Garage Policy Issuance Guidelines rev 06042014 · 32 As defined by the company Deductibles •...

Colony Specialty - Garage Policy Issuance Guidelines Ed. 01/14 [1]

GARAGE POLICY ISSUANCE GUIDELINES

2014 Issuance Changes Update Effective

Date Pg. # Description

2/25/14 1/1/14 4 Returned custom paint exclusion wording to the manual 3/12/14 1/1/14 All state pages Added Privacy Notice as a mandatory form – it is currently

generated automatically in Docu Corp 3/12/14 1/1/14 8 Corrected typo of form number GT1601 3/12/14 1/1/14 7 Added WI to the states where G1506 does not apply 06/03/14 01/01/14 65 Removed CT3003VT from the Virginia forms 07/08/14 01/01/14 5 Correct available limits for on-hook 09/05/14 01/01/14 11 Amend distance to water

Contacting us: Send Policies, Applications, MVRs, Endorsements, inspections and other Documentation by eMail to [email protected] Send Submissions to [email protected] If you have any questions, please call or email your regional underwriter or underwriting assistant directly.

TABLE OF CONTENTS

Policy Prefix & Libraries 2 Use of Symbols 2 Deductibles 2 Forms and Endorsements 2 Premium Placement Assistance 3 Approved Endorsement Wording 4-5 Optional Coverage Endorsements 6-7 Admitted Optional Garage Forms 8 Non-Admitted Optional Garage Forms 9-10 Property Forms 11 Detailed Forms Library by State 12-58


POLICY ISSUANCE

Policy Prefix and Libraries: There is 1 policy prefix - GP for Garage Policy. There are 2 form Libraries - Non-Admitted & Admitted. Scheduled Autos may only be written on a Garage policy in states where our Dealer, Service and Scheduled Auto Coverages are all written as 100% Admitted or as 100% Non-Admitted. Please refer to the Area of Operations chart to determine if a state meets this rule. For all other states, vehicles must be scheduled on a Commercial Auto policy with a BA or MC prefix. Follow the Commercial Auto guidelines based on the use of the vehicle. The Area of Operations Chart indicates where the Scheduled Autos need to be written for each state. Use of Numeric Symbols

22 For Liability of Car / Truck / Trailer Dealers 22 For Combined Med Pay (Premises & Auto) for Dealers

(No Symbol applies for Premises only Medpay – complete limit and premium fields and attach proper form)

25 For PIP 22 For UM / UIM if coverage can be rejected in your State 26 For UM / UIM if coverage cannot be rejected in your State 27 For any coverage on Specifically Described “Autos” 28 For Hired Auto Liability 29 For Non-Owned Auto Liability 30 For Garagekeepers 31 For Dealers Physical Damage 32 As defined by the company

Deductibles • Optional Liability deductibles of $500, $1,000 or more are available if approved by your

Company Underwriter. See Exceptions to Binding Authority. • Our minimum per auto deductible for Specified Causes of Loss, or Comprehensive is $500,

with an aggregate equal to five (5) times the per auto deductible. • Our minimum per auto deductible for Collision is $500. Higher deductibles are recommended

for Mobile operations, for Truck Tractors and Semi-Trailers; and when we’ve agreed to a higher maximum limit per vehicle.

• Wind Hail Flood Deductibles for Garagekeepers Comprehensive Primary and DOL have options of $1,000, $2,500 or $5,000 per vehicle with maximum deductible options or No maximum deductible, $25,000 maximum deductible and $50,000 maximum deductible..

• Earthquake Deductibles (Apply for DOL when vehicles are stored inside a building in AR, CA, KY, IL, IN, MO, MS & TN only) start at $1,000 per vehicle with a $250,000 maximum sublimit..

• Please make sure the deductibles entered on the form in Docucorp match the options selected in Colony Rater.


Forms and Endorsements The libraries displayed in these Guidelines and as they exist in DocuCorp are complete. You may not:

• Add or alter any forms; • Delete mandatory forms; • Alter the operation of our DocuCorp issuance system without the written permission of

both Colony’s DocuCorp Developer and a Colony Transportation Manager.


PREMIUM PLACEMENT ASSISTANCE 1) G1501 Garage Coverage Part Declarations:

a) Most Endorsement Premium is entered as a total at the bottom of the G1501 under “Premium for Endorsements”: These endorsement premiums include Related Operations, Drive Other Car, Plates, Stop Gap, Waiver, On-Hook, Drive-Away, Value Limitation, False Pretense and Additional Coverage for Wreckers in Oklahoma. i) Exceptions:

(1) Add Broadened Coverage to the Liability Premium. (2) Add Michigan Property Damage Liability Buy-Back to the Liability Premium (3) Add Michigan Broadened Coverage Collision to the Collision Premium

2) G1500 COMMON POLICY DECLARATIONS:

a) Manually enter the Michigan MCCA Assessment below the Commercial Inland Marine Coverage Part. b) Enter the total of all Property premiums, including the Automotive Service Tools & Equipment Floater premium, in

the Commercial Property Coverage Part.

APPROVED ENDORSEMENT WORDING The following wording is approved for use on manuscript endorsements. The wording of any other manuscript endorsement must be pre-approved by Colony Specialty. If you are adding an exclusion using our Blank Endorsement GT1514 or our Restrictive Endorsement GT1514a or CA2507 Locations and Operations Not Covered, during the policy term, add a line for the insured's signature. Boat Repair (Service risks - Garagekeepers) Use CA9954 and define Symbol 32 Insert: Any customer's watercraft left with you for repair, while ashore on premises where you conduct "Garage Operations".

