2021/22 Earthquake Insurance PolicyINVOICE
INVOICE # ACCOUNT #
502700 LAQUINT-02
INVOICE DATE BALANCE DUE ONRemit to: NFP Property & Casualty Services, Inc.
5/12/2021 5/12/2021NFP P & C WEST
PO BOX 840803
Los Angeles, CA 90084-0803
AMOUNT PAID AMOUNT DUE
($14,631.56)
Phone:(714) 505-5550
City of La Quinta Payment Options
78-495 Calle Tampico
La Quinta, CA 92253
1. Mail check to: NFP Property & Casualty Services, Inc.
See Remittance Address Above
2. Pay On-line at:
https://nfp-wes.epaypolicy.com
Note: ePay charges a fee for on-line pay services.
3. Pay via ACH or Wire, see instructions below.
Premium due upon receipt or by the due date shown, whichever is later.
Wire or ACH Transfer:
Account Name:NFP Property & Casualty Services Inc Routing:121000248
Bank Name:Wells Fargo Bank Checking Account:4964972301
Bank Address:420 Montgomery Street, San Francisco, CA 94104 Bank Swift:BIC WFBIUS6S (International)
Please include the invoice number to help us identify the incoming wire.
Carrier:Lloyds Syndicate 2623 (Beazley Furlonge Limited)
Policy Period:2/7/2021 to 2/7/2022
POLICY TYPE POLICY NUMBER EFF. DATEEFF. DATE DESCRIPTION AMOUNT
Earthquake - Commercial W14D19210801 2/7/2021 Delete 42-800 Washington St.
(Washington Apts)
($14,171.00)
Earthquake - Commercial W14D19210801 2/7/2021 Surplus Lines Tax ($425.13)
Earthquake - Commercial W14D19210801 2/7/2021 Stamping Fee ($35.43)
TOTAL INVOICE BALANCE:($14,631.56)
Overnight Lockbox Services: 840803, ATTN: NFP P & C WEST, 3440 FLAIR DRIVE, El Monte, CA 91731
5/12/2021 Servicing Office: NFP, 1551 North Tustin Avenue, Suite 500, Santa Ana, CA 92705 Page 1 of 1
For informational purposes only. This document does not amend, extend, or alter coverage. Please refer to any actual policy(s) for specific terms, conditions, limitations, and
exclusions. P&C Insurance Services provided through NFP Property & Casualty Services, Inc.. Doing business in California as NFP Property & Casualty Insurance Services, Inc.
(License # OF15715). LA&H Insurance Services provided through NFP Corporate Services (NY), LLC. Doing business in California as NFP Corporate Insurance Services, LLC
(License # OF44161). Both entities are subsidiaries of NFP Corp. (NFP).
SPRJU1
ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.
Page 1 of 1 07-May-2021cc
Policy N umber: W14D19210801 Endorsement Number: 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Insured: City of La Quinta
Endorsement
Effective:
07-Feb-2021
at 12:01 a.m. standard t ime at the Insured’s address shown on the
Declarations page of this policy .
This endorsement attaches to and forms part of the ab ove referenced policy
issued by certain Underwriters at Lloyd’s, London.
It is agreed that the following location is deleted from the Schedule of Locations and Values
on File with the Underwriter:
Location Values & Coverages Reported
42-800 Washington St
La Quinta, CA 92253
$
$
$
5,074,000
125,000
330,000
Buildings
Personal Property
Business Income with Extra Expense and Rental Income
The Total Insured Value for this policy has decreased by $5,529,000 to a new amount of:
$64,474,939 .
The Total Limit of Liability in any one occurrence for all above coverages combined remains
unchanged .
The premium(s) payable for this change endorsement is:
$ 14,171 Policy Premium
$ Declined Certified Acts of Terrorism Premium
$ N/A Equipment Breakdown Premium
$ N/A Inspection Fee(s)
$ 14,171 Total Return Term Premium for above stated change.
California Premium:
NonTaxable Fees:
Taxable Fees:
Surplus Lines Tax:
Stamping Fee:
($14,171.00)
($ 425.13)
($ 35.43)
1321634_1 Page 1 of 3
BINDER ISSUED: 08-Feb-2021
Terra Mullins
AmWINS Insurance Brokerage of California -
Irvine, CA
2010 Main Street
Ste 700
Irvine, CA 92614
BINDER
We are pleased to offer the following Binder for the above captioned account as per the quotation
dated 08-Feb-2021.
Policy Number: W14D19210801
Renewal of:W14D19200701
Insurer:Syndicate 2623/623 at Lloyd's.
Beazley Lloyd's Syndicate 2623 - 82%
Beazley Lloyd's Syndicate 623 - 18%
Unique Market Reference: B6012BUSA21
Insured's Name:City of La Quinta
Insured's Address:78-495 Calle Tampico
La Qunita, CA 92253
Location(s):78-495 Calle Tampico
La Quinta, CA 92253
As per schedule on file with Underwriter
Policy Period: From: 07-Feb-2021
To:07-Feb-2022
Both dates at 12:01 a.m. Standard Time at the Insured’s Address
Limit Peril(s)Coverage(s)
$10,000,000 Each Occurrence
and in the Annual Aggregate in
respect of Earthquake
Earthquake Real Property
Personal Property
Valuable Papers
Electronic Data Processing
Media
Business Income
Extra Expense
Rental Income
Ordinance or Law - Undamaged
Portion (Cov A)
Location: All/All
$2,500,000 Sub-Limit Ordinance or Law - Demolition
(Cov B) and Increased Cost of
Construction (Cov C)
combined
Location: All/All
1321634_1 Page 2 of 3
Deductible Peril(s)
10.00 % Values Per Unit of Insurance
$25,000 Minimum Per Occurrence
Earthquake
Coinsurance Valuation Coverage(s)
Nil Replacement Cost Real Property
Personal Property
Nil Actual Loss Sustained Business Income
Extra Expense
Rental Income
Total Insurable Value:$70,003,939
Premium:$179,400
Min. Earned Prem.%:25 %
T.R.I.A.:Declined
Inspection Fees:$300
Binder Comments:Contingent Tax Revenue Endorsement included as expiring.
Business Income includes Bond Rental Income.
Conditions:Ordinance or Law coverage included for loss to the undamaged portion of the
Building (Cov A)within the limit of insurance applicable to Real Property (FS
C 488).
FS C 494:Optional Valuation,Section 9.is amended to show Replacement
Cost applies to Real Property and Personal Property.
FS C 494: Limits of Insurance , Section 7. Item B. is deleted in it's entirety.
Forms and Endorsements Effective at Inception:
LMA3102B
(amended)
Lloyd's Certificate
FS C 422 01 13 General Cover Declarations Page
FS C 426 12 12 Supplemental Declarations Page
FS C 424 Schedule of Forms and Endorsements
FS C 494 05 17 Beazley Earthquake Policy
FS C 493 10 12 Statement of Deductible for Earthquake and/or Flood if Covered By This
Policy
FS C 513 06 13 Time Element Endorsement to Beazley Earthquake Policy
USES0114-004 Contingent Tax Revenue Interruption Extension
FS C 488 10 12 Ordinance or Law Endorsement
FS C 500 10 12 Valuable Papers and Records Extension
LMA5393 Communicable Disease Endorsement
LSW1135B Lloyd's Privacy
LMA3100 Sanction Limitation and Exclusion Clause
LMA5390 TRIA Not Purchased Clause
Subjectivities:
1321634_1 Page 3 of 3
1.Favorable Inspection by Beazley E&S within 45 days of inception and Compliance to
Recommendations as Applicable.
2.Inspection contact name and phone number due within 14 days of binding
COMMISSION PERCENTAGES SHOWN ARE FOR DIRECT COMMISSION ONLY AND DO NOT INCLUDE
ANY APPLICABLE CONTINGENT COMMISSION OR OTHER FORMS OF COMPENSATION.
THIS RISK IS BOUND ON THE BASIS SHOWN ABOVE.IT DOES NOT NECESSARILY PROVIDE THE
TERMS AND/OR COVERAGES REQUESTED.WE ARE NOT RESPONSIBLE FOR INACCURACIES ABOUT
WHICH THE INSURED DOES NOT NOTIFY US OF IMMEDIATELY.
THIS BINDER WILL BE TERMINATED AND SUPERSEDED UPON DELIVERY OF THE FORMAL POLICIES
OR CERTIFICATES ISSUED TO REPLACE IT.IF THERE IS ANY CONFLICT BETWEEN THE TERMS AND
CONDITIONS OF THIS BINDER AND THE TERMS AND CONDITIONS OF THE POLICY (OR
CERTIFICATE),WHEN ISSUED,THE TERMS AND CONDITIONS OF THE POLICY (OR CERTIFICATE)
SHALL GOVERN.
