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Home My WebLink AboutRobert M. Marshall and Agnes Marshall - 1949-11-08 i .i i- i i 1 P 1 f s i MU r Z-HIS AORN-SHENT y dated WX 1st dGY of Hartho 19599 a d by aro. 1 CITY MATINGTOR BEWHIj ,. a municipal corperaxti+con, hareinnftor TOCT cofxvanienes y � < referred tG aasw CITY AND 4 Alp MJ:IMMU and giOi7i5 IR M• Y..4RSTIA.LL, 7r, s rasforrsd to a s q LICENSEE +. cat I T N S rS R a Hw r WiXREASI t`ity by agrasment dated YmI7 lei,, 1948,wiith the HunA:ineten beach Couq)any', accured pera,ssrion to sae the. 4 zurfaaa of a certain parcel of lard in tho City of MmUngtm uonoh finr golf ec.iirso purposeaw said agreawnt being madLL�,ed� amnd*6 and sitandad l raid t WIEIRSAS, said agroement, as moAifieA s aamnded and i 1 i extandedw is to term�ctad aat tno aaffa �igae date of We agreement for the rkaasm that the City of uUntingtem Beach to negotiating with the h`wUndtaan Banah Comp to t®rrairwcte e MAIO agreownt in oonsiflgratl= for a now agraema--nt covering said p;raverty to Zamzry let, 1975; and j ' HEREAS O Licences hareUa has.. by egreament dated 71 7 1 1' �.ww..ip,frw , !!!R! . .7.llZ�+.�s.�'t�^"LIZ`1�. r • r44M.RT . wMtM+�ww.+wgJ� w1 1 t } 1 ` --.r.wva .............�.... _a..�...... _..» .. .... .. t . ..... ,-.... s,....7►�..._. .,.. .. .. _ .. ._ ..,. ,_. ._.... ..... ,.. • _.._. . .. ....ems t , r ` r i i i 1 ti the 6th da r of Novenbert 1949, been perrI t`3ed by City to op- orate a gulf course upon s hLid land and has made extenarIV4 iepr€ twnts therein and cone ructed cartaein bt ,dings thereon; 1 and ill-VRE S, the pasties desire to tsrx' mir cte said agrees» wnt of Nov mbar Otht 19489 as modifledt act aded _§rW extended, ,§1 r r and sntar into A now egr+ecamant whereby City ahall permit t. License* to use the surface of the above mentimed 1=4 for they sole purpoaus and on the terms harei.naftor dot forths f RQU TFUIfiEF'OREt for and in consideration of the pres�- C i.sen and of the terms and conditions horainaf ter set fort i , the parties agract as follows t . y 1. City, for and in consideration of ghat payments rl herein provided to bo redo and subject to the conditions and agraem.ents herein stated to be kept; and performed by Liaenac-i f and subject to revocation and torminaticn as heroinatter pre- videdp goes hereby give the Licenses pnivission to use th"a surfaca a those certain parosla of 1W situate in the City i 4 of Huntington Beach, County of Orsnge t State of California, f bring batwtan 23rd Strast and lrth Street and northerly of t Palm Avenue t more particularly show outlined in reds m tho plat a t hashed hereto marka d xhibit A" and made a part hereof t .for the sole purpose of construating and maintsainin, thereon a golf ceUrse. .a x 29 The psraistion hereby given shall continue in fore until January Ist;t 1975, pro idadt hovevert that either party harsto ahall have the right to tormi -ate this License 2. '.4, ex•- •r.- .w..-..�«rre:es�-;.. _.. _ --'per---,-t, — — { i rti ' r i at any ti.ae by serving three (3) years' written notice upon the othare Liema tes ag ress ,that upon any termination of this egreament they xi$lt within thirty (30) days thereafter reeavvo y From the above ramtioned pr6misea all or their property pl,aosd thereon by Licensee under this agreemvat or andor sold apvtoont dated Noesr►tbar 8, 19491 and that thoy mbal.l..e within thirty (30) 17„ days from any termii.natlon dais, surrender and deliver to City the quAet and peaceable possession of suoh premixem in as ;food order, repair and condition as they were in at than time of the exeaution of this license, reasonable use and veer alorm except. ;i ed. 3o Licensee shall pay to City for the privilegs hors. i.n given, the fallo s (A) Twely* paraent (12' ) of the gross green fe►os receiv®d from, the dato heraef through t Jae 1963, and 'minty percent (20%) of the gross ,green fees from and after J,4,v let, 19632 and t Cb) Ono ldmdred Dollars 0100*00; per month throtbp Jim , 1963, commencing on tlr-1 date iaregf; and (a) Four Poweent (am) of the ;brass r+saeipta from the sal.as of food and beverages which are sold on the promises except as , hereinafter providedt and (d) Ton percent (10�) or the gross reosip►ts frca auay faturae driving range or pitch and putt golf czurse installed on the par- cola outlined In red on Exhibit A s Ths pouents provided for In this Paxagra.ph, 3 shan be maths no later than the 151-h day of tho month f011w-dng the month in Vhiah suoh frtgs are recaived. ` �. Uven*ee sgress that it will, at all t1nea &wing 34 1 i r . a •i j 1 i f the centinuanv* of thim agreawnt hoop oaM presdaest inoludi ail rai.rvayso groons, bunkersi toes and ol.l buildingso, struct- urom and -Vibar property erected or pl.,acad tharoan by Licensee in � a nowt: ,und attractive ordarp reprir wW condition at Licsnaee l s own expense. License* further agrees that it vill at &T1 times maintain order on the prerAsas and that it vi,l,l not sublat nor ; <r use tho Promises for the vending ing of any merchandise other tmn i golf supplies and those Items usually sold in a gold' course club- house Pxaept as hti rsina.Mr provided# laeohol.ia boveragam whall s - be permitted to be sold on the prastisos, but City may terminate this permisc on to ael.l aloohollo ovarages at any tim City in Its scale t'isaretion so dosi.res by giv-ing Licensee writton notice ' to cacse such sales of alcoholl a bovtarageas No aleoho2la beverageo r may tv sold on the prcr ioiv after such writ-ton natica i`mz City to cause tho selling of wich alcoholic boverages $hall be rocaived by 7 i Urtensee, Notwithstanding -tieing to the contrary is this Agree memo !'*,-A provisicns of Paragraph 3 (c) shall lao termina!:Sd when and If tho r1ght to sail alcoholic beverages has been teradnated j as herein Prcvtdedt except t»xie right of City to collect such sins that hnve thovvtoZore aoavxas ad# In the avomt also olio boverag- as shall btu sold after U*ens%4 shall hAva rani eived such notice by City to cocce such sales, City shall hava the right to torm1nate 4 this cgrea nt. If Licona#e shall bo in default in the parformanee of 7 any of its obligations undar this license other titan the cessatice of the sales of alcoholic boverages as provid1ad above f and if for i a period of n1no-ty► (90) days after wri.tt*n nation given to it at a its ofriee at tjngtan reach, Ca.li.fornla, by Licensor, Liconsee ,y b shall fail to co. imenae ther*nfter diligently €+,nd in gco:, faith to 4W rrmxx,were t r tj } 7 1 ;t i c 4 i i } pros#cuts the ros*dying of such default, City relay terminate this Agroaewnt, , i• 1 This 11conoo is parsonal to .&foot ses and. Licensee s thall not sell nor assign any of the privileges hereby gi"n ►tithout the written consent of City, provided,, how-rer, Li©ensas may assign this permit to a corporation in w1dah the Licansoo < - herein ovne one hundred percent (3.00%) of the outstanding and � A authorized stock, a , �. Lioansee shall and gill pay, befog* the sate boom ' e0mas delinquent all chargsss taxas,y rates and assessments upon ,. or against any property or improvenvnts plaeod by or for Li.cens- ea upon said pramlaes, r 7. Mcensaa shall carry public liability and proporty damaga insurance of the nature and in amounts from time to time rewired by City of riot loss thibn Tw Hundred houcand Dollars ($200,000,00) to oroteot City, the Runtington Beach Company and Standard Oil Company of Calirorrla from and against all loss, cost, liability and oxpqnse of any eaPaoter with respect to Any claim or dem nd .for Injuxy to, or death tW parsons and Par dano ago to, or loss of property, or W exponse dirvotly or indireatly arlstrLS ou; of or attributed to Lh t exercise of i;Aaonoaey its agawllww, servants, 9i vioyoes or invitees or the use of aa14 Uosne- ad area or the exercise or enjajzent by Licensee or aum of said eraous of xivils es extanded h-.�rab ranted, Sunh public F 3 p' g y g P , liability and propo r ty damage insurance a:all include City of MAti,ngton Beach, A xwUcipat aor orati.ca, Mantin.gton Boaah Comp ► 4 and standard Oil Company of Conlifornia, as parties insured, ash R t+ shall ba carried ioith insurancs companf.es autrorlsod to do insur- ance busiowas in the State of Callfornia and teas Worse of suoh in.. t 5• i r t k r F r t s urssneq policies Mall be approved in writing by City, This license i a made subject to all valid and sz6ft isting li*onxess<$ leases, grants, exception& and reservations n.f«. f ecting said p rami zes and it is male with full knowledge that tbare nxist upon said premises oil and got lectsses$ tmtveen sus%id Huntington beach Company$ sea Lessor$ and. r:tmndard Oil Ccmpuq$ arc Lassen, under Valch leavas3 the interest of Standard Oil { Company is nov ownad by btan4ard Oil Co:rpasny of California; and .a r } Ci.ty's licensor excepts and reserves, and said Lloonaee agrass that City' se licensors its successors and assigns and. Bald Standard Oil t o,-,.-parry of California $ its eucce s sor s and a p sIgns shall have the right nt any IIs~ = tend i`rom time to tint, to operate the whole j of said premises w any portion hereof for the purpose of drill- .. :t in.g and sxp?ori,n- for or p,oduaing oil$ gas, petralo=, or petro- leum products or hydrocarbon substances (and water for such opera- ticns) and for the erocti.on and maintenanco tharoon of the naeaw L l '• ass y s+t$r a fst�;il itios for such pro3uots pmduced on caiu lands, And the right to construct, erect, vaintain, use, operate, repair r rspl acc, renew and rnnav* thereon and thereffra all pipe linen, t power linev, derricks$ tolophone arA telegraph lines and other = i sequi,pmgnt, buildi>rx-3 and struotures an way be reasonably nocessssary i i for tha production$ starve and diptribution of such products durM ing the term hereof without let or hindrance fron Licensee&, ` • Xaitt"4er o agronmeat nor any notles of or rotor. once to this mp.T.emant s M11 be raoarded and$ in the event of • such recor4 ati.on by or on 'behalf of Licensees thin agreement shall j thereupon i.pso f,aoto becom .null and roid, 10s Llooreseae shall at &11 t,im+es$ at hire own expense g y employ a p ref®s sS cnal golfer $oho sbml2 be sin duty and he available at said golf course. i 60 j e G Y t S x f: t • S i 11. Llesnoee agroas to faitYifui ly c " per vi.�,t all r:} ; •.:. rules *Ad regulations imposed by any goverxmental aut1writy goveraing the buxiness herein cantescplatad, 129 Licansae KEi eas to keep books of eocount and records of account and such records insofar as they apply tv green fees, aalo of road wW dr.lnk Items and Pi,tah and mutt feen and t; rantals ray he aud1ted b"/ tw City Auditor at all reasonable times, Pi AI j P { 13,,. 'Ltt nothing in thlo Agreement shall be deemed to i :t excuse Zloonsea from the payment of llceaseeas license tax or other lawful taxes lmpdawd l.� any gtverawntal alathority 4nd lfcanae affreem to pay' said taxes prior to delinquency, 14. That all the labor to be p e rf vaned and materials to be i"urnishad in the operation of Lieensaa harei.n ahall be at the sole oost and exponse of. 11cancee md City shalt not ue _ charged with, or liable for any }part thereof and lieennee shall protoat acid land against liens of every character &rising; from his operatlent thereon, 159 Liceneee herein shall receive no greater rita hereby than recolved by tae City in the A-greement between City o:r Huntington Beach and the fhmtingtc. ^3aa©h. C+ mpuW and this license !ihall ba subjaat to all Ow applicable terms, conditions, coven& ` f s ants and provisions of said Master Lease t*tyeen City of Huntingta i z Deach and the Huntington Deiqch Company rha: are applicable to this License kgraewnt with liceneee, uy termination of the Master Agre©mert between City cf �ivtntington Beach a� i3untiangtau ��8ch Comipany shall automatically tarminate this license, 4 16. This ilZroama:at s,' All be effective so of" the lat day of March s 19599 provided a iuvsver a that in no event shall this 7. -i i r S • 1 INS l Al"cownt become effective prior to tho datt of the now agreo wiat boUlsen City of Huntington Beath and k1untIngton ,Sege, Ctompany. 179 The LicIonse ,Agreamut between City And Liftnet,a hera in dated the 8th daq of Havomber,, I V49, a a tvdiff ed q amandod and extended is hereby wa�a uted and made of no f'txr�hor fpr� or +ef,fgc t as of the effootive date of this Agrcome t. ; IN bITI r.83 MMW a the Ct,ty ban caused its corporate t nam and seal to be lierounto annexed by ita for and attested by its M7 Clark, therounto duly authorized, and hiaaase$ hag set r-� his hz=1 thia flay of 1959• GITY GW HMIT MG s.OH Sig AG11 e a municipal corporati sa e , i . f mayor s , S CITE' of HOB. T M. HtSiILL ......,.. Y Ald Afl us s A* 28," AOBL� RT M* M SUALLa. .LICENSED PECINFIVAI 1 t k r • t •, 71!�!1r7*!:!T!'!'!!"''.''S''!. .- - _. .-. :tit.'^SY!'!'�i1:�},''CSL�L..:IY'! R". i t F r f r -- ti 5 ! r 1; j STREET MAIN z , NUN7{NaTON 9EACti UNION k1vt1 SCHO{l; F 1 ! 0 GRAMMAR SCHOOL P 4 � ` • r Y 4�4 y + N, \` HUNTI NGTON BEACH GOLF COURSE t f .. ! ' � I t *= THIS AQMMET undo end antared into, by, and � Illy �a'rain t�esf,$xxail , AND ;i RC+DERT PM RAMALL Snd and 14fe a �ointnta t harelo designatod W 1 T X S 8 S B T He 14MMARf by a rep nt Matt th i nth day oir Novjj;tb*r� 1949, 1xttwoan City and )iarSltajl# City gr&nt.sd A pare to y Iftrahall to oporfato a golf vottran upon cartnin Itoid loaned by + ` CU7 from tivc llmtinjiton Unach Company, Oiich ,agreaMnt with f Mr,roball wav mWplemantad by o rtivmn.ts of rat 1950 tad JWW 9521 and M.EIRPA , tha agreanmut betvaou the Goity of fluntbigton reach m l the Itunt:6 ngton Atiach Cov%pane Matadi July 11 19! luo +! boan 7e:►difled by, ,agraiszont dated Fabn%ary 20, 1950 and by arxeefo Mont d avtad the 5t1l dn7 of AU,gUStt j 19"3 and thi l ev day of AUg- t t ust y 1957;'and } i C .vy. and Hai:shall desire to gx;d if3 r tlto aagr a e» 4 i menu abmv referred to ImWoan City end cars ).x 1 i ti 1101' '',t f. eiiti; for and in acgiaift ation of tho prow-me 1 i ' ises and of tha eovenants hroratimfter sot xorth9 the parties i I G ,A W 1 .1 '7T—-------y'!— T"'!!K•'!1X'..`!R'N:�T jaC_"�1.:Y1'!:'^.L711ri^.'1ti117SAL'7sit".xtSfii`�`n'tL'RS!!'aI�.KLYTLYS_!t:':+o`t`fret!Ttt.: Y'2:...o��:.LKiiILS�:._*"""...�• 1'!t'�'!"S':ST.^.M:R"""`""'�-=-_-__ _ 1 M'.?Al7l r r i f t `-- hereto hereby agree as folltswsi . l• That portion of said agreament dated November 8, 1949, reading; as follmins "lo Thvzt Marshall doss hereby agree to coritruct at his own expense a regulation eigbtesn•hoYO golf u d o described in he a aehod • � ;l course upon aa�i property t tt agTooment and to maintain, manage and operate amid golf course and to furrd ah all expense,ss of upkesp, ; including labor , �repairat i.nauxance and reritt�l 'pay- able { able to the said Huntington Beach Company for said property." is hereby deleted effective July 19 1953, and the following proviso ion is hereby inserted in l,iou tharsof j . 3 i "l. That 14arshall doea hereby agroe to conxtruCt at his ovii arpense a regulation eighteen-hold golf course upon said property described in the attached zg ►•a�+ nt, send to nai:ntain� MSWOO and cpsrbt+s spid y golf courac and to .furnish all expenses of upkeep, including labor, rapail!oy uti.lition and insur; ice; to pay to City am rental for tha premises th= sum of One Rundrod Dollars 0100,00) per month comiena- ► ing on this 1st day of November$ 1949} and continuo ing on the Ist of each and eery month thereafter, v to and including t1w month of Fund, 19588 said rerito al to be In addition to the payment to City of the paroantage of the playing fees as provided in para- graph numbered 4. That on and aftor the 1st- clay of :ulyf 1958, Marshall shall pay to City only the t it percentago of pUying foos am provided In paragraph 4 S t t " ! a^rr--+errac e .IM •• r-yes_•-ssrt'�'W t r i ` t t i. 1! ! . i Y l 1 `'- 0 That Portion of said agroerant of Ifoysts:Wr 8f IV 9# rVAUAS AM f'0111WO� Thin ngreertnnt shall apntinue for the reminder of the Poriod of ten ycare from MW after the 1st day of July, 1940t as not forth in vax.d egreemnt 'betwow the =t:t ton Beach Ct��') s'a' my and the City of Iit�yt�tt�s Saaaeh, oubSeot to the right of the Hunti ton Beach 4 +f fwT i ' o aompe y to terminato said agrae nt upon ons yv are sTittap tsotias as aet forth ttmraino" i is heraby d4leted wnd the following provision is harabyr insorted in 11ext tharea s 't90 This &grov ant shall continue until tha 30th c of Jura 1963, as net forth in tha agra:srnnt of i Heath r^.ov + as nodi fled by the agreawat dated August �wh, 1,953 t sub jae to the right of City to terminate thin agreement upon throe years vrit2e i �p Ttmt + rw on a said agr4ement of Nwmriabor 1099 : rags in �!a .follows s 1110t, 'spat, thin agrear>ont In subject to aald agreow x ' wnt dMod ZM3,v Ll 1948 by and betvalon Uwtington . beach Gay~sYany ,arxil the City Of Huntington 13enath, s1d )irtrsMll acrage tin do and perform and tk be bmnd t by all of the terms, condit-ions aiii oaroasaant>a therain : c i4alliod to 're dons and pqrf'o=ad by the WAY of Via y is taraby dolated rnd the !'ollo^Ang provision Is Mroby insert," ed in liou t 1wreof t , ` ._: '.''!'.!^._+^'!:':'M3`911".^!''iMt"lWra•..:v..p-•a{tYf`ISM!K?t?'^..�tOf4♦i;-«.'tSisGti'ZA47::CY.Y.:SYY.4'N' 1ri5Ci7'47e:1t0=L":IC^MtAtlS:t.:A�'t'S.'�.".YriLY:Jt`JY.1:. •••rnc.v_fy++ .y�a�'yr;t�,a\ ... .. 1 ' f t I ; • L , r r `. "10. That this agreement is subject to said agree» ment dated July 1, 19489 by and between she Hunt- ington Beach Corlparq and the City of Huntington ,x ` Bauch as said agreement has been modifiee, and amended by agreements of February, 1150, August, 1953 and August ! 1957, and Marshall agrees to do and porforw And to be bound by all the terms evon- 4itiona and covenants therein contained to be done and performed by the City of Huntington Beach .{ except as herein otherwise specified, 'rf M.arsta l i shall be in default in the performance of any of y his obligations under this lease and if for a period cf sj.xty (60) days after written notice given to hita at his office on the leased premises in the City of Huntington Beach t California, by C Cityq karshall shall fail to commenc i thereafter A diligently and in ;good faith to prosecute *ha remedy-- .. .. k ing of such defaults City ray terminate this agree- ment, t jAY 1+. That portion of said agreement of November St 1949y N reading as follows : "lb. In the event the City secures an extension of the agreement with the Huntington Beach Company, desig- nated an Exhibit "A" attached hereto, Marshall iw hereby .ranted an option to extend this agreement g P g 1 for the same term as said extension from the Hunting- ton Beach Company, but not to exceed five years, and the compensation to be paid Marshall during the term of said extension agreement shall be fixed by a Board << 4� •� +w*r -rrn--�+-r-rt... ._....- +_ zT,r.�^.M�*•r.-ur.-r.+-wrsrns�,r-�rs.x^sraa:�sr:eti.+:earl.Ursa:s++^'sr.+-T:yrez,nr�::rczeatava�:r+es�sssrr..r';s�:+....""�Ist�' .:�caaccCs32. ..,.�cf�+ _ vc+rrrur+W' i r i r r f � of Abrit;rator;t sha11 ba final." �`- Is he reW/ d*lat a4 g e:t 4 the following provisions is hereby in. sart4d In lieu thereof't 1116, In the sve.nt City secures an extension of � the a ffraoment with the Huntington Danch Company, designatod as nxhiblt All attaahed hereto, beyond Zuna 3O, 1963, t3ars2z1l is hereby granW an option i to BSc te::d this agrea gent for tha acme terra as said exten ington Be,nah Co% but :si.ora �"�ct� t:a� Bunt, �.5.�ri not to exceed seven years, and the rentals or t ' companzation to a paid by Marshall to UL,4 City during the tarn of said extension shall be mutually agreed ups between the parties haresto prior to the S s r. 30th day ©z .'dune, 1963; provIda:d, however?. th4t HarshRll ,shall give notice in writing to the City Clark of said City on or before April 11 1963, of hio i.n.tentLon to exercise the option herialn granted, In the event that City shall not I:ava secured a written a .re . nt +a9.th the iluntington Beach Grimpg`ny y for &n extension of the Said agraarmnt --i.th the Huntington I inah Co::pan;' on or before dune 3t1, �.�}�i3, than the optim heralm provided, shall be null and j void Marshall shall have the rights and privilo es grant ad by, and stall be sv:b jo*t tos and be boxmd by all. of the appl-t-'. ;y imble to-Amnf coMi.tions, covonants and pravvi.si,orxs of that certain axgroewnt dated tha lot clay of hu;mat, 1.957, by and : batwean tlao Huntington Beach Coenpsny and the City of Hunt- ington mach which 3=ndas tho agreemeat datad Jul�j 1st, w �N t� •1 r �", •�w..l.rww=r..rw.'+,,nn w.n rwY'�'Z w'w.:'u._.�+'""'T„ ....... ... '. �'.'Y '!'�'uT.'l�.f"!'4351.CNJrYe.:�.",�+rwRt!:;":32"7C1'!':i'n.�.wRE'!."St1`!S!'tYf:St� `!S'Lt.+ ".►.,5."�• s J 4 w. a j r C t k L 1 betwoon tha MMt1n9tcn DgSi h Company and the city oi. Ihmtw Sing on Beaeht tie modLftod and a-manded by dare Pts of Feima.ry 20th$ 1950, Avirunt 5th, 1953 and Zunc lot# 1956g A copy of SP-Ld agrcamant of Auevat lot, 1957 b%Ing attachad heristap = : 6* As harolin viodifted tvA amandadt aa4 d a. cmant of t November 8y 1V#qv as mc4ii'ied by Ova suppl.a=.#ntal agreawnts of VA71 1950 and Junep 19520 sha11 retain 1n full rorca w3d affaat. i IN VI &C'3 UY.109010! the City Sae caused Its corporate ' nam and seal to be hereunto annavad b-I* i a.s :flyer wA attasted by its City Clark# trsa rountra dui au orizods w4 Walml . Iwo , set his 1mrA this day" 'of------- 1 a CITY W .MITINGTO BBACM HOW City LI��i` .s w.w.wwlr.wr t • ! �f rwr 1 i , r , 'ISFrazz. MARSHALL t 4 k } i t ' a i t 60 t n) r.,^-r- +.,.wr► r_e`.,.+�... ��..„..r.+....._...^""'n"�..�,.r,2trx�.x�.�stt�.-r_rar_srmxsrsr.r_sMrtre�rs...,..«... ! 4 'A 4 i i S b t r 412T Or t Y We pnpe"I +o otl ;me 20 19V, is to 9spueredea aw foropiM taaetrb�rasR cart ir�eewwlat►+n lsti�e�t lire Qiiy' e�C �>�sAi�1►�r. 1�orsx,� ,�► �ee��aro S" Itolresi tt. MaroWl rwri Ao"s A. MrarhaYl, as L�►e}�c�s�.�/r'�ir{�i�M�"iX�Ti�' rAt dm,,C/roc.A;*OLFCrtV WlfX i �� on or eW%% Q*e SW 4iW of S raker, 19490 \ like parti,as he reta entered Lake a carrtain ogrea ssat is. whiolk, a3axe other thimpr wthen agrveo to sagatrues at US *%PS SS aa. rewla•tian 19-helo 4 self' ovw%6 ups vropwty lowed )w th+s +pity frm the Butiaglas D eaa3a Oampanyo \ t a coargo.ration, taader detc of &LY 1, 1.9451 $a& iAHAMS, x"A Mar6hall to anwtmti4 a mew prOPaW to %12e city of ftntse, tas► 3anoh to amtract ,A elst baue eosti" not tare ahox $1360M,00 een saris -Prop"tri earl, WWaMt, *44 patios desire to a odifr sad ua and pwap&A 15 of t *Aid W)emast Of the SM Aar bf lave+sbar, lgkt votwm the esmM Pwtieoo U iaor"aaate the vim propase 1, of 1arakel1 tar the ooutnebiaan of sa i ' aalut bmwe xad than sontritinsion of tine 01fir towards swA oes0n4tionj 4 NOW VWXMI4 JA SOMS14ori►tles of the cormentel, f ions and i egroel►ba hersta ent*Uod to be to" &W pearforsoi 3q and Volvoon ter r i respoetivu pertive hersUi, hhs W% es htre'to a4reo rue fol.lowsa j1 Y 1 1. °flaunt pi►ra g nph io. 15 of the a oomeat IsOveas the Wties autorod Into an of the Nth* &V of NOYMber, 19 90 Tina MA the SMe 1s k�wev eanaalled &ad doo'luvi of we fartbor force *ad effe6. 1 t 2. t 1n 11m thoTwit cut v1Q the Sane tom a*. affeet as if ot►i.gix l;r eaS forth 1A alai.@. o-P41 I spoe+wfat of Avvesur tt; 1549, lastwoers tithe p grttes horato, the part les duo h+ar*W aor►betitutd urns p1s©e In said .x a grement. as y&rPVmrh nmlmwtoat lg9 the follovitat "ibat N&r>shaa.tl is S1v4a tk4 p*r*1ss9ox to sonstro0 a alsl mso 4 . as Said p"pert F MOt to 094064 to Est tha awn 09 MgQW*000 aril that "M entire grease fee reettea.s is 4M swul of Sea per as*% prooee#1! MR to the L City 1w ftr/hall wler than pretest ao*wsoa't rat 1 to waived until the outirea h � r r - a 2 rl sasWw"Im surfs et bias Irtildi t +ins owes" La for #wssas. " . , x6"Iml lmwwllr arts*$ is set up a sate "ltail.A LM riWA ,IassUsts is this S Litr YirAt X&U* ►i leak tN Uw OW Of XR*$•U4[% t Sse►oh, to be uset selsl.Y lilt ;he "Raiim tift of this %uI4UW. L ss91als V ft of all srsimmwtWL sr 4tv tut Uw3l" Will "of h"3 aA =A* arable to _. . ` ottlaial sswiker tt the Gilf ii&daIstr*ti+ta scM rrItlea rots"t* am of $5r00900 tovotts a wo' slu rs has heft * sib aader !ht salstimc speou bi mi mpm valskmit sf tM above sWet tmout to Xard*11, sa3A KarshaU Wass to adTaww the raeraisixg- mm4ssary awnutt set to tsts*a $186000.000 for the *fmpteslea wS ihs 40 how"t tke ratinwatt of the $93.OW-00 000% of fibs itlwAt►ms lhs Wild.c stNau u 00141f ` they proporty of Me City of Fdatistot DII uAk« « As staled is the *rL#IW mmavAd. all saixtenamplo, upke4p, ,. rnaire asd lmsur>an#s vUl lie tome l' Marshall 4 rL" the life of th* originat, 84"W+a u Upm r0ires tat of the mxbm # ,C��00 lsaM&I^X east, f ftis rental paid to the My vaderr W aster exlstis; ogrem s it I { T i 7 t l t 7 t � 7 i t f d "i y t: t •'i 1 ' ' 'r... , .. .. +•t«+t!�ART r:'sttycs�.trc`_rt�i+. zytzxx�ttrreeeasrerr_�-tMi .,, arm-��^�tA L�astrxtertr • xi r I t i pyA SUPPLEMENTAL AGREEMENT THIS SUPPLEMENTAL .AGREEMENT made and entered into the �f day of Nay, 1950, by and BEVVEEN A _ � CITY OF HUNTINGTON REACH, A Municipal Corporation, hereinafter designated as ^ CITY , :i AND ROBERT M. tLUSHALL and ' .AGNES A. MARSHALL, As Joint Tenants , i hereinafter designated as 14ARSHALL, WITNESSETH: IF,�t�:AS , an or about the $tll day of November, the� i 7 parties hereto entered into a certain agreement in which, among other things , Marshall agrees to construct at his expense a regulation 18-hole golf course upon property leased by the City from the Huntington Beach Company, a corporation, under date of. July 11 1948; and WfiEREAS said. hiar:ha11 has submitted a prUpa511 to the City to construct a clubhouse costing not less than 31.1�,000.00 on said property; and ' I.IrHEREAS , said parties desire -to modify and wmtind paragraph 15 of said agreement of the 8th day of Piovember , 1949, betti°eNn the above parties to incorporate the new proposal of 114a.rsball i for the cvn•structivil of said clubhouse and the contribution of t the City toward such construction; 4 NOW THEREFORE, in consideration of the covenants , conditions and agreements herein contained to be done and performed by and s 5 1• ! ..,` - _`•"Y*R'5.. .. _ ..... ti, j�R'^.1'Y'w•+e'±"n.ww•.a'Yi?M'lMnP6711 .'i]Qft]y"L".S!MV'7�71L1230 't13�.''LyJ2ESSYI�SS.".