The URL can be used to link to this page

Browse Search

Home My WebLink About000281.tiff a Serving Colorado's Counties Colorado Counties Casualty & Property Pool Excess Liability Insuring Agreement & Summary Available on-line at www.ctsi.orq in to: Members only y CAPP Insuring Agreements aooag/ CT I Colorado Counties Casualty and Property Pool 2012 Excess Liability Policy One Beacon Policy No. 791-00-03-55-0001 Summaries are brief outlines of the coverages afforded under the insurance policies. Since summaries are for informational purposes only,they should not be construed to constitute the entire insurance contracts. As the policies may contain additional coverages and restrictions, the exact wording should be consulted. Brief Summary of Liability Deductibles This information is provided to present counties with a simple overview of county deductibles in the pool. It does not provide information on limits. The pool insuring agreements contain actual coverages and limits. The county has $0 deductible for liability claims' The pool pays the first$250,000 of each claim CAPP's excess insurance carrier pays the next$10 million per claim `Generally, there is no deductible on liability claims. The board and membership have adopted deductibles for certain types of claims. Information on these claims is contained in the CAPP Operations Manual. Liability claims subject to a county deductible: Claim type County Deductible Employment Termination $10,000 Inverse Condemnation $125,000 Regulatory Taking Herbicide and Pesticide $2,500 Operations Lawyer's Professional $500 Liability • Colorado Counties Casualty and Property Pool c/o CTSI 800 Grant Street, Ste 400 Denver, CO 80204 2012 Current Schedule of Insurance Policy Period: January 1, 2012 to January 1, 2014 Date Prepared: April 18, 2012 Prepared by: Arthur J. Gallagher Risk Management Services, Inc. 6399 South Fiddlers Green Circle,Suite 200 Greenwood Village,CO 80111 800.333.3231 303.773.9776(Fax) www.ajgrms.com IMPORTANT: This summary is an outline of the coverages by the insurers. It does not include all the terms,coverages,exclusions, limitations,and conditions of the actual contract language. The policies themselves must be read for those details. d Property Pool e Named Insured Schedule (as of 1/1/2012) Colorado Counties Casualty and Property Pool including the following members: Alamosa Gilpin Otero Archuleta Grand Ouray Baca Gunnison Park Bent Hinsdale Phillips Chaffee Huerfano Prowers Cheyenne Jackson Pueblo Clear Creek Kiowa Rio Blanco Conejos Kit Carson Rio Grande Castilla Lake Routt Crowley La Plata Saguache Custer Las Animas San Juan Delta Lincoln San Miguel Dolores Logan Sedgwick Eagle Mineral Summit Elbert Moffat Teller Fremont Montrose Washington Garfield Morgan Weld Yuma Page 1 1 and Property Pool Excess Liability - Atlantic Specialty (Claims Made Form) Carrier: Atlantic Specialty Insurance Company(OneBeacon) Policy Number: 791-00-03-55-0001 Policy Period: January 1, 2012 to January 1, 2013 Limits: Amounts Coverages $ 10,000,000 Auto Liability, Each Occurrence $ 10,000 Auto Medical Payments. Each Person $ 10,000,000 Personal Injury, Property Damage(Includes Law Enforcement and EMTs) $ 10,000 Premises Medial Payments, Each Person $ 1,000,000 Sewer Backup $ 10,000,000 Public Officials Errors and Omissions $ 10,000,000 Employee Benefit Liability Aggregate Limits of Coverage(Apply Separately to CAPP and for each Participating Member County(PMC)): Amounts Coverages $ 10,000,000 In any One Policy Year, Personal Injury, Property Damage $ 10,000,000 In any One Policy Year, Products/Completed Operations $ 10,000,000 In any One Policy Year, Public Officials Liability Errors and Omissions $ 10,000,000 In any One Policy Year, Employee Benefit Liability Self Insured Amounts Coverages Retention (SIR): $ 250,000 Each Occurrence or Wrongful Act(includes Defense Costs) $ 6,000,000 In any One Policy Year. This aggregate does not include any amounts payable by a PMC for any Occurrence or Wrongful Act as outlined in such County's Agreement for Partially Self-Funded Program issued by CAPP as follows: • SIR is not eroded by the first$75,000 of loss and loss expense for Summit County • SIR is not eroded by the first$125,000 of loss and loss expense for Eagle, Pueblo, and Weld Counties • SIR aggregate is also not eroded by the loss and loss expense for $10,000 ETR deductible loses Page 16 find Property Pool 11) Excess Liability - Atlantic Specialty Continued) (Claims Made Form) Coverages • Premises and Operations Included: • Products/Completed Operations • Law Enforcement Liability • Employee Benefit Liability • Public Officials Errors and Omissions Retroactive July 1, 1986 except for the following Counties: Dates: • Cheyenne County: 2/16/1987 • Delta County: 7/1/1998 • Fremont County: 7/1/1987 • Grand County: 7/1/1987 • Lake County: 7/1/1987 • Montrose County: 7/1/1987 • Weld County: 1/15/1986 • Custer County (LEL Personal injury and Property Damage only): 1/1/1997 Defense • Defense Costs are included in the SIR Provisions: • Defense Costs are in addition to the Limits of Liability Definition of • Means any formal or written demand or Suit for monetary relief, against an Insured, Claim: 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 Page 17 r e: Kii. and Property Pool z. Excess Liability - Atlantic Specialty Continued) (Claims Made Form) Extended • Extended Reporting Period (ERP) is available in the event of Cancellation or Non- Reporting Renewal of Policy. Provisions: • Available upon payment of additional premium of not more than 200%of the total expiring premium • If additional premium paid when due, the Company will treat a claim as if made on the expiration date of the policy for a period of 35 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. • ERP will not take effect unless the additional premium is paid when due. If that premium is paid when due, the endorsement may not be cancelled. • The ERP will not reinstate or increase the Limits of Liability or extend the policy period. Coverage Form: • CAPP Manuscript Policy Form • Claims-Made Coverage Form Terms/Conditions: • rd Year of Three Rate Guarantee Endorsement—60% of qualifying losses • Health Care Professional Services Coverage for any Insured who is NOT a medical doctor, psychologist, physiotherapist or nurse practitioner. • Coverage is provided for administrative duties performed by a medical doctor, psychologist, psychotherapist or nurse practitioner in the scope of their duties. • Cross Liability Provision • Non-Owned Watercraft Liability(Under 26 Feet in Length) • Other Insurance Clause—excess over SIR, excess over any other valid and collectible insurance • 90 days Notice of Cancellation or Termination of Policy • Non-Waiver of Governmental Immunity • Bankruptcy and Insolvency Clause • Action Against the