HOMEOWNERS G-PAK POLICY PROGRAM

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1 HOMEOWNERS G-PAK POLICY PROGRAM POLICY FORMS AND DESCRIPTION OF COVERAGE ELIGIBILITY APPLICATION GUIDELINES PROPERTY COVERAGES - SECTION I LIMITS OF LIABILITY DEDUCTIBLES OPTIONAL COVERAGES AND LIMITS OF LIABILITY SCHEDULED PERSONAL PROPERTY (ENDORSEMENT HO 04 61) SCHEDULED PERSONAL PROPERTY (IM ENDORSEMENT) LIABILITY COVERAGES - SECTION II GENERAL INSTRUCTIONS BUSINESS PURSUITS (ENDORSEMENT HO 24 71) INCIDENTAL FARMING PERSONAL LIABILITY (ENDORSEMENT HO 24 72) RECREATIONAL MOTOR VEHICLE LIABILITY COVERAGE (ENDORSEMENT GM WI 10) SECONDARY/SEASONAL PREMISES LIABILITY LIMITATION (ENDORSEMENT GM WI 07) SECONDARY RESIDENCE PREMISES (ENDORSEMENT GM 20) PERSONAL INJURY (ENDORSEMENT HO 24 82) PERMITTED INCIDENTAL OCCUPANCIES (ENDORSEMENT HO 04 42) PERMITTED INCIDENTAL OCCUPANCIES (ENDORSEMENT HO 24 43) INCREASED LIMITS AND EXTENSIONS TO OTHER PROPERTIES WATERCRAFT LIABILITY (ENDORSEMENT HO 24 75) SPECIAL HOMEOWNERS FILINGS THREE OR FOUR FAMILY DWELLINGS (OWNER-OCCUPIED) INFLATION GUARD (ENDORSEMENT GM WI 15) NEW HOME DISCOUNT WATERBED LIABILITY (ENDORSEMENT GM WI 21) HOMEOWNERS ADVANTAGE ENDORSEMENT (ENDORSEMENT GM WI 22) COLLAPSE COVERAGE ENDORSEMENT (ENDORSEMENT GM WI 25) THEFT COVERAGE ENDORSEMENT (ENDORSEMENT GM WI 26) SPECIAL LOSS SETTLEMENT (ENDORSEMENT GM WI 23) REPLACEMENT OR REPAIR COST PROTECTION (ENDORSEMENT GM WI 03) WATER BACK UP OF SEWERS OR DRAINS (ENDORSEMENT GM WI 28) AUTO HOME DISCOUNT SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.1

2 INSURANCE SCORE MODIFICATION CLAIM SURCHARGE PLAN SPECIAL PROTECTION CLASS RATES FIRE DEPARTMENT SERVICE CHARGE ZONE DEFINITIONS - COUNTIES GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

3 HOMEOWNERS G-PAK PROGRAM POLICY FORMS AND DESCRIPTION OF COVERAGE The specific policy forms and endorsements should be consulted for exact contract conditions. 1. Homeowner Forms Issued by Germantown Mutual Insurance Company under the G- PAK Program. The following apply to the ISO HO2000 Program: Form HO-2 Broad Form Form HO-3 Special Form Form HO-4 Contents Broad Form Form HO-6 Unit Owners Form 2. Section I Property Coverage Coverage A Dwelling (Coverage must be written at 80 to 100% of Replacement Cost) Coverage B Other Structures (10% of Coverage A amount) Coverage C Personal Property (50% of Coverage A amount) Coverage D Loss of Use (20% of Coverage A amount) (40% of Coverage A amount Form HO-6) 3. Section II Liability Coverage Coverage E Personal Liability (Limits of,000 to $500,000 available) Coverage F Medical Payments to Others (Limits of $1,000 to $5,000) ELIGIBILITY 1. Form HO-2 or HO-3 may be issued: A. To an owner-occupant of a dwelling which is used exclusively for private residential purposes and contains not more than four families and with not more than two boarders or roomers per family. B. To cover dwellings in the course of construction, provided the policy is issued only in the name of the intended owner-occupant of the dwelling, subject to all the rules and premiums contained in this manual. 2. Form HO-4 may be issued to: A. The tenant (non-owner) of a dwelling or an apartment situated in a single or multifamily dwelling or apartment building. B. The tenant (non-owner) of an apartment located in a commercial structure. 3. FORM HO-6 may be issued to: The owner of a condominium unit which is used exclusively for residential purposes and is not occupied by more than one family with one boarder or roomer. Secondary units are allowed with supporting HO-3 or HO-5 (Diamond) business. 4. A Homeowner Form 2 or Form 3 policy may be issued to a seasonal/secondary dwelling, subject to underwriting. 5. Incidental office, professional, private school and studio occupancies are permitted provided: A. The premises is occupied primarily for dwelling purposes and: B. There is no other business conducted on the premises. SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.3