�2. „'Sjt1.Z"L7S:'L"' 317� . t f.. i + 1 1 t i , I between the respective parties hereto, the parties hereto agree as follows: ! � 1. That paragraph numbered 11 of the agreement between x the parties , Entered into as of the 8th day of ;November, 1949, be and the save is hw�reby cancelled and dsc' ared of no further force and effect. 2 . That in lieu thereof and with tine same force and f effect as if originally set forth in said original agreement of November 8 1949, between the parties hereto, -tile parties do hereby substitute and place in said agreement , as paragraph :r numbered 15, the following: "'that 1-1arshall is given the permission to construct t a 3 clubhouse on said property , and in the event of such con- structi.on the City agrees to pay, $5,000,00 toward such rj I construction, said sun of money to be paid only f rorn and ` out of 751% of the green fees payable to the City from Narsha.11 by reason of this agreement , provided that Marshall shall likewise pay not less than � 10,000.00 toward said clubhouse . " x• IN WITNESS WHEREOF the City has caused its corporate name and seal ;;o be hereunto annexed by its Mayor and attested i by its City Clerk duly ^uthorined, and Marshall has set his hand as of the day and year in this Supplemental Agreement first above ` written. CITY OF Hbli'TINGTON BEACH A municipal Corporation, ' f ATTEST: Mayor 77 City' Clerk CITY Bober , M. Marshall Agnes A. "-hall tl •• ,•,...:,•>+�.:c��s.�+�sz .�. ._ .......-�. �... Far_-�►�ncnsr.�s>sr:�u,.�..,ra r , i 4 ,t t t ' 1 �-- The above and foregoing Supplemental Agreement not, having ,r- been executed by Marshall until on or :about the ,6 day of June , 1952, and certain questions as to t l%; validity of said Agreement having arisen due to the late exr; ,4- ttiorx by Marshall , and `,the City having reconsidered said Agreement f i.nds and de- termines that it is for the best interes-ts of City and fc•.r public ,? purposes and for the promotion of the health, s.Rfety and welfare of _said City that a Clubhouse be constructed or.. the prr.p�rty ;f leased to Marshall of a minimum quality of not leas than that con- . templated at the time of the execution of said su;>ilease , and 1 f ' The Council has found and determined that said quality of construction at the present cost of materials would be not less than the sure of Fifteen Thousand ($15,000) Dollars , and That in order to carry out the intention and understanding of the parties at the time of the execution of said sublease ., City should release to Marshall from seventy five (75%) per cent , of the green fees pair; by Marshall to City under the terms of ' said sublease , an amount riot exceeding Five Thousand ($5,000) Dol- lars , as set forth in said Agreement. NOVI T Ht�'FORE , in cons idera t ion of the premises , the parties • 4 agree ' That the foregoing Supplemental Agreement he re-executed and in accordance therewith, that upon the construction by Marshall upon the property subleased to him by City of a Clubhouse costing not leer than Fifteen Thousand ($15,000) nollars , that City release to Msj shall to,.!ard said construction the sum of Five Thousand ' ($5,000) Dollars as set forth in the foregoing Supplemental Agree- menk. ; said sum so to be released shall to from seventy five ( 751j) per cent of the green foea heretofore paid by Marshall to the City ; said sum is to be released to Marshall after the commencement of the construction of said Clubhouse and at such time as valid bills 4 t, 'i 1 ,..�...»;... ......,....r;..�;.«r........,..ya.-�..+.»..-.,,,....+�•.,.,- �::tit+.-pers...r�ex�..:�r.-�..:4^c-rem-�crm-s..`-s.,_—:may^�t�C .... r 4 't , r r T { 4 t i shall be incurred or payments made by Marshall in tha construction. thereof in exc s-a of. Ten Thousand (310 ,000) Dollars . t r` £iv :FITNESS WFiE'i SOF , the City has caused the corporate name ,1 and seal `.n be hereunto annexed by its Mayor rind attested by it:: City Clerk duly authorized , and Mar3ha.11 has set hts hand on tbi.s .„day of ; ,YYJt t= .._....+. , a+952• y CITY OF HWf I►NGTON BP,ACH , t a Muni cipal Corporation, 4.f Hy t MAYOR ;, Y. AT ST : ` L 1� (.tti1 t Y `fir "# My Clerk rr, CITY �g >Y � Y Robert M. Marshall Agnes A • 'Marshall r.. URaB ALL ` tie "k r 4 t � ..' /'T'!'l•"'...-. .. .!!•_•S c".'^».T':T'2':'.!.�f".!.Tf'.":11a'.t+.`Y.t+.'?StF'r!t'!'T^_`i��'Rtrt l7i`l.'.C'.��^.!!.'S!'1!'.ti"��t'!�i,. ...:6JY1L.i Yrx7tii.C1.;.T.�Y...1tlL':1t.:i:]tt►uiT"�7er ".' ...+. +•r�YL•.... ..�.�.....»«.iw �SL+�Ywt'l t• T M �� ..a .........+w......i ...., .. ... •... _.... :.. ... .... , .. . •..,. u..rw+tt/:r+Y.Y='. .. ., - .... �.......�..... Y... -r-v....,v.......�...,.+.... J__.}.......r.,. ...->.r.r.1.�.. I F rr' ; O 1 AGREEMENT S 2 THIS AGREE 21 1 made and entered into as of this 8th 3 day of November , 1949t by and 4 BETWEEN t THE CITY OF .HUNT INGTON BEACH, k,. G a Muni^ipal Corporation, hereinafter designated as g C I'I.lY, "t AND b s 10 ROBERT M. MARSHALL and AGNES A. MAIISHALi}, 11 an Joint Ten.Fnts x! hereinafter design- ted as 13 yl 1LItRKTALL. UITNESSETH : - ` 16 1.4i'i,111EAS , the City of I;untingtort Beach , by a certain F 17 agreement da teta July 11 19481 by and between the Huntington Beach tha C t s:v of Huntington Beach , se_ur•ed permission from 1$ Company and 19 said Iuntington Leach Corarany for a period of ten years to operate ' - 20 a golf course upon cPrtait: land belonging to the said Hu.ntingtcrs 21 ., Beach Company more part-icularly as set io.th in the t.—ms and con-- 22 ditions in that certain agreement by and between the City of 2:1 �� Huntington Beach and the. Huntington ',�each Company dated July 19 24 19481 a coley of which agreement is hereto attached and made a part 2.3 hereof$ together with the exhibit Gc,t forth in said agreement , and # 26 `dIIEtFiEAu , said Marshall has submitted a proposal to the i 27 City of Huntington Beach to rec:onstr•u:.t the present nine hole golf 28 course into a regulation eighteen ho1Q golf course , and In the t � 30 construction and reconstruction thereof said Marshall proposes to 31 expend from "351 QGO toa5MQQ. 32 iyUt�I �'FIGRErQi�E, in consideration of the covenants , con-- I `I ��' M,.•�r•rww.ew+wnn++ tte'!i►SfIR! .2:."4!f!l .Y^ } i •1. .... .. _,. .�..�r�.rrw+r+........,-.mow... ,.. .. • • ....... . .. r I ...s ... • ..... .. ._�•... .t t 1 1 ` Tt fl ` i 1 ditions and agreements herein contained to be done and performed 2 by and between the respective parties hereto , the parties hereto / ', ':..•R 3 do hereby agree as follows 4 1. That Marshall does hereby agree to construct at his a I ' 5 oin expense a regulation eighteen hole golf course upon said prop- a G erty described in the attached agreement and to maintain , manage t S - 7 and operate said golf course and to furnish all expenses of upkeep, } , 8 including labor , repairs , insurance and rental payable to the said 0 Huntington Beach Company for said property . 10 2 . That Marshall agrees to commence operations of tho ; reconstruction of said regulation eighteen hole go" ' course within 1`? ; fifteen days after the execution and delivery of this agreement , 131 and to continue diligently until said course is constructed , pro- , , vided, however, that Marshall agrees to complete the same within 15 one ycnr from date hereof. _d 16 3 . That Marshall agrees to supply to the City a good j 17 and sliffic,ieijt surety bond conditioned upon the faithful per- 18 19 forman,ie of the terms and conditions of this agreement. Provided , 20 howzvec, that if and when said regulation e1l:ghteen hole golf course 21 is constructed in accordance with the terms hereof, said Mond may bond shall be to the sung of 000.00. • ! h2 b.. cancelled. Said bo. all �5 , 2 21; 4. That Marshall hereby agrees to pay to the City tan per cent ;. i the cross income arrived from playing fens on said 24 P , p y �. , y f. 25 golf course , the amount to be evidenced by numbered tickets . t 26 Said tickets tc be secured front the City of Huntington Bench, i 27 and that the balance of said playing fees shall be retained by r 28 Marshall for his own ov.cotint . s 20 j. That Marshall agrees that when said regulat:ion 30 eighteen hole golf course is ready for use that he will at his 4• 31 own expense , employ a professictial golfer who shall be on duty 32 and be available at said golf coL.rse . L 1 2 f 1 11., .. ...+.-. `� r.".+.......•�.v..._.. .. ....a. a♦ ! ... ... .. a .. __.. w..Y'•.1.1�. i .. .. ....•.......•r. .a ..... n... .. _ ' ♦ J •....r ..r.1 t I( 1 s s: ti i i 1. 6. That all equipment now used at said golf course `�- 2 at the pretsent nine hole golf course, and owned by the City, shall E + 3 remain on the aouree , provided,, that Marchall agrees to maintain + { 4 and repl,aoe said equipment ae the spiae ma-y be necessary. v 7. That green fees to be' charE.,ed shall be seventy--five r G cents on week days , and one dollar tirent —f,'Lve cents on Saturdays , 7 Sundays and Holidays ,y , provided, that Marshall, cdith the consent 3 8 of said City, may raise or lower said. feet; to such rate as may 9 be deemed reasonable, provided, that nothing herein shall be eon-- ; 10 s trued to prevent Marshall from selling gals' accessories , light 1.1 refreshments , sandwiches and other incidentals usuEilly sold in 11 connection with a. golf course. !� 13 8. That Marehri.l.1 agrees at all *times to indemnify and 14, hold the City ha.rmleras on account of any public liability or 1 property damage arising from the use of sed'd golf course , and lU shall carry ineurii Der in the sun of $200,000.00 public liability .f 17 insurance , and $200,000.00 property diunagc insurance, which 38 insurance shall inure to the benefit of tho City of Huntington 1B Beach. 20 9. This agreement shall continue for the remainder 21 of the period of ten years from and after the lot day of July, h 22 1948, as set forth in said agreement between the Huntington Beach ' 2.3 CoiApsny and the City of Huntington Beach, subject to the right ' # 24 of the Huntington Beach Company to terminate said agreement upon 25 one years written notice as set forth therein. ?0, That this agreement is subject to said agreement 27 dated July 1, 1948 by and between Huntington Beaci Company and the 2$ City of Huntington Beach., and Marshall agrees to do and perform { 29 and to be bound by ,all. of the terms, conditions and covenants 30 therein contained to be done and performed by the City of 31 Huntington Beach. 32 , +' rrt!'+^lr•uwr.++Aw++.!.!r_Pr *r'.!+rww!+.+P+'+'Vn _ . ► �CC i1 f i i 4 t 1 11 . That Marshall agrees t,t: faithfuily comply with all 21 rules and regulp.tions imposed by any govermmnntel authority govern. ; - 3 In 44.he business herein conte:mplRted. 4 12. Th,,A Marshall agrees to keep bon?xs of account rind 5 records of account and such records In go fn.r as mnv apply to G � ercen fees may be audited by the City Auditor at all titles . h 7 11. That noth.int in this agreamen t, s heill be deemed tc 8 ex(---%ae Maruhall from the pay rient of t.icens ee , licensee wax and ;. 9 other^ lawful tn:.ee imposed by sny governmental authority, r+2d 10 sAid Marshall agreen to Day amid taxes prior to delinquency. 11 14. That: n1l the I sbor to be nerforrmed Find materials 12 to be fv.rnlshecl In the onerAti.ons of Marcohrall hereunder shR11. be 13 At', ;he cost r,nd expense -)f Yprehall., erd the City shall not be 4 -14 eh;a.r,ea.bl�� with, a, Liable for, any par 0 thereof ; -nd Msrshall. 15 shall protect #3 ail1 land PC;ainat liens of e�actry chRrae ter ;r�:.c: :: 16 ':.:,.:. his ope.rnt;ions thereon . 1.7 15 . That MarshAll is given the permission to construct 18 s Uub rouse on s pi d properly term in the event o:' suc:h construction 19 the City $gees to pay $2,00 .00 tovra.rd such construction, said 20 sum of money to be paid only from, F�nd cut of 75 per cent of the 2Y. monove p synble to the City from Ma.rsbp.11 by reason of this agree- r` 22 ment , provi,.(,,d, uhnt MR.rGhn).l shall likewise pray not less than 23 $2, 500 .00 toward. anid club house . 2`} 16. in the event the City securee an ex-tension of the 25 n ree-sent wi t,h the HuntinSton BArch Company, designs ted as 20 Exhibit "All attached hereto, Mai ah311 is hereby -:I r,nt',?d an npti.on < 27 to extend this acreement for the same term ae acid. extension from c 28 the Huntint:•fon peach Company, but not to exceed f 1ve yerirv , and 29 4he compensation to be paid Marohnll during the term of said 4 30 extension nc-reement shsal.l. by Y . f'1.. Act >7y a Board of Arbitrators , one ' 31 member 10 be selected by Ma.rahnll, one member by the City, and 32 t ho t,.,o thus selected to seleot: the third member. said DoEsrd of rl' �r•�•••«••••e+rn r.�+�.nex�.�*+.•R,�-r.,...r...r„s«s�,rr..rr• reneufnoK.'sti,.rxac:aaw4x.t+asauasrr•,<••n•^r�c�sxan:frsasxrrrtirst .....�•�-+ ._..,.... � e!+�a'L�tr.ct��'Ln��:ern� . . i i t t y s Arbitrators after conside.rinE all facts bearinj,, thereon ehAll. 2 determine a. reasonable compensation for Marshall , and the dea - � 3 :.lion of acid Board of A.rb.1tratora shall be finRl. . 4 IN WITH:'5:a the City has cautied the corporkte � ii ' . n9r1-4 and seal to bE hereunto ann-exed by Its Mayor and attested by its City by duly authorized, and Mprsh—,,11 has net his hand 4, -(� $ as of the dray and •Par in this agreement first above viri tten. 9 10 1:t CITY OF Fit TIPiGTON REACH, ;s s. Municl, ..1 CorporatigAl ' 12 13 1.1 ATTEST: 15 City► C3.erk� 1G CITY 17 181 19 1 20 Robert M. Merat'.c,1.1 21 3 fines A . M_;rehtl 1 u'; MARSHALL 24 2, 26 >' 27 `; h3 29 >,• 30 f 31 32 r.� e� +n�+�+�`'.w-r+--+ee+.en.r.+.. ,n•.n,•� -nt+-.r�n.Y.�awtpyr� Kmesntr�++ear+xantrt�.lrro�u.�rfnx+ats*v�+w�.�gr.+.ay.ww++.sw �'.�"�' "�.�5� '�ee1EY'.'1"1'a.�Zr.' 1 N xl k 1 t r t t i i � l 1 t 1 M HUNTINGTON BEACH COUNTRY CLUB ' ! AFVENTEENTH AND QUINCY STREETS P.O DGA 148 ' HUNTINGTON BEACH , CALIFORNIA P. M. M,%RSHALL DINING ROOM t� r MANAGER PHONE 536.0109 J }. i 900 MARSHALL GOLF SHOP J GOLr PAOFE9RIONAL PHONE 836.3412 ! ' 1 r Aoril 4, 19156 APPR()vF.D ny CITY C�JUI�'CII. I I t3 ^ounc it City of Huntington 1 �tak�.: L-�,,.-,-A-PRI1� �,�%�.GIs....... ' California i ---.�.........................� C' -. Attention : `ir. Paul C. Jones, City Clerk Cl' CL Vic Gentlemen: This letter is in reference to our agreement dated March 1 , 1959 , for operation of the Huntington Beach (country Club, which agreement is to be terminated as of Augu;, 25, 1968, per Huntington Beach Company' s letter to the City dated August 25, 1965 We are presently negotiating with Huntington: Beach Company to sell them our interest at the Huntington Beach Country Club, under which they would receive all of the assets t` of the Country Club and operate the faeilitios themselves. n Huntington Beach Company would agree to accept and abide by Y all of the conditions of the above lease until its termination in 1968, and it would furnish you with a letter to this effect if you so desired. 1 It Is respectfully requested that the City of Huntington Baac;'a consent to the sale and assiViment of our 04. Interest to Huntington Beach Company at this times on that we may proceed to finalize our agreement. F Very truly yours , ' Robert M. Marshall Ades A. Marshall lr s Robert M. Marshall, Jr. cc : Mr. Boyle Miller, City Administrator cc : Huntington Beach Company ` :1 ;.1 r.M..+w....+•r.+:^►r+ww'Ka"-+r!ll�arrJ�.rt:rerne.tnn-MJz.•!rn....em.. -a '� arM�l�>t: --- ^�^�' 4`rfR.lt>!e'srr1+ � ?M w GS+tiTS'R'L1.'LLXICSC"F*1fC..'4Y'11121L';'Y.7>t:"•:L:S'.'tt2't•.C^!1"f.�'"fST.[l�.Lr,- • nw..ewr - 4 , • f 1 1 HUNTINGTON BEACH COUNTRY CLUB SEVENTEENTH AND QUINCY STREETS P.O. Box 148 HUNTINGTON BEACH , CALIFORNIA 1 R M. MARRHALL DINING ROOM 04&NAOER rHO!JL 636-RIOI 4. BOH MARSHALL GOLr SHOP GOLF rR0►E6SIONAL 24.36-41413 AWROVE'd RYCITY COUNCIL City Council _ �_.l._$1966_._. 19. ... Y City of Huntington Beach &ld U,04 California cuTY cc.exx.ws A.ttontion: Fail! Paul C. Jcnleap City Clerk r.' Ge'ntlem en t This letter is in reference to our agreezent darted March 1 , 1959, for operation of the Huntington Lech Country Club, which agreement is to be terminated as of kugust: 25, 1968, p*r Huntington Deaeeh Company' s letter to +'ice City dated August 25s 1965 F d • We aara presentlInterost, negotiating with Fount.big-ttion Peaoh Company to sell them our at the Huntington Deaoh Country Club, under which they could receive all of the assets of thes Country Club and operate tbo tacilities thentelvep, t Huntington Bsaoh Company would agree to accept and abide by all of the conditl,ons of the aboya lease until its termination t An 1968, and it would furnish you; with a letter to this eff*ct Alf you so desired, xt is reapootfully requested that the City of Huntington .oaah consent to the sale acid aesignmertt of our interest to Huntington. Baaah Company at t;-Ii►:e time MO that wa ! may proceed to finel.ism our agreement. ,j 'fiery truly fours, + r Robert M. Marshall x •1 y 1' Z I ! t/1 • �/� ' Y es A, Ma3.Ta al4l.l *at Hir, 9oy'le Millor, City Adminfatraxtor c o t Huntington Banoh Company► ..rwetw+w.iwr..*^t"r,'!4w . .y,...r..•rM•..—«.r 1 ._.. _ rr—�-w-ti.. _ .. .s��,r•:;r-ar.Mez r ss�er,.uxs rr �r.rem secsr�+me+er...x r�or,�.�t�*:nar►srasua:-•+•^*�sr �....n:_�ar�ra+t.Txt . 1 c t i i1 t 7 1 f t DUPLICATE � L.:OMPRFHENSIVE LIABILITY POLICY L>riC �'r' ` PACI S' HHDZ.MHnTYC0,MP-A/ XY LOS ANGELES 54. CALIFORNIA r Endorsements Attached Proviou>t Policy 1AC 230 I TO 14 ]DIMUSIM Underwriting Office I" AXIKM Producer WiA DECL �IONS =WXNWA SUCH .COMM CMJMv I= ;WAS �M HIS, Item 1, Name Insured > A AG, � Ai BMW No e�hsa�sy 't , AddrPsa 0'� �°'�' fret"'y �C At Zone ORA S Mi►il'ol�.} The rram,):J insured is rr=W+ . Part!dual, Part .. ,. a n of t B�laln OPMT F�� =11 MACH CO �� ? r'.d:r }�1? tzm+�:� tn3lrrnd lSLAMM ,p,, CIM � / Item 2. i''ohr_y P-niod: From hMi j to y 12:01 A, t� a lmlett nd recss of the nrzmpd insured as str� W 7 Item 3. The insuranc.-� afforded In only with roopect to such and so mnny of Ihr+ following coverages as nr-�- indi- rind hi, bpo-itir, limits of liability. The limit of the comrxiny's liability against each such coveratin shall brr cis stated herein., to all of the loans of t}rfs ' I,!icy having mfore,ncrr thereto COVERAGES LIMITS OF LIABILITY s s 00 each parson rA. Bodily Injury Liability S eacb.. occurrence S aggregate products r O t B. Property Damage Liability—Automobile _ S each accident y S each accident y n o , $ aggregate operations c C. Property Damage Liability—Except Automobile aggregatN protective : o � •�q �y� � aggregate products00 Sr Rfi!-7d° q aggregate contractual d i 1 csrirr#•4sN+' ' Fstimated premium Is puyab!e: $ •v449a4*�` to advance, &3100 an the first anniversary, j and $ 6wago on the second anniversary. They I,,t and 2nd anniversary premiums do not Include the premiums for the auirx+iohlle coverages. If po}:cy period is for more than one year, the automobile prnr70%.ms for the second and third years will be charged in accort1m. with the company's automobile manual of rules and rates In effect on :he first and second annivernary dates. Irem A. During the past three years no inaursr has canceled insurance, Issued to the n,.tred insured, similar to that afforded hereunder. unless oth/*rwiso s?ated hevt?in: noIMMOT-I t Countersigned at LOS AMUNs ", MIA `, ! `r f on 2?6 ` AuTNomizra RCPRr%CNTA VC = Form XIB001g W 1062 env.6-1 62 { 1 COMPREHENSIVE LIABILITY POLICY I z z LAC 3.5LV.43 R(JftK „%TIt t � Insured O s l W < + i' t3 Address Ims 90 ap ��}��1,�� r �y /� � t 0 n ��iiTwFJ►i+ti>: Chi CALMM ! w Incrpiton L`csteA � Renewal olLAC130224 i� !�f x w E epiration Dat© ` A �y � 7 Audit 13asir Z ' Producer 6 f PLEASE RL1t0 YOUR POLICY 1 ' i e t t 1 ( PACIR-C. HH]DEMIUMP COMPAZY LOS ANGELES $4, CALIFCRNIA (A stock insurance company, herein called the company) Agrees with the insured, named in the declarations made a part hereof, in consideration of the payment of the premium and in ;oliance upon the stator rents in :he declarations and subject to tho limits of liability, exclusions, conditions and other terms o` this policy: 4 INSURING AGREEMENTS 1 Coverage A-Bodily Injury Liability Ili Definition of Insured To pay on behalf of the insured all sums which the insured shall The unqualified word "insured" includes the named insured And become legally obfiegaterf to parr as damages because of bodily inlays, also Includes (1) under covetages A and C, except with respect to s sic.knesa or disease, including death at tiny time resultirg therefrom, the ownership, maintenance or use of automobiles while away frorn sustained by any perscn. premises owned, rented or controlled by the named insured or the ; ways immediate)}y' adjoining, any executive ollieer, diiectct or stock- Coverage 6—Property decease liability—Automgbile holder thereof wk:ile acting within the scope of his duties as such, c,. and any organization or proprielcr with respect to real estate manage. ' To pay on behalf of the Insured all sums which the Insured shall mr?ni for 1hA named insured, and if the named insured is a porter r hocome legally obligated to pay as drimages because of injury to or ship, the unqualified word "insured" abo includes any partner R destnic"tion of prcperty, including the; loss of use thereof, caused by therein but only with respect to his liability as such, and (2) under accident and arising out of the ownrrrship. maintenance or use, of any covr-rages A and B, any person while using an owned automrAjile or automobne, a hired automobile and any person or organization legally reepon siL-le for rho use thereof, provided the actual use of the automobile ? Coverage C-ProVsrty Damage tiability-Facept Automobile is by the named insured or with his permisnicn, and an)' executive officer of that namP4 insurc-d with iespec• to the use cf a non own�,d i To pry on behalf of the insured all sums which the insured shall autemobita in if:. :,uatne-.is of the narned insured The Insurance be,:onle loelaily cbligated to pay as damages because of injury to or with respect tc aw., person or organizaticri other than the named destruction of prcperty, inchicfir,g the loss of u.t-? thereof, caused by insures) dohs not gply under division (2) of this insuri'ycT agreement. i } accident. (a' with respect to an automobile whit:r used with any tretiler owned or hired b-1 the insured and not savored by like insurance in the �{ 11 Defense, Settlement, Supplemeettory Payments o-tinpany; o: with respect to a trisiler while used with an/ nuto- With rashest it, s:ich insurance+ as is atfurdod by this N. Iicy, rho. mobile owne::i or aired by the insured and not covered by like comparty shall. insurance In the company; tti) defend any s,itt aomilst the insured alleging such injury, sick- art) to any peisen or organization, r,r to any acimit or employer, riess, disaa3e t;! Cie?!S+rUe'tlQn tad tr.+t3Gi11C� ff3'nafj(15 4r1 ,% cgllnt !hor+',t, q),..TA"n(J an aulut::ubllo ;i:.5 eigolv-y, 1•'`i air sIlcV thereof, even if such suit is atoundIPss. false or fraudulent; but srrvict+ statism, storage? rjauige tit public• 1 a:kang plat,•, with Ott, company may make such inve?sttgalion, nPgct -on and set- torpol"t to ,try occident or o7rutrence arising out A the rparntr-'n ! dement !A any ctai.m or suit as it detmis exFodiont; thoroot, but thla previriinn dcwz tic:t tipply lu a Teslit'r,t of tir,C snrne as tFe nnrr.-d inslit�xf, to a paririer.Aiip in whir.!; (b)(Ppay all rvirniurns on bonds to releaso attachrr,ews for an amount Si.r1i rr4ldr+n', or the named 1.isureci is a partner, or to any r not in exre4i of the applicable limit of liability of this policy, all F.,irtrier, t:gmil or ample fee• cA :ucl•. is7stder,l OT FaTtnrtship.. premiums on appeal bonds required in any such rietended suit, the Cost of ball band, rrgtiired of ;hr, insured in flit +veal o! (c) to any employee with resp4c.; to i!ijury to _�r RickrPss, cisrase or automobilrr accident or occurrence or autcr-obilr, traffic law de.sil, of an;.tliF+r amp;cyee. of rise sa;Tle ur.iFloye=r ti)lire+:i ill rile violation during tho pnhc,y prricrf, not to exceed V.00 per Imil courses of stirli tntiploymont in an ^,cceirrence arialner out r,f thy: bond. but w:thcw any ab'irjattun Io apply for or furnish tiny rnamtenanc- ar use cat an autoniohilo in tho busm oss of Ruch su•.h bonds; employer. (di with rPsrcT^_r to any hired :)ulonlorillo, to the owns t, of a (2)p•iy all expense=s incurred by the cam):any, all costs taxrrf thereof other than th- rice-d insurr'd, or to any agent or r'triplrnyne i against rho insured in any such suit anti all interest accruing after entry Of judgment until the rompany has paid or terideled of such ,wntr, cr 1r is•?r u or depositod in ceutt such purl of such iudgment as dce?s not (ei rltll r!? lust to any lion cwnod a i1C,mUf>lie�, tr, any executive �i axcead the limit tit the company's liability thereon: o.'h.air if s;ich iut.,rnnbde is owned by him or a merliber of :he i e (Xpay expenses incurred by they insuli?d for such irrirnedia+o same household. medical and surgical rp":,?f to others as shall he imp-nitive at _ the time of the injury; IV Policy Period, Territory ( This pcliicy applies only to accidents or or.