BM21 Travelers Residential BM 4245R337

User Manual: BM21

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TRAVELERSJ
Report Claims Immediately by Calling>
1·800·238·6225
Speak directly with a claim professional
24 hours a day, 365 days a year
'Unless Your Policy Requires Written Notice or Reporting

COMMERCIAL INSURANCE
(

A Custom Insurance Policy Prepared for:
CIBA RESIDENTIAL
655 N CENTRAL AVENUE
# 2100
GLENDALE CA 91203

....

TRAVELERSJ

One Tower Square, Hartford, Connecticut 06183

TRAVELERS CORP. TEL: 1-800-328-2189
APARTMENT BLDGS
COMMON POLICY DECLARATIONS
ISSUE DATE: 04/24/12
POLICY NUMBER: M5J-BM21-4245R337-TIL-12
INSURING COMPANY:
TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
1. NAMED INSURED AND MAILING ADDRESS:
CIBA RESIDENTIAL (AS PER IL T8 00)
655 N CENTRAL AVENUE
# 2100
GLENDALE, CA 91203
2. POLICY PERIOD:
3. LOCATIONS
Premises
Loc. No.

From 03/31/12 to 03/30/14 12:01 A.M. Standard Time at
your mailing address.

Bldg.
No.

Address

Occupancy

ON FILE WITH COMPANY

4. COVERAGE PARTS FORMING PART OF THIS POLICY AND INSURING COMPANIES:
BOILER AND MACHINERY COV PART DECLARATIONS
BM TO 53 10 05 TIL

(

5. NUMBERS OF FORMS AND ENDORSEMENTS
FORMING A PART OF THIS POLICY:
SEE IL T8 01 10 93
6. SUPPLEMENTAL POLICIES: Each of the following is a separate policy
containing its complete provisions:
Policy

7. PREMIUM SUMMARY:
Provisional Premium
Due at Inception
Due at Each

Policy No.

Insuring Company

NAME AND ADDRESS OF AGENT OR BROKER:
R-T SPECIALTY INS SERV (CBX29)
3400 W OLIVE AVE 3RD FLOOR
BURBANK, CA 91505

COUNTERSIGNED BY:
Authorized Representative
DATE:,____________________

IL TO 02 11 89 (REV. 09-07)
OFFICE: DIAMOND BAR

PAGE 1 OF 2

TRAVELERS't'
TAXES AND SURCHARGES
POLICY NUMBER: MSJ-BM21-424SR337-TIL-12
EFFECTIVE DATE: 03/31/12
ISSUE DATE: 04/24/12
DESCRIPTION

AMOUNT

WV BM SURCHARGE INSURANCE PREMIUM
KENTUCKY BOILER MACHINERY FUND SURCHARGE
FIGA - 2008 BOILER & MACHINERY
FL CAT FUND EMERGENCY ASSESSMENT SURCHARGE - BM

IL TO 02 11 89

PAGE

2 OF

189
OFFICE: DIAMOND BAR
PRODUCER NAME: R-T SPECIALTY INS SERV

CBX29

(

TRAVELERS't'
POLICY NUMBER:
EFFECTIVE DATE:
ISSUE DATE:

M5J-BM21-4245R337-TIL-12
03-31-12
04-24-12

LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS
BY LINE OF BUSINESS.
IL
IL
IL
IL
IL

TO
T8
TO
TO
T8

02
01
01
30
00

11
10
01
12

COMMON POLICY DECLARATIONS
FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
COMMON POLICY CONDITIONS
NON-STANDARD PAYMENT SCHEDULE
GENERAL PURPOSE ENDORSEMENT

89
93
07
90

BOILER AND MACHINERY

(

BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM
BM

TO
T8
T8
T8
T8
TO
T1
T3
T4
T4
T5
T9
T9
T9
T9
T9
T9
T9
T9
T9
T9
T9
T9

53
00
01
02
03
52
57
64
02
39
94
11
36
37
38
39
40
43
48
49
50
52

10 05

08
08
12
08
01
01
04
08
08
08
12
08
08
08
08
08
04
74 06

02
02
04
02
03
08
07
02
02
02
06
02
02
02
02
02
97

ENERGYMAX21-EQUIPMENT BREAKDOWN DEC
GENERAL PURPOSE ENDORSEMENT
GENERAL PURPOSE ENDORSEMENT
GENERAL PURPOSE ENDORSEMENT
GENERAL PURPOSE ENDORSEMENT
ENERGYMAX 21 TABLE OF CONTENTS
ENERGYMAX 21 COVERAGE FORM
ADDITIONAL NAMED INSURED,LOSS PAYEE,MORT
COVERED PREMISES - SPECIAL SCHEDULE
PERILS ELIMINATION ENDORSEMENT
TERRORISM RISK INS ACT 2002 DISCLOSURE
NC CHANGES
FLORIDA CHANGES - LOSS PAYMENT
KANSAS CHANGES-INSPECTION APPRAISAL
MINNESOTA CHNG-EXAM OF BOOKS , TRANSFER OF
MISSOURI CHANGES-LEGAL ACTION,MOPC GUAR
NEBRASKA CHANGES - APPRAISAL
WISCONSIN CHANGES-NOTICE OF BREAKDOWN
WASHINGTON CHANGES-EXCLUSIONS AND APPRAI
UTAH CHANGES-LEGAL ACTION AGAINST US
TEXAS CHANGES - DEFENSE,JOINT LOSS
OKLAHOMA CHANGES - REPLACEMENT COST
TEXAS CHANGES - FUNGUS DECAY, WET/DRY

INTERLINE ENDORSEMENTS
IL T3 79 01
IL 01 03 05
IL 01 04 09
lL 01 06 09
IL 01 10 09
lL 01 22 05
IL 01 56 09
lL 01 59 09
IL 01 60 07
lL 01 63 07

IL T8 0110 93

08
05
07
07
07
06
07
07
02
02

CAPS ON LOSSES FROM CERT ACTS OF TERROR
CALIFORNIA CHANGES - ACTUAL CASH VALUE
CALIFORNIA CHANGES
VIRGINIA CHANGES-APPRAISAL
NV CHANGES-CONCEALMENT,MISREP OR FRAUD
NEBRASKA CHANGES-ACTUAL CASH VALUE
IN CHANGES CONCEAL MISREPRESENT OR FRAUD
NE CHANGES-FRAUD OR MISREPRESENTATION
KS CHANGES-CONCEALMENT, MISREP OR FRAUD
ARKANSAS CHANGES

PAGE:

1 OF

(

TRAVELERS't
POLICY NUMBER:

M5J-BM21-4245R337-TIL-12

EFFECTIVE DATE:

03-31-12

ISSUE DATE:

04-24-12

INTERLINE ENDORSEMENTS (CONTINUED)
IL
IL
IL
IL
IL
IL

IL
IL
IL
IL
IL
IL

01
01
01
01
01
01
01
01
01
01
02
T9

65 09 08
67 09 08
69 09 07
71 09 07
75 07 02
77 10 10
78 09 07
79 10 02
80 09 07
84 09 07
70 09 08
56 04 93

ND CHANGES-EXAM OF YOUR « RECORDS
MT CHANGES-CONFORMITY WITH STATUES
CO CHANGES CONCEAL MISREP OR FRAUD
TEXAS CHANGES-LOSS PAYMENT
FL CHANGES-LEGAL ACTION AGAINST US
OK CHANGES-CONCEAL,MISREPRESENT OR FRAUD
NEW MEXICO CHANGES
OKLAHOMA NOTICE
MT CHANGES-CONCEAL, MISREPRESENT, FRAUD
SOUTH DAKOTA CHANGES-APPRAISAL
CA CHANGES-CANCELLATION « NON-RENEWAL
TX CHANGES-NOTICE OF CLAIM OR SETTLEMENT

(

ILT8011093

PAGE:

2 OF

COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions:

(

A. Cancellation
1. The first Named Insured shown in the Declarations may cancel this policy by mailing or
delivering to us advance wriUen notice of
cancellation.
2. We may cancel this policy or any Coverage
Part by mailing or delivering to the first
Named Insured wriUen notice of cancellation
at least:
a. 10 days before the effective date of cancellation if we cancel for nonpayment of
premium; or
b. 30 days before the effective date of cancellation if we cancel for any other reason.
3. We will mail or deliver our notice to the first
Named Insured's last mailing address known
to us.
4. Notice of cancellation will state the effective
date of cancellation. If the policy is cancelled,
that date will become the end of the policy
period. If a Coverage Part is cancelled, that
date will become the end of the policy period
as respects that Coverage Part only.
5. If this policy or any Coverage Part is cancelled, we will send the first Named Insured
any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than
pro rata. The cancellation will be effective
even if we have not made or offered a refund.
6. If notice is mailed, proof of mailing will be
sufficient proof of notice.

during the policy period and up to three years
afterward.
D. Inspections And Surveys

B. Changes
This policy contains all the agreements between
you and us concerning the insurance afforded.
The first Named Insured shown in the Declarations is authorized to make changes in the terms
of this policy with our consent. This policy's terms
can be amended or waived only by endorsement
issued by us as part of this policy.

1. The first Named Insured shown in the Declarations:
a. Is responsible for the payment of all premiums; and

C. Examination Of Your Books And Records
We may examine and audit your books and
records as they relate to this policy at any time

1. We have the right to:
a. Make inspections and surveys at any
time;

b. Give you reports on the conditions we
find; and

c. Recommend changes.
2.

We are not obligated to make any inspections, surveys, reports or recommendations
and any such actions we do undertake relate
only to insurability and the premiums to be
charged. We do not make safety inspections.
We do not undertake to perform the duty of
any person or organization to provide for the
health or safety of workers or the public. And
we do not warrant Ihat conditions:
a. Are safe or healthful; or
b. Comply with laws, regulations, codes or
standards.

Paragraphs 1. and 2. of this condition apply
not only to us, but also to any rating, advisory, rate service or similar organization
which makes insurance inspections, surveys,
reports or recommendations.
4. Paragraph 2. of this condition does not apply
to any inspections, surveys, reports or recommendations we may make relative to certification, under state or municipal statutes, ordinances or regulations, of boilers, pressure
vessels or elevators.

E. Premiums

b. Will be the payee for any return premiums we pay.
2. We compute all premiums for this policy in
accordance with our rules, rates, rating plans,
premiums and minimum premiums. The premium shown in the Declarations was computed based on rates and rules in effect at

IL TO 01 01 07 (Rev. 06·09) Includes the copyrighted material of Insurance Services Office, Inc. with its permission.

Page 1 of 2

(

the time the policy was issued. On each reo
newal continuation or anniversary of the effective date of this policy, we will compute
the premium in accordance with our rates
and rules then in effect.
F. Transfer Of Your Rights And Duties Under
This Policy
Your rights and duties under this policy may not
be transferred without our written consent except
in the case of death of an individual named insured.

If you die, your rights and duties will be transferred to your legal representative but only while

acting within the scope of duties as your legal
representative. Until your legal representative is
appointed, anyone having proper temporary custody of your property will have your rights and
duties but only with respect to that property.
G. Equipment Breakdown Equivalent to Boiler
and Machinery
On the Common Policy Declarations, the term
Equipment Breakdown is understood to mean
and include Boiler and Machinery and the term
Boiler and Machinery is understood to mean and
include Equipment Breakdown.

This policy consists of the Common Policy Declarations and the Coverage Parts and endorsements listed in that
declarations form.
In return for payment of the premium, we agree with the Named Insured to provide the insurance afforded by a
Coverage Part forming part of this policy. That insurance will be provided by the company indicated as insuring
company in the Common Policy Declarations by the abbreviation of its name opposite that Coverage Part.
One of the companies listed below (each a stock company) has executed this policy, and this policy Is countersigned by the officers listed below:
The Travelers Indemnity Company (IND)

(

The Phoenix Insurance Company (PHX)
The Charter Oak Fire Insurance Company (COF)
Travelers Property Casualty Company of America (TIL)
The Travelers Indemnity Company of Connecticut (TCT)
The Travelers Indemnity Company of America (TIA)
Travelers Casualty Insurance Company of America (ACJ)

tJ~c.~
Secretary

Page 2 of 2

President

Includes the copyrighted material of Insurance SeNices Office, Inc. with its permission.

IL TO 01 01 07 (Rev. 06-09)

NON-STANDARD PAYMENT SCHEDULE
POLICY NUMBER: M5J-BM21-4245R337-TIL-12
EFFECTIVE DATE: 03/31/12
ISSUE DATE: 04/24/12

PAYMENT DUE DATES

IL TO 30 12 90

AMOUNT

PAGE

1 OF

OFFICE: DIAMOND BAR
189
PRODUCER NAME: R-T SPECIALTY INS SERV

CBX29

(
POLICY NUMBER: M5J -BM21-4245R337-TIL-12

GENERAL PURPOSE ENDORSEMENT

NAMED INSURED IS AMENDED TO READ:
COMMERCIAL INDUSTRIAL BUILDING OWNER'S ALLIANCE, INC. DOING BUSINESS AS CIBA
INSURANCE SERVICES, AND ITS AFFILIATED, SUBSIDIARY, AND ASSOCIATED COMPANIES
AND/OR CORPORATIONS AS NOW EXIST OR MAY HEREAFTER BE CONSTITUTED OR ACQUIRED
(KNOWN AS ClBA RESIDENTIAL); ANY ASSOCIATE OF THE COMMERCIAL INDUSTRIAL
BUILDING OWNER'S ALLIANCE, INC. TO WHOM EVIDENCE OF BOILER « MACHINERY
INSURANCE OR A CERTIFICATE OF INSURANCE HAS BEEN ISSUED AND WHICH DESCRIBES
THE SPECIFIC LOCATION COVERAGE IS LIMITED TO BY CIBA INSURANCE SERVICES.

IL T8 00

Page

(

BOILER AND MACHINERY
(
\

BOILER AND MACHINERY
\

...

TRAVELERSJ

One Tower Square, Hartford, Connecticut 06183

ENERGYMAX21
EQUIPMENT BREAKDOWN PROTECTION

POLICY NUMBER: M5J-BM21-4245R337-TIL-12
ISSUE DATE:04-24-12

INSURING COMPANY:
TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
EFFECTIVE DATE: Same as policy unless otherwise specified:
THESE DECLARATIONS APPLY TO ALL LOCATIONS COVERED BY THIS POLICY
EXCEPTIONS:
Insurance applies only to coverage for which a Limit of Insurance, a number of Days/Hours, the word INCLUDED,
or other coverage indicator is shown at a Covered Premises. If INCLUDED is shown, then the limit for that coverage is part of the "Total Limit per Breakdown".
LIMIT OF INSURANCE OR DAYS/HOURS

COVERAGE
"Total Umit per Breakdown"
1

Property Damage

2a Business Income

$
$
$

INCLUDED WITH BREAKDOWN LIMIT

50,000,000
INCLUDED WITH BREAKDOWN LIMIT

Business Income "Period of Restoration" extension 3 a
2b Extra Expense
Extra Expense "Period of Restoration" extension

Days

$
$

2c Spoilage Damage

Days

2d Utility Interruption
Coverage applies only if interruption lasts at least:
2e Brands & Labels
2f Contingent Time Element
Covered Premises:

500,000
1,000,000

Hours

$
$

1,000,000
NOT COVERED

$
$
$
$

50,000

10,000,000

SEE BM T8 01

Sales, Services or Materials:

2g "Data" or "Media"
2h Error in Description
2i

Expediting Expense

Newly Acquired Locations
Number of Days of coverage

2,000,000
1,000,000

9 a Days

2k Ordinance or Law, Demolilion, Increased
Cost of Construction

The most we will pay for direct damage to "Covered Property" is the Limit of Insurance shown for each of the following. These limits are a part of, not in addition to, the Property Damage Limit shown in 1 above. The minimum
limit for each of the following is $25,000.
COVERAGE LIMITATIONS
Ammonia Contamination

Hazardous Substance
Water Damage
BM TO 531005
PRODUCER:

LIMIT OF INSURANCE

$
$
$

Includes copyrighted material of Insurance Services Office Inc., 2000
with its permission.
OFFICE

1,000,000
1,000,000
500,000
Page 1 of 2

(
CONDITIONAL and OPTIONAL COVERAGES
Number of Days for Nolice of Cancellalion
60 Days
Except: 10 days for non-payment of Premium
"Diagnoslic Equipment" (Included or Excluded)

EXCLUDED

"Produclion Machines" (Included or Excluded)

INCLUDED

The deduclible applies only to a coverage for which an amount, hours, days, the word INCLUDED or other coverage indicator is shown. If INCLUDED is shown under the deductible, then the deduclible for that coverage is part
of the Combined Deduclible or other deduclible identified.
AMOUNT, HOURS, DAYS or PERCENTAGE

DEDUCTIBLE

NOT COVERED

Combined Deductible:
Property Damage:
Business Income:
Extra Expense:
Spoilage Damage:
Utility Interruplion:
Conlingent Time Element:
Ammonia Contaminalion:

SEE BM T8 00
COMBINED WITH PROPERTY DAMAGE
INCLUDED WITH PROPERTY DAMAGE
INCLUDED WITH PD DEDUCTIBLE
INCLUDED WITH PD DEDUCTIBLE
NOT COVERED
INCLUDED WITH PD DEDUCTIBLE

Other:

NUMBERS OF FORMS, SCHEDULES AND ENDORSEMENT FORMING PART OF THIS COVERAGE PART
ARE ATTACHED AS A SEPARATE LISTING.

Page 2 of 2

Includes copyrighted material of Insurance Services Office Inc., 2000
with its permission.

BM TO 5310 05

(
BOILER AND MACHINERY
GENERAL PURPOSE ENDORSEMENT

POLICY NUMBER: M5J-BM2l-4245R337-TIL-12

THIS ENDORSEMENT CHANGES THE POLICY.

PLEASE READ IT CAREFULLY.

PROPERTY DAMAGE DEDUCTIBLES:
============================

THE DEDUCTIBLE AMOUNT SPECIFIED IN THE SPECIFIC LOCATION'S CERTIFICATE OF
INSURANCE ISSUED FOR TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
EQUIPMENT BREAKDOWN PROTECTION POLICY NUMBER 4245R337 SUBJECT TO A
MINIMUM OF $5,000.
NUMBERS OF FORMS, SCHEDULES AND ENDORSEMENT FORMING PART OF THIS COVERAGE
PART ARE ATTACHED AS A SEPARATE LISTING.

2012 The Travelers Indemnity Company.

(
8M T8 00

Page

(
BOILER AND MACHINERY
GENERAL PURPOSE ENDORSEMENT

POLICY NUMBER: M5J-BM21-4245R337-TIL-12

THIS ENDORSEMENT CHANGES THE POLICY.

PLEASE READ IT CAREFULLY.

ORDINANCE OR LAW, DEMOLITION, INCREASED COST OF CONSTRUCTION LIMITS
====================================================================
$

500,000

$5,000,000

ALL BUILDINGS BUILT IN 1969 OR OLDER.
ALL OTHER COVERED LOCATIONS

2012 The Travelers Indemnity Company.

8M T8 01

Page

(
BOILER AND MACHINERY
GENERAL PURPOSE ENDORSEMENT

POLICY NUMBER: MSJ-BM21-424SR337-TIL-12

THIS ENDORSEMENT CHANGES THE POLICY.

PLEASE READ IT CAREFULLY.

RISKS ATTACHING
================
Coverage provided under this Policy shall apply only to members insured whose
coverage is:
a. Effective between 03-31-2012 and 03-30-2014; and
b. Ends no later than the expiration date of this policy, 03-30-2014
12:00 Midnight Standard Time at your mailing address.

2012 The Travelers Indemnity Company.

BM T8 02

Page

BOILER AND MACHINERY
GENERAL PURPOSE ENDORSEMENT

POLICY NUMBER: MSJ-BM21-424SR337-TIL-12

THIS ENDORSEMENT CHANGES THE POLICY.

PLEASE READ IT CAREFULLY.

POLICY EXPIRATION
=================
The Policy Period shown in the Common Policy Declarations IL TO 02 is changed
to the following:
2. POLICY PERIOD: From 03-31-2012 12:01 A.M. Standard Time at your
mailing address

03-30-2014 12:00 Midnight Standard Time at your mailing address

2012 The Travelers Indemnity Company.

BM T8 03

Page

ENERGYMAX 21
EQUIPMENT BREAKDOWN PROTECTION
TABLE OF CONTENTS

A. Coverage .......................................................................................................................................... 1
1.