THE SURPLUS LINES INSURERS (CERTAIN UNDERWRITERS AT LLOYD'S,LONDON)WITH WHICH THE
COVERAGE IS BEING QUOTED ARE NOT LICENSED TO DO INSURANCE BUSINESS IN THIS STATE AND
ARE NOT SUBJECT TO SUPERVISION BY THIS STATE.IN THE EVENT OF THE INSOLVENCY OF A
SURPLUS LINES INSURER,LOSSES WILL NOT BE COVERED BY ANY STATE INSOLVENCY FUND.IF
THIS QUOTE IS BOUND,THE POLICY MAY NOT BE SUBJECT TO ALL OF THE REGULATIONS OF THE
SUPERINTENDENT PERTAINING TO RATES AND POLICY FORMS.
Erich Jahnke
Beazley Insurance Services
CA License Number 0G55497
725 S. Figueroa Street, Suite 2050
Los Angeles, CA 90017
t: (818)409-3474
c: (818)389-7320
e: erich.jahnke@beazley.com
LMA3102B Page 1 of 7
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
LMA3102B (amended)
Certificate
Of
Beazley Insurance Services
101 California St Ste 1850
San Francisco CA94111
U.S.A
CA License #0G55497
(hereinafter called "Correspondent")
Evidencing Placement of Insurance with certain
UNDERWRITERS AT LLOYD'S, LONDON
Correspondent hereby certifies that insurance as described herein has been effected with certain
Underwriters at Lloyd's, London.
IMPORTANT NOTICE
1.The insurance policy that you have purchased is being issued
by an insurer that is not licensed by the State of California.These
companies are called “nonadmitted” or “surplus line” insurers.
2.The insurer is not subject to the financial solvency regulation
and enforcement that apply to California licensed insurers.
3.The insurer does not participate in any of the insurance
guarantee funds created by California law.Therefore,these funds
will not pay your claims or protect your assets if the insurer
becomes insolvent and is unable to make payments as promised.
4.The insurer should be licensed either as a foreign insurer in
another state in the United States or as a non-United States (alien)
insurer.You should ask questions of your insurance agent,
broker,or “surplus line”broker or contact the California
Department of Insurance at the toll-free number 1-800-927-4357 or
internet website www.insurance.ca.gov.Ask whether or not the
insurer is licensed as a foreign or non-United States (alien)insurer
and for additional information about the insurer.You may also visit
the NAIC’s internet website at www.naic.org.The NAIC –the
National Association of Insurance Commissioners – is the regulatory
support organization created and governed by the chief insurance
regulators in the United States.
LMA3102B Page 2 of 7
5.Foreign insurers should be licensed by a state in the United
States and you may contact that state’s department of insurance to
obtain more information about that insurer.You can find a link to
each state from the NAIC internet website:
https://naic.org/state_web_map.htm.
6.For non-United States (alien)insurers,the insurer should be
licensed by a country outside of the United States and should be on
the NAIC’s International Insurers Department (IID)listing of
approved nonadmitted non-United States insurers.Ask your agent,
broker,or “surplus line”broker to obtain more information about
that insurer.
7.California maintains a “List of Approved Surplus Line
Insurers (LASLI).”Ask your agent or broker if the insurer is on
that list,or view that list at the internet website of the California
Department of Insurance:
www.insurance.ca.gov/01-consumers/120-company/07-lasli/lasli.cfm
8.If you,as the applicant,required that the insurance policy you
have purchased be effective immediately,either because existing
coverage was going to lapse within two business days or because you
were required to have coverage within two business days,and you
did not receive this disclosure form and a request for your signature
until after coverage became effective,you have the right to cancel
this policy within five days of receiving this disclosure.If you cancel
coverage,the premium will be prorated and any broker’s fee
charged for this insurance will be returned to you.
Such insurance has been placed in accordance with the limited authorization granted to the
Correspondent by certain Underwriters at Lloyd's,London,whose syndicate numbers and the
proportions underwritten by them can be ascertained from the office of the said Correspondent (such
Underwriters being hereinafter called ¨Underwriters¨)and in consideration of the premium specified
herein,Underwriters have agreed to bind themselves severally and not jointly each for his own part
and not one for another, their Executors and Administrators.
The Assured is requested to read this Certificate and if it is not correct,return it immediately to the
Correspondent for appropriate alteration.
SLC-3 (COR) California LMA3102B (amended)
LMA3102B Page 3 of 7
CERTIFICATE PROVISIONS
1.Signature Required.This Certificate shall not be valid unless signed by the Correspondent on the attached
Declaration Page.
2.Correspondent Not Insurer.The Correspondent is not an Insurer of the insurance described herein and
neither is nor shall be liable for any loss or claim whatsoever.The Insurers of such insurance are those
Underwriters at Lloyd's,London,whose names can be ascertained as hereinbefore set forth.As used in this
Certificate "Underwriters"shall be deemed to include incorporated as well as unincorporated persons or
entities that are Underwriters at Lloyd's, London.
3.Cancellation.If the insurance described herein provides for cancellation and if said insurance is cancelled
after the inception date, earned premium must be paid for the time the insurance has been in force.
4.Service of Suit Clause.In the event of the failure of Underwriters to pay any amount claimed to be due
under the insurance described herein,Underwriters have agreed that,at the request of the Assured,they will
submit to the jurisdiction of a Court of competent jurisdiction within the United States.Nothing in this
Clause constitutes or should be understood to constitute a waiver of Underwriters'rights to commence an
action in any Court of competent jurisdiction in the United States,to remove an action to a United States
District Court,or to seek a transfer of a case to another Court as permitted by the laws of the United States
or of any State in the United States.In any suit instituted against any one of them upon the insurance
described herein,Underwriters have agreed to abide by the final decision of such Court or of any Appellate
Court in the event of an appeal.
Underwriters have further agreed that service of process in such suit may be made upon FLWA Service
Corp,c/o Foley &Lardner,555 California Street,Suite 1700,San Francisco,CA 94104-1520.Underwriters
have agreed that such firm or person is authorized and directed to accept service of process on behalf of
Underwriters in any such suit and/or upon the request of the Assured to give a written undertaking to the
Assured that they will enter a general appearance upon Underwriters'behalf in the event that such a suit
shall be instituted.
Further,pursuant to any statute of any state,territory or district of the United States which makes provision
therefor,Underwriters have designated the Superintendent,Commissioner or Director of Insurance or other
officer specified for that purpose in the statute,or his successors in office,as their true and lawful attorney
upon whom may be served any lawful process in any action,suit or proceeding instituted by or on behalf of
the Assured or any beneficiary arising out of the insurance described herein,and have designated the above-
mentioned as the person to whom the said officer is authorized to mail such process or true copy thereof.
5.Assignment.The insurance described herein shall not be assigned either in whole or in part without the
written consent of the Correspondent endorsed hereon.
6.Attached Conditions Incorporated.The insurance described in this Certificate is subject to all provisions,
conditions and warranties set forth herein,attached,or endorsed,all of which are to be considered
incorporated herein as further descriptive of the insurance the placement of which is evidenced by this
Certificate.
7.Short Rate Cancellation.If the attached provisions provide for cancellation,the table below will be used
to calculate the short rate proportion of the premium when applicable under the terms of cancellation.
Premiums for cancellations pursuant to Paragraph 8 of the Notice on page 2 of this Certificate will be
prorated.
LMA3102B Page 4 of 7
Short Rate Cancellation Table For Term of One Year.
