Schulze RDP Declarations PDF

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State Auto Property and Casualty Insurance Company

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FI36 (01/16)
New Declaration
Dwelling Fire Policy
Members Home & Auto Issue Date: 12/09/2022
2855 Coolidge Hwy Ste 204
Troy, MI 48084-3216

Total Policy Premium


Named Insured $461.37
Arthur Schulze
Lisa Schulze Coverage is provided by
32331 Eastway Street Policy Number Policy Period the following State Auto Company
ROSEVILLE, MI 48066 1001562443 12/12/22 - 12/12/23 State Auto Property and Casualty Insurance
Company

Policy Period begins and ends at 12:01 a.m. standard time at the residence premises.

Insured Location:
18938 NORTHWAY ST
Your Coverages
ROSEVILLE, MI 48066
Property Coverages Limit Premium

A. Dwelling $220,300 $461.37

Liability Coverages Limit Premium

L. Liability $300,000 Included

M. Medical Payments $3,000 Included

Total Premium $461.37

Coverage at the above described location is provided only where a limit of liability or a premium is stated.

Coverage included by F. Other Coverages, at no


additional cost:
Visit us at StateAuto.com Coverages Limit
or call (800) 288-4425 Other Structures as shown in Coverage B. 10% of Coverage A limit, as additional insurance
customer service.
Debris Removal Included in the limit that applies to damaged property
Contact your independent Improvements, Alterations and Additions 10% of Coverage C limit, as additional insurance
agent at (248) 619-3400.
Worldwide Coverage 10% of Coverage C limit. Use of this coverage reduces
Coverage C limit.

Fair Rental and Additional Living Expense 20% of Coverage A limit, as additional insurance

Reasonable Repairs See form DP0002/DP0003 for details.

Property Removed Included in the limit that applies to property being


removed., lasting 30 days.

Trees, Shrubs and Other Plants Up to $500 per tree/shrub/plant up to 5% Coverage A


limit, as additional insurance

Fire Department Service Charge $500 per occurrence, as additional insurance

Collapse Included in A Dwelling and C.Personal Property limits.

Glass or Safety Glazing Material Included in A Dwelling and C.Personal Property limits.

DECOV-DF (10/20) Page 1 of 4 Agency 0019864


New Declaration
Dwelling Fire Policy
Members Home & Auto Issue Date: 12/09/2022
2855 Coolidge Hwy Ste 204
Troy, MI 48084-3216

Total Policy Premium


Named Insured $461.37
Arthur Schulze
Lisa Schulze Coverage is provided by
32331 Eastway Street Policy Number Policy Period the following State Auto Company
ROSEVILLE, MI 48066 1001562443 12/12/22 - 12/12/23 State Auto Property and Casualty Insurance
Company

Policy Period begins and ends at 12:01 a.m. standard time at the residence premises.

Insured Location: Coverage included by F. Other Coverages, at no


18938 NORTHWAY ST
ROSEVILLE, MI 48066 additional cost:
Coverages Limit

Ordinance or Law Up to 10% of Coverage A limit of liability, as additional


insurance

Your Deductibles
Deductibles Amount

All-Peril $1,000

Windstorm or Hail $1,000

Visit us at StateAuto.com Your Policy Information


or call (800) 288-4425 Policy type: DP3 Program: Standard Feet from hydrant: 500
Construction type: Brickonframe Protection class: 2 Miles from fire station: 5
customer service. Year built: 1963 Territory: 48066 Residence Type: Single Family Dwelling

Contact your independent


agent at (248) 619-3400.
Your Forms and Endorsements
• DF0121 (11/17) Special Provisions - Michigan

• DF179 (07/14) Lead and Pollution Exclusion Endorsement

• DF2073 (09/07) Amendment of Cancellation Provision

• DF2999MI (01/21) Actual Cash Value and Depreciation Definitions Endorsement

• DF3006 (11/21) Duties After Loss Amendatory Endorsement

• DF3010 (11/21) Swimming Pool Amendatory Endorsement

DECOV-DF (10/20) Page 2 of 4 Agency 0019864


New Declaration
Dwelling Fire Policy
Members Home & Auto Issue Date: 12/09/2022
2855 Coolidge Hwy Ste 204
Troy, MI 48084-3216

Total Policy Premium


Named Insured $461.37
Arthur Schulze
Lisa Schulze Coverage is provided by
32331 Eastway Street Policy Number Policy Period the following State Auto Company
ROSEVILLE, MI 48066 1001562443 12/12/22 - 12/12/23 State Auto Property and Casualty Insurance
Company

Policy Period begins and ends at 12:01 a.m. standard time at the residence premises.

Insured Location: Your Forms and Endorsements


18938 NORTHWAY ST
ROSEVILLE, MI 48066 • DL0121 (11/14) Special provisions - Michigan

• DL2401 (07/14) Personal Liability

• DL2411 (07/14) Premises Liability (Non-Owner Occupied Dwelling)

• DL2473 (05/04) Limited Fungi, Wet or Dry Rot or Bacteria Coverage - Michigan

• DL2489 (07/21) Cap on Losses From Certified Acts of Terrorism, Disclosure Pursuant To Terrorism
Risk Insurance Act
• DL2521 (11/14) Special Provisions - Michigan

• DP0003 (07/14) Dwelling Property 3- Special Form

Visit us at StateAuto.com
or call (800) 288-4425 • DP0422 (07/14) Limited Fungi Wet or Dry Rot or Bacteria Coverage
customer service.
• DP0470 (12/02) Premises Alarm or Fire Protection System
Contact your independent
agent at (248) 619-3400. • DP0538 (07/21) Cap on Losses From Certified Acts of Terrorism, Disclosure Pursuant To Terrorism
Risk Insurance Act
• FI36 (01/16) Dwelling Policy Cover Page

• FI36A (01/16) Your Dwelling Quick Reference

DECOV-DF (10/20) Page 3 of 4 Agency 0019864


New Declaration
Dwelling Fire Policy
Members Home & Auto Issue Date: 12/09/2022
2855 Coolidge Hwy Ste 204
Troy, MI 48084-3216

Total Policy Premium


Named Insured $461.37
Arthur Schulze
Lisa Schulze Coverage is provided by
32331 Eastway Street Policy Number Policy Period the following State Auto Company
ROSEVILLE, MI 48066 1001562443 12/12/22 - 12/12/23 State Auto Property and Casualty Insurance
Company

Policy Period begins and ends at 12:01 a.m. standard time at the residence premises.

Insured Location: Mortgagee, its successors and/or assigns:


18938 NORTHWAY ST
ROSEVILLE, MI 48066 LN#9876542153
Mortgage Center LLC
ISAOA/ATIMA
PO BOX 390606
Minneapolis, MN 55439

This declarations page with policy forms and endorsements completes the Policy. This Policy will
continue in force for the period indicated upon valid payment of the premium, when due.

Visit us at StateAuto.com
or call (800) 288-4425
customer service.

Contact your independent


agent at (248) 619-3400.

DECOV-DF (10/20) Page 4 of 4 Agency 0019864


Policy Number: 1001562443

STATE AUTO INSURANCE COMPANIES


CORPORATE HEADQUARTERS - 518 EAST BROAD STREET
COLUMBUS, OHIO 43215

Date: 12/09/2022 Policy: 1001562443

Insured: Arthur Schulze Agent: Members Home & Auto


Lisa Schulze 2855 Coolidge Hwy Ste 204
32331 Eastway Street
Troy, MI 48084-3216
ROSEVILLE, MI 48066

Telephone: (248) 619-3400

Thank you for your business! Of all the options available to you, we appreciate the fact that you chose
State Auto to provide your insurance protection.

We strive to provide quality coverage and service at a fair price. It is important to note that many factors
are used to develop insurance premiums. Among those items is an insurance bureau score based on
credit information. Your policy may be receiving a discounted rate and is the best rate available to you at
this time.

Changes may occur to an insurance bureau score over time. As we are made aware of changes to the
insurance bureau score, that information will be applied to your policy.

If there are items that are adversely impacting the insurance bureau score currently being applied to your
policy, we will list the top four factors impacting your score below.
# OF OPEN ACCOUNTS WITH BALANCE TO CREDIT LINE 75% OR MORE IS 2 OR MORE ZERO ACCOUNTS WITH BALANCE
TO CREDIT LINE 75% OR MORE IS BETTER
AVERAGE # OF MONTHS SALES FINANCE ACCTS HAVE BEEN ESTABLISHED IS 30 TO 63 MOS HAVING NO SALES
FINANCE ACCOUNTS IS BETTER
% OF OPEN RETAIL ACCOUNTS TO TOTAL OPEN ACCOUNTS IS 22.23% OR MORE HAVING NO OPEN RETAIL ACCOUNTS
IS BETTER
NUMBER OF OPEN DEPARTMENT STORE ACCOUNTS IS 1 TO 2 HAVING NO OPEN DEPARTMENT STORE ACCOUNTS IS
BETTER

You have right to request a free copy of your report by contacting the organization that provided it within 60
days at the following address:

LexisNexis Consumer Center


P.O. Box 105108
Atlanta, GA 30348-5108
1-800-456-6004

Or request the report through the Internet at: www.consumerdisclosure.com.

You will need to provide your report reference number with all correspondence.

Report Ref # 22343161122633

FCRA1 (01/10) Page 1 of 2


Policy Number: 1001562443

It is important to note that, while the above organization provided the information, it did not make the
decision regarding its use and, therefore, cannot answer any questions regarding your insurance premium.
However, if there is information on the report that you feel is incorrect or incomplete, you have the right to
dispute this information with the above-mentioned company.

Sincerely,

Personal Lines Underwriting

FCRA1 (01/10) Page 2 of 2


Policy Number: 1001562443

STATE AUTO INSURANCE COMPANIES


CORPORATE HEADQUARTERS - 518 EAST BROAD STREET
COLUMBUS, OHIO 43215

Date: 12/09/2022 Pol icy: 1001562443

Insured: Arthur Schulze Agent: Members Home & Auto


Lisa Schulze 2855 Coolidge Hwy Ste 204
32331 Eastway Street Troy, MI 48084-3216
ROSEVILLE, MI 48066 (248) 619-3400

Thank you for your business! Of all the options available to you, we appreciate the fact that you chose State Auto to provide your
insurance protection.
We strive to provide quality coverage and service at a fair price. It is important to note that many factors are used
to develop insurance premiums. Those items include information regarding prior insurance coverage. We use a
Current Carrier report from LexisNexis to verify this information.
Information shown in the Current Carrier report is adversely impacting the premium for this policy. Specifically,
the report shows:
Tenure with prior carrier is less than 73 months. (Auto)

Reference number: 0 (Home) Reference number : 22343161223635(Auto)

You may request a free copy of the report by contacting:


LexisNexis
P.O. Box 105108
Atlanta, GA 30348-5108
1-800-456-6004
www.consumerdisclosure.com
It is important to note that, while the above organization provided the information, they did not make the
decision that affected the premium on your policy; nor would they be able to tell you the reasons why this
decision was made. Nevertheless, if you would like to obtain a copy of the report to confirm its accuracy or
completeness, please call or write them directly at the above number or address within the next 60 days. If
there is information on the report that you feel is incorrect or incomplete, you have the right to dispute the
information with the above - mentioned company.

Sincerely,

Personal Lines Underwriting

FCRA3 (01/10) Page 1 of 1


Policy Number: 1001562443

STATE AUTO INSURANCE COMPANIES


CORPORATE HEADQUARTERS - 518 EAST BROAD STREET
COLUMBUS, OHIO 43215

Date: 12/09/2022 Policy: 1001562443

Insured: Arthur Schulze Agent: Members Home & Auto


Lisa Schulze 2855 Coolidge Hwy Ste 204
32331 Eastway Street
Troy, MI 48084-3216
ROSEVILLE, MI 48066

Telephone: (248) 619-3400

Thank you for your business! Of all the options available to you, we appreciate the fact that you chose
State Auto to provide your insurance protection.

We strive to provide quality coverage and service at a fair price. It is important to note that many factors
are used to develop insurance premiums. Those items include information regarding motor vehicle
records, loss history information, property characteristic and geographic information. The Fair Credit
Reporting Act requires us to notify you that your policy premium may be adversely affected as a result of
information from a consumer report.

The following incidents were listed on a consumer report, but not all of the reasons listed below may have
had an impact on your premium.

08/11/2021, All Other, Amount Paid = $500.00 (Home)

Reference number: 22343161424118 (Home)

You may request a free copy of the report by contacting:

Lexis Nexis Consumer Center


PO Box 105108
Atlanta, GA 30348-5108
1-800-456-6004
www.consumerdisclosure.com

You will need to provide your report reference number with all correspondence.

It is important to note that, while the above organization provided the information, they did not make the
decision that affected the premium on your policy; nor would they be able to tell you the reasons why this
decision was made. Nevertheless, if you would like to obtain a copy of the report to confirm its accuracy or
completeness, please call or write them directly at the above number or address within the next 60 days. If
there is information on the report that you feel is incorrect or incomplete, you have the right to dispute the
information with the above-mentioned company.

Sincerely,

Personal Lines Underwriting

FCRA4 (01/10) Page 1 of 1


Policy Number: 1001562443

IL N 001 09 03

FRAUD STATEMENT
Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly pre-
sents false information in an application for insurance is guilty of a crime and may be subject to fines and con-
finement in prison.

IL N 001 09 03 © ISO Properties, Inc., 2003 Page 1 of 1


Policy Number: 1001562443
Policy Number: 1001562443

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Policy Number: 1001562443
Policy Number: 1001562443

AGENCY CUSTOMER ID:


DATE (MM/DD/YYYY)
PERSONAL INSURANCE SUPPLEMENT 12/09/2022
AGENCY Members Home & Auto NAMED INSURED(S) Arthur Schulze

POLICY NUMBER 1001562443 EFFECTIVE DATE CARRIER State Auto Property and Casualty NAIC CODE
12/12/2022 Insurance Company 25127

EXTRAORDINARY LIFE CIRCUMSTANCES DISCLOSURE

An insurer authorized to do business in certain states that uses credit information to


underwrite or rate risks for a policy of personal insurance may, on written request from a
consumer, provide reasonable exceptions to the insurer's rates, rating classifications,
company or tier placement, or underwriting rules or guidelines for a consumer who has
experienced and whose credit information has been directly influenced by events
considered extraordinary life circumstances such as:

1. Catastrophic event, as declared by the federal or a state government.


2. Serious illness or injury, or serious illness or injury to an immediate family member.
3. Death of a spouse, child, or parent.

4. Divorce or involuntary interruption of legally owed alimony or support payments.

5. Identity theft.

6. Temporary loss of employment for a period of three months or more, if such loss
results from involuntary termination of employment.
7. Military deployment overseas.