Property Damage ........................................................................................................................ 1

Coverage Extensions ..................................................................................................................1
a. Business Income ................................................................................................................... 1
b. Extra Expense ......................................................................................................................1
c. Spoilage Damage ................................................................................................................. 1
d. Utility Interruption .................................................................................................................. 2
e. Brands & Labels .................................................................................................................... 2
f. Contingent Time Element ...................................................................................................... 2
g. Data or Media Coverage ....................................................................................................... 3
h. Error in Description ............................................................................................................... 3
i. Expediting Expense ..............................................................................................................3
j. Newly Acquired .....................................................................................................................3
k. Ordinance or Law Coverage .................................................................................................. 4

B. Exclusions .......................................................................................................................................5

(

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Ordinance or Law ........................................................................................................................ 5
Earth Movement ..........................................................................................................................5
Water (Flood, etc.) ...................................................................................................................... 5
Nuclear Hazard ........................................................................................................................... 5
War or Military Action .................................................................................................................. 5
Explosion .................................................................................................................................... 5
Fire or Combustion Explosion ...................................................................................................... 6
Chemical Recovery Boiler Furnace Explosion .............................................................................. 6
Testing ........................................................................................................................................6
Water or Other Means to Extinguish a Fire ..................................................................................6

11. "Data"j"Media" Costs ................................................................................................................... 6
12.
13.
14.
15.
16.
17.
18.
19.
20.

Depletion, Deterioration, Corrosion, Erosion, Wear and Tear ....................................................... 6
Hail or Windstonn ........................................................................................................................ 6
Other Perils (if not covered elsewhere) ........................................................................................ 6
Delay in, or Interruption of, any Business ..................................................................................... 6
Business Income, Extra Expense, Utility Interruption exclusion .................................................... 6
Lack or Excess of Power, Light, Heat, Steam or Refrigeration .....................................................6
Utility Interruption exclusion ......................................................................................................... 6
Other indirect result ..................................................................................................................... 7
Neglect to Save and Preserve ..................................................................................................... 7

C. Limits of Insurance ..........................................................................................................................7
1.
2.
3.
4.

"One Breakdown" ........................................................................................................................ 7
More than one Insured ................................................................................................................ 7
Multiple coverages ...................................................................................................................... 7
Direct Damage sublimits .............................................................................................................. 7
a. Ammonia Contamination ....................................................................................................... 7
b. Hazardous Substance ...........................................................................................................7
c. Water Damage ...................................................................................................................... 7

BM TO 52 08 02

Page 1 of 3

D. Deductible ........................................................................................................................................ 7
1.
2.

Application of Deductibles ........................................................................................................... 7
Determination of Deductibles ....................................................................................................... 8
a. Dollar Deductible ................................................................................................................... 8
b. Multiple per Unit Deductible ................................................................................................... 8
c. Time Deductible .................................................................................................................... 8
d. Multiple of Daily Value Deductible ......................................................................................... 8
e. Percentage of Loss Deductible .............................................................................................. 8
f. Minimum or Maximum Deductible ......................................................................................... 8

E. Conditions .......................................................................................................................................8
1.

Loss Conditions ........................................................................................................................... 8

a. Abandonment ....................................................................................................................... 8
b. Appraisal ............................................................................................................................... 9

c. Defense ................................................................................................................................ 9
d.

e.
f.

g.
h.
i.
j.
k.
I.

n.
o.

Duties in the Event of Loss or Damage .................................................................................. 9
Insurance Under Two or More Coverages ........................................................................... 10
Legal Action Against Us ...................................................................................................... 10
Other Insurance .................................................................................................................. 10
Privilege to Adjust with Owner ............................................................................................. 10
Reducing Your Loss ............................................................................................................ 10
Transfer of Rights of Recovery Against Others to Us ........................................................... 10
Loss Payment ..................................................................................................................... 11
Valuation ............................................................................................................................. 11
Business Income Report of Values ...................................................................................... 12
Business Income Coinsurance ............................................................................................ 12
Conditional Suspension of Coinsurance .............................................................................. 13

General Conditions .................................................................................................................... 13

a. Bankruptcy .......................................................................................................................... 13
b. Cancellation ........................................................................................................................ 13
c. Concealment, Misrepresentation or Fraud ........................................................................... 13
d. Currency ............................................................................................................................. 13
e. Liberalization ....................................................................................................................... 13
f. No Benefit to Bailee ............................................................................................................ 13
g. Policy Period, Coverage Territory ........................................................................................ 13
h. Values and Premium Adjustments ....................................................................................... 14
i. Suspension ......................................................................................................................... 14
Joint Disputed Loss Agreement ................................................................................................. 14

Definitions ...................................................................................................................................... 15
1.
2.
3.
4.
5.
6.
7.
8.

Breakdown ................................................................................................................................ 15
Business Income ....................................................................................................................... 16
Business Income Actual Annual Value ....................................................................................... 16
Business Income Estimated Annual Value ................................................................................. 16
Computer Equipment ................................................................................................................ 16
Covered Cause of Loss ............................................................................................................. 16
Covered Equipment. .................................................................................................................. 16
Covered Property ...................................................................................................................... 17

Page 2 of 3

BM TO 520802

(
9. Data .......................................................................................................................................... 17
10. Diagnostic Equipment ............................................................................................................... 17
lL Extra Expense ........................................................................................................................... 17
13. Hazardous Substance ............................................................................................................... 17
13. Media ........................................................................................................................................ 17
14. One Breakdown ........................................................................................................................ 17
15. Ordinary Payroll ........................................................................................................................ 17
16. Period of Restoration ................................................................................................................. 17
17. Production Machines ................................................................................................................. 17
18. Stock ......................................................................................................................................... 18
19. Total Limit per Breakdown ......................................................................................................... 18

BM TO 52 08 02

Page 3 of 3

BOILER AND MACHINERY

EnergyMax 21
EQUIPMENT BREAKDOWN PROTECTION
Various provIsions in this Policy restrict coverage.
Read the entire policy carefully to determine rights,
duties and what is and is not covered.

extent that they do not exceed the
amount of loss that otherwise would
have been payable under this Coverage Extension.

Throughout this Policy the words "you" and "your"
refer to the Named Insured shown in the Declarations
or as endorsed hereunder. The words "we", "us" and
"our" refer to the Company providing this insurance.

(3) The "Covered Equipment" must either
be "Covered Property" or be property
of others that is:

Other words and phrases that appear in quotation
marks have special meaning. Refer to Section F Delinitions.

(a) Located on or within 500 feet of a
Covered Premises insured under
this Policy; and

A. Coverage

(b) Used to supply air conditioning,
communication selVices, electric
power, gas, heating, refrigeration,
steam, water or waste treatment
to the described premises.

1. Property Damage
We will pay for direct damage caused by a
"Covered Cause of Loss" to "Covered Property" located at the Covered Premises described in the Declarations.

(1) We will pay the reasonable "Extra

"Covered Cause of Loss" is a "Breakdown" to
"Covered Equipment".

Expense" you necessarily incur to
operate your business during the "Period of Restoration".

Coverage Extensions
You may extend coverages provided under
Paragraph A.f. above. Coverage is provided
if either a limit, the word INCLUDED, or other
coverage indicator is shown for that coverage
in the Declarations. No coverage is provided
unless a limit, the word INCLUDED or other
coverage indicator is shown.

(2) We will consider the experience of
your business before the "Breakdown" and the probable experience
you would have had without the
"Breakdown" in determining the
amount of your payment.
(3) The "Covered Equipment" must either

These coverages apply only to that portion of
the loss or damage that is a direct result of a
"Covered Cause of Loss" that is not excluded
elsewhere in this policy. The "Breakdown"
must occur during the policy period, but expiration of the policy does not limit our liability
under these Coverage Extensions.
a.

be "Covered Property" or be property
of others that is:
(a) Located on or within 500 feet of a
Covered Premises insured under
this Policy; and
(b) Used to supply air conditioning,
communication selVices, electric

Business Income

power, gas, heating, refrigeration,

We will pay:

steam, water or waste treatment
to the described premises.

(1) Your actual loss of "Business In-

come" from a total or partial interruption of business during the "Period of
Restoration"; and
(2) The "Extra Expense" you necessarily

incur to reduce or avert the amount of
loss under this Coverage Extension.
We will pay for such expenses to the

BM T1 570802

Extra Expense

Spoilage Damage
(1) We will pay for spoilage damage to

raw materials, property in process or
finished products, provided all of the
following conditions are met:
(a) The raw material, property in process or linished products must be

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Page 1 of 18

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BOILER AND MACHINERY

in storage or in the course of being manufactured; and

(3) The "Covered Equipment" is used to
supply air conditioning, communication services, electric power, gas,
heating, refrigeration, steam, water or
waste treatment to your premises;
and

(b) You must own or be legally liable
under written contract for the raw
materials, property in process or
finished products; and

(4) The interruption of utility service to

(c) The spoilage damage must be
due to the lack or excess of
power, light, heat, steam or refrigeration.
(2) We will also pay any necessary expenses you incur to reduce or avert
the amount of loss under this Coverage Extension. We will pay such expenses to the extent that they do not
exceed the amount of loss that otherwise would have been payable under this Coverage Extension.

your Covered Premises lasts at least
the consecutive period of time shown
in the Declarations. Once this waiting
period is met, coverage will commence at the initial time of the interruption and will then be subject to all
applicable deductibles.
e.

(1) If branded or labeled merchandise

that is "Covered Property" is damaged by a "Breakdown", we may take
all or any part of the property at an
agreed or appraised value. If we take
such property, you may:

(3) The "Covered Equipment" must either

be "Covered Property" or be property
of others that is:

(a) Stamp the word SALVAGE on
the merchandise or its containers
if the stamp will not physically
damage the merchandise; or

(a) Located on or within 500 feet of a
Covered Premises insured under
this Policy; and

(

(b) Used to supply air conditioning,
communication services, electric
power, gas, heating, refrigeration,
steam, water or waste treatment
to the described premises.

(b) Remove the brands or labels if
doing so will not physically damage the merchandise. You must
re-Iabel the merchandise or its
containers to comply with any
law.

d. Utility Interruption

If you purchase Utility Interruption coverage and have selected coverage for
Business Income, Extra Expense and/or
Spoilage Damage, the selected coverage(s) are extended to include loss resulting from the interruption of utility
services provided all of the following conditions are met:
(1) The interruption is the direct result of

a "Breakdown" to "Covered Equipment" owned, operated or controlled
by the local private or public utility or
distributor that directly generates,
transmits, distributes or provides utility services which you receive; and
(2) The "Covered Equipment" is located

more than 500 feet from the affected
Covered Premises insured under this
Policy; and

Page 2 of 18

Brands & Labels

(2) We will pay the reasonable cost you

incur to perform the activity described
in Paragraphs (1 )(a) and (1 )(b), but
the total we will pay for these costs
and the value of the damaged property will not exceed the applicable
Limit of Insurance on such property.
f.

Contingent Time Element
(1) If you purchase Contingent Time

Element coverage and have selected
coverage for Business Income and/or
Extra Expense, the selected coverage(s) are extended to cover your
loss resulting from a "Breakdown" to
"Covered Equipment" at a location
shown in the Declarations, that is not
owned or operated by you and which:
(a) Wholly or partially prevents the
delivery of services or materials
shown in the Declarations, to you

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or from you 10 others for your account; or

error or omission in the description of a
location as insured under this Policy.

(b) Results in the loss of sales at
your Covered Premises shown in
the Declarations.

You agree to give us prompt notice of any
correction or addition to the description of
a location insured under this Policy.

(2) You shall use your influence to induce the contributing or recipient location to make use of any other machinery, equipment, supplies or
locations available in order to resume
operations and delivery of services or
materials to you, or the acceptance of
products or services from you. You
shall cooperate with the contributing
or recipient locations to this effect in
every way, but not financially unless
authorized by us.
g.

"Data" Or IlMedia" Coverage

If:
(1) you purchase "Data" or "Media" Coverage; and

(

(2) you have selected coverage for Business Income and/or Extra Expense;
and
(3) "Media" is damaged or "Data" is lost
or corrupted as a direct result of a
"Breakdown" to "Covered Equipment",
we will also pay your actual loss of "Business Income" and/or your "Extra Expenses" during the time necessary to:
(1) Research, recreate, replace or restore the damaged "Media" or lost or
corrupted "Data"; and
(2) Reprogram instructions used in any
covered "Computer Equipment".
There shall be no coverage for any "Data"
or "Media" that cannot be replaced, recreated, or restored.
The most we will pay under this Coverage
Extension for "Business Income" and/or
your "Extra Expense" incurred is the Limit
of Insurance indicated for "Data" or "Media" coverage in the Declarations.
h. Error in Description
We will pay your loss covered by this
Policy if such loss is otherwise not payable solely because of any unintentional

8M T1 570802

Expediting Expense
With respect to direct damage to "Covered Property" we will pay for the reasonable extra cost you necessarily incur to:
(1) Make temporary repairs; and/or

(2) Expedite the permanent repairs or
replacement of the damaged property.
j.

Newly Acquired Locations
We will automatically provide coverage at
newly acquired locations you have purchased or leased. This coverage begins
at the time you acquire the property and
continues for a period not exceeding the
number of days indicated in the Declarations for Newly Acquired Locations, under
the following conditions:
(1) You must promptly inform us in writing of the newly acquired locations;
and
(2) You agree to pay an additional premium as determined by us; and
(3) The coverage for these locations will
be subject to the same terms, conditions, exclusions and limitations as
other insured Covered Premises until
endorsed onto the Policy; and
(4) If the coverages and deductibles vary
for existing premises, then the coverages for the newly acquired locations
will be the broadest coverage, highest limits and highest deductibles applicable to the existing Covered
Premises.
(5) The coverage under this Coverage
Extension will end when any of the
following first occurs:
(a) This Policy expires; or
(b) The number of days specified in
the Declarations for this coverage
expires after the location is acquired; or
(c) The acquisition is reported to us
in writing; or

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BOILER AND MACHINERY

(d) The location is specifically insured by this Policy.
k.

most we will pay is the
increased cost of construction that we would
have paid to rebuild at
the
same
Covered
Premises; or

Ordinance or Law Coverage (including
Demolition and Increased Cost of
Construction)
The following applies despite the Ordinance or Law Exclusion and provided
these increases in loss are necessitated
by the enforcement of any ordinance, law,
rule, regulation or ruling that is in force at
the time of the "Breakdown", which regulate the demolition, construction, repair or
use of the building or structure. With respect to the building or structure that was
damaged as a result of a "Breakdown",
(1) We will pay for:

(a) The loss in value of the undamaged portion of the building or
structure as a consequence of
enforcement of an ordinance,
law, rule, regulation or ruling that
requires the demolition of undamaged parts of the same
building or structure;

(

(b) Your actual cost to demolish and
clear the site of the undamaged
parts of the same building or
structure as a consequence of
enforcement of an ordinance,
law, rule, regulation or ruling that
requires the demolition of such
undamaged property; and
(c) The increased cost actually and
necessarily expended to:
(i) Repair or reconstruct the undamaged or destroyed portions of the building or structure; and
(ii) Reconstruct or remodel the
undamaged portion of that
building or structure with
buildings or structures of like
materials, height, floor area,
and style for like occupancy,
whether or not demolition is
required on:
The
same
Covered
Premises or at another
location, if you so elect.
However, if you rebuild at
another location, the

Page 4 of 18

Another location if the
relocation is required by
the ordinance, law, rule,

regulation or ruling. The
most we will pay is the
increased cost of construction at the new location.
(d) If you have selected Business Income coverage and/or Extra Expense coverage, we will pay under this Coverage Extension the
additional loss of "Business Income" and/or your "Extra Expense" that you actually incur as
a direct consequence of enforcement of an ordinance, law,
rule, regulation or ruling.
(2) We will not pay for:

(a) Demolition or site clearing until
the undamaged portions of the
buildings or structures are actually demolished;
(b) Increase in loss until the damage
or destroyed buildings or structure are actually rebuilt or replaced and approved by the
regulating government agency;
(c) Loss due to any ordinance, law,
rule, regulation or ruling that:
(i) You were required to comply
with before the loss, even if
the building was undamaged;
and
(ii) You failed to comply with;
(d) Increase in loss, excess of the
amount required to meet the
minimum requirement of an ordinance, law, rule, regulation or

ruling enforcement at the time of
the "Breakdown"; or
(e) Increase in loss resulting from a
substance declared to be haz-

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BM T1 570802

BOILER AND MACHINERY

ardous to health or environment
by any government agency.

Property", except as provided under Coverage Extension 2.k.

(3) If:

However the words 'use' and 'operation' shall
be eliminated as respects a covered "Breakdown" to electrical supply and emergency
generating equipment located on any Covered Premises identified in the Declarations,
when continued operation is contingent on
the presence of such electrical supply and
emergency generating equipment as mandated by any government agency.

(a) The building or structure is damaged by a "Breakdown" that is
covered by this Policy; and
(b) There is other physical damage
that is not covered by this Policy;
and
(c) The building damage in its entirety results in enforcement of
ordinance, law, rule, regulation or
ruling;

then we will not pay the full amount of
the loss under this coverage. Instead,
we will pay only that proportion of
such loss; meaning the proportion
that the covered "Breakdown" loss
bears to the total physical damage.

3. Water

Earth movement including, but not limited to,
earthquake, landslide, land subsidence, mine
subsidence, sinkhole collapse or volcanic action.
a.

But if the building or structure sustains direct physical damage that is
not covered under this Policy and
such damage is the subject of the ordinance, law, rule, regulation or ruling, then there is no Ordinance or
Law coverage under this Policy even
if the building has also sustained
damage by a covered "Breakdown".

(

(4) If you have selected coverage for
Business Income andlor Extra Expense, then the "Period of Restoration" is extended to include the additional period of time required for
demolition, removal, repair, remodeling or reconstruction.
B. Exclusions
We will not pay for loss or damage caused directly or indirectly by any of the following. Such
loss or damage is excluded regardless of any
other cause or event that contributes concurrently
or in any sequence to the loss.
The exclusions apply whether or not the loss
event results. in widespread damage or affects a
substantial area.
1. Ordinance or Law
Increase in loss from the enforcement of any
ordinance, law, rule, regulation or ruling which
restricts or regulates the repair, replacement,
alteration, use, operation, construction, installation, clean-up or disposal of "Covered

BM T1 570802

Earth Movement

Flood, surface water, waves, tides, tidal
waves, tsunami, overflow of any body of
water, or their spray, all whether driven by
wind or not; or

b. Mudflow or mudslides; or
c.

Water damage caused by backup of
sewers, drains, or drainage piping; or

d. Water damage caused by the discharge
or leakage of a sprinkler system, sewer
piping or domestic water piping.
4.

Nuclear Hazard
Nuclear reaction or radiation, or radioactive
contamination, however caused.

5. War or Military Action
a.

War, including undeclared or civil war;

b. Warlike action by a military force, including action in hindering or defending
against an actual or expected attack, by
any government, sovereign or other
authority using military personnel or other
agents; or
c.

Insurrection,
rebellion,
revolution,
usurped power or action taken by governmental authority in hindering or defending against any of these.

6. An explosion
However we will pay for direct loss or damage
caused by an explosion of "Covered Equipment" of a kind specified in a. through f. below, and which is not otherwise excluded under this Section B. or elsewhere in this Policy:

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(
BOILER AND MACHINERY

Steam boiler; or

b. Electric steam generator; or

Riot; or

Smoke; or

Steam engine; or

Vandalism; or

Gas turbine or any other moving or rotating machinery, when such explosion is
caused by centrifugal force or mechanical
breakdown.

Vehicles; or

Steam piping; or

Fire or combustion explosion including
those that:
a. Result in a "Breakdown"; or
b. Occur at the same lime as a "Breakdown"; or
c.

(

h. Objects falling from aircraft or missiles; or

d. Steam turbine; or

g. Molten material; or

Ensue from a "Breakdown".

Explosion within the furnace of a chemical
recovery type boiler or within the gas passages from the furnace to the atmosphere.

Damage to "Covered Equipment" undergoing
a pressure or electrical test.

m. Weight of snow, ice, sleel.

15. A delay in, or an Interruption of, any
business, manufacturing or processing
activity except as provided in Business
Income coverage, Extra Expense coverage
andlor Utility Interruption Coverage.

16. With

respect to Business Income
coverage, Extra Expense coverage, Utility
Interruption
coverage,
Ihe
following
additional exclusions shall apply:
a.

The business Ihat would not or could nol
have been carried on if the "Breakdown"
had not occurred; or

10. Water or other means used to extinguish a
fire, even when the a!lempt is unsuccessful.

b. Your failure to use due diligence and dispalch to operale your business as nearly
normal as practicable at the Covered
Premises shown in the Declarations; or

11. Costs to research, reconstruct or restore

damaged "Datal! or "Media" except as
provided under Coverage Extension 2.g.
12. Depletion,
deterioration,
corrosion,
erosion, wear and tear, rust, fungus,
decay, wet or dry rot, or mold. However, if
a "Breakdown" ensues, we will pay the
ensuing loss or damage not otherwise
excluded.