Company Clause • Maintenance of Retained Limit Clause • Blanket Additional Insured—Designated Person or Organization—Blanket as required by Certificates of Insurance issued by Gallagher • Cancellation Notice by Agent Endorsement Page i8 d Property Pool Excess Liability - Atlantic Specialty (Continued) (Claims Made Form) Coverage • United States of America (including its territories and possessions), Puerto Rico Territory: and Canada • International waters or airspace, but only if the injury of damage occurs in the course of travel or transportation between any places included above • All other parts of the world if the injury or damages arise out of 1) goods or products made or sold by you in the territory described above; 2)the activities of any person whose home is in the territory described above, but is away for a short time on your business; or 3) personal and advertising injury offenses that take place through the internet or similar electronic means of communication— provided the Insured's responsibility to pay damages is determined in a suite on the merits in the territory described above or a settlement the carrier agrees to Exclusions Include • Terrorism but are not Limited • Sexual Advances—claims arising out of advances involving intentional physical to: 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 contact by another • Eminent Domain • Airport,Airfield, Hangar or Terminal • Activities in a fiduciary capacity • Workers'Compensation, Employers Liability • Operation of Housing Authorities, Port Authorities, School Boards or Railroad Boards • Uninsured Motorists • Nuclear • Asbestos, Mold, other Fungi or Bacteria (except where noted in policy form) • Pollution (except where noted in policy form) P • Breach of Contract(except where noted in policy form) Minimum Earned Premium: 25% Audit Terms: Non-Auditable Page 19 7)Cal;;;;'' a find Property Pool 41, Excess Liability - Atlantic Specialty (Continued) (Claims Made Form) Claims Reporting In the event of an Occurrence reasonably likely to involve the Company,written notice Instructions: containing particulars sufficient to identify the insured and other information with respect to the time place, and circumstances thereof, CTSI as Claims Administrator shall provide written notice to the Company as soon as practicable. CTSI shall provide to the Company as soon practicable, following notice the Company for 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 Claims are to be reported to: OneBeacon Governmental Risks 8000 IH 10 West, Ste 1045 San Antonio, RTX 78230 E-Mail: OBGRCIaims@OneBeacon.com Fax: 866-894-1633 And to: Arthur J. Gallagher Risk Management Services, Inc. 6399 S. Fiddler's Green Circle, Ste 200 Greenwood Village, CO 80111 Att: Kendall Trump Voice Mail: 303-889-2570 Direct E-Mail: kendall trumoCthaio.com Claims E-mail: AJGDenverClaimseaig.com Claims Fax Number: 303-220-7010 Page 110 d Property Pool • Master Crime — Hiscox Insurance Company, Inc. Carrier: Hiscox Insurance Company, Inc. Policy Number: UC21191167.12 Policy Period: January 1, 2012 to January 1, 2013 Insured: Members of Colorado Counties Casualty and Property Pool as they appear on the Named Insured Endorsement Policy Form: Discovery Form Retroactive Date: None Limits Insuring Agreement Deductible (Per Occurrence) (Per Loss) $1,000,000 Coverage A: Fidelity- Employee Theft $150,000 Coverage B: Forgery or Alteration $150,000 $1,000,000 Checks $1,000,000 Credit, Debit or Charge Cards Coverage C: Inside and Outside the premises $150,000 $1,000,000 Inside the Premises $1,000,000 Outside the Premises Coverage D: Computer and Funds Transfer Fraud $150,000 $1,000,000 Computer Fraud $1,000,000 Funds Transfer Fraud $1,000,000 Coverage E: Money Orders and Counterfeit Money $150,000 $250,000 Coverage F: Telephone Toll Fraud $150,000 $250,000 Coverage H. Virus and Licensing Violations $150,000 $50,000 Coverage I: Expense N/A Endorsements: • Named Insured Added (lists members) • Government Conversion with Faithful Performance Limit of Insurance $1,000,000 • Crime Elite Endorsement — Extended Period to Discover Loss— 120 days — Acts of Employees Learned of by you Prior to the Policy Period -$25,000 — Termination as to any employee—90 days(no coverage if termination due to theft or any other dishonest act committed by employee) — Termination as to any employee because of theft, forgery or any dishonest act committed by employee only if exceeds$25,000 — Definition of Employee amended to include any natural person independent contractor whom you have the right to direct and control while performing acts within the usual duties of an Employee • Persons or Classes of Persons included with Sublimit • Colorado Amendatory Endorsement(Endt No. 1) • Economic and Trade Sanctions Policyholder Notice Page 111 and Property Pool Master Crime - Hiscox Insurance Company, Inc. (Continued) Exclusions including • Confidential Information but not limited to: • Government Action • Indirect Loss • Legal Fee, Costs and Expenses • Nuclear • War, Military Action • Inventory Shortages • Accounting or Arithmetical Errors or Omissions—Coverage C • Kidnap, Ransom and Extortion • Money operated devices • Motor Vehicles or Equipment or Accessories • Vandalism • Fraudulent Preparation or Input—Coverage H Crime Application: For 2012, CAPP Crime Application required including new members Notification Only on losses exceeding 50%of the deductible Requirements of Losses: Page 1 12 • and Property Pool e xA •f.. Master Crime - Hiscox Insurance Company, Inc. (Continued) Claims Reporting When You or an Executive Employee discovers a loss or a situation that my Instructions: result in loss or damage to Money, Securities or Other Property that in your best estimate exceeds 50% of the Deductible, notify the carrier as soon as practicable and in no event later than 90 days after Discovery. If you have reason to believe that any loss except for loss covered under Fidelity, Coverage A, involves a violation of the law, you must also notify the local law enforcement authorities. Claims are to be reported to: Hiscox Att: Crime&Fidelity Claims Dept 520 Madison Ave, 32n° Floor New York, NY 10022 E-mail: D&Oclaims(alhiscox.com Fax: 212.922.9652 And to: Arthur J. Gallagher Risk Management Services, Inc. 6399 S. Fiddler's Green Circle, Ste 200 Greenwood Village, CO 80111 Att: Kendall Trump Voice Mail: 303-889-2570 Direct E-Mail: kendall trumoeaig.com Claims E-mail: A]GDenverClaims(aaio.com Claims Fax Number: 303-220-7010 Page 1 13 CSIi Colorado Counties Casualty and Property Pool 2012 Excess Liability Policy One Beacon Policy No. 791-00-03-55-0001 Summaries are brief outlines of the coverages afforded under the insurance policies. Since summaries are for informational purposes only, they should not be construed to constitute the entire insurance