4 6. A homeowners policy may not be issued to provide coverage on any property to which farm forms or rates apply. (Exception: Liability may be extended to provide coverage for incidental farming exposures. Please contact underwriting for approval) 7. A homeowners policy may not be issued to provide coverage on any mobile home, trailer home or house trailer, whether or not the unit is set on blocks, foundations or otherwise made stationary. 8. A homeowners policy may not be issued to any dwelling containing a solid fuel burning device (including but not limited to woodburning stoves, furnaces and free-standing fireplaces) which does not meet the installation requirements outlined in the Solid Fuel Devices Guidelines of the National Fire Prevention Association. Only one solid fuel device is allowed per each risk. A surcharge applies to qualifying units. 9. A homeowners policy may not be issued to provide coverage for tenant occupied dwellings or apartments (HO-4) containing woodburning stoves. 10. A homeowners policy may not be issued to provide coverage on vacant and/or unoccupied dwellings. 11. A homeowners policy may not be issued to provide coverage on any dwelling that does not have a central heating system. Space heat or woodburners as the sole source of heat are unacceptable. 12. Minimum acceptable electrical service for new business is 100 amps. 13. All dwellings submitted for homeowners coverage must be in good repair and show pride in ownership. Homes over 40 years of age should have updated or well maintained heating plants and electrical service. The roof should not exceed 20 years of age at the time of application. Exception: Permanent roofs or per inspection. 14. A homeowners policy may be issued for an applicant who owns up to two horses. 15. A homeowners policy may not be issued to provide coverage for an applicant who owns any animal with vicious tendencies (including certain breeds of dogs but not limited to: Rottweilers, Dobermans and Pit Bulls) or that has been the cause of a previous liability claim. Please contact underwriting prior to submitting any application for the owner of any exotic animal or pet of an unusual nature. 16. A homeowners policy may not be issued on any home that is full log construction. Split log construction and log sided homes are eligible for coverage in the G-Pak program. Please contact the underwriting department for approval prior to submitting. 17. Any swimming pool on the residence premises must be in a fenced and secure enclosure if in-ground or sidewalls lower than 48. No diving boards or slides are allowed. 18. The architecture and design of the dwelling and other structure must be compatible with present day building standards. 19. The applicant may not have had more than two losses in the past three years of a nature indicating less than average risk acceptability, or any unrepaired damage. A CLUE property report will be ordered on all applicants. A claims surcharge may apply. 20. A homeowner policy may be issued on a modular home (commonly referred to as a double-wide) if it has been placed on a permanent foundation. 21. A homeowner policy may not be issued on any home which has a flat roof. 22. A homeowner policy may not be issued on any structure which has been converted to a home. Examples: School houses, commercial buildings, barns, etc. 3.4 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

5 23. A homeowner policy may not be issued when a trampoline is present at the residence premises. APPLICATION GUIDELINES 1. Applications may be submitted utilizing an ACORD application or an electronically generated GMIC system application that is in ACORD format. All applications must be signed by the insured and the listed agent. Original copies of electronically submitted applications must be retained in the office of the agent. 2. Inspections, photos and replacement cost estimators will be ordered by GMIC from a professional inspection company on applications. Please notify all applicants that this inspection will take place. In most cases entry to the home will not be necessary and the applicant does not need to be home. If entry is needed, the applicant will be contacted in advance to arrange a time. 3. A woodburner inspection and photo of the unit will be ordered for any risk that includes a solid fuel burning device other than a standard masonry fireplace. All clearance requirements must be met as outlined on the questionnaire and in accordance with National Fire Prevention Association guidelines. Woodburners located in garages and outbuildings, or are the primary source of heat, or are double-vented, may not be submitted. LIMITS OF LIABILITY PROPERTY COVERAGES SECTION I The following minimum and maximum limits of liability are available: Limits of Liability Section I Coverage A Forms 2 & 3 Minimum $50,000 Maximum $400,000 Form 6 Minimum $10,000 Maximum,000 Coverage C Form 4 Minimum $4,000 Maximum $75,000 Form 6 Minimum $10,000 Maximum $75,000 Section II Coverage E All Forms Minimum,000 Maximum $500,000 Coverage F All Forms Minimum $1,000 Maximum $5,000 SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.5

