HIGH LIMIT GENERAL LIABILITY REQUIREMENTS



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Overview: Contract can offer High Limit General Liability limits to complement our existing product line. We can offer High Limit General Liability over a majority of our classes of business. Capacity: Eligibility: Maximum of $5,000,000 aggregate in excess of underlying General Liability except for the Condo/Homeowners Association, Apartment/Single Family Dwelling and Restaurant PDQs which are limited to one $1,000,000 layer in excess of the underlying GL limits. Contract is seeking to write over our PDQ acceptable classes. Any classes that are not in our PDQs, but are acceptable or submit in our class guide should be sent to your Contract underwriter. Contact our Brokerage Casualty Division if higher limits are required over Employee Benefits Liability, Hired & Non-Owned Auto and/or Liquor Liability (VA AZ). Forms: Underlying Limits: All mandatory forms per PDQ must be added. Mandatory forms may not be deleted without prior approval from your underwriter. Contract requires the following underlying limits: General Liability: General Aggregate Liability: $2,000,000 Products and Completed Operations: $1,000,000/$1,000,000 Personal & Advertising Injury Limit: $1,000,000 Occurrence Limit: $1,000,000 Quotations: Quotes provided by your Contract underwriter are valid for thirty (30) days unless otherwise specified. Procedures: Agency Access to Colony Agencies may quote High Limit General Liability over Colony Contract business through the Colony Contract online manual. Stand-alone Excess or Umbrella needs should be submitted to your Brokerage Underwriter (VA AZ). ELR-1 6-22-2010

Information Needed to Quote/Bind ACORD Applications (Commercial Insurance Application, General Liability Application, Umbrella Application and applicable supplemental applications). Three-year documented loss history. You may NOT pro-rate HLGL premiums without written approval from your Colony Underwriter. The minimum premium is $1,000 per $1,000,000 layer of increased occurrence limits. Under no circumstances may minimum premiums be pro-rated. You must send in a copy of your rating Worksheet with a copy of your policy A signed copy of the Policyholder Notice of Terrorism Insurance Coverage - TRIA2002 Notice 0108 must also be sent in with a copy of your policy. Policy Issuance The Contract Binding Division High Limit General Liability business will be issued by the agency. When writing High Limit General Liability policies in Contract you should show the total increased limits on the GL Declarations page in the limits section. This premium should be listed separately from the primary GL class codes and must be indicated as High Limit GL. See the last two pages of this document for a sample of how this should be completed. Prohibited The following Classes are not eligible for High Limit General Liability coverage: o 47051 Real Estate Development Property o 56488 Liquor Mfg o 57913 Pet Food Mfg o 59963 Wine Mfg Sparkling o 16292 Construction Operations (please submit) o 58161 Restaurants, Hotels, Motels Including Package Sales o 91580 Homebuilders Risks located in the following territories are not eligible for High Limit General Liability coverage: o West Virginia o Any of the five (5) Boroughs in New York ELR-2 6-22-2010

Any risk within the Contractors PDQ where the U146 Contractors Professional Liability Coverage Limitation has been added. Any risk requiring a per location or per project aggregate. Questions: Contact your underwriter or the Brokerage Casualty Division for questions about our Excess Casualty program for Umbrella policies. ELR-3 6-22-2010

SAMPLE PAGE COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS This coverage part consists of this Declarations form, the Common Policy Conditions, the Commercial General Liability Coverage Form and the endorsements indicated as applicable. (See COMMON POLICY DECLARATIONS for items 1 and 2.) POLICY NO. XX 111111 NAMED INSURED: Insured Name 3. LIMITS OF INSURANCE General Aggregate Limit (Other Than Products Completed Operations) $7,000,000 Products Completed Operations Aggregate Limit $6,000,000 Personal & Advertising Injury Limit $6,000,000 Each Occurrence Limit $6,000,000 Damage To Premises Rented To You Limit $100,000 Any One Premises Medical Expense Limit $5,000 Any One Person RETROACTIVE DATE (CG 00 02 only) Coverage A of this insurance does not apply to bodily injury or Property damage which occurs before Retroactive Date, if any, shown below. Retroactive Date: (Enter Date or None if no Retroactive Date Applies) Location of All Premises You Own, Rent or Occupy (Same as Item 1 unless shown below): Street address, Anytown, VA ADVANCE PREMIUM CLASSIFICATION CODE NO. PREMIUM BASIS RATE PR / CO ALL OTHER Daycare Center-Other than not for Profit 41715 100 50. incl. 5,000. High limit GL 5,000. 4. FORMS / ENDORSEMENTS APPLICABLE: TOTAL PREMIUM See Schedule of Forms and Endorsements U001 (07/02) FOR THIS $10,000 COVERAGE PART 5. FORM OF BUSINESS: Individual Joint Venture Partnership Organization (Other than Partnership or Joint Venture) Corporation Audit Period: Annual unless otherwise stated: Includes copyrighted material of Insurance Services Office, Inc. with its permission. DCJ6553 (07-02) Copyright, Insurance Services Office, Inc., 1984

SAMPLE PAGE COMMON POLICY DECLARATIONS POLICY NUMBER COLONY INSURANCE COMPANY XX 111111 COLONY SPECIALTY INSURANCE COMPANY COLONY NATIONAL INSURANCE COMPANY 9201 FOREST HILL AVENUE, SUITE 200 RICHMOND, VA 23235 RENEWAL OF: New PDQ CODE: 91B 1. NAMED INSURED AND MAILING ADDRESS: PRODUCER: Named Insured 2. POLICY PERIOD: From 01/01/2008 to 01/01/2009 12:01 A.M. Standard Time at your Mailing Address above. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL OF THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. 3. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. COVERAGE PARTS PREMIUM Commercial General Liability Coverage Part $10,000 Commercial Property Coverage Part $ Commercial Crime Coverage Part $ Commercial Inland Marine Coverage Part $ $ Premium Charge for Certified Acts of Terrorism Coverage Only ONE of $ these should be (Per Policyholder Disclosure TRIA2002Notice-1202 attached.) shown on the OR dec page Coverage for Certified Acts of Terrorism Rejected; Exclusion attached. (based on the (Per Policyholder Disclosure TRIA2002Notice-1202 attached.) insured s selection). Premium shown is payable: Total Policy at inception. Premium: $10,000 4. FORMS APPLICABLE TO ALL COVERAGES: See Schedule of Forms and Endorsements U001 (07/02) 5. BUSINESS DESCRIPTION: Daycare Center Not for Profit Only Countersigned: Date By: Authorized representative Includes copyrighted material of Insurance Services Office, Inc. with its permission. DCJ6550 (07/02) Copyright, Insurance Services Office, Inc., 1994