Boat Sales (Dealer risks - Physical Damage) Use CA9954 and define Symbol 32

Insert: Owned watercraft held for sale, while ashore on premises where you conduct "Garage Operations". Custom Paint Job Exclusion (Non-Admitted Only)

Use G1514a Restrictive Insert: We will not pay for restoration of a custom paint job, meaning "loss" shall not include any damages relating to a custom paint job, but shall be calculated

based on normal factory original paint. Mobile Equipment (farming or construction) Sales and Service Use CA9954 and define Symbol 32

Physical Damage Insert: Owned land vehicles used in (farming or construction) including any attached machinery or equipment held for sale. Garagekeepers Insert: Any customer’s land vehicles used in (farming or construction) including any attached machinery or equipment left in your care for service or repair.

Products Exclusion (Non-Admitted Only) Use GT1514a Restrictive Insert: We will not pay for "Bodily Injury" or "Property Damage" arising out of "Products" or "Work You

Performed".


Approved ENDORSEMENT Wording continued

Repossession Operations Exclusion Use CA2507

Insert for Dealers: Any operation to take back an "auto" from a buyer who has failed to make payments when due including wrongful repossession.

Insert for Tow Truck Operators (Repo Storage Lot): Any act of repossession including wrongful repossession. Retreaded Tires Exclusion (Non-Admitted Only)

Use GT1514a Restrictive

Insert: This insurance does not apply to "Bodily Injury”, “Property Damage”, “Personal Injury”, or “Advertising Injury” caused by an “accident”, “loss” or offense and resulting from the manufacture, distribution, or sale of Retreaded Tires in your “Garage Operations”. This exclusion also applies to any negligent act, error or omission in providing or failure to provide warnings or instructions about Retreaded Tires.

Retreaded Tires Not Covered (Admitted Only) Use CA2507

Insert: Manufacture, distribution, or sale of Retreaded Tires including any negligent act, error or omission in providing or failure to provide warnings or instructions about Retreaded Tires.

Theft Exclusion for Garagekeepers and/or Physical Damage (Non-Admitted Only) Use GT1514a Restrictive Insert: We will not pay for "loss" to a covered "auto" or to its equipment caused by Theft. Truck Rental Operations Exclusion Use CA2507 Insert: U-Haul Dealership; Ryder Truck Rental Agency; etc. Valet Special Event Endorsement Use GT3000

Insert: In consideration of the Fully Earned Additional Premium of $_______, coverage has been extended to include a special event on _______(xx/xx/xxxx date) (or from xx/xx/xxxx through xx/xx/xxxx), located at _________ (complete address). The Liability limit for this event is $________. The Garagekeepers limit for this event is $_______. The deductibles for this event are the same as listed in Item Six of the G1501.


OPTIONAL GARAGE COVERAGE ENDORSEMENTS

Additional Coverage for Related Operations (G1507) This endorsement is used to: 1] to provide coverage for and 2] to get more premium for exposures that are not generally part of garage operations. Available classes are listed in your Binding Authority.

Additional Insured – No Charge (CA2509) Landlord, (CA2048) Designated, (CA2047) Leased Equipment, (CA2001) Leased Autos, (CA2049) Franchisor (GT1601) 30 Day Notice Additional Insured – $250 per additional insured (GT1600) Designated - Primary and Non-Contributory: Available for All Garage Service Risks on a SUBMIT basis.

Broadened Coverage-Garages (CA2514) – Charge is 5% of Garage Liability Premium Buy-Back Schedules

On-Hook for Garagekeepers (G1505 and various versions or G1526 in KS, KY, MD, ME, NH, WV) . Available limits $10,000 to $250,000 per vehicle. The limit for each truck cannot be more than the Garagekeepers limit or less than the maximum limit per vehicle (MLPV).

Drive-Away Road Miles for Dealers Physical Damage-Collision (G1505, G1517 and various versions of each) Charge is $50 for each additional 100 miles 1] in excess of 50 road miles in KS, KY, MD, ME, NH & WV where G1517 is used for Dealers; and 2] in excess of 300 road miles in all other States where G1505 is used for Dealers. Maximum additional premium is $500.

Value Limitation for Dealers Physical Damage (G1505A and various versions) - This only applies to Car Dealers, Auctions, Dealers with Salvage and Wholesalers. - The maximum vehicle limit available is $750,000.

Drive Other Car Coverage-Broadened for Named Individuals (CA9910)

Charge is computed by Colony Rater (on the Misc tab). Available only when the Named Insured is a Corporation, you may use this endorsement to provide coverage for officers for Liability only at Financial Responsibility Single Limit.

Errors and Omissions for Auto Dealers (G1551, G1551NH):

Charge is $300 per policy $25,000 Liability Limit with a $100,000 Aggregate and a $1000 Deductible Extends Liability coverage to include damages arising out of error or omission in compliance with Federal, State or local statutory provisions:

o Requiring disclosure of credit terms to consumers obtaining credit to purchase an “auto” o Requiring disclosure of the odometer reading to consumers who purchase an “auto” o Requiring title registration on an “auto” sold by the insured o Requiring disclosure of terms and conditions applying to credit life insurance, credit disability

insurance, auto liability insurance, auto physical damage insurance or an extended warranty plan sold by the insured to cover an “auto” sold by the insured

False Pretense (CA2503) Refer to Company if test drives are not accompanied. Maximum Limit is $25,000.

Charge is $0.18 per hundred of the total physical damage limit. Fire Legal Liability (CA2510) Charge is $0.20 per hundred of limit.

Garagekeepers-Additional Coverage for Wreckers in Oklahoma (G1521)

o Legal Liability for Personal Property in a Customer’s Auto. o Charge is $200 for the endorsement.


