Filing at a Glance. General Information

Transcription

1 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Filing at a Glance Companies: American International South Insurance Company, National Union Fire Insurance Company of Pittsburgh, Pa. Product Name: Not-For-Profit Risk Protector SERFF Tr Num: AGNY State: Arkansas Program TOI: 05.0 Commercial Multi-Peril - Liability & SERFF Status: Closed State Tr Num: AR-PC Non-Liability Sub-TOI: CMP Sub-TOI Combinations Co Tr Num: AIC-07-MP-10 State Status: Filing Type: Form Co Status: Reviewer(s): Betty Montesi, Llyweyia Rawlins, Brittany Yielding Author: Jameka Harris Disposition Date: 10/02/2007 Date Submitted: 09/06/2007 Disposition Status: Approved Effective Date Requested (New): 10/06/2007 Effective Date (New): 10/02/2007 Effective Date Requested (Renewal): 10/06/2007 Effective Date (Renewal): 10/02/2007 General Information Project Name: Package of management and liability coverages for nonprofits. Status of Filing in Domicile: Pending Project Number: AIC-07-MP-10 Domicile Status Comments: Filing is pending in PA. Reference Organization: Reference Number: Reference Title: Advisory Org. Circular: Filing Status Changed: 10/02/2007 State Status Changed: 09/06/2007 Deemer Date: Corresponding Filing Tracking Number: Filing Description: The companies referenced in this filing submits fo your review and approval their Not-For-Profit Risk Protector Program (the "Program"). The Program consists of a package of management and liability coverages for non-profits. It includes coverages for directors and officers liability, employment practices liability, fiduciary liability, errors and omissions, crime Created by SERFF on 10/02/ :19 AM

2 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: and kidnap and ransom. Package of management and liability coverages for non-profits./aic-07-mp-10 Please refer to the attached Forms Listing for information about the forms included in this submission. Please note that the management and professional liability coverages will be priced on an (a) rate basis. The crime coverage will be rated in accordance with the currently filed ISO Crime/Fidelity loss costs and the kidnap and ransom coverage will be rated using the currently approved kidnap and ransom rating plan on file with your Department. Your favorable consideration and approval are respectfully requested. Company and Contact Filing Contact Information Jameka Harris, Filings Analyst jameka.harris@aig.com 175 Water Street, 17th Floor (212) [Phone] New York, NY (212) [FAX] Filing Company Information American International South Insurance CoCode: State of Domicile: Pennsylvania Company 70 Pine Street Group Code: Company Type: New York, NY Group Name: State ID Number: (212) ext. [Phone] FEIN Number: National Union Fire Insurance Company of CoCode: State of Domicile: Pennsylvania Pittsburgh, Pa. 70 Pine Street Group Code: Company Type: New York, NY Group Name: State ID Number: (212) ext. [Phone] FEIN Number: Filing Fees Created by SERFF on 10/02/ :19 AM

3 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Fee Required? Yes Fee Amount: $50.00 Retaliatory? No Fee Explanation: Per Company: No CHECK NUMBER CHECK AMOUNT CHECK DATE $ /04/2007 Created by SERFF on 10/02/ :19 AM

4 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Correspondence Summary Package of management and liability coverages for non-profits./aic-07-mp-10 Dispositions Status Created By Created On Date Submitted Approved Llyweyia Rawlins 10/02/ /02/2007 Amendments Item Schedule Created By Created On Date Submitted CONTRACT Form Jameka Harris 09/12/ /12/2007 EXCLUSION AMENDED - CARVEBACK FOR NON- INDEMNIFIA BLE DEFENSE COSTS (DO COVERAGE SECTION) Higher Form Jameka Harris 09/12/ /12/2007 Educational Amendatory Endorsement (DO and EPL Coverage Sections) Higher Educational Amendatory Endorsement (DO Form Jameka Harris 09/12/ /12/2007 Created by SERFF on 10/02/ :19 AM

5 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Coverage Section Only) Package of management and liability coverages for non-profits./aic-07-mp-10 NOT FOR Form Jameka Harris 09/12/ /12/2007 PROFIT HEALTHCAR E AMENDATO RY (DO Coverage Section Only) NOT FOR Form Jameka Harris 09/12/ /12/2007 PROFIT HEALTHCAR E AMENDATO RY (DO and EPL Coverage Sections) Forms Listing Supporting Document Jameka Harris 09/12/ /12/2007 Created by SERFF on 10/02/ :19 AM

6 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Created by SERFF on 10/02/ :19 AM

7 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Disposition Package of management and liability coverages for non-profits./aic-07-mp-10 Disposition Date: 10/02/2007 Effective Date (New): 10/02/2007 Effective Date (Renewal): 10/02/2007 Status: Approved Comment: Rate data does NOT apply to filing. Overall Rate Information for Multiple Company Filings Overall Percentage Rate Indicated For This Filing 0.000% Overall Percentage Rate Impact For This Filing 0.000% Effect of Rate Filing-Written Premium Change For This Program $0 Effect of Rate Filing - Number of Policyholders Affected 0 Created by SERFF on 10/02/ :19 AM

