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Century Surety Company

465 Cleveland Avenue


Westerville, Ohio 43082
614-895-2000
www.centurysurety.com
COMMERCIAL LINES POLICY
COMMON POLICY DECLARATIONS
POLICY NO.: CCP 554011 New
NAMED INSURED AND ADDRESS: CODE NO.: 5635A
GASPARD BELLS LLC INSUREDS AGENT:
9224 NEAL ROAD DAVE HOLLEY AGENCY INC
1501 VETERANS MEMORIAL DRIVE
ABBEVILLE LA 70510
ABBEVILLE LA 70510
POLICY PERIOD: From:07-10-2008 To:01-10-2009 at 12:01 A.M. Standard time at your mailing address shown above.
Business Description: VACANT BUILDING
Individual Joint Venture Partnership Limited Liability Company (LLC) Organization (Other than Partnership, LLC or Joint Venture)
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE
WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS
PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
PREMIUM
Commercial Property Coverage Part $1,620.00

POLICY FEE $250.00


LA TAX $93.50
75 % of the Policy Premium is fully earned as of the effective TOTAL $1,963.50
date of this policy and is not subject to return or refund.
Service of Suit (if form CCP 20 10 is attached) may be made upon:
Ark-LA-Tex Underwriters, Inc.
1945 East 70th Street, Suite C, Shreveport, LA 71105

Form(s) and Endorsement(s) made a part of this policy at time of issue*:


See Attached Schedule of Forms, CIL 15 00b 02 02
*Omits applicable Forms and Endorsements if shown in specific Coverage Part/Coverage Form Declarations.
Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing false or
deceptive statement is guilty of insurance fraud.

COMPANY REPRESENTATIVE:
Ark-LA-Tex Underwriters, Inc. Countersigned By
1945 East 70th Street Authorized Representative
Suite C
Shreveport LA 71105 07/15/2008 VLW

IN WITNESS WHEREOF, this Company has executed and attested these presents; but this policy shall not be valid unless countersigned by the duly Authorized
Agent of this Company at the Agency hereinbefore mentioned.

Secretary President

CSCP 10 01 03 06 Page 1 of 1
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Policy Number: CCP 554011 CIL 15 00b 02 02

SCHEDULE OF FORMS AND ENDORSEMENTS


(other than applicable forms and endorsements shown elsewhere in the policy)

Forms and Endorsements applying to the Coverage Parts listed below and made a part of this policy at time of issue:

Form/ Edition
Endt. # Date Title Total # of Forms Selected: 21

Forms Applicable to this Coverage part - INTERLINE-ALL COVERAGE PARTS


CCP 2010 03 07 Service of Suit Clause
CIL 1500B 02 02 Schedule of Forms and Endorsements
CSCP 1000 02 04 Century Insurance Group Policy Jacket
CSCP 1001 03 06 Century Insurance Group Common Policy Declaration
IL 0003 09 07 Calculation of Premium
IL 0017 11 98 Common Policy Conditions
TRIA 0001 01 07 Policyholder Disclosure Notice of Terrorism

7 Forms

Forms Applicable to this Coverage part - PROPERTY


CCF 1500 09 07 Commercial Property Coverage Part Declarations
CCF 1507 05 06 Windstorm or Hail Exclusion
CCF 1512 05 06 Multiple Deductible Form
CP 0010 04 02 Building and Personal Property Coverage Form
CP 0090 07 88 Commercial Property Conditions
CP 0140 07 06 Exclusion of Loss Due to Virus or Bacteria
CP 0450 07 88 Vacancy Permit
CP 1010 04 02 Cause of Loss - Basic Form
IL 0030 01 06 Exclusion of Terrorism
IL 0415 04 98 Protective Safeguards
IL 0935 07 02 Exclusion of Certain Computer-Related Losses
IL 0950 11 02 Coverage for Certified Acts of Terrorism; Cap on Losses
Conditional Exclusion of Terrorism (Relating to Disposition of Federal Terrorism Risk
IL 0995 01 07
Insurance Act)
LAPN 0001 02 07 Louisiana Commercial Property Insurance Policy Coverage Disclosure Summary

