Alameda City Council
October 6, 2026

All Rights Reserved

The payment of covered wage loss by us does not
mean that we admit we are liable under other
coverages of this policy.

EXCLUSIONS

Each of the exclusions set forth in the Exclusions
section of the Commercial Liability Coverage Form
(GL-100) and the Liability and Medical Coverage
Form (BGL-11) apply to the Additional Coverage
provided by this endorsement, unless otherwise
modified herein. The following exclusions apply only
to the Additional Coverage of this endorsement.

1. We do not pay for any wage or income loss if
such loss is covered under any Workers'
Compensation, occupational disease or disability
insurance policy, or to the extent that any
covered wage loss is paid to or on behalf of any
person covered herein by another policy,
program or plan of any kind.

2. We do not pay for any wage or income loss
arising directly or indirectly out of bodily injury
sustained by:

a. your employee, or by any person you have
hired to do work on your behalf; or

b. any student, day care participant or
camper, unless we provide medical
payments coverage that applies to such
person.

3. We do not pay for any wage or income loss
arising directly or indirectly out of bodily injury
that results in any mann er from the operation,
occupancy, maintenance, use, loading or
unloading of any auto, aircraft or watercraft of
any kind.

4. We do not pay for any wage or income loss
arising directly or indirectly out of bodily injury to
a person injured on that part of the premises that
the person normally occupies, or for any wage or
income loss sustained by any tenant of an
insured.

5. We do not pay for any wage or income loss
arising directly or indirectly out of bodily injury
sustained while taking part in any athletic
activity.

6. We do not pay for any wage or income loss
arising directly or indirectly out of bodily injury
sustained by any person staying at your facility,
if the facility regularly houses or cares for
persons who do not have a residence or who
have voluntarily or involuntarily placed
themselves, or been placed, at your facility.

7. We do not pay for any wage or income loss
arising directly or indirectly out of bodily injury
sustained by anyone who is:

a. trespassing on property when the injury
occurs;

b. on or in an area without permission; or

c. on or in an area that the person does not
have a reasonable belief they are entitled to
occupy.

8. We do not pay for any wage or income loss that
is not documented, or that is speculative in
nature.

9. Except in the case of coordinating details
associated with a life-threatening injury
to a
dependent, we do not pay for any wage or
income loss for time away from work due to
appointments with medical providers.

10. We do not pay for any wage or income loss for
time away from work by an injured person unless
required by a physician, or for time away from
work after a physician has authorized an injured
party to return to work.

11. Other than with respect to the following specified
Injury Exception, we do not pay for any wage or
income loss on behalf of any person who does
not sustain bodily injury.

Injury Exception: Despite the injury requirement
stated in Exclusion 11, we will provide the
Additional Coverage herein for covered wage
loss sustained by an uninjured person if:

a. bodily injury or death that is otherwise
covered herein is sustained by a dependent
of the uninjured person; and

b. the uninjured person misses time from work:
(1) to care for a dependent covered herein;
or (2) to coordinate funeral details and other
details associated with the death of a
dependent; or (3) to coordinate life care












 





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BGL-99 (4.0) Copyright, 2013 Brotherhood Mutual Insurance Co. Page 3 of 3 All Rights Reserved
details and other details associated with a
life-threatening injury to a dependent; and

c. the time away from work is essential for the
care of the injured person; or is related to the
coordination of funeral details and other
details associated with the death of a
dependent; or is related to the coordination of
life care details and other details associated
with a life-threatening injury to a
dependent.

HOW MUCH WE PAY

Each of the provisions set forth in the How Much We
Pay section of the Liability and Medical Coverage
Form (BGL-11) apply to the Additional coverage
provided by this endorsement, unless otherwise
modified herein. The following provisions apply to
the Additional Coverage of this endorsement.

1. We will pay two-thirds (2/3) of the reasonable,
necessary and documented covered wage loss
provided by the Additional Coverage of this
endorsement. In the event that another policy,
program or plan pays a portion of the covered
wage loss (but less than 2/3 of the covered
wage loss ), then we will pay the difference
between such portion and two-thirds (2/3) of the
covered wage loss.

2. We will pay no more than $3,500 per injured
person for any covered wage loss to which this
endorsement applies.

3. Coverage under this endorsement for an
uninjured person is limited to the following:

a. in the event of a non-life-threatening injury to
a dependent, we will pay up to two-thirds
(2/3) of the uninjured person's covered wage
loss for 40 hours of work, or $3,500,
whichever is less.

b. in the event of a life-threatening injury to,
or the death of, a dependent, we will pay up
to two-thirds (2/3) of the uninjured person's
covered wage loss for 80 hours of work, or
$3,500, whichever is less.

4. We will pay no more than $35,000 toward all
covered wage loss to which this endorsement
applies. This Coverage Aggregate Limit
represents the most that we will pay for covered
wage loss arising out of any one incident or
event, or any series of related incidents or
events. This $35,000 Coverage Aggregate Limit
will apply regardless of the number of persons
sustaining loss, or the total amount of lost wages
incurred by such persons.

CONDITIONS

Each of the provisions set forth in the Conditions
section of the Commercial Liability Coverage Form
(GL-100) and the Liability and Medical Coverage
Form (BGL-11) apply to the Additional Coverage
provided by this endorsement, unless otherwise
modified herein. The following condition applies to
the Additional Coverage of this endorsement.

1. Required Documentation:

If a person to whom coverage applies under this
endorsement is self-employed or is employed by
a relative, then such person must submit to us, at
our request, payroll records, tax returns and other
necessary records to document their covered
wage loss.

OTHER PROVISIONS

All other provisions of the Commercial General
Liability Coverage Form (GL-100) and the Liability
and Medical Coverage Form (BGL-11), apply to this
endorsement unless otherwise modified herein.












 

















 





04M5A0494326
BGL-112 (1.0) Copyright, 2020 Brotherhood Mutual Insurance Co. Page 1 of 14 All Rights Reserved
This Liability Coverage Endorsement is subject to the terms of the applicable Commercial Liability Coverage Form (GL-100) and the Liability and Medical Coverage Form (BGL-11). Only one liability coverage will apply to an occurrence and any related loss.N o liability coverage applies under this endorsement for loss of any kind associated with any auto, mobile equipment or owned aircraft. This endorsement is attached to and made part of the policy.

THIS INSURANCE ENDORSEMENT FORMS PART OF YOUR POLICY CONTRACT.

PLEASE READ IT CAREFULLY.

To report an international claim, visit the Claims page at www.brotherhoodmutual.com

WORLDWIDE LIABILITY AND MEDICAL EXTENSION

WITH OPTIONAL EXTENDED FOREIGN OPERATIONS COVERAGE

EXTENDING LIABILITY AND MEDICAL COVERAGES OF THIS POLICY TO

YOUR INTERNATIONAL LIABILITY EXPOSURES
Note: This endorsement extends the liability coverages and medical coverages of this policy to injuries sustained, claims brought, or lawsuits filed anywhere in the world. Additional coverage is extended to protect your ministry and its covered ministry representatives for exposures associated with international activity.

Coverage for extended foreign ministry operations is only provided if shown as Included on the declarations, and such coverage, if included, is subject to the Extended Foreign Ministry Operations Coverage Schedule of the declarations, as set forth in the How Much We Pay section of this endorsement.

No coverage applies under this endorsement for loss of any kind associated with any auto, mobile equipment or owned aircraft. Unless otherwise specifically indicated herein, no coverage applies to claims occurring in foreign territory unless such claim would otherwise be covered under this policy in the basic territory.

COVERAGE EXTENSIONS AND

PROVISION MODIFICATION
We provide the Coverage Extensions and Provision
Modifications described in this endorsement, but only
if Worldwide Liability and Medical Extension is
properly designated in the declarations of this policy, and only if you are a religious or not-for-profit
organization, or you are an organization that is
owned by or controlled by a religious or not-for-profit organization.

GENERAL DEFINITIONS
Each of the words or phrases defined in the Definition
section of the Commercial Liability Coverage Form
(GL-100) and the Liability and Medical Coverage
Form (BGL-11) apply to the Coverage Extensions
and other grants of coverage provided by this
endorsement, unless otherwise modified herein. The
following definitions apply only to this endorsement.

1. Covered person means, with respect to any
liability coverage or medical coverage of this
policy, only:
a. those persons or entities who are defined as
a “covered person” in an applicable liability or
medical endorsement; and
b. your foreign ministry participants.

If a covered person should die, then his or her
estate will be a covered person if a covered
claim is made against the estate.

2. Extended foreign ministry operations means
any operation, activity, mission work or related
travel undertaken by any person in foreign
territory if performed in furtherance of your
ministry operations, but only if such operation,
activity or travel is intended to extend, or does
extend, for more than 60 consecutive days. Any
activity undertaken on your behalf by a foreign-
based person will in all cases be part of your
extended foreign ministry operations ,e v e n i f












 





04M5A0494326
BGL-112 (1.0) Copyright, 2020 Brotherhood Mutual Insurance Co. Page 2 of 14 All Rights Reserved
undertaken in conjunction with a short-term
foreign trip , or with activity occurring in the
basic territory . Any communication, decision,
supervision, planning or other activity undertaken
by a covered person in connection with or in
support of extended foreign ministry
operations will be considered to be extended
foreign ministry operations, even if such
covered person is located in the basic territory
when such communication, decision, supervision,
planning or other activity occurs.

3. Foreign ministry participant means an
individual while working in, traversing, lodging in,
traveling in or otherwise located within, foreign
territory, but only when:
a. participating in a short-term foreign trip ;
and
b. acting on your behalf, for your benefit and
within the scope of his or her delegated
authority in furtherance of your ministry
operations.

If Extended Foreign Ministry Operations is shown
as Included for Worldwide Liability Extension
Coverage on the declarations, then foreign
ministry participant will also include individuals
(including foreign-based persons ) who are
participating in your extended foreign ministry
operations, but only when acting on your behalf,
for your benefit and within the scope of such
person’s delegated authority in furtherance of
your ministry operations.

4. Foreign-based person means an individual who
is stationed in, working in, living in, traversing
within, residing in, or otherwise located in foreign
territory for more than 60 days, or who intends
to remain in foreign territory for more than 60
days.

5. Foreign territory means:
a. land that is not part of the basic territory ;
and
b. international waters and airspace.

6. Kidnap/extortion incident means a situation in
which one or more persons are improperly seized
and detained against their will as a hostage or
hostages, and the release of such hostage or
hostages is conditioned upon an act or
transaction, including the payment of a ransom.

If more than one person is kidnapped through a
coordinated effort of one or more conspiring
kidnappers, such kidnapping will be considered a
single kidnap/extortion incident , even if the
acts of kidnapping occur over time.

7. Law enforcement inquiry means an
investigation undertaken by law enforcement
officials and directed against a person suspected
of committing a criminal offense under national,
territorial or local law, including any arrest,
detention or related prosecution for such alleged
offense. More than one such criminal
investigation, prosecution (or appeal thereof)
arising out of the same or related incidents,
allegations or events will be considered a single
law enforcement inquiry.

Law enforcement inquiry also includes an
investigation, detention, or imprisonment
undertaken by law enforcement officials in
foreign territory against a person suspected of
committing an offense under the laws or cultural
restrictions of the foreign territory, including any
arrest, detention or related prosecution for such
offense.

8. Leader means a person (whether or not a
director or officer) while serving as a member of
your governing board, or your administrator,
director, officer or trustee, but only if acting on
your behalf and within the scope of their
delegated authority as such.

9. Liability coverage means the liability coverages
provided by this policy (whether Principal,
Supplemental or Additional Coverage, and
whether such coverage is mandatory or optional).

But liability coverage does not include:
a. any coverage provided by an
Excess/Umbrella Liability Coverage Form, if
included as part of this policy; or
b. any coverage that may have been added to
this policy that applies to loss relating in any
manner to an auto or to mobile equipment,
regardless of who owns such auto or
equipment; or
c. any coverage that may have been added to
this policy that applies to loss relating in any
manner to any type of air conveyance that is
owned, operated or controlled by you or by
any covered person.

10. Medical coverage means any coverage
provided by this policy that is intended to pay for
covered medical expense regardless of fault.

11. Qualifying act of terrorism means a malicious
act that is certified by government officials as a












 





04M5A0494326
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qualifying act of terrorism under any national
terrorism law.

12. Short-term foreign trip means temporary travel
abroad in furtherance of your ministry operations
by one or more individuals who reside in the
basic territory; but only if such travel occurs:
a. in foreign territory;a n d
b. for no more than 60 consecutive days.

