Continental Casualty Company v. Duyzend et al

Filing 1

COMPLAINT against defendant(s) Does 1-100, Kathryn Cox, Henri F. Duyzend, Sharon Duyzend, Cheryl Grant, Beverly Hawley, Richard Hawley, David Hubert, Jill Ortiz, Satoko Prigmore, Thomas Prigmore, William Mark Smith, Daryl Stuart, Laurel Stuart, Kristine Walla, Robert Wallace, Dale Hollingsworth, Ruth Hollingsworth, Sarah Hollingsworth, Thomas Huber, Daniel O'Neal, Patricia O'Neal, Chris Stuart, Cyndi Sundby, Douglas Sundby, Derry Tiedeman, Nicole Tiedeman, Megan Walla, Anne Welsh, Tom Welsh, Sandy Zickuhr, Tracy Zickuhr, Zoe Zickuhr (Receipt # 0981-3321765), filed by Continental Casualty Company . (Attachments: # 1 Civil Cover Sheet, # 2 Exhibit A, # 3 Exhibit B, # 4 Exhibit C, # 5 Exhibit D, # 6 Exhibit E, # 7 Exhibit F, # 8 Exhibit G, # 9 Exhibit H, # 10 Exhibit I, # 11 Exhibit J, # 12 Exhibit K, # 13 Summons, # 14 Summons, # 15 Summons, # 16 Summons, # 17 Summons, # 18 Summons, # 19 Summons, # 20 Summons, # 21 Summons, # 22 Summons, # 23 Summons, # 24 Summons, # 25 Summons, # 26 Summons, # 27 Summons, # 28 Summons, # 29 Summons, # 30 Summons, # 31 Summons, # 32 Summons, # 33 Summons, # 34 Summons, # 35 Summons, # 36 Summons, # 37 Summons, # 38 Summons, # 39 Summons, # 40 Summons, # 41 Summons, # 42 Summons, # 43 Summons, # 44 Summons, # 45 Summons)(Nelson, Justin) Modified on 8/23/2013 to edit capitalization and spelling of party names(PM).

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EXHIBIT A Claims-Made Declarations NOTICE CNA for All the Commitments You Make' YOUR PROFESSIONAL LIABILITY INSURANCE IS WRITTEN ON A "CLAIMS MADE" BASIS AND PROVIDES COVERAGE FOR THOSE CLAIMS WHICH ARE THE RESULTS OF DENTAL INCIDENTS OCCURRING SUBSEQUENT TO THE PRIOR ACTS DATE STATED BELOW AND WHICH ARE FIRST MADE AGAINST YOU WHILE THIS INSURANCE IS IN FORCE. PLEASE DISCUSS THIS WITH YOUR AGENT. --- Policy Number--- DLP ~m 29fH7911 - -T- Policy Period 106/14/2667 ----~~~~;~~e-ls-pr~VidedBY To 06/14/20681-r Named Insured and Address Continental Casualty Company ' ---National Administrator ! ----'- Henri Duyzend DDS B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684-5875 18528 Firland Way N. Shoreline, WA 98133 State Administrator Number 970·05438-048487 I Limits of Insurance Each Claim . $8,000,000 f --- Aggregate $5,000,000 I Coverage , Professional Liability . _--+ --------- : Personal Injury Liability & Advertising Injury Liability Included . --j---. $5,000 ____ Each Person $25,000 $25,000 - - - - Each Aggregate $4,352,00 -- - - - --'--- Policy Premium I First Aid _ _ _ _ _ _ _ ______ _ Cla~, EmpIoymen t Prac t'tces L'la b'I't Y Defense 11 I. ____ Printed Endorsements Attached At Policy Issuance - See Attached Schedule of Endorsements This policy shall not be valid unless countersigned by a duly authorized representative of the company. Countersigned 8y _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative G-15155-C (Ed. 07/2000) ~~~e~ 03/28/2007 12:28:32 PM MBONILLA New Business CNA Declarations For Alitho Commitmen1sYou Make' j Fro~___ , Policy Number DLP 297117911 , 06/14/2007 Policy Poriod Coverage Is Provided By To ---- ---~ ---- --- ----- Continontal Casualty Company L4/2008 I --~ Named Insured and Address II--~-·- Henri Duyzend DDS B & B Protector Plans Inc. P.O. Box 15875 l 18528 Firland Way N. Shoreline, WA 98133 National AdminIstrator ___ _ _ Tampa, FL 33684·5875 ! Slate AdminIstrator Number Limits of Insurance $5,000,000 Coverage Each Occurrence -Aggregate ' General Liability - Occurrence ----.- $8,000.000 Included --. +' , Personal Injury Liability & Advertising Injury Liability - Occurrence $5,000,000 Aggregate $5,000 -- $1,000,000 ---- ------- ----- ---- .. _------ ----.- Products Hazard/Completed Operations Hazard =Occurrence "' Each Person ----Each Occurrence $10,000 Medical Payments - Occurrence -- --- -- --- __ Per occurrenc;"-l Non-Owned or~irecJAutomobile Liability - Occurrence $50,000 Per Suit Aggregate $50,000 $0 - - -1 Medical Waste Legal Expense Reimbursement - Occurrence Each Claim --Aggregate -! -- $0 INCLUDED 970·05438-048487 ERISA Fiduciary Liability - Claims-Made I --policy Premiu-m-- I Printed Endorsements Attached At Policy Issuance ~ See Attachod Schedule of Endorsements This policy shall not be valid unless countersigned by a duly authorized representative of the company. »",,---vv\ 'tArl- "--' Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Sl>crot"ry Authorized Representative G-135701-A (Ed. 06/2000) Issue 03/28/2007 12:28:32 PM Date: MBONILLA New Business Declarations CNA fur Ailihe CommitmentsYou Make' ----:F;om Policy Number DLP 297117911 I Policy Period 06/141200~7~ To: Coverage Is Provided By i --- 06/14/20oiIT~ Continental Casualty Company I i I I_ 1 ___ _ Named Insured and Address -~- National Administrator -I Henri Duyzend DDS B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684·5875 18528 Firland Way N. Shoreline, WA 98133 State Administrator Number 970.05438·048487 ---------- Insured Location Address ______ 18528 Firland Way N. Shoreline --~--- "'------ I --+--- - ---- Limits of Insurance $0 Inflation Guard Increase $721,000 Limit of Insurance 0% i WA I 98133 -----.L _ _ ~ __ _ Coverage Limit of Insurance 0% ___ --------,------ ~tate--J-ziP Code __ Inflation Guard Increase , Blanket Dental Practice Personal Property ----, ---- $500 : Building Deductible Amount I $3,000 Per Day@ 32.5 Days Valued Daily Limit -12Mont;'-s Limit of Time - $50,000--$0 $100,000 $15.000 Limit 01 Insurance I. A. . Money/Securities --- ---- -- - ---- - i Actu~1 Loss Su~tainedl Basic Cov;rage---- - -_ Building & Blanket Dental Practice Personal Property -----+- Practice Income JDe~tist'sElectronic -Equipment ' Rents -....; Employee Dishonesty (Applies Collectively To All Locations) I. B .• Benelit Plans Policy Premium INCLUDED L __ _ Printed Endorsements Attached At Policy Issuance - See Attached Schedule of Endorsements This policy shall not be valid unless countersigned by a duly authorized representative 01 the company. Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative G·15156·B (Ed. 06/2000) ~:~~ 03/28/2007 12:28:32 PM MBONILLA New Business Issued by the Siock Insurance Company Herein called The Company 970-05438-048487 ST. ADM. NUMBER ==.!02:18462 PRODUCER NUMBER Continental Casualty Company IIfIIflIA 297117911 POLICY NUMBE-R CNA Insurance Companies CNA Plaza Jbr AlitheCommilmEotsYou Maket Chicago, Illinois 60685 "'IVM. CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS Inception Dale Expiration Date 18528 Firland Way N. Shoreline, WA 98133 0611412007 0611412008 Endorsement Effeclive Dale It is agreed that the following persons or organizations are named insureds and complete the Declarations. Primary Location 18528 Firland Way N. Shoreline, WA 98133 Name Class: 1 PL Prior Acts Date EPL Prior Acts Date Henri Duyzend 80211 0611411988 0611411998 Risk Management Credit Applied National Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684-5875 G-89548-A (ED. 02197) Acct. No. 297117911 --------- Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative Issue Date: 0312812007 12:28:32 PM MBONILLA New Business Issued by the Stock Insurance Company Herein called The Company 018462 Continental Casualty Company IJfIAIA '#II1'fI14. 970-05438-048487 ST. ADM. NUMBER PRbDUCER~ NUMBER CNA Insurance Companies 297117911 CNA Plaza POLlCY"N~U"'M"B'ER fbrAl!lbcCommilmentsYouMaJro~ Chicago, Illinois 60685 CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Dllyzend DDS Inception Dale Expiration Dale 18528 Flrland Way N. Shoreline, WA 98133 06/14/2007 06/14/2008 Endorsement Effeelive Date Professional Corporation Name Class: PL Prior Acts Date EPL Prior Acts Date HENRI F. DUYZEND, DDS PS 80999 06/14/1988 06/14/1998 Henri Duyzend DDS National Administrator, Name and Address B & B Protector Plans Inc, P.O. Box 15875 Tampa, FL 33684·5875 G-89548-A (ED. 02/97) Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative ~:~~ Accl. No. 297117911 03/28/2007 12:28:32 PM MBONILLA New Business CNA lbr Allthe CummitmelltsYou Me.ke' ADDITIONAL INSURED - LEASED PREMISES - GL Person(s) or Entity(ies) Additional Insured Designation of Premises (Part Leased to You) Mooers Clinic LLC CIO Kelley Mooers 3625 50th Ave SW Seattle, WA 98116 18528 Firland Way N. We agree with you that the definition of you is changed to include the person(s) or entity(ies) named above but only with respect to liability which results from the owning. using or taking care of that part of the premises designated above which is leased to you. We will not defend or pay for: 1. Any injury or damage which takes place after you ceased to be a tenant of said premises; or 2. Structural alterations, new construction or demolition operations performed by or for the owner of the premises. All other provisions of the policy remain unchanged. Henri Duyzend 297117911 Insured Name Policy Number 06/14/2007 Countersigned By _ _ _ _ _ _ _ _ _ __ Effective date of this endorsement G-56427-E (Ed. 07/96) Authorized Agent Issue Date: 03/28/2007 12:28:32 PM MBONILLA New Business CNA ibr All the C()mmitment.sYou Make' For Attachment to Policy Number 297117911 WASHINGTON STOP-GAP EXTENSION GENERAL LIABILITY INSURANCE "It is agreed that this insurance covers your legal liability for injury of an employee of yours who sustains an injury which arises out of and in the course of his employment, provided such employee is reported and declared under the Worker's Compensation Fund of the State of Washington." The insurance granted by this extension shall not apply to: 1. injury, disease or death suffered or caused by an employee whose renumeration has not been included in the total remuneration upon which this premium extension is based; 2. aircraft, operation or the performance of any duty in connection with aircraft while in flight; 3. any premium, assessment, penalty, fine, or other obligation imposed by any woker's compensation law; 4. any claim for injury, disease, or death with respect to which you are deprived of any defense or defenses or is otherwise subject to penalty because of default in premium payment under, or any other failure to comply with the provisions of the worker's compensation law or laws of the State of Washington. The premium for the extension shall be computed upon the total payroll of the individual office. Estimated Annual Remuneration Rate per $100 of Remuneration Estimated Annual Premium INCL. $82,000 0.04 $80 All other provisions of the policy remain unchanged Authorized Representative AgenUBroker: Address: G-89678-046 (Ed. 05/05) Issue Date: 03/28/2007 12:28:32 PM MBONILLA New Business Issued by the Siock Insurance Company Herein called The Company 970-05438-048487 ST. ADM. NUMBER 018462 PRODU-CER NUMBER Continental Casualty Company IJfJIA'A ..1V1I4. 297117911 CNA Insurance Companies CNA Plaza FbrAlIlheCommltmenl~\buMa1re$ Chicago, illinois 60685 POLICY NUMBER CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS Inception Date Expiration Date 18528 Firland Way N. Shoreline, WA 98133 06/14/2007 06/14/2008 Endorsement Effective Date 12/21/2007 This policy has been cancelled pro-rata. Total Return Premium: $2,042.00 National Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 173569 Tampa, FL 33672 AccL No. 297117911 Countersigned By _______________ Authorized Represontative issue Date: 06/11/200804:15:15 PM GiGO Cancellation Policy Change Endorsement Professional Liability Coverage Part Dentists/Oral Surgeons HIPAA PROCEEDINGS ENDORSEMENT Policy Continental Casualty Company Issued· By: ' A Stock Company ! Policy No.: 297117911 , 1-- --, "--,-- Producer's i Pacific Underwriters Corp Name and; 12611 Des Moines Memorial Dr Address: ! POBox 68787 ; Seattle, WA 98168 Producer's Code: 970-05438-048487 I _ _ _L When Is Change Effective: Named . Henri Duyzend DDS Insured: ' 18528 Firland Way N. Shoreline, WA 98133 06/14/2007 at 12:01 a.m. hour and minute ----.L ______ HOW YOUR POLICY IS CHANGED: In consideration of the premium paid, we agree with you as follows: 1. A new section is added to the Policy as follows: HIPAA PROCEEDING SUPPLEMENT: In addition to the limits of liability, we will pay up to $10,000 for each of you for attorney fees charged by an attorney selected by us, and other reasonable costs, expenses or fees resulting from the investigation or defense of a HIPAA Proceeding. However, in no event shall the amount payable hereunder exceed $30,000 per policy period regardless of the number of you insured hereunder and regardless of the number of such proceedings. Such HIPAA Proceeding must begin during the policy period and must be reported to us within 30 days after you receive notice of such HIPAA Proceeding but in no event later than the end of the policy period. 2. Section VI. DEFINTIONS is amended to add a new definition as follows: "HIPAA Proceeding" means any federal proceeding alleging any breach of the responsibilities, obligations or duties imposed upon you under the Health Insurance Portability and Accountability Act of 1996 and any rules or regulations promulgated thereunder ("HIPAA"). All other terms and conditions remain the same. This Endorsement is effective only when signed by our authorized representative. (Authorized Representative) G-145117-A (Ed. 06/03) 1 I> Policy Change Endorsement NATIONAL DENTAL POLICY PROTECTED HEALTH INFORMATION/PRIVACY ENDORSEMENT ~ ~ ~ ~-r;~ ,--~~- Policy Issued By: Continental Casualty Company Producer's Name and Address: Pacific Underwriters Corp 12611 Des Moines Memorial Dr POBox 68787 Seattle, WA 98168 Producer's Code: Henri Duyzend DDS 18528 Firland Way N. Shoreline, WA 98133 When Is Change Effective: Named Insured: A Stock Company Policy No.: 297117911 970-05438-048487 06/14/2007 at 12:01 a.m. hour and minute HOW YOUR POLICY IS CHANGED: 1. As used in this Endorsement, the following terms are defined as follows: Individual means the person who is the subject of Protected Health Information. Individually Identifiable Health Information means information that is a subset of health information, including demographic information collected from an individual, and a. b. is created or received by you; relates to the past, present or future physical or mental health condition of an individual; the provision of health care to an individual; or the past, present or future payment for the provision of health care to an individual, and i. that identifies the individual; or ii. with respect to which there is a reasonable basis to believe the information can be used to identify the individual. Privacy Rule means those requirements set forth in 45 CFR 160 and 164 pertaining to the protection of Protected Health Information. Protected Health Information means Individually Identifiable Health Information you give us: a. transmitted by electronic media; b. maintained in any medium described in the definition of electronic media at 45 CFR 162.103; or c. transmitted or maintained in any other form or medium. Required by Law shall have the meaning set out in 45 CFR 164.501 and shall include a mandate contained in law that compels us to make a use or disclosure of protected health information and that is enforceable in a court of law including a civil or an authorized investigative demand. All other terms and conditions remain the same. This Endorsement is effective only when signed by our authorized representalive. (Authorized Repr<.sentative) G-145118-A (Ed. 06/03) Page 1 of 2 i Policy Change Endorsement 2. Subjecllo paragraph 3 below, il is agreed Ihal we may use or disclose Protected Health Information: a. as Required By Law; b. in performing our obligations under Ihis Policy, including bul nollimiled 10 Ihe proper defense, investigation and settlemenl of claims; c. 10 report violations of law 10 appropriale Federal and Slate aulhorities, consislent with § 164.502U)(1). 3. In order 10 fulfill our obligations 10 You wilh respecllo Protected Health Information, we will: a. use appropriale safeguards 10 mainlain Ihe securily of and prevenl use or disclosure of Ihe Protected Health Information olher Ihan as provided for by this Endorsemenl b. promptly reporllo You any use or disclosure of Ihe Protected Health Information in violation of Ihe requiremenls of Ihis Endorsemenl of which we become aware c. mitigale, 10 Ihe exlenl practicable, any harmful effecllhal is known 10 us of a use or disclosure of Protected Health Information by us in violation of the requiremenls of Ihis Endorsement. d. oblain reasonable assurances from persons or entities to whom Protected Health Information is disclosed Ihal it will remain confidential and used or furlher disclosed only as Required By Law or for Ihe purpose for which il was disclosed 10 Ihe person or entity, and Ihallhe person or entity will notify us of any ins lances of which il is aware in which Ihe confidentialily of Ihe information has been breached; make available 10 Ihe Secrelary of Ihe United Slates Deparlmenl of Health and Human Services, or its designee, inlernal practices, books, and records, including policies and procedures and Protected Health Information, relating to Ihe use and disclosure of Prolecled Health Information, for purposes of said Secrelary delermining Your compliance with the Privacy Rule, subject 10 all applicable legal privileges; make available 10 You, al our offices during normal business hours, our inlernal practices, books, and records, including policies and procedures and Protected Health Information, relating 10 Ihe use and disclosure of Protected Health Information for purposes of Your delermining its compliance wilh the Privacy Rute, provided You provides alleasl 7 days prior written request for such review. within 45 days after request by You, we will provide to You documenlation of any disclosures of Protected Heatth Information by us, and information retaled to such disclosures, as is required for You 10 respond 10 a requesl by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR § 164.528 e. f. g. 4. You agree Ihal You shall notify us of: a. any limilalions in Your notice of privacy practices in accordance with 45 CFR § 164.520, to Ihe exlent Ihal such limilation may affecl our use or disclosure of Prolecled Health Information. b. c. 5. 6. 7. any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, 10 Ihe exlenllhat such changes may affecl our use or disclosure of Protected Health Information. any reslriction to the use or disclosure of Protected Health Information Ihat You have agreed 10 in accordance with 45 CFR § 164.522, 10 Ihe exlenllhal such restriction may affecl our use or disclosure of Protected Health Information. You shall nol requesl us 10 use or disclose Protected Health Information in any manner Ihal would nol be permissible under Ihe Privacy Rule if done by You. Excepl as provided in paragraph (2) of Ihis section, upon lermination of all of our obligations under this Policy, we shall relurn or destroy all Protected Health Information received from You, or created or received by us on Your behalf. This provision shall apply 10 Protected Health Information Ihal is in the possession of our subconlraclors or agenls. We shall retain no copies of Ihe Protected Health Information. In Ihe evenllhat we delermine Ihal relurning or deslroying the Protected Health Information is infeasible, we shall provide 10 You notification of Ihe conditions thaI make relurn or deslruction infeasible. Upon such notification, we shall extend Ihe prolections of Ihis Endorsemenllo such Protected Health Information and limil further uses and disclosures of such Protected Health Information 10 those purposes thaI make Ihe relurn or destruction infeasible. All other provisions of the policy remain unchanged. G-145118-A (Ed. 06/03) Page 2 of 2 • IMPORTANT INFORMATION POLICYHOLDER DISCLOSURE NOTICE OF INSURANCE COVERAGE FOR ACTS OF TERRORISM You are hereby notified that under, and in accordance with, the Terrorism Risk Insurance Act of 2002, effective November 26, 2002, that you are entitled to insurance coverage for losses arising out of "Certified Acts of Terrorism" subject to all applicable policy provisions. You should know that under your policy, any covered losses caused by "Certified Acts of Terrorism" will be partially reimbursed by the United States under a formula established by federal law. Under this formula, the United States pays 90% of covered terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. The premium as of this date that is attributable to coverage for "Certified Acts of Terrorism" is $~. As used herein, "Certified Acts of Terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act of 2002. The federal Terrorism Risk Insurance Act of 2002 sets forth the following criteria for a "Certified Act of Terrorism": a. The act resulted in aggregate losses in excess of $5 million; and b. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals acting on behalf of any foreign person or foreign interest, as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Insured Name: Henri Duyzend Insured Address: 18528 Firland Way N. Shoreline, WA 98133 Policy Number: 297117911 Policy Effective Date: 14-JUN-07 G-144959-8 (Ed. 03/03) COVERAGE OF AND CAP ON LOSSES FOR CERTIFIED ACTS OF TERRORISM In consideration of the premium charge of $ __ 0_, it is agreed as follows: 1. The DEFINITIONS section is amended by the addition of the following new term: "Certified Act of Terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act of 2002. The federal Terrorism Risk Insurance Act of 2002 sets forth the following criteria for a Certified Act of Terrorism: a. The act resulted in aggregate losses in excess of $5 million; and b. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals acting on behalf of any foreign person or foreign interest, as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. 2. This Policy provides coverage for losses arising from Certified Acts of Terrorism subject to all other terms and conditions of this policy. 3. Under the federal Terrorism Risk Insurance Act of 2002, any losses caused by Certified Acts of Terrorism will be partially reimbursed by the United States under a formula established by federal law. Under this formula, the United States pays 90% of covered terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. 4. With respect to anyone or more Certified Acts of Terrorism, The Insurer will not pay any amounts for which the Insurer is not responsible under the terms of the federal Terrorism Risk Insurance Act of 2002 (including subsequent acts of Congress pursuant to the Act) due to the application of any clause in such law which results in a cap on the Insurer's liability for payments for terrorism losses. All other provisions of the Policy remain unchanged. G-144872-A (Ed. 01/03) Issued by the Stock Insurance Company Herein called The Company Continental Casualty Company 018462 970-05438-048487 ST. ADM: NUMBER PRODUCER NUMBER ""fAlA. 297117911 POLICY NUMBER CNA Insuranco CompanIes CNA Plaza fQl'AlllheC.ommibnentsYouMake' Chicago, illinois 60685 "'RM. CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS tnception Date Expiration Date 18528 Firland Way N. Shoreline, WA 98133 0611412007 0611412008 Endorsement Effective Date 0611412007 It is understood and agreed that the following change(s) have been made to the policy: Employee Practice Liability Defense and Indemnity (EPLI) has been amended to $250,000 All other provisions of the policy remain unchanged National Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684-5875 G-89548-A (ED. 02/97) Accl. No. 297117911 Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative Issue Date: 0512112007 08:52:33 PM YMALDO Endorsement Issued by the Stock Insurance Company Herein caned The Company Conlinental Casualty Company IJIIIAla. "''''14. 970-05438-048487 ST. ADM. NUMBER 018462 PRODUCER NUMBER 297117911 POLICY NUMBER - CNA Insurance Companies CNA Plaza FbrAlllheCommitmel1tsYouMaket Chicago, IllInois 60685 --- CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS Inception Date Expiration Dale 16526 Firland Way N. 06/14/2007 06/14/2008 Shoreline, WA 96133 Endorsement Effective Date 06/14/2007 It is understood and agreed that the following change(s) have been made to the policy: The EPUEPLI Coverage has been changed All other provisions of the policy remain unchanged National Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684-5875 G-89548-A (EO. 02/97) Acc\' No. 297117911 Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative ~!~e~ 05/21/200708:52:33 PM YMALDO Endorsement Issued by tho Stock Insurance Company Herein called The Company Continental Casually Company 018462 970-05438·048487 ST. ADM. NUMBER PRODUCER NUMBER IIfIIlIA 297117911 POLiCY NUMBER CNA Insurance Companies CNA Plaza FbtAllthoCommitmenl.sYouMake' Chicago, illinois 60685 'tin" CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS Inception Date Expiration Date 18528 Firland Way N. Shoreline, WA 98133 0611412007 0611412008 Endorsement Effective Dale 0611412007 It is understood and agreed that the following change(s) have been made to the policy: PC EPL has been deleted All other provisions of the policy remain unchanged National Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684-5875 G·89548-A (ED. 02/97) Acct. No. 297117911 Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative Issue Date: 05/21/200708:52:33 PM YMALDO Endorsement Issued by the Stock Insurance Company Herein called The Company 018462 Continental Casually Company 'sf''''" IfIIA.'A 970·05438·048487 ST. ADM. NUMBER PRODUCER NUMBER 297117911 rclucyNuMBER CNA Insurance Companies CNA Plaza Fbr All IheC{lmmi\ments\ou !oIake' Chicago, Illinois 60685 CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS Inception Date Expiration Dale 18528 Firland Way N. Shoreline, WA 98133 06/14/2007 06/14/2008 Endorsement Effective Date 06/14/2007 It is underslood and agreed that the following change(s) have been made to Ihe policy: PC EPLI has been added All other provisions of the policy remain unchanged National Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684·5875 G·89548·A (ED. 02197) Acc!. No. 297117911 Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative Issue Date: 051211200708:52:33 PM YMALDO Endorsement Issued by the Slack Insurance Company Herein called The Company Continental Casualty Company 018482 PRODUCER ~NUMBER IJIIAIA "''''M. 970-05438-048487 ST. ADM: NUMBER 297117911 POliCY NUMBER CNA Insuranco Companies CNA Plaza FbrAlIthoCommitmelttsYouMakct Chicago, Illinois 60685 - - CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS Inception Dale Expiration Dale 18528 Firland Way N. Shoreline, WA 98133 06/14/2007 06/14/2008 Endorsement Effeclive Dale 06/14/2007 The following endorsement has been deleted as of 06/14/2007 0-30015-046 (Ed. 05/05) Washington Employment Practices Liability Nalional Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684·5875 G-89548·A (ED. 02/97) Accl. No. 297117911 Issued by lile Stock Insurance Company Herein called The Company Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative Issue Dale: 05/21/200708:52:33 PM Endorsement YMALDO 970-05438-048487 Continental Casualty Company 018462 ST. ADM. NUMBER PRODUCER NUMBER PAIA. '-1'1114 297117911 POLICY NUMBER CNA Insurance Companies CNA Plaza FbrAlIthoCommitmentsYouMake' Chicago, Illinois 60685 CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzond DDS tnceplion Dale Expiration Date 18528 Firland Way N. Shoreline, WA 98133 0611412007 0611412008 Endorsement Effective Date 0611412007 The following endorsement has been deleted as of 06/14/2007 EPL For Professional Corporation HENRI F. DUYZEND, DDS PS National Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684·5875 G·89548·A (ED. 02/97) Ace!. No. 297117911 Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative Issue Date: 05/21/200708:52:33 PM YMALDO Endorsement ISSLled by tho Stock Insurance Company Herein called The Company Continental Casually Company 970-05438-048487 018462 PRODUCER NUMBER If1IIAIA. ..IIfIM. st. ADM. NUMBER 297117911 CNA Insurance Companies CNA Plaza fbrAJlthoCommitments\OuMake' Chicago, Illinois 60685 POLICY NuMBER CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insurod And Henri Duyzend DDS Expiration Date 18528 Flrland Way N. Shoreline, WA 98133 Mailing Inception Date 06/14/2007 06/14/2008 Address Endorsement Effective Date 06/14/2007 It is understood and agreed that the following change(s) have been made to the policy: Henri Duyzend, DDS has been amended to: Class 1 PL Prior Acts Date 06/14/1988 EPLI Prior Acts Date 06/14/1998 Liability Each Claim $5,000,000 Aggregate Each Consecutive Annual Period $8,000,000 Risk Management Credit Applied Practice Location: 18528 Firland Way N. Shoreline, WA 98133 All other provisions of the policy remain unchanged National Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684·5875 G-89548-A (ED. 02/97) Accl. No. 297117911 Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative Issue Date: 05/21/2007 08:52:33 PM YMALDO Endorsement Issued by the Stock Insurance Company Herein called The Company Continental CasuaUy Company PAl. "''''14.. 018462 PRODUCER NtJMBE~R 970-05438-048487 ST. ADM. NUMBER 297117911 POLICY N(J"M~B~E~R~ CNA Insurance Companies CNA Plaza IbrAllthoCommitmel1tsYouMake' Chicago, Illinois 60685 CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS Inception Date Expiration Dale 18528 Firland Way N. Shoreline, WA 98133 06/14/2007 06/14/2008 Endorsement Effective Dale 06/14/2007 It is understood and agreed that the following change(s) have been made to the policy: The following P.C. is amended to: Name: HENRI F. DUYZEND, DDS PS Henri Duyzend DDS National Administrator, Name and Address B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684-5875 G-89548-A (ED. 02/97) Accl. No. 297117911 Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative ~:~~ 05/21/200708:52:33 PM YMALDO Endorsement Issued by tile Stock Insurance Company Herein called The Company Continental Casualty Company ".,A ""'14. 018462 970-05438-048487 ST. ADM. NUMBER PRODUCER NUMBER 297117911 POLICY NUMBER CNA Insurance Companies CNA Plaza ~brAlllheCommilments'OuMake' Chicago, IllInois 60685 CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS Inception Date Expiration Dale 18528 Firland Way N. Shoreline, WA 98133 06/14/2007 06/14/2008 Endorsement Effeclive Date 06/14/2007 The following endorsement has been deleted as of 06/14/2007 EPL Defense Only Prior Acls Dale The above amendment pertains to National Administrator, Name and Address B & B Proleclor Plans Inc. P.O. Box 15875 Tampa, FL 33684-5875 G-89548-A (ED. 02197) Ace!. No. 297117911 Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ __ Authorized Representative ~:~e~ 05/21/200708:52:33 PM YMALDO Endorsement Issued by the Stock Insurance Company Herein called The Company 018462 PRODUCER NUM8E-R Continental Casualty Company 16UA. taft" 970-05438-048487 ST. ADM. NUMBE-R 297117911 POLICY NUMBER CNA Insurance Companies CNA Plaza fbrAlllheC<HnmilmenfsYouMIlke' Chicago. illinois 60685 CHANGE AND ATTACHING CLAUSE ENDORSEMENT Named Insured And Mailing Address Henri Duyzend DDS Inception Dale Expiration Date 18528 Flrland Way N. Shoreline, WA 98133 06/14/2007 06/14/2008 Endorsement Effeclive Date Total Policy Billed Premium: $67.00 National Administrator, Name and Address Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ B & B Protector Plans Inc. Authorized Representative P.O. Box 15875 Tampa, FL 33684-5875 G-89548-A (ED. 02/97) 06/14/2007 ~!