•-urrerc•tm which occur Wreimburse? the insured for all reasonable expenses. other than during rho policy period within North America, Efawail and fliploss of e?arninga, fn,nurPd al the t:ompany'u re?s?uQ91; territcrtes or posse?ssir,ris ct the United Stwas. With tesp•?ct to auto- a and the ameunttt no incurred, except settlements of claiins and suits, r irbiles this policy a',o applies to accidents or occurrences which 3 ate payable by the company in addition to tho applicable Itmit of occur during the policy period while the automobile to being trors" liabilit of this IIc •. Y t'o ) ported behxe-�n Fo[ts tl.etec-0. EXCLUSIONS This policy does not appiy: ~ tai to liability assumed by theinsured under any contract nr agreement (hl under coverage B, to inlays to or destrurtirr, ',,errs nwrIt'd C. except under coverages A and C. (it a contract as defined he.ein transported by the insured, or property re or (2) as respects the Insurance which is afforded for the Products the insured other than a residence or privti:• Hazard as defined, a warranty of goods or products: destroyed by a private passenger atitomohile covvtF•'j ii,., (b) to !n)ury, sickness, disease, death or destruction due to war, policy' Whether or not declared, civil war, Insurrection. rehe',lion or revolu• (i) undrtr coverage F ) rage C, except with respect to operations performed by lion, or to any act or condition incident to any of tho foregoing, with indeprmdent contractors and except with respect to liability assu:.;f-d ( 'spect to (is liability assumed by the insured under any contract by the insured under a contract as defined herein, to the wrier sir agreement or (2) expenses under Insuring Agtr?etnent l (b) (3): chip. maintenance, operation, use, loading or unloading of auto. (c) under coverages A and C. to any obliga•ion for which the insured mobiles if the accident occurs away frorn prerises owned by, ` may bee held liable in an action on a contract or an igteettinnt by rented to or controlled by the ramod insured or tht? ways Immedc- ( a person not a party theretc; ately adjoining; (d) under ccJarages A and C, except with respect to operaticrss per. (j) under coverage C, to injury to or destruction of fl) property owned former; by independent contractors and Pircapt with respect to lilt- or occupied by or rented to the insured, or (2) except with respect '-+tits „seemed by the insuredttncier a contract as defined herein, to liability under sidetrack ngreements covered by !his policy, loop- the ownership, maintenance, operation, use. loading or unloading (,fly used by the insured, or (3) except with respect to liability S '1) watercraft 11 the mccideni or occurrence coats away from under such stdwre-k agresiments or the use of elevators or esra- -mires owned by, rented to or controlled by the named Insnrtid, Ilttars a! premises owned by, ranted to or t:ant:o}fed by the named xcept insofar as thus par: of this exclv.,flon is .,Iaipd in !his policy insured, properly in the care, cushy or control of the insured or yr bn in,appl!cahlP, or (2) aircraft: property as to which the Insured for any purpose is erercising physical control, or (4) any goods, products or containers thereof } unaer coverages A and C, to liability impcsed upon the insured or manufactured, said. handled or distributed or premises alienated 1..)y any indemnitee, as a person or organization engaged in the business the named Insured, cr work camoie!ed by or for th,. named insurer', of manufacturing, selling or distributing alcoholic beverages, or as out of which the accident aris(n: an owner or lessor of premises used for such purtooses, by reason y of any statute or ctdin-ince pertaining to the sale-, gift, distribution Or undr?r covertigea C, to itriuty to or dea8.tnir-(i .n of buildings or property or use of any alcoholic, beverage: ;herein, wherever occurring, arising out of arty of the following t (f) under coverag== A. to any obligation for which the insured or any snit r3, if such n7tise occurs on or from pnemisses owned by or rented s to the named tnsured; (l) ths3 di c.iarcT_, ienka"I or avrar flout of i carrier an his insurer may be held liable under any workmen's come i # pennation, unemployment eompen?ation or disability berlefita law, voter or steam from plumbing, hearing, refrigeruting cr ;lit c.^..ndt- !:.:ning systems, standpipes for fire hose, or industrial ar domestic or under any similar law; cpplinr.cos, or any substeince from ciWomatic sptinklor systems, (2) (a) index coverage A, except with respect to liability assumed by the the r:.l!rTe q or fall of tanks or the comp,)nnt.t parts or supports insured tinder a contract as defined herein, to bodily injury to o- thereof whic.", form a part of automc-itic sprinkler systems or (3)ra,n sickness, disea3e or death of any employee of the lnsurad arising or 'snow ndmiltc,6 -i,Tectly to tha building interior through defective out of and in the course of his employment by that insured, other than r•'r,fs, lr-adars or .-poutit,?, of open or defective cicors, windows, sky- a domestic employee whose injury arises out of an automobile ',ghts, trcnsoms or ventilntos. but this exclusic'n ices riot apply to covered by this policy and fr•r wh:,se Injury benefits In whole at in !ins due to fire, to the use of,rhvatorr +�T e,rrin!ct: or to operat lot ia part are not payable or required to be provided under any work• l,._•rf:tmp'3 by independent contractors. men'a compensation last; if a t i '; �wwr.rn�+M.�w..n.�+.,+w _ A7� —s..!sulxutle7�sK••-rb�s:urn;rnlXxa�r»�xt7s�rnncr -a,eeWvvs.�c:.rorY.'�vs 't�3.a� taZ"a '" t1ttTtt _.. t i r : • '�� ATTACH ENDbfi5EMkNTS HERE f CONDITIONS I The conditions, excopt conditions 4, S, 6, 7 and 9, apply to all covera'Jas. Conditions 4, !r, 6, 7 and 9 apply Only to the COvera+7e Or coverages noted thorHunder. 4 I Promi+rm The ptsimiurn stated in the doclaratlona In an Pillimated for put;oses of transportation or while being oyetatyd solely for FsrenilI only. Upon tcrrimalicn of this policy, the earned la:omotnori, but not otherwise: if of the non-crawlor type. any}power premium til^till t).t comptutI in acrordancA with t)in rarnpany s rubes c•ano or shovel, dit(-h cr :tenth digger: and any air•comprossIng, 111•ta ranr.tr pll,ins, yit-miurns and Ininimtirn prorri Is apphrtibit) to building Or, vnctiurri c)eaning, 3prayfng -)r welding equipment or 'hilt in!)t1l.111c,� If titre itmrr:rd pto-ilium thus ra•1lnutnti exceeds the w?)l drilling nlacl:;nery. �+. ,-'!311111,lled adviii,:e p iernium paid, the na:ziod inrluind :that) flay the (c) Semitrailer. The word "ItaOr" includos -nmi:railer •'xc-.a it) itirt c,rsrnpan;• it 11+sc, till) c niFany :thrall return to the naineri , :oiv;rori tilo u:)crrainr^ti p,orifen paid by 3urh :risnted• t!t) Two or More Aulomobilee•The terms of this policy apply noparatoly W irwrl ti:!ed a!i a per?mitim basis. to e?Ich at!tomobile trained hereunder, but 3 motor vehicle, tend a i.. •„ ' trar.e: r;r trailr,rn attichnd thereto shall be hold to bi? one autorrvtbllrt !i r lho word 'aruninn:„n ' moans ihn total numbiI of prorsi:,n3, otheI as rwspecl:; limits of liability, th:11; nlTlp inynes o! tho named 1ns11Tr'ri, al3mii173rj to tho. evont iruititrd or to r•vnnts conducted on the premistas whethr?t cn pa;d lc; Use. Use of an automobile Includes the loading and unl;,ading t :i,inii;iaion tickoln. romplaciontaiy tortes or pastes; thefPci. I20 tho word "r-i " ntrans the) total eclat to fai 111,+ rlav;ed insure;! with i f Ptaducts }latrard. Thr tr'rnI "prrxht^ts }:alarm" means !•'•',,t'ct to r) 'r?lmtlrt,:g •rlf,)rrneJ f:t fl'r! n.snind In sure>•d durtnt the t + c, l F p• � i. gar,;3s cr nrc+ri:icts rtanutartulFd, void, handled or disirlhuted by policy rtl:iod by 11 do;..lndtml zrot!at:lt,rs, cr Ib:t any iridernnite.? the named insured cr by others trading under his name, If the i with t6spscf to dray r:ontinci cov!-tod key this policy. Ct all ^X'A I:?r r1."ctfle ni or cccutrenco oriurs af!er pGpsasaion of such goods Cr of 3111))t,1 In ct:ntu'+.titan with nac11 spt•!_Iflr pro}t•t:t, 111cludin7 !^e p �. ' ^r 3 ices has btr v Z by relln uirhrrd to othera b the named insured c'•:sl lA all lak,csr, ras!;,ti+I vine+ rrlup)rnunt hitr+isi v-d, usr!d err rat Cly others trading under his name and if such accidont c,r rinlignrp.�f for -v;e in (l-+' i+Xr+!•tltiGn :it %liCil wort[, Whothor fnlnimhnd occuTlnnCn oyc•ir% away born promirwit owrvd. rented or con. ' by tiro ClI !-r)l:ltacCi:.t er 3:1k;'Crn:[$'.'rCr, including all ftws, all:w- ttcilect by :60 named Ir13ured or on premiaos for which thrf am—os. or cc:nml:tsiom! made, p:aui or Ctin: t l;rnaific:sti.:r :'t.l!Gd in the company's manual excludes any p!I.t .I k•. i i3 ti;+f wcrd -rt.-oipts' rioaria 1r,e gross antrnint of nic ney ch,ltV(-'i by .:•,f !ix foregtlirg; provided, such goons or p,rndurts t lnilll k;n � In'ti•.•':i v, i u•:a: oni. ,nalncns by the r:a:raid insured or by de,!nieA to include any conta)nnr 1hPtt'..;f. other limn a, Vellfefe, 1 yam: iiiir:rvj the' pol'i:v ret!o,1 ;iq are rated nn ,I Trt^r)Ipst;: i:d:31.;. t,i.1 t kali plat mcludo Any vonding ma0iinN or any pmjx-rly. p n t n • t+. + n 1 t ' ) !-t'r,::r -1.tr1 r-rt•.p.s hem cri r,lsiinry. ksroa ir-aslinr� ',r mt�ticn plc.ur'-3 r f,t r than e,r-h ront.tinar, tr•rfed 11 or icrai d nr use of atf.r?rs Vld inr-N of 1•lxa;t C,!iL'.r Ihan !,ixon ,vitich tLo navi-d lnmirt•'i rrl- but nbl !,(Al: a t a n..- :a.wo oo n wad tr:illtn 6irortly to e Ivivvrnrnen'.tl t}:V r if thn a^Cld+?nv or occutrem },`CtiSrS af?r'r Such opera. !;:`rl5 !;dvn b•=Nn t:t:rvph,t,?d cr eband"N": cal cc-ruts away from .. t,} tit-• w•'ri :t'r:-.tirloWl"M :•,t'•li;`i the• entire rt,munr'tw'iC,tl �-lftu*,t p%I'!Tii::?,'!? ^•+'^n'i, Ir-rvvil of contrcl!r•%i by the rimnr?l inwiIr?+ ',t,ttn•.r !itr• f.•,-!„-, F.+,.,':,) }:-^{ p'/c}:rt !. Vt aa•i by it r•rlpa r.•l rr r,g t•f tiiri' paoCltit`;i. tprf 1ic,:ts shall nr,! !',n d-ntrapr1 inrcmp:yt- brcati.r,r •t'tilt' 'iwlol•l :I ,,,Pl 8 "t •v.',:,^.:'r +'9 :nl tie'-,ti i,r dr'l.r-!iwal' 'ftt)rrrir•'i or ��, 1 1 +nr 1,p:•+Ia ii •sn� F-• )• { F'r. !� a Inc, tut } il:'r•st! .t•,t:' •a't•. •, ,'! IC;,• ',• I Y ,•:a•:tit:,' till:. VI ..t9 It"I br+ tr.-'tit!i-I tlrtill" t II an ar 1.•trl7'?tit; Tnvidivi } •tt,...�. r„+y;•, .t'.�:I1 f 1}'•C'.,::(.lr%Ir'• Itl ':t' ,:i1 ! t• i rtf;!' !h, fr�ifvv i, shall n:. b! il!? ?a ! bra 'r?f t •,1' .:1"i i:i a'• tt f'.'t 1, t 11 •(p t r t r r• u ;p. a ititl5 :7:ar'+:1i9 ;71 119n k''f .il'.' "fII i'1(t^,• wi'hin !ill+ nrR f l,iy ft.arar3rdpl: ';:) piC'i( ill c'r dnlionty. wr':►d Sd)t, ;tit- t n rt ,! , n• i nx"i rt ircm •:r nnt',a rdi:roi Car,(b) !}:O rnai n!otmr;r:r+ of vnhi/•!iI 'Ir, f; 1ria:c Iltl . Ir ,f r rn { :•hart)•,-f y +hr: n, .. _ t i O`,,,nnri vi, uSP'3 1- nr In lk3half of tha inzu!f-d, frl iho ?xi3tencr? n,rr, i tns.sT-'i , T by soh+' t L!,rlthnri •ir !lot fits rv.,.t' r;r ni. rj:^r'it, ! lit k pi:'„l11+:':t fr';d rIt li::trt[r rtt+Ci r�!Irlltrp tilt• N•));r:} F.t'i,'.'i ,?Tl-1 of t.?oit. unlns!allol equipmont and abandoto-1 ,"i imlia'A -ni r•, r _ j + f r 1 tt. And ldo op:n!afiOnR for which the cta"£lfiratlon st,.ik(i in y c4131•1 1 futlnu lta, I:r+ in p!, r,o fc. a;:r.m.. t;on, a+!r lrinq or rc,ptir, aa'.1 :r:rfu+lr's tlrr? il;rt ''tan (axt w`'i„l th!• earn-+•f insur•!:J ar;1l tho co rrpiny's nianual specih-7rlly includes crmp)PI!ed op.s•ra• r t ) ' •' + r I!,=n) ,rid r rnit doo.tly to A g+.vrrn ttons. } uc•k; ,)t.: rs '.l).t na 1 ., p,lr.lt � - 1!;-,nV,1 dal ,.,foil: 4• llmii/of uchilitr Th-o it;r,it rat h.,rhiy injury itd]:Aity valr-d in tho ' ti; i)?.+ cV'ifri)1 � -:r:?! :7! hint.• +1+`lfl !::i' lrl:r;ltnl incllrr+?ri t,,J {A) fits };i,ig + n ,n f e `•vrtra•tn A det-ld►allort3 d9 3pr-1wable to eA::h person is fhrt 1 Ito' 1[IC)Ihl1n, 1:n t,n,lr rorn! PTOUon -, rt.l^}i Prt l rat t n, , r•. , } '1` } tl•p +,C' tr t p ri r Limit of ih{! :: 'mp%an;t S uab:hty t.,: rail damages, t h:' r lm i : ,nut i t rt ar t t it: .. t:p•lrtl. n rf .urf. aut.,:nrbiiP t } 1 r prising out r!f bmilly .. L.a,!�''t tit il:. •tt'1^r.h P •Nat, ! r t 2 ir:+'.'.I'i:.,( dtirnnt (?A }r)r calf? and lt,59 Ut $CtVI,`E',, .. r 7 K.y f1Ax}"IIUTiI (+m1IRPr9tlr)n C, IOF? AT1'i )•^,II' sicknosr, r: difearr. includingdrmvll a1 all' liln•) tolu11i[l tiltiq• j. .r ,1., p'1^k I.p, t:ana} r t'.1,.:R ,:r rip^);''Pry :tr!t✓ice of Fr„p•?rty r,r i y c' '' t. 1)r+ •' i i' !,, f::>in, suWained by One poison a5 Ill'? result of Say onl ocruyu nor+; !hA by .n ,rr ratrteri of p)rnpr,Y r.* f•]t 1 T1Inf� iitr:it r.! ntlrh liability s!mt�d in the rtnc)arations as appll:-ahita to "c+ach j.'f ell:•, r1'i,t,r t},la :11;h "'4:':It-,":: pe'f!.:.t•^1,rd 1sy rnw.tir :'jfrin:C 'Ni,:Cil •C,'ll:rbt:,"rl w, !ttki't?Ct f0 ll,r? ab vP ptrviSloll ) r•^ .,.t' n'•• +t ,r,t.: .� raUn, t i:•; .. 'n tt: i tty .+Igiltrt r)P:1tl: nl an motr,t ,-trTwir 1,lw Or }t' !c:!al Ifmil o; t+:ri :-omp,1 ny's liability for all da'; ,,gels, including '"•r:t.!.rl'i"'r+ 'ft:-! -.1'_•!' fPI �1^.1 .TfFtt) ;.f 'r:,)51 of i,lrn ' gliaii be JCS Cf :,via-ino for cirri and ivan of nnrvwfis, atrsinr otlt rf t)udily inluty, :+ .1}:.)i:-i i„ hr•' i Aulc:r.'c•h;lt+ r++t�•3. p:rcft•itit d i}:n r v nr r •st sea• sifAne.!i or disoize including death tit any time rnsuFtiug thc,toftom, il,:t'-;1 •u!•.:•rr•.h:la i'!a p,'u:r!ids::a tfu:i.ra.i:i`fr �;xiil}' In;ary S.:al:iftty ' sll:l!alrind by two cr in:,rn p:vrsons as tt;- result of ar•y cne occurr+snce t'r!•{ I)srr.a;-7n hi.ttlih'.;: ir.sllyd`lir: !:C)VP..'irt'a ih5' :rt'•^,res! ;,f iia• . 1.1!+ •',1 t:S tar+.:f ':^ .1 dirt,• , pTlitt�ty 1-.311; 1. [.. 5 .4}rch ant^etc- Y t + r F Y y wt T . � �' ` ' r"'` '^! 5. Limit+of l)aeilit T.1-. limit of rc )na da:ndao liability ,.A r!ri in j 1 hl:r' I1.:f <!:brali; "V;dnr;_':, cl rvr•h insil-mv--n to thi? narnc:d in:+,;,-ti ' � 'f.•rt•,:7rs p,it.r2 C. tit4 Ci�'-t7fdr:6r::i an ap:p,I:Cablt+ to •f,er11 A(^rtCirint'• • !�, t1'rt '.t f":•; t,�:,l::c I t"^.:r15 1`1P*1R 11:n 1,.11-.KI'1 •)(5t'g1S •�yVldr.r 1 t t F' u F },, f is the fotat limit of ttlri c•:m;'+,sny's Itn.,tfi.y tar al, 'hoer lisil,tl tint;'+:= 1!1 !h1, btinin-in of the name. i Ins,irP:f !!1,'.11:t„ tin i)m vpnr, .tririr rut :If it ' !o or dvr!ru!tion ni till prorinny of :t non C,`,t—r•. vil1onirbil':1 1,11 Al,' vrlGl`')yr'n;'. inrl!Airt;.i Hficp:r. :`.GtP p?c'T,Cr14 t;r C.T.jSRt'ltt'ina. Including the toss elf is ne? Ihi v oi, ill , { !I Tlanin.i 111:+11.,wi :.,mrnrsa!Pd for 01 csr r,f mr!h ,W:,rn' ilt'S "}:,.+ .':1!I! rf .try on,, 1, s!)a!- cnrnrlu:,rir:•n' term^ ,,t o !. a y i. ,. mp..Tyt!tP;lt riT :rper;fir, r p t'ttir.;l 1!I•^'v•ln r' M arty :oc- '1a Ili d!ri�r;t nt)tct!.". And rn1,wnnn!ATlI if !lit', S. limits of liciWify--Products S'.)btnct to the limit of 0ahlllty wit lI ;r+apr-Ct t ::,1n;t+rT :rll+tirCrf. •'•,Y,ht 7P.1 A dr.'t:. to "elf—)t oC:urpence" or ea^.h acindenf" , it !hn %,,j l? :is£. i nrtip myvt-e • metro all t!*ttp)!•'.yt�r+5, int:lu_iiRa the limits of bodily in)ury ilibiltly an•i j I Ctti• n!,. ;l t!:• r:.11nl,Cf I!1^,,.ih+d, nUt I I,Prr( nr,, r,trpr,lly a-Kra!'lo rldk?ilt:y 3t3i!?d in The rJeclaratiore; act •agr'rhgafn ? •n , , i . lCCft1C!5 wrt wiz ortivel lito Iota) ! 7 :A 'f. , s: . •f tt.. :r+ ;t •+},n ) n:ain•il:. }:'► r+n'f1 I;.t;art r,+ �,, ,•f •}. F I: Y a i 1 :raft, ihn com any s liability of ..1. .at 1! .. 'ran.•,-ey,,,. },. r.r+,;ti,,.t!:1 !"r1ltl!iii('t!! C..•r3: .l+i ,'lat:!9S7 a::".ing CUI :1 the r: pp �� a rrldarts�htz.ard. lilt rl:rh dtimagr•:s . ,►1�;'1, r'.•,! i'! 1',t -,! rv.orir r)r tire'-flip,!;: ,repaind or ar:qulrnri by the + r, 7. In•petHon and Audit rhn rcmr 1r,'{ al:,ll1 k+� pnrP.tittr+.i ro it;pot l t})r, n•17na in-tiv.-I -r by tAnrilhor ttt'iing unjor his name? sht11 bo ron- t it,rti[P') rr1':+t+'in;t (•p:nr4t,C,r2:,. ,t:itgniol)hn,; an'3 'i'.1^J:•.l 19 Art1:1'r :it cf r:irt art:rCfr:;t nr Otirtirrr-nce. r•;••ylfri8 ,1!1(t !•, XQ::l:rt0 Ard 1tl:il! lho W-31,Ind'F 1)-.tlk:t And rt'crCrf!' t' ii .11. ,buy :lint+ :1•: , •a tr;n pri icy porlod anti arly ex;ensloll !}rnrlr:! an•t 7. limits of I.Es).311ify ubrnt•' tr, 111P limit of Itnbility with rh5pert to "each w:thiii !hT 11•, a!!nr rhn hit. !.- } „'^,•r .+r A^-irf�nt the? linllt Of tc inrt dnmat;e liability si r,'rmitl,a,t,.n of this p.,.r.y, Ls !I ,!^ p T Y p Y ` r•,)•S!i +r)+!I t, p•r,,^l,ttln btrirr. i;r 'r',� silb.+-t rn-1'!ot C:f t!.t!: tR:,.:t•lr-. ;ta!rd in thA decl talions Ar 'drJfTf!r<Jatr? Op!!!dflOnf, ' 2 the Intil limit of 1};n ,mripany's liability for all damages Arising out r. DeFinh,cns rf 1n1ury 1.1 t". -11+strTlrttn n r:! pm ;prltly, incl!ding the+ los!a of urn lhrr,cf, ' + • ! cnlirr'f e,'1 0-,t) uwn-rship, mAWenitlr-1 Cir ti4f, of nretni':;nz oT opr?ra- } r.11 Contract. Thr word 'cctt,rart" mtienG, if In wri,tnt7, d ,nose ct p•tc+:n ;:n� .•,.^r.R)t^^.S l"ttT.r't'it,;•t, iltrrr•eln[1:1, rr!t7•.irl�a by muricip:al "::'.ti t!r,r' t.t'nA Ut 1 rnrnllnnlll;'iR premium basi6 :ir by etinttwors' equip. r I:1t:'" ;1'in!idrlC ,1'7f?r"'!t•Itf, ,-'r s,!t+vain[ cr Cn 'r?mr r " 1Lm bA9i5, -. ,� t rr-,t•r,u r.l ;,uh;r,-t t I tht limit (.: :lability With rasp ecl ,o "each accHanl". tic) Automobile. t.'x-''Fr '..hn r• ,tt,1';';l to lira . ,ritf•):'{. tin '�'c[tt ' 1G1i I:mat ^.' r ;C•p'n:!y tiaT:At7•T 1i7k7lllty atafId m the dnr.)lralious dR egc7:A• :!3•:} tl,' rTt,gir? •! 'trig ru-:,t vehi,•-io r l milior .1'! foliG'.l'[ }i n p?iGi,'ri;Vt,' is the !Cl!d1 Emit of this cGlapanly 3 liability for all i, arising out of injury to or dostruct:cn c f rTcp:erty, In,-ludir)n ;1) Owned Autorllobilp • -in autumobilo ownt+ci by it(, named l; f t:r•n +vrrof, cr,ised h • t) ,r.ra inns >d l r i^-ss } p• t 1 petfonnr�a lot th:.T named 1f t lea+sr=+tl: In^llrr--1 by ir.dftp rident ce7mirActcrrs or oeneral sup:ctvfaion :lifI by y '+ Hired A►stomoblio in itil m�biln usrd tvidt,i s t�nitA'! In i.r'itAlf 'ho c:�Tnt+d .r:su•l'd. oxrnp,f (a) maintAriatic-o and topalis at ptnmisns ' nf. cr icani-d to. the, naliI irl-ill-d p to..vic,i suet, nulotrr-,-Life I:' pvlrinri kv or Tr^,tP•I 1G tin named ir.aureri and fiat 4lrurturdl nitc?retinns -;wnnl 1•}' +,, t:,,t1•;'•,rntt In 'lira mizrin of 'a' il:o rinlrrl it:F'31od is Sit"ll F,rtt.ntrP!T vlh;cl, do n^, irtvo vr'i t.-hangings tho Jiln of or mo'/InC7 } ,• :r 'i t .1^, trK••r:iit,•rn CIf1Cr't ih+'i e., of (r) Ali ompit,yoie ,:r A7nn, n! buildings cr r!illni�iri,alites. r- 1 th+' rdtT)r'a trll;uod 1t,hr, ::1 .irtitifi,d ]n t1};!'rotitiq ,illcwanro of r t r-- t r + .,116ier.t !c the+ limit of liability v1}th rasp•�ct !� "each Arcident", rt,r any rc.:t r rat: u:•n of �ur;l rlu,c;m%biir-: limit J propo,Vy dar:,ige liability !tatnd in thr dQr:mration!; as "agq:r {! Non-owned Automobile -any c!hnr outcmt:hilrr late cnntiactual" ir. the total limit of the corip,',ny's liability for till 3'r,t ol- ilipmnnl rt!1a11 bn dPc+mrri an dU.:, 1 biro d,nnaie5 inning i:iul of tniury to or destruction of p,toper+y. int.-tuditici by CT r-a:tlerl cn ,rl out,:err, rile not so tin^t:rihn'.f, hlil 11he loss of use tfir roof, with tpsperl to liability aseum-:i by the fr• t;it' f'ti:nl"::.:P. ,f cf IIU+ t?r9 innlygF?• any Ira'allot. p ownr CrArla or s•.Irr+d Under rcntr.lct;i covr?r?-1 ry this pollcy in conlipc:ion Nitll opt?r l- 4!i,):'r,i, :iir'h ;r tr•�r^..•h Zrt: any fatm•typr.? nny c^r:^r•+Ict 1wrin for which there i<t ,ill "aggro late operations" limit of property , n,ier r.thn: in,vi r} tht• mix-ln•'ranail typo: any yradiir. scraper. damagti- liability staind in the+ dr!cln;atlons. t roll-)r or fnt-m ire,,,)+?mrr,t, arid, If no! subtrct to motr'r vehicto Th.-) llmiti, of nrop:•orly damrII liability :toted in the rinc!atatlont As :'tif3lr+lfiQrl. ,any 01 or oquip monl not spa-ifs++-i bnln'w, which i9 ",lggrr?gAle rF)nraNr:n9' "•ipgtr±gale+ protective" and "aggregate Con. 1 Psit7111F,d for t,re rt:ncipl►ly off pubitr rr.i }^ Irac'unt" apply st•!parately to oacl, prLlect 'with respect to o1lti.ralions Thr trltr.'x,Rrs ci srril:-d :+c)liipmont n1tali h- ,ionrnnd an•aulomebifr, bo+ ng perfcrmed away from prnrniv?a owned by or rented !o the named j xill:n low, AI - or cart it d oil in eutornobilr, o t above defined solely innurod. � �t-,' ;*!+•Nit-•C'^s*!3't:rr^.�rr•et+t•rll,•'Si'llat .. .-. .. :SiE�.tfRr'."[r"► W .C' 'll.+�L�'�^. "l'""ft"•' "r"""""+t••tt^eti `�'.,L'k'L!C•s.�.mrl. i t 3 I l ' !l ._ _:.+,..., .d„r Imo. .. , .. • •..., .- ,.,....... ...... - .. . ....- ....... .. ...._ .�.....,.,_•. t t( F t. •�r S. Severobilify of In►trests Talc• totrT, •'then in,lirecl- is used savlzi ly The insurance uncler this policy shall he excfass insurance Lhiti3 , an'i not cnIlectiviky, but the Inclusion hero- ?expect to loss agaitlnt which tho named insuted has other insurance' ' ir. r;f rntlre than one? ns::red shall not cponite to incToacce the hmils disr1wed to flip cornpar-y a3 in affeet on IN? effective date of This ft�jlwy of tha rornpany'e' lietbAity. and liporl flier ;;axis of whi::h premium credit fct other insU:anco i3 given but shall apply only in the amount by which the applicable ;imtt 9, Financial Responsibility laws Whov. thm po;i::y is artified as proof Ui llibi;ity s!aled In the (Inclaratinns eitc"Cls :he twal aprrll.ai:le !maws .:,Ylnt 7rTCp A irl ri R of finaticini rusponsibdity for thn tuts ire of ll."thtlity --A i11 and cotirrfible upon the basis ,'l u•ri!c:h .. under the plovisloaC Of tho vehi prerulutr, rredf! is riivt?n. t fiaan•:ial respon!itbility lave of .iny state or rrovir,co, such insurai:c- •]s 13 if!otderl by thi:l p-,'1icy for i;r.riily in!ur'• liability or !::r liv-perly 13. Subrogation In the {>tfr7t cf any piyini,ti1 Ltndor iiiiii j•rlicy. t};d liability shirt r:.]rllply with (il:, js;o',.. .I,S of such lwli wti+• Ir C.`.it if. 1 tl f:11)r i !!. lr„lry s. •a,l b tr,,l lr�i ) all the in.;lre`d .. .;t::•111 bo applir.lbk, 'Nish nlilj•.4•ct to my uch hi-vikly VWtrltj !,ut t':f th+• :icjht of i•'i'Cvr`ry 1!:•. .:!,;r aeJ,11nZ1 arty j:0M3'.n Or CfC79tliedt:^rl an:•1 !},•; rrtr:(rt9hip, mnint,•n]nre �f uatr thiring tho poll-). j.v,rlrA ,f any atrt:.. in:,,.ttr_il nl:a1i trx(c1:i•- ,:nd cic`I:vt'r lrestrurr:,-t::. anc7 j:+1i rrra artcI ri;t wll.i: E:1rt` :nsurod hurt?tindor. to !fie' n;ftt,vt t:t 1 •- c , >., ' 1 n' {> n{ r !n '.. A ^ . i me#. and ,irnit:: r; r'-'r :T 1. n r..^, ary cut•• sl ^ll r1 1 iF.•' 1!r,i ra;i ..f1.111 it lt7t71illy t{3(i311 a sty :t}Cl: ic\'A', bvt in �'..•ti1 in X.'f!.,•. Ctt tha 11n:,t!, ::;''t::a,J •Iflr:f i j)fE'+:t:fta 1 ; r C:I !;,Nh.liity sidlJa IT] this pt71:{-y Tt•..' 'a.....•':'1 i,U:e•a5 i' itt:!SIl S:fd•' 'i, r:ill ,1:! far n i 1.? t ! ;t 16. Thrre Year Petic A 1•{:! 't { f t'a•` ' vt F Y •] Y F�l r rl ^',,y,-• t.•{ - _rl�•vr{ r:;;h-it tt w�; a J:Qt Y 1i'Y i�' tt.•, n. , yr. :d'JP .••('n t.a)I:rTA•r'+i to -rlak? 1.t!"ft'+r 'rt'•? till-a3 p!tllry H!(,•Pj•1 R2INi' ,'pnif`t'17tiL•{> annUai rorio-f5 Ratr.n, fc! t.'J• . :+r !ho . . . r • • ' ' 1 ! ! :1li tf.„: Stlt'•:•t: j'r'T!;'1 !:1 at.rC7rtlariCr VJ1:!: •llr? t-G:T:j'.]^y ruios aC,i f.7! ral NOtlte to tht Comp:trtl In th- r =i1; ; nod-iv ite r, i-knf'sy rir rji3- j :,1ri5 C..r tl:!•tI!A•.t�tt And otJHl!1!int T11 of CdrTt''"t i+;t'rft`:::rii C!:il. I•' C:a 7' •'(150, In, -1:ng ,:" .., o, -ny J,ri.? r:J.Ultil ') ]! !!1•r 47r11 A nrulwll j,•strati. Aq:.i:•'•J3'4-' ii:stir, i .t , , y: ftr tn, ]rwory o or >� , , n z t r c•, li,tf. i,,y .7r 'a i •ir tT 1"!i7 if !'fY:1 t''• •Nil tt3n H:„ 3 ,tYll F !1 '.tits j:✓:ilt••y trill! 9jlply rl-r.a 11a1,j !ry .,1,'t• d lr• :�: �'1"'r i ') 'rt r:'f r,r un l7+'!.•,Jrf of '.11f,• tl!ilive {!t.'r 'i:r1l•,,T!'.n•']t,v '! an . ` .t .#��,' 1 �:r`_rt2`f cif it-,. CTi_ ! .. _ 17. Chants+ ;j..!:,,- !'. 7rr ,t Cl }.:-..Lv.r'.:i#•' ;r i t-y mly •' tl•'tf']:#t?fl'ti C7A fl::411 C!!3 GTCI:111C'gfiN+. ``11^.I1 fl�:!i:"H fil:Ylil CJt"Itriin jXltlirailC718 � / "1.#�`� j".;.�5,.'; 1 •.' - ?'.)l..-{a•I1t TC' Iclr'l+21{^J !1." ,Ci511R>:I r:TUi CTI?'t r,%R?CtT1CJfJly Obttainaf•la I2Ir,7f- 7 - i?r'rlt l'.: by +1hV 1"t}:(?f r7=TS:'II shal. nCf ,of{prt d tM,117e r t•. r� ^;r111t7n fr'^ •tir•nr7' lhi' t.t-n- t7�n 'r, :� r t o ,t. .1•' 1n Jt [:I:! ;• !'.i`: I :l. '.I, ..;r• f::2 'I !• ��• � .j. ; i.i t7J1(i -:r.-urlr, !:r•t>s ( .11::1: Ir,j i:y. !;• '• •y cr:l ,771ti r1!irTT. .Sr 4 .+f !1',r> :r:: .Tr' 1 c7nU ;f :1::7:!<]ltl•i t+J:'t''•?5! 1t:'f '1':• .-v.j r !i, t/':f!I•, y:f .',... •j,.'!ti;' .,, r .•!:!:. Ohl, :nt'..., rl• 1 ch,r:,tr,; b „'{.'• n. f 1!. Notits of Ctor,-n or Suit 1! t•l.11til ma.{n =:its i.t 171'' 1't., ' t ; 'stt -f • thE' tnS17:,>'1 'ht' iR„II•'ii :'1:)!i l:l:t {; !.,�•1• .. •. foi,!l9f,t '4 tt'{. .;!1:j'•a y wil?ry d{arnv!d !: !;r'lt :!1:ni"iAlf" 7t t 'y rl`,-olwr:i i,y [:u]. to t .. tnj tn9ct !.1`lv.r 18 Assignrn4-nt eti.. , tr:t.. ,' t, ...'• . :l+ t I .!: -y . !.•1'i r t 12 Asurtnnto and Coophration of the Imsu►tJ i!,.r ir,.u: 1:1 :t t ,,., ! - J tr• , , . .. . !t i I} i ..1'. f t •, . i •�/.tt+ '! �rrnl nr,y �1!. . 'i� n..^.i•�i tt°a:"�! _ .jai i•• . .•'•t!: -1: .. ..t: , .... :r, , 1 • l i fr'r iTl 'a1l1 :9 t� fir•. !' •1 ., :'' •� , 'r 1,•.. rn , ., .,I .•,.. � ' ., f t.i ' j y 'i •.fla , .1' 'i f;• ti`:,T3 +• <{ s` �r:a .•t1' .t s• , a: ',J, !n I•' at �� tr. L >,'r•'' l! .ar • ,t ifl >,`•f l,'t'fl^:'r`f niri•'r:^•>t!l ,; !it'i'Ut:l! • it v; '1 ,• 1 '..` , '4~ 7 1 ci :it .- ..''t ! 7 't.. t• ,.J'�;1:'.1 ( 1 { •t Ii.I T.i..f .•. .! •,' •. .. t i • : :t? ':.t' .,,I,1`, ,. !.. .. .r,. i.1;o +. (fi, 1'i.+' t1`• dt. t! 'f .1, .l ''• 1: L..•..!: - 1:, t.;l. .. "f •'XtY>; :t „t., 4'tl .•a•, .:,,' :y ,,:7k•. 1:, j.l:7:•'.. ., .. ... _! •'i•' , ln, ,! :, ...,•t !':r•. {;, , , .,. ' i •S::'a 'hl l t r, •a :n . ., trig e x1 r, ., ,1•r. ,! 1: ` ,••, •, � y •, 11:11r . . r.: ,t,.... '•1-• 1 ,. 'l!' 1' 7: t• ,... 1 . . ,1' ., Sil+•til",1l 7}. i :S!Jrnf SI >{;,•! ' 'f r` `L 1,, tt Ll 1'.r .( 1' 1.., i' a 1' 1• i, ;t+• •'• 13 Attion Against Corr,pany ii . ii'. 1 i\ Cnttntnnnn r It 1 1 :I i 1 1`1 , .1' %t. .i 1' , t .1 io. •r il. f•• .y t:., `t'.. tr+' { }: i 7'i. -r�. J1 .. r,. 1 t ... +' '; t f .:t, ] ..tt l�' ... l• • � :1. r•I•' " ;f ..1 rt..., t'. w . / ' ' ,: .• " 1 r t t .. ''. 1,.! .. ",, ' ( ,i. t .l J .r, t ,t. „ !, t, r .