Days
Insurance in
Force
Per Cent
of one year
Premium
Days
Insurance in
Force
Per Cent
of one year
Premium
Days
Insurance in
Force
Per Cent
of one year
Premium
Days
Insurance in
Force
Per Cent
of one year
Premium
1 5%
2 6
3 - 4 7
5 - 6 8
7 - 8 9
9 - 10 10
11 - 12 11
13 - 14 12
15 - 16 13
17 - 18 14
19 - 20 15
21 - 22 16
23 - 25 17
26 - 29 18
30 - 32 ( 1 mos )19
33 - 36 20
37 - 40 21
41 - 43 22
44 - 47 23
48 - 51 24
52 - 54 25
55 - 58 26
59 - 62 ( 2 mos )27
63 - 65 28
66 - 69 29%
70 - 73 30
74 - 76 31
77 - 80 32
81 - 83 33
84 - 87 34
88 - 91 ( 3 mos )35
92 - 94 36
95 - 98 37
99 - 102 38
103 - 105 39
106 - 109 40
110 - 113 41
114 - 116 42
117 - 120 43
121 - 124 ( 4 mos )44
125 - 127 45
128 - 131 46
132 - 135 47
136 - 138 48
139 - 142 49
143 - 146 50
147 - 149 51
150 - 153 ( 5 mos )52
154 - 156 53%
157 - 160 54
161 - 164 55
165 - 167 56
168 - 171 57
172 - 175 58
176 - 178 59
179 - 182 ( 6 mos )60
183 - 187 61
188 - 191 62
192 - 196 63
197 - 200 64
201 - 205 65
206 - 209 66
210 - 214 ( 7 mos )67
215 - 218 68
219 - 223 69
224 - 228 70
229 - 232 71
233 - 237 72
238 - 241 73
242 - 246 ( 8 mos )74
247 - 250 75
251 - 255 76
256 - 260 77%
261 - 264 78
265 - 269 79
270 - 273 ( 9 mos )80
274 - 278 81
279 - 282 82
283 - 287 83
288 - 291 84
292 - 296 85
297 - 301 86
302 - 305 ( 10 mos )87
306 - 310 88
311 - 314 89
315 - 319 90
320 - 323 91
324 - 328 92
329 - 332 93
333 - 337 ( 11 mos )94
338 - 342 95
343 - 346 96
347 - 351 97
352 - 355 98
356 - 360 99
361 - 365 ( 12 mos )100
Rules applicable to insurance with terms less than or more than one year:
A.If insurance has been in force for one year or less, apply the short rate table for annual insurance to the full
annual premium determined as for insurance written for a term of one year.
B.If insurance has been in force for more than one year:
1.Determine full annual premium as for insurance written for a term of one year.
2.Deduct such premium from the full insurance premium, and on the remainder calculate the pro rata
earned premium on the basis of the ratio of the length of time beyond one year the insurance has been in
force to the length of time beyond one year for which the policy was written.
3.Add premium produced in accordance with items (1) and (2) to obtain earned premium during full period
insurance has been in force.
8.The Certificate is intended for use as evidence of the placement of the insurance described herein, in
accordance with Section 1764 of the California Insurance Code.
9. It is hereby understood and agreed that whenever the word “Policy” appears herein it shall be deemed to read
“Certificate”
10. Cancellation. Notwithstanding any cancellation provisions within this Certificate it is hereby noted and agreed
that should a minimum earned premium percentage be shown in the declarations of this Certificate, then the
Underwriters shall retain as a minimum such percentage of premium stated.
11. Complaints Procedure. If you have a complaint with any aspect of your policy with Lloyd’s Underwriters: You
may contact the broker/agent who arranged your policy for you. Should you be dissatisfied with the outcome of
your broker’s resolution, please submit your written complaint to:
Beazley USA Services Inc.
141 Tremont Street – Suite 1200,
Boston MA 02111
U.S.A
LMA3102B Page 5 of 7
12. Law and Jurisdiction. This insurance shall be governed by the laws of California and subject to the exclusive
jurisdiction of the courts of the USA per the Service of Suit clause contained herein
13. Conformity to Statute. Any terms of this Certificate which may conflict with applicable statutes (or statutes
deemed applicable by a court of competent jurisdiction) are amended to conform with the minimum
requirements of such statutes.
14. Conformity. It is hereby noted and agreed that whenever the words “Assured” and “Insured” appear in this
Certificate they shall be deemed to be synonymous
It is hereby noted and agreed that whenever the words “Underwriters”, “Insurers”, “Company” appear in this
Certificate they shall be deemed to be synonymous
It is hereby noted and agreed that whenever the term “we”, “us” and “our” appears herein, same shall be
deemed to read “Insurers”
It is hereby noted and agreed that whenever the term “you” or “your” appears herein, same shall be deemed to
read “the Insured”
Insurance is effective with certain UNDERWRITERS AT LLOYD’S, LONDON
Percentage: 100%
LMA3102B Page 6 of 7
LLOYD’S SECURITY SCHEDULE
Syndicate 2623 82%
Syndicate 623 18%
LMA3102B Page 7 of 7
One Lime Street London EC3M 7HA
FS C 422 01 13 24-Feb-2021 6:59:13 PM Page 1 of 2
COMMERCIAL PROPERTY
FS C 422 01 13
GENERAL COVER DECLARATIONS PAGE
THE COVERHOLDER THE PRODUCER
Beazley Insurance Services
CA license #: 0G55497
101 California Street, Suite 1850
San Francisco, CA 94111
AmWINS Insurance Brokerage of California - Irvine,
CA
2010 Main Street
Ste 700
Irvine, CA 92614
Please send correspondence to the above address.
Beazley Lloyd’s Syndicate 2623-82%
Beazley Lloyd’s Syndicate 623-18%
Unique Market Reference: B6012BUSA21
POLICY NUMBER: W14D19210801 POLICY PERIOD
Renewal of W14D19200701 From:07-Feb-2021
To:07-Feb-2022
at 12:01 A.M. Standard Time at the Insured's
Address
INSURED'S NAME AND ADDRESS
City of La Quinta
78-495 Calle Tampico
La Qunita, CA 92253
PERILS INSURED AGAINST:
Earthquake
PREMIUM:
$179,400 Policy Premium
Declined Certified Acts of Terrorism Premium
$300 Inspection Fees
$179,700.00 Total Premium for above stated Policy Period
CLAIMS:
In case of loss, please refer notice immediately to:
Claims Manager
Beazley USA Services Inc.
141 Tremont Street, Suite 1200
Boston, MA 02111
Telephone: 617-239-2600
Fax: 617-239-2659
Email: propertyclaims@beazley.com
California Premium:
NonTaxable Fees:
Taxable Fees:
Surplus Lines Tax:
Stamping Fee:
$179,400.00
$ 300.00
$ 5,391.00
$ 449.25
FS C 422 01 13 24-Feb-2021 6:59:13 PM Page 2 of 2
Terms and Conditions Applicable: See FS C 426 12 12 Supplemental Dec Page and /or FS C 424 Schedule of
Forms as attached.
This contract is subject to US state surplus lines requirements. It is the responsibility of the surplus lines broker to
affix a surplus lines notice to the contract document before it is provided to the insured. In the event that the
surplus lines notice is not affixed to the contract document the insured should contact the surplus lines broker.
This Declaration, together with Policy jacket, the above policy wording and endorsements, issued to form a part
thereof, completes the above numbered policy.
Signed:Date Issued:24-Feb-2021
FS C 426 12 12 24-Feb-2021 6:59:13 PM Page 1 of 2
COMMERCIAL PROPERTY
FS C 426 12 12
SUPPLEMENTAL DECLARATIONS PAGE
POLICY NO. W14D19210801 EFFECTIVE DATE 07-Feb-2021
NAMED INSURED
City of La Quinta
78-495 Calle Tampico
La Qunita, CA 92253
£ See 'Additional Named Insured Schedule' attached to this policy.
LOCATION ADDRESS OF LOCATION
Loc.Bldg.
T As per Schedule on file with the Underwriter
Total Insured Value: $70,003,939
COVERAGE LIMIT OF LIABILITY
Real Property
Personal Property
Valuable Papers
Electronic Data Processing Media
Business Income
Extra Expense
Rental Income
Ordinance or Law - Undamaged
Portion (Cov A)
$10,000,000 Each Occurrence and in the Annual Aggregate in respect of
Earthquake
COVERAGE SUB-LIMIT
Ordinance or Law - Demolition (Cov
B) and Increased Cost of
Construction (Cov C) combined
$2,500,000 Sub-Limit
Total LIMIT OF LIABILITY in any one occurrence for all above coverages combined: $10,000,000
DEDUCTIBLE
10.00 % Values Per Unit of
Insurance
$25,000 Minimum Per Occurrence
Earthquake
POLICY FORM CHANGES
FS C 494: Optional Valuation, Section 9. is amended to show Replacement Cost applies to Real Property and
Personal Property.
FS C 494: Limits of Insurance , Section 7. Item B. is deleted in it's entirety.