contracts. As the policies may contain additional coverages and restrictions, the exact wording should be consulted. Brief Summary of Liability Deductibles This information is provided to present counties with a simple overview of county deductibles in the pool. It does not provide information on limits. The pool insuring agreements contain actual coverages and limits. The county has$0 deductible for liability claims* The pool pays the first$250,000 of each claim CAPP's excess insurance carrier pays the next$10 million per claim *Generally, there is no deductible on liability claims. The board and membership have adopted deductibles for certain types of claims. Information on these claims is contained in the CAPP Operations Manual. Liability claims subject to a county deductible: Claim type County Deductible Employment Termination $10,000 Inverse Condemnation $125,000 Regulatory Taking Herbicide and Pesticide $2,500 Operations Lawyer's Professional $500 Liability Ae AZ One Beacons. INSURANCE @vantage For Government Risks Atlantic Specialty Insurance Company 1 Beacon Lane Canton,Massachusetts 02021-1030 Common Policy Declarations Named Insured and Mailing Address Policy Number 791-00-03-55-0001 Colorado Counties Casualty and Property Pool Suite 400 800 Grant Street Denver, CO 80203-2944 II In return for the payment of the premium, and subject to all terms of this policy, we agree with you to provide the insurance as stated in this policy. Policy Period:from 01-01-2012 to 01-01-2013 at 12:01 A.M.Standard Time at your mailing address shown above. Exception: 12 Noon in New Hampshire The Named Insured is a(n): Public Entity Business Description: County Government Insurance Pool Producer: 0501179 Arthur J. Gallagher Risk Management Services, Inc. 6399 S. Fiddler's Green Cir., Suite 200 Greenwood Village, CO 80111 Total Premium: $1,779,392 Forms applicable to all Coverage Parts: See ASC 00 11, Schedule 2 4 wL 100 10 98 COMMON POLICY DECLARATIONS Copyright 2005,OneBeacon Insurance Group CAPP Excess Liability Page 1 In witness whereof,we have issued this policy,signed by the President and Secretary, but it shall not be valid unless countersigned by our duly authorized representative. Secretary President Countersigned Authorized Representative Date 4 V11100 10 98 COMMON POLICY DECLARATIONS Copyright 2005.OneBeacon Insurance Group CAPP Excess Liability Page 2 Policy Number 791-00-03-55-0001 Named Insured: Producer: Colorado Counties Casualty Arthur J. Gallagher Risk and Property Pool Management Services, Inc. Suite 400 800 Grant Street Denver, CO 80203-2944 Premium Statement for the period from 01-01-2012 to 01-01-2013 This policy consists of the following coverage parts for which a premium is indicated.This premium may be subject to adjustment. t+'.x sx , At inception 1st Anniversary 2nd Anniversary LIABILITY COVERAGE $1, 779, 392 FLAT CHARGE NOT SUBJECT TO ADJUSTMENT MC 00 02 01 98 Copyright 1998,OneBeacon Insurance Group PREMIUM STATEMENT CAPP Excess Liability Page 3 Policy Number: 791-00-03-55-0001 @vantage for Government Risks LIABILITY COVERAGE PART DECLARATIONS Limits of Insurance Coverage AUTOMOBILE LIABILITY $10,000,000 Each Occurrence AUTOMOBILE MEDICAL PAYMENTS $10,000 Each Person PERSONAL INJURY AND PROPERTY DAMAGE $10,000,000 Each Occurrence PREMISES MEDICAL PAYMENTS $10,000 Each Person SEWER BACK-UP $1,000,000 Each Occurrence PERSONAL INJURY AND PROPERTY DAMAGE $10,000,000 Aggregate Any One Policy Year PRODUCTS AND COMPLETED OPERATIONS $10,000,000 Aggregate Any One Policy Year PUBLIC OFFICIALS ERRORS&OMISSIONS LIABILIITY $10,000,000 Each Wrongful Act PUBLIC OFFICIALS ERRORS&OMISSIONS LIABILIITY $10,000,000 Aggregate Any One Policy Year EMPLOYEE BENEFIT ADMINISTRATION $10,000,000 Each Wrongful Act EMPLOYEE BENEFIT ADMINISTRATION $10,000,000 Aggregate Any One Policy Year Self-Insured Retention ALL COVERAGE $250,000 Each Occurrence or Wrongful Act $6,000,000 Aggregate Any One Policy Year Retroactive Date ALL PARTICIPATING MEMBER COUNTIES, July 1, 1986 EXCEPTIONS PER POLICY CHANGE 1 APPLY GRSGL 100 07 07 Copyright 2007,OneBeacon Insurance Group LIABILITY DECLARATIONS Page 1 of 1 CAPP Excess Liability Page 4 SPECIAL EXCESS LIABILITY POLICY FOR COLORADO COUNTIES CASUALTY AND PROPERTY POOL 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 Named Insureds as follows: INSURING AGREEMENT A. The Company will indemnify 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 the Company 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. 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 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 Insured's self-insured retention as specified in the Declarations. CAPPL Rev 01-2011 Page 1 of 23 CAPP Excess Liability Page 5 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 anyone Occurrence. (2)Automobile Medical Payments-The limit of liability is included in the Self-Insured Retention. 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 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 anyone 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 anyone 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. CAPPL Rev 01-2011 Page 2 of 23 CAPP Excess Liability Page 6 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 in the Coverage Territory. 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 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 1. premises owned, rented or leased by a Named Insured; 2.work done by a Named Insured; 3. any permitted user of autos the Named Insured is responsible for;or 4. 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 user 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. CAPPL Rev 01-2011 Page 3 of23 CAPP Excess Liability Page 7 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. 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 maybe 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 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)will not apply to resulting Personal Injury or Property Damage. CAPPL Rev 01-2011 Page 4 of 23 CAPP Excess Liability Page 8 (D)Health Care Professional Services To any liability arising out of the performance of or failure to perform health care professional services This exclusion only applies to any Insured who is a medical doctor, psychologist,psychotherapist or nurse practitioner. However,this exclusion does not apply to administrative duties performed by a medical doctor, psychologist, psychotherapist or nurse practitioner in the scope of their duties. (E)Failure To Supply The 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, (()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: (1)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; (2)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 (3)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. (3)As used in