OPTIONAL GARAGE COVERAGE ENDORSEMENTS continued Identity Recovery Coverage Endorsement (G1569 – not available in NC or NH) Charge is $9 per policy

o Additional Coverage under Physical Damage section: Case Management Service for up to 12 months for any one “identity theft” Expense Reimbursement with a $15,000 limit

Plate Coverage (other than Dealer Plates): Plates are scheduled on CA2027. Stop Gap Employers Liability in OH, WA, and WY (Non-Admitted only): (G1519)

Waiver of Transfer of Rights of Recovery (G1512) Charge is $150 each - $750 maximum Wind/Hail/Flood Deductible for Dealers Physical Damage (Admitted G1524) Wind, Hail, Flood Deductible - $50,000 Aggregate (G1524A) Refer to company Wind, Hail, Flood Deductible - $25,000 Aggregate (G1525B) Refer to company Wind/Hail/Flood Exclusion for Dealers Physical Damage (Admitted G1525)


ADMITTED OPTIONAL GARAGE FORMS (alphabetical by Title)

Form # Edition Title CA2048 02/99 Additional Insured-Designated GT1600 01/14 Additional Insured-Designated – Primary & Non-Contributory GT1601 01/14 Additional Insured-30 Day Notice CA2049 07/97 Additional Insured-Franchisor CA2001 03/06 Additional Insured-Lessor of Auto (do not use in KS or TN) CA0430 06/07 Additional Insured-Lessor & Loss Payee (use in TN) CA2047 07/97 Additional Insured-Lessor of Equipment CA2509 12/93 Additional Insured-Owners of Premises (Landlord) CT3792 01/13 Animal Exclusion - Injury or Damage Caused by Animals (do not use in IL, KS, ME, or NJ) CT3792IL 01/13 Animal Exclusion - Injury or Damage Caused by Animals (IL) CA9903 03/06 Automobile Medical Payments (do not use in PA or WV) CA9968 03/06 Automobile Medical Payments (use in WV) CT3819 11/11 Auto Wrecker Bailees Coverage CA2514 03/10 Broadened Coverages-Garage IL0003 09/08 Calculation of Premium GT6002 03/13 Cancellation Endorsement GT3000 03/13 Changes Endorsement with Premium Distribution Worksheet (Do Not use in Maine) GT3000A 03/13 Changes Endorsement with Premium Distribution Worksheet - Maine GT3598 03/13 Continuation of Named Insured Endorsement CA9954 07/97 Covered Auto Designation (to defineSymbol 32) CA9910 03/10 Drive Other Car Coverage G1506 10/02 Driver Exclusion (do not use in CT, KS, ME, MD, MI, NH, NC, NJ, SC, WI, WV) GT7002 01/13 Driver Limitation (do not use in IL, KS, MN, NH, or SC) GT7003MN 01/13 Driver Limitation (use in MN) G1604 01/14 Earthquake Deductible G1605 01/14 Earthquake Coverage Limit G1551 07/09 Errors and Omissions Coverage for Automobile Dealers (do not use in NH) G1551NH 07/09 Errors and Omissions Coverage for Automobile Dealers (use in NH) G1603 01/14 Exclusion-Dealers Physical Damage Floor Plan Arrangement CA2503 03/10 False Pretense Coverage CT3576 01/13 Firearms Exclusion (do not use in KS) CA2510 03/10 Fire Legal Liability G1526 05/12 Garagekeepers - On-Hook Endorsement (KS, KY, MD, ME, NH, WV) (for use with G1517 and G1518 only) G1569 02/11 Identity Recovery Coverage Endorsement (do not use in NC or NH) CA0301 03/10 Liability Deductible Endorsement (ME, MI, NV, NC, SC, TN) CA0302 03/10 Liability Deductible Endorsement (CT, IL, IA, KS, KY, MD, MN, NH, NJ, PA, WV) CA2507 12/93 Locations & Operations Not Covered CA9944 12/93 Loss Payee (do not use in TN) CA9987 10/05 Loss Payee (TN) CA2505 03/06 Premises Medical Payments CA2027 02/99 Registration Plates (other than Dealer Plates) GT100 03/13 Reinstatement Endorsement G1507 10/02 Related Operations G1511 10/02 Stated Amount Insurance G1509 06/05 Supplemental Schedule for Specifically Described Autos G1522 02/06 Supplemental Schedule for Valet Parking G1512 07/09 Waiver of Transfer of Rights G1524 01/14 Wind, Hail, Flood Deductible G1524A 01/14 Wind, Hail, Flood Deductible - $50,000 Aggregate G1524B 01/14 Wind, Hail, Flood Deductible - $25,000 Aggregate G1525 01/13 Wind, Hail, Flood Exclusion


NON-ADMITTED OPTIONAL GARAGE FORMS (alphabetical by Title)