8. Other events, as determined by the insurer.

If a consumer submits a request for an exception as set forth above, an insurer may, in its
sole discretion, but is not required to, do any of the following:

1. Require the consumer to provide reasonable written and independently verifiable


documentation of the event.
2. Require the consumer to demonstrate that the event had direct and meaningful impact
on the consumer's credit information.
3. Require such request to be made no more than sixty days from the date of the
application for insurance or the policy renewal.
4. Grant an exception despite the fact that the consumer did not provide the initial
request for an exception in writing.
5. Grant an exception where the consumer asks for consideration of repeated events or
the insurer has considered this event previously.

APPLICANT / NAMED INSURED SIGNATURE DATE (MM/DD/YYYY)

ACORD 66 (2011/05) © 2011 ACORD CORPORATION. All rights reserved.


The ACORD name and logo are registered marks of ACORD
Policy Number: 1001562443
Policy Number: 1001562443

State Auto Property & Casualty Insurance Company

THIS ENDORSEMENT CHANGES THE POLICY

ACTUAL CASH VALUE AND DEPRECIATION DEFINITIONS ENDORSEMENT


Forms DP0002 and DP0003

DEFINITIONS c. Structures that are not buildings; and


The following definitions are added: at “actual cash value” at the time of loss but
1. “Actual Cash Value” means the amount it not more than the amount required to repair
would cost to repair or replace covered or replace.
property with material of like kind and similar 2. Buildings covered under Coverage A or B at
quality reduced by the amount of replacement cost without deduction for
“depreciation” applicable to the lost or “depreciation,” subject to the following:
damaged covered property at the time of a. If, at the time of loss, the amount of
loss. insurance in this Policy on the damaged
Except where prohibited by law, the building is 80% or more of the full
calculation of “actual cash value” includes replacement cost of the building
the “depreciation” of all costs of repair or immediately before the loss, we will pay
replacement, including materials, labor, the cost to repair or replace, without
equipment, services, demolition, debris deduction for “depreciation,” but not
removal, tear-out, tear-off, installation, profit, more than the least of the following
overhead, and any applicable taxes and amounts:
fees. (1) The limit of liability under this Policy
The calculation of “actual cash value” that applies to the building;
applies to all damage to covered property, (2) The replacement cost of that part of
regardless of whether the covered property the building damaged with material
sustained partial or total loss. of like kind and quality and for like
2. “Depreciation” means the decrease in value use; or
of covered property at the time of loss (3) The necessary amount actually
attributable to factors including, but not spent to repair or replace the
limited to, physical deterioration, age, damaged building.
condition, estimated remaining useful life If the building is rebuilt at a new
expectancy, extent of use and premises, the cost described in (2)
obsolescence. above is limited to the cost which would
CONDITIONS have been incurred if the building had
E. Loss Settlement and F. Loss To A Pair Or been built at the original premises.
Set are replaced as follows: b. If, at the time of loss, the amount of
E. Loss Settlement insurance in this Policy on the damaged
In this condition E., the terms “cost to repair or building is less than 80% of the full
replace” and “replacement cost” do not include replacement cost of the building
the increased costs incurred to comply with the immediately before the loss, we will pay
enforcement of any ordinance or law, except to the greater of the following amounts, but
the extent that coverage for these increased not more than the limit of liability under
costs is provided in F.12. Ordinance Or Law. this Policy that applies to the building:
Covered property losses are settled as follows: (1) The “actual cash value” of that part
1. Property of the following types: of the building damaged; or
a. Personal Property; (2) That proportion of the cost to repair
b. Awnings, carpeting, household or replace, without deduction for
appliances, outdoor antennas and “depreciation,” that part of the
outdoor equipment, whether or not building damaged, which the total
attached to buildings; amount of insurance in this Policy

DF2999MI (01/21) Page 1 of 2


Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Policy Number: 1001562443

on the damaged building bears to 2. Pay the difference between “actual cash
80% of the replacement cost of the value” of the property before and after
building. the loss.
c. To determine the amount of insurance All other provisions of this Policy apply.
required to equal 80% of the full
replacement cost of the building
immediately before the loss, do not
include the value of:
(1) Excavations, footings, foundations,
piers, or any other structures or
devices that support all or part of the
building, which are below the
undersurface of the lowest
basement floor;
(2) Those supports described in (1)
above which are below the surface
of the ground inside the foundation
walls, if there is no basement; and
(3) Underground flues, pipes, wiring,
and drains.
d. We will pay no more than the “actual
cash value” of the damage until actual
repair or replacement is complete.
Once actual repair or replacement is
complete, we will settle the loss as
noted in 2.a. and 2.b. above.
However, if the cost to repair or replace
the damage is both:
(1) Less than 5% of the amount of
insurance in this policy on the
building; and
(2) Less than $2,500;
we will settle the loss as noted in 2.a.
and b. above whether or not actual
repair or replacement is complete.
e. You may disregard the replacement cost
loss settlement provisions and make
claim under this policy for loss to
buildings on an “actual cash value”
basis. You may then make claim for
any additional liability according to the
provisions of this Condition E. Loss
Settlement, provided you notify us,
within 180 days after the date of loss, of
your intent to repair or replace the
damaged building.
F. Loss To A Pair Or Set
In case of loss to a pair or set we may elect
to:
1. Repair or replace any part to restore the
pair or set to its value before the loss;
or

DF2999MI (01/21) Page 2 of 2


Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Policy Number: 1001562443

Privacy Statement

State Auto shares personal information with


We protect you and your nonaffiliated companies without your prior
authorization as permitted or required by law.
personal information They may use it to investigate fraud, respond to
At State Auto®, we believe that having the right insurance means court orders or conduct actuarial studies. We
knowing your family is protected in case the worst happens. also share it with insurance regulatory authorities,
As part of this commitment, we treat your personal information law enforcement and consumer reporting
responsibly. Our privacy statement explains how we collect, use, agencies. They may retain it or disclose it to
share and protect your personal information. other companies with which you do business.
These other companies use and disclose it to
Collecting personal information others as permitted by law. We obtain reports
We collect your personal information to provide our products prepared by an insurance-support organization.
and services. We collect personal information when you apply The insurance-support organization keeps copies
for insurance, file a claim, pay your insurance premium and and discloses them to others.
conduct other transactions with us or your independent agent.
We also collect your personal information from our affiliates, your Sharing your personal information
independent insurance agent, government entities, consumer for marketing
reporting agencies and other sources. State Auto may share your personal information
Here are some examples of the personal information that with other State Auto companies, including
we collect: information we receive from a credit reporting
n
agency, such as insurance score and claims
Name and address
history. If you would like to opt out of this
n Social Security number sharing, please fill out the opt-out form on the
n Credit and motor vehicle reports next page and mail it to the address on the form.
State Auto does not share your information with
n Claims and vehicle history other nonaffiliated companies so they can market
n Property information their own products to you, unless you give us
your permission. There is no need to opt out of
Sharing your personal information sharing with nonaffiliated companies. We will
State Auto does not sell your personal information to anyone. not use your medical information for marketing
We share your personal information with your independent agent purposes without your consent.
and other companies to provide you with products and services
that you request or expect from us. We also share your personal Securing your personal information
information as required or permitted by law. At State Auto, we protect your personal
information from unauthorized access and use
We may share your personal information to:
by implementing security measures that comply
n Service your policy or process a transaction you request with federal and state laws. Some of these
n Investigate and pay claims security measures include computer safeguards,
procedures, and secured files and buildings. We
n Comply with federal and state regulatory requests limit access to your personal information to those
n Market our products to you who need it to do their jobs.

Continued on back

StateAuto.com
AU303 (08/16) Page 1 of 2
Policy Number: 1001562443

Accessing your personal information Our Privacy Statement applies to current and
You can always ask us or your independent agent for a copy former customers of the State Automobile
of your personal information. To correct personal information Mutual Insurance Company and the affiliates
provided by another company, like a credit agency, you must and subsidiaries that offer personal insurance.
contact those companies directly. To correct personal information These include:
on your policy, you may contact your independent insurance n State Auto Property and Casualty
agent or State Auto. When requesting a correction please include Insurance Company
your name, address and policy number. Mail the inquiry to:
n Meridian Security Insurance Company
Personal Underwriting Support Dept.
n Milbank Insurance Company
State Auto Insurance Companies
P.O. Box 182822 n Patrons Mutual Insurance Company
Columbus, Ohio 43218-2822 of Connecticut
n Rockhill Insurance Company
n Plaza Insurance Company

State Auto Opt-Out Form


State Auto may share information about your transactions and experiences with other State
Auto companies, which are called affiliates. This information can include information we receive
from a credit reporting agency, such as insurance score and claims history. You may choose to
opt out of this sharing by completing this form and mailing it to the address below.

I prefer that State Auto not share my personal information with its affiliates.
State Auto does not share your information with other nonaffiliated companies so they can
market their own products to you, unless you give us your permission. There is no need to opt
out of sharing with nonaffiliated companies.

Arthur Schulze 1001562443


Insured First and Last Name Policy Number

32331 Eastway Street, ROSEVILLE, MI 48066


Address, City, State, and Zip Code

Please mail this form to:


Personal Underwriting Support Dept.
State Auto Insurance Companies
P.O. Box 182822
Columbus, Ohio 43218-2822

AU303 (08/16) Page 2 of 2


Policy Number: 1001562443

YOUR DWELLING PROPERTY


QUICK REFERENCE
READ YOUR POLICY CAREFULLY. This Dwelling Property Quick Reference provides only a brief outline of some of the
important features of your policy. This is not the insurance contract and only the actual policy provisions will control the
policy itself. This is a legal contract between you and your insurance company and sets forth, in detail, the rights and
obligations of both you and your insurance company. IT IS THEREFORE IMPORTANT THAT YOU READ YOUR
POLICY.
_________________________________________________________________________________________________

DECLARATIONS (Pages Numbered Separately)


YOUR NAME
LOCATION OF YOUR RESIDENCE
POLICY PERIOD
COVERAGES
AMOUNTS OF LIMITS
DEDUCTIBLE

PAGE NUMBER
(Beginning on)
MAJOR POLICY PROVISIONS
DP 0001 DP 0002 DP 0003
(07/14) (07/14) (07/14)
Agreement 1 1 1

Definitions 1 1 1

Coverage
Coverage A - Dwelling 1 1 1
Coverage B - Other Structures 1 1 1
Coverage C - Personal Property 1 1 1
Coverage D - Fair Rental Value 2 2 2
Additional Living Expenses NA 2 2
Other Coverages 2 2 2

Perils Insured Against 3 5 5

General Exclusions 4 7 8

Conditions 5 8 9
Insurable Interest And Limit of Liability 5 8 9
Deductible 5 8 9
Duties After Loss 6 8 10
Loss Settlement 6 9 10
Mortgage Clause 7 10 12
Cancellation 7 11 12
Nonrenewal 8 11 13
Policy Period 9 12 13

ENDORSEMENTS:
Endorsements apply if number and edition date are shown on the Declarations

See coverage forms for other conditions

FI36A (01/16) Page 1 of 1


Includes copyrighted material of Insurance Services Office, Inc., with its permission
Policy Number: 1001562443
Policy Number: 1001562443

DWELLING PROPERTY
DP 00 03 07 14

DWELLING PROPERTY 3 – SPECIAL FORM


AGREEMENT c. Other structures used in whole or in part for
We will provide the insurance described in this Policy commercial, manufacturing or farming
in return for the premium and compliance with all purposes. However, we do cover a
applicable provisions of this Policy. structure that contains commercial,
manufacturing or farming property solely
DEFINITIONS owned by you or a tenant of the dwelling,
In this Policy, "you" and "your" refer to the "named provided that such property does not
insured" shown in the Declarations and the spouse if include gaseous or liquid fuel, other than
a resident of the same household. "We", "us" and fuel in a permanently installed fuel tank of a
"our" refer to the company providing this insurance. vehicle or craft parked or stored in the
structure; or
COVERAGES
d. Gravemarkers, including mausoleums.
This insurance applies to the Described Location,
Coverages for which a limit of liability is shown and C. Coverage C – Personal Property
Perils Insured Against for which a premium is stated. 1. Covered Property
A. Coverage A – Dwelling We cover personal property, usual to the
1. We cover: occupancy as a dwelling and owned or used by
a. The dwelling on the Described Location you or members of your family residing with
shown in the Declarations, used principally you while it is on the Described Location. After
a loss and at your request, we will cover
for dwelling purposes, including structures
attached to the dwelling; personal property owned by a guest or servant
while the property is on the Described
b. Materials and supplies located on or next to Location.
the Described Location used to construct,
alter or repair the dwelling or other 2. Property Not Covered
structures on the Described Location; and We do not cover:
c. If not otherwise covered in this Policy, a. Accounts, bank notes, bills, bullion, coins,
building equipment and outdoor equipment currency, deeds, evidences of debt, gold
used for the service of and located on the other than goldware, letters of credit,
Described Location. manuscripts, medals, money, notes other
2. We do not cover land, including land on which than bank notes, passports, personal
the dwelling is located. records, platinum other than platinumware,
securities, silver other than silverware,
B. Coverage B – Other Structures tickets, stamps, scrip, stored value cards
1. We cover other structures on the Described and smart cards;
Location, set apart from the dwelling by clear b. Animals, birds or fish;
space. This includes structures connected to
the dwelling by only a fence, utility line or c. Aircraft, meaning any contrivance used or
designed for flight, including any parts
similar connection.
whether or not attached to the aircraft.
2. We do not cover:
We do cover model or hobby aircraft not
a. Land, including land on which the other used or designed to carry people or cargo;
structures are located;
d. Hovercraft and parts. Hovercraft means a
b. Other structures rented or held for rental to self-propelled motorized ground effect
any person not a tenant of the dwelling, vehicle and includes, but is not limited to,
unless used solely as a private garage; flarecraft and air cushion vehicles;
e. Motor vehicles or all other motorized land
conveyances.

