Read DOCUMENT: CGFILE (JBHD) DATE PRINTED: 04-06-93 text version

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<<<<< COMMERCIAL GENERAL LIABILITY FORMS ­ IA, MN, NE, ND, OK, SD >>>>>

The key listed below shows the letter designation assigned for the appropriate program(s). These letters are listed under the column titled PROGRAM USED IN. L = COMMERCIAL GENERAL LIABILITY Q = CHURCH PROTECTOR X = CONTRACTORS PROTECTOR Z = COMMERCIAL MULTI-LINE FORM NUMBERS & EDITION DATES___ COMP. PROG. USED IN LQXZ LQXZ LXZ LQXZ LQXZ LQXZ LZ TITLE_______________________________ COMMON POLICY DECLARATIONS COMMERCIAL LIABILITY DECLARATIONS CERTIFICATE OF INSURANCE ­ MINNESOTA DEPARTMENT OF LABOR AND INDUSTRY (MN) COMMERCIAL GENERAL LIABILITY COVERAGE FORM CALCULATION OF PREMIUM (IA, MN, ND, OK, SD) CALCULATION OF PREMIUM (NE) OWNERS & CONTRACTORS PROTECTIVE LIAB. COV. FORM COVERAGE FOR OPERATIONS OF DESIGNATED CONTRACTOR COMMON POLICY CONDITIONS NUCLEAR ENERGY LIAB. EXCLUSION ENDORSEMENT (BROAD FORM) CERTIFICATE OF LIABILITY INSURANCE (IA, MN, NE, ND, SD) PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM ADDITIONAL INTEREST RECORDING AND DISTRIBUTION OF MATERIAL OR INFORMATION IN VIOLATION OF LAW EXCLUSION KANSAS AND OKLAHOMA CHANGES-TRANSFER OF RIGHTS

(OK)

COMPUTER GENERATED COMPUTER GENERATED LIC-01G 01-11 MNDOL CG 00 01 IL 00 03 IL 00 03 CG 00 09 12-07 09-08 08-07 12-07 ISO ISO* ISO* ISO

IL 00 17 IL 00 21 ACORD 25 CG 00 37 ACORD 45 CG 00 68 CG 01 09

11-98 09-08 08-01 12-07 04-03 05-09 11-85

ISO* ISO* ACORD ISO ACORD ISO* ISO ISO ACORD ACORD ISO ISO ISO ISO* ISO* ISO* ISO* ISO* NSM* ISO* NSM ISO* ISO*

LQXZ LQXZ LQXZ LZ LQXZ LQXZ L LQXZ LQXZ LQXZ LQXZ LQXZ L LQXZ L LXZ LXZ L Q LXZ LZ LQXZ LQXZ

CG 01 20 07-98 ACORD 125 10-07 ACORD 126 CG 01 28 CG 01 44 CG 01 58 IL 01 65 IL 01 79 IL 02 32 IL 02 34 IL 02 36 NS-236 IL 02 45 CF-253 IL 02 59 IL 02 76 05-07 07-98 10-11 01-96 09-08 10-02 09-08 09-08 09-07 08-08 09-08 09-11 09-07 09-07

MINNESOTA CHANGES ­ TOWNHOUSES (MN) COMMERCIAL INSURANCE APPLICATION ­ APPLICANT INFORMATION SECTION COMMERCIAL GENERAL LIABILITY SECTION MINNESOTA CHANGES ­ CONDOMINIUMS (MN) SOUTH DAKOTA CHANGES (SD) OKLAHOMA CHANGES-ADDITIONAL INSURED (ENGINEERS OR ARCHITECTS) (OK) NORTH DAKOTA CHANGES - EXAMINATION OF YOUR BOOKS & RECORDS (ND) OKLAHOMA NOTICE (Fraud ­ guilty of a felony) (OK) SOUTH DAKOTA CHANGES ­ CANCELLATION AND NONRENEWAL (SD) NORTH DAKOTA CHANGES - CANCELLATION AND NONRENEWAL (ND) OKLAHOMA CHANGES-CANCELLATION AND NONRENEWAL

(OK)

OKLAHOMA CHANGES ­ CANCELLATION AND NONRENEWAL

(OK)

MINNESOTA CHANGES - CANCELLATION AND NONRENEWAL

(MN)