~e~ Acc!. No. 297117911 05/21/200708:52:33 PM YMALDO Endorsement THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMPUTER VIRUS AND SYSTEM PENETRATION EXCLUSION This endorsement modifies insurance provided under the following: BUILDING BLANKET DENTAL PRACTICE PERSONAL PROPERTY AND INCOME COVERAGE PART I. The following are added to Section II., EXCLUSIONS, paragraph A:. A "Computer Virus"; "System Penetration ll II. The following paragraphs are added to Section IV. DEFINITIONS: "Computer Virus" means any Electronic data introduced or implanted without authorization into electronic data processing equipment or Electronic data which causes the corruption, distortion, deletion, destruction, unauthorized copying or loss of functionality of Electronic data. "Electronic Data" means information, programs or instructions that have been converted to a form usable in electronic data processing systems. "System Penetration" means the intentional and malicious use of a computer to obtain unauthorized access to information and resources stored on electronic data processing equipment in the form of Electronic data. G-142813-A Ed. 02102 CNA For All thn ConunitmC'1\1./; You )fake' DEFENDANT'S REIMBURSEMENT COVERAGE PART LIMITS OF LIABILITY $ 500 per day $5.000 per suit I. COVERAGE AGREEMENT IV. We will repay you for the necessary expenses and loss of time you incur as a result of being a defendant or co-defendant in a civil suit. These amounts must result from your being required to attend a trial of the suit. The suit must be caused by an injury or damage covered by this policy. II. EXCLUSIONS This coverage does not apply to trials of lawsuits if an action for damages had been filed before the effective date of this policy, and entered upon the records of a court lawfully established to receive, hear, or adjudicate such actions. III. LIMITS OF LIABILITY This coverage applies separately to each insured dentist. The Limit of Liability stated above as "per day" is the maximum we will pay for each full day you are required to appear in court. A full day means your attendance during both the morning and afternoon sessions of the trial. If you are required to appear in court for only one-half day, our liability shall only be one-half the per day limit. Our liability for necessary expenses and loss of time resulting from anyone or more trial(s) arising out of the same alleged causes of actions, regardless of the number of days you are required to attend such trial(s), shall not exceed the "per suit" limit stated above. G-137664-A (Ed. 06/2000) SPECIAL CONDITIONS You must give us, or any of our authorized agents, written notice as soon as practicable following the last date of expenses or loss of time you incur. This notice shall contain details sufficient to identify you and all reasonably obtainable information regarding the time, place and circumstances of the loss. Also included must be the identity of the court and all parties to the action before the court. This coverage only applies to expenses and loss of time which occur during the policy period. CNA For All tho Commitments You Malro1> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI, WET ROT, DRY ROT AND MICROBE EXCLUSION This endorsement modifies insurance provided under the fol/owing: BUILDING BLANKET DENTAL PRACTICE PERSONAL PROPERTY AND INCOME COVERAGE PART The fol/owing is added to Section II, EXCLUSIONS, Paragraph A.: I. Fungi, Wet Rot, Dry Rot and Microbes Presence, growih, prOliferation, spread or any activity of fungi, wet or dry rot or microbes. This exclusion does not apply when fungi, wet or dry rot or microbes result from fire or lightning. II. A. Subparagraphs 5 of Section II., EXCLUSIONS, Paragraph B., is deleted in its entirety and replaced by the fol/owing: 5. B. Rust, or other corrosion, decay, deterioration, hidden or latent defect or any quality in property that causes it to damage or destroy itself; The fol/owing is added to Section II., EXCLUSIONS, Paragraph B.: The fol/owing causes of : (a) Dampness or dryness of atmosphere; (b) Changes in or extremes of temperature; or (c) Marring or scratching. III. Paragraph 11. of Section II., EXCLUSIONS, Part B., is deleted in its entirety and replaced by the fol/owing: 11. Continuous or repeated discharge, seepage or leakage of water, or the presence or condensation of humidity, moisture or vapor, that occurs over a period of 14 days or more. IV. The fol/owing is added to Section IV., DEFINITIONS: "Fungi" means any form of fungus, including but not limited to, yeast, mold, mildew, rust, smut or mushroom, and including any spores, mycotoxins, odors, or any other substances, products, or byproducts produced by, released by, or arising out of the current or past presence of fungi. But fungi does not include any fungi intended by the insured for consumption. "Microbe" means any non-fungal microorganism or non-fungal colony-form organism that causes infection or disease. Microbe includes any spores, mycotoxins, odors, or any other substances, products, or byproducts produced by, released by, or arising out of the current or past presence of microbes. Page 1 of 1 G-142812-A (ED. 02102) Incorporates materials copyrighted by Insurance Services Offices, reprinted with their permission Issued by Ihe Siock Insurance Company Herein called The Company 970·05438·048487 018462 Contlnental Casualty Company ST. ADM-NUMBER PRODUCER NUMBER /IfI1l1. flatllWl4. CNA Insurance Companies CNA Plaza fbrAllibeCommitmentsYouMake' Chicago, illinois 60685 297117911 POLICY NUMBE~ CHANGE AND ATTACHING CLAUSE ENDORSEMENT - - - - - - Named Insured And Mailing Address ... - " " - - - - Expiration Dale 06/14/2007 18528 Firland Way N. Shoreline, WA 98133 ---------_.--._-', ".".', Inception Dale Henri Duyzend DDS 06/14/2008 .... ... _ .. _ ...._ - - - Endorsement Effective Date ------ SCHEDULE OF ENDORSEMENTS G·89548-A (Ed. 02197) Change And AUaching Clause Endorsement 0·30015-046 (Ed. 05/05) Washington Employment Practices Liability G-11715-E46 (Ed. 04/89) Washington State Provisions G-135702-B46 (Ed. 05/05) General Liability Policy - Occurrence - WA G·137664-A (Ed. 06/00) Defendants Reimbursement Coverage Part G-140093-A46 (EiD. 01/01) Washington Amendatory Endorsement Cornman Cond!. G·142812-A (Ed. 02102) Fungi, Wet Rot. Dry Rot and Microbe Exclusion G·142813-A (Ed. 02102) Computer Virus and System Penetration Exclusion G·142815-A46 (Ed.08103) FungVMold/Mildew/YeasVMicrobe Exclusion & Water G-144156-A (Ed. 02102) Amendatory Endorsement - Cyber G·144959-B (Ed. 03/03) Policyholder Disclosure Notice G·145184-A (Ed. 06/03) Economic And Trade Sanctions Condition G·147290A (Ed. 03/04) Exclusion - Silica G·147309A (Ed. 03/04) Exclusion - Asbestos G-15160-B (Ed. 06/00) Employee Dishonesty Coverage Part G-15175·G46 (Ed. 12100) Washington State Provisions G-16856-B99 (Ed. 02192) Special Extra Expense (HIV) Claims-Made G·17739-B46 (Ed. 03/01) Washington Defense Coverage Amendatory Endorsement G·41500-C (Ed. 01/90) Common Policy Conditions G·58004-G46 (Ed. 01/01) Washington Amendatory Endorsement EPL For Professional Corporation G-124787-B (Ed. 02106) Professional Protector Plan Gold G-144872-A (Ed. 01/03) Certified Acts of Terrorism G·145117-A (Ed. 06/03) HIPAA Proceedings Endorsement G-145118-A (Ed. 06/03) Protected Health InformationlPrivacy Endorsement G·15158-E (Ed. 05/06) Professional tnsurance Policy Claims-Made G-15159-E (Ed. 02106) Building, Blanket Dental Practice Personal Property G·56427-E (Ed. 07/96) Additional Insured Leased Premises G·89678-D46 (Ed. 05/05) Washington Stop Gap Extension OFAC Policy Holder Notice For New Business - - -.. .--- - - - - , .. _ . _ - - " , . ,------- - National Administrator, Name and Address Countersigned By _ _ _ _ _ _ _ _ _ _ _ _ _ __ B & B Protector Plans Inc. P.O. Box 15875 Tampa, FL 33684-5875 Authorized Represenlative ~:~e~ G·89548·A (ED. 02197) Accl. No. 297117911 - - - - - - " " , - - - - - - - - - - - - - - .. - - . _ - - - 03/28/2007 12:28:32 PM MBONILLA CNA Fbr All tho Contmibnollts You Make'" THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Amendatory Endorsement This endorsement modifies insurance provided under the following: COMMON POLICY CONDITIONS GENERAL LIABILITY COVERAGE PART I. Section II, EXCLUSIONS of the General Liability Coverage Part is amended by the addition of the following: We will not defend, or pay under this Coverage Part for: Personal or advertising injury: 1. arising out of the infringement of copyright, patent, trademark. trade secret or other intellectual property rights. However. this exclusion does not apply to infringement in your advertisement, of copyright, trade dress or slogan. 2. committed by an insured whose business is: a. b. c. advertising, broadcasting, publishing or telecasting; designing or determining content of web-sites for others; or an internet search, access, content or service provider. However. this exclusion does not apply to items A.. B. and C. of the defintion of injury. For the purposes of this exclusion, the placing of frame, borders or links, or advertising, for you or others anywhere on the internet is not by iteself considered the business of advertising, broadcasting, publishing or telecasting. 3. 4. II. arising out of an electronic chatroom or bulletin board the insured hosts, owns, or over which the insured exercises control. Arising out of the unauhorized use of another's name or product in your e-mail address, domain name or metatag, or any other similar tactics to mislead another's potential customers. Section IV., DEFINITIONS, of the General Liability Coverage Part is amended following definitions: by the addition of the "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: A. Notices that are published include material placed on the internet or on similar electronic means of communication; and Page 1 of2 G-144156-A (ED. 02102) Incorporales materials copyrighted by Insurance Services Offices, reprinted with their permission CNA For All the Commihncnts You MalmG B. Regarding web-sites, only that part of a web-site that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. "Personal and Advertising Injury" means those offenses set forth in items A, B, C, 0, E, F and G of the definition of injury. III. Section IV., DEFINITIONS, of the General Liability Coverage Part, the definition of Damage is deleted and replaced by the following: "Damage" means: A. physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it. B. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance, electronic data is not tangible property. As used in this definition, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systemsand applications software, hard or floppy disks, CD-ROMS, tales, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. IV. Section XVIII. DEFINITIONS, of the Common Policy Conditions, the definition of Coverage Territory is deleted and replaced by the following: "Coverage Territory" means: A. the United States of America, including its territories and possessions; B. Puerto Rico; and c. Canada Coverage Territory includes Personal and Advertising Injury offenses that take place through the internet or similar electronic means of communication provided the insured's responsibility to pay damages is determined in a suit on the merits, in the territory described in A, B, or C above or in a settlement we agree to. Page 2 of2 G-144156-A (ED. 02102) Incorporates materials copyrighted by Insurance Services Offices, reprinted with their permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ECONOMIC AND TRADE SANCTIONS CONDITION The following condition is added to the Policy: ECONOMIC AND TRADE SANCTIONS CONDITION In accordance with laws and regulations of the United States concerning economic and trade embargoes, this policy is void from its inception with respect to any term or condition of this policy that violates any laws or regulations of the United States concerning economic and trade embargoes including, but not limited to the following: 1. Any insured under this Policy, or any person or entity claiming the benefits of such insured, who is or becomes a Specially Designated National or Blocked Person or who is otherwise subject to U.S. economic or trade sanctions; 2. Any claim or suit that is brought in a Sanctioned Country or by a Sanctioned Country Government, where any action in connection with such claim or suit is prohibited by U.S. economic or trade sanctions; 3. Any claim or suit that is brought by any Specially Designated National or Blocked Person or any person or entity who is otherwise subject to U.S. economic or trade sanctions; 4. Property that is located in a Sanctioned Country or that is owned by, rented to or in the care, custody or control of a Sanctioned Country Government, where any activities related to such property are prohibited by U.S. economic or trade sanctions; or 5. Property that is owned by, rented to or in the care, custody or control of a Specially Designated National or Blocked Person, or any person or entity who is otherwise subject to U.S. economic or trade sanctions. As used in this endorsement a Specially Designated National or Blocked Person is any person or entity that is on the list of Specially Designated Nationals and Blocked Persons issued by the U.S. Treasury Department's Office of Foreign Asset Control (O.F.A.C.) as it may be from time to time amended. As used in this endorsement a Sanctioned Country is any country that is the subject of trade or economic embargoes imposed by the laws or regulations of the United States of America. G-145184-A (Ed. 6/03) CNA fur An tlle Commitments You Make<3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - SILICA This endorsement modifies insurance provided under the following: COMMON POLICY CONDITIONS GENERAL LIABILITY COVERAGE PART I. THE GENERAL LIABILITY COVERAGE PART IS MODIFIED AS FOLLOWS: The Following is added to Section II. EXCLUSIONS: We will not defend. or pay under this Coverage Part for: 1. 2. II. injury arising in whole or in part out of the actual, alleged or threatened respiration or ingestion at any time of silica; or damage arising in whole or in part out of the actual. alleged or threatened presence of silica. THE COMMON POLICY CONDITIONS ARE MODIFIED AS FOLLOWS: The following is added to Section XVIII., Definitions: Silica means the chemical compound silicon dioxide (Si02) in any form. including dust which contains silica. G-147290-A (Ed. 3/04) Page 1 of 1 CNA For All the CommitmentsYou Makeli> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - ASBESTOS This endorsement modifies insurance provided under the following: COMMON POLICY CONDITIONS GENERAL LIABILITY COVERAGE PART I. THE GENERAL LIABILITY COVERAGE PART IS MODIFIED AS FOLLOWS: The Following is added to Section II. EXCLUSIONS: We will not defend. or pay under this Coverage Part for: 1. injury or damage arising in whole or in part out of the actual. alleged or threatened exposure at any time to asbestos; or 2. any loss. cost or expense that may be awarded or incurred: a. b. II. by reason of a claim or suit for any such injury or damage; or in complying with a governmental direction or request to test for, monitor, clean-up, remove, contain or dispose of asbestos. THE COMMON POLICY CONDITIONS ARE MODIFIED AS FOLLOWS: The following are added to Section XVIII., Definitions: Asbestos means the mineral in any form whether or not the asbestos was at any time: 1. airborne as a fiber, particle or dust; 2. contained in or formed a part of a product, structure, or other real or personal property; 3. carried on clothing; 4. inhaled or ingested; or 5. transmitted by any other means. Suit means a civil proceeding in which damages because of injury or damage to which this insurance applies are alleged. Suit includes: 1. an arbitration proceeding in which such damages are claimed and to which you must submit or does submit with our consent; or 2. any other alternative dispute resolution proceeding in which such damages are claimed and to which you submit with our consent. G-147309-A (Ed. 3/04) Page 1 of 1 CNA For All Ute Commitments You MakeliD INDEX OF PROVISIONS EMPLOYEE DISHONESTY COVERAGE PART TOPIC PAGE I. Coverage Agreements A. Money. Securities and Other Property B. Welfare and Pension Plans II. Exclusions A. Wrongful Acts by Partners B. Governmental Authority C. Indirect Damage D. Legal Action Expenses E. Nuclear F. War G. Previously cancelled Employees H. Inventory shortage III. Limits of Insurance A. Each Event B. IV. Non-Cumulation Definitions Blanket Dental Practice Personal Property Employee Event - V. Financial Interest Money Securities Wrongful Act Conditions A. Policy Period B. Duties in the Event of Damage C. Damage Covered Under More than One Coverage D. Legal Action Against Us E. Consolidation/Merger F. Discovery Period G. Joint Insured H. Loss Sustained During Prior Insurance I. Loss Sustained During multiple Periods J. Other Insurance K. Records L. Recoveries M. Valuation - Settlement G-15160-B (ED 06/00) 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1/2 1 2 2 2 2 2 2 2/314 2 2 2 3 3 3 3 3 3 3 3 3/4 4 CRIME COVERAGE PART EMPLOYEE DISHONESTY Subject to all of the Common Policy Conditions, and the Definitions contained in the Property Coverage Part applicable to Building, Blanket Dental Practice Personal Property and Income, we agree that: I. COVERAGE AGREEMENTS 2. payment of damage of any type for which you are legally liable. We will pay direct compensatory damage arising from damage covered under this Coverage Part; or 3. payment of costs, fees or other expenses you incur in establishing either the existence or the amount of damage under this insurance. We will pay for damage to Covered Property caused by or resulting from a Wrongful Act committed by any of your employees engaged in your regular service, acting alone or together with others. Covered Property means the following types of property for which a Limit of Insurance is shown on the Declarations: A. Money, Securities and Blanket Dental Practice Personal Property. Such Covered property may be: 1. owned or held by you; or 2. for which you are legally liable. D. that constitutes expenses related to any legal action; E. by nuclear reaction, radiation, contamination however caused; F. This insurance is for your benefit only. It provides no rights or benefits to any other entity. B. All Welfare and Pension plans requiring employee dishonesty insurance in accordance with Section 412 of the Employee Retirement Income Security Act of 1974, commonly known as ERISA. We will pay for damage caused by any employee while temporarily outside the Coverage Territory for a period of not more than 90 days. II. EXCLUSIONS G. caused by any emp loyee who has been cancelled under similar prior insurance and not reinstated since the last such cancellation; or H. the proof of which is dependent upon: 1. Profit and loss computation. III. LIMITS OF INSURANCE A. Each Event The most we will pay for damage in anyone Event is the Limit of Insurance shown on the Declarations for: A. resulting from any Wrongful Act committed by you or any of your partners whether acting alone or together with others; 1. Money, Securities and Blanket Dental Practice Personal Property; and 2. an additional limit of $15,000 for Welfare and Pension plans. Such Limits of Insurance shall apply collectively to Covered Property wherever located. B. Non-Cumulation B. resulting from seizure or destruction of property by order of governmental authority; Regardless of the number of years this insurance remains in force or the number of premiums paid, no Limit of Insurance cumulates from year to year or period to period. C. that is an indirect result of any act or Event covered by this Coverage Part including but not limited to damage resulting from: 1. your inability to realize income that you would have realized had there been no damage to Covered Property; G-15160-B (ED 06/00) an inventory computation; or 2. We will not pay for damage: In the event of damage caused by a Wrongful Act committed by any partner or in which a partner is concerned or implicated, we will only pay for damage in excess of the Financial Interest in your partnership of the partner involved in the damage. resulting from war, whether or not declared, warlike action, insurrection, rebellion or revolution, or any related act or incident; Page 1 of 4 IV. DEFINITIONS "Blanket Dental Practice Personal Property" means any tangible property other than Money and Securities that has intrinsic value but does not include any property listed in any other Coverage Part as Property Not Covered. "Employee" means: Any natural person: "Securities" means negotiable and non-negotiable instruments or contracts representing either Money or other property and includes: A. tokens, tickets, revenue and other stamps, whether represented by actual stamps or unused value in a meter, in current use; and B. evidences of debt issued in connection with credit or charge cards, which cards are not issued by you; A. while in your service, and for 30 days after termination of such service; and but does not include money. B. whom you compensate directly by salary, wages or commissions; and "Wrongful Act" means a dishonest act committed by an employee, whether identified or not, acting alone or with others, other than you or a partner, with the intent to: C. whom you have the right to direct and control while performing services for you; D. employed by an employment contractor while that person is subject to your direction and control and performing services for you excluding, however, any person while having care, and custody of property outside your premises. E. while in the service of any Welfare or Pension plan including as an insured under this Coverage Part, as fiduciary, trustee, admin-istrator, officer or employee and any other natural person while performing acts normally performed by a fiduciary, trustee, administrator, officer or employee as defined in Title 1 of the Employee Retirement Income Security Act of 1974 or any of its amendments. A. cause you to sustain damage; and also B. obtain financial benefit, other than salaries, commiSSions, fees, bonuses, promotions, awards, profit sharing, pensions or other employee benefits earned in the normal course of employment, for: 1. the employee; or 2. V. CONDITIONS A. agent, broker, factor, commission merchant, consignee, independent contractor or representative of the same general character; or B. director or trustee except while performing acts Subject to Emp[oyee Dishonesty Condition H., we will pay only for damage that you sustain through Wrongful Acts occurring during the policy period. B. Duties in the event of Damage Common Policy Condition III. is amended to include the following: coming within the scope of the usual duties of an employee. You must also: "Event" means all damage caused by an employee or in which any employee is involved, whether the result of a single, or series of, acts. "Financial Interest" means the value of the partner's interest in your partnership prior to deducting the amount of damage caused by such partner. Such value shall be determined as of the close of business on the date of discovery of damage. 1. give us a detailed, sworn proof of damage within 120 days; C. Damage Covered Coverage under more than One Common Policy Condition XI., for the purpose of this Coverage Part, is deleted and replaced by the following: currency, coins and bank notes in current use and having a face value; and [f 2 or more coverages of this insurance apply to the same damage, we will pay the lesser of: B. travelers checks, register checks and money orders held for sale to the public. G-15160-B (ED 06/00) submit to examination under oath at our request and give us a signed statement of your answers; 2. "Money" means: A. Policy Period Common Policy Condition I. is amended to include the following: Employee does not mean any: A. any entity intended by the employee to receive that benefit. Page 2 of 4 1. the actual amount of damage; or 2. 1. the sum of the Limits of Insurance applicable to those coverages. D. Legal Action Against Us Common Policy Condition XIII. is amended to include the following: a. until 90 days after you have filed proof of damage with us; and 2. the damage would have been covered by this insurance had it been in effect when the Wrongful Act was committed or happened. unless brought within 2 years from the date you discovered the damage. 2. E. Consolidation/Merger If through consolidation or merger with, or purchase of assets of, some other entity: 1. any additional persons become employees; 2. a. Damage Covered Under This and Prior Insurance Issued by Us 1. partly by this insurance; and 2. partly by any prior cancelled or terminated insurance that we or any affiliate had issued to you or any predecessor in interest; pay us an additional premium. Discovery Period 1. If this insurance or any of its coverages is cancelled or terminated as to any of you, damage sustained by that person is covered only if discovered no later than 1 year from the date of that cancellation or termination. the most we will pay is the larger of the amount recoverable under this insurance or the prior insurance. We will pay only for covered damage discovered no later than 1 year from the end of the policy period. 2. J. If any of you or your partners or officers has knowledge of any information relevant to this insurance, that knowledge is considered knowledge of all of you. 2. We will not pay more for damage sustained by more than one of you than the amount we would pay if all the damage had been sustained by one of you. K. An employee of any of you is considered to be an employee of all of you. 3. Records You must keep records of all Covered Property so we can verify the amount of any damage. L. Recoveries 1. H. Damage Sustained During Prior Insurance G-15160-B (ED 06/00) Other Insurance This insurance does not apply to damage recoverable or recovered under other insurance or indemnity. However, if the limit of the other insurance or indemnity is insufficient to cover the entire amount of the damage, this insurance will apply to that part of the damage not recoverable or recovered under the other insurance or indemnity but not for more than the Limit of Insurance. G. Joint Insured 1. the prior insurance had it remained in effect. If any damage is covered: give us written notice within 90 days thereafter; and b. I. this insurance as of its effective date; or b. you acquire the use and control of any additional premises; any insurance afforded for employees or premises also applies to those additional employees and premises, but only if you: The insurance under this Condition is part of, not in addition to, the Limits of Insurance applying to this insurance and is limited to the lesser of the amount recoverable under: a. or F. this insurance became effective at the time of cancellation or termination of the prior insurance; and b. You may not bring any legal action against us involving damage: 1. If you, or any predecessor in interest, sustained damage during the period of any prior insurance that you could have recovered under that insurance except that the time within Which to discover damage had expired, we will pay for it under this insurance, provided: Page 3 of 4 Any recoveries, less the cost of obtaining them, made after settlement of damage covered by this insurance will be distributed as follows: a. b. 2. c. to you, until you are reimbursed for any damage that you sustain that exceeds the Limit of Insurance; then to us, until we are reimbursed for the settlement made. (1) actual cash value of the property on the day the damage was discovered; Recoveries do not include any recovery: a. b. (2) cost of repairing the property or premises; or from insurance, suretyship, reinsurance, security or indemnity taken for our benefit; or (3) cost of replacing the property with property of like kind and quality. of original securities after duplicates of them have been issued. We may, at our option, pay the actual cash value of the property or repair or replace it. M. Valuation - Settlement 1. Subject to the applicable Limit of Insurance provision we will pay for: a. b. If we cannot agree with you upon the actual cash value or the cost of repair or replacement, the value or cost will be determined by arbitration. damage to Money for not more than its face value. In the event of damage to Money before the amount has been counted and recorded by you, payment shall not exceed such amount as is corroborated by reasonable estimates satisfactory to us. 2. We may, at our option, pay for damage: a. damage of Securities for not more than their value at the close of business on the day the damage was discovered. We may, at our option: in the Money of the country in which the damage occurred; or b. in the United States of America dollar equivalent of the Money of the country in which the damage occurred determined by the rate of exchange on the day the damage was discovered. 