this exclusion: (1)"hazardous properties" includes radioactive,toxic or explosive properties; (2) "nuclear material"means source material, special nuclear material, or byproduct material; (3)"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; CAPPL Rev 01-2011 Page 5 of 23 CAPP Excess Liability Page 9 (4)"spent fuel"means any fuel element or fuel component, solid or liquid.which has been used or exposed to radiation in a nuclear reactor; (5)"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(li)resulting from the operation by any person or organization of a nuclear facility included within the definition of nuclear facility below; (6)"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. (7) "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; (8) with respect to injury or to destruction of property,the world"injury"or "destruction" includes all forms of radioactive contamination of property. (G)Pollution Liability (1) Automobile Liability, Personal Injury, Property Damage or Public Officials Errors and Omissions arising directly or indirectly out of, or in any way related to the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of Pollutants: (a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to, any insured. However, this subparagraph does not apply to: (i) Bodily Injury if sustained within a building and caused by smoke, fumes, vapor or soot produced by or originating from equipment that is used to heat, cool or dehumidify the building, or equipment that is used to heat water for personal use, by the building's occupants or their guests; (ii) Bodily Injury or Property Damage for which you may be held liable, if you are a contractor and the owner or lessee of such premises, site or location has been added to your policy as an additional insured with respect to your ongoing operations performed for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any insured,other than that additional insured; or (Hi) Bodily Injury or Property Damage arising out of heat, smoke or fumes from a hostile fire; CAPPL Rev 01-2011 Page 6 of 23 CAPP Excess Liability Page 10 (b) At or from any premises, site or location which is or was at any time used by or for any insured or others for the handling, storage, disposal, processing or treatment of waste; (c) Which are or were at any time transported, handled, stored, treated, disposed of, or processed as waste by or for: (i)Any insured;or (ii)Any person or organization for whom you may be legally responsible; or (d) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the "pollutants" are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontractor. However,this subparagraph does not apply to: (i) Bodily Injury or Property Damage arising out of the escape of fuels, lubricants or other operating fluids which are needed to perform the normal electrical, hydraulic or mechanical functions necessary for the operation of "mobile equipment" or its parts, if such fuels, lubricants or other operating fluids escape from a vehicle part designed to hold, store or receive them.This exception does not apply if the"bodily injury" or "property damage" arises out of the intentional discharge, dispersal or release of the fuels, lubricants or other operating fluids, or if such fuels, lubricants or other operating fluids are brought on or to the premises, site or location with the intent that they be discharged, dispersed or released as part of the operations being performed by such insured, contractor or subcontractor; (e) At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, Pollutants. (2) Any loss, cost or expense arising directly or indirectly out of, or in any way related to any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to,or assess the effects of,"pollutants";or (b) Any Claim by or on behalf of a governmental authority because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to,or assessing the effects of, Pollutants. However, this paragraph does not apply to liability for damages because of Property Damage that the Insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such "claim by or on behalf of a governmental authority. (3)This exclusion does not apply to Bodily Injury or Property Damage that results from: (a) chemicals used in sewage treatment, swimming pool maintenance, or water purification operations; or (b) natural gas or propane gas used in sewage treatment, swimming pool maintenance, or water purification operations. CAPPL Rev 01-2011 Page 7 of 23 CAPP Excess Liability Page 11 Also, the Company will not apply this exclusion to Bodily Injury or Property Damage that results from the application or use of any Pollutants in the providing of: (a) Potable water supplied to others; or (b) Urgent response for the protection of property, human life, health or safety conducted away from premises owned by or rented to or regularly occupied by an Insured; or (c) Training operations by an Insured,; or (d) Water runoff from the cleaning of equipment used in an emergency service activity. (e) Fuels, lubricants, fluids, exhaust gases or similar Pollutants that are needed for or result from the normal electrical, hydraulic or mechanical functioning of a covered automobile and that escape, seep or migrate, or are discharged, dispersed or released,directly from a part of the covered automobile designed by its manufacturer to hold, store, receive or dispose of such Pollutants. (4) This exclusion does not apply to Bodily Injury or Property Damage to a building or its contents if such Bodily Injury or Property Damage is caused by the escape or back- up of sewage or waste water from any sewage treatment facility or fixed conduit or piping owned, operated, leased, controlled or for which an Insured has the right of way, but only if Bodily Injury or Property Damage occurs away from land owned or leased by an Insured; and does not result from any corrosive or radioactive Pollutants in the sewage or waste water. (5) This exclusion does not apply to the application of any pesticide or herbicide by or for an Insured if such application or use meets all legal or license requirements of any governmental agency or authority which apply to it. Paragraphs (3) and (4) of this exclusion only apply if the discharge is accidental, unintended and stopped as soon as possible. The entirety of any discharge or series of related discharges will be deemed a single discharge regardless of the length of time over which the "pollutants" are released. The entirety of any discharge or series of related discharges will be deemed to have occurred at the date the earliest discharge commenced. Discharge as used in this exclusion includes dispersal, seepage, migration, release or escape. (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. CAPPL Rev 01-2011 Page 8 of 23 CAPP Excess Liability Page 12 (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 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: (1)the aircraft is chartered with crew, including a pilot, not employed by the Insured; and (2)the Insured is not 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. CAPPL Rev 01-2011 Page 9 of 23 CAPP Excess Liability Page 13 (0)Known Occurrence or Wrongful Act To any claim or potential claim or Occurrence or Wrongful Act or circumstances for 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 no 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 GG(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 to Public Officials Liability coverage except as stated in exclusion GG(8)applying to Public Officials Liability only. CAPPL Rev 01-2011 Page 10 of 23 CAPP Excess Liability Page 14 (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 the Insured's advertising. (Y)Mold,Other Fungi, or Bacteria (1)To liability that results 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 (b)existence of mold or other fungi, or bacteria, In any form. CAPPL Rev 01-2011 Page 11 of 23 CAPP Excess Liability Page 15 But the Company will not apply this exclusion part to: (a)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; (b) 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 (c)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 is not 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 the Company 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 waste, 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,the Company will not cover any loss, cost, or expense that result 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; (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 Automobile Liability. CAPPL Rev 01-2011 Page 12 of 23 CAPP Excess Liability Page 16 (BB) Malicious,Dishonest,or Fraudulent Errors, Omissions, or Acts or Knowing Violation of Rights and Law 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, Hanger 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; (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, hanger or terminal. However,this exclusion does not apply to Automobile 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 statue 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; CAPPL Rev 01-2011 Page 13 of 23 CAPP Excess Liability Page 17 (6)Liability arising from faulty preparation of maps, plans, reports,survey, 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 ads 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. (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 a 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. CAPPL Rev 01-2011 Page 14 of 23 CAPP Excess Liability Page 18 r (HH) Under Automobile Liability To liability imposed on an Insured under any Uninsured/Underinsured Motorist law. 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 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 is 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 CAPPL Rev 01-2011 Page 15 of 23 CAPP Excess Liability Page 19 (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 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 arising 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. "Coverage Territory"means: A) The United States of America(including its territories and possessions), Puerto Rico and Canada; B) International waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph A. above; or C) All other parts of the world if the injury or damage arises out of: i. Goods or products made or sold by you in the territory described in Paragraph A. above; ii. The activities of a person whose home is in the territory described in Paragraph A. above, but is away for a short time on your business; or Hi. Personal Injury offenses that take place through the Internet or similar electronic means of communication provided the Insured's responsibility to pay Damages is determined in a Suit on the merits, in the territory described in Paragraph A. above or in a settlement the Company agrees to. "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 employee or officials of the Company or an Insured. CAPPL Rev 01-2011 Page 16 of 23 CAPP Excess Liability Page 20 "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: (A)personal injury or property damage covered under this agreement;and (B)the contract liability defense expenses incurred in connection with such personal injury or property damage. "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: (A)any type or form of mold or mildew; (B)any other type or form of fungus; or (C)any mycotoxin, spore, scent,or byproduct that is 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 practitioner which results 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; CAPPL Rev 01-2011 Page 17 of 23 CAPP Excess Liability Page 21 (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 from injury or death,or (i)if committed or directed for the purpose of protecting persons o property from damage, or (ii)to liability arising out of corporal punishment (I)Improper or erroneous service of civil papers. "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 material which is intended to be or have been recycled, reconditioned or reclaimed. "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: (A)first aid at the time of the accident, (B)necessary medical surgical, x-ray and dental services, including prosthetic devices; and C necessary ambulance, hospital, professional nursing, and funeral services. ( ) P 9 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 (A)physical tangible properly which occurs during the policy period, including the loss of use thereof at injury to or destruction of any time resulting therefrom, or (B)loss of use of tangible property which has not been physically injured or destroyed proved (C)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 antirust 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. CAPPL Rev 01-2011 Page 18 of 23 CAPP Excess Liability Page 22 "Ultimate Net Loss"means the sums for which an Insured is legally 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 Insured's Retained Limit and 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 giving by or for the Insured to the Company or any of its authorized agents as soon as practicable. (B)The Company shall be giving 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 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. The Named Insured 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 indemnity the Named Insureds for that part of such payment which is in excess of the retained limit, CAPPL Rev 01-2011 Page 19 of 23 CAPP Excess Liability Page 23 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: OneBeacon Governmental Risks 8000 IH 10 West, Ste 1045 San Antonio, RTX 78230 E-Mail: OBGRCIaimsc OneBeacon.com Fax: 866-894-1633 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 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. 