FS C 426 12 12 24-Feb-2021 6:59:13 PM Page 2 of 2
MORTGAGE HOLDER / LOSS PAYEE
Prem. No.Bldg. No.Mortgage Holder / Loss Payee Name and Mailing
Address
Interest
Mortgage Holder = MH
Loss Payee = LP
N/A
£ As per Schedule on file with the Underwriter
PREMIUM:
$179,400 Policy Premium
Declined Certified Acts of Terrorism Premium
$300 Inspection Fees
$179,700.00 Total Premium for above stated Policy Period
FS C 424 24-Feb-2021 6:59:13 PM Page 1 of 1
Schedule of All Forms and Endorsements
Named Insured:City of La Quinta
Policy Number:W14D19210801
Effective Date:07-Feb-2021
Number Name
LMA3102B (amended)Lloyd's Certificate
FS C 422 01 13 General Cover Declarations Page
FS C 426 12 12 Supplemental Declarations Page
FS C 424 Schedule of Forms and Endorsements
FS C 494 05 17 Beazley Earthquake Policy
FS C 493 10 12 Statement of Deductible for Earthquake and/or
Flood if Covered By This Policy
FS C 513 06 13 Time Element Endorsement to Beazley Earthquake
Policy
USES0114-004 Contingent Tax Revenue Interruption Extension
FS C 488 10 12 Ordinance or Law Endorsement
FS C 500 10 12 Valuable Papers and Records Extension
LMA5393 Communicable Disease Endorsement
LSW1135B Lloyd's Privacy
LMA3100 Sanction Limitation and Exclusion Clause
LMA5390 TRIA Not Purchased Clause
FS C 494 05 17 Page 1 of 9
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
FS C 494 05 17
BEAZLEY EARTHQUAKE POLICY
(hereinafter the “Policy”)
1.INSURING CLAUSE
Subject to its terms, exclusions, limitations and conditions, this Policy insures against direct physical loss or
damage caused directly by the peril of Earthquake (as defined below). All such losses must commence
during the Policy Period stated in the Declaration Page attaching to and forming part of this Policy (referred
to herein as the “Declaration”).
2.PROPERTY INSURED
Except for property excluded elsewhere in this Policy, this Policy insures real and business personal property
owned by the Insured, including improvements and betterments the Insured has an interest in, all to the
extent the location, description and value of such property is shown in the Declaration and has been declared
to and agreed by the Underwriters prior to being insured under this Policy (referred to herein as the “Property
Insured”).
3.SUM INSURED
This Policy shall not cover for more than the Limit of Liability stated in the Declaration in respect of each Loss
Occurrence, nor for more than any aggregate amount(s) during the Period of Insurance stated in the
Declaration in respect of specified causes.
4.DEDUCTIBLE(S) AND SUB-LIMIT(S)
Each Loss Occurrence shall be adjusted separately, and from the amount of each adjusted Loss Occurrence
the applicable deductible (as set out in the statement of deductible attached to and forming part of this policy)
shall be deducted and any sub-limit(s) applied.
5.EXCLUDED CAUSES OF LOSS
This Policy does not insure against any loss or damage, directly or indirectly caused by, or which is
contributed to by the following regardless of any other cause or event contributing concurrently or in any
other sequence thereto:
a.Earth Movement, as defined herein, except Earth Movement ensuing as a direct result of
Earthquake;
b.Flood
c.collapse;
d.sprinkler leakage;
e.wear, tear or gradual deterioration, wet rot or dry rot, spoilage, decay or decomposition, cracking,
settling, shrinking or expansion in buildings, structures or foundations, corrosion or rust, erosion,
leakage, any other gradually occurring loss;
f.inherent vice or latent defect;
g.mold, mildew, fungus, spores or other microorganism of any type, nature or description, including
but not limited to any substance whose presence poses an actual or potential threat to human
health;
FS C 494 05 17 Page 2 of 9
h.war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war,
rebellion, revolution, insurrection, military or usurped power, martial law, or warlike operations;
i.confiscation, requisition, detention, legal or illegal occupation, embargo, quarantine, or any result
of any order of public or government authority, which deprives the Insured of the use or value of
the Property Insured, nor for loss or damage arising from acts of contraband or illegal
transportation or illegal trade;
j.enforcement of any ordinance or law regulating the use, reconstruction, repair or demolition of
any Property Insured;
k.any loss, damage, costs, expenses, fine or penalty which is incurred, or sustained by or imposed
on the Insured at the order of any governmental agency, court, or other authority arising from any
cause whatsoever;
l.terrorism;
m.actual or threatened malicious use of pathogenic or poisonous biological or chemical materials;
n.nuclear reaction, nuclear radiation or radioactive contamination;
o.any kind of seepage or any kind of pollution and/or contamination, or threat thereof, whether or
not caused by or resulting from a peril insured or from steps or measures taken in connection with
the avoidance, prevention, abatement, mitigation, remediation, clean-up or removal of such
seepage or pollution and/or contamination or threat thereof; as used herein the term "any kind of
seepage or any kind of pollution and/or contamination" includes (but is not limited to):
i.seepage of, or pollution and/or contamination by, anything, including but not limited to,
any material designated as a "hazardous substance" by the United States Environmental
Protection Agency or as a "hazardous material" by the United States Department of
Transportation, or defined as a "toxic substance" by the Canadian Environmental
Protection Act for the purposes of Part II of that Act, or any substance designated or
defined as toxic, dangerous, hazardous or deleterious to persons or the environment
under any other Federal, State, Provincial, Municipal or other law, ordinance or
regulation; and
ii.the presence, existence, or release of anything which endangers or threatens to
endanger the health, safety or welfare of persons or the environment.
p.loss of earnings, delay or loss of market, however caused or arising and despite any preceding
loss insured hereunder, except to the extent this Policy includes a Time Element Endorsement
and then only to the extent insured under the terms and conditions of such Time Element
Endorsement;
q.action of Electronic Data whether or not contributed to, or aggravated by:
i.alteration, manipulation or destruction of computer media and data, the addition of a
Computer Virus, destructive code or similar instruction that disrupts the normal operation
of computer equipment or results in the loss of use or physical damage to computer
equipment or computer media and data;
ii.denial of service; including but not limited to unauthorized direction of a high volume of
messages or inquiries to a web site or e-mail destinations, effectively denying,
interrupting or limiting legitimate access;
iii.transfer of property caused by, resulting from, or arising out of unauthorized instructions
transmitted by a computer;
FS C 494 05 17 Page 3 of 9
iv.financial loss or any other loss or damage due to unauthorized viewing, copying or use of
any data (including proprietary or confidential information) by any person, even if such
activity is characterized as theft;
r.failure, malfunction or inadequacy of:
i.any of the following, whether belonging to the Insured or to others:
(a)computer hardware, including microprocessors
(b)computer application software
(c)computer operating systems and related software
(d)computer networks
(e)microprocessors (computer chips) not part of any computer system;
(f)any other computerized or electronic equipment or components;
nor does this Policy insure against repair, replacement or modification or any of the items
listed in this paragraph (i) in order to correct any deficiencies or change any features;
ii.any other products, and any services, data or function that directly or indirectly use or rely
upon, in any manner, and of the items listed in paragraph (i) above; due to the inability to
correctly recognize, process, distinguish, interpret or accept one or more dates or times;
an example is the inability of computer software to recognize the year 2000; or
iii.any advice, consultation, design, evaluation, inspection, installation, maintenance, repair,
replacement or supervision provided or done by the Insured or by others to determine,
rectify or test for, any potential or actual problems described in paragraph (i) above.
s.failure of any utility service provider to provide utility services;
t.cessation, fluctuation or variation in, or insufficiency of, water, gas or electricity supplies;
6.EXCLUDED PROPERTY
This Policy does not insure:
a.land (including but not limited to land on which Property Insured is located), water (other than
water contained in plumbing or fire fighting installations), or air, or any interest or right therein;
b.shafts, mines, tunnels, wells, ponds, dams, dikes, wharves, piers, jetties, docks, embankments,
bulkheads, earthen structures and the like, and any man-made property in or under the ground,
underwater or waterborne;
c.driveways, pavements, curbing, culverts sidewalks, roads, bridges, tunnels, pipelines, levies or
damns;
d.buildings or structures in the course of construction, including materials and supplies therefore,
except additions, alterations and repairs to Property Insured;
e.transmission, distribution, or feeder lines located more than 1000 feet from Property Insured;
f.neon signs and automatic or mechanical and/or electric signs, awnings, bric-a-brac, porcelains
and similar fragile articles, glass or any ornamentation or lettering thereon;
FS C 494 05 17 Page 4 of 9
g.asbestos; nor does this Policy insure against the cost of removal, disposal, decontamination or
replacement of Property Insured containing asbestos;
h.property in transit;
i.property sold by or under encumbrance to the Insured after it leaves the custody of the Insured or
an employee of the Insured;
j.accounts, bills, currency, money, notes, securities, deeds, evidence of debt and valuable papers;
k.aircraft or any other aerial device, watercraft, vehicles designed for highway use and/or any public
roads, or locomotives or rolling stock designed for railroad use;
l.animals, plants, growing crops and living things of all types;
m.jewelry, watches and watch movements, precious and semi-precious stones, gold, silver,
platinum and other precious alloys or metals;
n.fine arts, furs or garments trimmed with fur;
o.foundations of buildings, including pilings and construction equivalents to support a building, or
structures, machinery or boilers, if their foundations are below;
i.the lowest basement floor; or
ii.the surface of the ground if there is no basement;
p.property while covered under import and export ocean marine policies.