Short-term foreign trip includes temporary
travel by persons who reside in the basic
territory in support of your ministry operations in
foreign territory , but short-term foreign trip
does not include any trip, travel, work activity or
other activity of any kind that is undertaken by
any foreign-based person. Short-term foreign
trip also does not include extended foreign
ministry operations of any kind.

PROVISION MODIFICATION:

WORLDWIDE LIABILITY COVERAGE
Subject to the applicable terms of coverage, we
provide the following Provision Modification.

Definition of coverage territory:

Other than for the coverages specifically excluded
herein, wherever the definitions basic territory or
coverage territory appear in a liability coverage of
this policy (other than within this Worldwide Liability Coverage Endorsement), they will mean “anywhere
in the world”.

This means that all Principal Liability Coverages,
Supplemental Liability Coverages, and Additional
Liability Coverages provided by this policy will extend to claims or suits that are brought or filed anywhere in the world in relation to a covered act, error, omission, or incident occurring during the policy period .T h i s includes claims or suits that are brought or filed in the United States, its territories and possessions, but
also includes claims or suits that are pursued against
you or other covered persons in foreign countries.

Other than a broadening of the territory definition as
described above, all provisions, limits, limitations,
conditions, exclusions and other terms that apply to
the applicable liability coverage of this policy will
continue to apply to short-term foreign trips.

This Provision Modification will apply to short-term
foreign trips even if such trips are undertaken with
the purpose of supporting your foreign operations
that would otherwise constitute extended foreign
ministry operations.

Extended foreign ministry operations: This
Provision Modification will also conditionally apply to your extended foreign ministry operations ,b u t
only if Extended Foreign Ministry Operations is
shown as Included for Worldwide Liability Extension
Coverage on the declarations. Coverage limits
applicable to loss of any kind:

1. related to your extended foreign ministry
operations;o r

2. incurred by, caused by or related to any
foreign-based person;
will be subject to the Extended Foreign Ministry
Operations Coverage Schedule of the declarations,
as set forth in the How Much We Pay section of this
endorsement.

Coverage for your extended foreign ministry
operations will apply only if your organization has
also purchased a foreign liability policy, program, or
plan that:
a. provides commercial general liability
coverage for your extended foreign
ministry operations;a n d
b. is placed with a commercial lines carrier that
has been approved for your ministry
organization by Brotherhood Mutual.

Excluded Coverage – Excess/Umbrella Liability:

This Provision Modification will not apply to coverage
provided by an Excess/Umbrella Liability Coverage
Form, if included as part of this policy.

Accordingly, the definition of coverage territory as
set forth in the Commercial Liability Coverage Form
(GL-100) will continue to apply to coverage provided
by an Excess/Umbrella Liability Coverage Form, if
included as part of this policy, and Excess/Umbrella
Liability Coverage will not apply to any claims made
or suits brought outside of the basic territory.

Excluded Coverage – Auto Liability / Mobile
Equipment Liability / Owned Aircraft Liability:

This Provision Modification will not apply to any
endorsement of this policy that applies to loss arising out of an auto or mobile equipment (whether owned
or non-owned); nor will this Provision Modification
apply to any endorsement of this policy that applies
to loss arising out of any air conveyance of any kind
if such conveyance is owned by, operated by or
controlled by you or by any covered person.

Accordingly, the definition of coverage territory as
set forth in the Commercial Liability Coverage Form












 





04M5A0494326
BGL-112 (1.0) Copyright, 2020 Brotherhood Mutual Insurance Co. Page 4 of 14 All Rights Reserved
(GL-100) will continue to apply to any liability
endorsement of this policy that applies to loss of any
kind arising out of an auto or mobile equipment
(whether owned or non-owned). The definition of
coverage territory as set forth in the Commercial
Liability Coverage Form (GL-100) will continue to
apply to any liability endorsement of this policy that
applies to loss of any kind arising out of any air
conveyance of any kind if such conveyance is owned,
operated or controlled by you or by any covered
person.

No coverage will apply under the terms of such
endorsement to any vehicle use or owned aircraft use
that occurs outside of the basic territory , or to any
claim made or suit brought outside of the basic
territory if such claim or suit involves any vehicle, or any air conveyance that is owned by, operated by or
controlled by you or by any covered person.

PROVISION MODIFICATION:

WORLDWIDE MEDICAL COVERAGE
Subject to the applicable terms of coverage, we
provide the following Provision Modification.

Principal Coverage M, and any other medical
coverage provided by this policy will apply on a
worldwide basis. This means that the medical
coverage of this policy will apply to covered
persons who are injured: (1) within the United
States, its territories and possessions; or
(2) anywhere else in the world while such person is
away from the basic territory while engaged in a
short-term foreign trip during the policy period as
part of your ministry operations. We will pay for
covered medical expense whether such expense is
incurred in the United States or anywhere in the
world.

Other than a broadening of the territory definition as
described above, all provisions, limits, limitations,
conditions, exclusions and other terms that apply to
the applicable medical coverage of this policy will
continue to apply.

This Provision Modification will apply to short-term
foreign trips even if such trips are undertaken with
the purpose of supporting your foreign operations
that would otherwise constitute extended foreign
ministry operations.

Extended Foreign Ministry Operations: This
Provision Modification will conditionally apply to your extended foreign ministry operations , but only if
Extended Foreign Ministry Operations is shown as
Included for Worldwide Liability Extension Coverage
on the declarations.

ADDITIONAL LIABILITY COVERAGE

EXTENSIONS
Subject to the applicable terms of coverage, we
provide insurance for the following Additional Liability Coverage Extensions.

SHORT-TERM TRIP LIMITED KIDNAP

AND EXTORTION EXPENSE

REIMBURSEMENT COVERAGE
At your request, we will reimburse your ministry
organization up to $25,000 (in total) for the following expenses that you incur in response to a
kidnap/extortion incident that occurs anywhere in
the world in connection with a short-term foreign
trip during the policy period:
a. ransom costs incurred to pay for the release of
kidnapped individuals; and/or
b. costs to retain a hostage negotiator who is hired
by the ministry; and/or
c. costs to retain local security personnel to protect
remaining members of a traveling group until
they can be evacuated; and/or
d. costs incurred to set up a command center in
the country where the kidnap occurs; and/or
e. costs incurred to pay a reward or to
compensate an informant in connection with the
kidnapping; and/or
f. costs incurred to send up to two individuals to
the country, region or location where the kidnap
occurred; and/or
g. costs to retain a professional public relations
specialist or public relations firm; and/or
h. costs to retain a legal advisor to assist the
organization in responding to potential legal
claims associated with the incident if not
otherwise covered by this policy; and/or
i. costs to retain a professional independent
counselor or counseling service to meet with
individuals affected by the kidnapping; and/or
j. other additional reasonable and necessary
costs that are incurred by your ministry
organization as a direct result of the












 





04M5A0494326
BGL-112 (1.0) Copyright, 2020 Brotherhood Mutual Insurance Co. Page 5 of 14 All Rights Reserved
kidnap/extortion incident ,a n dw h i c h h a v e
been authorized in advance by us;
but only to the extent that such cost is a reasonable
and necessary expense, or such cost has been
authorized by us prior to being incurred.

This liability coverage extension applies to
kidnap/extortion incidents involving one or more
individuals engaged in a short-term foreign trip .N o
coverage applies to any kidnap/extortion incident
arising directly or indirectly out of or in connection
with any extended foreign ministry operations.

Payment of the above expenses will be subject to a
$25,000 limit, regardless of the number of covered
persons who are the subject of a kidnap/extortion
incident.

Such additional expense must be incurred during the
time that a kidnapped individual is being held
hostage, or within 30 days of the date upon which all
hostages have been released.

Limitations: This Short-term Trip Limited Kidnap and
Extortion Expense Reimbursement Coverage
provides reimbursement funds as described herein,
but it provides no hostage negotiation assistance nor
any other kidnap and ransom services. Coverage
applies only to kidnap/extortion incidents arising
out of short-term foreign trips . No coverage
applies to any loss, cost or expense related to any
kidnap/extortion incident arising out of any
extended foreign ministry operations.

SHORT-TERM FOREIGN TRIP

TERRORISM-RELATED TRAVEL

INTERRUPTION REIMBURSEMENT
At your request, we will reimburse your ministry
organization up to $100,000 (in total) for the following expenses that you incur in response to a qualifying
act of terrorism that disrupts a short-term foreign
trip during the policy period:
a. lodging expenses that are incurred as a
direct result of the cancellation of scheduled
transportation due to, and occurring within 72
hours of, a qualifying act of terrorism;
b. the increased cost incurred to re-route or re-
book comparable transportation as a
replacement for transportation that is
cancelled as a direct result of a qualifying
act of terrorism;
but only to the extent that such cost is a reasonable
and necessary expense, or such cost has been
authorized by us prior to being incurred. This
coverage applies to qualifying acts of terrorism
occurring in the United States, its territories or
possessions; in Canada; in international waters or
airspace; or in foreign territory.

This liability coverage extension applies to expenses
incurred in connection with a short-term foreign
trip. No coverage applies to any expenses incurred if
such expenses arise directly or indirectly out of or in connection with any extended foreign ministry
operations.

Payment of the above expenses will be subject to a
$100,000 limit, regardless of the number of covered
persons whose travel is interrupted by a qualifying
act of terrorism.

SHORT-TERM FOREIGN TRIP

DEATH REIMBURSEMENT COVERAGE

FOR YOUR LEADERS
At your request, we will pay an accidental death
benefit to your ministry organization in the amount of
$50,000 (in total) if your leader suffers an accidental injury that results in loss of life while on a short-term foreign trip during the policy period . Such loss of
life must occur not later than 180 days after the policy period expiration, the date of cancellation, or the date of non-renewal.

Limitation on Travel Death Reimbursement Coverage
This Short-Term Foreign Trip Death Reimbursement
Coverage for Your Leaders will not apply to any loss
of life that is caused by:
a. an act of suicide or attempted suicide;
b. an act of war; or
c. a disease, illness or medical condition
unrelated to an accident, regardless of where
such disease or illness is contracted.

This liability coverage extension applies to an
accidental injury that occurs on a short-term foreign
trip only. No coverage applies in connection with
extended foreign ministry operations.












 





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PROVISION MODIFICATION:

COVERAGE FOR FOREIGN MINISTRY
PARTICIPANTS – OTHER INSURANCE
Coverages to which Primary Coverage Applies:

Other than the coverages indicated within the
Coverages to Which Excess Coverage Applies
provision stated immediately below, and strictly
subject to all of the terms of this endorsement, any
coverage provided to a foreign ministry participant
or other covered person under the terms of this
endorsement will be provided on a primary basis. For
the coverages of this policy that are not subject to the excess coverage provision below, this means that the
coverage of this policy as conveyed through this
endorsement will be primary to any other available
insurance policy that provides any liability coverage
for any covered person designated herein.

Coverages to Which Excess Coverage Applies:

Subject to all of the terms of this endorsement, the
Principal and Supplemental Coverages of the
Commercial Liability Coverage Form (GL-100), the
Principal and Additional Coverages of the Fire Legal
Liability and Other Nonowned Property Damage
Liability Coverages Form (BGL-951), and the
Additional Coverages of the Broad Scope Media
Liability Coverage Form (BGL-41) will be strictly
excess with respect to any foreign commercial
general liability policy, program, or plan that provides commercial general liability coverage in relation to
your ministry operations in a foreign territory, as set forth in the How Much We Pay Section of this
endorsement.

PROVISION MODIFICATION:

LAW ENFORCEMENT INQUIRY IN

FOREIGN TERRITORY
(DETENTION/IMPRISONMENT) DEFENSE

REIMBURSEMENT
The definition of law enforcement inquiry , as
defined in the Definition section of this endorsement,
will replace and supersede the definition of “law
enforcement inquiry” in the Legal Liability Defense
Reimbursement Coverage Form (BGL-89) and
Religious Freedom Protection Coverage Form (BGL-
66), but only if Legal Liability Defense
Reimbursement Coverage and/or Religious Freedom
Protection Coverage are listed in the declarations,
and are included as part of this policy.

FOREIGN OPERATIONS IMAGE

RESTORATION EXTENSION
At your request, we will reimburse your ministry
organization up to $10,000 for the following expenses
that you incur as the result of or in connection with
an occurrence resulting in bodily injury , property
damage, personal injury , emotional injury ,
financial damage , or a law enforcement inquiry
otherwise covered by this policy that arises out of a
short-term foreign trip or your extended foreign
ministry operations (if coverage for such operations
is included as part of this policy):
a. costs to retain a professional public relations
specialist or public relations firm; and/or
b. costs to retain other outside professional
specialists;
for purposes of responding to a threat to the
reputation, image or effective operations of your
ministry organization.