13. A "Breakdown" that is caused directly or
indirectly by Hail or Windstorm.

14. A "Breakdown" that is the direct or indirect
result of the following causes of loss, if such
cause of loss is covered by another policy of
insurance or self-insurance risk retention plan
in force at the time of the loss, regardless of
deductible. Also excluded are all resulting
direct and indirect loss.
a.

Aircraft; or

The suspension, lapse or cancellation of
a contract following a "Breakdown" extending beyond the time business could
have resumed if the conlracl had not
lapsed, been suspended or canceled.

17. Lack or excess of power, light, heat, steam
or refrigeration except as provided by
Business Income coverage, Extra Expense
coverage, Utility Interruption coverage andlor
Spoilage Damage coverage.
18. With respect to Utility Interruption
coverage, any loss resulting from the
lollowing causes of loss whether or not
coverage for that cause of loss is provided by
another policy or self-insurance risk retention
plan you have. Also excluded are all resulting
direct or indirect loss.
a. Aircraft; or
b. Civil commotion; or

b. Civil commotion; or

d. Freezing caused by cold weather; or

Collapse; or

d. Freezing caused by cold weather; or

Impact of aircraft, missile or vehicle; or

Lightning; or

g. Molten material; or

Page60f 18

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BM T1 570802

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BOILER AND MACHINERY

h. Objects falling from aircraft or missiles; or
i.

Riot; or

Smoke; or

Vandalism; or

Vehicles; or

b. Hazardous Substance
The following applies despite the operation of the Ordinance or Law Exclusion:
If "Covered Property" is damaged, can·
taminated or polluted by a "Hazardous
Substance" as a direct result of a "Breakdown" to "Covered Equipment", we will
pay for any additional expenses incurred
by you for clean-up, repair, replacement
or disposal of that property.

m. Weight of snow, ice, sleet; or
n. Acts of Sabotage; or
o. Deliberate act(s) of load shedding by the
supplying or distributing utility.

As used here, additional expenses means
the additional cost incurred over and
above the amount that we would have
paid had no "Hazardous Substance" been
involved with the loss.

19. Any other indirect result of a "Breakdown"
to "Covered Equipment"' except as provided
under Business Income coverage, Extra
Expense coverage,
Spoilage
Damage
coverage, Utility Interruption coverage.

Ammonia is not considered to be a "Haz·
ardous Substance" as respects this limi·
tation.

20. Neglect by you to use all reasonable means
to save and preserve "Covered Property"
from further damage at and after the time of
loss.

If you have selected Business Income
coverage and/or Extra Expense cover·
age, we will also pay under this Coverage
Extension for any loss of "Business In·
come" or "Extra Expense" caused by
such contamination.

C. Limits of Insurance

1. The most we will pay for any and all cover-

(

ages for loss or damage from any "One
Breakdown" is the applicable Limit of Insur·
ance shown in the Declarations.

The maximum we shall pay for damage to
"Covered Property", "Business Income"
and/or "Extra Expense" under this cover·
age extension shall be the limit indicated
on the Declaration under Hazardous
Substance.

Any payment made will not be increased if
more than one insured is shown in the Decla·
rations.
For each coverage in Paragraph A.1. and
A.2. if:

INCLUDED is shown in the Declarations,
the limit for such coverage is part of, not
in addition to, the "Total Limit per Breakdown",

b. A limit is shown in the Declarations, we
will not pay more than the Limit of Insurance for each such coverage.
4.

The most we will pay for direct damage to
"Covered Property" for each of the following
is the amount indicated in the Declarations
under Coverage Limitations. The limits are
part of, not in addition to, the Limit of Insur·
ance for Property Damage.
a.

Ammonia Contamination

If "Covered Property" is contaminated by
ammonia as a direct result of a "Break·
down" to "Covered Equipment", we will
pay for this kind of damage, including sal·
vage expense.

BM T1 570802

Water Damage
If "Covered Property" is damaged by wa·
ter as a direct result of a "Breakdown" to
"Covered Equipment", we will pay for this
kind of damage, including salvage expense.

D. Deductibles
1. Application of Deductibles
We will not pay for loss or damage resulting
from any "One Breakdown" until the amount
of covered loss or damage exceeds the de·
ductible shown in the Declarations for each
applicable coverage. We will then pay the
amount of covered loss or damage in excess
of the deductible, up to the applicable Limit of
Insurance.
Deductibles apply separately for each appli·
cable coverage except if:

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BOILER AND MACHINERY

(3) Multiply the daily value in Paragraph
(2) by the number of daily value multiples shown in the Declarations. We
will first subtract this deductible
amount from any loss we would otherwise pay. We will then pay the
amount of loss or damage in excess
of the deductible, up to the applicable
Limit of Insurance.

a. A deductible is shown as Combined for
any of the coverages in the Declarations,
then we will first subtract the combined
deductible amount from the aggregate
amount of any loss to which the combined deductible applies; or
b. More than one "Covered Equipment" is
involved in "One Breakdown", then only
one deductible, the highest, shall apply
for each of the applicable coverages.
2.

If a deductible is expressed as a percentage of loss in the Declarations, we will not
be liable for the indicated percentage of
the gross amount of loss or damage (prior
to the applicable deductible or coinsurance) insured under the applicable coverage.

Determination of Deductibles
a.

Dollar Deductible
If a dollar deductible is shown in the
Declarations, we will first subtract the deductible amount from any loss we would
otherwise pay.

b. Multiple per Unit Deductible

(

Percentage of Loss Deductible

Minimum Or Maximum Deductible
(1) If:

If a multiple of units is shown in the Declarations, the deductible will be calculated
as the sum of the multiplier times the
number of units specified. (For example:
if the deductible is specified as $25/hp for
air conditioning units, and a covered 500
hp air conditioning unit suffered a "Breakdown", the deductible will be $25 times
500 hp which equals $12,500.)

(a) A minimum dollar amount deductible is shown in the Declarations;and
(b) The dollar amount of the Multiple
per Unit, Multiple of Daily Value
or the Percentage of Loss Deductible is less than the Minimum
Deductible:

c. Time Deductible

then the Minimum Deductible amount
shown in the Declarations will be the
applicable deductible.

If a time deductible is shown in the Declarations, we will not be liable for any loss
under that coverage that occurs during
that specified time period immediately
following a "Breakdown". If a time deductible is shown in days, each day shall
mean twenty-four consecutive hours.

(2) If:

(a) A maximum dollar amount deductible is shown in the Declarations;and
(b) The dollar amount of the Multiple
per Unit, Multiple of Daily Value
or the Percentage of Loss Deductible is greater than the
Maximum Deductible;

d. Multiple of Daily Value Deductible
If a multiple of daily value is shown in the
Declarations, this deductible will be calculated as follows:

entire Covered Premises
where the loss occurred, determine
the total amount of "Business Income" that would have been earned
during the "Period of Restoration"
had no "Breakdown" taken place.

Deductible
then
the Maximum
amount shown in the Declarations will
be the applicable deductible.

(1) For the

(2) Divide the result in Paragraph (1) by

the number of days the business
would have been open during the
"Period of Restoration". The result is
the daily value.

Page 8 of 18

E. Conditions
The following conditions apply in addition to the
Common Policy Conditions:

1. Loss Conditions
a.

Abandonment
There can be no abandonment of any
property to us.

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b. Appraisal
If you and we disagree on the value of the
property or the amount of loss, either may
make written demand for an appraisal of
the loss. In this event, each party will select a competent and impartial appraiser.
The two appraisers will select an umpire.
If they cannot agree, either may request
that a judge of a court having jurisdiction
make the selection. The appraisers will
state separately the value of the property
and amount of loss. If they fail to agree,
they will submit their differences to the
umpire. A decision agreed to by any two
will be binding. Each party will:
(1) Pay its chosen appraiser; and
(2) Bear the other expenses of the appraisal and umpire equally.
If there is an appraisal, we will still retain
our right to deny the claim.
c.

(

Defense
(1) If there is damage to property of another in your care, custody or control
and for which you are legally liable,
that was directly caused by a "Breakdown" to "Covered Equipment", we
will have the right and duty to defend
you against any suit alleging liability
for that property. However, we have
no duty to defend you against any
suit alleging liability for damage to
property not covered by this Policy.
(2) If a claim or suit is brought against
you alleging that you are liable for
damage to property of another that
was caused by a "Breakdown" to
"Covered Equipment", we will either:

(d) Preserve all repaired or replaced
"Covered Property" for our inspection, unless we authorize
otherwise; and
(e) As often as may be reasonably
required, permit us to inspect the
property proving the loss or damage and examine your books and
records; and

(f) Permit us to take samples of
damaged and undamaged property for inspection, testing and
analysis, and permit us to make
copies from your books and records; and
(g) Send us a signed, sworn proof of
loss containing the information
we request to investigate the
claim. You must do this within 60
days after our request. We will
supply you with the necessary
forms; and

(a) settle the claim or suit; or
(b) defend you against the suit but
keep for ourselves the right to
settle it at any point.

(i) Promptly send us any legal papers or notices received concerning the loss or damage; and

(1) You must see that the following are
done in the event of loss or damage
to "Covered Property":
(a) Give us a prompt notice of the
loss or damage. Include a description of the property invoived;
and

BM T1 570802

(c) Allow us a reasonable time and
opportunity to examine the property and Covered Premises before repairs are undertaken or
physical evidence of the "Breakdown" is removed. But you must
take whatever measures are
necessary to protect the property
and Covered Premises from further damage; and

(h) Cooperate with us in the investigation or settlement of the claim;
and

d. Duties in the Event of Loss or Damage

(

(b) As soon as possible, give us a
description of how, when and
where the loss or damage occurred; and

m Make

no statement that will assume any obligation or admit any
liability, for any loss or damage
for which we may be liable, without our consent.

(2) We may examine any Insured under
oath, white not in the presence of any
other Insured and at such times as
may be reasonably required, about

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Page 9 of 18

BOILER AND MACHINERY

any matter relaling 10 this insurance
or the claim, including an Insured's
books and records. In the event of an
examination, an Insured's answers
musl be signed.
e.

loss or damage with the owner of the
property. A receipt for payment from the
owner of that property will satisfy any
claim of yours against us.
i.

Reducing Your Loss

Insurance Under Two or More Coverages

As soon as possible after a "Breakdown"
you must:

If two or more of Ihis Policy's coverages
apply 10 the same loss or damage, we will
not pay more than the actual amount of
the loss or damage.

(1) Resume business, partially or com-

pletely; and

No one may bring a legal action against
us under this Policy unless:

(2) Make up for lost business within a
reasonable period of time. This reasonable period does not necessarily
end when operations are resumed;
and

(1) There has been full compliance with

(3) Make use of every reasonable means

Legal Action Against Us

all the terms of this Policy; and

to reduce or avert loss including:
(a) Working extra time or overtime at
the Covered Premises or at another location you own or acquire
to carryon the same operations;
or

(2) The action is brought within 2 years

after the date of the "Breakdown"; or
(3) We agree in writing that you have an

obligation to pay for damage to "Covered Property" of others or until the
amount of that obligation has been
determined by final judgment or arbitration award. No one has the right
under this Policy to bring us into any
action to determine your liability.

(

(b) Utilizing the property andlor
services of other concerns; or
(c) Using merchandise or other
property, such as surplus machinery, duplicate parts, equipment, supplies and surplus or reserve stock you own, control or
can obtain; or

g. Other Insurance
(1) You may have other insurance subject to the same plan, terms, conditions and provisions as the insurance
under this Policy. If you do, we will
pay our share of the covered loss or
damage. Our share is the proportion
that the applicable limit of Insurance
under this Policy bears to the Limits
of Insurance of all insurance covering
on the same basis.
(2) If there is other insurance covering
the same loss or damage, other than
that described in Paragraph (1), we
will pay only for the amount of covered loss or damage in excess of the
amount due from that other insurance, whether you can collect on it or
not. But we will not pay more than the
applicable Limit of Insurance.
h. Privilege to Adjust with Owner
In the event of loss or damage involving
property of others in your care, custody or
control, we have the right to settle the

Page 10 of 18

(d) Salvaging the damaged "Covered
Property".
j.

Transfer of Rights of Recovery Against
Others to Us

If any person or organization to or for
whom we make payment under this Policy has rights to recover damages from
another, those rights are transferred to us
to the extent of our payment.
That person or organization must do everything necessary to secure our rights
and must do nothing after loss to impair
them. But you may waive your rights
against 'another party in writing:
(1) Prior to a loss to your "Covered
Property" or covered income; or
(2) After a loss to your "Covered Property" or covered income only if, at
time of loss, that party is one of the
following:

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8M T1 570802

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BOILER AND MACHINERY

(a) Someone insured by this Policy;
(b) A business firm:
(i) Owned or controlled by you;
(ii) That owns or controls you; or
(c) Your tenant.
This will not restrict your insurance.
k.

Loss Payment
(1) In the event of loss or damage covered by this Policy, at our option, we
will either:
(a) Pay the value of lost or damaged
property; or
(b) Pay the cost of repairing or replacing the lost or damaged
property; or
(c) Take all or any part of the property at an agreed or appraised
value; or
(d) Repair, rebuild or replace the
property with other property of
like kind and quality.
(2) We will give notice of our intentions
within 30 days after we receive the
proof of loss.
(3) We will not pay more than your financial interest in the "Covered Property".
(4) We will pay for covered loss or damage within 30 days after we receive
the sworn proof of loss, if:
(a) You have complied with all of the
terms of the Policy; and
(b) We have reached agreement with
you on the amount of loss or an
appraisal award has been made
and we have not denied the
claim.

Valuation
(1) We will pay the amount you spend to
repair or replace "Covered Property"
directly damaged by a "Breakdown"
to "Covered Equipment". Our payment will be the smallest of:
(a) The cost to repair the damaged
property; or
(b) The cost to replace the damaged
property; or

8M T1 570802

(c) The amount you actually spend
that is necessary to repair or replace the damaged property.
But we will not pay for such damaged
property that is obsolete or useless to
you.
(2) If the cost of repairing or replacing a
part of "Covered Equipment" is
greater than:
(a) The cost of repairing the entire
"Covered Equipment"; or
(b) The cost of replacing the entire
"Covered Equipment";
we will pay only the smallest amount.
(3) If "Covered Equipment" cannot be
repaired or the cost to repair is more
than the cost to replace, and the
damage to the "Covered Equipment"
equals or exceeds 100% of the actual
cash value of the "Covered Equipment", you may choose to apply the
following provision.
New Generation Coverage - If you
want to replace damaged "Covered
Equipment" with a newer generation
"Covered Equipment" of the same
capacity, we will pay up to 25% more
than "Covered Equipment" of like
kind, quality and capacity would have
cost at the time of the "Breakdown".
(4) Except for New Generation Coverage, you must pay the extra cost of
replacing damaged property with
property of a better kind or quality or
of a larger capacity.
(5) If:

(a) Any damaged "Covered Property", that is intended for your
use, is protected by an extended
warranty, or maintenance or
service contract; and
(b) That warranty or contract becomes void or unusable due to a
"Breakdown";
we will reimburse you for the prorated
amount of the unused costs of nonrefundable, non-transferable warranties or contracts.

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BOILER AND MACHINERY

(6) Unless we agree otherwise in wriling,
if you do not repair or replace the
damaged property within 24 months
following the date of the "Breakdown", then we will pay only the
smaller of the:

had occurred, less any discounts
you offered and expenses you
otherwise would have had.
(10) Any salvage value of property
obtained for temporary repairs or use
following a "Breakdown" which
remains after repairs are completed
will be taken into consideralion in the
adjustment of any loss.

(a) Cost it would have taken to repair
or replace; or
(b) Actual cash value at the lime of
the "Breakdown".

(11) Pair, Sets or Parts

(7) If all of the following condilions are
met, property held by you for sale
will be valued at the selling price as if
no loss or damage had occurred, less
any discounts you offered 'and expenses you otherwise would have
had if:

(a) Pair or Set. In case of loss
caused by a "Covered Cause of
Loss" to any part of a pair or set
we may:
(i) Repair or replace any part to
restore the pair or set to its
value before the "Breakdown"; or

(a) The property was manufactured
by you; and

(ii) Pay the difference between
the value of the pair or set
before and after the "Break-

(b) The selling price of the property
is more than the replacement
cost of the property; and

(

down",

(b) Parts. In case of loss caused by a
"Covered Cause of Loss" to any
part of "Covered Property" consisling of several parts when
complete, we will only pay for the
value of the lost or damaged part.

(8) We will pay for loss to damaged
"Data" or "Media" as follows:
(a) Replacement cost for "Data" or
"Media" that are mass produced
and commercially available; and
(b) For all other "Data" or "Media", at
the cost of:
(i) Blank material for reproducing the records and
(ii) Labor to transcribe or copy
the records when there is a
duplicate.
(9) We will determine the value of "Covered Property" under Spoilage Damage Coverage as follows:
(a) For raw materials, the replacement cost;
(b) For goods in process, the replacement cost of the raw materials, the labor extended and the
proper proportion of overhead
charges; and
(c) For finished goods, the selling
price, as if no loss or damage

(

Page 12 of 18

m. Business Income Report of Values
You must report to us each year the
"business income estimated annual
value" for all Covered Premises to which
the Coverage Extension - Business Income applies.
n.

Business Income Coinsurance

We will not pay the full amount of any
"business income" loss if the "business
income actual annual value" is greater
than the "business income eslimated annual value" shown in your latest report.
Instead, we will determine the most we
will pay using the following steps:
(1) Divide the "business income estimated annual value" last reported to
us by the "business income actual
annual value" at the time of the
"Breakdown";
(2) Multiply the total amount of the covered loss of "business income" by the

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BM T1 570802

(
BOILER AND MACHINERY

figure determined in paragraph (1)
above;

(3) Subtract the applicable Deductible

The resulting amount, or the Business Income Limit, whichever is less, is the most
we will pay. We will not pay for the remainder of the loss.

Conditional Suspension of Coinsur-

(2) The "Covered Property"; or
(3) Your interest in the "Covered Prop-

erty"; or
(4) A claim under this Policy.

d. Currency
All amounts used herein are expressed in
United States currency and any loss
sustained under this policy shall be paid
in United States currency.

The Business Income Coinsurance provision is suspended if we have received
from you, prior to the "Breakdown", a
Business Income Report of Values as
follows:

If, in the event of loss or damage, the
amount of such loss or damage is computed in the foreign currency, the amount
of such loss or damage will then be converted into United States currency at the
rate of exchange as specified in the Wall
Street Journal as of the date the "Breakdown" occurred.

(1) The report must provide a "business

income estimated annual value" for
the Covered Premises affected by the
"Breakdown"; and

(

(2)

The "business income estimated annual value" must apply to an annual
period ending no more than 90 days
prior to the date of the "Breakdown".

Bankruptcy
The bankruptcy or insolvency of you or
your estate will not relieve us of an obligation under this Policy.

b. Cancellation
As respects this Policy, part 2 of the
"Cancellation" Condition of the Common
Policy Condition is replaced by the following:

We may cancel this Policy by mailing or
delivering to the first Named Insured
written notice of cancellation at least:

(1) 10 days before the effective date of
cancellation if we cancel for nonpayment of premium; or
(2) The number of days indicated in the

Declarations for Notice of Cancellation before the effective date of cancellation for any reason.

BM T1 570802

Liberalization

If we adopt any standard form revision for
general use that would broaden coverage
under this Policy without additional premium, the broadened coverage will immediately apply to this Policy if the revision is effective within 45 days prior to or
during the policy period.

General Conditions
a.

(1) This Policy; or

This provision applies separately to each
Covered Premises.

ance

Misrepresentation

This Policy is void in any case of fraud,
intentional concealment or misrepresentation of a material fact by you or any
other Insured, at any time, concerning:

from the amount determined in paragraph (2) above;

Concealment,
Fraud

No Benefit to Bailee
No person or organization, other than
you, having custody of "Covered Property" will benefit from this insurance.
Policy Period, Coverage Territory
Under this Policy:
(1) We cover loss or damage commenc-

ing;
(a) During the policy period shown in
the Declarations; and
(b) Within the coverage territory.
(2) The coverage territory is:

(a) The United States of America (including its territories and possessions);

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BOILER AND MACHINERY

(b) Puerto Rico; and

(3) There is disagreement between the
insurers as to whether there is coverage or as to the amount of the loss to
be paid, if any, by each insurer under
its own policies.

h. Values and Premium Adjustments
You shall report to us 100% of the total
insurable values at each Covered Premises every year as of the anniversary
date. The values shall be reported separately for each of the coverages provided.
Premium for each anniversary will be calculated for the ensuing period on the basis of rates in effect at the anniversary
date and for all values at risk.
You agree to keep the applicable records
for each policy year of the Policy Period
available for inspection by our representatives at all times during business hours,
and for a period of twelve months after
the end of the Policy year or after cancellation of this Policy.