•1. ,1, 1 7, .\•.,t ,t ,I,•,1 , i A l .. r>rt...l.arl�, ii' ..• rt!i;{pt t:-i. f• ,: , .,Y' rt i•,. 1 , :,., 't:r' t „ r..: .f. ,.{ ,,1. .. .r, 1:` l• rl !'v ' :, t t+ ,} T 1 1 1 , i )t '• t Ir,1. •,, l .1.., 1: F, t::L 1 . '', ]1:. •' ! :nq I d: r. ft t! tc: ;t"' t+,`'vrr.;t• r•1 '.i;t+ •r•• .r ! i 't ! i•' •'i 7' 'tI ., i i.t, i• ..•i 14. 01hpt inivtante f' F.,, tr'.? ;,,,i „7 t:.+r ,• r , r' 1 i, r t .. ;c t S 11: 7 3 .^.t^Yt''M"t b`I t}lt,t j•rtl,ry ti,, f \:, . -:,it` t l,e�• + - :i t! ...SI ,t!. ...1'1 :1'`• :1 tt ..r^..r t •,,. C {:%!li.` +.ir::i,:ir otians th.a iin irt,i t!s!� pnlfr { W -h this i-ofiC}• fcr ,1 grovott prc-p, t •: ,t !t t 1 !' ""1: r*1>T:iI!J' l� :+ / r'.f f! ,•r t7f 1 ' r .•` In if", A"-; .r7' r,ra T- Pr': ft 1 +r'j+i •.,nl,t 1121`tt ;{ llttnll:ty of idv}it'"{ anti �:,r:.'•,bl� !ri^t:f 7!1:"n it •21f15' �Q. pitso r . . -t1lnS-• �f;!vicf.•, •7a :a 'i •.,:� •. • r,1ni,'.i :t '<.u�'•i a'tr(>,•'• f { l•evcS i!?S11t1ryrn • ort r.,a.• tr• ,,- '1 inir-J Writ of 'fir, rn-.vn!trn.ir,-+ 'isr• A iry .`iw-i •1 f. . ,nl•;rlr.. :n3tifh."I •1 ,:r'nt of hire 1`191:: r,r ,f,n ,.:n I ,1I1V :1^.n f'v•{t„ { •; r- 1 d, t" ,,. _ .. ' n: .�ttt:!ill,:. .;hail F.e? •r x.f>^s :nsurr ,-rr ,? t t r r ,c:r,!1+ . 1 ,.{ 1, I„ : y n+ r1V f 11;V ,^,figf :Ali'f 1`1tf i ,>r.• .tf r•t: !• '.ti•:•nn r•' ;' 1^,••! •1; ,,, ' !j ',,..•!t..i,. :nt4!,r'f!trP 1�1' „ 1.ti 7.•...:7 ,. . ., 'L T,._r:r',f 'y -'t rt r.; ,1r , 'r i , •Ml:/, ' hi,., r.nf ' P.lclfic Inchsn:r,.'}- t' h:,rr c'aar,,i •!:!� I'• ili'; ,. !' Jr:• r; } r.:•+:•.:{t•.• ,±:. i .••>•, 't•'� t' (, , rJr•;�< 7 ti_ ir:.a lt'.:2 �11111Pra!t]•1N,{ 7 �, ' n r b y 1 •t Fri 1 :i t tit(? t r'tJt•1'i� y !7.14P , C{ll�t ,1't. 1"' •+ri,,...r•�r:1, _,1 ,t•, �(•.111'. t ' k ` t t • S ii 1 , I t ' t 4 1 !, d j ,t 1 t w 1 t r F t • i 1 f I 1 1 s' . F 1 r i 1 "'rr"""`�'�i_------------�_ �_..........._.—__._.....__.._-----��"o ---- -__ ..r..Tw �...__.._..-.�,.,r.�..—+.,..a+«.-'_"....�-.aft.. •`4•`'� • ti I CERTIFICATE OF INSURANCE 5. ? , THE CITY OF HUNTINGTON BEACH S HUNTINGTON BEACH, CALIFORNIA J . THIS IS TO CERTIFY .-Ls to the existence as of this date of the below described insurance with the Pacific f Indemnity Company, Should any chnnge occur in this in;uranc.e, the undersigned will endeavor to give written notice to the holder of this certificate, but failure to give such notice shall impose: no obligation or liability upon the company or the undersigned. 5 l i t z Name of Insured HU14TING'TON BEACH COUNTRY CLUB, INC. , ET AL '{ 1 ' Address of Insured P. 0. BOX i48, HUNTINGTON BaCH, CALIFORNIII Location of Risk STATE OF CALI10ORNIA Description of Risk OPERATIONS OF THE INSURED INCLUDINCI AUTOMOBILE AND � PR0DUGvrS LIABILI'.t.'Y i f Workmen's Compensation: Policy No. Term:from to a ti Compreliensive Liability• Policy No. LAC 158243 Tcrm: from 1-1-64 to 1--1-67 { Bodily Injury Liability $ 300,000 each person. $ 3001000,each occurrence. $300,U00. aggregate. PRODUCTS Property Damage Liability--Automobile $ 300,noo.each accident. —Property Damage Liabili�y--I:xccpt Automobile $ 300,GOO.tach accident, $300,000, aggregate. ; Owners', Landlords' and TCndnt5' Liability: ❑ Policy No. x Manufacturers' ;end Contractors' Liability: ❑ Term: from to { � Bodily I :lury Liability ea c -3on. $ eacnc de nt $ aggregate.. Property Da7)ng•e Liability $ eacll accident. $ aggregate. Policy No. Term: from to Ri�;�it\RKS: It is agreed the CITY OF HUNTINGTON BEACH is an Additional �. Insured under this policy, BUT ONLY AS RESPECTS .,he operations of the flamed Insured. Certified this_ 3RD (lay of DECEMBER _ 19� � DS :RJ BYRON FENLEY ily � r+ Form MMSM 35M 862 t t t 1 1 i) 4 i Y t F Y I Y V I7 � ,1 i S L ,I i .y i :j i 1 ,y I No. INTERIM PREMIUM ADJUSTMENT ENDORSEMENT ,a i It is a-reed that the: insured shall render to the: company at the end of each month period a statement 3 with the information necessary to comlillte the premium earned for such period on the basis upon which the policy ; , t Nothing herein cmitained shall be hrill to vary. alter, waive or extend any of the terms, conditions, agreementsor limit.-I- s tions of the policy other than as above stated. This endorsement forms a part of PACIFIC INDEi',INITY COMPANY i Policy Number & Ix' ,"+ � ©UPLICATS Issued to • ifemmMAN lwau- MOM eiiAs.i«f0A 1944 �ri� Add Endorsement Efiective• OMAN A p X4 r� / PRESIDENT. t Countersigned at by ( I / AUTHORIZED REPRESENTATIYK. Date of Issue L PRODUCEit. Dann IA041;1 10\1 260 DO NOT UCE THIS SPACE—FOR HOME OFFICE USE ONLY_ LIN[ AI ONO R! ■tl01tlt WIT 0-01tw1um tt-It CIt♦ CLAtt Lima 4Atlft p11[MIUV aftOt•Potts, CAMC•t. COMM, 11Att I, r 5 �t f 1 s. t ' i y i Y • a a i 8 r y ► y , v a No. t5 A.P. 4. R.P. ► IJ _ { Tim arzy Or h I film ma�.[��""��J(�Y'��MACH eA C�H �jC�(Wl��J �p •�� ` THE STA MA 1 r�TL tM'�.I# AX T U "ial %Y�PNIA '. ' M 3 the apomt0na of the Nwmt Irmur t, t t i \Inthing herein cotimined shall he held to vary. alter, waive sir extend am ►if the trrnl,. conditions, agrecnuents (it limita- tions of the policy other than as above stated.This endorsement f-irms a part of PACIFIC HXD1:MNITY COMPANY t Policy Number Ma 15824.13G1�lPUCAYI , 1 a IS51ted to Endorsement Effective- . i Countersigned at Y fv rS AN Mai eI L•OS / AUrmonu p REPRESENTATIVE. Date of Issue f' A PRunul:cR. Fat rn \1 r1(116 1(li M 762 r _ QO NOT USE THIS SPACE--FOR HOME OFFICE USE ONLY i USK +flNp EnKfi[ � S'► CITY CLASO LINE t naOfS rAgulUu IG110113 PIaFM.CAIM'C COMM. RAT[ t u is { • r f r 1 t 4 t i r �ti l � `�� .ss+►+ «rw �.rnwnr�r.�rxa+►eas,+�a:,�-arc. _ ensa+sar�+seaeeeeser, •trysts! rses=ssas�saaa�aa I r • t L , �; •t f i , I i' !� r 1, i . LOSS PAYABLE ENDORSEMENT (Norm 49A) f. if .loci CERTIFICATE OF INSURANCE ' T Name of Insured : �>�'� �l�wt�tu� ox:pu ovm* j'�� ,g ' Ago, :'1dt ress t►f Iritiureci : q k , R : n l tolii t "f erne . l-ro tram i�y to >� .� `,e. 7 i #► ti t; I)-scription of Atitomohilr " l:lc5cription of COV ,11g° . ` k% ith r"pect to tilt, interest of ' 1ke-4'9r.41 Mgt W� � .t aMfl its i:ncce4sur�; and as4it;n;, (hereinafter Called the lien-holder) in its capacity as conditional vendor or n:ortgager e r Whorwi e, in the property insured udder this pol'Icy, this; company hereby ,);tees as follows: 1, L(vi- or *,rave, if any, to the property described in this policy shall be payable firstly to the lien-holder and ' site►nlll•; to) the insmed, Cis their interest:; may appear, provided nevertheless that upr►il demand b% the lien- 1 wider trpoti the company for separate settletne.nt the ar:otlnt of said loss shall he pail{ dinwtly to the lien- ahlllller to the exte►tt of its interest and (lie balance, if any, shall he payahl•: tti the it►stire<f. 1. Tht: insurance under this pe►iicy as to the interest only of t{te iiewholder sliall nest be Impaired in any ivay by airy rhaiii',e in the title or owns slip of the property 1►r by any breach of warranty or contlition of the policy, or by any mnissioti or neglect, or by tilt• perfornian •e of any act in violation (if any teiris or conditions of the t` pt►licv or lwcau:e of the failtire to perform any act required by the tcrnis or ere►nllhions of tit(- polity or because ! of tilt snhjection of the property to anN• coeditions. use tir operation not permitted by the policy or because of in\• falsto, �;taterwnt concerning this policy or the sub,ect thereof, by the insured or the instired•s employees, l: ,,nits t►r represewatives: whether occurring before or after the attachment of this agreement, or whe.thr.r be- fore or after the lot::; 11lt(VIDF.l), however, that the wrongful conyers;on, embezzlement or secretion by the ` {rurchascr, mortgagor, or 1eK4'e iri pc-►Ksc:aitm cif the insured property under mortorage, rondibo teal sale con- � is tract. lease areement, or other contract is not covered tinder this polio•, unless specifically insured agaitist and preinium paid therefor. 3. In the evert of failure of the leisured to pay any prentitini tit addititimil premium which shall he or become due under the tcritu; of this: policy, this crmpany a�;r�:es tip �•iyt' written notice to the lien•holller of such nnn•pay- ment of premium after sixty (t'►O) clays front and within one hundred and twenty (120) clays after tlue elate of } 'tr s1141h premium and it is n contlition of the continuatice of tits right-. of the lien-Milder hereunder that the lien- holder whe:i so notified in writing by this company of (lie failure of the instire.d to pay such premitim shall iiay • or imisc to lie ►aid tile_ f.temium tine within ten (M) nays following receipt of the ttonipany's demand in writ- ;r ' ing therefor. II the lien-holiler shrill dt:cline, to pay said premium or additional liretnitittt, the rights of the lien- holder unticr this Loss Payable endorsement shall not he terminated befi►re ten (10) days after receipt of slid � j written notice by the licte-holiler. � f (river) ► Nothing herrin contained shall he held to vary, alter, waive or extend any of the terms, conditions, agreements or limita- tion }1 s of the iodic • other than as alcove stated. This endorsement forms a part of PACIi*It: INDEMNITY CUINI!'AN�' Polity Number DtlF'L1GAT�a i r Endorsement Efl:ective• PREnI.ENT. Catinterri;ned at by i i AUTHORIZED R£PRESENTATiVE. > • i i Date of Issue PRODUCER. Form 2AW2 1�(Al 46.1 _ pO PLOT USE THIS SPACE--FOR HOME OFFICE U$r. ONLV t�LINt I FIND I Y 11RROtt tIT•Tt C1TT _^Ty GLIry� L!N[ Oboe• ►RRMtON 0*026 ►Mt:11, CANC'p. CONN•PATR ' y r► I�RAt7"LPl�'1fClt"'T].RC'!tS"Z:.!!"C!Yt1'.1T1T�^tt�l+eR�!V'!°tt1 Po It _- - "'T.i MrPl 1 t 4 .,... ,. .....- • ,.... a ..i i -rr- ` a 1( t` t No. f NUCLEAR RNERGY LIABILITY EXCLUSION ENDORSOMENT r► (Broad Farm) t it is ag eed that the policy does not apply; `s }1. 1. Under any Li+ability Coverages to injury, sickness, disease, death or destruction r '�Y (a) with respect to which an insured under the policy is also an insured under 2 nuclear energy liability policy issued ;tiy ' Vnelear Energy Liability Insurance As.wociation, Mutual Atomic Energy .Liability Underwriters or Nuclsar Insurance r. Association of Canada, or would be an insured under any such policy but for its termination upon exhaustion of its limit � ii of liability; or (h) resulting front t1w hazardous properties of nuclear material and with respect to which (1) any pe►•son or organizntion i:i �quircd to maintain financial protk•c(ion pursuant to the Atomic Energy Act of 1954, or any tan• aniendatory thereof, �. or ,2) the utsia•ed is, a: had this policy not been issued would ire, entitled to indemnity from the United States of Amer- ica, or any agency thereof, und!-r any 2gr►.ement entered into by the United States of America, or any agency thereof, i with any person nr organization. If. Under any Vedical Payments Coverage, or under any Supplementary Paymcntz provision rtlating to immediate medical j or surgical relief, to expenses incurred :with respect to bodily injury, sickness, disease or death resulting front the hazardous properties of nuclear niat.•rial and arising out of the operation of a nuclear facility by any person or )rganization. } ill. Under any Liability Coverage, to injury, sickness, disease. death or destruction resulting from the hazardous properties of nuclear material,if !�j (a) the nuclear material (1) is at any nuclear facility owned by, or operated by or on behalf of, an insured or (2` has been I discharged or dispersed therefrom; (h) the nucicar material is captained in .pert ire) rr waste at any time possessed, handled, used, processed, stored, trans- ported or disposed of by or on behalt of an insured; or (e) the injury, sickness, disease, death or de;tructiou arises out of the furnishing by an insured of services, materials, parts cr egniptnent in coancction with the planning, construction, maintenance, operation or ose of airy nuclear iacilityt but if s .K ti mch iracility it located witbit: the United States of America, its territories or possessions or Canada, this exclusion (c) 3 applies only to injury to or destruction of property at such nuclear facility. ! IV. As used in this rndorsement. t i ' "hazrirdoua propertaes" include radioactive, toxic or explosive properties; "nuclear material" means scarce material, special nuclear material or Byproduct material; , "source materiai", "special nuclear material", and "byproduct material" have the meanings given them. in file Atomic Energy Act of 1954 or ir:any law :emendatory thereof; ► ! t ' "spent fuel" means any fuel element or furl component, solid or liquid, which has been used or exposed to radiation in a ' t nuclear reactor; "wtrste" means any waste material (1) containing byproduct material and (2) resulting from the operation by any person `i or orpnnization .,( any nuclear facility included within the definition of nu_icar facility under paragraph (a) or (b) thereof; r "nuclear facility"means (a) any nuclear reactor,(h) any equipment or device designed or used for (1) separating the frntopes of uranium or plutonium, (2) processing or utilizing spent (ue(, or (3) handling. processing or packaginp, waste, (c) any equipment or device used for rile processing, fabricating or alloying of special nuclear materiel if at any time the i total amount of such material in the. -.u.stody o the +nsu►ed at the premises where such equipment or device is located consists of or :ontains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 :z 1 grants of uranitim 235, ; 1 (d) any structure, basin, excavation, premises or place prepared or used for the storage or dispogai of waste, ti > and inciudes the site on which any of the foregoing is located,all operations condu.:ted on such site snd all premi3rs usrd for ` f i such operations; - "nuclear reactor" means any apparatus designed or used to sustain nuclear fretiion in n self-supporting chain reaction or to ' contain a critical mass of fissior:able material; ,f With respect to injury to or destruction of property, the word "injury" or "deatructiots" include all forms of radioactive contarainatior:of property, i Nothing herein contained shall he hold to vary, alter, waive or extend any cif the terms, conditions, agreements or limita- i + • tic,ns of the policy other than as above s:rtteri. `Thu.; etldorsenient forms -I !tart of PACIFIC INDE' 11ITY COMPANY I 'j Polio}' Number LAO IWAS OUPLIGATIRu e �t Mai 1 Issued o "A-4 f:ndorscrnent Effective• + PRESIDENT. .� i �1 , J Countersigned at LOS =MMUY 7'�`�"�' AUTHOMEn REPAE9ENTATIVE. G ; • Date of Issue PAODUCKA. Form 1t'4;2a 150M 562 i A&CY F,511 00 NOT USE"THIS !SPACE---FOR HOMC OFFiCC USE ONLI t/h[ a944 OwrOt ltT.Tt + city CLN[ { Llwt + SPOt• LtMIUM dw]sx MIt M, eAkc-a. COMM. ►ATf t ;± t l ,t • I s i r '3 i M t t{� / • I t ��- =-• AU•TOMOBfLE MEDICAL PAYMENTS ENDORSEMENT 4•I� r (To be t seo with LW Policy) A.P. R.1'. The company agrt•c, with the uanird ircur"d, suhicet to the limit of liahfiity, exclusions, conditions anti other tertnt cif 4his endorse- s inent: • INSURING AGREEMENTS ' 1. Automobile A4edieal Payments. To pay a'td reasonable exprn+cs irlturre(d within one year front (fir elate of accident for nrrcssarp f inedical, surgical and dental iti6iditig prosthetic deviser., awl nrcescary :tinftulance, hntpifal, professional nursing and i Division 1. To or for tack persnn wfin su,tainc hotdilt' injury, sickness or di,4case, rawrd by accident, ',thilr ill pr u(+on or ; whilt• mitering into or -dightilig from (attr a:ltornnbilr drsiuti2te,f herein by the fetter "X" i provided till- autottinbife if. Itcinct ( uil-d ley the named iu,arrd tit- with hip permission; 1 Division 2. *ro or for rich insured whn tugtaitts t:ndily injury, aickrlra or rticra4r. caused by accident, t61f, in or upon. or ' E: while rritt•ritur into or ifi ghtinq from, or 'i -ouuh brim: struck b}•, an autnrrtobile. +' Trailer, Stich insurance a. is afTorded by thi% endorsrrnrnt untirr divisinn I applifrt to a trailer dcRigtird for u5c with a privatr pa.st•nt rr automobile, if nett 'Irilip used for 11n'iur•s. ptirpo'es with another tvpc t,utontol'Ar and if not a horny• of?ire, story, .6s- r; relay nr passrnKrr trailer ,1 f Ternrorary Sub9titute Automobile. While art owned antomohife is withdr.tern frtun normal ttsn becatr.r of its breakdown, repair, T �' per%iriniz. in— (ll' Mch in-;xmince a` 1- afforded by thi. endnr%ulilent Iindrr rftvicion I with rt•511;•Ct to itit'h an eth lotltile i appliec with re'slsrt't to allothrr :tworm-;)i1c not so or'rird %*06lr temponiniv used as the slihstitute for surh aittomoi,ife. r - 2. Definition of Intured. With rrerert to they ivo rance ender division ?, the unqualified word ' ensured'• mrans thr person &%ia- S f oared ill the -chedul.• Ill thi, l-ndor-;ettwtit, anti while rr•idcitt� of tite saint• houschnld of anrl: dr<,iunated per,on, iris srtousr ; and thy` rt•latiye. of t niter: twovidt,ii. if =nth dreigtlatt•d pr•rSon shall die, the irte-urance under dit•ision 2 shall cover any persorl 1 who way ali iwitired at the ti-mv of ;t:(Ii death. °. t ! 3, Automobile Defined. (a i NVith resprct to the inurmice under division 1. the defini0olis of -Ailtonwhilr", ..Semitrailer'•, any! ' ri%n or Afore .1uh�mtthifc�" of tile polit'N' a;iply. } (h) With rrrcllr"et Io flit iwl ur arlcr iwdr r dtyi-irttt 2, tht• word "atitomolt lc ' ntt`atis a Innif n;utor vehicle tit trailer not owratrd on r:+if• or cr wh-t trrati•. hell dot-, not mean 0l a fartu type tractor tit, other ri,ttipnient desi►7nd for usr principally off public roads, r%:1't1nr it-bile artu.111%, flitch public roar(-,, or (2) ;t find motor vehicle (it- tiailer while looted for use ac a residence or if (11'rtitlFr� .rt)d 110t .114 a yrliirlt'. .. Deiignarion of Autc mobiles For Purposes of Divi•tlon 1 t t t; (1) An}' ov tied attitomobile. ` 0) ❑ 1A hind autctmohiie ❑ *Ali\ I;crtttt d ow tied pen ate p;t:urngrr autnti'ohi{r. (4) n $Arty ar;toniobilo dp?ignated in tlfi•: endorsement. A I I v attiomphiir within the Awomobile hla�ar•d defined in the fiaragr F.:trlorcrrnrnt, i trii 0 :any 11on 11%%ved autnnv,tt+le• if irr..uranic for the we thrreof is afforded tinder Coveratwc A of the policy. . •y '1'hr prernrlrnr rrdurti,•n re+trnlnrr deferntuled in as.^eta urn liith the rrrrtlia*- rrdnrtirn table +L*s net al 111y in thl't inttler nee. : - .b t SCHEDULE f 17csiranated Pcr=nti Insured fi 111it tit P trdtis#�k�ii $ carh personDWI , �i raw tntrt:ui Nothiru! herein colitaitu•rl ;hall he held to vary alter, waive or exIctid sit\• of flip terms, cmiditions, at,*recmrnts r iitnita- i truns of the' policy ether than as aIx' •e• state'ri. This etulon-ei ent foriwi a (tart of PACIFIC lXl)l ,Nl`lTY COMPANY Policv Number OUPLICATIi l ssttet; to r 1mZW�`� i �m1l lam + m �:u's Woo t t i Endorsement EtTec:ire• { PRESIDENT .� CUuntrrsi4ncd it '•f,�.rN.�s•.l;•:� AUTHORIZED PEPRESENTAr►ve 1tA '• ' S ;)ate of Issue • PRODUCER. t'prtn l 11U+'2a ;(11t ::fi' DO NOr USE THIS SPACE--FOR HOME JFFICE USt ONLY � . •• P.C. .tita __ _ _ 1 ••t.--'• � **.air 1T•Tt CIT♦ Ct A// Ct•.t RRC!/Ir.t HIUY ORO/•i►Rtrt. CA4C•tr. Comm RAT[ <� r ( r ' 4 4 , :`l rst.��'"htshssY'RYs�lr i`. i s a H R 'Y k l 1 i. S , A.P. USE OF OTHER AUTOMOBILES ENDORSEMENT H.P. Broad Form 1 (lndi•riduals, .Etnlilovees or Partners) (To he ut�rt; with I'LAC and LAC Policies) i it it agreed that such insurance as is afforded by the policy For Bodily Injur% Liability, for Property Damage Liability and for Auto- n10)ile 1le(lical t'aynirnts with respect to Itny owned auto►mobile applies With revert to an), other automobile,sahject to the following prtrvision►:: 1. Definition of Insured. Wob resjfeet to the. iitr.uranc for Bodily Injury Liabilit) and for Property Damage Liability the uriquali- y tied wur{i "irtsurcot" includra .' r'. ij; !.t) e:wll individual ttritited helots• and the spotise of s:Ich individual if a resident ( f 'trey sanie household, and { t (tit any other Person or organuatioti legally recpon`ible for if,C i+sr by ctich I-lime t individual or st►Uuse of 1n atio.i obile not Ott nod or hired by zilch $)tier person or organization. Iiourinq Agreement I11, (Definition of ►ncured, flues not apply to this insurance. ,t z ?. Exclurionrt. This endor.;ement does not apply: (at to any crnployee v:ith rr>ptct to itijury to or ;ict:nesa. .Iit ease or f.ieath of another employer of the same employer injtire-4 in thr rourrse of such eniploylnrnt in an acci,ivnt arising out of the maintenance stir .Ise of the antontr►I!ile it) the bnsines'; of such employer, :y thl if the individual allied helm% is all vmjvlo)•er, to the. emidoyer of such individual: iC► if the individual named below il� a partner, to the partnership of which such individual is a member; idt to any aut I11110,ile owlivil by gticl+ named indivirual or :i member of the same household other th.tn :I private chauffeur or a domestic servant of the nanied individital or .spnuse: tr1 hi any automci,ile while turd in a bu-ineGs or rccup.ttion •)f the named individual (it Jmuse, ittilr.s oilerated or -ircul►ied by suk h nartied individual, kpouse, pri%-kte chaut:rtir or doirie•lir servant; ` i f► to any areidetit ari-itig out of the oprrarron of an autornoliile <alvs agency, repair shop. crn•ive c-lati m. st•.irage uarare or pub- lie tiarl:mlt; •i,Ice. t` I (g) with respect to division I of Atimmohile Medical 1'aytnvrrts, unir4+ tile iuiury rrsulte from the operation of aur)i other auto,- I i ninbifc by Bitch naraed lnlhvi'ltial fir 11prtiksr tit on 1►rhalf of rithvr by <uch private c.l1alItTCLit or rintnrstic ;rrvant or fr;itn the s 1 orru1111lcy of said autor,Itthile by such wirned individual or spou-e or while it e automobile i5 uacd as a puhlir or livery con- t•ryance. 3. Other Insurance. This insurance 61:01 he etCess insorativc over :Illy other valid and collectible insurance for Bodily injury Lia- 't` hility, for l►roprrty 1);wwoe liability anti for Autotnr,hile Me-livil PaymentR. j 4. The insurance atforol-rd beCAlibe of nanunk I+erein ary persr,n is only with respect to Mich and -,o many (if the follotcing Cover,- atir.s as are illdicalcd by sperilk. premium charge or charge. for such pt:rson. ; j Premium t ilodily Injury lImperty hatnage Autontohile �.. `Tame of individual Liability Liability Medical 1'ayrttents f ,i is Total Premium VIA,`' s .� s+ ti •;j `'nthin herein contained shall be held to Marv. alter, waive or extend an:, of the terms. conditions, ngreements or limits- � thin• of the policy f,ther than as above stated. This endorsenient forms a Dart of i'ACIFIC 1NDI—MI ITY C01\1I'ANY nUPLfDATS j } 15sued to 9.771MV0 IM -3 °:i10-�"M 4t t"W a I, ST AL 4 Endorsement Effective.ectiv«. A." •t o I�� a r•nEei0ENT. 1 114 C01111tc.rsigned at wd— kv0=-q>lt mammam by AUTHORIZED REPRE5ENtATIVE i t•.. Date of Issue i` PRODUCER. 9 l-orn, 1(1*01zc 2;M 163 �:Qyt DO NpT USE TN15 SPACE—fOq HOME OrrIGE USE ONLY �•�++- ;' � , 1f-.-�--•�J_y.. -.11•r,l _ -\ill(, ' •-... ..�..-..� �L••♦ 1Yr (}AL11t/�(YiJ► -!'1l:•R /YrY ,N<' Fl .1 OyY N.T .. ' rwwn*r�rr•r*w+str �•tm VX LIMmrtsa. 'r 1 l t a ' , ' f � • t t + i 1, 7 i 3 r ' t , .,. .:�.; No. A.P. } l USE OF OTHER AUTOMOB)LES ENDORSEMENT R.P. Limited Form e (1 ndividlills, Employe t-s or Partners) a (To he used with ELAC and I,AC Policies) ti it k attreed that such insurance -is is afforded by the policy for Bodily injury Liability, for Property I)aniage Liability an(! for Auto- mowle medtcal Payments with respect to any owned private passenger automobile applies with respect to any other automobile, sul'- ;ect to the fullowitiv prnvi<ions: + �! J 1. Definition of Insured. With rrspect to the insurance for Bodily Injury Liability and for Property Danla�re• Liability the unquati- tied word "insured" Includes ' (a) each individual named below and the spouse of such individual if a reaident of the sane household, and + t Ir (b) any other person or on -atiOn legally responsible for the ute by Bach Warned individual or spouse of an automobile not ciwned or hired by inch other person or organization. t Insuring Agreement I11, Definition of Insurer}, does not apply to this insurance, ' 2. Exclusions. This endorsement does not apply: ial to any rmplo_Yce with respect to injury to or sickness, di-rase or death of nnother employer. of the same employer injured in the course of such employment in an nrcident arising out of the maintenance or test of the automobile in the business of such employer; ' (bi (f the individual natard helow ix an iniployce, to the employer of such individual; ;i (c), if the individual named bclow is a partner, to the partnership of which such individual k a membcr; i { f td) while t}re awomobile is used as a public or livery conveyance; (r) to any av:nntohile recited by nr furnished for regular use to such Warned individual or a inemher of the saner.household other i than a crivate chauffeur or ,lomeslic servant of the named individual or spouse; j (f) to anj .lutrnrwbile ;tile used in the husine:s or ocr.up:.tion of the named individual or spouse except a private passenger i :Iutomobile operated or- occupied by such named individual, spouse, private chauffeur or domestic servant; s (R) to any accidr.nt arising out (,f the operation of an automobile Riles agency, repair shop, service sIation, storage garage or 1 public poi.-Ling place; (it) with respect to division } of Automobile Medical Payment!, lJnleas the injury result( (ruar the operation of s•rrh other auto_ mobile by such named individual or spouse or on behalf of rither by such private cliaclffeur or domestic servant, tor front : the occupancy' of giiki autonobile by such Ilanled individual or spousr. 