6 DEDUCTIBLES 1. BASIC DEDUCTIBLES All G-PAK Homeowners Policies are written subject to a deductible applicable to losses occurring under Section I of the policy. This loss deductible applies on a per occurrence basis. The manual displays calculated rates for $1,000 deductible HO-2 / HO OPTIONAL DEDUCTIBLES HO-2 / HO-3 In addition to the deductible option displayed in the manual, G-PAK Homeowners Policies may be written with a *, $250*, $500, $2,500 or $5,000 deductible. The premiums for these deductible amounts are calculated as follows: Deductible Factors Deductible Amount 100* 250* 500 1,000 2,500 5,000 % Factor of Base *Not available for new business. OPTIONAL COVERAGES AND LIMITS OF LIABILITY 1. BUILDING ADDITIONS AND ALTERATIONS A. ALL FORMS (Endorsement HO ) (Building Additions and Alterations at Other Residence) When the policy is endorsed to provide this coverage at other residences, other than the residence premises, rented to an insured, apply a $5.00 premium charge for each $1,000 of coverage. B. FORM HO-4 (Endorsement HO ) (Building Additions and Alterations Increased Limits) When the limit of liability of 10% of Coverage C is increased, apply the applicable premium under Each Additional $1,000 column as found in the Basic Premium Charts for Form HO-4. C. FORM HO-6 1.) Basic Coverage Unit Owners Coverage A $10,000 Coverage A is provided at no additional charge. If increased limits are desired, multiply the increased limit times the rate for Each Additional $1,000 in the Basic Premium Chart. 2.) Special Coverage Unit Owners Coverage A (Endorsement HO ) The Section I Perils Insured Against may be broadened for Coverage A to cover additional risks of loss. The additional premium is developed as follows: a.) $10,000 Basic Policy Limit - $20.00; plus b.) Each Additional $1,000 of Coverage A - $ GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

7 2. EARTHQUAKE COVERAGE ALL FORMS (Endorsement HO ) When earthquake coverage is provided, it shall apply to all Section I Coverages for the same limits as provided under the policy. Any coverage provided by this endorsement will not be effective until 30 days after the requested effective date. All premiums fully earned at the time of attachment. The earthquake coverage deductible is 10% of the Coverage A amount. The premium for each $1,000 of insurance shall be developed as follows: HO-3, HO-6 Coverage A HO-3 Coverage C Increased Limits HO-4, HO-6 All Forms Other Structure or Coverage D (Increase or Added Limits) Earthquake Coverage All Forms HO Frame All Other Applied To 1.70 Not Available Coverage A Limit 1.50 Not Available Coverage C Increase 1.50 Not Available Coverage C Limit 1.70 Not Available Note: Exterior Masonry Veneer Rate as All Other. Earthquake Coverage does not apply to Masonry Veneer. Amount Increased or Added Only 3. LOSS ASSESSMENT ALL FORMS (Endorsement HO ) A. Residence Premises The form automatically provides, at no additional charge, $1,000 of loss assessment coverage, excluding Earthquake, for assessments relating to the residence premises. This limit may be increased for an additional premium and is developed as follows: Loss Assessment - Residence Premises End. HO Coverage Limit All Forms except HO-6 with End. HO HO-6 With End. HO , , B. Additional Locations The policy may be endorsed to provide loss assessment coverage pertaining to additional locations. The premiums listed apply to each location covered: Additional Locations Coverage Amount All Forms Except HO-3 and HO-6 with End. HO-3 or HO-6 With End. HO HO , , , SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.7

8 C. Loss Assessment Coverage for Earthquake (Endorsement HO ) When the policy is extended to cover loss assessment resulting from loss by earthquake, including land shock waves or tremors before, during or after volcanic eruption, the Limit of Liability shall be based on the unit-owners proportionate interest in total value of all collectively owned buildings and structures of the corporation or association of property owners. The following rates per of insurance shall apply: Loss Assessment Coverage for Earthquake End. HO Frame Masonry All Other Refer to Company 4. LOSS OF USE (INCREASED LIMIT) FORM HO-3, HO-4, HO-6: When the limit of liability for coverage D is increased, the premium shall be $2.00 per $1,000 of additional insurance. 5. OTHER STRUCTURES INCREASED LIMITS A. Increased Limit Form HO-3 (Endorsement HO ) When an additional amount of insurance is written on a specific structure, the premium shall be $2.00 per $1,000 of insurance and shall apply separately to each structure. B. Structures Rented to Others Residence Premises (Endorsement HO ) When coverage is provided on Other Structures rented to others for dwelling purposes, the additional premium shall be the sum of (1.) $3.00 per $1,000 of insurance applying separately to each such structure, and (2.) the appropriate charge for Section II, Additional Insured Locations Rented to Others. 6. PERSONAL PROPERTY A. Increased Limit Form HO-3 When the limit of liability for Coverage C is increased, the additional premium shall be $2.00 per $1,000 of insurance. The new coverage C limit may not exceed 75% of the Coverage A limit. B. Increased Limit on Personal Property in Other Residence (Endorsement HO ) When the limit of 10% of Coverage C at other residences is increased, the additional premium shall be $7.00 per $1,000 of insurance. C. Coverage C Increased Special Limits of Liability (Endorsement HO ) 1.) Jewelry, Watches and Furs The special limit of liability for theft of jewelry, watches and furs may be increased to a maximum of $5,000 but not exceeding $1,000 for any one article. The additional premium shall be $18.00 for each $1,000 increase. 3.8 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

