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HomeMy WebLinkAboutUpdate Documents - BOCCAcrisure Re UK Limited 1820 ARU on behalf of Acrisure London Wholesale Limited, an MARKET REFORM Appointed Representative CONTRACT RISK REFERENCE UNIQUE MARKET REFERENCE (UMR) Notice(s) ********* B1820********* Page 1 of 1 WASHINGTON SURPLUS LINES NOTICE This contract is registered and delivered as a surplus line coverage under the insurance code of the state of Washington, Title 48 RCW. It is not protected by any Washington state guaranty association law. LMA9085 01 September 2013 SURPLUS LINES BROKER: Acrisure Northwest Partners Insurance Services LLC PO Box 1788 Grand Rapids MI 49507 Surplus Lines License Number: 1189765 STATE OF FILING: Washington. US CLASSIFICATION: US Surplus Lines. Acrisure Re UK Limited MARKET REFORM 1820 ARU on behalf of Acrisure London Wholesale Limited,, an CONTRACT Appointed Representative RISK REFERENCE UNIQUE MARKET REFERENCE (UMR) Risk Details I RISK DETAILS / DECLARATIONS UNIQUE MARKET REFERENCE: B1820********* TYPE: Excess Liability Insurance. INTEREST: Excess Liability Insurance ONLY inrespect ofGeneral Uabi|ity, Law Enforcement Liability, Wrongful Acts and Auto Liability arising out ofthe operations of the Insured, as more fully set forth in the Policy Wording of the Lead Underlying Policy identified herein. Item 1. a) NAMED INSURED: (Snsmt County, and as more fully detai|ed in the Lead Underlying Policy identified herein. b) ADDRESS: POBox 37, Ephrata, \Nashington98823, USA Additional Insured(s): As more fully detailed in the Lead Underlying Policy identified herein. Item 2. a) Lead Underlying Policy No: VVCRG242533996 b) All other Underlying PoUcyNo(s): VVCRG242533996 c) Lead Underlying Insurer: Munich Reinsurance Arnehca,Inc. d) All other Underlying Insurer(s): Great American Insurance Company (Ist Excess) Berkley Insurance Company (2"uExcess) As more fully detailed in the Lead Underlying Policy identified herein. Item 3.Limit ofLiability (Insuring Agreement 2}: a)USO1O,OOO,OOO b) USO10,000,000 Annual Policy Aggregate all coverages combined including Auto Liability. Defense Costs shall reduce the Limits of Liability stated above. In Excess ofthe Underlying Limit. Item 4. Underlying Limits (Insuring Agreement 2}: a) UGD 15,000,000 Each Occurrence b)USD 15,000,000 Annual Aggregate USD 45,FOOOfOOO Group Aggregate Item 5. POLICY PERIOD: From: ----------- To: ------------ Both dates at12:O1emLocal Standard Time at the Address of the Acrisure Re UK Limited 1820 ARU on behalf of Acrisure London Wholesale Limited, an MARKET REFORM Appointed Representative CONTRACT RISK REFERENCE UNIQUE MARKET REFERENCE (UMR) Risk Details ********* B1820********* Page 2 of 3 Item 6. NOTICE OF CLAIMS TO: GLClaims@arcadian-risk.com and Claims@acrisureRe.com Acrisure London Wholesale Limited 9th Floor, 40 Leadenhall Street, London EC3A 2BJ, UK Item 7. PREMIUM: USD 800,000 for the Policy Period for 100% order (being USD 480,000 for the Policy Period for 60% order hereon). 35% minimum earned at inception. PAYMENT TERMS: Premium hereon is due at inception subject to the LSW 3000 Premium Payment Clause (30 days), as detailed herein. CHOICE OF LAW AND JURISDICTION: Law: This insurance shall be governed by and construed in accordance with the laws of: State of Washington, USA Jurisdiction: As per Service of Suit Clause provisions within the Lead Underlying Policy identified herein. Service of Suit Nominee: Lloyd's America, Inc. Attention: Legal Department 280 Park Avenue, East Tower, 25th Floor, New York, New York 10017, USA CONDITIONS: Policy Wording: London Short Excess Form 01-08 (Occ) to follow terms, conditions and exclusions (other than listed below) of the Lead Underlying Policy: Glyphosate Exclusion Endorsement. Sexual Abuse or Molestation Exclusion Endorsement. NMA 2918 War and Terrorism Exclusion. IL2010005 Sanctions Clause. LMA 5390 U.S. Terrorism Risk Insurance Act of 2002 as amended Not Purchased Clause. LMA 3333 (Re)Insurers Liability Clause. PFAS exclusion as per Exclusion 30. All loss, cost or expense, directly or directly or indirectly arising out of, resulting as a consequence of, or related to PFAS within the Lead Underlying Policy. All other terms and conditions as per Policy Wording identified above. NOTICES: LMA9085 Washington Surplus Lines Notice - other than those that may be contained in the Policy Wording. EXPRESS WARRANTIES: None - other than as may exist in this document or in the Policy Wording that forms part of this contract document. CONDITIONS PRECEDENT: None - other than as may exist in this document or in the Policy Wording that forms part of this contract document. Acrisure Re UK Limited MARKET REFORM 1820 ARU on behalf of Acrisure London Wholesale Limited., an