3. Other Insurance. This insurance shall be excess insurance twer any other valid and collectible insurance for Bodily Injury Lia- bility. for Property Damage I,;aliility and for Automobile Medical Iiaynuuts. i 4. The insurance afforded because of naming herein any person is only with respect to such and so tn:Iny cif the h liowing clover- p ages as are indicated by specific premium charge or charges far such person j ( t,. Premium Bodily injury Property DamaRc Automobile s ? Name of individual: Liability Liability Medical Paynlenti: i t 'I'olal t'remiurn ' 1 h Nothing hereitt contained shad he held to vary, alter, waive or extend any of the terI11S, conditions, agreements or limita- tions (if the Ix-)licy other than Is above stated. This endorsement forms a lout of PACIFIC INDEMNITY COMPANY t Policy Number • ' 'O ' '0216 UUPL!CATB I Issued to 'MM-A MCH OW&W Clmo Woa; 'i1 ft 4 Endorsement Etiective. ' � ip Pi:ESIDENT. t "AF ,gyp �C ► i Countersigned at by / AUTHORIZED nEPRESENrATIYE. t Date of Issue • PRODUCER. l'eittll 1( (1ldti ?.tf Y11 DO NOT USE THIS SPACE--FOR HOME OFFICE USE ONLY F I.I%t %that rot, CLASS LIN[ 6009G""Culuv GoOff Pat H. CA.C'17 CO.. mitt 1 it! i i t ..1 •. y 3 , ' A Y lS INDIVIDUAL FAMILY AUTOMOBILE ` MATERIAL DAEV`AGE" COVERAGE ENDORSP-MVENT ?_ (To be used only with LAC Pen;'Icy) This endorsement applies only to private passenger automobiles, farm antomobilea, utility autornobiles;, or trailers, each as defined }, herein. 4 SCHEDULE t Narned Insured Individual: +�' atMMILP at t i The insurance afforded applies only with respect to such of the ioliuwinx caveraFes as t;re indicated. The limit of the company's liability against each such coverage slta!l be as stated herein, subject to all the terms of thin endorsement having reference thereto. COVERAGES LIMITS OF LIABILITY Insert eret Coveredovc:ed" or l — � lb1�� P � D (1) Comprehenssive—Excluding Collision — _ _ 0-overt aetetiat or"Actual Carle (2) Personal Effects ly Collision Actual Cash Value less k a 0 s1+0 deductible � The total number of private passenger, farm and utility automobiles and trailers owned oil the effective date of this endorsement by { the named insured individual does not exceed the number of such automobiles described helow, unless otherwise Htated herein: Description of owned automnhile or trailer: y r identification)Number 1'utcha%ed + tarl�I trade Nattte 11txd�o lef Serial Nnmbet nr Mntur Nnrether Mont)).year New or Used i r 1 " AMP%) ;►: ;►% �� V44 ft ?a RAW ►fit i` INSURING AGREEMEI4TS + The company nnrees with the named insured: (lt) to pay general average and salvage charges for which tite insured becontes legally liable, as to the automobile being Coverage D (I)—Comprehensive---Excluding Collision transported. F (2)--Personal Effects Definitions: "named insured" means the individual named above c send also includes his spouse, if a resident of the same (1) To pay for lair; caused other than by collision to the owne`1 household; p .! } i automobile or to a non-owned automobile. For the: purpose h „ of this coverage, breakage of Flass anti loss caused by )unused means missiles, falling objects, fire, theft or larceny. explosion, (a) with respect to an owned automobile, earthquake, windstorm, hail, water. flood, tualictous tnischief (1) the named insured, and or vanclalism, riot or civil commotion, or colliding with a hird J '. '. or animal, sh.01 not he deemed to be loss caused by collision. (2} any person or organization (other that) a person ( or organization employed or otherwise engaged (2) To pay for loss caused by fire or lightning to robes, wearing in the automobile business or as a carrier or other ' alpparcl and other per.-mr;al effects which are the property of bailee for hire) maintaining, using or having i the tiattted insured or a relative, while such effects are in or custody of !;aid automobile with it pertiikEion of upon the owned automobile. the named insured and within the scope of such perntis,ion; Coverage E—Collision: 'f o pay for loss caused by collision to (b) with respect to a non-owned automobile, the named t the owned autornohile or to a non owned autontobilc but only for insured and any relative while using such automobile, the amount of each such loss in excess of the deductible amount i,rovided his actual operation or (ii he is not operat- stated in the schedule as applicable hereto-). The deductible ins) the other actual use thereof is with flee permission _. anlaltnt snail not apply to loss caused by a collision Witt) another or reasonably believed to be with the pennissiun, net x i automobile hisured by the company. the owner and is within the scope of such permission. r Supplementary Payments: In addition to the applicable limit of "relative" means a relative of the named insured who is a liability: resident of the same household; a ' 4 (a) to reimburse the insured for transportation expenses in- to +. ill I curseI during else period commencing' d8 hours after a theft owned automobile means ;1 curse.i by this endursrntent of the entire note»nabilc hag (a) a Irrivate passenger, farm or utility automobile or beer, repported to the Company and rite police, and tertnin• trallcr described ut this endorsement for which the i siting •vlren the automobile is returned to use or the company word "Covered" indicates that coverage is afforded, pny9 for the toss; provided that the company shall not he (h) a private passenger, farm or utility automobile or ; oh gated to pay aggreq lee expenses in excess of $10 per (By trailer ownership of which is acquired by the narned ` or totaling more than 5300. insured during tale endorsement period, provided A � I (OVER) l c 'I'Pei-A endorsement fnrntG a p;trt of tl!c policy to which it is attached, and is etie:ctive from the inception elate of the policy unless an effective elate is shown below. i (Complete following spaces when thin endorsement is not attached at time policy written.) PACiFIC INDI M\i'I'ti ♦aLIGY tetimetcrt ►_rrctrivr niktr: OUPLICATH AUTHONIIED PTsrPn srNTAT1VC 1'tlrm I11il5;c 20M 763 ' QO NOT USF THIS SPACE--FOFT HOME, OFFICE_ USE ONLY 1•trr/" t Nn Yr111r'+ne 1t"�7t C1Tr� CLASS -� TUNT 6.0/1 OPIRMIUM erns$ P•tu. CANC•D. Coww. wimr -! i t a ; " i 3 a I - , • i. `MILY PROTECTION COVERAGE FNDIaf . ,DENY (Automobile Bodily Injury Liability) r1,I'. ► r (California) R.P. (To be used with policies affording automobile Bodily Injury Liability coverage) l: fit consideration of the lrayntrut of the premium for this cndorsentent and subject to all of the teens of this e1.10orsetnrni, the company agrees with the named insurer) as follows: INSURING AGREEMENTS I. Damages for Bodily Injury Caused by Uninsured Automoblics The company will pay all sums which the insured of his legal representative shall he legally entitled io recovvr as damages ; t + front the owner or operator of an uninsured autt►t,tobile because of hodily injury, sickness or disease, including death result- , ink therefrom, hereinafter tailed -bodily injury", -instaired by the insured, caused by accident and arising out of the owner- 4 ship, n►ain:enance or use of such uninsured autornobile; provided, for the purposes of this endorcetnent, determination as to w:.';th(r the insured or such representative is teAatly entitled to recover :such damages, and if sL� the amount thereof, shall be made by agreement betwern the insured or such representative and tile,, company or, if they fail to agTce, by arbitration. No judgment against any person or organuration alleged 'o be legally responsible fir the hodily injury shall tee conclusive, as 1� hetween the insured and the company, of the istnes of liability of such person or vrganizalion or of the amount of damages to which the insured is leg-illy entitled unless such judgnreni is eutereci pursuant to an ic'':.a prosecuted by the insurrd with tilt written consent of the company, ; II. Definitions a (a) "insured" treads: ` (1) tile natued insured as stated in the policy (herein also referred to as the "principal named insured") and any person � designated as named insured in the schedule and, while residents of the same household, flit sputise of any such natued r insured and relatives of either; (2) anv other parson while occupying an insured autornohile; and f (3) any person, with respect to (Ninages he is entitled to recover because of bodily injury to which this endorsement ` applies suitained by an insured under (!) or (2) above. 'rite insurance applies separately with respect i(r each insured. but flit application of tl►e insurance to more than one insured y shall not operate to increase the limits of the company's liability, r (le,) "insured automobile" me:ns all autontohile: (1) described in the schedule as an insured automobile to rhich the !,oilily ir, pry liability coverage of the policy a,�plies; (2) while temporarily used as a substitute for an insured autonurl►ule as described in subparagraph (i) above, when +t•ith- drawn front normal use because of its breakdown, repair, servicing;, loss or destruction; (3) while being operated by a named insured or by his spouse if a resident of the !saner household; t but the terut "itrrt(red autontobile" shall not include: ;{ (i) an autainciirile while used as a public ur livery conveyance: (ii) an a•atoniolAe while being used withont the permission of the owner; (iii) under subparagraphs (21 and (3) above., all automobile owned by the principal narned insured ur by any named insured ri designated in the sclirdule or by any resident of the same household as such insured; or (iv) under subparagraphs (2) and (3) above, art automobile furnished for tine rt9lIlar use of tilt principal named insured or any resident of the same house told. t (c) "uninsured automobile" means: (1) an antomobile with respect to the ownership, maintenance or use of which there is, un at least the amounts specified by the financial responsibility law of the, state in which the insured automobile is principally garaged, no bodily injury ; liability bond or insurance policy applicable at the time of the accident with respect to any person or organ.zation s 3 legally responsible for the use of suet) auto..►obife, or with respect to which there is a bodily injury liability bond or + insurance policy applicable at the tinte of the accident but the company writing the sans denies coverage hereunder; or + (2) a hit-and-run automuhile as defined: tint the term "uninsured automobile" shae: not include: a (i) an insured automobile, i (ii) an automobile which is o%:ned or operated by a gels-insurer within the meaning of any motor vehicle financial respon- sibility law, motor carrier late or any similar law, : (iii) an automobile which is owned by the United States of Anterior. Canada, a state, a political subdivision of arty such government or an agency of any of the foregoing, (iv) a land motor vehicle or trailer if operated on rails or craft ler-treads or while, located for ttsr ac a residEnce or premisrs s and not as a vehicle, or (v) a farm type tractor or equiptne7it designed for use principally oJ#T public roads.except while actually upon public roads. 7 (d) "hit-and-run automobile" means an automobile which causes bodily injury to an insured arising out of physical contact of :; s such autoninhile with the: in+ured or with an automobile which the insurrd is occupying at the firm. of the accidrnt, provided: x (1) there cannot be ascertained the identity of either the operator or owner of such "hit-and-run autormrhile"; (2) the . i ;nsitred or someone on his behalf shall have reported the accident within 24 hours to a police, pence or judicial officer or to r the ( OmrnIS51(►nt'r of ,Motor Vehicles, and :+hall have filed with the company within 30 clays thereafter a state:rlrtt' under oath that the insured or his legal representative has a cause or causes of action arising out of such accident for datttages against a person or persons whose identity is unascertainable,and setting forth the facts in support thereof*, and (3) at the I company's request, the insured or his legal representative makes available for inspection the automohile which the insured ' was occupying at the time of the accident. ` (e) Occupying. "she word 'occupying" means in or upon or entering into or alighting front, (f) state. 'rite word "state" includes the District of Columbia, a territory or posse-;Aon of the United States, and a province of Canada. SCHEDULE Designation of natued insured for purposes of this endorsement (see insuring Agreement I i(a)1 [.units of Liability: •� a1 t # each person; /t�A'acWtt�ri� each accitlrnt. ,i 'Fitz a(lvance premium for this endorspncnt is $ Description of Insured Autontohiles heck appropriate: box '`• Any automobile owned by tile principal named insurrd ' Any private passenger type automobile owned by the principal named insured Cl Any witontobile to which are attached Deale's Autorobile fZegistration Plates issued in the name of the principal named ,y 3 insured C]Any automobile desit-n,tted in the declarations of the policy by the letters "F(r' and an automobile ownership of which is j, acquired during tilt, policy period by the principal :tamed insured as a replacement therefor (over) 1 Nothing 11Cfej11 rantaine(I shall 1)e hel.l to vary, altar, waive or extend any of the terms, conditions, agreenicits or litttita- tiOtts t,f the policy tither than as above t-tatted. This endurscilletit forms a )tart of PACIFIC Itihl:\INIT1- CCYNIPAINY Policy Number ' DUPLICATS Isstte.l to re,"' aa'f>ss• i-julorscnvitit H:fTeCtit'e • ! PRESIDENT. ' Countersigned at Ammus caafaltm by � r /'AUTHORIZED REPPROENTATIVE. ' 1 Date of Issue Form 2A(N1a 7iM 163 PRODUCER. MAP) b9 NOT USE THIS SPACE—FOR HCME OFFICE USE ONLY LW% f nlNn 1TATt LIYT CLAVA ►•.. C!'1•\IRFM CANC'H Co.". •A,'s• 4 I , r ,7 r ♦ 1 ,t! 1 1 , ti i� AU70MOBILE PHYSICAL DAMAGE ENDUKSEMENT Ao- ' (To be used with LAC Policy) It! consideration ni the payinetst of the werniunt and subject to the limit~ of liability, exclusions, contlitioni and other terms of this entforaetnent, cite ►:nnillany agtves to pay for direct and accidental less% of or d:tinage, as defined herein, to autom tiles awned 4 by or rrgistered in the natue of the in-ured, liercitfafter called loss, during the enelor.+ement periocr. The insurance afforded at the inception dale of this endorsement applies to the automobiles listed its a motor vehicle record Ilia ill tained fly the insured, and anly with respect to north and s0 many of the cnverag,cs as are indicated therein and as defined herein. ; s AUTOMATIC IRSURANCE? FOR NEWLY r• CQUIRF0 AUTOMOBILES 5 t The irtsuratf•:r afforded to automtshilrs net+ly acquired by the insured a; u:vncr or reKisterrd in the name of the insured during t cash 12-111oll. 1 term of the policy anal) apl►ly as fttllutvs: w.u� ! COMMERCIAL '1VPF AUTOMOBILES 3 `w... r (' t:uverat;e I) tc. all autamt.hflr.y cn�tittK file insnrr.<t � � �t�� ...._.... .. .. .... .. . ............... .... ....................,....or more Coverage H to all automobiles coming the insured Waf .................._..........................................t r more v (rich los" subject to $ �tl dec!Ixtihle) S t;OVV 19r E to .111 alttorllohilev c.036119 thu insured $ _...................................................._..................or more Coverage G to all atttr,mobifes soloist the insure~ S � ........ ................................or more � Coverage U to :tl[ autonittl,itea ,.ustitig the in:,utr t++�l i .or more k s Coverage 1. to all automobiles costing the aimed ,,r .. .................... ...........................'.. ...._......or afore i:XGE19 1ONS I 'a� a r `! T't21VATI: PASS `NM`R TYPI•: AUTOMOBILES Coverage 1) to all autoutohilr" cnairg the insured ..................c,r more ,. 1; Covrragr 1: to all automobiles t:i,atinjt till! insured S ► or more ' (each loss ,ul►ject to ,^ti deductible) Coverage I- to all autonttshiles costintz the insured ; of more :I coverage (i to all automobiles costiiiv the iusnred or rttare ' Coverage Il to all automobile; costing the instst•e(I : . or more ;i f.o c-tagr. I r,) all oltr.ntlnhtles costing file insni-ell 5 _........... . ... ....... ..................ur more ' < t i k aThe e:orrlpatty•+ lrtttit of liar l' c 11 or 1, on any newly actmired aulomohite sisall not exceed r35 Or file ce,st ho the its curets or1`;� t bILA ttt'cr, and isle catnpassy's total liability uttcfcr I), F, 1 if and 1, on all neMy acquire d :utornohih� Khali not cxt t rd 8 Deposit Premium 1'he• provisional deposit )remount for this enelorsirment is s and is for the period hegitt•tink with tine tn(epttnn f elate of this en'.lorr't•rm•nt mte� enditttt on thr• expiration of the policy or till, next annk-r,;ary date of the poliev. i INSURANCE t:OVI- iZAG14"S DF.VdNI:i) ? ? Coverage D---Comprehensive Loss of or Damage to the Automobile, Except by Colllsion or Upset. l.ocs !o the aute)mohiIt, ' fxct•pt i,,;s cawrel by collision of the autntttoleile with another object or by upset of file automolsile or by colli<ion of the automof?il+• t ith a vehicle to tt-hirh it is attached. rlreakaue of gla<s ants lorS canscd by rnis�iles. falling;object., fire, theft, explodon, earthquake, ` tvintistorm. hail, water, flood. ntalicinn,4 tnischie•f or vandali�tn, riot or civil cotnmotknt ,hall not he deettled Ins caused by collision or tlpeet. f Coverage F.--•Collision or Upset—Full or rieducti:le. trc the sutotnohile• c aure d ify o4lisit+r: of file autnntohile Mils anothrr object nr by upset of the auto fobilr. ht►t oniv for file antotsnt of each such 1nsK in c�crecs of the deductible amount, if any, Matrtl ;n e { the motor vehicle rerord or the paragralsh entitled Automatic ln•urance for Newly AcquitrA Automobiles a+ applirable hereto. Coverage F— Fir: Lightning and Transportation. Ln.s to tile, antnmnlsiie caused !al by iirt• or fitrhttting, (it) by srnohe nr sm11dot. tine to a .4u mm nnusn dd , al and f:ulity opelatiou of ally fixed hc•atin�; ctluipmcnt serving the premises in which file automobile i is lot:alrtl, or tc) by the stranding. sistkuils. Ie,rrntttg, collision or dcrailutrnt of any ct)nvcyancr in or upon tthich tt:r automahilr is ! hcink tran•partrth. v Coverage G—Thrh--Brond Form. t.ua to the` milontohile rntseel by theft, larcrtiv. ruhhery ter pilferage.. Coverage H—Windstorm, Hail, Earthquake or Esrplosion. l.o., to file nutomnt,ile cansrd by wind*torttt, hail, rarthquakt: or ' rKlslosian, excltnling tic+ or rtarn we csu-ircl h} rain. s+noev or aeet. whether or not wind-driven.. r Coverage I•--Combined Additional Coverage. Lo-y to site autnlnohde caused I,y titsdonrttt, hail. rarthtttlakr, rlcpMsinn, Tint or civil commotion, or thr forced Inntlitiv nt fallinc,, of any aircraft or of its pasts cr equipment. flood or rising heater, malicious flik. 1 t•llirf tsr :•andal?stlt, external di,•chargr or leakage of heater except lto�s trsuititig from rain, snot• or Meet wfsctlsrr or tint wind-driven: Isrovided, with resperi to each at►totuohiie ?lS =h:dl he, ch•rluctcd from rarh los< dosed by imdiciot►s in-chirf or vandalism. (OVER) t � r ` This endorsement forms a part (if the policy to whir,Ii it is attachedl, and is ^flcrtive frr,m the 1nceptio It (late r)f the policy ttifless art efI xtive date it; spools helr,tiv. t (Complete folIowint~ spaces when this endorsement is not attached at tithe policy written.) a of PACIFIC IN 1�F..1 i IN I T Y COIN i ANY r rot,rer NUNecR trrreeTlve IIATe i 0U11L.ICOP, ` 0f'/4# ! �~ /.i•` it .. t: hortn li'tiUtg ;t�l. ;fti3 _ AUTreor=roR RRSf.NTATIVC NUT IILIII TM1.4_I)PAGE---FOR NCiNiE Qr_f IcE_Ll E ONLY t,.tNt�t KING �NI',Kt7K�r t.TATT.�.. LI•V� _.............._ ClA!!9�- r~4 t.INC. I �t1RC1S4 rRCktUH ~f•Ro66 f*ACN.CAMC'D.l CD,.e,.e,RA7,^. ' l Ti ;4lMMtttT7S�S�►!�114 - _ t . t s. l� «...,,•,- �— .__.—__. +.....•..rw..-...,... .... ....-... . . ... .., • ,. .. ..• i., -�..�,1.T..1...aLr.... . r ,. ,. . ,.. .. .. ...._......... •. .. .- .. .� .. ..mow r... .r AUTOMOBILE ACCIDENTAL DEATH INDEMNITY. SPECIFIC .A � A.P. DISABILITY LND TOTAL DISABILITY BENEFITS ENDORSEMENT R.P• SCHEDULE The, insurance afforded is only with respect to such of the following covet ages a5 are ird;cated by specific premium charge: or charges, and only with respect to the person or persons designated herein as insured. —Conerager Insured Limitsof Premium Liability Principal Sum Per Insured A. Death Indemnity �. $ t ._ x _ $ $ $.___ 13. (1) Dismemberment and Lass of Sight � � (:1s shown in Table I ' f Anti subject to appli• $ -•;'i?.:t:- _.__.___._�_._.._.___._,.._..__.�_______.._._._....___...._.___._.._..._.. cat►le Principal Sum $ under Coverage.A) ' (2) Fracturei and -_ — -- - -- (as shown in Table - Dislocations It and subject to Benefits applicable Principal $ s c , Sum under Cpve►age ; A) $ Weekly indemnity C.Total Disability— ; _ Unlimited Perin►( $ _ __ $ ` $ 11 Total Disability— ____..___ __�.__._.. -. _ _ --. _____ _ ._ _..__. ____— ____.Y_.._._ $_-- y R r Maximum 2W a eels. _ -Total Premium 4 DECLARATIONS The named insured +hall lle as sta'col in the policy,if an individual or if husband and wife who are residents of the same hauschold; nthrrwise for the purpoer of these Declarations the named in,ared The maned intmed +lyd;Ares, with respect it) each prr:on desigtnated in the schedule x%an insured under the Total Disability Coverage, 1 H th.tt •tech peraut is engaged in a remunerative occupation; (2) t',iat the tutn of the weekly intictnnity afforded by this insurancr and by all prr%onal accident insurance carried by such person is not more thin ttt•o-third. of Iti, average weekly earnings during; the past twelve months. F.xceptmne, if -mv. to (I') or 'Abseare of an entry in this item tnean.s"No Exceptions." ' ti The ':nmpany agree%with the named insured. in ronsideration of Of payment of the premium and in reliance upon the declarations and .nh;rct to the limits of liability. exclusion'. Conditions and other teens at thi. endorsement and of the policy: l INSURING AGREEMENTS 1. Coverage A—Death indemnity .i TO pay the principal runt .tatrd in the�Chrdule in the event of the drath of the insured which •hall result directly and independently i of all other causes from hodily injury cattged by accident and sustained by the insured while in or upon or while entering into or ' alighting from, or through bring +truck by,an automobile, provided the death shall occur (1) within ninety days after the date of the accident, or (2) within fifty-two week, after the date of the accident and (hiring a period of continuous total disability of the 3 insured for which weekly indemnity is pa),ahlr under the 'Total Disability Coverage. (over' 1 Nothing herein contained shall he held to varv, alter, waive or extend any of the term.%, conditions, agreements or limita- lions (it the policy other than as above stated. 11 is endorsement forms a part of PACIFIC INDENINITN' 1 WIPAN�, Policy Number • DUPLICATE r i issued to • I?ndorsement Effective i PRESIDENT. � 9 �" � p � tit, ' � 4��.lid'i�q�t�l��: �•,'" " -rr.�I ,4}. Countersigned atby AUTHORIZED REPRESENTATIVE. ' W ` Date of Issue ' y PRODUCER. Form ..10)0c ,li\I ()ti, A1q72 00 NOT USE THIS SPACE—FOR HOME OFFICE USE ONLY e1Mr lIIgO i •IRD! /TAT[ CITY tLAlt LIME 00001 H1IMIUM alto•• ►mm. CANC-0. cUMM, MATR ,4 fit 1. (i .L"KA"•."..,5!/ .l' "'..:...""tS!`1IL'S2'..^""_.,•"'lkt.L7!'SSJT•,•.."! -Ylf2.. S.!•Mr,f11'!1T :. f 1 ' ,. �,. . . .y.,, ter c• .:i•:.+_ . . �.`�. ... 'iY.,.• wr. FAMILY AUTOMOBILE COVERAGE ENDORSEMENT No. (Individual Named Inatued) A.F. (To tit used only with LAC Policy) R.P. Declarations y Item 1. Automobile medical payments insurance is afforded only if a specific premium charge is shown belor�;, The lit^,it of the =r ' cOmpany's liability against such coverage shall fie as stated herein, subject to all the terms of the policy tefercnce thereto. r �+ Coverage ��~�• •� Limit of Liability s " ` Au►ann►I►ilc Medical Payments each arson� S � ' �' � � _�-- --- Item Z. The total number of private passenger, farm and utility automobiles owned on tivt effective (late of this policy by the named insured (Ines not exceed one, unless otherwise stated herein: 'a , S. i)escription of Owned Automobile: ' f f (t is agreed that: f ...:»;�.".. I. Liability Such insurance as is afforded by the ►()licy under coverage A with respect to bodil injury arising; out of the ownershi{), < e maintenance or use of any autuninbile, and under coverage It applies, subject to the following provisinns and flit applicable ! fi' ►' prnvisiuns of paragraph III: f" Coverages A anti It of Insuring Agreement I are replaced by the following;: } Coverage A--Bodily Injury Liability•---Automobile Coverage B -- Property Damage Liability-- AutomoWe l'o pay on 1101.11f of tine insured all sums which (fie insured shill become legally Obligated to pay as damages l:ecause b of; ti A. hodil) injury, sickne,s or disease, including (death resulting therefrom, hereinafter called "bodily injury," sustained by t any person; . it, injttry to or destruction of property, including; loss of tine thereof, hereinafter called "property damage": arising cent of the ownrrship, tuainteaauce or use of the nw•ned anttmioNic or any tton-owited atttotnobtle, f 'I'hr word "arcident." when used in the policy with respect to snrh coverages, is attrended to read "occurrence." f �. Insuring AVrer.tnent Ill is rc;,lacul Ivy the following: i t Persons Insured. 