3. In compliance with Title 1 of the Employee Retirement Income Security Act of 1974, or any of its amendments, payment by us under this Coverage Part to the first named insured shall be held for the use and benefit of any Welfare or Pension plans sustaining damage. If Money, Securities or Blanket Dental Practice Personal Property of two or more Welfare or Pension plans are commingled, recovery under this Coverage Part for damage to such Money, Securities or Blanket Dental Practice Personal Property shall be shared by such plans on a pro rata basis in accordance with the amount of coverage each plan is required to carry by the act. 4. (1) pay the value of such Securities or replace them in kind, in which event you must assign to us all your rights, title and interest in and to those Securities; Any property that we pay for or replace becomes our property. (2) pay the cost of any Lost Securities Bond required in connection with issuing duplicates of the Securities. However, we will be liable only for the payment of so much of the cost of the bond as would be charged for a bond having a penalty not exceed-ing the lesser of the (a) value of the Securities at the close of business on the day the damage was discovered; or (b) Limit of Insurance. G-15160-B (ED 06/00) damage to Blanket Dental Practice Personal Property other than Money and Securities or damage to the premises for not more than the: Page 4 of 4 CNA FOT All the. Conunitmcntli You }lako~ CLAIMS MADE SPECIAL EXTRA EXPENSE COVERAGE ENDORSEMENT HEALTH CARE PROVIDER IMPORTANT NOTICE COVERAGE UNDER THIS ENDORSEMENT ONLY APPLIES IF (1) YOU FIRST TEST HIV POSITIVE DURING THIS COVERAGE PERIOD, (2) THE CLAIM IS REPORTED TO US DURING YOUR LIFETIME AND (3) THE CLAIM IS ALSO REPORTED TO US DURING THIS COVERAGE PERIOD, UNLESS THE CLAIM REPORTING PERIOD HAS BEEN EXTENDED UNDER CONDITION VI. B. PLEASE READ THIS ENDORSEMENT CAREFULLY TO SEE WHAT OTHER LIMITATIONS AND CONDITIONS MAY APPLY TO YOUR CLAIM. I. COVERAGE AGREEMENT We agree with You to pay the Amount of Extra Expense Coverage as a result of You as a Named Insured testing positive for Human Immunodeficiency Virus, hereinafter referred to as "HIV", during the Coverage Period subject to the following terms and conditions. This must be the first time You tested positive for HIV. II. AMOUNT OF EXTRA EXPENSE COVERAGE The amount we will pay You under this endorsement shall be as follows: Physicians, Surgeons & Dentists named on the Declarations $150,000 per named insured All other health care providers named on the Declarations $ 25,000 per named insured The payment of this amount shall exhaust coverage under this endorsement, and no further amounts shall be recovered. Upon receipt of proof of loss and verification by us, we shall pay the applicable sum due to You. III. ENDORSEMENT EXCLUSIONS We will not pay, under this Coverage for any claim arising out of: A. Clinical Testing with a positive result for HIV prior to the effective date of this endorsement. B. Any act by You where You intentionally infect yourself with HIV. C. Taking drugs or narcotics that are not lawfully available unless prescribed by a qualified practitioner other than yourself and taken in accordance with the prescription. G-16856-899 (Ed. 02/92) 1 CLAIMS MADE IV. ADDITIONAL POLICY EXCLUSIONS We agree with You that when a claim is reported under this endorsement or under any Special Extra Expense Coverage Endorsement on a preceding policy, the policy to which this endorsement is attached is amended to include the following additional exclusion: We will not defend or pay under this Coverage Part for injury or damage resulting from the transmission by You of the Human Immunodeficiency Virus, "HIV", or any sickness, illness, disease or death at any time resulting therefrom which is contributed to, caused or exacerbated by the HIV. V. DEFINITIONS A. "You" for purposes of this endorsement means the Health Care Provider specifically named in the Declarations. "You" does not mean any locum tenens. "You" does not include anyone for whose professional acts or omissions You are legally responsible unless specifically named in the Declarations. B. "Coverage Period" for purposes of this endorsement is the Policy Term or Period shown in the Declarations. If this endorsement is issued after the inception of the Policy Term or Period, the effective date of this endorsement shall be the effective date stated at the end of this endorsement. C. "Clinical Testing" shall mean a blood specimen drawn from You by a qualified laboratory during the Coverage Period, the results of which shall be determined by accepted clinical practice prevailing at the time of diagnosis. A positive result for HIV must be established by a double positive enzyme-linked immunosorbent assay test and confirmed by a positive Food and Drug Administration approved Western Blot assay test, or by a positive result under an HIV test that is considered reliable by the Federal Centers for Disease Control. VI. CONDITIONS A. A claim under this endorsement is considered reported when You give written notice to us by registered or certified mail during Your lifetime of the positive result of a Clinical Testing diagnosing HIV during the Coverage Period, and supply a copy of the diagnosis and test results. This notice must be received by us within sixty (60) days of the date of the Clinicat Testing. You must also complete the Special Extra Expense Coverage Questionnaire supplied by us. B. Any claim reported to us outside of this Coverage Period will not be valid under this endorsement, except in the event that You have sent a blood specimen, drawn before or on the expiration date, for Clinical Testing, and such results of this Clinical Testing are unknown at the expiration date of coverage under this endorsement. In such an event You shall have thirty (30) days after the expiration date in which to report a claim under this endorsement in writing to us. C. Reporting a claim under this endorsement shall give us the right of access to all Your personal medical records, tests and reports, wherever located. Failure to provide access to this information shall be deemed a waiver of right to benefits under this endorsement. G-16856-B99 (Ed. 02/92) 2 CLAIMS MADE D. If a claim is reported under this endorsement, we shall have the right to require such further Clinical Testing as may be necessary, at a qualified laboratory of our choice, to confirm the diagnosis, such tests to commence within a reasonable period of time after the claim is reported. If the HIV diagnosis is confirmed, the Amount of Extra Expense Coverage will be paid to You by us after receipt of such confirmation. E. When a claim is reported under this endorsement and the policy to which this endorsement is attached is amended by Section IV, ADDITIONAL POLICY EXCLUSION, an unlimited extension of the claim reporting period is provided for HIV claims arising out of medical professional services rendered prior to the date a claim is reported under this endorsement and subsequent to the Prior Acts date stated on the Declarations. The Limits of Liability applicable to this claim reporting period shall be equal to the Limits of Liability stated on the Declarations. VII. CANCELLATION OR NON-RENEWAL If the policy to which this endorsement is attached is canceled or non-renewed then the coverage under this endorsement shall terminate at the same date as the policy non-renewal or termination date. In such circumstance, in the event that the results of a Clinical Testing on blood drawn during the Coverage Period and before the cancellation or non-renewal date are unknown at the cancellation or non-renewal date of this endorsement, You shall have an additional thirty (30) days after the cancellation or non-renewal date of this endorsement, You shall have an additional thirty (30) days after the cancellation or non-renewal date of this endorsement in which to make a written report of a claim to us. Any blood drawn from You for Clinical Testing after the cancellation or non-renewal date is excluded as the basis of a claim under this endorsement. This endorsement is a part of your policy and takes effect on the effective date of your policy, unless another effective date is shown below. Must Be Completed ENDT. NO. POLICY NO. Complete Only When This Endorsement Is Not Prepared wi h the PoliayOr Is Not to be Effective with the Policy ISSUED TO EFFECTIVE DATE OF THIS ENDORSEMENT Countersigned by _ _~~~~~_~~_ __ Authorized Representative CNA For AlitheCornmitmentsYou Makc~ Washington Amendatory Endorsement PROFESSIONAL LIABILITY COVERAGE PART Dentists/Oral Surgeons We agree with you that Section I. COVERAGE AGREEMENTS, is amended as follows: 1. The last paragraph of sub-item 4., is deleted and replaced with the following: The duty to defend ends by payment of the policy limits pursuant to, or in furtherance of, a judgement or settlement with, or on behalf of, the injured party, or by consent of the insured. We have no duty to and will not defend any claims not covered by this Coverage Part. 2. Sub-item 5., is amended to include the following: 5. We will also provide defense coverage if you become subject to a state regulatory "civil" investigation. This investigation must be the outcome of injury or damage resulting from a dental incident otherwise covered under this policy. In such case, we will pay your attorney fees, costs, expenses and select legal counsel. You must provide us with written notice of any state regulatory authority investigation: a. within the current policy period, plus five (5) days mailing time; and b. within 30 days after you have received notice of any investigation by the state regulatory authority. Your failure to comply with the above reporting conditions will make this endorsement voidable at our sole option. All other provisions of this policy remain unchanged. Insured Name Policy Number Effective date of this endorsement Countersigned By: _ _-:-c:---:--;--;---;-_ _ Authorized Agent G-17739-B46 (ED 03/01) CNA For All the Commitments You Malw~ INSURANCE COVERAGE COMMON POLICY CONDITIONS I. C. immediately forward all documents which you receive in connection with the claim to us; D. fully cooperate with us or our designee in the making of settlements, the conduct of suits or other proceedings, enforcing any right of contribution or indemnity against another who may be liable to you because of injury or damage. You shall attend hearings and trials, assist in securing and giving evidence, and obtaining the attendance of witnesses; and E. refuse, except at your own cost to voluntarily make any payment, assume any obligation or incur any expense other than reasonable medical expenses incurred at the time of the event. Policy Period; Coverage Territory We are providing insurance under this policy: A. beginning at 12:01 A.M. and ending at 12:01 A.M. during the policy period shown on the Declarations; and B. including any prior acts period if stated on the Declarations as applicable; C. within the coverage territory. II. Your Duties As The First Named On The Declarations When there are more than one of you named in this policy, the first of you named, on behalf of all others, will be: A. authorized to make changes in the terms of this policy with our consent; B. the payee of any premiums we refund; C. responsible for: 1. the payment of all premiums due; 2. keeping records of the information we need for premium computation, and sending us copies at such times as we may request; and 3. notifying us that you want to cancel this policy. III. IV. Separation of Insureds This policy applies separately to each of you against whom a claim is brought except with respect to: A. the limits of liability; and B. any of your duties as the first named on the Declarations V. Inspections and Surveys We have the right but are not obligated to: A. make inspections and surveys at any time; B. Give you reports on the conditions we find; C. recommend changes; or D. conduct loss control and prevention activity. Your Duties If there is a claim or you reasonably think there will be, you must do the following: A. notify us and your insurance agent in writing as soon as possible; B. specify the names and addresses of the injured people and any witnesses. Provide us with information on the time, place and nature of the event; Any inspections, surveys, reports, or relate only to recommendations insurability and the premiums to be charged. We do not: A. make safety inspections; G·41500·C (ED 01/90) Page 1 B. undertake to perform the duty of any entity to provide for the health and safety of workers or the public; nor C. warrant that conditions: 1. are safe or healthful; or 2. comply with laws, regulations, codes or standards. This provision applies not only to us, but also to any rating, advisory, rate service, or similar organization which makes insurance inspections, surveys, reports, recommendations, or gives loss control or prevention advice. VI. Examination Records of Your Books VIII. XI. XII. Under More Than One Transfer Of Rig his Of Recovery If any entity for whom we make payment under this policy has rights to recover amounts from another, those rights are transferred to us to the extent of our payment. That entity must do everything necessary to secure our rights and must do nothing after injury or damage to impair them. XIII. Legal Action Limitation You may not bring any legal action against us concerning this policy until: Transfer of Interest A. you have fully complied with all the You must first obtain our written consent to transfer or assign this policy. If you die, the policy will continue for the remaining part of the policy period; first, for the benefit of your legal representative while acting within their duties as such, and second, for the benefit of anyone having proper temporary custody of your property until a legal representative is appointed. IX. Insurance Coverage If more than one of this policy's coverages apply to the same injury or damage, we will not pay more than the limit of liability applicable to the most specifically described coverage, or, the actual amount of the injury or damage, whichever is less. Changes Notice to any of our agents or knowledge possessed by any such agent or any other person shall not act as a waiver or change in any part of this policy. It also will not prevent us from asserting any rights under the provisions of this policy. None of the provisions of this policy will be waived, changed or modified except by written endorsement issued to form a part of this policy. Other Insurance If you have other insurance which applies to the loss, the other insurance must pay first. It is the intent d this policy to apply to the amount of loss which is more than the limit of liability of the other insurance. We will not pay more than our limit of liability. and We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to 3 years afterward. VII. X. Concealment, Fraud provisions of this policy; and B. the amount of your obligation to pay has been decided. Such amount can be set by judgment against you after actual trial or by written agreement between you, us and the claimant. Misrepresentation, This policy is void in any case of fraud by you relating to it. It is also void if you intentionally conceal or misrepresent a material fact or circumstance concerning: A. this policy; B. any covered property; or C. your interest in the covered property or this insurance. XiV. Page 2 Any entity, or their legal representative, is entitled to recover under this policy after they have secured a judgment or written agreement. Recovery is limited to the extent of the insurance afforded by this policy. No entity has any right under this policy to include us in any action against you to determine your liability, nor will we be brought into such an action by you or your representative. If you or your estate becomes bankrupt or insolvent, it does not change any of our obligations under this policy. Premium All premium charges under this policy will be computed according to our rules and rating plans which apply at the inception of the current policy period. Premiums for this policy are payable to us in advance. They may be paid to us or our authorized representative. The first premium is due on the inception date of the policy. E. If notice is mailed, proof of mailing will be sufficient proof of notice. XVII. We will provide you with the following information relating to this and any preceding policy we have issued to you during the previous three years: You must keep accurate records of the information we will need to compute your premium. You agree to send us these records at the end of each policy period, or any other time we request them. XV. A. A list or other record of each claim, not previously reported to any other insurer, of which we were notified in accordance with these policy Condilions. We will include the date and brief description of the claim if that information was in the notice we received. B. A summary by policy year, of payments made and amounts reserved, stated separately, for each Aggregate Limit of Liability shown on the Declarations. Non-renewal We can non-renew this policy by giving written notice to the first of you named on the Declarations, at your last known address, at least 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. XVI. Amounts reserved are based on our judgment. They are subject to change and should not be regarded as ultimate settlement values. Cancellation This policy can be canceled by either the first of you named on the Declarations or us. A. The first of you named can cancel this policy at any time. To do so, you must: 1. return the policy to us or any of our authorized representatives; or 2. mail a written notice to us. telling when the cancellation is to be effective. We must receive the policy or written notice before the cancellation date. B. We can cancel this policy by giving written notice to the first of you named on the Declarations, at your last known address at least: 1. 10 days, if we cancel for nonpayment of premium; or 2. 30 days, if we cancel for any other reason; before the effective date of cancellation. C. Notice of cancellation will state the effective date of cancellation. This policy will end on that date. D. If we cancel, the refund will be prorata. If you cancel, the refund may be less than pro-rata. The cancellation will be effective even if we have not made or offered a refund. Your Right to Claim Information You must not disclose this information to any claimant or their representative without our written consent. If we cancel or elect not to renew this policy for any reason other than nonpayment of premium, we will provide such information no later than 30 days before the date of policy termination. In other circumstances, we will provide this information only if we receive a written request from you within 60 days after the end of the policy period. In this case, we will provide this information within 45 days of receipt of the request. We compile claim information for our own business purposes and exercise reasonable care in doing so. In providing this information to you we make no representations or warranties to insureds, insurers, or others to whom this information is furnished by or on your behalf. Cancellation or non-renewal will be effective even if we inadvertently provide inaccurate information. XVIII. Page 3 Definitions If any of the following terms are used in this policy, they will only have the meaning shown. A. physical injury to tangible property, including all resulting loss of Lise of that property; or B. loss of use of tangible property that is not physically injured. "Advertising Injury" means injury arising out of one or more of the following: "Hazardous Properties" includes radioactive, toxic or explosive properties. A. oral or written publication of material that: 1. slanders or libels an entity or disparages an entity's goods, products or services; or 2. violates an entity's right of privacy; B. misappropriation of advertising ideas or style of doing business; or C. infringement of copyright, title or slogan. "Hostile Fire" means one which becomes uncontrollable or breaks out from where it was intended to be. "Impaired Property" means tangible property other than your product or your work that cannot be used or is less useful because: A. it incorporates your product or your work that is known or thought to be defective, deficient, inadequate or dangerous; or B. you have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by: A. the repair, replacement, adjustment or removal of your product or your work; or B. your fulfilling the terms of the contract or agreement. "Anti -trust law" means those laws listed in: A. Title 15, Section 12, of the United States Code; B. the Federal Trade Commission Act; and C. any similar state law. "Auto" means a land motor vehicle, trailer or semi-trailer designed for use on public roads. Any attached apparatus or machinery is included. Mobile equipment is not included. "Injury" means bodily injury, sickness, disease, mental or emotional distress sustained by a person. Also included is death at any time as a result. "Claim Expenses" means: A. fees charged by an attorney we designate; and B. all other fees, costs and expenses which result from the investigation, adjustment, defense and appeal of a claim. "Insured Contract" means: A. a lease of premises; B. a sidetrack agreement; C. an easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad; D. an obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality. E. an elevator maintenance agreement; or F. the part of any other contract or agreement pertaining to your business, including an indemnification of a municipality in connection with work performed for a municipality, under which you assume the tort liability of another party to pay for injury or damage to a third party if the contract or agreement is made prior to the injury or damage. These expenses must be incurred by us or by you with our prior written consent. "Claim Expenses" does not include: A. salary charges of our regular employees or Company officials; or B. fees and expenses of independent adjusters. "Coverage Territory" means: A. the United States of America, including its territories and possessions; B. Puerto Rico; and C. Canada. "Damage" means: Page 4 "Insured Contract" does not mean that part of any contract or agreement: D. maintained primarily to provide mobility to: 1. road construction or resurfacing, or other construction equipment, whether or not sel~propelled; or 2. air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment, or devices used to raise or lower workers, if not self-propelled; or E. not described in A. through D.1 maintained primarily for purposes other than to carry persons or cargo. A. that indemnifies an entity for injury or damage arising out of or demolition construction operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road beds, tunnel, underpass or crossing; B. that indemnifies an architect, engineer or surveyor for injury or damage arising out of: 1. preparing, approving or failing to prepare or approve maps, drawings, OpiniOnS, reports, surveys, change orders, designs or speCifications; or 2. giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; C. under which you, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of your rendering or failure to render professional services, including those listed above and supervisory, inspection or engineering services; or D. that indemnifies any entity for damage by fire to premises rented or loaned to you. "Mobile Equipment" does not mean self-propelled vehicles: A. described in subparagraph D.2 of the definition of mobile equipment; nor B. equipment designed primarily for: 1. snow removal; 2. road maintenance, other than construction or resurfacing; or 3. street cleaning; "Named Insured" means the entity named on the Declarations of this policy as the named insured. "Non-owned Auto" means an auto not owned, registered, hired, leased or loaned to you. "Nuclear Facility" means: "Loading or unloading" means the handling of property: A. any nuclear reactor; B. any equipment or device designed or used for: 1. separating the isotopes of uranium or plutonium, 2. processing or utilizing spent fuel, A. after it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or auto; B. while it is in or on an aircraft, watercraft or auto; or C. while it is being moved from an aircraft, watercraft or auto to the place where it is finally delivered. ar 3. handling, processing or packaging waste; C. any equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in your custody at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; D. any structure, basin, excavation, premises or place prepared or used for the storage or disposal of waste. "Loading or unloading" does not mean the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, watercraft or auto. "Mobile Equipment" means any land vehicles, including any attached machinery or equipment: A. designed for use primarily off public roads; B. maintained for use solely on or next to premises you own or rent; C. that travels on crawler treads; Page 5 Nuclear Facility also includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations. by or for any of you or anyone for which you may be legally responsible. "Pollution" does not mean heat, smoke or fumes from a hostile fire. "Nuclear Reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material; With respect to injury to or of property, the word "destruction" includes all radioactive contamination of loss of use. "Products/Completed Operations Hazard" means injury or damage that happens away from premises you own or rent and arising out of your products or your work, except: destruction injury or forms of property or A. products that are still in physical possession; or B. work that has not yet completed or abandoned. your been "Source Material", "Special Nuclear Material", and "By-product Material" have the meanings given them in the Atomic Energy Act of 1954 or any or its amendments. "Pollutants" means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. "Spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor. "Pollution" means the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of pollutants; "Tort liability" means a liability that would be imposed by law in the absence of any contract or agreement. A. at or from any premises, site or location; 1. which is or was at any time: a. owned, occupied, rented or loaned to you; or b. used by or for any of you or others for the handling, storage, disposal, processing or treatment of waste. 2. on which any of you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations: a. if the pollutants are brought on or to the premises, site or location in connection with such operations by you, any contractor or subcontractor; or b. if the operations are to test for, monitor, clean up, "Waste" means any waste material: A. containing by-product material other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its source material content; and B. resulting from the operation by an entity of any nuclear facility included under the first two paragraphs of the definition of nuclear facility. "Your Premises" means A. the location described on the Declarations of this policy; B. any additional premises, used for business purposes, which may become insured under this policy, up to a maximum of 30 days; C. approaches immediately adjoining such premises. remove, contain, treat, detoxify or neutralize or in any way respond to , or assess the effects of pollutants; B. which are or were at any time transported, handled, stored, treated, disposed of, or processed as waste "Your product" means: A. Page 6 any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by; 1. you; others trading under your name; or 3. an entity whose business or assets you have acquired; and B. containers, other than vehicles, materials, parts, or equipment furnished in connection with such goods or products; C. warranties or representations made at any time with respect to the fitness, quality, durability or performance of any of the items listed above; or D. the providing of or failure to provide warnings or instructions. "Your work" will be considered completed, when, at the earliest of the following times: 2. A. all of the work called for in your contract has been completed; B. all of the work to be done at the site has been completed if your contract calls for work at more than one site; or C. that part of the work to be done at a job site has been put to its intended use by any entity other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. 'Your product" does not include vending machines or other property rented to or located for the use of others but not sold. This hazard does not include injury or damage arising out of: 'Your work" means: A. work or operations performed by you or on your behalf; and B. materials, parts or equipment furnished in connection with such work or operations; C. warranties or representations made at any time with respect to the fitness, quality, durability or performance of any of the items listed above; or D. the providing of or failure to provide warnings or instructions. A. the transportation of property, unless the injury or damage arises out of a condition in or on a \ehicle created by its loading or unloading; B. the existence of tools, uninstalled equipment or abandoned or unused materials; or C. products or operations for which the classification in this Coverage Part or in our manual of rules, includes products or completed operations. Page 7 CNA For All theConunitments You Make~ PROFESSIONAL LIABILITY COVERAGE PART DENTISTS/ORAL SURGEONS CLAIMS-MADE YOUR PROFESSIONAL LIABILITY INSURANCE IS WRITTEN ON A "CLAIMS-MADE" BASIS AND PROVIDES COVERAGE FOR THOSE CLAIMS WHICH ARE THE RESULT OF DENTAL INCIDENTS HAPPENING SUBSEQUENT TO THE PRIOR ACTS DATE, IF ANY, STATED ON THE DECLARATIONS AND WHICH ARE FIRST MADE AGAINST YOU WHILE THIS INSURANCE IS IN FORCE. NO COVERAGE EXISTS FOR CLAIMS FIRST MADE AGAINST YOU AFTER THE END OF THE POLICY PERIOD UNLESS, AND TO THE EXTENT, AN EXTENDED REPORTING PERIOD APPLIES. We are the stock insurance company named on the Declarations. Throughout this policy the words we, us and our refer to the company providing this insurance. We agree with you as follows: I. consent is being withheld, at our expense, we may request that a neutral Arbitrator decide whether your consent has been unreasonably withheld. The decision of the Arbitrator shall be binding. The selection of the Arbitrator, and the rules governing the arbitration, shall be determined according to rules promulgated by the American Arbitration Association. A finding by the arbitrator that consent has been unreasonably withheld will authorize the company to settle the claim. COVERAGE AGREEMENTS We will pay all amounts up to the limit of liability, which you become legally obligated to pay as a result of injury or damage. We will also pay claim expenses. The injury or damage must be caused by a dental incident arising out of the supplying of or failure to supply professional services by you or anyone for whose professional acts or omissions you are legally responsible. The dental incident as described above must happen on or after the prior acts date and claim therefore must be first made before the end of the policy period stated on the Declarations of this policy. Our payment of the limit of liability ends our duty to defend or settle. We have the right and will defend any claim. We will: We have no duty to and will not defend any claims not covered by this Coverage Part. 1. do this even if any of the charges of the claim are groundless, false or fraudulent; 2. investigate any claim as we feel appropriate; 3. negotiate and settle any claim; and 4. not settle any claim without your consent, which will not be unreasonably withheld. If your G-15158-E (Ed. 05/2006) Page 1 of 8 5. We will also provide defense coverage if you become subject to a state regulatory "civil" investigation. This investigation must be the outcome of injury or damage resulting from a dental incident otherwise covered under this policy. In such case, we will pay your attorney fees, costs, expenses and we will select legal counsel. You must provide us with written notice of any state regulatory authority investigation: 1. liability that you would have in the absence of the contract or agreement; 1. wilhin the current policy period; and 2. liability you assume in a contract with: 2. within 30 days after you have received notice of any investigation by the state regulatory authority. a. b. c. II. EXCLUSIONS d. We will not defend, or pay, under this Coverage Part for: A. but only as respects professional services provided by you; injury to: 1. 