8 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Item Type Item Name Item Status Public Access Supporting Document Uniform Transmittal Document-Property & Approved Yes Casualty Supporting Document (revised) Forms Listing Approved Yes Supporting Document Forms Listing Approved Yes Form Declarations Page Approved Yes Form General Terms and Conditions Approved Yes Form D&O Coverage Section Approved Yes Form EPL Coverage Section Approved Yes Form FLI Coverage Section Approved Yes Form Crime Coverage Section Approved Yes Form Employed Lawyers Coverage Section Approved Yes Form K & R Coverage Section Approved Yes Form Application Approved Yes Form Additional Insurers - Listed Affiliates Approved Yes (Specified Coverage Sections) Form Cancellation Endorsement - Short Rate Approved Yes Form Cancellation Endorsement Approved Yes Form Clause 7(A) Amended - Notice From Approved Yes Human Resources Department or General Counsel Form Clause 7(A) Amended - Notice From Approved Yes Human Rsources Department or General Counsel - 60 Days Form Clause 7 (A) Amended (45 Days) Approved Yes Form Clause 7 (A) Amended (60 Days) Approved Yes Form Clause 9 Amended to Provide A Waiver Approved Yes For Specific Transactions Form Commissions Exclusion Approved Yes Form Coordination of AIG Limits (Non-Stacking Approved Yes of Limits) Form Discovery Elected Approved Yes Endorsement Deleted Created by SERFF on 10/02/ :19 AM

9 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Form Approved Yes Form Endorsement Deleted Approved Yes Form Exclusion (C) Amended (Specific Related Approved Claims) Form Known Wrongful Act Exclusion Approved Yes Form Mandatory Arbitration Approved Yes Form Non-Employment Discrimination Claims - Separate Retention Approved Form Outside Entity Endorsement Approved Yes Form Policy Non-Cancellable By Either Insurer or Insured(s) Approved Form Policy Period Expanded Approved Yes Form Reliance Upon Other Carrier's ApplicationApproved Yes Form Side A Pollution Coverage Endorsement Approved Yes Form Form Form Form Form Form Specific Entity Exclusion (Claims Brought Approved Against) Specific Entity Exclusion (Claims Brought Approved By Or Against) Specific Investigation - Claim-Litigation- Event Or Act Exclusion Approved Subsidiary - Addition To The Definition Of Approved Subsidary Subsidiary - For Profit - Auto - Subsidiary Approved Percentage Decreased Subsidiary - For-Profit Auto Subsidiary Percentage Increased Form Subsidiary - Not-Profit-Profit - Auto - Subsidiary Percentage Decreased Form Subsidiary - Not-Profit-Profit Auto Subsidiary Percentage Increased Approved Approved Approved Form Tie-In Of Limits Endorsement Approved Yes Form Individual Insured(s) Definition Amended Approved Yes Form Punitive Damages Sublimit of Liability Approved Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Created by SERFF on 10/02/ :19 AM

10 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Form Sexual Misconduct and Child Abuse Approved Yes Exclusion Form Accreditation Exclusion Approved Yes Form Addition of Named Parent (CO-DefendantApproved Yes Basis) Form Antitrust Claims Separate Retention Approved Yes Form Antitrust Claims Separate Retention and Approved Yes Sublimit of Liability Form Antitrust Claims - Separate Retention Approved Yes Sublimit of Liability and Co-Insurance Form Antitrust Claims Sublimit of Liability Approved Yes Form Appendix B - Crisis Management Approved Yes Coverage Form BANKRUPTCY TRUSTEE, RECEIVER, Approved Yes LIQUIDATOR OR REHABILITATOR EXCLUSION Form BANKRUPTCY/INSOLVENCY/CREDITO Approved Yes RS EXCLUSION Form CAPTIVE INSURANCE COMPANY Approved Yes EXCLUSION Form CAPTIVE INSURANCE COMPANY Approved Yes EXCLUSION (WITH SPECIFIC CAPTIVE CARVEBACK) Form CLAUSE 5 AMENDED (SETTLEMENT Approved Yes WITHIN THE RETENTION AMOUNT) Form COINSURANCE ENDORSEMENT Approved Yes Form CONTINUITY DATES AMENDED Approved Yes Form CREDITORS AND DEBT HOLDERS Approved Yes EXCLUSION Form D&O SETTLEMENT OPPORTUNITY Approved Yes ENDORSEMENT (70/30) Form D&O SETTLEMENT OPPORTUNITY Approved Yes ENDORSEMENT (80/20) Form FAILURE TO EFFECT AND/OR MAINTAIN INSURANCE (DEFENSE Approved Yes Created by SERFF on 10/02/ :19 AM