Suspension

Whenever "Covered Equipment" is found
to be in, or exposed to, a dangerous condition, any of our representatives may
immediately suspend the insurance
against loss from a "Breakdown" to that
"Covered Equipment". This can be done
by delivering or mailing a written notice of
suspension to:
(1) Your last known address; or
(2) The address where the "Covered

Equipment" is located.
Once suspended in this way, your insurance can be reinstated only by an endorsement for that "Covered Equipment".
If we suspend your insurance, you will get
a pro rata refund of premium for that
"Covered Equipment". But the suspension will be effective even if we have not
yet made or offered a refund.

3. Joint or Disputed Loss Agreement

a. This condition is intended to facilitate
payment of insurance proceeds when:
(1) Both a commercial property policy

and this Policy are in effect; and
(2) Damage occurs to "Covered Prop-

erty" that is insured by the commercial property policy(ies) and this Policy; and

Page 140f 18

b. This condition does not apply if:
(1) Both the commercial property in-

surer(s) and we do not admit to any
liability; and
(2) Neither the commercial property in-

surer(s) nor we contend that coverage applies under the other insurer's
policy.
c.

The provisions of this condition apply only
if all of the following requirements are
met:
(1) The commercial property policy(ies)

carried by the Named Insured, insuring the "Covered Property", contains
a similar provision at the time of the
loss or damage, with substantially the
same requirements, procedures and
conditions as contained in this condition;and
(2) The damage to the "Covered Prop-

erty" was caused by a loss for which:
(a) Both the commercial property in-

surer(s) and we admit to some liability for payment under the respective policies; or
(b) There is disagreement between
the insurers with respect to:
i.

Whether the damage to the
"Covered
Property"
was
caused by a "Covered Cause
of Loss" insured under this
Policy or by a covered cause
of loss insured by the commercial property policy(ies);
or

ii. The extent of participation of
this Policy and of such commercial property policy(ies) in
a loss that is insured against,
partially or wholly, by any or
all of said policy(ies).
d. If the requirements listed in Paragraph c.
above are satisfied, the commercial property insurer(s) and we will make payment
per the following:

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BM T1 570802

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BOILER AND MACHINERY

(1) We will pay, after your written request, the entire amount of loss that
we have agreed is covered, if any, by
this Policy and one-half (1/2) the
amount of the loss that is in disagreement.

insurer(s) and the third appointed by
consent of the other two arbitrators.
(3) The decision by the arbitrators shall

be binding on the commercial property insurer(s) and us and that judgment upon such award may be entered in any court of competent
jurisdiction.

(2) The commercial property insurer(s)

will pay, after your written request,
the entire amount of loss that they
have agreed as being covered, if any,
by the commercial property policy(ies) and one-half (1/2) the amount
of loss that is in disagreement.
(3) Payments by the insurers of the

with such arbitration but not to intervene therein.

F. Definitions
1.

"Breakdown"

amounts that are in disagreement, as
described in Paragraphs (1) and (2),
do not alter, waive or surrender any
rights of any insurer against any other
with regard to the portion of the loss
for which each insurer is liable.

a. Means the following direct physical loss,

(4) The amount in disagreement to be

(2) Mechanical failure including rupture
or bursting caused by centrifugal
force; or

paid by us under this condition shall
not exceed the amount payable under the equivalent Loss Agreement(s)
of the commercial property policy(ies).
(5) The amount to be paid under this

condition shall not exceed the
amount we would have paid had no
commercial property policy(ies) been
in effect at the time of loss. In no
event will we pay more than the applicable Limit of Insurance shown in
the Declarations.
(6) Acceptance by you of sums paid under this condition does not alter,
waive or surrender any other rights
against us.

(4) You agree to cooperate in connection

Arbitration
(1) The payments by the commercial

property insurer(s) and us hereunder
and acceptance of those sums by
you signify the agreement between
the commercial property insurer(s)
and us to proceed with arbitration
within 90 days of such payment.
(2) The arbitrators shall be three in num-

ber, one of whom shall be appointed
by us and one of whom shall be appointed by the commercial property

BM T1 570802

that causes physical damage to "Covered
Equipment" and necessitates its repair or
replacement:
(1) Failure

of pressure
equipment; or

vacuum

(3) Electrical failure including arcing;

unless such loss or damage is otherwise
excluded within this Policy or any Endorsement forming a part of this Policy.

b. Does not mean or include:
(1) Malfunction including but not limited

to adjustment, alignment, calibration,
cleaning or modification; or
(2) Defects, erasures, errors, limitations

or viruses in "Computer Equipment",
"Data", "Media" and/or programs including the inability to recognize and
process any date or time or provide
instructions to "Covered Equipment".
However, if a "Breakdown" ensues,
we will pay the ensuing loss or damage not otherwise excluded; or
(3) Leakage at any valve, fitting, shaft
seal, gland packing, joint or connection; or
(4) Damage to any vacuum tube, gas

tube, or brush; or
(5) Damage to any structure or founda-

tion supporting the "Covered Equipment" or any of its parts; or

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Page 150f 18

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BOILER AND MACHINERY

(6) The functioning of any safety or protective device; or
(7) The cracking of any part on an inter-

nal combustion gas turbine exposed
to the products of combustion.
2.

"Business Income" means the:

(

(3) Communication

equipment
"Computer Equipment"; or

and

(4) Fiber optic cable.

b. "Covered Equipment" does not mean or
include any:

b. Continuing normal operating expenses
incurred, including "Ordinary Payroll".

(2) Part of pressure or vacuum equipment that is not under internal pressure of its contents or internal vacuum; or

"Business Income Actual Annual Value"
means the "Business Income" for the current
fiscal year that would have been earned had
no "Breakdown" occurred.
In calculating the "business income actual
annual value", we will take into account the
actual experience of your business before the
"Breakdown" and the probable experience
you would have had without the "Breakdown".

that is used in the generation, transmission or utilization of energy; or

Net Income (Net Profit or Loss before income taxes) that would have been
earned or incurred; and

(2) Electrical or mechanical equipment

"Business Income Estimated Annual
Value" means the "Business Income" as estimated by in the most recent Business Income Report of Values we have on file.

5. "Computer Equipment" means:
a.

Your programmable electronic equipment
that is used to store, retrieve and process
data; and

b. Associated peripheral equipment that
provides communication including input
and output functions such as printing or
auxiliary functions such as data transmission.
It does not include "Data" or "Media".

6. "Covered Cause of Loss" - see Page 1,
Paragraph A. 1.
7. "Covered Equipment"
a.

Means and includes any:
(1) Equipment designed and built to op-

erate under internal pressure or vacuum other than weight of contents;
For any boiler or fired vessel, the furnace of the "Covered Equipment" and
the gas passages from there to the
atmosphere will be considered as
outside the "Covered Equipment"; or

Page 16 of 18

(1) "Media"; or

(3) Insulating or refractory material; or
(4) Non-metallic

pressure or vacuum
equipment, unless it is constructed
and used in accordance with the
American Society of Mechanical Engineers (A.S.M.E.) code or a Code
that has been accepted by the National Board of Boiler and Pressure
Vessel Inspectors; or

(5) Catalyst; or

(6) Pressure vessels and piping that are
buried below ground and require the
excavation of materials to inspect,
remove, repair or replace; or
(7) Structure,

foundation, cabinet or
compartment supporting or containing the "Covered Equipment" or part
of the "Covered Equipment" including
penstock, draft tube or well casing; or

(8) Vehicle,

aircraft,
self-propelled
equipment or floating vessel, including
any
"Covered
Equipment"
mounted on or used solely with any
vehicle,
aircraft,
self-propelled
equipment or floating vessel; or

(9) Dragline, power shovel, excavation or

construction equipment including any
"Covered Equipment" mounted on or
used solely with any drag line, power
shovel, excavation or construction
equipment; or
(10) Elevator or escalator, but not
excluding any electrical machine or
apparatus mounted on or used with
this equipment; or

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BOILER AND MACHINERY

(11) Felt, wire, screen, mold, form,
pattern, die, extrusion plate, swing
hammer, grinding disc, cutting blade,
non-electrical cable, chain, belt, rope,
clutch plate, brake pad, non-metal
part or any part or tool subject to
periodic replacement; or
(12) Astronomical telescope, cyclotron,
nuclear reactor, particle accelerator,
satellites and/or spacecraft (including
satellite or spacecraft contents and/or
their launch sites); or
(13) "Diagnostic Equipment" unless shown
as INCLUDED in the Declarations; or
(14) "Production Machines" unless shown
as INCLUDED in the Declarations; or
(15) Equipment or any part of equipment
manufactured by you for sale.
S.

(

"Covered Property" means any property
that:
a.

You own; or

Is in your care, custody or control and for
which you are legally liable;

while located at the Covered Premises described in the Declarations.
"Covered Property" does not mean live animals, fish, birds or insects. It also does not
mean eggs intended to become live fish, birds
or insects.
9.

"Data" means:

Programmed and recorded
stored on "Media" and

Restoration" which remains after the
resumption of normal operations will be taken
into consideration in the adjustment of any
loss.
12. "Hazardous
Substance"
means
any
substance, other than ammonia, that has
been declared to be hazardous to health by a
government agency.
13. "Media" means electronic data processing or
storage material such as films, tapes, discs,
drums or cells.
14. "One Breakdown" means if an initial
"Breakdown" causes other "Breakdowns", all
will be considered "One Breakdown". All
"Breakdowns" at anyone premises that
manifest themselves at the same time and
are the direct result of the same cause will be
considered "One Breakdown".

15. "Ordinary Payroll" means payroll expenses
for all your employees except Officers,
Executives, Department Managers, and
Employees under contract.
"Ordinary Payroll" expenses include Payroll;
Employee benefits, if directly related to
payroll; FICA payments; Union dues; and
Worker's Compensation premiums.
16. "Period of Restoration" means the period of
time that:
a.

Begins at the time of the "Breakdown;
and

Ends the number of consecutive days indicated in the Declarations after the date
when the damaged property at the Covered Premises described in the Declarations could have been repaired or replaced with reasonable speed and similar
quality.

material

b. Programming records used for electronic
data processing, or electronically controlled equipment.
10. "Diagnostic
Equipment"
means
any
machine
or
apparatus
(other
than
astronomical telescopes, cyclotron, nuclear
reactor or particle accelerator) used solely for
research,
diagnosis, medical, surgical,
therapeutic, dental or pathological purposes.
11. "Extra Expense" means the additional cost
you incur to operate your business during the
"Period of Restoration" over and above the
cost that you normally would have incurred to
operate the business during the same period
had no "Breakdown" occurred.

Any salvage value of property obtained for
temporary use during the "Period of

8M T1 57 OS 02

17. "Production
Machines"
means
any
production or process machine or apparatus
that processes, forms, cuts, shapes, or grinds
raw materials, materials in process or finished
products, including all "Covered Equipment"
that is used solely with and/or forms an
integral part of the production or process or
apparatus. But "Production Machines" does
not include any:
a.

Pressure vessel or vacuum vessel, other
than any cylinder containing a movable
plunger or piston; or

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BOILER AND MACHINERY

b. Pump, compressor, fan or blower that
conveys raw materials, materials in process or finished products; or
c.

Separate enclosed gear set connected by
a coupling, clutch or belt; or

d. Separate driving electrical or mechanical
machine connected by a coupling clutch
or belt.

18. "Slack" means merchandise held in storage
or for sale, raw materials, property in process,
or finished products, including supplies used
in their packing or shipping.
19. "Tala I Limil per Breakdown" means the
total maximum amount payable for all
coverages provided under this Policy as the
result of "One Breakdown".

{

Page 18 of 18

Includes copyrighted material of Insurance Services Office, Inc., 2000

BM T1 570802

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY,

ADDITIONAL NAMED INSURED, LOSS PAYEE ANDIOR
MORTGAGEES - SPECIAL SCHEDULE
This endorsement modifies insurance provided under the following:

EnergyMax 21 Equipment Breakdown Protection
BOILER AND MACHINERY COVERAGE FORM Comprehensive
BOILER AND MACHINERY COVERAGE FORM Blanket
The following is being used on this policy in lieu of a
specific schedule of mortgagees, loss payees or additional named insureds entered in the policy:

rations or endorsements,
changed by endorsement.

Any mortgagee, loss payee or additional named insured that is on file with us, is considered as individually inserted in the applicable area of any decla-

An updated list of all mortgagees, loss payees and
additional named insureds applicable to the policy
for the upcoming policy year must be submitted.

BMT3641204

unless

specifically

At each anniversary of the policy:

Page 1 of 1

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COVERED PREMISES - SPECIAL SCHEDULE
This endorsement modifies insurance provided under the following:
EnergyMax 21 Equipment Breakdown Protection

The following is being used in this policy instead of a
specific schedule of premises included in the policy:

or Endorsements, unless specifically changed by
Endorsement.

All premises owned, operated or under the care,
custody or control of the Named Insured, that are:

At each anniversary of the policy:

located in the United States of America (including
its territories and possessions), Puerto Rico and
Canada; and

b. are on file with us; and
c.

for which values have been reported;

are considered as individually inserted in any Covered
Premises entry area of any Declarations, Schedules

you must submit an updated list of all premises to
be covered under the policy for the upcoming
policy year; and

b. the Newly Acquired Locations coverage extension
ceases to apply at any premises acquired prior to
that anniversary date and not on the most current
list of premises on file with us.

(

BM T4 02 08 02

Page 1 of 1

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PERILS ELIMINATION ENDORSEMENT
This endorsement modi lies insurance provided under Ihe following:
EnergyMax 21 Equipment Breakdown Protection

Paragraph B. Exclusions 14. is deleted and replaced
with the following:
B. 14. A "Breakdown" that is caused directly or indirectly by:
a. Aircraft or Vehicles, meaning physical
contact of an aircraft, a spacecraft, a
self-propelled missile, a vehicle or an
object thrown up by a vehicle or objects
falling from aircraft or spacecraft; or
b. Civil Commotion or Riot including acts
of striking employees and looting occurring at the time and place of a riot or civil
commotion; or

Collapse of a building or structure or
any part of a building or structure; or

BM T4 39 0103

d. Freezing caused by cold weather; or
. e.

Falling Objects (not including objects
that fall within a building or structure
unless the roof or an outside wall of the
building or structure is first damaged by
the falling object); or
Lightning; or

g. Discharge of Molten Material; or
h. Smoke (not including smoke from agricultural smudging or industrial operations); or
i.

Vandalism, meaning willful and malicious damage to, or destruction of, the
described property; or
Weight of snow, ice, or sleet.

Page 1 of 1

EQUIPMENT BREAKDOWN

THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY,

TERRORISM RISK
INSURANCE ACT OF 2002 DISCLOSURE
This endorsement applies to the insurance provided under the following:
BOILER AND MACHINERY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART

(

On December 26, 2007, the President of the United
States signed into law amendments to the Terrorism
Risk Insurance Act of 2002 (the "Act"), which, among
other things, extend the Act and expand its scope,
The Act establishes a program under which the Federal Government may partially reimburse "Insured
Losses" (as defined in the Act) caused by "acts of
terrorism". An "act of terrorism" is defined in Section
102(1) of the Act to mean 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.

8M T5 94 0108

The federal government's share of compensation for
Insured Losses is 85% of the amount of Insured
Losses in excess of each Insurer's statutorily established deductible, subject to the "Program Trigger",
(as defined in the Act). In no event, however, will the
federal government or any Insurer be required to pay
any portion of the amount of aggregate Insured
Losses occurring in anyone year that exceeds
$100,000,000,000, provided that such Insurer has
met its deductible. If aggregate Insured Losses exceed $100,000,000,000 in anyone year, your coverage may therefore be reduced.
The charge for Insured Losses under this Coverage
Part is included in the Coverage Part premium. The
charge that has been included for this Coverage Part
is indicated below, and does not include any charge
for the portion of losses covered by the Federal Government under the Act:
1% of your total Boiler and Machinery or Equipment Breakdown Coverage Part premium.

Page 1 of 1

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NORTH CAROLINA CHANGES
This endorsemenl modifies insurance provided under the following:
EnergyMax21 Equipment Breakdown Proteclion
BOILER AND MACHINERY COVERAGE PART

A. Paragraph (2) of the Legal Action Against Us
Condilion is replaced by the following:

to this Coverage Part) shall be extended by
45 days or by the number of days the disaster
declaralion or proclamalion remains in effect,
whichever number is greater.

(2) The aclion is brought within 3 years after

the date of "Breakdown"; or
B. The following condilion is added:
TIME PERIOD FOR PERFORMANCE OF CONTRACTUAL OBLIGATIONS

(

Whenever a state of disaster is proclaimed for the
state of North Carolina or for an area within this
state in accordance with state law, or whenever a
major disaster is declared for North Carolina or an
area within this state by the President of the
United States under the Stafford Act or its successors, the following provisions apply:
1.

If the "Covered Property" that has sustained
loss or damage is located within the geographic area designated in the disaster declaralion or proclamalion, the lime period for
your submission of a proof of loss (as set
forth in the Duties In The Event Of Loss Or
Damage Condilion or similar provision in this
Coverage Part or in an endorsement attached

BM T9 11 0407

Except as otherwise provided in Paragraph
1., the following applies if you or we reside in
or are located in the geographic area designated in the disaster declaralion or proclamalion:

If this Coverage Part or an endorsement attached to this Coverage Part imposes a lime
limitalion on you or us for performance of a
duty or any act (Including transmittal of informalion), and such performance would be required during the lime period covered by the
declaralion or proclamalion, your performance and our performance is subject to a deferral period of 30 days. The Commissioner of
Insurance may extend such deferral period.
C. When this endorsement is attached to the
BOILER AND MACHINERY COVERAGE PART,
the term "Breakdown" is replaced with "Accident".

Includes the copyrighted malerial of Insurance Services Office, Inc. with its permissIon.

Page 1 of 1

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

FLORIDA CHANGES
This endorsement modifies insurance provided under the following:
EnergyMax 21 Equipment Breakdown Protection

The LOSS PAYMENT condition dealing with the
number of days within which we must pay for the
covered loss or damages is replaced with the following:
Provided you have complied with all the terms of this
Policy. we will pay for covered loss or damage:

Within 20 days after we receive the sworn proof
of loss and reach written agreement with your; or

Within 30 days after we receive the sworn proof
of loss and;
a.

There is an entry of a final judgment; or

There is a filing of an appraisal award with us.

(

BM T9 360802

Includes copyrighted material of Insurance Services Office, Inc.

Page 1 of 1

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

KANSAS CHANGES - INSPECTIONS AND SURVEYS,
LEGAL ACTION AGAINST US, AND APPRAISAL
This endorsement modifies insurance provided under the following:
EnergyMax 21 Equipment Breakdown Protection

A. The Inspections And Surveys Common Policy
Condition is amended by the addition of the following:
If the "Covered Equipment" being insured is a
steam boiler and subject to KSA 44-923
(SB7), that steam boiler will be inspected at
least annually by us.
B. Paragraph E. Conditions 1. Loss Conditions 1.
Legal Action Against Us (2) is amended to read:
(2) The action is brought within 5 years after
the date of the "Breakdown"; or

(

C. Paragraph E. Conditions 1. Loss Conditions b.
Appraisal is replaced with the following:

(1) Pay its chosen appraiser; and

b. Appraisal

If we and you disagree on the value of the
property or the amount of loss, both parties may agree to an appraisal of the loss.
However, an appraisal will be made

BM T9 37 08 02

only if both you and we agree, voluntarily, to have the loss appraised. If
both parties so agree, each party will select a competent and impartial appraiser.
The two appraisers will select an umpire.
If they cannot agree, eilher may request
that selection be made by a judge of a
court having jurisdiction. The appraisers
will state separately the value of the
property and the amount of loss. If they
fail to agree, they must submit their differences to the umpire. A decision
agreed to by any two will be binding.
Each party will:

(2) Bear the other expenses of the appraisal and umpire equally.
If there is an appraisal, we will still retain
our right to deny the claim.

Includes copyrighted material of Insurance Services Office, Inc.

Page 1 of 1

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

MINNESOTA CHANGESEXAMINATION OF YOUR BOOKS AND RECORDS,
TRANSER OF RIGHTS OF RECOVERY, AND
CONCEALMENT, MISREPRESENTATION OR FRAUD
This endorsement modifies insurance provided under the following:
EnergyMax 21 Equipment Breakdown Protection

A. The EXAMINATION OF YOUR BOOKS AND
RECORDS Common Policy Condition is replaced
with the following:
We may examine and audit your books and
records as they relate to this policy at any
time during the policy period and up to one
year afterward.
B. The Transfer of Rights of Recovery Against
Others To Us condition is amended by the addition of the following:
Our rights do not apply against any person or
organization insured under this or any other
Coverage Part or Policy we issue with respect
to the same "Breakdown".