2. an employee of yours arising out of and in the course of employment by you; or 3. 4. the spouse, child, parent, brother, or sister of that employee as a consequence of 1. above. professional services rendered as a dentist under contract or agreement with a dentist or a provider of dental professional services; or a warranty of fitness or quality of any therapeutic agents or supplies you have furnished or supplied in connection with treatment you have performed; This exclusion applies: 1. 2. Health Maintenance Organizations; Preferred Provider Organizations; Independent Practice Associations; or Any other similar organization; whether you may be liable as an employer or in any other capacity; and D. to any obligation you have to indemnify some other entity because of such injury. injury or damage resulting from a dental incident which is also a willful violation of a statute, ordinance or regulation imposing criminal penallies; We will defend any civil suit against you seeking amounts which would be covered if this exclusion did not apply. In such case, we will pay only the fees, costs, and expenses of such defense; This exclusion does not apply: 1. to liability you assume under an insured contract; or 2. to a claim resulting from immediate dental care given to an employee after the injury andlor to a dental incident arising from your professional services to any employee. E. any liability you have as a proprietor, superintendent, director, administrative or executive officer of any: 1. B. C. any liability you assume under any contract or agreement. This exclusion does not apply to: G-15158-E (Ed. 05/2006) hospital, nursing home or sanitarium; 2. clinic with bed and board facilities; or 3. any amounts you or any entity must pay under any unemployment or Workers' Compensation, disability benefits, or other similar law; laboratory or business. This exclusion does not apply to Page 2 of 8 your professional liability arising out of laboratory facilities: 2, 1, you maintain for testing of your own patients; or 2, necessary to the practice of your specialty; 3, F, any injury, sickness, disease, death or destruction: 1, with respect to which you are also an insured under a Nuclear Energy Liability Policy issued by: a, b, c, b, Nuclear Energy Liability Insurance Association; Mutual Atomic Energy Liability Underwriters; or Nuclear Insurance Association of Canada, or would be an insured under any such policy if it had not terminated due to eXhaustion of its limit of liability; or 2, resulting from the hazardous properties of nuclear material and with respect to which: operated by or on your behalf; has been discharged or dispersed therefrom; is contained in spent fuel or waste at anytime possessed, handled, used, processed, stored, transported or disposed of by or on your behalf; or the injury, sickness, disease, death or destruction arises out of the furnishing by you of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility, If such facility is within the coverage territory, this subparagraph 3,b, applies only to injury to or destruction of property at such nuclear facility; G, b, 3, any entity is required to maintain financial protection pursuant to the Atomic Energy Act of 1954 or any of its amendments; or you are, or had this policy not been issued would be, entitled to indemnity from the United States of America or any of its agencies, under any agreement entered into by the United States of America or any of its agencies with any entity; resulting from the hazardous properties of nuclear material if: a, G-15158-E (Ed, 05/2006) H, a dental incident resulting from professional services by any dentist who is not an insured dentist. This exclusion does not apply, however, to any liability you may have as a result of such dental incident; injury or damage you expected or intended, or which a reasonable person could have expected; This exclusion does not apply to injury resulting from the use of reasonable force to protect persons or property, the nuclear material: 1, any fines, penalties, sanctions, government payments or the return or withdrawal of fees for patient treatment or any multiplication of amounts payable under this policy imposed by law; I. a, is at any nuclear facility owned or Page 3 of 8 J. any claim arising out of actual or alleged involvement in any: 1. anti-trust law violation; or 2. date if, on the inception date of this policy, you knew or had been told that it would result in a claim; or agreement or conspiracy to restrain trade; 2. This exclusion does not apply to claims arising from your activity at our request as a member of any committee, panel, or board which provides underwriting or claims advice or recommendations to us, provided your activity is within the scope of the committee's, panel's or board's established guidelines. K. which on the inception date of this policy is the subject of a: a. b. c. M. injury or damage arising out of pollution or pollutants; reported dental incident; pending claim or proceeding; or which is a paid claim. injury or damage for which you may be held liable as a result of loss of use of tangible property which has not been physically injured or destroyed if: This exclusion also applies to: 1. 1. a. b. l. arising out of a dental incident which happened: a. b. G-15158-E (Ed. 05/2006) request, demand or order that you or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants; or claim by or on behalf of a governmental authority for amounts because of testing for, monitoring, cleaning up removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of pollutants; any claim: 1. a delay in or lack of performance has been caused by or on your behalf under any contract or agreement; or 2. your products or work completed on your behalf do not meet the standards you have warranted or represented; Any loss, cost or expense arising out of any: prior to the prior acts date of this policy; after the prior acts Page 4 of8 We will cover loss of use of other tangible property if: 1. 2. N. the loss results from a sudden and accidental physical damage or destruction of your products or work completed by or on your behalf; and the products or work has been put to use by an entity other than you; amounts claimed as a result of the withdrawal, inspection, repair, replacement, or loss of use of your products. This also applies to work completed by or for you, and any property of which your products form a part. This exclusion only applies if the withdrawal from the market or use is due to a known or suspected defect or deficiency; O. any claim made against you, or any person for whose acts or omissions you are legally responsible, for any act of sexual intimacy, sexual molestation or sexual assault or any act similarly defined. C. Claim expenses are in addition to our limit of liability. D. All claims whenever made, shall be considered first made during the policy period in which the earliest claim arising out of such same or related dental incident was made, and all such claims shall be subject to the same limit of liability. E. The limits of liability shall apply separately to each of you. We will defend any civil suit against you seeking amounts which would be covered if this exclusion did not apply. In such case, we will pay only the fees, costs and expenses of such defense. P. a dental incident involving: 1. 2. Claim Expenses you, if at the time of the dental incident, you knew your state license (permanent or provisional) was suspended, revoked, terminated, not issued or fraudulently obtained, or restricted or on probationary status with respect to the specific professional services upon which the claim is based; or the prescribing or dispensing of controlled substances by you or anyone for whose acts you are legally responsible if the required license or registration to prescribe or dispense such controlled substances was not in effect. IV. DEFINITIONS "Claim" means the receipt of a demand for money or services, naming you and alleging a dental incident. "Claim" also means a dental incident which you report to us during the policy period which might result in a claim. The report of such dental incident must include: the date, time and place of the incident; B. what happened and what professional services you performed; C. the type of claim you anticipate; and Each Claim D. The limit of liability stated for each claim is the limit of our liability for all injury or damage arising out of, or in connection with, the same or related dental incident. III. A. the name and address of the injured party, and of any witnesses. All claims arising out of the same dental incident will be considered as having been made at the time the first report was made. LIMITS OF LIABILITY A. B. "Damage" means: Aggregate Subject to provision A. above, the total limit of our liability for all injury or damage shall not exceed the limit of liability stated as aggregate. All dental incidents for which claims are made during the policy period are included. The aggregate limit of liability applies to each annual policy period. G-15158-E (Ed. 0512006) Page 5 of 8 A. partial or total physical damage to tangible property. Such damage must happen on or after the prior acts date and during the policy period prior to expiration. Loss of use of damaged property is also included; B. loss of use of undamaged property. This loss of use must be caused by a dental incident during the policy period. "Insured Dentist" means the dentist named on the Declarations. "Dental Incident" means any act, error or omission in the supplying of or failure to supply professional services by you. This includes your responsibility for anyone acting under your direction or control, or for whose acts you are legally liable. We also include your professional services as a member of a formal accreditation, standards review or other professional board or committee related only to a professional dental society or a hospital. "Nuclear Material" means source material, special nuclear material or byproduct material. "Prior Acts date" means the date stated on the Declarations that is either: "Independent Contractor" means a person or entity who would be classified as such under the IRS definition. "Injury" as defined in the General Conditions, shall also include the following: A. malicious prosecution; B. false arrest, detention, imprisonment; a date concurrent with the effective date of the policy; or B. "Extended Reporting Period" means the time after the policy period, for reporting claims due to a dental incident. The dental incident must occur on or after the prior acts date and before the end of the policy period. A. a particular date other than the effective date of the policy upon which we and you ag ree that policy coverage will be applicable. "Professional Services" means those services for which you are licensed, trained and qualified to perform in your profession as a dentist. Professional Services also includes your activities as a member of a formal accreditation, standards review or other professional board or committee related only to a professional society or hospital. "Retire" means the complete withdrawal from the practice of dentistry. "Totally and permanently disabled" means that you have become so disabled, as a result of injury or disease, as to be wholly prevented from performing work or engaging in your own occupation for remuneration or profit. Such a condition must have existed continuously for not less than six months and must be expected to be continuous and permanent. C. wrongful entry or eviction or other invasion of the right of private occupancy; D. a violation of an individual's right to privacy; E. oral or written publication of material that: "You" or "Your" means: 1. slanders or libels an entity or disparages an entity's goods, products or services; or A. the entity named on the Declarations of this policy as the named insured; 2. violates a person's right of privacy; B. any dentist who becomes a partner, stockholder, or employee during the policy period provided that within 30 days after becoming a stockholder, partner, or employee: F. the performance of or failure to perform autopsies; G. testimony given at or arising out of inquests; and H. advertising injury. Page 6 of 8 you notify us of such appointment, election, ownership, or employment; 2. G-15158-E (Ed. 0512006) 1. on the date you notify us, all other dentists who are partners, officers, shareholders, or employees are named in this policy; and 3. such dentist immediately submits a completed application to us which we approve; we will give you this extended reporting period coverage at no charge. c. You or your estate must within 60 days after the end of this policy write to us telling us the coverage is wanted. We also require: any of your employees other than a dentist, but only while acting within the scope of their duties as such; or D. V. and are 55 years or older and have been continuously insured by us for at least the immediately preceding 5 years. any independent contractor dental hygienist of a named insured, but only while acting within the scope of one's duties related to the practice of your profession under sole direction or supervision of the named insured. 1. written proof of the date of your death; or 2. written proof of your total and permanent disability, including the date it occurred, certified by your attending physician. EXTENDED REPORTING PERIOD A. You agree to submit to medical examination(s) by any physician(s) we designate if requested. Termination If this policy is terminated for any reason other than failure to pay the premium, if such unpaid premium is paid in full and extended reporting period premium is paid in advance, you have the right to an extended reporting period, except those defined under you, C. and D. above. C. A prior acts date once established cannot be changed except at your written request approved by us in writing prior to that change being effective. To use this right, you must: 1. 2. B. write to us within 60 days of the termination telling us you want the extension; and pay the premium to us promptly when due. The premiums will be developed from the rules, rates, and rating plans in effect at the inception of the last policy period. VI. FIRST AID SUPPLEMENT A. If you: die or become totally and permanently disabled during the policy period; or Coverage We will reimburse you up to $5,000 each person for reasonable first aid expenses incurred by your patients and paid by you, for emergency medical care caused by a dental incident. We will not make any payment under this supplement without your consent. Death, Disability, or Retirement 1. The limits of liability stated under this policy at the time of termination, death, disability, or retirement will be the limits of liability applying to the extended reporting period. B. Exclusions We will not pay for first aid expenses: 2. retire during the policy period 1. G-15158-E (Ed. 05/2006) Page 7 of 8 for services provided by: VII. SPECIAL CONDITIONS a. b. you; or any entity under contract with you, to provide such services. The following Conditions apply in addition to the Common Policy Conditions. A. 2. 3. C. for any obligation you or any entity has under any unemployment or Worker's Compensation, Disability Benefits, or other similar law; or caused by the failure to render professional services. This policy applies to dental incidents taking place anywhere in the world; provided, however, that claim is made and suit is brought against you in the coverage territory. B. Special Conditions/Definitions 1. As soon as practicable, the injured person, or someone on their behalf, shall give us written proof of claim for first aid expenses, under oath if required. If we request, the injured person shall execute authorization to enable us to obtain medical reports and copies of records. The injured person will also submit to physical examinations by physicians selected by us. The examinations will be made when, and as often as we may reasonably require. 2. We may pay the injured person, or any entity rendering the services. However, payment will not imply an admission of liability. 3. First aid expenses means medical aid at the time of the accident, and, if incurred within 12 months of the accident, necessary: a. b. G-15158-E (Ed. OS/2006) medical, surgical, x-ray and dental services, drugs, medical and surgical supplies, including prosthetic devices; and ambulance, hospital, professional nursing and funeral services. Page 8 of 8 Territory Your Duty A claim for injury or damage is considered first made when you first receive notice of the claim. The notice must be given to us immediately and within the policy period or within 10 days after its expiration or termination. All claims arising out of the same dental incident will be considered as having been made at the time the first claim is made. C. Liberalization If we make any revision that would broaden the coverage under this Coverage Part without additional premium within 60 days prior to or during the policy period, the broadened coverage will immediately apply to this Coverage Part. CNA For A U the Commlt.ments You ~Iake· Attached to Policy Number: _ _ _ __ WASHINGTON EMPLOYMENT PRACTICES LIABILITY DEFENSE COVERAGE AMENDATORY ENDORSEMENT IMPORTANT NOTICE: THIS AMENDATORY ENDORSEMENT IS WRITTEN ON A "CLAIMS MADE" BASIS AND, WITH RESPECT TO CLAIMS WHICH ARE FIRST MADE AGAINST YOU WHILE THIS POLICY IS IN FORCE OR DURING ANY EXTENDED REPORTING PERIOD, ALLEGING WRONGFUL APPLICABLE EMPLOYMENT PRACTICES, PROVIDES COVERAGE ONLY FOR CERTAIN DEFENSE COSTS. NO COVERAGE IS PROVIDED FOR AWARDS, JUDGMENTS, SETTLEMENTS OR OTHER MONETARY SUMS RELATED TO SUCH CLAIMS. READ ALL TERMS OF THIS AMENDATORY ENDORSEMENT CAREFULLY. Prior Acts Date of this Amendatory Endorsement: (See Attached Dentist Schedule) Limits of Defense Coverage Payable By Us: $25,000 Each Claim $25,000 Annual Aggregate Per schedule under II. C. Each Claim Co·Payment: As a condition precedent to the availability of any defense coverage under this amendatory endorsement, the payment of the premium must be made when due. Subject to the terms of this amendatory endorsement, and the terms and conditions of the policy to which this endorsement is attached, we agree with you as follows: I. amendatory endorsement you did not know, or could not have reasonably foreseen that such wrongful employment practice would give rise to a claim. In such case, we will pay, subject to the limits of defense coverage stated above, and your copayment obligations described herein, and all other terms of this amendatory endorsement, the fees, costs and expenses of such defense. We will also select and assign defense counsel to defend the claim made against you. COVERAGE AGREEMENTS A. We have the right to and will defend you and we will pay claim expenses incurred on your behalf in the defense of any claim not otherwise excluded under this coverage part, alleging a wrongful employment practice against you which has been asserted by an employee as a result of a wrongful employment practice, even if the claim is groundless, false or fraudulent, provided that at or prior to the prior acts date of this 0-30015-046 (Ed. 05/05) Page 1 of 8 B. The wrongful employment practice 1. allow the attorney assigned by us must begin on or after the prior acts date of this amendatory endorsement and a claim must be first made against you after the prior acts date of this amendatory endorsement and reported to us prior to the end of the policy period stated on the policy Declarations and any applicable extended reporting period. to represent you to withdraw from representing you; C. All claims, whenever made, arising out of, or in connection with, the same or related wrongful employment practices, shall be considered to have been first made during the policy period in which the earliest claim arising out of such wrongful employment practice was made, and all such claims shall be subject to the same limits of defense coverage. 2. do nothing to impede or prohibit that attorney from withdrawing from your representation; and 3. cooperate with us and with that attorney to facilitate the withdrawal. II. LIMITS OF DEFENSE COVERAGE A. Each Claim The "each claim" limit of defense coverage stated above is the maximum we will pay for all claim expenses arising out of, or in connection with, the same or related wrongful employment practices, regardless of the number of you, claims or claimants. The limit of defense coverage applicable to "each claim" applies collectively to all persons or entities covered under the definition of you. The "each claim" limit of defense coverage applies regardless of the number of persons or entities who are covered under this policy. D. We have no duty to defend you or to pay claim expenses which are excluded from coverage under this amendatory endorsement. E. After you report a claim to us alleging a wrongful employment practice, and subject to all other terms of this amendatory endorsement, we will appoint an attorney to defend you. The attorney assigned by us to defend you will continue to be paid by us, subject to your co-payment obligations described herein, until our payment of claim expenses equals the limits of defense coverage. F. Once our payment of claim expenses equals the limits of defense coverage, you will be responsible for the payment of all further fees and expenses, including those of any attorney who thereafter may represent you. If you choose either not to continue to be represented by the attorney we originally assigned to represent you or you fail to agree with that attorney on the payment of future fees and expenses, you will: B. Annual Aggregate The total limit of our liability for all claim expenses for which claims are made during the policy period shall not exceed the "annual aggregate" limit of defense coverage. The "annual aggregate" limit applies to each annual policy period. The "annual aggregate" limit of defense coverage applies collectively to all persons or entities covered under the definition of you, regardless of the number of persons or entities who are covered under the policy. C. Co-Payment You will share with us in the payment of all claim expenses, up to the applicable limits of defense coverage as follows: D-30015-D46 (Ed. 05/05) Page 2 of 8 Claim Expenses Your Co-payment Our Payment % of each $ of the 0% First $5000 ~O % of each $ of the Next $30 000 $10,000 $20,000 Total ffi35,000 ffi10,000 state or local governmental body whose purpose is to address wrongful employment practices. §25,000 33.33% 100'% ~5,000 "Claim" does not include criminal: 66.67% You shall be billed directly for your co-payment and you agree to pay those amounts when due. You shall reimburse us within 30 days of notice of payment on your behalf by us for any amounts we have paid which are your co-payment obligation. 1. 2. indictments; 3. investigations; or 4. proceedings of any kind or nature. B. "Claim Expenses" means: 1. fees charged by an attorney Failure to satisfy your co-payment obligation under this provision may result in cancellation of your coverage. III. charges; selected and assigned by us to defend you; and 2. SPECIAL DEFINITIONS The definitions set forlh below, in addition to those definitions set forth in the policy, are applicable to this amendatory endorsement. To the extent there is any inconsistency between the definitions in the policy and the definitions of this amendatory endorsement, the definitions set forth below control, but only with respect to the coverage provided under this amendatory endorsement and for no other purposes whatsoever. "Claim Expenses" shall not include: 1. any awards, judgments, settlements or other monetary sums, including, but not limited to, court costs or attorneys' fees, paid or payable to an employee in connection with or on account of a claim; A. "Claim" means any: 1. 2. 3. all other reasonable fees, costs and expenses incurred or authorized by the attorney we select and assign to defend you, related to the investigation, adjustment and defense of a claim. demand for money or other relief by an employee naming you and alleging a wrongful employment practice; 2. proceeding initiated against you by an employee alleging a wrongful employment practice before any court, governmental body, or arbitrator or arbitration panel, which is legally authorized to render an enforceable civil judgment, award or order for money damages; or payment of insurance plan benefits claimed by or on behalf of retired employees, or that a claimant would have been entitled to as an employee had you provided the claimant with a continuation of insurance; 3. any fees, costs or expenses incurred or authorized by you, or anyone acting on your behalf, without our prior written consent; or 4. any claim expenses charged by an attorney who we did not assign to defend a claim asserted proceeding initiated against you by an employee before the United States Equal Employment Opportunity Commission or other D-30015-D46 (Ed. 05/05) Page 3 of 8 1. submission to such conduct is against you, unless we agreed in writing to pay these claim expenses before they were incurred. either implied or stated to be a term or condition of employment, or a factor in evaluating the individual's job performance, eligibility for promotion, eligibility for an increase in compensation or any other component of employment; or C. "Discrimination" means a termination of an employment relationship, a demotion, a failure or a refusal to hire or to promote, a payment of wages and/or of benefits, an assignment of job duties, of job responsibilities and/or of hours of work, or an assignment of supervisor(s), and/or an application of your employment policies or procedures which is motivated in whole or in part by the employee's color, race, sex, national origin, sexual orientation or preference, age, religion, creed, status as an individual with a disability (as defined in the Americans with Disabilities Act of 1990 including any amendments thereto or as determined by any court ruling), and/or pregnancy. D. "Employee" means an individual whose service or work is or was engaged and directed on a daily basis by you. This includes current or former full-time or part-time employees, current or former supervisory employees, and applicants for employment. 2. such conduct interferes either directly or indirectly with an individual's work performance by creating a hostile, offensive or intimidating environment. G. "Retire" means the complete cessation of performing work or engaging in your own occupation. H. "Supervisory Employees" means any employee of yours who has the authority to employ, promote, demote, terminate employment, grant salary increases, direct the work of, discipline, and/or evaluate the performance of other employees of yours. I. "Employee" does not mean seasonal or temporary workers, volunteers, owners, partners, shareholders or members of the named insured. "Totally and permanently disabled" means that you have become so disabled, as a result of injury or disease, as to be wholly prevented from performing work or engaging in your own occupation. Such a condition must have existed continuously for not less than six months and must be expected to be continuous and permanent. E. "Extended Reporting Period" means the time after the policy period for reporting claims due to an alleged wrongful employment practice. The claim must occur on or after the prior acts date and before the end of the policy period, and coverage is otherwise subject to all limitations and exclusions of this amendatory endorsement. J. "Wrongful Employment Practice" means one or more of the following alleged acts, insofar as they arise out of an employee's employment with you: discrimination, sexual harassment, wrongful termination, breach of any employment agreement, breach of the implied covenant of good faith and fair dealing, misrepresentation, equal pay violations, invasion of privacy, defamation, negligent or intentional infliction of emotional distress,retaliation, and/or any other violation of any federal, state or local F. "Sexual Harassment" means unwelcome sexual advances, requests for sexual favors, or verbal conduct or physical contact of a sexual nature when: 0-30015-046 (Ed. 05/05) Page 4 of 8 statute or ordinance relating to the above types of claims. K. "Wrongful Termination" means termination of an employment relationship in a manner which is in violation of any law or in breach of any employment agreement. C. alleging any wrongful employment practice which began before the prior acts date of this amendatory endorsement; D. of which you gave written notice, or were required to have given written notice, before the issuance of this amendatory endorsement to any insurer under any other policy in force prior to this policy; l. "You" or "Yours" means: 1. the named insured; 2. if the named insured is an individual, the person designated, but only with respect to the conduct of a business of which that individual is a sole proprietor; and 3. IV. any of the named insured's owners, executive officers, partners, shareholders of professional corporations, members of limited liability corporations, supervisory employees or members of the board of directors, trustees or governors, but only while acting within the scope of their duties as such. EXCLUSIONS We will not pay under this amendatory endorsement any awards, judgments, settlements, or monetary sums paid or payable to an employee on account of a claim or any fees, costs or expenses resulting from compliance with nonmonetary relief. In addition, we will not pay claim expenses incurred as a result of any claim: E. arising from facts, situations or circumstances which, as of the prior acts date of this amendatory endorsement, you knew or could have reasonably foreseen, or which a reasonable person could have foreseen, might be the basis of a claim against you alleging a wrongful employment practice; F. whose sole allegations seek the recovery of judgments or awards which are deemed uninsurable by law; G. alleging any wrongful employment practices for which you are liable as an administrator, executor, conservator, guardian, or any similar fiduciary capacity; H. under the Employee Retirement Income Security Act of 1974, Public Law 93-406, including amendments thereto, commonly referred to as "ERISA" or the Pension Reform Act of 1974; i. for unemployment compensation, or Workers' Compensation, disability benefits and/or other similar claims; J. under the Worker Adjustment and Retraining Notification Act, Public Law 100-379, (1988), including amendments thereto and/or other similar laws; A. brought by your spouse, child or other dependent; brought by any former or present director or officer, owner, shareholder, member, partner, predecessor or successor firm; 0-30015·046 (Ed. 05105) K. under the Family and Medical Leave Act, Public Law 103-3, (1993), including amendments thereto, and/or other similar laws; l. B. under any federal, state or local statutory law or common law or any of Page 5 of 8 their amendments which are similar to the statutes referred to in Sections IV. H. through IV. K. of this amendatory endorsement; M. under any government or administrative order or regulation relating to employment practices under which you have either implicitly or explicitly consented to be bound; applicable to this amendatory endorsement. To the extent there is any inconsistency between the conditions in the policy and the conditions of this amendatory endorsement, the conditions set forth below control, but only with respect to the coverage provided under this amendatory endorsement and for no other purposes whatsoever. A. Notice and Cooperation N. alleging any wrongful employment practices based on an alleged failure to pay wages and/or benefits due or payable to an employee, except where the alleged failure to pay wages and/or benefits is caused by discrimination; If a claim is made against you during the policy period for an alleged wrongful employment practice that happened after the prior acts date date of this amendatory endorsement, you must give written notice to us as soon as reasonably possible. O. alleging any wrongful employment Notice given by or on your behalf, or notice given by or on behalf of any claimant, to any of our licensed agents authorized by us to sell this amendatory endorsement in this state, with particulars sufficient to identify you, shall be deemed notice to us. practices committed by you or at your direction with actual or alleged dishonest, fraudulent, and/or criminal purpose; P. arising out of injury to any person, with the exception of a claim of wrongful employment practices; To the extent possible, notice should include: Q. arising out of or in connection with labor disputes or labor negotiations, including but not limited to the replacement of employees, lockouts, strikes, picket line violence, boycotts, union organizations, unfair labor practices or other similar actions; R. 1. the identity of the claimant(s) alleging the wrongful employment practice; 2. the identity of the person(s) who allegedly committed the wrongful employment practice and any witnesses; seeking damages, costs or expenses incurred by you pursuant to the Americans with Disabilities Act of 1990, including any amendments thereto or as determined by any court ruling with the exception of a claim for wrongful employment practices; or 3. the date(s) the alleged wrongful employment practice took place; and 4. a copy of any written complaint, S. arising out of the conduct of any partnership, joint venture, corporation or other entity of which you are a partner, owner, shareholder or member and which is not designated in this policy as a named insured. V. charge or demand. In addition to the above, you agree to immediately: 1. SPECIAL CONDITIONS The conditions set forth below, in addition to those set forth in the policy, are D-30015-D46 (Ed. 05/05) Page 6 of 8 fully cooperate with us or our designee in the investigation, the conduct of suits or other proceedings, or enforcing any right of contribution or indemnity against another who may be liable to you because of such alleged wrongful employment practice; 2. 