CONTRACT Appointed Representative RISK REFERENCE UNIQUE MARKET REFERENCE (UMR) Risk Details B1820********* Page 3 of 3 SU BJECTIVITIES : RETROACTIVE DATE: TAXES PAYABLE BY INSURED AND ADMINISTERED BY INSURER(S): RECORDING, TRANSMITTING AND STORING INFORMATION: None - other than as may exist in this document or in the Policy Wording that forms part of this contract document. Inception. None Where Acrisure London Wholesale Limited maintains risk and claim data/ information/ documents Acrisure London Wholesale Limited will hold data/ information/ documents electronically. OVERSEAS BROKER: Acrisure Northwest Partners Insurance Services, LLC 19401 40th Ave West., Suite 440, Lynnwood, Washington 98036, USA Acrisure Re UK Limited 1820 ARU on behalf of Acrisure London Wholesale Limited, an MARKET REFORM Appointed Representative CONTRACT RISK REFERENCE UNIQUE MARKET REFERENCE (UMR) Information ********* B1820********* Page 1 of 1 INFORMATION As held on file with Acrisure London Wholesale Limited, seen by Insurer(s) hereon. Lead Underlying Policy Number WCRG242533996 seen by Insurers hereon and held on file with Acrisure London Wholesale Limited. Acrisure Re UK Limited MARKET REFORM 1820 ARU on behalf of Acrisure London Wholesale Limited,, an CONTRACT Appointed Representative RISK REFERENCE UNIQUE MARKET REFERENCE (UMR) Security Details I SECURITY DETAILS I (RE)INSURERS LIABILITY CLAUSE (Re)Unsurer'sUiabUUity several not joint The liability of a (re)insurer under this contract is several and not joint with other (re)insurers party to this contract. A (re)insurer is liable only for the proportion of liability it has underwritten. A (re)insurer is not jointly liable for the proportion of liability underwritten by any other (re)insurer. Nor is a (re)insurer otherwise responsible for any liability of any other (re)insurer that may underwrite this contract. The proportion of liability under this contract underwritten by (re)insurer (or, in the case of Lloyd's syndicate, the total of the proportions underwritten by all the members ofthe syndicate taken together) is shown next to its stamp. This is subject always tothe provision concerning "signing" below. In the case of a Lloyd's syndicate, each member of the syndicate (rather than the syndicate itself) is a (re)insurer. Each member has underwritten a proportion ofthe total shown for the syndicate (that total itself being the total of the proportions underwritten by all the members of the syndicate taken together). The liability of each member of the syndicate is several and not joint with other members. A member is liable only for that member's proportion. A member is not jointly liable for any other member's proportion. Nor is any member otherwise responsible for any liability of any other (re)insurer that may underwrite this contract. The business address of each member is L|oydis, One Lime Street, London EC3M 7HA The identity of each member of Lloyd's syndicate and their respective proportion may be obtained by writing to Market Services, Lloyd's, at the above address. Proportion of liability Unless there is ""signing"" (see below), the proportion of liability under this contract underwritten by each (re)insurer (or, in the case of Lloyd's syndicate, the total of the proportions underwritten by all the members ofthe syndicate taken together) is shown next to its stamp and is referred to as its "written line,"'. Where this contract permits., written lines, orcertain written lines, may be adjusted ("signed"). In that case a schedule is to be appended to this contract to show the definitive proportion of liability under this contract underwritten by each (re)insurer (or, in the case of Lloyd's syndicate, the total oftheproportionsundenwhttenbyaUthernernbersofthesyndicatetakemtogether).Adefinitive proportion (or, in the case of a Uoydis syndicate, the total of the proportions underwritten by all the members ofaLloyd's syndicate taken together) isreferred toasa"signed |ine".The signed lines shown in the schedule will prevail over the written lines unless a proven error in calculation has occurred. Although reference is made at various points in this clause to "this contract" in the singular, where the circumstances so require this should be read as a reference to contracts in the plural. LMA3333 21June 2OO7 Acrisure Re UK Limited 1820 ARU on behalf of Acrisure London Wholesale Limited, an MARKET REFORM Appointed Representative CONTRACT RISK REFERENCE UNIQUE MARKET REFERENCE (UMR) Security Details ********* B1820********* Page 2 of 2 ORDER HEREON: BASIS OF WRITTEN LINES: BASIS OF SIGNED LINES: 60% order hereon Percentage of whole. Percentage of whole. SIGNING PROVISIONS: In the event that the written lines hereon exceed 100% of the order, any lines written "to stand" will