14 Forms

CIL 15 00b 02 02 Page 1 of 1


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IL 00 30 01 06

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EXCLUSION OF TERRORISM
This endorsement modifies insurance provided under the following:

BOILER AND MACHINERY COVERAGE PART


COMMERCIAL CRIME COVERAGE FORM
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
EQUIPMENT BREAKDOWN PROTECTION COVERAGE FORM
FARM COVERAGE PART
GOVERNMENT CRIME COVERAGE FORM
STANDARD PROPERTY POLICY

SCHEDULE
The Exception Covering Certain Fire Losses (Paragraph D.) applies to property located in the
following state(s), if covered under the indicated Coverage Form, Coverage Part or Policy:
State(s) Coverage Form, Coverage Part Or Policy

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. The following definition is added and applies un- 2. When one or both of the following applies:
der this endorsement wherever the term terrorism a. The effect is to intimidate or coerce a govern-
is enclosed in quotation marks. ment or the civilian population or any seg-
"Terrorism" means activities against persons, or- ment thereof, or to disrupt any segment of the
ganizations or property of any nature: economy; or
1. That involve the following or preparation for the b. It appears that the intent is to intimidate or
following: coerce a government, or to further political,
a. Use or threat of force or violence; or ideological, religious, social or economic
objectives or to express (or express opposi-
b. Commission or threat of a dangerous act;
tion to) a philosophy or ideology.
or
c. Commission or threat of an act that inter-
feres with or disrupts an electronic, com-
munication, information, or mechanical sys-
tem; and

IL 00 30 01 06 © ISO Properties, Inc., 2004 Page 1 of 2


B. The following exclusion is added: With respect to this item B.5., the immediately
preceding paragraph describes the threshold
EXCLUSION OF TERRORISM
used to measure the magnitude of an incident
We will not pay for loss or damage caused directly
of "terrorism" and the circumstances in which
or indirectly by "terrorism", including action in hin-
the threshold will apply, for the purpose of de-
dering or defending against an actual or expected
termining whether this Exclusion will apply to
incident of "terrorism". Such loss or damage is ex-
that incident. When the Exclusion applies to an
cluded regardless of any other cause or event that
incident of "terrorism", there is no coverage
contributes concurrently or in any sequence to the
under this Coverage Form, Coverage Part or
loss. But this exclusion applies only when one
Policy.
or more of the following are attributed to an
C. Exception Covering Certain Fire Losses
incident of "terrorism":
The following exception to the Exclusion Of Ter-
1. The "terrorism" is carried out by means of the
dispersal or application of radioactive material, rorism applies only if indicated and as indicated in
or through the use of a nuclear weapon or de- the Schedule of this endorsement.
vice that involves or produces a nuclear reac- If "terrorism" results in fire, we will pay for the loss
tion, nuclear radiation or radioactive contami- or damage caused by that fire, subject to all appli-
nation; or cable policy provisions including the Limit of In-
surance on the affected property. Such coverage
2. Radioactive material is released, and it appears
that one purpose of the "terrorism" was to for fire applies only to direct loss or damage by fire
release such material; or to Covered Property. Therefore, for example, the
coverage does not apply to insurance provided
3. The "terrorism" is carried out by means of the under Business Income and/or Extra Expense
dispersal or application of pathogenic or
coverage forms or endorsements that apply to
poisonous biological or chemical materials; or
those coverage forms, or to the Legal Liability
4. Pathogenic or poisonous biological or chemical Coverage Form or the Leasehold Interest Cover-
materials are released, and it appears that one
age Form.
purpose of the "terrorism" was to release such
materials; or D. Application Of Other Exclusions
5. The total of insured damage to all types of 1. When the Exclusion Of Terrorism applies in
property in the United States, its territories and accordance with the terms of B.1. or B.2.,
possessions, Puerto Rico and Canada ex- such exclusion applies without regard to the
ceeds $25,000,000. In determining whether the Nuclear Hazard Exclusion in this Coverage Form,
$25,000,000 threshold is exceeded, we will in- Coverage Part or Policy.
clude all insured damage sustained by prop- 2. The terms and limitations of any terrorism
erty of all persons and entities affected by the exclusion, or the inapplicability or omission of a
"terrorism" and business interruption losses terrorism exclusion, do not serve to create cov-
sustained by owners or occupants of the dam- erage for any loss or damage which would oth-
aged property. For the purpose of this provi- erwise be excluded under this Coverage Form,
sion, insured damage means damage that is Coverage Part or Policy, such as losses ex-
covered by any insurance plus damage that cluded by the Nuclear Hazard Exclusion or the
would be covered by any insurance but for the War And Military Action Exclusion.
application of any terrorism exclusions. Multiple
incidents of "terrorism" which occur within a 72-
hour period and appear to be carried out in
concert or to have a related purpose or com-
mon leadership will be deemed to be one inci-
dent, for the purpose of determining whether
the threshold is exceeded.