3. from your conduct will be paid by you and will not be reimbursed by us. forward copies of all documents received in connection with the claim to us; and 2. 3. B. Other Insurance With respect to this amendatory endorsement only, the following provision replaces paragraph XI. ("Insurance Under More Than One Coverage") of the "Common Policy Conditions" to which this amendatory endorsement is attached: With respect to any claim or claims to which this amendatory endorsement applies, no coverage shall be available under any other part of this policy or any other insurance policy issued by us. VII. EXTENDED REPORTING PERIOD Extended reporting period coverage applicable to claims ariSing from wrongful employment practices is available to you under the following conditions: AWARD OF COURT COSTS ANDIOR ATTORNEYS' OR OTHER FEES A. Awards to you andlor to us In the event that you, us, andlor the attorney assigned by us to represent you, are awarded court costs, attorneys' fees or other fees, the award shall be distributed to you and to us based on the percentage of total payment made by you and by us in defense of the claim up to the time the award is made. B. Sanctions 1. Unless otherwise prohibited by law, you will reimburse us or the attorney assigned by us to represent you, for any costs, attorneys' fees andlor fines that are assessed against us or the attorney assigned by us to represent you, and which result from conduct attributable to you. attend hearings and trials, assist in securing and giving evidence, completing narrative reports and in obtaining the attendance of witnesses. No one is authorized, except at your own cost, to voluntarily make any payment, assume any obligaton or incur any expense without our consent. VI. Any costs, attorneys' fees or fines ordered by a court or government agency to be paid to the court or government agency by us or the attorney assigned by us to represent you, resulting from our conduct or the conduct of the attorney assigned by us to represent you, will be paid by us. Any costs, attorneys' fees or fines ordered by a court or government agency to be paid by you resulting D-30015-D46 (Ed. 05/05) Page 7 018 A. Termination 1. die or become totally and permanently disabled during the policy period, or An extended reporting period is available for a period of one year upon termination of this policy. To exercise this right, you must: 2. retire during the policy period and are 55 years or older and have been continuously insured by us for at least the immediately preceding 5 years. 1. write to us within 60 days of the termination requesting to purchase the extended reporting period; and 2. pay the premium to us promptly when due. The premiums will be developed from the rules, rates, and rating plans in effect at the inception of the last policy period. we will provide this extended reporting period coverage at no charge. You or your estate must, within 60 days after the end of this policy, write to us telling us the coverage is wanted. We also require: However, if this policy is terminated for your non-payment of premium, the right is waived by you unless the unpaid premium is paid in full and the extended reporting period premium is paid in advance. 3. 2. any pending claim or proceedings. you to submit to medical examination(s) by any physician(s) we designate if requested. any paid claim; or b. written proof of your total and permanent disability, including the date it occurred, certified by your attending physician; or 3. Such extension for the reporting of wrongful employment practices shall not apply to: a. B. 1. written proof of the date of your death; or Death, Disability, or Retirement C. The limits of liability stated under this policy at the time of termination, death, disability, or retirement will be the limits of liability applying to the extended reporting period. If you: All other provisions of this policy remain unchanged. Countersigned by: _ _ _ _ _ _ _ __ Authorized Representative D-30015-D46 (Ed. 05/05) Page 8 018 CNA For AU the Commitments You Ma1m~ WASHINGTON AMENDATORY ENDORSEMENT INSURANCE COVERAGE COMMON POLICY CONDITIONS We agree with you that the Insurance Coverage Common Policy Conditions is amended as follows: Condition XII., Transfer Of Rights Of Recovery, is deleted and replaced with the following: In the event of any payment under this policy, we shall be subrogated to all of your rights of recovery against any person or entity to the extent of payment. After you have first recovered amounts paid, you must transfer to us your rights of recovery against any other party. You shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. You shall do nothing after loss to prejudice such rights. All other provisions of the policy remain unchanged. This endorsement is a part of your policy and takes effect on the policy effective date, unless a different date is specified below: Named Insured Policy Number Effective date of this endorsement Countersigned By: ---;;-""7-;--~--:---­ Authorized Agent G-140093-A46 (Ed. 01/01) CNA For All the Commitments YOu Make' MEDICAL PAYMENTS COVERAGE LIMITS OF LIABILITY $ 5,000 each person $10.000 each occurrence I. COVERAGE AGREEMENTS We will pay, regardless of fault, all Medical Expenses up to the stated Limit of Liability for "each person" and "each occurrence" due to an accident: 1. arising out of a condition in premises you own or rent; or 2. II. any immediately adjoining approaches. EXCLUSIONS We will not pay for medical expenses: A. for services provided by: 1. you; 2. any entity under contract with you, to provide such services. B. which are also included within the Products/Completed Operations Hazard; C. resulting from operations performed for you by independent contractors except for maintenance and repair of your premises or structural alterations at your premises which do not change the size of or involve the moving of buildings or other structures; D. to any person while engaged in maintenance, repair, alteration, demolition or new construction at your premises; E. to any person included in the definition of you while on your premises; F. to any other tenant if the injury occurs on that part of the premises rented from you; G. to your employees or the employees of your tenants or residents of your premises if the injury arises out of and in the course of employment; H. arising out of the owning, taking care of, operation, leasing, renting, entrusting to others, loading or unloading of any auto, non-owned auto, mobile equipment, watercraft or aircraft; I. resulting from selling, serving or giving any alcoholic beverage unless the injury occurs on your premises; J. to any person if any benefits for such injury are payable or required to be provided under any unemployment or Worker's Compensation, Disability Benefits, or other similar law; K. to any person practiCing, instructing or participating in any physical training, sports, athletic activity or contest whether on a formal or informal basis; 0-135702-B46 (Ed. 05/05) 1 L. III. caused by the failure to render professional services. SPECIAL CONDITIONS/DEFINITIONS A. As soon as practicable, the injured person, or someone on his behalf, shall give us written proof of claim for medical expenses, under oath if required. If we request, the injured person shall execute authorization to enable us to obtain medical reports and copies of records. The injured person will also submit to physical examinations by physicians selected by us. The examinations will be made when, and as often as we may reasonably require. B. We may pay the injured person, or any entity rendering the services. However, payment will not imply an admission of liability. c. Medical expenses means first aid at the time of the accident, and if incurred within 12 months of the accident, necessary: 1. medical, surgical, x-ray and dental services, drugs, medical and surgical supplies, including prosthetic devices; and 2. ambulance, hospital, professional nursing and funeral services. G-135702-B46 (Ed. 05/05) 2 NON-OWNED OR HIRED AUTOMOBILE LIABILITY COVERAGE LIMITS OF LIABILITY $1,000,000 per occurrence I, COVERAGE AGREEMENTS We will pay all amounts, up to the limit of liability, which you become legally obligated to pay as a result of injury or damage. We will also pay claim expenses. The injury or damage must be caused by an occurrence during the policy period, and arise out of using, taking care of, loading or unloading of any non-owned or hired auto. We have the right and will defend any claim. We will: A. do this even if any of the charges of the claim are groundless, false or fraudulent; B. investigate and settle any claim as we feel appropriate; The duty to defend ends by payment of the policy limits pursuant to, or in furtherance of, a judgement or settlement with, or on behalf of, the injured party, or by consent of the insured .. We have no duty to defend any claims not covered by this Coverage Part. II, EXCLUSIONS We will not defend, or pay, under this Coverage Part for: A. liability which you have assumed under any contract or agreement, except liability assumed under any short term contract or agreement of 6 months or less for a hired auto; B. any amounts you or any entity must pay under any unemployment or Worker's Compensation, Disability Benefits, or other similar law; C. injury to: 1. an employee of yours arising out of and in the course of employment by you; or 2. the spouse, child, parent, brother, or sister of that employee as a consequence of 1. above. D. damage to property which is: 1. owned or being transported by you; or 2. in your care, custody or control or rented to you, or over which you are exercising physical control; This exclusion does not apply to a residence or private garage damaged by a private auto covered by this Coverage Part. E. loss, under any circumstance, due to nuclear reaction, radiation, or contamination, regardless of cause; G-135702-B46 (Ed. 05/05) 3 F. injury or damage arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of pollutants: 1. that are, or that are contained in any property that is: a. being transported or towed by, handled, or handled for movement into, onto or from the non-owned or hired auto; b. otherwise in the course of transit by or on behalf of you; or c. being stored, disposed of, treated or processed in or upon the non-owned or hired auto. This does not apply to fuels, lubricants, fluids, exhaust gases or other similar pollutants that are needed for or result from the normal electrical, hydraulic or mechanical functioning of the non-owned or hired auto or its parts, if: a. pollutants escape, seep, migrate, or are discharged, dispersed or released directly from an auto part designed by its manufacturer to hold, store, receive or dispose of such pollutants; and b.the injury or damage or covered pollution cost or expense does not arise out of the operation of 1) cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; or 2) air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting or well servicing equipment. 2. before the pollutants or any property in which the pollutants are contained are moved from the place where they are accepted by you for movement into or onto the non-owned or hired auto; or 3. after the pollutants or any property in which the pollutants are contained are moved from the non-owned or hired auto to the place where they are finally delivered, disposed of or abandoned by you. 2. and 3. above do not apply to occurrences that occur away from premises owned by or rented to you with respect to pollutants not in or upon a non-owned or hired auto if: 1. the pollutants or any property in which the pollutants are contained are upset, overturned or damaged as a result of the maintenance or use of a non-owned or hired auto; and 2. the discharge, dispersal, seepage, migration, release or escape of the pollutants is caused directly by such upset, overturn or damage; G. injury or damage arising out of a non-owned auto used in the conduct of any partnership or joint venture of which you are a member and is not designated in this policy as a named insured; H. the liability of your partner arising out of an auto owned or registered in their name, if the named insured is a partnership; I. injury or damage due to war, whether or not declared, civil war, insurrection, rebellion, or revolution or to any act or condition incidental to any of the foregoing, with respect to liability you have assumed under an insured contract; G-135702-B46 (Ed. 05/05) 4 J. injury or damage resulting from the handling of property: before it is moved from the place where it is accepted by the person using a non-owned auto or a hired auto for movement into or onto the auto; 1. 2. after it is moved from a non-owned auto or hired auto to the place where it is finally delivered by the person using the auto; K. Injury resulting from the movement of property by a mechanical device, other than a hand truck, not attached to the non-owned auto or hired auto; L. injury or damage you expected or intended. This exclusion does not apply to injury resulting from the use of reasonable force to protect persons or property. III. LIMITS OF LIABILITY A. The limit of liability stated for "each occurrence" is the limit of our liability for all injury or damage arising out of, or in connection with, the same or related occurrence. This limit applies regardless of the number of you who are covered under this policy. B. Subject to the above, the total limit of our liability for all injury or damage shall not exceed the limit of liability stated as "aggregate", if applicable. All occurrences which happen during the policy period are included. The aggregate limit of liability applies to each annual policy period. This limit applies regardless of the number of you who are covered under this policy. C. Claim expenses are in addition to our limit of liability. All claims whenever made, shall be considered first made during the policy period in which the earliest claim ariSing out of such same or related occurrence was made, and all such claims shall be subject to the same limit of liability. IV. DEFINITIONS "Auto Business" means the business or occupation of selling, servicing, repairing, storing or parking of autos. "Covered pollution cost or expense" means any cost or expense arising out of any: A. Request, demand or order; or B. Claim by or on behalf of a governmental authority demanding, that you or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants. Covered pollution cost or expense does not include any cost or expense arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of pollutants: 1. that are, or that are contained in any property that is: a. being transported or towed by, handled, or handled for movement into, onto or from the non-owned or hired auto; b. otherwise in the course of transit by or on behalf of you; or c. being stored, disposed of, treated or processed in or upon the non-owned or hired auto. G-135702-B46 (Ed. 05/05) 5 This does not apply to fuels, lubricants, fluids, exhaust gases or other similar pollutants that are needed for or result from the normal electrical, hydraulic or mechanical functioning of the non-owned or hired auto or its parts, if: a. pollutants escape, seep, migrate, or are discharged, dispersed or released directly from an auto part designed by its manufacturer to hold, store, receive or dispose of such pollutants; and b. the injury or damage or covered pollution cost or expense does not arise out of the operation of 1) cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; or 2) air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting or well servicing equipment. 2. before the pollutants or any property in which the pollutants are contained are moved from the place where they are accepted by you for movement into or onto the non-owned or hired auto; or 3. after the pollutants or any property in which the pollutants are contained are moved from the non-owned or hired auto to the place where they are finally delivered, disposed of or abandoned by you. 2. and 3. above do not apply to occurrences that occur away from premises owned by or rented to you with respect to pollutants not in or upon a non-owned or hired auto if: a. the pollutants or any property in which the pollutants are contained are upset, overturned or damaged as a result of the maintenance or use of a non-owned or hired auto; and b. the discharge, dispersal, seepage, migration, release or escape of the pollutants is caused directly by such upset, overturn or damage. "Hired Auto" means an auto not owned by you which is used under contract on behalf of, or loaned to you. Such auto also shall not be owned by or registered in the name of: A. a partner or executive officer of yours; or B. an employee or agent of yours who is granted allowance of any sort for the use of such auto. "Occurrence" means an accident, including continuous or repeated exposure to conditions which result in injury and/or damage. Injury and damage arising from exposure to substantially the same general conditions shall be considered one occurrence. "You" or "Your" means: A. the named insured; B. any partner or executive officer of yours, but only while the non-owned auto is being used in your business; C. any other person while using an owned or hired auto with your permission, provided that the actual operation or other use, if not operating, is within the scope of your permission. With respect to injury or damage arising out of the loading or unloading of the auto, such other person shall only meet the definition of you if they are: G-135702-B46 (Ed. 05/05) 6 1. a lessee or borrower of the auto; or 2. an employee of yours or such lessee or borrower. D. any other entity, but only with respect to their liability because of acts or omissions of an insured under (A.) or (B.) above. You or Your does not include: A. any person while engaged in the business of this employer with respect to injury to any fellow employee of such person injured in the course of his employment; B. the owner or lessee, of whom you are sub-lessee, of a hired auto or the owner of a non-owned auto, or any agent or employee of any such owner or lessee; C. an executive officer with respect to an auto owned by that person or a member of their household; D. any entity, other than you, with respect to: 1. a motor vehicle while used with any trailer owned or hired by such entity and not covered by like insurance by us, except a trailer designed for use with a private passenger auto and not being used for business purposes with another type of motor vehicle; or 2. a trailer while used with any motor vehicle owned or hired by such entity and not covered by like insurance by us; E. any person while employed in or otherwise engaged in duties in connection with an auto business, other than an auto business operated by you. G-135702-B46 (Ed. 05/05) 7 MEDICAL WASTE LEGAL EXPENSE REIMBURSEMENT COVERAGE LIMIT OF LIABILITY: Per Suit: $50,000 Annual Aggregate: $50,000 We agree with you that Legal Expense Reimbursement Coverage will be provided as follows: I. COVERAGE AGREEMENT We will reimburse you for the necessary legal expenses incurred by you resulting from your being a defendant or co-defendant in a civil suit alleging violation of a law or regulation governing disposal of medical wastes. Such civil suit must be brought after the effective date of this policy. We have neither the right nor the duty to defend any claim arising from a defined incident. This coverage does not apply to any civil suit for any incident that happened prior to the effective date of this policy, nor to any incident which we are obligated to defend under the policy form to which this endorsement is attached. 11. LIMITS OF LIABILITY A. Per Suit The limit of liability stated above as "Per Suit" is the limit of liability for all legal expenses arising out of, or in connection with, the same or related civil suit. B. Annual Aggregate Subject to provision A. above, the total limit of liability for all legal expenses shall not exceed the limit of liability stated as "Annual Aggregate". This limit applies regardless of the number of civil suits filed against you during each annual policy period. The limits applicable to "Per Suit" and "Annual Aggregate" apply collectively for the entity named as the named insured, including such other entities who qualify for coverage under the definition of you. All civil suits whenever filed, including any and all appeals, shall be considered first filed during the policy period in which the earliest civil suit arising out of the same or related incident was filed, and all such civil suits shall be subject to the same limit of liability. 111. ADDITIONAL DEFINITIONS Civil suit includes administrative proceedings brought by the Federal or State Environmental Protection Agency as well as law suits brought in civil court. Incident means the actual or alleged improper disposing of any medical waste material that results in a civil suit being filed against you. Legal expenses means fees charged by the legal counsel you select and all other fees, costs and expenses, other than loss of income, which result from the investigation, defense and appeal of a civil suit. G-135702-B46 (Ed. 05/05) 8 IV. YOUR DUTIES You shall give us, or any of our authorized representatives, written notice as soon as practicable after you receive notice of the civil suit covered by this policy. Such notice shall contain details sufficient to identify you and all reasonably obtainable information regarding the time, place and circumstances of the civil suit, and shall identify the court and all parties to the action before the court. All other terms and condition of the policy remain unchanged. G-135702-B46 (Ed. 05/05) 9 CNA Th. AIlIh., Comruihnellts You. Makes DENTIST'S INSURANCE COVERAGE INDEX· OCCURRENCE 1. Your General Liability Policy is made up of the following items: Your Declarations Page· The Declarations Page summarizes specific information regarding your coverage. Common Policy Conditions· The items contained in the Common Conditions apply to every Coverage Part and Endorsement that make up your policy, unless a different or additional condition is mentioned in the respective Coverage Part. The Coverage Part(s) applicable to your policy· These are specific coverage agreements which detail the type of coverage afforded by this policy. Your policy may contain more than one Coverage Part, each providing a different, specific coverage. Endorsements· Most often, a policy will contain Endorsements which make the entire contract more complete. Endorsements are often added to aI/ow the policy to conform to individual state requirements, or may be used at the direction of the company, or may be used due to the specific nature of the risk insured. Endorsements attached to your policy at inception are listed on the Declarations Page. 2. To make your policy complete, you must have a Declarations Page, the Common Policy Conditions, and various Coverage Parts. 3. For ease in reviewing and locating information contained in the Coverage Parts, you can find the topics below on the page indicated. General Liability COVerage Agreements Exclusions Limits Of Liability Definitions Special Conditions Other Coverages Medical Payments Non-Owned or Hired Automobile Liability Medical Waste Legal Expense Reimbursement G-135702·B46 (Ed. 05105) Beginning on Page 1 1 5 6 8 Beginning on Paoe 1 1 1 CNA lbr All the CommUmelllsYou Make" GENERAL LIABILITY COVERAGE PART We are the stock insurance company named on the Declarations. Throughout this policy the words we, us and our refer to the company providing this insurance. We agree with you as follows: I. COVERAGE AGREEMENTS We will pay all amounts, up to the limit of liability, which you become legally obligated to pay as a result of Injury or damage. We will also pay claim expenses. The injury or damage must be caused by an occurrence during the policy period. We have the right and will defend any claim. We will: A. do this even if any of the charges of the claim are groundless, false or fraudulent; and B. investigate and settle any claim as we feel appropriate. The duty to defend ends by payment of the policy limits pursuant to, or in furtherance of, a judgement or settlement with, or on behalf of, the injured party, or by consent of the insured. We have no duty to defend any claims not covered by this Coverage Part. II, EXCLUSIONS We will not defend, or pay, under this Coverage Part for: A. injury to: 1. an employee of yours arising out of and in the course of employment by you; or 2. the spouse, child, parent, brother, or sister of that employee as a consequence of 1. above. This exclusion applies: 1. whether you may be liable as an employer or in any other capacity; and 2. to any obligation you have to indemnify some other entity because of such injury. This exclusion does not apply to liability you assume under an insured contract. B. any amounts you or any entity must pay under any unemployment or Workers' Compensation, disability benefits, or other similar law; C. loss of use of tangible property which has not been physically damaged if: 1. a delay in or lack of performance has been caused by or on your behalf under any contract or agreement; 2. your products or work completed on your behalf do not meet the standards you have warranted or represented. We will cover loss of use of other tangible property if: G-135702-B46 (Ed. 05105) Page 1 of 8 1. the loss results from a sudden and accidental physical damage or destruction of your products or work completed by or on your behalf; and 2. the products or work has been put to use by an entity other than you; D. amounts claimed as a result of the withdrawal, inspection, repair, replacement, or loss of use of your products. This also applies to work completed by or for you, and any property of which your products form a part. This exclusion only applies if the withdrawal from the market or use is due to a known or suspected defect or deficiency; E. liability which you have assumed under any contract or agreement, other than an insured contract. This exclusion does not apply to a warranty: 1. of fitness or quality of your products; or 2. that work performed by or on your behalf will be done in a workmanlike manner; F. damage to: 1. your products which arises out of such products or any of its parts; 2. work performed by or on your behalf arising out of: a. the work; b. any part of the work; or c. material, parts or equipment furnished in connection with the work; 3. property which is: a. owned, occupied or rented to you; b. used by you; c. in your care, custody or control, or over which you are exercising physical control; There are exceptions to this subsection 3. Subitems b. and c. do not apply to liability under a sidetrack agreement. Subitem c. does not apply to damage, other than to elevators, arising out of the use of an elevator at premises you own, rent, or control. We will pay up to $500,000 for each occurrence for your legal liability for damage to a premises in which you do not have a financial interest, or own, caused by: a. b. discharge, leakage or overflow of water or steam from a plumbing, heating, refrigeration or air conditioning system; or c. G-135702-B46 (Ed. 05/05) fire; rain which enters directly into the building through open doors, windows, skylights, transoms or ventilators. Page 2 of 8 4. premises you no longer own, rent, control or use, which arise out of such premises or any of its parts; G. injury or damage arising out of or resulting from the rendering of or failure to render any SCientific, professional, consulting or technical services; H. injury or damage for which you may be held liable as a result of: 1. causing or contributing to the alcoholic beverage intoxication of any person; 2. furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; 3. any statute, ordinance or regulalion relaling to the sale, gift, distribution or use of alcoholic beverages. This exclusion only applies if you: 1. manufacture, sell or distribute alcoholic beverages; 2. serve or furnish alcoholic beverages for a charge whether or not such activity: a. b. 3. requires a license; is for the purpose of financial gain or livelihood; or serve or furnish alcoholic beverages without a charge, if a license is required for such activity. I. an auto, non-owned auto, mobile equipment, watercraft, or aircraft which: 1. you own, use, take care of, operate, load or unload, lease or rent, or entrust to others; 2. is loaned to you or is operated, loaded or unloaded, for you by an employee in the course of employment by you; There are some exceptions. Coverage will apply on premises which you own, rent, or control to: 1. the parking of a non-owned auto; 2. watercraft while ashore; This exclusion does not apply to self-propelled lawn care or snow removal equipment of 10 horsepower or less. J. mobile equipment in, or while in practice or preparation for: 1. 