9 2.) Money and Securities The special limit of $200 on money may be increased to a maximum of $1,000. The $1,000 limit on securities may be increased to a maximum of $2,000. The additional shall be developed as follows: Premium per of Insurance Money $6.00 Securities $ ) Firearms The special limit of liability of $2,500 for loss by theft of firearms may be increased to a maximum of $6,000 in increments of. The additional premium shall be $3.00 for each increase. 4.) Silverware, Goldware and Pewterware The special limit of liability of $2,500 for loss by theft of these items may be increased to a maximum of $10,000 in increments of $500. The additional premium shall be $5.00 for each $500 increase. 7. RESIDENCE RENTAL THEFT (Endorsement HO for HO-6) When the policy is extended to cover loss by theft while the portion of the residence premises usually occupied by the insured is occasionally rented in whole or in part to others, or while there is rental to a room or boarder, the additional premium shall be $ BUSINESS PROPERTY INCREASED LIMITS (Endorsement HO ) A. The $2,500 limit of liability for business property on the residence premises may be increased to $10,000 in increments of $2,500. The premium for each $2,500 increase is $25. The limit of liability in excess of $2,500 does not apply to: 1.) Business property in storage or held as a sample or for sale or delivery after sale. 2.) Business property pertaining to a business actually conducted on the residence premises. (This exposure is addressed by HO Permitted Incidental Occupancies.) B. When the on-premises limit is increased, the off-premises limit of $25 is automatically increased at no additional premium charge, to an amount that is 10% of the total on-premises limit of liability. 9. SPECIAL COMPUTER COVERAGE (Endorsement HO ) The policy may be endorsed to insure personal computers and related equipment against additional risks of physical loss subject to certain exclusions. The policy deductible will apply. The additional premium is $ Not written on HO-4 with End. HO or HO-6 with HO SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.9

10 10. PERSONAL PROPERTY REPLACEMENT COST COVERAGE (Endorsement HO ) The Homeowners Policy may be endorsed to provide replacement cost coverage on contents (Coverage C). Under HO-4 or HO-6, the minimum limit of Coverage C eligible for this coverage is $10,000. The charge for this additional coverage is: Personal Property Replacement Cost End. HO Deductible Form Rate 100 and higher and higher WOODBURNER SURCHARGE Woodburners and other solid fuel heating devices will be surcharged due to the increased exposure to the hazard of fire. The additional charge for all units meeting eligibility and installation guidelines will be $ IDENTITY FRAUD EXPENSE COVERAGE (Endorsement HO ) The policy may be endorsed to provide coverage for identity fraud. We will pay up to $15,000 for expenses incurred by an insured as the direct result of any one identity fraud first discovered or learned of during the policy period. The additional premium is $ GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

11 SCHEDULED PERSONAL PROPERTY (Endorsement HO 04 61) Certain classes of personal property can be scheduled on the Homeowner policy through the use of this endorsement. These classes and rates are as follows: Class Deductible Rate Per Cameras Personal Use $0 $1.30 $1.00 Cameras Commercial $0 $1.90 Use $1.60 Fine Arts w/o Breakage Including Breakage w/o Breakage Including Breakage $0 $0 $0.37 $0.67 $0.33 $0.60 Furs $0 $0.30 Golfer s Equipment $0 $3.00 Jewelry $0 $50 $250 Musical Instruments Personal Use $0 $2.00 $0.90 $0.85 $0.80 $0.75 $1.10 $1.00 Musical Instruments $50. $2.50 Professional Use Stamps and/or Coins $0 $1.25 Silverware $0 $0.35 SCHEDULED PERSONAL PROPERTY (IM Endorsements) Certain classes of personal property (other than those provided coverage via Endorsement HO 04 61) may be afforded coverage through the attachment of various IM forms to the Homeowner policy. Those classes and rates are as follows: Class Form Deductible Rate Per Bicycles IM WI 01 $0 $8.50 Outboard Motors and Boats (including stern drive) IM WI 02 $0 $25 $50 $250 $500 $1,000 Personal Watercraft IM WI 02 $0 $25 $50 $250 $500 $1,000 $3.00 $2.50 $2.00 $1.70 $1.40 $1.20 $0.90 $3.50 $3.25 $3.00 $2.75 $2.50 $2.25 $2.00 SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.11