Reimbursement of such cost applies, however, only
to the extent that such cost is a reasonable and
necessary expense, or such cost has been
authorized by us prior to being incurred.

This liability coverage extension will not apply any
expense incurred as a result of any sexual act or
kidnap/extortion incident.

Costs covered herein must be incurred within 120
days of the date of the occurrence to which the
applicable coverage applies.

EXPANDED MEDICAL COVERAGE

FOR FOREIGN MINISTRY PARTICIPANTS
(Covered Endemic Disease, Environmental
Conditions; and Foreign Terrorism)
Subject to the applicable terms of coverage, we will
extend Principal Coverage M (Medical Payments) as
follows:

We pay reasonable and necessary medical
expenses not otherwise covered by this policy if
incurred by a foreign ministry participant as the
result of bodily injury caused by or resulting directly from:
a. a covered endemic disease; or
b. a covered environmental medical
condition;o r












 





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BGL-112 (1.0) Copyright, 2020 Brotherhood Mutual Insurance Co. Page 7 of 14 All Rights Reserved
c. foreign terrorism;
but only if such accidental injury, infection, disease or condition occurs:
(1) in foreign territory;a n d
(2) in connection with a short-term foreign trip
or your extended foreign ministry
operations (if coverage for such operations
is included as part of this policy); and
(3) during the policy period.

No deductible applies to this coverage.

We will pay up to the Coverage M Medical Limit
stated in the declarations for medical expenses
covered herein, subject to all of the terms of Principal Coverage M. We will pay such medical expense
whether the treatment is provided in foreign territory
or in the basic territory , but only if it is incurred
within one year of the date of the accident or the
onset of the infection, disease or medical condition.

ADDITIONAL MEDICAL COVERAGE

DEFINITIONS
(Covered Endemic Disease, Environmental
Conditions; and Foreign Terrorism)
Each of the words or phrases defined in the Definition
section of the Commercial Liability Coverage Form
(GL-100) and the Liability and Medical Coverage
Form (BGL-11) apply to the Expanded Medical
Coverage of this endorsement, unless otherwise
modified herein. The following definitions apply only
to the Expanded Medical Coverage of this
endorsement.

1. Covered endemic disease means a disease,
parasitic infection or other medical condition
that is either common to, or is constantly present
among, a population in a particular location or
region in foreign territory . Covered endemic
disease includes malaria, tuberculosis, typhoid
and similar diseases, but covered endemic
disease does not include any non-communicable
medical condition, such as malignant or non-
malignant growths, heart attack or stroke.

Covered endemic disease also does not include
any communicable disease, illness or infection
that has been declared to be a pandemic by the
World Health Organization or by any similar
global health agency.

2. Covered environmental medical condition
means an illness, infection or other medical
condition that:
a. is triggered by local or environmental
conditions; or
b. results from ingesting tainted food or water;
or
c. is otherwise sustained by or contracted by a
covered person due to his or her
involvement in a short-term foreign trip or
your extended foreign ministry operations
(if coverage for such operations is included
as part of this policy);
but only if such illness, infection or condition is
contracted in foreign territory . Covered
environmental medical condition includes
asthma attacks, food poisoning, water-borne
illnesses, heat exhaustion and other medical
conditions that are sustained or contracted
because of an individual’s involvement in a
short-term foreign trip or your extended
foreign ministry operations (if coverage for
such operations is included as part of this policy).

Covered environmental medical condition
does not include any illness, infection or condition
that has been declared to be a pandemic by the
World Health Organization or by any similar
global health agency.

3. Foreign terrorism means a malicious act
occurring in foreign territory that:
a. is violent, or is dangerous to human life,
property, or infrastructure; and
b. is undertaken in an effort to:
(1) terrorize a civilian population, or
(2) affect political or societal change; or
(3) destabilize a ruling authority or ruling
body; or
(4) influence governmental policy; or
(5) attack the policy, practices, symbols or
beliefs of any government institution, or
any religion, sect or belief system.

4. Parasitic infection means illness or tissue
damage that arises from the invasion of a human
body by a being that:












 





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a. is classified as a protozoan or helminth
organism; and
b. inhabits the human body, blood, fluids or
organs as a host.

Parasitic infection includes malaria, intestinal
worms, liver or lung flukes, elephantiasis,
sleeping sickness and other similar infections.

EXCLUSIONS
Each of the exclusions set forth in the Exclusions
section of the Commercial Liability Coverage Form
(GL-100), the Liability and Medical Coverage Form
(BGL-11) and other applicable liability endorsements
will apply to the Coverage Extensions and other
grants of coverage provided by this endorsement,
unless otherwise modified herein. The following
exclusions also apply.

1. Any coverage provided by an Excess/Umbrella
Liability Coverage Form, if included as part of this
policy, will not extend to loss of any kind
associated with an accident, incident, injury or
damage of any kind occurring in foreign
territory.

2. No coverage is provided herein with respect to
loss of any kind arising directly or indirectly out of
or in connection with the ownership, operation,
occupancy, renting, loaning, supervision,
maintenance, use, entrusting, control, loading or
unloading of any auto or mobile equipment
(whether such auto or equipment is owned or
non-owned), nor will coverage herein apply to the
supervision of any person(s) while occupying any
auto or mobile equipment (whether such auto or
equipment is owned or non-owned).

3. No coverage is provided herein with respect to
loss of any kind arising directly or indirectly out of
or in connection with:
a. any extended foreign ministry operations ;
or
b. any trip, travel, work activity or other activity
of any kind that is undertaken by any
foreign-based person;
unless Extended Foreign Ministry Operations is
shown as Included for Worldwide Liability
Extension Coverage on the declarations.

This exclusion does not apply, however, to your
covered electronic commerce activity nor to your
products distribution activity.

4. No coverage is provided herein with respect to
loss of any kind arising directly or indirectly out of
or in connection with the ownership or operation,
by any covered person, of any aircraft or other air
conveyance. But this exclusion does not apply
with respect to covered persons who are
occupying an aircraft or other air conveyance that
is owned, operated and controlled by a
commercial carrier, a charter company or other
third-party flight operator.

5. Other than for the Additional Liability Coverage
Extensions and Provision Modifications of this
endorsement, no coverage will apply under the
terms of this endorsement to claims occurring in
foreign territory unless such claim would
otherwise be covered under this policy in the
basic territory. This means that, other than for
the Additional Liability Coverage Extensions and
the Provision Modifications set forth within this
endorsement, this endorsement simply extends
coverages of this policy (if otherwise applicable)
to acts, incidents, events or exposures that occur
in foreign territory.

6. No coverage is provided herein with respect to
loss of any kind arising directly or indirectly out of
or in connection with any extended foreign
ministry operations unless your organization
has purchased a foreign liability policy, program,
or plan that:
a. provides commercial general liability
coverage for your extended foreign
ministry operations;a n d
b. is placed with a commercial lines carrier that
has been approved for your ministry
organization by Brotherhood Mutual.

This exclusion does not apply, however, to your
covered electronic commerce activity nor to your
products distribution activity.

HOW MUCH WE PAY
Each of the provisions set forth in the How Much We
Pay section of the Liability and Medical Coverage
Form (BGL-11) apply to the Coverage Extensions
and other grants of coverage provided by this
endorsement, unless otherwise modified herein. The
following provisions also apply.

1. Other Foreign Commercial General Liability
Coverage:

The Principal and Supplemental Coverages of
the Commercial Liability Coverage Form (GL-












 





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100), including Principal Coverage M (Medical
Payments) and any extensions of Principal
Coverage M included on your policy, the
Principal and Additional Coverages of the Fire
Legal Liability and Other Nonowned Property
Damage Liability Coverages Form (BGL-951),
and the Additional Coverages of the Broad Scope
Media Liability Coverage Form (BGL-41) are
strictly excess over any commercial general
liability policy, program, or plan (including direct,
excess and umbrella insurance) that provides
commercial general liability coverage for your
ministry operations in a foreign territory, even if
such insurance or coverage:
a. is stated to be secondary, excess or
contingent; or
b. has coverage available, but is not elected to
be used.

All other coverages of this policy will be provided
on a primary basis unless stated otherwise in the
applicable endorsement.

2. Short-Term Foreign Trips Coverage Limit:

For claims that arise directly out of and in
connection with a short-term foreign trip ,t h e
Coverage Limit shown in the declarations for all
applicable liability coverages of this policy,
subject to the General Occurrence Limit, the
Coverage Aggregate Limit and the General
Aggregate Limit, is the most we will pay for all
losses arising out of an occurrence to which
such liability coverage applies.

This Coverage Limit (related to short-term
foreign trips) is the most we will pay regardless
of:
a. the number of persons or entities to whom
this policy provides coverage;
b. the number of losses or related losses
arising directly or indirectly out of one or
more related acts, errors, omissions,
decisions, incidents, events or breaches of
duty;
c. the number of persons acted upon, or who
otherwise sustain injury, damage or loss;
d. the number of claims made or suits brought,
or the number of persons initiating such
claims or suits;
e. the number of acts, errors, omissions,
decisions, incidents, events, or breaches of
duty contributing to injury, damage or loss;
f. the extent or duration of the injury, loss, or
related loss;
g. the extent or duration of the wrongful activity
or the number of acts, errors or omissions,
decisions, incidents, events or breaches of
duty contributing to the injury, damage or
loss;
h. the number of our policy periods , or
portions thereof, over which any acts, errors,
omissions, decisions, incidents, events, or
breaches of duty contributing to injury,
damage or loss should occur; or over which
the injury, loss or related loss should occur;
or
i. the territory or territories within which the
acts, errors, omissions, decisions, incidents,
events or breaches of duty should occur.

3. Extended Foreign Ministry Operations
Coverage Limit:

No coverage will be provided for claims that arise
out of extended foreign ministry operations
unless shown as Included for Worldwide Liability
Extension Coverage on the
declarations.

If extended foreign ministry operations is
shown as Included for Worldwide Liability
Extension Coverage on the declarations, the
applicable limit of coverage for claims that arise
out of extended foreign ministry operations or
that are incurred by, caused by or related to any
foreign-based person will be the lesser of:
a. the Coverage Limit shown for Extended
Foreign Ministry Operations in the Extended
Foreign Ministry Operations Coverage
Schedule;
b. the Coverage Limit shown for a liability
coverage specifically listed within the
Extended Foreign Ministry Operations
Coverage Schedule;
c. the Coverage Limit shown in the
declarations for the applicable liability
coverage;o r
d. the specific limit of coverage set forth within
an applicable endorsement of this policy.

The applicable Coverage Limit (related to your
extended foreign ministry operations or to
foreign-based persons), subject to the General
Occurrence Limit, the applicable Coverage












 





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Aggregate Limit, and the General Aggregate
Limit, is the most we will pay regardless of:
a. the number of persons or entities to whom
this policy provides coverage;
b. the number of losses or related losses
arising directly or indirectly out of one or
more related acts, errors, omissions,
decisions, incidents, events or breaches of
duty;
c. the number of persons acted upon, or who
otherwise sustain injury, damage or loss;
d. the number of claims made or suits brought,
or the number of persons initiating such
claims or suits;
e. the number of acts, errors, omissions,
decisions, incidents, events, or breaches of
duty contributing to injury, damage or loss;
f. the extent or duration of the injury, loss, or
related loss;
g. the extent or duration of the wrongful activity
or the number of acts, errors or omissions,
decisions, incidents, events or breaches of
duty contributing to the injury, damage or
loss;
h. the number of our policy periods , or
portions thereof, over which any acts, errors,
omissions, decisions, incidents, events, or
breaches of duty contributing to injury,
damage or loss should occur; or over which
the injury, loss or related loss should occur;
or
i. the territory or territories within which the
acts, errors, omissions, decisions, incidents,
events or breaches of duty should occur.

Note: I f extended foreign ministry
operations coverage is shown as Included in
the declarations, applicable coverage limits
for extended foreign ministry operations
and/or involving foreign-based persons will
be subject to the Extended Foreign Ministry
Operations Coverage Schedule. Extended
foreign ministry operations limits will
typically be lower than if the claim: (1) arises
out of a short-term foreign trip; (2) does not
involve and foreign-based person ;o r( 3 )
arises out of local operations taking place in
the basic territory.

4. Short-Term Foreign Trips Coverage
Aggregate Limit:

For claims arising out of a short-term foreign
trip, the Coverage Aggregate Limit shown in the
declarations for all applicable liability
coverages of this policy, subject to the General
Aggregate Limit, is the most we will pay under
such liability coverage ,f o r a l l occurrences
taking place during the period to which the
Coverage Aggregate limit applies [as described
in Provision 8 of The How Much We Pay section
of the Liability and Medical Coverage Form (BGL-
11)].