GENERAL LIABILITY APPLICATION NEBRASKA CHANGES - CANCELLATION AND NONRENEWAL

(NE)

IOWA CHANGES ­ CANCELLATION AND NONRENEWAL (IA)

Page 1 of 8

<<<<< COMMERCIAL GENERAL LIABILITY FORMS ­ IA, MN, NE, ND, OK, SD >>>>>

The key listed below shows the letter designation assigned for the appropriate program(s). These letters are listed under the column titled PROGRAM USED IN. L = COMMERCIAL GENERAL LIABILITY Q = CHURCH PROTECTOR X = CONTRACTORS PROTECTOR Z = COMMERCIAL MULTI-LINE FORM NUMBERS & EDITION DATES___ CG 03 00 CG 04 37 CG 04 40 01-96 12-04 11-03 COMP. ISO ISO ISO NSM NSM ACORD NSM NSM NSM NSM NSM NSM NSM NSM NSM PROG. USED IN LXZ LQXZ LQXZ Q Z LQXZ LQXZ L Q LZ LZ LZ X X Q TITLE_______________________________ DEDUCTIBLE LIABILITY INSURANCE

(Applies to CGL and

Prod/Completed Operations Liab. Cov. Parts)

CF-455 3-08 CF-531 6-08 ACORD 815 06-05 CF-846 08-00 CF-914 CF-918 CF-920 CF-935 CF-936 CF-1092 CF-1094 CF-1140 03-08 01-12 08-08 11-05 11-05 01-12 6-08 11-05

CF-1142 CF-1181

05-91 11-05

NSM NSM*

Q Q

ELECTRONIC DATA LIABILITY STOP GAP ­ EMPLOYERS LIABILITY COVERAGE ENDORSEMENT (ND) CHURCH PROTECTOR POLICY JACKET COMMERCIAL MULTILINE POLICY JACKET INTERNATIONAL LIABILITY EXPOSURS SUPPLEMENT EXCLUSION (PUNITIVE, EXEMPLARY OR MULTIPLE DAMAGES) COMMERCIAL GENERAL LIABILITY POLICY JACKET NORTH STAR CHURCH PROTECTOR EXTENSION ENDORSEMENT NON-OWNED AUTO LIABILITY FARM EMPLOYERS LIAB. & FARM EMPLOYEES MED. PAY. INS. BASIC FARM PREMISES LIABILITY CONTRACTORS PROTECTOR APPLICATION CONTRACTORS PROTECTOR POLICY JACKET DIRECTORS & OFFICERS LIAB. COV. SEXUAL MISCONDUCT LIAB. COV. PASTORS COUNSELING LIAB. COV. Claims-Made Coverage SUPPLEMENTAL EXTENDED REPORTING PERIOD ENDORSEMENT MINNESOTA CHANGES (Examination of Your Books and Records, Prejudgment Interest and Transfer of Rights of Recovery Against Others to Us) (MN) (Applies to D&O, Sexual Misconduct and

Pastors Counseling Liab. Cov. Part)

CF-1183 NSCF-1243

12-03 08-11

NSM* NSM

Q LQXZ

AMENDATORY ENDORSEMENT - YOUR RIGHT TO CLAIM AND "OCCURRENCE" INFORMATION (MN, ND) NOTICE CONCERNING POLICYHOLDER RIGHTS IN AN INSOLVENCY UNDER THE MINNESOTA INSURANCE GUARANTY ASSOCIATION LAW (MN) (This notice must be given with

the application. The notice must be given in writing or in the same medium as the application for insurance. This notice would only be attached to renewal certificates if the renewal increases the dollar amount of a coverage by more than 100%.) (The NSCF-1243 will not show on the dec.!)