12 Class (continued) Form Deductible Rate Per Camping Trailers IM WI 04 $50 $2.00 (35 Maximum Length) Sports Equipment (other than guns) IM WI 05 $0 $50 $2.00 $1.80 $1.60 Sports Equipment IM WI 05 $0 $2.00 (Guns) Misc. Articles Contact Underwriting For approval. Recreational Motor Vehicles All Terrain Vehicles Recreational Motor Vehicles Snowmobiles 575 cc and under IM WI 07 $25 $50 $250 IM WI 10 $50 $250 $500 IM WI 10 $50 $250 $500 $1.75 $2.40 $2.20 $2.00 $1.50 $3.00 $2.50 $2.25 $2.15 $3.00 $2.50 $2.25 $ cc $50 $250 $500 $4.00 $3.50 $3.15 $ cc $50 $250 $500 Tools IM WI 11 $0 $50 $5.00 $4.50 $4.05 $3.85 $2.50 $2.25 $ GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

13 GENERAL INSTRUCTIONS LIABILITY COVERAGES - SECTION II When the limit of liability for Coverage E or F is increased, or coverage for additional exposures is provided, the additional premium shall be developed from the premium tables found in this section. The respective limits of liability for Coverage E and Coverage F must be uniform for all exposures covered under this policy. Coverage F limits are for each person and contemplates the aggregate limit of $25,000 for each accident. BUSINESS PURSUITS (Endorsement HO ) When coverage is provided for the liability of the insured arising out of business activities, other than a business of which he is owner or partner or maintains financial control, classify and apply charges separately for each person insured. Classifications 1.(A). Clerical Office Employees: Defined as those employees whose duties are confined to keeping the books or records, conducting correspondence, or who are engaged wholly in office work where such books or records are kept or where such correspondence is conducted, having no other duty of any nature in or about the employer s premises. This classification applies only to persons who are employed exclusively in separate buildings or on separate floors of buildings or in departments on such floors which are separated from all other work places of the employer by structural partitions and within which no work is performed other than clerical office duties. 2.(A). Salesmen, Collectors or Messengers: No installation, demonstration or servicing operations. 3.(B). Salesmen, Collectors or Messengers: Including installation, demonstration or servicing operations. 4.(C). Teachers: Athletic, laboratory, manual training, physical training and swimming instruction, excluding liability for corporal punishment of pupils. 5.(D). Teachers: Not otherwise classified, excluding liability for corporal punishment of pupils. 6.(E). Teachers: Liability for corporal punishment of pupils. Additional premium for this coverage must be added to premium for Classification C or D. For occupations not classified, please refer to the company. SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.13

14 Business Pursuits End. HO Cov. E 100,000 Class A Class B Class C Class D Class E Cov. E 300,000 Class A Class B Class C Class D Class E Cov. E 500,000 Class A Class B Class C Class D Class E INCIDENTAL FARMING PERSONAL LIABILITY (Endorsement HO ) When incidental farming operations are conducted on the residence premises, the premium for this coverage shall be as indicated below: Incidental Farming Personal Liability End. HO Cov. E 100,000 Premium Cov. E 300,000 Premium Cov. E 500,000 Premium GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

15 RECREATIONAL MOTOR VEHICLE LIABILITY COVERAGE (Endorsement GM WI 10) This coverage is intended for owned snowmobiles or 4 wheel recreational vehicles. Coverage is not available for motorcycles, motorbikes or 3 wheel recreational vehicles. Please provide the Driver License Number for each individual residing in the insured household or for anyone who is a regular operator of the vehicle. Recreational vehicle operators must have an MVR that would be acceptable for G-PAK auto coverage in order to be acceptable for recreational motor vehicle liability coverage. Recreational Motor Vehicles End. GM WI 10 Cov. E 100,000 1 st Vehicle Each Addl Cov. E 300,000 1 st Vehicle Each Addl Cov. E 500,000 1 st Vehicle Each Addl SECONDARY/SEASONAL PREMISES LIABILITY LIMITATION (Endorsement GM WI 07) When homeowner coverage is provided by Germantown Mutual Insurance Company on a secondary/seasonal residence premises, the liability coverage shall be included on the policy. Endorsement GM WI 07 will be attached to specify that liability coverage applies only to the residence premises insured by that policy. SECONDARY RESIDENCE PREMISES (Endorsement GM WI 20) When Homeowner coverage is provided by Germantown Mutual Insurance Company on the primary home but not the secondary/seasonal residence premises, liability coverage for the secondary/seasonal residence may be extended from the policy providing coverage on the primary residence with the appropriate charge being made for the extension of liability. Liability coverage is strictly limited to the secondary/seasonal residence premises. Secondary Residence Premises Cov. E 100,000 Premium Cov. E 300,000 Premium Cov. E 500,000 Premium SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.15

