Laserfiche WebLink
BUMNESS WBWaY CMVERAGE FORM <br />Z ApokoWe To MeTcW Expenses Cover3gee <br />e A, "rust' an e arm Onsured your trus"ees <br />VVe �,POH no� pay exj��enses for bo6h,,, in��vy": <br />are bso irsureds, but mmy *11h respect to <br />ther MAK as =Mns. <br />a, Any tnsuired <br />Tb any On xeck exago %cknker wKe 0 <br />1 Each c',f th(e foflc,�v,,6rig A apso �iri msurnd <br />b, Bred Person <br />a, Einployees And Volunteer Workers <br />To a peamn Wd W do wok kg Or on W0 <br />Y" o u r 1',,/ o I u rs` wh0e <br />Of 311y �nsmerj ar -.,) �enant io�f any 41sured <br />'A�or����o <br />pedowmg Wes WaNTe czdf <br />our busOess o your ployees" other <br />c, Oijury On NorrnaHy Occup�erl Prevn�ses <br />than erther your 'exeCUtk/e officers" (�� ✓ you <br />ro a persi:m, injiw'ed on that pe crf <br />as an organz0on other than a <br />fbe <br />P" _arybj'GS YC)j) rt ff' jt rJ'je e S <br />pailmeirshq), �okr� venture or firn�ted ��aWjily <br />nUMWY Occupies, <br />cornpany) or your rrranag !.,rs (it you are a <br />d, Workers' Compensaticm And Sim0jr <br />iiimited lbb0y carrqpany), bW only fcx acts <br />Laws <br />wNhm the scope of thek empaynnnu Q, <br />To <br />yic�u c�r mdWe pedr)�ming <br />,� dut,es reIatcd Icm <br />a perscn,, wheffier r)y ni!�A a i i <br />Me Cory"! 0 YWY Wows <br />AnTbyee 0 a, maned, q berrMhs for <br />the 1) )d4y rrpuG ," afe If' "uyabu e or must be', <br />Hov e ,,e none of these, 'tmipby es" or <br />rs-crv�ded under a workers m: )mpensatGon <br />"Windeer YwA kers" are insureds for <br />or dasabk hty t,,enefits)aw a sin0air l'avv <br />(1) "Bo&y kl,twry" cr. "personal and <br />e AhMs AcUvWes <br />Avuhsog "JI": <br />ro a person injured vvh,he pracfiang) <br />To you, kD YCK�r p�jrU)e�'�, 01. <br />Snstrkjcl.�ng or p'wlicipa�ing ki any physica� <br />nwnZers R you am a pwlershp <br />exurkes or game, spots or WhWc <br />co wenC ure), t your ernbers <br />COW& <br />(4 y(.'si are a 4rni�ed Piat)rNy <br />f. Piroducts-Campleted Operato.)ris Hazard <br />C�')Injpany�' C")r a <br />vvNe �n flie c��)uirse of his or her <br />lrrr'�ude(t w0h the "�,M),-JL[CtS <br />ernphymeM or pertamby TdAs <br />operaUons hazwd"' <br />WWd to IN: cordxt of yair <br />g. Bushess LAW: Oky ExcWsWns <br />t.,usiness, cr tc, your rrther <br />Exckjdr,,d un,,,Jer Business L)@Wfly Coveraqe, <br />W ol ed S' whi!e <br />per'1r',rrrwrg dutles related k; the <br />C, WHO IS AN INSURED <br />::mm", M YMU bmhess <br />1—" ymj am deslnWed A Te CeQnActns as <br />�b) F)) the sprl�)use, 4:hrd parent, <br />a, An mdNmduah you and your spouse are <br />bmther or �! s,te� of That c& <br />insureds, but on; y Mth rn adrw crg to <br />or that "voluntew <br />condU(1 oll: a bus4 eos whk�h you are t h e <br />vworker" as a C,,,f <br />Ste oNner <br />ParagraN,: h (1)(a) jno ,,e� <br />b� A �,mflnemhirp csr jonnt venture, you an� an <br />(c � Ffri which thefu, G ,viy obhgaVon <br />insured You� rnemt,,ers ycnir rr,,Wnera, and <br />�(�) share damages w1lh or `("'?Ipay <br />are alsoxsuireds, but only` mth <br />s,,.:)rn(wone eMse wd cw rriusl pa',✓ <br />respect t(,.) theo!)vokld Of yCAA LUSkless <br />danaqe ' becau5,e : flre 49P�4,fiy <br />c� A bmited NabiO,� corrip;iny yru an�,, an <br />�es'cibed in Piragiard* (1)�a) of <br />krsurei,i Your n"rembers are also �nsureds, <br />(b) above; or <br />but on10,V with respect k) 'he conduc� of y,,our <br />(d) AhIng out of his or her pRmdng <br />bkjsf�'ess Yroir managers, are msured5, but <br />cr f alNflg to provkie <br />Wy W mqmd to W Wes as ymr <br />health are se"ces, <br />nwagus <br />A YW am MA al to banns cAf <br />K oMmkWon Wer Wra) a pmVeNhp, <br />p coodlnq protessr(;NnJ care <br />�o nt 'Ger'[Ure or tirrited IaNiry CCMIPW) d€;,'yGa <br />ser,,Vices Paiagraph (d tJoes appifly <br />xeanVnsured <br />%) any, nurse, ernergency mjedk:�,'iN <br />, �,)jjt �7,fj�y yqf,�� r,�,o, <br />an�', � <br />techn�danl or l�)cvarneJc emt,floyed by <br />to thev dutes a�s your cffi�;�ers oq dYrec(oi�s <br />yc',u to suc�� services <br />butoNy <br />(2) <br />nth Iespet,,,t to kheu as stuckhrAders, <br />�ai) (),,,vned, oc,:;upk,,,,d or us,�,,d by, <br />Page 10 of 24 ]Ej ID <br />Fami SS 00 08 04 05 <br />APR C" 0 181 <br />3 <br />BY <br />