Form # Edition Title G1521 07/09 Additional Coverage for Wreckers in OK CA2048 02/99 Additional Insured-Designated GT1600 01/14 Additional Insured – Designated – Primary & Non-Contributory (do not use for Dealers) GT1601 01/14 Additional Insured –30 day Notice GT1602 01/14 Additional Insured – Blanket Designated (REPO PROGRAM ONLY) CA2049 07/97 Additional Insured-Franchisor CA2001 03/06 Additional Insured-Lessor of Auto (do not use in TN) CA0430 06/07 Additional Insured-Lessor & Loss Payee in TN CA2047 07/97 Additional Insured-Lessor of Equipment CA2509 12/93 Additional Insured-Owners of Premises (Landlord) CT3792 01/13 Animal Exclusion - Injury or Damage Caused by Animals (do not use in VA) CA9903 03/06 Automobile Medical Payments (do not use in CA, CO, WI or VA) CA0424 04/06 Automobile Medical Payments in CA CA0440 01/11 Automobile Medical Payments in CO CA9924 11/11 Automobile Medical Payments in WI CA2246 11/02 Auto Medical Expense and Income Loss (PIP) in VA CT3819 11/11 Auto Wrecker Bailees Coverage (do not use in MT) CT3819MT 01/13 Auto Wrecker Bailees Coverage (MT) GT1514 09/13 Blank Endorsement GT1514a 09/13 Blank - Restrictive Endorsement (select paragraphs) CA2514 03/10 Broadened Coverages-Garage CA2534 12/05 Broadened Coverages-Garage in VA IL0003 09/08 Calculation of Premium GT6002 03/13 Cancellation Endorsement GT3000 03/13 Changes Endorsement with Premium Distribution Worksheet(Do NOT use in ME) GT3000A 03/13 Changes Endorsement with Premium Distribution Worksheet (ME) GT3598 03/13 Continuation of Named Insured Endorsement CA9954 07/97 Covered Auto Designation (to define Symbol 32) CA9910 03/10 Drive Other Car Coverage CA0426 03/10 Drive Other Car Coverage in CA G1506 10/02 Driver Exclusion (do not use in OR, SD, VA) G1506OR 07/09 Driver Exclusion in OR (duplicate for Signatures) G1506A 07/09 Driver Exclusion in SD (duplicate for Signatures) G1604 0114 Earthquake Deductible G1605 0114 Earthquake Coverage Limit G1603 0114 Exclusion-Dealers Physical Damage Floor Plan Arrangement GT7002 01/13 Driver Limitation (do not use in FL, MN, SC or WA) GT7003MN 01/13 Driver Limitation (use in MN) GT7004FL 01/13 Driver Limitation (use in FL) G1551 07/09 Errors and Omissions Coverage for Automobile Dealers CA2503 03/10 False Pretense Coverage CT3576 01/13 Firearms Exclusion (do not use in VA) CA2510 03/10 Fire Legal Liability G1569 02/11 Identity Recovery Coverage Endorsement (do not use in NC) CA0301 03/10 Liability Deductible Endorsement Endorsement (AL, AZ, AR, CO, ID, LA, ME, MI, MS, MO, NE, NV, NM, NC, ND, OH, OK, RI, SC, SD, TN, TX, UT, VT, WI, WY) CA0302 03/10 Liability Deductible Endorsement (CA, CT, GA, FL, IL, IN, IA, KS, KY, MD, MN, MT, NH, NJ, OR, PA, WA, WV) CA0302 12/93 Liability Deductible Endorsement (VA) CA2507 12/93 Locations & Operations Not Covered CA9944 12/93 Loss Payee (do not use in TN) CA9987 10/05 Loss Payee in TN CA2505 03/06 Premises Medical Payments CA2027 02/99 Registration Plates (other than Dealer Plates) GT100 03/13 Reinstatement Endorsement G1507 10/02 Related Operations Endorsement


NON-ADMITTED OPTIONAL GARAGE FORMS CONTINUED (alphabetical by Title)

Form # Edition Title G1511 10/02 Stated Amount Insurance G1509 06/05 Supplemental Schedule for Specifically Described Autos G1522 02/06 Supplemental Schedule for Valet Parking G1512 07/09 Waiver of Transfer of Rights G1524 01/14 Wind, Hail, Flood Deductible G1524A 01/14 Wind, Hail, Flood Deductible - $50,000 Aggregate G1524B 01/14 Wind, Hail, Flood Deductible - $25,000 Aggregate G1525 01/13 Wind, Hail, Flood Exclusion THE SLB DATA FORM (08/11) IS MANDATORY IF THE FOLLOWING TYPES OF NON-ADMITTED POLICIES ARE WRITTEN:

o The risk state differs from the agents “home state” (domicile state). o The risk is multi-state (involving locations in different states). o The SL Broker used in the policy transaction is a broker other than the agency, or principle of the agency.

The form has become mandatory if the above types of policies are written.


PROPERTY MANDATORY FORMS (Non-Admitted Only)

Form # Edition Title

Mandatory Property forms for all states:

G1515 09/11 Garages-Building & Personal Property Declarations CP0090 07/88 Commercial Property Conditions CP0010 06/07 Building & Personal Property Coverage Form CP1032 08/08 Water Exclusion U284 06/05 Actual Cash Value Limitation Roofs and Roof Surfacing See State form lists for Additional State specific Mandatory Property Forms

Causes of Loss – Mandatory - must use one of these:

• CP1010 06/07 Basic Form • CP1020 06/07 Broad Form • CP1030 06/07 Special Form

Terrorism – Mandatory –must use one of these and provide signed TRIA Selection/Rejection form:

• IL0953 01/08 Terrorism Exclusion • IL0952 03/08 Terrorism Limited Coverage • U885 10/13 Conditional Exclusion of Terrorism

Mandatory Weather Restriction Forms (See Weather Restrictions to Binding Authority):

CP1054 06/07 Windstorm and Hail Exclusion

• In AL, GA,LA, MS, NC, SC, TX and VA if less than 75 miles inland or outside the Intracoastal Waterway • In CT, MD, ME, NH, NJ, NY, PA and RI if less than 25 miles or outside the Intracoastal Waterway • Anywhere in FL

OPTIONAL PROPERTY FORMS:

G1556 01/09 Automotive Service Tools & Equipment (For mobile operations and employee tools) G1700 01/14 Premier Endorsement G1701 01/14 Premier Plus Endorsement U284 06/05 Actual Cash Value Limitation – Roofs and Roof Surfacing (Mandatory If the building is to be

insured on a replacement cost basis and the construction is Frame, JM, or NC) CP1211 10/00 Burglary, Robbery (Theft) Protective Systems CP0030 06/07 Business Income (with Extra Expense) CP1218 06/07 Loss Payable CP0320 10/92 Multiple Deductible CP1440 06/07 Outdoor Signs CP1033 06/95 Theft Exclusion CP1054 06/07 Windstorm and Hail Exclusion (Unless Mandatory in Weather Restrictions above) CP0402 09/09 Increased Cost of Loss and Related Expenses For Green Upgrades


DETAILED FORMS LIBRARY BY STATE

ALABAMA (AL)

POLICY TYPE: Dealers (T02), Service (T03) NON-ADMITTED

Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003AL 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional State Forms

