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Policy Number: PHPK2293752 <br />PI-GLB-HS (10/ 11) <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />GENERAL LIABILITY DELUXE ENDORSEMENT: <br />HUMAN SERVICES <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE <br />It is understood and agreed that the following extensions only apply in the event that no other specific coverage for <br />the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and <br />limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on <br />this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this <br />endorsement. For complete details on specific coverages, consult the policy contract wording. <br />Coverage Applicable _ <br />Limit of Insurance <br />Page # <br />Extended Property Damage <br />Included <br />2 <br />Limited Rental Lease Agreement Contractual Liability <br />$50,000 limit <br />2 <br />Non -Owned Watercraft <br />Less than 58feet <br />2� <br />Damage to Property You Own, Rent, or Occupy <br />$30,000 limit <br />2...,_ . <br />Damage to Premises Rented to You <br />$1,000,000 <br />3 <br />HIPAA <br />Clarification <br />4 <br />Medical Payments _ <br />$20,000 <br />5— <br />Medical Payments - Extended Reporting Period <br />-....... 3 years <br />5 <br />Athletic Activities <br />Amended <br />5 <br />Supplementary Payments - Bail Bonds <br />$5,000 <br />5 <br />Supplementary Payment - Loss of Earnings <br />$1,000 per day <br />5 <br />Employee Indemnification Defense Coverage <br />$25,000 <br />5 <br />Key and Lock Replacement - Janitorial Services Client Coverage <br />$10,000 limit <br />6 <br />Additional Insured - Newly Acquired Time Period <br />Amended <br />8 <br />Additional Insured - Medical Directors and Administrators <br />Included <br />7 <br />Additional Insured - Managers and Supervisors (with Fellow <br />Em loyee Coverage) <br />Included <br />7 <br />Additional Insured - Broadened Named Insured <br />Included <br />7 <br />Additional Insured - Funding Source <br />Included <br />7 <br />Additional Insured - Home Care Providers <br />Included <br />7_ <br />Additional Insured - Managers, Landlords, or Lessors of Premises <br />Included <br />7 <br />Additional Insured - Lessor of Leased Equipment <br />Included <br />7 <br />Additional Insured - Grantor of Permits <br />Included <br />8 <br />Additional Insured - Vendor <br />Included <br />8� <br />Additional insured - Franchisor <br />Included <br />9_ <br />Additional Insured - When Required by Contract <br />Included <br />9 <br />Additional Insured - Owners, Lessees, or Contractors <br />Included <br />9 <br />Additional Insured - State or Political Subdivisions <br />Included <br />10 <br />Page 1 of 12 <br />Includes copyrighted material of Insurance Services Office, Inc., with its pe <br />Oc 2011 Philadelphia Indemnity Insurance Company <br />t <br />rrKt�p % <br />Rleki4larv�t�neittDlWsion - <br />Rlwstvso&APPgrnimar -' <br />AMA <br />tusk Managefnent fio'gzt. y. <br />