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PI-GLD-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 Insuranca <br />page # <br />Extended Property Damage <br />Included <br />2 <br />Limited Rental Lease Agreement Contractual Liability <br />$50,00011mit <br />2 <br />Non -Owned Watercraft <br />Less than 58 feet <br />2 <br />Damage to Property You Own, Rent, or Oecupy_-" <br />$30,000 limit <br />2 <br />Damage to Premises Rantsd to You <br />$1,000,p00 <br />3 <br />HIPAA <br />Clarification <br />4 <br />Medical Payments <br />$20,000 <br />5 <br />Medical Payments- Extended Reporting Period <br />- ..... <br />3 years <br />5 -"" <br />Athletic Activities <br />Amended <br />5 <br />Supplementary Payments -Bail Bonds <br />$5,OOo <br />5 <br />Supplementary Payment -Loss of Earnings -'-" <br />$1,000 perday <br />5 <br />Employee Indemnification Defense Coverage <br />Kay and Lock Replacement -,Janitorial Services �Ilent Coverage <br />$25,000 <br />5 <br />$10,000Ilmit <br />6 <br />Additional Insured - Newly Acquired lima Period <br />Amended <br />6 <br />Additional Insured -Medical Directors and Administrators <br />-Included <br />7 <br />Additional Insured - Managers and Supervisors (with Fellow <br />Em to ee.Covora a <br />Included <br />7 <br />Additional Insured - Broadened Named Insured <br />Included <br />7 <br />AdditionalInsured-FundmgSource <br />Included <br />7 <br />Additional Insured - Hnme Care Providers <br />Included <br />7 <br />Additional Insured -Managers,. Landlords, or Lessorsof Premises <br />- Included <br />7 <br />Additional insured - Lessor of Leased Equipment <br />MAdditional Insured - Grantor of Permits <br />Included <br />7 <br />Included - <br />8 <br />Additionallnsured-Vendor <br />Included <br />g <br />Additionallnsured-Franchisor <br />Included <br />g <br />Additional Insured- When Required by Oontract <br />Additionallnsured-Owners, Lessees, orConlractors <br />ncludod <br />Included <br />g <br />g <br />Additionallnsured State orPolllicalSubfivisions <br />Included <br />tp <br />Page 1 of 12 Reviewed by: <br />Includes copyrighted material of Insurance Services office, Inc., with Its permission. <br />© 2011 Philadelphia Indemnity Insurance Company I a <br />Silvia Cuevas <br />PRCSAIAdmirl. <br />