be allocated in full and all other lines will be signed down in equal proportions so that the aggregate signed lines are equal to 100% of the order without further agreement of any of the (re)insurers. However: a) in the event that the placement of the order is not completed by the commencement date of the period of insurance then all lines written by that date will be signed in full; b) the signed lines resulting from the application of the above provisions can be varied, before or after the commencement date of the period of insurance, by the documented agreement of the (re)insured and all (re)insurers whose lines are to be varied. The variation to the contracts will take effect only when all such (re)insurers have agreed, with the resulting variation in signed lines commencing from the date set out in that agreement. WRITTEN LINES / (RE)INSURERS PARTICIPATION: In a co-insurance placement, following (re)insurers may, but are not obliged to, follow the premium charged by the lead (re)insurer. (Re)insurers may not seek to guarantee for themselves terms as favourable as those which others subsequently achieve during the placement. The Insurers and their respective participation hereon is shown as per signing page(s) attaching to the rear of this Contract Document - Electronically signed. Acrisure Re UK Limited MARKET REFORM 1820 ARU on behalf of Acrisure London Wholesale Limited, an CONTRACT Appointed Representative Fiscal and RISK REFERENCE UNIQUE MARKET REFERENCE (UMR) Q Regulatory ******* B1820********* Page 1 of 1 FISCAL AND REGULATORY TAX PAYABLE BY INSURER(S): None. COUNTRY OF ORIGIN: USA REGULATORY RISK LOCATION: 10 0 % - USA OVERSEAS BROKER: Acrisure Northwest Partners Insurance Services, LLC 19401 40th Ave West, Suite 440, Lynnwood, Washington 98036, USA SURPLUS LINES BROKER: Acrisure Northwest Partners Insurance Services LLC PO Box 1788 Grand Rapids MI 49507 Surplus Lines License Number: 1189765 STATE OF FILING: Washington US CLASSIFICATION: US Surplus Lines ALLOCATION OF PREMIUM TO CODING: ----------- - 100% ALLOCATION OF PREMIUM TO YEAR OF ACCOUNT: REGULATORY CLIENT CLASSIFICATION: 2025 Commercial - Other. Attaching to and forming part of UMR: B1820********* Page 1of1 GLYPHOSATE EXCLUSION ENDORSEMENT Notwithstanding any other provision of this Policy, it is hereby understood and agreed that this Policy does not apply to actual or alleged Bodily Injury, Property Damage, Personal Injury or Advertising Liability directly or indirectly arising from or in connection with: 1. Glyphosate, whether used as the sole active ingredient or in any combination with any other active ingredient; or 2. any other good, product, material or substance which contains Glyphosate. As used herein, Glyphosate means glyphosate in any form, including but not limited to the following: A. The presence of glyphosate in any alloy, by-product, synthesized derivative, associated metabolites or waste (which includes materials to be recycled, reconditioned or reclaimed); B. Any good, product, material or substance that: a. has the same or similar formulary, formulation, function or structure as glyphosate; or b. is a derivative of glyphosate, The terms, declarations, insuring agreements, definitions, exclusions and conditions of this Policy otherwise remain unchanged. Attaching to and forming part of UMR: B1820********* Page 1of1 SEXUAL ABUSE OR MOLESTATION EXCLUSION ENDORSEMENT It is hereby agreed that this Policy does not apply to any Occurrence, injury, damage, expense, loss, cost, Liability, or legal obligation arising out of 1. The Actual or threatened abuse or molestation of any person, including but not limited to physical abuse, corporal punishment, sexual abuse, sexual molestation or sexual misconduct by an Insured, any employee of an Insured or anyone acting on behalf of a Insured; or 2. For which any Insured maybe held liable in causing or in failing to prevent such actual or threatened abuse or molestation as described in Item 1. above. The terms, declarations, insuring agreements, definitions, exclusions and conditions of this Policy otherwise remain unchanged. Attaching to and forming part of UMR: B1820********* Page 1of1 PREMIUM PAYMENT CLAUSE The (Re)Insured undertakes that premium will be paid in full to Underwriters within 30 days of inception of this policy (or, in respect of instalment premiums, when due). If the premium due under this policy has not been so paid to Underwriters by the 30th day from the inception of this policy (and, in respect of instalment premiums, by the date they are due) Underwriters shall have the right to cancel this policy by notifying the (Re)Insured via the broker in writing. In the event of cancellation, premium is due to Underwriters on a pro rats basis for the period