CF-1496 CF-1517 CF-1557 CF-1736

08-08 04-10 08-08 01-08

NSM NSM NSM* NSM*

LQXZ LZ L LQXZ

HIRED AUTO AND NON-OWNED AUTO LIABILITY DIRECTORS AND OFFICERS LIABILITY COVERAGE

ND, SD)

(IA, MN, NE,

CF-1791

12-03

NSM*

Q

AMENDATORY ENDORSEMENT CERTIFIED TERRORISM LOSS COVERAGE; NON-CERTIFIED TERRORISM LOSS EXCLUSION; NUCLEAR, BIOLOGICAL, CHEMICAL AND RADIOLOGICAL EXCLUSION; WAR AND MILITARY ACTION EXCLUSION (MN, NE, ND, OK, SD) AMENDATORY ENDORSEMENT ­ CANCELLATION AND NONRENEWAL FOR DIRECTORS AND OFFICERS LIABILITY,

Page 2 of 8

* Indicates a mandatory form

<<<<< COMMERCIAL GENERAL LIABILITY FORMS ­ IA, MN, NE, ND, OK, SD >>>>>

The key listed below shows the letter designation assigned for the appropriate program(s). These letters are listed under the column titled PROGRAM USED IN. L = COMMERCIAL GENERAL LIABILITY Q = CHURCH PROTECTOR X = CONTRACTORS PROTECTOR Z = COMMERCIAL MULTI-LINE FORM NUMBERS & EDITION DATES___ COMP. PROG. USED IN TITLE_______________________________ SEXUAL MISCONDUCT LIABILITY AND PASTORS COUNSELING LIABILITY (IA, MN, NE, ND, SD) CHURCH PROTECTOR APPLICATION CUSTOM FARM WORK (IA, MN, NE, ND, SD) FARM POLLUTION AND CLEAN UP COVERAGE (LIMITED COVERAGE) (IA, NE, ND, SD) FARM POLLUTION AND CLEAN UP COVERAGE (LIMITED COVERAGE) (MN) SOUTH DAKOTA CHANGES ­ DEFENSE IN ADDITION TO LIMITS OF INSURANCE (SD) SUPPLEMENTAL EXTENDED REPORTING PERIOD ENDORSEMENT (IA, MN, NE, ND, SD) NOTICE TO POLICYHOLDERS ­ NOTICE OF TERRORISM INSURANCE (MN, NE, ND, OK, SD) CERTIFIED TERRORISM LOSS COVERAGE; NON-CERTIFIED TERRORISM LOSS EXCLUSION (WITH LIMITED EXCEPTION); NUCLEAR, BIOLOGICAL, CHEMICAL AND RADIOLOGICAL EXCLUSION; WAR AND MILITARY ACTION EXCLUSION (IA) NOTICE TO POLICYHOLDERS ­ NOTICE OF TERRORISM INSURANCE (IA) SOUTH DAKOTA CHANGES ­ DEFENSE IN ADDITION TO LIMITS OF INSURANCE(SD) NOTICE TO POLICY HOLDERS CANCELLATION OR NONRENEWAL NOTICE TO BE SENT TO MINNESOTA DEPARTMENT OF LABOR AND INDUSTRY (MN) ADDITIONAL INSURED-CLUB MEMBERS ADDITIONAL INSURED-CONCESSIONAIRES TRADING UNDER YOUR NAME ADDITIONAL INSURED-CONDOMINIUM UNIT OWNERS CANCELLATION OR NONRENEWAL NOTICE TO BE SENT TO CERTIFICATE OF INSURANCE HOLDER WHEN REQUIRED BY LAW ADDITIONAL INSURED-CONTROLLING INTEREST ADDITIONAL INSURED - ENGINEERS, ARCHITECTS, OR SURVEYORS ADDITIONAL INSURED-USERS OF GOLFMOBILES ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS (FORM B) ADDITIONAL INSURED-MANAGERS OR LESSORS OF PREMISES ADDITIONAL INSURED-STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION ­ PERMITS OR AUTHORIZATIONS DRYWALL EXCLUSION ADDITIONAL INSURED-STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION ­ PERMITS OR AUTHORIZATIONS RELATING TO PREMISES