11 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 COST CARVE-BACK) Form FAILURE TO EFFECT AND/OR MAINTAIN INSURANCE EXCLUSION Form GENERAL E&O EXCLUSION - SPECIFIC SERVICE Form Form Form Form Approved Approved GOVERNMENTAL FUNDING DEFENSE Approved COSTS COVERAGE WITH SUBLIMIT INDIVIDUAL INSURED(S) DEFINITION AMENDED INSURANCE COMPANY ERRORS AND OMISSIONS EXCLUSION KNOWN WRONGFUL ACTS EXCLUSION Approved Approved Approved Form LOANS EXCLUSION Approved Yes Form MEDICAL MALPRACTICE EXCLUSION Approved Yes Form PARENT EXCLUSION Approved Yes Form PATENT COPYRIGHT EXCLUSION Approved Yes Form PENDING AND PRIOR LITIGATION ANDApproved KNOWN WRONGFUL ACTS EXCLUSION FOR EXCESS LIMITS Form PRIOR ACTS EXCLUSION Approved Yes Form Form Form PRIOR ACTS EXCLUSION FOR EXCESS COVERAGE PROFESSIONAL ERRORS AND OMISSIONS EXCLUSION PROFESSIONAL ERRORS AND OMISSIONS EXCLUSION (SPECIFIC SERVICE) Approved Approved Approved Form PUBLISHING LIABILITY EXCLUSION Approved Yes Form PUNITIVE DAMAGES SUB-LIMIT OF LIABILITY Approved Form REGULATORY EXCLUSION Approved Yes Form SEXUAL MISCONDUCT AND CHILD ABUSE EXCLUSION Approved Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Created by SERFF on 10/02/ :19 AM

12 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Form SPECIFIC INDIVIDUAL EXCLUSION Approved Yes Form SPONSOR - DEVELOPER EXCLUSION Approved Yes Form ADDITION OF NAMED PARENT (CO- Approved Yes DEFENDENT BASIS) Form CLAIM DEFINITION AMENDED Approved Yes (DELETE EEOC) Form CLAUSE 4 AMENDED TO WAIVE Approved Yes INSURER'S CONSENT TO SETTLEMENT WITHIN RETENTION AMOUNT Form CONTINUITY DATES AMENDED Approved Yes Form EMPLOYMENT PRACTICES LIABILITY Approved Yes PANEL COUNSEL FIRM LIST AMENDED Form EPL SETTLEMENT OPPORTUNITY Approved Yes ENDORSEMENT (70/30) Form EPL SETTLEMENT OPPORTUNITY Approved Yes ENDORSEMENT (80/20) Form NON-EMPLOYMENT DISRIMINATION Approved Yes (THIRD PARTY) CLAIMS COVERAGE DELETED Form PENDING AND PRIOR Approved Yes LITIGATION/KNOWN WRONGFUL ACTS EXCLUSION FOR EXCESS LIMITS Form PENDING AND PRIOR LITIGATION Approved Yes EXCLUSION FOR EXCESS LIMITS Form PRIOR ACTS EXCLUSION FOR Approved Yes EXCESS LIMITS Form PUNITIVE DAMAGES SUBLIMIT OF Approved Yes LIABILITY Form SEXUAL MISCONDUCT AND CHILD Approved Yes ABUSE EXCLUSION Form SUBLIMIT FOR NON-EMPLOYMENT DISCRIMINATION CLAIMS Approved Yes Created by SERFF on 10/02/ :19 AM

13 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Form 502 (c) ERISA PENALTY COVERAGE WITH SUBLIMIT Approved Form 502(I) AND 502 (i) - DELETED Approved Yes Form ACTUARIAL ERRORS AND OMISSIONSApproved EXCLUSION Form ADDITIONAL LISTED PLANS - AP Approved Yes Form ADDITIONAL LISTED PLANS Approved Yes Form AUTO PLAN THRESHOLD AMENDED Approved Yes Form BENEFITS WORDING - AMENDED Approved Yes Form CASH BALANCE AND PENSION EQUITY PLAN EXCLUSION Approved Form CONTINUITY DATES AMENDED Approved Yes Form Form Form FAILURE TO EFFECT AND/OR MAINTAIN INSURANCE EXCLUSION FAILURE TO EFFECT OR MAINTAIN FIDELITY BOND EXCLUSION ADDED FULL GOVERNMENT AND REGULATORY EXCLUSION Approved Approved Approved Form MULTIEMPLOYER EXTENSION Approved Yes Form PENDING AND PRIOR LITIGATION - KNOWN WRONGFUL ACTS EXCLUSION FOR EXCESS LIMITS Approved Form PRIOR ACTS EXCLUSION Approved Yes Form Form Form Form PRIOR ACTS EXCLUSION FOR EXCESS LIMITS REVERSION OF ASSETS EXCLUSION (GENERAL) REVERSION OF ASSETS EXCLUSION (PLAN TERMINATION) Approved Approved Approved SPECIFIC Approved INVESTIGATION/CLAIM/LITIGATION/EV ENT OR ACT EXCLUSION Form SPECIFIC INVESTMENT EXCLUSION Approved Yes Form STOCK FLUCTUATION Approved Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Created by SERFF on 10/02/ :19 AM

14 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 ENDORSEMENT Form VOLUNTARY COMPLIANCE LOSS Approved Yes RETENTION Form ADD CREDIT, DEBIT OR CHARGE Approved Yes CARD FORGERY Form AMEND TERRITORIAL LIMITS Approved Yes Form ATM EXCLUSION Approved Yes Form CLIENTS PROPERTY Approved Yes Form COINSURANCE Approved Yes Form CONVERT TO AGGREGATE LIMIT OF Approved Yes INSURANCE Form CRIME ADVANTAGE Approved Yes Form EXCLUDE DESIGNATED PERSONS OR Approved Yes CLASSES OF PERSONS AS EMPLOYEES Form EXCLUDE LOSS OF CLIENTS Approved Yes PROPERTY Form EXCLUDE SPECIFIED PROPERTY Approved Yes Form FUNDS TRANSFER FRAUD Approved Yes Form GUEST PROPERTY Approved Yes Form INCLUDE CHAIRPERSON AND Approved Yes SPECIFIED COMMITTEE MEMBERS AS EMPLOYEES Form INCLUDE SPECIFIED DIRECTORS OR Approved Yes TRUSTEES ON COMMITTEES AS EMPLOYEES Form INCLUDE SPECIFIED Approved Yes NONCOMPENSATED OFFICERS AS EMPLOYEES Form INCLUDE VOLUNTEER WORKERS Approved Yes OTHER THAN FUND SOLICITORS AS EMPLOYEES Form JOINT LOSS PAYABLE Approved Yes Form PRIOR THEFT OR DISHONESTY Approved Yes Created by SERFF on 10/02/ :19 AM