16 PERSONAL INJURY (Endorsement HO ) This endorsement is included when the Homeowners Advantage Endorsement GM 22 is added to the policy. PERMITTED INCIDENTAL OCCUPANCIES Residence Premises (Endorsement HO 04 42) 1. When the insured maintains an incidental office, professional, private school, or studio occupancy in the dwelling or in a separate structure on the premises, the limit of liability for Coverage C of Section I must be increased from 50 percent to not less than 60 percent of the Coverage A limit. An additional premium for the increased Coverage C limit must be charged as developed from the Premium section of this manual. Under a homeowners policy with Form HO-4 or HO-6, the minimum limit of liability for Coverage C shall be $20, When the insured gives professional instruction, such as music, dancing, or similar instruction in the dwelling, employs no assistants and there has been no physical alteration of the dwelling to accommodate the occupancy, the increased amount for Coverage C of Section I may be waived. PERMITTED INCIDENTAL OCCUPANCIES Other Residence (Endorsement HO 24 43) When the insured has permissible office, professional, private school, or studio occupancy in an additional residential premises occupied by the insured, other than the described premises, the additional premium for Endorsement HO is used as shown on the table. Permitted Incidental Occupancies Residence Premises Endorsement HO Permitted Incidental Occupancies Other Residence Endorsement HO Cov. E 100,000 HO HO Cov. E 300,000 HO HO Cov. E 500,000 HO HO GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

17 INCREASED LIMITS AND EXTENSIONS TO OTHER PROPERTIES Increased Limits Described Residence Premises Cov. E 300,000 Premium Cov. E 500,000 Premium Additional Residence Rented to Others 1, 2, 3 or 4 Families Endorsement HO Cov. E 100,000 1 Family Family Family Family Cov. E 300,000 1 Family Family Family Family Cov. E 500,000 1 Family Family Family Family SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.17

18 WATERCRAFT LIABILITY (Endorsement HO 24 75) Section II Liability Coverage may be extended from the Homeowner policy to stern drive (also known as I/O or inboard/outboard) watercraft and personal watercraft (jet skis/jet boats). Coverage for owned outboard motors regardless of horsepower is automatically extended from the basic policy from endorsement GM WI 01. Coverage may not be extended to inboard watercraft. Please provide driver license numbers for all operators in the insured household. The MVR s of all operators must meet the eligibility requirements of G-Pak auto to qualify for watercraft liability. Stern Drive Watercraft / Personal Watercraft / Sailboats with Auxiliary Power 101 HP or greater / 25 or less HP and length do not apply to Personal Watercraft HP does not apply to Sailboats Coverage F $1,000 $2,000 $3,000 $4,000 $5,000 Coverage E,000 $78 $86 $94 $102 $110 Stern Drive Watercraft / Sailboats with Auxiliary Power 101 HP or greater / HP does not apply to Sailboats 26 to 40 (40 Maximum) Coverage E $300,000 $101 $109 $117 $125 $133 Coverage E $500,000 $116 $124 $132 $140 $148 Coverage F $1,000 $2,000 $3,000 $4,000 $5,000 Coverage E,000 $116 $128 $140 $152 $164 Coverage E $300,000 $151 $163 $175 $187 $199 Coverage E $500,000 $166 $178 $190 $202 $214 Sailboats without Auxiliary Power 26 to 40 (40 Maximum) Coverage F $1,000 $2,000 $3,000 $4,000 $5,000 Coverage E,000 $32 $35 $38 $41 $44 Coverage E $300,000 $41 $44 $47 $50 $53 Coverage E $500,000 $56 $59 $62 $65 $ GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