CA2159 03/06 Uninsured Motorist CP1054 06/07 Wind and Hail Exclusion (May apply if Property is on the policy)

Mandatory Property forms when property is covered:

G1515 09/11 Garages-Building & Personal Property Declarations CP0090 07/88 Commercial Property Conditions CP0010 06/07 Building & Personal Property Coverage Form CP1032 08/08 Water Exclusion U284 06/05 Actual Cash Value Limitation Roofs and Roof Surfacing

Causes of Loss – must use one of these: CP1010 06/07 Basic Form CP1020 06/07 Broad Form CP1030 06/07 Special Form

Terrorism – must use one of these and provide signed TRIA Selection/Rejection form: IL0953 01/08 Terrorism Exclusion IL0952 03/08 Terrorism Limited Coverage U885 10/13 Conditional Exclusion of Terrorism

Mandatory Weather Restriction Forms: CP1054 06/07 Windstorm and Hail Exclusion

If risk is: • Within 75 miles from the Gulf, any bay or inter-coastal water • On any off shore or barrier Island located off the Gulf Coast


ALASKA (AK)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2388 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion AK Notice 08/08 Policyholder Notice-Surplus Lines AK Notice 04/07 Policyholder Notice-Attorney Fees CA0158 08/06 Changes-Garage IL0121 09/08 Changes-Attorneys Fees (Rule 82) IL0176 06/11 Changes-Appraisal IL0280 09/08 Cancellation & Non Renewal

PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders CP0155 07/07 Changes-(If Property is on policy) IL0107 07/02 Changes-(If Property is on policy) Optional CA2160 03/10 UM/UIM Mandatory Property forms when property is covered:

G1515 09/11 Garages-Building & Personal Property Declarations CP0090 07/88 Commercial Property Conditions CP0010 06/07 Building & Personal Property Coverage Form CP1032 08/08 Water Exclusion U284 06/05 Actual Cash Value Limitation Roofs and Roof Surfacing CP0155 08/06 Alaska – Changes IL0107 07/02 Changes – Loss Payment




ARIZONA (AZ)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO AZ 07/06 Policyholder Notice U173 07/02 Cancellation & Non Renewal CA0175 07/04 Changes-Concealment, Misrepresentation, Fraud

PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders Optional CA2139 07/09 UM CA2140 07/09 UIM Mandatory Property forms when property is covered:





ARKANSAS (AR)


Mandatory

SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003AR 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO AR 11/09 Policyholder Notice UIL0231 07/02 Cancellation & Non Renewal CA0162 10/07 Changes-Who is an Insured PrivacyNotice 02/13 Privacy Notice IL0909 03/98 AR Notice-Auto Parts ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2108 03/06 UMBI CA2166 03/06 UMPD CA3128 03/06 UIM CA2202 03/06 PIP (use only for Scheduled Private Passenger Autos)





Mandatory Weather Restriction

$2500 Wind/Hail Deductible up to $250,000 Total Insured Value (Building, Business Personal Property, and Business Income) per policy, any TIV over $250,000 requires 1% deductible.


CALIFORNIA (CA)


Mandatory

SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion

CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal CAPRNOTICE 09/11 California Notice – Premium Refunds D2 07/11 California Surplus Line Policyholder Notice CA0143 05/07 California Changes PrivacyNotice 02/13 Privacy Notice ILN119 01/10 California Auto Body Repair Consumer Bill of Rights ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2154 09/09 UMBI CA2155 06/10 UMPD CA0424 04/06 Auto Medical Payments – CA CA0426 03/10 Drive Other Car - CA Mandatory Property forms when property is covered:



Terrorism – must use one of these and provide signed TRIA Selection/Rejection form: IL0953 01/08 Terrorism Exclusion IL0952 03/08 Terrorism Limited Coverage

U885 10/13 Conditional Exclusion of Terrorism


COLORADO (CO)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal CA0113 01/11 Changes-Other Insurance PrivacyNotice 02/13 Privacy Notice IL0169 09/07 Changes-Concealment, Misrepresentation, Fraud IL0125 01/13 Colorado Changes – Civil Unions ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA0440 01/11 Auto Medical Payments - CO CA2150 01/11 UMBI CA2126 01/11 UMPD







CONNECTICUT (CT)

POLICY TYPE: Service (T03) NON-ADMITTED

Mandatory SIGCIC 10/13 Signature Page

G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2386 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion UIL0260 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice IL0140 09/08 Connecticut Changes – Civil Union ILP001 01/04 US Treasury Departments Office of Foreign Assets Control

(OFAC) Advisory Notice to Policyholders Mandatory Property forms when property is covered:






If risk is less than 25 miles inland or outside the Eastern U.S. Coast


CONNECTICUT (CT)

POLICY TYPE: Dealers (T02) ADMITTED

Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2386 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0107 10/97 Connecticut Changes CA0190 10/97 Connecticut Changes – Liability of Municipalities PrivacyNotice 02/13 Privacy Notice IL0140 09/08 Connecticut Changes – Civil Union IL0260 02/10 Connecticut Changes – Cancellation & Nonrenewal ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional

CA2022 10/97 Connecticut Transporter Plates Coverage CA2003 10/97 Connecticut Dealer or Repairer Plates Coverage

CA2157 03/06 Connecticut UM & UIM Coverage CA9939 09/94 Glass Coverage – Connecticut


FLORIDA (FL)


Mandatory SIGCICFL 10/13 Signature Page - Florida G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO FL 07/06 Policyholder Notice CA0267 11/12 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice CA0128 03/09 Changes-Appraisal ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional GT7004FL 01/13 Driver Limitation CA2172 10/09 UM CA2210 01/13 PIP Mandatory Property forms when property is covered:






GEORGIA (GA)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal CA0163 10/04 Changes-Garage PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2111 01/09 UM-Fill-In Or CA3137 01/09 UM-Add-On And GT7000 10/08 UM Offset Endorsement Mandatory Property forms when property is covered:





If risk is: • Within 75 miles of the Eastern U.S. Coast, any bay or inter-coastal water • On any off shore or barrier Island located off the Eastern U.S. Coast


IDAHO (ID)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal CA0118 11/00 Changes-Other Insurance PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA3115 03/06 UM CA3118 11/11 UIM Mandatory Property forms when property is covered:





ILLINOIS (IL)

POLICY TYPE: Dealers (T02), Service (T03) ADMITTED

Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504IL 01/14 Changes in Garage Coverage - Illinois G1505IL 01/14 Additional Garage Exclusions & Buy Back Schedules - Illinois G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0270 08/94 Cancellation & Non Renewal CA0120 06/03 Changes CA0104 03/06 Changes in Garage Coverage Form IL0147 09/11 IL Changes – Civil Union IL0162 09/08 Changes-Defense Costs IL NOTICE 07/13 IL Policyholder Notice PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2130 11/08 UMBI CA2153 03/06 UMPD CA2138 11/08 UIM CA0302 03/10 Liability Deductible - IL


INDIANA (IN)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO IN 07/06 Policyholder Notice IL0156 09/07 Indiana Changes – Concealment, Misrepresentation or Fraud UIL0272 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2144 12/11 UM CA3116 12/11 UIM CA0433 02/08 Indiana Changes – Pollution Exclusion CA0434 02/08 Indiana Changes – Amendment of Definition of Pollutants IL0117 12/10 Indiana Changes – Workers’ Compensation Exclusion






IOWA (IA)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO IA 07/06 Policyholder Notice (only if UM/UIM provided) IL0276 09/08 Cancellation & Non Renewal CA0160 02/03 Changes CA0182 03/06 Changes in Garage Coverage Form PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2112 03/06 UM/UIM


KANSAS (KS)


Mandatory AG005KS 10/13 Signature Page - Kansas G1500 01/14 Common Policy Declarations G1501A 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1517KS 01/14 Changes in Garage Coverage - Kansas G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2386 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0265 02/96 Cancellation & Non Renewal CA0122 04/13 Changes CA0448 12/10 Kansas Commercial Auto Coverage Changes PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2137 01/05 UM CA2214 10/97 PIP


KENTUCKY (KY)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2386 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion UIL0263 03/09 Cancellation & Non Renewal KYPolNot 11/08 Kentucky Policyholder Notice PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2176 09/06 UMBI CA2179 03/10 UIM CA2216 03/11 PIP Mandatory Property forms when property is covered:






KENTUCKY (KY) POLICY TYPE: Dealers (T02) ADMITTED

Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501A 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1517 01/14 Changes in Garage Coverage G1518 07/09 Additional Garage Limitations G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2386 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion IL0263 09/08 Cancellation & Non-Renewal CA0125 12/02 Changes CA0164 03/06 Changes-Garage KYPolNot 11/08 Kentucky Policyholder Notice PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2176 09/06 UMBI CA2179 03/10 UIM CA2216 03/11 PIP


LOUISIANA (LA)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2540 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal CA0103 03/10 Changes-Garage Liability PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA0413 08/07 Lessor - Additional Insured & Loss Payee CA2148 11/08 UMBI CA2181 01/10 UMPD Mandatory Property forms when property is covered:

G1515 09/11 Garages-Building & Personal Property Declarations CP0090 07/88 Commercial Property Conditions CP0010 06/07 Building & Personal Property Coverage Form CP1032 08/08 Water Exclusion U284 06/05 Actual Cash Value Limitation Roofs and Roof Surfacing LA Notice WD 09/13 Windstorm or Hail Deductible Or

LA Notice NOWD 09/13 Windstorm or Hail Exclusion Causes of Loss – must use one of these:

CP1010 06/07 Basic Form CP1020 06/07 Broad Form CP1030 06/07 Special Form


U885 10/13 Conditional Exclusion of Terrorism Mandatory Weather Restriction Forms: CP1054 06/07 Windstorm and Hail Exclusion



MAINE (ME)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion UIL0247 06/05 Cancellation & Non Renewal CT3003 05/13 Punitive or Exemplary Damage Exclusion PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders








MAINE (ME)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501A 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1517 01/14 Changes in Garage Coverage G1518 07/09 Additional Garage Limitations G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion IL0247 02/11 Cancellation & Non Renewal CA0134 06/09 Changes IL0189 09/07 Concealment, Misrepresentation or Fraud CA0176 06/09 Changes in Garage Coverage Form PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2174 06/08 UM


MARYLAND (MD)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control

(OFAC) Advisory Notice to Policyholders









MARYLAND (MD)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501A 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1517 01/14 Changes in Garage Coverage G1518 07/09 Additional Garage Limitations G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion (not for Auto only policies) CA2384 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0215 10/09 Cancellation CA0101 10/01 Changes in Garage Coverage Form CA0170 03/10 Changes PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2113 03/06 UM CA2219 02/13 PIP MD PIP NO 10/13 Maryland PIP Policyholder Notice


MICHIGAN (MI)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders







MICHIGAN (MI)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion

CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion IL0286 09/08 Cancellation & Non Renewal CA0110 03/11 Changes

PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders Optional CA9941 01/13 MI Property Damage Liability Buy-Back CA2222 03/11 Broadened coverage Collision CA2131 03/06 UM CA2220 03/11 PIP CA2224 03/06 Property Protection Endorsement (PPI) CA2221 03/94 Michigan Coordination of PIP CA0217 03/94 Michigan Changes – Cancellation and Non Renewal


MINNESOTA (MN)



Optional GT7003 MN 01/13 Driver Limitation – MN Mandatory Property forms when property is covered:






MINNESOTA (MN)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO MN 07/06 Policyholder Notice CA0218 06/00 Cancellation CA0138 02/07 Changes CA0133 02/07 Changes in Garage Coverage Form PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional GT7003 01/13 Driver Limitation - MN CA2124 09/08 UM/UIM CA2225 01/07 PIP


MISSISSIPPI (MS)



Optional CA2180 07/09 UMBI/PD (non-stacked) NOTE: A SIGNED AND DATED UM SELECTION FORM IS REQUIRED FOR ANY POLICY WITH A DEALER OR SCHEDULED AUTO EXPOSURE IN THIS STATE.