15 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Form PROTECTIVE DEVICES Approved Yes Form REVISION OF DISCOVERY Approved Yes Form Form Form SUBSEQUENT SUSTAINED LOSS EXCLUSION BAD FAITH EXCLUSION ENDORSEMENT CLAIMS ADJUSTER, TITLE ABSTRACTOR AND COLLECTION AGENT EXCLUSION ENDORSEMENT Approved Approved Approved Form CONTINUITY DATES AMENDED Approved Yes Form Form Form Form Form Form Form Form INDEPENDENT CONTRACTORS ENDORSEMENT (CLAIMS MADE AGAINST) NTELLECTUAL PROPERTY EXCLUSION ENDORSEMENT INVESTMENT ADVISOR EXCLUSION ENDORSEMENT LIMITED MOONLIGHTING EXCLUSION ENDORSEMENT MEDICAL MALPRACTICE EXCLUSION ENDORSEMENT MOONLIGHTING EXLCUSION ENDORSEMENT MOONLIGHTING SUB-LIMIT OF LIABILITY ENDORSEMENT PART TIME EMPLOYED LAWYERS COVERAGE ENDORSEMENT Form PENDING AND PRIOR LITIGATION - KNOWN WRONGFUL ACTS EXCLUSION FOR EXCESS LIMITS Approved Approved Approved Approved Approved Approved Approved Approved Approved Form PRIOR ACTS EXCLUSION Approved Yes Form PRIOR ACTS EXCLUSION FOR EXCESS LIMITS Approved Form SECURITIES CLAIM EXCLUSION Approved Yes SPECIFIC CORPORATE COUNSEL Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Created by SERFF on 10/02/ :19 AM

16 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Form Package of management and liability coverages for non-profits./aic-07-mp-10 EXCLUSION ENDORSEMENT (CLAIMS Approved MADE AGAINST) Yes Form Form TITLE SERVICES COVERAGE ENDORSEMENT DEDUCTIBLE (EXTORTION) ENDORSEMENT Approved Approved Form EMPLOYEE(S) REDEFINED Approved Yes Form Form Form TERRITORY AMENDATORY ENDORSEMENT ARKANSAS AMENDATORY ENDORSEMENT AMENDATORY ENDORSEMENT ARKANSAS Form CONTRACT EXCLUSION AMENDED - CARVEBACK FOR NON- Form Form Form Form INDEMNIFIABLE DEFENSE COSTS (DO COVERAGE SECTION) Higher Educational Amendatory Endorsement (DO and EPL Coverage Sections) Higher Educational Amendatory Endorsement (DO Coverage Section Only) NOT FOR PROFIT HEALTHCARE AMENDATORY (DO Coverage Section Only) NOT FOR PROFIT HEALTHCARE AMENDATORY (DO and EPL Coverage Sections) Approved Approved Approved Approved Approved Approved Approved Approved Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Created by SERFF on 10/02/ :19 AM

17 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Amendment Letter Package of management and liability coverages for non-profits./aic-07-mp-10 Amendment Date: Submitted Date: 09/12/2007 Comments: Ms. Rawlins, We wish to make a change to this filing by adding 5 additional endorsements for your review and approval. We apologize for any inconvenience this matter may cause. Very truly yours, Jameka Harris Changed Items: Form Schedule Item Changes: Form Form Edition Form Action Replaced Previous Readability Attachments Name Number Date Type Form # Filing # Score CONTRACT (9/07) Endorse New EXCLUSION AMENDED - CARVEBAC K FOR NON- INDEMNIFIA BLE DEFENSE COSTS (DO COVERAGE SECTION) ment/am endment /Conditio ns CONTRACT EXCLUSION AMENDED - CARVEBACK FOR NON- INDEMNIFIA BLE DEFENSE COSTS (DO COVERAGE SECTION).pd f Form Form Edition Form Action Replaced Previous Readability Attachments Created by SERFF on 10/02/ :19 AM