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Policy Number: 1001562443

This includes their equipment and parts D. Coverage D – Fair Rental Value
while such property is in or upon the vehicle 1. If a loss to property described in Coverage A,
or conveyance. B or C by a Peril Insured Against under this
However, this Paragraph 2.e. does not Policy makes that part of the Described
apply to: Location rented to others or held for rental by
(1) Portable electronic equipment that: you unfit for its normal use, we cover the fair
rental value of that part of the Described
(a) Reproduces, receives or transmits Location rented to others or held for rental by
audio, visual or data signals; and you less any expenses that do not continue
(b) Is designed so that it may be while that part of the Described Location rented
operated from a power source other or held for rental is not fit to live in.
than the electrical system of motor Payment will be for the shortest time required
vehicles and all other motorized land to repair or replace that part of the Described
conveyances. Location rented or held for rental.
(2) Motor vehicles or other motorized land 2. If a civil authority prohibits you from use of the
conveyances not required to be Described Location as a result of direct
registered for use on public roads or damage to a neighboring location by a Peril
property which are: Insured Against in this Policy, we cover the
(a) Used solely to service a residence; Fair Rental Value loss for no more than two
or weeks.
(b) Designed to assist the handicapped; 3. The periods of time referenced above are not
limited by the expiration of this Policy.
f. Watercraft of all types, other than rowboats
and canoes; 4. We do not cover loss or expense due to
cancellation of a lease or agreement.
g. Data, including data stored in:
(1) Books of account, drawings or other E. Coverage E – Additional Living Expense
paper records; or 1. If a loss to property described in Coverage A,
(2) Computers and related equipment. B or C by a Peril Insured Against under this
Policy makes the Described Location unfit for
We do cover the cost of blank recording or its normal use, we cover any necessary
storage media and of prerecorded increase in living expenses incurred by you so
computer programs available on the retail that your household can maintain its normal
market; standard of living.
h. Credit cards, electronic fund transfer cards Payment will be for the shortest time required
or access devices used solely for deposit, to repair or replace the Described Location or,
withdrawal or transfer of funds; if you permanently relocate, the shortest time
i. Water or steam; or required for your household to settle
elsewhere.
j. Gravemarkers, including mausoleums.
2. If a civil authority prohibits you from use of the
3. Property Removed To A Newly Acquired Described Location as a result of direct
Principal Residence damage to a neighboring location by a Peril
If you remove personal property from the Insured Against in this Policy, we cover the
Described Location to a newly acquired Additional Living Expense loss for no more
principal residence, the Coverage C limit of than two weeks.
liability will apply at each residence for the 30
3. The periods of time referenced above are not
days immediately after you begin to move the
limited by the expiration of this Policy.
property there. This time period will not extend
beyond the termination of this Policy. Our 4. We do not cover loss or expense due to
liability is limited to the proportion of the limit of cancellation of a lease or agreement.
liability that the value at each residence bears F. Other Coverages
to the total value of all personal property
covered by this Policy. 1. Other Structures
You may use up to 10% of the Coverage A
limit of liability for loss by a Peril Insured
Against to other structures described in
Coverage B.

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Policy Number: 1001562443

This coverage is additional insurance. 7. Property Removed


2. Debris Removal We insure covered property against direct loss
We will pay your reasonable expense for the from any cause while being removed from a
removal of: premises endangered by a Peril Insured
Against and for no more than 30 days while
a. Debris of covered property if a Peril Insured removed.
Against causes the loss; or
This coverage does not change the limit of
b. Ash, dust or particles from a volcanic liability that applies to the property being
eruption that has caused direct loss to a removed.
building or property contained in a building.
8. Trees, Shrubs And Other Plants
This expense is included in the limit of liability
that applies to the damaged property. We cover trees, shrubs, plants or lawns on the
Described Location for loss caused by the
3. Improvements, Alterations And Additions following Perils Insured Against:
If you are a tenant of the Described Location, a. Fire Or Lightning;
you may use up to 10% of the Coverage C limit
of liability for loss by a Peril Insured Against to b. Explosion;
improvements, alterations and additions, made c. Riot Or Civil Commotion;
or acquired at your expense, to that part of the d. Aircraft;
Described Location used only by you.
e. Vehicles not owned or operated by you or a
This coverage is additional insurance. resident of the Described Location; or
4. World-wide Coverage f. Vandalism Or Malicious Mischief, including
You may use up to 10% of the Coverage C damage during a burglary or attempted
limit of liability for loss by a Peril Insured burglary, but not theft of property.
Against to property covered under Coverage C, The limit of liability for this coverage will not be
except rowboats and canoes, while anywhere more than 5% of the Coverage A limit of
in the world. liability, or more than $500 for any one tree,
Use of this coverage reduces the Coverage C shrub or plant. We do not cover property grown
limit of liability for the same loss. for commercial purposes.
5. Rental Value And Additional Living This coverage is additional insurance.
Expense 9. Fire Department Service Charge
You may use up to 20% of the Coverage A We will pay up to $500 for your liability
limit of liability for loss of both fair rental value assumed by contract or agreement for fire
as described in Coverage D and additional department charges incurred when the fire
living expense as described in Coverage E. department is called to save or protect covered
This coverage is additional insurance. property from a Peril Insured Against. We do
6. Reasonable Repairs not cover fire department service charges if the
property is located within the limits of the city,
a. In the event that covered property is municipality or protection district furnishing the
damaged by a Peril Insured Against, we will fire department response.
pay the reasonable cost incurred by you for
necessary measures taken solely to protect This coverage is additional insurance. No
against further damage. deductible applies to this coverage.
b. If the measures taken involve repair to 10. Collapse
other damaged property, we will pay for a. The coverage provided under this Other
those measures only if that property is Coverage – Collapse applies only to an
covered under this Policy and the damage abrupt collapse.
to that property is caused by a Peril Insured b. For the purpose of this Other Coverage –
Against. This coverage does not: Collapse, abrupt collapse means an abrupt
(1) Increase the limit of liability that applies falling down or caving in of a building or any
to the covered property; or part of a building with the result that the
(2) Relieve you of your duties, in case of a building or part of the building cannot be
loss to covered property, as set forth in occupied for its intended purpose.
Condition D.2.

DP 00 03 07 14 © Insurance Services Office, Inc., 2013 Page 3 of 13


Policy Number: 1001562443

c. This Other Coverage – Collapse does not (2) The breakage of glass or safety glazing
apply to: material which is part of a covered
(1) A building or any part of a building that building, storm door or storm window
is in danger of falling down or caving in; when caused directly by earth
movement; and
(2) A part of a building that is standing,
even if it has separated from another (3) The direct physical loss to covered
part of the building; or property caused solely by the pieces,
fragments or splinters of broken glass or
(3) A building or any part of a building that safety glazing material which is part of a
is standing, even if it shows evidence of building, storm door or storm window.
cracking, bulging, sagging, bending,
leaning, settling, shrinkage or b. This coverage does not include loss:
expansion. (1) To covered property which results
d. We insure for direct physical loss to because the glass or safety glazing
covered property involving abrupt collapse material has been broken, except as
of a building or any part of a building if such provided in a.(3) above; or
collapse was caused by one or more of the (2) On the Described Location if the
following: dwelling has been vacant for more than
(1) The Perils Insured Against named under 60 consecutive days immediately before
Coverage C; the loss, except when the breakage
results directly from earth movement as
(2) Decay, of a building or any part of a provided for in a.(2) above. A dwelling
building, that is hidden from view, unless being constructed is not considered
the presence of such decay is known to vacant.
you prior to collapse;
c. This coverage does not increase the limit of
(3) Insect or vermin damage, to a building liability that applies to the damaged
or any part of a building, that is hidden property.
from view, unless the presence of such
damage is known to you prior to 12. Ordinance Or Law
collapse; a. The Ordinance Or Law limit of liability
(4) Weight of contents, equipment, animals determined in b. or c. below will apply with
or people; respect to the increased costs you incur
due to the enforcement of any ordinance or
(5) Weight of rain which collects on a roof; law which requires or regulates:
or
(1) The construction, demolition,
(6) Use of defective material or methods in remodeling, renovation or repair of that
construction, remodeling or renovation if part of a covered building or other
the collapse occurs during the course of structure damaged by a Peril Insured
the construction, remodeling or Against;
renovation.
(2) The demolition and reconstruction of the
e. Loss to an awning, fence, patio, deck, undamaged part of a covered building or
pavement, swimming pool, underground other structure, when that building or
pipe, flue, drain, cesspool, septic tank, other structure must be totally
foundation, retaining wall, bulkhead, pier, demolished because of damage by a
wharf or dock is not included under d.(2) Peril Insured Against to another part of
through (6) above, unless the loss is a that covered building or other structure;
direct result of the collapse of a building or or
any part of a building.
(3) The remodeling, removal or
f. This coverage does not increase the limit of replacement of the portion of the
liability that applies to the damaged covered undamaged part of a covered building or
property. other structure necessary to complete
11. Glass Or Safety Glazing Material the remodeling, repair or replacement of
a. We cover: that part of the covered building or other
structure damaged by a Peril Insured
(1) The breakage of glass or safety glazing Against.
material which is part of a covered
building, storm door or storm window;

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Policy Number: 1001562443

b. If you are an owner of a Described Location b. Involving collapse, including any of the
and that location: following conditions of property or any part
(1) Is insured for Coverage A or Unit- of the property:
owners Building Items, you may use up (1) An abrupt falling down or caving in;
to 10% of the limit of liability that applies (2) Loss of structural integrity, including
to Coverage A or Unit-owners Building separation of parts of the property or
Items at each Described Location; or property in danger of falling down or
(2) Is not insured for Coverage A or Unit- caving in; or
owners Building Items, you may use up (3) Any cracking, bulging, sagging, bending,
to 10% of the total limit of liability that leaning, settling, shrinkage or expansion
applies to Coverage B at each as such condition relates to (1) or (2)
Described Location. above;
c. If you are a tenant of a Described Location, except as provided in Other Coverage 10.
you may use up to 10% of the limit of Collapse; or
liability that applies to Improvements,
Alterations And Additions at each c. Caused by:
Described Location. Also, the words (1) Freezing of a plumbing, heating, air
"covered building" used throughout this conditioning or automatic fire protective
Other Coverage 12. Ordinance Or Law sprinkler system or of a household
refer to property at such a Described appliance, or by discharge, leakage or
Location covered under Other Coverage 3. overflow from within the system or
Improvements, Alterations And Additions. appliance caused by freezing. This
d. You may use all or part of this ordinance or provision does not apply if you have
law coverage to pay for the increased costs used reasonable care to:
you incur to remove debris resulting from (a) Maintain heat in the building; or
the construction, demolition, remodeling,
(b) Shut off the water supply and drain
renovation, repair or replacement of all systems and appliances of water.
property as stated in a. above.
However, if the building is protected by
e. We do not cover: an automatic fire protective sprinkler
(1) The loss in value to any covered system, you must use reasonable care
building or other structure due to the to continue the water supply and
requirements of any ordinance or law; or maintain heat in the building for
(2) The costs to comply with any ordinance coverage to apply.
or law which requires you or others to For purposes of this provision, a
test for, monitor, clean up, remove, plumbing system or household
contain, treat, detoxify or neutralize, or appliance does not include a sump,
in any way respond to, or assess the sump pump or related equipment or a
effects of, pollutants in or on any roof drain, gutter, downspout or similar
covered building or other structure. fixtures or equipment.
Pollutants means any solid, liquid, (2) Freezing, thawing, pressure or weight of
gaseous or thermal irritant or water or ice, whether driven by wind or
contaminant, including smoke, vapor, not, to a:
soot, fumes, acids, alkalis, chemicals (a) Fence, pavement, patio or swimming
and waste. Waste includes materials to pool;
be recycled, reconditioned or reclaimed.
(b) Footing, foundation, bulkhead, wall,
This coverage is additional insurance. or any other structure or device that
PERILS INSURED AGAINST supports all or part of a building or
A. Coverage A – Dwelling And Coverage B – other structure;
Other Structures (c) Retaining wall or bulkhead that does
1. We insure against direct physical loss to not support all or part of a building or
property described in Coverages A and B. other structure; or
2. We do not insure, however, for loss: (d) Pier, wharf or dock;
a. Excluded under General Exclusions; (3) Theft of property not part of a covered
building or structure;

DP 00 03 07 14 © Insurance Services Office, Inc., 2013 Page 5 of 13


Policy Number: 1001562443

(4) Theft in or to a dwelling or structure Pollutants means any solid, liquid,


under construction; gaseous or thermal irritant or
(5) Wind, hail, ice, snow or sleet to: contaminant, including smoke, vapor,
soot, fumes, acids, alkalis, chemicals
(a) Outdoor radio and television and waste. Waste includes materials
antennas and aerials, including their to be recycled, reconditioned or
lead-in wiring, masts or towers; or reclaimed;
(b) Trees, shrubs, plants or lawns; (f) Settling, shrinking, bulging or
(6) Vandalism and malicious mischief, theft expansion, including resultant
or attempted theft, and any ensuing loss cracking, of bulkheads, pavements,
caused by any intentional and wrongful patios, footings, foundations, walls,
act committed in the course of the floors, roofs or ceilings; or
vandalism or malicious mischief, theft or (g) Birds, rodents, insects or domestic
attempted theft, if the dwelling has been animals; or
vacant for more than 60 consecutive
days immediately before the loss. A (h) Nesting or infestation, or discharge
dwelling being constructed is not or release of waste products or
considered vacant; secretions, by any animals.
(7) Constant or repeated seepage or Exception To c.(8)
leakage of water or steam over a period Unless the loss is otherwise excluded, we
of weeks, months or years from within a cover loss to property covered under
plumbing, heating, air conditioning or Coverage A or B resulting from an
automatic fire protective sprinkler accidental discharge or overflow of water or
system or from within a household steam from within a:
appliance. (i) Storm drain, or water, steam or
For purposes of this provision, a sewer pipe, off the Described
plumbing system or household Location; or
appliance does not include a sump, (ii) Plumbing, heating, air
sump pump or related equipment or a conditioning or automatic fire
roof drain, gutter, downspout or similar protective sprinkler system or
fixtures or equipment; household appliance on the
(8) Any of the following: Described Location. This includes
(a) Wear and tear, marring, the cost to tear out and replace
deterioration; any part of a building, or other
structure, on the Described
(b) Mechanical breakdown, latent Location, but only when
defect, inherent vice or any quality in necessary to repair the system or
property that causes it to damage or appliance. However, such tear
destroy itself; out and replacement coverage
(c) Smog, rust or other corrosion, mold, only applies to other structures if
wet or dry rot; the water or steam causes actual
damage to a building on the
(d) Smoke from agricultural smudging or
industrial operations; Described Location.
(e) Discharge, dispersal, seepage, We do not cover loss to the system or
migration release or escape of appliance from which this water or steam
escaped.
pollutants unless the discharge,
dispersal, seepage, migration, For the purposes of this provision, a
release or escape is itself caused by plumbing system or household appliance
a Peril Insured Against named under does not include a sump, sump pump or
Coverage C. related equipment or roof drain, gutter,
downspout or similar fixtures or equipment.
General Exclusion A.3. Water, Paragraphs a.
and c. that apply to surface water and water
below the surface of ground do not apply to
loss by water covered under c.(8) above.