C. The CONCEALMENT, MISREPRESENTATION
OR FRAUD Condition is replace by the following:
We will not pay for any loss or damage if you
have:
1. Before a loss, willfully; or
2.

After a loss, willfully and with intent to defraud;

concealed or misrepresented any material
fact or circumstances concerning:
a. This Policy;
b. The "Covered Property";
c.

Your interest in the "Covered Property";

or
d. A claim under this Policy.

BM T9 3808 02

Includes copyrighted material of Insurance Services Office, Inc.

Page 1 of 1

(
BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY,

MISSOURI CHANGES - LEGAL ACTION, MPCIGA,
APPRAISAL, DUTIES, LOSS PAYMENT, CANCELLATION
This endorsement modifies insurance provided under the following:
EnergyMax 21 Equipment Breakdown Protection
Boiler and-Machinery Coverage Form
Cancellation Changes

A. When this Endorsement is attached to the Equipment Breakdown Protection form, the term Coverage Part in this Endorsement is replaced by the
term Policy.

B. The Legal Action Against Us Loss Condition in
the Equipment Breakdown Protection is deleted
and replaced with the following:
Legal Action Against Us
No one may bring legal action against us under
this Coverage Part unless:

(

1. There has been full compliance with all the
terms of this Coverage Part; and

2. The action is brought within 10 years after the
date of the "Breakdown"; or

3, We agree in writing that you have an obligation to pay for damage to Covered Property of
others or until the amount of that obligation
has been determined by final judgment or arbitration award. No one has the right under
this policy to bring us into an action to determine your liability.

this policy to bring us into an action to determine your liability.
D. Missouri Property And Casualty Insurance
Guaranty Association Coverage Limitations

1. Subject to the provisions of the Missouri
Property and Casualty Insurance Guaranty
Association Act (to be referred to as the Act),
if we are a member of the Missouri Property
and Casualty Insurance Guaranty Association
(to be referred to as the Association), the Association will pay claims covered under the
Act if we become insolvent.

2. The Act contains various exclusions, conditions and limitations that govern a claimant's
eligibility to collect payment from the Association and affect the amount of any payment.
The following limitations apply subject to all
other provisions of the Act:
a.

Claims covered by the Association do not
include a claim by or against an insured
of an insolvent insurer, if the insured has
a net worth of more than $25 million on
the later of the end of the insured's most
recent fiscal year or the December thirtyfirst of the year next preceding the date
the insurer becomes insolvent; provided
that an insured's net worth on such date
shall be deemed to include the aggregate
net worth of the insured and all of its affiliates as calculated on a consolidated
basis.

Payments made by the Association for
covered claims will include only that
amount of each claim which is less than

C. The Legal Action Against Us Loss Condition in
the Boiler and Machinery Coverage Form is deleted and replaced with the following:
Legal Action Against Us
No one may bring legal action against us under
this Coverage Part unless:
1,

There has been full compliance with all the
terms of this Coverage Part; and

The action is brought within 10 years after the
date of the "Accident"; or

3, We agree in writing that you have an obliga-

(

tion to pay for damage to Covered Property of
others or until the amount of that obligation
has been determined by final judgment or arbitration award. No one has the right under

BM T9 3912 06

$300,000.
However, the Association will not:
(1) Pay an amount in excess of the applicable limit of insurance of the policy from
which a claim arises; or

Includes the copyrighted material of Insurance Services Office, Inc. with its permission.
Includes the copyrighted malerial of The SI. Paul Travelers Companies, Inc.

Page 1 of 2

(
BOILER AND MACHINERY

(2) Return to an insured any unearned premium in excess of $25,000.

the claim, unless the investigation cannot reasonably be completed within such time; and

These limitations have no effect on the
coverage we will provide under this policy.

G. Paragraph (1) (c) of the Duties in the Event of
Loss or Damage Loss Condition of the Boiler
and Machinery Coverage Form is deleted and replaced by the following:

E. The Appraisal Loss Condition is deleted and replaced by the following:

(c) Allow us a reasonable time and opportunity to
examine the property and premises before
repairs are undertaken or physical evidence
of the "Accident" is removed. But you must
take whatever measures are necessary to
protect the property and premises from further damage. It is agreed that we shall complete our investigation of the claim within 30
days after the notification of the claim, unless
the investigation cannot reasonably be completed within such time; and

APPRAISAL
If we and you disagree on the value of the property or the amount of loss, either may make written demand for an appraisal of the loss. In this
event, each party will select a competent and impartial appraiser and notify the other of the appraiser selected within 20 days of the written demand for appraisal. The two appraisers will select
an umpire. If they cannot agree upon an umpire
within 15 days, we or you may request that selection be made by a judge of a court having jurisdiction. The appraisers will state separately the
value of the property and amount of loss. If they
fail to agree, they will submit their differences to
the umpire. The umpire shall make an award
within 30 days after the umpire receives the appraisers' submissions of their differences. A decision agreed to by any two will be binding.

H. Paragraph (2) of Loss Payment Loss Condition
of the Equipment Breakdown Protection form is
deleted and replaced with the following:
(2) We will give you notice of our intentions within
15 working days after the submission of all
forms necessary to establish the nature and
extent of the claim.

Each party will:
1.

Pay its chosen appraiser; and

Bear the other expenses of the appraisal and
umpire equally.

If there is an appraisal, we will still retain our right
to deny the claim.
F. Paragraph (1) (c) of the Duties in the Event of
Loss or Damage Loss Condition of the Equipment Breakdown Protection form is deleted and
replaced by the following:
(c) Allow us a reasonable time and opportunity to
examine the property and Covered Premises
before repairs are undertaken or physical evidence of the "Breakdown" is removed. But
you must take whatever measures are necessary to protect the property and Covered
Premises from further damage. It is agreed
that we shall complete our investigation of the
claim within 30 days after the notification of

The following is added to Loss Payment Clause
Loss Condition of Boiler and Machinery Coverage
Form:
(4) We will give you notice of our intentions within
15 working days after the submission of all
forms necessary to establish the nature and
extent of the claim.

Paragraph (2) of Cancellation General Conditions of the Equipment Breakdown Protection
form is deleted and replaced with the following:
(2) The number of days indicated in the Declarations for Notice of Cancellation before the effective date of cancellation for any other reason, but in no event less than the number of
days required by any statutory requirement.

K. The following is added to paragraph b. of Cancellation Changes, BM T5 49:
But the number of days shall in no event be less
than 30 days as required by Missouri statute.

(
Page 2 of 2

Includes the copyrighted material of Insurance Services Office, Inc. with its permission.
Includes the copyrighted material of The St. Paul Travelers Companies, Inc.

8M T9 3912 06

(
BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NEBRASKA CHANGES
This endorsement modifies insurance provided under the following:
EnergyMax 21 Equipment Breakdown Protection

APPRAISAL
The following is added to the Appraisal Condition:
As a precondition to any appraisal as oullined in this Condition, you and we must mutually agree to such an
appraisal. Once you and we have so agreed, the determination of the subsequent appraisal will be binding on
both parties.

BM T9 40 08 02

Includes copyrighted material of Insurance Services Office, Inc.

Page 1 of 1

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WISCONSIN CHANGES
This endorsement modifies insurance provided under the following:
EnergyMax 21 Equipment Breakdown Protection

A. Wherever notice of "Breakdown" is required to be
given immediately. that requirement is amended
to provide that the notice must be given promptly.

B. The Legal Action Against Us Condition is deleted.
C. The following is added to the Transfer Of Rights
Of Recovery Against Others To Us Condition:
We will be entitled to a recovery only after you
have been fully compensated for damages.

D. The Concealment, Misrepresentation Or Fraud
Condition is replaced by the following:
a.

(

No misrepresentation and no breach of affirmative warranty made by you or on your
behalf in the negotiation for or procurement of
this insurance affects our obligations unless,
if a misrepresentation, the person knew or
should have known that the representation
was false, and unless:
(1) We rely on the misrepresentation or af-

firmative warranty and the misrepresentation or affirmative warranty is either
material or made with intent to deceive; or
(2) The facts misrepresented or falsely warranted contribute to the loss.

b. No failure of a condition before a loss and no
breach of a promissory warranty affects our
obligation under this insurance unless such
failure or breach exists at the time of loss and
either:
(1) Increases the risk at the time of loss; or

BM T9 43 08 02

(2) Contributes to the loss.

E. The following are added:

1. Knowledge And Acts Of Agents
a.

If any of our agents knows any fact that
breaches a condition of this policy, we will
be considered to know it also if that fact:
(1) Is known to the agent at the time the

policy is issued or an application
made; or
(2) Later becomes known to the agent in
the course of his or her dealings as
an agent with you.

b. Any fact that breaches a condilion of this
policy and is known to the agent before
the loss will not:
(1) Void this policy; or
(2) Prevent a recovery in the event of

loss.

2. Conformity To Statute Or Rule
Any provision of this Coverage Part (including
endorsements which modify the Coverage
Part) that is in conflict with a Wisconsin statute or rule is hereby amended to conform to
that statute or rule.
The term rule means a valid rule promulgated
by the Commissioner of Insurance in accordance with the rule-making authority conferred under Wis. Stat. Ann. Section
227.11 (2) and published in the Wisconsin
Administrative Code.

Contains copyrighted material of Insurance Services Offices, Inc., 2000

Page 1 of 1

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WASHINGTON CHANGES
This endorsement modifies insurance provided under the following:
EnergyMax21 Equipment Breakdown Protection

A. In the Section titled Exclusions, the introductory
paragraph preceding the list of exclusions is replaced by the following paragraph, which pertains
to application of those exclusions:

We will not pay for loss or damage caused by any
of the excluded events described below. Loss or
damage will be considered to have been caused
by an excluded event if the occurrence of that
event:

Initiates a sequence of events that results in
loss or damage, regardless of the nature of
any intermediate or final event in that sequence.

B. In the Appraisat Condition, the last sentence is
replaced by the following:

Neither we nor you shall be held to have waived
any rights by any act relating to appraisal.

1. Directly and solely results in loss or damage;
or

(

BM T9 48 08 02

Includes copyrighted material of Insurance Services Office, Inc., 2000

Page 1 of 1

(
BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

UTAH CHANGES - LEGAL ACTION AGAINST US
This endorsement modifies insurance provided under the following:
EnergyMax21 Equipment Breakdown Protection

The Legal Action Against Us Condition is replaced by
the following:
LEGAL ACTION AGAINST US

No one may bring legal action against us under this
Policy unless action is brought within 3 years after the
date of the "Breakdown".

However, failure to give any notice or file any proof of
loss does not invalidate a claim made by you, if you
show that it was not reasonably possible to give the
notice or file the proof of loss within the prescribed
time and that notice was given or proof of loss filed as
soon as reasonably possible.

(

8M T9 49 08 02

Includes copyrighted material of Insurance Services Office, Inc., 2000

Page 1 of 1

BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

TEXAS CHANGES - DEFENSE, JOINT LOSS, DEFINITIONS
This endorsement modifies insurance provided under the following:
EnergyMax 21 Equipment Breakdown Protection

Defense
Paragraph E. Conditions, 1. Loss Conditions, c.
Defense is deleted and replaced with the following:
c.

Defense
1.

If there is damage to "Covered Property" of
another in your care, custody or control and
for which you are legally liable, that was directly caused by a "Breakdown" to "Covered
Equipment", we will have the right and duty to
defend you against any "Suit" alleging liability
for damage to that "Covered Property". However, we have no duty to defend you against
any "Suit" alleging liability for damage to
property not covered by this Policy.
If a claim or "Suit" is brought against you alleging that you are liable for damage to "Covered Property" of another that was caused by
a "Breakdown" to "Covered Equipment", we
will either:
(a) Settle the claim or "Suit"; or
(b) Defend you against the "Suit" but keep for
ourselves the right to settle it at any point.

3. We will pay the following Supplementary
Payments, with respect to any claim or any
"Suit" we defend:
(a) All expenses we incur;
(b) The cost of bonds to release attachments, but only for bond amounts within
the Limit of Insurance. We do not have to
furnish these bonds;
(c) All reasonable expenses incurred by you
at our request to assist us in the investigation or defense of the claim or "Suit",
including actual loss of earnings up to
$100 a day because of time off from
work;
(d) All costs taxed against you in any "Suit"
we defend;
(e) Pre-judgement interest awarded against
you on that part of the judgment we pay.
If we make an offer to pay the applicable

BM T9 50 08 02

Limit of Insurance, we will not pay any
pre-judgment interest based on that period of time after the offer; and
(I) All interest on the full amount of any
judgment that accrues after entry of the
judgment and before we have paid, offered to pay, or deposited in court the part
of the judgement that is within the Limit of
Insurance shown in the Declarations.
These payments will not reduce the Limit of
Insurance.
Joint or Disputed Loss Agreement
Paragraph E. Conditions, 3. Joint or Disputed loss
Agreement, e. Arbitration is deleted and replaced with
the following:
e. Arbitration
(1) If any of the circumstances in E.3.c.(2)(a)
and E.3.c.(2)(b) exist, then the commercial property insurer(s) and we agree to
submit our differences to arbitration within
90 days after payment of the loss under
the terms of this condition.
(2) You agree to cooperate with any arbitration procedures. There will be three arbitrators: one will be appointed by us, and
another will be appointed by the commercial property insurer(s). The two arbitrators will select a third arbitrator. If they
cannot agree, either may request that
selection be made by a judge of a court
having jurisdiction. A decision agreed to
by two of the three arbitrators will be
binding on both parties. Judgment on any
award can be entered in any court that
has jurisdiction.
(3) If we and commercial property insurers
agree to submit to arbitration as described in paragraph E.3.e.(I) above, the
insured will incur no delay in receiving
payment in the manner specified in paragraph E.3.d.

Page 1 of 2

BOILER AND MACHINERY

(4) Arbitration expenses will be apportioned
between insurers on the same basis that
the ultimate loss is apportioned.
Definitions
A. Paragraph F. Definitions, 1. "Breakdown" b. (2) is
deleted and replaced with the following:
(2) Defects, erasures, errors, limitations or viruses in "Computer Equipment" and programs; or

B. The following definition is added to Paragraph F.
Definitions of this Policy:
"Suit" means a civil proceeding and includes:
1. An arbitration proceeding in which damages
are claimed and to which you must submit or
do submit with our consent; or
2.

Any other altern alive dispute resolution proceeding in which damages are claimed and to
which you submit with our consent.

(

Page 2 of 2

BM T9 50 08 02

(
BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

OKLAHOMA CHANGES - REPLACEMENT COST
This endorsement modifies insurance provided under the following:

EnergyMax 21 Equipment Breakdown Protection
BOILER AND MACHINERY COVERAGE FORM Comprehensive
BOILER AND MACHINERY COVERAGE FORM Blanket

(

The following provision is added to the Valuation
Conditions:

ments are necessary for initiating or continuing the
repair or replacement.

We will pay. subject to the Limit of Insurance, no more
than the actual cash value of the damaged property
until the actual repair or replacement is complete.
However, if the actual cash value amount is insufficient to initiate andlor continue repair or replacement
of the damaged property, we will advance to you, as
the need arises, the additional amount(s) necessary
to initiate andlor continue the repair or replacement,
up to the difference between actual cash value and
the replacement cost of the damaged property and
subject to the applicable Limit of Insurance.

Under this loss settlement procedure, the following
special provisions apply:

In addition, if Ordinance or Law Coverage is included,
we will provide payments under Increased Cost of
Construction in advance of the completion of repair or
replacement of the property, if such advance pay-

BMT9 52 04 97

1. You shall promptly forward us the evidence of the
agreement with the party repairing or replacing
the damaged property, showing the cost and estimated completion date of the repairs or replacement.
2.

The total of all advances and other payments will
not exceed the amount of loss that we and you
have agreed will be reimbursed. We will send you
the balance, if any, of the loss payment that we
and you have agreed will be reimbursed, after
you forward to us evidence of the completion of
repairs to or replacement of the damaged property.

Page 1 of 1

(
BOILER AND MACHINERY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

TEXAS CHANGES - FUNGUS, DECAY, WET OR DRY ROT,
OR MOLD
This endorsement modifies insurance provided under the following:
EnergyMax 21 Equipment Breakdown Protection

Paragraph B. Exclusions 12. is deleted and replaced with the following:
B. 12. Depletion. detertoration. corrosion, erosion, wear and tear, or rust. However if a "Breakdown" ensues, we
will pay the ensuing loss or damage not otherwise excluded.

(

BM T9 740603

Page 1 of 1

(

INTERLINE
ENDORSEMENTS
I

(

INTERLINE
ENDORSEMENTS

(

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CAP ON LOSSES FROM CERTIFIED ACTS OF
TERRORISM
This endorsement modifies insurance provided under the following:
BOILER AND MACHINERY COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
DELUXE PROPERTY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
A. Cap On Certified Terrorism Losses
"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:

(

The act resulted in insured losses in excess
of $5 million in the aggregate, attributable to
all types of Insurance subject to the Terrorism
Risk Insurance Act; and

2. 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.

IL T3 79 0108

If aggregate insured losses attributable to terrorist
acts certified under the Terrorism Risk Insurance
Act exceed $100 billion in a Program Year (January 1 through December 31) and we have met our
insurer deductible under the Terrorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses
that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro
rata allocation in accordance with procedures established by the Secretary of the Treasury.

B. Application Of Exclusions
The terms and limitations of any terrorism exclusion, or the inapplicability or omission of a terrorism exclusion, do not serve to create coverage for
any loss which would otherwise be excluded under this Coverage Part or Policy, such as losses
excluded by the Nuclear Hazard Exclusion or the
War And Military Action Exclusion.

Includes the copyrighted material of Insurance Services Office, Inc. with its permission.

Page 1 of 1

(

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CALIFORNIA CHANGES - ACTUAL CASH VALUE
(Boiler And Machinery; Crime & Fidelity)
This endorsement modifies insurance provided under the following:
BOILER AND MACHINERY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
The following is added to any provision which uses
the term actual cash value:
Actual cash value is calculated as the amount it
would cost to repair or replace Covered Property. at
the time of loss or damage, with material of like kind
and quality, subject to a deduction for deterioration,
depreciation and obsolescence. Actual cash value

applies to valuation of Covered Property regardless
of whether that property has sustained partial or total
loss or damage.
The actual cash value of the lost or damaged
property may be significantly less than its replacement cos!.

(

IL 01030505

Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CALIFORNIA CHANGES
This endorsement modifies insurance provided under the following:
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART - FARM PROPERTY - OTHER FARM PROVISIONS FORM - ADDITIONAL
COVERAGES, CONDITIONS, DEFINITIONS
FARM COVERAGE PART - LIVESTOCK COVERAGE FORM
FARM COVERAGE PART - MOBILE AGRICULTURAL MACHINERY AND EQUIPMENT COVERAGE
FORM
STANDARD PROPERTY POLICY
A. When this endorsement is attached to the Standard Property Policy CP 00 99 the term Coverage
Part in this endorsement is replaced by the term
Policy.
B. The Concealment, Misrepresentation Or Fraud
Condilion is replaced by the following with respect
to loss ("loss") or damage caused by fire:

(

We do not provide coverage to the insured ("insured") who, whether before or after a loss
("loss"), has committed fraud or intentionally concealed or misrepresented any material fact or circumstance concerning:

1. This Coverage Part;
2.

make written request for an appraisal of the loss
("loss"). If the request is accepted, each party will
select a compelent and impartial appraiser. Each
party shall notify the other of the appraiser selected within 20 days of the request. The two appraisers will select an umpire. If they cannot
agree within 15 days, either may request that selection be made by a judge of a court having jurisdiction. The appraisers will state separately the
value of the property and amount of loss ("loss").
If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any
two will be binding. Each party will:

1. Pay its chosen appraiser; and
2. Bear the other expenses of the appraisal and

The Covered Property;

3. That insured's ("insured's") interest in the
Covered Property; or

4. A claim under this Coverage Part or Coverage Form.

If there is an appraisal, we will still retain our right
to deny the claim.
E. The Appraisal Condition in:

C. The Concealment, Misrepresentation Or Fraud
Condition is replaced by the following with respect
to loss ("loss") or damage caused by a Covered
Cause of Loss other than lire:
This Coverage Part is void if any insured ("insured"), whether before or after a loss ("loss"),
has committed fraud or intentionally concealed or
misrepresented any material fact or circumstance
concerning:

1. This Coverage Part;
2. The Covered Property;
3. An insured's ("insured's") interest in the Covered Property; or

4. A claim under this Coverage Part or Coverage Form.

D. Except as provided in E., the Appraisal Condition
is replaced by the following:
If we and you disagree on the value of the property or Ihe amount of loss ("loss"), either may
IL 01 040907

umpire equally.