7.LIMITS OF INSURANCE
The premium for this Policy is based upon the Statement of Values reported to and on file with the Insurers, or
attached to this Policy. In the event of any covered Loss Occurrence under this Policy, the liability of the
Underwriters shall, notwithstanding anything contained herein to the contrary, be limited to the least of the
following:
a.The actual adjusted amount of the Loss Occurrence within the coverage of the Policy, after
reduction for applicable deductible(s) and sub-limit(s);
b.an amount calculated by:
i.adding together, for each scheduled item of Property Insured which actually sustained
loss in the Loss Occurrence, 100% of the individually stated value, as shown in the
Declaration or any update thereto on file with Underwriters; and
ii.subtracting from the sum calculated in (i) applicable deductibles and primary and
underlying excess limits, and applying applicable sub-limits;
and further provided that if no value is shown for a scheduled item then there is no coverage for
that item; or
c.The Policy Limit of Liability or applicable sub-limit(s) of liability.
8.VALUATION
In case of loss of or damage to Property Insured, the basis of adjustment shall be as follows:
FS C 494 05 17 Page 5 of 9
a.on stock in process at the value of raw material and labor expended plus the proper proportion of
overhead charges;
b.on finished goods manufactured by the Insured, at the regular cash selling prices at the location
where the loss occurs, less all discounts and charges to which the property would have been
subject had no loss occurred;
c.property of others at the amount for which the Insured is liable but in no event to exceed the
actual cash value;
d.tenants improvements and betterments at Actual Cash Value if repaired or replaced by the
Insured; if repaired or replaced by others for the use of the Insured, there shall be no liability
hereunder;
e.on documents not specifically excluded, at value blank plus cost of transcribing;
f.on media storing Electronic Data, the cost of the blank media and, if and to the extent that the
media is repaired, replaced or restored, the costs of copying the Electronic Data from back-up or
form originals of a previous generation; for avoidance of doubt, such costs shall not include
research and engineering nor any costs of recreating, gathering or assembling such Electronic
Data media, nor does this Policy insure any amount pertaining to the value of such Electronic
Data to the Insured or to any other party, even if such Electronic Data cannot be recreated,
gathered or assembled;
g.all other property at Actual Cash Value immediately prior to the loss.
The above valuations shall also be used for the purpose of reporting values on the Declaration and will be
considered for the premium computation of this Policy.
Actual Cash Value wherever used in this Policy shall mean the amount it would cost to repair or replace
Property Insured as provided in this Policy, on the date of loss, with material of like kind and quality, with
proper deduction for obsolescence and physical depreciation.
9.OPTIONAL VALUATION
If shown in the Declaration, the following Optional Valuation applies separately to each item:
a.Replacement Cost wherever used in this Policy shall mean the amount it would cost, on the date
of the loss, to repair or replace Property Insured, with material of like kind and quality, without
deduction for deprecation.
Increased costs of repair or replacement due to operation of any written ordinance or other law
are not included in Replacement Cost.
Debris Removal Costs, as defined herein, are not included in Replacement Cost.
b.Replacement Cost shall replace Actual Cash Value in the Valuation section of this coverage form.
However, this Optional Valuation does not apply to:
i.contents of a residence;
ii.manuscripts; or
iii.media storing Electronic Data.
c.Where Replacement Cost coverage is selected such that this Optional Valuation section of the
Policy applies, it is subject to the following provisions:
FS C 494 05 17 Page 6 of 9
i.any settlement shall be based on whichever is the least of the cost of repairing, replacing
or reinstating the destroyed or damaged property with material of like kind and quality;
ii.the repair, replacement or reinstatement shall be on the same site and intended for the
same occupancy as the destroyed or damaged property;
iii.the repair, replacement or reinstatement must be executed with due diligence and
dispatch; and
iv.until repair, replacement or reinstatement has been effected, the amount of liability under
this Policy in respect of each Loss Occurrence shall be limited to the actual cash value at
the time of the Loss Occurrence.
d.Underwriters’ liability for loss under this Policy shall not exceed the smallest of the following
amounts:
i.the amount applicable to the destroyed or damaged property as calculated in Section 7,
Limits of Insurance;
ii.the replacement cost of the property or any part thereof identical with such property and
intended for the same occupancy and use; or
iii.the amount actually and necessarily expended in replacing said property or any part
thereof.
10.DEBRIS REMOVAL
This Policy, subject to all other terms and conditions, and without increasing the Policy Limit of Liability,
insures Debris Removal Costs, defined herein to be the costs necessarily incurred in connection with an
insured Loss Occurrence to remove from the Insured’s property solid remnants of Property Insured to permit
repair, replacement or reinstatement.
The maximum amount payable under this Policy for Debris Removal Costs is the greater of US$25,000
(twenty-five thousand dollars) or 10% (ten percent) of the total of the adjusted amounts of the other
components of the Loss Occurrence.
11.DUE DILIGENCE
The Insured shall use due diligence and do and concur in doing all things reasonable to avoid or diminish
any loss of or damage to the Property Insured. However, Underwriters liability, if any, for such expenses
shall be limited to the amount by which insured losses under this Policy are thereby reduced.
12.NOTIFICATION OF CLAIMS
The Insured upon knowledge of any Loss Occurrence likely to give rise to a claim hereunder shall give
immediate written advice thereof to the person(s) or firm named for the purpose in the Declaration. Any
losses shall not be insured by this Policy if such losses are not reported within a year of when the loss
occurred.
13.PROOF OF LOSS
The Insured shall render a signed and sworn proof of loss within ninety (90) days after the occurrence of a
loss (unless such period be extended by the written agreement of Underwriters) stating the time, place and
cause of loss, the interest of the Insured and of all others in the property, the sound value thereof and the
amount of loss or damage thereto.
14.SUBROGATION
FS C 494 05 17 Page 7 of 9
If the Underwriters become liable for any payment under this Policy in respect of loss or damage the
Underwriters shall be subrogated, to the extent of such payment, to all the rights and remedies of the Insured
against any party in respect of such loss or damage and shall be entitled at their own expense to sue in the
name of the Insured. The Insured shall give to the Underwriters all such assistance in its power as the
Underwriters may require to secure their rights and remedies and, at Underwriters’ request, shall execute all
documents necessary to enable Underwriters effectively to bring suit in the name of the Insured including the
execution and delivery of the customary form of loan receipt.
The Underwriters hereon agree that this Policy shall not be invalidated should the Insured waive in writing,
prior to loss affected thereby, any or all rights of recovery against any party for loss or damage occurring to
the property described herein. The Underwriters expressly waive subrogation against any subsidiary, parent,
associated, or affiliated company of the Insured, but the above waivers shall not apply where the party
otherwise protected by that waiver is supplying or receiving goods or services for which compensation
passes between the Insured and such other party.
15.PROTECTION MAINTENANCE
It is agreed that any protections provided for the safety of Property Insured shall be maintained in good order
throughout the Policy Period of this Policy and shall be in use at all times out of business hours or when the
Insured’s premises are left unattended, and that such protections shall not be withdrawn or varied to the
detriment of the interests of the Underwriters without their consent.
16.CANCELLATION
This Policy may be cancelled by the Insured at any time by written notice or by surrender of this Policy. This
Policy may also be cancelled by or on behalf of the Underwriters by delivering to the Insured or by mailing to
the Insured, by registered, certified or other first class mail, at the Insured’s address as shown in the
Declaration, written notice stating when, not less than thirty (30) days thereafter, or not less than ten (10)
days in the event of nonpayment of premiums, the cancellation shall be effective. The mailing of such notice
as aforesaid shall be sufficient proof of notice and this Policy shall terminate at the date and hour specified in
such notice.
