22-84131503-ITB Commercial Automobile Insurance Attachment I Expiring Policy thru END20.pdf

GPJ100 (01-20)

Commercial Auto Policy

Especially Designed For:

STATE OF FLORIDA

4050 ESPLANDE WAY

SUITE 315

TALLAHASSEE, FL 32399-0950

Underwritten by National Union Fire Insurance Company of Pittsburgh, Pa.

ITB No. 22-84131503-ITB Commercial Automobile Insurance Attachment I

Expiring Policy

GPJ100 (01-20)

National Union Fire Insurance Company of Pittsburgh, Pa.

RISK CONTROL POLICYHOLDER NOTICE

Dear Glatfelter Public Practice Client, Safety and health is a major concern in organizations today. These issues are important because of the major impact that accidents can have on an organization. Morale can often be affected as well as an organization’s finances. Insurance rarely covers all the expenses associated with accidents. There are often hidden costs that the organization must bear such as time spent reporting, documenting and investigating the accident.

Risk Control Guidelines Provided by Glatfelter Public Practice

As a valuable service to you, Glatfelter Public Practice provides risk control guidelines and programs to your organization in an effort to help you prevent and/or reduce the impact of accidents. Implementing Glatfelter Public Practice risk control measures could benefit your organization by reducing or eliminating the hidden costs of accidents while helping your organization to continue to serve your community.

Glatfelter Public Practice provides a number of programs and services to help you in your risk control effort. While most of these services are available to our clients at no additional cost, some may require a fee based on the scope of the service requested. Some of the services and programs that we provide to our clients include:

On-site risk control consultations Recommendations to control identifiable hazards Loss experience analysis Consultation on specific risk control-related problems Sample standard operating guidelines for vehicle operations Accident investigation procedures and forms

Risk Control Publications

Glatfelter Public Practice has many resources that you can access at no charge on our Web site. These include Communiqués, which are a one-page fact sheet, that presents a specific hazard and provides procedures for controlling the hazard. Glatfelter Public Practice also provides numerous training programs that you can access through our Risk Control Services. Please visit www.GlatfelterPublicPractice.com to view and order these resources.

Inquire About Our Risk Control Services

If you would like information about some of the above services and publications, please call Glatfelter Public Practice Risk Control at (800) 233-1957.

ITB No. 22-84131503-ITB

AU1000 (01-20)

AUTO POLICY DECLARATIONS

Named Insured and Mailing Address: Policy Number:

Policy Period: From

To at 12:01 AM Standard Time at your mailing address shown above

Type of Entity:

Business Description:

Estimated Coverage Part Premium: $

Taxes, Fees and Surcharges: $

Total Premium: $

The policy premium is payable on the dates and in the amounts shown below:

See Installment Schedule

GPNU-AU-0024153-01/000

10-20-2021 10-20-2022

MUNICIPALITY

MUNICIPALITY

10-22-2021

312,480.00

STATE OF FLORIDA

4050 ESPLANDE WAY

SUITE 315

TALLAHASSEE FL 32399-0950

312,480.00

ITB No. 22-84131503-ITB

President Secretary

AU1000 (01-20)

Named Insured: Policy Number:

Common Forms

See Schedule of Forms and Endorsements.

In return for payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in the policy. These declarations, the schedule of forms and endorsements, and any forms and endorsements we may later attach to reflect changes, make up and complete the above numbered policy.

Authorized representative (countersignature, where required) Date

The Company has caused this policy to be signed by its President and Secretary:

10-20-2022

10-22-2021

10-22-2021

STATE OF FLORIDA

Policy Number

SCHEDULE OF FORMS AND ENDORSEMENTS

Named Insured Effective Date:

12:01 A.M., Standard Time

Agency Name

10-20-21

Glatfelter Underwriting Services, Inc.

STATE OF FLORIDA

COMMON POLICY FORMS AND ENDORSEMENTS

89644 06-13 ECONOMIC SANCTIONS ENDORSEMENT

GCO300 01-20 COMMON POLICY CONDITIONS

IL 00 17 11-98 COMMON POLICY CONDITIONS

IL 00 21 09-08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDT

AUTOMOBILE FORMS AND ENDORSEMENTS

AU1001 01-20 AUTO PHYSICAL DAMAGE EXTENSION ENDORSEME

AU1002 01-20 AGREED VALUE ENDORSEMENT

AU1003 01-20 AUTO LIABILITY EXTENSION ENDORSEMENT

AU1005 01-20 WAIVER OF GOVERNMENTAL OR CHARITABLE IMM

AU1006. 01-20 CARE, CUSTODY OR CONTROL EXCLUSION ENDOR

AU1007 01-20 COMMANDEERED AUTO DEFINITION ENDORSEMENT

AU1009 01-20 INCIDENTAL GARAGE OPERATIONS

AU1017 01-20 AUTO PHYSICAL DAMAGE EXTENSION ENDORSEME

AU1029 01-20 MAXIMUM DEDUCTIBLE COMPREHENSIVE COVERAG

CA 00 01 10-13 BUSINESS AUTO COVERAGE FORM

CA 20 01 10-13 ADDL INSD-LESSOR

CA 01 28 01-21 FLORIDA CHANGES

CA 02 67 01-21 FL CHANGES - CANCELLATION AND NONRENEWAL

CA 22 10 01-21 FL PERSONAL INJURY PROTECTION

CA 20 02 10-13 SOUND RECEIVING EQUIP COVG -FIRE, POLICE

CA 20 15 10-13 MOBILE EQUIPMENT

CA 20 18 10-13 PROFESSIONAL SERVICES NOT COVERED

CA 24 02 12-93 PUBLIC TRANSPORTATION AUTOS

CA 99 03 10-13 AUTO MEDICAL PAYMENTS COVERAGE

CA 99 14 10-13 FIRE,FIRE/THEFT,FIRE/THEFT/WIND STORM

CA 99 15 12-93 GOVERNMENTAL BODIES AMENDATORY ENDT

CA 99 28 10-13 STATED AMOUNT INSURANCE

CA 99 44 10-13 LOSS PAYABLE CLAUSE

CA 99 48 10-13 POLLUTION LIAB BROAD COV FOR COV AUTO

POLICYHOLDER NOTICES

118477 03-15 POLICYHOLDER NOTICE - TAXES, ASSESSMENTS

91222 09-16 POLICYHOLDER NOTICE

AGLC105774 08-18 AIG PRIVACY NOTICE

INSTALLMENT SCHEDULE

Agency Name

DUE PREMIUM SURCHARGE

REVISED

INSTALLMENT TOTAL

Failure to pay the Installment Premium by the Date Due shown shall constitute non-payment of premium for which we may cancel this policy.

GPNU-AU-0024153-01/000

10-20-21

Glatfelter Underwriting Services, Inc.