1. Business Income (And Extra Expense) Coverage Form CP 00 30; and
2.

Business Income (Without Extra Expense)
Coverage Form CP 00 32;

is replaced by the following:
If we and you disagree on the amount of Net Income and operating expense or the amount of
loss, either may make written request for an appraisal of the loss. If the request is accepted,
each party will select a competent and impartial
appraiser. Each party shall notify the other of the
appraiser selected within 20 days of the request.
The two appraisers will select an umpire. If they
cannot agree within 15 days, either may request
that selection be made by a judge of a court having jurisdiction. The appraisers will state separately the amount of Net Income and operating
expense or amount of loss. If they fail to agree,
they will submit their differences to the umpire. A

Page 1 of 2

(
decision agreed to by any two will be binding.
Each party will:

b. Bear the other expenses of the appraisat and
umpire equally.

If there is an appraisal, we will still retain our right
to deny the claim.

Pay its chosen appraiser; and

Page 2 of 2

IL 01040907

(
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

VIRGINIA CHANGES - APPRAISAL
This endorsement modifies insurance provided under the following:
COMMERCIAL INLAND MARINE COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
The Appraisal Condition is replaced by the following:
APPRAISAL

If we and you disagree on the value of the property or the amount of loss, either may make written demand for an appraisal of the loss. In this
event, each party will select a competent and impartial appraiser. You and we must notify the
other of the appraiser selected within 20 days of
the written demand for appraisal. The two appraisers will select an umpire. If the appraisers do
not agree on the selection of an umpire within 15
days, the insured or the insurer may apply in writing, for the appointment of an umpire, to the judge
of the circuit court of the county or city in which
the damaged or destroyed property was located
at the time of loss. The appraisers will state separately the value of the property and amount of

IL 01 060907

loss. If the appraisers submit a written report of
an agreement to us, the amount agreed upon will
be the amount of the loss. If they fail to agree,
they will submit their differences to the umpire. A
decision agreed to by any two will set the amount
of loss. Any outcome of the appraisal will not be
binding on either party. Each party will:
1.

Pay its chosen appraiser; and

2. Bear the other expenses of the appraisal and
umpire equally.
However, if we make written demand for an appraisal of the loss, we will reimburse you for the
reasonable cost of your chosen appraiser, and for
your portion of the cost of the umpire.
If there is an appraisal, we will still retain our right
to deny the claim.

Page 1 of 1

(
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NEVADA CHANGES - CONCEALMENT,
MISREPRESENTATION OR FRAUD
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICy) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART - FARM PROPERTY - OTHER FARM PROVISIONS FORM - ADDITIONAL
COVERAGES. CONDITIONS, DEFINITIONS
FARM COVERAGE PART - LIVESTOCK COVERAGE FORM
FARM COVERAGE PART - MOBILE AGRICULTURAL MACHINERY AND EQUIPMENT COVERAGE
FORM
STANDARD PROPERTY POLICY
The CONCEALMENT, MISREPRESENTATION OR
FRAUD Condition is replaced by the following:
CONCEALMENT, MISREPRESENTATION OR
FRAUD

We will not pay for any loss ("loss") or damage in
any case of:

IL01100907

1. Concealment or misrepresentation of a material fact; or
2.

Fraud;

committed by an insured ("insured") at any time
and relating to a claim under this policy.

Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NEBRASKA CHANGES - ACTUAL CASH VALUE
This endorsement modifies insurance provided under the following:
BOILER AND MACHINERY COVERAGE PART
CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
FARM COVERAGE PART
STANDARD PROPERTY POLICY
The following is added to any provision which uses the term actual cash value:
In our determination of the actual cash value of Covered Property at the time of loss or damage. we will take into
account factors such as depreciation. deterioration and obsolescence.

IL 01 220506

Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

INDIANA CHANGES - CONCEALMENT,
MISREPRESENTATION OR FRAUD
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICy) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART
The CONCEALMENT, MISREPRESENTATION OR
FRAUD Condition is replaced by the following:

Concealment or misrepresentation of a material
fact or

CONCEALMENT,
FRAUD

Fraud

MISREPRESENTATION

We will not pay for any loss or damage in any case of:

IL 01 560907

committed by an insured at any time and relating to a
claim under this policy.

Page t of 1

(

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NEBRASKA CHANGES - FRAUD
OR MISREPRESENTATION
This endorsement modifies insurance provided under the following:
COMMERCIAL INLAND MARINE COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
The CONCEALMENT, MISREPRESENTATION OR
FRAUD General Condition is replaced by the following:

It is made with the intent to deceive;
c. We rely on it; and

MISREPRESENTATION OR BREACH OF CONDITION OR WARRANTY

1. A misrepresentation or warranty made by you or
on your behalf in the negotiation of or application
for this Coverage Part will void this policy if:

It is material;

d. We are deceived to our injury.
2.

A breach of warranty or condition will void the
policy if such breach exists at the time of loss and
contributes to the loss.

(

IL 01 590907

Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

KANSAS CHANGES - CONCEALMENT,
MISREPRESENTATION OR FRAUD
This endorsement modifies insurance provided under the following:
BOILER AND MACHINERY COVERAGE PART
CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
FARM COVERAGE PART
STANDARD PROPERTY POLICY
The CONCEALMENT, MISREPRESENTATION OR FRAUD Condition is replaced by the following:
CONCEALMENT, MISREPRESENTATION OR FRAUD
We will not pay for any loss or damage in any case of:

(

Concealment or misrepresentation of a material fact; or

Fraud;

committed by an insured at any time and relating to an insurance application, rating, claim or coverage under this
policy.

IL 01600702

ISO Properties, Inc., 2001

Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ARKANSAS CHANGES
This endorsement modifies insurance provided under the following:
BOILER AND MACHINERY COVERAGE PART
CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
FARM COVERAGE PART
A. When this endorsement is attached to the Standard Property Policy CP 00 99 the term Coverage
Part in this endorsement is replaced by the term
Policy.
B. The following is added to the Common Policy
Conditions:
MULTI-YEAR POLICIES

(

We may issue this policy for a term in excess of
twelve months with the premium adjusted on an
annual basis in accordance with our rates and
rules.
C.1. Except as provided in C.2. below, the Appraisal
Condition, if any, is replaced by the following:
a.

If we and you disagree on the value of the
property or the amount of loss ("loss"), either
party may make a written request for an appraisal of the loss ("loss"). However, an appraisal will be made only if both we and you
agree, voluntarily, to have the loss ("loss")
appraised. If so agreed, each party will select a competent and impartial appraiser.
The two appraisers will select an umpire. If
they cannot agree, either may request that
selection be made by a judge of a court having jurisdiction. The appraisers will state
separately the value of the property and
amount of loss ("loss"). If they fail to agree,
they will submit their differences to the umpire.

b. An appraisal decision will not be binding on
either party.
c.

If there is an appraisal, we will still retain our
right to deny the claim.

d. Each party will:

If we and you disagree on the amount of Net
Income and operating expense or the
amount of loss, either party may make a
written request for an appraisal of the loss.
However, an appraisal will be made only if
both we and you agree, voluntarily, to have
the loss appraised. If so agreed, each party
will select a competent and impartial appraiser. The two appraisers will select an
umpire. If they cannot agree, either may request that selection be made by a judge of a
court having jurisdiction. The appraisers will
state separately the amount of Net Income
and operating expense or amount of loss. If
they fail to agree, they will submit their differences to the umpire.
b. An appraisal decision will not be binding on
either party.
c. If there is an appraisal, we will still retain our
right to deny the claim.
d. Each party will:
(1) Pay its chosen appraiser; and
(2) Bear the other expenses of the appraisal and umpire equally.
D.1. This Paragraph, D.2., does not apply to the following:
Farm Liability Coverage Form

(1) Pay its chosen appraiser; and
(2) Bear the other expenses of the appraisal and umpire equally.

IL 01 630702

C.2. The Appraisal Condition in Business Income
Coverage Form (And Extra Expense) CP 00 30
Business Income Coverage Form (Without Extra
Expense) CP 00 32 and Capital Assets Program
Coverage Form (Output Policy), OP 00 01,
Paragraph A.7. Business Income And Extra Expense is replaced by the following:

Legal Liability Coverage Form
2. The 2-year limitation in the Legal Action Against
Us Condition is changed to 5 years.

ISO Properties, Inc., 2001

Page 1 of 1

(
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NORTH DAKOTA CHANGES - EXAMINATION
OF YOUR BOOKS AND RECORDS
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICy) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL LIABILITY UMBRELLA COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART
FARM UMBRELLA LIABILITY POLICY
LIQUOR LIABILITY COVERAGE PART
MEDICAL PROFESSIONAL LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

(

The Examination Of Your Books And Records
Common Policy Condition is replaced by the following:
EXAMINATION OF YOUR BOOKS AND RECORDS

Except as provided in 2. below, we may examine and audit your books and records as
they relate to this policy at any time during the
policy period and up to three years afterward.

IL 01650908

Any audit conducted to determine the premium due or to be refunded must be completed within 180 days after:
a.

The expiration date of the policy; or

b. The anniversary date, if this is a continuous policy or a policy written for a term
longer than one year;
unless you agree in writing to extend the audit
period.

Page t of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

MONTANA CHANGES - CONFORMITY
WITH STATUTES
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICy) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL LIABILITY UMBRELLA COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART
FARM UMBRELLA LIABILITY POLICY
LIQUOR LIABILITY COVERAGE PART
MEDICAL PROFESSIONAL LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
A. The following Condition is added:
Conformity with Monlana slalules. The provisions
of Ihis policy or Coverage Pari conform 10 Ihe
minimum requiremenls of Monlana law and conIrol over any conflicting statules of any slale in
which you reside on or after Ihe effective dale of
Ihis policy or Coverage ParI.
However. with respecl 10 insurance provided under Ihe Commercial Aulomobile Coverage Part.
while a covered "aulo" is away from Monlana:

1. We will increase the Limit of Insurance for Liabilily Coverage 10 meel Ihe limils specified
by a compulsory or financial responsibilily law
of Ihe jurisdiction where Ihe covered "aulo" is
being used. This exlension does not apply 10

Ihe limil or limils specified by any law governing molor carriers of passengers or property.
2.

We will provide Ihe minimum amounls and
Iypes of other coverages. such as no-faull.
required of oul-of-slale vehicles by Ihe jurisdiction where Ihe covered "aulo" is being
used.

No one will be entilled 10 duplicale paymenls
for Ihe same elemenls of loss.

B. Any provision of Ihis policy or Coverage Pari (including endorsemenls which modify Ihe policy or
Coverage Pari) Ihal does nol conform to Ihe
minimum requiremenls of a Monlana slatule is
amended 10 conform 10 such slalule.

(

IL 01 670908

Page 1 of 1

(
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

COLORADO CHANGES - CONCEALMENT,
MISREPRESENTATION OR FRAUD
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICy) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART - FARM PROPERTY - OTHER FARM PROVISIONS FORM - ADDITIONAL
COVERAGES, CONDITIONS, DEFINITIONS
FARM COVERAGE PART - LIVESTOCK COVERAGE FORM
FARM COVERAGE PART - MOBILE AGRICULTURAL MACHINERY AND
EQUIPMENT COVERAGE FORM
The CONCEALMENT, MISREPRESENTATION OR
FRAUD Condition is replaced by the following:
CONCEALMENT,
FRAUD

MISREPRESENTATION

We will not pay for any loss or damage in any case of:

Concealment or misrepresentation of a material
fact; or

Fraud;

committed by you or any other insured ("insured") at
any time and relating to coverage under this policy.

(

IL 01 690907

Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

TEXAS CHANGES - LOSS PAYMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL INLAND MARINE COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
A. Loss Payment

We will provide notification, as described in (2)(a) through (2)(d) above,
within:

1. With respect to the Crime And Fidelity Coverage Part and Equipment Breakdown Coverage Part, the following conditions are added.
2.

(i) 15 business days after we
receive the signed, sworn
proof of loss and all information we requested; or

With respect to the Commercial Inland Marine
Coverage Part, the following conditions replace Item E. Loss Payment in the Commercial Inland Marine Loss Conditions:
a.

(ii) 30 days after we receive the
signed, sworn proof of loss
and all information we requested, if we have reason to
believe the loss resulted from
arson.

Claims Handling

(1) Within 15 days after we receive written notice of claim, we will:

(

(a) Acknowledge receipt of the claim.
If we do not acknowledge receipt
of the claim in writing, we will
keep a record of the date,
method and content of the acknOWledgment;

If we have notified you that we need
additional time to reach a decision,
we must then either approve or deny
the claim within 45 days of such notice.

(b) Begin any investigation of the
claim; and

b. We will pay for covered loss or damage
within 5 business days after:

(c) Request a signed, sworn proof of
loss, specify the information you
must provide and supply you with
the necessary forms. We may request more information at a later
date, if during the investigation of
the claim such additional information is necessary.

(1) We have notified you that payment of
the claim or part of the claim will be
made and have reached agreement
with you on the amount of loss; or
(2) An appraisal award has been made.
However, if payment of the claim or part
of the claim is conditioned on your compliance with any of the terms of this policy, we will make payment within 5 business days after the date you have complied with such terms.

(2) We will notify you in writing as to
whether:
(a) The claim or part of the claim will
be paid;
(b) The claim or part of the claim has
been denied, and inform you of
the reasons for denial;

c. Catastrophe Claims

(c) More information is necessary; or
(d) We need additional time to reach
a decision. If we need additional
time, we will inform you of the
reasons for such need.

IL 01 71 0907

If a claim results from a weather related
catastrophe or a major natural disaster,
the claim handling and claim payment
deadlines described in a. and b. above
are extended for an additional 15 days.
Catastrophe or Major Natural Disaster
means a weather related event which is:

(1) Declared a disaster under the Texas
Disaster Act of 1975; or

Page 1 of 2

(
(2) Determined to be a catastrophe by

the State Board of Insurance.
d. The term "business day", as used in this
endorsement, means a day other than
Saturday, Sunday or a holiday recognized
by the state of Texas.

Page 2 of 2

B. With respect to the Commercial Inland Marine
Coverage Part the following is added:
We will not be liable for any part of a "loss" that
has been paid or made good by others.

IL 01 71 0907

(

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

FLORIDA CHANGES - LEGAL ACTION AGAINST US
This endorsement modifies insurance provided under the following:
BOILER AND MACHINERY COVERAGE PART
CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
FARM COVERAGE PART
The following replaces the second paragraph of the Legal Action Against Us condition:
LEGAL ACTION AGAINST US
Legal action against us involving direct physical loss or damage to property must be brought within 5 years from
the date the loss occurs.

(

IL 01 750702

Page 1 of 1

(

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

OKLAHOMA CHANGES - CONCEALMENT,
MISREPRESENTATION OR FRAUD
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICy) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART - FARM PROPERTY - OTHER FARM PROVISIONS FORM - ADDITIONAL
COVERAGES. CONDITIONS, DEFINITIONS
FARM COVERAGE PART - LIVESTOCK COVERAGE FORM
FARM COVERAGE PART - MOBILE AGRICULTURAL MACHINERY AND EQUIPMENT COVERAGE
FORM
STANDARD PROPERTY POLICY

(

A. When this endorsement is attached to the Standard Property Policy CP 00 99, the term Coverage Part in this endorsement is replaced by the
term Policy.
B. The Concealment, Misrepresentation Or Fraud
condition is replaced by the following:
Except as provided in Paragraphs C. and D., we
do not provide coverage in any case of fraud by
you as it relates to this Coverage Part at any time.
We also do not provide coverage if you or any
other insured ("insured"), at any time, intentionally
conceal or misrepresent a material fact concerning:
1.

This Coverage Part;

The Covered Property;

Your interest in the Covered Property; or

A claim under this Coverage Part.

C. The Concealment, Misrepresentation Or Fraud
condition in the Commercial Auto Coverage Part
is replaced by the following:
We do not provide coverage in any case of fraud
by you at any time as it relates to this Coverage
Part. We also do not provide coverage if you or
any other "insured", at any time, intentionally conceal or misrepresent a material fact concerning:

IL01771010

This Coverage Part;

The covered "auto";

Your interest in the covered "auto"; or

A claim under this Coverage Part.

However, this provision does not apply, but only
up to the compulsory or financial responsibility
limits required by Oklahoma law, if an "accident"
results in a third party liability claim against the
"insured" under this Coverage Part.
D. Under the Kidnap/Ransom And Extortion Coverage Form, the Conceatment, Misrepresentation
Or Fraud condition is replaced by the following:
We do not provide coverage in any case of fraud
by you as it relates to this insurance at any time.
We also do not provide coverage if you or any
other insured, at any time, intentionally conceal or
misrepresent a material fact concerning:
1. This insurance;

A person insured under this insurance;

The

Your interest in the "property" covered under

"property'~

covered under this insurance;

this insurance; or
5.

A claim under this insurance.

Page 1 of 1

(
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NEW MEXICO CHANGES - PROPERTY CLAIMS
SETTLEMENT IN THE EVENT
OF A CATASTROPHE
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICy) COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART
A. The provisions of this endorsement apply to a
claim for direct physical loss or damage to Covered Property. provided that:

1. The claim is for loss or damage that results

However, the time periods specified in C.1.
above will be extended by the period of time
taken to resolve the following situations:

from a catastrophe declared by the Superintendent of Insurance; and

a. We suspect the claim is fraudulent and

The catastrophic event is a Covered Cause of
Loss.

commence an investigation to make such
a determination;

B. The word loss, as used in this endorsement, includes "loss" as defined in certain coverage
forms.

b. You do not provide the necessary information regarding the nature of the claim,
following our request for such information;
or

(

amount of loss within 90 days after the
date on which you reported the claim.

C. The following provisions, C.1. and C.2., are
added to the policy and supersede any provisions
to the contrary:

c. You filed suit against us in connection
with the claim before expiration of the applicable 90-day period.

1. If you reported your claim to us:

a. Before the catastrophe was declared, we
will reach agreement with you on the
amount of loss within 90 days after the
date the catastrophe was declared;
b. After the catastrophe was declared, we
will reach agreement with you on the

IL 01 780907

D. All other provisions of this policy continue to apply
in the event of a catastrophe, including the Suit
Against Us and Appraisal conditions.

E. This endorsement does not invalidate our right to
deny your claim, nor the right of either party to
seek judgment in a court having jurisdiction.

Page 1 of 1

(

OKLAHOMA NOTICE
The following statement is added to the policy:
WARNING:

Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the
proceeds of an insurance policy, containing any false, incomplete or misleading information, is guilty of a felony.

(

IL 01 791002

Page 1 of 1

(
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

MONTANA CHANGES - CONCEALMENT,
MISREPRESENTATION OR FRAUD
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART - FARM PROPERTY - OTHER FARM PROVISIONS FORM - ADDITIONAL
COVERAGES, CONDITIONS, DEFINITIONS
FARM COVERAGE PART - LIVESTOCK COVERAGE FORM
FARM COVERAGE PART - MOBILE AGRICULTURAL MACHINERY AND
EQUIPMENT COVERAGE FORM
The CONCEALMENT, MISREPRESENTATION OR
FRAUD Condition is replaced by the following:
CONCEALMENT,
FRAUD

(

MISREPRESENTATION

We will not pay for loss ("loss") or damage in a case
of:

committed by you or any other insured ("insured"),
whether before or after the loss ("loss") and relating to
coverage of the loss ("loss") under this policy.
We will not pay for any loss ("loss") or damage in any
case if:
1.

Concealment or misrepresentation of a material
fact; or

fact; or

Fraud;

is committed by you or any other insured ("insured")
in the application for this policy.

1. Concealment or misrepresentation of a material
2.

IL 01800907

Page 1 of 1

(
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

SOUTH DAKOTA CHANGES - APPRAISAL
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICy) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
A. Except as provided in Paragraph B. of this endorsement. the Appraisal Loss Condition is replaced by the following:
APPRAISAL

(

Paragraph A.7. Business Income And Extra Expense is replaced by the following:
APPRAISAL

If we and you disagree on the value of the property or the amount of the loss both parties may
agree to an appraisal of the loss. If both parties
so agree. then each party will select a competent
and impartial appraiser. The two appraisers will
select an umpire. If they cannot agree, either may
request that selection be made by a judge of a
court having jurisdiction. The appraisers will state
separately the value of the property and the
amount of loss. If they fail to agree, they will submit their differences to the umpire. Any outcome
of the appraisal will not be binding on either party.
Each party will:
1. Pay its chosen appraiser; and

If we and you disagree on the amount of net income and operating expense or the amount of the
loss, both parties may agree to an appraisal of
the loss. If both parties so agree, then each party
will select a competent and impartial appraiser.
The two appraisers will select an umpire. If they
cannot agree, either may request that selection
be made by a judge of a court having jurisdiction.
The appraisers will state separately the amount of
net income and operating expense and the
amount of the loss. If they fail to agree, they will
submit their differences to the umpire. Any outcome of the appraisal will not be binding on either
party. Each party will:
1. Pay its chosen appraiser; and

Bear the other expenses of the appraisal and
umpire equally.