'ne following arc insureds tinder coverages A and It: v E1 (a) With reapccl to lite rowed autanu>hile, ` (1) lite narnecd insured and any resident of tile same household, (2) any other 1►rrsun using such autontobilt• with the pertnissiost of the nanied insured. provided his actual operation ? or (if lie is not operating;) hie: other ww.tual u,,e thereof is within the Qcohe (if such permission, and (.t) :uty (--titer prison or organisation but only with respect it) his of it, liability because of acts or t►iris+ions of an in- wrest under (a)(I) or (2) above; fb► With rc.pect to a non-owned automobile. (1) the tyvnrd insured, } a (2) any tclativc. hat only with respect to a private p.tssrnger antomn}vilc or frailrr, ; r provi'lcd his attual operation o- (if he is tint operating) the other actual rise" thereof is with tile permission, or reason- l j ably brltrvt,,l to he with the prrtnksinn, of ti.e termer .end is within the stoic of such pertnissiot, atop ' any other pcvwn r►r orpanrzation not ►,\vning rr hiring tile, antonlohite, but only with respect to Iris or it; liability l,t:cause of acts or omissions of an insured under (b)(i► or (2) above. .f 'file following definitionrc apply with re-41pect to insurance under coveraggera A and it: Inzined insured" trteans the individual named in Item t of the policy declarations and, except as itself in the Cancelation fCondition, also include Itis spouse, if a rrsidrnt of the: s;trne household; 1 "insured" ntr:tr►s a person Or otg;•tni7a0011 described under "Persons lncured"; t "rtlati.e" ntr:,ns a relative of file named insured who is a resident of file saute household; € 'owned automobile" niran3 ' (a) a private passenger, farm or utility automobile describer) in this endorsement for which a specific premium charge i indicates dint coverage is afforded, (b) a trailer owned by the name insured, ' fc) a private passenger, farm or utility automobile ownership of which is ac(µtired ill• lite mimed insured dnringz the policy period, provided t ( (1) it rrplarr:r an owned autotno,bile as defined in (a) ail(►ve, or r (') the company inures all private I+;v4srnger. farm and utility automobiles owned by flit- nanncd insured to the 1 3 ,late of stab arquisiticn and flit- ranted insured notifir-, (lie contpan • chtring flit- policy period c,r within ill day..3 After the date of ttcli actlnt,�ition of hie rle('tion to make tlti- antt no other policy inmcd h) the company ap- � plicablc to guclt autunnrrhilc, os' i (d) :t frn►porary substitute antont,}heir; t "temrx)rary substitute automobile" means anv aulonrobile fir trailer. not owned by the nanted insured, while temporarily u.ed with tilt, tt►t,rrrti"iovt of till- owner as a suhstitnic for the ow•nrd attt„rnohile or trailcr when withdrawn front nortnal use because. of its breakdown. repa r, s(•rvir.int;, pas% or destruction; Orris f•nnrd automobrte" uteirt. :tit atttontt,bilt. or trailcr not owned fir ,,r furnished for the rei velar use of either the natned nr,,und ,• :,ay relative, other dealt a trtnpnrary sul►stitille autonu,hile, titt lvvtixnger automobile" mean•; a four wbeel private passcn►ter, station wagon or jrep type automobile; ti "fall Automobile" mean ,et automohilr of the truck typ,• with a Had valracity of fifteen hundred pounds of less not turd kv-im— or rnnuncrcial purpo„cs tour than farrnifir; "(;I'lity antntnobile" otr;ms ;if, ,uttonv,hilr, olher than a farm automobile, ,with a load capacity of fifteen huttdred pounds or flit- ptck•ul, liod •, sellwi delivery or pallet truck type not usetl flit husin:ss or conrtnerri:tt purposes; "trailer" -neatis a trailer ,lrait:verti for tv;r with a priv,►tr passenger auttnntobile, if not bring uactl for httsinrss or commercial i tmrp(,srs with other fhau a private passctiger, f;srrn os ntility automobile, nr a fart;- wagon or frrnt implement while used t with ;t farm atttotttohile; } ( "automobile business" ntt,ans lite business of Occupation (,f yelling;, repairing. servicing, storing, (,t parking? auttltnobiles; � "use" of an ant,►nrt,hile includes the loading; and onloatfingr thereof; r "war" mans war, whellirr or no; drelared. civil war. insurrection, rchellion or revolution, or any act on condition incident it)anv of the foreg;oing;. t •1. The csclusi;►ns of the pnlicy, exrrpl excincion (I,*), are rrplared by the following: "l d'lic pulivy dory not splay, tinder coverage-, A and It: 1 (a) to any aotuntnbilc while used as a public or livery conveyance.. }rut this exclusion does not apply to the panted insured with re,;pec.t to ho,fily injury or property daniag;e which reculta front the named itvct:rctl's Occupancy of a non owned ' # autorrrnhile tither ilctn as Ow operator thereof; (h) to bodily injury or properh danuvl e raused int:ntionally by or at tilt, direction of tise insured; (c) to hottily injury it I►ropertt• datilave with te�pect to Nvhirh an insured mider the IvAicy is ate(, all inmteil under a nuclear rn(•rg;y liability )offer isslied by MwIcar Energy Liabilitv In mrative Assocvattnn, .\luttial :Atomic Energy Liability ' Underwritcrs or Nuclear (n,uranre 1s,ociatioty of Canada. or would lie an insured under my ouch policy 1►tvl for its tc:trriaationt upol► c.\llaustiun of its limit of liability; till to hntlily injury or property dan►agr arising; Out of flit- ol,rration of farm machinery; t j `; (over) 'Phis en(lorsetnent forms a hart of the polio to which it is ;attached, and is effective from the inception date of the policy ttillcss an effective date is shown below, (Complete following spaces when this endorsement is not attached at titne policy written.) of PACIFIC 1NDI'-Ml 1'l' COMPANY �►_ rower v+u►(nrn crrvrcrrve oxTe �.,- -• - - ., It is agreed `hat: I, Liability I Such iiisuranc:e as is a'forded by the policyy under coverage A with respect. it) bodily itijury arising out of the ownership, maintenance or us; of any automobile, and under cuver;tRe If. applies, subject to the following Provislons and tile. applicable provisions of paragrzpli 111: 1. Coverages A and if e( Instiring; Agreement l are replaced by the following: Coverage: A--- Bodily Inj` ry Liability-- Automobile Coverage B Property Dan►age Lia►b;liry--Automobile To Pay on behalf of the insured all stints which the inst,retl shall Itecome le+;:illy Obligated to ;.ay as damages because r of: A. f,ridily injury, sickness or disease., inclttcling; death resulting! therefrom, hereinafter called "hodify it jitry." sustained by all` person; It, injury to 1)r destruction of property, inr.luditig; toss of use thereof, hereinalte, railed "property damage"; arising out of the ownership, maintenance err use of the owned :ultolilol►ile or any nou•ownta autrnnobile. The word "accident." When Ilscd in thr pnlcy with respect to snot coverages. is atnended to read "occurrence." 2. frsuring; Ag;recrttent III is replaced by the following: Persons Insure(L The followuig are insured, under coverages A and B. : (a) Will rr�pcct to the owned atitortinhile, t N.. (I) li►e named insured and any resident of the ±;attic, hoas-ehoill, (2) any %,thee p-rson 11"ing; such attlotnohile with Cite pernrissi:+n of tile. nareped insured, provided his actttail operation or (if lie is not opc+alin{;) his other acitial list therrof is within the :2cope of such permission, and (3) any other persou or organization but, only with respect t,l hip or its liability hecmise of acts or ornissinnc of an in- Allred under (a)(1) or (2) above.: (h) With respect to a non-owned atitcamohile, 7 � (11 the named insured, , (2) ,illy relative, hilt only with respect to a private pa". ginger automobilr or trailer, provided his actual operation nr (if he is not operating) the tether actual use thereof is with Ihr permission, or reason- ably helielmd to lie with the. permiss on, of the owner and is within the scut2 of such permission, and i (3) Illy other per+imi or organizatioii not nwning; or hiring, the automobile, but only with respect to his or its liahility because of wets ur ontisston-, of rut insured under (b)(1) t►r (2) above. F `' 3, l'he following defutitions apply with respect to insurance under coverage% A and li: �i "Itamed insured" trim s the individual ;tamed ire Item i of the policy declarations and, except as used in the Cancelation + Condition, also includes his spo,ise if .1 resident of tilt trarite household. 's I "Insured" nttrtns a perf oli or org alli7a,tlon described ittider "Persons liv;ured"; T ti "relative" ":cans a relative of the named ill!;ilred who is a reeidcnt of the same household; .► "owived automobile" ineaus a (a) a private paswngter, farm or utility automobile described in this endorsement for which a specific premium charge indicates that coverage is afforded, (b) a trailer olvned by the natne insured, (c) 1 plicate {tasscnger, farm rir utility automobile (wticr%hip of ahtcii is arquired h) the nanied insured daring; the policy {a•r•�,ul, prnvidcd f I) it rrplares to mvtird ruttrimobile as defined in (,I) ahoy, or (2) ihr companv in-urrs MI private p:t;-icnc;cr, farm mill utility :ultonlohiles owned by the milled insured nil file tlIte of -141 ac( uisition anal the nante-I in%tirr,l Iu,titir% ti►r rrt:upany durh►I; the pofic% ;,rrity) t,r within ,if) days # titer tilt- d,ur if ;nett arr;nicuimn cif his cicctiral (m ntakr tltiA aml nr/ r►thrr policy issued by tilt- company ap plic ldr to such :lulutrrnhile, or td) :1 temporary %nil:tilule autltmtthilc: } „temporary substitute atito"tobile" Thralls ally autotnohile .►r trailer, not myncd by the nanied iwoir•rd, while t^triporarily u i� •r,l elite, the x•nlli�;,un Of the r,ct•r+er .1% a sue+�tilule for the oltnt•d anlmnu,hile err trailer whcn with+l•,ntc,; from normal use I hrralirr rt( ill �+rral:,lmclt, re.{lair, srrviciut;. lo%s ter t)c;trurlion; "non-owned automobile" mraw; :tit aimlot lbile mr trailer u,►t awned Iry t,r furni,,hed for Ilse rcKttlar usr of ei!her the named iiimred or :illy relative. rtlhet 111.111 ,1 trmuporary snbstilirte autmilol,ile; " "private passenger automobile' mc.tnti a four wheel private {risicng cr, st,ttiun ttapon fir jeep type autnnuil/iic; "farm automobile" mean•. an atitonmhilr of tilt- truck type %%ith a h,ad capacity of fifteru imndrr•d pound, nr IcAc not itself ' i imt hueinc�� ter rontnterc►at purjvo,%- other th,-isl fanning;; "utility nutotuohile" mean~ .w antorur,hilr, railer than a farm autonu+hilr, with a load raparity of fifiren hundred pounds or , (ecti of the pick-tit) hoot)•, sedan tle•litcry nr• pane) tntrk type out :►.e•d (or Imsincs, or c•nintnercial purpt�se;: ► K t "trailer" tticaus a trailer rdr%iglned for wr with :I pri;ale 11;w rag f,f mitorimbile, if not hritig usc-d for husiness or commercial '� purpo-cs with oilrr-r than ,I pruyatc pa-wilgter, farm or utility mitnmuhilr, or a farnt wagon tit faun impluitient while used t1 �t tth a faint mitolivilitle; "atttontohile husinesr;" means the hu�irst ss or 1►cclipation of yelling, repairing;, servicing;, stnringr tit- parking; autot►iohiles; •. "Ilse' of all Alttollwhile iurludec. tilt- placing; amd milmarfinu therruf. i "war" mraw %tear, whether for iml declared, civil tear, insurrection. rrhellion mr revolution, or any act or condition incident Io -lily of tile. forepoing. i 1. The excfucioils of the policy, except ruchoinu Ox), are replaced by the fnllatving: t ? •Chi polity does not apply, under covtrag et-, A and li: I fa) to and• automobile while used as :I public rtr livery convey.mcc, but tills rKrlt.iinn dot's not apply to thr named insured with respect to bodily injury or property damage which result; from the muted insured'; orrupancy of a non•owned � autonu,hilt meter that+ as the riperat,cr ;hereof, Ih) it, hotline injury or prnprrty d-unage can-wd intentionaliv by or at the dircrtion of the insured; }�ti (c) to hoilily inittry or ilroperty ,larllage with rrs;►fct to which till iucitrr.d under the I,oliry is also an insured +ulilc.r a nuclear I cnerizit liahility paltry i•-ard by V11cle•ar 1::ncrgty f_iahility incuraure Aecociation. 1luhtal Atomic f:nergy Liability t ('nlettvriters err tilde:tr iu,itt- nrr -Ii-me ation of Canada. t,r ±t,►ui,l he. an in,;ureil under ant• •tich policy Intl for its +� lerminarinn upon rflhaustion of its limit of liahility; 01 te. ho,hly itiltlry r,r propetll• dattinize arkii►p oral of lite n{rrrati m if farm rnarhinerv; (over) '}'his endorsement forms a hart of the billies to which it is attached, and is effective from the inception date of the Ilt)lic�• unless in effective date is shcnt•n below. (Complete following spaces when this endorsement is not attached at time policy written.) of PACIFIC iNi71�,NWrrY COMPANY q POLICY NUMBER [FFrCTIV[DATE t iNflrR[D QUPLICATe f� Form 111Oli1 40M 963 AUTNORIZ R trot C1[IITATtVK 00 NOT U4CTHIS SPACE—FOR ROME OFFICE URC ONLY rLINE K►NO PRKDE �4 STATE CiTYM '~ CLASS LitIF GROSSPR[MIUM GRaSSFREM,CANC•D. COMM.RATE a 1� 1 .� .. �. l"R77T"R[7C'r�M'xYlt'Mr"t•.h't?7lR.�tp.1•r�ts�'lRllmaTCi�:s!^lJL't.'l!'lYrf"etY.:'!.!^•'tf'Smt9'+:11CYYt7^l^_'9x1Y�S�J¢S.d.��' ,.,;-Sty' .,"'tC:3l�'*"""^""'t•.wa»�r.G".rS C�..s..'"rtiS.'`..1.^'-. 1.,""""'"a'2:'_'YLtSS1'TII�V.2'St'£P.11^�t'C".!':r�+ItA• 1 , f to- .. ,•...T.•�,a.•ai•�..� r•r e,..n......w•,.._: .. r.. .... .. a .. .. t .,. Y w1 , 1 t �, 1 (e) to bodily injury to auy fellow employee of the insured injured in the course of his employment if such injury arises out of the use of ;in aulom„bile in the business of his employer. but this exclusion does not apply to the named in- sured with res;,cet to injury sustainer) by any such fcllo%v ettlployee; if) to an owned atitoinobile %vliilc used by any person while such person is employed or otherwise engaged in the auto- ► mobile business, but this exclusion tlr►rs not apply to tilt: nanled insured; a resident of the same hwaseheld as th. named insurer), a partnership in which the named insured or such resident is a partner, or any partner, agent or ein- p.loyev of the named insured, such resident or partnership; t (K) it) a non-owne(l automobile while maintained or used by any person while such person is employed or otherwise en. gaged in ' f 1) the autornobilc husiness of the insured or of any other person or org-srization, (2) any other business or occupation of the insurer!, lint this exclusion fg)(2) does not apply to a private passeu er automobile operated or occupied by the named insured or by his private chauffeur or domestic servant or a trailer > used therewith or with an iowncd autontobile; i (It) to injury to or de<truction of (1) property owned or transported by file i:+sured or (2) property rented to or in charge of the insured other- than a residence or private garage; f x (i) to the ownership, maintenance, operation, use, loading or unloading of an automobile ownership of which is acquired fly tilt., named insured Boringg, the policy period or any tem}xirary substitute automobile therefor, if file named insured t has p•archa%ed other automobile liability insurance applicable to such automobile for which a specific premium charge has been made; t to bodily injury clue to tear, with respect to expenses tender Insuring Agreement 11(b)(3), 5 r (j) Y Y 1 P i II. Automobile Medim; Payments t Subject to the following provi.siom, to the ix)licy insuring agreement "Policy 11erioo, Territory" and to the provisions of i paragraph I It, the company will pair all reasonable expenses incurred within one vear from the (fate of accident for necessary a , medical, surgical. X-ray and dental services, includiuq prosthetic devices, and necessary anchnlance, hospital, professional nurs- intr anti funeral services: .•Z'.'-"'�t- Division 1. To or for the named insured acid each relative who sustains bodily injury, sickness or disease, including death t resulting tbevefrom, hereinafter called "bodily injury", caused by accident, i (a) while occupying the t,tvned atitotnobile, ib) While occupying; a null-mviled autc,nmbilr, but only if such person has, or rea+otlabfy believes he hail, the permission ) , of the owner to use the autornobilc and the use is within the. srupc of such permission, or d (c) through tieing struck by an autonnoNle or by a trailer of any type; ) Division 2. To or for any other person ,who sustains bodily ii,jury, caused by accident, while occupying; i (a) the owned automobile. while tieing; used by the narned inured, by any resirleat of the same household or by any other person with the permission of llte nanird insured; or i + (b) a non•owncd automobile, if the bodily injury results from (1) its operation or occupancy by the named insured or its operation un his behalf by his private chauffeur or domestic r servant, or 3 f2) its operation or occupancy by a relative, provided it is a private: passenger autocnobile or trailer, but only if such operator or occupant has, or teasonably brlirves he has, the permission of the owner to use the uuttr aj mobile and the use is within the scope of such permission. 1. Definitions. The definitions in paragraph 13 apply to this insurance, and under this paragraph 11: ` "occupying" means ill eir upon or entering into or alighting from. 2. Exclusions. The insurance under this paragraph I dons not apply to bodily injury: (a) sustained while occupying (I) an owned alttonlobRe. NvIlile used as a plittlic or livery c(inleyarice, oc (2) any vehicl . +' while (or,atzd for use as a residence or pretniscs; ' (h) gw;lained by the mimed instited or a relative while occupying or through being struck by (i) a farm type tractor or other equipment designed for use principally off public roads, while not upon public roads, or (ii) a vehicle operated nil rails fir crawler-treads; (c) sustained by auy person other than the named itivared or a relative, i (1) whir such person is occupying a non-owned aut,nnobile while ugeil as a public or livery conveyance, or (2) recclltiixg from the maintenance or itse of a non-owned autotttobile by Such person while employed or otherwise engaRrd in the attomobile business, or (3) residling from the n,aintri ;lace or use of a nott-owned automohile by such prr%on while: employed or otherwise eng;ag;ed in any either busiregq fir occu{„►tirnl, unless the bndil,y injury results from the operation or occupancy of s a private passenger autommbile by lite named insured fir by his private chauffeur or domestic servant, or of a trailer s used therewith or with an owned antnrrtobife: (it) sustained by -iny person who is employed in the auttltr.-,ltilr. husinccr, if the accident arises out of the operation thereof and if hencfits thrrefor are in whole or in part either payable or required to be provided under any workmen's corn- E {,Cris;itlnit tall'; ' (c) dtic to war. j 3. Limit of Liability. The lintit cif tia'iifity for autocnobile medical pavin.i-a% Mated in the family autontobile declarations as ' r applicable to "each person" is the limit of the company's liability for al, expen%rs incurred by or on behalf of each person who sustains bodily injury as the result of any one accident. A. Other insurance. If there is other automobile medical payments insurance against a kiss cowered by this paragraph If the c%lnlpany shall not hr liable under this paragraph If for a F;rcater proportion of stir)) loss than the applicable limit of pia hilitr -;tatefl in tits family autocnobile (feel aratirnt, bears to the total applicable limit of liability of all valid and eollertible d autnninli,lr. Itledical payttienta insurance; provided, however. the insurance with respect to a trrnpnrary sithstitltte autonlo- hile or non-owned autc►mn!,ife %hall lie excess insurance over any other valid and collectd)le automohile medical payments , i Itisitralire. ' I1I. Conditions r Policy Comfitions 10, It. 17. 19 and 20 apply with respect to the insurance under covtraces A and it and the automohile uiedic;d payments rowcrag;c. Purley Coll ill tiaus 1, 5, R. 9, 12, 13, 11 (arncne(rd by substituting "a temporary suhstitute autonire- + bier" for file wards "anv hires{ atii(imobile insured on a cost of hire basic;") and 15 apply only with respect to the insurance `, t undri coverage; A and It. All ether Conditions are replaces) by the following;: i 1. Premium If the named itisured disposes (if, acquires ntwnership of or replaces a private passenger, farm or utility antomo• f I bile any prerniwn adjustinent necessary shall he in.1de as of date of such change in accordance with lite manuals } in use by the Company, The tianted insured shall, upon request, furnish reasonable proof of the number of stick automobitrs and a degctiption thereof. s 2. Two or More Automobiles When two or more atitnmnhiles are insured hereunder, the terms of the policy shall apply separately to each, hilt an antoninhile and a trailer attached thereto shall be held to he one { automohile as respects limits of liability under coveraF;t:a A and It. ' 3, Action Against Company INC) action %flat, !ie aglitto the company unless, as a condition precedent thereto, there l Autolm?hile• Medical Ulavrnents shall have been fill) coirpliance with Al�the terms of the policy. - ( ; 4. Medical Reports. .Proof and Payment of Claim as Bonn air practicable the injured person or someone on his behalf sisal) \utoniobile Medical Payments give to ibr company twritrru proof of claim, under oath if requircd. and shal;, af`rr c ach request front the chulpany, execute authorization to cn- t able the. Cott) ,any to obtain medical rr orts and copies of records, The injured per(in shall submit to physical examination by phi•:icians .Accted by the company w�le.n and as often as the company may reagtinabl•v require. The company may pay the injured person or any person or org atliratum renderinsl the services and such payment shall 1 redlice kite alnolml pay able here under ft%t such injury. Payment herrunder shall tint constitute an admission of liability of any i pergoo or, excr{,t hereunder, of the company. 1 3. Assignment Assignment of interest under the policy shall not hind the company until its consent is endorsed hereon; if, however. the insured named in itc^1 L of the policy declarations or his spouse if a resident of the same j hongrhold, shall die, the pokey chill Cower (Ise the survivor as named insured, (2) his legal rtpresentative as named insured A, t tint only %while acting within'the- scope of his ehities as such, (3) any person having% prssp er temporary custody of an awned i aotonloj,ile, as tit itmirecl, until the, al,poininietit and qualification of such legal representative, Plitt (•i) under division 1 of : ,ults,mobil; medical payrnrnts an}• prrgrm who %was a relative at the time of such death. 6. Caneelation by Company Limited Afcer fh4 policy has been in effect for sixty days or, if the policy i4 a renewal, effective Coverag;rs A and it irnrncdiat,ily, the Cn,npany shalt not rxcrcise its right to cancel the inqurinrc afforded with resr !ct to automobiles rla4sified as private passenger autninol,ilcs tinder cover- ag es r\ and It unless- + i the named insured fails if' dkeharg;r when (lue_ art)- of hi:% obligations in eunnro•tion with the payment of prcttlium for this policy fir any in-tallinent thereof whether payable directly or under any premium finance plan: rir 2. the insurance was obtained throtig;h fraudulent tnisrcpresen tat ioia; or .1. the insured violates ativ of the terms and conditions of the policy; or t ti!e mined insured or any other operates, either resident in the same household, nr who customarily operates an auto- Mobile inured under tile. policy, I M==='" (a) has had his driver's licrnse �+isp:rnded of revoked during; the policy perind, or (b) is Cir hcronies subject to rpilctt,q} or heart attacks, and such individual cannot produce a certificate from a phy- sician testifying+ to his unqualifird ability to operate a mot(ir vehicle, Or (c) is or has been convicted of tie forfeits hail, during; the 36 tuontlis it itnciliatcly preceding; the effective date of file policy or dnri-ig tits policy period, for: S (1) airy fel,,uy, or .. e.. » (2) critziinaf nrglig;ence rc<uttin4 in dvAli, homicide: or aqs;otlt, arising t.ut of the s+g,r.ratlnrl of a rnnlor vr.hie)c, or .,, ..,....... _._._ r° (3) operating; a riliih"r vehicle while in all intoxicate,! (rintlitimi or ,while under ths• iotlnte,re e4 drugs, or .a (j) to bodily inj•iry title to tear, with respect to expenses under Insming Akreement 1I(b)(3). Ii. Aut"icibile Medical Payments S►tb;+act :o the falla%wint,► provisions. to the policy insuring agreement "Policy Period, Territory" and to the lrovisions of paragraph ill, the cornpany will pay all reasonable, expenses incurred within one year front the date of accident or necessary medical, surgical, X-ray and dental services, including prosthetic device.S, ana necessary ambulance, hospital, professional nurs- ►rig and funeral iervices: Division 1. To or far the named insured and each relative who sustains bodily injury, sickness or disease, including death ' resulting therefroin, hereinafter called "bodily injury", caused by accident, "+ (a) +0hilr occupying the ironed automobile, I er) while occupying a non-owned automobile, but only if such person has, or reasonably believes fie has, the permission i of the owner to use the automobile and the use is within the scope of such permission, or (c) Ifiroti,gh beinit struck by an automobile or by a trailer of any type; , ' Division 2. To c►r for any other person who sustains bodily injury, caused by accidma, why!: occupying ` (a) the owned automobile, while being used try the named insured, by any resident of the same household or by any other person with the permission of the narued insured; or (b) a non-owned automobile, if Cite bodily injury results from (1) its operation or occupancy by the named insured or its operation on his behalf by his private r.hauffeur or domestic ? servant, or (G) its operation or occupancy by a relative, provided it is a private passenger automobile or trailer, but only if such operator or occupant has, or reasonably believes he has, the permission of the owner to use the auto- tuohile and the use is within the scope of such permission. 1. Definitions, Tilt definitions in parig aph 13 apply to this insurance,and uncle: this paragraph I!: "occupying" means in or tilmn or entering into or alighting from, 2. Exclusions. 