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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURAN09 POLICY WC 00 04 29 R
<br />(Ed,1"f f3}
<br />TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT DISCLOSURE ENDORSEMENT
<br />This endorsement addreasoe the requirements of the Terrorism Risk Insurance Act of 2002 as amended and extended by
<br />the Terrorism Risk insurance Program Reauthorlxatlan Aal of 2015, It serves to notify you of certain Ilmitollons under the
<br />Act, and that your Insurance carrier Is charging a premium for losses that may ocour In the event of on Act of Torrorlem,
<br />Your policy provides coverage for workers compensation losses oaused by Act of Terrorism, Including workers
<br />compensation benefit obligations dictated by elate law. Coverage for such loesee Is still subject to all terms, definitions,
<br />oxolusions, and oonditlona in your pclloy, and any oppllooblo federal and/or state laws, rules, or regulallons.
<br />DOWtionsi
<br />The definitions provided In this ondoreament are based on and have the same meaning as the definitions In the Aot, It
<br />words or phrases not defined In this endorsement are defined in the Act,the definitions In the Act will apply.
<br />"Act" means the Terrorism Risk Insurance Act of 2002, which took offset on November 26. 2oo2 and any nmondments
<br />(hereto, Including any amendments resulting from the Terrorism Risk Insurance Program Reautharixatlon Act of 2010.
<br />"Act of Terrorism" means any act that Is certified by lho Secretary or the Treasury, In consultation with the Secretary of
<br />Homeland Security, and the Attorney General of the United Motes ps meeting all of the following requirements:
<br />a. The act Is an not of terrorism,
<br />b, The not Is violent or dangerous to human life, properly or Infraslruoture,
<br />c, The oot resulted in damage wlthin the United States, or outside of the United States in the case of the premises of
<br />United Slates missions or certain air oarders or vessels.
<br />d. The act has been oommlt4by an Individual or individuals as part of an effort to 000roa the civilian population of
<br />the United States or to Influence the policy or effect the conduct of the United Stales Government by cooroion.
<br />"Insured Lose" mean& any loss resulting from an act of t.onorlanl (and, oxoopt for Pennsylvania, Including an act of war, in
<br />the case of workers compensation) that is covered by primary or excess property and caeuolty Insurance Issued by an
<br />Insurer If the loss occurs In the United $totes or st the pronlisos of United $totes missions or to certain air oarriere or
<br />vessels.
<br />"Insurer Deductible" means, for the period beginning on January 1, 2016, and ending on December S1, 2020, an amount
<br />equal to 20% of our direct earned premiums, during, the Immediately preceding calendar year,
<br />Limitatton of Liability
<br />The Act limits our liability to you under this policy, If aggrogato Insured Losses exceed $100,000,000.000 in a calendar year
<br />and if we have met our Ineurer Deductible, we are not liable for the payment of any portion of the amount of Insured
<br />Lasses that exceeds $100,000,000,000; and for aggregate Insured Looses up to $100.000,000,000, we will pay only a pro
<br />rats share of such Insured Losses ae dotormfned by the Secretary of tho Treasury,
<br />Policyholder disclosure Notice
<br />1, Insured Losses would be partleliy reimbursed by the United States Government. If the aggregate Industry Insured
<br />Losses oxooed;
<br />a. $100,000,000, with respect to such Insured Losses occurring In calendar year 201S. the United States
<br />Government will pay 06%of our Insured Loseas that exceed our Insurer Deductible.
<br />b, $t20,000,000, with respect to such Insured Losses 000urrino In calendar year 2010, the Unitod States
<br />Government will pay 04%of our Insured Lasaes that exceed our Insurer Deduotible.
<br />o. $140,000,000, with respect to such Insured Losses occurring In calendar yonr 2W, the United Stales
<br />Government will pay 83% of our Insured Losses that exceed our Insurer Doduotiblo.
<br />d, $100,000,000, with respect to such Insured Woos%occurring in calendar year 2010, the United States
<br />Government will pay 82% of our Insured Losses that exceed our Insurer Deductible,
<br />e, $180,000,000, wlth reepoct to such Insured Lossos occurring In calendar year 2 WN
<br />tta�d -ED
<br />Government will pay S 1% of our Insured Lossos that exceed our Insurer Deduot�� U &�Xm Div BlomR � At'` ENT C)IviioNf. $200,000,000. with respect to such Insured Losses occurring In calendar year 20�Yf,l'�ad Saralee
<br />Government will pay $0% of our Insured Losses that exceed our Insurer Deductible, u
<br />C,i 2 � 2019
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