2. K. any prearranged or organized racing, speed or demolition contest, or any stunling activity; the transporting of mobile equipment by an auto which you own, operate or rent, or which is loaned to you; l. the operation or use, loading or unloading, of any snowmobile or trailer designed for use with a snowmobile; G-135702-B46 (Ed. 05105) Page 3 of 8 M. war, whether or not declared, or any civil war, insurrection, rebellion or revolution, or any incidental act or condition, with regard to: 1. liability you have assumed under a contract or agreement; or 2. expenses for first aid. N. the conduct of any partnership or joint venture of which you are a partner or member and which is not designated in this policy as a named Insured; O. any injury, sickness, disease, death or destruction: 1. with respect to which you are also an insured under a Nuclear Energy Liability Policy issued by: a. Nuclear Energy Liability Insurance Association; b. Mutual Atomic Energy Liability Underwriters; or c. Nuclear Insurance Association of Canada, or would be an insured under any such policy if it had not terminated due to exhaustion of its limit of liability; or 2. resulting from the hazardous properties of nuclear material and with respect to which: a. any entity is required to maintain financial protection pursuant to the Atomic Energy Act of 1954 or any of its amendments, or b. you are, or had this policy not been issued would be, entitled to indemnity from the United States of America or any of its agencies, under any agreement entered into by the United States of America or any of its agencies with any entity; 3. resulting from the hazardous properties of nuclear material if: a. the nuclear material: 1. is at any nuclear facility owned or operated by or on your behalf; or 2. has been discharged or dispersed therefrom; or 3. is contained in spent fuel or waste at anytime possessed, handled, used, processed, stored, transported or disposed of by or on your behalf; or b. the injury, sickness, disease, death or destruction arises out of the furnishing by you of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility. If such facility is within the coverage territory, this subparagraph 3.b. applies only to injury to or destruction of property at such nuclear facility. P. any fines, penalties, or the return or withdrawal of fees or government payments; Q. injury or damage you expected or intended, or which a reasonable person could have expected. G-135702-B46 (Ed. 05105) Page 4 of 8 This exclusion does not apply to injury resulting from the use of reasonable force to protect persons or property; R. any multiplication of amounts payable under this policy, imposed by law; S. any claim arising out of actual or alleged involvement in any: 1. anti-trust law violation; or 2. agreement or conspiracy to restrain trade. T. injury or damage arising out of pollution or pollutants: This exclusion also applies to: 1. Any loss, cost or expense arising out of any: a. request, demand or order that you or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants; or b. claim by or on behalf of a governmental authority for amounts because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of pollutants. U. any claim made against you, or any person for whose acts or omissions you are legally responsible for, any act of sexual intimacy, sexual molestation or sexual assault or any act similarly defined. We will defend any civil suit against you seeking amounts which would be covered if this exclusion did not apply. In such case, we will pay only the fees, costs and expenses of such defense; V. any injury or damage arising from any profession or business other than your practice of dentistry, which shall be defined by the applicable statutes and licensing laws of the jurisdiction in which you practice; or W. any direct or consequential injury or damage arising out of any: 1. 2. termination of employment; or 3. III. refusal to employ; coercion, demotion, reassignment, defamation, harassment, humiliation, discrimination or other employment related practices, policies, acts or omissions. LIMITS OF LIABILITY We will pay all amounts, up to the stated limits of liability, including amounts: A. EACH OCCURRENCE G-135702-646 (Ed. 05105) Page 5 of 8 The limit of liability stated for "each occurrence" is the limit of our liability for all injury or damage arising out of, or in connection with, the same or related occurrence. This limit applies regardless of the number of persons or organizations who are covered under this policy. B. AGGREGATE 1. The General Liability Aggregate Limit is the most we will pay, regardless of the number of occurrences, for all amounts payable under the Coverage Part due to injury or damage except injury or damage included in the Products/Completed Operations Hazard. The General Aggregate Limit of Liability applies to each annual policy period. 2. The Products/Completed Operations Aggregate Limit is the most we will pay, regardless of the number of occurrences, for all amounts payable under the Coverage Part due to injury or damage included within the Products/Completed Operations Hazard. The Products/Completed Operations Aggregate Limit applies to each annual policy period. The limits of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the limits of insurance. C. The "each occurrence" limit and the aggregate limit apply collectively regardless of the number of you who are covered under this policy. D. Claim Expense Claim expenses are in addition to the limit of liability. IV. DEFINITIONS "Claim" means the receipt of a demand for money or services, naming you and alleging injury and damage. "Damage" means: A. partial or total physical damage to tangible property. Such damage must happen during the policy period. Loss of use of damaged property is also included; B. loss of use of undamaged tangible property. This loss of use must be caused by an occurrence during the policy period. "Hostile Fire" means fire which escapes from its intended confines at or from premises you own, rent or occupy. "Injury" as defined in the General Conditions, shall also include the following: A. malicious prosecution; B. false arrest, detention, imprisonment; C. wrongful entry, or eviction, or other invasion of the right of private occupancy; D. a violation of an individual's right to privacy; G-135702-B46 (Ed. 05105) Page 6 of 8 E. oral or written publication of material that: a. slanders or libels an entity or disparages an entity's goods, products or services; or b. violates a person's right of privacy; F. assault, battery, mental anguish, mental shock, humiliation or hallucination; or G. advertising Injury. "Insured contract" as defined in the General Conditions, shall also mean business equipment contracts necessary to the practice of dentistry. "Loading or Unloading" means, with respect to any vehicle: A. the handling of property after it is moved from the place where it is accepted for movement into or onto a vehicle; B. while it is in or on a vehicle; C. while it is being moved from a vehicle to the place where it is finally delivered. Movement of property by mechanical device, other than a handtruck, which is not attached to the vehicle is not included. For purposes of this definition only, vehicle means auto, aircraft, mobile equipment or watercraft. "Nuclear Material" means Source Material, SpeCial Nuclear Material or By-product Material. "Occurrence" means an accident, including continuous or repeated exposure to conditions which: A. results in Injury and/or damage; and B. was not expected nor intended by you. Injury and damage arising from exposure to substantially the same general conditions shall be considered one occurrence. "You" or "Your" means: A. the named insured; B. if the named insured is an individual, the person designated, but only with respect to the conduct of a business of which that individual is a sole proprietor and the spouse of the named Insured with respect to the conduct of such business; C. any of your employees, executive officers, partners, stockholders or members of the board of directors, trustees or governors, but only while acting within the scope of their duties as such; D. any person, other than an employee, or organization while acting as real estate manager for you; and E. as respects the operation, for the purpose of movement upon a public highway, of mobile equipment registered under any motor vehicle registration law: 1. G-135702-B46 (Ed. 05105) an employee of yours while operating any such equipment in the course of Page 7 of 8 their employment, and 2. any other person while operating any such equipment registered in your name with your permission. This includes any entity legally responsible for such operation. This only applies if there is no other valid and collectible insurance available, either on a primary or excess basis, to such entity. No entity shall be an insured under this Definition E. with respect to: 1. 2. V. injury to any fellow employee of such person injured in the course of their employment; or damage to property you or the employer of any person described in above subparagraph E. 2. own, rent, occupy, or for which you or the employer are responsible. SPECIAL CONDITIONS The following Conditions apply in addition to the Common Policy Conditions. A. Financial Responsibility Laws If this policy is certified as proof of financial responsibility for the future under the provisions of any motor vehicle financial responsibility law, we agree that the coverage and limits of liability provided by this policy for Injury or damage shall comply with such law. In return, you agree to reimburse us for any payment we make which we would not have been obligated to make except for the agreement contained in this Condition. B. Territory This Coverage Part applies to injury or damage which occurs: 1. within the coverage territory; 2. within international waters or air space, provided the injury or damage does not occur in the course of travel to or from any other country, nation or state; or 3. anywhere in the world with respect to injury or damage ariSing out of your products sold within the coverage territory. Any claim must be made and suit must be brought within the coverage territory. G-135702-846 (Ed. 05/05) Page 8 of 8 CNA For All too Commitments You Make' PROFESSIONAL PROTECTOR PLAN GOLD This endorsement modifies insurance provided under the following: BUILDING BLANKET DENTAL PRACTICE PERSONAL PROPERTY AND INCOME COVERAGE PART I. Fine Arts - Increase in Limits Section I. COVERAGE AGREEMENTS, Paragraph A. Covered Property is amended as follows: • Item 2.d.(2) of Your Blanket Dental Practice Personal Property is deleted in its entirety and replaced as follows: (2) the most we will pay is $25,000 at each described premises with no more than $5,000 per item. II. Dentist's Electronic Equipment - Increase in Limits and Off-Premises added; Contingent Business Interruption added Section I. COVERAGE AGREEMENTS, Paragraph B. Covered Related Expenses is amended as follows: A. Item 16. Dentist's Electronic Equipment is amended as follows: 1. 2. the $25,000 limit is deleted and replaced with a $50,000 limit; Subject to a $15,000 sub-limit, this Covered Related Expense applies off-premises, anywhere in the world. This sub-limit is part of and not in addition to the limit shown in A.1. above. B. Contingent Business Interruption is added as follows: We will pay up to $500 per day, not exceeding a maximum of $15,000 for practice income you actually lose during the period of restoration following direct physical loss at the premises operated by others upon whom you depend to: 1. 2. 3. deliver materials or services to you, or others for your account; accept your product or services; or attract customers to your business. The damage must occur at such premises and be caused by or resulting from a covered cause of toss under this policy. III. LIMITATIONS deleted for interior of any building; gutters and downspouts; outdoor radio or television antennas; and stamps, tickets and letters of credit Section II. EXCLUStONS, Paragraph E. LIMITATIONS is amended as follows: • G-124787-B (ED. 02106) Items 1.a., 1.d., 1.1. and 2.c. are deleted in their entirety. Page 1 of 2 IV. Employee Dishonesty - Increase in Limits The following additional change applies: The limit of liabilily as stated in the Declarations for Employee Dishonesty is increased by $15,000. The total employee dishonesty limit of liability is determined by adding the above referenced $15,000 to the limil of liability stated on the Declarations. That new limit is the most we will pay for employee dishonesty. All other terms, condition and exclusions apply and remain unchanged. G-124787-8 (ED. 02106) Page 2 of 2 CNA For All tho COOllllitmentsYou Makcll: INDEX OF PROVISIONS BUILDING, BLANKET DENTAL PRACTICE PERSONAL PROPERTY AND INCOME COVERAGE PART TOPIC I. PAGE Coverage Agreements 1/6 A. Covered Property 1. Building 2. Blanket Dental Practice Personal Property - Contents Inside the Building - Off-premises - Accounts Receivable; Valuable Papers including x-ray records and patient charts Fine Arts - Money and Securities - Glass - Temporary Relocation 3. Practice Income 4. Extra Expense 5. Extended Practice Income 6. Rents B. Covered Related Expenses 1. Backup of Sewer or Drain Water Damage 2. Debris Removal 3. Preservation of Property 4. Fire Department Service Charges 5. Fire Extinguisher Recharge 6. Arson Reward 7. Cost of Research - Valuable Papers 8. Off Premises Power Failure 9. Condominium Property 10. Pollution Cleanup and Removal 11. Lawns, Trees, Shrubs, Plants, Signs 12. Personal Effects; Property of Others 13. Expenses to Reduce Income Loss; Income Loss Due to Civil Authority; Income Loss Related to Alterations and New Buildings 14. Money Orders and Counterfeit Paper Currency 15. Forgery and Alteration 16. Dentist's Electronic Equipment 17. Claim Data Expense 1 1/2 2 2 2 2 213 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4/5 5 5 5 5/6 6 6/7 C. New Acquired or Constructed Property D. Property Not Covered G-15159-E, ED. 02106 1 1 1 1 1 1 7 Pagei INDEX OF PROVISIONS-CONTINUED BUILDING, BLANKET DENTAL PRACTICE PERSONAL PROPERTY AND INCOME COVERAGE PART TOPIC II. III. Exclusions/Restrictions A. Concurrent Causes 1. Ordinance or Law 2. Earth Movement 3. Volcanic Eruption 4. Government Aclion 5. Nuclear 6. War; Military Action 7. Water B. 1. Artificial Electric Current 2. Delay, Loss of Use or Market 3. Smoke 4. Wear, Tear 5. Rust, Corrosion, 6. Smog 7. Contaminants or Pollutants 8. Settling, Cracking 9. Insects 10. Mechanical Breakdown 11. Seepage, Leakage 12. Frozen Plumbing, Heating, Air Conditioning Equipment 13. Dishonest or Criminal Acts 14. Fraudulent Scheme or False Pretense 15. Property in the Open 16. Cerlain Causes of Collapse C. 1. Weather Conditions 2. Indecision 3. Construction Related D. Special Exclusions 1. Finished Stock 2. Outdoor Television Equipment 3. Interference by Strikers 4. Any other consequential damage E. Limitations 1. Limitations 2. Limitation of Theft damage 8 8 8 8 8 8 8 8 8 8 8 8 8 8 8/9 9 9 9 9 9 9 9 9 9 9 9 9 9 10 10/11 LIMITS OF INSURANCE A. Maximum Amount Payable B. Praclice Income, Extra Expense and Extended Practice Income C. Covered Related Expenses D. Deductible E. Inflation Guard F. Valuation 1. Building/Dental Practice Personal Property 2. Siock 3. Glass 4. Tenanl's Improvements and Betterments 5. Valuable Papers and Records G-15159-E, ED. 02106 7/10 7 7 7 7 7 7 Page ii 10 10 10 10 10 10 10/11 11 11 11 11 INDEX OF PROVISIONS-CONTINUED BUILDING, BLANKET DENTAL PRACTICE PERSONAL PROPERTY AND INCOME COVERAGE PART PAGE 6. 7. 8. IV. - - Accounts Receivable Records Blanket Dental Practice Personal Property Building Covered Causes of Loss Damage Electronic Media and records Elevator Falling Objects Fine Arts Finished Stock Period of Restoration Practice Income Rents Sinkhole Collapse Specified Causes of Loss Stock Valuable Papers and Records Volcanic Action Water Damage E. F. G. H. I. J. K. L. M. G·15159·E, ED. 02106 11 11 11 11 11/12 12 12 12/13 13 13 13 13 13 13 13 13 13 13 14 14 14 14 14 14/17 Conditions A. B. C. D. 11 11 11/14 Definitions - V. Practice Income a. Actual Loss Sustained b. Valued Daily Limit c. Actual Loss Sustained during period of restoration Rents Actual Cash Value 14 14 14 14 14 14 Control of Property Legal Action Against Us Liberalization No Benefit to Bailee Other Insurance Transfer of Rights of Recovery Abandonment Appraisal Duties In the Event of Damage Payment for Damage Recovered Property Vacancy Mortgage Holders 15 15 15 15/16 16 16 16/17 Page iii CNA For All the Commitments You Make' BUILDING, BLANKET DENTAL PRACTICE PERSONAL PROPERTY AND INCOME COVERAGE PART Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. (1) the damage is caused by a covered cause of loss; and (2) the most we will pay is $10,000 at each described premises with no more than $1,000 per item. Throughout this policy, the words you and your refer to the named insured and anyone having a financial interest in your property as named in this policy. The words we, us and our refer to the Company providing this Insurance. Items valued at $1,000 or less are not considered fine arts. The limits of insurance for fine arts are in addition to the limits of insurance shown in the declarations. Words and phrases that appear in bold facing have special meaning. Refer to DEFINITIONS in the Common Policy Conditions and in this Coverage Part. I. e. COVERAGE AGREEMENTS A. Covered Property We will pay for all direct physical damage to Covered Property at the premises described on the Declarations caused by or resulting from any covered cause of loss. (1) theft, meaning any act of stealing; Covered Property means the following types of property for which a Limit of Insurance is shown on the Declarations or which is shown below: (2) disappearance; or (3) destruction. 1. Building; 2. Your Blanket Dental Practice Personal Property: a. We will not pay for damage: (1) resulting from accounting arithmetical errors or omissions; located: (2) in the open, or in a vehicle, within 1000 feet of the described premises. c. (3) to property contained in any moneyoriented device unless the amount of money deposited in it is recorded by a continuous recording instrument in the device off-premises, anywhere in the world. The most we will pay for damage when caused by or resulting from a covered cause of loss is $25,000. However, this coverage does not apply if the damage is covered under 2.g. below. The most we will pay for damage in any one event is: (1) $15,000 inside the premises for money and securities while: including accounts receivable records and other valuable papers and records including x-ray negatives and prints and patient's charts; (a) in or on the described premises; or (b) within a bank institution; and This coverage does not apply to your accounts receivable records or valuable papers and records in excess of 10 years of age. d. including fine following: G-15159-E, ED. 02/06 arts, or (2) due to the giving or surrendering of property in any exchange or purchase; or (1) in or on the building; or b. and money and securities used in your practice while at a bank or savings institution, within your living quarters or the living quarters of your partners or any employees having use and custody of the property, at the described premises, or in transit between any of these places, resulting directly from: or savings (2) $10,000 outside the premises for and securities while money anywhere else. subject to the All damage: Page 1 of 17 (1) caused by one or more persons; or (a) the stored property is more specifically insured; or (2) involving a single act or series of related acts; (b) the damage is covered under 2.b. above. is considered one event. 3. You must keep records of all money and securities so we can verify the amount of any damage. In the event of damage we determine the value as follows: We will pay for the actual loss of practice Income you sustain, or the Valued Daily Limit, as described under Limits of Insurance prOVision III.F.6., due to the necessary suspension of your practice during the The suspension period of restoration. must be caused by direct physical damage to the building or blanket dental practice personal property at the described premises caused by or resulting from a Covered Cause of Loss or power failure as described under paragraph I.B.8. will (1) money at its face value; and (2) securities at their value at the close of practice on the day the damage is discovered. f. Glass (1) We will pay for all glass other than art glass windows, including all lettering and ornamentation, located at the described premises: We will only pay for loss of practice income that occurs within 12 consecutive months after the date of direct physical damage or power failure as described under paragraph I.B.8. Practice income coverage shall apply separately to each location affected by such suspension of practice. (a) owned by you; or (b) owned by others but in your care, custody or control (2) We will also pay for necessary: 4. (a) expenses incurred to put up temporary plates or board up openings; (b) repair or replacement encasing frames; and of including temporary relocation of Your Blanket Dental Practice Personal Property subject to the following: We will only pay for extra expenses that you incur within 12 consecutive months after the date of direct physical damage or power failure as described under paragraph I.B.8. (1) If Your Blanket Dental Practice Personal Property is removed from the described premises and stored temporarily at a location you own, lease or operate while the described premises is being renovated or remodeled, we will pay for damage to that stored property caused by or resulting from a covered cause of loss: 5. Extended Practice Income We will pay for the actual loss of practice income you incur during the period that: a. (b) during the storage period of up to 90 consecutive days but not beyond expiration of this policy. begins on the date property, except finished stock, is actually repaired, rebuilt or replaced and your practice is resumed; and b. (a) up to $50,000 at each temporary location; and ends on the earlier of: (1) the date you could restore your practice with reasonable speed, to the condition that would have existed if no direct physical damage happened; or (2) This coverage does not apply if: G-15159-E, ED. 02106 Extra Expense Extra expense means the extra expenses necessarily incurred by you during the Period of Restoration to continue normal services and operations which are interrupted due to damage by a Covered Cause of Loss to the premises described, or power failure as described under You will exercise due paragraph I.B.8. diligence and dispatch to restore normal practice services. (c) expenses incurred to remove or replace obstructions. g. Practice Income Page 2 of 17 If it is necessary to move covered property from the described premises to preserve it from, or for repair of, damage by a covered cause of loss, we will pay for any direct physical damage to that property: (2) 12 consecutive months after the date determined in (1) above. Loss of practice income must be caused by direct physical damage at the described premises caused by or resulting from any covered cause of loss. 6. a. Rents The actual loss of rents or other income you sustain due to direct physical damage caused by or resulting from a Covered Cause of Loss to your building at the described premises, whether rented or not, for the length of time which is required to rebuild, repair, or replace it, beginning with the date of damage during the policy period, but not limited by its expiration. while it is being moved or while temporarily stored at another location; and b. only if the damage happens within 60 days after the property is first moved. 4. Fire Department Service Charge When the fire department is called to save or protect covered property from a covered cause of loss, we will pay up to $15,000 for your liability for fire department service charges: B. Covered Related Expenses a. assumed by contract or agreement prior to damage; or Back Up of Sewer or Drain b. required by local ordinance. We will pay up to $25,000 for damage to covered property caused by water that backs up from a sewer or drain. However, we will not provide coverage for damage due to water emanating from a sump pump well or similar device designed to prevent overflow, seepage or leakage of subsurface water. No deductible applies to this covered related expense. We will also pay for the following expenses: 1. 2. 5. We will pay up to an amount not exceeding $2,500 in anyone event for the cost of recharging your Underwriters Laboratories listed or Factory Mutual approved type ABC (multipurpose) fire extinguishers or dry chemical fixed pipe fire extinguishing systems after being used in fighting a fire on your premises on or adjoining premises. Debris Removal We will pay up to 25% of: a. b. the amount we pay for the direct physical damage to covered property; plus 6. for expense to remove debris of covered property caused by or resulting from a covered cause of loss that happens during the policy period. The expenses will be paid only if they are reported to us in writing within 180 days of the earlier of: 7. the date of direct physical damage; or b. Arson Reward We will pay up to $10,000 for information which leads to an arson conviction in connection with damage caused by fire Part. covered under this Coverage Regardless of the number of persons involved in providing information our liability will not be increased. the deductible in this policy applicable to that damage; a. Fire Extinguisher Recharge the end of the policy period. Valuable Papers and Records - Cost of Research a. We will pay your costs to research, replace or restore the lost information on damaged valuable papers and records, x-ray negatives and prints and patient charts including those which exist on electronic media and records, for which duplicates do not exist. b. This coverage does not apply to your valuable papers and records in excess of 10 years of age. This limitation does not apply to any additional debris removal limit provided in the Limits of Insurance section. This coverage does not apply to costs to: a. b. 3. extract pollutants from land or water; or remove, restore or replace polluted land or water. Preservation of Property G-15159-E, ED. 02106 Page 3 of 17 8. We will pay for your signs other than signs attached to your buildings, lawns, trees, shrubs and plants including debris removal expenses. Power Failure We will pay for damage to covered property caused by the failure of power or other utility service supplied to the described premises, resulting from direct physical damage which happens away from the described premises caused by a covered cause of loss. The interruption must result from a covered cause of loss to the following types of property not on the described premises, but supplying electricity, water, steam or gas to the described premises: a. c. b. switching stations; substations; The most we will pay for damage by a covered cause of loss is $10,000 at each described premises for lawns, trees, shrubs and plants, but not more than $ 2,500 for anyone tree, shrub or plant. We will not pay for damage to trees, shrubs, and plants resulting from the following causes of damage: windstorm or hail; vehicles; vandalism; disease or growth failure. d. transformers; or e. transmission lines. 12. Personal Effects and Property of Others If damage by a covered cause of loss results, we will pay for that resulting damage. a. Personal effects owned by you, your officers, your partners or your employees. The most we will pay for damage is $25,000 at each described premises. b. We will not pay for damage you sustain during the 24 hours immediately following direct physical damage to the power or other utility service. 9. The most we will pay for damage to signs by a covered cause of loss is $10,000 at each described premises. utility generating plants; b. a. Personal property of others in your care, custody or control located in or on the building or in the open, or in a vehicle, within 1000 feet of the described premises. The most we will pay for damage is $25,000 at each described premises. Our payment for damage to personal property of others will only be for the account of the owner of the property. Condominium Property If you are a condominium unit owner at a location insured under this policy, we will pay for damage to walls, floors, ceilings, floor coverings or any other property required by your condominium association agreement to be insured by you. However, we will not pay for damage to such walls, floors, ceilings, floor coverings or any other property if someone other than you pays to repair or replace it. 13. As respects practice income: a. We will pay any necessary expenses you incur, except the cost of extinguishing a fire: 10. Pollution Clean Up and Removal We will pay your expense up to $10,000 for the sum of all such expenses arising out of covered causes of loss happening during each separate 12 month period of the policy, to extract pollutants from land or water at the described premises if the release, discharge or dispersal of the pollutants is caused by or results from a covered cause of loss that happens during the policy period. The expenses will be paid only if they are reported to us in writing within 180 days of the earlier of: a. (1) to reduce the amount of damage; (2) to the extent that they do not exceed the amount of damage that otherwise would have Deen payable; under this Coverage Part. b. the end of the policy period. 