Page 3 of 8

CF-1829 CF-1844 CF-1845 CF-1846 CF-1887 CF-1888 CF-1895 CF-1897

01-12 03-06 03-06 03-06 04-10 04-10 01-08 01-09

NSM NSM NSM NSM NSM NSM NSM NSM*

Q LQXZ LQXZ LQXZ LZ LZ LQXZ LQXZ

CF-1898 CF-1902 CF-1903 CF-2001 CG 20 02 CG 20 03 CG 20 04 CF-2005

01-09 08-08 08-08 01-11 11-85 11-85 11-85 01-11

NSM NSM NSM NSM ISO ISO ISO NSM

LQXZ LQZ LQXZ LXZ LZ LQXZ LZ LXZ

CG 20 05 CG 20 07 CG 20 08 CG 20 10 CG 20 11 CG 20 12

11-85 07-04 11-85 07-04 01-96 05-09

ISO ISO ISO ISO ISO ISO

LZ LZ LZ LZ LZ LZ

CF 2013 CG 20 13

09-11 05-09

NSM ISO

LXZ LZ

* Indicates a mandatory form

<<<<< COMMERCIAL GENERAL LIABILITY FORMS ­ IA, MN, NE, ND, OK, SD >>>>>

The key listed below shows the letter designation assigned for the appropriate program(s). These letters are listed under the column titled PROGRAM USED IN. L = COMMERCIAL GENERAL LIABILITY Q = CHURCH PROTECTOR X = CONTRACTORS PROTECTOR Z = COMMERCIAL MULTI-LINE FORM NUMBERS & EDITION DATES___ CF 2014 CG 20 15 CG 20 17 CG 20 18 CG 20 22 CG 20 23 CG 20 24 CG 20 25 CG 20 26 CG 20 27 CG 20 28 CG 20 29 CG 20 31 CG 20 32 CG 20 33 01-12 07-04 10-93 11-85 10-01 10-93 11-85 11-85 07-04 11-85 07-04 11-85 07-04 07-04 07-04 COMP. NSM ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO PROG. USED IN LXZ LZ LZ LZ Q LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ TITLE_______________________________ EXTENDED PROPERTY DAMAGE ENDORSEMENT ADDITIONAL INSURED-VENDORS ADDITIONAL INSURED-TOWNHOUSE ASSOCIATIONS ADDITIONAL INSURED-MORTGAGEE, ASSIGNEE, OR RECEIVER ADDITIONAL INSURED-CHURCH MEMBERS AND OFFICERS ADDITIONAL INSURED-EXECUTORS, ADMINISTRATORS, TRUSTEES OR BENEFICIARIES ADD'L INSURED-OWNERS OR OTHER INTERESTS FROM WHOM LAND HAS LEASED ADD'L INSURED-ELECTIVE OR APPOINTIVE EXEC. OFFICERS OF PUBLIC CORP ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION ADDITIONAL INSURED-CO-OWNER OF INSURED PREMISES ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT ADDITIONAL INSURED-GRANTOR OF FRANCHISE ADDITIONAL INSURED ­ ENGINEERS, ARCHITECTS OR SURVEYORS ADDITIONAL INSURED ­ ENGINEERS, ARCHITECTS OR SURVEYORS NOT ENGAGED BY THE NAMED INSURED ADDITIONAL INSURED ­ OWNERS, LESSEES OR CONTRACTORS ­ AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ADDITIONAL INSURED ­ LESSOR OF LEASED EQUIPMENT ­ AUTOMATIC STATUS REQUIRED IN LEASE AGREEMENT WITH YOU ADDITIONAL INSURED ­ OWNERS, LESSEES OR CONTRACTORS ­ COMPLETED OPERATIONS EXCLUSION-ALL HAZARDS IN CONNECTION WITH DESIGNATED PREMISES EXCLUSION-ATHLETIC OR SPORTS PARTICIPANTS EXCLUSION-PRODUCTS-COMPLETED OPERATIONS HAZARD EXCLUSION-DESIGNATED PROFESSIONAL SERVICES EXCLUSION-MOVEMENT OF BUILDINGS OR STRUCTURES EXCLUSION-DESIGNATED PRODUCTS EXCLUSION-DESIGNATED WORK EXCLUSION-COVERAGE C-MEDICAL PAYMENTS EXCLUSION-NEW ENTITIES EXCLUSION-EMPLOYEES AS INSUREDS EXCLUSION-PERSONAL AND ADVERTISING INJURY CONTRACTUAL LIABILITY LIMITATION EXCLUSION-INTERCOMPANY PRODUCTS SUITS EXCLUSION-EXPLOSION, COLLAPSE AND UNDERGROUND PROPERTY DAMAGE HAZARD (SPECIFIED OPERATIONS)