STATE OF FLORIDA

10/20/2021 $312,480.00DEPOSIT $312,480.00

IT IS HEREBY AGREED AND UNDERSTOOD THAT THIS POLICY IS

PAYABLE ON INSTALLMENTS AS FOLLOWS:

SCHEDULE OF ADDITIONAL INTEREST(S)

Glatfelter Underwriting Services, Inc.

STATE OF FLORIDA

Loss Payee

ENTERPRISE FM TRUST

PO BOX 16805

SAINT LOUIS, MO 63105

DESCRIPTION APPLIES TO #9863

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 NISSAN ALTIMA #1034,#9208,#8857,#7163

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 NISSAN ALTIMA #8690,#0920, #7136

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 NISSAN ALTIMA #9226,#0499,#9100,#9855

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 NISSAN ALTIMA #8722,#8849,#7286,#8902

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 NISSAN ALTIMA #7198,#0646,#8753, #7459

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 NISSAN ALTIMA #1091,#1062,#7291,#0867

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 NISSAN ALTIMA #7272,#0450,#9229,#8669

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 NISSAN ALTIMA #2929, #4105,#5472, #4959

Addl Insured Lessor

ENTERPRISE FM TRUST

Glatfelter Underwriting Services, Inc.

STATE OF FLORIDA

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 NISSAN ALTIMA #0136,#2911,#3552

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2018 DODGE GRAND CARAVAN #0343, #0342, #1908

Loss Payee

BARTOW FORD

2800 US HWY 98 N

BARTOW, FL 33830

DESCRIPTION APPLIES TO 2018 FORD F150 #3686

Loss Payee

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2019 TOYOTA SIENNA #6900

Addl Insured Lessor

ENTERPRISE FM TRUST

PO BOX 16805

ST LOUIS, MO 63105

DESCRIPTION APPLIES TO 2019 TOYOTA #6900

Addl Insured Lessor

VT INC

6150 OMNI PARK DRIVE

MOBILE, AL 36609

DESCRIPTION APPLIES TO 2019 TOYOTA RAV 4 #8921 #7806 2020 VAN #8419

Addl Insured Lessor

WARD INTERNATIONAL TRUCKS, INC

WARD IDEALEASE LLC AND THE OWNER(S)

2200 MICHIGAN AVE

MOBILE, AL 36615

DESCRIPTION APPLIES TO 2018 INTERNATIONAL 4300 #4924

Loss Payee

VT INC TRUSTEE OF WORLD OMNI

PO BOX 991817

MOBILE, AL 36691

DESCRIPTION APPLIES TO VEHICLES TOYOTA #2477,#6372,#7515,#6786,#1573,

Loss Payee

VT INC TRUSTEE OF WORLD OMNI

PO BOX 991817

MOBILE, AL 36691

DESCRIPTION APPLIES TO TOYOTA #9143, #2835,#2263, #6759,#7622

Loss Payee

MERCEDES BENZ FINANCIAL SERVICES

PO BOX 5209

Glatfelter Underwriting Services, Inc.

STATE OF FLORIDA

CAROL STREAM, IL 60197

DESCRIPTION APPLIES TO 2018 MERCEDES E300 #2934

Loss Payee

ACME AUTO LEASING

440 WASHINGTON

NORTH HAVEN, CT 06473

DESCRIPTION APPLIES TO 2020 CHEVY TAHOE #6828

Loss Payee

THE BANCORP

3755 PARK LAKE STREET

ORLANDO, FL 32803

DESCRIPTION APPLIES TO 2020 CHEVROLET SILVERADO #9613

Loss Payee

NORTHGATE LINCOLN MERCURY INC DBA PARKS LINCOLN TAMPA

10505 NORTH FORIDA AVE

TAMPA, FL 33612

DESCRIPTION APPLIES TO 2020 LINCOLN #7651 AND 2021 LINCOLN #3338

Loss Payee

MUIRFIELD INC DBA PARKS FORD OF WESLEY CHAPEL

28739 SR 54 WEST

WESLEY CHAPEL, FL 33543

DESCRIPTION APPLIES TO 2020 FORD #5799

Loss Payee

BARTOW FORD

280 US HWY 98N

BARTOW, FL 33830

DESCRIPTION APPLIES TO 2020 FORD TRANSIT 350 #6181

Loss Payee

THE BANCORP

PO BOX 4307

TIMONIUM, MD 21094

DESCRIPTION APPLIES TO 2021 CHEVY SILVERADO #7986

Addl Insured Lessor

GENERAL SERVICE ADMINISTRATION (GSA)

4010 GUNN HWY

TAMPA, FL 33618

DESCRIPTION APPLIES TO 2021 HYUNDAI #0594, 2021 HYUNDAI #0564

Addl Insured Lessor

DOERING LEASING COMPANY

15300 W

CAPITOL DRIVE, WI 53005

DESCRIPTION APPLIES TO 2021 TOYOTA SEQUOIA #6244

Loss Payee

EP RENTS LLC

2525 CLARCONA ROAD

APOPKA, FL 32703

DESCRIPTION APPLIES TO 2021 M2-106 #9949 AND 2021 BROOM BEAR #0743

SCHEDULE OF NAMED INSURED(S)

Agency Name

GPNU-AU-0024153-01/000

10-20-21

Glatfelter Underwriting Services, Inc.

STATE OF FLORIDA

DEPARTMENT OF CHILDREN AND FAMILIES

DEPARTMENT OF FINANCIAL SERVICES

DEPARTMENT OF HEALTH

FLORIDA AGRICULTURAL & MECHANICAL UNIVERSITY

FLORIDA SCHOOL FOR THE DEAF AND BLIND

FLORIDA STATE UNIVERSITY

FLORIDA FISH & WILDLIFE COMMISSION

DEPARTMENT OF HIGHWAY SAFETY & MOTOR VEHICLES

JUSTICE ADMINISTRATION

COMMISSION

NEW COLLEGE OF FLORIDA

UNIVERSITY OF FLORIDA

UNIVERSITY OF NORTH FLORIDA

UNIVERSITY OF SOUTH FLORIDA

UNIVERSITY OF WEST FLORIDA

DEPARTMENT OF TRANSPORTATION

FLORIDA POLYTECHNIC UNIVERSITY

FLORIDA INTERNATIONAL UNIVERSITY

FLORIDA ATLANTIC UNIVERSITY

DOT FLORIDA DEPARTMENT OF TRANSPORTATION

89644 (6/13)

ENDORSEMENT

This endorsement, effective 12:01 A.M. forms a part of policy No. GPNU-AU-0024153-01/000 issued to STATE OF FLORIDA

By AMERICAN INTERNATIONAL GROUP, INC

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ECONOMIC SANCTIONS ENDORSEMENT

This endorsement modifies insurance provided under the following:

ALL COVERAGE PARTS

The Insurer shall not be deemed to provide cover and the Insurer shall not 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 the Insurer, its parent company or its ultimate controlling entity to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union or the United States of America.

AUTHORIZED REPRESENTATIVE

ITB No. 22-84131503-ITB

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

GCO300 (01-20) Copyright, American International Group, Inc., 2019.

All rights reserved. Includes copyrighted material of the

Insurance Services Office, Inc., with its permission.

COMMON POLICY CONDITIONS

All Coverage Parts included in this policy are subject to the following conditions.

A. Cancellation

1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation.

2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least:

a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or

b. 30 days before the effective date of cancellation if we cancel for any other reason.

3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us.

4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date.

5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund.

6. If notice is mailed, proof of mailing will be sufficient proof of notice.

7. If this Condition conflicts with your state’s requirements regarding cancellation or non-renewal, the provisions of any state-specific form attached to this policy will supersede this Condition to the extent of such conflict.

B. Changes

This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy.

C. Examination of Your Books and Records

We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward.

D. Inspections and Surveys

1. We have the right to:

a. Make inspections and surveys at any time;

b. Give you reports on the conditions we find; and

c. Recommend changes.

ITB No. 22-84131503-ITB

GCO300 (01-20) Copyright, American International Group, Inc., 2019.

All rights reserved. Includes copyrighted material of the

Insurance Services Office, Inc., with its permission.

2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions:

a. Are safe or healthful; or

b. Comply with laws, regulations, codes or standards.

3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations on our behalf.

4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recommendations we may make relative to certification, under state or municipal statutes, ordinances or regulations, of boilers, pressure vessels or elevators.

E. Liberalization

If we revise any coverage included in this policy, and if such revision does not require a premium charge, your policy will automatically provide the additional coverage as of the date the revision is effective in your state.

F. Premiums

The first Named Insured shown in the Declarations:

1. Is responsible for the payment of all premiums; and

2. Will be the payee for any return premiums we pay.

G. Titles

Throughout this policy, titles are intended for ease of reference only. They do not extend or restrict any coverage beyond what is specifically stated in the policy had no titles been used.

H. Transfer of Your Rights and Duties Under This Policy

Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured.

If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property.

ITB No. 22-84131503-ITB

IL 00 17 11 98

IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1

COMMON POLICY CONDITIONS

All Coverage Parts included in this policy are subject to the following conditions.

A. Cancellation

1. The first Named Insured shown in the Declara-tions may cancel this policy by mailing or deliv-ering to us advance written notice of cancella-tion.

2. We may cancel this policy by mailing or deliver-ing to the first Named Insured written notice of cancellation at least:

a. 10 days before the effective date of cancella-tion if we cancel for nonpayment of pre-mium; or

b. 30 days before the effective date of cancella-tion if we cancel for any other reason.

3. We will mail or deliver our notice to the first Named Insured’s last mailing address known to us.

4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date.

5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund.

6. If notice is mailed, proof of mailing will be suffi-cient proof of notice.

B. Changes

This policy contains all the agreements between you and us concerning the insurance afforded.

The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy’s terms can be amended or waived only by endorsement issued by us and made a part of this policy.

C. Examination Of Your Books And Records

We may examine and audit your books and re-cords as they relate to this policy at any time dur-ing the policy period and up to three years after-ward.

D. Inspections And Surveys

1. We have the right to:

a. Make inspections and surveys at any time;

b. Give you reports on the conditions we find;

and

c. Recommend changes.

2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in-surability and the premiums to be charged. We do not make safety inspections. We do not un-dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not war-rant that conditions:

a. Are safe or healthful; or

b. Comply with laws, regulations, codes or standards.

3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations.

4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recom-mendations we may make relative to certifica-tion, under state or municipal statutes, ordi-nances or regulations, of boilers, pressure ves-sels or elevators.

E. Premiums

The first Named Insured shown in the Declara-tions:

1. Is responsible for the payment of all premiums;

and

2. Will be the payee for any return premiums we pay.

F. Transfer Of Your Rights And Duties Under This Policy

Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named in-sured.

If you die, your rights and duties will be trans-ferred to your legal representative but only while acting within the scope of duties as your legal rep-resentative. Until your legal representative is ap-pointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property.

ITB No. 22-84131503-ITB

IL 00 21 09 08

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

IL 00 21 09 08 ISO Properties, Inc., 2007 Page 1 of 2

NUCLEAR ENERGY LIABILITY EXCLUSION

ENDORSEMENT

(Broad Form)

This endorsement modifies insurance provided under the following:

COMMERCIAL AUTOMOBILE COVERAGE PART

COMMERCIAL GENERAL LIABILITY COVERAGE PART

FARM COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

MEDICAL PROFESSIONAL LIABILITY COVERAGE PART

OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

UNDERGROUND STORAGE TANK POLICY

1. The insurance does not apply:

A. Under any Liability Coverage, to "bodily injury" or "property damage":

(1) With respect to which an "insured" under the policy is also an insured under a nu-clear energy liability policy issued by Nu-clear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwrit-ers, Nuclear Insurance Association of Can-ada or any of their successors, or would be an insured under any such policy but for its termination upon exhaustion of its limit of li-ability; or

(2) Resulting from the "hazardous properties" of "nuclear material" and with respect to which (a) any person or organization is re-quired to maintain financial protection pur-suant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the "in-sured" is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any person or organi-zation.

B. Under any Medical Payments coverage, to expenses incurred with respect to "bodily in-jury" resulting from the "hazardous properties" of "nuclear material" and arising out of the op-eration of a "nuclear facility" by any person or organization.

C. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from "hazardous properties" of "nuclear material", if:

(1) The "nuclear material" (a) is at any "nuclear facility" owned by, or operated by or on be-half of, an "insured" or (b) has been dis-charged or dispersed therefrom;

(2) The "nuclear material" is contained in "spent fuel" or "waste" at any time possessed, han-dled, used, processed, stored, transported or disposed of, by or on behalf of an "in-sured"; or

(3) The "bodily injury" or "property damage" arises out of the furnishing by an "insured" of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any "nu-clear facility", but if such facility is located within the United States of America, its terri-tories or possessions or Canada, this ex-clusion (3) applies only to "property dam-age" to such "nuclear facility" and any property thereat.

2. As used in this endorsement:

"Hazardous properties" includes radioactive, toxic or explosive properties.

"Nuclear material" means "source material", "special nuclear material" or "by-product material".

ITB No. 22-84131503-ITB

Page 2 of 2 ISO Properties, Inc., 2007 IL 00 21 09 08

"Source material", "special nuclear material", and "by-product material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof.

"Spent fuel" means any fuel element or fuel com-ponent, solid or liquid, which has been used or exposed to radiation in a "nuclear reactor".

"Waste" means any waste material (a) containing "by-product material" other than the tailings or wastes produced by the extraction or concentra-tion of uranium or thorium from any ore processed primarily for its "source material" content, and (b) resulting from the operation by any person or or-ganization of any "nuclear facility" included under the first two paragraphs of the definition of "nu-clear facility".

"Nuclear facility" means:

(a) Any "nuclear reactor";

(b) Any equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing "spent fuel", or (3) handling, processing or packaging "waste";

(c) Any equipment or device used for the proc-essing, fabricating or alloying of "special nuclear material" if at any time the total amount of such material in the custody of the "insured" at the premises where such equipment or device is located consists of or contains more than 25 grams of pluto-nium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235;

(d) Any structure, basin, excavation, premises or place prepared or used for the storage or disposal of "waste";

and includes the site on which any of the forego-ing is located, all operations conducted on such site and all premises used for such operations.

"Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material.

"Property damage" includes all forms of radioactive contamination of property.

ITB No. 22-84131503-ITB

Named Insured:

Policy Number:

AU1000 (01-20) Page:

AUTO COVERAGE PART DECLARATIONS

ITEM ONE: Named Insured - Refer to the Common or Auto Policy Declarations

ITEM TWO: Coverage and Covered Autos

This coverage part provides only those coverages activated by a Covered Auto Symbol or a Premium shown below:

Coverage Covered Auto

Symbols

Limit of Insurance (this is the most we will pay for any one accident or loss)

Premium

Covered Autos Liability (combined single limit) each accident

Personal Injury Protection (PIP) (or equivalent no-fault coverage)

Refer to ITEM THREE and each PIP or added PIP endorsement

Added Personal Injury Protection (or equivalent added no-fault coverage)

Separately stated in each added PIP endorsement

Property Protection Insurance (Michigan Only)

Separately stated in the P.P.I.

endorsement minus Ded. for each accident

Auto Medical Payments Each Insured

Medical Expense and Income Loss Benefits (Virginia only)

Separately stated in each Medical Expense and Income Loss Benefits endorsement

Uninsured Motorists (UM) Refer to ITEM THREE and the Uninsured Motorists endorsement

Underinsured Motorists (UIM) (when not included in UM coverage)

Refer to ITEM THREE and the Underinsured Motorists endorsement

Physical Damage ---- Comprehensive

Physical Damage ---- Specified Causes of Loss

Refer to ITEM THREE and

ITEM FOUR (if applicable)

Physical Damage ---- Collision

Physical Damage ---- Towing and Labor

Refer to ITEM THREE

Other Auto Coverages

Estimated Coverage Part Premium:

Taxes, Fees and Surcharges:

Total Premium:

7 $1,000,000

$ 228,032

$ 12,459

N/A

N/A

N/A

N/A

7 $ 17,464

$ 228

7 $ 50,360

N/A

$ 312,480.00

$ 312,480.00

N/A

7 $ 5,000 $ 3,937

GPNU-AU-0024153-01/000

10-20-2021 10-20-2022

10-22-2021

STATE OF FLORIDA

ITEM THREE: Schedule of Your Auto Coverage

Auto Schedule Summary

Veh.

Num.

Year Make Model PE Code

V.I.N. Value

GPNU-AU-0024153-01/000

10-20-2021 10-20-2022

10-22-2021

STATE OF FLORIDA

2015 ACV DUMP TRUCK 3BPZLJ0X6FF269695 PETERBILT OTH 1

2016 ACV 4T1BF1FK3GU609863 TOYOTA CAMRY OTH 2

2003 ACV 2PCH3349431014741 PREVOST HIGHWAY COAC OTH 3

2015 ACV SERVICE 1FBZX2ZM2FKA24998 FORD TRANSIT T-350 OTH 4

2014 ACV 5LMJJ2H57EEL08363 LINCOLN NAVIGATOR OTH 5

2015 ACV SERVICE 1FDFE4FS2FDA16094 FORD E-450 OTH 6

2015 ACV SERVICE 1FDFE4FSXGDC34415 FORD E-450 OTH 7

2016 ACV SERVICE 3C7WRNAL1GG342734 DODGE 5500 OTH 8

2015 ACV SERVICE 1FDEE3FS3FDA35047 GOSHEN COACH OTH 9

2015 ACV 1T7YU4E24F1284036 THOMAS 141YS BUS OTH 10

2015 ACV 1T7YU4E26F1284037 THOMAS 141YS BUS OTH 11

2015 ACV 1T7YU4E27F1284127 THOMAS WHITE BUS OTH 12

2015 ACV 1I7YU4E29F1284128 THOMAS WHITE BUS OTH 13

2016 ACV 2C4RDGBG3GR365853 DODGE CARAVAN SE OTH 14

2016 ACV 2C4RDGBG8GR364116 DODGE CARAVAN SE OTH 15

2016 ACV 2C4RDGBG6GR364115 DODGE CARAVAN SE OTH 16

2017 ACV 1BABNBCA5HF331038 BLUE BIRD BUS OTH 17

2017 ACV 1BABNBCA7HF331039 BLUE BIRD BUS OTH 18

2018 ACV 1BAKFCPAXJF337419 BLUE BIRD BUS OTH 19

2018 ACV 1BABNBCA9JF337415 BLUE BIRD BUS OTH 20

2011 ACV SERVICE 5TFMU4FN1BX002012 TOYOTA TACOMA OTH 21

2011 ACV SERVICE 1GT12ZC84BF142324 GMC SIERRA OTH 22

2006 ACV SERVICE 1GAHG39U361115869 CHEVY EXPRESS OTH 23

2012 ACV SERVICE 1GC4KZC86CF144915 CHEVY SILVERADO OTH 24

2012 ACV SERVICE 3TMMU4FNXCM046873 TOYOTA TACOMA OTH 25

2012 ACV JTDKDTB38C1505773 TOYOTA PRIUS OTH 26

2013 ACV 2C4RDGCG7DR693853 DODGE CARAVAN OTH 27

2015 ACV 1FMZK1YM8FKA12680 FORD TRANSIT WAGON X OTH 28

2016 ACV NM0GE9F76G1241748 FORD TRANSIT CONNECT OTH 29

2016 ACV NM0GE9F78G1259457 FORD TRANSIT CONNECT OTH 30

2014 ACV JTDKDTB36E1079875 TOYOTA PRIUS OTH 31

2014 ACV JTDKDTB3XE1081385 TOYOTA PRIUS OTH 32

2016 ACV SERVICE 1N6BD0CT8GN750498 NISSAN FRONTIER OTH 33

2016 ACV SERVICE 1N6BD0CT5GN750331 NISSAN FRONTIER OTH 34

2014 ACV 1F64F5DY2E0A04347 FORD WINNEBAGO OTH 35

2014 ACV 1F64F5DY9E0A03339 FORD WINNEBAGO OTH 36

2006 ACV 1GBG5V1246F421825 CHEVY CHAMPION BUS OTH 37

2006 ACV 1GBG5V1206F421322 CHEVY CHAMPION BUS OTH 38

2005 ACV 1GBE5V1285F509766 CHEVY CHAMPION BUS OTH 39

2005 ACV 1GBE5V1275F509466 CHEVY CHAMPION BUS OTH 40

2006 ACV SERVICE 1FTNS24W76DA85155 FORD ECONOLINE E250 OTH 41

2012 ACV 1FAHP3F27CL106365 FORD FOCUS OTH 42

2011 ACV SERVICE 1FMNE1BW8BDB31473 FORD 138 ECONOLINE E OTH 43

2003 ACV SERVICE 4UZAARBW43CL84659 FORD FREIGHTLINER MT OTH 44

2012 ACV 3FAHP0GA6CR418893 FORD FUSION OTH 45

2012 ACV 3FAHP0GA0CR418890 FORD FUSION OTH 46

2009 ACV 2FAHP71V39X142655 FORD CROWN VIC POLIC OTH 47

2011 ACV 1FAHP2DW2BG183250 FORD TAURUS SE OTH 48

2013 ACV 3FA6P0G71DR138537 FORD FUSION OTH 49

2013 ACV JTDBU4EEXDJ119957 TOYOTA COROLLA OTH 50

Veh.

Num.

Year Make Model PE Code

V.I.N. Value

GPNU-AU-0024153-01/000

10-20-2021 10-20-2022

10-22-2021

STATE OF FLORIDA

2014 ACV 1FM5K8B85EGA92010 FORD EXPORER OTH 51

2014 ACV 1FM5K8B87EGA92011 FORD EXPORER OTH 52

2012 ACV 2FMDK3JC1CBA34470 FORD EDGE OTH 53

2015 ACV 1GNKRFED5FJ192720 CHEVORLET TRAVERSE L OTH 54

2015 ACV 3GCPCPEC7FG145431 CHEVORLET SILVERADO OTH 55

2016 ACV 1FAHP2D86GG100413 FORD TAURUS SE OTH 56

2016 ACV 1FM5K8B85GGB97570 FORD EXPLORER OTH 57

2016 ACV 2G1WA5E33G1154877 CHEVY IMPALA LIMITED OTH 58

2016 ACV 3FA6P0G76GR398002 FORD FUSION S OTH 59

2017 ACV 3FA6P0G70HR108175 FORD FUSION OTH 60

2016 ACV SERVICE 1FTEW1EG2GKD82434 FORD F-150 OTH 61

2016 ACV SERVICE 1FT8W3CT8GED29096 FORD F-350 OTH 62

2011 ACV WD4PE8CC2B5566158 MERCEDES BENZ SPRINT OTH 63

2012 ACV 1FMCUODG7CKA30223 FORD ESCAPE OTH 64

2012 ACV 1FMCU0DG9CKA30224 FORD ESCAPE OTH 65

2006 ACV 1D4GP24E76B612661 DODGE CARAVAN OTH 66

2016 ACV 1FMCU0F7XGUA85966 FORD ESCAPE OTH 67

2017 ACV 1512E9569HE533278 FARBER S753 SERVICE OTH 68

2016 ACV 2C4RDGBG1GR285094 DODGE GRAND CARAVAN OTH 69

2016 ACV 2C4RDGBG9GR372161 DODGE GRAND CARAVAN OTH 70

2000 ACV 4UZ6XFBASYCH31191 FLEETWOOD DISCOVERY OTH 71

2000 ACV 4UZ6XFBAXYCG90833 FLEETWOOD DISCOVERY OTH 72

2016 ACV SERVICE 1FBZX2CM1GKB57343 FORD TRANSIT T-350 OTH 73

2017 ACV TRAILER 1J9GN3227GH030709 DODGEN 32’ GOOSENECK OTH 74

2015 ACV MOTORCYCLE 1HD1FHM1XFB622928 HD FLHP OTH 75

2005 ACV TRAILER 1KKVE53385L216541 KENT OTH 76

2017 ACV 1FDFE4FS9HDC31975 FORD SUPER DUTY E450 OTH 77

2017 ACV JTMRJREV6HD077456 TOYOTA RAV 4 HV OTH 78

2017 ACV JTMRJREV1HD077753 TOYOTA RAV 4 OTH 79

2016 ACV 4V4NC9EJ8GN948571 VOLVO VNL64T OTH 80

2015 ACV 2FMTK4J96FBC18054 FORD EDGE SEL AWD OTH 81

2016 ACV 1FAHP2D87GG123179 FORD TAURUS SE OTH 82

2017 ACV 1N4AL3AP4HC297542 NISSAN ALTIMA OTH 83

2017 ACV 1FM5K8B80HGC78705 FORD EXPLORER OTH 84

2016 KITCHEN TRAILER 4U3J04827GL015336 FVXL OTH 85

2017 ACV TRAILER 5WKBE1014H1045810 FREEDOM OTH 86

2017 ACV 1FM5K7B88HGB33941 FORD EXPLORER OTH 87

2017 ACV 1FMZK1YM0HKA34983 FORD TRANSIT OTH 88

2017 ACV 1FM5K7B87HGB33932 FORD EXPLORER 2 OTH 89

2017 ACV 3FA6P0G72HR236174 FORD FUSION 1 OTH 90

2017 ACV 3FA6P0UU3HR236176 FORD FUSION 2 (HYBRI OTH 91

2017 ACV 3FA6P0UU1HR236175 FORD FUSION 3 (HYBRI OTH 92

2017 ACV 3FA6P0G70HR236173 FORD FUSION 4 OTH 93

2018 ACV 4T1B31HKXJU501463 TOYOTA CAMRY OTH 94

2018 ACV 1N4AL3APXJC138823 NISSAN ALTIMA 2.5 OTH 95

2018 ACV 1N4AL3AP0JC139964 NISSAN ALTIMA 2.5 OTH 96

2018 ACV 1FM5K8B89JGA71381 FORD EXPLORER OTH 97

2018 ACV CARAVAN 2C4RDGBG0JR176438 DODGE OTH 98

2017 ACV 1FDFE4FS0HDC31976 GOSHEN COACH OTH 99

2018 ACV SONATA 5NPE24AA5JH707274 HYUNDAI OTH 100

Veh.

Num.

Year Make Model PE Code

V.I.N. Value

GPNU-AU-0024153-01/000

10-20-2021 10-20-2022

10-22-2021

STATE OF FLORIDA

2018 ACV 1FAHP2D88JG123909 FORD TAURUS OTH 101

2017 ACV BOLT 1G1FX6S06H4183309 CHEVROLET OTH 102

2018 ACV 1FBZX2ZG6JKA62723 FORD TRANSIT OTH 103

2018 ACV 1N4AL3AP0JC251034 NISSAN ALTIMA OTH 104

2018 ACV 1N4AL3AP8JC249208 NISSAN ALTIMA OTH 105

2018 ACV 1N4AL3AP7JC248857 NISSAN ALTIMA OTH 106

2018 ACV 1N4AL3AP2JC247163 NISSAN ALTIMA OTH 107

2018 ACV 1N4AL3AP8JC248690 NISSAN ALTIMA OTH 108

2018 ACV 1N4AL3AP9JC250920 NISSAN ALTIMA OTH 109

2018 ACV 1N4AL3APXJC247136 NISSAN ALTIMA OTH 110

2018 ACV 1N4AL3APXJC249226 NISSAN ALTIMA OTH 111

2018 ACV 1N4AL3AP6JC250499 NISSAN ALTIMA OTH 112

2018 ACV 1N4AL3APXJC249100 NISSAN ALTIMA OTH 113

2018 ACV 1N4AL3AP8JC249855 NISSAN ALTIMA OTH 114

2018 ACV 1N4AL3AP6JC248722 NISSAN ALTIMA OTH 115

2018 ACV 1N4AL3AP8JC248849 NISSAN ALTIMA OTH 116

2018 ACV 1N4AL3AP7JC247286 NISSAN ALTIMA OTH 117

2018 ACV 1N4AL3AP8JC248902 NISSAN ALTIMA OTH 118

2018 ACV 1N4AL3APXJC247198 NISSAN ALTIMA OTH 119

2018 ACV 1N4AL3AP4JC250646 NISSAN ALTIMA OTH 120

2018 ACV 1N4AL3AP6JC248753 NISSAN ALTIMA OTH 121

2018 ACV 1N4AL3AP1JC247459 NISSAN ALTIMA OTH 122

2018 ACV 1N4AL3AP1JC251091 NISSAN ALTIMA OTH 123

2018 ACV 1N4AL3AP5JC251062 NISSAN ALTIMA OTH 124

2018 ACV 1N4AL3AP0JC247291 NISSAN ALTIMA OTH 125

2018 ACV 1N4AL3AP9JC250867 NISSAN ALTIMA OTH 126

2018 ACV 1N4AL3AP7JC247272 NISSAN ALTIMA OTH 127

2018 ACV 1N4AL3AP9JC250450 NISSAN ALTIMA OTH 128

2018 ACV 1N4AL3AP5JC249229 NISSAN ALTIMA OTH 129

2018 ACV 1N4AL3AP6JC248669 NISSAN ALTIMA OTH 130

2018 ACV 3N1AB7AP5JY302929 NISSAN SENTRA OTH 131

2018 ACV 3N1AB7AP2JY304105 NISSAN SENTRA OTH 132

2018 ACV 3N1AB7AP1JY305472 NISSAN SENTRA OTH 133

2018 ACV 3N1AB7AP2JY304959 NISSAN SENTRA OTH 134

2018 ACV 3N1AB7AP4JY300136 NISSAN SENTRA OTH 135

2018 ACV 3N1AB7AP8JY302911 NISSAN SENTRA OTH 136

2018 ACV 3N1AB7AP0JY303552 NISSAN SENTRA OTH 137

2016 ACV 1G1ZC5ST2GF260385 CHEVROLET MALIBU OTH 138

2018 ACV 2C4RDGBG3JR310343 DODGE GRAND CARAVAN OTH 139

2018 ACV 2C4RDGBG1JR310342 DODGE GRAND CARAVAN OTH 140

2018 ACV 2C4RDGBG8JR311908 DODGE GRAND CARAVAN OTH 141

2017 ACV F150 1FTMF1EFSHKD56835 FORD OTH 142

2012 ACV F150 1FTEX1EM8CFC22581 FORD OTH 143

2014 ACV EXPLORER 1FM5K8B89EGC60389 FORD OTH 144

2017 ACV TUNDRA 5TFUM5F10HX072306 TOYOTA OTH 145

2017 ACV CHEROKEE 1C4PJMAB1HW513723 JEEP OTH 146

2018 ACV 1F66F5DY210A10975 WINNEBAGO/RV OTH 147

2018 ACV F150 1FTEW1E50JFA65122 FORD OTH 148

2018 ACV F150 1FTEW1E54JFA65124 FORD OTH 149

2018 ACV F150 1FTEW1E56JFA65125 FORD OTH 150

Veh.

Num.

Year Make Model PE Code

V.I.N. Value

GPNU-AU-0024153-01/000

10-20-2021 10-20-2022

10-22-2021

STATE OF FLORIDA

2018 ACV F150 1FTEW1E59JFA65121 FORD OTH 151

2018 ACV F150 1FTEW1E50JFA65119 FORD OTH 152

2018 ACV F150 1FTEW1EFXJKE95666 FORD OTH 153

2018 ACV F150 1FTEW1E58JKE95665 FORD OTH 154

2018 ACV 1FDFE4FS4JDC01465 GOSHEN COACH OTH 155

2017 ACV F250 1FT7W2B69HEE58256 FORD OTH 156

2011 ACV F250 FWC 1FT7W2B68BEB76147 FORD OTH 157

2018 ACV 1FM5K7D89JGC76030 EXPLORER OTH 158

2008 ACV F250 1FTSW21Y18EC82672 FORD OTH 159

2018 ACV SONATA 5NPE24AA0JH673941 HYUNDAI OTH 160

2019 ACV TRANSIT 1FTYR1YM0KKA16194 FORD OTH 161

2019 ACV TRANSIT WAGON 1FBVU4XM3KKA11595 FORD OTH 162

2019 ACV CRUZ 1G1BC5SM6K7100328 CHEVY OTH 163

2018 ACV RAV 4 JTMRJREV6JD242430 TOYOTA OTH 164

2019 ACV CARAVAN SE 2C4RDGBG2KR654747 DODGE OTH 165

2019 ACV EXPLORER 1FM5K7B87KGA37483 FORD OTH 166

2019 ACV GENESIS KMHG54JH0KU050528 HYUNDAI OTH 167

2019 ACV IMPALA 2G11X5S30K9143651 CHEVY OTH 168

2019 ACV IMPALA 2G11X5S31K9144503 CHEVY OTH 169

2019 ACV IMPALA 2G11X5S3XK9143818 CHEVY OTH 170

2019 ACV MALIBU 1G1ZC5ST6KF208198 CHEVROLET OTH 171

2019 ACV MALIBU 1G1ZC5ST4KF209687 CHEVROLET OTH 172

2018 ACV F150 1FTEW1EG5JFA33686 FORD OTH 173

2019 ACV SIENNA 5TDZZ3DC5KS006900 TOYOTA OTH 174

2019 ACV ESCAPE 1FMCU0F77KUC07157 FORD OTH 175

2012 ACV CIVIC 19XFB5F53CE000140 HONDA OTH 176

2019 ACV CARAVAN 2C4RDGBG3KR665000 DODGE OTH 177

2019 ACV CARAVAN 2C4RDGBG9KR664997 DODGE OTH 178

2019 ACV CARAVAN 2CYRDGBG2KR668999 DODGE OTH 179

2019 ACV CARAVAN 2C4RDGBG5KR665001 DODGE OTH 180

2019 ACV CARAVAN 2C4RDGBG0KR664998 DODGE OTH 181

2019 ACV CARAVAN 2C4RDGBG9KR502917 DODGE OTH 182

2019 ACV ESCAPE 1FMCU0F74KUC35210 FORD OTH 183

2019 ACV 2T3H1RFV4KW038921 TOYOTA RAV4 OTH 184

2019 ACV 2T3H1RFV7KC017806 TOYOTA RAV4 OTH 185

2020 ACV 8 PASSENGER VAN 5TDKZ3DC2LS028419 TOYOTA SIENNA OTH 186

2012 ACV VAN 1GAZGYFG7C1181899 CHEVROLET OTH 187

2016 ACV E-SERIES BUS 1FDEE3FL5GDC23496 FORD OTH 188

2014 ACV 6 PASS 52CG6SGA2E0010750 GEM OTH 189

2014 ACV 6 PASS 52CG6SGA2E0010747 GEM OTH 190

2006 ACV F150 1FTPW14V06KC79424 FORD OTH 191

2006 ACV E-250 1FTNS2EL2ADA34059 FORD OTH 192

2011 ACV TOWN-N-COUNTRY 2A4RR5DG4BR607538 CHRYSLER OTH 193

2005 ACV EXPLORER XLS 4X4 4D 1FMZU72K45ZA48845 FORD OTH 194

2011 ACV ESCAPE 1FMCU9DG2BKC12284 FORD OTH 195

2019 ACV WINNEBAGO 1F66F6DY2K0A00772 FORD OTH 196

2019 ACV WINNEBAGO 1F66F5DY2K0A01176 FORD OTH 197

2019 ACV 156 TRANSIT 350 HD 1FDES8PM2KKA38355 FORD OTH 198

2019 ACV TRANSIT VAN 1FBZX2CM7KKB39437 FORD OTH 199

2018 ACV 4300 1HTMMMML2JH674920 INTERNATIONAL OTH 200

Veh.

Num.

Year Make Model PE Code

V.I.N. Value

GPNU-AU-0024153-01/000

10-20-2021 10-20-2022

10-22-2021

STATE OF FLORIDA

2019 ACV F-250 CREW DIESEL 4X 1FT7W2BT4KEF87499 FORD OTH 201

2018 ACV E 300 WDDZF4JB7JA482934 MERCEDES OTH 202

2019 ACV TRANSIT CV350 MED RO 1FTBW1DM1KKA70799 FORD OTH 203

2019 ACV TUNDRA 5TFDM5F1XKX083840 TOYOTA OTH 204

2019 ACV TUNDRA 5TFDM5F13KX083856 TOYOTA OTH 205

2020 ACV TAHOE 2GNSKAKC9LR206828 CHEVY OTH 206

2020 ACV COROLLA JTDDPRAE0LJ079630 TOYOTA OTH 207

2020 ACV COROLLA JTDDPRAE0L1080938 TOYOTA OTH 208

2020 ACV COROLLA JTDDPRAE0L1081690 TOYOTA OTH 209

2020 ACV TRAVERSE LS FWD 1GNERFKW3LJ181729 CHEVROLET OTH 210

2020 ACV FUSION 3FA6P0G73LR104047 FORD OTH 211

2020 ACV FUSION 3FA6P0G76LR104236 FORD OTH 212

2019 ACV FLEX 2FMGK5B88KBA17893 FORD OTH 213

2020 ACV TRANSIT 350 WAGON 1FBAX2Y82LKA04974 FORD OTH 214

2020 ACV TERRAIN 3GKALMEV2LL205340 GMC OTH 215

2020 ACV EXPLORER 1FMSK7BH1LGB61205 FORD OTH 216

2018 $ 75,000TRANSIT 250 AMBULANC 1FDYR2CM5JKB40808 FORD BLS 217

2019 ACV GT4 FLA108390 ASPT OTH 218

2019 ACV SILVERADO 4X4 1GC1KREG9KF179521 CHEVROLET OTH 219

2020 ACV 24 PASSENGER 1FDAF5GYXKEG59491 ELDORADO OTH 220

2020 ACV 24 PASSENGER 1FDUF5GT6LDA01398 ELDORADO OTH 221

2020 ACV SILVERADO 3GCUYAEFXLG289613 CHEVROLET OTH 222

2020 ACV SUPER CREW 1FTFW1E53LKD06248 FORD OTH 223

2019 ACV ACADIA IGKKNMLS1KZ202802 GMC OTH 224

2020 ACV AVIATOR 5LM5J7XC8LGL27651 LINCOLN OTH 225

2020 ACV EXPLORER 1FM5K8GC1LGC75799 FORD OTH 226

2020 ACV TACOMA SR5 5TFCZ5AN9LX240234 TOYOTA OTH 227

2021 ACV RAV 4 HYBRID LE AWD 4T3L6RFVXMU017277 TOYOTA OTH 228

2021 ACV RAV 4 HYBRID LE AWD 4T3L6RFV2MU017015 TOYOTA OTH 229

2020 ACV WINNEBAGO WK138S 4UZACMFC8LCMF0347 FEIGHTLINER MC OTH 230

2020 ACV WINNEBAGO WK138S 4UZACMFC1LCMG2470 FEIGHTLINER MC OTH 231

2020 ACV TRANSIT 350 1FBVU4X82LKA46181 FORD OTH 232

2021 ACV AVIATOR 3LM5J7XC3MGL03338 LINCOLN OTH 233

2021 ACV SILVERADO 3GCPYAEH2MG207986 CHEVY OTH 234

2020 ACV SPRINTER 9 PASSENGER W1X5EDHY4LP228829 MERCEDES BENZ OTH 235

2020 ACV TRASIT 8 PASS VAN 1FMZK1Y87LKB00828 FORD OTH 236

2020 ACV TRASIT 8 PASS VAN 1FMZK1Y89LKB00829 FORD OTH 237

2020 ACV TRASIT 8 PASS VAN 1FMZK1Y80LKB74625 FORD OTH 238

2021 ACV VISION 71 PASS SCHOO 1BAKGCSA5MF375875 BLUEBIRD OTH 239

2022 ACV 84 PASS REAR ENG SCH 1BABNB6A3NF381105 BLUEBIRD OTH 240

2022 ACV 84 PASS REAR ENG SCH 1BABNB6A5NF381106 BLUEBIRD OTH 241

2019 ACV STREET LEGAL LOW SPE 5YNWAHBGXKS102528 MOKE OTH 242

2020 ACV SIERRA 3GTP9EED6LG101895 GMC OTH 243

2021 ACV SONATA HYBRID KMHL24JJ3MA030594 HYUNDAI OTH 244

2021 ACV SONATA HYBRID KMHL24JJ5MA030564 HYUNDAI OTH 245

2021 ACV SEQUOIA SR5 4X2 5TDAY5A14MS076244 TOYOTA OTH 246

2021 ACV M2-106 3ALACXFC8NDNE9949 FREIGHTLINER OTH 247

2021 ACV ELGIN/BROOM BEAR 1FVACXRE0MHMP0743 FREIGHTLINER OTH 248

Vehicle # Insured’s #:

Insured Entity:

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only) Auto Medical Payments Medical Exp. And Income Loss Benefits (VA only)

Uninsured Motorists (UM)

Underinsured Motorists (UIM)

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

Total:

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only)

Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

10-20-2022

10-22-2021

STATE OF FLORIDA

FL

$ 1,556 $ 32

$ 165

$ 408

DUMP TRUCK

3BPZLJ0X6FF269695

$ 1,000,000

$ 2,170

PETERBILT

Actual Cash Value

404990

See Endorsement

ACV

ACV

$ 5,000 $ 9

FL

$ 857 $ 31

$ 37

$ 157

4T1BF1FK3GU609863

$ 1,000,000

$ 1,095

TOYOTA CAMRY

Actual Cash Value

739800

See Endorsement

ACV

ACV

$ 5,000 $ 13

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only) Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only)

Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

10-20-2022

10-22-2021

STATE OF FLORIDA

FL

$ 1,863 $ 61

$ 282

$ 852

2PCH3349431014741

$ 1,000,000

$ 3,081

PREVOST HIGHWAY COACH

Actual Cash Value

560900

See Endorsement

ACV

ACV

$ 5,000 $ 23

FL

$ 294 $ 11

$ 62

$ 111

SERVICE

1FBZX2ZM2FKA24998

$ 1,000,000

$ 482

FORD TRANSIT T-350

Actual Cash Value

Service 014990

See Endorsement

ACV

ACV

$ 5,000 $ 4

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only) Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only)

Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

10-20-2022

10-22-2021

STATE OF FLORIDA

FL

$ 776 $ 31

$ 51

$ 204

5LMJJ2H57EEL08363

$ 1,000,000

$ 1,075

LINCOLN NAVIGATOR

Actual Cash Value

739800

See Endorsement

ACV

ACV

$ 5,000 $ 13

FL

$ 334 $ 11

$ 63

$ 102

SERVICE

1FDFE4FS2FDA16094

$ 1,000,000

$ 514

FORD E-450

Actual Cash Value

Service 214990

See Endorsement

ACV

ACV

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only) Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only)

Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

10-20-2022

10-22-2021

STATE OF FLORIDA

FL

$ 334 $ 11

$ 63

$ 102

SERVICE

1FDFE4FSXGDC34415

$ 1,000,000

$ 514

FORD E-450

Actual Cash Value

Service 214990

See Endorsement

ACV

ACV

$ 5,000 $ 4

FL

$ 378 $ 11

$ 88

$ 148

SERVICE

3C7WRNAL1GG342734

$ 1,000,000

$ 629

DODGE 5500

Actual Cash Value

Service 214990

See Endorsement

ACV

ACV

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only) Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only)

Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

10-20-2022

10-22-2021

STATE OF FLORIDA

FL

$ 327 $ 11

$ 57

$ 92

SERVICE

1FDEE3FS3FDA35047

$ 1,000,000

$ 491

GOSHEN COACH

Actual Cash Value

Service 214990

See Endorsement

ACV

ACV

$ 5,000 $ 4

FL

$ 1,898 $ 101

$ 104

$ 337

1T7YU4E24F1284036

$ 1,000,000

$ 2,455

THOMAS 141YS BUS

Actual Cash Value

620300

See Endorsement

ACV

ACV

$ 5,000 $ 15

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only) Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only)

Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

10-20-2022

10-22-2021

STATE OF FLORIDA

FL

$ 1,898 $ 101

$ 104

$ 337

1T7YU4E26F1284037

$ 1,000,000

$ 2,455

THOMAS 141YS BUS

Actual Cash Value

620300

See Endorsement

ACV

ACV

$ 5,000 $ 15

FL

$ 1,898 $ 101

$ 104

$ 337

1T7YU4E27F1284127

$ 1,000,000

$ 2,455

THOMAS WHITE BUS

Actual Cash Value

620300

See Endorsement

ACV

ACV

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only) Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only)

Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

10-20-2022

10-22-2021

STATE OF FLORIDA

FL

$ 1,898 $ 101

$ 104

$ 337

1I7YU4E29F1284128

$ 1,000,000

$ 2,455

THOMAS WHITE BUS

Actual Cash Value

620300

See Endorsement

ACV

ACV

$ 5,000 $ 15

FL

$ 1,045 $ 69

$ 42

$ 178

2C4RDGBG3GR365853

$ 1,000,000

$ 1,348

DODGE CARAVAN SE

Actual Cash Value

739800

See Endorsement

ACV

ACV

$ 5,000 $ 14

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only) Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only)

Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

10-20-2022

10-22-2021

STATE OF FLORIDA

FL

$ 1,045 $ 69

$ 42

$ 178

2C4RDGBG8GR364116

$ 1,000,000

$ 1,348

DODGE CARAVAN SE

Actual Cash Value

739800

See Endorsement

ACV

ACV

$ 5,000 $ 14

FL

$ 1,045 $ 69

$ 42

$ 178

2C4RDGBG6GR364115

$ 1,000,000

$ 1,348

DODGE CARAVAN SE

Actual Cash Value

739800

See Endorsement

ACV

ACV

$ 5,000 $ 14

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only) Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

Year: Use:

Make: Class Code:

Model: State:

V.I.N.: Territory:

Valuation:

Coverages: Limit of Insurance Deductible Premium

Covered Autos Liability (combined single limit) Personal Injury Protection (PIP) Added Personal Injury Protection

Property Protection Insurance (MI only)

Auto Medical Payments

Physical Damage ---- Comprehensive Physical Damage ---- Specified Causes of Loss Physical Damage ---- Collision Physical Damage ---- Towing and Labor

10-20-2022

10-22-2021

STATE OF FLORIDA

FL

$ 1,898 $ 101

$ 101

$ 349

1BABNBCA5HF331038

$ 1,000,000

$ 2,464

BLUE BIRD BUS

Actual Cash Value

620300

See Endorsement

ACV

ACV

$ 5,000 $ 15

FL

$ 1,898 $ 101

$ 101

$ 349

1BABNBCA7HF331039

$ 1,000,000

$ 2,464

BLUE BIRD BUS

Actual Cash Value

620300

See Endorsement

ACV

ACV

Commercial A