11. Lawns, Trees, Shrubs, Plants and Signs G-15159-E, ED. 02106 Civil Authority We will pay for the actual loss of practice income and rents you sustain caused by action of civil· authority that prohibits access to the described premises due to the direct physical damage to property, other than at the described premises, caused by or the date of direct physical damage; or b. Expenses to Reduce Damage. Page 4 of 17 We will pay for the actual loss of practice income you sustain due to direct physical damage at the described premises caused by or resulting from any covered cause of loss to: If you are sued for refusing to pay the covered instrument on the grounds that it has been forged or altered, and you have our written consent to defend against the suit, we will pay any reasonable legal expenses that you incur in that defense. The amount we will pay for these legal expenses will be a part of and not in addition to the limit of insurance applicable to the Forgery and Alteration coverage. (1) new buildings, whether complete or under construction; The most we will pay for any loss and legal defense is $10,000. b. resulting from any covered cause of loss. This coverage will apply for a period of up to 30 consecutive days from the time of that action. c. Alterations and New Buildings 16. Dentist's Electronic Equipment (2) alterations or additions to existing buildings; and We will pay for direct damage to covered dentist's electronic equipment (including extra expense), located on or within 1000 feet of the described premises, caused by or resulting from a covered electronic equipment cause of loss as defined below. The most we will pay for damage and extra expense covered by this covered related expense is $25,000. (3) machinery, equipment, supplies or building materials located on or within 1000 feet of the described premises and; (a) used in the construction, alterations or additions; or (b) incidental to the occupancy of new buildings. If such direct physical damage delays the start of your practice, the period of restoration will begin on the date your practice would have begun if the direct physical damage had not happened. 14. Money Orders Currency and Counterfeit For purposes of this coverage, dentist's electronic equipment means any electronic dental equipment, computers, dental chair, x-ray equipment or other components capable of accepting information, processing it according to a plan and producing the desired results. This includes any telephone components or equipment, telephone switchgear, operating programs, related software, facsimile transmission equipment, telex equipment and other related hardware used for the transmission of communications. It also includes software for electronic data processing, recording or storage media such as films, tapes, cards, discs, drums or cells. Paper We will pay for loss due to: a. the acceptance in good faith, in exchange for merchandise, money or services, of any post office or express money order, issued or claiming to have been issued by any post office or express company, if the money order is not paid upon presentation; or b. the acceptance in good faith in the regular course of business of counterfeit United States or Canadian paper currency. Covered electronic equipment cause of loss means risk of direct physical loss to dentist's electronic eqUipment except as excluded or limited below. The covered electronic eqUipment cause of loss also includes electrical disturbance. The most we will pay for any loss is $10,000. 15. Forgery and Alteration a. We will pay for loss resulting directly from forgery or alteration of, on or in any check, draft, promissory note, or similar written promise, order or direction to pay a sum certain in money, made or drawn by or drawn upon you or made or drawn by one acting as your agent or claiming to have been so made or drawn. G-15159-E, ED. 02106 We will not pay for loss or damage caused by or resulting from the exclusions as indicated below. Only the following exclusions as stated in this Coverage Part, Section iI. Exclusions Page 5 of 17 apply to equipment: a. b. c. d. e. f. g. h. dentist's taking inventories, making appraisals, preparing income statements and preparing other documentation. electronic exclusion A.4., Governmental Action; exclusion A.5., Nuclear Hazard; exclusion A.6., War and Military Action; exclusion B.2., Delay, loss of use or loss of market; exclusion BA., Wear and tear; exclusion B.5., Rust, corrosion; exclusion B.7., seepage, migration; exclusion B.13.,dishonest or criminal acts, b. (1) Any expenses incurred, directed or billed by or payable to attorneys, or their insurance adjusters associates or subsidiaries; (2) Any costs in connection with the Appraisal Condition as set forth in Section V. CONDITIONS; or (3) Any expenses incurred, directed or billed by or payable to insurance brokers or agents, or their associates or subsidiaries, without our written consent prior to such expenses being incurred. The following additional exclusions shall also apply: i. j. k. depreciation, obsolescence, dampness or dryness, cold or heat or any other cause of consequential loss or damage. error, omission in machine or incorrect programming instructions to a machine; errors, omissions or deficiencies in design, specification, materials or workmanship. c. Except as otherwise provided, the following provisions apply to property located in or on the building or in the open, or in a vehicle, within 1000 feet of the described premises. 1. You may extend the insurance provided by this Coverage Part as fallows: a. to apply to: (1) your new buildings while being built on the described premises; and (2) buildings you acquire at locations, other than the described premises, intended for similar use as the building described on the Declarations; The most we will pay for practice income as provided elsewhere in this Coverage Part for loss or damage covered by this covered related expense is $2,500. This is part of and not in addition to the $25,000 limit stated above for this coverage. The Valued Daily Limit as stated in the declarations will be used to determine the amount of the practice income loss. The Actual Loss Sustained provision of Practice Income Coverage does not apply and is not available for loss or damage to Dentist's Electronic Equipment. (3) your blanket dental practice personal property at any location you acquire. b. The most we will pay for damage under this Coverage Extension is: (1) $500,000 on each newly acquired Building; (2) $250,000 on Your Blanket Dental Practice Personal Property, at each newly acquired location, whether owned, leased, occupied or controlled by you. 17. Claim Data Expense We will pay the reasonable expenses you incur in preparing claim data when we require such data to show the extent of damage. This includes the cost of G-15159-E, ED. 02106 The most we will pay for preparation of claim data under this Covered Related Expense in anyone occurrence is $5,000 regardless of the number of premises involved. C. Newly Acquired or Constructed Property For purposes of this coverage electrical disturbance means electrical injury, magnetic injury, disturbance of electronic recordings or erasure of electronic recordings including damage caused by interruption of an electrical power supply, power surge, blackout or brownout. a. Under this Covered Related Expense, we will not pay for: Page 6 of 17 14. vehicles or sell-propelled machines, including aircraft or watercraft, that: c. You may extend your practice income coverage to apply at any location you acquire. a. 2. Insurance for each newly acquired location will end when any of the following first happens: a. This exclusion does not apply to: a. you report values to us. We will charge you additional premium for values reported from the date you acquire the property. D. Property Not Covered Covered property does not include: 1. accounts, bills, currency, deeds, evidence of debt, money, notes or securities, except as provided in paragraphs I.A.2.c., and I.A.2.e; 2. rowboats or canoes out of water at the described premises; 3. that you own. II. EXCLUSIONS A. We will not pay for damage caused directly or indirectly by any of the following. Such damage is excluded regardless of any other cause or event that contributes concurrently in any sequence to the damage. 1. automobiles; a. contraband, or property in the course of illegal transportation or trade; 6. the cost of excavations, grading, backfilling or filling; 7. fine arts with a value exceeding $1,000 per item except as provided in paragraph I.A.2.d.; 8. foundations of buildings, machinery or boilers if their foundations are below: 2. requiring the tearing down of any property, including the cost of removing its debris. Earth Movement Any earth movement other than sinkhole collapse, such as an earthquake, landslide, mine subsidence or earth sinking, rising or shifting. If damage by fire or explosion results, we will pay for that resulting damage. a. the lowest basement floor; or 3. b. the surface of the ground, if there is no basement; Volcanic Eruption Any volcanic eruption, explosion or effusion. If damage by fire, building glass breakage or volcanic action results, we will pay for that resulting damage. land, including land on which the property is located, or water; 4. 10. pilings, piers, wharves or docks; Governmental Action Seizure or destruction of property by order of governmental authority. 11. property that is covered under another coverage part of this or any other policy in which it is more specifically described, except for the excess of the amount due, whether you can collect on it or not, from that other insurance. We will pay for acts of destruction ordered by governmental authority and taken at the time of a fire to prevent its spread, if the fire would be covered under this coverage part. 12. retaining walls that are not part of the building; 5. Nuclear Hazard Nuclear reaction or radiation, or radioactive contamination, however caused. 13. underground pipes, flues or drains; or G-15159-E, ED. 02106 regulating the construction, use or repair of any property; or b. 4. bridges, roadways, walks, patios or other paved surfaces; 5. Ordinance or Law The enforcement of any ordinance or law: animals; 9. snow removal or lawn care equipment of less than 20 horsepower; or b. 90 days expire after you acquire or begin to construct the property; or c. are operated principally away from the described premises; this policy expires; or b. are licensed for use on public roads; or b. The most we will pay for loss is $100,000 at each location. Page 7 of 17 If damage by fire results, we will pay for that resulting damage. property that causes it to damag e or destroy itself; 6. smog; war, including undeclared or civil war; 7. b. warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or c. 7. War And Military Action a. 6. insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. seepage, migration, escape, release, discharge or dispersal of contaminants or pollutants unless the seepage, migration, escape, release, discharge or dispersal is itself caused by any of the specified causes of loss. But if damage by the specified causes of loss results, we will pay for the resulting damage by the Specified Causes of Loss; 8. settling, cracking, shrinking or expansion; 9. nesting or infestation, or discharge or release of waste products or secretions, by insects, birds, rodents, or other animals; Water a. Flood, surface water, waves, tides, tidal waves, overflow of any body of water, or their spray, all whether driven by wind or not; b. Mudslide or mudflow; c. Water that backs up from a sewer or drain except as provided under the covered related expenses; 10. mechanical breakdown, including rupture or bursting caused by centrifugal force; or explosion or other damage to steam boilers, steam pipe, steam engines or steam turbines, hot water boilers or other water heating equipment except sterilization heating equipment heating equipment or domestic water supply systems owned or leased by you, or operated under your control. If damage by fire or combustion explosion results, we will pay for that resulting damage. We will also pay for damage caused by or resulting from the explosion of gases or fuel within the furnace of any fired vessel or within the flues or passages through which the gases of combustion pass; d. Water under the ground surface pressing on, or flowing or seeping through: (1) foundations, walls, floors or paved surfaces; (2) basements, whether paved or not; or (3) doors, windows or other openings. 11. continuous or repeated seepage or leakage of water that happens over a period of 14 days or more; But if damage by fire, explosion or sprinkler leakage results, we will pay for that resulting damage. 12. water, or other liquids, powder or molten material that leaks or flows from plumbing, heating, air conditioning or other equipment, except fire protective systems, caused by or resulting from freezing, unless: B. We will not pay for damage caused by or resulting from any of the following: 1. artificially generated electric current, including electric arcing, that disturbs electrical devices, appliances or wires; a. you do your best to maintain heat in the building; or b. you drain the equipment and shut off the water supply if the heat is not maintained. If damage by fire results, we will pay for that resulting damage. 2. delay, loss of use or loss of market; 13. dishonest or criminal acts by you, any of your partners, employees, directors, trustees, authorized representatives or anyone to whom you entrust the property for any purpose: 3. smoke, vapor or gas from agricultural smudging or industrial operations; 4. wear and tear; 5. rust, corrosion, fungus, decay, deterioration, hidden or latent defect or any quality in G-15159-E, ED. 02106 a. Page 8 of 17 acting alone or with others; or b. whether or not happening during the hours of employment. antennas, including their lead-in wiring, masts or towers; This exclusion shall not apply to acts of destruction by your employees, but theft by employees is not covered. 3. any increase of damage caused by or resulting from: a. delay in rebuilding, repairing or replacing the property or resuming your practice, due to interference at the location of the rebuilding, repair or replacement by strikers or other persons; or 14. voluntary parting with any property by you or anyone else to whom you have entrusted the property if induced to do so by any fraudulent scheme, trick, device or false pretense; b. suspension, lapse or cancellation of any license, lease or contract. If the suspension, lapse or cancellation is directly caused by the suspension of your practice, we will cover such damage that affects your practice the period of income during restoration, but not beyond the period of restoration. 15. rain, snow, ice or sleet to personal property in the open; or 16. collapse, except as provided under the Definition of Covered Cause of Loss for ALL RISKS OF DIRECT PHYSICAL LOSS A., Collapse. C. We will not pay for damage caused by or resulting from any of the following. If damage by a covered cause of loss results, we will pay for the resulting damage: 4. any other consequential damage. E. 1. weather conditions. This exclusion only applies if weather conditions contribute in any way with a cause or event excluded in Exclusions II. A.1. through 7. Above to produce the damage; 2. LIMITATIONS 1. We will not pay for damage to: a. acts or decisions, including the failure to act or decide, of any entity; (1) the building first sustains damage by a covered cause of loss to its roof or walls through which the rain, snow, sleet, ice, sand or dust enters; or 3. faulty, inadequate or defective: a. planning, zoning, surveying, siting; development, (2) the damage is caused by or results from thawing of snow, sleet or ice on the building; b. design, specifications, workmanship, repair, construction, renovation, remodeling, grading, compaction; c. b. building materials and supplies not attached as part of the building or structure, unless held for sale by you, caused by or resulting from theft; c. materials used in repair, construction, renovation or remodeling; or property that is missing, where the only evidence of the loss or damage is a shortage disclosed on taking inventory, or other instances where there is no physical evidence to show what happened to the property; d. maintenance; of part or all of any property on or off the described premises. D. Special Exclusions As respects practice Income coverage, we will not pay for: 1. any damage caused by or resulting from: d. gutters and downspouts caused by or resulting from weight of snow, ice or sleet; a. damage or destruction of finished stock or prosthesis; or b. e. 2. any damage caused by or resulting from direct physical damage to radio or television Page 9 of 17 property that has been transferred to any entity or to a place outside the described premises on the basis of unauthorized instructions; or f. the time required to reproduce finished stock or prosthesis; G-15159-E, ED. 02106 the interior of any building caused by or resulting from rain, snow, sleet, ice, sand or dust, whether driven by wind or not, unless: outdoor radio or television antennas, including their lead-in wiring, masts or towers when damage is caused by windstorm, hail, rain, sleet, snow, ice or weight of ice. 2. We will not pay for damage to your building or your blanket dental practice personal property in anyone event until the amount of damage exceeds the deductible shown on the Declarations. We will then pay the amount of damage in excess of the deductible, up to the applicable limit of insurance. For damage by theft, the following types of property are covered only up to the limits shown: a. $2,500 for furs, fur garments, garments trimmed with fur; b. c. or E. Inflation Guard 1. The Limit of Insurance for building and blanket dental practice personal property to which this coverage applies will automatically increase by the quarterly percentage shown on the Declarations. $5,000 for jewelry, watches, watch movements, jewels, pearls, precious and semi-precious stones, bullion, gold, silver, platinum and other precious alloys or metals. This limit does not apply to jewelry and watches worth $100 or less per item; 2. The amount of increase will be: a. $250 for stamps, tickets and letters of credit. b. the percentage of quarterly increase shown on the Declarations applied pro rata during each year. III. LIMITS OF INSURANCE A. The most we will pay for damage in anyone event is the applicable limits of insurance shown on the Declarations. the most recent limit of insurance exclusive of this coverage; multiplied by F. Valuation We will determine the value of covered property in the event of damage as follows: B. The Limits of Insurance applicable to your Practice Income, Extra Expense and Extended Practice Income shall be subject to annual aggregate limit of insurance of $1,000,000 for any damage caused by a Covered Cause of Loss. 1. Building: Your Blanket Dental Practice Personal Property: a. On the basis of replacement cost, without deduction for depreciation. C. Unless otherwise indicated, the limits of insurance applicable to the covered related expenses are in addition to the limits of insurance shown on the declarations. Payments under the following Covered Related Expenses will not increase the applicable limit of insurance: b. This valuation does not apply to: (1) property of others; (2) contents of a residence; (3) manuscripts; 1. preservation of property; or (4) fine arts; 2. debris removal; but if: (5) outdoor equipment furniture; or a. the sum of direct physical damage and debris removal expense exceeds the limit of insurance; or c. we will pay up to an additional $25,000 for each location in anyone event. As respects practice income and rents the following will not increase the limit of insurance: a. Alterations and New buildings; (1) until the damaged property is actually repaired or replaced; and Expense to Reduce Damage. D. Deductible G-15159-E, ED. 02/06 You may make a claim for damage covered by this insurance on an actual cash value basis instead of on a replacement cost baSis. In the event you elect to have damage settled on an actual cash value basis, you may still make a claim on a replacement cost basis if you notify us of your intent to do so within 180 days after the damage. d. We will not pay on a replacement cost basis for any damage: b. Civil authority; and c. outdoor (6) stock. b. the debris removal expense exceeds the amount payable under the 25% debris removal for covered related expenses; 3. or Page100f17 (2) unless the repairs or replacement are made as soon as reasonably possible after the damage. b. labor to transcribe or copy the records when there is a duplicate. 6. These requirements do not apply when damages are $10,000 or less. Practice Income a. Actual Loss Sustained - If your practice is suspended due to physical damage at the described premises or power failure as described under paragraph I.B.8., we will pay for the actual loss of Practice Income you sustain in accordance with paragraph I.A.3. unless a Valued Daily Limit is shown on the declarations. If a Valued Daily Limit is shown on the declarations, Practice Income will be valued in accordance with paragraph III.F.6.b. below. b. Valued Daily Limit - If your practice is suspended due to physical damage at the described premises or power failure as described under paragraph I.B.8., we will pay up to the number of days shown on the declarations: e. We will not pay more for damage on a replacement cost basis than the least of: (1) the limit of insurance applicable to the damaged property; or (2) the cost to replace, on the same premises, the damaged property with other property: (a) of comparable quality; and material and (b) used for the same purpose; or f. 2. The amount you actually spend that is necessary to repair or replace the damaged property. Stock you have sold but not delivered at the selling price less discounts and expenses you otherwise would have had. (1) the limit per day shown on the Declarations if your practice is totally suspended; or 3. Glass at the cost of replacement with safety glazing material if required by law. . 4. (2) the proportion of the limit per day if your practice is partially suspended. This proportion shall be calculated as the ratio of reduced practice hours compared to normal practice hours. Tenant's improvements and betterments at: a. replacement cost of the damaged property if you make repairs promptly; b. a proportion of your original cost if you do not make repairs promptly. We will determine the proportionate value as follows: A day means a period of 24 hours, beginning at 12:01 A.M. and during which your practice was or would be conducted. (1) Multiply the original cost by the number of days from the damage to the expiration of the lease; and c. (2) Divide the amount determined in (1) above by the number of days from the installation of improvements to the expiration of the lease. 7. 5. Nothing if others pay for repairs or replacement. Rents or sustained. experience experience 8. If your lease contains a renewal option, the expiration of the renewal option period will replace the expiration of the lease in this procedure. c. Even if a Valued Daily Limit applies, you may alternatively make a claim for practice income covered by this insurance on an actual loss sustained basis during the period of restoration in accordance with Condition V.J.7. other income at actual loss Consideration will be given to the before the loss and the probable had no loss occurred. At actual cash value as of the time of damage, except as provided above. IV. DEFINITIONS "Accounts Receivable Records" means: Valuable papers and records, including those which exist on electronic media and records, other than prepackaged software programs, at the cost of: A. all sums due you from customers, provided you are unable to effect collection; a. blank materials for reproducing the records; and B. interest charges on any loan to offset impaired collections pending repayment of such amounts made uncollectible by damage; G-15159-E, ED. 02106 Page 11 of 17 C. collection expenses in excess of normal collection cost made necessary because of damage; and 1. additions under construction, alterations and repairs to the building; 2. D. other reasonable expenses incurred by you in re-establishing records of accounts receivable following such damage. "Blanket Dental Practice Personal Property" means property other than buildings, consisting of the following: materials, equipment, supplies and temporary structures, on or within 1000 feet of the described premises, used for making additions, alterations or repairs to the building. B. machinery and equipment; "Covered Causes of Loss" means ALL RISK OF DIRECT PHYSICAL LOSS except as excluded or limited in Section II. Of this Coverage Part. ALL RISK OF DIRECT PHYSICAL LOSS shall also include the following: C. stock; A. Collapse A. furniture and fixtures; 1. We will pay for damage caused by or resulting from collapse of a building or any of its parts caused only by one or more of the following: D. all other personal property owned by you and used in your practice; E. labor, materials or services furnished or arranged by you on personal property of others; and a. the specified causes of loss or breakage of building glass, all only as insured against in this Coverage Part; b. hidden decay; 1. made a part of the building you occupy but do not own; and c. hidden insect or vermin damage; d. weight of people or personal property; 2. e. weight of rain that collects on a roof; and f. use of defective material or methods in construction, remodeling or renovation if the collapse happens during the course of the construction, remodeling or renovation. F. your use interest as tenant in improvements and betterments. Improvements and betterments are fixtures, alterations, installations or additions: you acquired or made at your expense but cannot legally remove. "Building" means the building or structure described on the Declarations, including: A. completed additions; B. permanently installed; 2. 2. machinery; and We will not pay for damage to the following types of property unless the damage is a direct result of the collapse of a building; 3. equipment; a. 4. radio and television antennas and satellites including lead-in wiring and masts. outdoor radio or television antennas, including their lead-in wiring, masts or towers; b. awnings; gutters and downspouts; c. yard fixtures, outdoor swimming pools; d. fences; piers, wharves and docks; beach or diving platforms or appurtenances; or e. retaining walls; walks, roadways and other paved surfaces. 1. fences, fixtures; B. outdoor fixtures; C. an appurtenant structure for up to 10 percent of the building limit. D. personal property owned by you that is used to maintain or service the building or its premises, including: 1. fire extinguishing equipment; 2. 3. floor coverings; and 4. appliances used for refrigerating, ventilating, cooking, dishwashing or laundering; and Collapse does not include settling, cracking, shrinkage, bulging or expansion, nor shall this coverage increase the Limits of Insurance of this Coverage Part. outdoor furniture; B. Water Damage If damage caused by or resulting from covered water damage or other liquid, powder or molten material damage happens, we will also pay the E. If not covered by other insurance: G-15159-E, ED. 02106 Page120f17 cost to tear out and replace any part of the building to repair damage to the system or appliance from which the water or other substance escapes. We will not pay the cost to repair any defect that caused the damage; but we will pay the cost to repair or replace damaged parts of fire extinguishing equipment if the damage: 1. results in discharge of any sUbstance from an automatic fire protection system; or 2. is directly caused by freezing. "Damage" means partial or total loss of or damage to your covered property. "Electronic Media and Records" means: A. electronic data processing, recording or storage media such as films, tapes, discs, drums or cells. B. data stored on such media; or C. programming records used for electronically controlled equipment. "Elevator" means a hoisting or lowering device to connect floor or landings. It mayor may not be in service. It may consist of several parts, such as: a car or platform; a shaft, hoistway, stairway, or runway; power equipment and machinery. For the purpose of this Coverage Part, elevator does not include: A. an auto servicing hoist; C. any hod or material hoist used in construction operations; used exclusively for E. a dumbwaiter used exclusively for carrying property and having a compartment height of 4 or less feet. "Falling Objects" means damage to the interior of a building or property inside provided that the roof or an outside wall of the building is first damaged by a falling object. Falling objects does not include damage to: A. personal property in the open; or B. the interior of a building, or property inside a building, unless the roof or an outside wall of the building is first damaged by a falling object. "Fine Arts" means paintings, etchings, pictures, tapestries, statuary, marbles, bronzes, porcelains G-15159-E, ED. 02/06 "Finished Stock" manufactured. means stock you have "Period of Restoration" means the period of time that: A. begins 24 hours immediately following direct physical damage or power failure as described under paragraph I.B.8 caused by or resulting from any Covered Cause of Loss at the described premises or power failure as described in paragraph I.B.8.; and B. ends on the date when the property at the described premises should be repaired, rebuilt or replaced with reasonable speed and similar quality. Period of restoration does not include any increased period required due to the enforcement of any ordinance or law that: • regulates the construction, use or repair, or requires the tearing down of any property; or • requires you or others to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants. The expiration date of this policy will not cut short the period of restoration. "Practice Income" means the: B. a hoist without a platform outside a building, which does not have mechanical power or is not attached to a building wall; D. an inclined conveyor carrying property; or and bric-a-brac, art glass windows and other bona fide works of art or rarity, historical value or artistic merit. A. net income, meaning net profit or loss before income taxes, that would have been earned or incurred; and B. continuing normal operating expenses, including payroll. "Rents" or other income means the sum of: A. gross income from the described property; B. the amount of all charges assumed by the tenants which would otherwise be your obligations; and C. rental value of that portion occupied by you or vacant portions that would have been rented had no damage occurred. "Sinkhole Collapse" means the sudden sinking or collapse of land into underground empty spaces created by the action of water on limestone or dolomite. This cause of damage does not include: A. the cost of filling sinkholes; or B. sinking or collapse of land into man-made underground cavities. Page 130f17 4 Years in Wyoming; "Specified Causes of Loss" means the following: fire; lightning; explosion; windstorm or hail; smoke; aircraft or vehicles; riot or civil commotion; fire extinguishing vandalism; leakage from equipment; sinkhole collapse; volcanic action; failing objects: weight of snow, ice or sleet; water damage. "Stock" means merchandise held in storage or for sale, raw materials and in-process or finished goods, including supplies used in their packing or shipping. "Valuable Papers and Records" means written, printed or otherwise inscribed documents and records including books, maps, films, drawings, abstracts, deeds, mortgages, manuscripts, x-ray negatives and prints and patient's charts. "Volcanic Action" means direct damage resulting from the eruption of a volcano when the damage is caused by: 3 Years in Maryland, Norlh Carolina, North Dakota or Ulah; or 2 Years in all other States; aller the date on which the direct physical damage happened. C. Liberalization If we adopt any revision that would broaden the coverage under this Coverage Part without additional premium within 45 days prior to or during the policy period, the broadened coverage will immediately apply to this Coverage Part. D. No Benefits to Bailee No entity, other than you, having custody of covered property will benefit from this insurance. E. Other Insurance A. airborne volcanic blast or airborne shock waves; 1. You may have other insurance subject to the same plan, terms, conditions and provisions as the insurance under this Coverage Part. If you do, we will pay our share of the covered damage. Our share is the proportion that the applicable limit of insurance under this Coverage Part bears to the limits of insurance of all insurance covering on the same basis. 2. If there is other insurance covering the same damage, other than that described in 1. Above, we will pay onty for the amount of covered damage in excess of the amount due from that other insurance, whether you can collect on it or not. But we will not pay more than the applicable limit of insurance. B. ash, dust or particulate matter; or C. lava flow. All volcanic eruptions that happen within any 168hour period will constitute a single event. Volcanic action does not include the cost to remove ash, dust or particulate matter that does not cause direct physical damage to the described property. "Water Damage" means accidental discharge or leakage of water or steam as the direct result of the breaking or cracking of any part of a system or appliance containing water or steam. V. CONDITIONS The following Conditions apply in addition to the Common Policy Conditions. F. Transfer of Rights of Recovery The following is added to the Common Policy Conditions: A. Control of Property Any act or neglect of any person other than you beyond your direction or conlrol will not affect this insurance. You may waive your rights against another party in writing: 1. prior to damage to your covered property or covered income. The breach of any condition of this Coverage Part at anyone or more locations will not affect coverage at any location where, at the time of damage, the breach of condition does not exist. 2. B. Legal Action Against Us a. No one may bring a legal action against us under this Coverage Part unless the action is brought within: someone insured by this insurance; b. The following is added to the Common Policy Conditions: a business; (1) owned or controlled by you; or (2) that owns or controls you; or 6 Years in South Dakota; (3) your tenant. 5 Years in Florida or Kansas; G-15159-E, ED. 02106 aller damage to your covered property or covered income only if, at the time of damage, that party is one of the following: This will not restrict your insurance. Page 140f17 7. If requested, permit us to question you under oath at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. In such event, your answers must be signed. 8. Send us a signed, sworn statement of damage containing the information we request to investigate the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. 9. G. Abandonment Cooperate with us in the investigation or settlement of the claim. There can be no abandonment of any property to us. H. Appraisal If we and you disagree on the value of the property, the amount of net income and operating expense, or the amount of damage, either may make written demand for an appraisal of the damage. In this event, each party will select a competent and impartial appraiser. The two appraisers will select an umpire. If they cannot agree, either may request that selection be made by a judge of a court having jurisdiction. The appraisers will state separately the value of the property and amount of damage. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will be binding. Each party will: 10. Resume all or part of your practice as quickly as possible. J. Payment for Damage 1. In the event of damage covered by this Coverage Part, at our option we will either: 1. pay its chosen appraiser; and b. pay the cost of repairing or replacing the damaged property; If there is an appraisal, we will still retain our right to deny the claim. I. a. pay the value of damaged property; 2. bear the other expenses of the appraisal and umpire equally. c. take all or any part of the property at an agreed or appraised value; or Duties In the Event of Damage d. repair, rebuild or replace the property with other property of like kind and quality. You must see that the following are done in the event of damage to covered property: 2. 3. 4. 5. 6. At our request, give us complete inventories of the damaged and undamaged property. Include quantities, costs, values and amount of damage claimed. We will pay for covered damage within 30 days after we receive the sworn statement of damage if: a. Page 15 of 17 you have complied with all of the terms of this Coverage Part; and b. Permit us to inspect the property and records proving the damage. Also permit us to take samples of damaged property for inspection, testing and analysis. G-15159-E, ED. 02106 We may elect to defend you against suits arising from claims of owners of property. We will do this at our expense. 6. Take all reasonable steps to protect the Covered Property from further damage by a covered cause of loss. If feasible, set the damaged property aside and in the best possible order for examination. Also keep a record of your expenses for emergency and temporary repairs, for consideration in the This will not settlement of the claim. increase the limit of insurance. We may adjust damages with the owners of damaged property if other than you. If we pay the owners, such payments will satisfy your claims against us for the owners' property. We will not pay the owners more than their financial interest in the covered property. 5. As soon as possible, give us a description of how, when and where the damage happened. We will not pay you more than your financial interest in the covered property. 4. 2. Give us prompt written notice of the Include a description of the damage. property involved. We will give notice of our intentions within 30 days after we receive the sworn statement of damage. 3. 1. Notify the police if a law may have been broken. we have reached agreement with you on the amount of damage, or an appraisal award has been made. We will pay recovery expenses and the expenses to repair the recovered property, subject to the limit of insurance. 7. The amount of practice income loss will be determined based on: a. the net income of the practice before the direct physical damage happened; b. Vacancy If the building where damage happens has been vacant for more than 60 consecutive days before the damage, we will: the likely net income of the practice if no damage happened; c. l. the operating expenses, including payroll expenses, necessary to resume your practice with the same quality of service that existed just before the direct physical damage; and 1. not pay for any damage caused by any of the following even if they are covered causes of loss: a. vandalism; d. other relevant sources of information, including: (1) your financial records accounting procedures; b. c. (3) deeds, liens or contracts. We will reduce the amount of your practice income recovery by any amounts paid to you, or to the extent you can resume your practice, in whole or in part, by using damaged or undamaged property, including merchandise or stock, at the described premises or elsewhere. 2. 8. K. reduce the amount we would otherwise pay for the damage by 15%. M. Mortgage Holders 1. The term "mortgage holder" includes: a. b. the owner of the building at the described premises which is leased or rented to you, but only during the time you are a tenant in that building; c. the owner of any equipment, materials or supplies which are leased to you, but only while at the described premises; and d. the period, beginning with the date of direct, physical damage, necessary to repair, rebuild or replace, with reasonable speed and similar quality, other property at the described premises due to damage caused by the same event. any trustees; any creditor with whom you have entered a contract for the sale of covered property whose interest is established by written contract. 90 consecutive days from the date of direct physical damage; or b. actual or attempted theft; A building is vacant when it does not contain enough blanket dental practice personal property to conduct customary practice, but buildings under construction are not considered vacant. We will not pay for any loss of practice income caused by direct physical damage to electronic media and records after the longer of: a. water damage; or e. (2) bills, invoices and other vouchers; and building glass breakage; d. and sprinkler leakage, unless you have protected the system against freezing; If you sustain any rents or other income reduction covered under this Coverage Part which exceeds the amount of coverage, all recoveries on account of the damage, less the actual cost of recovery, shall be applied to the reimbursement of you to the extent of your uninsured amount less the deductible amount. 2. We will pay for covered damage to covered property to each mortgage holder shown on the Declarations in their order of precedence, as interests may appear. 3. The mortgage holder has the right to receive damage payment even if the mortgage holder has started foreclosure or similar action on the covered property. 4. If we deny your claim because of your acts or because you have failed to comply with the terms of this Coverage Part, the Recovered Property If either you or we recover any property after damage settlement, that party must give the other prompt notice. At your option, the property will be returned to you. You must then return to us the amount we paid to you for the property. G-15159-E, ED. 02106 Page160f17 mortgage holder will still have the right to receive damage payment if the mortgage holder: a. pays any premium due under this Coverage Part at our request if you have failed to do so; b. submits a signed, sworn statement of damage within 60 days after receiving notice from us of your failure to do so; and c. has notified us of any change in ownership, occupancy or substantial change in risk known to the mortgage holder. All of the terms of this Coverage Part will then apply directly to the mortgage holder. 5. If we pay the mortgage holder for any damage and deny payment to you because of your acts or because you have failed to comply with the terms of this Coverage Part: a. the mortgage holder's rights under the mortgage will be transferred to us to the extent of the amount we pay; and b. the mortgage holder's right to recover the full amount of the mortgage holder's claim will not be impaired. At our option, we may pay to the mortgage holder the whole principal on the mortgage plus any accrued interest. In this event, your mortgage and note will be transferred to us and you will pay your remaining mortgage debt to us. 6. If we cancel this policy, we will give written notice to the mortgage holder at least: a. b. 7. 10 days before the effective date of cancellation if we cancel for your nonpayment of premium; or 30 days before the effective date of cancellation if we cancel for any other reason. If we elect not to renew this policy, we will give written notice to the mortgage holder at least 10 days before the expiration date of this policy. G-15159-E, ED. 02106 Page 17 of 17 WASHINGTON AMENDATORY ENDORSEMENT BUILDING, BLANKET DENTAL PRACTICE PERSONAL PROPERTY AND INCOME COVERAGE PART 1. directly and solely results in damage; or We agree with you that the Building, Blanket Dental Practice Personal Property and Income Coverage Part is amended as follows: A. 2. initiates a sequence of events that results in damage, regardless of the nature of any intermediate or final event in that sequence. Under Section I., COVERAGE AGREEMENTS, A, Property Covered, 2.,Your Blanket Dental Practice Personal Property, the following is added: D. Section II. EXCLUSIONS, B.5. and B.9. are modified to include the following: Your Blanket Dental Practice Personal Property includes personal effects and property of others that you lease or rent under written contract to the extent of your liability for the damage. But this exclusion shall not apply as specifically described in Section IV., DEFINITIONS, "Covered Causes of Loss," A Collapse. B. Section I. COVERAGE AGREEMENTS, B., Covered Related Expenses, 12., Personal Effects and Property of Others, b., is deleted and replaced by the following: b. Under Section II. EXCLUSIONS, B.13., the following is added: E. This exclusion or the Concealment, Misrepresentation, Fraud Condition will not apply to deny an insured's claim for an otherwise covered property loss if caused by an act of domestic abuse by another insured under the policy, and the insured making the claim files a police report and cooperates with any law enforcement investigation, and did not cooperate in or contribute to the creation of the damage. Personal property of others: (1) in your care, custody or control, except as provided in Your Blanket Dental Practice Personal Property above; and (2) located in or on the building described on the Declarations or in the open, or in a vehicle, within 100 feet of the described premises. The most we will pay for damage is $10,000 at each described premises. Our payment, for damage to personal property of others will only be for the account of the owner of the property. Domestic abuse means physical harm, bodily injury, assault, or the infliction of fear of imminent physical harm, bodily injury or assault between family or household members. It includes sexual assault of one family or household member against another, stalking as defined by RCW 9A46.11 a of one family or household member by another family or household member, or intentionally, knowingly or recklessly causing damage to property so as to intimidate or attempt to control the behavior of another family or household member. C. Under Section II. EXCLUSIONS A., the first paragraph is deleted and replaced as follows: A We will not pay for damage caused by any of the excluded events described below. Damage will be considered to have been caused by an excluded event if the occurrence of that event: G·15175·G46 (Ed. 01/01) F. Page 1 of 3 Section III. LIMITS OF INSURANCE, F., Valuation, 1., Building; Your Blanket Dental Practice Personal Property:, e. (2) is replaced by the following: (2) the cost to replace, on the same premises, the damaged property with other new property: G. matter following a volcanic eruption. Subsequent deposits arising from the movement of volcanic dust or ash by wind or other means are not covered. Section IV. DEFINITIONS, 'Volcanic Action" is deleted and replaced by the following: The following provision applies only to I., COVERAGE AGREEMENTS, A, Property Covered, 5., Extended Practice Income and 6., Rents. UVolcanic Action" means direct damage resulting from the eruption of a volcano when the damage is caused by: The period of restoration arising from the need to remove is the time necessary to remove the matter described with reasonable speed from the Covered Property. A Volcanic blast or airborne shock waves; or B. Ash, dust or particulate matter. Votcanic Action does not include damage caused by, resulting from, contributed to or aggravated by: Volcanic Action does not mean damage to: A Land; A. Fire, B. Explosion, C. Flood, surface water, waves, tides, tidal waves, overfiow of any body of water, or their spray, all whether driven by wind or not; or D. Earth movement, including but not limited to earthquake, volcanic eruption, landslide, lava now, mud ftow, earth sinking, earth rising or shifting. B. Property in the open or in open sheds; or C. Portions of buildings not completely enciosed, or personal property contained within those buildings. All volcanic eruptions that occur within any 72-hour period will constitute a single event. Covered Related Expenses inciudes the cost to: a. b. remove the ash, dust or particulate matter from the interior and exterior surfaces of the covered building; and ciean equipment and stock. If stock cannot be returned to its state before the volcanic eruption, the measure of damage will be the reduction in actual cash value. H. Under section V. CONDITIONS, H., Appraisal, the last paragraph does not apply. I. Insurance Commissioner's Regulation No. 335/wAC-284-21-010 requires that Form 372 (Ed. 11-50) or Form 438 BFU (Ed. 5-42) be endorsed on this policy to replace this Condition. Payment for removal applies only to the initial deposit of ash, dust or particulate G-15175-G46 (Ed. 01101) Section V. CONDITIONS, M., Mortgage Holders is replaced by the following: Page 20f3 All other provisions of the policy remain unchanged. This endorsement is a part of your policy and takes effect on the policy effective date, unless a different date is specified below: Named Insured Policy Number Effective date of this endorsement Countersigned By: _ _ _ _ _ _ _ _ _ _ __ Authorized Agent G-15175-G46 (Ed. 01101) Page 30f3 CNA For All the Commitmcntsyou Make" STATE PROVISIONS - WASHINGTON Any cancellation or non-renewal provisions contained in the policy to which this endorsement is attached are deleted and replaced by the following: I. hour the cancellation is effective. The policy will end on that date. The grounds for such cancellation shall also be stated. Cancellation E. If notice is mailed, proof of mailing will be sufficient proof of notice. A. This policy can be canceled by either the first of you named or us. 1. You can cancel this policy at any time. To do so, you must: a. return the policy to us or any of our authorized representatives; or b. mail a written notice to us; stating when the cancellation is to be effective. We must receive the policy or written notice before the cancellation date. 2. We can cancel this policy by giving written notice to you at least: a. 10 days, if cancellation is for nonpayment of premium. However, you may continue the coverage by payment in full at any time prior to the date the cancellation is effective; or b. 45 days if cancellation is for any other reason; before the date the cancellation is effective. B. We will mail or deliver notice to you at the last mailing address known to us. A copy shall also be mailed or delivered to your agent. C. We will also mail or deliver notice to any Mortgage Holder, pledgee or other person shown by the policy to have an interest in any loss which may happen under this policy, at their last mailing address known to us. The notice will be the same as that mailed or delivered to the first of you named. D. Notice of cancellation will state the date and G-11715-E46 (ED. 04189) F. If this policy is canceled, we will send the first of you named any premium refund due. If we cancel, the refund will be pro-rata. If you cancel, the refund will be at least 90% of the pro-rata refund. The cancellation will be effective even if we have not made or offered a refund. II. Non-Renewal If we decide not to renew this policy, 45 days advance written notice shall be mailed or delivered to you at the address shown in this policy. Like notice shall also be mailed to each mortgagee, pledgee, or other person shown by the policy to have an interest in any loss which may happen. A copy shall also be mailed or delivered to your agent. The notice shall include the reason for such non-renewal. In the event we are willing to renew this policy, a premium billing notice shall be mailed or delivered to you at the address shown in this policy not less than 20 days in advance of the renewal or anniversary date of this policy. The premium billing notice shall be based upon the rates and rules applicable to the ensuing policy period. If we or our authorized representatives fail to provide the required notice, you shall be entitled to renewal of this policy at the same premium rate and policy conditions as the expiring policy. Such renewal shall not prevent us from making changes in the rates andlor contract provisions of the policy once during the term of its renewal after at least 20 days advance notice of such change has been given to you. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FUNGI/MOLD / MILDEW / YEAST / MICROBE EXCLUSION AND WATER DAMAGE LIMITATION WASHINGTON This endorsement modifies insurance provided under the following: COMMON POLICY CONDITIONS GENERAL LIABILITY COVERAGE PART I. THE GENERAL LIABILITY COVERAGE PART IS MODIFIED AS FOLLOWS: The following is added to Section II, EXCLUSIONS: We will not defend, or pay under this Coverage Part for: loss due to fungi or microbes, meaning: 1. Injury or damage arising out of or relating to, in whole or in part, the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence of, or growth or presence of any fungi or microbes. 2. Any loss cost or expense arising out of or relating to Ihe testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, remediating, or disposing of, or in any way responding to or assessing the effects of fungi or microbes by any insured or anyone else. 3. Damage caused by water where there also exists any damage arising out of or relating to, in whole or in pari, the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence of, or growth or presence of any fungi or microbes. This exclusion does not apply where your business is food processing, sales, or serving, and the Injury is caused solely by food poisoning in connection with such processing, sales or serving. II. THE COMMON POLICY CONDITIONS ARE MODIFIED AS FOLLOWS: The following is added to Section XVIII,. Definitions: "Fungi" means any form of fungus, including but not limited to, yeast, mold, mildew, rust, smut or mushroom, and including any spores, mycotoxins, odors, or any other substances, products, or byproducts produced by, released by, or arising out of the current or past presence of fungi. But fungi does not include any fungi intended by the insured for consumption. "Microbe" means any non-fungal microorganism or non-fungal, colony-form organism that causes infection or disease. Microbe includes any spores, mycotoxins, odors, or other substances, products, or byproducts produced by, released by, or arising out of the current or past presence of microbes. But microbe does not mean microbes that were transmitted directly from person to person. Page 1 of 1 G-142815·A46 (ED. 08/03) Incorporates materials copyrighted by Insurance Services Offices, reprinted with their permission CNA fbr All tho Commitments You Maims WASHINGTON AMENDATORY ENDORSEMENT GENERAL LIABILITY COVERAGE PART B. We agree with you that the General Liability Coverage Part is amended as follows: Section II., EXCLUSIONS, H., is deleted and replaced by the following: H. A. Section II., EXCLUSIONS, A. applies only to injury to any of your employees whose employment is not subject to the Industrial Insurance Act of Washington (Washington Revised Code Title 51). injury or damage for which you may be held liable as a result of: A. 2. an employee of yours arising out of and in the course of employment by you; or any obligation to share a loss with or repay someone else who must indemnify because of the injury. This exclusion does not apply to liability you assume under an insured contract. Named Insured Effective Date of Endorsement (Ed. 01101) furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or 3, injury to: 1. G-58004-G46 causing or contributing to the alcoholic beverage intoxication of any person; 2. With respect to injury to your employees whose employment is subject to the Insurance Act of Washington, Section II., EXCLUSIONS, A. is deleted and replaced with the following: 1. any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. This exclusion only applies if you: 1. manufacture, sell or distribute alcoholic beverages; or 2. serve or furnish alcoholic beverages whether or not such activity is for the purposes of financial gain or livelihood. All other provisions of this policy remain unchanged, Policy Number Countersigned By:: _ _ _ _ _ _ _ _-,---_ Authorized Agent CNA For Alltho Commitments. You :'tlalw* POLICYHOLDER NOTICE Economic and Trade Sanctions Conditions Ethics and proper business conduct has been the cornerstone of CNA since 1897. While much has changed during the last century, our commitment to these core values has not wavered. We strongly believe that proper business conduct is more than the practice of avoiding wrong; it is also a matter of choosing to do right. Nowhere is this more essential than helping in the fight against terrorism. As such, we are committed to complying with U.S. Department of Treasury Office of Foreign Asset Control (OFAC) requirements. Through a variety of laws, OFAC administers and enforces economic sanctions against countries and groups of individuals, such as terrorists and narcotics traffickers. These laws prohibit all United States citizens (including corporations and other entities) and permanent residents from engaging in transactions with sanctioned countries and with individuals and entities on the Specially Designated Nationals (SDN) list. Because all U.S. citizens and companies are subject to this law, we wanted to be sure you were aware of its scope and restrictions. If you haven't already done so, you may want to consider discussing this issue with your legal counsel to ensure you are in compliance. For insurance companies, accepting premium from, issuing a policy to, insuring property of, or making a claim payment to an individual or entity that is the subject of U.S.-imposed economic sanctions or trade embargoes usually are violations of these laws and regulations. Fines for violating OFAC requirements can be substantial. CNA has established an OFAC compliance program part which includes the use of exclusionary policy language. We believe this makes good business sense for CNA and you. The purpose of this letter is to advise you that your policy includes OFAC exclusionary policy language, which may reduce or eliminate certain coverage. Specifically, if it is determined that your policy violates certain Federal or State laws or regulations, such as the U.S. list of Specially Designated Nationals or Blocked Persons (organizations or individuals associated with terrorist groups), any term or condition of your policy will be null and void to the extent it violates the applicable laws or regulations of the United States. We're sure you share our commitment to compliance and thank you for your cooperation. Your policy language reads as follows: ECONOMIC AND TRADE SANCTIONS CONDITION The following condition is added to the Policy: ECONOMIC AND TRADE SANCTIONS CONDITION In accordance with laws and regulations of the United States concerning economic and trade embargoes, this policy is void from its inception with respect to any term or condition of this policy that violates any laws or regulations of the United States concerning economic and trade embargoes including, but not limited to the following: 1. Any insured, or any person or entity claiming the benefits of an insured, who is or becomes a Specially Designated National or Blocked Person or who is otherwise subject to U.S. economic or trade sanctions; 2. Any claim or "suit" that is brought in a Sanctioned Country or by a Sanctioned Country Government, where any action in connection with such claim or suit is prohibited by U.S. economic or trade sanctions; OFACNB Page lof2 CNA For All the Commitments You Make3> 3. Any claim or "suit" that is brought by any Specially Designated National or Blocked Person or any person or entity who is otherwise subject to U.S. economic or trade sanctions; 4. Property that is located in a Sanctioned Country or that is owned by, rented to or in the care, custody or control of a Sanctioned Country Government, where any activities related to such property are prohibited by U.S. economic or trade sanctions; or 5. Property that is owned by, rented to or in the care, custody or control of a Specially Designated National or Blocked Person, or any person or entity who is otherwise subject to U.S. economic or trade sanctions. As used in this endorsement a Specially Designated National or Blocked Person is any person or entity that is on the list of Specially Designated Nationals and Blocked Persons issued by the U.S. Treasury Department's Office of Foreign Asset Control (OFAC) as it may be from time to time amended. As used in this endorsement a Sanctioned Country is any country that is the subject of trade or economic embargoes imposed by the laws or regulations of the United States of America. THIS DISCLOSURE NOTICE DOES NOT PROVIDE COVERAGE NOR DOES THIS NOTICE REPLACE ANY PROVISIONS OF YOUR POLICY. YOU SHOULD READ YOUR POLICY AND REVIEW YOUR DECLARATIONS PAGE FOR COMPLETE INFORMATION ON THE COVERAGE AND PRICE OF YOUR POLICY. IF THERE IS ANY CONFLICT BETWEEN THE POLICY AND THIS NOTICE, THE PROVISIONS OF THE POLICY SHALL PREVAIL. YOUR INDEPENDENT INSURANCE AGENT WILL BE ABLE TO EXPLAIN THE TERMS OF THE CONTRACT IN DETAIL. OFACNB Page 2of2

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