18 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Name Number Date Type Form # Filing # Score Higher (9/07) Endorse New Higher Educational Amendatory Endorsemen t (DO and EPL Coverage ment/am endment /Conditio ns Educational Amendatory Endorsement (DO and EPL Coverage Sections).pdf Sections) Form Form Edition Form Action Replaced Previous Readability Attachments Name Number Date Type Form # Filing # Score Higher (9/07) Endorse New Higher Educational Amendatory Endorsemen t (DO Coverage Section Only) ment/am endment /Conditio ns Educational Amendatory Endorsement (DO Coverage Section Only).pdf Form Form Edition Form Action Replaced Previous Readability Attachments Name Number Date Type Form # Filing # Score NOT FOR (9/07) Endorse New NOT PROFIT HEALTHCA RE AMENDATO RY (DO Coverage Section Only) ment/am endment /Conditio ns FOR PROFIT HEALTHCAR E AMENDATOR Y (DO Coverage Section Only).pdf Form Form Edition Form Action Replaced Previous Readability Attachments Name Number Date Type Form # Filing # Score NOT FOR (9/07) Endorse New NOT PROFIT HEALTHCA ment/am endment FOR PROFIT HEALTHCAR Created by SERFF on 10/02/ :19 AM

19 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: RE AMENDATO RY (DO and EPL Coverage Sections) Package of management and liability coverages for non-profits./aic-07-mp-10 /Conditio ns E AMENDATOR Y (DO and EPL Coverage Sections.pdf Created by SERFF on 10/02/ :19 AM

20 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Supporting Document Schedule Item Changes: User Added -Name: Forms Listing Comment: SFD Forms Listing pdf Created by SERFF on 10/02/ :19 AM

21 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Form Schedule Package of management and liability coverages for non-profits./aic-07-mp-10 Review Status Approved Approved Approved Approved Approved Form Name Form # Edition Form Type Action Action Specific Readability Attachment Date Data Declarations Page General Terms and Conditions D&O Coverage Section EPL Coverage Section FLI Coverage Section (2/07) Declaration New s/schedule NPRP DECLARATI ONS - COUNTRY WIDE (ADMITTED).pdf (3/07) Policy/CoveNew rage Form GENERAL TERMS AND CONDITION S (ADMITTED).pdf (3/07) Policy/CoveNew D&O rage Form COVERAGE SECTION (ADMITTED).pdf (3/07) Policy/CoveNew EPL rage Form COVERAGE SECTION (ADMITTED).pdf (3/07) Policy/CoveNew FLI rage Form COVERAGE SECTION (ADMITTED).pdf Created by SERFF on 10/02/ :19 AM

22 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Approved Crime Coverage Section (3/07) Policy/CoveNew rage Form CRIME COVERAGE SECTION (ADMITTED).pdf Approved Employed (3/07) Policy/CoveNew Lawyers Coverage Section rage Form EMPLOYED LAWYERS COVERAGE SECTION (ADMITTED).pdf Approved K & R Coverage Section (3/07) Policy/CoveNew KRE rage Form COVERAGE SECTION (ADMITTED).pdf Approved Application (5/07) Application/ New Binder/Enro llment NPRP Application - COUNTRY WIDE.pdf Approved Additional Insurers - Listed Affiliates (Specified Coverage Sections) (3/07) Endorseme New nt/amendm ent/conditi ons ADDITIONA L INSUREDS LISTED AFFILIATES (SPECIFIED COVERAGE SECTIONS). pdf Approved Cancellation (6/07) Endorseme New Endorsement - nt/amendm CANCELLA Short Rate ent/conditi TION Created by SERFF on 10/02/ :19 AM

23 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 ons ENDORSEM ENT SHORT RATE (ALL COVERAGE SECTIONS). pdf Approved Approved Approved Cancellation (6/07) Endorseme New Endorsement nt/amendm ent/conditi ons CANCELLA TION ENDORSEM ENT (ALL COVERAGE SECTIONS). pdf Clause 7(A) (6/07) Endorseme New Amended - nt/amendm CLAUSE Notice From ent/conditi 7(a) Human ons AMENDED - Resources NOTICE Department or FROM General Counsel HUMAN RESOURCE S OR GENERAL COUNSEL (GT&Cs AMENDMEN T).pdf Clause 7(A) (6/07) Endorseme New Amended - nt/amendm CLAUSE Notice From ent/conditi 7(a) Human Rsources ons AMENDED - Department or NOTICE General Counsel FROM - 60 Days HUMAN RESOURCE Created by SERFF on 10/02/ :19 AM

24 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 S OR GENERAL COUNSEL - 60 DAYS (GT&Cs AMENDMEN T).pdf Approved Clause 7 (A) (6/07) Endorseme New Amended (45 Days) nt/amendm ent/conditi ons CLAUSE 7(a) AMENDED - 45 DAYS (GT&Cs AMENDMEN T).pdf Approved Clause 7 (A) (6/07) Endorseme New Amended (60 Days) nt/amendm ent/conditi ons CLAUSE 7(a) AMENDED - 60 DAYS (GT&Cs AMENDMEN T).pdf Approved Clause (5/07) Endorseme New Amended to Provide A Waiver For Specific Transactions nt/amendm ent/conditi ons CLAUSE 9 AMENDED TO PROVIDE A WAIVER FOR SPECIFIC TRANSACTI ON(S) (GT&Cs AMENDMEN T).pdf Created by SERFF on 10/02/ :19 AM