CG 20 34

07-04

ISO

LZ

CG 20 37 CG 21 00 CG 21 01 CG 21 04 CG 21 16 CG 21 17 CG 21 33 CG 21 34 CG 21 35 CG 21 36 CG 21 37 CG 21 38 CG 21 39 CG 21 41 CG 21 42

07-04 07-98 11-85 11-85 07-98 07-98 11-85 01-87 10-01 03-05 10-01 11-85 10-93 11-85 12-04

ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO

LZ LZ LZ LZ LQXZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ

* Indicates a mandatory form

Page 4 of 8

<<<<< COMMERCIAL GENERAL LIABILITY FORMS ­ IA, MN, NE, ND, OK, SD >>>>>

The key listed below shows the letter designation assigned for the appropriate program(s). These letters are listed under the column titled PROGRAM USED IN. L = COMMERCIAL GENERAL LIABILITY Q = CHURCH PROTECTOR X = CONTRACTORS PROTECTOR Z = COMMERCIAL MULTI-LINE FORM NUMBERS & EDITION DATES___ CG 21 43 12-04 COMP. ISO PROG. USED IN LZ TITLE_______________________________ EXCLUSION-EXPLOSION, COLLAPSE AND UNDERGROUND PROPERTY DAMAGE HAZARD (SPECIFIED OPERATIONS EXCEPTED) LIMITATION OF COVERAGE TO DESIGNATED PREMISES OR PROJECT EXCLUSION-FIRE DAMAGE LEGAL LIABILITY EMPLOYMENT - RELATED PRACTICES EXCLUSION EXCLUSION ­ FINANCIAL SERVICES EXCLUSION ­ DESIGNATED ONGOING OPERATIONS EXCLUSION ­ DESIGNATED OPERATIONS COVERED BY A CONSOLIDATED WRAP-UP INSURANCE PROGRAM POLLUTION EXCLUSION ENDORSEMENT EXCLUSION ­ FUNERAL SERVICES EXCLUSION ­ COUNSELING SERVICES EXCLUSION ­ PROFESSIONAL VETERINARIAN SERVICES EXCLUSION ­ YEAR 2000 COMPUTER­RELATED AND OTHER ELECTRONIC PROBLEMS FUNGI OR BACTERIA EXCLUSION EXCLUSION ­ EXTERIOR INSULATION AND FINISH SYSTEMS SILICA OR SILICA-RELATED DUST EXCLUSION ABUSE OR MOLESTATION EXCLUSION ­ SPECIFIED PROFESSIONAL SERVICES TOTAL POLLUTION EXCLUSION ENDORSEMENT (IA, NE, ND, OK,

SD)

CG 21 44 CG 21 45 CG 21 47 CG 21 52 CG 21 53 CG 21 54 CG 21 55 CG 21 56 CG 21 57 CG 21 58 CG 21 60 CG 21 67 CG 21 86 CG 21 96 CG 21 97 CG 21 98 CG 22 24 CG 22 28 CG 22 29 CG 22 30 CG 22 31 CG 22 33 CG 22 34 CG 22 36 CG 22 37 CG 22 38 CG 22 39 CG 22 40 CG 22 42

07-98 07-98 12-07 07-98 01-96 01-96 09-99 07-98 07-98 07-98 09-98 12-04 12-04 03-05 12-07 12-07 07-98 12-04 11-85 07-98 07-98 07-98 07-98 07-98 07-98 07-98 07-98 01-96 11-85

ISO ISO ISO ISO ISO ISO ISO* ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO

LZ LZ LZ L L L LQXZ L L L LQXZ LQXZ LQXZ LQXZ LQXZ LQXZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ

EXCLUSION-INSPECTION, APPRAISAL AND SURVEY COMPANIES AMENDMENT-TRAVEL AGENCY TOURS (LIMITATION OF COVERAGE) EXCLUSION-PROPERTY ENTRUSTED EXCLUSION-CORPORAL PUNISHMENT EXCLUSION-RIOT, CIVIL COMMOTION OR MOB ACTION ­ GOVERNMENTAL SUBDIVISIONS EXCLUSION-TESTING OR CONSULTING ERRORS AND OMISSIONS EXCLUSION-CONSTRUCTION MANAGEMENT ERRORS AND OMISSIONS EXCLUSION-PRODUCTS & PROFESSIONAL SERVICES (DRUGGISTS) EXCLUSION-PRODUCTS & PROFESSIONAL SERVICES (OPTICAL & HEARING AID ESTABLISHMENTS) EXCLUSION ­ FIDUCIARY OR REPRESENTATIVE FINANCIAL INSTITUTIONS EXCLUSION-CAMPS OR CAMPGROUNDS EXCLUSION-MEDICAL PAYMENTS TO CHILDREN DAY CARE CENTERS EXCLUSION-EXISTENCE OR MAINTENANCE OF STREETS, ROADS, HIGHWAYS OR BRIDGES

Page 5 of 8

* Indicates a mandatory form

<<<<< COMMERCIAL GENERAL LIABILITY FORMS ­ IA, MN, NE, ND, OK, SD >>>>>

The key listed below shows the letter designation assigned for the appropriate program(s). These letters are listed under the column titled PROGRAM USED IN. L = COMMERCIAL GENERAL LIABILITY Q = CHURCH PROTECTOR X = CONTRACTORS PROTECTOR Z = COMMERCIAL MULTI-LINE FORM NUMBERS & EDITION DATES___ CG 22 43 CG 22 44 CG 22 45 CG 22 48 CG 22 50 CG 22 52 CG 22 53 CG 22 54 CG 22 56 CG 22 60 CG 22 63 CG 22 64 CG 22 65 CG 22 66 CG 22 67 CG 22 68 CG 22 69 CG 22 70 CG 22 71 CG 22 72 CG 22 74 CG 22 75 CG 22 76 07-98 07-98 07-98 03-05 11-88 10-93 11-85 11-85 07-98 12-07 01-96 07-98 09-99 11-85 10-93 09-97 10-01 11-85 10-01 03-05 10-01 07-98 07-98 COMP. ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO PROG. USED IN LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LZ LQXZ LZ LZ LQZ LQZ LZ LZ LZ TITLE_______________________________ EXCLUSION-ENGINEERS, ARCHITECTS OR SURVEYORS PROFESSIONAL LIAB. EXCLUSION ­ SERVICES FURNISHED BY HEALTH CARE PROVIDERS EXCLUSION ­ SPECIFIED THERAPEUTIC OR COSMETIC SERVICES EXCLUSION - INSURANCE AND RELATED OPERATIONS EXCLUSION - FAILURE TO SUPPLY EXCLUSION - MEDICAL PAYMENTS COVERAGE INMATES, PATIENTS OR PRISONERS EXCLUSION - LAUNDRY AND DRY CLEANING DAMAGE EXCLUSION - LOGGING AND LUMBERING OPERATIONS EXCLUSION - INJURY TO VOLUNTEER FIREFIGHTERS LIMITATION OF COVERAGE - REAL ESTATE OPERATIONS STEVEDORING OPERATIONS LIMITED COMPLETED OPERATIONS COVERAGE PESTICIDE OR HERBICIDE APPLICATOR COVERAGE OPTICAL & HEARING AID ESTABLISHMENTS MISDELIVERY OF LIQUID PRODUCTS COVERAGE CORPORAL PUNISHMENT OPERATION OF CUSTOMERS AUTOS ON PARTICULAR PREMISES DRUGGISTS REAL ESTATE PROPERTY MANAGED COLLEGES OR SCHOOLS (LIMITED FORM) COLLEGES OR SCHOOLS LIMITED CONTRACTUAL LIABILITY COVERAGE FOR PERSONAL AND ADVERTISING INJURY PROFESSIONAL LIABILITY EXCLUSION - COMPUTER SOFTWARE PROFESSIONAL LIABILITY EXCLUSION - HEALTH OR EXERCISE CLUBS OR COMMERCIALLY OPERATED HEALTH OR EXERCISE FACILITIES PROFESSIONAL LIABILITY EXCLUSION - ELECTRONIC DATA PROCESSING HAZARDOUS MATERIAL CONTRACTORS EXCLUSION ­ CONTRACTORS ­ PROFESSIONAL LIABILITY EXCLUSION ­ ERRONEOUS DELIVERY OR MIXTURE AND RESULTING FAILURE OF SEED TO GERMINATE ­ SEED MERCHANTS MINNESOTA CHANGES ­ LIMITED CONTRACTUAL LIABILITY COVERAGE FOR PERSONAL AND ADVERTISING INJURY PROFESSIONAL LIABILITY EXCLUSION ­ ELECTRONIC DATA PROCESSING SERVICES AND COMPUTER CONSULTING OR PROGRAMMING SERVICES SNOW PLOW OPERATIONS COVERAGE LAWN CARE SERVICES COVERAGE