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Policy Number: 1001562443

Under 2.b. and c. above, any ensuing loss to 10. Falling Objects
property described in Coverages A and B not This peril does not include loss to property
excluded or excepted in this Policy is covered. contained in the building unless the roof or an
B. Coverage C – Personal Property outside wall of the building is first damaged by
We insure for direct physical loss to the property a falling object. Damage to the falling object
described in Coverage C caused by a peril listed itself is not covered.
below unless the loss is excluded in the General 11. Weight Of Ice, Snow Or Sleet
Exclusions. This peril means weight of ice, snow or sleet
1. Fire Or Lightning which causes damage to property contained in
2. Windstorm Or Hail the building.
This peril does not include loss to: 12. Accidental Discharge Or Overflow Of Water
Or Steam
a. Property contained in a building caused by
rain, snow, sleet, sand or dust unless the a. This peril means accidental discharge or
direct force of wind or hail damages the overflow of water or steam from within a
building causing an opening in a roof or wall plumbing, heating, air conditioning or
and the rain, snow, sleet, sand or dust automatic fire protective sprinkler system or
enters through this opening; from within a household appliance.
b. The following property when outside of the b. This peril does not include loss:
building: (1) To the system or appliance from which
(1) Canoes and rowboats; or the water or steam escaped;
(2) Trees, shrubs, plants or lawns. (2) Caused by or resulting from freezing
except as provided in Peril Insured
3. Explosion Against 14. Freezing; or
4. Riot Or Civil Commotion (3) On the Described Location caused by
5. Aircraft accidental discharge or overflow which
This peril includes self-propelled missiles and occurs off the Described Location.
spacecraft. c. In this peril, a plumbing system or
household appliance does not include a
6. Vehicles
sump, sump pump or related equipment; or
7. Smoke a roof drain, gutter, downspout or similar
This peril means sudden and accidental fixtures or equipment.
damage from smoke, including the emission or d. General Exclusion A.3. Water, Paragraphs
puffback of smoke, soot, fumes or vapors from a. and c. that apply to surface water and
a boiler, furnace or related equipment. water below the surface of the ground do
This peril does not include loss caused by not apply to loss by water covered under
smoke from agricultural smudging or industrial this peril.
operations. 13. Sudden And Accidental Tearing Apart,
8. Vandalism Or Malicious Mischief Cracking, Burning Or Bulging
This peril does not include loss by pilferage, This peril means sudden and accidental tearing
theft, burglary or larceny. apart, cracking, burning or bulging of a steam
or hot water heating system, an air conditioning
9. Damage By Burglars or automatic fire protective sprinkler system, or
a. This peril means damage to covered an appliance for heating water.
property caused by burglars. We do not cover loss caused by or resulting
b. This peril does not include: from freezing except as provided in the peril of
(1) Theft of property; or freezing below.
(2) Damage caused by burglars to property 14. Freezing
on the Described Location if the dwelling a. This peril means freezing of a plumbing,
has been vacant for more than 60 heating, air conditioning or automatic fire
consecutive days immediately before protective sprinkler system or of a
the damage occurs. A dwelling being household appliance, but only if you have
constructed is not considered vacant. used reasonable care to:
(1) Maintain heat in the building; or

DP 00 03 07 14 © Insurance Services Office, Inc., 2013 Page 7 of 13


Policy Number: 1001562443

(2) Shut off the water supply and drain all This Exclusion A.1. applies whether or not the
systems and appliances of water. property has been physically damaged.
However, if the building is protected by an 2. Earth Movement
automatic fire protective sprinkler system, Earth Movement means:
you must use reasonable care to continue
the water supply and maintain heat in the a. Earthquake, including land shock waves or
building for coverage to apply. tremors before, during or after a volcanic
eruption;
b. In this peril, a plumbing system or
household appliance does not include a b. Landslide, mudslide or mudflow;
sump, sump pump or related equipment; or c. Subsidence or sinkhole; or
a roof drain, gutter, downspout or similar
d. Any other earth movement including earth
fixtures or equipment.
sinking, rising or shifting.
15. Sudden And Accidental Damage From This Exclusion A.2. applies regardless of
Artificially Generated Electrical Current whether any of the above, in A.2.a. through
This peril does not include loss to tubes, A.2.d., is caused by an act of nature or is
transistors, electronic components or circuitry otherwise caused.
that is a part of appliances, fixtures, computers,
However, direct loss by fire or explosion
home entertainment units or other types of resulting from any of the above, in A.2.a.
electronic apparatus. through A.2.d., is covered.
16. Volcanic Eruption
3. Water
This peril does not include loss caused by
This means:
earthquake, land shock waves or tremors.
a. Flood, surface water, waves, including tidal
GENERAL EXCLUSIONS wave and tsunami, tides, tidal water,
A. We do not insure for loss caused directly or overflow of any body of water or spray from
indirectly by any of the following. Such loss is any of these, all whether or not driven by
excluded regardless of any other cause or event wind, including storm surge;
contributing concurrently or in any sequence to the
b. Water which:
loss. These exclusions apply whether or not the
loss event results in widespread damage or affects (1) Backs up through sewers or drains; or
a substantial area. (2) Overflows or is otherwise discharged
1. Ordinance Or Law from a sump, sump pump or related
equipment;
Ordinance Or Law means any ordinance or
law: c. Water below the surface of the ground,
including water which exerts pressure on,
a. Requiring or regulating the construction, or seeps, leaks or flows through a building,
demolition, remodeling, renovation or repair sidewalk, driveway, patio, foundation,
of property, including removal of any
swimming pool or other structure; or
resulting debris. This Exclusion A.1.a. does
not apply to the amount of coverage that d. Waterborne material carried or otherwise
may be provided under Other Coverage 12. moved by any of the water referred to in
Ordinance Or Law; A.3.a. through A.3.c. of this exclusion.
b. The requirements of which result in a loss This Exclusion A.3. applies regardless of
in value to property; or whether any of the above, in A.3.a. through
A.3.d., is caused by an act of nature or is
c. Requiring you or others to test for, monitor, otherwise caused.
clean up, remove, contain, treat, detoxify or
neutralize, or in any way respond to, or This Exclusion A.3. applies to, but is not limited
assess the effects of, pollutants. to, escape, overflow or discharge, for any
reason, of water or waterborne material from a
Pollutants means any solid, liquid, gaseous dam, levee, seawall or any other boundary or
or thermal irritant or contaminant, including
containment system.
smoke, vapor, soot, fumes, acids, alkalis,
chemicals and waste. Waste includes However, direct loss by fire or explosion
materials to be recycled, reconditioned or resulting from any of the above, in A.3.a.
reclaimed. through A.3.d., is covered.

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Policy Number: 1001562443

4. Power Failure 1. Weather conditions. However, this exclusion


Power Failure means the failure of power or only applies if weather conditions contribute in
other utility service if the failure takes place off any way with a cause or event excluded in A.
the Described Location. But if the failure of above to produce the loss.
power or other utility service results in a loss, 2. Acts or decisions, including the failure to act or
from a Peril Insured Against on the Described decide, of any person, group, organization or
Location, we will pay for the loss caused by governmental body.
that Peril Insured Against. 3. Faulty, inadequate or defective:
5. Neglect a. Planning, zoning, development, surveying,
Neglect means your neglect to use all siting;
reasonable means to save and preserve b. Design, specifications, workmanship,
property at and after the time of a loss. repair, construction, renovation,
6. War remodeling, grading, compaction;
War includes the following and any c. Materials used in repair, construction,
consequence of any of the following: renovation or remodeling; or
a. Undeclared war, civil war, insurrection, d. Maintenance;
rebellion or revolution; of part or all of any property whether on or off
b. Warlike act by a military force or military the Described Location.
personnel; CONDITIONS
c. Destruction or seizure or use for a military A. Insurable Interest And Limit Of Liability
purpose.
Even if more than one person has an insurable
Discharge of a nuclear weapon will be deemed interest in the property covered, we will not be
a warlike act even if accidental. liable in any one loss:
7. Nuclear Hazard 1. For an amount greater than the interest of a
This Exclusion A.7. pertains to Nuclear Hazard person insured under this Policy at the time of
to the extent set forth in the Nuclear Hazard loss; or
Clause of the Conditions. 2. For more than the applicable limit of liability.
8. Intentional Loss B. Deductible
Intentional Loss means any loss arising out of Unless otherwise noted in this Policy, the following
any act you or any person or organization deductible provision applies:
named as an additional insured commits or
conspires to commit with the intent to cause a With respect to any one loss:
loss. 1. Subject to the applicable limit of liability, we will
In the event of such loss, neither you nor any pay only that part of the total of all loss payable
such person or organization is entitled to that exceeds the deductible amount shown in
coverage, even those who did not commit or the Declarations.
conspire to commit the act causing the loss. 2. If two or more deductibles under this Policy
9. Governmental Action apply to the loss, only the highest deductible
amount will apply.
Governmental Action means the destruction,
confiscation or seizure of property described in C. Concealment Or Fraud
Coverage A, B or C by order of any We provide coverage to no persons insured under
governmental or public authority. this Policy if, whether before or after a loss, one or
This exclusion does not apply to such acts more persons insured under this Policy have:
ordered by any governmental or public 1. Intentionally concealed or misrepresented any
authority that are taken at the time of a fire to material fact or circumstance;
prevent its spread, if the loss caused by fire 2. Engaged in fraudulent conduct; or
would be covered under this Policy.
3. Made false statements;
B. We do not insure for loss to property described in
Coverages A and B caused by any of the relating to this insurance.
following. However, any ensuing loss to property
described in Coverages A and B not precluded by
any other provision in this Policy is covered.

DP 00 03 07 14 © Insurance Services Office, Inc., 2013 Page 9 of 13


Policy Number: 1001562443

D. Duties After Loss E. Loss Settlement


In case of a loss to covered property, we have no In this Condition E., the terms "cost to repair or
duty to provide coverage under this Policy if the replace" and "replacement cost" do not include the
failure to comply with the following duties is increased costs incurred to comply with the
prejudicial to us. These duties must be performed enforcement of any ordinance or law except to the
either by you or your representative: extent that coverage for these increased costs is
1. Give prompt notice to us or our agent; provided in Other Coverages F.12. Ordinance Or
Law. Covered property losses are settled as
2. Protect the property from further damage. If follows:
repairs to the property are required, you must:
1. Property of the following types:
a. Make reasonable and necessary repairs to
protect the property; and a. Personal property;
b. Keep an accurate record of repair b. Awnings, carpeting, household appliances,
expenses; outdoor antennas and outdoor equipment,
whether or not attached to buildings; and
3. Cooperate with us in the investigation of a
claim; c. Structures that are not buildings;
4. Prepare an inventory of damaged personal at actual cash value at the time of loss but not
property showing the quantity, description, more than the amount required to repair or
actual cash value and amount of loss. Attach replace.
all bills, receipts and related documents that 2. Buildings under Coverage A or B at
justify the figures in the inventory; replacement cost without deduction for
5. As often as we reasonably require: depreciation, subject to the following:
a. Show the damaged property; a. If, at the time of loss, the amount of
insurance in this Policy on the damaged
b. Provide us with records and documents we building is 80% or more of the full
request and permit us to make copies; and replacement cost of the building
c. Submit to examination under oath, while not immediately before the loss, we will pay the
in the presence of another named insured, cost to repair or replace, without deduction
and sign the same; for depreciation, but not more than the least
of the following amounts:
6. Send to us, within 60 days after our request,
your signed, sworn proof of loss which sets (1) The limit of liability under this Policy that
forth to the best of your knowledge and belief: applies to the building;
a. The time and cause of loss; (2) The replacement cost of that part of the
b. Your interest and that of all others in the building damaged with material of like
property involved and all liens on the kind and quality and for like use; or
property; (3) The necessary amount actually spent to
repair or replace the damaged building.
c. Other insurance which may cover the loss;
d. Changes in title or occupancy of the If the building is rebuilt at a new premises,
property during the term of the Policy; the cost described in (2) above is limited to
the cost which would have been incurred if
e. Specifications of damaged buildings and the building had been built at the original
detailed repair estimates; premises.
f. The inventory of damaged personal b. If, at the time of loss, the amount of
property described in D.4.; and insurance in this Policy on the damaged
g. Receipts for additional living expenses building is less than 80% of the full
incurred and records that support the fair replacement cost of the building
rental value loss. immediately before the loss, we will pay the
greater of the following amounts, but not
more than the limit of liability under this
Policy that applies to the building:
(1) The actual cash value of that part of the
building damaged; or

Page 10 of 13 © Insurance Services Office, Inc., 2013 DP 00 03 07 14


Policy Number: 1001562443

(2) That proportion of the cost to repair or G. Appraisal


replace, without deduction for If you and we fail to agree on the amount of loss,
depreciation, that part of the building either may demand an appraisal of the loss. In this
damaged, which the total amount of event, each party will choose a competent and
insurance in this Policy on the damaged impartial appraiser within 20 days after receiving a
building bears to 80% of the written request from the other. The two appraisers
replacement cost of the building. will choose an umpire. If they cannot agree upon
c. To determine the amount of insurance an umpire within 15 days, you or we may request
required to equal 80% of the full that the choice be made by a judge of a court of
replacement cost of the building record in the state where the Described Location
immediately before the loss, do not include is located. The appraisers will separately set the
the value of: amount of loss. If the appraisers submit a written
(1) Excavations, footings, foundations, piers report of an agreement to us, the amount agreed
or any other structures or devices that upon will be the amount of loss. If they fail to
support all or part of the building, which agree, they will submit their differences to the
are below the undersurface of the umpire. A decision agreed to by any two will set
lowest basement floor; the amount of loss.
(2) Those supports in (1) above which are Each party will:
below the surface of the ground inside 1. Pay its own appraiser; and
the foundation walls, if there is no 2. Bear the other expenses of the appraisal and
basement; and umpire equally.
(3) Underground flues, pipes, wiring and H. Other Insurance And Service Agreement
drains.
If property covered by this Policy is also covered
d. We will pay no more than the actual cash by:
value of the damage until actual repair or
replacement is complete. Once actual 1. Other fire insurance, we will pay only the
repair or replacement is complete, we will proportion of a loss caused by any peril insured
settle the loss as noted in 2.a. and b. against under this Policy that the limit of liability
above. applying under this Policy bears to the total
amount of fire insurance covering the property;
However, if the cost to repair or replace the or
damage is both:
2. A service agreement, this insurance is excess
(1) Less than 5% of the amount of over any amounts payable under any such
insurance in this Policy on the building; agreement. Service agreement means a
and service plan, property restoration plan, home
(2) Less than $2,500; warranty or other similar service warranty
we will settle the loss as noted in 2.a. and agreement, even if it is characterized as
b. above whether or not actual repair or insurance.
replacement is complete. I. Subrogation
e. You may disregard the replacement cost You may waive in writing before a loss all rights of
loss settlement provisions and make claim recovery against any person. If not waived, we
under this Policy for loss to buildings on an may require an assignment of rights of recovery
actual cash value basis. You may then for a loss to the extent that payment is made by
make claim for any additional liability us.
according to the provisions of this Condition If an assignment is sought, the person insured
E. Loss Settlement, provided you notify us, must sign and deliver all related papers and
within 180 days after the date of loss, of cooperate with us.
your intent to repair or replace the damaged
building. J. Suit Against Us
F. Loss To A Pair Or Set No action can be brought against us unless there
has been full compliance with all of the terms
In case of loss to a pair or set, we may elect to: under this Policy and the action is started within
1. Repair or replace any part to restore the pair or two years after the date of loss.
set to its value before the loss; or
2. Pay the difference between actual cash value
of the property before and after the loss.