25 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Approved Approved Approved Approved (5/07) Endorseme New nt/amendm ent/conditi ons COMMISSIO NS EXCLUSION (ALL COVERAGE SECTIONS). pdf (5/07) Endorseme New Commissions Exclusion Coordination of AIG Limits (Non- Stacking of Limits) Discovery Elected Endorsement Deleted nt/amendm ent/conditi ons COORDINA TION OF AIG LIMITS (NON- STACKING OF LIMITS) (ALL COVERAGE SECTIONS). pdf (6/07) Endorseme New nt/amendm ent/conditi ons DISCOVER Y ELECTED (ALL COVERAGE SECTIONS OTHER THAN CRIME AND KRE (IF APPLICABL E)).pdf (6/07) Endorseme New nt/amendm ENDORSEM ent/conditi ENT ons DELETED (ALL Created by SERFF on 10/02/ :19 AM

26 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 COVERAGE SECTIONS). pdf Approved Endorsement (6/07) Endorseme New Deleted nt/amendm ent/conditi ons ENDORSEM ENTS DELETED (ALL COVERAGE SECTIONS). pdf Approved Exclusion (C) (6/07) Endorseme New Amended (Specific Related Claims) nt/amendm ent/conditi ons EXCLUSION (C) AMENDED (SPECIFIED RELATED CLAIMS) (GT&Cs AMENDMEN T).pdf Approved Known Wrongful (6/07) Endorseme New Act Exclusion nt/amendm ent/conditi ons KNOWN WRONGFUL ACT EXCLUSION (ALL COVERAGE SECTIONS OTHER THAN CRIME AND KRE (IF APPLICABL E)).pdf Approved Mandatory (6/07) Endorseme New Created by SERFF on 10/02/ :19 AM

27 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Arbitration Package of management and liability coverages for non-profits./aic-07-mp-10 nt/amendm ent/conditi ons MANDATOR Y ARBITRATI ON (GT&Cs AMENDMEN T).pdf Approved Approved Approved Non-Employment (6/07) Endorseme New Discrimination Claims - Separate Retention nt/amendm ent/conditi ons NON- EMPLOYME NT DISCRIMIN ATION CLAIMS - SEPARATE RETENTION (GT&Cs AMENDMEN T).pdf (6/07) Endorseme New nt/amendm ent/conditi ons OUTSIDE ENTITY ENDORSEM ENT (GT&Cs AMENDMEN T).pdf Outside Entity Endorsement Policy Non- Cancellable By Either Insurer or Insured(s) (6/07) Endorseme New nt/amendm ent/conditi ons POLICY NON- CANCELLA BLE BY EITHER INSURED OR INSURER (GT&Cs Created by SERFF on 10/02/ :19 AM

28 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 AMENDMEN T).pdf Approved Approved Approved Approved Policy Period Expanded Reliance Upon Other Carrier's Application Side A Pollution Coverage Endorsement Specific Entity (6/07) Endorseme New nt/amendm ent/conditi ons POLICY PERIOD EXPANDED (ALL COVERAGE SECTIONS). pdf (6/07) Endorseme New nt/amendm ent/conditi ons RELIANCE UPON OTHER CARRIER'S APPLICATI ON (AFFIRMATI VE REPRESEN TATION) (ALL COVERAGE SECTIONS). pdf (6/07) Endorseme New nt/amendm SIDE A ent/conditi POLLUTION ons COVERAGE ENDORSEM ENT (GT&Cs AMENDMEN T).pdf (3/07) Endorseme New Exclusion (Claims nt/amendm SPECIFIC Created by SERFF on 10/02/ :19 AM

29 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 Brought Against) ent/conditi ons ENTITY EXCLUSION (CLAIMS BROUGHT AGAINST) (ALL COVERAGE SECTIONS). pdf Approved Approved Specific Entity (3/07) Endorseme New Exclusion (Claims Brought By Or Against) nt/amendm ent/conditi ons SPECIFIC ENTITY EXCLUSION (CLAIMS BROUGHT BY OR AGAINST) (ALL COVERAGE SECTIONS). pdf Specific Investigation - Claim-Litigation- Event Or Act Exclusion (7/07) Endorseme New nt/amendm ent/conditi ons SPECIFIC INVESTIGA TION- CLAIM- LITIGATION -EVENT OR ACT EXCLUSION (ALL COVERAGE SECTIONS OTHER THAN CRIME AND Created by SERFF on 10/02/ :19 AM

30 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 KRE (IF APPLICABL E)).pdf Approved Subsidiary - Addition To The Definition Of Subsidary Approved Subsidiary - For Profit - Auto - Subsidiary Percentage Decreased Approved Subsidiary - For- Profit Auto Subsidiary Percentage Increased (6/07) Endorseme New nt/amendm ent/conditi ons SUBSIDIAR Y - ADDITION TO THE DEFINITION OF SUBSIDIAR Y (GT&Cs AMENDMEN T).pdf (6/07) Endorseme New nt/amendm ent/conditi ons SUBSIDIAR Y FOR- PROFIT AUTO- SUBSIDIAR Y PERCENTA GE DECREASE D (GT&Cs AMENDMEN T).pdf (6/07) Endorseme New nt/amendm SUBSIDIAR ent/conditi Y FORons PROFIT AUTO- SUBSIDIAR Y PERCENTA GE Created by SERFF on 10/02/ :19 AM