that Underwriters are on risk but the full policy premium shall be payable to Underwriters in the event of a loss or occurrence prior to the date of termination which gives rise to a valid claim under this policy. It is agreed that Underwriters shall give not less than 15 days prior notice of cancellation to the (Re)Insured via the broker. If premium due is paid in full to Underwriters before the notice period expires, notice of cancellation shall automatically be revoked. If not, the policy shall automatically terminate at the end of the notice period. Unless otherwise agreed, the Leading Underwriter (and Agreement Parties if appropriate) are authorised to exercise rights under this clause on their own behalf and on behalf of all Underwriters participating in this contract. If any provision of this clause is found by any court or administrative body of competent jurisdiction to be invalid or unenforceable, such invalidity or unenforceability will not affect the other provisions of this clause which will remain in full force and effect. Where the premium is to be paid through a London Market Bureau, payment to Underwriters will be deemed to occur on the day of delivery of a premium advice note to the Bureau. 11/01 LSW3000 Attaching to and forming part of UMR: B1820********* Page 1of1 U.S. TERRORISM RISK INSURANCE ACT OF 2002 AS AMENDED NOT PURCHASED CLAUSE This Clause is issued in accordance with the terms and conditions of the "U.S. Terrorism Risk Insurance Act of 2002" as amended as summarized in the disclosure notice. It is hereby noted that the Underwriters have made available coverage for "insured losses" directly resulting from an "act of terrorism" as defined in the "U.S. Terrorism Risk Insurance Act of 2002", as amended ("TRIA") and the Insured has declined or not confirmed to purchase this coverage. This Insurance therefore affords no coverage for losses directly resulting from any "act of terrorism" as defined in TRIA except to the extent, if any, otherwise provided by this policy. All other terms, conditions, insured coverage and exclusions of this Insurance including applicable limits and deductibles remain unchanged and apply in full force and effect to the coverage provided by this Insurance. LMA5390 09 January 2020 Attaching to and forming part of UMR: B1820********* Page 1of1 WAR AND TERRORISM EXCLUSION ENDORSEMENT Notwithstanding any provision to the contrary within this insurance or any endorsement thereto it is agreed that this insurance excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any of the following regardless of any other cause or event contributing concurrently or in any other sequence to the loss; (1) war, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power; or (2) any act of terrorism. For the purpose of this endorsement an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear. This endorsement also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to (1) and/or (2) above. If the Underwriters allege that by reason of this exclusion, any loss, damage, cost or expense is not covered by this insurance the burden of proving the contrary shall be upon the Assured. In the event any portion of this endorsement is found to be invalid or unenforceable, the remainder shall remain in full force and effect. NMA2918 08/ 10/2001 Attaching to and forming part of UMR: B1820********* Page Iof1 SANCTION LIMITATION AND EXCLUSION CLAUSE No (re)insurer shall be deemed to provide cover and no (re)insurer shall be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim -or provision of such benefit would expose that (re)insurer to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America. JL2010/005 15 September 2010 Attaching to and forming part of UMR: B1820********* Page 1 of 2 LONDON SHORT EXCESS FORM 01-08 (OCC) INSURING AGREEMENTS: 1. COVERAGE - Underwriters hereby agree, subject to the limitations, terms and conditions contained herein, to pay all sums which the Insured shall be obligated to pay by reason of the liability arising out of the hazards covered by and as more fully defined in the Lead Underlying Policy (as stated in Item 2. a) of the Declarations and hereinafter referred to as "Lead Underlying Policy"); provided always however, that this Policy shall not apply until the Underlying Insurers (as stated in Items 2.c) and 2.d) of the Declarations and hereinafter referred to as "Underlying Insurers") have paid or have been held liable to pay the full amount of their respective Limit(s) of Liability in accordance with Insuring Agreement 2. Underwriter further agree that this Policy will follow the same terms, definitions, exclusions and conditions (except as otherwise provided herein) as are, at inception hereof, contained in the Lead Underlying Policy. Notwithstanding the foregoing, in the event that any of the following amendment(s) are subsequently made to the terms, definitions, exclusions and conditions of the Lead Underlying Policy in effect at inception hereof: 1. any change which is subject to an additional premium charge, 2. the inclusion of an additional coverage extension endorsement, 3. any change to the insuring agreements, definitions and exclusions which is intended to broaden the scope of the coverage already provided, other than Insureds or Named Insureds added without an additional premium charge, then such amendment(s) shall not be binding upon the Company unless otherwise agreed in writing by the Company. 