MISSOURI (MO)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal CA0165 10/06 Changes-Who is an Insured CA0166 03/06 Changes-Pollution PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2104 12/12 UM CA3104 09/10 UIM Mandatory Property forms when property is covered:






$2500 Wind/Hail Deductible up to $250,000 Total Insured Value (Building, Business Personal Property, and Business Income) per policy, any TIV over $250,000 requires 1% deductible.


MONTANA (MT)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0220 10/03 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA3135 12/07 UM (Non-Stacked) CA3133 12/07 UIM (Non-Stacked) Mandatory Property forms when property is covered:






NEBRASKA (NE)










NEVADA (NV)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion UIL0251 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders







NEVADA (NV)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion IL0251 09/07 Cancellation & Non Renewal CA0136 03/10 Changes IL0110 09/07 Concealment, Misrepresentation & Fraud IL0115 01/10 NV Changes – Domestic Partnership PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders



NEW HAMPSHIRE (NH)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501NH 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1517NH 01/14 Changes in Garage Coverage – New Hampshire G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CT3003NH 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0262 01/10 Cancellation & Non Renewal CA0111 01/10 Changes IL0187 09/07 Concealment, Misrepresentation & Fraud IL0145 09/08 Changes-Civil Union PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders



NEW JERSEY (NJ)










NEW JERSEY (NJ)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504NJ 01/14 Changes in Garage Coverage – New Jersey G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2386 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0108 03/99 NJ Changes-Garage Liability CA0184 09/95 NJ Changes-Physical Damage Inspection CA0187 09/95 NJ Changes-Loss Information IL0141 09/08 NJ Changes-Civil Union IL0208 09/07 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control

(OFAC) Advisory Notice to Policyholders Optional CA0204 04/11 NJ Changes – Cancellation for Oversized Vehicles CA2114 02/08 UM/UIM CA2230 03/06 PIP CA2231 03/06 NJ Added PIP


NEW MEXICO (NM)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0250 02/99 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA3129 08/11 UMBI/PD-(Non-Stacked)

NOTE: A SIGNED AND DATED UM SELECTION FORM IS REQUIRED FOR ANY POLICY WITH A DEALER OR SCHEDULED AUTO EXPOSURE IN THIS STATE.







NEW YORK (NY)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0152 11/11 New York Changes in Garage Coverage Form CA0225 01/11 New York Changes – Cancellation IL0183 08/08 New York Changes – Fraud PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional IL0185 08/08 New York Changes – Calculation of Premium Mandatory Property forms when property is covered:








NORTH CAROLINA (NC)










NORTH CAROLINA (NC)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505NC 01/14 Additional Garage Exclusions & Buy Back Schedules – North Carolina G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0126 07/10 Changes CAN002 02/10 NC UM/UIM Notice (required for owned autos) PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders



NORTH DAKOTA (ND)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal NDNotice 10/11 ND Policyholder Notice PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2183 11/11 UM CA2186 11/11 UIM CA2234 03/06 PIP Mandatory Property forms when property is covered:






OHIO (OH)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal CA0145 03/06 Changes-Garage Liability PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2133 06/10 UMBI CA3117 03/06 UMPD G1519 08/05 Stop-Gap Employers Liability Mandatory Property forms when property is covered:






OKLAHOMA (OK)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2386 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion IL0179 10/02 Policyholder Notice IL0177 10/10 OK Changes – Concealment, Misrepresentation, or Fraud CA0132 03/94 Changes-Other Liability UIL0236 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders








$2500 Wind/Hail Deductible up to $250,000 Total Insured Value (Building, Business Personal Property, and Business Income) per policy, any TIV over

$250,000 requires 1% deductible.


OREGON (OR)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505OR 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2386 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO OR 07/06 Policyholder Notice CA0149 01/10 Oregon Changes IL0142 09/08 Oregon Changes – Domestic Partnership U173 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2105 01/10 UMBI/UIM CA2187 01/10 UMPD CA2236 01/10 PIP G1506OR 07/09 Driver Exclusion – OR







PENNSYLVANIA (PA)

POLICY TYPE: Service Only (T03) NON-ADMITTED Mandatory

SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion IL0910 07/02 Policyholder Notice UIL0246 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders








PENNSYLVANIA (PA)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion IL0910 07/02 Policyholder Notice IL0246 09/07 Cancellation & Non Renewal IL0120 05/11 Pennsylvania Changes – Defense Costs CA0157 03/06 Changes in Garage Coverage Form CA0180 09/97 Changes PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2192 06/12 UM (Non-Stacked) CA2193 06/12 UIM (Non-Stacked) CA2237 03/06 First Party Benefits (PIP) CA2238 03/95 PA Added & Combination First Party Benefit Endorsement CA2256 03/95 PA Extraordinary Medical Benefits Coverage Endorsement NOTE: A SIGNED AND DATED UM SELECTION FORM IS REQUIRED FOR ANY POLICY WITH A DEALER OR SCHEDULED AUTO EXPOSURE IN THIS STATE.