19 SPECIAL HOMEOWNERS FILINGS THREE OR FOUR FAMILY DWELLINGS (OWNER OCCUPIED) (Eligible for Form HO-3) Our HO-3 may be written to include three or four family owner-occupied dwellings. When a three or four family home is written, the limit for Coverage C-Personal Property will be 50% of the Coverage A-Dwelling limit. Each tenant must have their own HO-4 policy to provide coverage for their Personal Property and Liability. Any dwelling that includes a commercial occupancy of any kind is ineligible. INFLATION GUARD (Endorsement GM WI 15) This endorsement is attached to each policy. The Coverage A limit will automatically be increased at renewal each year by a percentage amount commensurate with the change in building costs for our geographic area of operation. NEW HOME DISCOUNT A discount from the base rate is granted for new home construction. The discount starts at 21% for new construction and decreases 3% at each renewal for 7 years. WATERBED LIABILITY (Endorsement GM WI 21) HO-4 or HO-6 The policy may be extended to cover property damage caused by an occurrence and arising out of the insureds ownership or use of a waterbed on the residence premises. Coverage afforded up to,000. Premium $17.00 annually. HOMEOWNERS ADVANTAGE ENDORSEMENT (Endorsement GM WI 22) The Homeowners Advantage Endorsement may be added to form HO-3 at an additional annual premium of $ This endorsement provides several additional coverages that are summarized below. Please refer to the form for specifics. Section I Enhancements CREDIT CARD, ELECTRONIC FUND TRANSFER CARD OR ACCESS DEVICE, FORGERY AND COUNTERFEIT MONEY limit is increased from $500 to $1,000. REFRIGERATED PROPERTY COVERAGE provides up to $500 for loss to contents of a refrigerator or a freezer due to power interruption or mechanical failure. Deductible. Endorsement HO is attached to the policy. WATER BACKUP AND SUMP PUMP DISCHARGE OR OVERFLOW provides up to $2,500 for damages caused by the backing up of sewers, drains or sump pumps at the residence premises. $250 Deductible. Endorsement GM WI 28 is attached to the policy. FOGGING OF THERMOPANE WINDOWS provides up to $500 for each occurrence. DEBRIS REMOVAL COVERAGE provides up to $150 for the expenses from removal of debris of trees, shrubs and plants caused by windstorm or hail. IDENTITY FRAUD EXPENSE COVERAGE provides up to $15,000 for expenses incurred due to Identity Fraud. $250 Deductible. Endorsement HO is attached to the policy. Section II Enhancements PERSONAL INJURY COVERAGE affords protection for personal injury arising out of one or more of the following occurrences: 1. false arrest, detention or imprisonment, malicious prosecution; SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.19

20 2. libel, slander, defamation of character; or 3. invasion of privacy, wrongful eviction or wrongful entry. Endorsement HO is attached to the policy. COLLAPSE COVERAGE ENDORSEMENT (Endorsement GM WI 25) For new dwellings in the course of construction, the Homeowners policy may be extended to provide coverage for loss caused by bulging, cracking, or collapse of foundations. The endorsement is available for dwellings that are under construction by a qualified general contractor. The coverage is only written in the name of the homeowner and may not be issued to or for the contractor. Coverage is provided for a nine month period or when the premises are occupied by the insured, whichever occurs first. This coverage is subject to the same deductible as that which applies to the basic Section I coverages. The premium is a $35.00 flat charge which is a minimum, fully earned premium at the time that it is written. Not available for prefabricated or modular homes. THEFT COVERAGE ENDORSEMENT (Endorsement GM WI 26) For new dwellings under construction, this endorsement extends the policy to provide coverage for theft of building materials which will become, or have become, a permanent part of the dwelling or other structures. This coverge is written only in conjunction with the collapse endorsement. Coverage is provided for a nine month period or when the premises are occupied by the insured, whichever occurs first. This coverage is subject to the same deductible as that which applies to the basic Section I coverages. There is a $25.00 flat charge which is a minimum, fully earned premium at the time that it is written. Not available for prefabricated or modular homes. SPECIAL LOSS SETTLEMENT (Endorsement GM WI 23) This endorsement is used to insure homes in our G-Pak program at Coverage A limits which are less than 80% of the calculated replacement cost of the home and avoid the application of a co-insurance penalty. Typically, these are large older homes with a very high replacement cost in relationship to the current market value. The endorsement also allows Replacement Cost Coverage on other than certain specified items that are covered at ACV and provides that repairs will be made with current, commonly used building materials. Homes insured under this endorsement must be in good repair and show pride in ownership. We will not issue coverage on any home when the requested Coverage A is less than 50% of replacement cost. The following additional surcharge applies to the base rate: +20% REPLACEMENT OR REPAIR COST PROTECTION (Endorsement GM WI 03) COVERAGE A DWELLING Allows payment of up to a maximum of 120% of the Coverage A limit shown in the declarations in the event of a total loss that exceeds the Coverage A limit. Coverage A must be written at 100% of the estimated replacement cost of the dwelling at the time of application and the insured must notify the company within 30 days of completion, or any alterations to the dwelling which increase the replacement cost of the dwelling by 5% or more. Not applicable to Protection Class 10 business. The annual premium for this endorsement is $ GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