DP 00 03 07 14 © Insurance Services Office, Inc., 2013 Page 11 of 13


Policy Number: 1001562443

K. Our Option b. At our option, we may pay to the mortgagee


If we give you written notice within 30 days after the whole principal on the mortgage plus
we receive your signed, sworn proof of loss, we any accrued interest. In this event, we will
may repair or replace any part of the damaged receive a full assignment and transfer of the
property with material or property of like kind and mortgage and all securities held as
quality. collateral to the mortgage debt.
L. Loss Payment 5. Subrogation will not impair the right of the
mortgagee to recover the full amount of the
We will adjust all losses with you. We will pay you mortgagee's claim.
unless some other person is named in the Policy
or is legally entitled to receive payment. Loss will O. No Benefit To Bailee
be payable 60 days after we receive your proof of We will not recognize any assignment or grant any
loss and: coverage that benefits a person or organization
1. Reach an agreement with you; holding, storing or moving property for a fee
regardless of any other provision of this Policy.
2. There is an entry of a final judgment; or
P. Cancellation
3. There is a filing of an appraisal award with us.
1. You may cancel this Policy at any time by
M. Abandonment Of Property returning it to us or by letting us know in writing
We need not accept any property abandoned by of the date cancellation is to take effect.
you. 2. We may cancel this Policy only for the reasons
N. Mortgage Clause stated below by letting you know in writing of
the date cancellation takes effect. This
1. If a mortgagee is named in this Policy, any loss
cancellation notice may be delivered to you, or
payable under Coverage A or B will be paid to
the mortgagee and you, as interests appear. If mailed to you at your mailing address shown in
more than one mortgagee is named, the order the Declarations. Proof of mailing will be
sufficient proof of notice.
of payment will be the same as the order of
precedence of the mortgages. a. When you have not paid the premium, we
2. If we deny your claim, that denial will not apply may cancel at any time by letting you know
to a valid claim of the mortgagee, if the at least 10 days before the date
cancellation takes effect.
mortgagee:
a. Notifies us of any change in ownership, b. When this Policy has been in effect for less
occupancy or substantial change in risk of than 60 days and is not a renewal with us,
which the mortgagee is aware; we may cancel for any reason by letting you
know at least 10 days before the date
b. Pays any premium due under this Policy on cancellation takes effect.
demand if you have neglected to pay the
premium; and c. When this Policy has been in effect for 60
days or more, or at any time if it is a
c. Submits a signed, sworn statement of loss renewal with us, we may cancel:
within 60 days after receiving notice from us
of your failure to do so. Policy conditions (1) If there has been a material
relating to: misrepresentation of fact which if known
to us would have caused us not to issue
(1) Appraisal; the Policy; or
(2) Suit Against Us; and (2) If the risk has changed substantially
(3) Loss Payment; since the Policy was issued.
also apply to the mortgagee. This can be done by letting you know at
least 30 days before the date cancellation
3. If we decide to cancel or not to renew this takes effect.
Policy, the mortgagee will be notified at least
10 days before the date cancellation or d. When this Policy is written for a period of
nonrenewal takes effect. more than one year, we may cancel for any
reason at anniversary by letting you know
4. If we pay the mortgagee for any loss and deny at least 30 days before the date
payment to you:
cancellation takes effect.
a. We are subrogated to all the rights of the 3. When this Policy is canceled, the premium for
mortgagee granted under the mortgage on the period from the date of cancellation to the
the property; or expiration date will be refunded pro rata.

Page 12 of 13 © Insurance Services Office, Inc., 2013 DP 00 03 07 14


Policy Number: 1001562443

4. If the return premium is not refunded with the 2. With respect to your property, the person
notice of cancellation or when this Policy is having proper temporary custody of the
returned to us, we will refund it within a property until appointment and qualification of
reasonable time after the date cancellation a legal representative.
takes effect. V. Nuclear Hazard Clause
Q. Nonrenewal 1. "Nuclear hazard" means any nuclear reaction,
We may elect not to renew this Policy. We may do radiation or radioactive contamination, all
so by delivering to you, or mailing to you at your whether controlled or uncontrolled or however
mailing address shown in the Declarations, written caused, or any consequence of any of these.
notice at least 30 days before the expiration date 2. Loss caused by the nuclear hazard will not be
of this Policy. Proof of mailing will be sufficient considered loss caused by fire, explosion or
proof of notice. smoke, whether these perils are specifically
R. Liberalization Clause named in or otherwise included within the
If we make a change which broadens coverage Perils Insured Against.
under this edition of our Policy without additional 3. This Policy does not apply to loss caused
premium charge, that change will automatically directly or indirectly by nuclear hazard, except
apply to your insurance as of the date we that direct loss by fire resulting from the
implement the change in your state, provided that nuclear hazard is covered.
this implementation date falls within 60 days prior W. Recovered Property
to or during the policy period stated in the
Declarations. If you or we recover any property for which we
have made payment under this Policy, you or we
This Liberalization Clause does not apply to will notify the other of the recovery. At your option,
changes implemented with a general program the property will be returned to or retained by you
revision that includes both broadenings and or it will become our property. If the recovered
restrictions in coverage, whether that general property is returned to or retained by you, the loss
program revision is implemented through payment will be adjusted based on the amount
introduction of: you received for the recovered property.
1. A subsequent edition of this Policy; or X. Volcanic Eruption Period
2. An amendatory endorsement. One or more volcanic eruptions that occur within a
S. Waiver Or Change Of Policy Provisions 72-hour period will be considered as one volcanic
A waiver or change of a provision of this Policy eruption.
must be in writing by us to be valid. Our request Y. Loss Payable Clause
for an appraisal or examination will not waive any If the Declarations shows a loss payee for certain
of our rights. listed insured personal property, that person is
T. Assignment considered an insured in this Policy with respect to
Assignment of this Policy will not be valid unless that property.
we give our written consent. If we decide to cancel or not renew this Policy, that
U. Death loss payee will be notified in writing.
If you die, we insure: Z. Policy Period
1. Your legal representatives but only with This Policy applies only to loss which occurs
respect to the property of the deceased during the policy period.
covered under the Policy at the time of death;

DP 00 03 07 14 © Insurance Services Office, Inc., 2013 Page 13 of 13


Policy Number: 1001562443
Policy Number: 1001562443

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DUTIES AFTER LOSS AMENDATORY ENDORSEMENT


Forms DP0001, DP0002, DP0003

CONDITIONS
Item 1. of Provision D. Duties After Loss is
replaced as follows:

1. Give prompt notice to us or our agent.


With respect to a loss caused by the
peril of windstorm or hail, that notice
must occur no later than 365 days after
the date of loss;

DF3006 (11/21)
Includes copyrighted material of Insurance Services Office, Ind., with its permission.

____________________________________________________________________
Policy Number: 1001562443

IMPORTANT INFORMATION FOR OUR


MICHIGAN POLICYHOLDERS

All companies offering homeowner insurance in Michigan must comply with the Essential Insurance Act, Public
Act 145, of 1979. The intent of this law is to assure that affordable homeowner insurance is available to all eligible
Michigan residents.

In keeping with the requirements of the law, we base the determination of premiums and underwriting rules based
on the requirements of Michigan laws. The use and effect of rating factors can vary among insurers and, to some
extent, could affect premiums. Likewise, expenses and losses may vary among companies and any differences
are reflected in the premiums a company charges.

As part of the requirements of the Michigan law, the following information is available and can be provided to you
upon your request:
* A description of the specific rating classifications by which the rates and premiums for the policy have
been determined:
* A description of all of the insurer's underwriting rules and
* A general explanation of the extent to which rates or premiums vary among policyholders.

If you would like to obtain any additional information about the rating of your premium or any information required
to calculate and confirm the accuracy of your specific premium, you can contact your agent as listed on the
Declarations Page or send a written request to State Auto Insurance Group, PO Box 182822, Columbus, Ohio
43218-2822. The written request should specify an address for returning the information to you. You may want to
contact your agent to determine if you are eligible for insurance from an affiliate of the insurer or under a different
rating plan that may provide to you insurance at a more favorable premium.

RIGHT TO APPEAL

You have the right to appeal when you have reason to believe that the Company has improperly denied you
homeowners insurance or charged you an incorrect premium. To initiate the appeal procedure, contact your
State Auto Insurance Companies Agent for an explanation.

If further clarification is needed after talking to your agent, contact State Auto Insurance Companies, c/o Personal
Lines Underwriting, PO Box 182822, Columbus, Ohio 43218-2822; Telephone Number 800-444-9950. State Auto
Insurance Companies may also be contacted on the web at www.stateauto.com.

If your complaint cannot be resolved through the mail or by telephone, you may request a private, informal
conference with managerial-level Company personnel.

At your request, for a minimal charge, you will receive copies of information relating to the denial of coverage or
the premium charged.

If resolution of your complaint is not completed within thirty (30) days or if you are not satisfied with the
Company's decision, you may appeal the matter to the Michigan Commissioner of Insurance within 120 days
after we have delivered our decision.

The contact information to submit a complaint for review is as follows: Department of Insurance and Financial
Services. Street address: 530 W Allegan Street, 7th Floor Lansing MI 48993. Post Office Box: PO Box 30220
Lansing, MI 48909-7720. Phone: 517-284-8800 or 877-999-6442 (toll free).

FI658A (06/21)
Policy Number: 1001562443

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

SWIMMING POOL AMENDATORY ENDORSEMENT


Form DP0003

PERILS INSURED AGAINST


A. Coverage A – Dwelling And Coverage B – Other Structures
2. We do not insure, however, for loss:

Paragraph c.(2) is deleted and replaced by the following:


c.(2) Freezing, thawing, pressure or weight of water or ice, whether driven by wind or not, to a:
(a) Fence, pavement or patio;
(b) Swimming pool, hot tub or spa, including their filtration and plumbing systems;
(c) Footing, foundation, bulkhead, wall, or any other structure or device that supports all
or part of a building or other structure;
(d) Retaining wall or bulkhead that does not support all or part of a building or other
structure; or
(e) Pier, wharf or dock;

DF3010 (11/21)
Includes copyrighted material of Insurance Services Office, Ind., with its permission.

____________________________________________________________________
Policy Number: 1001562443

Personal Liability

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

SPECIAL PROVISIONS – MICHIGAN

PERSONAL LIABILITY ADDITIONAL POLICY 3. When this Policy is cancelled, the premium for
CONDITIONS the period from the date of cancellation to the
Under E. Cancellation, Paragraph 1., the first expiration date will be refunded pro rata,
paragraph of Paragraph 2., and Paragraph 3. are subject to Paragraph 5. below.
replaced by the following: The following paragraph is added:
1. You may cancel this Policy at any time by 5. The minimum earned premium will not be less
letting us know of the date cancellation is to than the pro rata premium for the expired time
take effect. or $25, whichever is greater.
2. We may cancel this Policy by letting you know All other provisions of this Policy apply.
in writing of the date cancellation takes effect.
This cancellation notice may be mailed to you
at your address last known to us or our
authorized agent.

DL0121 (11/14) © Insurance Services Office, Inc., 2014 Page 1 of 1


Policy Number: 1001562443
Policy Number: 1001562443

Dwelling Liability

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

LIMITED FUNGI, WET OR DRY ROT, OR BACTERIA


COVERAGE – MICHIGAN
FOR USE WITH FORM DL 24 01

SCHEDULE

These Limits Of Liability apply to the total of all loss or costs payable under this endorsement, regardless of the
number of "occurrences", the number of claims made, or the number of locations insured under this endorse-
ment and listed in this Schedule.

Coverage L – Aggregate Sublimit Of Liability For "Fungi", Wet Or Dry Rot, Or Bacteria $ 50,000

Entries may be left blank if shown elsewhere in this policy for this coverage.

DEFINITIONS However, our total liability under Coverage L for


The following Definition is added: the total of all damages arising directly or indirect-
ly, in whole or in part, out of the actual, alleged or
"Fungi" means any type or form of fungus, includ- threatened inhalation of, ingestion of, contact with,
ing mold or mildew, and any mycotoxins, spores, exposure to, existence of, or presence of any
scents or by-products produced or released by "fungi", wet or dry rot, or bacteria will not be more
fungi. This does not include any fungi that are, are than the Coverage L – Aggregate Sublimit Of Lia-
on, or are contained in, a good or product intend- bility for "Fungi", Wet Or Dry Rot, Or Bacteria.
ed for consumption. That sublimit is the amount shown in the Sched-
CONDITIONS ule. This is the most we will pay regardless of the:
Condition 1. Limit Of Liability is deleted and re- a. Number of locations insured under the policy to
placed by the following: which this endorsement is attached;
1. Limit Of Liability b. Number of persons injured;
Our total liability under Coverage L for all damag- c. Number of persons whose property is dam-
es resulting from any one "occurrence" will not be aged;
more than the Coverage L – Limit Of Liability d. Number of "insureds";
shown in the Declarations. This limit is the same
regardless of the number of "insureds", claims e. Number of "occurrences"; or
made or persons injured. All "bodily injury" and f. Number of claims made.
"property damage" resulting from any one accident This sublimit:
or from continuous or repeated exposure to sub-
stantially the same general harmful conditions will a. Is within the Coverage L – Limit Of Liability;
be considered to be the result of one "occur- b. Does not increase the Coverage L – Limit of
rence". Liability; and
Our total liability under Coverage M for all medical c. Applies separately to each consecutive annual
expense payable for "bodily injury" to one person period and to any remaining period of less than
as the result of one accident will not be more than 12 months, starting with the beginning of the
the Coverage M – Limit Of Liability shown in the policy period shown in the Declarations.
Declarations.

DL2473 (05/04) © ISO Properties, Inc., 2003 Page 1 of 2


Policy Number: 1001562443

Dwelling Liability
With respect to damages arising out of "fungi", wet or
dry rot, or bacteria described in 1. Limit Of Liability
of this endorsement, Condition 2. Severability Of
Insurance is deleted and replaced by the following:
2. Severability Of Insurance
This insurance applies separately to each "in-
sured" except with respect to the Aggregate Sub-
limit of Liability described in this endorsement un-
der Condition 1. Limit Of Liability. This condition
will not increase the limit of liability for this cover-
age.
All other provisions of the policy apply.