RHODE ISLAND (RI)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0148 12/06 Rhode Island Changes CA0273 01/10 Cancellation & Non Renewal IL0161 03/12 Rhode Island Changes – Civil Union PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2143 08/13 UMBI CA3149 08/13 UMPD








SOUTH CAROLINA (SC)

POLICY TYPE: Service Only (T03) NON-ADMITTED

Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0230 04/10 Cancellation & Non Renewal NOSCB 07/06 SC Notice of Right to Cancel (Must be attached to Insured’s copy of the G1501) PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders








SOUTH CAROLINA (SC)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0230 04/10 Cancellation & Non Renewal CA0150 03/06 Changes NOSCB 07/06 SC Notice of Right to Cancel (Must be attached to Insured’s copy of the G1501) PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2119 03/06 UM CA2188 04/13 UIM


SOUTH DAKOTA (SD)



Optional CA2141 03/06 UM/UIM G1506A 07/09 Driver Exclusion - SD Mandatory Property forms when property is covered:






TENNESSEE (TN)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO TN 07/06 Policyholder Notice U173 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA0430 06/07 Additional Insured – Lessor and Loss Payee – TN CA9987 10/05 Loss Payee







TENNESSEE (TN)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO TN 07/06 Policyholder Notice IL0250 09/08 Cancellation & Non Renewal CA0146 07/01 Changes PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2120 03/06 UM/UIM CA0430 06/07 Additional Insured – Lessor & Loss Payee – TN CA9987 10/05 Loss Payee - TN


TEXAS (TX)

POLICY TYPE: Dealers (T02), Service T03) NON-ADMITTED

Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504TX 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion TX Notice 06/13 Policyholder Notice U173 07/02 Cancellation & Non Renewal CA0197 03/12 Texas Changes – Garage Coverage Form PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2109 05/13 UMBI/UMPD/UIM CA2264 07/08 PIP







If risk is: o Within 75 miles from the Gulf, any bay or inter-coastal water o On any off shore or barrier Island located off the Gulf Coast

Weather Deductible Requirement: o $2500 Wind/Hail Deductible up to $250,000 Total o Insured Value (Building, Business Personal Property, and Business Income) per policy, any TIV over

$250,000 requires 1% deductible.


UTAH (UT)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion U173 07/02 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2162 10/10 UMBI CA2136 01/09 UMPD CA3106 10/10 UIM CA2244 03/06 PIP CA2263 09/94 Utah PIP – Exclusion of Loss of Income Benefits







VERMONT (VT)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations

G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage

G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form

CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003VT 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion IL0219 09/08 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders







VIRGINIA (VA)


Mandatory SIGCSIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504VA 01/14 Changes in Garage Coverage - VA G1505VA 01/14 Additional Garage Exclusions & Buy Back Schedules - VA G1562 02/10 Garage Policyholder Notice CA0005 03/06 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO VA A 07/06 Policyholder Notice NO VA B 07/06 Policyholder Notice-Optional Benefits CA0195 08/08 Changes in Garage Coverage Form CA0268 12/05 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2246 11/02 Auto Medical Expense and Income Loss (PIP) UCA2121 11/02 UM (Includes Limits Schedule) CA2534 12/05 Broadened Coverage – Garage – VA CA9952 11/02 Virginia Limited Subrogation Rights








WASHINGTON (WA)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504WA 01/14 Changes in Garage Coverage G1505WA 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2392 01/06 Terrorism Exclusion CA2543 03/06 Fungi or Bacteria Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion UIL0146 08/10 Cancellation & Non Renewal PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2134 01/08 Underinsured Motorists CA2257 03/06 PIP (use only for Individual Named Insured) G1519 08/05 Stop-Gap Employers Liability







WEST VIRGINIA (WV)









WEST VIRGINIA (WV)


Mandatory AG005 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501A 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1517 01/14 Changes in Garage Coverage G1518 07/09 Additional Garage Limitations G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2537 03/06 Fungi or Bacteria Other Than Auto Exclusion CA2384 01/06 Terrorism Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion CA0252 03/94 WV Changes - Cancellation CA0183 09/02 Changes CA0181 03/06 Changes in Garage Coverage Form PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2122 02/12 UM/UIM CA9968 03/06 Auto Medical Payments - WV PA0235 11/04 West Virginia Changes – Cancellation and Non Renewal

(attach when named insured is an individual and there is a covered auto of the private passenger type)


WISCONSIN (WI)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion NO WIA 07/06 Policyholder Notice U173 07/02 Cancellation & Non Renewal CA0117 11/11 Changes NOWIIRC 08/09 WI – Notice To Policyholders Insured Requested Cancellations PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2103 11/11 UM CA2145 11/11 UIM CA9924 11/11 Automobile Medical Payments – WI Mandatory Property forms when property is covered:






WYOMING (WY)


Mandatory SIGCIC 10/13 Signature Page G1500 01/14 Common Policy Declarations G1501 01/13 Garage Coverage Part Declarations G1502 04/03 Schedule of Forms & Endorsements G1504 01/14 Changes in Garage Coverage G1505 01/14 Additional Garage Exclusions & Buy Back Schedules G1562 02/10 Garage Policyholder Notice CA0005 03/10 Garage Coverage Form CA2384 01/06 Terrorism Exclusion CA2537 03/06 Fungi or Bacteria Exclusion CT3003 05/13 Punitive or Exemplary Damage Exclusion U094 06/13 Service of Suit IL0017 11/98 Common Policy Conditions IL0021 09/08 Nuclear Energy Exclusion UIL0252 07/02 Cancellation & Non Renewal IL0114 09/08 Changes-Defense Costs CA0144 03/94 Wyoming Changes – Duty to Defend PrivacyNotice 02/13 Privacy Notice ILP001 01/04 US Treasury Departments Office of Foreign Assets Control (OFAC) Advisory Notice to Policyholders

Optional CA2123 03/06 UMBI G1519 08/05 Stop-Gap Employers Liability






Garage Policy Issuance Guidelines rev 06042014 · 32 As defined by the company Deductibles •...

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Transcript of Garage Policy Issuance Guidelines rev 06042014 · 32 As defined by the company Deductibles •...