IL 00 30 01 06 © ISO Properties, Inc., 2004 Page 2 of 2


THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CONDITIONAL EXCLUSION OF TERRORISM


(RELATING TO DISPOSITION OF FEDERAL
TERRORISM RISK INSURANCE ACT)
This endorsement modifies insurance provided under the following:

BOILER AND MACHINERY COVERAGE PART


COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART EQUIPMENT
BREAKDOWN PROTECTION COVERAGE FORM
FARM COVERAGE PART STANDARD PROPERTY POLICY
STANDARD PROPERTY POLICY

SCHEDULE

The Exception Covering Certain Fire Losses (Paragraph D.) applies to property located in the
following state(s), if covered under the indicated Coverage Form, Coverage Part or Policy:
State(s) Coverage Form, Coverage Part Or Policy

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Applicability Of The Provisions Of This En- a. The federal Terrorism Risk Insurance
dorsement Program ("Program"), established by the
1. The provisions of this endorsement be- come Terrorism Risk Insurance Act, has ter-
applicable commencing on the date minated with respect to the type of in-
when any one or more of the following first surance provided under this Coverage
occurs. But if your policy (meaning the pol- Form, Coverage Part or Policy; or
icy period in which this endorsement ap-
plies) begins after such date, then the pro-
visions of this endorsement become
applicable on the date your policy begins.

IL 09 95 01 07 © ISO Properties, Inc., 2005 Page 1 of 3


b. A renewal, extension or replacement of the "Terrorism" means activities against persons, or-
Program has become effective with- ganizations or property of any nature:
out a requirement to make terrorism 1. That involve the following or preparation for the
coverage available to you and with revi- following:
sions that:
(1) Increase our statutory percentage a. Use or threat of force or violence; or
deductible under the Program for ter- b. Commission or threat of a dangerous act;
rorism losses. (That deductible de- or
termines the amount of all certified c. Commission or threat of an act that inter-
terrorism losses we must pay in a feres with or disrupts an electronic, com-
calendar year, before the federal gov- munication, information, or mechanical sys-
ernment shares in subsequent pay- tem; and
ment of certified terrorism losses.); 2. When one or both of the following applies:
or a. The effect is to intimidate or coerce a gov-
(2) Decrease the federal government's
ernment or the civilian population or any
statutory percentage share in poten-
segment thereof, or to disrupt any segment
tial terrorism losses above such de-
of the economy; or
ductible; or
(3) Redefine terrorism or make insur- ance b. It appears that the intent is to intimidate or
coerce a government, or to further political,
coverage for terrorism subject
ideological, religious, social or economic
to provisions or requirements that
objectives or to express (or express opposi-
differ from those that apply to other
tion to) a philosophy or ideology.
types of events or occurrences under
C. The following exclusion is added:
this policy.
2. If the provisions of this endorsement be- EXCLUSION OF TERRORISM
come applicable, such provisions: We will not pay for loss or damage caused directly
a. Supersede any terrorism endorsement or indirectly by "terrorism", including action in hin-
already endorsed to this policy that ad- dering or defending against an actual or expected
dresses "certified acts of terrorism" incident of "terrorism". Such loss or damage is ex-
and/or "other acts of terrorism", but only cluded regardless of any other cause or event that
with respect to loss or damage from an contributes concurrently or in any sequence to the
incident(s) of terrorism (however de- fined) loss. But this exclusion applies only when one
that occurs on or after the date or more of the following are attributed to an in-
when the provisions of this endorse- cident of "terrorism":
ment become applicable; and 1. The "terrorism" is carried out by means of the
b. Remain applicable unless we notify you dispersal or application of radioactive material,
of changes in these provisions, in re- or through the use of a nuclear weapon or de-
sponse to federal law. vice that involves or produces a nuclear reac-
3. If the provisions of this endorsement do NOT tion, nuclear radiation or radioactive contami-
become applicable, any terrorism en- nation; or
dorsement already endorsed to this policy, 2. Radioactive material is released, and it ap-
that addresses "certified acts of terrorism" pears that one purpose of the "terrorism" was
and/or "other acts of terrorism", will con- to release such material; or
tinue in effect unless we notify you of 3. The "terrorism" is carried out by means of the
changes to that endorsement in response dispersal or application of pathogenic or poi-
to federal law. sonous biological or chemical materials; or
B. The following definition is added and applies under 4. Pathogenic or poisonous biological or chemical
this endorsement wherever the term terrorism is materials are released, and it appears that one
enclosed in quotation marks. purpose of the "terrorism" was to release such
materials; or