'The insurance. under .his paragraph 11 does not apply to bodily injury: (a) ststained while Occupying (1) an owned automobile while used as a public or livery conveyance, or (2) any vehicle ► while located for use as a residence or premises; (b) sustained by the narned in-tured or a relative while occup)•ir,F••� or thro-,igh being struck by (i) a farm type tractor or p other crimpitient designed for use principally off public roads, while not upon public roads, or Oil a vehicle operated h on rails or crawler-treads; (c) sustained by any person other than the named insured or a relative, (1) while such person is occupyilg a non-owned au tnrnnbile while used as a public ar livery conveyance, or (2) resultin from live maititetianr.e or use of a note-owned automohile by such person while employed or otherwise '. enKagerrin the automobile busities4, or ` .� (3) resultin' front the maintenance or use of a nc- o wiled automobile by slide person while employed or otherwise engage(Fin any other business or occupation. unless the bodily injury results from tile operation or occupancy of a a private passerger automobile by the named insured or by his private chauffeur or domestic servant, or of a trailer used therewith or with an owned automobile; ' (d) sustained by any person who i4 cmployed in the autonrohil:• business, if tl:c accident arises out of the operation thereof y e` and if hesieftts therefor are in who a or in part either parable or required to he provided under any workmen's corn- ;. ( pensation taw; ; (e) due to war. ,T ,.1 3. Limit of Liability. The limit of liability for automobile medical payrnents stated in the family automobile declarations as applicable to "each person" 19 the {unit of the company's liablbty for all Cxherl9Cs incurred by or on behalf of each person ; 3 who silstaitis bodily itijury ai the result of ,1ny one accident. , 4, Other Insurance. if there is other automobile niediral payments insurance against a loss cowered by this paragraph 11 tit_ 1 l oompany shall not be liableunder this paragraph 11 for a greater proportion of such loss than the applicable limit of lia- bility :tafcd in the, family anlottl chile declarationv hears to Cite total applicable litnit of liability of all valid and collectible j amtn11141bile medical payments insurance.; provided, however, fire itlstirance with respect to a temporary substitute attt0tTl0- bile_ or num•tl%wnrd automobile shall he excess insurance over any other valid and collectible automobile medical payments in:;n canoe. ;, iII• Conditions Policy Conditions If), 11, 17, 19 and 40 apply with respect to the insurance tinder coverages A and It and the automobile nlertlical payntents coverage. Policy 1L.timhtions 4, 5, H. 9, 12, 13, 14 (amentled by stilts ti tit ting "a temporary substitute automn- bile" for the words "any hired Automobile insured on a cost of hire hasis") and 15 apple' only with respect to lite insurance under coverage. 1 and It. All other Cnntliti+m5 are replaced fly file iollowinq: a 1. Premium If [lie named insured dispoies of, acquires owner;itip of or replaces a private. passenger, (.arm or utility autoinu• bile any premium adjustment necessary shall for made ar of date of stick change in accordance with the manuals in tisr by the company. The named insured shall, upon request, furnish reasonable proof of the number of such automobiles and a description thereof. ? } 2• Two or More Automobiles When two or more automobiles are insured hereunder, the terms of the }}mlicy shall apply t separately to each, but an autonlubtle and a trailer attached tliereto shall !►e held to be one. t Eamtontobile as respertti limits of liability under coverages A and It. 3. Action Againqt Company No action shall air against the company unless, aK a condition prcccdcnt thereto, there Y Automobile \iedical Payments shall halve beer full compliance with all Khe terns of tile, policy. 4. Medical Reports, Proof and Payment of Claim As snnn a.r practicable the injured person or someone on Ili. behalf shall Automobile 1ier)tcal haylTt+`TitS give to the company written prcluf of claim, under oath if required, and shall, after each request from tilt, company, execute authorization to en- i a!ile the enni ►amv to obtain medical reports anti copies of records. The injured petsor, shall submit to physical examination fly plivsicians •curled Fty the company when and ac often as the company may reasnmal►ty requite. A ` 'rite company inati• pay the injured person or any prrvon nr organizati( m rendering tilt. scTvices and such payment shall reduce the atimunt payable hcremider for such injury. Payincnt hrretooh!r shall not constitt+re an adinission of liability of any prrcnn or, rtcrpt lereunder, of the company. ; t S, Assignment Assignment of interest untter the policy shall not hind the company until its consent is endorsed hereon; if, however, the_ insured named in Item 1, of the policy declarations or Ilia spwt+ a if a resident of the same household, Shall die, cite policy s{ia11 cover (1) the Furvivor as name,) insured, (2) his legal representative as named insured { but only awhile acting vvithit-, the scope of hie duties as such, (3) any person Ir:►ving proper temporary custody of an owned{ autrnn0fiile, as an insured, tiatil the appointment and qualification of such legal •epresetititive, and (4) under division 1 of 1 1 aniontnhile. medical pavinenta anv person who %w.a a relative at the tittle of such death, t j 6. Cancelation by Company Limited A(ter this policy hat aeon in effect for sixty days or, if the policy is a renewal, effective 1 i Coverages A and Id irnniediately, the coo, ;.All) shall not exercise its right to cancel the insitrancr afforded a 1 with respect to xtrhtntobilts classified as private passenger automobiles under cover- ages 1% anti It unless. y i the militetl unified fall. to discharge twhrn tine any of Iris obligations in connection with the paynent of premium for 4 this $wliry or any installment tic-rCoi whrthr•r p:iyahly dirretly or untter wy prrrnititn finance plan; or ', the insutwice %%a, obtained throimb fraiidultiit misrepresentation: or i .1 the irlsnred violates any of the terms and conditions of the policy; or +' 1 the n:+nird insured of any other ol%ermo+r, ritliet resident in the -atiw household, or wain CIIMOTttarily operates an auto- Intthilc it►fured nndrr hr policy, ti } (a) iris had hie drt%er's ticetise zusprtideil or revoked dtiritig the policy perind, or tj # (h) is tyn ccroinrc --ubiert tit cpilrpsy or heart attacks, and sitcl! ;wlividual cannot pi-mlure a certificate from a phi- i sivi:►Tl tr�-,tifying to hie imiqu:ditir•i ability to operale a mil! chiclr, or i (;) is or has been convicted of or forfeits flail, durinf, the 36 months immediately preceding the effective elate of the ► ' lnilicy or dnriug the policy period, for: I i i) any felotl•y, or `. ? (?) criminal nrglicencr. re<rtltiniz in death, homicide or assault. -arising snit of the operation cif a motor vehicle, or i j iJ) operating* a motor vehicle while iu an intoxicate'! condition or while under cite: infdurnee of drugs, or ,• (4) icawin►t file scent: of an accident without Molipitig to reliort, or (5) theft of a motor vehicle, or (fi) ill:thing false 4tatenirnts in an application for a driver's license, or } t7) a third violation. conuttitted within :a period ni i,S rnoutlis, cif (i) any •►rdit!it -e or regulation limiting file .sperd of inclor vehicles or fill ;idle of the provisions ill ttie mottle vehich laws of :lily statr, the violation of %which cans:iti}tes a nticdrnirannr, t t:-thee or not the %iolations %were repetitions of the :flame offense: or were different offenic. ;± , t i+ 7. Family Automobile Declarations 'I'!ac declarations of this cndnrscmrnl and 11rnts 1, 2 and J of the. policy declarations apply to the insurance under rnvcrar,es A and iI and automobile *:iedical payments Form 1110R.1 -10\1 V6.1 ....., ..,, .�......_ _..._.. s,+�•,x.s.�.,.«.rnr.c,.oar.a��s��,:a-..sa.s=rs�:o� :wnc.:.•nc�.-:�•r�x�sr,'xrrs'az�'�ra�esr+was+sc�rssttin:zrztr�mn�wr►res++t. +•' rt,w�^_'2s^^.ctr■.--�—+^'!,S!'�,i' 1n+r+ea�•n.q..wr-•sw! ....._. .,�- i 3 t .. 1 , ♦ .._ ...e..................... «.._..... ..,rn» .... m.._n YN.+Y 1. ri( r 1. . �1, • ' • No. t. COMPRE i`r.NSIVE PERSONAL LIABILITY A13ORSEVENT A.F. , R.P. DI£CLARATIONS t Item 1. Named Insure��d,,��et, "AT � a . si t '►ts , Address "` v mans O' MAo VAiWV0&4U (No. street Citi, a one County stale) The principal residence premises are located at the above address, unless stated herein: Item 2. (a) The principal resident. premises designated above are the only premises where the named insured or spouse maintains a residence, other than business property and farms; (b) No business pursuits are conducted at the premises; (c) There are at the premises no swimming or wading pools capable of being filled to a depth of more than thirty inches at any point. , Ex--eptions, if any, to (a), (b) or (c): Item 3. The number of full tittle residence employees, wherever kxated,of the named insured or spouse and of all other insureds who + are residents of the named insureds,household, is not more than two, unless othcrwise stated berein: r Item i, The insurance afforded is only with respect to such of the following coveragc6 as are indicated by,specific premium charge or charges. Tile limit of the company's liability against each such coverage shall be as stated herein, subject to all the terms `�- of this endorsement having reference thereto. COVERAGES LIMITS OF LIABILITY� PREMIUM Comm. i ,_�;,:;sx.:.,r±• •1. Personal Liability _.._..._._..._.....__._.._..._._.._....,.. ._. :.., .._� r__._...._..___.. _.._...�_. �_.._.. i1 . #ea_ch occurrence 2. Personal Medical Payments r6 W*ach person 23,0M. each accident _ 3. Physical Damage to Property S^ �250. each occurrence Addidong Charges -Coverages 1 and 2 Rate Wading or Swlmmirts• Pools Outboard Motors HP Owner(if not named Inured) Rate a Motor A $ y Motor B Motor C � :Per }'o--fl"ci6ed st,vre. ! { "e'er Moms or C wnbsnatiust, Total Premlutl Tile company agrees with the insured, named in the declarations of this endorsement, hereinafter called "named insured", in con- l ;i sideration of the payment of the premium and in reliance upon the statements in such declarations and subject to all of the teirns { ? of this endorsement: INSURING AGREEMENTS I. Coverage t--Personal Liability To pay on behalf of the insured all sums which the in- The insurance afforded under coverage I applies sepa- sured shall. become legally obligated to pay as datuages rarely to each insured ahai,vit whoat claim is made or snit e t because of bodily injury or property damage. ani the coin- is brought but the inclusion herein of more thass one insurra piny shall defend any suit against the insured alleging such shall not operate to increase the limit of the company's buddy injury or property damage and seeking damages liability• which are payable under thr, terms of this endorstmcn)' IV. Defvtitiona ` even if any of the altegatictts of the suit are groundless, false or fraudulent; but the company may make such in- Wherever used in this endorsement: vestigation and settlement of any claim or suit as it deems "bodily injury" means bodily injury, sickness or dis- ti expedient. rase, including death tesulting therefrom, sustained by ¢ d any person; "property damage" means injury to or destruction of ` Coverage 2--Personal Medical Payments property, including loss of uie thereof; To pay all reasonable expenses incurred within nit year "premises a means, unless otherwise. indicated, (1) all ' �. front the date of accident for necessary medical, strgical, premises :vhere the named insured or his spouse main- X-ray and dental services, including prosthetic devices, and tains a residence and includes private approaches ' { necessary ambulance, hospital, professional nursing and thereto and other premises and private approaches i funeral services, to or for each person who sustains bodily thereto for use in connection with said residence, ex- . injury caused by accident, cept business property and farms, (2) individual or } r family cemetery plots yr burial vaults, (3) premises (1) while en the premises with the permission of an in- in which an insured is temporarily residing, if not i sured, or owned by all insured, and (4) vacant land, other than t x . (2) while elsewhere if such bodily injury (a) arises out of farm land, owned by or tentcd to an insured. Land i �' the lttentises or a condition to the ways immediately shalt not be deemed vacant following the continence- w r adjoining, (b) is caused by the activities of an insured. ment of any construction operations thereon unless ?f (,) is caused( by the activities of or is sustained by a such operations are being performed solely by inde- i residence entployee and arises out of and in the course pendent eontrac.ars in connection with the construe- -if his employment by an insured or (d) is caused by an tion of a one or two family duelling for the insured; anitnal owned by or in tilt care of an insured. "business property" includes (1) property on which a business is conducted, and (2) property rented in whale or in part to others, or held for such rental, by j Coverage 3—Physical. Damage to Property the insured. T!te insisred's property shall not constitute "business property" because of (a) occa=ional rental of To pa • for loss of property of others caused by an itt- the insured's residence; (b) rental in whole or in part i sured. "Loss" means damage or destruction but dots not to others of a one or two family dwelling usually occu- ' include disappearance, abstraction or loss of use. pied in part by the insured as a residence, unless such ; 4 rental is for the accommodation of tnc,re than two roomers or hoartlets; (c) rental of slsace in the in- II. Supplementary Payments sured's residence for ofrtce., school or studio occupancy; p With respect to such insurance as is afforded by this or (d) rental or holding for rental of not more than j endorsement for 13r:rconal Liability Coverage, the company three car spaces or stalls in garages or stables; shall pay, in addition to the applicable limit of liability: "business" includes trade, profession or occupation; } "residence tmployee" means an employce of an insured (a) all expenses incurred by the company, all casts tared whose dirties are in connection with ttse ownership, against the insured in any dcfendcd sort and all interest maintettan,:e or use of the premises, including the main- oil the entire amount of any judgment therein -xhich tenance or use of automobiles or teams, or who per. accrues alter entry of the judgtvtent and before the forms elsewhere duties of a similar nature not in con- i company has prid or tendered or deposited in court nection with an insured's business; that part of the judgment which does not exceed the "automobile" means a land motor vehicle, trailer or limit of the contrany's liability thereon; .,i emitrxiler, but the terra 'autamabilt does not include t (b) premiums on appeal bonds required in and such suit, any crawler or farm-type tractor, farm implement and, premiums art bunch to release attachments fcir an if not subject to rrtotnr vehicle reRistration, an egtlip- anrount not in exec+s of the applicable limit of liahility ment which is designed for use principally off public of this endorsement, but without any obligation to roads; _.• apply for tar furnish any such bonds; "midget automobile" meads a land snot^!- vehicle of the i type commonly referred to as a "midget automobile". (c) expenses incurred by tits insured for such immediate "kart", "Ra-hart medical and surgical relief to others -is shall he. ins- , "speed-mobile" or by comparable Warne, whether cnnrmcrcially built (it otherwise; perative at tht: time of the accident; "undeclared outboard motor" tnenns i (d) All reasonable expenses, other than loss of earnings, (1) an outboard motor of more than ten hnt'sepox•er, incurred by the insured at the company's rcquc:it. or { (2) a combination of outboard stators of more than ' ten horsepower in the aggregate and used with Tit. Definition of Insured n single watercraft, The mqualitird word "insured" includes- (a) the named if not declared in the declarations and a premium instr►etl and (b) if residents of his hou.�chnld♦ ltic spouse, charge enttred therefor. the telative; of either, anti any other person order the age V. Insurance for Newly Acquired Outboard Motors i of teccnty-,sac in the cart: of an insured. The %+old "in- Part (3) of Exclusion() dots tint apply to a watercrafti� cured" afar includes, under coverages 1 and 1, (1) with powered by an undeclared outboard motor, ownership of respect to anitnal� and watercraft owned by an insured• which is acquired during the rndorsemcnt period by tin ` t -my person or oraani:atiotr legally rrsponsifile then"hir•, ex- insured included within parts (al or (h) of the ''UcCmitirm erpt a purcon urinct or having euctody or possession of anv of Insurer!". ! .tech atfli al or watercraft without the permissitnt of tare owntr, and (2) with respect to farm tractors and trailer,; Vi, Endorsement Period .r and self-propelled or motor or animal drawn farm imply- "Phis cndorscnrcnt applies onlc to occurrences happrning meats. any ctstployec of an insttred while ctigaged in tile on and after the effective date I' 'cof and daring the polic,• ettslrlovinent of the insured. period. i .. >_.. (OVER) -. ._.. ....... ..- _.,,...,... _... Adilitlonal Charges—Covera es I And 2 Ratev Y Wading or Swimming Pooht s Outboard Motors_ HP Owner(if not named insured) Rate Motor hl Motor R - Motor C i •Par Pool speczfi above. Total Premium 'Oiler Motor or Combination. _ The company agrees with the insured, named its the declarations of this endorsement, hereinafter called "named insured", in can- sideration of the payment of the the premium and In reliance upon the statements in such declarations and subject to all of the terms of this mndorsement: INSURING AGREEMENTS } t I. Coverage I--Personal Liability ' To pay on behalf of the Insured all sums which the In. The insurance afforded under covera(;e 1 applies scpa- surel shall become legally obligated to par as damages rately to each insured ap.iu%t whom claim is made or suit because of bodily injury or property damage, and the cam- is brought but the inclusion herein of more than one insured ' ppony shall defend any cult against the insured alleging such shall not operate to increase the limit of the company's bodily injury or property datnage atut seeking ( triages liability. which are payable under the terms of this endorsement, IV. Definitions even if any of the allegations of the ;tiit nre groundless, false or fraudulent; but the company Wray make such in- Wherever used in this endorsement: l vestigation and settlement of any claim or suit as it drems "bodily Injury" means bodily injury, sickness or dis- expt.-dient. ease, including death resulting thertfrom, sustained b; ; any person; . r "property datnage" means injury to or destruction of a Coverage 2---Poraonol Medical Payments property, including loss of use thereof; ' t To pay all reasonable expenses incurred within one year "premises" means, unless otherwise indicated, (1) all from the date of accident for necessary medical, surgical, premises where the named insured or his spouse main- s: X-ray and dental services, including prosthetic devices, and tarns a residence and includes private approaches z r necessary ambulance, hospital, proessional nursing and thereto and other premises and private approaches t: ;( funtrai services, to or for each person who sustains bodily thereto for use in connection with said residence, ex 41 - inittry caused by accident, ctpt business property and farms, (2) individual or 1 while on the premises with the permission of an in- family cemetery plots or burial vaults, (1) premises i ' O 1 in which an insured is temporarily residing, if not Lured, or owned by an insured, and (4) vacant Iznd, other than (2) while elsewhere if such bodily injury (a) arises out of farm land, owned by or rented to an insured. Land the premises or a condition In the wa.-i tmrnediattly shall not be deemed scant folio:ving the comrnence- adjoining, (b} is caused by the activities of an insures. went of any construction opera ti;,ns thereon unless (c) is caused by the activities of or is sustained by a such Optrahans are bring performed solely by inde- residcnce employee and arises Out of anti in.tht course pendent contractors in connection with the construc- 1 of his employment by an insured or (d) is caused by an stun of a one or two family dwelling for the insured; animal owned by or in the care of an insured. 'business property" includes (1) property on which a L business is conducted, and (2) property rented in Y whole or in part to others, or held for such rental, by r' Coverage 3--Physical Damage to Property the insured. The insured's property shall not constitute To a far lass of property of ethers caused by an art- "business property" because of (a) occasional rental of p Y p the insured s residence; (b) rental in whole or in part sured. "Loss means damage or destruction but does not to others of a one or two f-Amily dwelling usually occu- i include disappearance, abstraction or loss of use. pied in part by the insured as a residence, unless such C rental is for the accommodation of more than two roattiera or boarders: (c) rental of spate in the in- It. SupplemettUry Payments sured's residence for office, school or studio occupancy; With respect to such insurance as is afforded by this or (d) rental or holding for rental of not more than : endorsement dorseent for Personal Liability lability Coverage, the company three car spaces or stalls its garages or stables, ' shall pay, in addition to the applicable limit of liability: business" includes Italic, profession or occupation; "residence employee" means an employee of an insured (a) ail expenses Incurred by the company, all casts taxed whose duties are in connection with the ownership, against the insured in any defended suit and all interest maintenance Or use of the premises, including the Main- oil the entire amount a any judgment therein which tenance or use of automobiles or turns, or who per- accrues after entry of the judgment anti before the forms elsewhere duties of a similar nature not in con- company has paid or tendered or deposited in court nection with an insur,d's business; that part of the lodgment which does not exceed the .,automobile„ means, a land motor vehicle, trailer or limit of the company's liability thereon; semitrailer, but the term "automobile" does not include (b) preinhi cis on appeal bonds required in any such suit, any crawler or farm-type tractor, farm implement and, brcmiumv on bonds to release attachments for an if not subject to motor vehicle it-gistration, anyy equip• f amount not in excess of the applicable limit of liability meet which is designed for use prircipa.liy off public of this endorsement, hilt without any obligation to roads., apply for or furnish any such bonds; "midget automobile" means a land inotor vehicle of the s ' e exptnar.! incurred b the insured for such immediate type commonly referred to as a "midget automobile", ( ) y "kart", "go•l:art", "=peed-irtohile" or by a comparable medical and surgical relief to others as shall be im- name., whether camntercialfy built or otherwise; 1 peratire at the time of the accident; of un-leclared outboard motor" mean:' t i d) Alt reasonable expenses,enses other than los.: of earnirgs,( p (1) an outboard motor cif mart than ten horsepower, s incurred by the insured at the cainpany's request. or t (2) a conibinatinti of outboard motors of more than r tell horsepower in the aggregate and used with III. Definition of Insured a single watercraft, • fhc unqualified ecurd "insured" incladrs (a) the named if not declared in the declarations and a premium insin-ed and (h) if resident, cif his house-hold. his IP011 . charge entered therefor. ; i the telatiyes ui tither. and any (,tiler livrsim under the age V. insurance for Newly Acquired Outboard Motors (if twenty-one in the care u{ an insured. 'nit. word "in- I'art (3) of Exclusion (b) dices not apply to a n•atrrcraft j sured" ai'n includes, under coverages 1 and (l) Witti prowered by an undt•clarcd outboard niotor, ownirship of i respect to taniriirak and watercraft mined by an inured, which is acquired during they endnrsenient period by an • rtni person or organir.ation Itt;ally re;lwnsible therefor, rr- instircd inclnrled within part« (a) or ([►) of the "Definition ' cept a pe•rsrti using or having custody nr possession (if any of Insured", oich sninial or watercraft without the of the owiivr, and (2) N%,ith respect to fintiv tractors in([ trailers VI. Endorsement Period And .elf propelled or motor sir animal drawn farm imple.- This endorsement applies only to occurrences happening ntetits. any enipluyre of an in{tired while rn(~aged in the tin and after the effective date hereof !ind during the policy eniplm•mrnt of the insured. period. (OVER) Nothing herein contained shall be held to vary, alter, waive or extent] any of the terms, conditions, agreements or limita- tions of the policy other than ns above stated. This endorsement forms a part of PACIFIC INDEMNITY COMPANY f Policy Nittnher . OUPLIGATS =A',i!( I��,.WTV 't'14 (r,4 L r,p s, i1rj AAA issued to y ►}yet 1 f� l EndorsementifTectivc. ( •t PR"I DENT. ' .- �x �� tn!SS �►y� v y {p t , L ��Mtl'� �3'i�Cevlt.>il•� �IR•t'"�V��d��i� /'�"!�f`.,��'J��'/'•'+'/V � Cnunfcrsifinetl at b y i AUTHOnIxED REPnE80ITATIVE. e Elate of Issue I. PRODUCER. 1'nrtu li)gtl.tf all\1 lri3 (Rev. 4.16.61) 00 NOT UBE: THIS SPACE---FOR HOMx OFFICE USC ONLY { LINE ' 1ltND Pttomot ST\Tt CITY CL\ee LIItt OPORa PPE041UN 01#009 PP[H, CANC-O. COYH. PATS Y 1 ' � e�'itL"..?f'L"�'lSSI�Rd'L'!!:Y! txx72+-1:Y:!M„r:1•C"SS�4.Tye.TS�.•/:+'.L'.sir.+-r.N.+- 1 . � '•"' Y!-.l`J' 'B.tlx2,�tl�.k�ttz:1NERATS� 1 1 ;i 1 , ,5 r' EXCLUSIONS This endorsement dons not apply: law, but this subdivision (2) does not apply with respect to coverage I unless such benefits are payable or required to be (a) (1) to any business pursuits of an insured, except, under provided by the insured; i - coverages 1 and 2, ,activities therein which are ordinarily a under incident to non-business pursuits and, subject to all other ( ) coverage 1; with respect to liability assumed by the exclusions of the endorstment, those activities of the named Insured under any contract or agreement, under Insuring Insured or spouse incidental to his or her employment by Agreement 11 (c) and under coverage 2, to bodily injury or t another, (2) to the rendering of any professional service or property damage due to war, whether or not declared, civil cite emission thnrcof, or (3) to any act or omission in con- war, insurrection, rebellion or revolution, or to any act or condition incident to any of the foregoing; nection with premises, other than as defined, which are owned, rented or controlled by an Insured l but this sub- (f) under coverage 1, to property damage to property used by, division (3) does not apply with respect to bodily 111jUry to rented to or 1n the care, cu!tody or control of the insured or { a residence employee arising out of and in the course of his property as to which the insured for any purpose..is exec- employment by the insured; cising physical control; (I,) under covrra►tes 1 and 2, to the ownership, maintenance. (g) under coverage 1, to sickness or disease of any residence t w ol,cration, use-, loading or unloading of (1) autotnobiles cur employee unless prior to thirty-six months after the end midget atitouu,biles while away from the premises or the of the endorsement period written claim is made or suit is ivays ininiediately adjoining, except under coverage i with brought against the insured for dsma es because of such i respect to operaiic►ns l,y independent contractors for non- sickness or disease or death.resulting therefrom; �- itu%inrss purposes cif an inmirrcl not invn(ving a:rtontohilrs niched nr hired by the insured, (2) watercraft owne,l by or (h) antler coverage 1, to bodily injury ors property damage with 1 c rented to an insured, while away tram tile. prr.mitcs, if with respect to which an insured under this endorsement is also an insured under a nuclear energy liability policy issued by inboard ntatar pnivcr rxcrrdinq fifty borsrp.�wrr or if a i tailing vcs,.el with or without auxiliary power and twenty-six Nuclear Energy Liability Insurance r r NuCi Association Mutual fret or more m over-;ill (rnglli. (3) watercraft while away Atomic Energy Liability Underwritersold or Nuclear)Insurance c Association of Canada, or would be at, insured under any from the prcmkes and powcrrtl is whole or in part by an such policy•but for its termination upon exhaustion of its ttnderlared outhoard motor otrucd by an insured, or (4) air- limit of liability; j craft; but. with respect to bodily injury to x residence em- t i i� cr, arisen* snit of and in the course- of hi,.i employment (i) under coverage 2, to bodily in ury to (1) any insured within ! ' blyay the insueed, harts (t), (2) anal (3) of 1},is exclusion ticthe meaning of parts (a) and 1b) of Insuring Agreement III not apply, and part (4) applies enly while ouch employee is or (2) any person, other than a reAdence employee, if such } enuaged in the operation or maintenance of aircraft. person is regularly residing on file premises, or is on the 1 t premises because of a business conducted thereon, or is in- { (c) under coverages 1 and 2, to bodily injury or property lured by an accident arising out of such business; } 1 damage caused intentionally by or at the direction of the t ' insured; (j) under coverage 3, to loss.(1) arising out of the ownership, $ maintenance, operation use. loading or unloading of any ! (it) under coverages 1 and 2, to bodily 'injury to any person (1) land motor.vehicle, trailer or setnitrailcr, farce machinery or ' if the insured has in effect on the date of the occurrence a equipment, aircraft or watercraft; or (2) of property owned t I' policy providing workmen's compensation or occupational by or rented to any insured, any resident of the named in- t disease benefits therefor, or (2) if benefits therefor are in %ured's household or any tenant of the insured; or (3) i whole or in part either payable or required to tie provided caused intentionally by an insured over the age of awe vc ' 1 under any workmen's compensation or occupational disease years. a CONDITIONS Application of Provision~ of Policy, and Endorsement. rcnce of loss, exhibit the damaged property, if within his control, ;t None of the terms of the policy except• the Cance}.,tion Con- and cooperate with the company in all matters pertaining to the p p loss or claims with respect thereto. ; dition applies to the coverage afforded by this endorsement. t r None of the terms of this endorsement applies to the coverage , ± afforded by the policy. 8. Action Against Company No action shall lie against the Coverage I company unless, as a condition y Conditions 12, 13, 14 and 15 of this endorsement apply to all pprecedent thereto, the insured ; coverages. The other conditions of this endorsement apply to shall have fully co nplied with all the terms of this endorsement, f the coverages noted thereunder. nor until the amount of the insured's obligation to pay shall have been finally determined eitlier by judgment against the insured .. 1. Limits of Liability The limit of liability stated in the de• after actual trial or by written agreement of the insured, the Coverages I and 2 elarations for coverage. 1 is the limit of claimant and the company. the company's liability for all damages s including damages for care and loss of services, as the result of Any person or organization or the legal representative thereof any one occurrence. who has secured such judgment or written agreement shall there- F after be entitled to recover under this endorsement to the extent - The limit of liability stated in the declarations for coverage 2 of the insurance afforded by this endorsement. No person or as attltlicable to "each person" is the limit of the cetnpany's organization shall have any right under this endorsement to joi11 liability for all expenses incurred by or on behalf of each person the company as a party to any action against the insured to ;' who sustains hodily injury a% the result of any one accident; the determine the insured'it liability, nor shall the company be im- ., ! limit of liability staled in the declarations for coverage 2 as ap- pleaded by the insured or his le al representative. Bankruptcy plicable to "each accident" is, subject to the above provision or insolvency of the insured er o� the insured's estate shall not i respecting each person, the total limit of the company's liability relieve the company of any of its obligations hereunder. for all expenses incurred by or on behalf of two or more. person• ' who sustain bndiiy °njury as the result of any one accident. g, Action Against Company No action shall lie against the ' Coverages 2 and ; company unless, as a condition 2. Limits of Liability; The limit of the company's Vahility precedent thereto, there shall Settlement Options for loss of property arising out of any have been full compliance with all the terms of this endorsement, *+r Coverage 3 one occurrence sliall not exceed (1) nor until thirty days after the required proofs of claim have been i the actual cask value of the property filed with the company. at time of loss, nor (2) what it would then cost to repair or replace the property with other of like kind and quality, nor (3) tile- applicable limit of liability stated in the declarations. 10. Other Insurance If the insured has other insurance again%+ 1 Coverage. 1 a lass covered by this endorsement, the The company may pay for the loss in mnney or may repair or compan;• shall .not he liable under this r irpliie the property and may settle any claim for lass of prop- enrinrfrnicnt for a boozier proportion of -such 1u�s than the ape 1 rty ither with the insured or the on*ner thereof. Auy property plicahle litnit of liability statctl in the declarations bearsto the o pid for or replaced shall, at the optign of the company, total applicablr limit of liability of all valid unit collectible in- 1, , bream•: the properly of the company, Payment hereunder shall surance against such lass. provided that with respect to loss ( ( t+ not constitute an admission of liability of the insured or. except arising out of the nwrcership, maintenance, olivration, use, load- 3 hereunder, of the company, ins: or unloading of (1) any automobile or inidget automobile at z� the premises or the ways immediately arijoininx or (2) water- { j 3. Notice of Occurrence When an occurrence takes place craft, tlii-. insurance ,.half not apply to the extent that any valid ; t Coverages 1 and 2 written notice shall be given by or and collectible insurance, whether an n primary, excess or can- r on behalf of !he.insured to file cum• tingent bads. i% available to the insured. pany or any of its authorized agents as soon as practicable. Such ; notice shall contain particulars sufficient to identify, the instired It. Subrogation In the event of any payment under this en- and also reasonably obtainable information re5pr_eting the. time. Coverage 1 dorsemcnt, the company shalt be subrogaced 7 place and circumstances of the occurrence, the names and act- to all the insured's rights of recovery there. :j dresses of the injured and of available witnesses• for against any per*on err organization and the insured shall } execute and deliver instruments and papers and do whatever I 4. Notice of Claim or Suit If claim is made or suit is brought else is necessary to secure such rights. The insured shall do Coverage 1 a ainst the insured, the insured nothing after loss to prejudice such rights. s all immediately forward to the company every demand, notice, summons or other process re- ceived by him or his representative. 12. Changes Notice to any agent or knowledge possessed by any agent or by any other person shall not effect a wniv_r or a change in any part of this endorsement or estop ., S. Assistance and Cooperation The insured shall cooperate the company from asserting any right tinder the terms of this ; >; of the Insured with the company and, upon end,.-racment; nor shall the terms of this endors_ment be waived at Coverage I the company's request. assist or changed, except by endorsement issued to effect a change in • in making settlemMnts, in the this endorsement. conduct of suits, and in enforcing any right of contribution or in- demnity+ against any person or organization who may be liable to the insured because of bodily injury or property damage with respect to which insurance is afforded under this endorsement; , and the insured shall attend hearings and trials and assist in 13. Assignment Assigmment of interest under this endorse- securing and giving evidence and obtaining the attendance of nient shall not bind the company until its j witner4ses. The insured shall not, except at his own cost, voltin- consent is endorsed hereon. If, however, the named insured shall , tarily make any pavment, aFsurnc any obligation or Incur any die, this endorsement shall cover the named insureds spouse, if expense other than for such immviiate riedical and surgical relief a resident of the same hnnr.ehold at the time of such death, and to others as shall be imperative at tht: time of the accident. legal representative as. named insureds; provided that notice of '. cancelation addressed to the named insured and trailed to the L' address shown in this endorsement shalt be sufficient notice to 6. Medical Reports; Proof and As sawn as practicable the in- effect cancelatinn of this endorsement. If the legal representative nxt ~x��, titrK,. Payment of Claim ]tired person or someone eel of the named insured was not an insured at the time of the death Coverage 2 his behalf shall give to the of the named Insured, this endorsement shall apply to surh legal coinpanv avrittcn proof of repre.%entative tints with respect to the premises of the original claim, under cath if required, and shrill, . ter each request from named insu•Cd. This endorsement shall also cover as insured the company, execute authorization to enable the company to while a resident of said premises, any person who was an insure obtain medical reports and copies of records. The injured person at the time of such death. ::}ta11 submit to physical examination fly physicians selected by } the company when and as often as the company may reasonably �. require. 14, Cancelation if the named insured under this endorsement „y rna is not named as insured in the policy and the The cum ? R p. Y pay the injured person or any person or policy is canceled by the company, this endorsement shall be + r• t , a. d •r „y1 quN t,.► / yin �.r UII11' Nr title -Wu. c lewytl.' vt v •r r5V 1, Q IC . f •. tugs,led in the operation of maintenance a, aircraft; persoct is regularly residing en the premises, or is on the not, R premises betaure of a business conducted thereon, or is in- . (c) under coverair:s 1. and 1. to bodily injuq or property fared by an accident arising out of such business; damage caused intentionally by or at the direction of the insured; (j) under coverage 3, to loss (1) arising out of the,ownersh}f, maintenance, operation, use, loadings or unloildmg of anp (d) under coverages 1 and 2, to bodily injury to'any person .(1) land motor vehicle, tra;le: or semitr-tiler, farm machinery or if the insured has in effect on the date of the occurrence a equipment, aircraft or watercraft; or (2) of pioneers owned policy prcviding workmen's compensation or occupational by or rented to any insured, any resident of the namcd in- disease. benefits therefor, or (2) if benefits therefor are in sured's household or any tenant of Me`insured; or, (3; f whale or in art either payable or required to be provide.: a«.;aid intentionally by ar+. insured over the age of tv+e1}ve under any workmen's compensation or occupational disease years. CONDITIONS Application of Provisions of Policy and Endorsement. rence of lass, exhibit the damaged property, if within his control, and cooperate with the company in all matters pertaining to the None of the terms of the policy except the.Cancelation.Con- lose or claims with respect thereto.:.. + dition applies to •the coverage afforded by this endorsement. None of the terms of this endorsement applies to the coverage ' 4� afforded by the polity. B. .-..23on Agatrist Company No act,.on shall lie against .the k Coverage 1 company unless, as a condition R Conditions 12,' 13, 14'aod'M of this endorsement apply to all tecedent thereto, the . insured ;'y coverages. The other conditions `of this andor+ement apply to shalt have fully complied with all the: terms of this endorsement. the coverages rooted thereunder. nor until the amount of the insured's obligation to pay shall have been finally'determined either by Judgment against the insured 1. Limlts' of Llabihtp ' The limit of lfxbiiit� stated in the de- after actual`trial or by written agreement of the insured, the Coverages I and 2 clarations for coverage I Is the limit of daimons and the,rampany, •- the company's liability for all-damages Any person or or anization or'the legal representative thereof including damages for care.and loss of services, as the, result of , any cne occurrence. who Nam, secured such judgment or%v.itten agreement shall these- after be entitled to recover under this endorsement to the extent Thy limit of liability stated in the declarations for coverage 2 of the insurance afforded by this endorsement. No person ur �- as rvp;:licable to ."each kserson" is the limit of the company's organization shall have any right under this endorsement to join •=V! liabillity for all expenses incurred by or on behalf of each person the company as a pairt7,to any action against the insured to who sustains bodily Injury as the result of any one accident; the determine the Insured's liahility,.nor ahall the company be ini- limit of liability stated in the declarations for coverage 2 as ap- pleaded by the insured or his legal representative. . Bankruptcy plicable to "each accident" is, subject to the above provision or Insolvency of the insurcd or of the insured's'estate shall not respecting each person, the total limit of flit company's liability relieve the company of any of its obligations hereunder. for all expenses incurred by or on behalf of two or more persons f+ who sustain bodily injury as the result of any one accident, g• Action Against Company No action shall lie against the s Coverages 2 and 3 company unless, as a condition 2. Limits of Liability; The limit of the company's lability precedent thereto, there shall j t Settitment Options for loss of property arising out of any have been full compliance with all the terms of this endorsement, ;+ Coverage 3 one occurrence 311211 not exceed (1) nor until thirty days after the required proofs of claim have been 1 the actual cash value of the property filet} with the company, t at time of loss, nor (2) what it would then cost to repair or i < replace the property with other of like kind and quality, nor (3) tht applicable limit of liability stated in the declarations. 10. Other Insurance If the insured has other insurance against " Coverage 1 a loss covered by this endorsement, tine The company may.pay for the loss in money or may repair or company shall not be liable unit r this replace the property and may settle any claim for lass of prop- endor."ment for a greater proporti.�si of sorb ions titan the ap- city either with the insured or the owner thereof. Any property plirahle limit cif liability stated in the declarations hears to the i sr paid for or replaced shall. at the option of the company, total applicable limit at liability of all valid anti collectible in- i tirtcamc the property of the company. . Payment hereunder shall Durance against such loss, provided that with respect to loss ' ' not constitute an a ki31an of liability of the insured or, except arising out of the ownership, maintenance. operation, use, load- I rereunder, of the. company. ing or unloading of (1) any automobile or midget automobile at �{ the premises ov the `Nays immediately adjoining or (2) water- 3. Notice of Occurrence When an occurrence takes place the Ihia is!surattcr shall not apl►fy to the extent that any valid + Coverages 1 and 2 written notice shall be given by nr and colirctible insurance, whether on a primary, excess or con- on behalf of the Insured to the cant- tingeni hams, is available to the insured. 1• pany or any of its authorized agents as soon as practicable. Such notice shall contain particulars sufficient to Identif• the insured 11. Subrogation In the event of any paytrcnt under this en- and also reasonably obtainable infortration respecting the time, Coverage 1 dorsement, the company shall be subra ated <` place and circumstances of the occurrence, the names and ad- ' dresses of the Injured and of available witnesses. to all the insured's rights of recovery there- dresses against any person or organization and the Insured shall i 3 execute and deliver instruments and papers and do whatever 4. Notice of Claim or Suit If claim is made or suit is brought else is necessary to secure such rights. The insured shall do { Coverage 1 against the insured, the insured nothing after loss to prejudice such rights. shall immediately forward to the company every demand, notice, summons or other process re- ceived by him or his representative. 12. Changes Notice to any agent or knowledge possessed by any agent or by any other person shall not effect s r j a waiver or a change in any part of this endorsement or estop S. Assistance and Cooperation The insured shall cooperate the company from asserting any right under the terms of this of the Insared with the company and, upon endorsement; nor shall the termet of this endorsement be waived s Coverage i ge 1 the company's request, assist or changed, except by endorsement issued to effect a change in in making settlements. n the this endorsement. } conduct of suits, art(] in enforcing any right of effntributiun or in- demnity against any person or ar aniratioa who may be liable ' `a the insured because of bodily injury or property damage with i ' a r aspect to which insurance is afforded under this endorsement; and the insured shall attend hearings and trials and assist in 13. Assignment Assignment of interest tinder this endorse- ' securing and giving e4dence and obtaining the attendance of inent shall not bind the company until its witnesses. The insured shall not, except at his own cost, volun- consent is endorsed hereon. If, however, the named insured shall tarily make any payment, assume any obligation nr incur any die, this endorsement shall cover the named Insured's spouse, if i expense other than for Stich immediate medical and surRical relief a resident of the same household at the time of such death, and to others at shalt be imperative at the time of the accident. legal representative as named insureds; provided that notice of } cancelation addressed to the named ;nsured and mailed to the. ' 6. Medical Reports; Proof and As loan as tactical>Ir the in- address shown in this endorsement shall he sufficient notice to i f e. p effect cancelation of this endorsement. If the legal representative ! Payment of Claim jured pperson or someone on of the named insured was not an insured at the time of the death c Coverage 2 his behalf shall give to the of the named insured, this endorsement shall apply to t.uch legal . company written proof of representative only with respect to the premisea of the original Balm, under oath if required, and shall, after each request from namtd insured. This endorsement shall also cover as insured I the company, execute authorization to enable the company to while a resident of said premises, any person who was an insurccl obtain medical reports stnd copies of records. The injured person at the time of such death, r x r shall submit to physical examination by physicians selected by i the company when and as often as the company may reasonably require. 14. Canceladon .f the named in:-rred under tilts endorsement is not named as insured in the policy and the i The company may pap the injtited perseii or any person or policy is canceled by the company, this endorsement shall be 1 organization rendering the services and such payment shall canceled by notice to the namcd insured in the same manner as reduce the amount payable hereunder for .4urls inftir Payment is required for cancelation of flit policy. hereunder shall not constitute admission of liability Wilie insured .? or, except hereunder, of the company, 15. DezL-r 1-,:ns By acceptance of this endorsement the named ' i insured agrees that the statements in the 7. Insured's Duties Whe:r. When lass occurs, the insured shall declarations are his arfrcements and reppresentations, that this Loss Occurs give written notice as soon as prac- endorsement nt is i:<streri in reliance upon tlit truth of such repre- tt Coverage 3 ticable to the rompany or any of its sentations and that this endorsement embodie.i all agreements authorized agents, file sworn proof existing between himself and the company or arcs of its agents of toss with the company -!thin ninety-one days after the occur- relating to this insurance, i • k k 4 1 ,+yL et f� Morro l MOM 50M 163 �. r• {Hev, A•tE•61) 1 A Y � 1 •`'? «:aa*•vZRm--^*t!^.-""-•'+^�*['!-.•-'�1x74'Yfy'f�".'r+.+rr!t+�-�`,!'+r!^"Tti+s*""'r'-"�'-t'-C]h73R'^."}!"'=L!'1'!fft`.4".`JCt�l�eS3..�C»SIT!YC.lYtlPttplaCMxC'��.'^.R"71:"rtCtsYZR'.YfSLZ1�.IitT1'C[ .1C1?7'.S".lt�e•�w.rw.rr+.Y.!iZ�-"k.3 •-�• Y �''!'T r► { .t 1 Y. i• r• I, r . s t 7 i s{ { { i 4 d A t , ,I r , No. A.P. } I { R.P. INDIVIDUAL AND OnIER.5 AS NAMED INSURED ENDORSEMENT (Limited to Solely Owned Business) � 4 4 Endorsement Does Not Apply to Automobile Liability It is agreed that such insurance a: , 'Tnrded by the policy to an individual named in the declarations as insured applies only j in connection with the conduct of a bw, rz5 of whir.1i a named insured, or exclusively a combination of named insureds, is the sole owner, i r "Business" includes trade, profession or occupation and the c%vnership, maintenance or use of farms, and of property { rented in whole or in part to others, or held for such rental, by the insured other than (a) the insureds residence if rented occasionally or if a two family dwelling usually occupied in part by the insured or (b) garages and stables incidental to such 3 # residence unless more than three car spaces or stalls are so rented or held. x Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, agreements or limits- 1 tions of the policy othc:. than as above stated. This endorsement forms a part of PACIFIC INDENINITY CO.�1fPANY Policy Number LAO 146243 I ,+ Issued to • ► �, �it�k'i _►� t *� 'ztm j 110.140 Im ku", � Endorsement Effective. m ins A,� Ie. PRISID17 IWT. Countersigned at .t *� ` � gat +t t �1A by �. 4 l AUTHORIZED MTREBENTATIVRC. F hate of Issue Form MOM 15M 662 ,ttal�ea' N.B. (Pic. Gmt) Adc. DO NOT Usti THIIN BPACC---rOR tIOME OFFICE UNE ONLY _, i ! LINE RIND 11RROR STATt airy CLAEii LINO OROIS{YRiMIYM ORls•►n»V.CANC•I, Irk' 7 �• ti 1 R S + i r � i e t{ a \•I r;. e."nw.R:t+fX 11 qq?. �sT�t:+�i`"rt�Ttss+t�"�•'LA77!51.1 :...s+��rS�s�S,,."'etA.`lilstTi'as�t"".a'�.afi3slCGC""^' .. .Y '!• rt1 _.f'.!e!�Rer. t r { I 1 i I 'I t d