Broadform Liability 38 P PLB

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Albert Douglas
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1 Policy Schedule Class of Insurance: Policy Number: The Insured: Address of the Insured: Broadform Liability 38 P PLB Athletics Australia Australian Masters Athletics, irun, the following affiliated Member Associations, Queensland Athletics, Athletics Western Australia, Athletics New South Wales, Athletics Victoria, Athletics North Queensland, Athletics South Australia, Athletics Tasmania and Northern Territory Athletics and all affiliated clubs and bodies including all members, coaches, directors and officers, executives, voluntary workers, officials, referees, approved event managers and race directors, directors and officers and or subsidiary and/or related Corporations as defined under Australian Corporations Law and/or financiers and all parties for whom the Insured undertakes to insure for their respective rights, interests and liabilities C/- Willis Australia Ltd Level 28 Angel Place, 123 Pitt Street SYDNEY NSW 2000 The Business: Administration, coordination, promotion and development of sports affiliated with Athletics Australia, risk management and governance of sanctioned events, games, tournaments and training sessions. Period of Insurance: From: 1/04/2015 at 4:00 pm To: 1/04/2016 at 4:00 pm Limit of Liability: Our maximum liability in respect of any claim or any series of claims caused by or arising out of one Occurrence will not exceed: Our total aggregate liability during any one Period of Insurance for all claims arising out of Products will not exceed: $20,000,000 $20,000, SUB-LIMITS Errors and Omissions $10,000,000 Molestation (Annual) $250,000 Molestation (Whilst in Miami) $1,000,000 USD Care, Custody & Control $250,000 v11.14 Page 1

Associations, Queensland Athletics, Athletics Western Australia, Athletics New South Wales, Athletics Victoria, Athletics North Queensland, Athletics South Australia, Athletics Tasmania and Northern

2 Policy Schedule Deductible: You will pay the following amount(s) in respect of each Occurrence and/or Claim, except as stated elsewhere within Policy Endorsements: Products Property Damage: $1,000 Personal Injury: $1,000 All Other Claims Property Damage: $1,000 Premium: Personal Injury: $1,000 And For $5,000 Molestation $10,000 USA & Canada claims As per Tax Invoice Policy Wording: Endorsements: Leisure Plus Broadform Liability Wording QM with the following endorsements 1. Exclusion 3.13 is hereby deleted. Territorial limit is extended to USA and Canada for athletes attending events in those countries. MOLESTATION ENDORSEMENT: Exclusion 3.21 is hereby deleted. This Policy does not apply to Personal Injury arising out of or as a result of the molesting or interfering with any person by: (a) You; (b) any of Your Employees; (c) any person acting on Your behalf; however it is understood and agreed that We will defend any action, suit or proceeding against You arising out of an allegation against You of molestation or interfering with any person by: (a) You; (b) any of Your Employees; (c) any person acting on Your behalf. The limit of liability hereby provided is $250,000 any one Occurrence and in the aggregate in respect of all claims made and reported to Us during the Period of Insurance. v11.14 Page 2

Injury: $1,000 All Other Claims Property Damage: $1,000 Premium: Personal Injury: $1,000 And For $5,000 Molestation $10,000 USA & Canada claims As per Tax Invoice Policy Wording: Endorsements:

3 Policy Schedule The limit of indemnity is extended to $1,000,000 USD for the insured s representative whilst in Miami. Errors and Omissions It is hereby declared and agreed that with effect from 01/04/2007: Personal Injury or Property Damage arising from providing such professional advice or service is not given for a fee except where such professional advice or service is given in Your capacity as a coach, instructor, referee. Our liability in respect of such professional advice or service shall be limited to $10,000,000 any one Occurrence and in the aggregate in respect of all claims made and reported to Us during the Period of Insurance. Security: Percent Underwriter 100%% QBE Insurance (Australia) Limited ABN Business Code: Insured Location: Melbourne VIC 3000 Signed: Signed: Date: 5 May 2015 for and on behalf of Pen Underwriting Pty Ltd ABN v11.14 Page 3

a fee except where such professional advice or service is given in Your capacity as a coach, instructor, referee.

GROUP PERSONAL ACCIDENT POLICY SCHEDULE

QBE INSURANCE (AUSTRALIA) LIMITED ABN 78 003 191 035 GROUP PERSONAL ACCIDENT POLICY SCHEDULE Policy Number: AN A044726 PAD Policy Wording: The Insured: The Business: Period of Insurance: QBE QM 360-0312