IL 09 95 01 07 © ISO Properties, Inc., 2005 Page 2 of 3


5. The total of insured damage to all types of D. Exception Covering Certain Fire Losses
property in the United States, its territories and The following exception to the Exclusion Of Terror-
possessions, Puerto Rico and Canada ex- ism applies only if indicated and as indicated in the
ceeds $25,000,000. In determining whether the Schedule of this endorsement.
$25,000,000 threshold is exceeded, we will in-
If "terrorism" results in fire, we will pay for the loss
clude all insured damage sustained by property
or damage caused by that fire, subject to all appli-
of all persons and entities affected by the "ter-
cable policy provisions including the Limit of Insur-
rorism" and business interruption losses sus-
ance on the affected property. Such coverage for
tained by owners or occupants of the damaged
fire applies only to direct loss or damage by fire to
property. For the purpose of this provision, in-
Covered Property. Therefore, for example, the
sured damage means damage that is covered
coverage does not apply to insurance provided
by any insurance plus damage that would be
under Business Income and/or Extra Expense
covered by any insurance but for the applica-
coverage forms or endorsements that apply to
tion of any terrorism exclusions. Multiple inci-
those coverage forms, or to the Legal Liability
dents of "terrorism" which occur within a 72-
Coverage Form or the Leasehold Interest Cover-
hour period and appear to be carried out in
age Form.
concert or to have a related purpose or com-
mon leadership will be deemed to be one inci- E. Application Of Other Exclusions
dent, for the purpose of determining whether 1. When the Exclusion Of Terrorism applies in
the threshold is exceeded. accordance with the terms of C.1. or C.2., such
exclusion applies without regard to the Nuclear
With respect to this Item C.5., the immediately
preceding paragraph describes the threshold Hazard Exclusion in this Coverage Form, Cov-
used to measure the magnitude of an incident erage Part or Policy.
of "terrorism" and the circumstances in which 2. The terms and limitations of any terrorism
the threshold will apply, for the purpose of de- exclusion, or the inapplicability or omission of a
termining whether this Exclusion will apply to terrorism exclusion, do not serve to create cov-
that incident. When the Exclusion applies to an erage for any loss or damage which would oth-
incident of "terrorism", there is no coverage erwise be excluded under this Coverage Form,
under this Coverage Form, Coverage Part or Coverage Part or Policy, such as losses ex-
Policy. cluded by the Nuclear Hazard Exclusion or the
War And Military Action Exclusion.

IL 09 95 01 07 © ISO Properties, Inc., 2005 Page 3 of 3


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NOTE TO AGENT:
It is required by federal law that you provide this document to the insured.

POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM


INSURANCE COVERAGE
You are hereby notified that under the Terrorism Risk Insurance Act of 2002 (TRIA), as extended
December 22, 2005, that we have included this TRIA Coverage and associated premium, in your policies
and insurance coverage for losses arising out of acts of terrorism, as defined in Section 102(1) of the Act.