21 WATER BACK UP OF SEWERS OR DRAINS (Endorsement GM WI 28) Coverage for damage to the dwelling and limited coverage for certain items of personal property may be provided for loss caused by water which backs up through sewers or drains or which overflows from a sump pump and which is not caused by the negligence of any insured. All other water damage exclusions still apply. This coverage may not be written for risks located in designated flood zones or any area that has been prone to previous flooding. This coverage will not be effective until 30 days from the requested effective date. A $250 deductible applies to all losses under this endorsement. The following limits and rates are available: AUTO - HOME DISCOUNT Limit of Liability Premium $1,000 $10.00 $2,500 $20.00 $5,000 $35.00 $10,000 $50.00 $25,000 $75.00 A discount is available when GMIC writes the Homeowners and the Personal Auto coverage for the same insured. The discount for the Homeowners coverage is 10% of the base Homeowner premium. The discount will be applied at the inception of the policy if the auto policy is currently in force or at the next renewal if the auto policy is written during the current Homeowner policy period. If the auto policy lapses or is cancelled during the current Homeowner policy period, the discount will not be removed from the Homeowner policy until the next renewal of the policy. This discount is available only for HO-2, HO-3 and HO-6 policies on primary homes. INSURANCE SCORE MODIFICATION The following factors will be allowed against the base rate according to the applicants Attract Auto insurance score obtained from ChoicePoint at the time of application. Score Factor 575 & Lower & Higher 0.7 If an insurance score can not be obtained, the applicant will be considered in the range. SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.21

22 CLAIM SURCHARGE PLAN Previous claims for new applicants as well as new claims for an existing insured are subject to a surcharge. Claims occurring within the past 36 months from the effective date of coverage with Germantown Mutual Insurance Company will be considered for new applicants. We use ChoicePoint CLU reports to determine past claim activity. Claims occurring after the inception date of coverage with Germantown Mutual Insurance Company will be reviewed for applicability of a surcharge. The surcharge applies to the base rate under the following guidelines: 1 st Weather Related Loss (Wind or Hail) No Surcharge 1 st Chargeable Loss 10% 2 nd Chargeable Loss 30% 3 rd Chargeable Loss 50% 4 th Chargeable Loss 100% Claims made under Coverage F - Medical Payments and any claims closed without payment are not considered chargeable occurrences. Surcharges added to new business and current policyholders will be deleted at the 1 st renewal of the policy, 36 months from the date of the claim. SPECIAL PROTECTION CLASS RATES Germantown Mutual has developed a special protection class for certain homes in Protection Class 9. To be eligible the home must: 1. be written in G-Pak program; 2. include inflation guard; 3. be built in 1945 or later, or it must be remodeled in the last 25 years with new wiring, heating, and plumbing; 4. have Coverage A amount of $40,000 or more; 5. be Form HO-2 or HO-3; 6. not be a seasonal dwelling; 7. be insured to at least 90% of replacement cost; 8. be a Class 9 home within 6 road miles of a lower class responding fire department; 9. not have a wood-burning heating unit. If a home qualifies, request Special Protection Class I. The Special Protection Class rate is a factor of.76 x the Class 9 Base Rate. FIRE DEPARTMENT SERVICE CHARGE (Endorsement GM WI 39) This endorsement allows limits of coverage for Fire Department Service Charges in excess of the basic amount (500) provided by the policy. This endorsement is allowed on all HO-2 / HO-3 / HO-4 / HO-6 policies. Limit Premium $1,000 $10.00 $2,000 $30.00 $3,000 $50.00 $4,000 $70.00 $5,000 $ GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

23 ZONE DEFINITIONS - Counties ZONE 1 ZONE 2 ZONE 3 Brown Calumet Door Kewaunee Manitowoc Outagamie Ozaukee Sheboygan Washington Waukesha Columbia Dane City of Madison Dodge Fond du Lac Jefferson City of Prairie du Sac Sauk City Winnebago Green Lafayette Rock Walworth ZONE 4 ZONE 5 ZONE 6 City of Milwaukee Milwaukee County Kenosha Other than City of Other than City of Milwaukee Kenosha Racine Other than City of Racine ZONE 7 ZONE 8 Adams Clark Crawford Eau Claire Grant Green Lake Iowa Jackson Juneau La Crosse Lincoln Marathon Marquette Monroe City of Kenosha 53140, 53142, 53143, 53144, City of Racine 53402, 53403, 53404, 53405, 53406, 53407, Oneida Portage Richland Sauk Other than Sauk City Other than Prairie du Sac Shawano Trempealeau Vernon Waupaca Waushara Wood SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.23

24 ZONE DEFINITIONS Counties (continued) ZONE 9 ZONE 10 Ashland Barron Bayfield Buffalo Burnett Chippewa Douglas Marinette Menomonie Oconto Pepin Pierce Polk Price City of Superior Other than City of Superior Dunn Florence Forest Iron Langlade Rusk Sawyer St. Croix Taylor Vilas Washburn 3.24 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN SEPT 2015

25 THIS PAGE LEFT INTENTIONALLY BLANK. SEPT 2015 GERMANTOWN MUTUAL INSURANCE COMPANY - WISCONSIN 3.25

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