Page 6 of 8

CG 22 77 CG 22 78 CG 22 79 CG 22 81

07-98 07-98 07-98 01-96

ISO ISO ISO ISO

LZ LZ LZ L

CG 22 85 CG 22 88

12-01 07-98

ISO ISO

L LZ

CG 22 92 CG 22 93

12-07 12-07

ISO ISO

LZ LZ

* Indicates a mandatory form

<<<<< COMMERCIAL GENERAL LIABILITY FORMS ­ IA, MN, NE, ND, OK, SD >>>>>

The key listed below shows the letter designation assigned for the appropriate program(s). These letters are listed under the column titled PROGRAM USED IN. L = COMMERCIAL GENERAL LIABILITY Q = CHURCH PROTECTOR X = CONTRACTORS PROTECTOR Z = COMMERCIAL MULTI-LINE FORM NUMBERS & EDITION DATES___ CG 23 01 CG 24 01 CG 24 03 CG 24 04 CG 24 05 CG 24 07 CG 24 10 CG 24 11 CG 24 12 CG 24 16 CG 24 18 12-04 12-04 11-85 05-09 12-04 01-96 07-98 12-04 11-85 12-07 09-99 COMP. ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO PROG. USED IN LQXZ L LZ LZ LZ LZ LZ LZ LZ LZ L TITLE_______________________________ EXCLUSION ­ REAL ESTATE AGENTS OR BROKERS ERRORS OR OMISSIONS NON-BINDING ARBITRATION (MN, ND, OK) WAIVER OF CHARITABLE IMMUNITY WAIVER OF TRANSFER RIGHTS OF RECOVERY AGAINST OTHERS TO US FINANCIAL INSTITUTIONS ­ FIDUCIARY INTEREST ONLY PRODUCTS/COMPLETED OPERATIONS HAZARD REDEFINED EXCESS PROVISION - VENDORS FIDUCIARIES - FIDUCIARY INTEREST BOATS CANOES OR ROWBOATS SEED MERCHANTS ­ COVERAGE FOR ERRONEOUS DELIVERY OR MIXTURE AND RESULTING FAILURE OF SEED TO GERMINATE (Applies to CGL Cov. Part) SEED MERCHANTS ­ COVERAGE FOR ERRONEOUS DELIVERY OR MIXTURE (RESULTING FAILURE OF SEED TO GERMINATE NOT INCLUDED) (Applies to CGL Cov. Part) SEED MERCHANTS ­ COVERAGE FOR ERRONEOUS DELIVERY OR MIXTURE AND RESULTING FAILURE OF SEED TO GERMINATE (Applies to Prod/Completed Ops. Cov. Part) SEED MERCHANTS ­ COVERAGE FOR ERRONEOUS DELIVERY OR MIXTURE (RESULTING FAILURE OF SEED TO GERMINATE NOT INCLUDED) (Applies to Prod/Compl Ops. Cov. Part) DESIGNATED CONSTRUCTION PROJECTS GENERAL AGGREGATE LIMIT DESIGNATED LOCATIONS GENERAL AGGREGATE LIMIT MINNESOTA CHANGES (MN) (Applies to CGL Cov. Part) SOUTH DAKOTA CHANGES ­ NON-BINDING ARBITRATION (SD) NORTH DAKOTA CHANGES ­ NOTICE OF CANCELLATION ­ PESTICIDE APPLICATORS (ND) MINNESOTA CHANGES ­ DUTIES CONDITION (MN) EARLIER NOTICE OF CANCELLATION PROVIDED BY US PERSONAL INJURY LIABILITY PRINCIPALS PROTECTIVE LIABILITY COVERAGE PESTICIDE OR HERBICIDE APPLICATOR COVERAGE SOUTH DAKOTA CHANGES - CANCELLATION (SD) (Applies to

Owners & Contractors Protective Liab. Cov. Part)

CG 24 19

09-99

ISO

L

CG 24 20

09-99

ISO

L

CG 24 21

09-99

ISO

L

CG 25 03 CG 25 04 CG 26 05 CG 26 45 CG 26 56 CG 26 81 CG 28 04 CG 28 05 CG 28 07 CG 28 12 CG 28 22 CG 28 43 CG 28 74 CG 29 21

05-09 05-09 02-07 12-04 10-99 12-04 10-93 10-01 12-07 10-01 09-02 02-07 12-89 12-03

ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO ISO

LZ LZ LXZ LQXZ L LQXZ L LZ LZ LZ LZ LZ LZ L

MINNESOTA CHANGES

Protective Liab. Cov. Part)

(MN) (Applies to Owners & Contractors

NEBRASKA CHANGES - CANCELLATIONS AND NONRENEWAL

(NE) (Applies to Owners & Contractors Protective Liab. Cov. Part)

NORTH DAKOTA NONRENEWAL (ND)

Cov. Part)

CHANGES

-

CANCELLATION

AND

(Applies to Owners & Contractors Protective Liab.

CG 29 27

12-87

ISO

L

IOWA CHANGES ­ CANCELLATION AND NONRENEWAL (IA)

Page 7 of 8

* Indicates a mandatory form

<<<<< COMMERCIAL GENERAL LIABILITY FORMS ­ IA, MN, NE, ND, OK, SD >>>>>

The key listed below shows the letter designation assigned for the appropriate program(s). These letters are listed under the column titled PROGRAM USED IN. L = COMMERCIAL GENERAL LIABILITY Q = CHURCH PROTECTOR X = CONTRACTORS PROTECTOR Z = COMMERCIAL MULTI-LINE FORM NUMBERS & EDITION DATES___ CG 29 33 CG 29 35 10-06 05-09 COMP. ISO ISO PROG. USED IN L LZ TITLE_______________________________ OKLAHOMA CHANGES - CANCELLATION AND NONRENEWAL

(OK) (Applies to Owners & Contractors Protective Liab. Cov. Part)

ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION ­ PERMITS OR AUTHORIZATIONS (Applies to Owners & Contractors Protective Liab.

Cov. Part)

CG 29 51

12-07

ISO

LZ

EMPLOYMENT - RELATED PRACTICES EXCLUSION

Pollution Liability Coverage Part)

(MN, ND, OK,

SD) (Applies to Owners and Contractors Protective Liability Coverage Part and

CG 29 77

12-90

ISO

LZ

NORTH DAKOTA CHANGES - EXAMINATION OF YOUR BOOKS & RECORDS (ND) (Applies to Owners & Contractors Protective Liab. Cov.

Part)

CG 29 88

10-93

ISO

L

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Applies to Owners & Contractors Protective Liab. Cov.

Part)

CG 29 96 CG 31 31

02-07 12-04

ISO ISO

L LQXZ

MINNESOTA

CHANGES

(MN)

(Applies

to

Products/Completed

Operations Liability Coverage Part)

FUNGI OR BACTERIA EXCLUSION

Coverage Part)

(Applies to Owners & Contractors

Protective Liab. Cov. Part and Products/Completed Operations Liability

CG 31 52 CG 31 66 CG 31 67 CG 33 70

11-02 12-04 12-04 03-05

ISO ISO ISO ISO

LXZ L L L

MINNESOTA CHANGES ­ PREMIUM AUDIT CONDITION

to Principal Protective Liability Coverage Endorsement CG 28 07)

(Applies

EXCLUSION ­ EXTERIOR INSULATION AND FINISH SYSTEMS

(Applies to Owners and Contractors Protective Liab. Cov. Part)

EXCLUSION ­ EXTERIOR INSULATION AND FINISH SYSTEMS

(Applies to Prod/Completed Ops. Liab. Cov. Part)

SILICA OR SILICA-RELATED DUST EXCLUSION (Applies to Owners

and Contractors Prot Liab. Cov. Part and Prod/Completed Ops Liab. Cov. Part)

* Indicates a mandatory form

Page 8 of 8

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DOCUMENT: CGFILE (JBHD) DATE PRINTED: 04-06-93

8 pages

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