5.Action Against the Company No action shall lie against the Company with respect to anyone 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 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. CAPPL Rev 01-2011 Page 20 of 23 CAPP Excess Liability Page 24 "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: (A)another insurance company; (B)a risk retention group; (C)a self-insurance method or program,other than any funded by CAPP and over which this agreement applies; (D)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: 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. CAPPL Rev 01-2011 Page 21 of 23 CAPP Excess Liability Page 25 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 and be the responsibility of the Named Insureds except for any reduction thereof solely by payment 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. 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 Insured 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(90)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 prorate. 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 cancellation and to 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. CAPPL Rev 01-2011 Page 22 of 23 CAPP Excess Liability Page 26 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(30)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 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. CAPPL Rev 01-2011 Page 23 of 23 CAPP Excess Liability Page 27 SCHEDULE 1 • Effective 01-01-2012 ,this schedule forms a part of Policy No. 791-00-03-55-0001 • (At the time stated in the policy) issued to Colorado Counties Casualty and Property Pool by Atlantic Specialty Insurance Company EXTENDED NAMED INSURED • The following Colorado Counties Casualty & Property Pool Participating Member Counties are included as part of the NAMED INSURED: Alamosa Logan Archuleta Mineral Baca Moffat Bent Montrose Chaffee Morgan Cheyenne Otero Clear Creek Ouray Conejos Park Costilla Phillips Crowley Prowers Custer Pueblo Delta Rio Blanco Dolores Rio Grande Eagle Routt Elbert Saguache Fremont San Juan Garfield San Miguel Gilpin Sedgwick Grand Summit Gunnison Teller Hinsdale Washington Huerfano Weld Jackson Yuma Kiowa Kit Carson La Plata Lake Las Animas Lincoln ASC 00 11 01 98 Copyright 1998,OneBeacon Insurance Group POLICY SCHEDULE CAPP Excess Liability Page 28 SCHEDULE 2 Effective 01-01-2012 ,this schedule forms a part of Policy No. 791-00-03-55-0001 (At the time stated in the policy) issued to Colorado Counties Casualty and Property Pool by Atlantic Specialty Insurance Company Common Policy Declarations, 4 VIL 100 01 98, continued: Forms Applicable to All Coverage Parts: 4 VIL 100 10 98 COMMON POLICY DECLARATIONS ASC 00 02 01 98 PREMIUM STATEMENT GRSGL 100 07 07 LIABILITY COVERAGE PART DECLARATIONS CAPPL (Rev 01/2011) SPECIAL EXCESS LIABILITY POLICY FORM ASC 00 11 01 98 SCHEDULE 1 - NAMED INSURED ASC 00 11 01 98 SCHEDULE 2 - LIST OF COMMON DEC FORMS ASC 00 10 01 98 POLICY CHANGE 1 - RETROACTIVE DATES ASC 00 10 01 98 POLICY CHANGE 2 - TERRORISM EXCLUSION ASC 00 10 01 98 POLICY CHANGE 3 - EMPLOYEE BENEFITS PROGRAM ADMINISTRATION LIABILITY ASC 00 10 01 98 POLICY CHANGE 4 - CANCELLATION NOTICE ASC 00 10 01 98 POLICY CHANGE 5 - SELF-INSURED RETENTION GRSGL 301 07 07 ADDITIONAL INSURED - DESIGNATED PERSON VIL 219 02 05 THREE YEAR RATE GUARANTEE ASC 00 14 01 98 NON-POLICY FORM • • MC 0011 01 98 Copyright 1998,OneBeacon Insurance Group POLICY SCHEDULE CAPP Excess Liability Page 29 POLICY CHANGE 1 Effective 01-01-2012 ,this endorsement forms a part of Policy No. 791-00-03-55-0001 (At the time stated in the policy) issued to Colorado Counties Casualty and Property Pool • by Atlantic Specialty Insurance Company (The information provided for above is required to be completed only when this endorsement is issued for attachment to the policy subsequent to its effective date.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • The Retroactive Date for all Colorado Counties Casualty and Property Pool Participating Member Counties is July 1, 1986 with the exception of the following Participating Member Counties: • Cheyenne County-Retroactive Date is February 16, 1987 Delta County- Retroactive Date is July 1, 1988 • Fremont County- Retroactive Date is July 1, 1987 Grand County- Retroactive Date is July 1, 1987 Lake County- Retroactive Date is April 1, 1987 Montrose County-Retroactive Date is July 1, 1987 Weld County- Retroactive Date is January 15, 1986 Custer County- Retroactive Date is January 1, 1997 The Custer County Retroactive Date of January 1, 1997 applies only to Law Enforcement Operations. • ASC 0010 01 98 Includes copyrighted material of Insurance Services Office,Inc. POLICY CHANGE CAPP Excess Liability Page 30 POLICY CHANGE 2 Effective 01-01-2012 ,this endorsement forms a part of Policy No. 791-00-03-55-0001 (At the time stated in the policy) issued to Colorado Counties Casualty and Property Pool by Atlantic Specialty Insurance Company (The information provided for above is required to be completed only when this endorsement is issued for attachment to the policy subsequent to its effective date.) EXCLUSION OF CERTIFIED ACTS OF TERRORISM AND EXCLUSION OF OTHER ACTS OF TERRORISM COMMITTED OUTSIDE THE UNITED STATES This endorsement modifies insurance provided under the following: SPECIAL EXCESS LIABILITY POLICY FORM A. The following exclusion is added: This insurance does not apply to: TERRORISM "Any injury or damage"arising,directly or indirectly, out of a"certified act of terrorism", or out of an"other act of terrorism" that is committed outside of the United States (including its territories and possessions and Puerto Rico), but within the "coverage territory". However, with respect to an "other act of terrorism", this exclusion applies only when one or more of the following are attributed to such act: 1. The total of insured damage to all types of property exceeds $25,000,000 (valued in US dollars). In determining whether the$25,000,000 threshold is exceeded, we will include all insured damage sustained by property of all persons and entities affected by the terrorism and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision, insured damage means damage that is covered by any insurance plus damage that would be covered by any insurance but for the application of any terrorism exclusions;or 2. Fifty or more persons sustain death or serious physical injury. For the purposes of this provision, serious physical injury means: a. Physical injury that involves a substantial risk of death;or ASC 00 10 01 98 POLICY CHANGE Page 1 of 2 CAPP Excess Liability Page 31 b.Protracted and obvious physical disfigurement;or c. Protracted loss of or