Page 2 of 2 © ISO Properties, Inc., 2003 DL2473 (05/04)


Policy Number: 1001562443

Dwelling Liability

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

SPECIAL PROVISIONS – MICHIGAN

DEFINITIONS ADDITIONAL COVERAGES


The following paragraph is added to Paragraph A.: Under Paragraph A. Claim Expenses, the following
If the spouse ceases to be a resident of the same is added:
household during the policy period, the spouse will 5. Prejudgment interest awarded against the
be considered "you" and "your" under this Policy "insured" on that part of the judgment we pay.
but only until the earlier of: CONDITIONS
1. The effective date of another policy listing the Under Paragraph C. Duties After "Occurrence", the
spouse as a named insured; or first paragraph and Paragraph 5. are replaced by the
2. The end of the policy period. following:
LIABILITY COVERAGES In case of an "occurrence", you or another
Under Paragraph A. Coverage L – Personal "insured" or someone acting on behalf of the
Liability, in DL 24 01 and Endorsement DL 24 82, "insured" will perform the following duties that
Paragraph 1. is replaced by the following: apply. We have no duty to provide coverage under
this Policy if your failure to comply with the
1. Pay up to our limit of liability for the damages following duties is prejudicial to us. You will help
for which an "insured" is legally liable. us by seeing that these duties are performed. Any
Paragraph 1. is replaced by the following in notice given to us or any of our authorized agents
Endorsement DL 34 12: in this state containing particulars sufficient to
1. Pay for the damages for which an "insured" is identify the "insured" will be deemed notice to us:
legally liable, subject to the Aggregate Limit Of 1. Give notice to us or our agent as soon as is
Liability, as shown in the Schedule and practical, which sets forth:
described in Section II – Conditions, A. a. The identity of the Policy and the "named
Aggregate Limit Of Liability; and insured" shown in the Declarations;
EXCLUSIONS b. Reasonably available information on the
Under Paragraph E. Coverage L – Personal time, place and circumstances of the
Liability And Coverage M – Medical Payments To accident or "occurrence"; and
Others, Paragraph 8. Controlled Substance is c. Names and addresses of any claimants and
replaced by the following: witnesses;
8. Controlled Substance 5. With respect to Paragraph C. Damage To
"Bodily injury" or "property damage" arising out Property Of Others, under Additional
of the use, sale, manufacture, delivery, transfer Coverages, submit to us within 60 days after
or possession by any person of a Controlled the loss, a sworn statement of loss and show
Substance(s) as defined by the Federal Food the damaged property, if in an "insured's"
and Drug Law at 21 U.S.C.A. Sections 811 and control.
812. Controlled Substances include but are not Failure to submit the statement of loss within
limited to cocaine, LSD, marijuana and all 60 days does not invalidate your claim, if you
narcotic drugs. show that it was not reasonably possible to do
However, this exclusion does not apply: so and also show that you submitted the
statement as soon as reasonably possible;
a. To the legitimate use of prescription drugs
by a person following the lawful orders of a Paragraph F. Suit Against Us is replaced by the
licensed health care professional; or following:
b. To the "insured(s)" who has no knowledge F. Suit Against Us
of the involvement with a controlled 1. No action can be brought against us unless
substance(s). An "insured's" knowledge of there has been full compliance with all of the
such involvement must be shown by us by terms under this Policy.
competent evidence of such knowledge.

DL2521 (11/14) © Insurance Services Office, Inc., 2014 Page 1 of 2


Policy Number: 1001562443

Dwelling Liability
2. No one will have the right to join us as a party Paragraph H. Other Insurance is replaced by the
to any action against an "insured". following:
3. Also, no action with respect to Coverage L can H. Other Insurance
be brought against us until the obligation of If there is other applicable liability insurance, we
such "insured" has been determined by final will pay only our share of the loss. Our share is the
judgment or agreement signed by us. proportion that our limit of liability bears to the total
This paragraph (F.3.) does not apply if we fail of all applicable limits. However, any insurance we
to respond within a reasonable time after a provide for a vehicle or watercraft is excess over
written request as to whether we agree that the any other valid and collectible insurance except
"insured" has an obligation to pay. insurance written specifically to cover as excess
over the limits of liability that apply in this Policy.
All other provisions of this Policy apply.

Page 2 of 2 © Insurance Services Office, Inc., 2014 DL2521 (11/14)


Policy Number: 1001562443

# # H{ippmrk#Jmvi#
XLMW#IRHSVWIQIRX#GLERKIW#XLI#TSPMG]1##TPIEWI#VIEH#MX#GEVIJYPP]1#

WTIGMEP#TVSZMWMSRW#;#QMGLMKER#
DEFINITIONS G. Appraisal
The following paragraph is added: If you and we fail to agree on the amount of loss,
If the spouse ceases to be a resident of the same either may demand an appraisal of the loss. In this
household during the policy period, the spouse will be event, each party will choose a competent and
considered "you" and "your" under this Policy but independent appraiser within 20 days after receiving
only until the earlier of: a written request from the other. The two appraisers
1. The effective date of another policy listing the will choose a competent and impartial umpire. If they
spouse as a named insured; or cannot agree upon an umpire within 15 days, you or
we may request that the choice be made by a judge
2. The end of the policy period. of the circuit court for the county in which the loss
GENERAL EXCLUSIONS occurred or where the Described Location is located.
The appraisers will separately set the amount of loss.
The following paragraphs are added to 8. Intentional
If the appraisers submit a written report of an
Loss:
agreement to us, the amount agreed upon will be the
This exclusion does not apply, with respect to loss to amount of loss. If they fail to agree, they will submit
covered property, to you or any person or their differences to the umpire. A decision agreed to
organization named as an additional insured who by any two will set the amount of loss.
does not commit or conspire to commit any act that
Each party will:
results in loss caused by a covered peril. We cover
such person or organization only to the extent of that 1. Pay its own appraiser; and
person's or organization's legal interest, but not 2. Bear the other expenses of the appraisal and
exceeding the applicable limit of liability. umpire equally.
We may apply reasonable standards of proof to (This is Condition H. in Form DP0001.)
claims for such loss.
The following paragraph is added to I. Subrogation:
(This is Exclusion A.8. in Forms DP0001 and
DP0003, and Exclusion 8. In Form DP0002.) If we pay an insured for a loss caused by another
insured who commits, or directs another to commit,
CONDITIONS any act that results in a loss, the rights of the
Paragraph C. Concealment Or Fraud is replaced by the insured to recover damages from the insured who
following: committed, or directed another to commit, such an
act are transferred to us to the extent of our
C. Concealment Or Fraud
payment. The insured may not waive such rights.
1. With respect to loss caused by fire, we provide no (This is Condition J. in Form DP0001.)
coverage for loss to a person insured under this
Paragraph J. Suit Against Us is replaced by the
Policy who has:
following:
a. Intentionally concealed or misrepresented any
J. Suit Against Us
material fact or circumstance;
No action can be brought against us unless there has
b. Engaged in fraudulent conduct; or
been full compliance with all of the terms under this
c. Made false statements; Policy and the action is started within two years after
relating to this insurance. the date of loss. The time for commencing an action
2. With respect to loss caused by a peril other than is tolled from the time the insured notifies the insurer
fire, we provide coverage to no persons insured of the loss until the insurer formally denies liability.
under this Policy for loss if, whether before or (This is Condition K. in Form DP0001.)
after a loss, one or more persons insured under
Paragraph L. Loss Payment is replaced by the
this Policy have:
following:
a. Intentionally concealed or misrepresented any
L. Loss Payment
material fact or circumstance;
We will adjust all losses with you. We will pay you
b. Engaged in fraudulent conduct; or
unless some other person is named in the Policy or is
c. Made false statements; legally entitled to receive payment. Loss will be
relating to this insurance. payable 30 days after we receive your proof of loss
and:
Paragraph G. Appraisal is replaced by the following:
HJ3454#+4424;,#Teki#4#sj#5#
Mrgpyhiw#gst}vmklxih#qexivmep#sj#Mrwyvergi#Wivzmgiw#Sjjmgi/#Mrg1/#{mxl#mxw#tivqmwwmsr1
# # #
Policy Number: 1001562443

# # H{ippmrk#Jmvi#
1. Reach an agreement with you; b. When this Policy has been in effect for less
2. There is an entry of a final judgment; or than 55 days and is not a renewal with us, we
may cancel by letting you know at least 30
3. There is a filing of an appraisal award with us. days before the date cancellation takes effect.
If a municipality has elected to apply the provisions c. When this Policy has been in effect for 55
of Michigan Public Act 217, a part of our payment for days or more, or at any time if it is a renewal
loss to insured real property in that municipality due with us, we may cancel:
to fire, explosion, windstorm or hail, vandalism or
malicious mischief or riot or civil commotion will be (1) If there has been a material
withheld in the event that the loss is subject to the misrepresentation of fact which if known
provisions of the Act. We will pay the withheld to us would have caused us not to issue
amount either to the municipality, a licensed the Policy; or
contractor performing services on the insured (2) If the risk has changed substantially
property or to you and the mortgagee, if any, since the Policy was issued.
according to the provisions of Public Act 217. We will This can be done by letting you know at least 30
notify you, any mortgagee and the municipality of days before the date cancellation takes effect.
any loss subject to the provisions of Public Act 217. The following paragraph is added:
If a municipality has elected to apply the provisions of 5. The minimum earned premium will not be less than
MICH. COMP. LAWS § 500.3011, any further the pro rata premium for the expired time or $25,
payment for claims for loss or damage to your whichever is greater.
covered property caused by fire or explosion of
$2,000 or more will be withheld if you have failed to (This is Condition Q. in Form DP0001.)
submit a required report to the fire or law Paragraph Q. Nonrenewal is replaced by the following:
enforcement authority designated by the municipality. Q. Nonrenewal
(This is Condition M. in Form DP0001.)
We may elect not to renew this Policy. We may do so
The following paragraph is added to N. Mortgage by mailing to you, at your address last known to us or
Clause: our authorized agent, written notice at least 30 days
If a municipality has elected to apply the provisions before the expiration date of this Policy. Proof of
of Michigan Public Act 217, a part of our payment for mailing will be sufficient proof of notice.
loss to insured real property in that municipality due (This is Condition R. in Form DP0001.) All
to fire, explosion, windstorm or hail, vandalism or
malicious mischief or riot or civil commotion will be
withheld in the event that the loss is subject to the All other provisions of this Policy apply.#
provisions of the Act. We will pay the withheld
amount either to the municipality, a licensed
contractor performing services on the insured
property or to you and the mortgagee, if any,
according to the provisions of Public Act 217. We will
notify you, any mortgagee and the municipality of
any loss subject to the provisions of Public Act 217.
If a municipality has elected to apply the provisions of
MICH. COMP. LAWS § 500.3011, any further
payment for claims for loss or damage to your
covered property caused by fire or explosion of
$2,000 or more will be withheld if you have failed to
submit a required report to the fire or law
enforcement authority designated by the municipality.
(This is Condition O. in Form DP0001.)
Under P. Cancellation, Paragraph 1., the first paragraph
of Paragraph 2., and Paragraphs 2.b. and 2.c. are
replaced by the following:
1. You may cancel this Policy at any time by letting
us know of the date cancellation is to take effect.
2. We may cancel this Policy by letting you know in
writing of the date cancellation takes effect. This
cancellation notice may be mailed to you at your
address last known to us or our authorized agent.
HJ3454#+4424;,#Teki#5#sj#5#
Mrgpyhiw#gst}vmklxih#qexivmep#sj#Mrwyvergi#Wivzmgiw#Sjjmgi/#Mrg1/#{mxl#mxw#tivqmwwmsr1
# # #
Policy Number: 1001562443

LEAD AND POLLUTION EXCLUSION ENDORSEMENT

The following exclusions are added to the Personal Liability policy exclusions.

This policy does not apply to:

1. Actual or alleged "bodily injury," that would not have occurred in whole or in part but for the direct or
indirect ingestion, inhalation or absorption of lead, or lead compounds, in any form.

2. Actual or alleged "property damage" or "personal injury," which would not have occurred in whole or part
but results directly or indirectly from lead, or lead compounds, in any form.

3. "Bodily injury," "personal injury" or "property damage" which would not have occurred in whole or part, but
for the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of
pollutants at any time.

4. Any loss, cost or expense arising out of any:

a. Governmental direction or request, or that of any and all other entities, demand, order or statutory or
regulatory requirements that any insured or others test for, monitor, clean up, remove, contain, treat,
detoxify or neutralize, or in any way respond to, or assess the effects of lead, lead compounds or
pollutants.

b. Claim or suit by or on behalf of a governmental authority for damages because of testing for,
monitory, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way
responding to, or assessing the effects of lead, lead compounds, or pollutants.

Pollutants means any solid, liquid, gaseous, or thermal irritant or contaminant including smoke, vapor, soot,
fumes, acid, alkalis, chemicals and waste. Waste includes material to be recycled, reconditioned or reclaimed.

Exclusion 3 above, does not apply to "bodily injury," "personal injury" or "property damage" arising out of heat,
smoke or fumes from a hostile fire at the "insured location." As used here, a hostile fire means one which
becomes uncontrollable or breaks out from where it was contained or was intended to be.

DF179 (07/14)
___________________________________________________________________________
Policy Number: 1001562443
Policy Number: 1001562443

AMENDMENT OF CANCELLATION PROVISION

CONDITIONS

Paragraph P.1., Cancellation is replaced by the following:

1. Any "named insured" may cancel this policy at any time by returning it to us or by letting us know in
writing of the date cancellation is to take effect.

This is paragraph Q.1. in form DP0001.

All remaining cancellation provisions are unchanged.

DF2073 (09/07)
___________________________________________________________________________
Policy Number: 1001562443
Policy Number: 1001562443

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!
Policy Number: 1001562443

POLICY NUMBER: DWELLING PROPERTY


DP 05 38 07 21

THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN


RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK
INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR
CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY.

CAP ON LOSSES FROM CERTIFIED ACTS OF


TERRORISM; DISCLOSURE PURSUANT TO
TERRORISM RISK INSURANCE ACT
SCHEDULE

SCHEDULE – PART I
Terrorism Premium (Certified Acts):

Additional information, if any, concerning the terrorism premium:

SCHEDULE – PART II
Federal share of terrorism losses 80 %
(Refer to Paragraph C. in this endorsement.)

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Cap On Losses From Certified Acts Of "Certified act of terrorism" means an act that is
Terrorism certified by the Secretary of the Treasury, in
If: accordance with the provisions of the federal
Terrorism Risk Insurance Act, to be an act of
1. Aggregate insured losses attributable to terrorism pursuant to such Act. The federal
terrorist acts certified under the Terrorism Risk Terrorism Risk Insurance Act includes the
Insurance Act exceed $100 billion in a calendar following criteria in a "certified act of terrorism":
year; and
1. The act resulted in insured losses in excess of
2. We have met our insurer deductible under the $5 million in the aggregate, attributable to all
Terrorism Risk Insurance Act; types of insurance subject to the Terrorism
we shall not be liable for the payment of any Risk Insurance Act; and
portion of the amount of such losses that exceeds 2. The act:
$100 billion, and in such case insured losses up to
that amount are subject to pro rata allocation in a. Is violent or dangerous to:
accordance with procedures established by the (1) Human life;
Secretary of the Treasury.