31 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 INCREASED (GT&Cs AMENDMEN T).pdf Approved Approved Approved Subsidiary - Not (6/07) Endorseme New Profit-Profit - Auto - Subsidiary Percentage Decreased nt/amendm ent/conditi ons SUBSIDIAR Y NOT-FOR- PROFIT AUTO- SUBSIDIAR Y PERCENTA GE DECREASE D (GT&Cs AMENDMEN T).pdf Subsidiary - Not (6/07) Endorseme New Profit-Profit Auto nt/amendm SUBSIDIAR Subsidiary ent/conditi Y NOT-FOR- Percentage ons PROFIT Increased AUTO- SUBSIDIAR Y PERCENTA GE INCREASED (GT&Cs AMENDMEN T).pdf Tie-In Of Limits (6/07) Endorseme New TIE- Endorsement nt/amendm IN OF ent/conditi LIMITS ons ENDORSEM ENT - COMMON Created by SERFF on 10/02/ :19 AM

32 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 CLAIMS (ALL COVERAGE SECTIONS). pdf Approved Approved Approved Individual Insured(s) Definition Amended Punitive Damages Sublimit of Liability Sexual Misconduct and Child Abuse Exclusion (3/07) Endorseme New nt/amendm ent/conditi ons INDIVIDUAL INSURED(S) DEFINITION AMENDED (D&O AND EPL COVERAGE SECTION).p df (4/07) Endorseme New nt/amendm ent/conditi ons PUNITIVE DAMAGES SUBLIMIT OF LIABILITY (D&O AND EPL COVERAGE SECTIONS). pdf (5/07) Endorseme New nt/amendm SEXUAL ent/conditi MISCONDU ons CT AND CHILD ABUSE EXCLUSION (D&O AND EPL COVERAGE Created by SERFF on 10/02/ :19 AM

33 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 SECTIONS). pdf Approved Approved Approved Approved Accreditation Exclusion Addition of Named Parent (CO-Defendant Basis) Antitrust Claims Separate Retention Antitrust Claims Separate Retention and Sublimit of Liability (6/07) Endorseme New nt/amendm ent/conditi ons ACCREDITA TION EXCLUSION (D&O COVERAGE SECTION).p df (5/07) Endorseme New nt/amendm ent/conditi ons ADDITION OF NAMED PARENT (CO- DEFENDAN T BASIS) (D&O COVERAGE SECTION).p df (6/07) Endorseme New nt/amendm ANTITRUST ent/conditi CLAIMS ons SEPARATE RETENTION (D&O COVERAGE SECTION).p df (6/07) Endorseme New nt/amendm ANTITRUST ent/conditi CLAIMS ons SEPARATE RETENTION AND Created by SERFF on 10/02/ :19 AM

34 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 SUBLIMIT OF LIABILITY (D&O COVERAGE SECTION).p df Approved Antitrust Claims (6/07) Endorseme New Separate Retention Sublimit of Liability and Co- Insurance nt/amendm ent/conditi ons ANTITRUST CLAIMS - SEPARATE RETENTION SUBLIMIT OF LIABILITY AND CO- INSURANC E (D&O COVERAGE SECTION).p df Approved Antitrust Claims Sublimit of Liability Approved Appendix B - Crisis Management Coverage (6/07) Endorseme New nt/amendm ent/conditi ons ANTITRUST CLAIMS SUBLIMIT OF LIABILITY (D&O COVERAGE SECTION).p df (6/07) Endorseme New nt/amendm APPENDIX ent/conditi B - CRISIS ons MANAGEME NT Created by SERFF on 10/02/ :19 AM

35 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 COVERAGE (D&O COVERAGE SECTION).p df Approved Approved Approved BANKRUPTCY (5/07) Endorseme New TRUSTEE, RECEIVER, LIQUIDATOR OR REHABILITATOR EXCLUSION nt/amendm ent/conditi ons BANKRUPT CY TRUSTEE, RECEIVER, LIQUIDATO R OR REHIBILAT OR EXCLUSION (D&O COVERAGE SECTION).p df BANKRUPTCY/I (5/07) Endorseme New NSOLVENCY/CR EDITORS EXCLUSION nt/amendm ent/conditi ons BANKRUPT CY INSOLVENC Y CREDITOR S EXCLUSION (D&O COVERAGE SECTION).p df CAPTIVE (5/07) Endorseme New INSURANCE nt/amendm CAPTIVE COMPANY ent/conditi INSURANC EXCLUSION ons E COMPANY Created by SERFF on 10/02/ :19 AM

36 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 EXCLUSION (D&O COVERAGE SECTION).p df Approved CAPTIVE (3/07) Endorseme New INSURANCE COMPANY EXCLUSION (WITH SPECIFIC CAPTIVE CARVEBACK) nt/amendm ent/conditi ons CAPTIVE INSURANC E COMPANY EXCLUSION (WITH SPECIFIC CAPTIVE CARVEBAC K) (D&O COVERAGE SECTION).p df Approved CLAUSE (5/07) Endorseme New AMENDED (SETTLEMENT WITHIN THE RETENTION AMOUNT) nt/amendm ent/conditi ons CLAUSE 5 AMENDED (SETTLEME NT WITHIN THE RETENTION AMOUNT) (D&O COVERAGE SECTION).p df Approved COINSURANCE (5/07) Endorseme New ENDORSEMENT nt/amendm ent/conditi ons COINSURA NCE ENDORSEM ENT (D&O Created by SERFF on 10/02/ :19 AM