If we submit to an appraisal, we will retain our
right to deny the claim.

Bear the other expenses of the appraisal and
umpire equally.

If we submit to an appraisal, we will retain our
right to deny the claim.

B. The Appraisal Condition in Capital Assets Program Coverage Form (Output Policy), OP 00 01,

IL 01 840907

Page 1 of 1

(
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CALIFORNIA CHANGES - CANCELLATION
AND NONRENEWAL
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICy) COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
MEDICAL PROFESSIONAL LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
A. Paragraphs 2. and 3. of the Cancellation Common Policy Condition are replaced by the following:

(

All Policies In Effect For 60 Days Or Less
If this policy has been in effect for 60 days or
less. and is not a renewal of a policy we have
previously issued, we may cancel this policy
by mailing or delivering to the first Named Insured at the mailing address shown in the
policy and to the producer of record, advance
written notice of cancellation, stating the reason for cancellation, at least:
a.

10 days before the effective date of cancellation if we cancel for:
(1) Nonpayment of premium; or

(2) Discovery of fraud by:
(a) Any insured or his or her representative in obtaining this insur-

ance; or
(b) You or your representative in
pursuing a claim under this policy.
b. 30 days before the effective date of cancellation if we cancel for any other reason.

3. All Policies In Effect For More Than 60
Days
a.

If this policy has been in effect for more
than 60 days, or is a renewal of a policy
we issued, we may cancel this policy only
upon the occurrence, after the effective

IL 02 70 09 08

date of the policy, of one or more of the
following:
(1) Nonpayment of premium, including
payment due on a prior policy we issued and due during the current policy term covering the same risks.
(2) Discovery of fraud or material misrepresentation by:

(a) Any insured or his or her representative in obtaining this insur-

ance; or
(b) You or your representative in
pursuing a claim under this policy.
(3) A judgment by a court or an administrative tribunal that you have violated
a California or Federal law, having as
one of its necessary elements an act
which materially increases any of the
risks insured against.
(4) Discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by you or
your representative, which materially
increase any of the risks insured
against.
(5) Failure by you or your representative
to implement reasonable loss control
requirements, agreed to by you as a
condition of policy issuance, or which
were conditions precedent to our use
of a particular rate or rating plan, if

Page 1 of 3

(
that failure materially increases any
of the risks insured against.
(6) A determination by the Commissioner
of Insurance that the:
(a) Loss of, or changes in, our reinsurance covering all or part of the
risk would threaten our financial
integrity or solvency; or
(b) Continuation of the policy coverage would:
(i) Place us in violation of California law or the laws of the
state where we are domiciled; or
(ii) Threaten our solvency.
(7) A change by you or your representative in the activities or property of the
commercial or industrial enterprise,
which results in a materially added,
increased or changed risk, unless the
added, increased or changed risk is
included in the policy.

b. We will mail or deliver advance written
notice of cancellation, stating the reason
for cancellation, to the first Named Insured, at the mailing address shown in
the policy, and to the producer of record,
at least:
(1) 10 days before the effective date of
cancellation if we cancel for nonpayment of premium or discovery of
fraud; or
(2) 30 days before the effective date of
cancellation if we cancel for any other
reason listed in Paragraph 3.a.

(

B. The following provision is added to the Cancellation Common Policy Condition:

cel this coverage for any reason, except
as provided in b. and c. below.

b. We may not cancel this policy solely because the first Named Insured has:
(1) Accepted an offer of earthquake coverage; or
(2) Cancelled or did not renew a policy
issued by the California Earthquake
Authority (CEA) that included an
earthquake policy premium surcharge.
However, we shall cancel this policy if the
first Named Insured has accepted a new
or renewal policy issued by the CEA that
includes an earthquake policy premium
surcharge but fails to pay the earthquake
policy premium surcharge authorized by
the CEA.
c. We may not cancel such coverage solely
because corrosive soil conditions exist on
the premises. This Restriction (c.) applies
only if coverage is subject to one of the
following, which exclude loss or damage
caused by or resulting from corrosive soil
conditions:
(1) Capital Assets Program Coverage
Form (Output Policy);
(2) Commercial Property Coverage Part
- Causes Of Loss - Special Form; or
(3) Farm Coverage Part - Causes Of
Loss Form - Farm Property, Paragraph D. Covered Causes Of Loss Special.
C. The following is added and supersedes any provisions to the contrary:
NONRENEWAL

1. Subject to the provisions of Paragraphs C.2.
and C.3. below, if we elect not to renew this
policy, we will mail or deliver written notice
stating the reason for non renewal to the first
Named Insured shown in the Declarations
and to the producer of record, at least 60
days, but not more than 120 days, before the
expiration or anniversary date.

Residential Property
This provision applies to coverage on real
property which is used predominantly for
residential purposes and consisting of not
more than four dwelling units, and to coverage on tenants' household personal property
in a residential unit, if such coverage is written under one of the following:

We will mail or deliver our notice to the first
Named Insured, and to the producer of record, at the mailing address shown in the policy.

Commercial Property Coverage Part
Farm Coverage Part - Farm Property - Farm
Dwellings, Appurtenant Structures And
Household Personal Property Coverage Form
a. If such coverage has been in effect for 60
days or less, and is not a renewal of coverage we previously issued, we may can-

Page 2 of 3

Residential Property
This provision applies to coverage on real
property used predominantly for residential
purposes and consisting of not more than four
dwelling units, and to coverage on tenants'
household property contained in a residential

IL 02 70 09 08

(
unit, if such coverage is written under one of
the following:

and equitable, and that is responsive
to the changes in our reinsurance position.

Capital Assets Program (Output Policy) Coverage Part

c. We will not refuse to renew such coverage solely because the first Named Insured has cancelled or did not renew a
policy, issued by the California Earthquake Authority that included an earthquake policy premium surcharge.
d. We will not refuse to renew such coverage solely because corrosive soil conditions exist on the premises. This Restriction (d.) applies only if coverage is subject to one of the following, which exclude
loss or damage caused by or resulting
from corrosive soit conditions:
(1) Capital Assets Program Coverage
Form (Output Policy);
(2) Commercial Property Coverage Part
- Causes Of Loss - Special Form; or

Commercial Property Coverage Part
Farm Coverage Part - Farm Property - Farm
Dwellings, Appurtenant Structures And
Household Personal Property Coverage Form
a. We may elect not to renew such coverage for any reason, except as provided in
b., c. and d. below:
b. We will not refuse to renew such coverage solely because the first Named Insured has accepted an offer of earthquake coverage.

(

However, the following applies only to insurers who are associate participating insurers as established by Cal. Ins. Code
Section t0089.16. We may elect not to
renew such coverage after the first
Named Insured has accepted an offer of
earthquake coverage, if one or more of
the following reasons applies:
(1) The nonrenewal is based on sound
underwriting principles that relate to
the coverages provided by this policy
and that are consistent with the approved rating plan and related documents filed with the Department of
Insurance as required by existing law;
(2) The Commissioner of Insurance finds
that the exposure to potential losses
will threaten our solvency or place us
in a hazardous condition. A hazardous condition includes, but is not limited to, a condition in which we make
claims payments for losses resulting
from an earthquake that occurred
within the preceding two years and
that required a reduction in policyholder surplus of at least 25% for
payment of those claims; or
(3) We have:
(a) Lost or experienced a substantial

reduction in the avaitability or
scope of reinsurance coverage;
or
(b) Experienced a substantial increase in the premium charged
for reinsurance coverage of our
residential property insurance
poliCies; and

(3) Farm Coverage Part - Causes Of
Loss Form - Farm Property, Paragraph D. Covered Causes Of Loss Special.
We are not required to send notice of nonrenewal in the following situations:
a. If the transfer or renewal of a policy, without any changes in terms, conditions, or
rates, is between us and a member of our
insurance group.
b.

c. If you have obtained replacement coverage, or if the first Named Insured has
agreed, in writing, within 60 days of the
termination of the policy, to obtain that
coverage.
d. If the policy is for a period of no more
than 60 days and you are notified at the
time of issuance that it will not be renewed.
e.

the Commissioner has approved a
plan for the nonrenewals that is fair
IL 02 70 09 08

If the policy has been extended for 90
days or less, provided that notice has
been given in accordance with Paragraph
C.1.

If the first Named Insured requests a
change in the terms or conditions or risks
covered by the policy within 60 days of
the end of the policy period.
If we have made a written offer to the first
Named Insured, in accordance with the
timeframes shown in Paragraph C.1., to
renew the policy under changed terms or
conditions or at an increased premium
rate, when the increase exceeds 25%.

Page 3 of 3

(

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

TEXAS CHANGESNOTICE OF CLAIM OR SETTLEMENT
This endorsement modifies insurance provided under the following:

BOILER AND MACHINERY COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
FARM LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
PHARMACISTS PROFESSIONAL LIABILITY COVERAGE FORM
VETERINARIANS PROFESSIONAL LIABILITY COVERAGE PART
CATASTROPHE UMBRELLA POLICY
EMPLOYEE BENEFITS LIABILITY
PROVISIONS

If a claim is made againsl you under a casually policy, we must notify you of Ihe initial offer to compromise or
settle the claim. We must do so within 10 business days after Ihe date on which the offer is made.
If a claim under a casualty policy is settled, we must notify you within 30 days of Ihe settlement.

(

IL T9 56 04 93

Page 1 of 1

(

POLICYHOLDER NOTICES
(

(

POLICYHOLDER NOTICES

.....

TRAVfLfRSJ
Dear Valued Customer,

Travelers Boiler & Machinery appreciates your Equipment Breakdown Insurance business. We understand that
life and business are dynamic and the best way to serve you is to deliver highly-rated and customized services
that behave the same way - evolving to keep in synch with life and business as they change.
Travelers Boiler & Machinery offers the following exceptional services as part of your insurance coverage:
ENGINEERING SERVICES
Proactive Boiler Inspections and Object Management
Travelers Boiler & Machinery performs inspections on boilers and pressure vessels as required by jurisdictions
across Ihe country. Travelers can help you with the identification of any boilers or pressure vessels which require
inspection according to state or city laws. If your business has this equipment, we can perform the inspection.
Speak with your Equipment Breakdown professional for more information.
Help Line Support for Inspections
When life is out of synch our Help Line staff is available to provide you with assistance on any questions, problems, or concerns about our engineering services. To schedule an inspection or seek help with inspections,
call toll-free at 1-800-425-4119. We also provide you with dedicated support via fax at 1-877-764-9535 and offer
our assistance via email at boilinsP@travelers.com. Support by phone, fax, and email are available between 8:00
a.m. to 5:00 p.m. Eastern Time.
Risk Control and Loss Prevention Information Warehouse
With 100 years of experience in the Equipment Breakdown Insurance business, Travelers Boiler & Machinery
wants to share with you the broad range of innovative risk control and loss prevention solutions we have developed over the years. Travelers Boiler & Machinery also shares information such as preventive maintenance guidelines for machinery and equipment as well as workplace safety topics beyond just Boiler & Machinery. Our information can be accessed by calling 1-800-425-4119 or viewing our website at www.travelers.com/riskcontrol.
CLAIM SERVICES

24/7/365 Claim Reporting
Travelers Boiler & Machinery offers you a variety of ways to report your claim and the peace of mind of knowing
our local claim professionals manage claims with a blend of skill, tenacity, and common sense.
To report an Equipment Breakdown (Boiler and Machinery) loss:
•

Contact Your Agent

•

Call toll-free at 1-800-238-6225; or

•

Fax your loss information to us toll free at 1-877-QUIK-FAX (1-877-784-5329).

Sharing our Experience
During the claim investigation process, our Claim Support Manager, claim staff and field engineers act as technical resources and help you by suggesting reputable repair companies and contractors in your area so you can get
back up and running quickly. Speak with your claim professional for more information.

PN BM 17 07 06

Page 1 of 1

(

NOTICE TO MICHIGAN POLICYHOLDERS
THIS POLICY IS EXEMPT FROM THE FILING REQUIREMENTS OF SECTION 2236 OF THE INSURANCE
CODE OF 1956,1956 PA 218, MCl 500.2236.

PN T3 54 04 03

Page 1 of 1

IMPORTANT NOTICE -INDEPENDENT AGENT AND BROKER
COMPENSATION
NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY
PROVISION OF YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY
CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND TO
DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR POLICY. PLEASE CONTACT
YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE OR
ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND THIS
NOTICE, THE PROVISIONS OF YOUR POLICY PREVAIL.

For information about how Travelers compensates independent agents and brokers, please visit
www.travelers.com, call our toll-free telephone number 1-866-904-8348, or request a written copy from Marketing
at One Tower Square, 2GSA, Hartford, CT 06183.

(

PN T4 54 0108

Page 1 of 1

(

IMPORTANT NOTICE - POLICYHOLDER INFORMATION - ARKANSAS
NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF
YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE
INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES
UNDER YOUR POLICY. PLEASE CONTACT YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS
ABOUT THIS NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND
THIS NOTICE, THE PROVISIONS OF YOUR POLICY PREVAIL.

In the event you need to contact someone about this policy, please contact your agent as shown on your policy or
in the material accompanying the policy. If you need additional assistance, you may contact us at the address
listed below:
Travelers
One Tower Square
Hartiord, CT 06183
Telephone: 1·800-328-2189
If you feel we have failed to provide you with reasonable and adequate service, feel free to contact:
Arkansas Insurance Department
1200 West Third Street
Little Rock, Arkansas 72201

Telephone: (501) 371-2640 or (800) 852-5494

PNT4711209

Page 1 of 1

(

IMPORTANT NOTICE - COMPLAINTS -ILLINOIS
NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND
ANY PROVISION OF YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY
CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND
TO DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR POLICY. PLEASE
CONTACT YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS ABOUT THIS
NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY
AND THIS NOTICE. THE PROVISIONS OF YOUR POLICY PREVAIL.
If you are having problems you may contact your insurance agent directly or you may contact the company at:
Mail:

Consumer Affairs
One Tower Square. 5MS
Hartford, CT 06183

Phone:

(860) 277·1561 or

Email:

consumeraffairs@travelers.com

The address of the consumer complaint division of the Illinois Division of Insurance is:

IDFRP Division of Insurance
Consumer Division
320 W Washington St
Springfield, IL 62767
Complaints may also be filed electronically to the Illinois Division of Insurance at
http://www.idfpr.com/DOI/Mainiconsumer.asp

PNT5 6811 08

Page 1 of 1

(
ISSUE DATE: 04-24-12

POLICY NUMBER: M5J-BM21-4245R337-TIL-12

IMPORTANT NOTICE - DISCLOSURE OF LOCAL GOVERNMENT
TAXES - KENTUCKY
In compliance with Kentucky Administrative Regulation 806 KAR 2:092 we are providing the amount of Kentucky
local government tax being charged to you and the taxing jurisdiction to which the tax is due. Any applicable collection fee is included in the tax.
Amount of
Taxing Jurisdiction
Local Government Tax
BOWLING GREEN
FORT THOMAS
FRANKFORT
HOPKINSVILLE
LEXINGTON-FAYETTE
LOUISVILLE-JEFFERSON
NEWPORT
NICHOLASVILLE

$
$
$

$
$

$
$
$

2
11
14
27
33
48
93
3

(

PN T5 82 03 09

Page 10f 1

BOILER AND MACHINERY INSURANCE
IMPORTANT CHANGES IN YOUR COVERAGE
ADVISORY NOTICE TO POLICYHOLDERS
This is a summary of the major changes in the Boiler and Machinery Policy. No coverage is provided by this
summary nor can it be construed to replace any provision of the policy. You should read your policy and review
your Declarations Pages for complete information on the coverage you are provided. If there is any conflict between the policy and this summary, THE PROVISIONS OF THE POLICY SHALL PREVAIL.
Some of the language of the new policy has been restated and repunctuated for clarity and readability but with no
change in coverage intent.
The areas within the policy that broaden, reduce or clarify coverage are highlighted below.

EnergyMax 21
Equipment Breakdown Protection
BROADENINGS AND NARROWINGS OF COVERAGE
Broadenings of Coverage
Utility Interruption coverage has been broadened to
include refrigeration and waste treatment selVices.
Brands and Labels coverage has been broadened to
provide coverage for the expenses incurred in
stamping the word SALVAGE on damaged merchandise or removing brands and labels on damaged
merchandise.
Contingent Time Element coverage has been added
to the Coverage Extensions, providing optional coverage extensions to Business Income andlor Extra
Expense for loss to "Covered Equipment" that is not
owned or operated by the Insured and that causes a
loss at a Covered Premises shown in the Declarations.
"Data" or "Media" coverage has been added to the
Coverage Extensions, providing optional coverage for
loss of income andlor extra expenses incurred to
research, recreate, replace or restore damaged
"Media" or lost or corrupted "Data".
.
An exception has been added to the Ordinance or
Law exclusion that provides coverage for electrical
supply and emergency generating equipment that is
required by law to be present in order to operate.
The exclusion for loss caused by falling objects has
been restricted to objects falling from aircraft or
missiles.

PN BM 140902

The exclusion for any loss that continues beyond the
date the damaged property is repaired or replaced
has been deleted.
The exclusion for delay in rebuilding, repairing or
replacing property or resuming operations due to the
interference of strikers has been deleted.
A new valuation condition has been added to provide
coverage for any loss in value of an extended warranty or maintenance or selVice contract.
The condition regarding valuation if property is not
repaired or replaced is extended from 18 months to
24 months.
Selling Price valuation has been extended to all
property held by the Insured for sale.
Pair, Sets or Parts coverage has been added to
provide coverage for loss in value of undamaged
property.
The definition of "Covered Equipment" has been
expanded to provide coverage for ovens, stoves,
furnaces, incinerators, pots, kilns, conveyors, cranes
and hoists.
The exclusion for non-metallic pressure or vacuum
equipment under the definition of "Covered Equipment" has been reduced to provide coverage for
equipment constructed and used in accordance with
codes accepted by the National Board of Boiler and
Pressure Vessel Inspectors.

Page 1 of 3

The exclusion for buried pressure vessels and piping
has been reduced to exclude only buried pressure
vessels and piping that require excavation to inspect,
remove, repair or replace.

A new condition, Insurance Under Two or More
Coverages, has been added to clarify how we will
apply coverage when multiple coverages are involved
in a loss.

Coverage for "Diagnostic Equipment" is available as
an optional coverage and will be identified for coverage with an entry on the Declarations.

A new exclusion under the Definition of "Covered
Equipment" has been added to exclude astronomical
telescopes, cyclotrons, nuclear reactors, particle
accelerators, satellites andlor spacecraft (including
satellites or spacecraft contents andlor their launch
sites.)

Narrowings of Coverage

Sinkhole collapse has been added to the list of examples of Earth Movement that are excluded.
Water exclusion has been broadened to match terminology used in standard property policies. The exclusion has been expanded to exclude all types of rising
water as well as mudslides, mudflow, water damage
caused by backup of sewers, drains or drainage
piping. Loss caused by Water is excluded regardless
if coverage is avaitable under another policy. This will
delete overlap coverage with options that are commonly found available under property policies.

(

The exclusion for fire or explosion has been expanded to also exclude fire or explosion within electrical equipment. This will delete overlap coverages with
standard property policies.
Loss caused by Hail or Windstorm is excluded regardless if coverage is available under another policy.
This will delete overlap coverage with standard property policies.
Loss caused by impact of aircraft, missile or vehicle
and caused by molten material have been added to
the exclusion for loss caused by specified perils. Loss
caused by these perils is only excluded if there is
coverage under another policy.
With respect to Utility Interruption coverage, the
exclusion for loss caused by listed perils has been
expanded to exclude the perils of Objects falling from
an aircraft or missile, Freeze from weather, Impact of
aircraft, missiles, vehicles, Molten material and
Sabotage.
The exclusion for neglect by the Insured to save and
preserve "Covered Property" has been expanded to
apply to all coverages.
Defense coverage has been moved from the Coverage section to the Conditions section of the policy.
This coverage is now subject to the "Total Limit per
Breakdown" .
Water Damage limitation has been changed to apply
to all "Covered Equipment".

Page 2 of 3

Other Changes

A clarification has been added that "Covered Property" must be located at the Covered Premises described in the Declarations.
A clarification has been added to describe how Coverage Extensions are triggered and how the sublimits
will be applied.
The Coverage Extensions have been reordered to list
the traditional coverages of Business Income, Extra
Expense, Spoilage and Utility Interruption first. All
other Coverage Extensions follow after these 4 and
are listed alphabetically.
Extended Business Income is deleted as a separate
Coverage Extension. It is now included in the Definition of "Period of Restoration".
Under the Spoilage coverage, a clarification is added
that coverage applies to owned property, as well as
property that is not owned but for which the Insured is
legally liable. A second clarification is added that loss
caused by excess as well as lack of power, light, heat,
steam or refrigeration is covered.
Off Premises Service Interruption coverage has been
renamed Utility Interruption. Terminology has been
added to clarify the intent to cover services regardless
if the supplier generates or provides the service. The
8-hour fixed waiting period requirement to trigger
Utility Interruption coverage has been changed to a
variable field that will be completed on the Declarations.
Ordinance or Law Coverage (including Demolition
and Increased Cost of Construction) has been reworded to more closely agree with industry standard
wordings for both Property and Boiler and Machinery
policies. No coverage change is intended. Wording
has also been added to clarify that coverage is included for loss of income or extra expenses if Business Income andlor Extra Expense coverages are
provided.

PN BM 14 09 02

The testing exclusion has been changed to use
generic terminology.
A clarification has been added that self-insurance risk
retention plans are considered to be another policy of

insurance.
An additional exclusion for any other indirect result of
a "Breakdown" to "Covered Equipment" has been
added for clarification purposes.
Ammonia Contamination, Hazardous Substance and
Water Damage have been moved to the Limitation
section of the policy.
Deductible wording has been changed for clarification
purposes.
Valuation wording has been added to clarify how
"Covered Property" will be valued at various stages of
process.
Salvage value wording has been added to clarify how
we will treat salvage in the event of a loss.

An additional condition, No Benefit to Bailee, has
been added to clarify that no Bailee shall benefit from
the coverages provided.
An additional condition, Currency, has been added to
clarify that US currency applies to all locations, including Canadian.
The Values condition has been modified to clarify that
values should be reported separately by location and
by coverage.
The Suspension condition has been modified to clarify
that if a suspension occurs, a pro rata premium will be
returned to the Insured.

PN BM 140902

Additional Insured and Mortgage Holders Conditions
have been deleted. These conditions will be addressed through endorsement when necessary.
The definition for "Accident" has been replaced with a
definition for "Breakdown".
An exclusion for explosion within the furnace of a
chemical recovery type boiler or within the gas passages from the furnace to the atmosphere has been
added for clarification purposes.
The exclusion for depletion, deterioration, corrosion,
erosion or wear and tear has been moved from the
Definitions section, under the definition of "accident",
to the Exclusion section of the policy. Rust, fungus,
decay, wet or dry rot or mold have been added to the
list of excluded conditions to match standard property
terminology. This is for clarification purposes. Coverage is still provided if a "Breakdown" ensues from
these conditions.
Exclusions to the definition of "Breakdown" have been
added for Malfunction and Leakage for clarification
purposes.
A new exclusion under the Definition of "Breakdown"
has been added that excludes any defects, erasures,
errors, limitations or viruses in "Computer Equipment", including the inability to recognize or process
dates. This is for clarification purposes and was
previously addressed via Endorsement.
Definitions for "Computer Equipment", "Data", "Diagnostic Equipment", "Ordinary Payroll", "Period of
Restoration", "Production Machines", "Stock" and
"Total Limit per Breakdown" have been added for
clarification purposes.

Page 3 of 3

(

IMPORTANT NOTICE - FILING COMPLAINTS WITH THE INDIANA
DEPARTMENT OF INSURANCE
NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF
YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR
POLICY. PLEASE CONTACT YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS ABOUT THIS
NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND THIS NOTICE,
THE PROVISIONS OF YOUR POLICY PREVAIL.
Questions regarding your policy or coverage should be directed to:
Travelers
(800) 328-2189

If you (a) need Ihe assistance of the governmental agency thai regulates insurance; or (b) have a complainl you
have been unable to resolve with your insurer, you may contact Ihe Department of Insurance by mail, telephone
or email:
State of Indiana Department of Insurance
Consumer Services Division
311 West Washington Street, Suite 300
Indianapolis, Indiana 46204
Consumer Hotline: (800) 622-4461; (317) 232-2395

(

Complaints can be filed electronically at www.in.gov/ldoi

(

PN IN 010510

Page 1 of 1

(

IMPORTANT NOTICE - RISK MANAGEMENT PLANS - FLORIDA
NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF
YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR
POLICY. PLEASE CONTACT YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS ABOUT THIS
NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND THIS NOTICE,
THE PROVISIONS OF YOUR POLICY PREVAIL.
Florida loss control insurance statutes require insurers to provide commercial policyholders, at their request, with
guidelines for risk management plans. Travelers' Risk Control Department has available guidelines to assist you
with your accident prevention activities. These guidelines are available to you free of charge.
A risk management plan shall include safety measures for different exposures, including, as applicable, pollution
and environmental hazards; disease hazards; accidental occurrences; fire hazards and fire prevention and detection; liability for acts from the course of business; slip and fall hazards; product injury; and hazards unique to a
particular class or category of insureds. Training in safety management techniques and safety management
counseling services are also available.
If you would like to request assistance with risk management or your safety program, please call our Risk Control
Department at 407-388-3307. For access to over 1,600 safety and health resources, including training programs,
checklists,
management
guides,
etc.
visit
our
Risk
Control
Customer
Portal
at
http://www.travelers.comiriskcontrol.

(

PN TO 60 0510

Page 1 of 1

NOTICE -IMPORTANT INFORMATION REGARDING YOUR INSURANCEVIRGINIA
NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF
YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE
INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES
UNDER YOUR POLICY. PLEASE CONTACT YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS
ABOUT THIS NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND
THIS NOTICE, THE PROVISIONS OF YOUR POLICY PREVAIL.
Should you need to contact anyone about this insurance for any reason, please contact your agent. If you have
additional questions you may contact Travelers at:
One Tower Square
Hartford, CT 06183

1·800·328-2189
Travelers.com
If you have been unable to contact or obtain satisfaction from our company or your agent, you may contact the
Virginia State Corporate Commission's Bureau of Insurance at:
State Corporation Commission, Virginia Bureau of Insurance
PO Box 1157
Richmond, VA 23218
Toll free: 1-877-310-6560
Richmond, VA area: 804-371-9741
Email: bureauofinsurance@scc.virginia.gov
Written correspondence is preferable so that a record of your inquiry is maintained. When contacting your agent,
company or the Bureau of Insurance, have your policy number available.

PN T1 01 0510

Page 1 of 1

IMPORTANT NOTICE - CONTACT INFORMATION - MISSOURI
NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF
YOUR POLICY. YOU SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR
POLICY. PLEASE CONTACT YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS ABOUT THIS
NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND THIS NOTICE,
THE PROVISIONS OF YOUR POLICY PREVAIL.

Questions regarding your policy or coverage should be direcled 10 your agenl or us at:
Travelers
One Tower Square
Hartlord, CT 06183
(800) 328-2189
Travelers.com

(

PN T2 040510

Page 1 of 1

(

IMPORTANT NOTICE - CONTACT INFORMATION - FLORIDA
NO COVERAGE IS PROVIDED BY THIS NOTICE. THIS NOTICE DOES NOT AMEND ANY PROVISION OF
YOUR POLICY. YOUR SHOULD REVIEW YOUR ENTIRE POLICY CAREFULLY FOR COMPLETE INFORMATION ON THE COVERAGES PROVIDED AND TO DETERMINE YOUR RIGHTS AND DUTIES UNDER YOUR
POLICY. PLEASE CONTACT YOUR AGENT OR BROKER IF YOU HAVE ANY QUESTIONS ABOUT THIS
NOTICE OR ITS CONTENTS. IF THERE IS ANY CONFLICT BETWEEN YOUR POLICY AND THIS NOTICE,
THE PROVISIONS OF YOUR POLICY PREVAIL.
Please review your policy carefully. Should you have any questions concerning coverages, billings, additions or
deletion, please contact your agent. Should you feel the need for additional information or wish to make a complaint, we offer the following number:
For information or to make a complaint, call:
1-800-328-2189

PNT2190510

Page 1 of 1

.....

(

TRAVELERSJ

NOTICE TO POLICYHOLDERS
JURISDICTIONAL INSPECTIONS
Dear Policyholder;
Many states and some cities issue certificates permitting the continued operation of certain equipment such as
boilers, water heaters, pressure vessels, etc. Periodic inspections are normally required to renew these certificates. In most jurisdictions, insurance company employees who have been licensed are authorized to perform
these inspections.

If:
•

You own or operate equipment that requires a certificate from a state or city to operate legally, and

•

We Insure that equipment under this Policy, and

•

You would like us to perform the next required inspection;

Then;
Call this toll-free number -1-800-425-4119

(

When you call this number, our representative will ask you for the following information:
•

Name of your business (as shown on this Policy)

•

Policy Number

•

Location where the equipment is located. Including Zip Code.

•

Person to contact and phone number for scheduling of inspection

•

Type of equipment requiring inspection

•

Certificate inspection date and certificate number

Or;
Fill in the form on the reverse side of this notice and fax it to the toll-free number indicated on that form.
Please note the following:
•

Your jurisdiction may charge you a fee for renewing a certificate. It is your responsibility to pay such a fee.

•

All the provisions of the INSPECTIONS AND SURVEYS Condition apply to the inspections described in this
notice.

REMINDER
If new equipment is installed or old equipment replaced that requires a jurisdictional inspection please let us
know by calling our toll-free number listed above.

PN T1 890699

Page 1 of 2

(

REQUEST FOR JURISDICTIONAL INSPECTION
Name of
Business: - - - - - - - - - - - - - - ; - ; ; - : - = : - : c c : : - , - : : - ; : ; - - : - ; ; : - , - : ; - - - - - - - - - - - - (As Shown on Policy)
Policy
Number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Location of Equipment:

State

City

Zip Code

Person to Contact for Scheduling Inspection: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Telephone Number of Person to Contact:

Equipment Type

Certificate Number

Certificate Expiration Date

Fax Form to 1-877-764-9535
Completed by:

Page 2 of 2

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Phone Number:

PN T1 890699

POLICY OVERPRINT

PAGE 1 OF 1

POLICY NUMBER: M5J-BM21-4245R337-TIL-12
RATER: HF3F

ISSUE DATE: 04/24/12

APARTMENT BLDGS
EFFECTIVE DATE: 03/31/12
EXPIRATION DATE: 03/30/14
INSUREDS NAME: CIBA RESIDENTIAL

NEW/RENEWAL: N

PAYMODE: N

SOLICITOR CODE:

AUDIT FREQUENCY: N

SAl: 7490B0062

RESPONSIBILITY: F

MSI: Y

WATCH FILE: 0

RATING MODE: G

SURVEY CODE: 2

SPECIAL CODE: BA

REINSURANCE: N

PROGRAM CODE: N94

AUTO FILINGS:

FEDERAL TAX ID:
PREMIUM SUMMARY
S.B.

ACCOUNT
MONTH

EFF.
DATE

PREMIUM

NON
PREMIUM

TOTAL:

OFFICE: DIAMOND BAR
189
PRODUCER NAME: R-T SPECIALTY INS SERV

CBX29

TOTAL

TRAVELERSJ

PREMIUM SPLIT FORM

PAGE

1 OF

POLICY NUMBER: M5J-8M21-4245R337-TIL-12
RATER: HF3F

ACCOUNT
MONTH

EFFECTIVE
DATE

ISSUE DATE: 04/24/12

COMM ITEM
NC
PREM

COMM ITEM
NC
87

COMM ITEM
NC
88

COMM ITEM
NC
G8

PREMIUM

B7=WVBMIPS

88=KYBMFS

G8=FIGA088

(

TOTAL:

189
OFFICE: DIAMOND 8AR
PRODUCER NAME: R-T SPECIALTY INS SERV

CBX29

....

TRAVELERSJ

PREMIUM SPLIT FORM

PAGE

2 OF

POLICY NUMBER: M5J-BM21-4245R337-TIL-12
RATER: HF3F

ACCOUNT
MONTH

EFFECTIVE
DATE

ISSUE DATE: 04/24/12

COMM ITEM
NC
H2

COMM ITEM

PREMIUM

TOTAL:

H2=FLCATBM

OFFICE: DIAMOND BAR
189
PRODUCER NAME: R-T SPECIALTY INS SERV

CBX29

CHANGE EFFECTIVE DATE: 03·31·12
CHANGE ENDORSEMENT NUMBER: 0001

TRAVELERSJ

One Tower Square, Hartford, Connecticut 06183

CHANGE ENDORSEMENT
Named Insured:
CIBA CUSTOM & INDUSTRIAL
Polic¥ Number: M5J-BM21-4245R349-TIL-12
Policy Effectlve Date: 03/31/12
Issue Date: 6/08/12
Premium $

INSURING COMPANY:
TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
Effective from 03/31/12 at the time of day the policy becomes effective.
THIS INSURANCE IS AMENDED AS FOLLOWS:

NAMED INSURED ENDORSEMENT, IL T8 00, 01-00, IS AMENDED AS FOLLOWS:
THE NAMED INSURED IS AMENDED TO READ:
THE MEMBER OF COMMERCIAL INDUSTRIAL BUILDING OWNER'S ALLIANCE, INC.
("CIBA") HOLDING VALID EVIDENCE OF COMMERCIAL PROPERTY INSURANCE TO
WHICH THIS FORM IS ATTACHED AS ISSUED BY CIBA INSURANCE SERVICES, INC.
ON BEHALF OF THE COMPANY

(

PREMIUM IS PAYABLE AS FOLLOWS:
$

$
NAME AND ADDRESS OF AGENT OR BROKER:
R-T SPECIALTY INS SERV (CBX29)
3400 W OLIVE AVE 3RD FLOOR
BURBANK, CA 91505

COUNTERSIGNED BY:

Authorized Representative
DATE:,____________________

IL TO 07 09 87
PAGE
OFFICE: DIAMOND BAR

1 OF

......
TRAVELERSJ

CHANGE EFFECTIVE DATE: 03-31-12
CHANGE ENDORSEMENT NUMBER: 0001

POLICY NUMBER:

MSJ-BM21-424SR349-TIL-12

EFFECTIVE DATE:

03-31-12

ISSUE DATE:

06-08-12

LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS
BY LINE OF BUSINESS.
IL
IL
IL
IL

TO
T8
TO
T8

IL T8 01 1093

07 09 87
01 10 93
30 12 90
00

CHANGE ENDORSEMENT
FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
NON-STANDARD PAYMENT SCHEDULE
GENERAL PURPOSE ENDORSEMENT

PAGE:

1 OF

NON-STANDARD PAYMENT SCHEDULE
POLICY NUMBER: MSJ-BM21-424SR349-TIL-12
EFFECTIVE DATE: 03/31/12
ISSUE DATE: 06/08/12

AMOUNT

PAYMENT DUE DATES

(

IL TO 30 12 90

PAGE

1 OF

OFFICE: DIAMOND BAR
189
PRODUCER NAME: R-T SPECIALTY INS SERV

CBX29

CHANGE EFFECTIVE DATE: 03-31-12
CHANGE ENDORSEMENT NUMBER: 0001

POLICY NUMBER: MSJ-BM21-424SR349-TIL-12

GENERAL PURPOSE ENDORSEMENT

(

NAMED INSURED IS AMENDED TO READ:
THE MEMBER OF COMMERCIAL INDUSTRIAL BUILDING OWNER'S ALLIANCE, INC. ("CIBA")
HOLDING VALID EVIDENCE OF COMMERCIAL PROPERTY INSURANCE TO WHICH THIS FORM IS
ATTACHED AS ISSUED BY CIBA INSURANCE SERVICES, INC. ON BEHALF OF THE COMPANY

IL T8 00

Page

CHANGE EFFECTIVE DATE: 03·31·12
CHANGE ENDORSEMENT NUMBER: 0001

OVERPRINT/CHANGE SLIP

PAGE

1 OF

POLICY NUMBER: MSJ-BM21-424SR349-TIL-12
RATER: HF3F

ISSUE DATE: 06/08/12

OFFICES & STORES - ALL OTHER
EFFECTIVE DATE: 03/31/12
EXPIRATION DATE: 03/30/14
CHANGE EFFECTIVE DATE: 03/31/12
INSUREDS NAME: CIBA CUSTOM & INDUSTRIAL
PRORATA FACTOR: 1.000

SHORT RATE FACTOR: 1.000

NEW/RENEWAL: N

PAYMODE: N

SOLICITOR CODE:

AUDIT FREQUENCY: N

SAl: 2369X6138

RESPONSIBILITY: F

MSI: Y

WATCH FILE: 0

RATING MODE: G

SURVEY CODE: 2

SPECIAL CODE: BA

REINSURANCE: N

PROGRAM CODE: N91

AUTO FILINGS:

FEDERAL TAX ID:
PREMIUM SUMMARY
S.B.

ACCOUNT
MONTH

EFF.
DAT

PREMIU

NON
PREMIUM

TOTAL:

OFFICE: DIAMOND BAR
189
PRODUCER NAME: R-T SPECIALTY INS SERV

CBX29

TOTA

CHANGE EFFECTIVE DATE: 03-31-12
CHANGE ENDORSEMENT NUMBER: 0001

TRAVELERS't
PREMIUM SPLIT FORM

PAGE

1 OF

POLICY NUMBER: MSJ-BM21-424SR349-TIL-12
RATER: IlF3F

ACCOUNT
MONTH

EFFECTIVE
DATE

ISSUE DATE: 06/08/12

COMM ITEM
NC
PREM

COMM ITEM

PREMIUM

OFFICE: DIAMOND BAR
189
PRODUCER NAME: R-T SPECIALTY INS SERV

CBX29

CHANGE EFFECTIVE DATE: 03·31·12
CHANGE ENDORSEMENT NUMBER: 0001

TRAVELERSJ

One Tower Square, Hartford, Connecticut 06183

CHANGE ENDORSEMENT
Named Insured:
CIBA RESIDENTIAL
Policy Number: M5u-BM21-4245R337-TIL-12
Policy Effective Date: 03/31/12
Issue Date: 06/08/12
Premium $

INSURING COMPANY:
TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
Effective from 03/31/12 at the time of day the policy becomes effective.
THIS INSURANCE IS AMENDED AS FOLLOWS:
NAMED INSURED ENDORSEMENT, IL T8 00, 01-00, IS AMENDED AS FOLLOWS:
THE NAMED INSURED HAS BEEN AMENDED TO READ:
THE MEMBER OF COMMERCIAL INDUSTRIAL BUILDING OWNER'S ALLIANCE, INC.
("CIBA") HOLDING VALID EVIDENCE OF COMMERCIAL PROPERTY INSURANCE TO
WHICH THIS FORM IS ATTACHED AS ISSUED BY CIBA INSURANCE SERVICES, INC.
ON BEHALF OF THE COMPANY

(

0::::::
0_
0_
0_

PREMIUM IS PAYABLE AS FOLLOWS:

0::::::

NAME AND ADDRESS OF AGENT OR BROKER:
R-T SPECIALTY INS SERV (CBX29)
3400 W OLIVE AVE 3RD FLOOR
BURBANK, CA 91505

COUNTERSIGNED BY:
Authorized Representative

DATE: _ _ _ _ _ _ _ _ __
PAGE
IL TO 07 09 87
OFFICE: DIAMOND BAR

000074

1 OF

....

CHANGE EFFECTIVE DATE: 03·31-12
CHANGE ENDORSEMENT NUMBER: 0001

TRAVELERSJ

POLICY NUMBER:

M5J-BM21-4245R337-TIL-12

EFFECTIVE DATE:

03-31-12

ISSUE DATE:

06-08-12

LISTING OF FORMS, ENDORSEMENTS AND SCHEOULE NUMBERS
THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEOULES AND ENDORSEMENTS
BY LINE OF BUSINESS.
IL
IL
IL
IL

TO
T8
TO
T8

07 09 87
01 10 93
30 12 90
00

CHANGE ENDORSEMENT
FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
NON-STANDARD PAYMENT SCHEOULE
GENERAL PURPOSE ENDORSEMENT

-=
0_

IL T8 01 1093
000075

PAGE:

1 OF

NON-STANDARD PAYMENT SCHEDULE
POLICY NUMBER: M5J-BM21-4245R337-TIL-12
EFFECTIVE DATE: 03/31/12
ISSUE DATE: 06/08/12

PAYMENT DUE DATES

AMOUNT

-=
0:::::

0:::::

---

000076

IL TO 30 12 90

PAGE

1 OF

OFFICE: DIAMOND BAR
189
PRODUCER NAME: R-T SPECIALTY INS SERV

CBX29

t;HAN(JE EFFECTIVE DATE: 03·31·12
CHANGE ENDORSEMENT NUMBER: 0001

POLICY NUMBER: M5J-BM21-4245R337-TIL-12

GENERAL PURPOSE ENDORSEMENT

0_
0_

=
,=

000077

I L T8 00

Page

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