DP 05 38 07 21 © Insurance Services Office, Inc., 2020 Page 1 of 2


Policy Number: 1001562443

(2) Property; or D. Cap On Insurer Participation In Payment of


(3) Infrastructure; and Terrorism Losses
b. Is committed by an individual or individuals; If aggregate insured losses attributable to terrorist
and acts certified under the Terrorism Risk Insurance
Act exceed $100 billion in a calendar year and we
c. Is part of an effort: have met our insurer deductible under the
(1) To coerce the civilian population of the Terrorism Risk Insurance Act, we shall not be
United States; or liable for the payment of any portion of the amount
(2) To influence the policy or affect the of such losses that exceeds $100 billion, and in
conduct of the United States such case insured losses up to that amount are
Government by coercion. subject to pro rata allocation in accordance with
procedures established by the Secretary of the
B. Disclosure Of Premium Treasury.
In accordance with the federal Terrorism Risk
Insurance Act, we are required to provide you with
a notice disclosing the portion of your premium, if
any, which can be attributed to coverage for
terrorist acts certified under that Act. The portion
of your premium which can be attributed to such
coverage is shown in the Schedule of this
endorsement or the Declarations.
C. Disclosure Of Federal Participation In Payment
Of Terrorism Losses
The United States Government, Department of the
Treasury, will pay a share of terrorism losses
insured under the federal program. The federal
share equals a percentage (as shown in Part II of
the Schedule of this endorsement or in the policy
Declarations) of that portion of the amount of such
insured losses that exceeds the applicable insurer
retention. However, if aggregate insured losses
attributable to terrorist acts certified under the
Terrorism Risk Insurance Act exceed $100 billion
in a calendar year, the Treasury shall not make
any payment for any portion of the amount of such
losses that exceeds $100 billion.

Page 2 of 2 © Insurance Services Office, Inc., 2020 DP 05 38 07 21


Policy Number: 1001562443

DWELLING
DP 04 70 12 02

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PREMISES ALARM OR FIRE PROTECTION SYSTEM


We acknowledge the installation of an alarm system and/or automatic sprinkler system approved by us on the
Described Location. You agree to maintain this system or systems, for which we have granted a credit, in working
order and to let us know promptly of any change, including removal, made to the system(s).

DP 04 70 12 02 © ISO Properties, Inc., 2002 Page 1 of 1


Policy Number: 1001562443
Policy Number: 1001562443

PERSONAL LIABILITY
DL 24 01 07 14

PERSONAL LIABILITY
AGREEMENT 2. "Bodily injury" means bodily harm, sickness or
We will provide the insurance described in this Policy disease, including required care, loss of
in return for the premium and compliance with all services and death that results.
applicable provisions of this Policy. 3. "Business" means:
DEFINITIONS a. A trade, profession or occupation engaged
A. In this Policy, "you" and "your" refer to the "named in on a full-time, part-time or occasional
insured" shown in the Declarations and the spouse basis; or
if a resident of the same household. "We", "us" b. Any other activity engaged in for money or
and "our" refer to the company providing this other compensation, except the following:
insurance. (1) One or more activities, not described in
B. In addition, certain words and phrases are defined (2) through (4) below, for which no
as follows: "insured" receives more than $2,000 in
1. "Aircraft liability", "hovercraft liability", "motor total compensation for the 12 months
vehicle liability" and "watercraft liability", before the beginning of the policy
subject to the provisions in b. below, mean the period;
following: (2) Volunteer activities for which no money
a. Liability for "bodily injury" or "property is received other than payment for
damage" arising out of the: expenses incurred to perform the
activity;
(1) Ownership of such vehicle or craft by an
"insured"; (3) Providing home day care services for
which no compensation is received,
(2) Maintenance, occupancy, operation, other than the mutual exchange of such
use, loading or unloading of such services; or
vehicle or craft by any person;
(4) The rendering of home day care
(3) Entrustment of such vehicle or craft by services to a relative of an "insured".
an "insured" to any person;
4. "Employee" means an employee of an
(4) Failure to supervise or negligent "insured", or an employee leased to an
supervision of any person involving such "insured" by a labor leasing firm under an
vehicle or craft by an "insured"; or agreement between an "insured" and the labor
(5) Vicarious liability, whether or not leasing firm, whose duties are other than those
imposed by law, for the actions of a performed by a "residence employee".
child or minor involving such vehicle or 5. "Insured" means:
craft.
a. You and residents of your household who
b. For the purpose of this definition: are:
(1) Aircraft means any contrivance used or (1) Your relatives; or
designed for flight except model or
hobby aircraft not used or designed to (2) Other persons under the age of 21 and
carry people or cargo; in your care or the care of a resident of
your household who is your relative;
(2) Hovercraft means a self-propelled
motorized ground effect vehicle and b. A student enrolled in school full time, as
includes, but is not limited to, flarecraft defined by the school, who was a resident
and air cushion vehicles; of your household before moving out to
attend school, provided the student is under
(3) Watercraft means a craft principally the age of:
designed to be propelled on or in water
by wind, engine power or electric motor; (1) 24 and your relative; or
and (2) 21 and in your care or the care of a
(4) Motor vehicle means a "motor vehicle" resident of your household who is your
as defined in 7. below. relative;

DL 24 01 07 14 © Insurance Services Office, Inc., 2013 Page 1 of 8


Policy Number: 1001562443

c. With respect to animals or watercraft to h. Any part of a premises occasionally rented


which this Policy applies, any person or to an "insured" for other than "business"
organization legally responsible for these use.
animals or watercraft which are owned by 7. "Motor vehicle" means:
you or any person described in 5.a. or b.
"Insured" does not mean a person or a. A self-propelled land or amphibious vehicle;
organization using or having custody of or
these animals or watercraft in the course of b. Any trailer or semitrailer which is being
any "business" or without consent of the carried on, towed by or hitched for towing
owner; or by a vehicle described in a. above.
d. With respect to a "motor vehicle" to which 8. "Occurrence" means an accident, including
this Policy applies: continuous or repeated exposure to
(1) Persons while engaged in your employ substantially the same general harmful
or that of any person described in 5.a. or conditions, which results, during the policy
b.; or period, in:
(2) Other persons using the vehicle on an a. "Bodily injury"; or
"insured location" with your consent. b. "Property damage".
Throughout this Policy, when the word an 9. "Property damage" means physical injury to,
immediately precedes the word "insured", the destruction of, or loss of use of tangible
words an "insured" together mean one or more property.
"insureds". 10. "Residence employee" means:
6. "Insured location" means: a. An employee of an "insured", or an
a. The "residence premises"; employee leased to an "insured" by a labor
b. The part of other premises, other structures leasing firm, under an agreement between
and grounds used by you as a residence; an "insured" and the labor leasing firm,
and whose duties are related to the
maintenance or use of the "residence
(1) Which is shown in the Declarations; or premises", including household or domestic
(2) Which is acquired by you during the services; or
policy period for your use as a b. One who performs similar duties elsewhere
residence; not related to the "business" of an "insured".
c. Any premises used by you in connection A "residence employee" does not include a
with a premises described in a. and b. temporary employee who is furnished to an
above; "insured" to substitute for a permanent
d. Any part of a premises: "residence employee" on leave or to meet
(1) Not owned by an "insured"; and seasonal or short-term workload conditions.
(2) Where an "insured" is temporarily 11. "Residence premises" means:
residing; a. The one-family dwelling where you reside;
e. Vacant land, other than farm land, owned b. The two-, three- or four-family dwelling
by or rented to an "insured"; where you reside in at least one of the
f. Land owned by or rented to an "insured" on family units; or
which a one-, two-, three- or four-family c. That part of any other building where you
dwelling is being built as a residence for an reside;
"insured"; and which is shown as the "residence
g. Individual or family cemetery plots or burial premises" in the Declarations.
vaults of an "insured"; or "Residence premises" also includes other
structures and grounds at that location.

Page 2 of 8 © Insurance Services Office, Inc., 2013 DL 24 01 07 14


Policy Number: 1001562443

LIABILITY COVERAGES b. Is not registered for use on public roads or


A. Coverage L – Personal Liability property, but such registration is required
by a law, or regulation issued by a
If a claim is made or a suit is brought against an government agency, for it to be used at the
"insured" for damages because of "bodily injury" or place of the "occurrence"; or
"property damage" caused by an "occurrence" to
which this coverage applies, we will: c. Is being:
1. Pay up to our limit of liability for the damages (1) Operated in, or practicing for, any
for which an "insured" is legally liable. prearranged or organized race, speed
Damages include prejudgment interest contest or other competition;
awarded against an "insured"; and (2) Rented to others;
2. Provide a defense at our expense by counsel (3) Used to carry persons or cargo for a
of our choice, even if the suit is groundless, charge; or
false or fraudulent. We may investigate and (4) Used for any "business" purpose except
settle any claim or suit that we decide is for a motorized golf cart while on a
appropriate. Our duty to settle or defend ends golfing facility.
when our limit of liability for the "occurrence"
has been exhausted by payment of a judgment 2. If Exclusion A.1. does not apply, there is still no
or settlement. coverage for "motor vehicle liability", unless the
"motor vehicle" is:
B. Coverage M – Medical Payments To Others
a. In dead storage on an "insured location";
We will pay the necessary medical expenses that
are incurred or medically ascertained within three b. Used solely to service a residence;
years from the date of an accident causing "bodily c. Designed to assist the handicapped and, at
injury". Medical expenses means reasonable the time of an "occurrence", it is:
charges for medical, surgical, X-ray, dental,
(1) Being used to assist a handicapped
ambulance, hospital, professional nursing,
person; or
prosthetic devices and funeral services. This
coverage does not apply to you or regular (2) Parked on an "insured location";
residents of your household except "residence d. Designed for recreational use off public
employees". As to others, this coverage applies roads and:
only:
(1) Not owned by an "insured"; or
1. To a person on the "insured location" with the
permission of an "insured"; or (2) Owned by an "insured" provided the
"occurrence" takes place:
2. To a person off the "insured location", if the
"bodily injury": (a) On an "insured location" as defined
in Definition B.6.a., b., d., e. or h.; or
a. Arises out of a condition on the "insured
location" or the ways immediately adjoining; (b) Off an "insured location" and the
"motor vehicle" is:
b. Is caused by the activities of an "insured";
(i) Designed as a toy vehicle for use
c. Is caused by a "residence employee" in the by children under seven years of
course of the "residence employee's" age;
employment by an "insured"; or
(ii) Powered by one or more
d. Is caused by an animal owned by or in the batteries; and
care of an "insured".
(iii) Not built or modified after
EXCLUSIONS manufacture to exceed a speed
A. "Motor Vehicle Liability" of five miles per hour on level
ground;
1. Coverages L and M do not apply to any "motor
vehicle liability" if, at the time and place of an
"occurrence", the involved "motor vehicle":
a. Is registered for use on public roads or
property;

DL 24 01 07 14 © Insurance Services Office, Inc., 2013 Page 3 of 8


Policy Number: 1001562443

e. A motorized golf cart that is owned by an (b) More than 50 horsepower and not
"insured", designed to carry up to four owned by or rented to an "insured";
persons, not built or modified after or
manufacture to exceed a speed of 25 miles (2) One or more outboard engines or
per hour on level ground and, at the time of motors with:
an "occurrence", is within the legal
boundaries of: (a) 25 total horsepower or less;
(1) A golfing facility and is parked or stored (b) More than 25 horsepower if the
there, or being used by an "insured" to: outboard engine or motor is not
owned by an "insured";
(a) Play the game of golf or for other
recreational or leisure activity (c) More than 25 horsepower if the
allowed by the facility; outboard engine or motor is owned
by an "insured" who acquired it
(b) Travel to or from an area where during the policy period; or
"motor vehicles" or golf carts are
parked or stored; or (d) More than 25 horsepower if the
outboard engine or motor is owned
(c) Cross public roads at designated by an "insured" who acquired it
points to access other parts of the before the policy period, but only if:
golfing facility; or
(i) You declare them at policy
(2) A private residential community, inception; or
including its public roads upon which a
motorized golf cart can legally travel, (ii) Your intent to insure them is
which is subject to the authority of a reported to us in writing within 45
property owners association and days after you acquire them.
contains an "insured's" residence. The coverages in (c) and (d) above
B. "Watercraft Liability" apply for the policy period.
1. Coverages L and M do not apply to any Horsepower means the maximum power
"watercraft liability" if, at the time of an rating assigned to the engine or motor by
"occurrence", the involved watercraft is being: the manufacturer.
a. Operated in, or practicing for, any C. "Aircraft Liability"
prearranged or organized race, speed This Policy does not cover "aircraft liability".
contest or other competition. This exclusion D. "Hovercraft Liability"
does not apply to a sailing vessel or a
predicted log cruise; This Policy does not cover "hovercraft liability".
b. Rented to others; E. Coverage L – Personal Liability And Coverage
M – Medical Payments To Others
c. Used to carry persons or cargo for a
charge; or Coverages L and M do not apply to the following:
d. Used for any "business" purpose. 1. Expected Or Intended Injury
2. If Exclusion B.1. does not apply, there is still no "Bodily injury" or "property damage" which is
coverage for "watercraft liability" unless, at the expected or intended by an "insured", even if
time of the "occurrence", the watercraft: the resulting "bodily injury" or "property
damage":
a. Is stored;
a. Is of a different kind, quality or degree than
b. Is a sailing vessel, with or without auxiliary initially expected or intended; or
power, that is:
b. Is sustained by a different person, entity or
(1) Less than 26 feet in overall length; or property than initially expected or intended.
(2) 26 feet or more in overall length and not However, this Exclusion E.1. does not apply to
owned by or rented to an "insured"; or "bodily injury" or "property damage" resulting
c. Is not a sailing vessel and is powered by: from the use of reasonable force by an
(1) An inboard or inboard-outdrive engine or "insured" to protect persons or property;
motor, including those that power a
water jet pump, of:
(a) 50 horsepower or less and not
owned by an "insured"; or