2. LIMIT OF LIABILITY - Underwriters shall be liable only to pay sums up to: USD (as stated in Item 3.a) of the Declarations) in respect of each Occurrence - subject to a limit of: USD (as stated in Item 3.b) of the Declarations) in the aggregate during the currency of this Policy,, separately in respect of each hazard insured with an aggregate limit in the Lead Underlying Policy but liability shall attach to Underwriters only after the Underlying Insurers have paid or have been held liable to pay the full amount of their respective Limit(s) of Liability as follows: USD (as stated in Item 4.a) of the Declarations) in respect of each Occurrence, but USD (as stated in Item 4.b) of the Declarations) in the aggregate during the currency of this Policy, separately in respect of each hazard insured with an aggregate limit in the Lead Underlying Policy which in turn is excess of various insurances and/or retentions as more fully set forth in the Lead Underlying Policy. Attaching to and forming part of UMR: B1820********* Page 2of2 CONDITIONS: 1. MAINTENANCE OF UNDERLYING INSURANCE - It is a condition of this Policy that the Underlying Policy/ies (as stated in Items 2.a) and 2.b) of the Declarations and hereinafter referred to as "Underlying Policy/ies") shall be maintained in full force and effect, except for any reduction of the aggregate limits contained therein solely by payment of any loss(es). In the event of the Insured"s failure to maintain the Underlying Policy/ies in full force and effect and except with respect to the aforementioned aggregate reduction, coverage hereunder shall not be invalid, but shall apply to the same extent that it would have applied had there been compliance with this condition. In the event any Underlying Policy stated in Item 2.b) of the Declarations excludes loss(es) which are covered by the Lead Underlying Policy and subsequently covered hereunder in accordance with the provisions of Insuring Agreement 1 - Coverage, the Underwriters shall not drop down to apply in place of such excluded coverage. 2. ASSISTANCE AND CO-OPERATION - Underwriters shall not be called upon to assume charge of the settlement or defense of any claim made or suit brought or proceeding instituted against the Insured however Underwriters shall have the right and shall be given the opportunity to associate with the Insured or the Insured's underlying insurers, or both, in the defense and control of any claim, suit or proceeding relative to an Occurrence where the claim or suit involves, or appears reasonably likely to involve Underwriters, in which event the Insured and Underwriters shall co-operate in all things in the defense of such claim, suit or proceeding. 3. CANCELLATION The Named Insured or the Underwriters hereon shall have the right to cancel this Policy in accordance with the cancellation provisions of the Lead Underlying Policy. Such notice shall be sent to the Underwriters via the entity stated in Item 6.b) of the Declarations. In the event of cancellation by the Named Insured, the minimum earned Premium hereunder shall be 35% of the amount stated in Item 7. of the Declarations. 4. OTHER INSURANCE - If other valid and collectible insurance is available to the Insured covering a loss also covered by this Policy, other than a Policy that is specifically written to apply in excess of this Policy, the insurance afforded by this Policy shall apply in excess of and shall not contribute with such other insurance. 5. NOTICE OF OCCURRENCE - Whenever the Insured has information from which they may reasonably conclude that an Occurrence covered hereunder involves injuries or damages which, in the event that the Insured should be held liable, is likely to involve this Policy, notice shall be sent to the Underwriters via the entity stated in Item 6.a) of the Declarations as soon as practicable, provided, however, that failure to give notice of any Occurrence which at the time of its happening did not appear to involve this Policy, but which, at a later date would appear to give rise to claims hereunder, shall not prejudice such claims.