auxiliary or volunteer), if such
damages are directly or indirectly related to
their employment by you.
c. Damages arising out of the ownership,
maintenance, management, operation, use,
control, loading or unloading of any "auto', or
motor or propelled vehicle of any kind,
watercraft or aircraft:
(1) Owned or operated by, rented or loaned to
any insured; or
(2) Operated by any person on behalf of, or in
the course of employment by, an insured.
d. Liability assumed under any contract or
agreement except mutual law enforcement
assistance agreements between political
subdivisions.
e. Claims arising out of any act, "wrongful act',
service or duty for anyone other than you.
This exclusion does not apply if the act or
service is a result of a mutual law enforcement
as-sistance agreement or contract between
political subdivisions, nor does it apply to any
activities approved by you.
f. Claims arising out of the insured=s
employment policies or practices, including,
but not limited to application for employment,
refusal to employ, termination of employment,
coercion, demotion, evaluation, reassignment,
discipline, defamation, harassment (including
sexual harassment), humiliation,
discrimination or violation of civil rights.
g. Any claim that results in a final legal determ-
ination that any insured has:
(1) Committed any criminal, dishonest, bad
faith or fraudulent act, error or omission or
intentional malicious act, error or
omission; or
(2) Deliberately violated, or had knowledge of
or consented to the violation of, any
federal, state or local statute, ordinance,
rule or regulation.
This exclusion does not apply to any other
insured where there is no legal finding that
such other insured actively joined in:
(a) An act described in g. (1) above;
(b) Or had knowledge of, or consented to, the
violation described in g. (2) above.
h. "Property damage' to property:
(1) Owned, used or occupied by or rented to
the insured; or
(2) In the care, custody or control of the
insured, or over which the insured is, for
any purpose, exercising physical control.
This exclusion h. (2) does not apply to
property on persons at the time of their
arrest.
i. Any claim arising out of the:
(1) Furnishing by an insured of services,
materials, parts or equipment in
connection with, or
(2) Planning, construction, maintenance, exis-
tence or use of any nuclear reactor or
device, nuclear waste storage or disposal
site or any other nuclear facility, the
transportation of nuclear material, or the
hazardous properties of nuclear material.
j. Any claim seeking:
(1) Anything other than money damages;
(2) Injunctive, mandamus, declamatory or
equitable relief; or
(3) Wages or other employee compensation,
overtime or similar claims, even if
designated as liquidated damages, under
any federal, state or local statutes, rules,
or ordinances or regulations or claims
arising from collective bargaining
agreements, or awards or settlements.
k. Any claim made against an insured by another
insured.
I. (1) Any claim, "suit`, proceeding, damages,
loss, cost or expense:
(a) Arising out of any actual, alleged or
threatened emission, discharge,
dispersal, seepage, migration, release
or escape of "pollutants' at any time;
or
(b) Arising out of any request, demand or
order for any "clean up of
"pollutants'; or
(c) incurred as result of any "clean up of`
"pollutants';
(2) The investigation, settlement or defense of
any claim, "suit', proceeding, damages,
loss, cost or expense excluded by (1)
above or alleging or in any way involving
the above.
As used in this exclusion:
"Pollutants' include any noise, solid semi-
solid, liquid, gaseous or thermal irritant or
contaminant, including smoke, vapor, soot,
fumes, mists, acids, alkalis, chemicals,
biological and etiologic agents or materials,
electromagnetic or ionizing radiation and
energy, genetically engineered materials,
teratogenic, carcinogenic and mutagenic
materials, "waste' and any other irritant or
contaminant.
"Waste' includes any materials to be
disposed, recycled, reconditioned or
reclaimed.
"Clean up oP includes monitoring, removal,
con-tainment, treatment, detoxification or
neutrali-zation of, testing for or response in
any way to, or assessment of the effects of
"pollutants'.
m. Liability arising out of the rendering of, or
failure to render, professional services by a
member of the medical profession.
G-129286-A (ED. 11197) PAGE 2 of 8
n. The liability of an insured for fines, penalties,
costs or expenses imposed by law or arising
from any complaint or enforcement action of
any federal, state or local governmental
regulatory agency, or damages which may be
deemed uninsurable by law or under law.
o. Any claim for damages arising out of, or
alleged to have arisen out of, the transmission
of, or exposure to, a communicable disease.
(1) As respects this exclusion, AIDS (Acquired
Immune Deficiency Syndrome) will be
considered a communicable disease.
(2) This exclusion includes such damages
claimed because of negligent training,
supervision, recruitment, policies or
procedures.
Supplementary Payments
We will pay, with respect to any claim or "suit we
defend:
1. All expenses we incur, subject to the deductible
amount. Refer to LIMITS OF INSURANCE AND
DEDUCTIBLE (Section III).
2. Up to $250 for the cost of bail bonds required
because of "injury' to which this insurance
applies.
3. The cost of bonds to release attachments in a
"suit' we defend, but only for bond amounts
within the applicable Limit of Insurance. We do
not have to furnish these bonds.
4. All reasonable expenses incurred by the insured at
our request to assist us in the investigation or
defense of the claim or "suit', including actual
loss of earnings up to $100 a day because of time
off from work.
5. All costs taxed against the insured in a "suit' we
defend.
6. Pre-judgment interest awarded against the
insured on that part of the judgment we pay. If we
make an offer to pay the applicable Limit of
Insurance, we will not pay any pre-judgment
interest based on that period of time after the
offer.
8. Premium on appeal bonds in any "suit' we defend.
9. Reasonable expenses incurred for "first aid` to
others at the time and place of an accident, for
"bodily injury` to which this insurance applies.
These payments will not reduce the Limits of
Insurance.
SECTION II"WHO IS AN INSURED
1. You are an insured.
2. Each of the following is also an insured, but only
while acting within the scope of their duties for
you:
a. Your law enforcement officers and, in the event
of their death, incapacity or bankruptcy, their
heirs, executors, administrators, assigns and
legal representatives;
b. The political entity or subdivision of which the
law enforcement agency is a part, department
or bureau and its public officials, provided
such political entity or subdivision is legally
constituted at the inception date of this policy;
and
c. All other employees and authorized volunteers
of the law enforcement agency.
No person or organization is an insured with respect
to the conduct of any current or past partnership or
joint venture that is not shown as a Named Insured in
the Declarations.
SECTION III"LIMITS OF INSURANCE AND
DEDUCTIBLE
1. The Limits of Insurance shown in the Declaration
and the rules below fix the most we will pay
regardless of the number of:
a. Insureds;
b. Claims made or "suits' brought; or
c. Persons or organizations making claims or
bringing "suits'.
2. The Aggregate Limit is the most we will pay for all
damages to which this insurance applies.
7. All interest on the full amount of any judgment 3. Subject to 2. above, the Each Wrongful Act Limit
that accrues after entry of the judgment and is the most we will pay for the sum of all damages
before we have paid, offered to pay, or deposited arising out of the same "wrongful act' to which
in court the part of the judgment that is within the this insurance applies.
applicable Limit of Insurance.
G-129286-A (ED. 11197) PAGE 3 of 8
4. a. Subject to 3. above, the Each Wrongful Act
Limit applies in excess of the Deductible
shown in the Declarations. By accepting this
insurance the insured agrees that such
Deductible will be uninsured and borne by the
insured.
b. The terms of this insurance, including those
with respect to your duties in the event of an
incident, "wrongful act', claim or "suit', apply
irrespective of the application of the
deductible amount.
c. We may, at our discretion, pay all or part of
any deductible shown in the Declarations.
Upon notice of such payment you shall
promptly reimburse us for the amount we
paid.
d. Claims based on or arising out of:
(1) The same "wrongful act' or the related
"wrongful acts` of one or more insureds;
or
(2) Riot, insurrection or civil disturbance
which results in an official proclamation of
a state of emergency, temporary curfew or
martial law will be considered a single
claim, to which only one Each Wrongful Act
Limit, and Deductible, will apply.
The Deductible, as referred to in this policy, will
apply to the sum of damages and "defense
expenses'.
The limits of this policy apply separately to each
consecutive annual period and to any remaining
period of less than 12 months, starting with the
beginning of the policy period shown in the
Declarations, unless the policy period is extended
after issuance for an additional period of less than 12
months. In that case, the additional period will be
deemed part of the last preceding period for purposes
of determining the Limits of Insurance.
SECTION IV" CONDITIONS
1. Bankruptcy.
Bankruptcy or insolvency of the insured will not
relieve us of our obligations under this policy.
2. Cancellation
a. The first Named Insured shown in the Dec-
larations may cancel this policy by mailing or
delivering to us advance written notice of
cancellation.
b. We may cancel this policy by mailing or
delivering to the first Named Insured written
notice of cancellation at least:
(1) 10 days before the effective date of
cancellation if we cancel for nonpayment of
premium; or
(2) 60 days before the effective date of
cancellation if we cancel for any other
reason.
c. We will mail or deliver our notice to the first
Named Insured=s last mailing address known
to us.
d. Notice of cancellation will state the effective
date of cancellation. The policy period will end
on that date.
e. If this policy is canceled, we will send the first
Named Insured any premium refund due. If we
cancel, the refund will be pro rata. If the first
Named Insured cancels, the refund may be
less than pro rata. In all cases, refunded
premium will be less any earned minimum
premium. The cancellation will be effective
even if we have not made or offered a refund.
f. If notice is mailed. proof of mailing will be
sufficient proof of notice.
3. Changes
This policy contains all the agreements between
you and us concerning the insurance afforded. The
first Named Insured shown in the Declarations is
authorized to make changes in the terms of this
policy with our consent. This policy=s terms can be
amended or waived only by endorsement issued
by us and made a part of this policy.
4. Duties in the Event of Incident, Wrongful
Act, Claim or Suit.
a. You must see to it that we are given written
notice as soon as practicable of an incident or
"wrongful act' which may result in a claim. To
the extent possible, notice should include:
(1) All available information about the
circumstances concerning the incident or
"wrongful act' including:
(a) How, when and where it took place;
and
G-129286-A (ED. 11/97) PAGE 4 of 8
(b) The names and addresses of any
witnesses and persons seeking
damages; and
(2) What claim you think may result.
However, even when you notify us of an
incident or "wrongful act`, this does not relieve
you of your obligation to also notify us of any
resulting claim or "suit'.
b. When you first learn of a claim made or "suit'
brought against any insured, you must:
(1) Immediately record the specifics of the
claim or "suit' and the date received; and
(2) Notify us as soon as practicable.
You must see to it that we receive written
notice of the claim or "suit' as soon as
practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
claim or a "suit':
(2) Authorize us to obtain records and other
information;
(3) Cooperate with us in the investigation,
settlement or defense of the claim or
"suit`;
(4) Assist us, upon our request, in the
enforcement of any right against any
person or organization who may be liable
to the insured because of damages to
which this insurance may also apply; and
(5) In no way jeopardize our rights after an
incident or "wrongful act`.
d. No insureds will, except at their own cost,
voluntarily make a payment, assume any
obligation or incur any expense, other than for
"first aid`, without our written consent.
5. Examination Of Your Books And Records
We may examine audit and copy your books and
records as they relate to this policy at any time
during the policy period and up to three years
afterward.
6. Governmentallmmunity.
G-129286-A (ED. 11/97)
Because you are a public institution, you may be
entitled to governmental immunity. This policy
does not constitute a waiver of any governmental
immunity to which you are entitled.
7. Inspections And Surveys
We have the right but are not obligated to:
a. Make inspections and surveys at any time;
b. Give you reports on the conditions we find;
and
c. Recommend changes.
Any inspections, surveys, reports or recommen-
dations relate only to insurability and the
premiums to be charged. We do not make safety
inspections. We do not undertake to perform the
duty of any person or organization to provide for
the health or safety of workers or the public. And
we do not warrant that conditions:
a. Are safe or healthful; or
b. Comply with laws, regulations, codes or
standards.
This condition applies not only to us, but also to
any rating, advisory, rate service or similar
organization which makes insurance inspections,
surveys, reports or recommendations.
8. Legal Action Against Us.
No legal action may be brought against us unless,
as a condition precedent thereto, the insured has
fully complied with all the terms of this policy. In
addition, no person or organization has a right
under this policy:
a. To join us as a party or otherwise bring us into
a "suit' asking for damages from an insured;
or
b. To sue us on this policy unless all of its terms
have been fully complied with.
A person or organization may sue us to recover
on, an agreed settlement or on a final judgment
against an insured obtained after an actual trial;
but we will not be liable for damages that are not
payable under the terms of this policy or that are
in excess of the applicable Limit of Insurance. An
agreed settlement means a settlement and release
of liability signed by us, the insured and the
claimant or the claimant=s legal representative.
9. Other Insurance.
PAGE 5 of 8
a. Except for such other insurance that is pur-
chased specifically to be excess of the Limits
of Insurance provided by this policy, the
insurance provided by this policy form is
excess over any other collectible insurance and
its deductible or self-insured retention
provisions. The presence of a deductible or
self-insured retention in such other insurance
will not amend the deductible provision of this
policy.
b. When this insurance is excess, we will have no
duty to defend any claim or "suit' that any
other insurer has a duty to defend. If no other
insurer defends, we will undertake to do so,
but we will be entitled to the insured=s rights
against all those other insurers.
c. When this insurance is excess over other
insurance, we will pay only our share of the
damages, if any, that exceeds the sum of:
(1) The total amount that all such other
insurance would pay for the damages in
the absence of this insurance; and
(2) The total of all deductible and self-insured
amounts under all that other insurance.
d. When both this insurance and other insurance
apply to the loss on the same excess basis, we
will share with such other insurance by the
method described below:
(1) If all of the other insurance permits
contribution by equal shares, we will follow
this method also. Under this approach,
each insurer contributes equal amounts
until it has paid its applicable Limit of
Insurance or none of the loss remains,
which comes first.
(2) If any of the other insurance does not
permit contribution by equal shares, we
will contribute by limits. Under this
method, each insurers share is based on
the ratio of its applicable Limit of
Insurance to the total applicable Limit of
Insurance of all insurers.
10.Premium Audit.
If the Declarations states that the policy is subject
to audit:
a. The premium shown in the Declarations is a
deposit premium only. At the close of each
audit period we will compute the earned
premium for that period.
b. Audit premiums are due and payable on notice
to the first Named Insured. If the sum of the
advance and audit premiums paid for the
policy term is greater than the earned
premium, we will return the excess to the first
Named Insured.
c. The first Named Insured must keep records of
the information we need for premium
computation, and send us copies at such
times as we may request.
11.Premiums
The first Named Insured shown in the
Declarations;
a. Is responsible for the payment of all
premiums; and
b. Will be the payee for any return premiums we
pay.
12.Representations.
By accepting this policy, the Named Insured
agrees that:
a. The statements in the Declarations and in the
application for insurance are accurate and
complete;
b. Those statements are based upon represen-
tationswhich the insureds made to you, and
which you made to us; and
c. We have issued this policy in reliance upon
those representations.
13.Separation Of Insureds.
Except with respect to the Limits of Insurance,
and any rights or duties specifically assigned to
the first Named Insured, this insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom
claim is made or "suit' is brought.
14.Settlement.
If the first Named Insured, on behalf of all
insureds, refuses to consent, within a reasonable
period of time, to any settlement offer we
G-129286-A (ED. 11/97) PAGE 6 of 8
recommend and elects to contest the claim or
continue any legal proceedings in connection with
such claim then, subject to the provisions of
Section III -Limits of Insurance, our liability fo; the
claim will not exceed the amount for which the
claim could have been settled, plus the cost of
defense incurred by us up to the date of such
refusal.
15.Transfer Of Rights Of Recovery Against
Others To Us.
If the insured has rights to recover all or part of
any payment we have made under this policy,
those rights are transferred to us. The insured
must do nothing after loss to impair them. At our
request, the insured will bring "suit' or transfer
those rights to us and help us enforce .them.
16.Your Authority And Duties.
The first Named Insured shown in the Declarations
agrees to act on behalf of all insureds with respect
to cancellation, notice of any incident, "wrongful
act', claim or "suit', payment or return of any
premium, or consent to a claim settlement that
we recommend. Each insured, by accepting this
insurance, agrees to:
a. Have the first Named Insured act for them in
such matters; and
b. Promptly notify the first Named Insured, in
writing, of any incident or "wrongful act' which
may result in a claim, or of any claim or "suit'
brought against them-
SECTION V"DEFINITIONS
1. "Auto` means a land motor vehicle, trailer or
semi-trailer designed for travel on public roads.
2. "Bodily injury' means:
a. Any physical harm to a person=s health,
including sickness or disease; and
b. Any metal harm to, or the death of, the same
person described in 2.a. above, as a direct
result of such physical harm.
3. "Coverage territory' means:
a. The United States of America (including its
territories and possessions), Puerto Rico and
Canada; and
b. All other parts of the world if:
(1) The "wrongful acY is committed by an
insured whose home is in the territory
described in (a.) above, but is away for a
short time on your business; and
(2) The insured=s responsibility to pay
damages is determined in a "suit' on the
merits in the territory described in (a.)
above or in a settlement to which we
agree.
4. "Defense expenses` mean expenditures including,
but not limited to, our costs of investigations,
experts, adjustment services, legal services, court
costs, and other similar expenses.
5. "First aid' means the rendering of emergency
medical treatment by any of your law enforcement
officers, but only when care by a licensed medical
professional is not immediately available.
6. "Injury' means "bodily injury', "property damage`
or "personal injury`;
a. The insured did not expect or intend. "Injury'
resulting from the use of reasonable force to
protect persons or property will not be
considered expected or intended; and
b. Arising out of the insured=s duties to provide
law enforcement and/or other activities
approved by you.
7. "Personal injury` means injury, other than "bodily
injury', arising out of one or more of the following:
a. False arrest; wrongful detention or wrongful
imprisonment;
b. Malicious prosecution;
c. Assault and battery from the use of reasonable
force to protect persons or property;
d. Discrimination, unless uninsurable by law;
e. Humiliation;
f. False or improper service of process;
g. Violation of property rights;
h. Violation of civil rights, unless uninsurable by
law;
i. Wrongful eviction or wrongful entry, or other
violations of the right of private occupancy;
and
G-129286-A (ED. 11/97) PAGE 7 of 8
j. The oral or written publication of material
that:
(1) Defames, slanders or libels a person or
org-anization or disparages a person=s or
org-anization=s goods, products or
services; or
(2) Violates a person=s right of privacy.
However, "personal injury' does not include
the oral or written publication of material in
the course of, or related to, advertising, broad-
casting, telecasting or videotaping activities
conducted by or on behalf of any insured.
8. "Property damage' means:
a. Physical injury to tangible property, including
all resulting loss of use of that property; or
b. Loss of use of tangible property that is not
physically injured.
9. "Suit' means a civil proceeding in which damages
to which this insurance applies are alleged. "Suit`
includes:
a. An arbitration proceeding in which such
damages are claimed and to which you must
submit or do submit with our consent; or
b. Any other alternative dispute resolution
proceeding in which such damages are
claimed and to which you submit with our
consent.
10. "Wrongful act' means any actual or alleged error
or misstatement or act or omission or neglect or
breach of duty, including misfeasance and
nonfeasance, by the insured in the discharge of
duties for you.
"Wrongful act' includes allegations of
malfeasance, but only if they are ultimately proven
to be groundless. This insurance does not apply
to malfeasance if there is a final legal
determination that such has taken place.
G-129286-A (ED. 11/97) PAGE 8 of 8
Ci~IA
For All the Commitments You Make®
THIS ENDORSEMENT CHANGES THE POLICY.
PLEASE READ IT CAREFULLY.
ADDITIONAL EXCLUSIONS
If shown by an "X" below as excluded, this insurance does not apply to any claim arising out of the "operations" or
"activities" of:
Excluded
(~ 1. Airports, aircraft and other aviation related activities;
2. Fire fighting services;
® 3. Ambulance, emergency medical or rescue services;
4, Detention, correction or prison facilities;
5
As used in this endorement:
a. "Operations" or "activities" include those of any unit, board, commission or similar body, and their officials, members,
employees, volunteers, and any persons provlding services under any mutual aid or similar agreement; and
b. "Hospitals" includes al- hospitals, clinics, nursing homes, rehabilitation facilities, psychiatric facilities and any other
similar health care facilities.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured Kerr County Juvenile Facility Policy Number 223452468
Endorsement Effective 01/01/2003 Countersigned By
u onze eperesen a Ive
G-129291-A
(ED. 11!97)
t~l/A
FkgAlltbe CommitnaenfeYou hfaloe'
THIS ENDORSEMENT CHANGES THE POLICY.
PLEASE READ IT CAREFULLY.
INCIDENTAL PROFESSIONAL LIABILITY ENDORSEMENT
The following is added to the definition of "bodily injury` (DEFINITIONS "Section V):
c. Subject to 2.a. and b. above, coverage is provided for "bodily injury' arising out of the rendering of, or
failure to render, "health care services` by your medical employees, other than medical doctors or
dentists, while acting within the scope of their duties for you.