impairment of the function of a bodily member or organ;or 3. The terrorism involves the use, release or escape of nuclear materials, or directly or indirectly results in nuclear reaction or radiation or radioactive contamination;or 4. The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials; or 5. Pathogenic or poisonous biological or chemical materials are released, and it appears that one purpose of the terrorism was to release such materials. With respect to this exclusion, Paragraphs 1.and 2.describe the thresholds used to measure the magnitude of an incident of an"other act of terrorism"and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. B. The following definitions are added: 1. For the purposes of this endorsement, "any injury or damage"means any injury or damage covered under any Coverage Part to which this endorsement is applicable, and includes but is not limited to"bodily injury", "property damage", "personal and advertising injury", "injury"or"environmental damage"as may be defined in any applicable Coverage Part. 2. "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. The criteria contained in the Terrorism Risk Insurance Act for a "certified act of terrorism"include the following: in excess of $5 million in the aggregate, attributable to all types of a. The act resulted in insured losses insurance subject to the Terrorism Risk Insurance Act; b. The act resulted in damage: (1) Within the United States(including its territories and possessions and Puerto Rico);or (2) Outside of the United States in the case of: (a) An air carrier (as defined in Section 40102 of title 49, United States Code) or United States flag vessel (or a vessel based principally in the United States, on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States), regardless of where the loss occurs;or (b) The premises of any United States mission;and c. 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 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. 3. "Other act of terrorism" means a violent act or an act that is dangerous to human life, property or infrastructure that is committed by an individual or individuals and that appears to be part of an effort to coerce a civilian population or to influence the policy or affect the conduct of any government by coercion, and the act is not a"certified act of terrorism". Multiple incidents of an "other act of terrorism"which occur within a seventy-two hour period and appear to be carried out in concert or to have a related purpose or common leadership shall be considered to be one incident. C. In the event of any incident of a "certified act of terrorism" or an "other act of terrorism" that is not subject to this exclusion, coverage does not apply to any loss or damage that is otherwise excluded under this Coverage Part. ASC 0010 01 98 Includes copyrighted material of Insurance Services Office,Inc.with its permission POLICY CHANGE CAPP Excess Liability Page 32 POLICY CHANGE 3 Effective 01-01-2012 ,this endorsement forms a part of Policy No. 791-00-03-55-0001 (At the time stated in the policy) issued to Colorado Counties Casualty and Property Pool by Atlantic Specialty Insurance Company (The information provided for above is required to be completed only when this endorsement is issued for attachment to the policy subsequent to its effective date.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMPLOYEE BENEFITS PROGRAM ADMINISTRATION LIABILITY (CLAIMS-MADE) This endorsement modifies insurance provided under the following: SPECIAL EXCESS LIABILITY POLICY FORM The SPECIAL EXCESS LIABILITY POLICY FORM, INSURING AGREEMENT is changed to add: F. In consideration of the premium charged and subject to the terms, definitions and exclusions hereunder, the Company will pay on behalf of the Named Insured 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. ASC 00 10 01 98 POLICY CHANGE Page 1 of 2 CAPP Excess Liability Page 33 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 Benefits 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. 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 or suits brought on account of any act, error or omission in 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 anyone policy year. B. $10,000,000 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. $10,000,000 Aggregate limit is the most the Company is responsible for in Damages in anyone 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. ASC 00 10 01 98 Includes copyrighted material of Insurance Services Office.Inc.with its permission POLICY CHANGE CAPP Excess Liability Page 34 • • POLICY CHANGE 4 Effective 01-01-2012 ,this endorsement forms a part of Policy No. 791-00-03-55-0001 (At the time staled in the policy) issued to Colorado Counties Casualty and Property Pool by Atlantic Specialty Insurance Company (The information provided for above is required to be completed only when this endorsement is issued for attachment to the policy subsequent to its effective date.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAPPL(rev.01/2011)SPECIAL EXCESS LIABILITY POLICY FORM, CONDITIONS, is changed to add: 18. Cancellation Notice by Agent In the event of cancellation or non-renewal of this policy, by the Company or Named Insured, the first Named Insured authorizes the producer of record to send notice of the applicable cancellation or non-renewal on its behalf to any person or organization which the first Named Insured or other Named Insured has agreed to provide notice of cancellation or non-renewal of this policy;and provided the name and address of such person or organization to the producer of record. The first Named Insured represents that the producer of record has agreed to provide such notice. Failure of the producer of record to provide the notice will not impose liability of any kind on the Company or producer of record or invalidate the cancellation or non-renewal. ASC 0010 01 98 Includes copyrighted material of Insurance Services Office,Inc. POLICY CHANGE CAPP Excess Liability Page 35 POLICY CHANGE 5 Effective 01-01-2012 ,this endorsement forms a part of Policy No. 791-00-03-55-0001 (At the time stated in the policy) issued to Colorado Counties Casualty and Property Pool by Atlantic Specialty Insurance Company (The information provided for above is required to be completed only when this endorsement is issued for attachment to the policy subsequent to its effective date.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAPPL (rev. 01/2011) SPECIAL EXCESS LIABILITY POLICY FORM, LIMITS OF COVERAGE AND SELF-INSURED RETENTION, paragraph A. 