Page 4 of 8 © Insurance Services Office, Inc., 2013 DL 24 01 07 14


Policy Number: 1001562443

2. "Business" c. Destruction, seizure or use for a military


a. "Bodily injury" or "property damage" arising purpose.
out of or in connection with a "business" Discharge of a nuclear weapon will be deemed
conducted from an "insured location" or a warlike act even if accidental;
engaged in by an "insured", whether or not 6. Communicable Disease
the "business" is owned or operated by an
"insured" or employs an "insured". "Bodily injury" or "property damage" which
arises out of the transmission of a
This Exclusion E.2. applies but is not limited communicable disease by an "insured";
to an act or omission, regardless of its
nature or circumstance, involving a service 7. Sexual Molestation, Corporal Punishment
or duty rendered, promised, owed, or Or Physical Or Mental Abuse
implied to be provided because of the "Bodily injury" or "property damage" arising out
nature of the "business". of sexual molestation, corporal punishment or
b. This Exclusion E.2. does not apply to: physical or mental abuse; or
(1) The rental or holding for rental of an 8. Controlled Substance
"insured location"; "Bodily injury" or "property damage" arising out
(a) On an occasional basis if used only of the use, sale, manufacture, delivery, transfer
as a residence; or possession by any person of a Controlled
Substance as defined by the Federal Food and
(b) In part for use only as a residence, Drug Law at 21 U.S.C.A. Sections 811 and
unless a single-family unit is 812. Controlled Substances include but are not
intended for use by the occupying limited to cocaine, LSD, marijuana and all
family to lodge more than two narcotic drugs. However, this exclusion does
roomers or boarders; or not apply to the legitimate use of prescription
(c) In part, as an office, school, studio or drugs by a person following the lawful orders of
private garage; and a licensed health care professional.
(2) An "insured" under the age of 21 years Exclusions A. "Motor Vehicle Liability", B.
involved in a part-time or occasional, "Watercraft Liability", C. "Aircraft Liability", D.
self-employed "business" with no "Hovercraft Liability" and E.4. "Insured's" Premises
employees; Not An "Insured Location" do not apply to "bodily
3. Professional Services injury" to a "residence employee" arising out of
and in the course of the "residence employee's"
"Bodily injury" or "property damage" arising out employment by an "insured".
of the rendering of or failure to render
professional services; F. Coverage L – Personal Liability
4. "Insured's" Premises Not An "Insured Coverage L does not apply to:
Location" 1. Liability:
"Bodily injury" or "property damage" arising out a. For any loss assessment charged against
of a premises: you as a member of an association,
a. Owned by an "insured"; corporation or community of property
owners;
b. Rented to an "insured"; or
b. Under any contract or agreement entered
c. Rented to others by an "insured"; into by an "insured". However, this
that is not an "insured location"; exclusion does not apply to written
contracts:
5. War
(1) That directly relate to the ownership,
"Bodily injury" or "property damage" caused
maintenance or use of an "insured
directly or indirectly by war, including the
following and any consequence of any of the location"; or
following: (2) Where the liability of others is assumed
by you prior to an "occurrence";
a. Undeclared war, civil war, insurrection,
rebellion or revolution; unless excluded in a. above or elsewhere in
this Policy;
b. Warlike act by a military force or military
personnel; or

DL 24 01 07 14 © Insurance Services Office, Inc., 2013 Page 5 of 8


Policy Number: 1001562443

2. "Property damage" to property owned by an 2. To any person eligible to receive benefits


"insured". This includes costs or expenses voluntarily provided or required to be provided
incurred by an "insured" or others to repair, under any:
replace, enhance, restore or maintain such a. Workers' compensation law;
property to prevent injury to a person or
damage to property of others, whether on or b. Non-occupational disability law; or
away from an "insured location"; c. Occupational disease law;
3. "Property damage" to property rented to, 3. From any:
occupied or used by or in the care of an a. Nuclear reaction;
"insured". This exclusion does not apply to
"property damage" caused by fire, smoke or b. Nuclear radiation; or
explosion; c. Radioactive contamination;
4. "Bodily injury" to any person eligible to receive all whether controlled or uncontrolled or
any benefits voluntarily provided or required to however caused; or
be provided by an "insured" under any:
d. Any consequence of any of these; or
a. Workers' compensation law;
4. To any person, other than a "residence
b. Non-occupational disability law; or employee" of an "insured", regularly residing
c. Occupational disease law; on any part of the "insured location".
5. "Bodily injury" or "property damage" for which ADDITIONAL COVERAGES
an "insured" under this Policy: We cover the following in addition to the limits of
a. Is also an insured under a nuclear energy liability:
liability policy issued by the: A. Claim Expenses
(1) Nuclear Energy Liability Insurance We pay:
Association;
1. Expenses we incur and costs taxed against an
(2) Mutual Atomic Energy Liability "insured" in any suit we defend;
Underwriters;
2. Premiums on bonds required in a suit we
(3) Nuclear Insurance Association of defend, but not for bond amounts more than
Canada; the Coverage L limit of liability. We need not
or any of their successors; or apply for or furnish any bond;
b. Would be an insured under such a policy 3. Reasonable expenses incurred by an "insured"
but for the exhaustion of its limit of liability; at our request, including actual loss of earnings
or (but not loss of other income) up to $250 per
day, for assisting us in the investigation or
6. "Bodily injury" to you or an "insured" as defined defense of a claim or suit; and
under Definition 5.a. or b.
4. Interest on the entire judgment which accrues
This exclusion also applies to any claim made after entry of the judgment and before we pay
or suit brought against you or an "insured" to:
or tender, or deposit in court that part of the
a. Repay; or judgment which does not exceed the limit of
b. Share damages with; liability that applies.
another person who may be obligated to pay B. First Aid Expenses
damages because of "bodily injury" to an We will pay expenses for first aid to others
"insured". incurred by an "insured" for "bodily injury" covered
G. Coverage M – Medical Payments To Others under this Policy. We will not pay for first aid to an
"insured".
Coverage M does not apply to "bodily injury":
C. Damage To Property Of Others
1. To a "residence employee" if the "bodily injury":
1. We will pay, at replacement cost, up to $1,000
a. Occurs off the "insured location"; and per "occurrence" for "property damage" to
b. Does not arise out of or in the course of the property of others caused by an "insured".
"residence employee's" employment by an
"insured";

Page 6 of 8 © Insurance Services Office, Inc., 2013 DL 24 01 07 14


Policy Number: 1001562443

2. We will not pay for "property damage": C. Duties After "Occurrence"


a. Caused intentionally by an "insured" who is In case of an "occurrence", you or another
13 years of age or older; "insured" will perform the following duties that
b. To property owned by an "insured"; apply. We have no duty to provide coverage under
this Policy if your failure to comply with the
c. To property owned by or rented to a tenant following duties is prejudicial to us. You will help
of an "insured" or a resident in your us by seeing that these duties are performed:
household; or
1. Give written notice to us or our agent as soon
d. Arising out of: as is practical, which sets forth:
(1) A "business" engaged in by an a. The identity of the Policy and the "named
"insured"; insured" shown in the Declarations;
(2) Any act or omission in connection with a b. Reasonably available information on the
premises owned, rented or controlled by time, place and circumstances of the
an "insured", other than the "insured "occurrence"; and
location"; or
c. Names and addresses of any claimants and
(3) The ownership, maintenance, witnesses;
occupancy, operation, use, loading or
unloading of aircraft, hovercraft, 2. Cooperate with us in the investigation,
watercraft or "motor vehicles". settlement or defense of any claim or suit;
This Exclusion d.(3) does not apply to a 3. Promptly forward to us every notice, demand,
"motor vehicle" that: summons or other process relating to the
"occurrence";
(a) Is designed for recreational use off
public roads; 4. At our request, help us:
(b) Is not owned by an "insured"; and a. To make settlement;
(c) At the time of the "occurrence", is not b. To enforce any right of contribution or
required by law, or regulation issued indemnity against any person or
by a government agency, to have organization who may be liable to an
been registered for it to be used on "insured";
public roads or property. c. With the conduct of suits and attend
CONDITIONS hearings and trials; and
A. Limit Of Liability d. To secure and give evidence and obtain the
attendance of witnesses;
Our total liability under Coverage L for all
damages resulting from any one "occurrence" will 5. With respect to Paragraph C. Damage To
not be more than the Coverage L Limit Of Liability Property Of Others under Additional
shown in the Declarations. This limit is the same Coverages, submit to us within 60 days after
regardless of the number of "insureds", claims the loss a sworn statement of loss and show
made or persons injured. All "bodily injury" and the damaged property, if in an "insured's"
"property damage" resulting from any one accident control;
or from continuous or repeated exposure to 6. No "insured" shall, except at such "insured's"
substantially the same general harmful conditions own cost, voluntarily make payment, assume
shall be considered to be the result of one obligation or incur expense other than for first
"occurrence". aid to others at the time of the "bodily injury".
Our total liability under Coverage M for all medical D. Duties Of An Injured Person – Coverage M –
expense payable for "bodily injury" to one person Medical Payments To Others
as the result of one accident will not be more than 1. The injured person or someone acting for the
the Coverage M Limit Of Liability shown in the injured person will:
Declarations.
a. Give us written proof of claim, under oath if
B. Severability Of Insurance required, as soon as is practical; and
This insurance applies separately to each b. Authorize us to obtain copies of medical
"insured". This condition will not increase our limit reports and records.
of liability for any one "occurrence".
2. The injured person will submit to a physical
exam by a doctor of our choice when and as
often as we reasonably require.

DL 24 01 07 14 © Insurance Services Office, Inc., 2013 Page 7 of 8


Policy Number: 1001562443

E. Payment Of Claim – Coverage M – Medical J. Subrogation


Payments To Others An "insured" may waive in writing before a loss all
Payment under this coverage is not an admission rights of recovery against any person. If not
of liability by an "insured" or us. waived, we may require an assignment of rights of
F. Suit Against Us recovery for a loss to the extent that payment is
made by us.
1. No action can be brought against us unless
there has been full compliance with all of the If an assignment is sought, an "insured" must sign
terms under this Policy. and deliver all related papers and cooperate with
us.
2. No one will have the right to join us as a party
to any action against an "insured". Subrogation does not apply to Coverage M or
Paragraph C. Damage To Property Of Others
3. Also, no action with respect to Coverage L can under Additional Coverages.
be brought against us until the obligation of
such "insured" has been determined by final K. Concealment Or Fraud
judgment or agreement signed by us. We do not provide coverage to an "insured" who,
G. Bankruptcy Of An "Insured" whether before or after a loss, has:
Bankruptcy or insolvency of an "insured" will not 1. Intentionally concealed or misrepresented any
relieve us of our obligations under this Policy. material fact or circumstance;
H. Other Insurance 2. Engaged in fraudulent conduct; or
This insurance is excess over other valid and 3. Made false statements;
collectible insurance except insurance written relating to this insurance.
specifically to cover as excess over the limits of
liability that apply in this Policy.
I. Policy Period
This Policy applies only to "bodily injury" or
"property damage" which occurs during the policy
period.

Page 8 of 8 © Insurance Services Office, Inc., 2013 DL 24 01 07 14


Policy Number: 1001562443

POLICY NUMBER: PERSONAL LIABILITY


DL 24 89 07 21

THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN


RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK
INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR
CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY.

CAP ON LOSSES FROM CERTIFIED ACTS OF


TERRORISM; DISCLOSURE PURSUANT TO
TERRORISM RISK INSURANCE ACT
SCHEDULE

SCHEDULE – PART I
Terrorism Premium (Certified Acts):

Additional information, if any, concerning the terrorism premium:

SCHEDULE – PART II
Federal share of terrorism losses 80 %
(Refer to Paragraph C. in this endorsement.)

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Cap On Losses From Certified Acts Of "Certified act of terrorism" means an act that is
Terrorism certified by the Secretary of the Treasury, in
If: accordance with the provisions of the federal
Terrorism Risk Insurance Act, to be an act of
1. Aggregate insured losses attributable to terrorism pursuant to such Act. The federal
terrorist acts certified under the Terrorism Risk Terrorism Risk Insurance Act includes the
Insurance Act exceed $100 billion in a calendar following criteria in a "certified act of terrorism":
year; and
1. The act resulted in insured losses in excess of
2. We have met our insurer deductible under the $5 million in the aggregate, attributable to all
Terrorism Risk Insurance Act; types of insurance subject to the Terrorism
we shall not be liable for the payment of any Risk Insurance Act; and
portion of the amount of such losses that exceeds 2. The act:
$100 billion, and in such case insured losses up to
that amount are subject to pro rata allocation in a. Is violent or dangerous to:
accordance with procedures established by the (1) Human life;
Secretary of the Treasury.

DL 24 89 07 21 © Insurance Services Office, Inc., 2020 Page 1 of 2


Policy Number: 1001562443

(2) Property; or D. Cap On Insurer Participation In Payment of


(3) Infrastructure; and Terrorism Losses
b. Is committed by an individual or individuals; If aggregate insured losses attributable to terrorist
and acts certified under the Terrorism Risk Insurance
Act exceed $100 billion in a calendar year and we
c. Is part of an effort: have met our insurer deductible under the
(1) To coerce the civilian population of the Terrorism Risk Insurance Act, we shall not be
United States; or liable for the payment of any portion of the amount
(2) To influence the policy or affect the of such losses that exceeds $100 billion, and in
conduct of the United States such case insured losses up to that amount are
Government by coercion. subject to pro rata allocation in accordance with
procedures established by the Secretary of the
B. Disclosure Of Premium Treasury.
In accordance with the federal Terrorism Risk
Insurance Act, we are required to provide you with
a notice disclosing the portion of your premium, if
any, which can be attributed to coverage for
terrorist acts certified under that Act. The portion
of your premium which can be attributed to such
coverage is shown in the Schedule of this
endorsement or the Declarations.
C. Disclosure Of Federal Participation In Payment
Of Terrorism Losses
The United States Government, Department of the
Treasury, will pay a share of terrorism losses
insured under the federal program. The federal
share equals a percentage (as shown in Part II of
the Schedule of this endorsement or in the policy
Declarations) of that portion of the amount of such
insured losses that exceeds the applicable insurer
retention. However, if aggregate insured losses
attributable to terrorist acts certified under the
Terrorism Risk Insurance Act exceed $100 billion
in a calendar year, the Treasury shall not make
any payment for any portion of the amount of such
losses that exceeds $100 billion.

Page 2 of 2 © Insurance Services Office, Inc., 2020 DL 24 89 07 21


Policy Number: 1001562443

PERSONAL LIABILITY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PREMISES LIABILITY
(Non-owner Occupied Dwelling)

SCHEDULE

Location Number Of Families

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

DEFINITIONS EXCLUSIONS
Definition 6. "insured location" is extended to include Exclusion E.2. "business" does not apply to the rental
the premises shown in the Schedule above. or holding for rental of the premises shown in the
LIABILITY COVERAGES Schedule.
Coverage L – Personal Liability and Coverage M – All other provisions of this Policy apply.
Medical Payments To Others are restricted to apply
only with respect to "bodily injury" and "property
damage" arising out of the:
1. Ownership;
2. Maintenance;
3. Occupancy; or
4. Use;
of the premises shown in the Schedule.

DL2411 (07/14) Page 1 of 1

© Insurance Services Office, Inc., 2013


Policy Number: 1001562443

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