The term "act of terrorism" means any act that is certified by the Secretary of the Treasury, in
concurrence with the Secretary of State and the Attorney General of the United States, to be an act of
terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to
have resulted in damage within the United States, or outside the United States in the case of an air
carrier or vessel, or the premises of a United States mission; and to have been committed by an
individual or individuals acting on behalf of any foreign person or foreign interest, as part of an effort to
coerce the civilian population of the United States, or to influence the policy or affect the conduct of the
United States Government by coercion.

NOTICE OF GOVERNMENT REINSURANCE PARTICIPATION:

Any losses caused by certified acts of terrorism would be partially reimbursed by the United States
under a formula established by federal law (TRIA). Under this formula, the United States pays 90% (85%
in 2007) of covered terrorism losses exceeding the statutorily established deductible paid by the
insurance company providing the coverage.

The portion of your annual premium that is attributable to coverage for acts of terrorism is:
Property $ 32
Inland Marine
Crime Excluded
General Liability
Garage Excluded
Total $ 32
This premium is not refundable in the event that Congress does not extend TRIA coverage beyond
12-31-07.
(Except in OH, IN, WI, WV and AZ)

Name of Insurer: Century Surety Company

Policy Number: CCP 554011

TRIA 0001 0107


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Century Surety Company
COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS
Policy No.: CCP 554011 Effective Date: 07-10-2008 **
NAMED INSURED: GASPARD BELLS LLC 12:01 A.M. Standard Time

DESCRIPTION OF PREMISES:
PREM BLDG LOCATION ADDRESS CITY ST ZIP CONST OCCUPANCY P/C
NO
1 1 301 ADLY DRIVE Abbeville LA 70510 Joisted Masonry VACANT RESTAURANT PC - 3

COVERAGES PROVIDED - Insurance at the described premises applies only for which a limit of insurance is shown
PREM BLDG OCC COVERAGE LIMIT INSURED VALUATION COVERED CAUSES OF LOSS COINS RATE
NO CODE
1 1 1180 Building $280,000 ACV Basic Form 80% 0.567

RC means Replacement Cost, ACV means Actual Cash Value; MP means Minimum Premium

OPTIONAL COVERAGES - Applicable only when entries are made in the schedule below
PREM BLDG CODE COVERAGE LIMIT INSURED COVERED CAUSES OF LOSS COINS RATE
NO

EB means Equipment Breakdown, BI means Business Income, EE means Extra Expense

PREM BLDG MONTHLY LIMIT OF MAXIMUM PERIOD EXTENDED PERIOD


NO INDEMNITY OF INDEMNITY OF INDEMNITY

MORTGAGE HOLDERS
PREM BLDG MORTGAGE HOLDER NAME AND MAILING ADDRESS
NO
01 01 CHASE BANK PO BOX 9001020, LOUISVILLE KY 40290-1020

DEDUCTIBLE
See Attached Form CCF 1512
FORMS AND ENDORSEMENTS (other than applicable Forms and Endorsements shown elsewhere in the policy):
Forms and Endorsements applying to this Coverage Part and made part of this policy at time of issue:

See Attached Schedule of Forms CIL 15 00B 02 02

PREMIUM
Subtotal for this Coverage Part $1,588 Minimum Premium for this Coverage Part: $750
TRIA Coverage $32
Premium for this Coverage Part $1,620

THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE


NAME OF THIS INSURED AND THE POLICY PERIOD
CCF 15 00 09 07 Page 1 of 1
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POLICY NUMBER: CCP 554011 CCF 1507 0506

WINDSTORM OR HAIL EXCLUSION

This endorsement modifies insurance provided under the following:


CAUSES OF LOSS – BASIC FORM
CAUSES OF LOSS – BROAD FORM
CAUSES OF LOSS – SPECIAL FORM
STANDARD PROPERTY POLICY

This Exclusion applies to the following premise(s) only:


Prem. No. Bldg. No. Location Address
1 1 301 ADLY DRIVE Abbeville LA 70510

A. The following is added to the EXCLUSIONS section and is therefore not a Covered Cause of Loss:

WINDSTORM OR HAIL
We will not pay for loss or damage:

1. Caused directly or indirectly by Windstorm or Hail, regardless of any other cause or event that
contributes concurrently or in any sequence to the loss or damage; or
2. Caused by rain, water, snow, sand or dust, whether driven by wind or not, if that loss or damage would
not have occurred but for the Windstorm or Hail.
But if Windstorm or Hail results in a cause of loss other than rain, water, snow, sand or dust, and that
resulting cause of loss is a Covered Cause of Loss, we will pay for the loss or damage caused by such
Covered Cause of Loss. For example, if the Windstorm or Hail damages a heating system and fire results,
the loss or damage attributable to the fire is covered subject to any other applicable policy provisions

B. Under C. ADDITIONAL COVERAGE – COLLAPSE , in the Causes of Loss – Broad Form, windstorm or hail
is deleted from paragraph 2.a.

C. Under C. ADDITIONAL COVERAGE – COLLAPSE , in the Causes of Loss – Broad Form, item 2.e. Weight
of rain that collects on roof is deleted and under D. ADDITIONAL COVERAGE – COLLAPSE in the Causes
of Loss Special Form, item 2.e. Weight of rain that collects on roof is deleted.

D. In the Causes of Loss – Special Form, windstorm or hail is deleted from the definition of “specified causes
of loss” in G. Definitions.

E. Under F. ADDITIONAL COVERAGE EXTENSIONS – 1. PROPERTY IN TRANSIT, in the Causes of


Loss – Special Form, windstorm or hail is deleted from paragraph b.(1).

If no premises is described above, this exclusion applies to all premises covered by this policy.

Includes copyrighted material of Insurance Services Office, Inc. with its permission.
CCF 1507 0506 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1
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CCF 1512 0506

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

MANDATORY PROPERTY DEDUCTIBLE FORM


(FIXED DOLLAR DEDUCTIBLES)

This endorsement modifies insurance provided under the following:

BUILDING AND PERSONAL PROPERTY COVERAGE FORM


BUILDERS' RISK COVERAGE FORM

SCHEDULE

The Deductibles applicable to any one occurrence are shown below and the Deductibles apply as indicated by
checking one of the boxes below:
Each Building (regardless of the number of premises)
Each Premises (regardless of the number of buildings on the premises)

Prem. Bldg. Coverage Type Deductible Covered Causes


No. No. of Loss **
1 1 Building 1000 1

** For each deductible listed in this Schedule, enter the number corresponding to the Covered Cause(s) of Loss
to which that deductible applies (or enter the description):
(1) All Covered Causes of Loss
(2) All Covered Causes of Loss except Windstorm or Hail
(3) All Covered Causes of Loss except Theft
(4) All Covered Causes of Loss except Windstorm or Hail and Theft
(5) All Covered Causes of Loss except Water Damage
(6) Windstorm or Hail
(7) Theft
(8) Water Damage

Section D. Deductible is deleted in its entirety including the Examples and replaced with the following:
A. In any one occurrence of loss or damage (hereinafter referred to as loss), we will first reduce the amount of
loss if required by the Coinsurance Condition or the Agreed Value Optional Coverage. If the adjusted amount
of loss is less than or equal to the Deductible, we will not pay for that loss. If the adjusted amount of loss
exceeds the Deductible, we will then subtract the Deductible from the adjusted amount of loss, and will pay
the resulting amount or the Limit of Insurance, whichever is less.
B. In the event that loss or damage occurs to Covered Property at more than one building location as a result of
one occurrence, the schedule above will determine how the deductible will apply, either to each premises or
to each building.
C. When the occurrence involves loss to more than one item of Covered Property and separate Limits of
Insurance apply, the losses will not be combined in determining application of the Deductible. But the
Deductible will be applied only once per occurrence for that Covered Property.
D. The terms of this endorsement do not apply to any Earthquake Deductible or to any Windstorm or Hail
Percentage Deductible provided elsewhere in this policy.