If this Policy shall be cancelled by the Insured the Underwriters shall retain the customary short rate
proportion of the premium hereon, except that if this Policy is on an adjustable basis the Underwriters shall
receive the earned premium hereon or the customary short rate proportion of any minimum premium
stipulated herein whichever is the greater.
If this Policy shall be cancelled by or on behalf of the Underwriters the Underwriters shall retain the pro rata
proportion of the premium hereto, except that if this Policy is on an adjustable basis the Underwriters shall
receive the earned premium hereon or the pro rata proportion of any minimum premium stipulated herein
whichever is the greater.
Payment or tender of any unearned premium by the Underwriters shall not be a condition precedent to the
effectiveness of cancellation but such payment shall be made as soon as practicable.
If the period of limitation relating to the giving of notice is prohibited or made void by any law controlling the
construction thereof, such period shall be deemed to be amended so as to be equal to the minimum
requirements of the statute concerning cancellation in the relevant jurisdiction.
17.ABANDONMENT
There shall be no abandonment to the Underwriters of any property.
18.ASSIGNMENT
Assignment or transfer of this Policy shall not be valid except with the written consent of Underwriters.
19.EXCESS INSURANCE
FS C 494 05 17 Page 8 of 9
Permission is granted to the Insured to have excess insurance over the limit of liability set forth in this Policy
without prejudice to this Policy and the existence of such insurance, if any, shall not reduce any liability under
this Policy.
20.EXAMINATION UNDER OATH
If required by the Underwriters, in the event of a claim being made under this Policy, the Insured, or if a
Company of other body, then the appropriate representatives , shall submit to examination on oath at such
reasonable times and places as may be arranged
21.INSPECTION AND AUDIT
The Underwriters shall be permitted but not obligated to inspect the Insured’s property at any time. Neither
the Underwriters’ right to make inspection nor the making thereof nor any report thereon shall constitute an
undertaking, on behalf of or for the benefit of the Insured or others, to determine or warrant that such
property is safe.
The Underwriters may examine and audit the Insured’s books and records at any time during the Policy
period and extensions thereof and within three years after the final termination of this Policy, as far as they
relate to the subject matter of this Insurance.
22.ASSISTANCE AND COOPERATION
The Insured shall cooperate with the Underwriters and, upon Underwriter’s request, shall assist in securing
and giving evidence, and obtaining the attendance of witnesses.
23.SALVAGE AND RECOVERIES
All salvages, recoveries and payments recovered or received subsequent to a loss settlement under this
Policy shall be applied as if recovered or received prior to the said settlement and all necessary adjustments
shall be made by the parties hereto.
24.MISREPRESENTATION AND FRAUD
This entire Policy shall be void if the Insured has willfully concealed or misrepresented, in writing or
otherwise, any material facts or circumstances concerning this Policy or the subject matter thereof or any
claim thereunder.
25.TITLES OF PARAGRAPHS
The several titles of the various paragraphs of this form (and of endorsements and supplemental contracts, if
any, now or hereafter attached to this Policy) are inserted solely for convenience or reference and shall not
be deemed in any way to limit the provisions to which they relate.
26.MINIMUM EARNED PREMIUM
In the event of cancellation of this Policy by the Insured, a minimum premium of 25 % of the Policy premium
shall become due and payable by the Insured regardless of any conditions of the Policy to the contrary.
Failure of the Insured to make timely payment of premium shall be considered a request by the Insured for
the Underwriters to cancel. In the event of such cancellation by the Underwriters for non-payment, the
minimum premium shall be immediately due and payable. Cancellation for non-payment of premium may be
rescinded at the discretion of the Underwriters by payment of the full amount of premium due to the
Underwriters and upon verification by the Underwriters that the Property Insured is in essentially the same or
better condition than at the time of cancellation. In the event the premium due is paid after the cancellation
date has become effective, there may be, at the discretion of the Underwriters, a lapse in coverage between
the date of cancellation and the date the premium was paid.
FS C 494 05 17 Page 9 of 9
27.ADDITIONAL DEFINITIONS
a.Loss Occurrence wherever used in this Policy shall mean:
b.the sum of all individual losses or series of individual losses resulting from or arising out of and
directly occasioned by any one event. Earthquake wherever used in this Policy shall mean:
collapse, falling, cracking, rupturing, shifting, crushing, breaking, bursting, fracturing, or shattering
of Property Insured resulting from a shock, shaking, tremor, and/or convulsion of the earth’s
surface caused by natural seismic forces, or from the eruption, explosions or effusion of a
volcano.
Loss resulting directly or indirectly from any resulting peril shall not be insured hereunder, except
that this Policy shall insure direct physical loss or damage to Property Insured resulting directly
from Earth Movement ensuing as a direct result of Earthquake.
When the term Loss Occurrence applies to a loss or series of losses from the peril Earthquake
and the peril of Earth Movement ensuing as a direct result of Earthquake, one event shall be
construed to be all losses arising during a continuous period of 168 hours. When filing a proof of
loss the Insured may elect the moment at which the 168 hour period shall be deemed to have
commenced, which shall not be earlier than the first loss to occur at any covered location. The
Insured may select only one continuous period of 168 hours for any Loss Occurrence that
includes Earthquake and/or Earth Movement ensuing as a direct result of that Earthquake.
c.Earth Movement wherever used in this Policy shall mean:
landslide, mudslide, mudflow, sinkhole or earth sinking, subsidence, rising or shifting including
soil conditions which caused settling or other disarrangement of foundations or other parts of
realty.
Soil conditions include contraction, expansion, freezing, thawing, erosion, improperly compacted
soil and the action of water under the ground surface.
d.Flood wherever used in this Policy shall mean:
i.inundation of normally dry land by natural or human cause;
ii.tsunami, seaquake; and/or
iii.surface water, waves, tide or tidal water, and the rising (including the overflow or
breaking of boundaries) of lakes, ponds, reservoirs, levies, rivers, harbors, streams, and
other similar bodies of water, whether driven by wind or not.
e.Electronic Data wherever used in this Policy shall mean:
facts, concepts and information converted to a form useable for communications, interpretation or
processing by electronic and electromechanical data processing or electronically controlled
equipment and includes programs, software and other coded instructions for the processing and
manipulation of data or the direction and manipulation of such equipment.
f.Computer Virus wherever used in this Policy shall mean:
a set of corrupting, harmful or otherwise unauthorized instructions or code including a set of
maliciously introduced unauthorized instructions or code, programmatic or otherwise, that
propagate themselves through a computer system or network of whatsoever nature. COMPUTER
VIRUS includes but is not limited to ‘Trojan Horses’, ‘worms’ and ‘time or logic bombs’.
FS C 493 10 12 Page 1 of 1
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
FS C 493 10 12
This endorsement, subject to its stated terms and conditions, is subject to the terms and conditions of
the Policy to which it attaches.
STATEMENT OF DEDUCTIBLE FOR EARTHQUAKE AND/OR
FLOOD IF COVERED BY THIS POLICY
As respects any Loss Occurrence directly or indirectly caused by, or contributed to by the peril of Earthquake, and
the peril of Earthmovement ensuing as a direct result of Earthquake, Underwriters shall not be liable for loss to
any unit of insurance unless such loss exceeds an amount equal to the greater of (i) the Minimum Deductible
stated below; or (ii) 10% of the individually stated value for each unit of insurance which actually sustained loss in
the Loss Occurrence, and then only for its proportions of such excess amounts. The following shall each be
considered a separate unit of insurance:
a)each separately-scheduled building or structure;
b)the contents of each separately-scheduled building or structure; and
c)to the extent this Policy includes a Time Element Endorsement, Operations (as defined therein)
conducted at each separately-scheduled building or structure
A minimum sum of $25,000 shall be deducted from the amount of each adjusted Loss Occurrence (hereinafter
referred to as the “Minimum Deductible”).