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 anyone 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. • • • • ASC 00 10 01 98 Includes copyrighted material of Insurance Services Office,Inc. POLICY CHANGE • CAPP Excess Liability Page 36 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: SPECIAL EXCESS LIABILITY POLICY FORM PERSONS OR ENTITIES INSURED is amended to include as an insured the person or organization shown below, but only with respect to liability arising out of your premises or operations. [If no entry appears below, the information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.] Name of person or organization: Blanket as required by Certificates of Insurance • • GRSGL301(07-07) O2007 OneBeacon Insurance Group. Includes copyrighted Page 1 of 1 material of the Insurance Services Office,Inc.with its GENERAL LIABILITY permission. CAPP Excess Liability Page 37 POLICY NUMBER: 791-00-03-55-0001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THREE YEAR RATE GUARANTEE This endorsement modifies the insurance provided by the following: CAPPL(rev.01/2011)SPECIAL EXCESS LIABILITY POLICY FORM The following is added to CONDITIONS 17.Three Year Rate Guarantee 1. OneBeacon America Insurance Company and the Colorado Counties Casualty & Property Pool agree that the rates charged under the policy are guaranteed to remain unchanged for(3) years and that we will use these rates to calculate the policy's annual premium at each anniversary subject to: a. Policy Limits, Self-Insured Retention, and policy terms and conditions remain unchanged from the initial effective date of January 1, 2011; b. A loss ratio (the total of loss payments, reserves, and loss adjustment expenses divided by earned premium) not exceeding sixty (60) percent in any one twelve (12) month period; or c. No material change in exposure or increase in hazard. 2. If the conditions in 1.a., 1.b., or 1.c. are not met, the rate will be changed effective at any anniversary date following the annual period in which such condition is not met. Effective Date of Rate Guarantee: 01-01-2011 VIL 219 02 05 Includes copyrighted material of Insurance Services Office,Inc. Page 1 of 1 copyright 20oa, OneBeacon Insurance Group CAPP Excess Liability Page 38 POLICY NUMBER: 7910003550001 The following forms were sent to you with your policy,but they are not part of your policy.They contain information which you may find useful about your policy, insurance in general, your premium payments, or other topics of interest. These forms do not give you insurance coverage. Refer to the forms that are part of your policy to determine if a loss is covered, and what we will pay, as well as your rights and duties. CLD 142 TERRORISM DISCLOSURE NOTICE ASC 0014 01 98 Copyright 1998,OneBeacon Insurance Group NON-POLICY FORMS CAPP Excess Liability Page 39 *10 One Beacons INSURANCE Insured Name and Address: Policy Number: 791-00-03-55 Colorado Counties Casualty and Property Pool POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE You were notified that under rights granted by the Terrorism Risk Insurance Act, as amended, you have a right to purchase insurance coverage for losses arising out of acts of terrorism as defined in Section 102(1) of the Act. Under the Act, the term "act of terrorism" means any 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;to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission; and to have been committed by an individual or individuals 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. COVERAGE FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM, AS DEFINED IN THE ACT, MAY BE PARTIALLY REIMBURSED BY THE UNITED STATES GOVERNMENT IN ACCORDANCE WITH A FORMULA ESTABLISHED UNDER THE ACT. UNDER THE FORMULA, THE UNITED STATES GOVERNMENT WOULD PAY 85% OF COVERED TERRORISM LOSSES THAT EXCEED THE STATUTORILY IMPOSED DEDUCTIBLE FOR WHICH THE INSURANCE COMPANY IS RESPONSIBLE. THE PREMIUM CHARGED FOR THIS COVERAGE IS PROVIDED BELOW AND DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSSES COVERED BY THE UNITED STATES GOVERNMENT UNDER THE ACT. THE ACT CONTAINS A $100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES EXCEEDS$100 BILLION IN ANY ONE CALENDAR YEAR. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEED$100 BILLION,YOUR COVERAGE MAY BE REDUCED. The premium required for your terrorism coverage would have been: $9,832 The premium shown above is calculated based in part on the federal participation in payment of terrorism losses as set forth in the Terrorism Risk Insurance Act. The federal program established by the Act is scheduled to terminate at the end of 12/31/14. If the federal program terminates or if the level or terms of federal participation change,the estimated premium shown above may not have been appropriate. If this policy contains a Conditional Exclusion, continuation of coverage for certified acts of terrorism, or termination of such coverage,will be determined upon disposition of the federal program, subject to the terms and conditions of the Conditional Exclusion. If this policy does not contain a Conditional Exclusion, coverage for certified acts of terrorism will continue. In either case, when disposition of the federal program is determined, we would have recalculated the estimated premium shown above and would have charged additional premium or refunded excess premium,if indicated. You were given an offer of terrorism coverage required under the Act, which you elected to reject. You do not have coverage for losses arising from an act of terrorism as defined in the Act, unless you have a sublimit endorsement attached to your policy. CLD 142 01 08 Copyright 2008,OneBeacon Insurance Group Page 1 of 2 CAPP Excess Liability Page 40 If your policy includes Property Coverage in one or more of these states: CA, CT, GA, HI, IA, IL, MA, ME, MO, NC, NJ, NY,OR, RI,VA,WA,WI,or WV;the following statement applies: The terrorism exclusion makes an exception for(and thereby continues your coverage for) property fire losses resulting from an act of terrorism. Therefore, if you reject the offer of terrorism coverage, that rejection does not apply to fire losses resulting from an act of terrorism-the coverage in your policy for such fire losses will continue. If such a loss occurs,and is certified under the Act,the loss may be reimbursed by the United States government under the formula detailed above. The portion of your policy premium attributable to terrorism (fire only)coverage in all of the states listed above, in which your policy provides property coverage, is$ . This amount is included in your policy premium and cannot be rejected. You need to take no action with respect to this notice. You will receive a bill for your policy premium which will include the amount required for your coverage for fire losses resulting from an act of terrorism, if applicable. If you have any questions about this notice, please contact your agent. Page 2 of 2 Copyright 2008,OneBeacon Insurance Group OLD 142 01 08 CAPP Excess Liability Page 41 Hello