CCF 1512 0506 Page 1 of 1


Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Copyright, Insurance Services Office, Inc., 1998
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POLICY NUMBER: CCP 554011 COMMERCIAL PROPERTY

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

VACANCY PERMIT
This endorsement modifies insurance provided under the following:
BUILDING AND PERSONAL PROPERTY COVERAGE FORM
CONDOMINIUM ASSOCIATION COVERAGE FORM
CONDOMINIUM COMMERCIAL UNIT-OWNERS COVERAGE FORM
STANDARD PROPERTY POLICY

Schedule

Excepted Causes of Loss Permit Period


Prem. Bldg.
No. No. Vandalism Sprinkler Leakage From To
1 1 07-10-2008 01-10-2009

A. The VACANCY Loss Condition does not apply to direct physical loss or damage:
1. At the locations; and
2. During the Permit Period; shown in the Schedule or in the Declarations.
B. This Vacancy Permit does not apply to the Excepted Causes of Loss indicated in the Declarations or by an "X" in the
Schedule.

CP 04 50 07 88 Copyright, ISO Commercial Risk Services, Inc., 1983, 1987 Page 1 of 1


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INTERLINE
IL 04 15 04 98

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PROTECTIVE SAFEGUARDS
This endorsement modifies insurance provided under the following:
COMMERCIAL PROPERTY COVERAGE PART
FARM COVERAGE PART

SCHEDULE

Protective Safeguards
Prem. No. Bldg. No.
Symbols Applicable
1 1 P-9

Describe any "P-9":


Building to be locked and secured.

A. The following is added to the: (3) Tanks, their component parts and supports;
Commercial Property Conditions and
General Conditions in the (4) Pumps and private fire protection mains.
Farm Property – Other Farm
Provisions Form – Additional Coverages, b. When supplied from an automatic fire protective
Conditions, Definitions system:
General Conditions in the Mobile Agricultural
Machinery and Equipment Coverage Form (1) Non-automatic fire protective systems; and
General Conditions in the Livestock Coverage
(2) Hydrants, standpipes and outlets.
Form
PROTECTIVE SAFEGUARDS "P-2" Automatic Fire Alarm, protecting the
entire building, that is:
1. As a condition of this insurance, you are
required to maintain the protective devices a. Connected to a central station; or
or services listed in the Schedule above.
b. Reporting to a public or private fire
2. The protective safeguards to which this
endorsement applies are identified by the alarm station.
following symbols: "P-3" Security Service, with a recording
"P-1" Automatic Sprinkler System, including system or watch clock, making hourly rounds
related supervisory services. covering the entire building, when the premises
Automatic Sprinkler System means: are not in actual operation.
a. Any automatic fire protective or ex- "P-4" Service Contract with a privately
tinguishing system, including con- owned fire department providing fire protection
nected: service to the described premises.
(1) Sprinklers and discharge noz- "P-9" The protective system described in the
zles; Schedule.
(2) Ducts, pipes, valves and fittings;

IL 04 15 04 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 2


B. The following is added to the EXCLUSIONS sec- We will not pay for loss or damage caused by
tion of: or resulting from fire if, prior to the fire, you:
CAUSES OF LOSS – BASIC FORM 1. Knew of any suspension or impairment in
CAUSES OF LOSS – BROAD FORM any protective safeguard listed in the
CAUSES OF LOSS – SPECIAL FORM Schedule above and failed to notify us of
MORTGAGE HOLDERS ERRORS AND that fact; or
OMISSIONS COVERAGE FORM 2. Failed to maintain any protective safeguard
STANDARD PROPERTY POLICY listed in the Schedule above, and over
CAUSES OF LOSS FORM – FARM which you had control, in complete working
PROPERTY order.
MOBILE AGRICULTURAL MACHINERY AND If part of an Automatic Sprinkler System is shut
EQUIPMENT COVERAGE FORM off due to breakage, leakage, freezing condi-
LIVESTOCK COVERAGE FORM tions or opening of sprinkler heads, notification
to us will not be necessary if you can restore
full protection within 48 hours.

IL 04 15 04 98 Copyright, Insurance Services Office, Inc., 1997 Page 2 of 2

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