The following paragraph is added to 2. Exclusions, m. (COVERAGE "SECTION I):
However, this exclusion m. does not apply to the rendering of, or failure to render, "health care services` by
your medical employees, other than medical doctors or dentists, while acting within the scope of their duties
for you.
As used in this endorsement "health care services' means:
a. Medical or nursing services or treatment, or the furnishing of food or beverages in connection therewith;
or
b. The furnishing or dispensing of drugs, medical supplies or appliances.
This endorsement changes the policy effective on the inception date of the policy unless another date is
indicated below.
Named Insured
Policy Number
Endorsement Effective
Countersigned By
(Authorized
Representative)
G 129292-A
(ED. 11/97) Endorsement Number.
~~i/A
For All the CommitmeateYou Make°
THIS ENDORSEMENT CHANGES THE POLICY.
PLEASE READ IT CAREFULLY.
PRIOR CLAIMS AND POTENTIAL CLAIMS EXCLUSION
This policy does not apply to any claim or loss arising out of any matter that was listed, or should have been
listed, in the application(s) on which we relied for the issuance of this policy.
This endorsement changes the policy effective on the inception date of the policy unless another date is
indicated below.
Named Insured
Endorsement Effective
G-129296-A
(ED. 11 /97)
Policy Number
Countersigned By
(Authorized
Representative)
Endorsement Number:
CI11A
For All the Commitments You Make®
ADDITIONAL DECLARATIONS
For attachment to policy no. 223452468
The Additional Declarations below are an extension of those stated in the Declarations of the Policy to which this
Schedule is attached
SCHEDULE
		Premium Basis As		
Description of Hazards	Class Code	Described in the
Schedule	Rate	Advance Premium
Governmental Subdivision	44110	40 (e)		$13
959
not State or Federal				,
G-129300-A
(ED. 11 /97)
CHA
For All the Cae~e~s Yoo Ma>ae•
COLUMBIA CASUALTY COMPANY
SERVICE OF SUIT CLAUSE
It is agreed that in the event of the failure of the Insurer to pay any amount claimed to be due hereunder, the Insurer, at the
request of the insured, will submit to the jurisdiction of any court of competent jurisdiction within the United States and will
comply with all requirements necessary to give such court jurisdiction and all mafters arising hereunder shall be
determined in accordance with the law and practice of-such court.
It is further agreed that service of process in such suit may be made upon the General Counsel, Columbia Casualty, CNA
Plaza, Chicago, IL and that in any suit instituted against such person upon this policy, the Insurer will abide by the final
decision of such court or of any appellate court in the event of an appeal.
The above-named is authorized and directed to accept service of process on behalf of the Insurer in any such suit and,
upon the request of the insured, to give a written undertaking to the insured that he will enter a general appearance upon
the Insurer's behalf in the event such suit shall be instituted.
Further, pursuant to any statute of any state, territory• or district of the United States which makes provision therefor, the
Insurer hereby designates the Superintendent, Commissioner or Director of Insurance or other officer specified for that
purpose in the statue, or his successor or successors in office, as its true and lawful attorney upon whom may be served
any lawful process in any action, suit or proceeding instituted by or on behalf of the insured or any beneficiary hereunder
arising out of this contract of insurance, and hereby designates the above-named as the person to whom the said officer is
authorized to mail such process or true copy thereof.
All other provisions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the following described Policy issued by the designated
Insurer takes effect on the effective date of said Policy, unless another effective date is shown below, at the hour stated in
said Policy and expires concurrently with said Policy.
Must Be Completed
ENDT. NO. POLICY NO.
civ~-
Far All the Conwittmente You Mukt~
Complete Only When This Endorsement !s Not Prepared with the Policy
Or is Not to be Effective with the Policy
ISSUED TO EFFECTIVE DATE OF
THIS ENDORSEMENT
Countersigned by
Authorized Representative
G-15956-A99
(ED. 06/93)
COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are sub;ec! to the following conditions.
A. CANCELLATION
1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance
written notice of cancellation.
2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least:
a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or
b. 30 days before the effective date of cancellation if we cancel for any other reason.
3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us.
4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date.
5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund
will be pro rata. If the first Named Insured cancels, the refund may be less than pro. rata. The cancellation will be
effective even if we have not made or offered a refund.
6. If notice is mailed, proof of mailing will be sufficient proof of notice.
B. CHANGES
This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured
shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms
can be amended or waived only by endorsement issued by us and made a part of this policy.