5. Extended Foreign Ministry Operations
Coverage Aggregate Limit:

No coverage will be provided for claims that arise
out of extended foreign ministry operations
unless shown as Included for Worldwide Liability
Extension Coverage on the declarations.

If extended foreign ministry operations is
shown as Included for Worldwide Liability
Extension Coverage on the declarations,t h e
Coverage Aggregate Limit for claims that arise
out of extended foreign ministry operations or
that are incurred by, caused by or related to any
foreign-based person will be the lesser of:
a. the Coverage Aggregate Limit shown for
Extended Foreign Ministry Operations in the
Extended Foreign Ministry Operations
Coverage Schedule;
b. the Coverage Aggregate Limit shown for a
liability coverage specifically listed within
the Extended Foreign Ministry Operations
Coverage Schedule;
c. the Coverage Aggregate Limit shown in the
declarations for the applicable liability
coverage;o r
d. the specific aggregate limit of coverage set
forth within an applicable endorsement of this
policy.

The applicable Coverage Aggregate Limit,
subject to the General Aggregate Limit, is the
most we will pay under such liability coverage
for all occurrences taking place during the
period to which the Coverage Aggregate Limit
applies [as described in Provision 8 of the How
Much We Pay section of the Liability and Medical
Coverage Form (BGL-11)].

6. If an occurrence to which any liability coverage
of this policy applies consists of activity occurring












 





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on more than one date during any policy period
or policy periods , such activity, together with
any related loss , will constitute a single
occurrence, and the date of occurrence will be
considered to be the earlier of:
a. the date on which the last alleged wrongful
act out of which the claim arises is
demonstrated to have occurred; or
b. the last day that we provided any coverage
to you for such act.

The policy forms, endorsements and limits in
effect on the date of occurrence will govern
coverage with respect to all claims arising directly
or indirectly out of the occurrence.

7. If an occurrence to which any liability
coverage of this policy applies consists of
activity occurring both in the basic territory and
in foreign territory in connection with your
extended foreign ministry operations ,s u c h
activity, together with any related loss , will
constitute a single occurrence arising out of
your extended foreign ministry operations.

8. We will make every effort to respond to claims
covered herein to the extent that we are
permitted to do so by law. But we will be able to
make payment under the terms of this
endorsement only to the extent that such
payment does not violate applicable trade
sanctions, governmental restrictions, or other
similar international payment restrictions. If we
are prevented by law, or otherwise, from
defending a covered person, then, subject to the
terms, limits and other stated limitations of this
policy, we will reimburse the covered person for
reasonable and necessary expenses incurred for
the defense of a claim, lawsuit, action, or
proceeding to which this insurance applies and
that we would have otherwise been able to
exercise our right and duty to defend.

Reimbursement of such defense costs will be
conveyed to the extent that the cost incurred was
reasonable and necessary, unless we are
specifically prohibited by law from conveying the
reimbursement to the covered person.

If a
covered person becomes legally obligated
to pay damages to which this insurance applies
and we are prevented by law, or otherwise, from
paying such sums on behalf of the covered
person, then, subject to the terms, limits and
other limitations of this policy, we will reimburse
the covered person for such sums, to the extent
that the cost incurred was reasonable and
necessary. Reimbursement of such damages will
be conveyed unless we are specifically prohibited
by law from conveying the reimbursement to the
covered person.

9. Currency Used:

All payment that is conveyed under the terms of
this endorsement will be paid in U.S. Dollar
currency unless foreign law or other
circumstances dictate that payment must be
made in the currency of a foreign country. In this
situation, we will endeavor to work through
domestic and foreign financial institutions to
arrange for payment in the required foreign
currency.

10. Reasonable Costs:

Costs to which this endorsement would otherwise
apply will be paid or reimbursed by us only to the
extent that such costs are reasonable and
necessary, or such costs have been authorized in
advance by us.

HOW MUCH WE PAY
(KIDNAP AND EXTORTION EXPENSE

REIMBURSEMENT COVERAGE)
In addition to the above How Much We Pay
provisions, the following provisions will also apply to the Kidnap and Extortion Expense Reimbursement
coverage of this endorsement.

1. K & E Expense Reimbursement Limit:

We will pay no more than $25,000 toward all
expenses that are covered within the Kidnap and
Extortion Expense Reimbursement coverage of
this endorsement. This $25,000 limit applies to
all covered expenses that are incurred in relation
to any kidnap/extortion incident.

2. Application of the Kidnap and Extortion Limit:

The $25,000 expense reimbursement limit set
forth above represents the most we will pay
under the Kidnap and Extortion Expense
Reimbursement coverage of this endorsement
regardless of:
a. the amount of ransom being sought or other
conditions being demanded;
b. the total cost or expense required to respond
to a kidnap/extortion incident locally or
internationally; or
c. the number of covered persons or other
persons who are taken hostage or who
otherwise are impacted by a
kidnap/extortion incident.












 





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If more than one person is kidnapped through a
coordinated effort of one or more conspiring
kidnappers, such kidnapping will be considered
to be a single kidnap/extortion incident, even if
the acts of kidnapping occur over time.

3. Coverage Requests:

Coverage under the Kidnap and Extortion
Expense Reimbursement coverage of this
endorsement will apply based on your request
for coverage. The leaders of your organization
are responsible for identifying and submitting the
expenses for which reimbursement is sought.

4. Order of Payments:

Covered bills and expenses under the Kidnap
and Extortion Expense Reimbursement coverage
of this endorsement will be paid in the order that
they are received by us until the limit of
coverage has been paid, at which point payment
under this reimbursement coverage will cease.

5. Communication to Affected Persons:

You will also be responsible for assisting us in
communicating to affected persons the manner in
which, and the extent to which, payment under
the terms of this endorsement will apply.

LIMITATION
Nothing in this endorsement will act to increase any
limits of coverage stated within: (1) the
declarations; or (2) the Extended Foreign Ministry
Operations Coverage Schedule (if applicable); and
no terms of the policy are modified through this
endorsement, unless such terms are specifically
modified herein.

CONDITIONS
Each of the conditions set forth in the Conditions
section of the Commercial Liability Coverage Form
(GL-100) and the Liability and Medical Coverage
Form (BGL-11) apply to the Coverage Extensions
and other grants of coverage provided by this
endorsement, unless otherwise modified herein. The
following conditions also apply.

1. Extending the “Basic Territory” Coverage of
Your Policy to Foreign Territory:

Other than for the Additional Liability Coverage
Extensions and Provision Modifications of this
endorsement, no coverage will apply under the
terms of this endorsement to claims occurring in
foreign territory unless such claim would
otherwise be covered under this policy in the
basic territory. This means that, other than for
the Additional Liability Coverage Extensions and
Provision Modifications, this endorsement simply
extends coverages of this policy (if otherwise
applicable) to acts, incidents, events or
exposures that occur in foreign territory.

Coverage is automatically extended through this
endorsement, subject to the terms provided
herein, to short-term foreign trips as follows:

Short-term Foreign Trips: Unless otherwise
specifically modified under the terms of this
endorsement, or specifically modified within
the Extended Foreign Ministry Operations
Coverage Schedule shown on the
declarations, all provisions, limits,
limitations, conditions, exclusions and other
terms that apply to the applicable coverages
of this policy will apply to a short-term
foreign trip.

Coverage may also conditionally be extended
through this endorsement, subject to the terms
provided herein, to your extended foreign
ministry operations as follows:

Extended Foreign Ministry Operations: If
extended foreign ministry operations is shown as
Included on the declarations for Worldwide Liability
Extension Coverage, then, unless otherwise
specifically modified under the terms of this
endorsement or specifically modified within the
Extended Foreign Ministry Operations Coverage
Schedule shown on the declarations, all provisions,
limitations, conditions, exclusions and other terms
that apply to the applicable coverages of this policy
will apply to loss of any kind:
a. related to your extended foreign ministry
operations;o r
b. incurred by, caused by or related to any
foreign-based person.

Coverage for your extended foreign ministry
operations will apply only if your organization has
also purchased a foreign liability policy, program, or
plan that:
a. provides commercial general liability
coverage for your extended foreign
ministry operations;a n d
b. is placed with a commercial lines carrier that
has been approved for your ministry
organization by Brotherhood Mutual.












 





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2. Liability Coverage Grant (following coverage ):

All liability coverage that is conveyed through
this endorsement is subject to the limits,
limitations, conditions, exclusions and other
terms stated in the applicable liability form or
endorsement, unless otherwise modified herein,
and is also subject to the applicable terms set
forth in this endorsement.

3. Medical Coverage Grant (following coverage ):

All medical coverage that is conveyed through
this endorsement is subject to the limits,
limitations, conditions, exclusions and other
terms stated in the applicable medical form or
endorsement, unless otherwise modified herein,
and is also subject to the applicable terms set
forth in this endorsement.

4. Worldwide Coverage (for claims made/suits
brought in foreign territory ): The Coverage
Extensions and other grants of coverage
provided by this endorsement will apply on a
worldwide basis to claims brought against
covered persons if: (1) the claim is made;
and/or (2) the suit is filed; in foreign territory.

5. Worldwide Legal Defense: The Defense
Coverage(s) provided by the applicable forms
and endorsements of this policy will apply to
claims made or suits brought in foreign territory.

We will identify and work with foreign-based
attorneys, translation services, and other service
providers to appropriately defend covered
persons in foreign countries. We will also apply
any applicable defense reimbursement coverage
of the policy to covered lawsuits and covered
foreign law enforcement inquiries that may occur
or be pursued in foreign countries. Other than a
broadening of the territory definition as described
above all provisions, limits, limitations,
conditions, exclusions and other terms that apply
to the applicable defense coverage(s) of this
policy will continue to apply. For Defense
Coverage(s) applicable to your extended
foreign ministry operations and specifically
listed in the Extended Foreign Ministry
Operations Coverage Schedule of the
declarations, however, the Coverage Limit
shown in the schedule will apply.

Nothing in the Defense Coverage provided by
this policy shall be construed to obligate us in
any way to pay for any actual or alleged damage,
injury or loss of any kind sustained by any
person, or any related judgment or award that
arises directly or indirectly out of any loss.

6. Kidnap & Extortion Expense Reimbursement
Coverage: We will reimburse up to $25,000 for
common expenses that are incurred in response to
kidnap/extortion incidents. Such expenses
include ransom costs, hostage negotiator expenses,
costs incurred to set up a command center,
professional public relations or legal consultation
expenses, and other enumerated reasonable and
necessary expenses that are incurred by your
ministry organization in response to a
kidnap/extortion incident . This Expense
Reimbursement Coverage applies to incidents
occurring anywhere in the world. All stated
conditions, limits, limitations, exclusions and other
terms of this Expense Reimbursement Coverage
will apply.

7. Expanded Medical Coverage for Foreign
Ministry Participants (Covered Endemic
Disease, Environmental Conditions; and Foreign
Terrorism): Coverage M (medical payments) will
apply to foreign ministry participants who incur
medical costs in connection with specified
endemic disease; environmental medical
conditions; or foreign terrorism while engaged
in a short-term foreign trip or extended foreign
ministry operations . All conditions, limits,
limitations, exclusions and other terms of the
policy will continue to apply unless otherwise
modified herein.

8. Representations: By accepting this Coverage
Endorsement, you agree:
a. the entries pertaining to this coverage on the
declarations page are based upon
representations which you or any insured
have made to us;
b. any information that you have provided to us
regarding your foreign trips, your foreign-
based workers and the scope of your activity
in foreign territory is essentially accurate;
c. your organization has also purchased a
foreign liability policy, program, or plan that:
(1) provides commercial general liability
coverage for your extended foreign
ministry operations,a n d
(2) is placed with a commercial lines carrier
that has been approved for your ministry
organization by Brotherhood Mutual,
if coverage for extended foreign ministry
operations is provided through this
endorsement and shown as included for
Worldwide Liability Extension Coverage on
the
declarations;












 





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d. to notify Brotherhood Mutual if such foreign
liability policy, program or plan is cancelled at
any time while this Coverage Endorsement is
in effect; and
e. we have issued this Coverage Endorsement
in reliance upon such representations.

OTHER PROVISIONS
All other provisions of the Commercial Liability
Coverage Form (GL-100), the Liability and Medical
Coverage Form (BGL-11) and other applicable forms
of the policy will continue to apply.












 





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This Liability Coverage Endorsement is subject to the terms of the applicable Commercial Liability Coverage Form (GL-100) and the Liability and Medical Coverage Form (BGL-11). Only one liability coverage will apply to an occurrence and any related loss. This endorsement is attached to and made part of the policy.

THIS INSURANCE ENDORSEMENT FORMS PART OF YOUR POLICY CONTRACT.

PLEASE READ IT CAREFULLY.

MINISTRY OPERATIONS

COVERAGE LIMITS
– HIGH HAZARD ACTIVITIES –

PROVISION MODIFICATION

HIGH HAZARD ACTIVITIES

COVERAGE LIMIT

Liability Limits - The coverage/occurrence limit
for any applicable liability coverage that applies to
loss arising directly or indirectly out of or in
connection with any high hazard activity is
reduced to $100,000, unless a different High
Hazard Activity Liability Limit is specifically
indicated on the declarations, and then only for
the type of high hazard activity indicated.

Medical Payments Limits - The medical
payments coverage limit for any applicable
medical payments coverage that would pay in
relation to any high hazard activity is reduced to
$0, unless a different High Hazard Activity Medical
Limit is specifically indicated on the declarations,
and then only for the type of high hazard activity
indicated.

ADDITIONAL DEFINITIONS

Each of the defined words or phrases set forth in
the Definitions section of the Commercial Liability
Coverage Form (GL-100), and the Liability and
Medical Coverage Form (BGL-11) will continue to
apply. The following definitions apply only to the
provisions of this endorsement:

General contractor means any person or entity
who oversees or directs the performance of
construction or demolition work, and to whom
workers or subcontractors report in connection
with the work undertaken. The owner of property
on which such work is being performed will be
considered a general contractor with respect to
work on the premises unless the owner has hired
an outside independent contractor to oversee and
direct the work.

High hazard activity means any of the following:

a. Skate Park Operations : The
development, construction, maintenance,
oversight or use of any ramps, half-pipes,
slopes or similar structures that:

(1) are designed for, or are intended to be
used in connection with, any roller
skates, skate boards, bicycles, roller
blades, or any other similar wheeled
conveyance; and

(2) are arranged by, installed by,
operated by, or otherwise made
available for use by your organization;
and

(3) are located on premises that you own
or otherwise control; and

b. Fireworks Sales : The sale, marketing,
distribution, or storage of fireworks of any
kind if undertaken: (1) on any premises
that you own, occupy or control; or (2) on
your behalf or for your benefit, whether
on or away from your premises; and

c. Fireworks Display : The display of any
fireworks on your behalf: (1) by you, your
leaders, your employees, or your












 





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appointed persons ; or (2) by an any
other person or organization that is hired
by you or that is acting on your behalf to
exhibit the fireworks display; and

d. Major Construction Oversight/
Indemnification: Work of any kind on any
major construction/demolition project if
you, or any of your leaders , your
employees, or your appointed persons:

(1) act as a general contractor on your
behalf; or

(2) indemnify any contractor, or otherwise
assume liability for the contractor’s
negligence, in connection with any
major construction/demolition
project.

Major construction/demolition project means
the building of a new structure or the addition onto,
demolition, renovation, or remodeling of, an
existing structure that you own, use or occupy (or
that you intend to own, use or occupy in the
future), but only if:

a. the construction involves the installation of
pre-fabricated rafters or trusses; or

b. the structure, or addition being built, when
completed, will encompass more than
5,000 square feet; or

c. the demolition, renovation, or remodeling
is of a structure encompassing more than
5,000 square feet.

HOW MUCH WE PAY

Each of the provisions set forth in the How Much
We Pay section of the Liability and Medical
Coverage Form (BGL-11) apply to the coverages
of this policy, except to the extent that the
Provision Modification of this endorsement and the
following provisions limit the policy’s coverages.

1. Limit of Liability Coverage : We will pay no
more than $100,000 per occurrence for loss
arising directly or indirectly out of or in
connection with any high hazard activity
(unless a different High Hazard Activity
Liability Limit is specifically indicated on the
declarations, and then only for the type of
high hazard activity indicated). This High
Hazard Liability Limit will replace and
supersede: (1) the General Occurrence Limit
of the policy; and (2) any other otherwise-
applicable coverage limits of the policy, for
loss arising in any manner out of any high
hazard activity . This High Hazard Activity
Liability Limit is the most we will pay for loss
arising out of or in connection with any high
hazard activity regardless of the amount of
loss incurred, the number of persons
sustaining loss, or the number of related acts,
errors, omissions, decisions or events that
contribute to the loss.

2. Limit of Premises Medical Coverage : We
will pay no medical expense arising in any
manner out of or in connection with any high
hazard activity (unless a High Hazard Activity
Medical Limit other than $0 is specifically
indicated on the declarations, and then only
for the type of high hazard activity indicated).

This High Hazard Medical Limit will replace
and supersede all other medical limits of the
policy for medical expense arising in any
manner out of any high hazard activity.

3. Aggregate Limits : Provisions relating to
Aggregate Limits in the How Much We Pay
section of the Liability and Medical Coverage
Form (BGL-11) will apply to loss arising out of
any high hazard activity, and the amount that
we pay for such loss will be subject to the
general aggregate limit of the policy and to
any applicable coverage aggregate limit.

OTHER PROVISIONS

All other provisions of the Commercial Liability
Coverage Form (GL-100) and the Liability and
Medical Coverage Form (BGL-11) will continue to
apply.













 





04M5A0494326

BGL100 A-1 (2.2) Brotherhood Mutual Insurance Company Page 1 of 1

COMMERCIAL LIABILITY ENDORSEMENT

CONDITIONS

The following Condition provision 5 replaces and
supersedes Condition 5 of the Commercial Liability
Coverage Form (GL-100):

5. Premium Audit
The premium shown on the declarations may
be an estimated premium subject to audit. If
so, we will compute the final earned premium
following each period for which an audit is to
be done. If the earned premium is more than
the estimated premium paid by you, we will
provide you with a notice of additional
premium due for the difference. Any audit
premium balance is due no later than the date
specified as the Due Date on the additional
premium notice.

If the final earned premium is less than the
estimated premium paid by you, at our option
we will return the difference to you or credit it
against the renewal premium.

You must maintain records of the information
that is necessary for computing the earned
premium. Copies of the records must be sent
to us at the end of the policy period or when
requested by us.

SCOPE

All other policy provisions of the policy remain
unchanged.

This Liability Coverage Endorsement is subject to the terms of the Commercial Liability Coverage Form (GL-100). It modifies the ‘Conditions’ section of the Commercial Liability Coverage Form (GL-100) as stated herein.

-Please read this carefully-












 

















 





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04M5A0494326
BGL-152 (1.0) Copyright, 2013 Brotherhood Mutual Insurance Co. Page 1 of 1 All Rights Reserved

This Liability Coverage Endorsement is subject to the terms of the applicable Commercial Liability Coverage Form (GL-100) and the Liability and Medica l Coverage Form (BGL-11). Only one liability coverage will apply to an occurrence and any related loss. This endorsement is attached to and made part of the policy.

THIS INSURANCE ENDORSEMENT FORMS PART OF YOUR POLICY CONTRACT.

PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED ENDORSEMENT

ADDITIONAL CONDITION

ADDITIONAL CONDITION

The following additional condition is added to the
Conditions section of the Liability and Medical
Coverage Form (BGL-11):

Additional Insureds: With respect to any
person or entity shown on the declarations
as an Additional Insured or who is otherwise
designated by the Named Insured and
recognized by us as an Additional Insured,
we will provide Principal Coverage L of the
Commercial Liability Coverage Form (GL-
100) to such Additional Insured (they will be
considered an insured for Principal
Coverage L), but only to the extent that such
person or entity is legally liable for the acts of
you, your leader , your employee, or your
appointed person . Such coverage will be
limited to that which is specifically provided
by Principal Coverage L, and will be strictly
subject to the terms of this policy. No
coverage will apply to any independent acts,
errors, or omissions of an Additional Insured.

OTHER PROVISIONS

All other provisions of the applicable Commercial
Liability Coverage Form (GL-100) and the
Liability and Medical Coverage Form (BGL-11)
remain unchanged.












 

















 





04M5A0494326
EX-220 CA (1.0) Copyright, 2023 Brotherhood Mutual Insurance Co. Page 1 of 1 All Rights Reserved

This Endorsement is subject to the terms of the Commercial Liability Coverage Form (GL-100) and the Liability and Medical Coverage Form (BGL-11).

T
HIS INSURANCE ENDORSEMENT FORMS PART OF YOUR POLICY CONTRACT.

PLEASE READ IT CAREFULLY.

MINISTRY OPERATIONS

THIS EXCLUSIONARY ENDORSEMENT APPLIES TO ALL LIABILITY COVERAGES

OF THE POLICY AND ALL MEDICAL COVERAGES OF THE POLICY

INFECTIOUS DISEASE LIABILITY EXCLUSION
~ PUBLIC HEALTH EMERGENCIES ~

DEFINITIONS

Each of the words or phrases set forth in the
Definitions section of the Commercial Liability
Coverage Form (GL-100) and the Liability and
Medical Coverage Form (BGL-11) will continue to
apply. The following definition also applies to the
Additional Exclusion set forth herein:

1. Infectious disease means any of the
following:

a. any infectious virus, bacterium or other
microorganism that can result in human
illness, regardless of the means of
transmission or the extent of the infection
within a population; or

b. any disease, illness or harmful bodily
condition of any kind (whether
symptomatic or asymptomatic) that can
be transmitted in any manner from one
organism to another organism; or

c. the mutation or variation of any
communicable disease or contagious
illness, whether such disease or illness is
known, unknown, recognized or
unrecognized.

ADDITIONAL EXCLUSION THAT

APPLIES TO ALL LIABILITY AND

MEDICAL COVERAGES

Each of the exclusions set forth in the Exclusions
section of the Commercial Liability Coverage
Form (GL-100) and the Liability and Medical
Coverage Form (BGL-11) will continue to apply.

The following exclusion also applies to all liability
and medical coverages of the policy:

1. We do not pay for loss of any kind that arises
directly or indirectly out of or in connection
with the actual or alleged transmission of an
infectious disease that has been
categorized as a public health emergency (or
as a pandemic) by:

a. the World Health Organization; or

b. any federal, state or local governmental
authority.

We will, however, extend the coverage of the
Legal Liability Defense Reimbursement Coverage
Form (BGL-89), if included as part of this policy,
for such loss, subject to the Proceeding Limit and
all terms of the Legal Liability Defense
Reimbursement Coverage Form (BGL-89).

OTHER PROVISIONS

All other provisions of the Commercial Liability
Coverage Form (GL-100) and the Liability and
Medical Coverage Form (BGL-11) will continue to
apply.












 

















 





04M5A0494326

EX 909 (1.0) Copyright, 2007 Brotherhood Mutual Insurance Co. Page 1 of 1 All Rights Reserved

ASBESTOS EXPOSURE EXCLUSION -
SCOPE

The following Asbestos Exposure Exclusion applies to all liability and medical coverages of the policy.

- PLEASE READ THIS CAREFULLY -

ASBESTOS EXPOSURE EXCLUSION

In addition to the other excl usions of the policy, the following exclusion will apply to all liability and
medical coverages:

We do not pay for bodily injury , property
damage or other actual or alleged loss of any
kind arising directly or indirectly out of or in
connection with exposure to asbestos in any
form or quantity. This exclusion will apply
regardless of the manner in which the exposure
to asbestos should occur.

The exclusion contained herein applies to all liability and medical coverages of the policy.

OTHER PROVISIONS

All other provisions of the policy remain unchanged.













 

















 





04M5A0494326
Copyright, American Association of Insurance Services, Inc., 2006 AAIS
GL 0363 08 06

AMENDATORY ENDORSEMENT

CALIFORNIA
Definitions is amended to include the following:

Throughout this policy, any reference to "your" spouse includes a person who is "your" registered domestic partner as defined or recognized by California law.

Throughout this policy, any reference to "your" relative or "your" resident relative includes a relative of "your" registered domestic partner.

GL 0363 08 06












 

















 





04M5A0494326
AAIS This endorsement changes
GL 0950 12 99 the policy

KNOWN INJURY OR DAMAGE AMENDMENTS

The Commercial Liability Coverage is amended
as follows:

1. Under Definitions, the following definition is
added:
"Designated insured" means:
a. "you" and "your" spouse, but only with
respect to the conduct of a business of
which "you" are the sole owner, if "you"
are shown on the "declarations" as an
individual;
b. "you" and all "your" partners or members
and their spouses, but only with respect
to the conduct of "your" business, if "you"
are shown on the "declarations" as a
partnership or a joint venture;
c. "you" and all "your" members and
managers, but only while acting within the
scope of their duties, if "you" are shown
on the "declarations" as a limited liability
company; and
d. "you" and all "your" executive officers and
directors, but only while acting within the
scope of their duties, if "you" are shown
on the "declarations" as an organization
(other than a partnership, joint venture, or
limited liability company). It also includes
"your" stockholders, but only for their
liability as such; or
e. any "employee" who is authorized to give
or receive notice of an "occurrence" or a
claim.

2. Under Principal Coverages, Coverage L and,
if applicable, Coverage N are amended by
the addition of the following:

This insurance applies only to:
a. "Bodily injury" or "property damage"
which is not a continuation of, resumption
of, or change in "bodily injury" or
"property damage" that was known by a
"designated insured" prior to the
inception date of the policy period. If a
"designated insured" knew, as stated
under the Knowledge of Bodily Injury or
Property Damage Condition, prior to the
inception date of the policy period, that
"bodily injury" or "property damage" had
occurred, any continuation of, resumption
of, or change in such "bodily injury" or
"property damage" will be deemed to
have been known by the "designated
insured" prior to the inception date of the
policy period.
b. "Bodily injury" or "property damage" that
occurs during the policy period and which
is not a continuation of, resumption of, or
change in "bodily injury" or "property
damage" which was known by a
"designated insured", as stated under the
Knowledge of Bodily Injury or Property
Damage Condition, to have occurred
prior to the inception date of this policy
period, will include any continuation of,
resumption of, or change in such "bodily
injury" or "property damage" after the end
of this policy period.

3. Under Defense Coverage, the following is
added:
"We" have no duty to defend a suit or claim
seeking "damages" because of "bodily injury"
or "property damage" which was known by a
"designated insured", as stated under the
Knowledge of Bodily Injury or Property
Damage Condition, prior to the inception date
of the policy period.












 





04M5A0494326
AAIS
GL 0950 12 99

4. Under Conditions, the following condition is
added:

Knowledge of Bodily Injury or Property
Damage -- Knowledge of "bodily injury" or
"property damage" will be deemed to have
occurred at the earliest of the following times:
a. when a suit, claim, or demand for
"damages" alleging "bodily injury" or
"property damage" is received by any
"designated insured";
b. when any "designated insured" reports
the "bodily injury" or "property damage" to
"us" or any other insurer; or
c. when any "designated insured" becomes
aware of anything that indicates that
"bodily injury" or "property damage" may
have occurred or is occurring.

GL 0950 12 99
Copyright, American Association of Insurance Services, 2000 











 





04M5A0494326
AAIS GL-890
Ed 1.0
GL-890 Ed 1.0 AAIS

Copyright MCMXCII, American Association of Insurance Services

This endorsement changes the Commercial
Liability Coverages provided by this policy
-- PLEASE READ THIS CAREFULLY --

LEAD LIABILITY EXCLUSION

The Commercial Liability Coverage is amended as
follows:

The following are added:

We do not pay for:

1. actual or alleged bodily injury arising out of the
ingestion, inhalation or absorption of lead in any
form;

2. actual or alleged property damage (or personal
injury or advertising injury , if provided by the
Commercial Liability Coverage) arising out of any
form of lead;

3. any loss, cost or expense arising out of any request, demand or order that any insured or others test for,
monitor, clean up, remove, contain, treat, detoxify or
neutralize or in any way respond to or assess the
effects of lead; or

4. any loss, cost or expense arising out of any claim or suit by or on behalf of any governmental authority for
damages resulting from testing for, monitoring,
cleaning up, removing, containing, treating,
detoxifying or neutralizing or in any way responding
to or assessing the effects of lead.

EXCLUSIONS THAT APPLY TO

ALL COVERAGES












 

















 





04M5A0494326
BGL-939AI SP (1.0) Copyright, 2007 Brotherhood Mutual Insurance Co. Page 1 of 1 All Rights Reserved

PROVISION MODIFICATION
This Endorsement is subject to the terms of the Commercial Liability Coverage Form (GL-100), the Liability and Medical Coverage Form (BGL-11) and the Excess/Umbrella Liability Coverage Form (BGL-931 or BGL- 939).
- PLEASE READ THIS CAREFULLY -

PROVISION MODIFICATION-

EXCESS LIABILITY- COVERAGE FOR INDICATED

ADDITIONAL INSUREDS
The definition of qualified covered person within
the Excess Liability Coverage Form (BGL-931 or
BGL-939) is modified. The following entities will be
considered to be qualified covered persons for
purposes of applying the applicable excess liability
limits provided by form BGL-931 or BGL-939 in
relation to premises/operations liability coverage
(Principal Coverage L) exposures:

Those persons entities who are listed on a
Certificate of Insurance issued with respect to
this policy by us or by our agent
representative, but only if the Certificate of
Insurance:

1. Includes a Limit entry for Excess/Umbrella
Liability coverage, and

2. Specifically states that a person or entities
who are listed thereon are covered for
excess liability.

All provisions relating to Additional Insureds within
this policy will apply to the Additional Insureds
specified above for the excess liability coverage
provided herein.

HOW MUCH WE PAY
Each of the provisions set forth in the How Much
We Pay section of the Liability and Medical
Coverage Form (BGL-11) and the Excess/Umbrella
Liability Coverage form (BGL-931 or BGL-939)
apply to the coverage provided by this
endorsement, unless otherwise modified herein.

The following provisions apply to the Provision
Modification of this endorsement.

1. The most we will pay on behalf of an Additional
Insured for whom a Certificate of Insurance
indicates that excess liability applies is the
lesser of:
a. the Each Occurrence limit of coverage
entered on the Certificate of Insurance for
Excess/Umbrella Liability coverage, or
b. if shown, the limit of excess liability
coverage specifically stated as applying to
an Additional Insured.

2. The limit of coverage provided to an Additional
Insured by this endorsement is shared with the
Named Insured and with all other qualified
covered persons to whom the coverage of the
Excess/Umbrella Liability Coverage form (BGL-
931 or BGL-939) applies. Nothing in this
endorsement will be construed to increase the
limit of such coverage, as indicated in the
Declarations, provided to the Named Insured
and any other qualified covered persons for
any loss or related loss.

3. Provisions 2 and 4 of the How Much We Pay
section of the Excess/Umbrella Liability
Coverage form (BGL-931 or BGL-939) are
modified to the extent that the limit described in
provision 1 of the How Much We Pay section of
this endorsement is the most that we will pay
for any loss or related losses on behalf of the
Additional Insureds to whom coverage is
provided by this endorsement.

OTHER PROVISIONS
All other provisions of the Commercial Liability
Coverage Form (GL-100), the Liability and Medical
Coverage Form (BGL-11) and the Excess Liability
Coverage Form (BGL-931 or BGL-939) will
continue to apply.












 

















 





04M5A0494326
BGL-978 (4.1) Copyright, 2016 Brotherhood Mutual Insurance Co. Page 1 of 2 All Rights Reserved
This Liability Coverage Endorsement is subject to the terms of the Nonowned Vehicle Coverage Form (BGL-71) or the Broad Form Nonowned Vehicle Coverage Form (BGL-71B), and the Commercial Liability Coverage Form (GL-100) and the Liability and Medical Coverage Form (BGL-11). Only one liability coverage will apply to an occurrence and any related loss. This endorsement is attached to and made part of the policy.

THIS INSURANCE ENDORSEMENT FORMS PART OF YOUR POLICY CONTRACT.

PLEASE READ IT CAREFULLY.

MINISTRY OPERATIONS

COVERAGE EXTENSION

VEHICLE RENTED WITH DRIVER

AGREEMENT
We provide the Coverage Extension described in
this endorsement, but only if both this
endorsement (BGL-978) and the Nonowned
Vehicle Coverage Form (BGL-71) or the
Broadened Nonowned Vehicle Coverage Form
(BGL-71B) are properly designated in the
declarations of this policy.

DEFINITIONS
Each of the words or phrases defined in the
Definition section of the Commercial Liability
Coverage Form (GL-100), the Liability and
Medical Coverage Form (BGL-11), and the
Nonowned Vehicle Coverage Form (BGL-71) or
Broadened Nonowned Vehicle Coverage Form
(BGL-71B) apply to this endorsement, unless
otherwise modified herein. The following
definitions apply only to the Coverage Extension
of this endorsement.

1. Authorized operator means:
a. Your leader or your employee, but only
while operating or using a nonowned
vehicle on your behalf and for the
benefit of your organization; and
b. Any other person, but only while such
person is operating or using a
nonowned vehicle at the request of
your leader, your employee, or your
appointed person, and only if operated:
1) on your behalf and for the benefit of
your organization; or
2) for the sole purpose of gratuitously
parking such vehicle on your
premises or ways immediately
adjoining your premises (free valet
parking).

2. Covered person means you; and your
leaders while acting on your behalf and
within the scope of their delegated authority.

Covered person also includes the
authorized operator of your rented vehicle,
but does not include any other operator of a
nonowned vehicle who is not an authorized
operator.

COVERAGE EXTENSION
We will extend the Additional Coverages set forth
in the applicable Nonowned Vehicle Coverage
Form (BGL-71) or Broadened Nonowned Vehicle
Coverage Form (BGL-71B) to covered loss
arising out of the use of a nonowned vehicle
that is provided with a driver pursuant to a
charter, lease or rental agreement.

LIMITATION
Nothing in this endorsement will act to increase
any limits of coverage, or to in any way modify
any terms of the policy other than the terms
specified herein. No Excess Liability Coverage of
this policy will apply to the Coverage Extension of
this endorsement.












 





04M5A0494326
BGL-978 (4.1) Copyright, 2016 Brotherhood Mutual Insurance Co. Page 2 of 2 All Rights Reserved

EXCLUSIONS
Exclusions 6 and 12 of the Nonowned Vehicle
Coverage Form (BGL-71); and Exclusion 6 of the
Broadened Nonowned Vehicle Coverage Form
(BGL-71B) are deleted to the extent that
coverage is otherwise provided herein.

OTHER PROVISIONS
All other provisions of the policy remain
unchanged.












 





04M5A0494326
Policyholder Coverage Notice

MEDICAL COVERAGE EXTENSION
-CLERGY ACCIDENTAL DEATH COVERAGE-
-FORM BGL-998 or BGL-998B-
A clergy accidental death coverage form has been added to your Ministry First policy. The coverage form can be seen on the Schedule of Liability Coverages, which is a part of your policy.

Important
: The following information is not meant as professional tax advice. Always consult with your tax consultant before implementing a program that could impact tax liability. Please further note that relevant statutes and IRS regulatory guidelines are subject to change at any time.

THE POTENTIAL TAX IMPACT OF CLERGY ACCIDENTAL DEATH PAYMENTS AND HOW BROTHERHOOD MUTUAL'S CLERGY ACCIDENTAL DEATH COVERAGE WORKS:* Brotherhood Mutual offers Clergy Accidental Death coverage with the following death payments amounts:

Form BGL-998: $15,000
Form BGL-998B: $25,000
Form BGL-998 has a $100,000 per accident limit, and Form BGL-998B has a $150,000 per accident limit.

When a church purchases the optional Clergy Accidental Death coverage as part of its MinistryFirst insurance policy, Brotherhood Mutual will pay the applicable death payment if any of the church's full-time employee pastors or ministers dies during the policy period as a result of an accident covered by the policy. If coverage applies, this death payment will be paid whether or not the clergy was working at the time of death, and will be paid in addition to any other insurance benefits. Under the terms of this coverage, the governing board of the church must provide Brotherhood Mutual, in writing, the name of the designated payee. This can be the church itself, a surviving spouse, or any other person or entity designated as the payee by the church's governing board. Brotherhood Mutual will then pay the applicable death payment to the designated payee.

Why The Clergy Death Payment Could Be Taxable:

PREMIUM TAX ISSUES
: If the church is the named payee under the policy, the premiums are not taxable to the minister. If anyone else is the payee under the policy, then you should check with your tax consultant regarding the calculation of the taxable portion.

BENEFIT TAX ISSUES
: If the church designates a surviving spouse or any party other than the church itself as the payee, the proceeds may be subject to federal income tax. Under the Internal Revenue Code, employee death benefits paid by or on behalf of an employer are generally taxable to the employee's estate or to any other payee. Because Brotherhood Mutual's Clergy Accidental Death coverage provides an accidental death payment that can be paid to an individual on behalf of the clergy’s employer, such benefit would be considered taxable under the Internal Revenue Code in most cases.

BN-998 (1.0) Brotherhood Mutual Insurance Company Page 1 of 3 











 





04M5A0494326
What This Means to a Church Policyholder:

If the church designates an employee's estate, his or her surviving spouse, or any other person or entity (other than the church) as the payee of the Accidental Death payment, the payment could be taxable. If the payment is taxable, the church will be responsible for preparing and sending any required tax information forms (i.e., Form 1099-R) to the designated payee in the year the benefit is paid. Regardless of the taxability of the payment, the church is responsible for filing Form 8925 with the Internal Revenue Service annually. Since churches are normally exempt from filing income tax returns, the church will need to check with its tax consultant to determine the proper way to file Form 8925.

A Way That Tax Liability May Be Eliminated: The proceeds from the policy will, generally, not be subject to federal income taxes if the church meets the following conditions:

The church must employ the pastor for at least a portion of the 12 month period before his or her death or the pastor must be a member of the church’s governing body or the pastor must be a highly compensated employee as defined by the Internal Revenue Service.
The church must receive qualified written consent from the pastor by the earlier of the date the pastor begins his or her employment with the church or the date the church purchases the policy. In connection with the written consent, the church must provide the pastor with a qualifying written notice that it intends to secure a policy in the applicable death payment amount on the pastor's life, and that the church will be the payee. The written notice and consent must be made in accordance with statutory requirements. The church is encouraged to check with its tax consultant to develop proper notice and consent forms.
The church must adopt a qualifying self-funded Employee Death Benefit Plan as described in Internal Revenue Code, Section 7702(j). This Employee Death Benefit Plan can be funded with proceeds from Brotherhood Mutual's Clergy Accidental Death coverage. In the Employee Death Benefit Plan, the church may designate that it will pay the insurance proceeds to an employee's estate or surviving spouse.

Assuming all conditions are met, the benefit will, generally, not be taxable to the church or the minister’s family.

Setting Up An Employee Death Benefit Plan:

If your church plans to implement an Employee Death Benefit Plan, first check with your tax consultant. Ask the tax consultant whether the following language can be adopted by the governing body to meet the requirements of Section 7702(j) of the Internal Revenue Code. If this language meets Internal Revenue Code requirements, then the Employee Death Benefit Plan can distribute the insurance proceeds to a qualified predetermined payee:
"Effective immediately, the church is enacting a qualified Employee Death Benefit Plan on behalf of its full-time employee clergy who die as a result of a qualifying accident. Payment under this plan will be made only if the church has in force at the time of death a policy of insurance that includes Clergy Accidental Death coverage; and only to the extent that such coverage provides payment in connection with such death. Under this plan the governing board of the church will direct any such insurance payment be made to the church. The BN-998 (1.0) Brotherhood Mutual Insurance Company Page 2 of 3 











 





04M5A0494326
church will then, in turn, distribute these proceeds to the surviving spouse of the employee clergy and, if there is no surviving spouse, then to the employee's estate. Nothing in this plan will obligate the church to make any payment out of any funds other than accidental death insurance proceeds, if any, that are paid to the church under the aforementioned policy of insurance."
Check with Your Tax Consultant:

For the reasons outlined above, it’s important that the church checks with its tax consultant on how to comply with the steps necessary to make the insurance proceeds exempt from federal income taxes.

Contact your Agent:

Your Brotherhood Mutual agent will be please to answer any questions you may have concerning your policy.
*Coverage will be governed by the terms of the insurance policy. See your insurance policy for specific language regarding this coverage.

Please read your policy carefully
NOTE: No coverage of any kind is provided by this notice form.

BN-998 (1.0) Brotherhood Mutual Insurance Company Page 3 of 3 











 

















 





04M5A0494326

EX-0261X (3.0) Brotherhood Mutual Insurance Company Page 1 of 2 Includes Copyrighted Material of American Association of Insurance Services, Inc., 2002

This endorsement changes
EX-0261 X (3.0) the policy

(LIABILITY)

TERRORISM EXCLUSION
- CERTIFIED AND NON-CERTIFIED ACTS OF TERRORISM -

ADDITIONAL EXCLUSIONS THAT APPLY TO

ALL LIABILITY AND MEDICAL COVERAGES

In addition to the other exclusions of the policy,
the following exclusions will apply to all liability
and medical coverages of the policy:

1. C
ERTIFIED Act of Terrorism Exclusion - We
will not pay for loss of any kind arising
directly or indirectly out of or in connection
with any CERTIFIED act of terrorism . Such
loss is excluded regardless of any other
cause or event that contributes concurrently
or in any sequence to the loss.

2. NON-CERTIFIED Act of Terrorism Exclusion-
We will not pay for loss of any kind arising
directly or indirectly out of or in connection
with any NON-CERTIFIED act of terrorism .

Such loss is excluded regardless of any
other cause or event that contributes
concurrently or in any sequence to the loss.

EXCEPTION TO NON-CERTIFIED ACT

EXCLUSION

The following applies only to Exclusion 2 above,
and only to loss that does not involve any
nuclear, biological or chemical materials:

1. Scope of Loss Exception - If a
NON-
CERTIFIED act of terrorism results in:

a. damage to buildings at multiple
insured locations causing less than
$25 million in property damage in the
aggregate to all such buildings; and

b. less than fifty persons sustaining
death or serious physical injury;

then we will apply the liability coverage
that is otherwise provided by Principal
Coverage L of this policy. For purposes
of part b. of this Exception, the phrase
“serious physical injury” means the
permanent or protracted impairment of
the function of a bodily member of organ.

CONDITIONS

1. The following provision is added.

a. Neither the terms of this endorsement
nor the terms of any other terrorism
endorsement attached to this policy will
be construed to provide coverage for any
loss that would otherwise be excluded
under any form, endorsement or
provision of this policy, including, but not
limited to:

1) any exclusions that address war,
military action, or biological, chemical
or nuclear hazard; or

2) any other exclusion of the policy.

DEFINITIONS

In addition to the words and phrases defined
elsewhere in this policy, the following definition
will apply to the provisions of this endorsement:

1. CERTIFIED act of terrorism means an act
causing total insured loss that meets or
exceeds the insured loss threshold of any
federal Terrorism Risk Insurance Act, and
that is certified by an authorized individual
under the Act:

a. to be an act of terrorism; and

b. to be a violent act or an act that is
dangerous to human life, property, or
infrastructure; and

c. to have resulted in damage:

1) within the United States; or













 





04M5A0494326

EX-0261X (3.0) Brotherhood Mutual Insurance Company Page 2 of 2 Includes Copyrighted Material of American Association of Insurance Services, Inc., 2002

2) to an air carrier (as defined in
section 40102 of title 49, United
States Code); to a United States
flag vessel (or a vessel based
principally in the United States,
on which United States income
tax is paid and whose insurance
coverage is subject to regulation
in the United States), regardless
of where the loss occurs; or at
the premises of any United
States mission; and

d. to have been committed by an
individual or individuals as part of an
effort to coerce the civilian population
of the United States or to influence
the policy or affect the conduct of the
United States Government by
coercion.

A
CERTIFIED act of terrorism includes,
but is not limited to, a certified terrorist
act involving:

1) Explosives, firearms, conventional
weapons, or the use of aircraft,
watercraft, missiles, autos or persons
as weapons or as a means of
transporting weapons;

2) the use, release, dispersal,
application or escape of any nuclear
or radioactive materials of any kind;

3) any nuclear reaction or the release of
any radiation, or any radioactive
contamination;

4) the use, release, dispersal,
application or escape of any
biological or chemical materials that
have any injurious, pathogenic or
poisonous effect of any kind; or

5) any contamination of property,
interruption of any business or
ministry operation, or any other
damage, loss or expense arising
directly or indirectly out of the
situations set forth in items1) through
4) immediately above.

2. NON-CERTIFIED act of terrorism means a
malicious act that is not certified by
government officials as a qualifying “act
of terrorism” under any federal Terrorism
Risk Insurance law, but only if such act:

a. is violent or is dangerous to human
life, property, or infrastructure; and

b. is undertaken in an effort to coerce
the civilian population of the United
States or to influence the policy or
affect the conduct of the United
States Government by coercion.

A
NON-CERTIFIED act of terrorism
includes, but is not limited to, a non-
certified terrorist act involving:

1) Explosives, firearms, conventional
weapons, or the use of aircraft,
watercraft, missiles, autos or persons
as weapons or as a means of
transporting weapons;

2) the use, release, dispersal,
application or escape of any nuclear
or radioactive materials of any kind;

3) any nuclear reaction or the release of
any radiation, or any radioactive
contamination;

4) the use, release, dispersal,
application or escape of any
biological or chemical materials that
have any injurious, pathogenic or
poisonous effect of any kind; or

5) any contamination of property,
interruption of any business or
ministry operation, or any other
damage, loss or expense arising
directly or indirectly out of the
situations set forth in items1) through
4) immediately above.

OTHER PROVISIONS

All provisions of the Commercial Liability
Coverage Form (GL-100) and the Liability and
Medical Coverage Form (BGL-11) will apply to
this exclusionary endorsement unless specifically
modified herein.












 





04M5A0494326

EX-0281X (3.0) Brotherhood Mutual Insurance Company Page 1 of 2 Includes Copyrighted Material of American Association of Insurance Services, Inc., 2002

This endorsement changes
EX-0281 X (3.0) the policy

(LIABILITY)

NUCLEAR, CHEMICAL AND BIOLOGICAL TERRORISM EXCLUSION
- CERTIFIED AND NON-CERTIFIED ACTS OF TERRORISM -

ADDITIONAL EXCLUSION THAT APPLIES TO

ALL LIABILITY AND MEDICAL COVERAGES

In addition to the other exclusions of the policy,
the following exclusion will apply to all liability and medical coverages of the policy:

1. We will not pay for loss of any kind arising
directly or indirectly out of or in connection
with any act of nuclear, chemical or
biological terrorism. Such loss is excluded
regardless of any other cause or event that
contributes concurrently or in any sequence
to the loss.

CONDITIONS

1. The following provision is added.

a. Neither the terms of this endorsement
nor the terms of any other terrorism
endorsement attached to this policy will
be construed to provide coverage for any
loss that would otherwise be excluded
under any form, endorsement or
provision of this policy, including, but not
limited to:

1) any exclusions that address war,
military action, or biological, chemical
or nuclear hazard; or

2) any other exclusion of the policy.

DEFINITIONS

In addition to the words and phrases defined
elsewhere in this policy, the following definition
will apply to the provisions of this endorsement:

1. Act of nuclear, chemical or biological
terrorism means either: (1) a
CERTIFIED act
of nuclear, chemical or biological
terrorism; or (2) a NON-CERTIFIED act of
nuclear, chemical or biological terrorism.

2. CERTIFIED act of nuclear, chemical or
biological terrorism means an act causing
total insured loss that meets or exceeds the
insured loss threshold of any federal
Terrorism Risk Insurance Act, and that is
certified by an authorized individual under the
Act:

a. to be an act of terrorism; and

b. to be a violent act or an act that is
dangerous to human life, property, or
infrastructure; and

c. to have resulted in damage:

1) within the United States; or

2) to an air carrier (as defined in
section 40102 of title 49, United
States Code); to a United States
flag vessel (or a vessel based
principally in the United States,
on which United States income
tax is paid and whose insurance
coverage is subject to regulation
in the United States), regardless
of where the loss occurs; or at
the premises of any United
States mission; and

d. to have been committed by an
individual or individuals as part of an
effort to coerce the civilian population
of the United States or to influence
the policy or affect the conduct of the
United States Government by
coercion; and

e. to involve one or more of the
following:

1) the use, release, dispersal,
application or escape of any
nuclear or radioactive materials
of any kind; or

2) any nuclear reaction or the
release of any radiation, or any
radioactive contamination; or













 





04M5A0494326

EX-0281X (3.0) Brotherhood Mutual Insurance Company Page 2 of 2 Includes Copyrighted Material of American Association of Insurance Services, Inc., 2002

3) the use, release, dispersal,
application or escape of any
biological or chemical materials
that have any injurious,
pathogenic or poisonous effect of
any kind; or

4) any contamination of property,
interruption of any business or
ministry operation, or any other
damage, loss or expense arising
directly or indirectly out of the
situations set forth in items 1)
through 3) immediately above.

3. NON-CERTIFIED act of nuclear, chemical
or biological terrorism means a
malicious act that is not certified by
government officials as a qualifying “act
of terrorism” under any federal Terrorism
Risk Insurance law, but only if such act:

a. is violent or is dangerous to human
life, property, or infrastructure; and

b. is undertaken in an effort to coerce
the civilian population of the United
States or to influence the policy or
affect the conduct of the United
States Government by coercion; and

c. involves one or more of the following:

1) the use, release, dispersal,
application or escape of any
nuclear or radioactive materials
of any kind; or

2) any nuclear reaction or the
release of any radiation, or any
radioactive contamination; or

3) the use, release, dispersal,
application or escape of any
biological or chemical materials
that have any injurious,
pathogenic or poisonous effect of
any kind; or

4) any contamination of property,
interruption of any business or
ministry operation, or any other
damage, loss or expense arising
directly or indirectly out of the
situations set forth in items 1)
through 3) immediately above.

OTHER PROVISIONS

All provisions of the Commercial Liability
Coverage Form (GL-100) and the Liability and
Medical Coverage Form (BGL-11) will apply to
this exclusionary endorsement unless specifically
modified herein.













 

















 





SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:

CONTACT
(A/C, No):

FAX
E-MAIL
ADDRESS:

PRODUCER
(A/C, No, Ext):

PHONE

INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be e ndorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A st atement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO D INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-

STATUTE
PER

LIMITS(MM/DD/YYYY)

POLICY EXP
(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR

CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE

DAMAGE TO RENTED
$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY


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PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

GENERAL LIABILITY DELUXE ENDORSEMENT:

HUMAN SERVICES

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE

It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording.

Coverage Applicable Limit of Insurance Page #
Extended Property Damage Included 2
Limited Rental Lease Agreement Contractual Liability $50,000 limit 2 Non-Owned Watercraft Less than 58 feet 2
Damage to Property You Own, Rent, or Occupy $30,000 limit 2 Damage to Premises Rented to You $1,000,000 3
HIPAA Clarification 4
Medical Payments $20,000 5
Medical Payments Extended Reporting Period 3 years 5
Athletic Activities Amended 5
Supplementary Payments Bail Bonds $5,000 5
Supplementary Payment Loss of Earnings $1,000 per day 5 Employee Indemnification Defense Coverage $25,000 5
Key and Lock Replacement Janitorial Services Client Coverage $10,000 limit 6 Additional Insured Newly Acquired Time Period Amended 6 Additional Insured Medical Directors and Administrators Included 7 Additional Insured Managers and Supervisors (with Fellow Employee Coverage)
Included 7
Additional Insured Broadened Named Insured Included 7 Additional Insured Funding Source Included 7
Additional Insured Home Care Providers Included 7
Additional Insured Managers, Landlords, or Lessors of Premises Included 7 Additional Insured Lessor of Leased Equipment Included 7 Additional Insured Grantor of Permits Included 8
Additional Insured Vendor Included 8
Additional Insured Franchisor Included 9
Additional Insured When Required by Contract Included 9 Additional Insured Owners, Lessees, or Contractors Included 9 Additional Insured State or Political Subdivisions Included 10 3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10
Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11
Bodily Injury includes Mental Anguish Included 11
Personal and Advertising Injury includes Abuse of Process, Discrimination
Included 11

A. Extended Property Damage

SECTION I

COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY , Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following:

a. Expected or Intended Injury

This exclusion does not apply t
reasonable force to protect persons or property.

B. Limited Rental Lease Agreement Contractual Liability

SECTION I
COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY , Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following:

(3)
named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements.
liability insurance of the client.

C. Non-Owned Watercraft

SECTION I

COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY , Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following:

(2) A watercraft you do not own that is:

(a) Less than 58 feet long; and

(b) Not being used to carry persons or property for a charge;

This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent.

D. Damage to Property You Own, Rent or Occupy

SECTION I

COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE 3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

LIABILITY , Subsection 2. Exclusions, Paragraph j. Damage to Property, Item (1) is deleted in its entirety and replaced with the following:

(1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury

your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision.

E. Damage to Premises Rented to You

1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the w

a. The last paragraph of SECTION I

COVERAGES, COVERAGE A BODILY INJURY AND
PROPERTY DAMAGE LIABILITY , Subsection 2. Exclusions; is deleted in its entirety and replaced by the following:

Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III
LIMITS OF INSURANCE.

b. SECTION III LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following:

Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner.

c. SECTION V
DEFINITIONS, Paragraph 9.a., is deleted in its entirety and replaced by the following:

A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract";

2. SECTION IV
COMMERCIAL GENERAL LIABILITY CONDITIONS , Subsection 4. Other Insurance , Paragraph b. Excess Insurance, (1) (a) (ii) is deleted in its entirety and replaced by the following:

That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner;

3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of:

3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

a. $1,000,000; or

b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.

This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof.

F. HIPAA

SECTION I

COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY , is amended as follows:

1. Paragraph 1. Insuring Agreement is amended to include the following:

We will pay those sums that the insured becomes legally obligated to pay as damages because ity and Accountability Act (HIPAA). We have

2. Paragraph 2. Exclusions is amended to include the following additional exclusions:

This insurance does not apply to:

a. Intentional, Willful, or Deliberate Violations

b. Criminal Acts

riminal penalties under the HIPAA.

c. Other Remedies

Any remedy other than monetary damages for penalties assessed.

d. Compliance Reviews or Audits

Any compliance reviews by the Department of Health and Human Services.

3. SECTION V
DEFINITIONS is amended to include the following additional definitions:

a.

b.

c. regulations included in the
H I P A A .
3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

G. Medical Payments Limit Increased to $20,000, Extended Reporting Period

If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part:

1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of:

a. $20,000; or
b. The Medical Expense Limit shown in the Declarations of this Coverage Part.

2. SECTION I
COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement , a. (3) (b) is deleted in its entirety and replaced by the following:

(b) The expenses are incurred and reported to us within three years of the date of the a c c i d e n t .

H. Athletic Activities

SECTION I
COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following:

e. Athletic Activities

To a person injured while taking part in athletics.

I. Supplementary Payments

SECTION I
COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows:

1. b. is deleted in its entirety and replaced by the following:

1. b. Up to $5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these.

1.d. is deleted in its entirety and replaced by the following:

1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a day because of time off from work.

J. Employee Indemnification Defense Coverage

SECTION I
COVERAGES, SUPPLEMENTARY PAYMENTS COVERAGES A AND B the following is added:

We will pay
occurring in the course of employment.

proceeding is $25,000 regardl
.

3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

K. Key and Lock Replacement Janitorial Services Client Coverage

SECTION I COVERAGES, SUPPLEMENTARY PAYMENTS COVERAGES A AND B is amended to include the following:

W

, up to a $10,000 limit per occurrence and $10,000
policy aggregate.

We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that

authorized representatives or any one to
purpose commit, whether acting alone or in collusion with other persons.

The following, when used on this coverage, are defined as follows:

a. "Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services.

b. "Employee" means:

(1) Any natural person:

(a) While in your service or for 30 days after termination of service;

(b) Who you compensate directly by salary, wages or commissions; and

(c) Who you have the right to direct and control while performing services for you; or

(2) Any natural person who is furnished temporarily to you:

(a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is o n l e a v e ; o r

(b) To meet seasonal or short-term workload conditions;

while that person is subject to your direction and control and performing services for you.

(3) "Employee" does not mean:

(a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general c h a r a c t e r ; o r

(b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee."

c . "Manager" means a person serving in a directorial capacity for a limited liability company.

L. Additional Insureds

SECTION II
WHO IS AN INSURED is amended as follows:

1. If coverage for newly acquired or formed organizations is not otherwise excluded from this 3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following:

a. Coverage under this provision is afforded until the end of the policy period.

2. Each of the following is also an insured:

a. Medical Directors and Administrators Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient.

b . Managers and Supervisors Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and -
employment by you or performing duties
related to the conduct of your business.

This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company.

c. Broadened Named Insured
Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance.

d. Funding Source
Any person or organization with respect to their liability arising out of:

(1) Their financial control of you; or

(2) Premises they own, maintain or control while you lease or occupy these premises.

This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization.

e. Home Care Providers
At the first Named Insured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled.

f. Managers, Landlords, or Lessors of Premises
Any person or organization with respect
to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions:

This insurance does not apply to:

(1)
e a tenant in that premises; or

(2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization.

g. Lessor of Leased Equipment
Automatic Status When Required in Lease Agreement
W i t h Y o u Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or 3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

or
aused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization.

A
when their contract or agreement with you for such leased equipment ends.

With respect to the insurance afforded to these additional insureds, this insurance does not

h. Grantors of Permits
Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision:

(1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies:

(a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures;

(b) The construction, erection, or removal of elevators; or

(c) The ownership, maintenance, or use of any elevators covered by this insurance.

i. Vendors

which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions :

(1) The insurance afforded the vendor does not apply to:

( a ) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement;

( b ) Any express warranty unauthorized by you;

(c) Any physical or chemical change in the product made intentionally by the vendor;

(d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container;

( e ) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products;

( f ) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product;

3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

( g ) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or

(h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to:

( i ) The exceptions contained in Sub-paragraphs (d) or (f); or

( i i ) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products.

(2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing.

j. Franchisor
Any person or organization with respect to their liability as the grantor of a franchise to you.

k. As Required by Contract Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations

l. Owners, Lessees or Contractors
Any person or organization, but only with respect to
liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by:

(1) Your acts or omissions; or

(2) The acts or omissions of those acting on your behalf;

in the performance of your ongoing operations for the additional insured when required by a contract.

With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:

This insurance does not apply to "bodily injury" or "property damage" occurring after:

( a ) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or

( b ) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

m. State or Political Subdivisions Any state or political subdivision as required, subject to the following provisions:

(1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract.

(2) This insurance does not apply to:

(a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or

(b) "Bodily injury" or "property damage" included within the "products-completed operations hazard."

M. Duties in the Event of Occurrence, Claim or Suit

SECTION IV
COMMERCIAL GENERAL LIABILITY CONDITIONS , Paragraph 2. is amended as follows:

a. is amended to include:

This condition

(1) You, if you are an individual;

(2) A partner, if you are a partnership; or

(3) An executive officer or insurance manager, if you are a corporation.

b. is amended to include:

This condition
is known to:

(1) You, if you are an individual;

(2) A partner, if you are a partnership; or

(3) An executive officer or insurance manager, if you are a corporation.

N. Unintentional Failure To Disclose Hazards

SECTION IV
COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following:

It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.

O. Transfer of Rights of Recovery Against Others To Us

SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of 3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

Recovery Against Others To Us is deleted in its entirety and replaced by the following:

If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them.

Therefore, the i
ecovery prior to the occurrence of a
loss, provided the waiver is made in a written contract.

P. Liberalization

SECTION IV
COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:

If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state.

Q. Bodily Injury
Mental Anguish

SECTION V DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following:

njury means:

a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and

b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time.

R. Personal and Advertising Injury
Abuse of Process, Discrimination

If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of amended as follows:

1. SECTION V DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following:

b. Malicious prosecution or abuse of process;

2. SECTION V
DEFINITIONS, Paragraph 14. is amended by adding the following:

Discrimination based on race, color, religion, sex, age or national origin, except when:

a. Done intentionally by or at the direction of, or with the knowledge or consent of:

(1) Any insured; or

(2) Any executive officer, director, stockholder, partner or member of the insured;

b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured;
3+3.













 





PI-GLD-HS (10/11)

Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company

c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or

d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling.

The above does not apply to fines or penalties imposed because of discrimination.

3+3.













 





NPU-VIP 2026-2027 Page 1 of 1

THIS ENDORSEMENT CHANGES THE MEMORA NDUM OF COVERAGE. PLEASE READ IT

CAREFULLY
NonProfits’ United Vehicle Insurance Pool

ADDITIONAL COVERED PARTY ENDORSEMENT
This endorsement modifies coverage provided under the following:

NPU VEHICLE INSURANCE POOL MEMORANDUM OF COVERAGE
With respect to coverage provided by this endorsement, the provisions of the Memorandum of Coverage apply unless modified by the endorsement.
“Who is a Covered Party” in Section II of the Memorandum of Coverage is changed by adding the following:

Who is a Covered Party including any person or organization named on the Certificate of Coverage as a Certificate Holder from whom you have leased an auto, from which you have received funding for your operations, or for whom you provide services. These persons or organization are provided coverage under the Memorandum of Coverage if they require to be named, and you agree to name them as an additional covered party in a written contract or agreement executed prior to any “loss”, but only with respect to liability arising out of the ownership, use, maintenance, loading or unloading of a covered auto. Coverage provided under this endorsement is primary and insurance maintained by additional covered party is Non-Contributory. Coverage provided under this endorsement is limited to the Limits of Liability stated on the Memorandum of Coverage Declarations.

Cancellation:

Should the above-described Memorandum of Coverage be cancelled before the expiration date thereof, NPU will endeavor to mail 30 days written notice to the certificate holder named on the certificate, but failure to do so shall impose no obligation or liability of any kind upon NPU, its agents or representatives.

Contribution Payments:

Those persons or organizations are not responsible for paying contributions for your coverage.

Covered Party and MOC Number: As shown on the Certificate of Coverage attached.

Effective Date: July 1, 2026, to July 1, 2027 (or otherwise indicated) Authorized Representative: