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)
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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
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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
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B1820*********
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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*********
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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*********
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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*********
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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*********
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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*********
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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*********
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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*********
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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*********
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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.