C. EXAMINATION OF YOUR BOOKS AND RECORDS
We may examine and audit your books and records as they relate to this policy at any time during the policy period and up
to three years afterward.
D. INSPECTIONS AND SURVEYS
We have the right but are not obligated to:
1. Make inspections and surveys at any time;
2. Give you reports on the conditions we find; and
3. Recommend changes.
Any inspections, surveys, reports or recommendations relate only to insurability and the premiums to be charged. We do
not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the
health or safety of workers or the public. And we do not warrant that conditions:
1. Are safe or healthful; or
2. Comply with laws, regulations, codes or standards.
This condition applies not only to us, but also to any rating, advisory, rate service or similar organization which makes
insurance inspections, surveys, reports or recommendations.
E. PREMIUMS
The first Named Insured shown in the Declarations:
1. Is responsible for the payment of all premiums; and
2. Will be the payee for any return premiums we pay.
IL 00 17 (11/85) Page 1 of 2
F. TRANSFER OF YOUR RIGHTS AND DUTIES UNDER THIS POLICY
Your rights and duties under this policy may not be transferred without our written consent except in the case of death of
an individual named insured.
If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of
duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody
of your property will have your rights and duties but only with respect to that property.
IL 00 17 (11/85) Page 2 of 2
ANA
IMPORTANT INFORMATION
POLICYHOLDER DISCLOSURE
NOTICE OF INSURANCE COVERAGE
FOR ACTS OF TERRORISM
You are hereby notified that under the Terrorism Risk Insurance Act of 2002, effective November 26, 2002, that you
are entitled to insurance coverage for losses arising out of acts of terrorism, as defined in the Act, subject to all
applicable policy provisions.
You should know that any covered losses caused by acts of terrorism will be partially reimbursed by the United
States under a formula established by federal law. Under this formula, the United States pays 90% of covered
terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the
coverage. The premium as of this date that is attributable to coverage for acts of terrorism is $0.00.
G-144216-A
(Ed. 11/02)
INSURANCE IN TOUCH WITH BUSINESS
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
FUNGI /MOLD /MILDEW /YEAST 1 MICROBE EXCLUSION
AND WATER DAMAGE LIMITATION
This endorsement modifies insurance provided under the following:
LAW ENFORCEMENT LIABILITY POLICY
A. The following exclusion is added to Paragraph 2., Exclusions, of Section I -Coverage:
This insurance does not apply to:
Fungi and Microbes
(1) "Bodily injury"'personal injury` or "property damage` arising out of or relating to, in
whole or in part, the actual, alleged or threatened inhalation of, ingestion of, contact
with, exposure to, existence of, or growth or presence of any "fungi` or "microbes`.
(2) Any loss, cost or expense arising out of or relating to the testing for, monitoring, cleaning
up, removing, containing, treating, detoxifying, neutralizing, remediating, or disposing of,
or in any way responding to or assessing the effects of "fungi` or "microbes` by any
insured or by anyone else.
(3) "Property damage` caused by water where there also exists any "property damage`
arising out of or relating to, in whole or in part, the actual, alleged or threatened
inhalation of, ingestion of, contact with, exposure to, existence of, or growth or presence
of any "fungi` or "microbes`.
This exclusion applies regardless of any other cause or event that contributes concurrently
or in any sequence to such injury or damage, loss, cost or expense.
This exclusion does not apply where your business is food processing, sales, or serving, and
the "bodily injury` is caused solely by food poisoning in connection with such processing,
sales, or serving.
B. The following definitions are added to Section V -Definitions:
"Fungi` means any form of fungus, including but not limited to, yeast, mold, mildew, rust,
smut or mushroom, and including any spores, mycotoxins, odors, or any other substances,
products, or byproducts produced by, released by, or arising out of the current or past
presence of fungi. But "fungi` does not include any fungi intended by the insured for
consumption.
"Microbe` means any non-fungal microorganism or non-fungal, colony-form organism that
causes infection or disease. "Microbe' includes any spores, mycotoxins, odors, or any other
substances, products, or byproducts produced by, released by, or arising out of the current
or past presence of microbes. But "microbe' does not mean microbes that were
transmitted directly from person to person.
C-129531-A
(ED. 01/02)
Page 1 of 1
Incorporates materials copyrighted by Insurance Services Office, reprinted with their permission.