37 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 COVERAGE SECTION).p df Approved Approved Approved Approved CONTINUITY DATES AMENDED CREDITORS AND DEBT HOLDERS EXCLUSION D&O SETTLEMENT OPPORTUNITY (6/07) Endorseme New nt/amendm ent/conditi ons CONTINUIT Y DATES AMENDED (D&O COVERAGE SECTION).p df (5/07) Endorseme New nt/amendm ent/conditi ons CREDITOR S AND DEBT HOLDERS EXCLUSION (DO COVERAGE SECTION).p df (5/07) Endorseme New D&O nt/amendm SETTLEME ent/conditi NT ENDORSEMENT (70/30) ons OPPORTUN ITY ENDORSEM ENT (70%- 30%) (D&O COVERAGE SECTION).p df D&O SETTLEMENT OPPORTUNITY (5/07) Endorseme New D&O nt/amendm SETTLEME ent/conditi NT ENDORSEMENT ons OPPORTUN Created by SERFF on 10/02/ :19 AM

38 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 (80/20) ITY ENDORSEM ENT (80%- 20%) (D&O COVERAGE SECTION).p df Approved Approved Approved FAILURE TO EFFECT AND/OR MAINTAIN INSURANCE (DEFENSE COST CARVE- BACK) FAILURE TO EFFECT AND/OR MAINTAIN INSURANCE EXCLUSION GENERAL E&O EXCLUSION (5/07) Endorseme New nt/amendm ent/conditi ons FAILURE TO EFFECT AND_OR MAINTAIN INSURANC E EXCLUSION (DEFENSE COSTS CARVE- BACK) (D&O COVERAGE SECTION).p df (5/07) Endorseme New nt/amendm ent/conditi ons FAILURE TO EFFECT AND_OR MAINTAIN INSURANC E EXCLUSION (D&O COVERAGE SECTION).p df (3/07) Endorseme New nt/amendm GENERAL Created by SERFF on 10/02/ :19 AM

39 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: SPECIFIC SERVICE Package of management and liability coverages for non-profits./aic-07-mp-10 ent/conditi ons E&O EXCLUSION - SPECIFIC SERVICE (D&O COVERAGE SECTION).p df Approved Approved Approved GOVERNMENTA (5/07) Endorseme New L FUNDING DEFENSE COSTS COVERAGE WITH SUBLIMIT nt/amendm ent/conditi ons GOVERNME NTAL FUNDING DEFENSE COSTS COVERAGE WITH SUBLIMIT (D&O COVERAGE SECTION).p df INDIVIDUAL (3/07) Endorseme New INSURED(S) nt/amendm INDIVIDUAL DEFINITION ent/conditi INSURED(S) AMENDED ons DEFINITION AMENDED (D&O COVERAGE SECTION).p df INSURANCE (5/07) Endorseme New COMPANY nt/amendm INSURANC ERRORS AND ent/conditi E OMISSIONS ons COMPANY EXCLUSION ERRORS AND Created by SERFF on 10/02/ :19 AM

40 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 OMMISSION S EXCLUSION (D&O COVERAGE SECTION).p df Approved Approved Approved Approved KNOWN WRONGFUL ACTS EXCLUSION LOANS EXCLUSION MEDICAL MALPRACTICE EXCLUSION PARENT EXCLUSION (5/07) Endorseme New nt/amendm ent/conditi ons KNOWN WRONGFUL ACT EXCLUSION (D&O COVERAGE SECTION).p df (5/07) Endorseme New nt/amendm ent/conditi ons LOANS EXCLUSION (D&O COVERAGE SECTION).p df (4/07) Endorseme New nt/amendm MEDICAL ent/conditi MALPRACTI ons CE EXCLUSION (D&O COVERAGE SECTION).p df (6/07) Endorseme New nt/amendm PARENT ent/conditi EXCLUSION ons (D&O Created by SERFF on 10/02/ :19 AM

41 SERFF Tracking Number: AGNY State: Arkansas First Filing Company: American International South Insurance State Tracking Number: AR-PC Company,... Company Tracking Number: AIC-07-MP-10 TOI: 05.0 Commercial Multi-Peril - Liability & Non- Sub-TOI: CMP Sub-TOI Combinations Liability Product Name: Not-For-Profit Risk Protector Program Project Name/Number: Package of management and liability coverages for non-profits./aic-07-mp-10 COVERAGE SECTION).p df Approved PATENT (4/07) Endorseme New COPYRIGHT EXCLUSION nt/amendm ent/conditi ons PATENT COPYRIGH T EXCLUSION (D&O COVERAGE SECTION).p df Approved PENDING AND PRIOR LITIGATION AND KNOWN WRONGFUL ACTS EXCLUSION FOR EXCESS LIMITS (3/07) Endorseme New nt/amendm PENDING ent/conditi AND PRIOR ons LITIGATION - KNOWN WRONGFUL ACTS EXCLUSION FOR EXCESS LIMITS (D&O COVERAGE SECTION).p df Approved PRIOR ACTS (5/07) Endorseme New EXCLUSION nt/amendm ent/conditi ons PRIOR ACTS EXCLUSION (D&O COVERAGE SECTION).p df Approved PRIOR ACTS (3/07) Endorseme New Created by SERFF on 10/02/ :19 AM