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Address Info: 1150 O Street, P.O. Box 758, Greeley, CO 80632 | Phone:
(970) 400-4225
| Fax: (970) 336-7233 | Email:
egesick@weld.gov
| Official: Esther Gesick -
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a Serving Colorado's Counties April 12, 2005 To: CAPP Designated Correspondents From: Patti Bronikowski, Manager-Risk Programs RE: CAPP Certificates of Insurance Revised Certificates of Participation Enclosed are your 2004 and 2005 Colorado Counties Casualty and Property Pool Insuring Agreements. Since we didn't receive the 2004 policies from the excess insurance carriers until 2005, we decided to put both years into one binder. Also enclosed are revised Certificates of Participation for 2004 and 2005. Please discard the certificates you have and replace them with these. The only change in the Certificates is on page 2: A. Liability From $250,000 per claim/occurrence to $3 million per claim/occurrence except for auto which is non-aggregated, subject to the following: All liability coverages are provided on a claims-made coverage form. except for The revision has to do with the termination of auto PIP (personal injury protection) which was signed into law in July 2003. This revision does not change your coverage, it is merely a technicality to reflect the language in the CAPP Insuring Agreements. Please contact me if you have any questions. 255 County Technical Services, Inc. Administration&Loss Prevention 800 Grant Street • Suite 400 Claims(CAPP&CWCP) Phone:303.861.0507 Phone:303.861.0507 1-800.544.7868 Fax:303.861.2832 Denver, Colorado • 80203 Fax:303.861.1022 email: ctsi@ctsi.org Certificate of Participation Colorado Counties Casualty and Property Pool (CAPP) For the Coverage Period January 1, 2005 through December 31, 2005 WELD COUNTY Colorado Counties Casualty and Property Pool(CAPP)hereby certifies that Weld County is a participating Member of CAPP for the period beginning January 1,2005 through December 31,2005. The coverages, conditions of membership, and other provisions applicable to members of CAPP are as described in CAPP's Bylaws and Intergovernmental Agreement and in the applicable excess policies, Policy Statements and endorsements thereto, copies of which have been or will be provided to Weld County. The types and monetary limits of the coverages provided to Weld County through membership in CAPP, in consideration of the payment of its contributions,are limited, as of the date of this certificate,to those which are shown below. The scope,terms, conditions, and limitations of coverages are governed by the aforementioned agreement and policies. I. The types of coverages, subject to the limit on CAPP's liability in Section II below, are as follows: A. Property(including EDP, mobile equipment,and autq physical damage) B. Liability 1. Bodily Injury,Property Damage(General Liability,Auto Liability) 2. Wrongful Acts committed in the conduct of duties(Public Entity Management Liability) 3. Bodily Injury, Property Damage,Personal Injury(Law Enforcement Liability) 4. Errors or omissions in the administration of an insured's employee benefits(Employee Benefits Liability) 5. Injury resulting from healthcare professional services rendered by EMTs(Emergency Medical Professional Liability) C. Crime 1. Monies and Securities(inside) 2. Monies and Securities(outside) 3. Employee Fidelity D. Boiler and Machinery II. CAPP Retention,Aggregate Limits,and Member Deductibles For the coverages described in Section I,CAPP shall be liable only for payment of the self-insured retention and only to a total annual aggregate amount for members of CAPP as a whole of the amount of the CAPP loss fund for the coverage period. CAPP's per claim/occurrence retention are limited to the following for the foregoing coverages: A. $150,000 per claim/occurrence property B. $250,000 per claim/occurrence liability(per coverage line) C. $150,000 per claim/occurrence crime D. $5,000 per loss boiler and machinery CAPP Certificate of Participation-Revised 4/05 In addition,there is a maintenance deductible of$500, which applies to each of the County's first party claims/occurrences/losses. Payment of the deductible reduces the amount otherwise payable under the applicable CAPP retention. Pertaining to all liability losses, CAPP has purchased an aggregate retention protection of$4 million. Coverages in excess of the foregoing retention are provided only by the excess insurers in applicable excess policies, and are payable only by those excess insurers. The limits of coverage provided by the excess insurers are as follows: A. Liability From$250,000 per claim/occurrence to $3 million per claim/occurrence except for auto which is non-aggregated, subject to the following: All liability coverages are provided on a claims-made coverage form. In no event shall the maximum per claim/occurrence payment exceed the following for general liability, auto liability,public entity management liability, law enforcement liability,employee benefits liability or medical professional liability claims subject to the Governmental Immunity Act: $150,000 per person and$600,000 per occurrence. Additional limits, sublimits and aggregates apply as provided in the applicable excess policies. B. Crime None C. Boiler and Machinery From$5,000 to the cost of repair/replacement for each actual loss sustained up to$50 million. Additional limits, sublimits and aggregates apply as provided in the applicable excess policies. D. Property From$150,000 to $50 million each occurrence. "All Risk" basis with sublimits of$1 million newly acquired property, $5 million new construction each occurrence and$500,000 unscheduled locations. Sublimits of$1 million for property in Flood Zone A and $10 million for property in Flood Zones B,D and X500. Newly acquired property must be reported within 60 days.Additional limits, sublimits and aggregates apply as provided in the applicable excess policies. The excess insurers for the coverage period are St.Paul Fire and Marine Insurance Co. and Lexington Insurance Co. Information concerning the CAPP loss fund for the coverage period may be obtained by contacting CAPP through its Administrator, County Technical Services,Inc. (CTSI). Colorado Counties Casual and Property Pool By: Allen E. Chapman, CTSI Executive Director April 7, 2005 CAPP Certificate of Participation- Revised 4/05 Certificate of Participation Colorado Counties Casualty and Property Pool (CAPP) For the Coverage Period January 1, 2004 through December 31, 2004 WELD COUNTY Colorado Counties Casualty and Property Pool (CAPP)hereby certifies that Weld County is a participating Member of CAPP for the period beginning January 1,2004 through December 31,2004. The coverages, conditions of membership,and other provisions applicable to members of CAPP are as described in CAPP's Bylaws and Intergovernmental Agreement and in the applicable excess policies,Policy Statements and endorsements thereto,copies of which have been or will be provided to Weld County. The types and monetary limits of the coverages provided to Weld County through membership in CAPP, in consideration of the payment of its contributions, are limited, as of the date of this certificate,to those which are shown below. The scope,terms,conditions,and limitations of coverages are governed by the aforementioned agreement and policies. I. The types of coverages,subject to the limit on CAPP's liability in Section II below,are as follows: A. Property(including EDP,mobile equipment,and auto physical damage) B. Liability 1. Bodily Injury,Property Damage(GeneralLiability,Auto Liability) 2. Wrongful Acts conunitted in the conduct of duties(Public Entity Management Liability) 3. Bodily Injury, Property Damage,Personal Injury(Law Enforcement Liability) 4. Errors or omissions in the administration of an insured's employee benefits(Employee Benefits Liability) 5. Injury resulting from healthcare professional services rendered by EMTs(Emergency Medical Professional Liability) C. Crime 1. Monies and Securities(inside) 2. Monies and Securities(outside) 3. Employee Fidelity D. Boiler and Machinery II. CAPP Retention,Aggregate Limits,and Member Deductibles For the coverages described in Section I,CAPP shall be liable only for payment of the self-insured retention and only to a total annual aggregate amount for members of CAPP as a whole of the amount of the CAPP loss fund for the coverage period. CAPP's per claim/occurrence retention are limited to the following for the foregoing coverages: A. $150,000 per claim/occurrence property B. $250,000 per claim/occurrence liability(per coverage line) C. $150,000 per claim/occurrence crime D. $5,000 per loss boiler and machinery CAPP Certificate of Participation-Revised 4/05 In addition, there is a maintenance deductible of$500, which applies to each of the County's first party claims/occurrences/losses. Payment of the deductible reduces the amount otherwise payable under the applicable CAPP retention. Pertaining to all liability losses, CAPP has purchased an aggregate retention protection of$4 million. Coverages in excess of the foregoing retention are provided only by the excess insurers in applicable excess policies,and are payable only by those excess insurers. The limits of coverage provided by the excess insurers are as follows: A. Liability From$250,000 per claim/occurrence to$3 million per claim/occurrence except for auto which is non-aggregated, subject to the following: All liability coverages are provided on a claims-made coverage form. In no event shall the maximum per claim/occurrence payment exceed the following for general liability,auto liability,public entity management liability, law enforcement liability, employee benefits liability or medical professional liability claims subject to the Governmental Immunity Act: $150,000 per person and$600,000 per occurrence. Additional limits, sublimits and aggregates apply as provided in the applicable excess policies. B. Crime None C. Boiler and Machinery From$5,000 to the cost of repair/replacement for each actual loss sustained up to$50 million. Additional limits, sublimits and aggregates apply as provided in the applicable excess policies. D. Property From$150,000 to$50 million each occurrence. "All Risk" basis with sublimits of$1 million newly acquired property, $5 million new construction each occurrence and$500,000 unscheduled locations. Sublimits of$1 million for property in Flood Zone A and$10 million for property in Flood Zones B,D and X500. Newly acquired property must be reported within 60 days. Additional limits, sublimits and aggregates apply as provided in the applicable excess policies. The excess insurers for the coverage period are St. Paul Fire and Marine Insurance Co. and Lexington Insurance Co. Information concerning the CAPP loss fund for the coverage period may be obtained by contacting CAPP through its Administrator, County Technical Services,Inc. (CTSI). Colorado Counties Casualt and Property Pool By: Allen E. Chapman, CTSI Executive Director April 7, 2005 CAPP Certificate of Participation-Revised 4/05 t F,, w CTSI & Broker n Contacts .x x 9fi'h,, t . i. h r ;4a )41'-';"71'4,4 cry 2 2005 Excess Casualty 2005 Excess Property 4 2004 Excess Casualty 2004 Excess Property CTSI Colorado Counties Casualty and Property Pool County Technical Services, Inc. (CTSI) 800 Grant St, Suite 400 Denver, Colorado 80203 (303) 861-0507 (303) 861-2832 fax General Administration and Coverage Questions Allen Chapman, Executive Director Patti Bronikowski, Manager - Risk Programs Brenda Hostetler, Risk Management Analyst Property and Liability Claims Questions Rodney Capron, Claims Manager Janet Grossnickle, Senior Claims Examiner Enid Cordova, Claims Examiner Josie Brodie, Claims Technician Brokerage Services Arthur J. Gallagher and Co. 6399 S. Fiddlers Green Circle, Suite 200 Greenwood Village, CO 80111 Phone (800) 333-3231 Monica Drummer, Account Manager Certificates of Insurance and Placement of Ancillary Coverages Nicole Schlueter, CISR, Account Assistant Phone (303) 889-2614 Fax (303) 889-2615 C SI Colorado Counties Casualty and Property Pool 2005 Excess Casualty Policy Policy No. GP06301696 The summary included in this binder is a brief outline of the coverages afforded under the insurance policy. Since it is for informational purposes only, it should not be construed to constitute the entire insurance contract. As the policies may contain additional coverages and restrictions, the exact wording should be consulted. i Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool Retroactive Dates: �.. July 1, 1986 except: January 15, 1986 Weld County February 16, 1987 Cheyenne County April 1, 1987 Lake County July 1, 1987 Grand, Montrose, and Fremont Counties July 1, 1988 Delta County July 1, 1997 Custer County for Law Enforcement only Coverage: Claims Made Excess Liability. The Insurer agrees to pay on behalf of the Named Insured Ultimate Net Loss (in excess of the retained limit) liability which the Insured assumes under contract with a Participating Member County or becomes legally obligated to pay as damages because of: • Personal Injury • Property Damage • Public Officials E&O Insureds: • CAPP and Participating Member Counties • Former or current elected or appointed officials, including committee members, trustees, boards or commissions, and district attorneys and their assistants while acting for or on behalf of the Named Insured. • Past or present employees, agents, or volunteers of the Named Insured while acting for or on behalf of the Named Insured. • Any person using an automobile owned or hired by a Participating Member County providing the actual use of the automobile is within the scope and permission thereof. Exclusions Including But Not Limited To: • Obligations under any workers' compensation, occupational disease, unemployment compensation or disability benefits law, or under any similar law. • Property Damage to: — Real Property occupied by or leased to a Named Insured, its agents or subcontractors — Real or Personal Property in a Named Insured's care, custody or control, (coverage will attach excess of SIR and excess of any valid and collectible insurance) This account summary is a brief outline of the coverages afford691 under your insurance policies since it is for informational purposes only,it should not be construed to constitule the entire insurance contract As your policies may contain additional coverages and restrictions,the exact wording should be consulted. Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool Excess Casualty - Claims Made Policy Information: Carrier: St. Paul Fire and Marine Insurance Company Policy Numbe:r GP06301696 Policy Period: January 1, 2005 to January 1, 2006 Annual Premium: $1,313,602 Limits of Liability: $ 2,750,000 Automobile Liability, Each Occurrence $ 5,000 Automobile Medical Payments, Each Person $ 2,750,000 Personal Injury, Property Damage, Each Occurrence $ 5,000 Premises Medical Payments, Each Person $ 1,000,000 Sewer Back-Up, Each OLLui-fence $ 2,750,000 Public Officials Errors and Omissions Liability, Each Wrongful Act $ 2,750,000 Employee Benefits, Each Wrongful Act (Claims Made) $ 2,750,000 Employee Benefits, Aggregate $ 250,000 Employee Benefits, Self-Insured Retention Aggregate Limits of Coverage, in any one policy year: $ 2,750,000 Personal Injury, Property Damage $ 2,750,000 Products & Completed Operations $ 2,750,000 Public Officials Errors and Omissions Liability These aggregate limits above apply separately for CAPP and for each Participating Member County (PMC) Self-Insured Retained Limit (Including Indemnity and Defense): $ 250,000 Each Occurrence or Wrongful Act $ 4,500,000 In Any One Policy Period Participating Member Counties As Named Insureds: Alamosa, Archuleta, Baca, Bent, Chaffee, Cheyenne, Clear Creek, Conejos, Costilla, Crowley, Custer, Delta, Dolores, Eagle, Elbert, Fremont, Garfield, Gilpin, Grand, Gunnison, Hinsdale, Huerfano, Jackson, Klima, Kit Carson, Lake, La Plata, Las Animas, Lincoln, Logan, Mineral, Montrose, Morgan, Otero, •Ouray, Park, Phillips, Prowers, Pueblo, Rio Blanco, Rio Grande, Routt, Saguache, San Juan, Sedgwick, Summit, Teller, Washington, Weld, Yuma This account summary is a bnel outline of the coverages afforded under your insurance policies Since it is for informational purposes only,it should not be construed to constitute the entire insurance contract As your policies may contain additional coverages and resmctons,the exact wording should be consulted. !1 Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool • As respects liability assumed by a Named Insured under any contract: — To any claim from any arbitration proceeding wherein the Company is not entitled to exercise with the Named Insured their rights in the choice of arbitrators, and in the conduct of such proceedings — If the indemnitee of Named Insured is an architect, engineer or surveyor, to the liability of the indemnitee, his agents or employees arising out of: - The preparation or approval of contracts, maps, plans, drawing, etc., or; - The giving or the failure to give directions or instructions by the indemnitee — Exclusions do not apply to resulting Personal Injury and Property Damage • Liability arising out of the performance of or failure to perform health professional services. • Failure to supply a specific amount of electrical power, fuel or water or to liability arising out of the interruption of the electrical power, fuel or water supply • Nuclear Energy Liability • Discharge, dispersal, release or escape of pollutants, including cleanup • Noise Pollution Liability • Manufacture of, mining of, use of, sale of, installation of, removal of, distribution of or exposure to, asbestos products, asbestos fibers or asbestos dust • Liability imposed upon an Insured under the Employee Retirement Income Security Act of 1974 • Claims arising out of advances involving intentional physical contact, whether consensual or not. Exclusion applies only to any person who has made any sexual advances involving intentional physical contact or who knowingly participated in such conduct by another. • Liability arising out of ownership, maintenance, or use, including the loading or unloading of aircraft. • Ownership, maintenance or use, including loading or unloading, of aircraft, or watercraft over 26' in length, if said watercraft is used to carry persons for hire • War • Circumstances notified to other insurance carriers • Claims resulting from occurrences prior to the Retroactive Date(s) • Advertising, Broadcasting, Publishing or Telecasting Operations • Premises Medical Expenses for any of the following: — A person injured on that part of your premises that the person normally occupies — Coverage provided under Products and Completed Operations Liability ! — A person injured while practicing for or participating in any athletic or sports contest or exhibition sponsored, conducted or directed by an Insured — Any person who is sentenced and imprisoned in, committed to, confined in, or detained in any county jail or other detention facility • Any claim or suit that seeks declaratory or injunctive relief • Back wages, overtime or other wage related compensation • Liability that results from the failure of any insured to do what is required by contract or agreement This account summary is a brief outline of the coverages afforded under your insurance policies since it is for informational purposes only it should not be construed to constitute'he entire insurance contract As your policies may contain additional coverages and restrictions.the exact wording should be consulted r, Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool • Liability that results from eminent domain, inverse condemnation, regulatory taking, adverse possession or dedication by adverse use • Liability for bodily injury to an employee of the Insured arising out of and in the course of his or her — Employment by the protected person or — Performance of duties related to the conduct of the protected person's operations • Liability that results from any actual or alleged infringement or violation of any of the following rights or laws, — Copyright, Patent, Trade dress, Trade name, Trade Secret, Trademark, Other intellectual property rights or laws — But does not apply to bodily injury or property damage that results from Products Liability or Completed Operations Liability or Personal Injury that results from the unauthorized use of any copyrighted or trademarked advertising material, slogan, style, or title of others in your advertising • Liability that result from any actual, alleged, or threatened, absorption, ingestion, or inhalation of mold or other fungi, or bacteria, in any form by any person or existence of mold or other fungi, or bacteria, in any form — But this exclusion doesn't apply to bodily injury, property damage, or medical expenses that result from mold or other fungi, or bacteria, which are, or are on., in, or part of, any good products that's intended to be consumed as a food, beverage, or medicine — Bodily injury or medical expenses that result from bacteria which are directly transmitted solely by or from another person to the person sustaining the bodily injury or — Bodily injury or medical expenses that result from a bacterial infection which develops in connection with physical harm to the person sustaining the bodily injury, if such physical harm isn't excluded by this exclusion part, or any other part of this exclusion, and a claim or suit is made or brought against the protected person for such physical hann • Liability for Personal Injury, Property Damage or Premises Medical Payments to any person who is on a Named Insured's nursing home or assisted living facility premises for the purpose of receiving any medical evaluation, care or treatment • Liability for Personal Injury, Property Damage or Premises Medical Payments arising of the operations of any hospital or medical clinic, including — Ownership, maintenance or use of any premises used in such operation — Products Liability arising from products that are distributing in such operations — Completed Operations Liability for operations done anywhere that is related in the operation of such hospital or medical clinic • Liability arising out of any Malicious, Dishonest, or Fraudulent Errors, Omissions, or Acts of Knowing Violation of Rights and Laws committed in the performance of or failure to perform Health Care Professional Services This account summary is a bnel outline of the coverages afforded under your insurance policies Since it is for informational purposes only,it should not be construed to constitute me entire insurance contract As your policies may contain additional coverages and restnctions,the exact wording should be consulted. Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool • Liability arising out of the operations of any ski facility, including — The ownership, maintenance or use of any premise used in such operation — Product Liability arising from products that are distributed in each operation — Completed Operations Liability for operations done anywhere that is related to the operation of such ski facility. • Liability arising of the rental of ski equipment • Liability arising out of the practicing for or participating in rodeo events of any kind • Liability arising out of the operation of any airport, airfield, hanger or terminal, including — Ownership, maintenance or use of any premises used n such operations — Product Liability arising from products that are distributed in such operation — Completed Operations Liability for operations done anywhere that is related to the operation of such airport, airfield, hanger or terminal • Under Public Officials Error and Omissions Liability: — Automobile Liability, Personal Injury or Property Damage — Liability arising out of estimates of probable costs or cost estimates being exceeded or for faulty preparation of bid specifications or failure to award contracts in accordance with statute or ordinance — Injury to, destruction or disappearance of any tangible property (including money) or the loss of use thereof — Willful commission of a crime or other dishonest or fraudulent act — Financial gain to which an Insured is not legally entitled — Faulty preparation of maps, plans reports, surveys, designs, bid documents, or specifications; but this exclusion does not apply to these services when provided by an Insured for a Named Insured — Activities in a fiduciary capacity — Eminent domain, inverse condemnation, regulatory taking adverse possession or dedication by adverse use (does not apply to zoning variances, zoning or rezoning decisions) — Improper administration or collection of taxes — Activities or operations of Housing Authorities, Port Authorities, School Boards, or Railroad Boards — Multiplied Damages — Violation ERISA and other employment laws, however, exclusion does not apply to loss that results from retaliatory action against employees — Liability that results to any employee strike or lockout, however, exclusion does not apply to loss that results from retaliatory action against employees — Breach of Contract. However, this exclusion will not apply to any oral or implied employment related contract or agreement Cancellation: • 90 Days Notice for any other reason then Non-Payment • 10 Days Notice for Non-Payment This account summary is a Onel outline of the coverages afforded under your insurance polices Since it is for informational purposes only.it should not be construed to conshlule the entire insurance contract. As your policies may contain additional coverages and restrictions,the exact wording should be consulted pine. Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool Endorsements/Forms: • Named Insured • Retroactive Date Endorsement • Employee Benefits Program Administration Liability • Uninsured or Underinsured Motorists Rejection Form • Form MCS — 90 • Terrorism Risk Insurance Act of 2002 — Certified Act of Terrorism Exclusion • Self-Insured Retention Revision Endorsement Extended Reporting Period: You may purchase a 36 month period * of Extended Reporting after termination or non- renewal by payment of not more than 200% of the annual premium within 30 days of the effective date of termination or non-renewal. *A period of time in which to report to the Insurer claims made during the Extended Reporting Period for acts which occurred prior to termination or non-renewal. The Limit of Liability is not reinstated during this Extended Reporting Period. Important Reporting Requirements: Written notice of occurrence reasonably likely to involve the Company, "as soon as practicable" of all claims which involve: (i) Death; (ii) Brain damage; (iii) Paraplegic or quadriplegic impairment; ^� (iv) Eyesight; (v) Third degree burns; (vi) Traumatic loss of or surgical amputation of a limb; (vii) A serious case where, in the judgment of the Insured or its defense counsel, reserves exceed $125,000 1 This account summary is a heel outline of the coverages afforded under your insurance policies since it is for informational purposes only,it should not be construed to constilule the entire insurance contract As your policies may contain additional coverages and reslncl,ons.the exact wording should be consulled. DELIVERY INVOICE mestPBul Company: ST. PAUL FIRE & MARINE INSURANCE COMPANY Policy Inception/Effective Date: 01/01/05 N Agency Number: 0549614 S COLORADO COUNTIES CASUALTY & PROPERTY U POOL (SEE CONTINUATION) Transaction Type: R 800 GRANT STREET RENEWAL OF POLICY E SUITE 400 Transaction number: 001 D DENVER CO 80203 Processing date: 01/07/05 14: 17 Policy Number: GP06301696 A MARSH USA INC G 1225 17TH ST PLAZA STE 2100 E DENVER CO 80202-5534 N T Policy Description Amount Surtax/ Number Surcharge GP06301696 SERIES 1000 POLICY $1 , 313,602.00 Thr policy is a claims-made policy a'--_I-I provides liability coverage c.ly if a claim is made during the policy period or any applicable extended reporting period. t, 40724 Ed.12-90 Printed in U.S.A. Page 1 INSURED COPY f TM°StF9ul WHY YOU SHOULD REPORT LOSSES TO US PROMPTLY Reporting new losses, claims, or potential claims to us promptly can be critical. It helps us to resolve covered losses or claims as quickly as possible and often reduces their overall cost. Prompt reporting: • Better protects your interests. • Helps us to try to resolve losses or claims more quickly and to everyone's satisfaction - yours, any claimant's and ours; and • Often reduces the overall cost of a loss or claim - losses or claims reported more than five days after they happen cost on average 35% more than those reported earlier. Use the What To Do If You Have A Loss form that is a part of your policy to help you promptly report losses, claims, or potential claims. That form outlines the information that must normally be submitted as part of the reporting process. It describes the duties you and other persons or organizations protected under your policy have if your policy provides: • Property protection and there is a loss that may be covered under that protection; or • Liability protection and an accident, act, error, event, incident, offense, or omission happens or is committed that may result in liability damages or other amounts which may be covered under that protection. • To report losses, claims, or potential claims to us, we can be contacted easily and quickly through our web site or by fax. WWW.STPAUL W.STPAUL .COM The St. Paul's online site for reporting losses, claims, and potential claims has been designed to be as simple and user-friendly as possible. In fact, the site can even remember key information so that you don't have to continually re-enter the same data over and over again. If you report your loss, claim, or potential claim online, you will immediately receive a claim tracking number and be able to print out a copy of the report for your records. DEDICATED FAX NUMBERS • Use these dedicated numbers to report a loss, claim, or potential claim by fax to the appropriate claim professionals. Auto, Property or General Liability 1-888-329-8734 Transportation 1-813-663-3980 Public Sector 1-800-PUBLICS Fast Food Program 1-800-578-4549 Foreign Risk Services 1-800-329-8734 Lawyers Professional Liability 1-651-310-3657 Professional Liability/Errors And Omissions 1-888-329-8734 ND027 Rev. 3-04 Printed in U.S.A. -1- oSt.Paul Fire and Marine Insurance Co. 2004 All Rights Reserved TM°St&uI DISCLOSURE NOTICE TERRORISM RISK INSURANCE ACT OF 2002 The certified acts of terrorism premium charge shown below is for coverage under this policy for insured losses covered by the Terrorism Insurance Program established by the Terrorism Risk Insurance Act of 2002 (the Act). That Program applies to certain losses, if otherwise covered by your policy, that result from an "act of terrorism," as that term is defined in and certified under the Act (insured losses). This terrorism premium does not include any charges for the portion of insured losses covered by the Federal Government under the Act. The Federal Government shares in the payment of insured losses under the Act, and the amount of its share is 90% of such losses that exceed the applicable insurer deductible. If $0 is shown below for the certified acts of terrorism premium charge, this policy provides such terrorism coverage for no premium charge. The certified acts of terrorism premium charge shown below does not apply to any insuring agreement or coverage part in this policy for which you did not accept our offer, for a premium charge, of such terrorism coverage. If you did not accept our offer of such terrorism coverage, this policy contains one or more exclusions that apply to certified acts of terrorism under each such insuring agreement or coverage part. The Act establishes a cap on our liability to pay for insured losses if the aggregate amount of insured losses under the Act exceeds $100,000,000,000 during the applicable period for all insureds and all insurers combined. In that case, we will not be liable for the payment of any amount that exceeds such aggregate amount of $100,000,000,000. Name of Insured: COLORADO COUNTIES CASUALTY & PROPERTY Policy Number: GP06301696 Effective Date: 01/01/05 Certified Acts Of Terrorism Premium Charge: $0.00 Processing Date: 01/07/05 14: 17 001 D0100 Rev. 3-03 Printed in U.S.A. -1- INTRODUCTION "eStFBUi This policy protects against a variety of Policy Number: GP06301696 losses. There are also some restrictions. We've written this policy in plain, easy-to- ST PAUL emt- understand English. We encourage you to read it carefully to determine what is and MAIL CODE 1TON what is not covered, as well as the rights 385 WASHINGTON STREET and duties of those protected. ST. PAUL MN 55102-1118 In return for your premium, we'll provide the Your policy is composed of General Rules, protection stated in this policy. an explanation of What To Do If You Have A Loss, one or more Coverage Summaries, We, us, our, and ours mean St. Paul Fire and and one or more Insuring Agreements Marine Insurance Company. We're a capital explaining your coverage. It may also stock company located in St. Paul, include one or more endorsements. Minnesota. Endorsements are documents that change The wordsyou, your policy. The Policy Forms List shows your, and yours mean the all the forms included when this policy insured named here, which is a begins. COUNTY POOL One of our authorized representatives will COLORADO COUNTIES CASUALTY & PROPERTY also countersign the policy. 800 GRANT STREET SUITE 400 This policy will begin on 01/01/05 DENVER CO 80203 and will continue until 01/01/06 ***INSURED NAMES CONTINUED ON BACK)• ' Your former policy number is automatically replaced: GP06301492 Your premium for the policy period shown is: $1 ,313,602.00 .^ However, please refer to the Premiums section of the General Rules to see how final premiums are determined. Our authorized representative is: 0549614 MARSH USA INC rest enr t 1225 17TH ST PLAZA STE 2100 DENVER CO 80202-5534 el."- Authorized Representative Date o eeae Processing Date 01/07/05 14:17 001 40800 Ed. 5-87 Printed in U.S.A. Introduction ®St.Paul Fire and Marine Insurance Co.1984 All Rights Reserved Page 1 POLICY FORM LIST meStPmUI Here's a list of all forms included in your policy, on the date shown below. These forms are listed in the same order as they appear in your policy. Title Form Ed. Nbr Date Disclosure Notice Terrorism Risk Insurance Act Of 2002 D0100 03-03 Introduction - St. Paul Fire And Marine Insurance Company 40800 05-87 Policy Form List 40502 01-80 Special Excess Liability Policy for Public Entities - Declarations CAPPLD 01-05 Named Insured Endorsement 40502 01-80 Special Excess Liability Policy for Public Entites — Insuring Agreement CAPPL 01-05 Retroactive Date Endorsement 40502 01-80 Employee Benefits Program Administration Liability-Claims-Made Endt. 40502 01-80 Uninsured or Underinsured Motorists Rejection 40502 01-80 Motor Carrier Policies of Insurance For Public Liability MCS 01-96 Terrorism Risk Insurance Act of 2002 Certified Acts Of CAAP 01-04 Terrorism Exclusion Endorsement Self-Insured Retention Revision Endorsment 40502 01-80 NAME OF INSURED: Colorado Co. Casualty & Property Pool PAGE 1OF1 POLICY NO: GP06301696 EFFECTIVE DATE: 01/01/2005 L5— Form 40502 01-80 SPECIAL EXCESS LIABILITY POLICY FOR PUBLIC ENTITIES Declarations THIS IS A CLAIMS-MADE POLICY - PLEASE READ THIS POLICY CAREFULLY Policy Number: GP06301696 Named Insured and Mailing Address: COLORADO COUNTIES CASUALTY & PROPERTY POOL (CAPP) This policy is a claims-made policy 800 GRANT STREET, SUITE 400 - which provides liability c: only it a claim is made dr• he DENVER, COLORADO 80203 policy period or any applc::,oie extended reporting period. POLICY PERIOD: From 01/1/2005 to 01/01/2006 at 12:01 AM standard time at Named Insured's mailing address as shown above LIMITS OF LIABILITY AND RETENTION: a) Self-Insured Retention Limit $250,000 each occurrence or wrongful act $4,500,000 in any one policy year b) Automobile Liability $2,750,000 each occurrence Automobile Medical Payments $5,000 each person c) Personal Injury, Property Damage $2,750,000 each occurrence Premises Medical Payments: $5,000 each person Sewer Back-Up $1,000,000 each occurrence d) Public Officials Errors and Omissions Liability: $2,750,000 each wrongful act e) Aggregate Limits of Coverage: Personal Injury, Property Damage: $2,750,000 in any one policy year Products & Completed Operations: $2,750,000 in any one policy year Public Officials Errors and Omissions Liability: $2,750,000 in any one policy year These aggregate limits above apply separately for CAPP and for each Participating Member County (PMC) RETROACTIVE DATE: JULY 1, 1986 Unless otherwise endorsed ..olorado Counties Casualty&Property Pool St.Paul Fire& Marine Insurance Company Form CAPPLD Rev. 01-2005 TheSPduI NAMED INSURED ENDORSEMENT 24.Kiowa It is agreed that the Participating Member 25.Kit Carson Counties named hereunder are included 26.Lake as Named Insureds: 27.La Plata 28.Las Animas 1. Alamosa 29.Lincoln 2. Archuleta 30.Logan 3. _Baca 31.Mineral 4. Bent 32.Montrose 5. Chaffee 33.Morgan 6. Cheyenne 34.Otero 7. Clear Creek 35.Ouray 8. Conejos 36.Park 9. Costilla 37.Phillips 10.Crowley 38.Prowers 11.Custer 39.Pueblo 12.Delta 40.Rio Blanco 13.Dolores 41.Rio Grande 14.Eagle 42.Routt 15.Elbert 43.Saguache 16.Fremont 44. San Juan 17.Garfield 45. Sedgwick 18.Gilpin 46.Summit 19.Grand 47.Teller 20.Gunnison 48.Washington 21.Hinsdale 49.Weld 22.Huerfano 50.Yuma 23.Jackson l Other Terms All other terms of the policy remain the same. Name of Insured Policy Number GP06301696 Effective Date 01-01-2005 COLORADO CO.CASUALTY&PROPERTY POOL 40502 Ed. 1-80 Customized Form ©St. Paul Fire and Marine Insurance Co. 1980 Page 1 of 1 7 SPECIAL EXCESS LIABILITY POLICY FOR PUBLIC ENTITIES THIS IS A CLAIMS MADE FORM. READ YOUR POLICY CAREFULLY. r Certain provisions in this policy restrict coverage. Read the entire policy carefully to determine your rights and duties and what is not covered. In consideration of the payment of the premium, and in reliance upon the statements in the Declarations made a part hereof and subject to the limits of liability, exclusions, conditions and other terms of this policy, the Company agrees with the Named Insureds as follows: INSURING AGREEMENT A. The Company will pay on behalf of the Insureds that portion of the Ultimate Net Loss in excess of the Retained Amount, which the Insureds shall become legally obligated to pay as damages (excluding all fines, penalties, punitive or exemplary damages) because of Automobile Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions Liability caused by an Occurrence or Wrongful Act to which this insurance applies. B. This insurance applies to Automobile Liability, Personal Injury, Property Damage or Public Officials Errors and Omissions Liability only if a claim for such damages: (1) is first made against an Insured during the policy period and written notice of such claim is received by a Named Insured, or us, whichever comes first, AND (2) is attributable to an occurrence or wrongful act which occurred on or after the Retroactive Date shown in the Declarations. C. This insurance also applies to Automobile Medical Payments and Premises Medical Payments, as defined in this policy, subject to the limits of coverage, exclusions, and other terms and conditions. D. All claims for damages because of Automobile Liability, Personal Injury and Public Officials Errors and Omission Liability to the same person, (including damages claimed by any person or organization for care, loss of consortium, loss of services or death resulting at any time) will be deemed to have been made at the time the first of those claims is made against an Insured. E. All claims for damages because of Property Damage causing loss to the same person or organization as a result of an occurrence will be deemed to have been made at the time the first of those claims is made against an Insured. St. Paul Fire& Marine Insurance Company Page 1 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final U DEFENSE COSTS The Company shall have the right and opportunity, but not the obligation, to be associated with the Named Insureds in the defense of any claims made, suits brought, or proceedings instituted which are or may be covered under this policy, and the Named Insureds and the Company shall cooperate to the fullest extent possible. If the Company avails itself of the opportunity to be associated in the defense, it shall do so at its own expense. Defense Costs are part of the Insureds' retained limit, and any payment of amounts incurred for defense will serve to reduce the Insureds' self-insured retention as specified in the Declarations. However, Defense Costs are in addition to the limits of coverage, and any payment of amounts incurred for defense do not reduce the limits of liability or aggregate limits of coverage. LIMITS OF COVERAGE AND SELF-INSURED RETENTION Regardless of the number of(1) Insureds under this policy, (2) persons or organizations who sustain injury or damage, or (3) claims made or suits brought on account of Automobile Liability, Personal Injury, Property Damage or Public Officials Errors and Omissions the Company's liability is limited as follows: A. Self-Insured Retention (1) The each occurrence or wrongful act self-insured retention shown in the declarations is the amount the Named Insureds are responsible for, including Defense Costs, in any one occurrence and/or wrongful act, before the limits,of coverage will apply. (2)The aggregate self-insured retention shown in the declarations is the total amount the Named Insureds are responsible for, including defense costs, for all retained amounts in any one policy year. B. (1) Automobile Liability - The Company's liability shall be only for the Ultimate Net Loss in excess of the Insureds' retained limit, and shall not exceed the amount specified in the declarations as the result of any one occurrence. (2) Automobile Medical Payments - The limit of liability is included in the Self- Insured Retention. C. (I) Personal Injury and Property Damage -The Company's liability shall be only for the Ultimate Net Loss in excess of the Insureds' retained limit, and shall not exceed the amount specified in the declarations as the result of any one occurrence. However, the Company's liability for Ultimate Net Loss is further limited by the following: (a) Premises Medical Payments —The limit of liability is included in the Self-Insured St. Paul Fire&Marine Insurance Company Page 2 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final 9 Retention. (b) Sewer Back-Up —The Company's liability shall be only for the Ultimate Net Loss in excess of the Insured's retained limit for personal injury and property damage that results from the back-up of sewage into a building from any sewage facility or sanitary sewer that an Insured owns, operates or maintains, and shall not exceed the sublimit specified in the declarations as the result of any one occurrence. D. Public Official's Errors and Omissions Liability - The Company's liability shall be only for the Ultimate Net Loss in excess of the Insureds' retained limit, and shall not exceed the amount specified in the declarations as the result of any one Wrongful Act. E. Aggregate Limits of Liability -This policy is subject to aggregate limits of liability as stated in the Declarations. These aggregate limits of liability are the maximum amount that will be paid under this policy for all Occurrences or Wrongful Acts during the Policy Period applying separately to: (A) Personal Injury and Property Damage (B) Products and Completed Operations (C) Public Officials Errors and Omissions Liability These aggregates apply separately for each Named Insured. The aggregates do not apply to Automobile Liability. For the purpose of determining the limit of the Company's liability, all Automobile Liability, Personal Injury or Property Damage claims arising out of continuous or repeated exposure to substantially the same general conditions shall be considered as arising out of one Occurrence. In addition, all Public Officials Errors and Omissions taking place over more than one Policy Period insured by this Company shall be deemed to have taken place during the last Policy Period and only the Limit of Liability for that Policy Period shall apply. TERRITORY This policy applies to Automobile Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions Liability occurring anywhere in the world. PERSONS OR ENTITIES INSURED Each of the following is an Insured to the extent set forth below: (A)The Named Insured. The Named Insured includes the Named Insured stated in the Declarations and each Participating Member County (as scheduled in the Named St. Paul Fire&Marine Insurance Company Page 3 of 26 r1 Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final /D Insured Endorsement). (B)Those individuals who were or now are elected or appointed officials of the Named Insureds, including members of their governing bodies or any other committees, trustees, boards or commissions of the Named Insureds; district attorneys, their assistants and staff while acting for or on behalf of district attorneys; agents, volunteers, and Useful Public Servants; all of the foregoing while acting for or on behalf of the Named Insureds. Exception: Members of the following boards or commissions are not Insureds: Housing Authorities, Port Authorities, School Boards, or Railroad Boards. (C)Past or present employees of a Named Insured while acting for or on behalf of a Named Insured. (D) Any person or organization as required by contract, but only for injury or damage that results from • premises owned, rented or leased by a Named Insured; • work done by a Named Insured; • any permitted user of autos the Named Insured is responsible for; or • any other obligations pursuant to an intergovernmental agreement entered into by a Named Insured. (E) Any person while using an automobile owned or hired by a Named Insured and any person or organization legally responsible for the use thereof, provided the actual use of the automobile is for or on behalf of a Named Insured and within the scope and permission thereof, and to include any official, trustee or employee of a Named Insured with respect to the use of non-owned automobiles in the business of a Named Insured. This Policy with respect to any person or organization other than a Named Insured does not apply: 1 to any person or organization or to any agent or employee thereof, operating an automobile sales agency, repair shop, service station, storage garage or public parking place, with respect to any accident arising out of the operation thereof; 2. to any employee of a Named Insured with respect to Bodily Injury to another employee of the same Named Insured injured in the course of such employment in an accident arising out of the maintenance or use of an automobile in the business of such employer; ` 3. with respect to any hired automobile, to the owner or a lessee thereof, other than a Named Insured, nor to any agent or employee of such owner or lessee. St. Paul Fire&Marine Insurance Company Page 4 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final // EXCLUSIONS This policy does not apply to: (A) Workers Compensation To any obligation for which an Insured or any carrier as the insurer for an Insured may be held liable under any worker's compensation, occupational disease, unemployment compensation or disability benefits law, or under any similar law. (B) Property In a Named Insured's Care, Custody or Control To any liability for Property Damage to: (I) Real Property occupied by or leased to a Named Insured, its agents or subcontractors; or (2) Real or Personal Property in a Named Insured's, its agent's or subcontractor's care, custody or control or as to which a Named Insured, its agents or subcontractors is for any purpose exercising control, unless no other valid and collectible insurance is available to a Named Insured. - (C) Contract Liability Limitations As respects liability assumed by a Named Insured under any contract: (1) To any claim,judgment or agreement from any binding arbitration proceeding wherein the Company is not entitled to exercise with the Named Insureds their rights in the choice of arbitrators, and in the conduct of such proceedings; (2) If the Indemnitee of the Named Insured is an architect, engineer or surveyor, to the liability of the Indemnitee, his/her agents or employees, arising out of: (a) The preparation or approval of contracts, maps, plans, drawings, opinions, reports, tests, surveys, change orders, designs or specifications, or; (b) The giving or the failure to give directions or instructions by the Indemnitee, his agents or employees, provided such giving or failure to give is the primary cause of Personal Injury or Property Damage. Except that (a) and (b) above will not apply to resulting Personal Injury or Property Damage. (D) Health care professional services To any liability arising out of the performance of pr failure to perform health care professional services. This exclusion does not apply to any Insured who isn't a medical doctor, psychologist, psychotherapist or nurse practitioner. St. Paul Fire&Marine Insurance Company Page 5 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final /L (E) Failure To Supply To liability arising out of the failure to supply a specific amount of electrical power, fuel or water or to liability arising out of the interruption of the electrical power, fuel or water supply. However, this exclusion does not apply if the failure to supply results from accidental damage to tangible property owned or used by any Insured to obtain, produce, process, or