If this Policy includes a Flood Endorsement, then as respects any Loss Occurrence directly or indirectly caused
by, or contributed to by, the peril of Flood, Underwriters shall not be liable for loss to any unit of insurance unless
such loss exceeds an amount equal to the greater of (i) the Minimum Deductible stated below; or (ii) N/A of the
individually stated value for each unit of insurance which actually sustained loss in the Loss Occurrence, and then
only for its proportions of such excess amounts. The following shall each be considered a separate unit of
insurance:
a)each separately-scheduled building or structure;
b)the contents of each separately-scheduled building or structure; and
c)to the extent this Policy includes a Time Element Endorsement, Operations (as defined therein)
conducted at each separately-scheduled building or structure
A minimum sum of N/A shall be deducted from the amount of each adjusted Loss Occurrence (hereinafter
referred to as the “Minimum Deductible
FS C 513 06 13 Page 1 of 3
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
FS C 513 06 13
TIME ELEMENT ENDORSEMENT TO
BEAZLEY EARTHQUAKE POLICY
In consideration of the premium paid and subject to the terms,exclusions,limitations and conditions of
the Policy to which this Endorsement is attached,and also to the following additional terms,exclusions,
limitations and conditions, this Policy is extended to insure against:
Actual Loss of Business Income sustained by the Insured during the Period of
Restoration due to the necessary suspension of the Insured’s Operations caused directly
by physical loss of, or damage to, Property Insured directly caused by a Peril Insured.
Extra Expense consisting of those expenses incurred by the Insured to conduct Operations during
the Period of Restoration and that are above the expenses which would have been incurred by
the Insured to conduct Operations during the Period of Restoration had there been no physical
loss of, damage to, Property Insured directly caused by a Peril Insured.
1)Definitions:
a)Actual Loss of Business Income, as used in this Endorsement, means:
i)an amount calculated by adding:
(1)gross earnings that would have been earned,including rental income from tenant
occupancy of the Property Insured,had there been no necessary suspension of the
Insured’s Operations; and
(2)continuing normal operating expenses incurred,including ordinary payroll and,as to
manufacturing facilities, the net sales value of production;
ii)provided that the amount of Actual Loss of Business Income will be determined based on:
(1)the financial records and accounting procedures of the Insured prior to the Loss
Occurrence;
(2)budgets,forecasts or other estimates of what the financial performance of the Insured’s
Operations would have been had the Peril Insured not occurred; and
(3)other relevant sources of information, including:
(a)the Insured’s financial records and accounting procedures;
(b)bills, invoices, and other vouchers; and
(c)deeds, liens, rental agreements or contracts; and
iii)in no event shall the Actual Loss of Business Income include any amount attributable to an
estimate of the gross earnings that would have been earned as a result of favorable business
conditions caused by the impact of the Peril Insured on customers, competitors or others.
FS C 513 06 13 Page 2 of 3
b)Extra Expense, as used in this Endorsement, means:
i)an amount calculated by adding:
(1)the reasonable and necessary operating expenses that exceed normal operating expenses
that would have been incurred by the Insured to conduct Operations during the Period of
Restoration had there been no physical loss, damage or destruction of Property Insured
directly caused by a Peril Insured; and
(2)such further reasonable and necessary expenses incurred during the Period of Restoration
to avoid or minimize the necessary suspension of the Insured’s Operations directly
caused by a Peril Insured sustained at Property Insured, but only to the extent that such
expenses actually reduce the loss.
ii)Extra Expense may include reasonable and necessary relocating expenses and costs to equip
and operate replacement or temporary locations.
iii)Underwriters will deduct from the total Extra Expense the salvage value that remains of any
property bought for temporary use during the Period of Restoration, measured at the end of
the Period of Restoration.
c)Operations, as used in this Endorsement, means:
the regular business activities of the Insured occurring at Property Insured, including rental of
Property Insured to others.
d)Period of Restoration, as used in this Endorsement, means:
the period of time that:
(i)begins with the date the Peril Insured was sustained at the Property Insured; and
(ii)ends on the earlier of :
1.when the Property Insured could have been repaired,rebuilt or replaced using
due diligence and dispatch; or
2.the date when the Insured could have restored Operations to the levels that
would have existed if the Peril Insured had not occurred,whether by means of
an alternate location or otherwise;
2)Additional Coverage:
Extended Business Income
If the necessary suspension of the Insured’s Operations produces an Actual Loss of Business Income
as insured by this Policy,Underwriters will pay for the Actual Loss of Business Income sustained by
the Insured during the period that:
(i)Begins on the date the Property Insured is actually repaired rebuilt or replaced and
Operations are resumed; and
(ii)Ends on the earlier of:
1.The date the Insured could restore operations with due diligence and
dispatch,to the level which would generate the business income amount
that would have existed if no direct physical loss or damage had occurred;
or
2.30 consecutive days after the date determined in 2) (ii) 1 above.
FS C 513 06 13 Page 3 of 3
3)Exclusions: This Endorsement and the Policy to which it attaches do not insure:
a)any Actual Loss of Business Income or Extra Expense caused by or resulting from damage to or
destruction of finished stock,defined herein as stock you have manufactured or stock consisting
of alcoholic products being aged,excepting stock held for sale on the premises of any Property
Insured the Insured is operating as a retail outlet;
b)any Actual Loss of Business Income or Extra Expense caused by or resulting from damage to or
destruction of business personal property while in transit;
c)any Actual Loss of Business Income or Extra Expense caused by or resulting from delay in
rebuilding,repairing or replacing the Property Insured or resuming Operations due to
strikers; or
d)any Actual Loss of Business Income or Extra Expense caused by or resulting from the
suspension,lapse or cancellation of any license,lease,contract or order for any reason other than
as a direct result of the necessary suspension of the Insured’s Operations directly caused by
physical loss of or damage to Property Insured directly caused by a Peril Insured.
e)any Actual Loss of Business Income or Extra Expense caused by or resulting from the enforcement
of any ordinance or law regulating the use,reconstruction,repair or demolition of any property
Insured hereunder.
USES0114-004 Page 1 of 1
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
USES0114-004
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDATORY ENDORSEMENT
CONTINGENT TAX REVENUE INTERRUPTION EXTENSION
In consideration of the premium paid,and subject to the exclusions,conditions and limitations of the policy to
which this Extension is attached,and to the provisions contained within this endorsement,it is agreed that the
following additional coverage is added to this Policy:
We will pay for the actual loss of sales and property tax revenue collected by or due to you.Such loss of revenue
must be caused by direct physical loss of damage to property of the type insured by this Policy not owned or
operated by you caused by a Covered Cause of Loss.
In the event of such damage or destruction,we shall only be liable with limitations as indicated here,if the
following conditions (a) and (b) are both met:
a.The total revenue is reduced to less than 97.5%of the Insured’s anticipated revenue had no physical loss
or damage occurred.
b.We shall pay for the actual loss sustained for only the length of time as would be required with the excise
of due diligence and dispatch to rebuild,replace the contributing property commencing with the date of
physical loss or damage to the contributing property, but not limited by the expiration date of this Policy.
This extension of coverage does not include any increased period of time required due to the enforcement of any
ordinance or law that;
i)Regulates the construction, use or repair, or requires the tearing down, for any property; or
ii)Requires testing for,monitor,clean up,remove contain,treat detoxify or neutralize,or in any way respond
to or assess the effects of pollutants.
Such loss recovery after deductible shall be limited to whichever is the least of:
i)The sub limit as shown on the declaration
ii)The actual loss sustained
iii)The difference in amount between 97.5%of the anticipated revenue and the actual total revenue after the
loss.
FS C 488 10 12 Page 1 of 2
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
FS C 488 10 12
This endorsement, subject to its stated terms and conditions and the terms and conditions of the Policy
to which it attaches, adds coverage otherwise excluded under the Policy.
ORDINANCE OR LAW ENDORSEMENT
The coverage set forth in this Endorsement applies only to those locations specifically listed in the schedule
below:
SCHEDULE
Building/Premises Sublimit for
Coverage B
(Demolition Cost)
Sublimit for
Coverage C
(Increased Cost of
Construction)
Combined Sublimit for
Coverage B and C
All/All $2,500,000 Sub-limit
1.Coverage
If a Peril Insured causes direct physical loss or damage to Property Insured and that item of Property
Insured is shown on the Schedule above, then this Policy provides the following with respect to that item
of Property Insured:
a)Coverage A — Loss to the Undamaged Portion of an Item of Property Insured.
If enforcement of any written ordinance or other law in force at the time of the physical loss or damage
requires the demolition of undamaged portions of the item of Property Insured, Underwriters will pay for:
(i)the Actual Cash Value of such undamaged portions or,
(ii)if Replacement Cost coverage is selected such that the Optional Valuation section of the
Policy applies to the item of Property Insured and the item of Property Insured is actually
repaired, replaced or rebuilt, the Replacement Cost of such undamaged portions.
b)Coverage B — Demolition Cost.