transmit such service. (F) Nuclear Energy Liability To Automobile Liability, Personal Injury, Property Damage, or Public Official's Liability: (1) (a) With respect to which an Insured is also an Insured under a nuclear energy policy issued by the Nuclear Energy Liability-Property Insurance Association, Mutual Atomic Energy Liability Underwriters of Nuclear Insurance Association of Canada, or would be an Insured under any such policy but for its termination upon exhaustion of its limit of liability; or (b) Resulting from the hazardous properties of nuclear material and with respect to which (i) any person or any organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, (ii) the Insured is, or had this policy not been available would, be, entitled to indemnity from the United States of America or any agency thereof, with any person or organization. (2) Under any liability coverage, to injury, sickness, disease, death or destruction resulting from the hazardous properties of nuclear material, if: (a) The nuclear material (i) is at any nuclear facility owned by the Insured or operated by the Insured or on the Insured's behalf, or (ii) has been discharged or dispensed therefrom; (b) The nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed, stored, transported or disposed of by the Insured or on the Insured's behalf; or (c) The injury, sickness, disease, death or destruction arises out of the furnishing by the Insured of services, materials, parts or equipment in connection with the planning,construction, maintenance, operating or use of any nuclear facility, but if such facility is located within the United States of America, its territories or Canada, this exclusion (3) applies only to injury or Property Damage to such nuclear facility and any property threat. • St. Paul Fire&Marine Insurance Company Page 6 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final /3 (3) As used in this exclusion: (a) "hazardous properties" includes radioactive, toxic or explosive properties; (b) "nuclear material" means source material, special nuclear material, or byproducts material; (c) "source material", "special nuclear material" and "by-product material" have the meanings given them in the Atomic Energy Act of 1954 or any law amendatory thereof; (d) "spent fuel" means any fuel element or fuel component, solid or liquid,. which has been used or exposed to radiation in a nuclear reactor; (e) "waste" means any waste material (i) containing by-product 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 contents and (ii) resulting from the operation by any person or organization of a nuclear facility included within the definition of nuclear facility below; (f) "nuclear facility" means: (i) any nuclear reactor (ii) any equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing spent fuel, or (3) handling, processing or packaging wastes; (iii) 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 the Insured's 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; (iv) any structure, basin, excavation, premises or place prepared or used for storage or disposal of waste, and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations. (g) "nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction to contain a critical mass of fissionable material; St. Paul Fire&Marine Insurance Company Page 7 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final /Y (h) with respect to injury or to destruction of property, the word "injury" or "destruction" includes all forms of radioactive contamination of property. (G) Pollution Liability (1)To any claim or suit, or any obligation to defend any claims or suits, for Automobile Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions arising out of the discharge, dispersal, release or escape of Pollutants, anywhere in the world; However, this part of the exclusion doesn't apply to Automobile Liability that results from pollution caused by fuels, lubricants, fluids, exhaust gases or similar Pollutants that: (a) are needed for or result from the normal electrical, hydraulic or mechanical functioning of a covered auto, other than the operation of specialized equipment; and (b) escape, seep or migrate, or are discharged, dispersed or released, directly from a part of the covered auto designed by its manufacturer to hold, store, receive or dispose of such Pollutants. Nor does this part of the exclusion apply to Automobile Liability that results from pollution from property of others which: (a) isn't in your care, custody or control; (b) isn't being transported or towed by or for you; and (c) is damaged by an accident due to the ownership, maintenance or use of a covered auto. Nor does this part of the exclusion apply to General Liability that results from the application or use of: (a) chlorine or sodium hypochlorite in any Insured's sewage treatment, swimming pool maintenance, or water purification operations; or (b) any pesticide or herbicide by or for any Insured; if such application or use meets all legal or license requirements of any governmental agency or authority which apply to it. Nor does this part of the exclusion apply to General Liability that results from the back-up of sewage into a building from any sewage facility or sanitary sewer that is owned, operated or maintained by any Insured. However, we won't cover any claim or suit to the extent that they result from any corrosive or radioactive material or waste in the sewage. St. Paul Fire&Marine Insurance Company Page 8 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final /L (2) To any loss, cost or expense arising out of any governmental direction or request that the Insured test for, monitor, clean up, remove, contain, treat, detoxify or neutralize Pollutants; (3) To any loss, cost, or expense incurred by a governmental unit or other third party, including but not limited to cost of investigation and monitoring and attorney's fees relating to activities in connection with efforts to test for, monitor, clean up, remove, contain, trace, detoxify or neutralize Pollutants. "Pollutants" means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste material. Waste material includes materials which are intended to be or have been recycled, reconditioned or reclaimed. Heat, smoke or fumes are not considered Pollutants when they result from a hostile fire at, on, in, or from a Named Insured's premises. (H) Noise Pollution Liability To any claim or suit, or any obligation to defend any claims or suits, for Automobile Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions arising from complaints of noise pollution. "Noise pollution" includes loud or irritating sounds. (I) Asbestos Liability (1) To any liability for Automobile Liability, Personal Injury, Property Damage, Public Officials Errors and Omissions, occupational disease, or death at any time arising out of the manufacture of, mining of, use of, sale of, installation of, removal of, distribution of or exposure to, asbestos products, asbestos fibers or asbestos dust; or, (2) To any obligation of the Insured to indemnify any party because of damage arising out of such Automobile Liability, Personal Injury, Property Damage, Public Officials Errors and Omissions, occupational disease, or death, at any time as a result of the manufacture of, mining of, use of, sale of, installation of, removal of, distribution of or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; or (3) To any obligation to defend any suit or claim against the Insured alleging Automobile Liability, Personal Injury, or Property Damage, or Public Officials Errors and Omissions and seeking Damages, if such suit or claim arises from Personal Injury, or Property Damage, or Wrongful Acts, resulting or contributed St. Paul Fire&Marine Insurance Company Page 9 of 26 i—. Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final /& to, by any and all manufacture of, mining of, use of, sales of, installation of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; (4) To any loss, cost, expense, fine or penalty arising out of any of the foregoing Items 1, 2, and 3. (J) ERISA As respects liability imposed upon an Insured (or which is imputed to an Insured) under the "Employee Retirement Income Security Act of 1974" and any law amendatory thereof; (K) Sexual Advances To claims arising out of advances involving intentional physical contact, whether consensual or not. This exclusion applies only to any person who has made any sexual advances involving intentional physical contact or who knowingly participated in such conduct by another. (L) Aircraft To liability arising out of the ownership, maintenance or use, including the loading or unloading of aircraft. However, this exclusion does not apply to aircraft that is not owned or chartered by an Insured if: (a) the aircraft is chartered with crew, including a pilot, not employed by the Insured; and (b) the Insured isn't using the aircraft to carry persons or property for a charge. (M) Watercraft To liability arising out of the ownership, maintenance or use, including loading or unloading, of watercraft over 26 feet in length, but this exclusion only applies if said watercraft is used to carry persons for hire. (N) War To loss or damage or indirectly occasioned by, happening through or in consequence of war, invasion, acts of foreign enemies, any weapon of war employing atomic fission or radioactive force whether in time of peace or war, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power, confiscation or nationalization or requisition or destruction of or damage to property by or under the order of any government or public or local authority unless such acts of destruction by order of civil authority is at the time of and for the purpose of preventing spread of fire. (O) Known Occurrence or Wrongful Act To any claim or potential claim or Occurrence or Wrongful Act or circumstances for St.Paul Fire&Marine Insurance Company Page 10 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final /7 which a Named Insured has provided notice to any other insurance company before the policy period in the Declarations. (P) Prior Occurrence or Wrongful Act To any claim resulting from an Occurrence or Wrongful Act which occurred prior to the Retroactive Date in the Declarations. (Q) Advertising, Broadcasting, Publishing or Telecasting Operations To liability for a publication or utterance arising from advertising, publishing, broadcasting or telecasting done by an Insured that: (1) slanders or libels a person or organization or disparages a person's or organization's goods, products, property or services, and piracy and infringement of copyright or of property; or (2) violates a person's right of privacy. (R) Premises Medical Expenses of Certain Persons To Premises Medical Payments coverage for any of the following: (1) a person injured on that part of your premises that the person normally occupies. (2) coverage provided under Products and Completed Operations Liability. (3) a person injured while practicing for or participating in any athletic or sports contest or exhibition sponsored, conducted or directed by an Insured. (4) any person who is sentenced and imprisoned in, committed to, confined in, or detained in any county jail or other detention facility. (S) Equitable Relief To loss or any amount required to comply with a court order that results from any action or demand, or any part of any claim or suit that seeks declaratory or injunctive relief. (T) Back Wages To loss for back wages, overtime or other wage related compensation for Persons or Entities Insured, or from collective employee bargaining agreements. (U) Breach of Contract To liability arising out of breach of contract, whether express or implied, or arising out of non-completion of or delay in contract, or arising out of non-compliance with contract deadlines. However, this exclusion shall not apply to the Public Officials Liability coverage except as stated in exclusion (14) applying to Public Officials Liability only. (V) Eminent Domain To liability that results from eminent domain, inverse condemnation, regulatory taking, adverse possession or dedication by adverse use. However, this exclusion shall not apply St. Paul Fire& Marine Insurance Company Page 11 of 25 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final /f to Public Officials Liability coverage except as stated in exclusion (8) applying to Public Officials Liability only. (W) Employers Liability (1) To liability for bodily injury to an employee of the Insured arising out of and in the course of his or her: (a) employment by the protected person; or (b) performance of duties related to the conduct of the protected person's operations. (2) To liability for bodily injury to the spouse or any child, parent, brother, or sister of that employee if such bodily injury results from the bodily injury to the employee. This exclusion applies whether the Insured may be held liable as an employer or in any other capacity, such as a property owner or product manufacturer. This exclusion also applies to any obligation of the Insured to share damages with or repay someone else who must pay damages because of bodily injury to any employee of the Insured. However, this exclusion does not apply to bodily injury for which the Insured has assumed liability under contract. (X) Intellectual Property To liability that results from any actual or alleged infringement or violation of any of the following rights or laws: (1) Copyright. (2) Patent. —� (3) Trade dress. (4) Trade name. (5) Trade secret. (6) Trademark. (7) Other intellectual property rights or laws. But this exclusion does not apply to: (a) bodily injury or property damage that results from Products Liability or Completed Operations Liability; or (b) personal injury that results from the unauthorized use of any copyrighted or trademarked advertising material, slogan, style, or title of others in your advertising. (Y) Mold, Other Fungi, or Bacteria (1) To liability that result from any actual, alleged, or threatened: (a) absorption, ingestion, or inhalation of mold or other fungi, or bacteria, in any form by any person; or • St.Paul Fire& Marine Insurance Company Page 12 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final -� /9 (b) existence of mold or other fungi, or bacteria, in any form. But we won't apply this exclusion part to: (i) bodily injury, property damage, or medical expenses that result from mold or other fungi, or bacteria, which are, or are on, in, or part of, any good product that's intended to be consumed as a food, beverage, or medicine; (ii) bodily injury or medical expenses that result from bacteria which are directly transmitted solely by or from another person to the person sustaining the bodily injury; or (iii) bodily injury or medical expenses that result from a bacterial infection which develops in connection with physical harm to the person sustaining the bodily injury, if such physical harm isn't excluded by this exclusion part, or any other part of this exclusion, and a claim or suit is made or brought against the protected person for such physical harm. (2) Nor will we cover damages that results from any actual, alleged, or threatened: (a) absorption, ingestion, or inhalation of any other solid, liquid, gaseous, or thermal irritant or contaminant, including smoke, vapors, soot, fumes, acids, alkalis, chemicals, and waster, in any form by any person; or (b) existence of any such irritant or contaminant in any form; (c) and is part of any claim or suit that also alleges any injury or damage described as excluded in the first paragraph of this exclusion. (3) Also, we won't cover any loss, cost, or expense that results from any request, demand, order, or statutory or regulatory requirement that any protected person or others: (a) test for, monitor, clean up, remove, contain, treat, detoxify, or neutralize mold or other fungi, or bacteria, in any form; or (b) respond to, or assess, in any way the effects of mold or other fungi, or bacteria, in any form. Because mold or other fungi, or bacteria, can be pollutants, and any such other irritants or contaminants are pollutants, this exclusion applies in addition to the pollution liability exclusion or any other pollution-related exclusion made part of this agreement. (Z) Patient Injury To liability for Personal Injury, Property Damage or Premises Medical Payments to any person who is on a Named Insured's nursing home or assisted living facility premises for the purpose of receiving any medical evaluation, care or treatment. (AA) Hospitals and Medical Clinics To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of the operation of any hospital or medical clinic, including: (1) the ownership, maintenance or use of any premises used in such operation; St. Paul Fire&Marine Insurance Company Page 13 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final (2) Product Liability arising from products that are distributed in such operation; or (3) Completed Operations Liability for operations done anywhere that is related to the operation of such hospital or medical clinic. However, this exclusion does not apply to Auto Liability. (BB) Malicious, Dishonest, or Fraudulent Errors, Omissions, or Acts or Knowing Violation of Rights and Laws To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of any malicious, dishonest, or fraudulent errors, omissions, or acts or knowing violation of rights and laws committed in the performance of, or failure to perform, health care professional services. (CC) Ski Facility To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of the operation of any ski facility, including: (1) the ownership, maintenance or use of any premises used in such operation; (2) Product Liability arising from products that are distributed in such operation; or (3) Completed Operations Liability for operations done anywhere that is related to the operation of such ski facility. However, this exclusion does not apply to cross country ski operations at a premises not normally operated as a full-time ski facility. Nor does it apply to Auto Liability. (DD) Ski Equipment Rental To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of the rental of ski equipment. However, this exclusion does not apply to rental of ski equipment at a premises not normally operated as a full-time ski facility. (EE) Rodeo Participants To liability for Personal Injury, Property Damage or Premises Medical Payments as a result of practicing for, or participating in, rodeo events of any kind. (FF) Airport, Airfield, Hangar or Terminal To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of the operation of an airport, airfield, hangar or terminal, including: (1) the ownership, maintenance or use of any premises used in such operation; St. Paul Fire&Marine Insurance Company Page 14 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final C,)/ (2) Product Liability arising from products that are distributed in such operation; or (3) Completed Operations Liability for operations done anywhere that is related to the operation of such airport, airfield, hangar or terminal. r. However, this exclusion does not apply to Auto Liability. (GG) Under Public Officials Error and Omissions Liability, to: (1) Automobile Liability, Personal Injury or Property Damage as defined in the policy; (2) Liability of any Insured arising out of estimates of probable costs or cost estimates being exceeded or for faulty preparation of bid specifications or failure to award contracts in accordance with statute or ordinance which under law must be submitted for bids; (3) Injury to, destruction or disappearance of any tangible property (including money) or the loss of use thereof. (4) Liability arising from the willful commission of a crime or other dishonest or fraudulent act; (5) Liability from obtaining financial gain to which an Insured is not legally entitled; (6) Liability arising from faulty preparation of maps, plans, reports, surveys, designs, bid documents, or specifications; but this exclusion does not apply to these services when provided by an Insured for a Named Insured; (7) Liability from activities in a fiduciary capacity. (8) Liability from eminent domain, inverse condemnation, regulatory taking, adverse possession or dedication by adverse use. This exclusion does not apply to zoning variances, zoning or rezoning decisions or to the acts of a Participating Member County's Treasurer, Sheriff, Health Department or their respective employees, volunteers or agents. (9) Liability arising from the improper assessment, calculation, or collection of taxes,or loss that reflects any tax obligation. This exclusion does not apply to the administration functions involved in the collection or refund of taxes. (10) Liability arising from the activities or operations of Housing Authorities, Port Authorities, School Boards, or Railroad Boards. St.Paul Fire&Marine Insurance Company Page 15 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final 2- (11) Liability for that portion of any multiplied damage award which exceeds the amount multiplied. (12) Liability that results from any violation of any of the duties or responsibilities required of any Insured as an employer by the following laws, amendments to those laws, or similar provisions of any other laws, rules or regulations: (a) Fair Labor Standards Act, except the Equal Pay Act (b) National Labor Relations Act. (c) Worker Adjustment and Retraining Notification Act. (d) Consolidated Omnibus Budget Reconciliation Act of 1985 (e) Occupational Safety and Health Act. (f) Employee Retirement Income Security Act of 1974. However, this exclusion does not apply to loss that results from retaliatory action against any employee for the employee's exercising of rights afforded by such laws. (13) Liability that results to any employee on strike or lockout or temporarily or permanently replaced due to any labor dispute, including breach of a collective bargaining agreement. However, this exclusion does not apply for loss that results from retaliatory action taken in response to any of your employees for participating in any strike or lockout. (14) To liability arising out of breach of contract, whether express or implied, or arising out of non-completion of or delay in contract, or arising out of non-compliance with contract deadlines. However, this exclusion shall not apply to an employment- related claim alleging a breach of an implied contract of employment. An implied contract of employment is one that arises or is alleged to arise out of one or more statements in an Insured's personnel handbook, employment policy manual, or similar document, but does not include any express contract of employment for services between any claimant and an Insured. However, exclusions number (2), (4), (5), (6), and (7) do not apply to any contingent or vicarious liability of a Participating Member County arising out of one or more of the above referenced wrongful acts committed by an elected or appointed official of a Named Insured. DEFINITIONS When used in this policy (including endorsements forming a part hereof): "Automobile Liability" means Bodily Injury and Property Damage resulting from the ownership, maintenance, use or operation of any auto owned, rented, leased, or borrowed St. Paul Fire& Marine Insurance Company Page 16 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final z3 by any Insured. It includes loading or unloading to or from such auto. "Automobile Medical Payments" means reasonable expenses, in excess of any other insurance, for necessary medical and funeral services incurred and reported within three years from the date of an accident to or for any Insured, or anyone else who sustains Bodily Injury caused by an accident involving a covered auto. For the purposes of this section, "other insurance" means valid and collectible insurance, or the funding of losses, available through: (A) another insurance company; (B) a risk retention group; (C) a self-insurance method or program, other than any funded by CAPP; (D) any similar risk transfer method. "Bacteria" means any type or form of bacterium or any mycotoxin, spore, scent, or byproduct that's produced or released by such bacterium. "Bodily Injury" means any harm to the health of other persons, including physical harm, sickness, disease, disability, shock, mental anguish, humiliation, mental injury, or death. "Claim" means any formal or written demand or Suit for monetary relief, against an Insured, or circumstances from which a Named Insured reasonably believes a formal or written demand for monetary relief will be forthcoming, but only if a Named Insured becomes aware of such during the policy period and written notice is provided to the Company during the policy period or no later than sixty (60) days following non-renewal or cancellation. "Company" means the insurer(s) specified in the Declarations. "Completed Operations Liability" includes Bodily Injury and Property Damage arising out of operations or reliance upon a representation or warranty made at any time with respect thereto, but only if the Bodily Injury or Property Damage occurs after such operations have been completed or abandoned and occurs away from premises owned by or rented to an Insured. "Operations" include materials, parts or equipment furnished in connection therewith. Operations shall be deemed completed at the earliest of the following times: (A)When all operations to be performed by or on behalf of the Insured under the contract have been completed; (B)When all operations to be performed by or on behalf of the Insured at the site of the operations have been completed; or St. Paul Fire&Marine Insurance Company Page 17 of 26 �..,� Colorado Counties Casualty&Property Pool Form CAPPL Rev.01-2005 Final (C)When the portion of the work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. Operations which may require further service or maintenance work, or correction, repair or replacement because of any defect or deficiency, but which are otherwise completed shall be deemed completed. The "Completed Operations Hazard" does not include Bodily Injury or Property Damage arising out of: (A) Operations in connection with the transportation of property unless the Bodily Injury or Property Damage arises out of a condition in or on an automobile created by the loading or unloading thereof; (B) The existence of tools, uninstalled equipment or abandoned or unused materials. "Damages" means monetary damages, and includes damages for death and for care and loss of services resulting from Personal Injury and damages for loss of use of property resulting from Property Damage, and damage resulting from Public Officials Errors and Omissions. "Defense Costs" means attorney's fees, costs and expenses and other fees, costs and expenses incurred in connection with the investigation, adjustment, defense and appeal of a Claim or Suit covered hereunder. Defense Costs include the defense costs of an Indemnitee when the Named Insureds assume liability for personal injury or property damage, and associated defense costs under a covered contract. However, Defense Costs do not include the office expenses of the Company or an Insured nor the salaries of ^• employees or officials of the Company or an Insured. "Health care professional services" includes: (A) any dental, medical, mental, nursing, surgical, x-ray, or other health care professional service, including any advice, instruction, food, or beverage provided with such service; (B) the dispensing of drugs or medical or dental supplies and appliances; and (C) the handling or treatment of corpses, including autopsies, organ donations, and other postmortem procedures. "Indemnitee" means any person or organization, other than an Insured, who is a party to a covered contract and is held harmless or protected under that contract by a Named Insured for liability for: • personal injury or property damage covered under this agreement; and • the contract liability defense expenses incurred in connection with such personal injury or property damage. St. Paul Fire& Marine Insurance Company Page 18 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final "Insured" means any person or organization qualifying as an Insured under the Persons or Entities Insured section of this policy. The insurance afforded applies separately to each Insured against whom claim is made or suit is brought. "Mold or other fungi" means: (1) any type or form of mold or mildew; (2) any other type or form of fungus; or (3) any mycotoxin, spore, scent, or byproduct that's produced or released by such mold, mildew, or other fungus. "Occurrence" means: (A) an accident or event, including continuous or repeated exposure to conditions or (B) an error, omission, or negligent act in their performance of, or failure to perform, health care professional services by any Insured who isn't a medical doctor, psychologist, psychotherapist or nurse practioner which result in Personal Injury or Property Damage. All such exposure to substantially the same general conditions shall be deemed one "Occurrence." "Personal Injury" means: (A) Bodily Injury; (B) False arrest, false imprisonment, wrongful detention, or malicious prosecution; (C) Violation of civil rights; (D)Wrongful entry into, or eviction of any person from, a room, dwelling, or premises that a person occupies, or other invasion of the right of private occupancy; (E) A publication or utterance that slanders or libels a person or organization, including defamation, or disparages a person's or organization's goods, products, property or services; (F) Piracy and infringement of copyright or of written or intellectual property; (G)A publication or utterance that violates a person's right of privacy; (H)Assaplt and battery, not committed by or at the direction of, or with the consent of an Insured. However, this limitation does not apply i) if committed or directed for the purpose of protecting persons from injury or death, or property from damage, or ii) to liability arising out of corporal punishment St. Paul Fire&Marine Insurance Company Page 19 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2005 Final 2� (I) Improper or erroneous service of civil papers. "Premises Medical Payments" means medical expenses, in excess of any other insurance, incurred because of Bodily Injury to someone other than an Insured under this policy caused by an accident on an Insured's premises or as part of an Insured's operations regardless of fault, that are incurred and reported within one year of the date of the accident. These include expenses for: 1. first aid at the time of the accident, 2. necessary medical surgical, x-ray and dental services, including prosthetic devices; and 3. necessary ambulance, hospital, professional nursing, and funeral services. For the purposes of this section, "other insurance" means valid and collectible insurance, or the funding of losses, available through: (A) another insurance company; (B) a risk retention group; (C) a self-insurance method or program, other than any funded by CAPP; (D) any similar risk transfer method. "Products Liability" means Bodily Injury and Property Damage arising out of an Insured 's products or reliance upon a representation or warranty with respect thereto, but only if the Bodily Injury or Property Damage occurs away from premises owned by or rented to an Insured and after physical possession has been relinquished to others. "Property Damage" means (1) physical injury to or destruction of tangible property which occurs during the policy period, including the loss of use thereof at any time resulting therefrom, or (2) loss of use of tangible property which has not been physically injured or destroyed provided such loss of use is caused by an Occurrence during the policy period. "Public Officials Errors and Omissions" means any and all Wrongful Acts by an Insured arising from an action or inaction or ministerial act, mistake, misstatement, error, omission, or violation of antitrust statutes by an Insured in the discharge of duties for a Named Insured. "Suit" means a civil proceeding in which damages are alleged. It includes a binding arbitration proceeding for damages, and any other binding Alternative Dispute Resolution, to which the Insured submits with the Company's consent. "Ultimate Net Loss" means the sums for which an Insured is legally liable as Damages by reason of a judgment or settlement made with the written consent of the claimant, the Named Insureds and the Company, after making deductions for all recoveries for other valid and collectible insurance, excepting, however, the Insureds' Retained Limit and St. Paul Fire& Marine Insurance Company Page 20 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final 27 shall include all Defense Costs. "Wrongful Act" means any actual or alleged act, error or omission, arising out of the conduct or performance of any elected or appointed officials of a Named Insured in the performance of his or her duties. All such exposure to substantially the same general conditions shall be deemed one Wrongful Act. Wrongful act includes but is not limited to wrongful termination or discrimination based upon race, religion, nationality, national origin, color, creed, sex or age. CONDITIONS 1. Cross Liability Except with respect to Limits of Insurance, and any rights or duties specifically assigned to the first Named Insured, this insurance applies as if each Named Insured were the only Named Insured; and separately to each Insured against whom claim is made or suit is brought. 2. Insured's Duties in the Event of Occurrence, Claim or Suit (A) In the event of an Occurrence reasonably likely to involve the Company, written notice containing particulars sufficient to identify the Insured and also reasonably obtainable information with respect to the time, place, and circumstances thereof, and the names and addresses of the injured and of available witnesses, shall be given by or for the Insured to the Company or any of its authorized agents as soon as practicable. (B) The Company shall be given notice as soon as practicable, following notice to the first Named Insured (CAPP), of all claims which involve: • Death. • Brain damage. • Paraplegic or quadriplegic impairment. • Loss of eyesight. • Third degree burns. • Traumatic loss of or surgical amputation of a limb. • A serious case where, in the judgment of the Insured or its defense counsel, reserves exceed $125,000. (C) The Named Insureds shall cooperate with the Company and upon its request assist in 1 making settlements, in the conduct of suits and in enforcing any right of contribution or indemnity against any person or organization who may be liable to the Named Insureds because of Personal Injury or Property Damage with respect to which insurance is afforded under this policy; and the Insured shall attend hearings and trials and assist in securing and giving evidence and obtaining the attendance of witnesses. St. Paul Fire&Marine Insurance Company Page 21 of 26 Colorado Counties Casualty&Property Pool ,e'•••• Form CAPPL Rev.01-2005 Final The Named Insureds shall not, except at their own cost, voluntarily make any payment, assume any obligation or incur any expense. However, in the event that the amount of Ultimate Net Loss becomes certain either through trial court judgment or agreement among the Named Insureds, the claimant and the Company, then the Named Insureds may pay the amount of Ultimate Net Loss to the claimant to effect settlement and, upon submission of due proof thereof, the Company shall indemnify the Named Insureds for that part of such payment which is in excess of the retained limit, or will upon request of the Named Insureds, make such payment to the claimant on behalf of the Insured. (D) Whenever the first Named Insured (CAPP) has information from which the first Named Insured (CAPP) may reasonably conclude that an Occurrence or Wrongful Act covered hereunder involves injuries or damages, which in the event that an Insured should be held liable, is likely to involve this policy, notice shall be sent to: St. Paul Fire & Marine Insurance Company P.O. Box 5490 Denver, CO 80217-5490 Street address: 2000 S. Colorado Blvd., Suite 2-480 Denver, CO 80222-7910 Phone (303) 300-9000 as soon as practicable, provided, however, that failure to give notice of any Occurrence or Wrongful Act which at the time of its happening, did not appear to involve this policy but which at a later date, would appear to give rise to claims hereunder, shall not prejudice such claims. 3. Settlement Consent The Company shall have the right to propose a settlement for any claim or suit within an applicable Self-Insured Retention or the available limit of coverage, but only if it is reasonably certain that the claim or suit will exceed the Self-Insured Retention. If the Named Insured refuses to consent to a settlement, the Company will limit the total amount it will pay for damages and defense costs to no more than the amount it would have paid had the Named Insured given consent to the proposed settlement. 4. Appeals hi the event the Named Insureds elect not to appeal a judgment in excess of the retained limit, the Company may elect to do so at its own expense, but in no event shall the liability of the Company for Ultimate Net Loss exceed the applicable amount specified in the Limits of Liability section of the Declarations plus all defense costs necessary and incident to such appeal. St. Paul Fire& Marine Insurance Company Page 22 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final 2 / 5. Action Against the Company No action shall lie against the Company with respect to any one Occurrence or Wrongful act unless, as a condition precedent hereto, the Named Insureds shall have fully complied with all the terms of this policy, nor until the amount of the Insureds' obligation to pay an amount of Ultimate Net Loss in excess of the retained limit shall have been finally determined either by judgment against an Insured after actual trial, or by written agreement of the Named Insureds, the claimant and the Company. Any person or organization or the legal representative thereof who has secured such judgment or written agreement shall thereafter be entitled to recover under this policy to the extent of insurance afforded by this policy. Nothing contained in this policy shall give any person or organization any right to join the Company as co-defendant in any action against the Named Insureds to determine an Insured's liability. 6. Bankruptcy and Insolvency Bankruptcy or insolvency of the Named Insureds shall not relieve the Company of any of its obligations hereunder. 7. Other Insurance This insurance is excess insurance that applies over self-insured retentions. If there is any other insurance for Automobile Liability, including Hired and Non-Owned Autos, Personal Injury, Property Damage, Automobile Medical Payments, Premises Medical Payments, or Public Official's Errors and Omissions Liability covered by this insurance, this insurance is excess of that other insurance. "Other insurance" means valid and collectible insurance, or the funding of losses, other than insurance bought specifically to apply in excess of this insurance, that's available through: • another insurance company; • a risk retention group; • a self-insurance method or program, other than any funded by CAPP and over which this agreement applies; • any similar risk transfer method. 8. Subrogation The Company shall be subrogated to the extent of any payment hereunder to all the Insureds' rights of recovery. The Named Insured shall do nothing after loss to prejudice such rights and shall do everything necessary to secure such rights. Any amount so recovered shall be apportioned as follows: St. Paul Fire&Marine Insurance Company Page 23 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final Any party, including the Named Insured, having paid an amount in excess of the Self- Insured Retention limit plus the limit of liability hereunder shall be reimbursed first to the extent of actual payment. If any balance then remains unpaid, it shall be applied to reimburse the Named Insureds. The expenses of all such recovery proceedings shall be apportioned in the ratio of the respective recoveries. If there is no recovery in proceedings conducted solely by the Named Insured, it shall bear the expenses thereof. The company shall waive its right to subrogate against a third party for any payment made under this policy, but only if: (A) the Participating Member County agreed to waive its rights to subrogation under a contract or agreement; (B) the waiver was prior to the occurrence of the loss; and (C) subrogation is not pursued by the First Named Insured (CAPP). 9. Changes Notice to any agent or knowledge possessed by any agent or by any other person shall not effect a waiver or change in any part of this policy or stop the Company from asserting any right under the terms of this policy, nor shall the terms of this policy be waived or changed , except by endorsement issued to form a part of this policy. 10. Assignment Assignment of interest under this policy shall not bind the Company until its consent is endorsed hereon; however, if an Insured shall die, such insurance as is afforded by this policy shall apply (A) to the Insured's legal representative, as the Insured, but only while acting within the scope of his duties as such and (B) with respect to the property of an Insured to the person having temporary custody thereof as Insured, but only until the appointment and qualification of the legal representative. 11. Maintenance of Retained Limit The amount stated in the Declarations as the Self-Insured Retention Limit applicable to each occurrence or wrongful act claim shall be maintained intact and be the responsibility of the Named Insureds except for any reduction thereof solely by payment for Automobile l Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions as defined and otherwise covered by this Policy. The failure of the Named Insureds to comply with this Condition will not render the Company liable for a greater amount than it would have been liable had the Named Insured complied herewith. St. Paul Fire&Marine Insurance Company Page 24 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final "\ 6/ The failure of the Named Insureds to maintain the Self-Insured Retention limit, including, but not limited to the insolvency, bankruptcy, liquidation or failure of CAPP to pay on behalf of the Named Insureds, will not impose any liability, contractually or otherwise, upon the Company to assume the defense or incur any expenses on behalf of the Named Insureds under this Policy. 12. Cancellation This policy may be canceled by the first Named Insured (CAPP) by surrender thereof to the Company or any of its authorized agents, or by mailing to the Company written notice stating when thereafter the cancellation shall be effective. The policy may be canceled by the Company by mailing to the first Named Insured at the address shown in this policy written notice stating when not less than ninety days thereafter such cancellation shall be effective. Provided that the first Named Insured fails to discharge when due any of its obligations in connection with the payment of premium for the policy or any installment thereof, whether payable directly to the Company or its agent or indirectly under a premium finance plan or extension of credit, this policy may be canceled by the Company by mailing to the first Named Insured at the address shown in the policy, written notice stating when not less than ten days thereafter such cancellation shall be effective. The mailing of notice as aforesaid shall be sufficient proof of notice. The time of surrender or effective date and hour of cancellation stated in the notice shall become the end of the Policy Period. Delivery of such written notice either by the first Named Insured or by the Company shall be equivalent to mailing. If the first Named Insured cancels, earned premium shall be computed in accordance with the customary short rate table and procedure. If the Company cancels, earned premium shall be computed prorata. Premium adjustment may be made either at the time cancellation is effective or as soon as practicable after cancellation becomes effective, but payment or tender of unearned premium is not a condition of cancellation. No cancellation or termination of the Policy whether by or at the request of the first Named Insured or by the Company, shall take effect prior to the expiration of Ninety (90) days after written notice of such cancellation or termination is sent by registered mail to the Commissioner of Insurance, State of Colorado, Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202, unless an earlier date of such cancellation or termination is approved by said Commissioner of Insurance, State of Colorado. 13. First Named Insured The first Named Insured (CAPP) is authorized to act on behalf of all Named Insureds and other Insureds with respect to the giving and receiving of notice of cancellation and to St. Paul Fire& Marine Insurance Company Page 25 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final 52 receiving any return premium that may become payable under this policy. The first Named Insured is responsible for the payment of all premiums, but the other Named Insureds jointly and severally agree to make such premium payments in full if the first Named Insured fails to pay the amount due within (30) days after the company gives a written demand for payment to the first Named Insured. 14. Extended Reporting Period In the event of cancellation or non-renewal by the Company for any reason except non- payment of premium, the first Named Insured, upon payment of an additional premium of not more than 200% of the total expiring premium shall have the right to extend the period whereby a Claim is treated by the Company as made on the expiration date of this Policy for a period of thirty-six (36) months, but any such Claim must arise from an Occurrence prior to the date on which the Extended Reporting Period commenced and after the Retroactive Date. The first Named Insured must make a written request for an Extended Reporting Period within 30 days after the expiration of the policy period and pay the additional premium within 30 days after said request. The Extended Reporting Period Endorsement will not take effect unless the additional premium is paid when due. If that premium is paid when due, the endorsement may not be canceled. The Extended Reporting Period will not reinstate or increase the Limits of Liability or extend the policy period. 15. Claim Information The Company, upon request of the first Named Insured and within thirty days thereafter, shall supply sufficient information to the first Named Insured about closed or paid claims, claims for which the Company has established reserves, and claims for which the company has received notices of incidents which could give rise to claims. 16. Non-Waiver of Governmental Immunity It is hereby understood and agreed that nothing in this policy nor in any Participating Member County's coverage under this policy waives, or is intended to waive, any l immunity granted to any Insured or to increase the maximum amount that may be recovered under the Colorado Governmental Immunity Act pursuant to Colo. Revs. Stat. Section 24-10-101 et. seq., including 24-10-114. St. Paul Fire&Marine Insurance Company Page 26 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2005 Final 15 TheW WWI RETROACTIVE DATE ENDORSEMENT The retroactive date shown on the Declarations page does not apply to the following Participating Member Counties. Instead, the retroactive dates shown below apply to the respective Participating Member Counties listed. Cheyenne County February 16, 1987 Delta County July 1, 1988 Fremont County July 1, 1987 Grand County July 1, 1987 Lake County April 1, 1987 Montrose County July 1, 1987 Weld County January 15, 1986 The retroactive date shown on the Declarations page does not apply to Personal Injury or Property Damage that result from Law Enforcement Operations of Custer County. Instead, the retroactive date for Law Enforcement Operations of Custer County is July 1, 1997. Other Terms All other terms of the policy remain the same. Name of Insured Policy Number GP06301696 Effective Date 01/01/05 COLORADO CO. CASUALTY& PROPERTY POOL 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page 1 of 1 L.J Te$rWald EMPLOYEE BENEFITS PROGRAM ADMINISTRATION LIABILITY - CLAIMS-MADE ENDORSEMENT THIS IS A CLAIMS MADE FORM. READ YOUR POLICY CAREFULLY. In consideration of the premium charged and subject to the terms, definitions and exclusions hereunder, the Company will pay on behalf of the Named Insureds amounts in excess of the Self- Insured Retention that the Named Insureds are legally obligated to pay as damages because of an act, error, or omission committed in the Administration of the Named Insured's Employee Benefits Program for its present or former employees. This insurance applies only if a claim for such damages: (1) is first made against an Insured during the policy period and written notice of such claim is __ received by a Named Insured, or us, whichever comes first, AND (2) is attributable to a wrongful act which occurred on or after the Retroactive Date shown in the Declarations. Definitions "Employee Benefits Program" means • pension and profit sharing plans; • Individual Retirement Account (IRA) plans; • Salary reduction plans under Internal Revenue Code 401(k) or amendments; • Savings plans; • Group plans for life, health, dental, disability, automobile, homeowners, and legal advice insurance; • Social security system benefits; • Workers' compensation and unemployment insurance; • Travel and vacation plans; and • Educational tuition reimbursement plans. "Administration" means (a) giving counsel to employees with respect to an Employee Benefit Program; (b) interpreting an Employee Benefit Program; • (c) handling records in connection with an Employee Benefit Program; (d) effecting enrollment, termination or cancellation of employees under an Employee Benefit Program; provided all such acts are authorized by the Named Insured. Name of Insured Policy Number GP06301696 Effective Date 01-01-2005 COLORADO COUNTY CASUALTY&PROPERTY POOL 40502 Ed. 1-80 Customized Form © St.Paul Fire and Marine Insurance Co. 1980 Page 1 of 3 35— Limits of Coverage and Self-Insured Retention Regardless of the number of (1) Insureds under this policy, (2) persons or organizations making claims or bringing suits, or (3) claims made or suits brought on account of any act, error or omission in the Administration of the Named Insured's Employee Benefit Program, the Company's liability is limited as follows: A. $250,000 Self-Insured Retention each wrongful act is the amount the Named Insureds are responsible for, including defense costs, before the limits of coverage will apply. The Self- Insured Retention for Employee Benefits Liability applies toward the aggregate self-insured retention shown in the declarations. The aggregate retention is the total amount the Named Insureds are responsible for, including Defense Costs, for all retained amounts in any one policy year. B. $2,750,000 Each wrongful act limit is the most the Company is responsible for in Damages from a single wrongful act or a series of related wrongful acts. C. $2,750,000 Aggregate limit is the most the Company is responsible for in Damages in any one policy year. This aggregate applies separately for each Named Insured. Exclusions This policy does not apply under this endorsement: A. Personal Injury or Property Damage; To liability for Personal Injury or Property Damage as defined in this policy, including loss of use of tangible property. B. Dishonest Acts To any dishonest, fraudulent, criminal or malicious act or omission. C. Failure to Comply With Law. To any claim that results from the intentional violation of any workers' compensation, unemployment insurance, social security or disability benefits law or administrative interpretation of such laws. D. Failure to Pay Benefits To any claim that results from the failure to provide benefits because they are not properly funded or an insurance company's failure to comply with the terms of its policy. E. Advice To any claim that results from advice given to any employee to participate or not to participate in any stock subscription, individual retirement account or salary reduction plan. F. Investment of Funds To any claim that results from the investment or non-investment of employee benefit funds, or the failure of any investment to perform as any Insured said it would. Name of Insured Policy Number: GP06301696 Effective Date: 01-01-2005 COLORADO COUNTY CASUALTY&PROPERTY POOL 40502 Ed. 1-80 Customized Form © St.Paul Fire and Marine Insurance Co. 1980 Page 2 of 3 (/ G. Termination of Plan To any claim that results from the termination of any employee benefit plan. H. Fines, Taxes, or Penalties -. To liability for fines, taxes or penalties imposed by law or other matters which may be uninsurable under law. Other Terms All other terms of the policy remain the same. Name of Insured Policy Number: GP06301696 Effective Date:01-01-2005 COLORADO COUNTY CASUALTY &PROPERTY POOL 40502 Ed. 1-80 Customized Form ©St. Paul Fire and Marine Insurance Co. 1980 Page 3 of 3 L97 �, TMSt19ul TERRORISM RISK INSURANCE ACT OF 2002 CERTIFIED ACTS OF TERRORISM EXCLUSION ENDORSEMENT 1. It is hereby understood and agreed that the following is added to the Exclusions section. This change excludes coverage. Certified acts of terrorism To any Personal Injury, Property Damage, Medical Payments or Public Official's Errors or Omissions Liability that result from any certified act of terrorism. This exclusion does not apply to Automobile Liability. 2. It is hereby understood and agreed that the following is added to the Definitions section. "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 includes the following criteria for such an act of terrorism: • The act resulted in aggregate losses in excess of$5 million; and • 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 of America, including its territories and possessions and Puerto Rico, or to influence the policy or affect the conduct of the United States Government by coercion. Other Terms All other terms of your policy remain the same. • St. Paul Fire & Marine Insurance Company Colorado Counties Casualty & Property Pool CAAP Terrorism Exclusion 01-05 TMeStPauI SELF-INSURED RETENTION REVISION ENDORSEMENT It is hereby understood and agreed that Section A. of the Limits of Coverage and Self-Insured Retention section is deleted and replaced by the following. A. Self-Insured Retention (1) The each occurrence or wrongful act self-insured retention shown in the declarations is the amount the Named Insureds are responsible for, including Defense Costs, in any one occurrence and/or wrongful act, before the limits of coverage will apply. (2)The aggregate self-insured retention shown in the declarations is the total amount the Named Insureds are responsible for, including defense costs, for all retained amounts in any one policy year. However, the aggregate self-insured retention does not include any amounts payable by a Participating Member County for any occurrence or wrongful act as outlined in such county's Agreement for Partially Self-Funded Program issued by the Colorado Counties Casualty and Property Pool. Other Terms All other terms of the policy remain the same. i Name of Insured Policy Number GP06301696 Effective Date 01/01/05 COLORADO CO. CASUALTY& PROPERTY POOL Endorsement 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page 1 of 1 39 FORM MCS-90 OMB NO. 2125-0074 (Ed 1-96) It is understood and agreed that no condition, provision, stipulation, or limitation contained in the policy, this endorsement, or any other endorsement thereon, or violation thereof, shall relieve the company from liability or from the payment of any final judgment, within the limits of liability herein described, irrespective of the financial condition, insolvency or bankruptcy of the insured. However, all terms, conditions and limitations in the policy to which the endorsement is attached shall remain in full r force and effect as binding between the insured and the company. The insured agrees to reimburse the company for any payment made by the company on account of any accident, claim, or suit involving a breach of the terms of the policy, and for any payment that the company would not have been obligated to make under the provisions of the policy except for the agree- ment contained in this endorsement. It is further understood and agreed that, upon failure of the company to pay any final judgment recovered against the insured as provided herein, the judgment creditor may maintain an action in any court of competent jurisdiction against the company to compel such payment. The limits of the company's liability for the amounts prescribed in this endorsement apply separately, to each accident, and any payment under the policy because of any one accident shall not opterate to reduce the liability of the company for the payment of final judgments resulting from any other accident. • The Motor Carrier Act of 1980 requires limits of financial responsibility according to the type of carriage and commodity transported by the motor carrier. It is the MOTOR CARRIER'S obligation to obtain the required limits of financial responsibility. THE SCHEDULE OF LIMITS SHOWN BELOW DOES NOT PROVIDE COVERAGE. The limits shown in the schedule are for information purposes only. SCHEDULE OF LIMITS Public Liability Type of Carriage 1 Commodity Transported Minimum Insurance /-, (1) For-hire Property (Non-hazardous). S 750,000 (In interstate or foreign commerce). (2) For-hire and Private Hazardous substances as defined in 49 CFR 171.8, S 5,000,000 (in interstate, transported in cargo tanks, portable tanks, or hopper type foreign, or intrastate commerce). vehicles with capacities in excess of 3,500 water gallons; or in bulk Divisions 1.1, 1.2 and 1.3 materials, Division 2.3, Hazard Zone A, or Division 6.1, Packing Group 1, Hazard Zone A material; in bulk Division 2.1 or 2.2; or Highway route controlled quantities of a Class 7 material, as defined in 49 CFR 173.403. (3) For-hire and Private (in interstate or Oil listed in 49 CFR 172.101; hazardous waste, hazardous $ 1,000,000 foreign commerce: materials and hazardous substances defined in 49 CFR in any quantity) 171.8 and listed in 49 CFR 172.101. but not mentioned or (in intrastate in (2) above or (4) below. commerce: in bulk only). (4) For-hire and Private (In interstate or Any quantity of Division 1.1, 1.2 or 1.3 material, any quantity S 5,000,000 foreign commerce). of Division 2.3, Hazard Zone A, or Division 6.1, Packing Group 1, Hazard Zone A material; or highway route controlled quantities of a Class 7 material, as defined in 49 CFR 1 73.403. 1 Note - The type of carriage listed under numbers (1), (2), and (3) apply to vehicles with a gross vehicle weight rating of 10,000 pounds or more. The type of carriage listed under number (4)applies to all vehicles with a gross vehicle weight rating of less than 10,000 pounds. 2 �O FORM MCS-90 OMB NO. 2125-0074 (Ed 1-96) ENDORSEMENT FOR MOTOR CARRIER POLICIES OF INSURANCE FOR PUBLIC LIABILITY UNDER SECTIONS 29 AND 30 OF THE MOTOR CARRIER ACT OF 1980 Issued to Colorado Counties Casualty & Property Pool �. of 800 Grant Street ,Suite 400, Denver Co 80203 Dated at St. Paul , MN this 1 day of January , 2005 Amending Policy No. GP06301696 Effective Date 01/01/05 Countersigned by: Authorized Company Representative Name of Insurance Company St. Paul Fire & Marine Insurance Company The policy to which this endorsement is attached provides primary or excess insurance, as indicated by " X ", for the limits shown: This insurance is primary and the company shall not be liable for amounts in excess of S for each acci- dent. ®This insurance is excess and the company shall not be liable for amounts in excess of $ 2,750,000. for each acci- dent in excess of the underlying limit of $ 250,000. for each accident Whenever required by the Federal Highway Administration (FHWA or the Interstate Commerce Commission (ICC). the company agrees to furnish the FHWA or the ICC a duplicate of said policy and all its endorsements. The company also agrees, upon telephone request by an authorized representative of the FHWA or the ICC, to verify that the policy is in force as of a particular date. .The telephone number to call us is: Cancellation of this endorsement may be effected by the company or the insured by giving (1) thirty-five (35) days notice in writing to the other party (said 35 days notice to commence from the date the notice is mailed, proof of mailing shall be suffi- cient proof of notice), and (2) if the insured is subject to the ICC's jurisdiction, by providing thirty (30) days notice to the ICC (said 30 days notice to commence from the date the notice is received by the ICC at its office in Washington, D.C.). DEFINITIONS AS USED IN THIS ENDORSEMENT ACCIDENT includes continuous or repeated exposure to conditions which results in bodily injury, property damage, or envi- ronmental damage which the insured neither expected nor intended. MOTOR VEHICLE means a land vehicle, machine, truck, tractor, trailer, or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property, or any combination thereof. BODILY INJURY means injury to the body, sickness, or disease to any person, including death resulting from any of these. ENVIRONMENTAL RESTORATION means restitution for the loss, damage, or destruction of natural resources arising out of the accidental discharge, dispersal, release or escape into or upon the land, atmosphere, watercourse, or body of water, of any commodity transported by a motor carrier. This shall include the cost of removal and the cost of necessary measures taken to minimize or mitigate damage to human health, the natural environment, fish, shellfish, and wildlife. _ PROPERTY DAMAGE means damage to or loss of use of tangible property. PUBLIC LIABILITY means liability for bodily injury, property damage, and environmental restoration. The insurance policy to which this endorsement is attached provides automobile liability insurance and is amended to assure compliance by.:the insured, within the limits stated herein, as a motor carrier of property, with Sections 29 and 30 of the Motor Carrier Act Of-1980 and the rules and regulations of the Federal Highway Administration (FHWA) and the Interstate Commerce Commission.OCC). In consideration of the premium stated in the policy to which this endorsement is attached, the insurer (the company)agrees to pay, within the limits of liability described herein, any final judgment recovered against the insured for public liability resulting from negligence in the operation, maintenance or use of motor vehicles subject to the financial responsibility requirements of Sections 29 and 30 of the Motor Carrier Act of 1980 regardless of whether or not each motor vehicle is specifically described in the policy and whether or not such negligence occurs on any route or in any territory authorized to be served by the insured or elsewhere. Such insurance as is afforded, for public liability, does not apply to injury to or death of the insured's employees while engaged in the course of their employment, or property transported by the insured, designated as cargo. 1 TheSiPatil UNINSURED OR UNDERINSURED MOTORISTS REJECTION r. The Named Insureds have agreed to reject any and all Uninsured Motorists Coverage (including underinsured motorists coverage). Dated: 7 f-oS By: Colorado Counties Casualty and Property Pool and Participating Member Counties: uthorize e esentative eyrcI dE T/R 6fne Title Other Terms All other terms of the policy remain the same. 1 Name of Insured Policy Number GP06301696 Effective Date 01/01/2005 COLORADO CO. CASUALTY&PROPERTY POOL Processing Date 01/07/2005 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page I of 1 9a crsi Serving Colorado's Counties June 13, 2005 To: CAPP Designated Correspondents From: Patti Bronikowski, Manager-Risk Programs RE: 2005 CAPP Insuring Agreements — Replacement Pages You recently received the white three-ring binder with the 2005 and 2004 Colorado Counties Casualty and Property Pool Insuring Agreements. Please remove and discard Section 3, 2005 Excess Property Policy, Policy No. 0604612 and replace it with the attached Section 3. Thank you. • County Technical Services, Inc. Administration&Loss Prevention 800 Grant Street • Suite 400 Claims (CAPP &CWCP) Phone:303.861.0507 Phone: 303.861.0507 1-800.544.7868 Fax:303.861.2832 Denver, Colorado • 80203 Fax:303.861.1022 email: ctsi@ctsi.org .CTSI r^ Colorado Counties Casualty and Property Pool 2005 Excess Property Policy Policy No. 0604612 The summary included in this binder is a brief outline of the coverages afforded under the insurance policy. Since it is for informational purposes only, it should not be construed to constitute the entire insurance contract. As the policies may contain additional coverages and restrictions, the exact wording should be consulted. /"` ai June 13, 2005 Excess Property Insurance Summary Colorado Counties Casualty and Properly Pool 1 Excess Property - Claims Made Policy Information: Carrier: Lexington Insurance Company Policy Number: 0604612 Policy Period: January 1, 2005 to January 1, 2006 Annual Premium: $765,720 + 3,2% Colorado Surplus Lines Tax and Fees Limits of Liability: $ 50,000,000 Primary Loss Limit, Per Occurrence Deductible: $ 150,000 Each Occurrence or Wrongful Act Named Insured: Colorado Counties Casualty and Property Pool and Participating Member Counties. Insured includes: any official, trustee or employee of the Named Insured while acting within the scope of his duties as such, and any person, organization, trustee or estate to whom the Named Insured is obligated by virtue of written contract or agreement to provide insurance, such as is offered by this Insurance, but only in respect to operations by or on behalf of the Named Insured. This account summary is a Onel Outline of he coverages afforded under your insurance policies Since,l is for informational purposes only,it should not be cOnsWed to constitute the entire insurance COnlracl. As your policies er. may contain additional ooverages and reslncuons,the exact wording should be consulted Excess Property Insurance Summary Colorado Counties Casualty and Property Pool Participating Member Counties As Named Insureds: Alamosa, Archuleta, Baca, Bent, Chaffee, Cheyenne, Clear Creek, Conejos, Costilla, Crowley, Custer, Delta, Dolores, Eagle, Elbert, Fremont, Garfield, Gilpin, Grand, Gunnison, Hinsdale, Huerfano, Jackson, Kiowa, Kit Carson, Lake, La Plata, Las Animas, Lincoln, Logan, Mineral, Montrose, Morgan, Otero, Ouray, Park, Phillips, Prowers, Pueblo, Rio Blanco, Rio Grande, Routt, Saguache, San Juan, Sedgwick, Summit, Teller, Washington, Weld, Yuma Valuation: • Replacement Cost (If property not repaired, rebuilt or replaced within two years, Actual Cash Value applies). SubLimits: --- $ 1,000,000 Flood Limit in Zone A, Annual Aggregate $ 10,000,000 Flood Limit in Zone B, D, and X500, Annual Aggregate $ 50,000,000 Flood Limit in Zone C, Annual Aggregate S 25,000,000 Earthquake Limit, Annual Aggregate $ 1,000,000 Newly Acquired Property, per location (values in excess of$1,000,000 to be reported within 60 days) $ 5,000,000 Builders Risks, Renovations, Repairs made by the Insured at any location (Including new locations) within the Territorial limits of the Policy, any one occurrence $ 500,000 Unscheduled Locations, any one occurrence $ 50,000 Personal Property of Others $ 1,000,000 Ordinance Deficiency $ 1,000,000 Extra Expense Exclusions Including But Not Limited To: • Moth, vermin or insects, wear or tear, rust, wet or dry rot, or mold • Radioactive contamination or other contamination (except by hostile fire) • Loss of use, delay, or loss of markets • Breakdown of machinery or boiler explosion (exclusion does not apply to EDP equipment and media) • Dampness of atmosphere or variation in temperature except as caused by Fire or Extended Coverage perils or loss by freezing. !i • Loss of electrical appliances, including wiring • Settling, normal shrinkage or expansion of foundations, walls, floors or ceilings • Loss by mechanical derangement, inherent vice or latent defect • Loss from processing or faulty workmanship • Shrinkage, evaporation, loss of weight or leakage • Inventory shortage This account summary is a tone)outline of the coverages afforded under your insurance policies Since it is for informatwnal purposes only.II should not be construed to consLwte the entire insurance Contract As your policies may Contain addmonal coverages and resincions,the exact wording should be consulted Excess Property Insurance Summary Colorado Counties Casualty and Property Pool i^• Property Excluded: • Animals, aircraft, standing timber, growing crops, land, currency, money, notes, securities, bridges, culverts, roadways, streets, walks, or paved surfaces, dams, docks, piers, and wharves. Endorsements: • Pollution, Contamination, Debris Removal Exclusion Endorsement • Occurrence Limit of Liability • Combined Property/Boiler & Machinery Millennium Endorsement • Mold/Fungus Exclusion • Property Endorsement • _ War Risk and Terrorist Exclusion • Named Insured Endorsement Cancellation: • 90 Days Notice for any other reason then Non-Payment • • 10 Days Notice for Non-Payment J.1 This account summary is a bnel outline of the coverages afforded under your insurance policies Since n is for intonnalional purposes only.it should not be construed 10 Constitute the entire insurance Contract As your policies �'\. may conlain additional coverages and resmctrons.the exact wording should be consulted Excess Property Insurance Summary Colorado Counties Casualty and Property Pool 2 mailer and Machinery: Coverage and Limits: $ Included Equipment Breakdown Sublimits: $ 1,000,000 Extra Expense $ 100,000 Ammonia Contamination $ 100,000 Expediting Expenses $ 100,000 Water Damage .� 5 100,000 Hazardous Substances $ 100,000 Spoilage $ 100,000 Pollution Cleanup and Removal Valuation: • Repair or Replacement Deductibles: $ 5,000 Extra Expense $ 1 , 5,000 Spoilage $ 5,000 All Other Loss or Damage Coverage: • Direct damage caused by an "Accident" (sudden and accidental breakdown) to a covered object This account summary is a bnel outline of the overages afforded under your insurance policies Since o is for i nlonnalional puryoses only,PI should not be construed to constitute the entire insurance contract. AS your policies may contain add,lional coverages and Ie5lnclions,the exact wording should be consulted. /� Excess Property Insurance Summary Colorado Count es Casualty and Property Pool Covered Objects: • Comprehensive, Including Production Machinery Covered Locations: • Any location in the U.S. which is owned by an Insured or leased by and operated under the control of an Insured and for which the Insured is legally liable. Exclusions Including But Not Limited To: • Electronic Recordings • Media This acwum summary is a brief oulline of Ire coverages afforded under your insurance policies Since ad IOr informational purposes only, should not be consirued 10 constilule the entire insurance contract As your policies jam, may contain addilional coverages and reslnchons,me enact wording should be consuued LEXINGTON INSURANCE COMPANY Administrative Offices: 100 Summer Street, Boston, Massachusetts 02110-2103 (hereinafter called the Company) COMMERCIAL PROPERTY POLICY DECLARATIONS POLICY NUMBER: 0604612 RENEWAL OF: 0413367 ITEM 1. Named Insured: COLORADO COUNTIES CASUALTY AND PROPERTY POOL Address: 800 GRANT STREET, SUITE 400 DENVER CO 80203 ITEM 2. Policy Period: From 01/01/05 To 01/077-0-6 at 12:01 A.M. Standard Time at the address of the named insured shown above. ITEM 3. Limit of Insurance: $50,000,000 PRIMARY LOSS LIMIT PER OCCURRENCE SUBLIMITS AND ANNUAL AGGREGATES FOR EARTHQUAKE AND FLOOD AS PER POLICY Total Premium $765,720 Minimum Earned Premium $191 ,430 ITEM 4. Perils: ,++ ALL RISK INCLUDING EARTHQUAKE AND FLOOD AND BOILER & MACHINERY ITEM 5. Description of Property Covered: Coinsurance REAL AND PERSONAL PROPERTY, RENTS, BOILER & MACHINERY AND AS PER POLICY FORM Al ITEM 6. Mortgagee Clause: Loss, if any shall be payable to: ITEM 7. Forms Attached: See attached forms schedule 4& PRPDEC(Ed.01/911 thorized epresentative OR Lxiii9 Countersignature (In states where applicable) / NOTICE 1 . THE INSURANCE POLICY THAT YOU HAVE PURCHASED IS BEING ISSUED BY AN INSURER THAT IS NOT LICENSED BY THE STATE OF CALIFORNIA. THESE COMPANIES ARE CALLED "NON-ADMITTED" OR "SURPLUS LINE" INSURERS. 2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL SOLVENCY -REGULATION AND ENFORCEMENT WHICH APPLIES TO CALIFORNIA LICENSED INSURERS. 3. THE INSURER DOES NOT PARTICIPATE IN ANY OF THE INSURANCE GUARANTEE FUNDS CREATED BY CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE PAYMENTS AS PROMISED. 4. CALIFORNIA MAINTAINS A LIST OF ELIGIBLE SURPLUS LINE INSURERS APPROVED BY THE INSURANCE COMMISSIONER. ASIC YOUR AGENT OR BROKER IF THE INSURER IS ON THAT LIST. 5. FOR ADDITIONAL INFORMATION ABOUT THE INSURER YOU SHOULD ASK QUESTIONS OF YOUR INSURANCE AGENT, BROKER, OR "SURPLUS LINE" BROKER OR CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE AT THE FOLLOWING TOLL-FREE TELEPHONE NUMBER: 1 -800-927-4357. r-. D-2 FORM (1/1999) LEXINGTON INSURANCE COMPANY ANY REFERENCE IN THE POLICY FORM TO CONTACT IN WRITING THE COMPANY'S CLAIM OR LEGAL DEPARTMENTS SHOULD USE THE ADDRESSES PROVIDED BELOW. Attn: Claim Department Lexington Insurance Company 100 Summer Street Boston, Massachusetts 02110-2103 Attn: Legal Department Lexington Insurance Company 100 Summer Street . Boston, Massachusetts 02110-2103 v LEXINGTON INSURANCE COMPANY Administrative Offices: 100 Summer Street, Boston, Massachusetts 02110-2103 (hereinafter called the Company) COMMERCIAL PROPERTY POLICY DECLARATIONS LEXINGTON INSURANCE COMPANY Notice to Colorado Policyholders This contract is delivered as surplus line insurance under the 'Nonadmitted Insurance Act.' The insurer issuing this contract is not admitted in Colorado but is an approved nonadmitted insurer. There is no protection under the provisions of the 'Colorado Insurance Guaranty Association Act.' If this policy is written on a claims-made basis, the following applies: This policy is a claims-made policy which provides liability coverage only if a claim is made during the policy period or any applicable extended reporting period. Colorado Fraud Warning It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies. PRPDEC (Ed.01/91) LX1119 FORMS SCHEDULE Named Insured: COLORADO COUNTIES CASUALTY AND PROPERTY POOL Policy No: 0604612 Effective Date: 01/01/2005 Form Number Edition Date Endorsement Number Title PRIMAS 01/91 IM SCHEDULE PRPDEC 01/91 PROPERTY DEC PR9015 01/91 POLLUTION CONTAMINATION FORM PR9014 01/91 OCCURRENCE LIMIT OF LIABILITY PR9019 01/94 STANDARD PROPERTY CONDITIONS Y69813 02/98 COMB. PROP/B&M MILLENNIUM END . LX9512 08/02 MOLD/FUNGUS EXCLUSION PR9514 09/02 PROPERTY ENDORSEMENT PR9513 09/01 WAR RISK & TERRORIST EXCLUSION BRK/MAN BROKER'S MANUSCRIPT FORMS D-2 SLA D-2 NOTICE wi 3C018(Ed.12/87) m2as INLAND MARINE • Schedule of Coverage .-t\ Policy Number: 0604612 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL Description of Premises Perils Limit Percent of Coins AS PER SCHEDULE ON FILE PRIMAS(ED.01/91) • OCCURRENCE LIMIT OF LIABILITY It is understood and agreed that the following special terms and conditions apply to this policy: 1. The limit of liability or Amount of Insurance shown on the face of this policy, or endorsed onto this policy, is the total limit of the Company's liability applicable to each occurrence, as hereafter defined. Notwithstanding any other terms and conditions of this policy to the contrary, in no event shall the liability of the Company exceed this limit or amount irrespective of the number of locations involved. The term "occurrence" shall mean any one loss, disaster, casualty or series of losses, disasters, or casualties, arising out of one event. When the term applies to loss or losses from the perils of tornado, cyclone, hurricane, windstorm, hail, flood, earthquake, volcanic eruption, riot, riot attending a strike, civil commotion, and vandalism and malicious mischief one event shall be construed to be all losses arising during a continuous period of 72 hours. When filing proof of loss, the Insured may elect the moment at which the 72 hour period shall be deemed to have commenced, which shall not be earlier than the first loss to the covered property occurs. 2. The premium for this policy is based upon the Statement of Values on file with the Company, or at- tached to this policy. In the event of loss hereunder, liability of the Company, subject to the terms of paragraph one (1) above, shall be limited to the least of the following: a. The actual adjusted amount of loss, less applicable deductible(s). CEP The total st d value for the property involv , s shown on the I -Sfatement of Values on file with t Company, less applicable ded ctible(s). Deleted '- See Endorsement ill c. The limit of Liability or Amount of Insurance shown on the face of this policy or endorsed onto this policy. PR9014(Ed.01/91) V111141 • LEXINGTON INSURANCE COMPANY Standard Property Conditions r. endorsement effective 01/01/05 , forms a part of Policy Number 0604612 . _uedto COLORADO COUNTIES CASUALTY AND PROPERTY POOL by Lexington Insurance Company (hereinafter called "the Company"). In consideration of the premium charged, the following clauses are hereby made applicable under this policy. MINIMUM EARNED PREMIUM CLAUSE In the event of cancellation of this policy by the Insured, a minimum premium of $ 191 ,430 shall become earned, any provision of the policy to the contrary notwithstanding. Failure of the Insured to make timely payment of premium shall be considered a request by the Insured for the Company to cancel on the Insured's behalf. In the event of such cancellation for non-payment of premium, the minimum earned premium shall be due and payable; provided, however, such cancellation shall be rescinded if the Insured remits and the Company receives the full policy premium with 10 days after the date of issuance of the cancellation notice. Such re- mittance and acceptance by the Company shall not effect the minimum earned premium provision of this endorsement. In the event of any other cancellation by the Company, the earned premium shall be computed-pru-rata, not subject to the minimum earned premium. POLICY DEDUCTIBLE Each claim for loss or damage separately occurring shall be adjusted separately and from each such adjusted claim, the amount of $ 150,000 shall be deducted. Notwithstanding the foregoing, the deductible amount applying to certain peril(s) insured against by this policy shall be as follows: 5,000 deductible applying to PER ACCIDENT FOR BOILER AND MACHINERY deductible applying to deductible applying to r' deductible applying to deductible applying to III the event of any other insurance covering the property insured hereunder, whether or not concurrent, the deductible(s) specified herein shall apply in full against that portion of any claim for loss or damage which the Company is called upon to pay under the provisions of the Apportionment Clause irrespective of any provisions to the contrary of such other insurance. CANCELLATION CLAUSE Except and to the extent of the Minimum Earned Premium Clause which is part of this policy, this clause supersedes other cancellation clauses made a part of this policy. CANCELLATION: This policy may be cancelled by the Insured by surrender thereof to the Company or by mailing to the Company written notice stating when thereafter such cancellation shall be effective. This policy may be cancelled by the Company by mailing to the Insured, at the mailing address shown in this policy or last known address, written notice, stating when, not less than 60 days thereafter (10 days for non-payment of premium) such cancellation shall be ef- fective. The effectiveness of cancellation is not dependent on the return of unearned premium witp the notice. Proof of mailing of notice as aforesaid shall be sufficient proof of notice. The effective date and hour of cancellation stated in the notice shall become the end of the policy period. Delivery of such written notice either by the Insured or the Company shall be equivalent to mailing. If the Insured cancels, earned premium shall be computed in accordance with the cus- tomary short rate table and procedure. If the Company cancels, earned premium shall be computed pro rata. Premium adjustment shall be made as soon as practicable after cancellation becomes effective. SERVICE OF SUIT CLAUSE Service of Suit: In the event of failure of the Company to pay any amount claimed to be due hereunder, the Company, at the request of the Insured, will submit to the jurisdiction of a court of competent jurisdiction within the United States. Nothing in this condition constitutes or should be understood to constitute a waiver of the Company's rights to com- rr'- ce an action in any court of competent jurisdiction in the United States to remove an action to a United States .:t Court or to seek a transfer of a case to another court as permitted by the laws of the United States or of any stare in the United States. It is further agreed that service or process in such suit may be made upon Counsel, Legal Department, Company stated on Declarations, 100 Summer Street, Boston, Massachusetts, 02110-2103, or his or her representative, and that in any suit instituted against the Company upon this policy, the Company will abide by the final decision 1 of 2 PR9019 (Ed.01/94) of such court or of any appellate court in the event of an appeal. Further, pursuant to any statute of any state, territory, or district of the United States which makes provision therefor, the Company hereby designates the Superintendent, Commissioner or Director of Insurance, other officer specified for .—.. that purpose in the statute, or his successor or successors in office as its true and lawful attorney upon whom may be served any lawful process in any action, suit, or proceeding instituted by or on behalf of the Insured or any beneficiary hereunder arising out of this policy of insurance and hereby designates the above named Counsel as the person to whom the said officer is authorized to mail such process or a true copy thereof. WAR RISK EXCLUSION CLAUSE The Company shall not be liable for any loss, caused directly or indirectly, by (1) hostile or warlike action in time of peace or war, whether or not declared, including action in hindering, combating or defending against an actual, im- pending or expected attack (a) by government or sovereign power (dejure or de facto) or by any authority maintaining or using military, naval or air forces; or (b) by military, naval or air forces; or (c) by an agent of any such government, power, authority or force (2) any weapon of war employing atomic fission or radioactive force whether in time of peace or war, whether or not its discharge was accidental; (3) insurrection, rebellion, revolution, civil war, usurped power, or action taken by government authority in hindering, combating, or defending against such an occurrence, seizure or de- struction; (4) any consequence of any of the foregoing. NUCLEAR EXCLUSION CLAUSE The Company shall not be liable for loss by nuclear reaction or nuclear radiation or radioactive contamination all whether controlled or not, and whether such loss be direct or indirect, proximate or remote, or be in whole or in part caused by, contributed to, or aggravated by the peril(s) insured against in this policy. If the peril of fire is insured under this policy, then, subject to the foregoing and all provisions of this policy, direct loss by fire resulting from nuclear reaction or nu- clear radiation or radioactive contamination is insured against by this policy. SALVAGE AND RECOVERY CLAUSE All salvages, recoveries and payments recovered or received either prior or subsequent to a loss settlement under this policy shall be applied as if recovered or received prior to the said settlement and all necessary adjustments shall be made by the parties hereto, including deduction of the Company's cost of recovery or salvage. REPORTING CLAUSE Notwithstanding that the Insured may be obligated to report full values for premium purposes, the Company's maximum limit of liability shall not exceed that amount stated as the policy limit of liability. PROOF OF LOSS AND PAYMENT The Insured shall complete and sign a sworn proof of loss within ninety (90) days after the occurrence of a loss (unless such period be extended by the written agreement of the Company) stating the time, place and cause of loss, the interest of the Insured and of all others in the property, the sound value thereof and the amount of loss or damage thereto, and all other insurance thereon. All adjusted claims shall be due and payable thirty (30) days after the presentation and acceptance of satisfactory proof(s) of loss at the office of the Company at 100 Summer Street, Boston, Massachusetts 02110-2103. GOVERNMENT ACTIVITY CLAUSE The Company shall not be liable for loss or damage caused by or gsulting from: (1) the seizure or destruction of prop- erty insured by this policy by any government body, including any customs or quarantine action, or (2) confiscation or destruction of any property by order of any government or public authority, except an order to destroy property to pre- vent the spread of fire or explosion. IN WITNESS WHEREOF, the Company has caused this policy to be executed and attested, but this policy shall not be valid unless countersigned in the Declarations by one of its duly authorized representatives. ta,.‘sectut, >it Irak johi Secretary Chairman of the Board and CEO /O 2 of 2 PR9019 (Ed.01/94) • ENDORSEMENT This endorsement, effective 12:01 AM 01/01/2005 Forms a part of policy no.: 0604612 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY COMBINED PROPERTY/BOILER & MACHINERY MILLENNIUM ENDORSEMENT This policy is hereby amended as follows: A. The Insurer will not pay for Damage or Consequential Loss directly or indirectly caused by, consisting of, or arising from, the failure of any computer, data processing equipment, media microchip, operating systems, microprocessors (computer chip), integrated circuit or similar device, or any computer software, whether the property of the Insured or not, and whether occurring before, during or after the year 2000 that results from the inability to: 1. correctly recognize any date as its true calendar date; 2. capture, save, or retain, and/or correctly manipulate, interpret or process any data or information or command or instruction as a result of treating any date other than its true calendar date; and/or 3. capture, save, retain or correctly process any data as a result of the operation of any command which has been programmed into any computer software, being a command which causes the loss of data or the inability to capture, save, retain or correctly process such data on or after any date. B. It is further understood that the Insurer will not pay for the repair or modification of any part of an electronic data processing system or its related equipment, to correct deficiencies or features of logic or operation. C. It is further understood that the Insurer will not pay for Damage or Consequential Loss arising from the failure, inadequacy, or malfunction of any advice, consultation, design, evaluation, inspection, installation, maintenance, repair or supervision done by the Insured or for the Insured or by or for others to determine, rectify or test, any potential or actual failure, malfunction or inadequacy described in A. above. Such Damage or Consequential Loss described in A, B, or C above, is excluded regardless of any 1•i other cause that contributed concurrently or in any other sequence. This endorsement shall not exclude subsequent Damage or Consequential Loss, not otherwise excluded, which itself results from a Defined Peril. Defined Peril shall mean fire, lightning, explosion, aircraft or vehicle impact, falling objects, windstorm, hail, tornado, hurricane, cyclone, riot, strike, civil commotion, vandalism, malicious mischief, earthquake, volcano, tsunami, freeze or weight of snow, sudden and accidental breakdown of an object, including mechanical and electrical breakdown. All other terms, conditions and exclusions of this policy remain unchanged. AUTHORIZED REPRESENTATIVE 69813 (2/98): nR Cnuntersinnature (In dates where annlirahlal ENDORSEMENT This endorsement, effective 12:01 AM 01/01/2005 Forms a part of policy no.: 0604612 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MOLD / FUNGUS EXCLUSION - Refer to Endorsement I/1 for additional wording. In consideration of the premium charged, it is hereby understood and agreed that this policy is amended as follows. The Company shall not be liable for any loss or damage caused by, arising out of, contributed to, or resulting from fungus, mold(s), mildew or yeast; or any spores or toxins created or produced by or emanating from such fungus, mold(s), mildew or yeast; (a) fungus includes, but is not limited to, any of the plants or organisms belonging to the major group fungi, lacking chlorophyll, and including mold(s), rusts, mildews, smuts and mushrooms; (b) mold(s) includes, but is not limited to, any superficial growth produced on damp or decaying organic matter or on living organisms, and fungi that produce mold(s); (c) spores means any dormant or reproductive body produced by or arising or emanating out of any fungus, mold(s), mildew, plants, organisms or microorganisms, regardless of any other cause or event that contributes concurrently or in any sequence to such loss. All other terms, conditions, definitions, exclusions, limitations and provisions of the Policy remain the same. /� Authorized Representative OR Countersignature (In states where applicable) txos» MR/I1g1 ENDORSEMENT This endorsement, effective 12:01 AM 01/01/2005 Forms a part of policy no.: 0604612 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY PROPERTY ENDORSEMENT It is noted and agreed that this policy is hereby amended as follows: The Insurer will not pay for Damage or Consequential loss directly or indirectly caused by, consisting of, or arising from: 1. Any functioning or malfunctioning of the internet or similar facility, or of any intranet or private network or similar facility, 2. Any corruption, destruction, distortion, erasure or other loss or damage to data, software, or any kind of programming or instruction set, rac 3. Loss of use or functionality partial or entire of data, coding, whether program, software, any computer or computer system or other device dependent upon any microchip or embedded logic, and any ensuing liability or failure of the Insured to conduct business. This Endorsement shall not exclude subsequent damage or Consequential loss, not otherwise excluded, which itself results from a Defined Peril. Defined Peril shall mean: Fire, Lightning, Earthquake, Explosion, Falling Aircraft, Flood, Smoke, Vehicle Impact, Windstorm or Tempest. Such Damage or Consequential loss described in 1, 2, or 3 above is excluded regardless of any other cause that contributed concurrently or in any other sequence. • All other terms, conditions and exclusions of this policy remain unchanged. !i Authorized Representative OR /? Countersignature (In states where applicable) Ll ENDORSEMENT This endorsement, effective 12:01 AM 01/01/2005 Forms a part of policy no.: 0604612 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY WAR RISK AND TERRORIST EXCLUSION It is hereby understood and agreed, that notwithstanding any other war risk or terrorist exclusion that may be in the policy or any clause limiting or attempting to limit the application of any endorsements to the policy, this policy is amended as follows: The policy does not cover loss or damage to property caused by, resulting from, contributed to or aggravated by any of the following perils, whether such loss or damage is accidental or intentional, intended or unintended, direct or indirect, proximate or remote or in whole or in part caused by, contributed to or aggravated by any perils insured by the policy: (1) war, hostile or warlike action in time of peace or war, whether or not declared, including action in hindering, combating or defending against an actual, impending or expected attack: (a) by government or sovereign power (de jure or de facto) or by any authority maintaining or using military, naval or air forces; or (b) by military, naval or air forces; or (c) by an agent of any such government, power, authority or force. (2) any weapon of war employing atomic fission or radioactive force whether in time of peace or war, whether or not its discharge was accidental; (3) insurrection, rebellion, revolution, civil war, usurped power, or action taken by government authority in hindering, combating, or defending against such an occurrence, seizure or destruction; (4) any act of one or more persons, whether known or unknown and whether or not agents of a sovereign power, for Terrorist purposes; (5) hijacking or any unlawful seizure or wrongful exercise or control Of any mode of transportation, including but not limited to aircraft, watercraft, truck(s), train(s) Of automobile(s), including any attempted seizure of control, made by any person or persons, for Terrorist purposes. Such loss or damage is excluded regardless of any other cause, event or intervention that contributes concurrently or in any sequence to the loss or damage. Terrorist purpose means the use or threatened use of any unlawful means, including the use of force or violence against any person(s) or property @es), for the actual or apparent purpose of intimidating, coercing, punishing or affecting society or some portion of society or government. All other terms, conditions and exclusions of the policy remain unchanged. /Per Authorized Representative OR Countersignature (In states where applicable) opoci q lno/M% • POLLUTION, CONTAMINATION, DEBRIS REMOVAL EXCLUSION ENDORSEMENT /e".• Property Not Covered This policy does not cover land, land values or water. 2. Pollution and Contamination Exclusion. This policy does not cover loss or damage caused by, resulting from, contributed to or made worse by actual, alleged or threatened release, discharge, escape or dispersal of CONTAMINANTS or POLLUTANTS, all whether direct or indirect, proximate or remote or in whole or in part caused by, contributed to or aggravated by any physical damage insured by this policy. Nevertheless, if fire is not excluded from this policy and a fire arises directly or indirectly from seepage or con- tamination or pollution, any loss or damage insured under this policy arising directly from that fire is insured, subject to the provisions of this policy. CONTAMINANTS or POLLUTANTS means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, Soot, fumes, acids, alkalis, chemicals and waste, which after its release can cause or threaten damage to human health or human welfare or causes or threatens damage, deterioration, loss of value, marketability or loss of use to property insured hereunder, including, but not limited to, bacteria, fungi, virus, or hazardous substances as listed in the Federal Water, Pollution Control Act , Clean Air Act, Resource Conserva- tion and Recovery Act of 1976, and Toxic Substances Control Act or as designated by the U. S. Environmental Protection Agency. Waste includes materials to be recycled, reconditioned or reclaimed. This exclusion shall not apply when loss or damage is directly caused by fire, lightning, aircraft impact, explosion, riot, civil commotion, smoke, vehicle impact, windstorm, hail, vandalism, malicious mischief. This exclusion shall also not apply when loss or damage is directly caused by leakage or accidental discharge from automatic fire protective systems. Asbestos Exclusions This policy does not cover - a) Asbestos, dioxin or polychlorinated biphenols (hereinafter all referred to as "Materials") removal from any good, product or structure unless the asbestos is itself damaged by fire, lightning, aircraft impact, explosion, riot, civil commotion, smoke, vehicle impact, windstorm or hail, vandalism, malicious mischief, leakage or accidental discharge from automatic fire protective system. b) Demolition or increased cost of reconstruction, repair, debris removal or loss of use necessitated by the enforcement of any law or ordinance regulating such Materials; c) Any governmental direction or request declaring that such Materials present in or part of or utilized on any undamaged portion of the insured's property can no longer be used for the purpose for which it was intended or installed and must be removed or modified. The coverage afforded does not apply to payment for the investigation or defense of any loss, damage or any cost, loss of use expense, fine or penalty or for any expense or claim or suit related to any of the above. 4. Debris Removal Exclusion The Company will pay the expense within the sum insured to remove debris of insured property damaged or de- stroyed by an insured peril during the policy term. The Company will not pay the expense to: /an) Extract contaminants or pollutants from the debris; or b) Extract contaminants or pollutants from land or water; or c) Remove, restore or replace contaminated or polluted land or water; or 1 of 2 PR9015(Ed.01/91) d) Remove or transport any property or debris to a site for storage or decontamination required because the • d - property or debris is affected by pollutants or contaminants, whether or not such removal, transport, or de- contamination is required by law or regulation. It is a condition precedent to recovery under this extension that the Company shall have paid or agreed to pay for direct physical loss or damage to the property insured hereunder and that the Insured shall give written notice to the Company of intent to claim for cost of removal of debris or cost to clean up not later than 180 days after the date of such physical loss or damage. 5. Authorities Exclusion Notwithstanding any of the provisions of this policy, the Company shall not be liable for loss, damage, costs, ex- penses, fines or penalties incurred or sustained by or imposed on the Insured at the order of any Government Agency, Court or other Authority arising from any cause whatsoever. 2of2 PR9015(Ed.01/91) Named Insured Endorsement r It is agreed that the Participating Member Counties named hereunder are included as Named Insureds: 1. Alamosa 26. Lake 2. Archuleta 27. La Plata 3. Baca 28. Las Animas 4. Bent 29. Lincoln 5. Chaffee 30. Logan 6. Cheyenne 31. Mineral 7. Clear Creek 32. Montrose 8. Conejos 33. Morgan 9. Costilla 34. Otero 10. Crowley 35. Ouray 11. Custer 36. Park 12. Delta 37. Phillips 13. Dolores 38. Prowers 14. Eagle 39. Pueblo 15. Elbert 40. Rio Blanco 16. Fremont 41. Rio Grande 17. Garfield 42. Routt 18. Gilpin 43. Saguache 19. Grand 44. San Juan 20. Gunnison 45. Sedgwick 21. Hinsdale 46. Summit 22. Huerfano 47. Teller 23. Jackson 48. Washington 24. Kiowa 49:• Weld 25. Kit Carson 50. Yuma Other Terms All other terms of the policy remain the same. r Name of Insured: Colorado Counties Casualty 8 Property Pool Page 1 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s sera capps3005Nntrer capp le.ngton.awac 05-06 ompeny cu1'h iom.doc • Coverage Summary 1 . This policy covers Blanket Real, Personal Property, Contractors Equipment, Fine Arts, Glass, Valuable Papers, Data Processing Equipment and Media, Extra Expense, Builders Risks and Installations, Transit, and Vehicle Damage. 2. Limit of Liability The insurer(s) shall not be liable hereunder in any one loss, casualty or disaster for more than $50,000,000. per occurrence. For sublimits refer to Insuring Agreement, page 1 of 10, paragraph III. 3. Each claim for loss or damage shall be adjusted separately and the Insurer's liability shall be limited to that amount excess of$150,000 except $5,000 per accident for Boiler & Machinery coverage. Insuring Agreement I. NAME OF INSURED It is agreed that the unqualified word "Insured" wherever used in this insurance includes not only the Named Insured but also - any official, trustee or employee of the Named Insured while acting within the scope -� of his duties as such, and any person, organization, trustee or estate to whom the Named Insured is obligated by virtue of written contract or agreement to provide insurance such as is offered by this Insurance, but only in respect to operations by or on behalf of the Named Insured; II. TERRITORY This policy covers anywhere in the Continental United States of America and Canada. III. ULTIMATE NET LOSS In calculating the amount of Ultimate Net Loss, this insurance is deemed to have the following maximum sublimits: ` A. $1,000,000 In the aggregate annually as respects any Flood loss in Zone A. B. $10,000,000 In the aggregate annually as respects any Flood loss in Zone B, D and X500. C. $50,000,000 In the aggregate annually as respects any Flood loss in Zone C. -�, Name of Insured: Colorado Counties Casualty 8 Property Pool Page 2 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 ichNp�pp10050^^pev capp ieimplonawac 05-DS pppeny pokey form doe l8, D. $25,000,000 In the aggregate annually as respects any Earthquake less. E. $1,000,000 Newly acquired property, per location, values in excess of$1,000,000 arc to be reported to this Company in sixty (60) days. F. $5,000,000 Builders risks, renovations, repairs made by the Insured at any location (including new locations) within the territorial limits of the policy, any one occurrence. G. S 500,000 At any unscheduled location, any one occurrence. H. $ 50,000 Personal property of others. I. $1,000,000 Ordinance deficiency J. $1,000,000 Extra expense IV. SERVICE ORGANIZATION This Insurance is issued to the Insured on the express condition that the Insured undertakes to utilize at all times the services of County Technical Services, Inc. Claims Management Department. This Service Organization shall perform the following duties: A. Discharge the Insured's obligation under the terms of this Agreement by administering a complete claims handling program. B. Maintain accurate records of all reported claims and details incident to loss and expense F"4 payments. C. Furnish monthly claims records on an approved form. The acceptance of these services shall be a condition precedent to any liability which may attach to the Underwriters in accordance with the terms and conditions of this Insurance. Property Insurance AGREEMENT A - BUILDING AND CONTENTS: Underwriters agree, subject to the limitations, terms and conditions of this Insurance, to indemnify the Insured for risks of physical loss or damage to All Real or Personal Property of every kind and description, wherever located, 4.1 occurring during the period of this Insurance. AGREEMENT B - AUTOMOBILE: Underwriters agree, subject to the limitations, terms and conditions of this Insurance, to indemnify the Insured for loss or damage to Automobiles owned by the Insured or on which the Insured has an obligation to provide adequate insurance, wherever located, against Risks of Direct Physical Loss, including Collision of the Automobile with another object. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 3 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s YMagroppvW9rmver capp lennpran.awac 05-06 pmcenY Ochry torn,Doc /9 Definitions I. PROPERTY OF THE INSURED: The term "Insured's Property" shall mean All Real and Personal Property, including leasehold improvements or betterments which the Insured owns, property which the Insured holds on consignments or agrees to insure by any contractual agreement normal to its operations. 2. AUTOMOBILE: The term "Automobile" shall mean any motor vehicle, trailer or semi- trailer, including its equipment and any other equipment permanently attached thereto. The word "Trailer" shall include semi-trailer. 3. ULTIMATE NET LOSS: The words "Ultimate Net Loss" in respect of this section shall be understood to mean the loss sustained by the Insured after making deductions for all recoveries and salvages. 4. VALUABLE PAPERS: The term Valuable Papers shall mean written, printed or otherwise inscribed documents and records, including books, maps, films, drawings, abstracts, deeds, mortgages and manuscripts, but does not mean money and securities, but includes additional costs to research or restore damaged documents, drawings or records. 5. ACCOUNTS RECEIVABLE: The term "Accounts Receivable" shall mean: a) All sums due the Insured from customers provided the Insured is unable to effect collection thereof as the result of covered loss or damage to records of accounts receivable; b) Interest charges on any loan to offset impaired collections pending repayment of such sums made uncollectible by such loss or damage: c) Collection expense in excess of normal collection caused and made necessary because of such loss or damage; d) Other expenses when reasonably incurred by the Insured in re-establishing records of accounts receivable following such loss and/or damage. The following special exclusions apply to Accounts Receivable Coverage; this policy does not insure against: I) Loss due to bookkeeping, accounting or billing errors or omissions; `1 2) Loss, the proof of which as to factual existence, is dependent upon an audit of records or an inventory computation, but this shall not preclude the use of such procedures in support of claim for loss which the Insured can prove, through evidence wholly apart therefrom, is due solely to a risk of loss to records of accounts receivable not otherwise excluded hereunder; 3) Loss due to alteration, falsification, manipulation, concealment, destruction or disposal of records of accounts receivable committed to conceal the wrongful giving, taking, Name of Insured: Colorado Counties Casualty 8 Property Pool Page 4 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s KbVpkappr1005vmvpr cape ierrrglon-awac 05-06 properly Pak,'or",00C o2 obtaining or withholding of money, securities or other property but only to the extent of such wrongful giving, taking, obtaining or withholding. 6. OCCURRENCE: "Occurrence" means all covered loss, damage, or a sequence of losses or damage, casualties or disasters, arising from a single event or catastrophe. So far as loss involving in whole or in part, the perils of wind, (including hurricanes, tornadoes, cyclones), snow, rain, or hail is concerned a single event shall mean one single atmospheric disturbance during a continuous period of seventy-two (72) hours (not limited by the date on which coverage under this policy ceases). Excluded Perils With regard to all property, this insurance does not insure against: • I. Loss by moth, vermin, termites or other insects; wear, tear or gradual deterioration; rust, wet or dry rot, or mold. 2. Loss or damage caused by: a) Radioactive or fissionable material. b) Contamination, other than by (a) above, unless directly resulting from Fire or Extended Coverage perils. 3. Loss resulting from loss of use, delay or loss of markets. r^ 4. Breakdown of machinery and/or boiler explosion but not excluding loss resulting therefrom. This exclusion shall not apply as respects to EDP equipment and media. 5. Loss resulting from dampness of atmosphere or variation in temperature unless caused by the perils of Fire and Extended Coverage. This exclusion shall not be deemed to exclude loss resulting from freezing. 6. Loss of electrical appliances or devices of any kind, including wiring, arising from electrical injury or disturbance to the said electrical appliances or devices or wiring from artificial causes unless fire or explosion ensues, and then only for direct loss or damage caused by fire or explosion. 7. Loss by normal settling, normal shrinkage or normal expansion in foundations, walls, floors or ceilings. 8. Loss by mechanical derangement, inherent vice or latent defect. 9. Loss resulting from processing or faulty workmanship, unless fire and/or explosion ensues, and then only for direct loss or damage caused by such ensuing fire or explosion. 10. Loss resulting from shrinkage, evaporation, loss of weight or leakage, unless such loss is caused directly by fire or the combating thereof, lightning, windstorm, hail explosion, strike, riot or civil commotion, aircraft, vehicles, breakage of pipes or apparatus, sprinkler leakage, vandalism and malicious mischief, theft or attempted theft. Name of Insured: Colorado Counties Casualty&Property Pool Page 5 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1, 2006 5\ON-PcappQ0O5,m\,e"caop le,np,onanac 05.06 ompeM poocy Ion"aoc 9 11. Inventory shortage, mysterious disappearances or loss resulting from any kind of infidelity or dishonesty on the part of the Insured or any of his employees. 12. Pollution caused directly or indirectly by the release, discharge, dispersal, seepage, migration, or escape of pollutants or contaminants unless the release, discharge, dispersal, seepage, migration, or escape is caused by fire, lightning, explosion, windstorm, hail, leakage from fire protection equipment, smoke, vehicles and aircraft, riot, civil commotion, vandalism, sinkhole collapse, volcanic action, falling objects, weight of snow, ice or sleet, or water damage. However, this policy does not cover the costs arising out of the enforcement of any law, ordinance, regulation, or order by civil or judicial authority requiring the removal, disposal, replacement, cleanup, restoration or containment of insured property or for costs to monitor or test for the existence or effects of pollutants. This exclusion applies regardless of any cause or event that contributes concurrently or in any sequence to the loss. Excluded Property Animals, aircraft, standing timber, growing crops, land, currency, money, notes, securities, bridges, culverts, roadways, streets, walks, or paved surfaces, dams, docks, piers and wharves. Conditions 1. VALUATION. The Underwriters shall not be liable for loss or damage in excess of. A. (Real and Personal Property - other than automobile) - the cost to repair, rebuild or replace the destroyed or damaged property in a condition equal to but not superior to or more extensive than its condition when new. If the Insured decides to replace destroyed or damaged property on another site, cost of such site is not included hereunder. It is a requirement that if the Insured does not repair, replace or rebuild the property within two years from the date of loss, this property shall be valued at ACV. B. (Automobile) - the actual cash value of the automobile at the time of loss. 2. DEBRIS REMOVAL. This Insurance covers the expense of removal from the premises `i containing the property insured hereunder of debris remaining after any loss hereby insured against, except that there shall be no liability assumed for the expense of removal of any foundations. 3. REMOVAL CLAUSE. This Insurance covers the expense and damage occasioned by removal from the premises endangered by the perils insured against wherever such property is located or removed for preservation. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 6 of 23 Policy No.: 0604612 Policy Term: January 1, 2005 to January 1,2006 s scli\a.(i\capoS2 51,m\,es caps)Iessgmnawac O5-08 pocenr Mk"Wm 00C as 4. ARCHITECTS FEES. This Insurance covers the additional assessment involving architects' fees for consultations arising from losses resulting from an insured peril. Fees are limited to seven (7%) percent of replacement cost. 5. APPRAISAL. In the event the Insured and Underwriters are unable to agree as to the amount necessary to rebuild, repair or replace the damaged or destroyed property or the actual amount of reimbursement to be paid, each party shall name a competent and disinterested umpire. The appraisers together shall obtain reconstruction estimates, and calculated the amounts of reimbursement due, and failing to agree, shall submit their differences to the umpire. The award, in writing, duly verified by any two shall determine the point in question. Both parties shall pay the cost of their own appraisers and equally pro rate the cost of the umpire. 6. CIVIL AUTHORITY CLAUSE. Notwithstanding anything contained in this Insurance, property which is insured under this Insurance is also covered against the risk of damage or destruction by civil authority during a conflagration and for the purpose of retarding the same; provided that neither such conflagration nor such damage or destruction is caused or contributed to by war, invasion, revolution, rebellion, insurrection or other hostilities or warlike operations. 7. ORDINANCE DEFICIENCY CLAUSE. Notwithstanding anything contained herein to the contrary, the Underwriters shall be liable also for the loss occasioned by the enforcement of any state or municipal law, ordinance or code, which necessitates, in repairing or rebuilding, replacement of material to meet such requirements. If demolition is required to comply with such enforcement, Underwriters shall also be liable for such additional costs. 8. EXPENSE TO REDUCE OR PREVENT LOSS. This Insurance also covers such expenses as are necessarily incurred for the purpose of reducing or preventing any loss under this Insurance not exceeding, however, the amount by which the loss under this Insurance is thereby reduced. General Conditions 1. PREMIUM PROVISION See Declarations Page. 2. SALVAGE AND RECOVERY CLAUSE All salvages, recoveries and payments recovered or received subsequent to a loss settlement under this Insurance shall be applied as if recovered or received prior to the said settlement and all necessary adjustments shall be made by the parties hereto. r-� Name of Insured: Colorado Counties Casualty 8 Property Pool Page 7 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s‘pN>Meapp 3NS,mTer caoo,eunp,on-awac OS 06 vinery Policy font doc a3 • 3. INSPECTIONS, AUDIT AND VERIFICATION OF VALUES The Underwriters or their duly authorized representatives shall be permitted at all reasonable times during continuance of this Insurance to inspect the premises used by the Insured and to examine the Insured's books or records so far as they relate to coverage afforded by this Insurance. 4. RECORDS It is hereby understood and agreed that the records and books as kept by the Insured shall be acceptable to Underwriters in determining the amount of loss or damage covered hereunder. 5. DUE DILIGENCE CLAUSE Thy Insured shall use due diligence and do and concur in doing all things reasonably practicable to avoid or diminish any loss of or damage to the property herein insured. 6. CURRENCY The premium and losses under this Insurance are payable in United States currency. Payment of premium shall be made to Marsh Inc. 7. BANKRUPTCY AND INSOLVENCY In the event of the bankruptcy or insolvency of the Insured or any entity comprising the Insured, the Underwriters shall not be relieved of the payment of any claims hereunder because of such bankruptcy or insolvency. 8. OTHER INSURANCE If the Insured has other Insurance against loss covered by this Insurance the Underwriters shall be liable, under the terms of this Insurance, only as excess of coverage provided by such other Insurance and no monies payable or collectable from such other insurance shall accrue in the aggregate loss fund of this Insurance. 9. MORTGAGE CLAUSE 1 The interest of any mortgagor on property covered hereunder is included as if a separate endorsement were attached hereto to the extent of the amount of mortgage as of the date of loss subject to the limits of liability set forth in this Insurance. Name of Insured: Colorado Counties Casualty&Property Pool Page 8 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s‘c4\>t03pp2200Sn ve.op°Fenryiooa+x 05-06 ompenr Wier(Wm 00C O.7y 10. CLAIMS /^ The Insured shall immediately notify Underwriters through County Technical Services, Inc. Claims Management Department by registered mail, of any occurrence, the cost of which is likely to result in payment by Underwriters under this Insurance. Underwriters shall have the opportunity to be associated with the Insured in defense of any claims, suits, or proceedings relative to an occurrence wherein the opinion of the Underwriters, their liability under this Insurance is likely to be involved, in which case the Insured and Underwriters shall cooperate to the mutual advantage of both. 11. NOTICE OF LOSS The insured shall as soon as practicable report to this Company or its agent every loss or damage which may become a claim under this Policy and shall also file with the Company or its agent within ninety (90) days from date of loss a detailed sworn proof of loss. Failure by the Insured to report the said loss or damage and to file such proof of loss as hereinbefore provided shall invalidate any claim under this Policy for such loss. 12. EXAMINATION UNDER OATH The Insured shall submit, and so far as in within his/her or their power shall cause all other persons interested in the property and members of the household and employees to submit, to examinations under oath by any persons named by the Company, relative to any and all matters in connection with a claim and subscribe the same and shall produce for examination �` all books of account, bills, invoices, and other vouchers or certified copies thereof if originals be lost, at such reasonable time and place as may be designated by the Company or its representatives, and shall permit extracts and copies thereof to be made. 13. SETTLEMENT OF LOSS All adjusted claims shall be paid or made good to the insured within sixty (60) days after presentation and acceptance of satisfactory proof of interest and loss at the office of this Company. No loss shall be paid hereunder if the insured has collected the same from others. 14. LOSS PAYMENTS When it has been determined that Undenvriters are liable under this Insurance, Underwriters shall thereafter promptly reimburse the Insured for all payment made in excess of the amounts stated in the Limits Agreement. All adjusted claims shall be paid or made good to the Insured within thirty days after their presentation to County Technical Services, Inc. Claims Management Department and acceptance by Underwriters of satisfactory proof of interest and loss. r Name of Insured: Colorado Counties Casualty 8 Property Pool Page 9 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1, 2006 s¢Iii icappQW6\m,ev can,lenngl0na.+ac 0506 property pohcY lcm,doe O23 15. NO BENEFIT TO BAILEE This insurance shall in no wise inure directly or indirectly to the benefit of any carrier or other bailee. 16. APPEAL In the event the Insured and Underwriters are unable to agree to the advisability of appealing a judgment, a disinterested attorney, mutually agreeable to the Underwriters and the Insured, shall be retained and directed to render a written opinion as to his recommendation concerning such appeal. Such written recommendation shall be binding on both the Insured and Underwriters. Fees of such retained attorney shall be borne equally by both parties for the services of rendering his recommendation only. The Insured's portion of such fee shall not accrue in the aggregate loss fund. 17. LITIGATION PROCEEDINGS No suit to recover on account of loss under this Insurance shall be brought until ninety days after the proof of loss shall have been furnished, nor at all unless commenced within twenty- seven months from the date upon which loss occurred, if such loss is within the knowledge of the Insured; if not, the twenty-seven months shall begin upon notice to the Insured to such loss or claim. 18. SUBROGATION The Underwriters shall be subrogated to all rights which the Insured may have against any person or other entity in respect to any claim or payment made under this Insurance, and the Insured shall execute all papers required by the Underwriters and shall cooperate with the Underwriters to secure Underwriter's rights. In case any reimbursement obtained or recovery made by the Insured or the Underwriters on account of any loss covered by this Insurance, the net amount of such reimbursement or recovery, after deducting the actual cost of obtaining or making the same, shall be first applied in the following order a) Amount of loss which exceeds the applicable limit of liability. b) To reduce the Underwriters' loss until the Underwriters are fully reimbursed. c) To reduce the Insured's loss because of the application of the aggregate loss fund. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 10 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s rchU.g capp2005rnnoer capp iu.nc on.awac 066.06 property peR'h lomr dot 026 19. WAIVER OF SUBROGATION This Insurance shall not be invalidated if the Insured by written agreement has waived or shall waive its right of recovery from any party for loss or damage covered hereunder; provided, that any such waiver is made prior to the occurrence of said loss or damage. 20. CONFLICTING STATUTES In the event that any provision of this Insurance is unenforceable by the Insured under the laws of any state or other jurisdiction wherein it is claimed that the Insured is liable for any injury covered hereby because of non-compliance with any statute thereof, then this policy shall be enforceable for the Insured with the same effect as if it complied with such statutes. 21. ASSIGNMENT Assignment of interest under this Insurance shall not bind the Underwriters until the Underwriters' consent is endorsed hereon. 22. PAIR, SET OR PARTS It is understood and agreed that, in the event of loss of or damage to any article or articles which are a part of a set, the measure of loss of or damage to such article or articles shall be a reasonable and fair proportion of the total value of the set, giving consideration to the importance of said article or articles; but in no event shall such loss or damage be construed n to mean total loss of set. In case of loss or injury to any part of the insured property consisting, when complete for sale or use, of several parts, this Company shall only be liable for the insured value of the part lost or damaged. 23. SUE AND LABOR; In case of loss or damage, it shall be lawful and necessary for the Insured, his/her or their factors, servants and assigns, to sue, labor, and travel for, in and about the defense, safeguard and recovery of the property insured hereunder, or any part thereof without prejudice to this insurance; nor shall the acts of the Insured or this Company, in recovering, saving and preserving the property insured in case of loss or4damage, be considered a waiver or an acceptance of abandonment; to the charge whereof this Company will contribute according to the rate and quantity of the sum herein insured. 24. SUIT No suit, action or proceeding for the recovery of any claim under this Policy shall be sustainable in any court of law or equity unless the same be commenced within twelve (12) Name of Insured: Colorado Counties Casualty& Properly Pool Page l I of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 $,cb,a.G,cappaoosv m,er calls io✓glonawac 05.05 properly Wl¢y 0,m aoc 027 months next after discovery by the Insured of the occurrence which gives rise to the claim. Provided, however, that if by the laws of the State within which this Policy is issued such limitation is invalid, then any such claims shall be void unless such action, suit or proceeding be commenced within the shortest limit of time permitted by the laws of such State to be fixed herein. 25. APPRAISAL If the insured and the Company fail to agree as to the amount of loss, each shall, on the written demand of either, made within sixty days after receipt of proof of loss by the Company, select a competent and disinterested appraiser, and the appraisal shall be made at a reasonable time and place. The appraisers shall first select a competent and disinterested umpire, and failing for fifteen days to agree upon such umpire, then, on the request of the Insured or the Company, such umpire shall be selected by a judge of a court of record in the state in which such appraisal is pending. The appraisers shall then appraise the loss, stating separately the actual cash value at the time of loss and the amount of loss, and failing to agree shall submit their differences to the umpire. An award in writing of any two shall determine the amount of toss. The Insured and the Company shall each pay his/her or its chosen appraiser and shall bear equally the other expenses of the appraisal and umpire. The Company shall not be held to have waived any of its rights by any act relating to appraisal. 26. CANCELLATION This Policy may be canceled by the Inured by mailing to the Company written notice stating when thereafter shall cancellation shall be effective. This Policy may be canceled by the Company by mailing to the Insured at the address shown in the Policy or last known address written notice stating when no fewer than (90) ninety days thereafter such cancellation shall be effective. The mailing to notice as aforesaid shall be sufficient proof of notice, and the effective date of cancellation stated in the notice shall become the end of the policy period. Delivery of such written notice either by the Insured or by the Company shall be equivalent to mailing. If this Insurance shall be cancelled by the Insured, the Underwriters shall retain the customary short rate proportion of the premium hereon, except that if this Insurance is on an adjustable basis the Underwriters shall receive the earned premium hereon or the customary short rate proportion of any minimum premium stipulated herein whichever is the greater. If this Insurance shall be cancelled by or on behalf of the Underwriters, the Underwriters shall retain the pro rata proportion of the premium hereon; except that if this insurance is on an adjustable basis, the Underwriters shall receive the earned premium hereon or the pro rata proportion of any minimum premium stipulated herein which is the greater. Name of Insured: Colorado Counties Casualty& Property Pool Page 12 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 3 thu.mcapo\2005Vmve,capo ieainoIonanac 05-M pmpe'Y W°cY Ip,m a0C a1 • • Payment or tender of any unearned premium by the underwriters shall not be a condition precedent to the effectiveness of Cancellation by such payment shall be made as soon as practicable. If the period of limitation relating to the giving of notice is prohibited or made void by any law controlling the construction thereof, such period shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law. Subject otherwise to all terms, clauses, and conditions as heretofore. 27. CHANGES By acceptance of this Insurance, the Insured agrees that it embodies all agreements existing between the Insured and Underwriters or any of its agents relating to this Insurance. None of the provisions, conditions or other terms of this Insurance shall be waived or altered except by endorsement; nor shall notice to any agent or knowledge possessed by any agent or by any other person be held to effect a waiver or change in any part of this Insurance. 28. FRAUDULENT CLAIMS If the Insured shall make any claim knowing the same to be false or fraudulent, as regards amount or otherwise, this Insurance shall become void and all claim hereunder shall be forfeited. ,' 29. MISREPRESENTATION OR FRAUD This Policy shall be void if the Insured has concealed or misrepresented any material fact or circumstances concerning this insurance or the subject thereof of in case of any fraud, attempted fraud or false swearing by the Insured touching any matter relating to this insurance or subject thereof, before or after a loss. Earth Movement Coverage Earth Movement means: • any earth movement, other than sinkhole collapse, such as earthquake, landslide, mine subsidence or earth sinking, rising or shifting including that caused by subsidence, settling, contraction, or expansion of soils. • eruption, explosion, or effusion of a volcano other than volcanic action. If more than one earth movement or volcanic eruption occurs within any 72 hour period, we'll consider this one occurrence. The 72 hour period will not be shortened by the expiration of the policy. Name of Insured: Colorado Counties Casualty& Property Pool Page 13 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s rO`.agrcaop2OONmnre,caop ieiy?ona.ac os-06 proven',Policy Nrm aoc 027 The limit shown in the coverage summary for earthquake is the most this company will pay for all direct loss or damage caused by a single earthquake. Flood Coverage Flood, mudslide or mudflow, and surface water are covered perils. Flood means waves, tides or tidal water, the rising of bodies of water and streams, or the overflowing or breaking of their boundaries, whether driven by wind or not. Surface water means water which accumulates or flows on the surface of the ground, and is created by natural causes such as rain, melted snow, or rising springs, but which follows no defined watercourse and does not gather into or from a natural body of water. This company is not liable for more than the limits shown in the coverage summary. Transit Extension Insuring Clause This insurance is hereby extended to cover Personal property of the Insured or property held by the Insured in trust or on commission or on consignment for which the Insured may be held legally liable while in due course of transit within the limits of the Continental United States of America (excluding Hawaii) and Canada, against All Risks of Direct Physical Loss or Damage to the property insured occurring during the period of this policy (including general average and salvage charges on shipments covered while waterborne). Perils Excluded This extension does not insure against: 1. Loss or damage to personal property resulting from: shrinkage, evaporation, loss of weight, leakage of glass or other fragile articles, marring, scratching, exposure to light, or change in color, texture or flavor, unless such loss is caused directly by fire or the combating thereof, lightning, windstorm, hail, explosion, strike, riot or civil commotion, aircraft, vehicles, breakage of pipes or apparatus, sprinkler leakage, vandalism and malicious mischief, theft or attempted theft. 2. Loss of use, delay or loss of markets. 3. Loss or damage caused by or resulting from moth, vermin, termites, or other insects, inherent vice, latent defect, wear, tear or gradual deterioration; contamination; rust, wet or dry rot, mold, dampness of atmosphere, smog or extremes of temperature. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 14 of 23 '""t Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 •‘cI,Ssykcapp,2005\mvev capp Ie..npIonawac f206 goceny pokey lam,asp SO 4. Loss or damage caused by or resulting from misappropriation, conversion, infidelity or any dishonest act on the part of the Insured or other party of interest, his or their employees or P."` agents to others to whom the property may be delivered or entrusted (carriers for hire excepted). 5. Loss or damage to the property insured occasioned by war, invasion, hostilities, acts of foreign enemies, civil war, rebellion, insurrection, military or usurped power or martial law or confiscation by order of any government or public authority. 6. Loss or damage arising directly or indirectly from nuclear reaction, nuclear radiation or radioactive contamination however such nuclear reaction, nuclear radiation or radioactive contamination may have been caused. Nevertheless, if a fire arises directly or indirectly from nuclear reaction, nuclear radiation or radioactive contamination, any loss or damage arising directly from that fire shall (subject to the provisions of this Policy) be covered excluding, however, all loss or damage caused by nuclear reaction, n fear radiation or radioactive contamination arising directly or indirectly from that fire. 7. Loss or damage caused by breakdown or derangement of refrigerating units. Deductible(s) Each loss or series of losses arising out of one event shall be adjusted separately and from the amount of each such adjusted loss the sum(s) stated shall be deducted. P Property Excluded This Extension does not cover: 1. a. Aircraft, watercraft, vehicles designed for highway use, animals,jewelry, precious stones and furs or garments trimmed with fur. b. Currency, money, notes, securities, deeds, and evidences of debt 2. Property in due course of ocean marine transit. 3. Shipments by mail after delivery into the custody of the Post Office Department. 4. Samples while in the care, custody or control of salesmen. Ai Conditions 1. The Insured may accept without prejudice to this insurance the ordinary bills of lading or receipts issued by carriers including those containing released and/or partially released value provisions, but the Insured shall not enter into any special agreement with carriers releasing them from their common law or statutory liability. Name of Insured: Colorado Counties Casualty&Property Pool Page 15 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 a kua.o,v04V WSvm,er cape le.^quo^awac 0106 properly poky form lot 2. Property insured hereunder shall he valued as follows: a. Sold property at the actual net invoice price of the Insured. b. Unsold property at the actual cash value of the property at the time any loss or damage occurs with property deduction for depreciation and in no event to exceed what it would cost to repair or replace the property with material of like kind and quality. Extra Expense Coverage 40/80/100% Of Limit: It is agreed that if the property covered under Insuring Agreement A is damaged or destroyed by perils insured against during the period of this Insurance so as to necessitate the incurrence of Extra Expense (as defined below) the Underwriters shall be liable for the Extra Expense so incurred, not exceeding the actual-less sustained, for not exceeding such length of time, hereinafter referred to as the "period of restoration". It is further agreed that this extension of coverage shall not operate to increase the Underwriters limits of liability hereunder. Underwriters shall be liable for no greater percentage of the amount of this Policy than is stated below for the determined period of restoration. • 40% if period of restoration is not in excess of one month; • 80% if period of restoration exceeds one month but does not exceed two months; • 100% if period of restoration exceeds two months. Definitions: A. Extra Expense: The term "Extra Expense" means the excess (if any) of the total cost incurred during the period of restoration chargeable to the operation of the Insured's business, over and above the total cost that would normally have been incurred to conduct the business during the same period had no damage or destruction occurred. B. Normal: The term "Normal" wherever used herein shall mean; the condition that would have existed had no loss occurred. C. Month: The word "month" wherever used herein means 30 consecutive days. D. Period of Restoration: The term "period of restoration" means such length of time commencing with the date of darftage and not limited by the date of expiration of this policy, as would be required with the exercise of due diligence and dispatch to repair, rebuild or replace such part of the Insured's property as has been damaged or destroyed. Name of Insured: Colorado Counties Casualty& Property Pool Page 16 of 23 -� Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s Kesp\c)ppV W5Mm,ev capp leyinplorspeoC WOG properly po,'cy tom,doc Conditions: A. Resumption of Operations: It is a condition of this Insurance that as soon as practicable, the Insured shall resume normal operations of the business and shall dispense with such extra expense. B. Interruption by Civil Authority: Liability hereunder is extended to include actual loss as covered hereunder, sustained during the period of time, not exceeding two weeks, when as a direct result of a peril insured against, access to the premises in which the property described is located is prohibited by order of civil authority. Exclusions: In addition to the General Exclusions of this Insurance, Underwriters shall not be liable for Extra Expense resulting from: A. The suspension, lapse or cancellation of any lease, license, contract or order beyond the period of restoration; B. Interference at premises by strikers or other persons with rebuilding, repairing or replacing the property damaged or destroyed or with the resumption or continuation of business; C. Enforcement of any local or state ordinance or law regulating construction, repair or demolition of buildings or structures; Further, Underwriters shall not be liable for: A. More than the amount set forth in the limits of liability for each premises; !"t B. Loss of income; C. The cost of repairing or replacing any of the real or personal property covered hereunder, or the cost of research or other expense necessary to replace or restore damage or destroyed books of account, abstracts, drawings, card index systems or other records (including film, tape, disc, drum, cell or other magnetic recording or storage media for electronic data processing), that have been damaged or destroyed by the perils insured against, except cost in excess of the normal cost of such repair, replacement or restoration necessarily incurred for the purpose of reducing loss under this policy. In no event shall such excess cost exceed the amount by which the total extra expense loss othenvise payable under this policy is thereby reduced; D. Loss resulting from theft of any property which at the time of loss is not an integral part of a building or structure (except direct loss by pillage and looting occurring during and at the immediate place of a riot or civil commotion), unless loss by a peril not excluded in this policy ensues from theft or attempted theft, and then the Undenvriters shall be liable for only such ensuing loss; E. Any other consequential or remote loss. r-� Name of Insured: Colorado Counties Casualty 8 Property Pool Page 17 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s¢i sa ncapp‘n05km,rer COUP Ie.bgionavae 05.06 pmpeM W L<y form floe 53 Pollution Cleanup and Removal Notwithstanding any conditions or terms contained elsewhere in this policy, coverage is extended for a limit of$25,000 any one occurrence to cover the cost to clean up and remove pollutants that are: 1. In the land or water at an insured location provided the discharge, seepage, migration, release, escape or dispersal is due to fire, lightning, explosion, windstorm, hail, leakage from fire protection equipment, smoke, vehicles and aircraft, riot, civil commotion, vandalism, sinkhole collapse, volcanic action, falling objects, weight of snow, ice or sleet, or water damage. For example: a fire at an insured location causes chemicals to run onto the ground and into a nearby river. This policy will pay to clean up the pollution that is in the land and water at the insured premises up to the limit of liability of this extension. This policy will not pay to clean up land or water away from an insured premises; 2. In the land or water away from an insured premises but only when pollution or contamination is caused by the collision, upset or overturn of a transporting vehicle which is owned, operated, rented, leased or borrowed by the Insured. Coverage is provided under this extension only if the following conditions are met: A. the cause of loss occurs during the policy period; r B. the pollution must occur at an insured location except as provided for in clause 2. above. C. the clean-up and removal costs must be incurred and reported to the company within one hundred eighty (180) days of either the date of direct physical loss or damage or the end of the policy period, whichever is earlier. Liability for loss under this extension shall not exceed $25,000 in any one occurrence or $25,000 in the aggregate for all such losses in any one policy year. However, these limits will apply separately to each county member listed as a Named Insured. Name of Insured: Colorado Counties Casualty&Property Pool Page 18 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 5. loll UppQ406\vm,e,capo lea'flglon.awac 05.06 popenv roury ronn m[ Equipment Breakdown Coverage Limits: Equipment Breakdown: Included in $50,000,000 Limit Extra Expense: S 1,000,000 Expediting Expenses: $ 100,000 Hazardous Substances: 5 100,000 Spoilage: $ 100,000 Water Damage: 5 100,000 Ammonia Contamination: S 100,000 Pollution Cleanup: S 100,000 Deductibles: Extra Expense: S 5,000 Spoilage: S 5,000 All Other Loss or Damage: $ 5,000 Coverage: It is agreed that if the property insured by Insuring Agreement A of Section I is damaged or destroyed by an "Accident" to "covered equipment" during the period of this Insurance, the Underwriters shall be liable for said damage. r- Definitions: A. Accident: The tern "accident means direct physical loss or damage that results from mechanical breakdown, including rupture or bursting caused by centrifugal force; artificially generated electrical current, including electrical arcing, that disturbs electrical devices, appliances or wires; loss or damage to steam boilers, steam pipes, steam engines or steam turbines caused by or resulting from any condition or event inside such equipment; or loss or damage to hot water boilers or other water heating equipment caused by or resulting from any condition or event inside such boilers or equipment. B. Covered Equipment: The term "covered equipment" means property insured which is built to operate under vacuum or pressure other than weight of contents; or generates, transmits or utilizes energy. 41 None of the following is "covered equipment": — A structure, foundation, cabinet, compartment or air supported structure or building; — Insulating or refractory material; — Vehicles, including self-propelled vehicles; — Excavation or construction equipment; — Sewer piping, underground vessels or piping, any piping forming a part of a sprinkler system; Name of Insured: Colorado Counties Casualty& Property Pool Page 19 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 S‘dnsPOpp2OG3wmive,caps ieo-g,onawac 06'06 pmpely POKY form doc — Water piping other than boiler feedwater piping, boiler condensate return piping or water piping forming a part of a refrigerating or air conditioning system; — Equipment manufactured by you for sale; or — Equipment primarily used to generate electric power, however this does not apply to emergency generators. C. Perishable Goods: The tern "perishable goods" means business personal property maintained under controlled conditions for its preservation which is susceptible to loss or damage if controlled conditions change. Additional Coverages: The following additional coverages also apply to loss caused by or resulting from an "accident" to "covered equipment". The limit for each additional coverage is shown In the Equipment Breakdown Schedule. The limits for these additional coverages are not in addition to the limits of coverage for building or business personal property shown in III Ultimate Net Loss. In addition, the coverages and limits for newly acquired property, builders risks, and unscheduled locations in the policy to which this endorsement is attached also apply to coverage provided by this endorsement. Coverage provided for extra expense in the policy to which this endorsement is attached also applies to coverage provided by this endorsement. The extra expense limit is shown in the Equipment Breakdown Schedule. A. Expediting Expenses: If property insured is damaged or destroyed by an "accident", the Underwriters shall be liable for reasonable extra cost to make temporary repairs and expedite permanent repairs or replacement. B. Hazardous Substances: The Underwriters shall be liable for additional expenses incurred for cleanup; repair or replacement; or disposal of property insured which is damaged, contaminated or polluted by any substance other than ammonia that has been declared to be hazardous to health by a governmental agency. The Underwriters shall not be liable for more than the limit for Hazardous Substances shown in the Equipment Breakdown Schedule. C. Spoilage: The Underwriters shall be liable for loss of"perishable goods"due to Spoilage, and shall also be liable for any necessary expenses incurred to reduce the amount of loss under this coverage to the extent that they do hot exceed the amount of loss that otherwise would have been payable under this coverage. If the Insured is unable to replace the "perishable goods" before its anticipated sale, the amount of payment will be determined on the basis of the sales price of the "perishable goods" at the time of the "accident," less discounts and expenses that otherwise would have been incurred. Otherwise payment will be determined in accordance with the Valuation condition. The Underwriters shall not be liable for more than the limit for Spoilage shown in the Equipment Breakdown Schedule. Name of Insured: Colorado Counties Casualty&Property Pool Page 20 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s,ci a g,capp\20D5vmve,caop Ses ng,onawac 05.06 popery poky'cam sloe L�� D. Water Damage: If property insured is damaged by water as a result of an "accident" to covered refrigerating or air conditioning vessels and piping, the most the Underwriters shall not be liable for more than the amount shown in the Equipment Breakdown Schedule for this kind of damage, including salvage expense. E. Ammonia Contamination: If property insured is contaminated by ammonia as a result of an "accident" to "covered equipment" the Underwriters shall not be liable for more than the amount shown in the Equipment Breakdown Schedule for this kind of damage, including salvage expense. Exclusions: A. Electronic Recordings: The Underwriters shall not be liable for loss to electronic recordings caused by electrical or magnetic injury, disturbance or erasing. B. Media: The Underwriters shall not be liable for loss resulting from any defect, virus, loss of data, or other situation within electronic media and records. But if loss or damage from an "accident" results, there shall be liability for that resulting loss. Suspension: When any "covered equipment" is found to be in, or exposed to, a dangerous condition, any representative of the Underwriters may immediately suspend the insurance against loss from an "accident" to that "covered equipment". This can be done by mailing or delivering a written notice of suspension to the address as shown in the policy, or the address where the equipment is located. Once suspended in this way, the insurance can be reinstated only by written notice from the Underwriters. If so suspended, the Insured shall receive pro-rata refund of premium. But the suspension will be effective even if a refund has not yet made or offered. Builders Risk Equipment Breakdown Coverage Limit: $ 5,000,000 Builders Risk Equipment Breakdown $ 5,000 Builders Risk Equipment Breakdown Deductible Combined, All Equipment Breakdown Coverage Equipment Breakdown: 1 . We'll pay for loss caused by or resulting from an "Accident' to "covered equipment." As used in this endorsement, an "Accident" means direct physical loss as follows: A. Loss to covered property caused or made worse by mechanical breakdown; B. Loss to electrical equipment, including wiring, caused by electricity other than lightning; or Name of Insured: Colorado Counties Casualty 8 Property Pool Page 21 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s\C6R0\expo\005vm\m.cap',.eo,ryiouawac 0106 pTcew poky form ooe C. Explosion, rupture or bursting of steam boilers, steam pipes, steam turbines or steam • engines. If an initial "Accident" causes other"Accidents" all will be considered one "Accident." All "Accidents" that are the result of the same event will be considered one "Accident." "Covered equipment" means covered property built to operate under vacuum or pressure, other than weight of contents, or used for the generation, transmission or utilization of energy. 2. The following additional coverages also apply to loss caused by or resulting from an "Accident" to "covered equipment": A. Expediting Expenses With respect to your damaged covered property, we'll pay, up to $25,000, the reasonable - - extra cost to: I. Make temporary repairs; and 2. Expedite permanent repairs or replacement. B. Pollution cleanup and removal We will pay up to $25,000, unless otherwise shown on the coverage summary, for additional expenses your incur for: 1. Cleanup; 2. repairs or replacement; or 3. disposal of covered property which is damaged, contaminated or polluted as a result of an accident by pollutants as defined in the Property Protection. This limitation also applies to damage, contamination or pollution caused by ammonia that is used as a refrigerant. C. CFC Refrigerants We will pay for the additional cost to repair or replace covered property because of the use or presence of a refrigerant containing CFC (chlorinated fluorocarbon) substances. This means the additional expense to do the least expensive of the following: 1. Repair the damaged property and replace any lost CFC refrigerant; 2. Repair the damaged property, retrofit the system to accept a non-CFC refrigerant and charge the system with one using a non-CFC refrigerant. 3. Replace the system with one using a non-CFC refrigerant. Additional costs mean those beyond what would have been required had no CFC refrigerant been involved. Name of Insured: Colorado Counties Casualty&Property Pool Page 22 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 s\cina-mcapp\2OO5VmAev capo lex'ny(on.axac 05-06 propeoy pokey loan Poo 3i" D. Soft Costs, Rents and Loss of Income We will pay for your soft costs, loss of rental income and loss of business income. This coverage applies only if the Delayed Completion Coverage Endorsement or the Delayed Completion— Loss of Income Coverage Endorsement is part of this policy. All terms and conditions of those endorsements apply to this additional coverage. Exclusions — Losses We Won't Cover: 1 . All exclusions and limitations apply except Electrical equipment and Mechanical breakdown. 2. We won't pay under this endorsement for loss or damage caused by or resulting from: A. The breakdown of any structure, foundation, cabinet, compartment or air supported structure or building; B.—The breakdown of any insulating or refractory material; C. The breakdown of any sewer piping, any underground vessels or piping, any piping forming a part of a sprinkler system or water piping other than boiler feedwater piping, boiler condensate return piping or water piping forming a part of a refrigerating or air conditioning system; D. The explosion of gases or fuel within the furnace of any fired vessel or within the flues or passages through which the cases of combustion pass; E. An "Accident" to any equipment not located at the location shown in the Coverage Summary; or F. Loss caused by delay, loss of market, loss of use, or any indirect loss. O'er This exclusion doesn't apply to coverage provided under the additional coverage for Soft Costs, Rents and Loss of Income. ♦t Name of Insured: Colorado Counties Casualty 8 Property Pool Page 23 of 23 Policy No.: 0604612 Policy Term: January 1,2005 to January 1, 2006 s\cI.t ppvcosvnnbea capp Penng(on.r«ac o6-a6 pmpeny WpN lone aoc 33 ENDORSEMENT # 1 This endorsement, effective 12:01 AM 01/01/2005 Forms a part of policy no.: 0604612 Issued to: COLORADO COUNTIES CASUALTY & PROPERTY POOL By: LEXINGTON INSURANCE COMPANY It is hereby understood and agreed that the following changes are made to the policy: 1. Form PR9014 — Occurrence Limit of Liability— is amended to delete paragraph 2b. 2. Form LX9512 — Mold / Fungus Exclusion — is amended to add the following: However, the Company agrees that the first $25,000 per occurrence of any loss or damage caused by, arising out of, contributed to, or resulting from fungus, mold(s), mildew or yeast; or any spores or toxins created by or emanating from such fungus, mold(s), mildew or yeast, shall be considered to apply against the policy deductible. All other terms and conditions remain unchanged. 11 Name of Insured: Colorado Counties Casualty&Property Pool Page I Of 1 Policy No.: 0604612 Policy Term: January 1,2005 to January 1,2006 •ScI\a.Olcapp52005vmVe+capp leninpion a*ac 05-06 yropeny 00th"lorrn aoc 7D Cc;•18-C4 II:Cam From-WESTEPEN RISK SPKIALISTS 2I3-6E3-3365 T-420 P CC2/n2 F-665 r� POLICYHOLDER DISCLOSURE STATEMENT UNDER TERRORISM RISK INSURANCE ACT OF 2002 You are hereby notified that under the federal Terrorism Risk Insurance Act of 2002 (the "Act" ) effective November 26, 2002 , you now have a right to purchase insurance coverage for losses arising out of an Act of Terrorism, which is defined in the Act as an act certified by the Secretary of the Treasury (i) to be an act of terrorism, (ii ) to be a violent act or an act that is dangerous to (A) human life; (B) property or (C) infrastructure, (iii) to have resulted in damage within the United States, or outside of the United States in case of an air carrier or vessel or the premises of a U. S . mission and (iv) to have been 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. You should read the Act for a complete description of its coverage. The Secretary' s decision to certify or not to certify an event as an Act of Terrorism and thus covered by this law is final and not subject to review. There is a $100 billion dollar annual cap on all losses resulting from Acts of Terrorism above which no coverage will be provided under this policy and under the Act unless Congress makes some other determination . For your information, coverage provided by this policy for losses caused by an Act of Terrorism may be partially reimbursed by the United States under a formula established by the Act . Under this formula the United States pays 90% of terrorism losses covered by this law exceeding a statutorily established deductible that must be met by the insurer, and which deductible is based on a percentage of the insurer' s direct earned premiums for the year preceeding the Act of Terrorism. Unless you sign this foim and return it to us rejecting Terrorism Coverage under the Federal Act, you will be covered for Terrorism as defined in the Act and your premium for that coverage is $35, 000 . 00 . INSURED: Colorado Counties Casualty and Property Pool _I re .y overage in accordance with the Act. 9a-g-n r red N/ah' 7//y2,0-173.4,2 Print Name/Title /6 -7 S— (1y Date r� INFORCEMITH EXCLUSION 1/ C I Colorado Counties Casualty and Property Pool 2004-Excess Casualty Policy Policy No. GP06301492 The summary included in this binder is a brief outline of the coverages afforded under the insurance policy. Since it is for informational purposes only, it should not be construed to constitute the entire insurance contract. As the policies may contain additional coverages and restrictions, the exact wording should be consulted. Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool Excess Casualty - Claims Made Policy Information: Carrier: St. Paul Fire and Marine Insurance Company Policy Numbe:r GP06301492 Policy Period: January 1, 2004 to January 1, 2005 Annual Premium: $1,223,176 Limits of Liability: $ 2,750,000 Automobile Liability, Each Occurrence $ 5,000 Automobile Medical Payments, Each Person $ 2,750,000 Personal Injury, Property Damage, Each Occurrence $ 5,000 Premises Medical Payments, Each Person $ 1,000,000 Sewer Back-Up, Each Occurrence $ 2,750,000 Public Officials Errors and Omissions Liability, Each Wrongful Act $ 2,750,000 Employee Benefits, Each Wrongful Act (Claims Made) $ 2,750,000 Employee Benefits, Aggregate $ 250,000 Employee Benefits, Self-Insured Retention Aggregate Limits of Coverage, in any one policy year: $ 2,750,000 Personal Injury, Property Damage $ 2,750,000 Products & Completed Operations $ 2,750,000 Public Officials Errors and Omissions Liability These aggregate limits above apply separately for CAPP and for each Participating Member County (PMC) Self-Insured Retained Limit (Including Indemnity and Defense): $ 250,000 Each Occurrence or Wrongful Act $ 4,000,000 In Any One Policy Period Participating Member Counties As Named Insureds: Alamosa, Archuleta, Baca, Bent, Chaffee, Cheyenne, Clear Creek, Conejos, Costilla, Crowley, Custer, Delta, Dolores, Eagle, Elbert, Fremont, Garfield, Gilpin, Grand, Gunnison, Hinsdale, Huerfano, Jackson, Kiowa, Kit Carson, Lake, La Plata, Las Animas, Lincoln, Logan, Mineral, Montrose, Morgan, Otero, Ouray, Park, Phillips, Prowers, Pueblo, Rio Blanco, Rio Grande, Routt, Saguache, San Juan, Sedgwick, Summit, Teller, Washington, Weld, Yuma This account summary is a bner outline of the coverages afforded under your insurance policies Since it is for mlormalional purposes only,it should not be construed to constitute the entire insurance contract. As your policies may contain additional coverages and resintlrons the exact wording should be consulted Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool Retroactive Dates: July 1, 1986 except: "'h., January 15, 1986 Weld County February 16, 1987 Cheyenne County April 1, 1987 Lake County July 1, 1987 Grand, Montrose, and Fremont Counties July 1, 1988 Delta County July 1, 1997 Custer County for Law Enforcement only Coverage: Claims Made Excess Liability. The Insurer agrees to pay on behalf of the Named Insured Ultimate Net Loss (in excess of the retained limit) liability which the Insured assumes under contract with a Participating Member County or becomes legally obligated to pay as damages because of: • Personal Injury • Property Damage • Public Officials E&O Insureds: • CAPP and Participating Member Counties • Former or current elected or appointed officials, including committee members, trustees, boards or commissions, and district attorneys and their assistants while acting for or on behalf of the Named Insured. • Past or present employees, agents, or volunteers of the Named Insured while acting for or on behalf of the Named Insured. • Any person using an automobile owned or hired by a Participating Member County providing the actual use of the automobile is within the scope and permission thereof Exclusions Including But Not Limited To: • Obligations under any workers' compensation, occupational disease, unemployment compensation or disability benefits law, or under any similar law. • Property Damage to: — Real Property occupied by or leased to a Named Insured, its agents or subcontractors i — Real or Personal Property in a Named Insured's care, custody or control, (coverage will attach excess of SIR and excess of any valid and collectible insurance) This account summary is a Cnel outline of the coverages atforded under your insurance policies. Since it is for inlormalgnal purposes only,it should not be construed 10 constitute the entire insurance contract. As your policies may contain additional coverage,and restnclions.the exact wording should be consulted /1 Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool • As respects liability assumed by a Named Insured under any contract: — To any claim from any arbitration proceeding wherein the Company is not entitled to exercise with the Named Insured their rights in the choice of arbitrators, and in the conduct of such proceedings — If the indemnitee of Named Insured is an architect, engineer or surveyor, to the liability of the indemnitee, his agents or employees arising out of: - The preparation or approval of contracts, maps, plans, drawing, etc., or; - The giving or the failure to give directions or instructions by the indemnitee — Exclusions do not apply to resulting Personal Injury and Property Damage • Liability arising out of the performance of or failure to perform health professional services. • Failure to supply a specific amount of electrical power, fuel or water or to liability arising out of the interruption of the electrical power, fuel or water supply • Nuclear Energy Liability • Discharge, dispersal, release or escape of pollutants, including cleanup • Noise Pollution Liability • Manufacture of, mining of, use of, sale of, installation of, removal of, distribution of or exposure to, asbestos products, asbestos fibers or asbestos dust • Liability imposed upon an Insured under the Employee Retirement Income Security Act of 1974 • Claims arising out of advances involving intentional physical contact, whether consensual or not. Exclusion applies only to any person who has made any sexual i-. advances involving intentional physical contact or who knowingly participated in such conduct by another. • Liability arising out of ownership, maintenance, or use, including the loading or unloading of aircraft. • Ownership, maintenance or use, including loading or unloading, of aircraft, or watercraft over 26' in length, if said watercraft is used to carry persons for hire • War • Circumstances notified to other insurance carriers • Claims resulting from occurrences prior to the Retroactive Date(s) • Advertising, Broadcasting, Publishing or Telecasting Operations • Premises Medical Expenses for any of the following: — A person injured on that part of your premises that the person normally occupies — Coverage provided under Products and Completed Operations Liability — A person injured while practicing for or participating in any athletic or sports contest or exhibition sponsored, conducted or directed by an Insured — Any person who is sentenced and imprisoned in, committed to, confined in, or detained in any county jail or other detention facility • Any claim or suit that seeks declaratory or injunctive relief • Back wages, overtime or other wage related compensation • Liability that results from the failure of any insured to do what is required by contract or agreement This account summary Is a onel outline of the coverages*fettled under your insurance policies Since it¢Ice "ewe mlormatiOnal Purposes only,i l should not be construed to conslitule the entire insurance contract As your policies may contain addll,onal coverages and reslnclions the exact wording should be consulted. Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool • Liability that results from eminent domain, inverse condemnation, regulatory taking, adverse possession or dedication by adverse use • Liability for bodily injury to an employee of the Insured arising out of and in the course of his or her — Employment by the protected person or — Performance of duties related to the conduct of the protected person's operations • Liability that results from any actual or alleged infringement or violation of any of the following rights or laws, — Copyright, Patent, Trade dress, Trade name, Trade Secret, Trademark, Other intellectual property rights or laws — But does not apply to bodily injury or property damage that results from Products Liability or Completed Operations Liability or Personal Injury that results from the unauthorized use of any copyrighted or trademarked advertising material, slogan, style, or title of others in your advertising • Liability that result from any actual, alleged, or threatened, absorption, ingestion, or inhalation of mold or other fungi, or bacteria, in any form by any person or existence of mold or other fungi, or bacteria, in any form — But this exclusion doesn't apply to bodily injury, property damage, or medical expenses that result from mold or other fungi, or bacteria, which are, or are on., in, or part of, any good products that's intended to be consumed as a food, beverage, or medicine — Bodily injury or medical expenses that result from bacteria which are directly transmitted solely by or from another person to the person sustaining the bodily injury or — Bodily injury or medical expenses that result from a bacterial infection which develops in connection with physical harm to the person sustaining the bodily injury, if such physical harm isn't excluded by this exclusion part, or any other part of this exclusion, and a claim or suit is made or brought against the protected person for such physical harm • Liability for Personal Injury, Property Damage or Premises Medical Payments to any person who is on a Named Insured's nursing home or assisted living facility premises for the purpose of receiving any medical evaluation, care or treatment • Liability for Personal Injury, Property Damage or Premises Medical Payments arising of the operations of any hospital or medical clinic, including — Ownership, maintenance or use of any premises used in such operation — Products Liability arising from products that are distributing in such operations — Completed Operations Liability for operations done anywhere that is related in the operation of such hospital or medical clinic • Liability arising out of any Malicious, Dishonest, or Fraudulent Errors, Omissions, or Acts of Knowing Violation of Rights and Laws committed in the performance of or failure to perform Health Care Professional Services This account summary is a onel outline of the coverages afforded under your insurance policies Since 0 is for informational purposes only.it should not be construed to constitute the entice insurance contract As your policies may contain additional coverages and reslnctins.'tie enact warding should be consulted ^` Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool • Liability arising out of the operations of any ski facility, including — The ownership, maintenance or use of any premise used in such operation — Product Liability arising from products that are distributed in each operation — Completed Operations Liability for operations done anywhere that is related to the operation of such ski facility. • Liability arising of the rental of ski equipment • Liability arising out of the practicing for or participating in rodeo events of any kind • Liability arising out of the operation of any airport, airfield, hanger or terminal, including — Ownership, maintenance or use of any premises used n such operations — Product Liability arising from products that are distributed in such operation — Completed Operations Liability for operations done anywhere that is related to the operation of such airport, airfield, hanger or terminal • Under Public Officials Error and Omissions Liability: — Automobile Liability, Personal Injury or Property Damage — Liability arising out of estimates of probable costs or cost estimates being exceeded or for faulty preparation of bid specifications or failure to award contracts in accordance with statute or ordinance — Injury to, destruction or disappearance of any tangible property(including money) or the loss of use thereof — Willful commission of a crime or other dishonest or fraudulent act — Financial gain to which an Insured is not legally entitled — Faulty preparation of maps, plans reports, surveys, designs, bid documents, or .—� specifications; but this exclusion does not apply to these services when provided by an Insured for a Named Insured — Activities in a fiduciary capacity — Eminent domain, inverse condemnation, regulatory taking adverse possession or dedication by adverse use (does not apply to zoning variances, zoning or rezoning decisions) — Improper administration or collection of taxes — Activities or operations of Housing Authorities, Port Authorities, School Boards, or Railroad Boards — Multiplied Damages — Violation ERISA and other employment laws, however, exclusion does not apply to loss that results from retaliatory action against employees — Liability that results to any employee strike or lockout, however, exclusion does not apply to loss that results from retaliatory action against employees — Breach of Contract. However, this exclusion will not apply to any oral or implied employment related contract or agreement Cancellation: ▪ 90 Days Notice for any other reason then Non-Payment • 10 Days Notice for Non-Payment this account summary is a brief oNLne of the coverages afforded under your insurance policies Since a Is for informational purposes only.it snould not be construed to constitute 111e entire insurance contract As your policies may contain adoiUonal coverages and reslnctions,the exact wording should be consulted Excess Casualty Insurance Summary Colorado Counties Casualty and Property Pool Endorsements: • Named Insured • Employee Benefits Program Administration Liability • Retroactive Date endorsement • Colorado Personal Injury Protection (Automobile) • Form MCS — 90 Extended Reporting Period: You may purchase a 36 month period * of Extended Reporting after termination or non- renewal by payment of not more than 200% of the annual premium within 30 days of the effective date of termination or non-renewal. *A period of time in which to report to the Insurer claims made during the Extended Reporting Period for acts which occurred prior to termination or non-renewal. The Limit of Liability is not reinstated during this Extended Reporting Period. Important Reporting Requirements: Written notice of occurrence reasonably likely to involve the Company, "as soon as practicable" of all claims which involve: (i) Death; (ii) Brain damage; (iii) Paraplegic or quadriplegic impairment; (iv) Eyesight; (v) Third degree bums; (vi) Traumatic loss of or surgical amputation of a limb; (vii) A serious case where, in the judgment of the Insured or its defense counsel, reserves exceed $125,000 This account summary is a bnet outline of the coverages afforded under your insurance policies Since it is for infomatonal purposes only,it should not be construed to Constitute the entire insurance contract Ps your policies may contain additional coverages and reslnctions.the enact wording should be consulted. „� DELIVERY INVOICE meStRIUI Company: ST. PAUL FIRE & MARINE INSURANCE COMPANY I Policy Inception/Effective Date: 01/01/04 N Agency Number: 0549614 S COLORADO COUNTIES CASUALTY & PROPERTY U POOL (SEE CONTINUATION) Transaction Type: R 800 GRANT STREET RENEWAL OF POLICY E UNIT E Transaction number: 001 D DENVER CO 80203 Processing date: 01/21/04 14:49 Policy Number: GP06301492 A MARSH USA INC G 1225 17TH ST PLAZA STE 2100 E DENVER CO 80202-5534 N T Policy Description Amount Surtax/ Number Surcharge GP06301492 SERIES 1000 POLICY $1,223,176.00 This ro!icy is a chims.made policy _. .;,,rage only i; "_ . _.__. : _ring the policy peric,j or any applicable extended reporting period. 1 40724 Ed.12-90 Printed in U.S.A. Page 1 INSURED COPY meStIbul WHY YOU SHOULD REPORT LOSSES TO US PROMPTLY Reporting new losses, claims, or potential claims to us promptly can be critical. It helps us to resolve covered losses or claims as quickly as possible and often reduces their overall cost. Prompt reporting: • Better protects your interests. • Helps us to try to resolve losses or claims more quickly and to everyone's satisfaction - yours, any claimant's and ours; and • Often reduces the overall cost of a loss or claim - losses or claims reported more than five days after they happen cost on average 35% more than those reported earlier. Use the What To Do If You Have A Loss form that is a part of your policy to he/p you promptly report losses, claims, or potential claims, That form outlines the information that must normally be submitted as part of the reporting process. It describes the duties you and other persons or organizations protected under your policy have if your policy provides: • Property protection and there is a loss that may be covered under that protection; or • Liability protection and an accident, act, error, event, incident, offense, or omission happens or is committed that may result in liability damages or other amounts which may be covered under that protection. To report losses, claims, or potential claims to us, we can be contacted easily and quickly through our web site or by fax. W W W.STPAUL .COM The St. Paul's online site for reporting losses, claims, and potential claims has been designed to be as simple and user-friendly as possible. In fact, the site can even remember key information so that you don't have to continually re-enter the same data over and over again. If you report your loss, claim, or potential claim online, you will immediately receive a claim tracking number and be able to print out a copy of the report for your records. DEDICATED FAX NUMBERS Use these dedicated numbers to report a loss, claim, or potential claim by fax to the appropriate claim professionals. Auto, Property or General Liability 1 1-888-329-8734 Transportation 1-813-663-3980 Public Sector 1-800-PUBLICS Fast Food Program 1-800-578-4549 Foreign Risk Services 1-800-329-8734 ND027 Ed. 7-03 Printed in U.S.A. -1- eSt.Paul Fire and Marine Insurance Co. 2003 All Rights Reserved TheStFISUI DISCLOSURE NOTICE TERRORISM RISK INSURANCE ACT OF 2002 The certified acts of terrorism premium charge shown below is for coverage under this policy for insured losses covered by the Terrorism Insurance Program established by the Terrorism Risk Insurance Act of 2002 (the Act). That Program applies to certain losses, if otherwise covered by your policy, that result from an "act of terrorism," as that term is defined in and certified under the Act (insured losses). This terrorism premium does not include any charges for the portion of insured losses covered by the Federal Government under the Act. The Federal Government shares in the payment of insured losses under the Act, and the amount of its share is 90% of such losses that exceed the applicable insurer deductible. If $0 is shown below for the certified acts of terrorism premium charge, this policy provides such terrorism coverage for no premium charge. The certified acts of terrorism premium charge shown below does not apply to any insuring agreement or coverage part in this policy for which you did not accept our offer, for a premium charge, of such terrorism coverage. If you did not accept our offer of such terrorism coverage, this policy contains one or more exclusions that apply to certified acts of terrorism under each such insuring agreement or coverage part. The Act establishes a cap on our liability to pay for insured losses if the aggregate amount of insured losses under the Act exceeds $100,000,000,000 during the applicable period for all insureds and all insurers combined. In that case, we will not be liable for the payment of any amount that exceeds such aggregate amount of $100,000,000,000. Name of Insured: COLORADO COUNTIES CASUALTY & PROPERTY Policy Number: GP06301492 Effective Date: 01/01/04 Certified Acts Of Terrorism Premium Charge: $0.00 Processing Date: 01/21/04 14:49 001 D0100 Rev. 3-03 Printed in U.S.A. -1- INTRODUCTION TMeStThuI This policy protects against a variety of Policy Number: GP06301492 losses. There are also some restrictions. We've written this policy in plain, easy-to- ST PAUL understand English. We encourage you to MAIL CODE 104F read it carefully to determine what is and 385 WASHINGTON STREET what is not covered, as well as the rights ST. PAUL MN 55102-1118 and duties of those protected. In return for your premium, we'll provide the Your policy is composed of General Rules, protection stated in this policy. an explanation of What To Do If You Have A Loss, one or more Coverage Summaries, We, us, our, and ours mean St. Paul Fire and and one or more Insuring Agreements Marine Insurance Company. We're a capital explaining your coverage. It may also stock company located in St. Paul, include one or more endorsements. Minnesota. Endorsements are documents that change your policy. The Policy Forms List shows The words you, your, and yours mean the all the forms included when this policy insured named here, which is a begins. COUNTY POOL One of our authorized representatives will COLORADO COUNTIES CASUALTY & PROPERTY also countersign the policy. 800 GRANT STREET UNIT E This policy will begin on 01/01/04 DENVER CO 80203 and will continue until 01/01/05 ***INSURED NAMES CONTINUED ON BACK*** Your former policy number is automatically replaced: 6P06301129 Your premium for the policy period shown is: $1,223, 176.00 However, please refer to the Premiums section of the General Rules to see how final premiums are determined. Our authorized representative is: 0549614 7I,_�j1 MARSH USA INC 'Presi enr t 1225 17TH ST PLAZA STE 2100 DENVER CO 80202-5534 Authorized Representative Date /4 )sy Secretary Processing Date 01/21/04 14:49 001 40800 Ed. 5-87 Printed in U.S.A. Introduction cSt.Paul Fire and Marine Insurance Co.1984 All Rights Reserved Page 1 POLICY FORM LIST meStmUI Here's a list of all forms included in your policy, on the date shown below. These forms are listed in the same order as they appear in your policy. Title Form Ed. Nbr Date Disclosure Notice Terrorism Risk Insurance Act Of 2002 D0100 03-03 Introduction - St. Paul Fire And Marine Insurance Company 40800 05-87 Policy Form List 40502 01-80 Special Excess Liability Policy for Public Entities- Declarations CAPPLD 01-04 Named Insured Endorsement 40502 01-80 Special Excess Liability Policy for Public Entites—Insuring Agreement CAPPL 01-04 Retroactive Date Endorsement 40502 01-80 Employee Benefits Program Administration Liability-Claims-Made Endt. 40502 01-80 Uninsured or Underinsured Motorists Rejection 40502 01-80 Motor Carrier Policies of Insurance For Public Liability MCS 01-96 Terrorism Risk Insurance Act of 2002 Certified Acts Of CAAP 01-04 Terrorism Exclusion Endorsement Maintenance Self-Insured Retention Endorsement 40502 01-80 1 NAME OF INSURED: Colorado Co. Casualty & Property Pool PAGE IOFI POLICY NO: 6206301492 EFFECTIVE DATE: 01/01/2004 Form 40502 01-80 SPECIAL EXCESS LIABILITY POLICY FOR PUBLIC ENTITIES Declarations THIS IS A CLAIMS-MADE POLICY - PLEASE READ THIS POLICY CAREFULLY Policy Number: GP06301492 Named Insured and Mailing Address: COLORADO COUNTIES CASUALTY & PROPERTY POOL(CAPP) 800 GRANT STREET,UNIT E DENVER, COLORADO 80203 POLICY PERIOD: From 01/1/2004 to 01/01/2005 at 12:01 AM standard time at Named Insured's mailing address as shown above LIMITS OF LIABILITY AND RETENTION: a) Self-Insured Retention Limit $250,000 each occurrence or wrongful act $4,000,000 in any one policy year b) Automobile Liability $2,750,000 each occurrence Automobile Medical Payments $5,000 each person c) Personal Injury, Property Damage $2,750,000 each occurrence Premises Medical Payments: $5,000 each person Sewer Back-Up $1,000,000 each occurrence d) Public Officials Errors and Omissions Liability: $2,750,000 each wrongful act e) Aggregate Limits of Coverage: Personal Injury, Property Damage: l $2,750,000 in any one policy year Products & Completed Operations: $2,750,000 in any one policy year Public Officials Errors and Omissions Liability: $2,750,000 in any one policy year These aggregate limits above apply separately for CAPP and for each Participating Member County (PMC) RETROACTIVE DATE: JULY 1, 1986 Unless otherwise endorsed Colorado Counties Casualty&Property Pool St. Paul Fire & Marine Insurance Company Form CAPPLD Rev. 01-2004 ThestRiui NAMED INSURED ENDORSEMENT 24.Kiowa It is agreed that the Participating Member 25. Kit Carson Counties named hereunder are included 26.Lake as Named Insureds: 27.La Plata 28.Las Animas 1. Alamosa 29.Lincoln 2. Archuleta 30.Logan 3. Baca 31.Mineral 4. Bent 32.Montrose 5. Chaffee 33.Morgan 6. Cheyenne 34.Otero 7. Clear Creek 35.Ouray 8. Conejos 36.Park 9. Costilla 37.Phillips 10.Crowley 38.Prowers 11.Custer 39. Pueblo 12.Delta 40.Rio Blanco 13.Dolores 41.Rio Grande 14.Eagle 42.Routt 15.Elbert 43. Saguache 16.Fremont 44. San Juan 17.Garfield 45. Sedgwick 18.Gilpin 46. Summit 19.Grand 47.Teller 20.Gunnison 48. Washington 21.Hinsdale 49. Weld 22.Huerfano 50.Yuma 1 23.Jackson Other Terms All other terms of the policy remain the same. •••••••, Name of Insured Policy Number GP06301492 Effective Date 01-01-2004 COLORADO CO.CASUALTY& PROPERTY POOL 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page 1 of 1 7 SPECIAL EXCESS LIABILITY POLICY FOR PUBLIC ENTITIES THIS IS A CLAIMS MADE FORM. READ YOUR POLICY CAREFULLY. Certain provisions in this policy restrict coverage. Read the entire policy carefully to determine your rights and duties and what is not covered. In consideration of the payment of the premium, and in reliance upon the statements in the Declarations made a part hereof and subject to the limits of liability, exclusions, conditions and other terms of this policy, the Company agrees with the Named Insureds as follows: INSURING AGREEMENT A. The Company will pay on behalf of the Insureds that portion of the Ultimate Net Loss in excess of the Retained Amount, which the Insureds shall become legally obligated to pay as damages (excluding all fines, penalties, punitive or exemplary damages) because of Automobile Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions Liability caused by an Occurrence or Wrongful Act to which this insurance applies. B. This insurance applies to Automobile Liability, Personal Injury, Property Damage or Public Officials Errors and Omissions Liability only if a claim for such damages: (1) is first made against an Insured during the policy period and written notice of such claim is received by a Named Insured, or us, whichever comes first, AND (2) is attributable to an occurrence or wrongful act which occurred on or after the Retroactive Date shown in the Declarations. C. This insurance also applies to Automobile Medical Payments and Premises Medical Payments, as defined in this policy, subject to the limits of coverage, exclusions, and other terms and conditions. D. All claims for damages because of Automobile Liability, Personal Injury and Public Officials Errors and Omission Liability to the same person, (including damages claimed by any person or organization for care, loss of consortium, loss of services or death resulting at any time) will be deemed to have been made at the time the first of those claims is made against an Insured. E. All claims for damages because of Property Damage causing loss to the same person or organization as a result of an occurrence will be deemed to have been made at the time the first of those claims is made against an Insured. St. Paul Fire& Marine Insurance Company Page 1 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final DEFENSE COSTS The Company shall have the right and opportunity, but not the obligation, to be „sm., associated with the Named Insureds in the defense of any claims made, suits brought, or proceedings instituted which are or may be covered under this policy, and the Named Insureds and the Company shall cooperate to the fullest extent possible. If the Company avails itself of the opportunity to be associated in the defense, it shall do so at its own expense. Defense Costs are part of the Insureds' retained limit, and any payment of amounts incurred for defense will serve to reduce the Insureds' self-insured retention as specified in the Declarations. However, Defense Costs are in addition to the limits of coverage, and any payment of amounts incurred for defense do not reduce the limits of liability or aggregate limits of coverage. LIMITS OF COVERAGE AND SELF-INSURED RETENTION Regardless of the number of(1) Insureds under this policy, (2) persons or organizations who sustain injury or damage, or (3) claims made or suits brought on account of Automobile Liability, Personal Injury, Property Damage or Public Officials Errors and Omissions the Company's liability is limited as follows: r^+ A. Self-Insured Retention (1) The each occurrence or wrongful act self-insured retention shown in the declarations is the amount the Named Insureds are responsible for, including Defense Costs, in any one occurrence and/or wrongful act, before the limits of coverage will apply. (2) The aggregate self-insured retention shown in the declarations is the total amount the Named Insureds are responsible for, including defense costs, for all retained amounts in any one policy year. B. (1) Automobile Liability- The Company's liability shall be only for the Ultimate Net Loss in excess of the Insureds' retained limit,and shall not exceed the amount specified in the declarations as the result of any one occurrence. (2) Automobile Medical Payments - The limit of liability is included in the Self- Insured Retention. 1 C. (1) Personal Injury and Property Damage- The Company's liability shall be only for the Ultimate Net Loss in excess of the Insureds' retained limit, and shall not exceed the amount specified in the declarations as the result of any one occurrence. However, the Company's liability for Ultimate Net Loss is further limited by the following: (a) Premises Medical Payments—The limit of liability is included in the Self-Insured St. Paul Fire& Marine Insurance Company Page 2 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final 9 Retention. (b) Sewer Back-Up —The Company's liability shall be only for the Ultimate Net Loss in excess of the Insured's retained limit for personal injury and property damage that results from the back-up of sewage into a building from any sewage facility or sanitary sewer that an Insured owns, operates or maintains, and shall not exceed the sublimit specified in the declarations as the result of any one occurrence. D. Public Official's Errors and Omissions Liability - The Company's liability shall be only for the Ultimate Net Loss in excess of the Insureds' retained limit, and shall not exceed the amount specified in the declarations as the result of any one Wrongful Act. E. Aggregate Limits of Liability- This policy is subject to aggregate limits of liability as stated in the Declarations. These aggregate limits of liability are the maximum amount that will be paid under this policy for all Occurrences or Wrongful Acts during the Policy Period applying separately to: (A) Personal Injury and Property Damage (B) Products and Completed Operations (C) Public Officials Errors and Omissions Liability These aggregates apply separately for each Named Insured. The aggregates do not apply to Automobile Liability. For the purpose of determining the limit of the Company's liability, all Automobile Liability, Personal Injury or Property Damage claims arising out of continuous or repeated exposure to substantially the same general conditions shall be considered as arising out of one Occurrence. In addition, all Public Officials Errors and Omissions taking place over more than one Policy Period insured by this Company shall be deemed to have taken place during the last Policy Period and only the Limit of Liability for that Policy Period shall apply. TERRITORY This policy applies to Automobile Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions Liability occurring anywhere in the world. PERSONS OR ENTITIES INSUIl2ED Each of the following is an Insured to the extent set forth below: (A)The Named Insured. The Named Insured includes the Named Insured stated in the Declarations and each Participating Member County (as scheduled in the Named St. Paul Fire& Marine Insurance Company Page 3 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final /O Insured Endorsement). (B)Those individuals who were or now are elected or appointed officials of the Named Insureds, including members of their governing bodies or any other committees, trustees, boards or commissions of the Named Insureds; district attorneys, their assistants and staff while acting for or on behalf of district attorneys; agents, volunteers, and Useful Public Servants; all of the foregoing while acting for or on behalf of the Named Insureds. Exception: Members of the following boards or commissions are not Insureds: Housing Authorities, Port Authorities, School Boards, or Railroad Boards. (C)Past or present employees of a Named Insured while acting for or on behalf of a Named Insured. (D) Any person or organization as required by contract, but only for injury or damage that results from • premises owned, rented or leased by a Named Insured; • work done by a Named Insured; • any permitted user of autos the Named Insured is responsible for; or • any other obligations pursuant to an intergovernmental agreement entered into by a Named Insured. (E) Any person while using an automobile owned or hired by a Named Insured and any person or organization legally responsible for the use thereof, provided the actual use i-- of the automobile is for or on behalf of a Named Insured and within the scope and permission thereof, and to include any official, trustee or employee of a Named Insured with respect to the use of non-owned automobiles in the business of a Named Insured. This Policy with respect to any person or organization other than a Named Insured does not apply: 1 to any person or organization or to any agent or employee thereof, operating an automobile sales agency, repair shop, service station, storage garage or public parking place, with respect to any accident arising out of the operation thereof; 2. to any employee of a Named Insured with respect to Bodily Injury to another employee of the same Named Insured injured in the course of such employment in l an accident arising out of the maintenance or use of an automobile in the business of such employer; 3. with respect to any hired automobile, to the owner or a lessee thereof, other than a Named Insured, nor to any agent or employee of such owner or lessee. St. Paul Fire& Marine Insurance Company Page 4 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final // EXCLUSIONS This policy does not apply to: (A) Workers Compensation To any obligation for which an Insured or any carrier as the insurer for an Insured may be held liable under any worker's compensation, occupational disease, unemployment compensation or disability benefits law, or under any similar law. (B) Property In a Named Insured's Care, Custody or Control To any liability for Property Damage to: (1) Real Property occupied by or leased to a Named Insured, its agents or subcontractors; or (2) Real or Personal Property in a Named Insured's, its agent's or subcontractor's care, custody or control or as to which a Named Insured, its agents or subcontractors is for any purpose exercising control, unless no other valid and collectible insurance is available to a Named Insured. (C) Contract Liability Limitations As respects liability assumed by a Named Insured under any contract: (1) To any claim,judgment or agreement from any binding arbitration proceeding wherein the Company is not entitled to exercise with the Named Insureds their rights in the choice of arbitrators, and in the conduct of such proceedings; (2) If the Indemnitee of the Named Insured is an architect, engineer or surveyor, to the liability of the Indemnitee, his/her agents or employees, arising out of: (a) The preparation or approval of contracts, maps, plans, drawings, opinions, reports, tests, surveys, change orders, designs or specifications, or; (b) The giving or the failure to give directions or instructions by the Indemnitee, his agents or employees, provided such giving or failure to give is the primary cause of Personal Injury or Property Damage. Except that (a) and (b) above will not apply to resulting Personal Injury or Property Damage. (D) Health care professional services To any liability arising out of the performance of or failure to perform health care professional services. This exclusion does not apply to any Insured who isn't a medical doctor, psychologist, psychotherapist or nurse practitioner. St. Paul Fire& Marine Insurance Company Page 5 of 26 Colorado Counties Casualty &Property Pool �.. Form CAPPL Rev. 01-2004 Final /2 (E) Failure To Supply To liability arising out of the failure to supply a specific amount of electrical power, fuel or water or to liability arising out of the interruption of the electrical power, fuel or water supply. However, this exclusion does not apply if the failure to supply results from accidental damage to tangible property owned or used by any Insured to obtain, produce, process, or transmit such service. (F) Nuclear Energy Liability To Automobile Liability, Personal Injury, Property Damage, or Public Official's Liability: (1) (a) With respect to which an Insured is also an Insured under a nuclear energy policy issued by the Nuclear Energy Liability-Property Insurance Association, Mutual Atomic Energy Liability Underwriters of Nuclear Insurance Association of Canada, or would be an Insured under any such policy but for its termination upon exhaustion of its limit of liability; or (b) Resulting from the hazardous properties of nuclear material and with respect to which (i) any person or any organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, (ii) the Insured is, or had this policy not been available would, be, entitled to indemnity from the United States of America or any agency thereof, with any person or organization. (2) Under any liability coverage, to injury, sickness, disease, death or destruction resulting from the hazardous properties of nuclear material, if: (a) The nuclear material (i) is at any nuclear facility owned by the Insured or operated by the Insured or on the Insured's behalf, or (ii) has been discharged or dispensed therefrom; (b) The nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed, stored, transported or disposed of by the Insured or on the Insured's behalf; or (c) The injury, sickness, disease, death or destruction arises out of the furnishing by the Insured of services, materials, parts or equipment in connection with the planning, construction, maintenance, operating or use of any nuclear facility, but if such facility is located within the United States of America, its 1 territories or Canada, this exclusion (3) applies only to injury or Property Damage to such nuclear facility and any property threat. St. Paul Fire&Marine Insurance Company Page 6 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final /3 (3) As used in this exclusion: (a) "hazardous properties" includes radioactive, toxic or explosive properties; (b) "nuclear material" means source material, special nuclear material, or byproducts material; (c) "source material", "special nuclear material" and "by-product material" have the meanings given them in the Atomic Energy Act of 1954 or any law amendatory thereof; (d) "spent fuel" means any fuel element or fuel component, solid or liquid,. which has been used or exposed to radiation in a nuclear reactor; (e) "waste" means any waste material (i) containing by-product 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 contents and (ii) resulting from the operation by any person or organization of a nuclear facility included within the definition of nuclear facility below; (f) "nuclear facility" means: (i) any nuclear reactor (ii) any equipment or device designed or used for (I) separating the isotopes of uranium or plutonium, (2) processing or utilizing spent fuel, or (3) �. handling, processing or packaging wastes; (iii) 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 the Insured's 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; (iv) any structure, basin, excavation, premises or place prepared or used for storage or disposal of waste, and includes the site on which any of the foregoing is located, all operations conducted on such site qnd all premises used for such operations. (g) "nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction to contain a critical mass of fissionable material; St. Paul Fire& Marine Insurance Company Page 7 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev.01-2004 Final /X (h) with respect to injury or to destruction of property, the word "injury" or "destruction" includes all forms of radioactive contamination of property. (G) Pollution Liability (1) To any claim or suit, or any obligation to defend any claims or suits, for Automobile Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions arising out of the discharge, dispersal, release or escape of Pollutants, anywhere in the world; However, this part of the exclusion doesn't apply to Automobile Liability that results from pollution caused by fuels, lubricants, fluids, exhaust gases or similar Pollutants that: (a) are needed for or result from the normal electrical, hydraulic or mechanical functioning of a covered auto, other than the operation of specialized equipment; and (b) escape, seep or migrate, or are discharged, dispersed or released, directly from a part of the covered auto designed by its manufacturer to hold, store, receive or dispose of such Pollutants. Nor does this part of the exclusion apply to Automobile Liability that results from pollution from property of others which: (a) isn't in your care, custody or control; (b) isn't being transported or towed by or for you; and (c) is damaged by an accident due to the ownership, maintenance or use of a covered auto. Nor does this part of the exclusion apply to General Liability that results from the application or use of: (a) chlorine or sodium hypochlorite in any Insured's sewage treatment, swimming pool maintenance, or water purification operations; or (b) any pesticide or herbicide by or for any Insured; if such application or use meets all legal or license requirements of any governmental agency or authority which apply to it. Nor does this part of the exclusion apply to General Liability that results from the back-up o¢sewage into a building from any sewage facility or sanitary sewer that is owned, operated or maintained by any Insured. However, we won't cover any claim or suit to the extent that they result from any corrosive or radioactive material or waste in the sewage. St. Paul Fire& Marine Insurance Company Page 8 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final (2) To any loss, cost or expense arising out of any governmental direction or request that the Insured test for, monitor, clean up, remove, contain, treat, detoxify or neutralize Pollutants; (3) To any loss, cost, or expense incurred by a governmental unit or other third party, including but not limited to cost of investigation and monitoring and attorney's fees relating to activities in connection with efforts to test for, monitor, clean up, remove, contain, trace, detoxify or neutralize Pollutants. "Pollutants" means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste material. Waste material includes materials which are intended to be or have been recycled, reconditioned or reclaimed. Heat, smoke or fumes are not considered Pollutants when they result from a hostile fire at, on, in, or from a Named Insured's premises. (H) Noise Pollution Liability To any claim or suit, or any obligation to defend any claims or suits, for Automobile Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions arising from complaints of noise pollution. "Noise pollution" includes loud or irritating sounds. (I) Asbestos Liability (1) To any liability for Automobile Liability, Personal Injuy, Property Damage, Public Officials Errors and Omissions, occupational disease, or death at any time arising out of the manufacture of, mining of, use of, sale of, installation of, removal of, distribution of or exposure to, asbestos products, asbestos fibers or asbestos dust; or, (2) To any obligation of the Insured to indemnify any party because of damage arising out of such Automobile Liability, Personal Injury, Property Damage, Public Officials Errors and Omissions, occupational disease, or death, at any time as a result of the manufacture of, mining of, use of, sale of, installation of, removal of, distribution of or exposure to asbestos, asbestos products, asbestos fibers or 1 asbestos dust; or (3) To any obligation to defend any suit or claim against the Insured alleging Automobile Liability, Personal Injury, or Property Damage, or Public Officials Errors and Omissions and seeking Damages, if such suit or claim arises from Personal Injury, or Property Damage, or Wrongful Acts, resulting or contributed St. Paul Fire& Marine Insurance Company Page 9 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final /Y to, by any and all manufacture of, mining of, use of, sales of, installation of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; (4) To any loss, cost, expense, fine or penalty arising out of any of the foregoing Items 1, 2, and 3. (J) ERISA As respects liability imposed upon an Insured (or which is imputed to an Insured) under the "Employee Retirement Income Security Act of 1974" and any law amendatory thereof; (K) Sexual Advances To claims arising out of advances involving intentional physical contact, whether consensual or not. This exclusion applies only to any person who has made any sexual advances involving intentional physical contact or who knowingly participated in such conduct by another. (L) Aircraft To liability arising out of the ownership, maintenance or use, including the loading or unloading of aircraft. However, this exclusion does not apply to aircraft that is not owned or chartered by an Insured if: (a) the aircraft is chartered with crew, including a pilot, not employed by the Insured; and (b) the Insured isn't using the aircraft to carry persons or property for a charge. (M) Watercraft To liability arising out of the ownership, maintenance or use, including loading or unloading, of watercraft over 26 feet in length, but this exclusion only applies if said watercraft is used to carry persons for hire. (N) War To loss or damage or indirectly occasioned by, happening through or in consequence of war, invasion, acts of foreign enemies, any weapon of war employing atomic fission or radioactive force whether in time of peace or war, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power, confiscation or nationalization or requisition or destruction of or damage to property by or under the order of any government or public or local authority unless such acts of destruction by order of civil authority is at the time of and for the purpose of preventing spread of fire. (O) Known Occurrence or Wrongful Act To any claim or potential claim or Occurrence or Wrongful Act or circumstances for St. Paul Fire& Marine Insurance Company Page 10 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev.01-2004 Final / 7 which a Named Insured has provided notice to any other insurance company before the policy period in the Declarations. (P) Prior Occurrence or Wrongful Act To any claim resulting from an Occurrence or Wrongful Act which occurred prior to r-� the Retroactive Date in the Declarations. (Q) Advertising, Broadcasting, Publishing or Telecasting Operations To liability for a publication or utterance arising from advertising, publishing, broadcasting or telecasting done by an Insured that: (1) slanders or libels a person or organization or disparages a person's or organization's goods, products, property or services, and piracy and infringement of copyright or of property; or (2) violates a person's right of privacy. (R) Premises Medical Expenses of Certain Persons To Premises Medical Payments coverage for any of the following: (1) a person injured on that part of your premises that the person normally occupies. (2) coverage provided under Products and Completed Operations Liability. (3) a person injured while practicing for or participating in any athletic or sports contest or exhibition sponsored, conducted or directed by an Insured. (4) any person who is sentenced and imprisoned in, committed to, confined in, or detained in any county jail or other detention facility. (S) Equitable Relief To loss or any amount required to comply with a court order that results from any -� action or demand, or any part of any claim or suit that seeks declaratory or injunctive relief. (T) Back Wages To loss for back wages, overtime or other wage related compensation for Persons or Entities Insured, or from collective employee bargaining agreements. (U) Breach of Contract To liability arising out of breach of contract, whether express or implied, or arising out of non-completion of or delay in contract, or arising out of non-compliance with contract deadlines. However, this exclusion shall not apply to the Public Officials Liability coverage except as stated in exclusion (14) applying to Public Officials Liability only. (V) Eminent Domain To liability that results from eminent domain, inverse condemnation, regulatory taking, adverse possession or dedication by adverse use. However, this exclusion shall not apply St. Paul Fire& Marine Insurance Company Page 11 of 26 Colorado Counties Casualty&Property Pool r� Form CAPPL Rev. 01-2004 Final to Public Officials Liability coverage except as stated in exclusion (8) applying to Public Officials Liability only. e•-• (W) Employers Liability (1) To liability for bodily injury to an employee of the Insured arising out of and in the course of his or her: (a) employment by the protected person; or (b) performance of duties related to the conduct of the protected person's operations. (2) To liability for bodily injury to the spouse or any child, parent, brother, or sister of that employee if such bodily injury results from the bodily injury to the employee. This exclusion applies whether the Insured may be held liable as an employer or in any other capacity, such as a property owner or product manufacturer. This exclusion also applies to any obligation of the Insured to share damages with or repay someone else who must pay damages because of bodily injury to any employee of the Insured. However, this exclusion does not apply to bodily injury for which the Insured has assumed liability under contract. (X) Intellectual Property To liability that results from any actual or alleged infringement or violation of any of the following rights or laws: (1) Copyright. (2) Patent. (3) Trade dress. (4) Trade name. (5) Trade secret. (6) Trademark. (7) Other intellectual property rights or laws. But this exclusion does not apply to: (a) bodily injury or property damage that results from Products Liability or Completed Operations Liability; or (b) personal injury that results from the unauthorized use of any copyrighted or trademarked advertising material, slogan, style, or title of others in your advertising. (Y) Mold, Other Fungi, or Bacteria (1) To liability that result from any actual, alleged, or threatened: (a) absorption, ingestion, or inhalation of mold or other fungi, or bacteria, in any form by any person; or St. Paul Fire& Marine Insurance Company Page 12 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2004 Final l? (b) existence of mold or other fungi, or bacteria, in any form. But we won't apply this exclusion part to: (i) bodily injury, property damage, or medical expenses that result from mold or other fungi, or bacteria, which are, or are on, in, or part of, any good product that's intended to be consumed as a food, beverage, or medicine; (ii) bodily injury or medical expenses that result from bacteria which are directly transmitted solely by or from another person to the person sustaining the bodily injury; or (iii) bodily injury or medical expenses that result from a bacterial infection which develops in connection with physical harm to the person sustaining the bodily injury, if such physical harm isn't excluded by this exclusion part, or any other part of this exclusion, and a claim or suit is made or brought against the protected person for such physical harm. (2) Nor will we cover damages that results from any actual, alleged, or threatened: (a) absorption, ingestion, or inhalation of any other solid, liquid, gaseous, or thermal irritant or contaminant, including smoke, vapors, soot, fumes, acids, alkalis, chemicals, and waster, in any form by any person; or (b) existence of any such irritant or contaminant in any form; (c) and is part of any claim or suit that also alleges any injury or damage described as excluded in the first paragraph of this exclusion. (3) Also, we won't cover any loss, cost, or expense that results from any request, demand, order, or statutory or regulatory requirement that any protected person or others: (a) test for, monitor, clean up, remove, contain, treat, detoxify, or neutralize mold or other fungi, or bacteria, in any form; or (b) respond to, or assess, in any way the effects of mold or other fungi, or bacteria, in any form. Because mold or other fungi, or bacteria, can be pollutants, and any such other irritants or contaminants are pollutants, this exclusion applies in addition to the pollution liability exclusion or any other pollution-related exclusion made part of this agreement. (Z) Patient Injury To liability for Personal Injury, Property Damage or Premises Medical Payments to any person who is on a Named Insured's nursing home or assisted living facility 1 premises for the purpose of receiving any medical evaluation, care or treatment. (AA) Hospitals and Medical Clinics To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of the operation of any hospital or medical clinic, including: (I) the ownership, maintenance or use of any premises used in such operation; St. Paul Fire& Marine Insurance Company Page 13 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final a� (2) Product Liability arising from products that are distributed in such operation; or (3) Completed Operations Liability for operations done anywhere that is related to the operation of such hospital or medical clinic. However, this exclusion does not apply to Auto Liability. (BB) Malicious, Dishonest, or Fraudulent Errors, Omissions, or Acts or Knowing Violation of Rights and Laws To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of any malicious, dishonest, or fraudulent errors, omissions, or acts or knowing violation of rights and laws committed in the performance of, or failure to perform, health care professional services. (CC) Ski Facility To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of the operation of any ski facility, including: (1) the ownership, maintenance or use of any premises used in such operation; (2) Product Liability arising from products that are distributed in such operation; or (3) Completed Operations Liability for operations done anywhere that is related to the operation of such ski facility. However, this exclusion does not apply to cross country ski operations at a premises not normally operated as a full-time ski facility. Nor does it apply to �.� Auto Liability. (DD) Ski Equipment Rental To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of the rental of ski equipment. However, this exclusion does not apply to rental of ski equipment at a premises not normally operated as a full-time ski facility. (EE) Rodeo Participants To liability for Personal Injury, Property Damage or Premises Medical Payments as a result of practicing for, or participating in, rodeo events of any kind. (FF) Airport, Airfield, Hangar or Terminal To liability for Personal Injury, Property Damage or Premises Medical Payments arising out of the operation of an airport, airfield, hangar or terminal, including: (1) the ownership, maintenance or use of any premises used in such operation; St. Paul Fire&Marine Insurance Company Page 14 of 26 r. Colorado Counties Casualty& Properly Pool Form CAPPL Rev. 01-2004 Final (2) Product Liability arising from products that are distributed in such operation; or (3) Completed Operations Liability for operations done anywhere that is related to the operation of such airport, airfield, hangar or terminal. However, this exclusion does not apply to Auto Liability. (GG) Under Public Officials Error and Omissions Liability, to: (1) Automobile Liability, Personal Injury or Property Damage as defined in the policy; (2) Liability of any Insured arising out of estimates of probable costs or cost estimates being exceeded or for faulty preparation of bid specifications or failure to award contracts in accordance with statute or ordinance which under law must be submitted for bids; (3) Injury to, destruction or disappearance of any tangible property (including more)) or the loss of use thereof. (4) Liability arising from the willful commission of a crime or other dishonest or fraudulent act; (5) Liability from obtaining financial gain to which an Insured is not legally entitled; (6) Liability arising from faulty preparation of maps, plans, reports, surveys, designs, �. bid documents, or specifications; but this exclusion does not apply to these services when provided by an Insured for a Named Insured; (7) Liability from activities in a fiduciary capacity. (8) Liability from eminent domain, inverse condemnation, regulatory taking, adverse possession or dedication by adverse use. This exclusion does not apply to zoning variances, zoning or rezoning decisions or to the acts of a Participating Member County's Treasurer, Sheriff, Health Department or their respective employees, volunteers or agents. (9) Liability arising from the improper assessment, calculation, or collection of taxes, i or loss that reflects any tax obligation. This exclusion does not apply to the administration functions involved in the collection or refund of taxes. (10) Liability arising from the activities or operations of Housing Authorities, Port Authorities, School Boards, or Railroad Boards. St. Paul Fire& Marine Insurance Company Page 15 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final �CZ (1 1) Liability for that portion of any multiplied damage award which exceeds the amount multiplied. (12) Liability that results from any violation of any of the duties or responsibilities required of any Insured as an employer by the following laws, amendments to those laws, or similar provisions of any other laws, rules or regulations: (a) Fair Labor Standards Act, except the Equal Pay Act (b) National Labor Relations Act. (c) Worker Adjustment and Retraining Notification Act. (d) Consolidated Omnibus Budget Reconciliation Act of 1985 (e) Occupational Safety and Health Act. (f) Employee Retirement Income Security Act of 1974. However, this exclusion does not apply to loss that results from retaliatory action against any employee for the employee's exercising of rights afforded by such laws. (13) Liability that results to any employee on strike or lockout or temporarily or permanently replaced due to any labor dispute, including breach of a collective bargaining agreement. However, this exclusion does not apply for loss that results from retaliatory action taken in response to any of your employees for participating in any strike or lockout. (14) To liability arising out of breach of contract, whether express or implied, or arising out of non-completion of or delay in contract, or arising out of non-compliance with contract deadlines. However, this exclusion shall not apply to an employment- related claim alleging a breach of an implied contract of employment. An implied contract of employment is one that arises or is alleged to arise out of one or more statements in an Insured's personnel handbook, employment policy manual, or similar document, but does not include any express contract of employment for services between any claimant and an Insured. However, exclusions number (2), (4), (5), (6), and (7) do not apply to any contingent or vicarious liability of a Participating Member County arising out of one or more of the above referenced wrongful acts committed by an elected or appointed official of a Named Insured. 1 DEFINITIONS When used in this policy (including endorsements forming a part hereof): "Automobile Liability" means Bodily Injury and Property Damage resulting from the ownership, maintenance, use or operation of any auto owned, rented, leased, or borrowed St. Paul Fire& Marine Insurance Company Page 16 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final 073 by any Insured. It includes loading or unloading to or from such auto. "Automobile Medical Payments" means reasonable expenses, in excess of any other insurance, for necessary medical and funeral services incurred and reported within three years from the date of an accident to or for any Insured, or anyone else who sustains Bodily Injury caused by an accident involving a covered auto. For the purposes of this section, "other insurance" means valid and collectible insurance, or the funding of losses, available through: (A) another insurance company; (B) a risk retention group; (C) a self-insurance method or program, other than any funded by CAPP; (D) any similar risk transfer method. "Bacteria" means any type or form of bacterium or any mycotoxin, spore, scent, or byproduct that's produced or released by such bacterium. "Bodily Injury" means any harm to the health of other persons, including physical harm, sickness, disease, disability, shock, mental anguish, humiliation, mental injury, or death. "Claim" means any formal or written demand or Suit for monetary relief, against an Insured, or circumstances from which a Named Insured reasonably believes a formal or written demand for monetary relief will be forthcoming, but only if a Named Insured becomes aware of such during the policy period and written notice is provided to the Company during the policy period or no later than sixty (60) days following non-renewal or cancellation. ^� "Company" means the insurer(s) specified in the Declarations. "Completed Operations Liability" includes Bodily Injury and Property Damage arising out of operations or reliance upon a representation or warranty made at any time with respect thereto, but only if the Bodily Injury or Property Damage occurs after such operations have been completed or abandoned and occurs away from premises owned by or rented to an Insured. "Operations" include materials, parts or equipment furnished in connection therewith. Operations shall be deemed completed at the earliest of the following times: (A)When all operations to be performed by or on behalf of the Insured under the contract have been completed; (B)When all operations to be performed by or on behalf of the Insured at the site of the operations have been completed; or St. Paul Fire& Marine Insurance Company Page 17 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final O1>f (C)When the portion of the work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. Operations which may require further service or maintenance work, or correction, repair or replacement because of any defect or deficiency, but which are otherwise completed shall be deemed completed. The "Completed Operations Hazard" does not include Bodily Injury or Property Damage arising out of: (A) Operations in connection with the transportation of property unless the Bodily Injury or Property Damage arises out of a condition in or on an automobile created by the loading or unloading thereof; (B) The existence of tools, uninstalled equipment or abandoned or unused materials. "Damages" means monetary damages, and includes damages for death and for care and loss of services resulting from Personal Injury and damages for loss of use of property resulting from Property Damage, and damage resulting from Public Officials Errors and Omissions. "Defense Costs" means attorney's fees, costs and expenses and other fees, costs and expenses incurred in connection with the investigation, adjustment, defense and appeal of a Claim or Suit covered hereunder. Defense Costs include the defense costs of an Indemnitee when the Named Insureds assume liability for personal injury or property damage, and associated defense costs under a covered contract. However, Defense Costs do not include the office expenses of the Company or an Insured nor the salaries of employees or officials of the Company or an Insured. "Health care professional services" includes: (A) any dental, medical, mental, nursing, surgical, x-ray, or other health care professional service, including any advice, instruction, food, or beverage provided with such service; (B) the dispensing of drugs or medical or dental supplies and appliances; and (C) the handling or treatment of corpses, including autopsies, organ donations, and other postmortem procedures. "Indemnitee" means any person or organization, other than an Insured, who is a party to a covered contract and is held harmless or protected under that contract by a Named Insured for liability for: • personal injury or property damage covered under this agreement; and • the contract liability defense expenses incurred in connection with such personal injury or property damage. St. Paul Fire& Marine Insurance Company Page 18 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2004 Final a� "Insured" means any person or organization qualifying as an Insured under the Persons or Entities Insured section of this policy. The insurance afforded applies separately to each Insured against whom claim is made or suit is brought. "Mold or other fungi" means: (1) any type or form of mold or mildew; (2) any other type or form of fungus; or (3) any mycotoxin, spore, scent, or byproduct that's produced or released by such mold, mildew, or other fungus. "Occurrence" means: (A) an accident or event, including continuous or repeated exposure to conditions or (B) an error, omission, or negligent act in their performance of, or failure to perform, health care professional services by any Insured who isn't a medical doctor, psychologist, psychotherapist or nurse practioner which result in Personal Injury or Property Damage. All such exposure to substantially the same general conditions shall be deemed one "Occurrence." — "Personal Injury" means: (A) Bodily Injury; (B) False arrest, false imprisonment, wrongful detention, or malicious prosecution; (C) Violation of civil rights; (D)Wrongful entry into, or eviction of any person from, a room, dwelling, or premises that a person occupies, or other invasion of the right of private occupancy; (E) A publication or utterance that slanders or libels a person or organization, including defamation, or disparages a person's or organization's goods, products, property or services; (F) Piracy and infringement of copyright or of written or intellectual property; (G)A publication or utterance that violates a person's right of privacy; (H)Assault and battery, not committed by or at the direction of, or with the consent of an Insured. However, this limitation does not apply i) if committed or directed for the purpose of protecting persons from injury or death, or property from damage, or ii) to liability arising out of corporal punishment St. Paul Fire& Marine Insurance Company Page 19 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2004 Final (I) Improper or erroneous service of civil papers. "Premises Medical Payments" means medical expenses, in excess of any other insurance, incurred because of Bodily Injury to someone other than an Insured under this policy caused by an accident on an Insured's premises or as part of an Insured's operations regardless of fault, that are incurred and reported within one year of the date of the accident. These include expenses for: 1. first aid at the time of the accident, 2. necessary medical surgical, x-ray and dental services, including prosthetic devices; and 3. necessary ambulance, hospital, professional nursing, and funeral services. For the purposes of this section, "other insurance" means valid and collectible insurance, or the funding of losses, available through: (A) another insurance company; (B) a risk retention group; (C) a self-insurance method or program, other than any funded by CAPP; (D) any similar risk transfer method. "Products Liability" means Bodily Injury and Property Damage arising out of an Insured 's products or reliance upon a representation or warranty with respect thereto, but only if the Bodily Injury or Property Damage occurs away from premises owned by or rented to an Insured and after physical possession has been relinquished to others. "Property Damage" means (1) physical injury to or destruction of tangible property which occurs during the policy period, including the loss of use thereof at any time resulting therefrom, or (2) loss of use of tangible property which has not been physically injured or destroyed provided such loss of use is caused by an Occurrence during the policy period. "Public Officials Errors and Omissions" means any and all Wrongful Acts by an Insured arising from an action or inaction or ministerial act, mistake, misstatement, error, omission, or violation of antitrust statutes by an Insured in the discharge of duties for a Named Insured. "Suit" means a civil proceeding in which damages are alleged. It includes a binding arbitration proceeding for damages, and any other binding Alternative Dispute Resolution, to which the Insured submits with the Compax+y's consent. "Ultimate Net Loss" means the sums for which an Insured is legally liable as Damages by reason of ajudgment or settlement made with the written consent of the claimant, the Named Insureds and the Company, after making deductions for all recoveries for other valid and collectible insurance, excepting, however, the Insureds' Retained Limit and St. Paul Fire&Marine Insurance Company Page 20 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final a7 shall include all Defense Costs. "Wrongful Act" means any actual or alleged act, error or omission, arising out of the conduct or performance of any elected or appointed officials of a Named Insured in the performance of his or her duties. All such exposure to substantially the same general conditions shall be deemed one Wrongful Act. Wrongful act includes but is not limited to wrongful termination or discrimination based upon race, religion, nationality, national origin, color, creed, sex or age. CONDITIONS 1. Cross Liability Except with respect to Limits of Insurance, and any rights or duties specifically assigned to the first Named Insured, this insurance applies as if each Named Insured were the only Named Insured; and separately to each Insured against whom claim is made or suit is brought. 2. Insured's Duties in the Event of Occurrence, Claim or Suit (A) In the event of an Occurrence reasonably likely to involve the Company, written notice containing particulars sufficient to identify the Insured and also reasonably obtainable information with respect to the time, place, and circumstances thereof, and the names and addresses of the injured and of available witnesses, shall be given by or for the Insured to the Company or any of its authorized agents as soon as practicable. (B) The Company shall be given notice as soon as practicable, following notice to the —� first Named Insured (CAPP), of all claims which involve: • Death. • Brain damage. • Paraplegic or quadriplegic impairment. • Loss of eyesight. • Third degree bums. • Traumatic loss of or surgical amputation of a limb. • A serious case where, in the judgment of the Insured or its defense counsel, reserves exceed $125,000. (C) The Named Insureds shall cooperate with the Company and upon its request assist in making settlements, in the conduct of suits and in enforcing any right of contribution or indemnity against any person or organization who may be liable to the Named Insureds because of Personal Injury or Property Damage with respect to which insurance is afforded under this policy; and the Insured shall attend hearings and trials and assist in securing and giving evidence and obtaining the attendance of witnesses. St. Paul Fire& Marine Insurance Company Page 21 of 26 Colorado Counties Casualty& Property Pool r\ Form CAPPL Rev. 01-2004 Final The Named Insureds shall not, except at their own cost, voluntarily make any payment, assume any obligation or incur any expense. However, in the event that the amount of �. Ultimate Net Loss becomes certain either through trial court judgment or agreement among the Named Insureds, the claimant and the Company, then the Named Insureds may pay the amount of Ultimate Net Loss to the claimant to effect settlement and, upon submission of due proof thereof, the Company shall indemnify the Named Insureds for that part of such payment which is in excess of the retained limit, or will upon request of the Named Insureds, make such payment to the claimant on behalf of the Insured. (D) Whenever the first Named Insured (CAPP) has information from which the first Named Insured (CAPP) may reasonably conclude that an Occurrence or Wrongful Act covered hereunder involves injuries or damages, which in the event that an Insured should be held liable, is likely to involve this policy, notice shall be sent to: St. Paul Fire & Marine Insurance Company P.O. Box 5490 _ _ Denver, CO 80217-5490 Street address: 2000 S. Colorado Blvd., Suite 2-480 Denver, CO 80222-7910 Phone (303) 300-9000 as soon as practicable, provided, however, that failure to give notice of any Occurrence or Wrongful Act which at the time of its happening, did not appear to involve this policy but which at a later date, would appear to give rise to claims hereunder, shall not prejudice such claims. 3. Settlement Consent The Company shall have the right to propose a settlement for any claim or suit within an applicable Self-Insured Retention or the available limit of coverage, but only if it is reasonably certain that the claim or suit will exceed the Self-Insured Retention. If the Named Insured refuses to consent to a settlement, the Company will limit the total amount it will pay for damages and defense costs to no more than the amount it would have paid had the Named Insured given consent to the proposed settlement. 4. Appeals In the event the Named Insureds elect not to appeal a judgment in excess of the retained limit, the Company may elect to do so at its own expense, but in no event shall the liability of the Company for Ultimate Net Loss exceed the applicable amount specified in the Limits of Liability section of the Declarations plus all defense costs necessary and incident to such appeal. St. Paul Fire& Marine Insurance Company Page 22 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2004 Final 27 5. Action Against the Company No action shall lie against the Company with respect to any one Occurrence or Wrongful act unless, as a condition precedent hereto, the Named Insureds shall have fully complied with all the terms of this policy, nor until the amount of the Insureds' obligation to pay an amount of Ultimate Net Loss in excess of the retained limit shall have been finally determined either by judgment against an Insured after actual trial, or by written agreement of the Named Insureds, the claimant and the Company. Any person or organization or the legal representative thereof who has secured such judgment or written agreement shall thereafter be entitled to recover under this policy to the extent of insurance afforded by this policy. Nothing contained in this policy shall give any person or organization any right to join the Company as co-defendant in any action against the Named Insureds to determine an Insured's liability. 6. Bankruptcy and Insolvency Bankruptcy or insolvency of the Named Insureds shall not relieve the Company of any of its obligations hereunder. 7. Other Insurance This insurance is excess insurance that applies over self-insured retentions. If there is any other insurance for Automobile Liability, including Hired and Non-Owned Autos, Personal Injury, Property Damage, Automobile Medical Payments, Premises Medical Payments,or Public Official's Errors and Omissions Liability covered by this insurance, �. this insurance is excess of that other insurance. "Other insurance" means valid and collectible insurance, or the funding of losses, other than insurance bought specifically to apply in excess of this insurance, that's available through: • another insurance company; • a risk retention group; • a self-insurance method or program, other than any funded by CAPP and over which this agreement applies; • any similar risk transfer method. 8. Subrogation The Company shall be subrogated to the extent of any payment hereunder to all the Insureds' rights of recovery. The Named Insured shall do nothing after loss to prejudice such rights and shall do everything necessary to secure such rights. Any amount so recovered shall be apportioned as follows: St. Paul Fire&Marine Insurance Company Page 23 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2004 Final �3a Any party, including the Named Insured, having paid an amount in excess of the Self- Insured Retention limit plus the limit of liability hereunder shall be reimbursed first to the extent of actual payment. If any balance then remains unpaid, it shall be applied to reimburse the Named Insureds. The expenses of all such recovery proceedings shall be apportioned in the ratio of the respective recoveries. If there is no recovery in proceedings conducted solely by the Named Insured, it shall bear the expenses thereof. The company shall waive its right to subrogate against a third party for any payment made under this policy, but only if: (A) the Participating Member County agreed to waive its rights to subrogation under a contract or agreement; (B) the waiver was prior to the occurrence of the loss; and (C) subrogation is not pursued by the First Named Insured (CAPP). 9. Changes Notice to any agent or knowledge possessed by any agent or by any other person shall not effect a waiver or change in any part of this policy or stop the Company from asserting any right under the terms of this policy, nor shall the terms of this policy be waived or changed , except by endorsement issued to form a part of this policy. 10. Assignment Assignment of interest under this policy shall not bind the Company until its consent is endorsed hereon; however, if an Insured shall die, such insurance as is afforded by this policy shall apply (A) to the Insured's legal representative, as the Insured, but only while acting within the scope of his duties as such and (B) with respect to the property of an Insured to the person having temporary custody thereof as Insured, but only until the appointment and qualification of the legal representative. 11. Maintenance of Retained Limit The amount stated in the Declarations as the Self-Insured Retention Limit applicable to each occurrence or wrongful act claim shall be maintained intact and be'the responsibility of the Named Insureds except for any reduction thereof solely by paymejttt for Automobile Liability, Personal Injury, Property Damage, or Public Officials Errors and Omissions as defined and otherwise covered by this Policy. The failure of the Named Insureds to comply with this Condition will not render the Company liable for a greater amount than it would have been liable had the Named Insured complied herewith. St. Paul Fire&Marine Insurance Company Page 24 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final L5/ The failure of the Named Insureds to maintain the Self-Insured Retention limit, including, but not limited to the insolvency, bankruptcy, liquidation or failure of CAPP to pay on behalf of the Named Insureds, will not impose any liability, contractually or otherwise, upon the Company to assume the defense or incur any expenses on behalf of the Named Insureds under this Policy. 12. Cancellation This policy may be canceled by the first Named Insured (CAPP) by surrender thereof to the Company or any of its authorized agents, or by mailing to the Company written notice stating when thereafter the cancellation shall be effective. The policy may be canceled by the Company by mailing to the first Named Insured at the address shown in this policy written notice stating when not less than ninety days thereafter such cancellation shall be effective. Provided that the first Named Insured fails to discharge when due any of its obligations in connection with the payment of premium for the policy or any installment thereof, whether payable directly to the Company or its agent or indirectly under a premium finance plan or extension of credit, this policy may be canceled by the Company by mailing to the first Named Insured at the address shown in the policy, written notice stating when not less than ten days thereafter such cancellation shall be effective. The mailing of notice as aforesaid shall be sufficient proof of notice. The time of surrender or effective date and hour of cancellation stated in the notice shall become the end of the Policy Period. Delivery of such written notice either by the first Named Insured or by the Company shall be equivalent to mailing. If the first Named Insured cancels, earned premium shall be computed in accordance with the customary short rate table and procedure. If the Company cancels, earned premium shall be computed prorata. Premium adjustment may be made either at the time cancellation is effective or as soon as practicable after cancellation becomes effective, but payment or tender of unearned premium is not a condition of cancellation. No cancellation or termination of the Policy whether by or at the request of the first Named Insured or by the Company, shall take effect prior to the expiration of Ninety (90) days after written notice of such cancellation or termination is sent by registered mail to the Commissioner of Insurance, State of Colorado, Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202, unless an earlier date of such cancellation or termination is approved by said Commissioner of Insurance, State of Colorado. 13. First Named Insured The first Named Insured (CAPP) is authorized to act on behalf of all Named Insureds and other Insureds with respect to the giving and receiving of notice of cancellation and to St. Paul Fire& Marine Insurance Company Page 25 of 26 Colorado Counties Casualty& Property Pool Form CAPPL Rev. 01-2004 Final 3 receiving any return premium that may become payable under this policy. The first Named Insured is responsible for the payment of all premiums, but the other Named Insureds jointly and severally agree to make such premium payments in full if the first Named Insured fails to pay the amount due within (30) days after the company gives a written demand for payment to the first Named Insured. 14. Extended Reporting Period In the event of cancellation or non-renewal by the Company for any reason except non- payment of premium, the first Named Insured, upon payment of an additional premium of not more than 200% of the total expiring premium shall have the right to extend the period whereby a Claim is treated by the Company as made on the expiration date of this Policy for a period of thirty-six (36) months, but any such Claim must arise from an Occurrence prior to the date on which the Extended Reporting Period commenced and after the Retroactive Date. The first Named Insured must make a written request for an Extended Reporting Period within 30 days after the expiration of the policy period and pay the additional premium within 30 days after said request. The Extended Reporting Period Endorsement will not take effect unless the additional premium is paid when due. If that premium is paid when due, the endorsement may not be canceled. The Extended Reporting Period will not reinstate or increase the Limits of Liability or extend the policy period. 15. Claim Information The Company, upon request of the first Named Insured and within thirty days thereafter, shall supply sufficient information to the first Named Insured about closed or paid claims, claims for which the Company has established reserves, and claims for which the company has received notices of incidents which could give rise to claims. 16. Non-Waiver of Governmental Immunity It is hereby understood and agreed that nothing in this policy nor in any Participating Member County's coverage under this policy waives, or is intended to waive,any immunity granted to any Insured or to increase the maximum amount that may be recovered under the Colorado Governmental Immunity Act pursuant to Colo. Revs. Stat. Section 24-10-101 et. seq., including 24-10-114. ,••••••• St. Paul Fire&Marine Insurance Company Page 26 of 26 Colorado Counties Casualty&Property Pool Form CAPPL Rev. 01-2004 Final 33 TheSIRItli RETROACTIVE DATE ENDORSEMENT The retroactive date shown on the Declarations page does not apply to the following Participating Member Counties. Instead, the retroactive dates shown below apply to the respective Participating Member Counties listed. Cheyenne County February 16, 1987 Delta County July 1, 1988— Fremont County July 1, 1987 Grand County July 1, 1987 Lake County April 1, 1987 Montrose County July 1, 1987 Weld County January 15, 1986 The retroactive date shown on the Declarations page does not apply to Personal Injury or Property Damage that result from Law Enforcement Operations of Custer County. Instead, the retroactive date for Law Enforcement Operations of Custer County is July 1, 1997. Other Terms All other terms of the policy remain the same. • Name of Insured Policy Number GP06301492 Effective Date 01/01/04 COLORADO CO. CASUALTY& PROPERTY POOL — 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page 1 of I gy TheSEMIS EMPLOYEE BENEFITS PROGRAM ADMINISTRATION LIABILITY- r-. CLAIMS-MADE ENDORSEMENT THIS IS A CLAIMS MADE FORM. READ YOUR POLICY CAREFULLY. In consideration of the premium charged and subject to the terms, definitions and exclusions hereunder, the Company will pay on behalf of the Named Insureds amounts in excess of the Self- Insured Retention that the Named Insureds are legally obligated to pay as damages because of an act, error, or omission committed in the Administration of the Named Insured's Employee Benefits Program for its present or former employees. This insurance applies only if a claim for such damages: (I) is first made against an Insured during the policy period and written notice ofisuch claim is received by a Named Insured, or us, whichever comes first, AND (2) is attributable to a wrongful act which occurred on or after the Retroactive Date shown in the Declarations. Definitions "Employee Benefits Program" means • pension and profit sharing plans; • Individual Retirement Account (IRA) plans; • Salary reduction plans under Internal Revenue Code 401(k) or amendments; • Savings plans; • Group plans for life, health, dental, disability, automobile, homeowners, and legal advice insurance; • Social security system benefits; • Workers' compensation and unemployment insurance; • Travel and vacation plans; and • Educational tuition reimbursement plans. "Administration" means (a) giving counsel to employees with respect to an Employee Benefit Program; (b) interpreting an Employee Benefit Program; 1 (c) handling records in connection with an Employee Benefit Program; (d) effecting enrollment, termination or cancellation of employees under an Employee Benefit Program; provided all such acts are authorized by the Named Insured. • ,rte Name of Insured Policy Number GP06301492 Effective Date 01-01-2004 COLORADO COUNTY CASUALTY & PROPERTY POOL 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page 1 of 3 Limits of Coverage and Self-Insured Retention Regardless of the number of(1) Insureds under this policy, (2) persons or organizations making claims or bringing suits, or (3) claims made or suits brought on account of any act, error or omission in the Administration of the Named Insured's Employee Benefit Program, the Company's liability is limited as follows: A. $250,000 Self-Insured Retention each wrongful act is the amount the Named Insureds are responsible for, including defense costs, before the limits of coverage will apply. The Self- Insured Retention for Employee Benefits Liability applies toward the aggregate self-insured retention shown in the declarations. The aggregate retention is the total amount the Named Insureds are responsible for, including Defense Costs, for all retained amounts in any one policy year. B. $2,750,000 Each wrongful act limit is the most the Company is responsible for in Damages from a single wrongful act or a series of related wrongful acts. C. $2,750,000 Aggregate limit is the most the Company is responsible for in Damages in any one policy year. This aggregate applies separately for each Named Insured. Exclusions This policy does not apply under this endorsement: A. Personal Injury or Property Damage; To liability for Personal Injury or Property Damage as defined in this policy, including loss of use of tangible property. B. Dishonest Acts To any dishonest, fraudulent, criminal or malicious act or omission. C. Failure to Comply With Law. To any claim that results from the intentional violation of any workers' compensation, unemployment insurance, social security or disability benefits law or administrative interpretation of such laws. D. Failure to Pay Benefits To any claim that results from the failure to provide benefits because they are not properly funded or an insurance company's failure to comply with the terms of its policy. 1 E. Advice To any claim that results from advice given to any employee to participate or not to participate in any stock subscription, individual retirement account or salary reduction plan. F. Investment of Funds To any claim that results from the investment or non-investment of employee benefit funds, or the failure of any investment to perform as any Insured said it would. Name of Insured Policy Number: GP06301492 Effective Date: 01-01-2004 COLORADO COUNTY CASUALTY&PROPERTY POOL 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page 2 of 3 G. Termination of Plan To any claim that results from the termination of any employee benefit plan. H. Fines, Taxes, or Penalties To liability for fines, taxes or penalties imposed by law or other matters which may be uninsurable under law. Other Terms All other terms of the policy remain the same. • 'r` Name of Insured Policy Number: GP06301492 Effective Date: 01-01-2004 COLORADO COUNTY CASUALTY& PROPERTY POOL 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page 3 of 3 37 TheSYmuI UNINSURED OR UNDERINSURED MOTORISTS REJECTION The Named Insureds have agreed to reject any and all Uninsured Motorists Coverage (including underinsured motorists coverage). Dated: April 15, 2004 By: Colorado Counties Casualty and Property Pool and Participating Member Counties: C C L' Authorized Representative CTSI Executive Director Title Other Terms All other terms of the policy remain the same. Name of Insured Policy Number GP06301492 Effective Date 01/01/2004 COLORADO CO. CASUALTY& PROPERTY POOL Processing Date 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page 1 of 1 3f FORM MCS-90 OMB NO. 2125-0074 (Ed 1-96) ENDORSEMENT FOR MOTOR CARRIER POLICIES OF INSURANCE FOR PUBLIC LIABILITY UNDER SECTIONS 29 AND 30 OF THE MOTOR CARRIER ACT OF 1980 Issued to Colorado Counties Casualty & Property Pool of 800 Grant Street, Unit E, Denver Co 80203 Dated at St. Paul, MN this 1 day of January , 2004 Amending Policy No. GP06301492 Effective Date 01/01/04 Countersigned by: Authorized Company Representative Name of Insurance Company St. Paul Fire & Marine Insurance Company The policy to which this endorsement is attached provides primary or excess insurance, as indicated by " X ", for the limits shown: This insurance is primary and the company shall not be liable for amounts in excess of S for eac>F acci— dent NThis insurance is excess and the company shall not be liable for amounts in excess of $ 2,750,000, for each acci— dent in excess of the underlying limit of $ 250,000. for each accident Whenever required by the Federal Highway Administration (FHWA or the Interstate Commerce Commission (ICC), the company agrees to furnish the FHWA or the ICC a duplicate of said policy and all its endorsements. The company also agrees, upon telephone request by an authorized representative of the FHWA or the ICC, to verify that the policy is in force as of a particular date. The telephone number to call us is: Cancellation of this endorsement may be effected by the company or the insured by giving (1) thirty—five (35) days notice in writing to the other party (said 35 days notice to commence from the date the notice is mailed, proof of mailing shall be suffi— /"� cient proof of notice), and (2) if the insured is subject to the ICC's jurisdiction, by providing thirty (30) days notice to the ICC (said 30 days notice to commence from the date the notice is received by the ICC at its office in Washington, D.C.). DEFINITIONS AS USED IN THIS ENDORSEMENT ACCIDENT includes continuous or repeated exposure to conditions which results in bodily injury, property damage, or envi— ronmental damage which the insured neither expected nor intended. MOTOR VEHICLE means a land vehicle, machine, truck, tractor, trailer, or semitrailer propelled or drawn by mechanical power and used on a highway for transporting property, or any combination thereof. BODILY INJURY means injury to the body, sickness, or disease to any person, including death resulting from any of these. ENVIRONMENTAL RESTORATION means restitution for the loss, damage, or destruction of natural resources arising out of the accidental discharge, dispersal, release or escape into or upon the land, atmosphere, watercourse, or body of water, of any commodity transported by a motor carrier. This shall include the cost of removal and the cost of necessary measures taken ttio minimize or mitigate damage to human health, the natural environment, fish, shellfish, and wildlife. PROPERTY DAMAGE means damage to or loss of use of tangible property. PUBLIC LIABILITY means liability for bodily injury, property damage, and environmental restoration. The insurance policy to which this endorsement is attached provides automobile liability insurance and is amended to assure compliance by the insured, within the limits stated herein, as a motor carrier of property, with Sections 29 and 30 of the Motor Carrier Act of 1980 and the rules and regulations of the Federal Highway Administration (FHWA) and the Interstate Commerce Commission (ICC). In consideration of the premium stated in the policy to which this endorsement is attached, the insurer (the company) agrees to pay, within the limits of liability described herein, any final judgment recovered against the insured for public liability resulting p"-• from negligence in the operation, maintenance or use of motor vehicles subject to the financial responsibility requirements of Sections 29 and 30 of the Motor Carrier Act of 1980 regardless of whether or not each motor vehicle is specifically described in the policy and whether or not such negligence occurs on any route or in any territory authorized to be served by the insured or elsewhere. Such insurance as is afforded, for public liability, does not apply to injury to or death of the insured's employees while engaged in the course of their employment, or property transported by the insured, designated as cargo. 1 (39 FORM MCS-90 OMB NO. 2125-0074 (Ed 1-96) It is understood and agreed that no condition, provision, stipulation, or limitation contained in the policy, this endorsement, or any other endorsement thereon, or violation thereof, shall relieve the company from liability or from the payment of any final judgment, within the limits of liability herein described, irrespective of the financial condition, insolvency or bankruptcy of the insured. However, all terms, conditions and limitations in the policy to which the endorsement is attached shall remain in full force and effect as binding between the insured and the company. The insured agrees to reimburse the company for any �. payment made by the company on account of any accident, claim, or suit involving a breach of the terms of the policy, and for any payment that the company would not have been obligated to make under the provisions of the policy except for the agree- ment contained in this endorsement. It is further understood and agreed that, upon failure of the company to pay any final judgment recovered against the insured as provided herein, the judgment creditor may maintain an action in any court of competent jurisdiction against the company to compel such payment. The limits of the company's liability for the amounts prescribed in this endorsement apply separately, to each accident, and any payment under the policy because of any one accident shall not opterate to reduce the liability of the company for the payment of final judgments resulting from any other accident. The Motor Carrier Act of 1980 requires limits of financial responsibility according to the type of carriage and commodity transported by the motor carrier. It is the MOTOR CARRIER'S obligation to obtain the required limits of financial responsibility. THE SCHEDULE OF LIMITS SHOWN BELOW DOES NOT PROVIDE COVERAGE. The limits shown in the schedule are for information purposes only. SCHEDULE OF LIMITS Public Liability Type of Carriage 1 Commodity Transported Minimum Insurance (1) For-hire Property (Non-hazardous). S 750,000 (In interstate or foreign commerce). (2) For-hire and Private Hazardous substances as defined in 49 CFR 171.8, $ 5.000,000 (in interstate, transported in cargo tanks, portable tanks, or hopper type foreign, or intrastate commerce). vehicles with capacities in excess of 3,500 water gallons; or in bulk Divisions 1.1. 1.2 and 1.3 materials, Division 2.3, Hazard Zone A, or Division 6.1, Packing Group 1, Hazard Zone A material; in bulk Division 2.1 or 2.2; or Highway route controlled quantities of a Class 7 material. as defined in 49 CFR 173.403. (3) For-hire and Private (in interstate or Oil listed in 49 CFR 172.101; hazardous waste, hazardous S 1.000.000 foreign commerce: materials and hazardous substances defined in 49 CFR in any quantity) 171.8 and listed in 49 CFR 172.101, but not mentioned or (in intrastate in (2) above or (4) below. commerce: in bulk only). 1 (4) For-hire and Private (In interstate or Any quantity of Division 1.1. 1.2 or 1.3 material, any quantity $ 5,000,000 foreign commerce). of Division 2.3, Hazard Zone A. or Division 6.1, Packing Group 1, Hazard Zone A material; or highway route controlled quantities of a Class 7 material, as defined in 49 CFR 173.403. 1 Note - The type of carriage listed under numbers (1), (2). and (3) apply to vehicles with a gross vehicle weight rating of 10,000 pounds or more. The type of carriage listed under number (4) applies to all vehicles with a gross vehicle weight rating of less than 10,000 pounds. $2 2 TheStRiul TERRORISM RISK INSURANCE ACT OF 2002 CERTIFIED ACTS OF TERRORISM EXCLUSION ENDORSEMENT 1. It is hereby understood and agreed that the following is added to the Exclusions section. This change excludes coverage. Certified acts of terrorism To any Personal Injury, Property Damage, Medical Payments or Public Official's Errors or Omissions Liability that result from any certified act of terrorism. This exclusion does not apply to Automobile Liability. 2. It is hereby understood and agreed that the following is added to the Definitions section. "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 includes the following criteria for such an act of terrorism: • The act resulted in aggregate losses in excess of$5 million, and • The act is a violent act, or an act that is dangerous to human life, property, or infrastructure, and is committed by an individual or individuals acting on behalf of any foreign person or foreign interest, as part of an effort to coerce the civilian population of the United States of America, including its territories and possessions and Puerto Rico, or to influence the policy or affect the conduct of the United States Government by coercion. Other Terms All other terms of your policy remain the same. 1 St. Paul Fire & Marine Insurance Company Colorado Counties Casualty & Property Pool CAAP Terrorism Exclusion 01-04 The.$RlU) MAINTENANCE SELF-INSURED RETENTION ENDORSEMENT It is hereby understood and agreed that Section A. of the Limits of Coverage and Self-Insured Retention section is deleted and replaced by the following. A. Self-Insured Retention (1) The each occurrence or wrongful act self-insured retention shown in the declarations is the amount the Named Insureds are responsible for, including Defense Costs, in any one occurrence and/or wrongful act, before the limits of coverage will apply. (2) The aggregate self-insured retention shown in the declarations is the total amount the Named Insureds are responsible for, including defense costs, for all retained amounts in any one policy year. However, the aggregate self-insured retention does not include any amounts payable by a Participating Member County as maintenance self-insured retentions as shown below. Participating Member County Maintenance Self-Insured Retention Eagle County $125,000 each occurrence or wrongful act Pueblo County $125,000 each occurrence or wrongful act Weld County $125,000 each occurrence or wrongful act Summit County $ 75,000 each occurrence or wrongful act It is hereby understood and agreed that the following is added to the Definitions section. "Maintenance Self Insured Retention" means that part of the Ultimate Net Loss that is paid by a Participating Member County and which serves to erode the each occurrence or wrongful act self-insured retention shown in the declarations. Other Terms All other terms of the policy remain the same. Name of Insured Policy Number GP06301492 Effective Date 01/01/04 COLORADO CO. CASUALTY& PROPERTY POOL Endorsement 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page I of 1 �-y� POLICY CHANGE ENDORSEMENT Ihe$tIbul This endorsement summarizes the changes to your policy. All other terms of your policy not affected by these changes remain the same. How Your Policy Is Changed GENERAL INFORMATION The following form is added to your policy: Self-Insured Retention Revision Endorsement The following form is deleted from your policy: Maintenance Self-Insured Retention Endorsement C1 Premium Change Which Is Due Now Additional premium $0.00 Returned Premium $0.00 If issued after the date your policy Policy issued to begins, these spaces must be completed COLORADO COUNTIES CASUALTY & PROPERTY and our representative must sign below. Authorized representative Endorsement takes effect Policy Number 01/01/04 GP06301492 Processing Date: 05/07/04 08:43 002 40704 Ed.5-84 Printed in U.S.A. Endorsement 1.5©St.Paul Fire and Marine Insurance Co.1984 All Rights Reserved Page 1 mestful SELF-INSURED RETENTION REVISION ENDORSEMENT It is hereby understood and agreed that Section A. of the Limits of Coverage and Self-Insured Retention section is deleted and replaced by the following. A. Self-Insured Retention (I) The each occurrence or wrongful act self-insured retention shown in the declarations is the amount the Named Insureds are responsible for, including Defense Costs, in any one occurrence and/or wrongful act, before the limits of coverage will apply. (2) The aggregate self-insured retention shown in the declarations is the total amount the Named Insureds are responsible for, including defense costs, for all retained amounts in any one policy year. However, the aggregate self-insured retention does not include any amounts payable by a Participating Member County for any occurrence or wrongful act as outlined in such county's Agreement for Partially Self-Funded Program issued by the Colorado Counties Casualty and Property Pool. Other Terms All other terms of the policy remain the same. 1 Name of Insured Policy Number GP06301492 Effective Date 01/01/04 'a". COLORADO CO. CASUALTY& PROPERTY POOL Endorsement 40502 Ed. 1-80 Customized Form © St. Paul Fire and Marine Insurance Co. 1980 Page I of 1 CTSI Colorado Counties Casualty and Property Pool 2004 Excess Property Policy Policy No. 0413367 The summary included in this binder is a brief outline of the coverages afforded under the insurance policy. Since it is for informational purposes only, it should not be construed to constitute the entire insurance contract. As the policies may contain additional coverages and restrictions, the exact wording should be consulted. 1 Excess Property Insurance Summary Colorado Counties Casualty and Property Pool 1 Excess Property - Claims Made Policy Information: Carrier: Lexington Insurance Company/Allied World Insurance Company Policy Number: 0413367 Policy Period: January 1, 2004 to January 1, 2005 Annual Premium: $506,920 + 3.2% Colorado Surplus Lines Tax and Fees Limits of Liability: $ 10,000,000 *Loss Limit - All Risk of Direct Physical Loss or Damage including Real Property, Personal Property, Boiler &Machinery, Flood and Earthquake $ 40,000,000 Annual Aggregate *Lexington Insurance Company Limit of Liability - $7,500,000 (75%) part of $10,000,000. Allied World Assurance Company Limit of Liability is $2,500,000 (25%) part of$10,000,000. Deductible: $ 150,000 Each Occurrence or Wrongful Act Named Insured: Colorado Counties Casualty and Property Pool and Participating Member Counties. Insured includes: any official, trustee or employee of the Named Insured while acting within the scope of his duties as such, and any person, organization, trustee or estate to whom the Named Insured is obligated by virtue of written contract or agreement to provide insurance, such as is offered by this Insurance, but only in respect to operations by or on behalf of the Named Insured. This account summary is a brief ouglne of the coverages afforded under your insurance policies since it Is for t^` intomlalgnal purposes only.It should not be construed to constitute the entire Insurance contract As your policies may conlam additional coverages and respKlons,the exact wording should be consulted. Excess Property Insurance Summary Colorado Counties Casualty and Property Pool Participating Member Counties As Named Insureds: —. Alamosa, Archuleta, Baca, Bent, Chaffee, Cheyenne, Clear Creek, Conejos, Costilla, Crowley, Custer, Delta, Dolores, Eagle, Elbert, Fremont, Garfield, Gilpin, Grand, Gunnison, Hinsdale, Huerfano, Jackson, Kiowa, Kit Carson, Lake, La Plata, Las Animas, Lincoln, Logan, Mineral, Montrose, Morgan, Otero, Ouray, Park, Phillips, Prowers, Pueblo, Rio Blanco, Rio Grande, Routt, Saguache, San Juan, Sedgwick, Summit, Teller, Washington, Weld, Yuma Valuation: • Replacement Cost (If property not repaired, rebuilt or replaced within two years, Actual Cash Value applies). • Actual Cash Value for Automobiles SubLimits: $ 1,000,000 Flood Limit in Zone A, Annual Aggregate $ 10,000,000 Flood Limit in Zone B, D, and X500, Annual Aggregate $ 50,000,000 Flood Limit in Zone C, Annual Aggregate $ 25,000,000 Earthquake Limit, Annual Aggregate $ 1,000,000 Newly Acquired Property, per location (values in excess of$1,000,000 to be reported within 60 days) $ 5,000,000 Builders Risks, Renovations, Repairs made by the Insured at any location (Including new locations) within the Territorial limits of the Policy, any one occurrence $ 500,000 Unscheduled Locations, any one occurrence $ 50,000 Personal Property of Others $ 1,000,000 Ordinance Deficiency $ 1,000,000 Extra Expense This account summary is a bile'(Mime of the coverages afforded under your insurance policies Sbce ills for informational purposes only.11 should not be construed to consulate the enure insurance contract. AS your pollcres nay contain additional overages and rosl tte:to ,the exact wording should be CMSufed. Excess Property Insurance Summary Colorado Counties Casualty and Properly Pool Exclusions Including But Not Limited To: • Vermin or insects, wear or tear, rust, wet or dry rot, or mold • Radioactive contamination or other contamination (except by hostile fire) • Loss of use, delay, or loss of markets • Breakdown of machinery or boiler explosion (exclusion does not apply to EDP equipment and media) • Dampness of atmosphere or variation in temperature except as caused by Fire or Extended Coverage perils or loss by freezing. • Loss of electrical appliances, including wiring • Settling, normal shrinkage or expansion of foundations, walls, floors or ceilings • Loss by mechanical derangement, inherent vice or latent defect • Loss from processing or faulty workmanship • Shrinkage, evaporation, loss of weight or leakage • Inventory shortage Property Excluded: • Animals, aircraft, standing timber, growing crops, land, currency, money, notes, securities, bridges, culverts, roadways, streets, walks, or paved surfaces, dams, docks, piers, and wharves. Endorsements: • Transit Extension Insuring Clause (excludes ocean marine transit and property in the custody of the Post Office Department) • Combined Property/Boiler& Machinery Millennium Endorsement • Mold/Fungus Exclusion Endorsement • War Risk and Terrorist Exclusion Cancellation: • 90 Days Notice for any other reason then Non-Payment • 10 Days Notice for Non-Payment This account summary is a bnef outline of the coverages afforded under your insurance mimes. Since It is for �.� nfMnatgrNl purposes ally,X should not be construed to constitute the entire Insurance contract. As your policies may contain additional coverages and restrictions.the exact wording should be consulted. Excess Property Insurance Summary Colorado Counties Casualty and Property Pool 2 Boiler and Machinery: Coverage and Limits: $ Included Combined for Property Damage, Business Income, Extra Expense, Expediting Expense, Off Premises Service Interruption, Ammonia Contamination, Water Damage, Brands and Labels, Newly Acquired Locations, and Errors in Description Sublimits: $ 1,000,000 Extra Expense $ 100,000 Ammonia Contamination $ 100,000 Expediting Expenses $ 100,000 Water Damage $ 100,000 Hazardous Substances $ 100,000 Spoilage $ 100,000 Pollution Cleanup and Removal $ 5,000,000 Builders Risk Equipment Breakdown Valuation: Repair or Replacement Deductibles: $ 5,000 Extra Expense $ 5,000 Spoilage $ 5,000 All Other Loss or Damage This account summary is a bnel outlne of the coverages afforded under your insurance policies. Since it is for nfom,ahonal purposes only,It should not be cansbued to constitute the entire insurance contract. As your policies may COntan additional Coverages and reslMt.ons.the exact wording should be Consulted. v�� Excess Property Insurance Summary Colorado Counties Casualty and Property Pool Coverage: • Direct damage caused by an "Accident" (sudden and accidental breakdown) to a covered object Covered Objects: • Comprehensive, Including Production Machinery Covered Locations: • Any location in the U.S. which is owned by an Insured or leased by and operated under the control of an Insured and for which the Insured is legally liable. Exclusions: • Electronic Recordings • Media Pus account summary a a brief outline of the coverages afforded under your insurance policies. Since It is for re Informational purposes only.It should not be construed to constitute the entire insurance contract As your policies r may Denbo additional coverages and restrictions,the exact wording should be consulted LEXINGTON INSURANCE COMPANY Administrative Office 100 Summer Street, Boston, Massachusetts 02110-2103 (hereinafter called the Company) COMMERCIAL PROPERTY POLICY DECLARATIONS POLICY NUMBER: 0413367 RENEWAL OF: NEW ITEM 1. Named Insured: COLORADO COUNTIES CASUALTY AND PROPERTY POOL Address: 800 GRANT STREET, SUITE 400 DENVER CO 80203 ITEM 2. Policy Period: From 01/01/04 To 01/01/05 at 12:01 A.M. Standard Time at the address of the named insured shown above. ITEM 3. Limit of Insurance: $50,000,000 PRIMARY PER OCCURRENCE SUBLIMITS AND ANNUAL AGGREGATES AS PER POLICY Total Premium $625,000 Minimum Earned Premium $ 156,250 ITEM 4. Perils: ALL RISK INCLUDING EARTHQUAKE AND FLOOD r'M 5. Description of Properly Covered: Coinsurance REAL AND PERSONAL PROPERTY, RENTS, BOILER AND MACHINERY AND AS PER POLICY FORM LOCATED AS PER STATEMENT OF VALUES ON FILE WITH THE INSURANCE COMPANY ITEM 6. Mortgagee Clause: Loss, if any shall be payable to: INSURED OR ORDER 3, i ITEM 7. Forms Attached: See attached forms schedule �y�7 /- Authorized Represen ative OR PRPDEC(Ed.01/91) Countersignature(In states where applicable) LX1119 INSURED'S COPY / NOTICE 1 . THE INSURANCE POLICY THAT YOU HAVE PURCHASED IS BEING ISSUED BY AN INSURER THAT IS NOT LICENSED BY THE STATE OF CALIFORNIA. THESE COMPANIES ARE CALLED "NON-ADMITTED" OR "SURPLUS LINE" INSURERS. 2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL SOLVENCY REGULATION AND ENFORCEMENT WHICH APPLIES TO CALIFORNIA LICENSED INSURERS. 3. THE INSURER DOES NOT PARTICIPATE IN ANY OF THE INSURANCE GUARANTEE FUNDS CREATED BY CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE PAYMENTS AS PROMISED. -� 4. CALIFORNIA MAINTAINS A LIST OF ELIGIBLE SURPLUS LINE INSURERS APPROVED BY THE INSURANCE COMMISSIONER. ASK YOUR AGENT OR BROKER IF THE INSURER IS ON THAT LIST. 5. FOR ADDITIONAL INFORMATION ABOUT THE INSURER YOU SHOULD ASK QUESTIONS OF YOUR INSURANCE AGENT, BROKER, OR "SURPLUS LINE" BROKER OR CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE AT THE FOLLOWING TOLL-FREE TELEPHONE NUMBER: 1 -800-927-4357. O D-2 FORM (1/1999) INSURED'S COPY LEXINGTON INSURANCE COMPANY ANY REFERENCE IN THE POLICY FORM TO CONTACT IN WRITING THE COMPANY'S CLAIM OR LEGAL DEPARTMENTS SHOULD USE THE ADDRESSES PROVIDED BELOW. Attn: Claim Department Lexington Insurance Company 100 Summer Street Boston, Massachusetts 02110-2103 Attn: Legal Department Lexington Insurance Company 100 Summer Street Boston, Massachusetts 02110-2103 1 INSURED'S COPY LEXINGTON INSURANCE COMPANY Administrative Offices: 100 Summer Street, Boston, Massachusetts 02110-2103 (hereinafter called the Company) COMMERCIAL PROPERTY POLICY DECLARATIONS LEXINGTON INSURANCE COMPANY Colorado Fraud Warning IT IS UNLAWFUL TO KNOWINGLY PROVIDE FALSE, INCOMPLETE, OR MISLEADING FACTS OR INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING OR ATTEMPTING TO DEFRAUD THE COMPANY. PENALTIES MAY INCLUDE IMPRISONMENT, FINES, DENIAL OF INSURANCE, AND CIVIL DAMAGES. ANY INSURANCE COMPANY OR AGENT OF AN INSURANCE COMPANY WHO KNOWINGLY PROVIDES FALSE, INCOMPLETE, OR MISLEADING FACTS OR INFORMATION TO A POLICYHOLDER OR CLAIMANT FOR THE PURPOSE OF DEFRAUDING OR ATTEMPTING TO DEFRAUD THE POLICYHOLDER OR CLAIMANT WITH REGARD TO A SETTLEMENT OR AWARD PAYABLE FROM INSURANCE PROCEEDS SHALL BE REPORTED TO THE COLORADO DIVISION OF INSURANCE WITHIN THE DEPARTMENT OF REGULATORY AGENCIES. PRPDEC (Ed.01/91) LX1119 INSURED'S COPY FORMS SCHEDULE Named Insured: COLORADO COUNTIES CASUALTY AND PROPERTY POOL Policy No: 0413367 Effective Date: 01/01/2004 Form Number Edition Date Endorsement Number Title PRPDEC 01/91 PROPERTY DEC PR9O15 01/91 POLLUTION CONTAMINATION FORM PR9014 01/91 OCCURRENCE LIMIT OF LIAB. PR9019 01/94 STANDARD PROPERTY CONDITIONS Y69813 02/98 COMB. PROP/B&M MILLENNIUM END. PR9024 01/91 AMENDMENT SOS CLAUSE-CA LX9512 08/02 MOLD/FUNGUS EXCLUSION PR9514 09/02 PROPERTY ENDORSEMENT PR9513 09/01 WAR &TERRORIST EXCLUSION BRKR BROKERS MANUSCRIPT POLICY FORM r 01/99 D-2 SLA FORM D-2 NOTICE 1 DOC018(Ed. 12/87) LX0295 INSURED'S COPY OCCURRENCE LIMIT OF LIABILITY It is understood and agreed that the following special terms and conditions apply to this policy: 1. The limit of liability or Amount of Insurance shown on the face of this policy, or endorsed onto this policy, is the total limit of the Company's liability applicable to each occurrence, as hereafter defined. Notwithstanding any other terms and conditions of this policy to the contrary, in no event shall the liability of the Company exceed this limit or amount irrespective of the number of locations involved. The term "occurrence" shall mean any one loss, disaster, casualty or series of losses, disasters, or casualties, arising out of one event. When the term applies to loss or losses from the perils of tornado, cyclone, hurricane, windstorm, hail, flood, earthquake, volcanic eruption, riot, riot attending a strike, civil commotion, and vandalism and malicious mischief one event shall be construed to be all losses arising during a continuous period of 72 hours. When filing proof of loss, the Insured may elect the moment at which the 72 hour period shall be deemed to have commenced, which shall not be earlier than the first loss to the covered property occurs. 2. The premium for this policy is based upon the Statement of Values on file with the Company, or at- tached to this policy. In the event of loss hereunder, liability of the Company, subject to the terms of paragraph one (1) above, shall be limited to the least of the following: a. The actual adjusted amount of loss, less applicable deductible(s). b. The total stated value for the property involved, as shown on the latest Statement of Values on file with the Company, less applicable deductible(s). c. The limit of Liability or Amount of Insurance shown on the face of this policy or endorsed onto this policy. 4 PR9014(Ed.01/91) LX1083 INSURED'S COPY • LEXINGTON INSURANCE COMPANY Standard Property Conditions This endorsement effective 01/01/04 , forms a part of Policy Number 0413367 issued to COLORADO COUNTIES CASUALTY AND PROPERTY POOL by <ington Insurance Company (hereinafter called "the Company"). In consideration of the premium charged, the following clauses are hereby made applicable under this policy. MINIMUM EARNED PREMIUM CLAUSE In the event of cancellation of this policy by the Insured, a minimum premium of $156,250 shall become earned, any provision of the policy to the contrary notwithstanding. Failure of the Insured to make timely payment of premium shall be considered a request by the Insured for the Company to cancel on the Insured's behalf. In the event of such cancellation for non-payment of premium, the minimum earned premium shall be due and payable; provided, however, such cancellation shall be rescinded if the Insured remits and the Company receives the full policy premium with 10 days after the date of issuance of the cancellation notice. Such re- mittance and acceptance by the Company shall not effect the minimum earned premium provision of this endorsement. In the event of any other cancellation by the Company, the earned premium shall be computed pro-rata, not subject to the minimum earned premium. POLICY DEDUCTIBLE Each claim for loss or damage separately occurring shall be adjusted separately and from each such adjusted claim, the amount of $150,000 shall be deducted. Notwithstanding the foregoing, the deductible amount applying to certain peril(s) insured against by this policy shall be as follows: 5,000 deductible applying to PER ACCIDENT FOR BOILER AND MACHINERY deductible applying to deductible applying to deductible applying to deductible applying to I➢—the event of any other insurance covering the property insured hereunder, whether or not concurrent, the ictible(s) specified herein shall apply in full against that portion of any claim for loss or damage which the Company is called upon to pay under the provisions of the Apportionment Clause irrespective of any provisions to the contrary of such other insurance. CANCELLATION CLAUSE Except and to the extent of the Minimum Earned Premium Clause which is part of this policy, this clause supersedes other cancellation clauses made a part of this policy. CANCELLATION: This policy may be cancelled by the Insured by surrender thereof to the Company or by mailing to the Company written notice stating when thereafter such cancellation shall be effective. This policy may be cancelled by the Company by mailing to the Insured, at the mailing address shown in this policy or last known address, written notice, stating when, not less than 60 days thereafter (10 days for non-payment of premium) such cancellation shall be ef- fective. The effectiveness of cancellation is not dependent on the return of unearned premium with the notice. Proof of mailing of notice as aforesaid shall be sufficient proof of notice. The effective date and hour of cancellation stated in the notice shall become the end of the bolicy period. Delivery of such written notice either by the Insured or the Company shall be equivalent to mailing. If the Insured cancels, earned premium shall be computed in accordance with the cus- tomary short rate table and procedure. If the Company cancels, earned premium shall be computed pro rata. Premium adjustment shall be made as soon as practicable after cancellation becomes effective. SERVICE OF SUIT CLAUSE Service of Suit: In the event of failure of the Company to pay any amount claimed to be due hereunder, the Company, at the request of the Insured, will submit to the jurisdiction of a court of competent jurisdiction within the United States. Nothing in this condition constitutes or should be understood to constitute a waiver of the Company's rights to com- mence an action in any court of competent jurisdiction in the United States to remove an action to a United States District Court or to seek a transfer of a case to another court as permitted by the laws of the United States or of any stain the United States. It is further agreed that service or process in such suit may be made upon Counsel, Legal Dr ment, Company stated on Declarations, 100 Summer Street, Boston, Massachusetts, 02110-2103, or his or her representative, and that in any suit instituted against the Company upon this policy, the Company will abide by the final decision 1 of 2 �y PR9019 (Ed.01/94) / u iio INRI IFPn'.C nnpv of such court or of any appellate court in the event of an appeal. Further, pursuant to any statute of any state, territory, or district of the United States which makes provision therefor, the Company hereby designates the Superintendent, Commissioner or Director of Insurance, other officer specified for that purpose in the statute, or his successor or successors in office as its true and lawful attorney upon whom may be served any lawful process in any action, suit, or proceeding instituted by or on behalf of the Insured or any beneficiary hereunder arising out of this policy of insurance and hereby designates the above named Counsel as the person to whom the said officer is authorized to mail such process or a true copy thereof. WAR RISK EXCLUSION CLAUSE The Company shall not be liable for any loss, caused directly or indirectly, by (1) hostile or warlike action in time of peace or war, whether or not declared, including action in hindering, combating or defending against an actual, im- pending or expected attack (a) by government or sovereign power (dejure or de facto) or by any authority maintaining or using military, naval or air forces; or (b) by military, naval or air forces; or (c) by an agent of any such government, power, authority or force (2) any weapon of war employing atomic fission or radioactive force whether in time of peace or war, whether or not its discharge was accidental; (3) insurrection, rebellion, revolution, civil war, usurped power, or action taken by government authority in hindering, combating, or defending against such an occurrence, seizure or de- struction; (4) any consequence of any of the foregoing. NUCLEAR EXCLUSION CLAUSE The Company shall not be liable for loss by nuclear reaction or nuclear radiation or radioactive contamination all whether controlled or not, and whether such loss be direct or indirect, proximate or remote, or be in whole or in part caused by, contributed to, or aggravated by the peril(s) insured against in this policy. If the peril of fire is insured under this policy, then, subject to the foregoing and all provisions of this policy, direct loss by fire resulting from nuclear reaction or nu- clear radiation or radioactive contamination is insured against by this policy. SALVAGE AND RECOVERY CLAUSE All salvages, recoveries and payments recovered or received either prior or subsequent to a loss settlement under this policy shall be applied as if recovered or received prior to the said settlement and all necessary adjustments shall be made by the parties hereto, including deduction of the Company's cost of recovery or salvage. REPORTING CLAUSE Notwithstanding that the Insured may be obligated to report full values for premium purposes, the Company's maximum limit of liability shall not exceed that amount stated as the policy limit of liability. PROOF OF LOSS AND PAYMENT The Insured shall complete and sign a sworn proof of loss within ninety (90) days after the occurrence of a loss (unless such period be extended by the written agreement of the Company) stating the time, place and cause of loss, the interest of the Insured and of all others in the property, the sound value thereof and the amount of loss or damage thereto, and all other insurance thereon. All adjusted claims shall be due and payable thirty (30) days after the presentation and acceptance of satisfactory proof(s) of loss at the office of the Company at 100 Summer Street, Boston, Massachusetts 02110-2103. GOVERNMENT ACTIVITY CLAUSE The Company shall not be liable for loss or damage caused by or resulting from: (1) the seizure or destruction of prop- erty insured by this policy by any government body, including any customs or quarantine action, or (2) confiscation or destruction of any property by order of any government or public authority, except an order to destroy property to pre- vent the spread of fire or explosion. IN WITNESS WHEREOF, the Company has caused this policy to be executed and attested, but this policy shall not be valid unless countersigned in the Declarations by one of its duly authorized representatives. jai drat l Secretary Chairman of the Board and CEO 2 of 2 PR9019 (Ed.01/94) Lx1101 INSURED'S COPY ENDORSEMENT This endorsement, effective 12:01 AM 01/01/2004 Forms a part of policy no.: 0413367 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY COMBINED PROPERTY/BOILER & MACHINERY MILLENNIUM ENDORSEMENT This policy is hereby amended as follows: A. The Insurer will not pay for Damage or Consequential Loss directly or indirectly caused by, consisting of, or arising from, the failure of any computer, data processing equipment, media microchip, operating systems, microprocessors (computer chip), integrated circuit or similar device, or any computer software, whether the property of the Insured or not, and whether occurring before, during or after the year 2000 that results from the inability to: 1. correctly recognize any date as its true calendar date; 2. capture, save, or retain, and/or correctly manipulate, interpret or process any data or information or command or instruction as a result of treating any date other than its true calendar date; and/or 3. capture, save, retain or correctly process any data as a result of the operation of any command which has been programmed into any computer software, being a command which causes the loss of data or the inability to capture, save, retain or correctly process such data on or after any date. B. It is further understood that the Insurer will not pay for the repair or modification of any part of an electronic data processing system or its related equipment, to correct deficiencies or features of logic or operation. C. It is further understood that the Insurer will not pay for Damage or Consequential Loss arising from the failure, inadequacy, or malfunction of any advice, consultation, design, evaluation, inspection, installation, maintenance, repair or supervision done by the Insured or for the Insured or by or for others to determine, rectify or test, any potential or actual failure, malfunction or inadequacy described in A. above. Such Damage or Consequential Loss described in A, B, or C above, is excluded regardless of any other cause that contributed concurrently or in any other sequence. This endorsement shall not exclude subsequent Damage or Consequential Loss, not otherwise excluded, which itself results from a Defined Peril. Defined Peril shall mean fire, lightning, explosion, aircraft or vehicle impact, falling objects, windstorm, hail, tornado, hurricane, cyclone, riot, strike, civil commotion, vandalism, malicious mischief, earthquake, volcano, tsunami, freeze or weight of snow, sudden and accidental breakdown of an object, including mechanical and electrical breakdown. All other terms, conditions and exclusions of this policy remain unchanged. 9 69813 (2/98) AUTHORIZED REPRESENTATIVE OR Countersignature (In states where applicable) INSURED'S COPY ENDORSEMENT This endorsement, effective 12:01 AM 01/01/2004 Forms a part of policy no.: 0413367 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MOLD/ FUNGUS EXCLUSION In consideration of the premium charged, it is hereby understood and agreed that this policy is amended as follows. The Company shall not be liable for any loss or damage caused by, arising out of, contributed to, or resulting from fungus, mold(s), mildew or yeast; or any spores or toxins created or produced by or emanating from such fungus, mold(s), mildew or yeast; (a) fungus includes, but is not limited to, any of the plants or organisms belonging to the major group fungi, lacking chlorophyll, and including mold(s), rusts, mildews, smuts and mushrooms; (b) mold(s) includes, but is not limited to, any superficial growth produced on damp or decaying organic matter or on living organisms, and fungi that produce mold(s); (c) spores means any dormant or reproductive body produced by or arising or emanating out of any fungus, mold(s), mildew, plants, organisms or microorganisms, regardless of any other cause or event that contributes concurrently or in any sequence to such loss. All other terms, conditions, definitions, exclusions, limitations and provisions of the Policy remain the' same. 1 Authorized Representative OR Countersignature (In states where applicable) LX9512 (08/02) INSURED'S COPY ENDORSEMENT ,.� This endorsement, effective 12:01 AM 01/01/2004 Forms a part of policy no.: 0413367 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY PROPERTY ENDORSEMENT It is noted and agreed that this policy is hereby amended as follows: The Insurer will not pay for Damage or Consequential loss directly or indirectly caused by, consisting of, or arising from: 1. Any functioning or malfunctioning of the internet or similar facility, or of any intranet or private network or similar facility, 2. Any corruption, destruction, distortion, erasure or other loss or damage to data, software, or any kind of programming or instruction set, 3. Loss of use or functionality whether partial or entire of data, coding, program, software, any computer or computer system or other device dependent upon any microchip or embedded logic, and any ensuing liability or failure of the Insured to conduct business. This Endorsement shall not exclude subsequent damage or Consequential loss, not otherwise excluded, which itself results from a Defined Peril. Defined Peril shall mean: Fire, Lightning, Earthquake, Explosion, Falling Aircraft, Flood, Smoke, Vehicle Impact, Windstorm or Tempest. Such Damage or Consequential loss described in 1, 2, or 3 above is excluded regardless of any other cause that contributed concurrently or in any other sequence. All other terms, conditions and exclusions of this policy remain unchanged. Authorized Representative OR Countersignature (In states where applicable) PR9514(09/02) wicl'RED'S COPY ENDORSEMENT This endorsement, effective 12:01 AM 01/01/2004 Forms a part of policy no.: 0413367 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY WAR RISK AND TERRORIST EXCLUSION It is hereby understood and agreed, that notwithstanding any other war risk or terrorist exclusion that may be in the policy or any clause limiting or attempting to limit the application of any endorsements to the policy, this policy is amended as follows: _ -- The policy does not cover loss or damage to property caused by, resulting from, contributed to or aggravated by any of the following perils, whether such loss or damage is accidental or intentional, intended or unintended, direct or indirect, proximate or remote or in whole or in part caused by, contributed to or aggravated by any perils insured by the policy: (1) war, hostile or warlike action in time of peace or war, whether or not declared, including action in hindering, combating or defending against an actual, impending or expected attack: (a) by government or sovereign power (de jure or de facto) or by any authority maintaining or using military, naval or air forces; or (b) by military, naval or air forces; or (c) by an agent of any such government, power, authority or force. (2) any weapon of war employing atomic fission or radioactive force whether in time of peace or war, whether or not its discharge was accidental; (3) insurrection, rebellion, revolution, civil war, usurped power, or action taken by government authority in hindering, combating, or defending against such an occurrence, seizure or destruction; (4) any act of one or more persons, whether known or unknown and whether or not agents of a sovereign power, for Terrorist purposes; (5) hijacking or any unlawful seizure or wrongful exercise or control of any mode of transportation, including but not limited to aircraft, watercraft, truck(s), train(s) or automobile(s), including any attgmpted seizure of control, made by any person or persons, for Terrorist purposes. Such loss or damage is excluded regardless of any other cause, event or intervention that contributes concurrently or in any sequence to the loss or damage. Terrorist purpose means the use or threatened use of any unlawful means, including the use of force or violence against any person(s) or property (ies), for the actual or apparent purpose of intimidating, coercing, punishing or affecting society or some portion of society or government. All other terms, conditions and exclusions of the policy remain unchanged. Authorized Representative OR /o2-- Countersignature (In states where applicable) PR9513 (09/01) INSURED'S COPY Named Insured Endorsement It is agreed that the Participating Member Counties named hereunder are included as Named Insureds: 1. Alamosa 26. Lake 2. Archuleta 27. La Plata 3. Baca 28. Las Animas 4. Bent 29. Lincoln 5. Chaffee 30. Logan 6. Cheyenne 31. Mineral 7. Clear Creek 32. Montrose 8. Conejos 33. Morgan 9. Costilla 34. Otero 10. Crowley 35. Ouray 11. Custer 36. Park 12. Delta 37. Phillips 13. Dolores 38. Prowers 14. Eagle 39. Pueblo 15. Elbert 40. Rio Blanco 16. Fremont 41. Rio Grande 17. Garfield 42. Routt 18. Gilpin 43. Saguache 19. Grand 44. San Juan 20. Gunnison 45. Sedgwick 21. Hinsdale 46. Summit 22. Huerfano 47. Teller 23. Jackson 48. Washington 24. Kiowa 49. Weld 25. Kit Carson 50. Yuma Other Terms All other terms of the policy remain the same. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 1 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s%41\a•glcap0100svmicapp Ie.ington-a..ac 04-05 property policy loan dac Coverage Summary 1. This policy covers Blanket Real, Personal Property, Contractors Equipment, Fine Arts, Glass, Valuable Papers, Data Processing Equipment and Media, Extra Expense, Builders Risks and Installations, Transit, and Vehicle Damage. 2. Limit of Liability The insurer(s) shall not be liable hereunder in any one loss, casualty or disaster for more than $50,000,000. per occurrence. For sublimits refer to Insuring Agreement, page 1 of 10, paragraph III. 3. Each claim for loss or damage shall be adjusted separately and the Insurer's liability shall be limited to that amount excess of$150,000 except $5,000 per accident for Boiler & Machinery coverage. Insuring Agreement I. NAME OF INSURED It is agreed that the unqualified word "Insured" wherever used in this insurance includes not only the Named Insured but also - any official, trustee or employee of the Named Insured while acting within the scope of his duties as such, and any person, organization, trustee or estate to whom the ^' Named Insured is obligated by virtue of written contract or agreement to provide insurance such as is offered by this Insurance, but only in respect to operations by or on behalf of the Named Insured; II. TERRITORY This policy covers anywhere in the Continental United States of America and Canada. III. ULTIMATE NET LOSS In calculating the amount of Ultimate Net Loss, this insurance is deemed to have the following maximum sublimits: A. $1,000,000 In the aggregate annually as respects any Flood loss in Zone A. B. $10,000,000 In the aggregate annually as respects any Flood loss in Zone B, D and X500. C. $50,000,000 In the aggregate annually as respects any Flood loss in Zone C. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 2 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s.Id4ao ca0\3004 rmkapp leain0lnn-awac 04-05 pm0eny 00ury toll doc // D. $25,000,000 In the aggregate annually as respects any Earthquake loss. E. $1,000,000 Newly acquired property, per location, values in excess of$1,000,000 are to be reported to this Company in sixty (60) days. F. $5,000,000 Builders risks, renovations, repairs made by the Insured at any location (including new locations) within the territorial limits of the policy, any one occurrence. G. $ 500,000 At any unscheduled location, any one occurrence. H. $ 50,000 Personal property of others. I. $1,000,000 Ordinance deficiency J. $1,000,000 Extra expense IV. SERVICE ORGANIZATION This Insurance is issued to the Insured on the express condition that the Insured undertakes to utilize at all times the services of County Technical Services, Inc. Claims Management Department. This Service Organization shall perform the following duties: A. Discharge the Insured's obligation under the terms of this Agreement by administering a complete claims handling program. B. Maintain accurate records of all reported claims and details incident to loss and expense payments. C. Furnish monthly claims records on an approved form. The acceptance of these services shall be a condition precedent to any liability which may attach to the Underwriters in accordance with the terms and conditions of this Insurance. Property Insurance AGREEMENT A - BUILDING AND CONTENTS: Underwriters agree, subject to the limitations, terms and conditions of this Insurance, to indemnify the Insured for risks of physical loss or damage to All Real or Personal Property of every kind and description, wherever located, occurring during the period of this Insurance. AGREEMENT B - AUTOMOBILE: Underwriters agree, subject to the limitations, terms and conditions of this Insurance, to indemnify the Insured for loss or damage to Automobiles owned by the Insured or on which the Insured has an obligation to provide adequate insurance, wherever located, against Risks of Direct Physical Loss, including Collision of the Automobile with another object. Name of Insured: Colorado Counties Casualty&Property Pool Page 3 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s>ep0}p\capp\00cbm‘capp ienrgionawac 04.05 pmpe0Y policy lomi.00c /5 Definitions 1. PROPERTY OF THE INSURED: The term "Insured's Property" shall mean All Real and Personal Property, including leasehold improvements or betterments which the Insured owns, property which the Insured holds on consignments or agrees to insure by any contractual agreement normal to its operations. 2. AUTOMOBILE: The term "Automobile" shall mean any motor vehicle, trailer or semi- trailer, including its equipment and any other equipment permanently attached thereto. The word "Trailer" shall include semi-trailer. 3. ULTIMATE NET LOSS: The words "Ultimate Net Loss" in respect of this section shall be understood to mean the loss sustained by the Insured after making deductions for all recoveries and salvages. 4. VALUABLE PAPERS: The term Valuable Papers shall mean written, printed or otherwise inscribed documents and records, including books, maps, films, drawings, abstracts, deeds, mortgages and manuscripts, but does not mean money and securities, but includes additional costs to research or restore damaged documents, drawings or records. 5. ACCOUNTS RECEIVABLE: The term "Accounts Receivable" shall mean: a) All sums due the Insured from customers provided the Insured is unable to effect collection thereof as the result of covered loss or damage to records of accounts receivable; b) Interest charges on any loan to offset impaired collections pending repayment of such sums made uncollectible by such loss or damage: c) Collection expense in excess of normal collection caused and made necessary because of such loss or damage; d) Other expenses when reasonably incurred by the Insured in re-establishing records of accounts receivable following such loss and/or damage. The following special exclusions apply to Accounts Receivable Coverage; this policy does not insure against: 1) Loss due to bookkeeping, accounting or billing errors or omissions; 2) Loss, the proof 6f which as to factual existence, is dependent upon an audit of records or an inventory computation, but this shall not preclude the use of such procedures in support of claim for loss which the Insured can prove, through evidence wholly apart therefrom, is due solely to a risk of loss to records of accounts receivable not otherwise excluded hereunder; 3) Loss due to alteration, falsification, manipulation, concealment, destruction or disposal of records of accounts receivable committed to conceal the wrongful giving, taking, Name of Insured: Colorado Counties Casualty&Property Pool Page 4 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 /wn sKp\yytapp\2W4,m,capp 1e.nylon-awac 04-05 properly policy loon doc obtaining or withholding of money, securities or other property but only to the extent of such wrongful giving, taking, obtaining or withholding. 6. OCCURRENCE: "Occurrence" means all covered loss, damage, or a sequence of losses or damage, casualties or disasters, arising from a single event or catastrophe. So far as loss involving in whole or in part, the perils of wind, (including hurricanes, tornadoes, cyclones), snow, rain, or hail is concerned a single event shall mean one single atmospheric disturbance during a continuous period of seventy-two (72) hours (not limited by the date on which coverage under this policy ceases). Excluded Perils With regard to all property, this insurance does not insure against: 1. Loss by moth, vermin, termites or other insects; wear, tear or gradual deterioration; rust, wet or dry rot, or mold. 2. Loss or damage caused by: a) Radioactive or fissionable material. b) Contamination, other than by (a) above, unless directly resulting from Fire or Extended Coverage perils. 3. Loss resulting from loss of use, delay or loss of markets. 4. Breakdown of machinery and/or boiler explosion but not excluding loss resulting therefrom. This exclusion shall not apply as respects to EDP equipment and media. 5. Loss resulting from dampness of atmosphere or variation in temperature unless caused by the perils of Fire and Extended Coverage. This exclusion shall not be deemed to exclude loss resulting from freezing. 6. Loss of electrical appliances or devices of any kind, including wiring, arising from electrical injury or disturbance to the said electrical appliances or devices or wiring from artificial causes unless fire or explosion ensues, and then only for direct loss or damage caused by fire or explosion. 7. Loss by normal settling, normal shrinkage or normal expansion in foundations, walls, floors or ceilings. 8. Loss by mechanical derangement, inherent vice or latent defect. 9. Loss resulting from processing or faulty workmanship, unless fire and/or explosion ensues, and then only for direct loss or damage caused by such ensuing fire or explosion. 10. Loss resulting from shrinkage, evaporation, loss of weight or leakage, unless such loss is caused directly by fire or the combating thereof, lightning, windstorm, hail explosion, strike, riot or civil commotion, aircraft, vehicles, breakage of pipes or apparatus, sprinkler leakage, vandalism and malicious mischief, theft or attempted theft. Name of Insured: Colorado Counties Casualty&Property Pool Page 5 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s mNatcapo totew m c,pp innnglomawac 0605 ympedy policy 1ppn doe /7 11. Inventory shortage, mysterious disappearances or loss resulting from any kind of infidelity or dishonesty on the part of the Insured or any of his employees. 12. Pollution caused directly or indirectly by the release, discharge, dispersal, seepage, migration, or escape of pollutants or contaminants unless the release, discharge, dispersal, seepage, migration, or escape is caused by fire, lightning, explosion, windstorm, hail, leakage from fire protection equipment, smoke, vehicles and aircraft, riot, civil commotion, vandalism, sinkhole collapse, volcanic action, falling objects, weight of snow, ice or sleet, or water damage. However, this policy does not cover the costs arising out of the enforcement of any law, ordinance, regulation, or order by civil or judicial authority requiring the removal, disposal, replacement, cleanup, restoration or containment of insured property or for costs to monitor or test for the existence or effects of pollutants. This exclusion applies regardless of any other cause or event that contributes concurrently or in any sequence to the loss. Excluded Property Animals, aircraft, standing timber, growing crops, land, currency, money, notes, securities, bridges, culverts, roadways, streets, walks, or paved surfaces, dams, docks, piers and wharves. Conditions I . VALUATION. The Underwriters shall not be liable for loss or damage in excess of. A. (Real and Personal Property- other than automobile) - the cost to repair, rebuild or replace the destroyed or damaged property in a condition equal to but not superior to or more extensive than its condition when new. If the Insured decides to replace destroyed or damaged property on another site, cost of such site is not included hereunder. It is a requirement that if the Insured does not repair, replace or rebuild the property within two years from the date of loss, this property shall be valued at ACV. B. (Automobile) - the actual cash value of the automobile at the time of loss. 2. DEBRIS REMOVAL. This Insurance covers the expense of removal from the premises containing the property insured hereunder of debris remaining after any loss hereby insured against, except that there shall be no liability assumed for the expense of removal of any foundations. 3. REMOVAL CLAUSE. This Insurance covers the expense and damage occasioned by removal from the premises endangered by the perils insured against wherever such property is located or removed for preservation. Name of Insured: Colorado Counties Casualty&Property Pool Page 6 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s\cAa-Mcaoo 200 a,rm\capp iewratomawac C405 p'opedy pokey form doc /( 4. ARCHITECTS FEES. This Insurance covers the additional assessment involving architects' fees for consultations arising from losses resulting from an insured peril. Fees are limited to seven (7%) percent of replacement cost. 5. APPRAISAL. In the event the Insured and Underwriters are unable to agree as to the amount necessary to rebuild, repair or replace the damaged or destroyed property or the actual amount of reimbursement to be paid, each party shall name a competent and disinterested umpire. The appraisers together shall obtain reconstruction estimates, and calculated the amounts of reimbursement due, and failing to agree, shall submit their differences to the umpire. The award, in writing, duly verified by any two shall determine the point in question. Both parties shall pay the cost of their own appraisers and equally pro rate the cost of the umpire. 6. CIVIL AUTHORITY CLAUSE. Notwithstanding anything contained in this Insurance, property which is insured under this Insurance is also covered against the risk of damage or destruction by civil authority during a conflagration and for the purpose of retarding the same; provided that neither such conflagration nor such damage or destruction is caused or contributed to by war, invasion, revolution, rebellion, insurrection or other hostilities or warlike operations. 7. ORDINANCE DEFICIENCY CLAUSE. Notwithstanding anything contained herein to the contrary, the Underwriters shall be liable also for the loss occasioned by the enforcement of any state or municipal law, ordinance or code, which necessitates, in repairing or rebuilding, replacement of material to meet such requirements. If demolition is required to comply with such enforcement, Underwriters shall also be liable for such additional costs. 8. EXPENSE TO REDUCE OR PREVENT LOSS. This Insurance also covers such expenses as are necessarily incurred for the purpose of reducing or preventing any loss under this Insurance not exceeding, however, the amount by which the loss under this Insurance is thereby reduced. General Conditions 1. PREMIUM PROVISION See Declarations Page. 2. SALVAGE AND RECOVERY CLAUSE All salvages, recoveries and payments recovered or received subsequent to a loss settlement under this Insurance shall be applied as if recovered or received prior to the said settlement and all necessary adjustments shall be made by the parties hereto. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 7 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 S McN-gkapp\20O4vm,capp lexinglor-awac 04-O5 properly Wl!ry loin,doc /9 3. INSPECTIONS, AUDIT AND VERIFICATION OF VALUES The Underwriters or their duly authorized representatives shall be permitted at all reasonable times during continuance of this Insurance to inspect the premises used by the Insured and to examine the Insured's books or records so far as they relate to coverage afforded by this Insurance. 4. RECORDS It is hereby understood and agreed that the records and books as kept by the Insured shall be acceptable to Underwriters in determining the amount of loss or damage covered hereunder. 5. DUE DILIGENCE CLAUSE The Insured shall use due diligence and do and concur in doing all things reasonably practicable to avoid or diminish any loss of or damage to the property herein insured. 6. CURRENCY The premium and losses under this Insurance are payable in United States currency. Payment of premium shall be made to Marsh Inc. 7. BANKRUPTCY AND INSOLVENCY In the event of the bankruptcy or insolvency of the Insured or any entity comprising the Insured, the Underwriters shall not he relieved of the payment of any claims hereunder because of such bankruptcy or insolvency. 8. OTHER INSURANCE If the Insured has other Insurance against loss covered by this Insurance the Underwriters shall be liable, under the terms of this Insurance, only as excess of coverage provided by such other Insurance and no monies payable or collectable from such other insurance shall accrue in the aggregate loss fund of this Insurance. 9. MORTGAGE CLAUSE The interest of any mortgagor on property covered hereunder is included as if a separate endorsement were attached hereto to the extent of the amount of mortgage as of the date of loss subject to the limits of liability set forth in this Insurance. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 8 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 '^/ s:Kin>0Kdpp,20Mcm1capp iemnOWmawac 0605 p open policy Imm ooc 2 10. CLAIMS The Insured shall immediately notify Underwriters through County Technical Services, Inc. Claims Management Department by registered mail, of any occurrence, the cost of which is likely to result in payment by Underwriters under this Insurance. Underwriters shall have the opportunity to be associated with the Insured in defense of any claims, suits, or proceedings relative to an occurrence wherein the opinion of the Underwriters, their liability under this Insurance is likely to be involved, in which case the Insured and Underwriters shall cooperate to the mutual advantage of both. 11. NOTICE OF LOSS The insured shall as soon as practicable report to this Company or its agent every loss or damage which may become a claim under this Policy and shall also file with the Company or its agent within ninety (90) days from date of loss a detailed sworn proof of loss. Failure by the Insured to report the said loss or damage and to file such proof of loss as hereinbefore provided shall invalidate any claim under this Policy for such loss. 12. EXAMINATION UNDER OATH The Insured shall submit, and so far as in within his/her or their power shall cause all other persons interested in the property and members of the household and employees to submit, to examinations under oath by any persons named by the Company, relative to any and all matters in connection with a claim and subscribe the same and shall produce for examination all books of account, bills, invoices, and other vouchers or certified copies thereof if originals be lost, at such reasonable time and place as may be designated by the Company or its representatives, and shall permit extracts and copies thereof to be made. 13. SETTLEMENT OF LOSS All adjusted claims shall be paid or made good to the insured within sixty(60) days after presentation and acceptance of satisfactory proof of interest and loss at the office of this Company. No loss shall be paid hereunder if the insured has collected the same from others. 14. LOSS PAYMENTS VVhen it has been determined that Underwriters are liable under this Insurance, Underwriters shall thereafter promptly reimburse the Insured for all payment made in excess of the amounts stated in the Limits Agreement. All adjusted claims shall be paid or made good to the Insured within thirty days after their presentation to County Technical Services, Inc. Claims Management Department and acceptance by Underwriters of satisfactory proof of interest and loss. Name of Insured: Colorado Counties Casualty&Property Pool Page 9 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s\crea-0\capp\2004emlcapp leurgrpma+2c 0405 properly poky form.doe 15. NO BENEFIT TO BAILEE This insurance shall in no wise inure directly or indirectly to the benefit of any carrier or other bailee. 16. APPEAL In the event the Insured and Underwriters are unable to agree to the advisability of appealing a judgment, a disinterested attorney, mutually agreeable to the Underwriters and the Insured, shall be retained and directed to render a written opinion as to his recommendation concerning such appeal. Such written recommendation shall be binding on both the Insured and Underwriters. Fees of such retained attorney shall be borne equally by both parties for the services of rendering his recommendation only. The Insured's portion of such fee shall not accrue in the aggregate loss fund. 17. LITIGATION PROCEEDINGS No suit to recover on account of loss under this Insurance shall be brought until ninety days after the proof of loss shall have been furnished, nor at all unless commenced within twenty- seven months from the date upon which loss occurred, if such loss is within the knowledge of the Insured; if not, the twenty-seven months shall begin upon notice to the Insured to such loss or claim. 18. SUBROGATION The Underwriters shall be subrogated to all rights which the Insured may have against any person or other entity in respect to any claim or payment made under this Insurance, and the Insured shall execute all papers required by the Underwriters and shall cooperate with the Underwriters to secure Underwriter's rights. In case any reimbursement obtained or recovery made by the Insured or the Underwriters on account of any loss covered by this Insurance, the net amount of such reimbursement or recovery, after deducting the actual cost of obtaining or making the same, shall be first applied in the following order a) Amount of loss which exceeds the applicable limit of liability. b) To reduce the Underwriters' loss until the Underwriters are fully reimbursed. c) To reduce the Insured's loss because of the application of the aggregate loss fund. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 10 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s.sliss- Capp 2®4 n,capp lex'ngtOn-awac 04.05 property gik),Coma doc 19. WAIVER OF SUBROGATION This Insurance shall not be invalidated if the Insured by written agreement has waived or shall waive its right of recovery from any party for loss or damage covered hereunder; provided, that any such waiver is made prior to the occurrence of said loss or damage. 20. CONFLICTING STATUTES In the event that any provision of this Insurance is unenforceable by the Insured under the laws of any state or other jurisdiction wherein it is claimed that the Insured is liable for any injury covered hereby because of non-compliance with any statute thereof, then this policy shall be enforceable for the Insured with the same effect as if it complied with such statutes. 21. ASSIGNMENT Assignment of interest under this Insurance shall not bind the Underwriters until the Underwriters' consent is endorsed hereon. 22. PAIR, SET OR PARTS It is understood and agreed that, in the event of loss of or damage to any article or articles which are a part of a set, the measure of loss of or damage to such article or articles shall be a reasonable and fair proportion of the total value of the set, giving consideration to the importance of said article or articles; but in no event shall such loss or damage be construed to mean total loss of set. In case of loss or injury to any part of the insured property consisting, when complete for sale or use, of several parts, this Company shall only be liable for the insured value of the part lost or damaged. 23. SUE AND LABOR; In case of loss or damage, it shall be lawful and necessary for the Insured, his/her or their factors, servants and assigns, to sue, labor, and travel for, in and about the defense, safeguard and recovery of the property insured hereunder, or any part thereof without prejudice to this insurance; nor shall the acts of the Insured or this Company, in recovering, saving and preserving the property insured in case of loss or damage, be considered a waiver or an acceptance of abandonment; to the charge whereof this Company will contribute according to the rate and quantity of the sum herein insured. 24. SUIT No suit, action or proceeding for the recovery of any claim under this Policy shall be sustainable in any court of law or equity unless the same be commenced within twelve (12) Name of Insured: Colorado Counties Casualty&Property Pool Page 11 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 'tl a-\capp\d04'm,¢app ie,,nplon.awac 0605 property poncy Form doe ( months next after discovery by the Insured of the occurrence which gives rise to the claim. Provided, however, that if by the laws of the State within which this Policy is issued such limitation is invalid, then any such claims shall be void unless such action, suit or proceeding be commenced within the shortest limit of time permitted by the laws of such State to be fixed herein. 25. APPRAISAL If the insured and the Company fail to agree as to the amount of loss, each shall, on the written demand of either, made within sixty days after receipt of proof of loss by the Company, select a competent and disinterested appraiser, and the appraisal shall be made at a reasonable time and place. The appraisers shall first select a competent and disinterested umpire, and failing for fifteen days to agree upon such umpire, then, on the request of the Insured or the Company, such umpire shall be selected by a judge of a court of record in the state in which such appraisal is pending. The appraisers shall then appraise the loss, stating separately the actual cash value at the time o�'ross and the amount of loss, and failing to agree shall submit their differences to the umpire. An award in writing of any two shall determine the amount of toss. The Insured and the Company shall each pay his/her or its chosen appraiser and shall bear equally the other expenses of the appraisal and umpire. The Company shall not be held to have waived any of its rights by any act relating to appraisal. 26. CANCELLATION This Policy may be canceled by the Insured by mailing to the Company written notice stating when thereafter such cancellation shall be effective. This Policy may be canceled by the Company by mailing to the Insured at the address shown in this Policy or last known address written notice stating when no fewer than (90) ninety days thereafter such cancellation shall be effective. The mailing of notice as aforesaid shall be sufficient proof of notice, and the effective date of cancellation stated in the notice shall become the end of the policy period. Delivery of such written notice either by the Insured or by the Company shall be equivalent to mailing. If this Insurance shall be cancelled by the Insured, the Underwriters shall retain the customary short rate proportion of the premium hereon, except that if this Insurance is on an adjustable basis the Underwriters shall receive the earned premium hereon or the customary short rate proportion of any minimum premium stipulated herein whichever is the greater. If this Insurance shall be cancelled by or on behalf of the Underwriters, the Underwriters shall retain the pro rata proportion of the premium hereon; except that if this insurance is on an adjustable basis, the Underwriters shall receive the earned premium hereon or the pro rata proportion of any minimum premium stipulated herein whichever is the greater. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 12 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 sr clhsyVcppScoArrMcapp iexi,proma ac 04-05 p,peny ocLn formaoc a, Payment or tender of any unearned premium by the Underwriters shall not be a condition precedent to the effectiveness of Cancellation by such payment shall be made as soon as practicable. If the period of limitation relating to the giving of notice is prohibited or made void by any law controlling the construction thereof, such period shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law. Subject otherwise to all terms, clauses and conditions as heretofore. 27. CHANGES By acceptance of this Insurance, the Insured agrees that it embodies all agreements existing between the Insured and Underwriters or any of its agents relating to this Insurance. None of the provisions, conditions or other terms of this Insurance shall be waived or altered except by endorsement; nor shall notice to any agent or knowledge possessed by any agent or by any other person be held to effect a waiver or change in any part of this Insurance. 28. FRAUDULENT CLAIMS If the Insured shall make any claim knowing the same to be false or fraudulent, as regards amount or otherwise, this Insurance shall become void and all claim hereunder shall be forfeited. 29. MISREPRESENTATION OR FRAUD This Policy shall be void if the Insured has concealed or misrepresented any material fact or circumstances concerning this insurance or the subject thereof of in case of any fraud, attempted fraud or false swearing by the Insured touching any matter relating to this insurance or subject thereof, before or after a loss. Earth Movement Coverage Earth Movement means: • any earth movement, other than sinkhole collapse, such as earthquake, landslide, mine subsidence or earth sinking, rising or shifting including that caused by subsidence, settling, contraction, or expansion of soils. • eruption, explosion, or effusion of a volcano other than volcanic action. If more than one earth movement or volcanic eruption occurs within any 72 hour period, we'll consider this one occurrence. The 72 hour period will not be shortened by the expiration of the policy. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 13 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s 1tloaQ\capp\200abm0capp iextnglomawac 04-05 property moi¢y loon doc The limit shown in the coverage summary for earthquake is the most this company will pay for all direct loss or damage caused by a single earthquake. Flood Coverage Flood, mudslide or mudflow, and surface water are covered perils. Flood means waves, tides or tidal water, the rising of bodies of water and streams, or the overflowing or breaking of their boundaries, whether driven by wind or not. Surface water means water which accumulates or flows on the surface of the ground, and is created by natural causes such as rain, melted snow, or rising springs, but which follows no defined watercourse and does not gather into or from a natural body of water. This company is not liable for more than the limits shown in the coverage summary. Transit Extension Insuring Clause This insurance is hereby extended to cover Personal property of the Insured or property held by the Insured in trust or on commission or on consignment for which the Insured may be held legally liable while in due course of transit within the limits of the Continental United States of America (excluding Hawaii) and Canada, against All Risks of Direct Physical Loss or Damage to the property insured occurring during the period of this policy (including general average and salvage charges on shipments covered while waterborne). Perils Excluded This extension does not insure against: 1. Loss or damage to personal property resulting from: shrinkage, evaporation, loss of weight, leakage of glass or other fragile articles, marring, scratching, exposure to light, or change in color, texture or flavor, unless such loss is caused directly by fire or the combating thereof, lightning, windstorm, hail, explosion, strike, riot or civil commotion, aircraft, vehicles, breakage of pipes or apparatus, sprinkler leakage, vandalism and malicious mischief, theft or attempted theft. 2. Loss of use, delay or loss of markets. 3. Loss or damage caused by or resulting from moth, vermin, termites, or other insects, inherent vice, latent defect, wear, tear or gradual deterioration; contamination; rust, wet or dry rot, mold, dampness of atmosphere, smog or extremes of temperature. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 14 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 S d.\s9SnppO0O4 nnkcapp iecinplonawac 04 05 ympeny wl,cy runn dac 4. Loss or damage caused by or resulting from misappropriation, conversion, infidelity or any dishonest act on the part of the Insured or other party of interest, his or their employees or agents to others to whom the property may be delivered or entrusted (carriers for hire excepted). 5. Loss or damage to the property insured occasioned by war, invasion, hostilities, acts of foreign enemies, civil war, rebellion, insurrection, military or usurped power or martial law or confiscation by order of any government or public authority. 6. Loss or damage arising directly or indirectly from nuclear reaction, nuclear radiation or radioactive contamination however such nuclear reaction, nuclear radiation or radioactive contamination may have been caused. Nevertheless, if a fire arises directly or indirectly from nuclear reaction, nuclear radiation or radioactive contamination, any loss or damage arising directly from that fire shall (subject to the provisions of this Policy) be covered excluding, however, all loss or damage caused by nuclear reaction, nuclear radiation or radioactive— contamination arising directly or indirectly from that fire. 7. Loss or damage caused by breakdown or derangement of refrigerating units. Property Excluded This Extension does not cover: I. a. Aircraft, watercraft, vehicles designed for highway use, animals,jewelry, precious stones �-. and furs or garments trimmed with fur. b. Currency, money, notes, securities, deeds, and evidences of debt 2. Property in due course of ocean marine transit. 3. Shipments by mail after delivery into the custody of the Post Office Department. 4. Samples while in the care, custody or control of salesmen. Conditions 1. The Insured may accept without prejudice to this insurance the ordinary bills of lading or receipts issued by carriers including those containing released and/or partially released value provisions, but the Insured shall not enter into any special agreement with carriers releasing them from their common law or statutory liability. 2. Property insured hereunder shall be valued as follows: a. Sold property at the actual net invoice price of the Insured. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 15 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s'c$\a-\capp2OOYmWpp ieaitgioe-are 0.05 properly policy form doc 27 b. Unsold property at the actual cash value of the property at the time any loss or damage occurs with property deduction for depreciation and in no event to exceed what it would cost to repair or replace the property with material of like kind and quality. ^, Extra Expense Coverage 40/80/100% Of Limit: It is agreed that if the property covered under Insuring Agreement A is damaged or destroyed by perils insured against during the period of this Insurance so as to necessitate the incurrence of Extra Expense (as defined below) the Underwriters shall be liable for the Extra Expense so incurred, not exceeding the actual loss sustained, for not exceeding such length of time, hereinafter referred to as the "period of restoration". It is further agreed that this extension of coverage shall not operate to increase the Underwriters limits of liability hereunder. Underwriters shall be liable for no greater percentage of the amount of this Policy than is stated below for the determined period of restoration. • 40% if period of restoration is not in excess of one month; ▪ 80% if period of restoration exceeds one month but does not exceed two months; • 100% if period of restoration exceeds two months. Definitions: A. Extra Expense: The term "Extra Expense" means the excess (if any) of the total cost incurred during the period of restoration chargeable to the operation of the Insured's business, over and above the total cost that would normally have been incurred to conduct the business during the same period had no damage or destruction occurred. B. Normal: The term "Normal" wherever used herein shall mean; the condition that would have existed had no loss occurred. C. Month: The word "month" wherever used herein means 30 consecutive days. D. Period of Restoration: The term "period of restoration" means such length of time commencing with the date of damage and not limited by the date of expiration of this policy, as would be required with the exercise of due diligence and dispatch to repair, rebuild or replace such part of the Insured's property as has been damaged or destroyed. 1 Conditions: A. Resumption of Operations: It is a condition of this Insurance that as soon as practicable, the Insured shall resume normal operations of the business and shall dispense with such extra expense. B. Interruption by Civil Authority: Liability hereunder is extended to include actual loss as covered hereunder, sustained during the period of time, not exceeding two weeks, when as a Name of Insured: Colorado Counties Casualty 8 Property Pool Page 16 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 sKIn>gkapp\20M4 .,g WntyOm,mtcaoo ieaton-awac 04-OS property Iwo V direct result of a peril insured against, access to the premises in which the property described is located is prohibited by order of civil authority. Exclusions: In addition to the General Exclusions of this Insurance, Underwriters shall not be liable for Extra Expense resulting from: A. The suspension, lapse or cancellation of any lease, license, contract or order beyond the period of restoration; B. Interference at premises by strikers or other persons with rebuilding, repairing or replacing the property damaged or destroyed or with the resumption or continuation of business; C. Enforcement of any local or state ordinance or law regulating construction, repair or demolition of buildings or structures; Further, Underwriters shall not be liable for: A. More than the amount set forth in the limits of liability for each premises; B. Loss of income; C. The cost of repairing or replacing any of the real or personal property covered hereunder, or the cost of research or other expense necessary to replace or restore damage or destroyed books of account, abstracts, drawings, card index systems or other records (including film, tape, disc, drum, cell or other magnetic recording or storage media for electronic data processing), that have been damaged or destroyed by the perils insured against, except cost in excess of the normal cost of such repair, replacement or restoration necessarily incurred for the purpose of reducing loss under this policy. In no event shall such excess cost exceed the amount by which the total extra expense loss otherwise payable under this policy is thereby reduced; D. Loss resulting from theft of any property which at the time of loss is not an integral part of a building or structure (except direct loss by pillage and looting occurring during and at the immediate place of a riot or civil commotion), unless loss by a peril not excluded in this policy ensues from theft or attempted theft, and then the Underwriters shall be liable for only such ensuing loss; E. Any other consequential or remote loss. Pollution Cleanup and Removal Notwithstanding any conditions or terms contained elsewhere in this policy, coverage is extended for a limit of$25,000 any one occurrence to cover the cost to clean up and remove pollutants that are: 1. In the land or water at an insured location provided the discharge, seepage, migration, release, escape or dispersal is due to fire, lightning, explosion, windstorm, hail, leakage from fire protection equipment, smoke, vehicles and aircraft, riot, civil commotion, vandalism, Name of Insured: Colorado Counties Casualty 8 Property Pool Page 17 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 S cli\a 9\capp\2004Vm\capp ie+tngtouawac 04-05 property policy form 00C c29 sinkhole collapse, volcanic action, falling objects, weight of snow, ice or sleet, or water damage. For example: a fire at an insured location causes chemicals to run onto the ground and into a nearby river. This policy will pay to clean up the pollution that is in the land and water at the insured premises up to the limit of liability of this extension. This policy will not pay to clean up land or water away from an insured premises; 2. In the land or water away from an insured premises but only when pollution or contamination is caused by the collision, upset or overturn of a transporting vehicle which is owned, operated, rented, leased or borrowed by the Insured. Coverage is provided under this extension only if the following conditions are met: A. the cause of loss occurs during the policy period; --- B. the pollution must occur at an insured location except as provided for in clause 2. above. C. the clean-up and removal costs must be incurred and reported to the company within one hundred eighty(180) days of either the date of direct physical loss or damage or the end of the policy period, whichever is earlier. Liability for loss under this extension shall not exceed $25,000 in any one occurrence or $25,000 in the aggregate for all such losses in any one policy year. However, these limits will apply separately to each county member listed as a Named Insured. Equipment Breakdown Coverage Limits: Equipment Breakdown: Included in $50,000,000 Limit Extra Expense: $ 1,000,000 Expediting Expenses: $ 100,000 Hazardous Substances: $ 100,000 Spoilage: $ 100,000 Water Damage: $ 100,000 Ammonia Contamination: $ 100,000 Pollution Cleanup: $ 100,000 Deductibles: Extra Expense: $ 5,000 Spoilage: $ 5,000 All Other Loss or Damage: $ 5,000 Name of Insured: Colorado Counties Casualty& Property Pool Page 18 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s.kabd�ppV004Vmlcapy ie.ingion awac 0405 p,oyedy paasy loin doc 3O Coverage: r- It is agreed that if the property insured by Insuring Agreement A of Section I is damaged or destroyed by an "Accident" to "covered equipment" during the period of this Insurance, the Underwriters shall be liable for said damage. Definitions: A. Accident: The term "accident means direct physical loss or damage that results from mechanical breakdown, including rupture or bursting caused by centrifugal force; artificially generated electrical current, including electrical arcing, that disturbs electrical devices, appliances or wires; loss or damage to steam boilers, steam pipes, steam engines or steam turbines caused by or resulting from any condition or event inside such equipment; or loss or damage to hot water boilers or other water heating equipment caused by or resulting from any condition or event inside such boilers or equipment. B. Covered Equipment: The term "covered equipment" means property insured which is built to operate under vacuum or pressure other than weight of contents; or generates, transmits or utilizes energy. None of the following is "covered equipment": — A structure, foundation, cabinet, compartment or air supported structure or building; — Insulating or refractory material; — Vehicles, including self-propelled vehicles; — Excavation or construction equipment; i — Sewer piping, underground vessels or piping, any piping forming a part of a sprinkler system; — Water piping other than boiler feedwater piping, boiler condensate return piping or water piping forming a part of a refrigerating or air conditioning system; — Equipment manufactured by you for sale; or — Equipment primarily used to generate electric power, however this does not apply to emergency generators. C. Perishable Goods: The term "perishable goods" means business personal property maintained under controlled conditions for its preservation which is susceptible to loss or damage if controlled conditions change. Additional Coverages: The following additional coverages also apply to loss caused by or resulting from an "accident" to "covered equipment". The limit for each additional coverage is shown in the Equipment Breakdown Schedule. The limits for these additional coverages are not in addition to the limits of coverage for building or business personal property shown in III Ultimate Net Loss. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 19 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s lcabykapps2000nn\capo leo,nomnawac 04-05 pmcenv policy Corm dos /J C / In addition, the coverages and limits for newly acquired property, builders risks, and unscheduled locations in the policy to which this endorsement is attached also apply to coverage provided by this endorsement. Coverage provided for extra expense in the policy to which this endorsement is attached also applies to coverage provided by this endorsement. The extra expense limit is shown in the Equipment Breakdown Schedule. A. Expediting Expenses: If property insured is damaged or destroyed by an "accident", the Underwriters shall be liable for reasonable extra cost to make temporary repairs and expedite permanent repairs or replacement. B. Hazardous Substances: The Underwriters shall be liable for additional expenses incurred for cleanup; repair or replacement; or disposal of property insured which is damaged, contaminated or polluted by any substance other than ammonia that has been declared to be hazardous to health by a governmental agency. The Underwriters shall not be liable for more than the limit for Hazardous Substances shown in the Equipment Breakdown Schedule. C. Spoilage: The Underwriters shall be liable for loss of"perishable goods" due to Spoilage, and shall also be liable for any necessary expenses incurred to reduce the amount of loss under this coverage to the extent that they do not exceed the amount of loss that otherwise would have been payable under this coverage. If the Insured is unable to replace the "perishable goods" before its anticipated sale, the amount of payment will be determined on the basis of the sales price of the "perishable goods" at the time of the "accident," less discounts and expenses that otherwise would have been incurred. Otherwise payment will be determined in accordance with the Valuation condition. The Underwriters shall not be liable for more than the limit for Spoilage shown in the Equipment Breakdown Schedule. D. Water Damage: If property insured is damaged by water as a result of an "accident" to covered refrigerating or air conditioning vessels and piping, the most the Underwriters shall not be liable for more than the amount shown in the Equipment Breakdown Schedule for this kind of damage, including salvage expense. E. Ammonia Contamination: If property insured is contaminated by ammonia as a result of an "accident" to "covered equipment" the Underwriters shall not be liable for more than the amount shown in the Equipment Breakdown Schedule for this kind of damage, including salvage expense. Exclusions: A. Electronic Recordings: The Underwriters shall not be liable for loss to electronic recordings caused by electrical or magnetic injury, disturbance or erasing. B. Media: The Underwriters shall not be liable for loss resulting from any defect, virus, loss of data, or other situation within electronic media and records. But if loss or damage from an "accident" results, there shall be liability for that resulting loss. Name of Insured: Colorado Counties Casualty& Property Pool Page 20 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 S\C"-nap0\200n,mncapp 15,ngIpn.a,ac 04-05 ymyeny pol,cY fom,doc Suspension: When any "covered equipment" is found to be in, or exposed to, a dangerous condition, any representative of the Underwriters may immediately suspend the insurance against loss from an "accident" to that "covered equipment". This can be done by mailing or delivering a written notice of suspension to the address as shown in the policy, or the address where the equipment is located. Once suspended in this way, the insurance can be reinstated only by written notice from the Underwriters. If so suspended, the Insured shall receive pro-rata refund of premium. But the suspension will be effective even if a refund has not yet made or offered. Builders Risk Equipment Breakdown Coverage Limit: $ 5,000,000 —Builders Risk Equipment Breakdown Equipment Breakdown: 1. We'll pay for loss caused by or resulting from an "Accident' to "covered equipment." As used in this endorsement, an "Accident" means direct physical loss as follows: A. Loss to covered property caused or made worse by mechanical breakdown; B. Loss to electrical equipment, including wiring, caused by electricity other than lightning; or C. Explosion, rupture or bursting of steam boilers, steam pipes, steam turbines or steam engines. If an initial "Accident" causes other "Accidents" all will be considered one "Accident." All "Accidents" that are the result of the same event will be considered one "Accident." "Covered equipment" means covered property built to operate under vacuum or pressure, other than weight of contents, or used for the generation, transmission or utilization of energy. 2. The following additional coverages also apply to loss caused by or resulting from an "Accident" to "covered equipment": A. Expediting Expenses With respect to your damaged covered property, we'll pay, up to $25,000, the reasonable extra cost to: 1. Make temporary repairs; and 2. Expedite permanent repairs or replacement. ' Name of Insured: Colorado Counties Casualty&Property Pool Page 21 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s KInag\capQRCW\rmIcapp leingmnawac 04.05 pmpenr W pq Farm,doc '?J B. Pollution cleanup and removal We will pay up to $25,000, unless otherwise shown on the coverage summary, for additional expenses your incur for: 1. Cleanup; 2. repairs or replacement; or 3. disposal of covered property which is damaged, contaminated or polluted as a result of an accident by pollutants as defined in the Property Protection. This limitation also applies to damage, contamination or pollution caused by ammonia that is used as a refrigerant. C. CFC Refrigerants We will pay for the additional cost to repair or replace covered property because of the use or presence of a refrigerant containing CFC (chlorinated fluorocarbon) substances. This means the additional expense to do the least expensive of the following: 1. Repair the damaged property and replace any lost CFC refrigerant; 2. Repair the damaged property, retrofit the system to accept a non-CFC refrigerant and charge the system with one using a non-CFC refrigerant. 3. Replace the system with one using a non-CFC refrigerant. Additional costs mean those beyond what would have been required had no CFC refrigerant been involved. D. Soft Costs, Rents and Loss of Income We will pay for your soft costs, loss of rental income and loss of business income. This coverage applies only if the Delayed Completion Coverage Endorsement or the Delayed Completion — Loss of Income Coverage Endorsement is part of this policy. All terms and conditions of those endorsements apply to this additional coverage. Exclusions — Losses We Won't Cover: 1. All exclusions and limitations apply except Electrical equipment and Mechanical breakdown. 2. We won't pay under this endorsement for loss or damage caused by or resulting from: A. The breakdown of any structure, foundation, cabinet, compartment or air supported 1 structure or building; B. The breakdown of any insulating or refractory material; C. The breakdown of any sewer piping, any underground vessels or piping, any piping forming a part of a sprinkler system or water piping other than boiler feedwater piping, boiler condensate return piping or water piping forming a part of a refrigerating or air conditioning system; D. The explosion of gases or fuel within the furnace of any fired vessel or within the flues or passages through which the cases of combustion pass; Name of Insured: Colorado Counties Casualty 8 Property Pool Page 22 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 S KNzmcaopa004vm,capp:Niaplonawac 04.05 pmceny Whcy dam aoc 3/ E. An "Accident" to any equipment not located at the location shown in the Coverage Summary; or F. Loss caused by delay, loss of market, loss of use, or any indirect loss. This exclusion doesn't apply to coverage provided under the additional coverage for Soft Costs, Rents and Loss of Income. Name of Insured: Colorado Counties Casualty 8 Property Pool Page 23 of 23 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s rclea-grcapp\20ocrrmMipp lexiy,onawwac 04-05 properly policy form eoc ENDORSEMENT # ENDT 1 This endorsement, effective 12:01 AM 01/01/2004 Forms a part of policy no.: 0413367 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY It is hereby understood and agreed that the following changes are made to the policy forms. 1 . Earth Movement Endorsement is amend to replace 168 hours with 72 hours. 2. Extension of Coverage Endorsement- Pollution Cleanup and Removal ; Add to the last paragraph of the Endorsement: "However, these limits will apply Separately to each County Member listed in the Named Insured Endorsement." 3. Equipment Breakdown Schedule: amend to add a sublimit Of $100,000 for Pollution Cleanup. All other terms and conditions remain the unchanged. l.{ Authorized Representative OR LEXDOC021 Countersignature (In states where applicable) LX0404 3(/� T' INC(IRFf 'S C.CWY ENDORSEMENT # ENDT 2 This endorsement, effective 12:01 AM 01/01/2004 Forms a part of policy no.: 0413367 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY It is understood and agreed that form PR 9014 is amended to Delete clause 28. All other terms and conditions remain unchanged.C-771 .t--X 1414—'14-4-01"--21 Authorized Representative OR LEXDOC021 Countersignature (In states where applicable) LX0404ci 2' INSURED'S COPY ENDORSEMENT # 4 This endorsement, effective 12:01 AM 10/01/2004 Forms a part of policy no.: 0413367 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY In consideration of the Return Premium shown below, it is agreed that the following changes are added as respects to Endorsement #3. The effective date of adding the following ____ _is—amended to 11/01/2004 in lieu of 10/01/2004 101 E . Lowel Avenue Eads, CO 81036 �n N1 �w a (,o Building Value : $ 1 , 700,000 / Additional Premium charged of $238.00 is amended to $ 158.00 Return Premium . $80.00 All other terms and conditions remain unchanged . 1 R 0 NOV -" 2004 MA?Sli csA (N ` Authorized R presentative OR LEXDOC021 Countersignature (In states where applicable) LX0404 3� ENDORSEMENT # 3 This endorsement, effective 12:01 AM 10/12/2004 Forms a pan of policy no.: 0413367 Issued to: COLORADO COUNTIES CASUALTY AND PROPERTY POOL By: LEXINGTON INSURANCE COMPANY In consideration of the additional premium charged shown below, it is agreed that the following locations are added to the Schedule of Locations of this policy: Effective 03/03/2004 - 1180 County Road 16 Park Fairplay, CO 80440 Building Value: $ 1 ,900,000 Effective 06/24/2004 501 N. Park Breckenridge, CO 80424 SwM /pl Building Value: $1 ,700,000 Effective 07/01/2204 1365 S. Camino Del Rio P ( t1' Durango, CO 81303 (( ((jt Building Value: $4,667,000 �fll/p%` , Effective 10/0004 w I (,e a t„1 2 101 E . Lowel Avenue Eads, CO 81036 14; D Building Value: $1 , 700,000 Effective 10/12/2004 519 W. Rio Grande Gunnisnon, CO 81230 h) Wert/VI 50f't. Building Value: $3,200,000 ` Additional Premium 3,396.00 $ RSF�,. 1e�ED4 20D4 It is also agreed that this endorsement does not change MA.R5.1 !i.,iH�, the limits of liability provided by this policy. ES.V E F1 All other terms, sublimits and conditions remain unchanged. LEXDOC011 Authorized Repres?mative OR LX0404 Countersignature (In states where applicable) ENDORSEMENT # 5 This endorsement, effective 12:01 AM 01/01/2004 —� Forms a part of policy no.: 0413367 Issued to: COLORADO COUNTIES CASUALTY & PROPERTY POOL By: LEXINGTON INSURANCE COMPANY It is hereby understood and agreed that the following changes are made to the policy: Form LX9512 — Mold / Fungus Exclusion — is amended to add the following: However, the Company agrees that the first $25,000 per occurrence of any loss or damage caused by, arising out of, contributed to, or resulting from fungus, mold(s), mildew or yeast; or any spores or toxins created by or emanating from such fungus, mold(s), mildew or yeast, shall be considered to apply against the policy deductible. All other terms and conditions remain unchanged. 1 Name of Insured: Colorado Counties Casualty 8 Property Pool Page 1 of 1 Policy No.: 041 3367 Policy Term: January 1,2004 to January 1,2005 s'c\a.p\capm20MNnYapp laxingldn gopeM ender 5 dOc POLICYHOLDER DISCLOSURE STATEMENT UNDER TERRORISM RISK INSURANCE ACT OF 2002 You are hereby notified that under the federal Terrorism Risk Insurance Act of 2002 (the "Act" ) effective November 26 , 2002 , you now have a right to purchase insurance coverage for losses arising out of an Act of Terrorism, whi h is defined in the Act as an act certified by the Secretary of the Treasury (i ) to be an act of terrorism, (ii ) to be a violent act or an act that is dangerous to (A) human life; (B) property or (C) infrastructure, (iii ) to have resulted in damage within the United States, or outside of the United States in case of an air carrier or vessel or the premises of a U. S . mission and (iv) to have been 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 . You should read the Act for a complete description of its coverage. The Secretary' s decision to certify or not to certify an event as an Act of Terrorism and thus covered by this law is final and not subject to review. There is a $100 billion dollar annual cap on all losses resulting from Acts of Terrorism above which no coverage will be provided under this policy and under the Act unless Congress rakes some other determination. For your information, coverage provided by this policy for losses caused by an Act of Terrorism may be partially reimbursed by the United States under a formula established by the Act . Under this formula the United States pays 90% of terrorism losses covered by this law exceeding a statutorily established deductible that must be met by the insurer, and which deductible is based on a percentage of the insurer' s direct earned premiums for the year preceeding the Act of Terrorism. - Unless you sign this form and return it to us rejecting Terrorism Coverage under the Federal Act, you will be covered for Terrorism as defined in the Act and your premium for that coverage is $35 , 000 . 00 . INSURED: Colorado Counties Casualty and Property Pool h� eject coverage in accordance with the Act . � igna e of insured 1/2-6-4/ ZaA<Crz' exe-curnc D/e oa c Print Name/Title /—/ 7" '12.5 _ Date INFORCEANITH EXCLUSION 9/
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