If enforcement of any written ordinance or other law in force at the time of the physical loss or damage
requires the demolition of undamaged portions of the item of Property Insured, Underwriters will pay the
reasonable and necessary cost to demolish and clear undamaged portions of the item of Property Insured
from the premises on which it is located, subject to the following condition:
(i)Underwriters will not pay more under Coverage B for the item of Property Insured than
the Sublimit(s) shown in the Schedule above. If no Sublimit is shown for that item of
Property Insured, Coverage B does not apply.
c)Coverage C — Increased Cost of Construction.
To the extent the item of Property Insured is repaired, replaced or rebuilt (at the same or other premises),
Underwriters will pay for the increased cost to repair, replace or rebuild the item of Property Insured
caused by enforcement of any written ordinance or other law in force at the time of the physical loss or
damage, whether such increased costs are incurred with respect to damage or undamaged portions of the
item of Property Insured, subject to the following conditions:
i)Underwriters will not pay under Coverage C until the item of Property Insured is actually
repaired, replaced or rebuilt (at the same or other premises), and further provided that the
repair, replacement or rebuilding must occur as soon as reasonably possible and, in any
event, within two years after the physical loss or damage.
ii)Underwriters will not pay more under Coverage C than the increased cost of construction
at the same premises, unless the written ordinance or other law requires relocation to
other premises.
FS C 488 10 12 Page 2 of 2
iii)Underwriters will not pay more under Coverage C for the item of Property Insured than
the Sublimit(s) shown in the Schedule above. If no Sublimit is shown for that item of
Property Insured, Coverage C does not apply.
d)Additional Conditions Applicable to Coverages A, B and C:
a.This Endorsement is subject to, and does not increase, the Limits of Insurance specified in the
Policy.
b.In no event shall Underwriters’ total liability with respect to the item of Property Insured exceed
the lesser of (i) the amount the Insured actually spends to demolish and clear undamaged parts
of the item of Property Insured from the premises on which it is located plus the amount the
Insured actually spends to repair, replace or rebuild the item of Property Insured, or (ii) the
amount it would cost to demolish and clear undamaged parts of the item of Property Insured from
the premises on which it is located plus the amount it would cost to repair, replace or rebuild the
item of Property Insured on the same premises.
c.Underwriters will not pay under this endorsement for the costs associated with the enforcement of
any written ordinance or other law which requires any action (including, but not limited to testing,
monitoring, clean-up, or treatment) with respect to:
i.mold;
ii.asbestos; or
iii.“any kind of seepage or any kind of pollution and/or contamination” as that phrase is defined
in the Policy.
FS C 500 10 12 Page 1 of 1
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
FS C 500 10 12
This endorsement, subject to its stated terms and conditions and the terms and conditions of the Policy
to which it attaches, adds coverage otherwise excluded under the Policy.
VALUABLE PAPERS AND RECORDS EXTENSION
In consideration of the premium paid, and subject to the exclusions, conditions and limitations of the policy to
which this Extension is attached, this Policy is extended to cover physical loss or damage to valuable papers and
records that are the Insured’s property or property of others in the Insured’s care custody and control and while
such valuable papers and records are kept inside the Insured building(s) shown in the declarations.
In the event of a physical loss or damage as insured under this Policy the basis of valuation shall be on the lesser
of the following:
a) The cost to repair the item(s) with other(s) of a like kind and quality.
b) The cost to replace the item(s) with other(s) of a like kind and quality.
“Valuable Papers and Records” are defined as written, printed, or otherwise inscribed documents and/or records,
including books, maps, films, drawings, abstracts, deeds, mortgages and manuscripts. Valuable Papers and
records does not mean money, securities, converted data, programs or instructions used in the Insured’s data
processing operations, including the materials on which the data is recorded.
“Money “ is defined as currency, coins, bank notes and bullion; and travellers checks, register checks and money
orders held for sale to the public.
“Securities” are defined as all negotiable and non negotiable instruments or contracts representing either money
or other property and includes revenue and other stamps in current use, tokens, and tickets but does not include
money.
Underwriters shall not be liable under this Extension for more than any Specific Valuable Papers sub-limit stated
in the Declaration, which shall be part of and not additional to the Policy limit stated in the Declaration.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED
LMA5393 Page 1 of 1
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
LMA5393
COMMUNICABLE DISEASE ENDORSEMENT
(For use on property policies)
1.This policy,subject to all applicable terms,conditions and exclusions,covers losses attributable to
direct physical loss or physical damage occurring during the period of insurance.Consequently and
notwithstanding any other provision of this policy to the contrary,this policy does not insure any loss,
damage,claim,cost,expense or other sum,directly or indirectly arising out of,attributable to,or oc-
curring concurrently or in any sequence with a Communicable Disease or the fear or threat (whether
actual or perceived) of a Communicable Disease.
2.For the purposes of this endorsement,loss,damage,claim,cost,expense or other sum,includes,but
is not limited to, any cost to clean-up, detoxify, remove, monitor or test:
2.1. for a Communicable Disease, or
2.2. any property insured hereunder that is affected by such Communicable Disease.
3.As used herein, a Communicable Disease means any disease which can be transmitted by means of
any substance or agent from any organism to another organism where:
3.1. the substance or agent includes, but is not limited to, a virus, bacterium, parasite or other
organism or any variation thereof, whether deemed living or not, and
3.2. the method of transmission, whether direct or indirect, includes but is not limited to, airborne
transmission, bodily fluid transmission, transmission from or to any surface or object, solid, liquid
or gas or between organisms, and
3.3. the disease, substance or agent can cause or threaten damage to human health or human
welfare or can cause or threaten damage to, deterioration of, loss of value of, marketability of or
loss of use of property insured hereunder.
4.This endorsement applies to all coverage extensions, additional coverages, exceptions to any exclu-
sion and other coverage grant(s).
All other terms, conditions and exclusions of the policy remain the same.
LMA5393
25 March 2020
LSW1135B (06/03)Page 1 of 1
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
LSW1135B
LLOYD'S PRIVACY POLICY STATEMENT UNDERWRITERS AT
LLOYD'S, LONDON
The Certain Underwriters at Lloyd's, London want you to know how we protect the confidentiality of your non-
public personal information. We want you to know how and why we use and disclose the information that we have
about you. The following describes our policies and practices for securing the privacy of our current and former
customers.
INFORMATION WE COLLECT
The non-public personal information that we collect about you includes, but is not limited to:
•Information contained in applications or other forms that you submit to us, such as name, address, and social
security number
•Information about your transactions with our affiliates or other third-parties, such as balances and payment
history
•Information we receive from a consumer-reporting agency, such as credit-worthiness or credit history
INFORMATION WE DISCLOSE
We disclose the information that we have when it is necessary to provide our products and services. We may also
disclose information when the law requires or permits us to do so.
CONFIDENTIALITY AND SECURITY
Only our employees and others who need the information to service your account have access to your personal
information. We have measures in place to secure our paper files and computer systems.
RIGHT TO ACCESS OR CORRECT YOUR PERSONAL INFORMATION
You have a right to request access to or correction of your personal information that is in our possession.
CONTACTING US
If you have any questions about this privacy notice or would like to learn more about how we protect your privacy,
please contact the agent or broker who handled this insurance. We can provide a more detailed statement of our
privacy practices upon request.
LMA3100 Page 1 of 1
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
LMA3100
Sanction Limitation and Exclusion Clause
No (re)insurer shall be deemed to provide cover and no (re)insurer shall be liable to pay any claim or
provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of
such benefit would expose that (re)insurer to any sanction, prohibition or restriction under United Nations
resolutions or the trade or economic sanctions, laws or regulations of the European Union,
United Kingdom or United States of America.
LMA3100
15 September 2010
LMA5390 Page 1 of 1
POLICY NUMBER: W14D19210801 COMMERCIAL PROPERTY
LMA5390
U.S Terrorism Risk Insurance Act of 2002 as amended
Not Purchased Clause
This Clause is issued in accordance with the terms and conditions of the "U.S. Terrorism Risk
Insurance Act of 2002" as amended as summarized in the disclosure notice.
It is hereby noted that the Underwriters have made available coverage for “insured losses” directly
resulting from an "act of terrorism" as defined in the "U.S. Terrorism Risk Insurance Act of 2002", as
amended (“TRIA”) and the Insured has declined or not confirmed to purchase this coverage.
This Insurance therefore affords no coverage for losses directly resulting from any "act of terrorism" as
defined in TRIA except to the extent, if any, otherwise provided by this policy.
All other terms, conditions, insured coverage and exclusions of this Insurance including applicable
limits and deductibles remain unchanged and apply in full force and effect to the coverage provided by
this Insurance.
LMA5390
09 January 2020
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNALTERED.