Condo Docs Holly Glen2

DATE(MM/DD/VYYY)
DATE (MM/DD/YYYY)
CERTIFICATE
CERTIFICATE OF
OF LIABILITY
LIABILITY INSURANCE
INSURANCE
01/21/2016
THIS CERTIFICATE IS ISSUED AS A MATTER MAHER OF INFORMATION
INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
RIGHTS UPON HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE
BELOW. INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN BETWEEN THE ISSUING INSURER(S), AUTHORIZED
ISSUING INSURER(S),
REPRESENTATIVE OR PRODUCER,PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER.
IMPORTANT: If It the
the certificate
certiticate holder
holder is an ADDITIONAL INSURED, policy(ies) must
INSURED, the policy(ies) must be endorsed. It SUBROGATION IS WAIVED, subject to
endorsed. If to
the
the terms and conditions of ot the policy, certain
the policy, policies may
certain policies may require
require an
an endorsement. A statement on this certificate
certiticate does
does not
not confer rights to
conter rights to the
the
certiticate holder in lieu
certificate lieu of
ot such endorsement(s).
such endorsement(s).
PRODUCER CONTACT
NAME:
NAME:
PHONE FAX
(A/C! No,
(A/C, Ext):
No! Ext): No):
(A/C, No):
E-MAIL
Wilson Insurance
Wilson Agency Inc
Insurance Agency ADDRESS:
3213 VIRGINIA BEACH BLVD
BEACH BLVD INSURER(S) AFFORDING
INSURER(S) AFFORDINGCOVERAGE
COVERAGE NAIC#
NAIC #
BEACH
VIRGINIA BEACH VA 23452-5725 INSURERA:
INSURER A: NATIONWIDE MUTUAL INSURANCE
NATIONWIDE INSURANCE COMPANY 23787
INSURED
INSURED B::
INSURER B
INSURER NATIONWIDE FIRE INSURANCE
NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
COMP? 23779
GLEN, A CONDOMINIUM
HOLLY GLEN, ASSOCIATION, INC.
CONDOMINIUM ASSOCIATION, INC. INSURER C
INSURER C::
C/O PROPERTY MANAGEMENT ASSOCIATES D::
INSURER D
INSURER
LN
2235 HOLLY BERRY LN E::
INSURER E
INSURER
CHESAPEAKE 233255605
VA 23325-5605 INSURERF:
INSURER F:
COVERAGES NUMBER:
CERTIFICATE NUMBER: REVISION NUMBER:
REVISION NUMBER:
THIS IS
THIS IS TO
TO CERTIFY THAT THE
CERTIFY THAT THE POLICIES
POLICIES OF
OF INSURANCE
INSURANCE LISTED
LISTED BELOW HAVE BEEN
BELOW HAVE BEEN ISSUED
ISSUED TO THE INSURED
TO THE NAMED ABOVE
INSURED NAMED ABOVE FOR THE POLICY
FOR THE POLICY PERIOD
PERIOD
INDICATED. NOTWITHSTANDING
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM
ANY REQUIREMENT, TERM OR
OR CONDITION
CONDITION OF ANY CONTRACT
OF ANY CONTRACT OR OR OTHER
OTHER DOCUMENT WITH RESPECT
DOCUMENT WITH RESPECT TO
TO WHICH
WHICH THIS
THIS
MAY BE
CERTIFICATE MAY
CERTIFICATE BE ISSUED
ISSUED OR
OR MAY PERTAIN, THE
MAY PERTAIN, THE INSURANCE
INSURANCE AFFORDED BY THE
AFFORDED BY THE POLICIES
POLICIES DESCRIBED HEREIN IS
DESCRIBED HEREIN IS SUBJECT
SUBJECT TO ALL THE
TO ALL TERMS,
THE TERMS,
EXCLUSIONS AND CONDITIONS
EXCLUSIONS AND CONDITIONS OF
OF SUCH
SUCH POLICIES.
POLICIES. LIMITS
LIMITS SHOWN MAY HAVE
SHOWN MAY HAVE BEEN
BEEN REDUCED
REDUCED BYBY PAID
PAID CLAIMS.
CLAIMS.
1NSR
INSR ADDL SUBR
ADDL SUBFi POLICY EFF POLICY EXP
LTR
LTR TYPEOFINSURANCE
TYPE OF INSURANCE INZD
INSD wyp
WVD POLICYNUMBER
POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY)
(MM/DD/YYYY) (MM/DD/YYYY) LIMITS
LIABILITY
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
EACH OCCURRENCE $
$ 1,000,000
1,000,000
TO RENTED
DAMAGE TO
CLAIMS-MADE
CLAIMS-MADE OCCUR occurrence)
(Ea occurrence)
PREMISES (Ea $
$ 300,000
MED EXP
MED EXP (Any one person)
person) $
$ 5,000
A 1,000,000
HA/NO 1,000,000 BPHM 2482951730
ACP BPHM 01/01/2016 01/01/2017 PERSONAL&ADVINJURY
PERSONAL & ADV INJURY $
$ 1,000,000
1,000,000
GEN’L AGGREGATE
GEN'L PER:
AGGREGATE LIMIT APPLIES PER: AGGREGATE
GENERAL AGGREGATE $
$ 2,000,000
EEj
POLICY DPRO-
JECT
!‘I- LOC COMP/OP AGG
PRODUCTS -- COMP/OP $
$
$
$
2,000,000
OTHER:
OTHER:
AUT OMOBILE LIABILITY
AUTOMOBILE SINGLE LIMIT
COMBINED SINGLE $
(Ea accident)
(Ea accident)
ANY AUTO BODILY INJURY person)
INJURY (Per person) $
$
ALL OWNED
OWNED 1 SCHEDULED
$
accident) $
BODILY INJURY (Per accident)
HLi
AUTOS
AUTOS AUTOS
AUTOS
NON-OWNED DAMAGE
PROPERTY DAMAGE $
HIRED AUTOS
AUTOS AUTOS
AUTOS (Per accident)
(Per accident)
$
—
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EACH OCCURRENCE $
$
EXCESS LIAB CLAIMS-MADE
CLAIMS-MADE AGGREGATE $
$
— — DED RETENTION$$
RETENTION $
$
COMPENSATION
WORKERS COMPENSATION PER 0TH-
OTH-
EMPLOYERS’ LIABILITY
AND EMPLOYERS' STATUTE
STATUTE ER
Y/N
N
ANYPROPRIETOR/PARTNER/EXECUTIVE
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
OFFICER/MEMBER EXCLUDED? [_J
r9
N/A
N /A
EACH ACCIDENT
E.L. EACH
$
$
$
(Mandatory in NH) EMPLOYEE $
E.L. DISEASE -- EA EMPLOYEE
IfIf yes,
yes, describe under
— DESCRIPTION OF OPERATIONS
DESCRIPTION OPERATIONS below DISEASE -- POLICY LIMIT
E.L. DISEASE $
$
DESCRIPTION 101, Additional

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Schedule, may be attached if more space is required)
Additional Remarks Schedule, required)
named insured
Certificate holder is named insured on
on the above listed policy
listed policy
Hired and
Hired and Nonowned coverage is
Nonowned Auto coverage provided for under the above listed
is provided listed Business policy ?? $1,000,000 Each
Business Owners policy Each Common
Common Cause / $2,000,000
Aggregate
Employee Dishonesty Coverage is provided for under the above mentioned

is provided mentioned Businessowners
Businessowners policy with employees.
with a limit of $250,000 for 8 employees.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF
SHOULD ANY OF THE ABOVE DESCRIBED
THE ABOVE DESCRIBED POLICIES BE CANCELLED
POLICIES BE CANCELLED BEFORE
BEFORE
THE DATE THEREOF,
EXPIRATION DATE
THE EXPIRATION THEREOF, NOTICE WILL BE
NOTICE WILL BE DELIVERED
DELIVERED IN
IN
ACCORDANCE WITH THE
ACCORDANCE WITH THE POLICY
POLICY PROVISIONS.
PROVISIONS.
GLEN, A CONDOMINIUM
HOLLY GLEN, ASSOCIATION, INC.
CONDOMINIUM ASSOCIATION, INC.
C/O PROPERTY MANAGEMENT ASSOCIATES
AUTHORIZED REPRESENTATIVE
LN
2235 HOLLY BERRY LN Joseph Pellizzi
Joseph Pellizzi
CHESAPEAKE VA 23325-5605
All rights reserved.

© 1988-2014 ACORD CORPORATION. All reserved.
25(2014/01)
ACORD 25 (2014/01) The ACORD name and registered marks
and logo are registered marks of ACORD
-D
PREMIER BUSINESSOWNERS - HABITATIONAL (NATIONWIDE)

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TABPAGE (07-02)00
78GJ
78GJ N
N INSURED COPY
INSURED COPY ACP
ACP 24-8-2951730
24-8-2951730 24
24 0003712
0003712
IN 72530704
IMPORTANT INSURANCE INFORMATION

Please read this Notice carefully. No coverage is provided by this notice nor can it be construed to replace any
provision of your policy. You should read your policy and review your declarations page for complete information
on the coverages you are provided. If there is any conflict between the policy and this notice, the provisions of the
policy shall prevail.
FLOOD EXCLUSION NOTICE
The General Assembly of Virginia enacted and amended section 38.2-2125 of

the Code of Virginia. This section mandates that we advise you that your
property insurance policy does not provide coverage for flood, surface water,
waves, tidal water or other overflow of a body of water. You will not have
coverage for property damage from floods unless you take steps to purchase a
separate policy of flood insurance. Such a policy may be available from the
National Flood Insurance Program. Contents coverage may also be available
under the flood policy for an additional premium.
If you would like more information about obtaining flood coverage under the
National Flood Insurance Program, please contact your agent.
1N72530704 Pagelofi
ACP BPHM2482951730
ACP BPHM2482951730 INSURED COPY
INSURED COPY 24
24 03713
03713
IN 78091115
******* IMPORTANT INSURANCE INFORMATION *******

provision oT your policy. You should read your policy and review your declaralions page for complete inlormalion
on Ihe coverages you are provided. IT there is any conflict between Ihe policy and this notice, Ihe provisions of Ihe
DATA BREACH & IDENTITY RECOVERY SERVICES

Data Breach Services Information:
Through a partnership with Hartford Steam Boiler, you have access to a data breach risk
management portal called the eRiskHub®. The portal is designed to help you understand data
information exposures, help you plan and be prepared for a data breach, and establish a
response plan to manage the costs and minimize the effects of a data breach.
Key features of the portal include:
Incident Response Plan Roadmap suggested steps your business can take following
—
data breach incident. Having an incident response plan prepared in advance of a

breach can be useful for defense of potential litigation.
• Online Training Modules ready-to-use training for your business on privacy best
—
practices and Red Flag Rules.

• Risk Management Tools- assist your business in managing data breach exposures
including self-assessments and state breach notification laws.
• eRisk Resources a directory to quickly find external resources on pre and post-breach
—
disciplines.
• News Center cyber risk stories, security and compliance blogs, security news, risk
—
management events, and helpful industry links.

• Learning Center best practices and white papers written by leading authorities.
—
To access the eRiskHub®portal:

• Enter in your browser.
• Complete the information, including your name and company. Your User ID and
Password are case-sensitive.
• Enter your assigned access code: 12116-73.
• Enter the challenge word on the screen, and click “Submit” and follow the instructions to
complete your profile setup.
• You can now login to the portal.
You also have access to a help-line to answer breach related questions. Insureds having
questions pertaining to how to prepare for a breach, help in identifying a breach, or other
questions pertaining to breach related best practices can call our breach preparedness helpline.
Experienced professionals are able to provide insights to help insureds understand the
complicated environment pertaining to breaches of personal information. The breach
preparedness help-line is 877-800-5028.
1N78091115 Pagelof2
ACP BPHM2482951730
INSURED COPY 24
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03714
IN 78091115
In addition, you have the ability to purchase Data Compromise Insurance coverage and
CyberOne Insurance coverage.
The Data Compromise coverage covers the costs incurred by an insured to respond to a data
breach, including expenses related to forensic information technology review, legal review,
notification to affected individuals, services to affected individuals, public relations services.
Insureds will also have the ability to include Data Compromise Defense and Liability coverage
which covers the liability from a suit brought by an individual affected by the data breach.
CyberOne coverage protects businesses against damage to electronic data and computer
systems from a virus or other computer attack. It also protects a business’s liability to third
parties that may have suffered damage due to security weaknesses in the business’s
computer system.
Identity Recovery Services Information:

Through a partnership Hartford Steam Boiler, you will have access to a Toll-Free Identity
Recovery Help Line designed to provide education about identity theft and identity theft risks.
The toll-tree Help Line is staffed by experienced identity theft counsellors who can answer
questions and provide useful information and resources to identity theft victims. The Identity
Recovery Help Line number is 877-800-5028.
In addition, you have the ability to buy Identity Recovery insurance coverage as an included
element of Data Compromise coverage or separately, on its own. The Identity Recovery
coverage insures against the theft of identities of the insured’s key owners, officers, and
resident family members. The coverage provides the services of an identity theft case
manager and pays for various out-of-pocket expenses due to a covered identity theft,
including:
• Legal fees for answer of civil judgments and defense of criminal charges
• Phone, postage, shipping fees
• Notary and filing fees
• Credit bureau reports
• Lost Wages and Child or Elder Care
• Mental Health Counseling costs (Not Available in NY)
• Miscellaneous Expense coverage
ACP BPHM2482951730 INSURED COPY 24 03715
Page2of2 1N78091115
Nationwide® NATIONWIDE MUTUAL
MUTUAL INSURANCE CO 45 80455
On Your Side ONE NATIONWIDE
ONE PLAZA
NATIONWIDE PLAZA
COLUMBUS, OH 43215-2220
RENEWAL
RENEWAL
PREMIER BUSINESSOWNERS POLICY

PREMIER HABITATIONAL
COMMON DECLARATIONS
Policy Number:
Policy Number: ACP
ACP BPHM 2482951730
BPHM 2482951730
Named Insured:
Named Insured: HOLLY
HOLLY GLEN A CONDO
GLEN A CONDO ASSOC
ASSOC INC
INC
Mailing Address:
Mailing Address: 4605 PEMBROKE LAKE
LAKE CIR STE 302
VIRGINIA VA
BEACH, VA
VIRGINIA BEACH, 23455-6448
23455-6448
Agency: Wilson Insurance
Agency: Agency Inc
Insurance Agency Inc
Address: VIRGINIA BEACH
Address: VA 23452-5725
BEACH VA
Agency Phone
Agency Phone Number:
Number: (757)340-0028
(757)340-0028
Policy Period:
Policy Period: Effective From
Effective From 01-01-16 To 01-01-17
To
12:01 AM Standard
12:01 AM Standard Time
Time at your principal
at your principal place
place of
of business.
business.
Form of
Form your business
of your entity: CORPORATION
business entity:
Description of
Description your business:
of your business: HOMEOWNERS ASSOCIATION
IN RETURN
IN RETURN FOR THE PAYMENT
FOR THE PAYMENT OF THE PREMIUM
OF THE AND SUBJECT
PREMIUM AND SUBJECT TO ALL THE
TO ALL THE TERMS
TERMS OF POLICY,
THIS POLICY,
OF THIS
WE AGREE
WE AGREE TO
TO PROVIDE THE INSURANCE
PROVIDE THE INSURANCE STATED IN THIS
STATED IN THIS POLICY.
POLICY.
CONTINUATION PROVISION:
CONTINUATION PROVISION: If If we offer
offer to
to continue your coverage
continue your coverage and you or
and you your representative
or your representative dodo not accept,
not accept,
policy will
this policy
this automatically terminate on
will automatically expiration date of the current policy
on the expiration policy period
period stated above. Failure
Failure to
pay the
pay required premium
the required premium when
when due
due shall
shall mean that you
mean that have not
you have accepted our
not accepted our offer
offer to
to continue your coverage.
continue your coverage.
policy will
This policy will terminate sooner if any portion
if any portion of the current policy
policy period
period premium
premium is is not paid when
not paid when due.
RENEWAL POLICY NOTICE:

RENEWAL NOTICE: InIn an keep insurance
an effort to keep premiums as low as possible,
insurance premiums possible, we have
have streamlined
your renewal
your policy by
renewal policy by not including printed
not including printed copies
copies of policy forms
of policy forms or
or endorsements
endorsements that have not
that have changed from
not changed from
your expiring
your expiring policies,
policies, unless they include
unless they include variable information
information that unique to you.
is unique
that is your prior
you. Refer to your prior policies
policies for
printed copies
printed copies of
of these forms. If you have
If you have aa need any form,
need for any form, they are available
they are by request
available by request from your agent.
from your agent.
FLOOD EXCLUSION:
FLOOD EXCLUSION: The General Assembly of
General Assembly Virginia mandates
of Virginia mandates we advise you
we advise you that your property
that your property
policy does not provide
insurance policy
insurance provide coverage
coverage for flood, surface
surface water, waves, tidal
tidal water or other overflow of
a body of
a body of water. You will
water. You not have
will not coverage for
have coverage damage to
for damage to your property from
your property from floods unless you
floods unless you take
steps to purchase
steps purchase a seperate
seperate flood insurance policy.
policy. Such policy, which
Such a policy, which can provide contents
can also provide contents
coverage, may
coverage, may be
be available
available from
from the National
National Flood
Flood Insurance Program. Please
Insurance Program. Please contact your agent
contact your agent for
information obtaining flood coverage
information about obtaining coverage under the National
National Flood
Flood Insurance Program.
Insurance Program.
PREMIUM $$
TOTAL POLICY PREMIUM 2,518.00
2 ,518.00
Previous Policy Number

Previous Policy Number
ACP BPHM 2472951730

2472951730 ENTRY DATE
DATE 11-05-15
ACP BPHM ENTRY 11-05-15
Countersignature
Countersignature Date
Date
These Common
These Common Policy Declarations, together
Policy Declarations, together with the Common
with the Common Policy Conditions, Coverage
Policy Conditions, Coverage Form Declarations,
Form Declarations,
Coverage Forms
Coverage Forms and any endorsements
and any endorsements issued
issued to
to form
form aa part thereof, complete
part thereof, complete the Policy numbered
the Policy numbered above.
above.
PB 81
PB (01-01)
81 00 (01-01) Page 11 of 2
2
DIRECT BILL
DIRECT BILL 78GJ
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ABM INSURED COPY
INSURED COPY UID
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12 24
24 03716
03716
PREMIERSCHEDULE OF NAMED INSUREDS POLICY

BUSINESSOWNERS Policy Period:
Policy Number: ACP BPHM 2482951730 From 01-01-16 To 01-01-17
Named Insured: SCHEDULE OF NAMED INSUREDS Policy Period:
Policy Number:
HOLLY GLEN ACPASSOC
A CONDO BPHM
INC2482951730 From 01-01-16 To 01-01-17
Named Insured:
HOLLY GLEN A CONDO ASSOC INC
PB 81 00 (01-01) Page 2 of 2
INSURED COPY 24 03717
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NATIONWIDE MUTUAL INSURANCE COMPANY
MUTUAL COMPANY CONDITIONS ENDORSEMENT
NATIONWIDE MUTUAL INSURANCE COMPANY
POLICYHOLDER MEMBERSHIP IN THE COMPANY
(Applicable Only toMUTUAL COMPANY
Policies Issued by Nationwide CONDITIONS ENDORSEMENT
Mutual Insurance Company in States other than the State of
Texas)
POLICYHOLDER
Because this policyMEMBERSHIP IN THE COMPANY
is issued by Nationwide Mutual Insurance Company (the “Company”), the first named insured
(Applicable Only to Policies Issued
listed on the declarations page (“named by Nationwide Mutual
insured”) is Insurance
a member Companyinissuing
of theCompany States the
other thanwhile
policy the State
this orofany
Texas)
other policy issued by the Company is in force. While a member, the named insured is entitled to one vote only –
Because this
regardless of policy is issued
the number by Nationwide
of policies Mutual
issued to Insurance
the named Company
insured – either(the “Company”),
in person the first
or by proxy named insured
at meetings of
listed on the
members Company.page (“named insured”) is a member of the Company issuing the policy while this or any
declarations
of the
The policy meeting
otherannual issued byofthe Company
members is inCompany
of the force. While member,
a held each
will be theyear
named insured
at the HomeisOffice
entitled to one
of the vote only
Company in
—
regardless of the number of policies issued to the named insured —

either in person or by proxy at
Columbus, Ohio, at 10 a.m. on the first Thursday of April. If the Board of Directors of Nationwide Mutual Insurance meetings of
members of
Company the Company.
should elect to change the time or place of that meeting, the Company will mail notice of the change to
the annual meeting
Themember’s of members
last known address. ofThe
the Company will mail be held
thiseach year
notice at the10Home
at least days Office of theofCompany
in advance in
the meeting
Columbus, Ohio, at 10 a.m. on the first Thursday of April. If the Board of Directors of Nationwide Mutual Insurance
date.
Company
This policyshould elect to change
is non-assessable, the time
meaning that place
or the of that
named meeting,
insured Company
thesubject
is not will assessment
to any the change
mail notice ofbeyond the to
the member’s last known address.
premiums required for each policy term.The Company will mail this notice at least 1 0 days in advance of the meeting
date.
POLICYHOLDER DIVIDEND PROVISIONS
This policy is non-assessable, meaning that the named insured is not subject to any assessment beyond the
The namedrequired
premiums insuredfor
is entitled to any
each policy Dividends which are declared by the Board of Directors of the Company in
term.
accordance with law and which are applicable to coverages provided in this policy.
POLICYHOLDER is entitled to any
The named insuredMEMBERSHIP IN Dividends which are
THE COMPANY declared by the Board of Directors of the Company in
IN TEXAS
accordance with law and which are applicable to coverages
(Applicable Only to Policies Issued by Nationwide Mutual Insurance in this policy.
providedCompany in the State of Texas)
1. MUTUALS – MEMBERSHIP AND VOTING NOTICE. The named insured is notified that, by virtue of this
POLICYHOLDER
policy, MEMBERSHIP
the named insured IN THE
is a member COMPANY
of the Nationwide IN Mutual
TEXASInsurance Company of Columbus, Ohio, (the
(Applicable Only to Policies Issued by Nationwide Mutual
“Company”) and is entitled, as is lawfully provided in the charter, Insurance Companyand
constitution, in the State to
by-laws Texas)
of vote either in person
1. by
or MUTUALS — or all meetingsAND
proxy in anyMEMBERSHIP VOTING
of said Company.NOTICE.
Each The named
member insured to
is entitled is only onethat,
notified voteby virtue of this
regardless of the
policy, the
number named insured
of policies owned. isThea member of the Nationwide
annual meetings Mutual of
of the members Insurance Company
the Company of Columbus,
are held in the Home Ohio, (the at
Office,
Columbus, and isonentitled,
“Company”)Ohio, the firstas is lawfully
Thursday provided
of April, in each charter,
in theyear, constitution,
at 10:00 and by-laws to vote either in person
o’clock a.m.
or by
2. proxy in any
MUTUALS or all meetings ofCLAUSE
– PARTICIPATION said Company.
WITHOUT EachCONTINGENT
member is entitled to onlyNo
LIABILITY. vote regardless
oneContingent of the
Liability: This
number of policies owned. The annual meetings of the members of the Company are held in the Home
policy is non-assessable. The named insured is a member of the Company and shall participate, to the extent and
Office, at
Columbus, Ohio, on the first Thursday of April, in each year, at 10:00 o’clock a.m.
upon the conditions fixed and determined by the Board of Directors in accordance with the provisions of law, in
2. MUTUALS
the distribution ofPARTICIPATION
— dividends so fixedCLAUSE WITHOUT CONTINGENT LIABILITY. No Contingent Liability: This
and determined.
the distribution of dividends so fixed and determined.
IN WITNESS WHEREOF: Nationwide Mutual Insurance Company has caused this policy to be signed by its
President and Secretary, and countersigned by a duly authorized representative of the Company.
IN WITNESS WHEREOF: Nationwide Mutual Insurance Company has caused this policy to be signed by its
President and Secretary, and countersigned by a duly authorized representative of the Company.
Secretary President
fri
Secretary President
SP 00 01 01 08 Page 1 of 1
SP 00 01 01 08 Page 1 of 1
PREMIER BUSINESSOWNERS
POLICY
PREMIER
PROPERTY DECLARATIONS Policy Period:
Policy Period:
Policy Number:
Policy Number: ACP BPHM2482951730 From 01-01-16 To
From To 01-01-17
01-01-17
Description of
Description of Premises
Premises Number:
Number: 001001 Building Number:
Building Number: 001
001 Construction:
Construction: NON-COMBUSTIBLE
Premises Address
Premises Address 2235 HOLLY BERRY
BERRY LN
LN CHESAPEAKE VA
VA 23325-5605
Occupancy OL Classification:
Occupancy Classification: HOMEOWNERS ASSOCIATIONS
Described as:
Described as: HOA & FENCES
WE PROVIDE
WE PROVIDE INSURANCE
INSURANCE ONLY
ONLY FOR
FOR THOSE
THOSE COVERAGES
COVERAGES INDICATED BY A
INDICATED BY A LIMIT
LIMIT OR BY "INCLUDED".
OR BY INCLUDED.
The Property Coverage
The Property Coverage provided
provided at
at this premises is
this premises is subject to aa $$
subject to Deductible, unless
500 Deductible, unless otherwise
otherwise stated.
stated.
COVERAGES LIMITS OF INSURANCE
Building Replacement Cost
Building -- Replacement Cost Extension
Extension $44,200
$ 44,200
Business Personal
Business Property --
Personal Property NOT PROVIDED
NOT PROVIDED
ADDITIONAL COVERAGES -- the Coverage Form Form Includes
Includes other Additional Coverages not shown.
Business Income
Business Income --ALS 12 Months
ALS -- 12 NOHourWaiting
Months -- NO Period --60
Hour Waiting Period DayOrdinary
60 Day Payroll Limit
Ordinary Payroll Limit INCLUDED
INCLUDED
Extra Expense -- Actual
Extra Expense Actual Loss
Loss Sustained (ALS) -- 12
Sustained (ALS) 12 Months
Months -- NO
NOHour Waiting Period
Hour Waiting Period INCLUDED
INCLUDED
Equipment Breakdown
Equipment Breakdown INCLUDED
INCLUDED
Automatic Increase
Automatic Increase inin Insurance Building
Insurance -- Building 2%
2%
Automatic Increase
Automatic Increase inin Insurance
Insurance -- Business
Business Personal Property
NOT PROVIDED
Up of
Back Up
Back of Sewer
Sewer andand Drain
Drain Water (limit shown
Water (limit shown perper Building,
Building, subject
subject to $25,000 policy
to $25,000 policy aggregate)
aggregate)
$5,000
$ 5,000
Appurtenant Structures
Appurtenant Structures -- 10%
10% of Building Limit
of Building Limit of
of Insurance
Insurance -- maximum $50,000 any
maximum $50,000 any one
one structure
structure INCLUDED
INCLUDED
Increased Cost
Increased Cost ofof Construction
Construction $25,000
$ 25,000
INCREASED LIMITS
OPTIONAL INCREASED Included Limit
Included Limit Limit
Additional Limit
Account Receivable
Account Receivable $25,000
$ 25,000 $25,000
$ 25,000
Valuable Papers and
Valuable Papers and Records
Records (At(At the
the Described Premises)
Described Premises) $25,000
$ 25,000 $25,000
$ 25,000
Forgery and
Forgery and Alteration
Alteration $10,000
$ 10,000 $10,000
$ 10,000
Money and
Money and Securities
Securities -- Inside
Inside the
the Premises
Premises $10,000
$ 10,000 $10,000
$ 10,000
Outside the
Outside the Premises (Limited)
Premises (Limited) $10,000
$ 10,000 $10,000
$ 10,000
Outdoor Signs
Outdoor Signs $2,500
$ 2,500 $2,500
$ 2,500
Outdoor Trees, Shrubs,
Outdoor Trees, Shrubs, Plants
Plants and
and Lawns
Lawns $10,000
$ 10,000 $10,000
$ 10,000
Business Personal
Business Property Away
Personal Property Away From
From Premises
Premises $15,000
$ 15,000 $15,000
$ 15,000
Business Personal
From Premises
Premises -- Transit
Transit $15,000
$ 15,000 $15,000
$ 15,000
Electronic Data
Electronic Data $10,000
$ 10,000 $10,000
$ 10,000
Interruption of
Interruption Computer Operations
of Computer Operations $10,000
$ 10,000 $10,000
$ 10,000
Building Property
Building Property of of Others
Others $10,000
$ 10,000 $10,000
$ 10,000
purchased coverage options.
OPTIONAL COVERAGES -- Other frequently purchased options.
Employee Dishonesty
Employee $250,000 Policy
Dishonesty $250,000 Policy Occurrence
Occurrence INCLUDED
INCLUDED
Ordinance or
Ordinance Law -- 11 -- Loss
or Law Loss to Undamaged Portion
to Undamaged Portion NOT
NOT PROVIDED
PROVIDED
2 -- Demolition
2 Demolition Cost
Cost and
and Broadened
Broadened Increased
Increased Cost
Cost of
of Construction
Construction NOT
NOT PROVIDED
PROVIDED
Virginia (Broad)
Virginia (Broad) NOT
NOT PROVIDED
PROVIDED
Ordinance or
Ordinance or Law
Law Broadened
Broadened NOT
NOT PROVIDED
PROVIDED
PROTECTIVE SAFEGUARDS
This premise has
This premise has Protective Safeguards identified
Protective Safeguards by symbols
identified by symbols below.
below. Insurance
Insurance for
for Fire
Fire or Burglary and
or Burglary Robbery
and Robbery
at this
at this premise will be
premise will excluded ifif you
be excluded you do
do not notify us
not notify immediately ifif any
us immediately any of
of these safeguards are
these safeguards impaired.
are impaired.
See PB 04 30 for
See description of
for aa description of each symbol. APPLICABLE
each symbol. APPLICABLE SYMBOLS:
SYMBOLS: NOT NOT APPLICABLE
APPLICABLE
PB 81
PB 01(04-11)
81 01 (04-11) NATIONWIDE MUTUAL INSURANCE COMPANY Page 11 of 2
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03719
POLICY
MORTGAGEE ASSIGNMENT INFORMATION
MORTGAGEE INFORMATION Policy Period:
Policy Period:
Policy Number:
Policy Number: ACP BPHM2482951730 From 01-01-16To
From 01-01-l6To 01-01-17
Additional Interest:
Additional Interest: Interest Number:
Interest Number: Loan Number:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
PB 81
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03720
POLICY
PREMIER
Policy Period:
Policy Number:
From To 01-01-17
01-01-17
Description of
Premises Number:
Building Number: 002 Construction:
Premises Address
BERRY LN
LN CHESAPEAKE VA
VA 23325-5605
Occupancy Classification: FENCES (HABITATIONAL)
(HABITATIONAL)
Described as:
Described as: STREET LIGHTPOLES & SPRINKLER SYSTEM
WE PROVIDE
INSURANCE ONLY
ONLY FOR
FOR THOSE
THOSE COVERAGES
OR BY INCLUDED.
provided at
at this premises is
otherwise stated.
stated.
Building Replacement cost
Building -- Replacement cost $53,700
$ 53,700
Business Personal
NOT PROVIDED
Business Income
INCLUDED
Months -- NO
INCLUDED
Equipment Breakdown
INCLUDED
Automatic Increase
2%
Automatic Increase
NOT PROVIDED
Up of
Back Up
Back of Sewer
Sewer andand Drain
Building, subject
aggregate)
$5,000
$ 5,000
of Insurance
one structure
structure INCLUDED
INCLUDED
Increased Cost
$ 25,000
INCREASED LIMITS
Additional Limit
Account Receivable
$ 25,000 $25,000
$ 25,000
Valuable Papers and
Records (At(At the
$ 25,000 $25,000
$ 25,000
Forgery and
Alteration $10,000
$ 10,000 $10,000
$ 10,000
Money and
Inside the
the Premises
Premises $10,000
$ 10,000 $10,000
$ 10,000
Outside the
$ 10,000 $10,000
$ 10,000
Outdoor Signs
$ 2,500 $2,500
$ 2,500
Plants and
and Lawns
Lawns $10,000
$ 10,000 $10,000
$ 10,000
Business Personal
From Premises
Premises $15,000
$ 15,000 $15,000
$ 15,000
Business Personal
From Premises
Premises -- Transit
Transit $15,000
$ 15,000 $15,000
$ 15,000
Electronic Data
$ 10,000 $10,000
$ 10,000
Interruption of
$ 10,000 $10,000
$ 10,000
Building Property
Others $10,000
$ 10,000 $10,000
$ 10,000
Employee Dishonesty
Occurrence INCLUDED
INCLUDED
Ordinance or
NOT PROVIDED
PROVIDED
2 -- Demolition
2 Demolition Cost
Cost and
and Broadened
Broadened Increased
Increased Cost
Cost of
of Construction
Construction NOT
NOT PROVIDED
PROVIDED
Virginia (Broad)
NOT PROVIDED
PROVIDED
Ordinance or
Ordinance or Law
Law Broadened
Broadened NOT
NOT PROVIDED
PROVIDED
This premise has
below. Insurance
Insurance for
for Fire
or Burglary Robbery
and Robbery
at this
be excluded you do
do not notify us
are impaired.
See PB 04 30 for
See description of
APPLICABLE
PB 81
PB 01(04-11)
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03721
POLICY
Policy Period:
Policy Number:
From 01-01-l6To 01-01-17
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
PB 81
PB 01(04-11)
81 01 (04-11) Page 22 of 22
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03722
POLICY
PREMIER
Policy Period:
Policy Number:
From To 01-01-17
01-01-17
Description of
Premises Number:
Building Number: 001
001 Construction:
Premises Address
BERRY LN
LN CHESAPEAKE VA
VA 23325-5605
Occupancy Classification: HOMEOWNERS ASSOCIATIONS
Described as:
Described as: HOA & FENCES
WE PROVIDE
INSURANCE ONLY
ONLY FOR
FOR THOSE
THOSE COVERAGES
OR BY INCLUDED.
provided at
at this premises is
otherwise stated.
stated.
$ 30,800
Business Personal
NOT PROVIDED
Business Income
INCLUDED
Months -- NO
INCLUDED
Equipment Breakdown
INCLUDED
Automatic Increase
2%
Automatic Increase
NOT PROVIDED
Up of
Back Up
Back of Sewer
Sewer andand Drain
Building, subject
aggregate)
$5,000
$ 5,000
of Insurance
one structure
structure INCLUDED
INCLUDED
Increased Cost
$ 25,000
INCREASED LIMITS
Additional Limit
Account Receivable
$ 25,000 $25,000
$ 25,000 $50,000
$ 50,000
Valuable Papers and
Records (At(At the
$ 25,000 $25,000
$ 25,000
Forgery and
Alteration $10,000
$ 10,000 $10,000
$ 10,000
Money and
Inside the
the Premises
Premises $10,000
$ 10,000 $10,000
$ 10,000
Outside the
$ 10,000 $10,000
$ 10,000
Outdoor Signs
$ 2,500 $2,500
$ 2,500
Plants and
and Lawns
Lawns $10,000
$ 10,000 $10,000
$ 10,000
Business Personal
From Premises
Premises $15,000
$ 15,000 $15,000
$ 15,000
Business Personal
From Premises
Premises -- Transit
Transit $15,000
$ 15,000 $15,000
$ 15,000
Electronic Data
$ 10,000 $10,000
$ 10,000
Interruption of
$ 10,000 $10,000
$ 10,000
Building Property
Others $10,000
$ 10,000 $10,000
$ 10,000
Employee Dishonesty
Occurrence INCLUDED
INCLUDED
Ordinance or
NOT PROVIDED
PROVIDED
2 -- Demolition
2 Demolition Cost
Cost and
and Broadened
Broadened Increased
Increased Cost
Cost of
of Construction
Construction NOT
NOT PROVIDED
PROVIDED
Virginia (Broad)
NOT PROVIDED
PROVIDED
Ordinance or
Ordinance or Law
Law Broadened
Broadened NOT
NOT PROVIDED
PROVIDED
This premise has
below. Insurance
Insurance for
for Fire
or Burglary Robbery
and Robbery
at this
be excluded you do
do not notify us
are impaired.
See PB 04 30 for
See description of
APPLICABLE
PB 81
PB 01(04-11)
2
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03723
POLICY
Policy Period:
Policy Number:
From 01-01-l6To 01-01-17
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
Loan Number:
Interest:
Interest:
PB 81
PB 01(04-11)
81 01 (04-11) Page 22 of 22
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03724
POLICY
PREMIER
Policy Period:
Policy Number:
From To 01-01-17
01-01-17
Description of
Premises Number:
Building Number: 002 Construction:
Premises Address
BERRY LN
LN CHESAPEAKE VA
VA 23325-5605
Occupancy Classification: FENCES (HABITATIONAL)
(HABITATIONAL)
Described as:
Described as: LIGHT POLES & SPRINKLER SYSTEM
WE PROVIDE
INSURANCE ONLY
ONLY FOR
FOR THOSE
THOSE COVERAGES
OR BY INCLUDED.
provided at
at this premises is
otherwise stated.
stated.
$ 44,100
Business Personal
NOT PROVIDED
Business Income
INCLUDED
Months -- NO
INCLUDED
Equipment Breakdown
INCLUDED
Automatic Increase
2%
Automatic Increase
NOT PROVIDED
Up of
Back Up
Back of Sewer
Sewer andand Drain
Building, subject
aggregate)
$5,000
$ 5,000
of Insurance
one structure
structure INCLUDED
INCLUDED
Increased Cost
$ 25,000
INCREASED LIMITS
Additional Limit
Account Receivable
$ 25,000 $25,000
$ 25,000
Valuable Papers and
Records (At(At the
$ 25,000 $25,000
$ 25,000
Forgery and
Alteration $10,000
$ 10,000 $10,000
$ 10,000
Money and
Inside the
the Premises
Premises $10,000
$ 10,000 $10,000
$ 10,000
Outside the
$ 10,000 $10,000
$ 10,000
Outdoor Signs
$ 2,500 $2,500
$ 2,500
Plants and
and Lawns
Lawns $10,000
$ 10,000 $10,000
$ 10,000
Business Personal
From Premises
Premises $15,000
$ 15,000 $15,000
$ 15,000
Business Personal
From Premises
Premises -- Transit
Transit $15,000
$ 15,000 $15,000
$ 15,000
Electronic Data
$ 10,000 $10,000
$ 10,000
Interruption of
$ 10,000 $10,000
$ 10,000
Building Property
Others $10,000
$ 10,000 $10,000
$ 10,000
Employee Dishonesty
Occurrence INCLUDED
INCLUDED
Ordinance or
NOT PROVIDED
PROVIDED
2 -- Demolition
2 Demolition Cost
Cost and
and Broadened
Broadened Increased
Increased Cost
Cost of
of Construction
Construction NOT
NOT PROVIDED
PROVIDED
Virginia (Broad)
NOT PROVIDED
PROVIDED
Ordinance or
Ordinance or Law
Law Broadened
Broadened NOT
NOT PROVIDED
PROVIDED
This premise has
below. Insurance
Insurance for
for Fire
or Burglary Robbery
and Robbery
at this
be excluded you do
do not notify us
are impaired.
See PB 04 30 for
See description of
APPLICABLE
PB 81
PB 01(04-11)
2
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ABM INSURED COPY
INSURED COPY UID
UID 12
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03725
MORTGAGEE
PREMIER ASSIGNMENT INFORMATION
BUSINESSOWNERS POLICYFrom Policy Period:
Policy Number: ACP BPHM2482951730 01-01-l6To 01-01-17
Additional Interest: Interest Number: Loan Number:
Interest: MORTGAGEE ASSIGNMENT INFORMATION Policy Period:
Policy Number: ACP BPHM2482951730 From 01-01-16To 01-01-17
Interest:
Interest:

Interest:
Interest:

Interest:
Interest:

Interest:
Interest:

Interest:
Interest:

Interest:
Interest:

Interest:
Interest:

Interest:
Interest:

Interest:
Interest:

Interest:
PB 81 01(04-11) Page 2 of 2
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PB 81 01 (04-11) Page 2 of 2
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POLICY
LIABILITY DECLARATIONS
LIABILITY DECLARATIONS Policy Period:
Policy Period:
Policy Number:
Policy Number: ACP BPHM2482951730 01-01-16 To
From 01-01-16
From 01-01-17
To 01-01-17
LIMITS OF INSURANCE
Each Occurrence
Each Occurrence Limit
Limit of
of Insurance
Insurance Per Occurrence
Per Occurrence $11 ,,000,000
$ 000,000
Medical Payments Coverage
Medical Payments Coverage SubSub Limit
Limit Per Person
Per Person $5,000
$ 5,000
Property Damage
Tenants Property
Tenants Damage Legal
Legal Liability
Liability Sub
Sub Limit
Limit Per Covered
Per Covered Loss
Loss $300,000
$ 300,000
Personal and
Personal Advertising Injury
and Advertising Injury Per Person
Per Person Or Organization
Or Organization $11 ,,000,000
$ 000,000
Products —
Completed Operations
Products – Completed Operations Aggregate
Aggregate All Occurrences
All Occurrences $2,000,000
$ 2,000,000
General Aggregate
General Aggregate All Occurrences
$ 2,000,000
(Other than
(Other than Products Completed Operations)
Products – Completed
—
Operations)
ADDITIONAL INSUREDS STATUS

AUTOMATIC ADDITIONAL
following persons
The following
The persons or organizations are
or organizations automatically insureds
are automatically you and
insureds when you they have
and they have agreed in aa written
agreed in written
contract or
contract agreement that
or agreement that such person or
such person organization be
or organization be added
added as
as an
an additional
additional insured
insured on your policy.
on your policy.
Co-Owners of
Co-Owners of Insured
Insured Premises
Premises
Controlling Interest
Controlling Interest
Grantor of
Grantor of Franchise
Franchise or or License
License
Lessors of
Lessors of Leased Equipment
Leased Equipment
Managers or
Managers or Lessors
Lessors ofof Leased
Leased Premises
Premises
Mortgagee, Assignee
Mortgagee, Assignee or or Receiver
Receiver
Owners or
Owners or Other
Other Interest
Interest from
from Whom
Whom Land
Land has
has been
been Leased
Leased
State or
State or Political
Political Subdivisions
Subdivisions - Permits
-
Relating to
Permits Relating to Premises
Premises
PROPERTY DAMAGE DEDUCTIBLE

NONE
NONE
OPTIONAL COVERAGES
Hired Auto
Hired Liability Coverage
Auto Liability Coverage n c l u d e d iin
IIncluded Each Occurrence
n Each Occurrence L
Limit off IInsurance
imit o nsurance
Nonowned Auto
Nonowned Liability Coverage
Auto Liability Coverage n c l u d e d iin
IIncluded Each Occurrence
n Each Occurrence L
Limit off IInsurance
imit o nsurance
Directors &
Directors & Officers Liability
Officers Liability PPer Occurrence
e r Occurrence $11 ,,000,000
$ 000,000
Directors &
Directors & Officers
Officers Liab-Retro
Liab-Retro Date
Date 01/01/08
01/01/08 AAggregate
ggregate $11 ,,000,000
$ 000,000
81 03 (06-12)
PB 81 NATIONWIDE MUTUAL INSURANCE COMPANY 1 of 2
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03727
POLICY
PREMIER
FORMS AND ENDORSEMENTS
FORMS AND ENDORSEMENTS SUMMARY
SUMMARY Period:
Policy Period:
Number: ACP BPHM2482951730
Policy Number: From 01-01-16 To 01-01-17
From
FORM NUMBER
FORM TITLE
PB1216
PB1216 0904
0904 VIRGINIA EFFECTIVE
VIRGINIA EFFECTIVE TIMETIME CHANGES
CHANGES -- REPL REPL AA
PB0002
PB0002 1114
1114 PREMIER BUSINESSOWNERS
PB0006
PB0006 1114
PREMIER BUSINESSOWNERS L LIABILITY COVERAG
I A B I L I T Y COVERAG
PB9045
PB9045 0515
0515 VIRGINIA AMENDATORY
VIRGINIA AMENDATORY ENDORSEMENT
ENDORSEMENT
PB0009
PB0009 1114
PREMIER BUSINESSOWNERS COMMON COMMON POLICYPOLICY CON
CON
L10021
L I0021 0101
0101 NUCLEAR ENERGY
NUCLEAR ENERGY L LIABILITY EXCLUSION
I A B I L I T Y EXCLUSION
PB0404
PB0404 0101
0101 HIRED AUTO
HIRED AND NON-OWNED
AUTO AND NON-OWNED AUTO AUTO L LIABILITY
IABILITY
PB5422
PB5422 0406
0406 AMENDMENT -- EMPLOYEE
AMENDMENT EMPLOYEE DISHONESTY
DISHONESTY OPTIONAL OPTIONAL
PB0412
PB0412 0101
0101 LIMITATION OF
LIMITATION OF COVERAGE
COVERAGE TO TO DESIGNATED
DESIGNATED PREMISES
PREMISES
PB4100
PB4100 0515
0515 AND OFFICERS
DIRECTORS AND
DIRECTORS OFFICERS L LIABILITY (COOPER
I A B I L I T Y (COOPER
PB6005
PB6005 1109
1109 ADDITIONAL INSURED
ADDITIONAL INSURED -- HOMEOWNERS
HOMEOWNERS ASSOCIAT ASSOCIAT
EN7281
EN7281 0706
0706 IMPORTANT INFORMATION
IMPORTANT INFORMATION REGARDING
REGARDING YOUR YOUR INS
INS
PB2999
PB2999 0215
0215 EXCLUSION -- FUNGI
EXCLUSION FUNGI OROR BACTERIA
BACTERIA
PB2998
PB2998 0908
0908 EXCLUSION -- VIOLATION
EXCLUSION VIOLATION OF OF CONSUMER
CONSUMER PROTEC PROTEC
PB5403
PB5403 0411
0411 REPLACEMENT COST
REPLACEMENT COST EXTENSION-
EXTENSION- BUILDING BUILDING
PB1504
PB1504 1114
1114 ACCESS OR
ACCESS OR DISCLOSURE
DISCLOSURE OF OF CONFIDENTIAL
CONFIDENTIAL OR OR
PB0523
PB0523 0715
0715 CAP ON
CAP ON LOSSES
LOSSES FRFOM
FRFOM CERTIFIED
CERTIFIED ACTS ACTS OFOF TERRORISM
TERRORISM
IMPORTANT NOTICES
IMPORTANT NOTICES
IIN
N77288
288 0904
0904 IMPORTANT NOTICE-ENDORSEMENT
IMPORTANT NOTICE-ENDORSEMENT PROVIDING
PROVIDING CLAIMS MADE COVERAGE
CLAIMS MADE COVERAGE
IIN
N77280
280 0904
0904 IMPORTANT NOTICE
IMPORTANT AVAIL OF
NOTICE -- AVAIL OF ORDINANCE
ORDINANCE OR LAW COVERAGE
OR LAW COVERAGE -- VIRG
VIRG
IIN
N77672
672 0113
0113 VIRGINIA EARTHQUAKE EXCLUSION
VIRGINIA EARTHQUAKE EXCLUSION
IIN
N77253
253 0704
0704 FLOOD EXCLUSION
FLOOD EXCLUSION NOTICE
NOTICE
IIN
N77809
809 1115
1115 DATA BREACH
DATA BREACH & IDENTITY RECOVERY
& IDENTITY RECOVERY SERVICES
SERVICES
81 03 (06-12)
PB 81 iage 2 of
Page 01 2
INSURED COPY
INSURED COPY 24
24 03728
03728
EFFECTIVE DATE: 12:01 AM Standard Time, BUSINESSOWNERS
(at your principal place of business) PBAI 02(01-01)
ACKNOWLEDGEMENT OF ADDITIONAL INSURED STATUS

MANAGERS OR LESSORS OF LEASED PREMISES
Person or Organization Designated as an Additional Insured:
PROPERTY MANAGEMENT
PROPERTY MANAGEMENT ASSOCIATES
ASSOCIATES
4605 PEMBROKE
4605 LAKE CIRCLE
PEMBROKE LAKE CIRCLE STE
STE 302
302
VIRGINIA BEACH
VIRGINIA BEACH VA 234556448
VA 234556448
Designated Premises (Part Leased to the Named Insured):

2235 HOLLY
2235 BERRY LN
HOLLY BERRY LN
CHESAPEAKE
CHESAPEAKE VA 233255605
VA 233255605
This form has been sent to you to acknowledge your status as an additional insured under our, meaning the
issuing Company stated below, insurance policy issued to the Named Insured shown below.
Under our Premier Businessowners Liability Coverage Form, Section II. WHO IS AN INSURED provides as
follows:
Any of the following persons or organizations are automatically insureds when you [i.e. the Named Insured
stated below] and such person or organization have agreed in a written contract or agreement that such
person or organization be added as an additional insured on your policy providing general liability coverage.
Managers or Lessors of Leased Premises
Any person or organization from whom you lease premises is an additional insured, but only with respect to
their liability arising out of your use of that part of the premises leased to you, subject to the following
additional exclusion:
This insurance, including any duty we have to defend “suits”, does not apply to structural alterations, new
construction or demolition operations performed by or for such person or organization.
HOWEVER, their status as additional insured under this policy ends when you cease to be a tenant of such
premises.
The policy language set forth above is subject to all of the terms and conditions of the policy issued to the Named
Insured shown below. For your information, our Named Insured, the Policy Number, Policy Term and Limits of
Insurance are stated below.
Named Insured HOLLY GLEN

HOLLY A CONDO
GLEN A CONDO ASSOC
ASSOC INC
INC
Issuing Company: NATIONWIDE MUTUAL

NATIONWIDE MUTUAL INS
INS COMPANY
COMPANY
Policy Number: ACP BPHM2482951730
ACP BPHM2482951730
Policy Term: 01-01-16 To
01-01-16 To 01-01-17
01-01-17
Limits of Insurance: Per Occurrence
Per Occurrence $1,000,000
$1,000,000
All Occurrences
$2,000,000
PB Al 02 (01-01) Page 1 of I
ACP BPHM2482951730
INSURED COPY 24
24 03729
03729
B USIN ESSOWN ERS
PB 05 23 07 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CAP ON LOSSES FROM CERTIFIED

ACTS OF TERRORISM
This endorsemeni modifies insurance provided under the following:
PREMIER BUSINESSOWNERS PROPERTY COVERAGE FORM

PREMIER BUSINESSOWNERS LIABILITY COVERAGE FORM
The following provisions are added to the If aggregate insured losses attributable to terrorist
Businessowners Policy and apply 10 Properly and acts certified under the Terrorism Risk Insurance
Liabilily Coverages: Ad exceed $100 billion in a calendar year and we
A. CAP ON CERTIFIED TERRORISM LOSSES have met our insurer deductible under Ihe
Terrorism Risk Insurance Act, we shall not be
‘Certified aol of lerrorism” means an act thai is liable for the payment of any portion of the amount
certijied by Ihe Secretary oT the Treasury, in of such losses that exceeds $100 billion, and in
accordance wilh Ihe provisions oT the federal such case insured losses up to that amount are
Terrorism Risk Insurance Act, to be an act of subjeci to pro rala allocation in accordance with
terrorism pursuant to such Act. The criteria procedures established by Ihe Secretary of Ihe
contained in the Terrorism Risk Insurance Act for Treasury.
a “certified ad of lerrorism” include Ihe Tol lowing:
B. The terms and limitations of any terrorism
1. The aol resulted in insured losses in excess of exclusion, or Ihe inapplicabilily or omission of a
$5 million in the aggregate, attributable to all lerrorism exclusion, do not serve to create
types of insurance subject to the Terrorism coverage Tor loss or injury or damage Ihat is
Risk Insurance Act; and otherwise excluded under this Policy.
2. The act is a violent act or an act that is
dangerous to human life, property or
infrastructure and is committed by an individual
or individuals as part of an effort 10 coerce Ihe
civilian populalion of Ihe United Stales or to
influence the policy or affecl Ihe conduct oT Ihe
United States Government by coercion.
PB 05 23 07 15 Includes copyrighted material of ISO Properties, Inc., with its permission Page 1 of 1
ACP BPHM2482951730
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03730
BUSINESSOWNERS
BUSINESSOWNERS
PB 29
PB 29990215
99 02 15
THE POLICY.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
PLEASE READ IT CAREFULLY.
EXCLUSION - FUNGI
EXCLUSION FUNGI OR
OR BACTERIA
BACTERIA -
This endorsement
This endorsement modifies
modifies insurance provided under
insurance provided under the following:
the following:
PREMIER LIABILITY COVERAGE
BUSINESSOWNERS LIABILITY COVERAGE FORM
FORM
A.. In
A.. In Section COVERAGES, COVERAGE
Section I.I. COVERAGES, COVERAGE A A-
- LIABILITY, under
LIABILITY, paragraph 2.
under paragraph EXCLUSIONS,
2. EXCLUSIONS,
BODILY INJURY
BODILY INJURY AND AND PROPERTY
PROPERTY DAMAGE DAMAGE the following exclusions
the following exclusions are are added:
added:
LIABILITY, under
LIABILITY, paragraph 2.
under paragraph EXCLUSIONS,
2. EXCLUSIONS, insurance, including
This insurance,
This including any any duty
duty wewe have
have to to
the following exclusions
the following exclusions are are added:
added: “suits, does
defend "suits",
defend does not apply to:
not apply to:
This insurance, including
This insurance, including any any duty
duty wewe have
have to to Fungi or
Fungi or Bacteria
Bacteria
defend “suits, does
defend "suits", does not apply to:
not apply to: a. “Personal
a. “Personal and advertising injury”
and advertising injury” which
which
Fungi or
Fungi or Bacteria
Bacteria would not not have occurred, in
have occurred, in whole or or inin part,
part,
“Bodily injury”
a. “Bodily
a. injury” or “property damage”
or “property damage” whichwhich but for:
but for:
would
would not not have occurred, in
have occurred, in whole
whole or or in in part,
part, 1) The
1) actual, alleged
The actual, alleged oror threatened
threatened
but for:
but for: inhalation of,
inhalation of, ingestion
ingestion of,of, contact
contact with,
with,
1) The
1) actual, alleged
The actual, alleged or or threatened
threatened exposure to,
exposure to, existence
existence of, of, or presence
or presence
inhalation of,
inhalation of, ingestion
ingestion of, of, contact
contact with,with, of, any
of, any “fungi”
“fungi” or or bacteria
bacteria on on oror within
within a a
exposure to,
exposure to, existence
existence of, of, or presence
or presence building or
building structure, including
or structure, including its its
of, any
of, any “fungi”
“fungi” or or bacteria
bacteria on on oror within aa contents; or
contents; or
building or
building structure, including
or structure, including its its 2) The
2) The failure
failure toto warn
warn oror to
to disclose
disclose the the
contents; or
contents; or presence of
presence “fungi” or
of "fungi" bacteria;
or bacteria;
2) The
2) The failure
failure to to warn or or to
to disclose
disclose the the regardless of
regardless of whether
whether any any other cause,
other cause,
presence of
presence “fungi” or
of "fungi" bacteria;
or bacteria; event, material
event, material or product contributed
or product contributed
regardless of
regardless of whether
whether any any other cause,
other cause, concurrently or
concurrently or inin any
any sequence
sequence to to such
such
event, material
event, material or product contributed
or product contributed injury or
injury damage.
or damage.
concurrently or
concurrently or in in any
any sequence
sequence to to such
such b. Any
b. loss, cost
Any loss, cost or expenses arising
or expenses arising out
out of of the
the
injury or
injury damage.
or damage. testing for, monitoring,
testing for, monitoring, cleaning
cleaning up, up,
b. Any
b. loss, cost
Any loss, cost or expenses arising
or expenses arising out
out of of the
the removing, containing,
removing, containing, treating,
treating, detox-ifying,
detox-ifying,
testing for, monitoring,
testing for, monitoring, cleaning
cleaning up, up, neutralizing, remediating
neutralizing, remediating or disposing of,
or disposing of, or
or
removing, containing,
removing, containing, treating,
treating, detoxifying,
detoxifying, in any
in any wayway responding
responding to, to, or assessing the
or assessing the
neutralizing, remediating
neutralizing, remediating or disposing of,
or disposing of, or
or effects of,
effects of, “fungi”
“fungi” or bacteria, by
or bacteria, by any
any insured
insured
in any
in any wayway responding
responding to, to, or assessing the
or assessing the or by any
or by any other person or
other person entity.
or entity.
effects of,
effects of, “fungi”
“fungi” or bacteria, by
or bacteria, by any
any insured
insured C. In Section
C. In Section V. V. DEFINITIONS
DEFINITIONS the following
the following
or by any
or by any other person or
other person entity.
or entity. definition is
definition is added:
added:
HOWEVER, this
HOWEVER, this exclusion
exclusion does does not apply to
not apply any
to any “Fungi” means
“Fungi” means any any type
type or
or form
form of fungus,
of fungus,
“fungi” or
"fungi" or bacteria
bacteria that are, are
that are, are onon oror are
are including mold
including mold or mildew, and
or mildew, and anyany mycotoxins,
mycotoxins,
contained in,
contained in, aa good
good or product intended
or product intended for for spores, scents
spores, scents or byproducts produced
or byproducts produced or or
bodily digestion.
bodily digestion. released by
released by fungi.
fungi.
B. In
B. In Section COVERAGES, COVERAGE
Section I.I. COVERAGES, COVERAGE B B–
—
PERSONAL AND
PERSONAL AND ADVERTISING
ADVERTISING INJURY INJURY
All terms
All terms and
and conditions
conditions of
of this policy apply
this policy apply unless
unless modified by this
modified by this endorsement.
endorsement.
PB 29
PB 29 99
99 02
02 15
15 copyrighted material
Includes copyrighted
Includes material of
of Insurance
Insurance Services Office, Inc.,
Services Office, Inc., with permission.
its permission.
with its Page 11 of
Page of 11
ACP BPHM2482951730
INSURED COPY 24
24 03731
03731
BUSINESSOWNERS
BUSINESSOWNERS
PB 41
PB 41 00
000515
05 15
THIS ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY.
CHANGES THE POLICY. PLEASE READ IT
CAREFULLY.
THIS ENDORSEMENT
THIS ENDORSEMENT PROVIDES
PROVIDES CLAIMS-MADE
CLAIMS-MADE COVERAGE.
COVERAGE.
AND OFFICERS
DIRECTORS AND
DIRECTORS LIABILITY
OFFICERS LIABILITY
(COOPERATIVES OR
(COOPERATIVES CONDOMINIUMS)
OR CONDOMINIUMS)
This endorsement
the following:
FORM
SCHEDULE
SCHEDULE
Limits Of
Limits Of Insurance:
Insurance: See the
See Liability Declarations
the Liability Declarations
Coverage Period:
Coverage Period: Beginning from
Beginning from the
the Retroactive
Retroactive Date
Date to
to the
the end
end of
of the Policy Period
the Policy Period stated in the
stated in the
Declarations for
Declarations for this policy.
this policy.
Retroactive Date:
Retroactive Date: See the
See Liability Declarations
the Liability Declarations
A. The
A. following is
The following is added
added to Section I.I. COVERAGES:
to Section COVERAGES: damages for
damages “wrongful acts"
for "wrongful acts” to
to which
which
this insurance
this insurance does
does not apply.
not apply.
DIRECTORS AND
DIRECTORS AND OFFICERS LIABILITY
OFFICERS LIABILITY
(COOPERATIVES OR
(COOPERATIVES CONDOMINIUMS)
OR CONDOMINIUMS) c.
c. We may, at
We may, at our
our sole discretion,
sole discretion,
investigate any
investigate any "wrongful
“wrongful acts"
acts” and
and
1. INSURING
1. INSURING AGREEMENT
AGREEMENT settle any “claim” or “suit” that may
We will
We pay those
will pay those sums up to
sums up to the applicable
the applicable result. But:
result. But:
Limit of Insurance that the “insured”,, as as (1). The
(1). The amount
amount we will pay
we will pay for damages
for damages
defined in
defined in this endorsement, becomes
this endorsement, becomes is limited
is limited asas described
described in in B.
B. LIMITS
LIMITS
legally obligated
legally obligated to pay as
to pay damages for
as damages any
for any OF INSURANCE
OF INSURANCE that follows; and
that follows; and
claims” made arising out of a “wrongful act”
committed during
committed during the Coverage Period
the Coverage Period (2). Our
(2). right and
Our right duty to
and duty to defend
defend willwill end
end
shown in
shown in the
the Schedule
Schedule of of this
this endorsement
endorsement when we have have used used upup the
the
and to
and to which this insurance
which this applies. A
insurance applies. A applicable limit
applicable limit ofof insurance
insurance in in the
the
claim damages will
seeking damages
claim” seeking be deemed
will be deemed to to payment of
payment of judgments
judgments or or
have been
have made when notice of such “claim”
been made settlements under
settlements under this coverage.
this coverage.
is received
is received and and recorded
recorded by by an
an “insured”
insured or or No other
No obligation or
other obligation liability to
or liability pay sums
to pay sums or or
us, whichever
by us,
by comes first
whichever comes during the
first during the perform acts
perform acts oror services
services is is covered
covered unless
unless
Coverage Period
Coverage Period shown
shown inin the
the Schedule
Schedule ofof explicitly provided
explicitly provided for for under
under
this endorsement.
this endorsement. Any Any “claims” received SUPPLEMENTARY PAYMENTS
SUPPLEMENTARY PAYMENTS —
and recorded
and recorded by by the
the “insured” sixty
insured within sixty COVERAGES A
COVERAGES A AND
AND B. B.
(60) days
(60) days after
after the
the end
end of
of the policy period
the policy period 2. SUPPLEMENTAL
2. SUPPLEMENTAL EXTENDED EXTENDED
will be considered
will be considered to to have
have been
been received
received REPORTING PERIOD
REPORTING PERIOD
within
within the policy period.
the policy We will
period. We have the
will have the
IfIf the policy to
the policy to which
which thisthis DIRECTORS
DIRECTORS AND AND
right and duty to defend any “insured”
OFFICERS LIABILITY
OFFICERS LIABILITY endorsement
endorsement is is
against a “suit” seeking those damages for a
claim” for which there is coverage under attached is
attached is cancelled
cancelled or or non-renewed
non-renewed for for
any reason, you
any reason, you have
have the option to
the option to extend
extend
DIRECTORS AND
DIRECTORS AND OFFICERS LIABILITY.
OFFICERS LIABILITY.
the reporting period
the reporting period of of this
this endorsement
endorsement
HOWEVER,
HOWEVER, upon payment
upon payment of of an
an additional premium.
additional premium.
a. No coverage applies for any wrongful
a. ongful HOWEVER, this
HOWEVER, supplemental extended
this supplemental extended
acts” which occur prior to the reporting period
reporting period applies:
applies:
Retroactive Date
Retroactive Date shown
shown inin the
the
Declarations, and a. Only to a wrongful act” which occurred
a.
Declarations, and during the Coverage Period; Period; and
during the Coverage and
b. We
b. We will have no
will have duty to
no duty to defend
defend the
the
“insured” against any “suit” seeking
PB 41
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Page of 44
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b. Only ifif this

b. Only option is
this option is exercised
exercised within
within orientation, marital
orientation, status, religion
marital status, religion or
or
sixty (60)
sixty (60) days
days after
after the expiration date
the expiration date religious belief, age,
religious belief, age, economic
economic
of the
of policy or
the policy or this
this endorsement.
endorsement. status, income,
status, income, medical condition,
medical condition,
In Section
3. In
3. COVERAGES, under
Section I.I. COVERAGES, under D.D. pregnancy, parenthood
pregnancy, parenthood or or mental
mental or
or
SUPPLEMENTARY PAYMENTS,
SUPPLEMENTARY PAYMENTS, the the physical disability;
physical disability;
following provision
following provision is is added:
added: (2) Any
(2) state, federal
Any state, federal or governmental
or governmental
Paragraph 1.
Paragraph 1. of
of the
the SUPPLEMENTARY
SUPPLEMENTARY antitrust statute
antitrust statute or regulation,
or regulation,
PAYMENTS COVERAGES
PAYMENTS -
COVE RAG ES A A AND
AND B B also
also including but
including but not
not limited
limited toto the
the
applies to
applies to the coverage provided
the coverage provided by
by Racketeer Influenced
Racketeer Influenced and Corrupt
and Corrupt
DIRECTORS AND
OFFICERS LIABILITY. Organizations Act
Organizations (RICO), the
Act (RICO), the
Securities Act
Securities Act of 1 933, the
of 1933, the
4. EXCLUSIONS
4. EXCLUSIONS Exchange Act
Securities Exchange
Securities Act of 1934, or
of 1934, or
The following exclusions
The following apply to
exclusions apply to any state
any state Blue law;
Sky law;
Blue Sky
DIRECTORS AND
OFFICERS LIABILITY. (3) The
(3) Employees’ Retirement
The Employees' Retirement Income
Income
insurance, including
This insurance,
This including anyany duty
duty we
we have
have 1974; or
Security Act
Security (E.R.l.S.A.) of
Act (E.R.I.S.A.) of 1974; or
to defend “suits”, does not apply to claims”:
(4) Any
(4) Any other
other similar statutes,
similar statutes,
a. For “bodily injury” or “personal and
a. ordinances, orders,
ordinances, orders, directives
directives oror
advertising injury”.
adv
regulations.
regulations.
b. Due to “property damage” to any owned
b.
i. punitive damages.
For punitive
For damages.
or non-owned
or property, including
non-owned property, including loss
loss of
of
use thereof
use thereof oror loss
loss of earnings
of earnings HOWEVER, if a suit” is brought against
therefrom, whether
therefrom, whether such such loss
loss shall
shall be
be the “insured” with respect to a “claim” for
direct or
direct or indirect
indirect or or of contingent nature.
of contingent nature. acts or
acts alleged acts
or alleged falling within
acts falling within thethe
coverage of
coverage of this endorsement, seeking
this endorsement, seeking
c. For
c. For an accounting of
an accounting profits or
of profits or losses
losses compensatoryand
both compensatory
both punitive or
and punitive or
made from
made from the purchase or
the purchase or sale
sale of
of exemplary damages,
exemplary damages, then then we will
we will
securities.
securities.
provide aa defense
provide defense to to such
such action
action without
d. For
d. salary, compensation
For salary, compensation or or bonuses
bonuses liability for
liability for such punitive or
such punitive exemplary
or exemplary
voted
voted toto “directors” or officers” by by your
your damages.
damages.
Board of
Board of Directors.
Directors. j.j. If judgments adverse to the “insured”
e. For
e. anything other
For anything other than money
than money establish that
establish that their
their affirmative dishonesty
affirmative dishonesty
damages.
damages. or actual
or actual intent
intent to
to deceive
deceive or or defraud
defraud
f. Based
f. Based on on or
or attributable
attributable to any:
to any: was material to
was material to the
the cause
cause of of action
action so so
(1) “Wrongful acts” in judgmentt or
(1) or adjudicated.
adjudicated.
discretion in
discretion in procuring
procuring andand k. For
k. any injury
For any injury or damage arising
or damage arising outout of:
of:
maintaining insurance
maintaining insurance or bonds;
or bonds; (1) Asbestos
(1) including but
Asbestos including but not
not limited
limited to
to
(2) Failure
(2) Failure or or omission
omission in in effecting
effecting and
and any injury
any injury or damage related
or damage related to,to,
maintaining insurance
maintaining insurance or bonds; or
or bonds; or arising or
arising alleged to
or alleged to have
have arisen
arisen out
out
(3) Wrongful acts” with respect to
(3) of any
of use, exposure,
any use, existence,
exposure, existence,
amounts, forms,
amounts, forms, conditions
conditions or or detection, removal,
detection, removal, elimination,
elimination,
provisions of
provisions of insurance
insurance or or bonds.
bonds. avoidance, act,
avoidance, act, error,
error, omission,
omission,
failure to
failure to disclose
disclose or or warn ofof the
the
g. For
g. transactions of any “insured” gaining
For transact presence of
presence of asbestos
asbestos or any other
or any other
a personal profit
a personal profit or advantage not
or advantage not duty involving
duty asbestos;
involving asbestos;
equitably by
shared equitably
shared by your
your owners.
owners.
(2) Electromagnetic
(2) Electromagnetic emissions
emissions or or
h. For
h. any liability
For any liability or legal obligation
or legal obligation of any
of any radiation including but
radiation including but not
not limited
limited toto
“insured” arising out of any of the any injury
any injury or damage related
or damage related to,to,
following:
following: arising or
arising alleged to
or alleged to have
have arisen
arisen out
out
(1) Any
(1) federal, state,
Any federal, state, county,
county, municipal
municipal of any
of use, exposure,
any use, existence,
exposure, existence,
or local
or local law,
law, ordinance, order,
ordinance, order, detection, removal,
detection, removal, elimination,
elimination,
directive or
directive regulation barring
or regulation barring avoidance, act,
avoidance, act, error,
error, omission,
omission,
discrimination, including
discrimination, including but
but not
not failure to
failure to disclose
disclose or or warn
warn ofof the
the
limited to
limited to those
those based
based on race,
on race, presence of
presence electromagnetic
of electromagnetic
color, national
color, origin, ancestry,
national origin, ancestry, emissions or
emissions or radiation
radiation or any other
or any other
citizenship, gender,
citizenship, gender, sexual
sexual
Page 22 of
Page of 44 All terms
All and conditions
terms and conditions of
modified by endorsement.
this endorsement. PB 41
PB 41 00
000515
05 15
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INSURED COPY 24
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03733
PB 41
PB 41 00
000515
05 15
duty involving
duty involving electromagnetic
electromagnetic defamation, harassment,
discipline, defamation,
discipline, harassment,
emissions or
emissions radiation;
or radiation; humiliation or
humiliation discrimination; or
or discrimination; or
(3) Lead
(3) including but
Lead including but notnot limited
limited to any
to any (4) The
(4) spouse, child,
The spouse, child, parent,
parent, brother
brother or or
injury or
injury damage related
or damage related to, to, arising
arising sister of
sister of that person as
that person as aa
or alleged to
or alleged to have
have arisen
arisen out out of any
of any consequence of
consequence any of
of any of the
the
use, exposure,
use, existence, detection,
exposure, existence, detection, employment-related practices
employment-related practices
removal, elimination,
removal, elimination, avoidance,
avoidance, act, act, described in
described in Paragraphs
Paragraphs (1), (1), (2),
(2), or
or
error, omission,
error, omission, failure
failure to to disclose
disclose or or (3) above.
(3) above.
warn
warn of of the presence of
the presence of lead
lead or any
or any This exclusion
This applies:
exclusion applies:
duty involving
other duty
other involving lead; lead; or or
(1) Whether the insured” may be liable
(1)
(4) Radon
(4) Radon or any other
or any other radioactive
radioactive as an
as employer or
an employer in any
or in any other
other
emissions, manmade
emissions, manmade or natural,
or natural, capacity; and
capacity; and
including but
including but notnot limited
limited to any injury
to any injury
damage related
or damage
or related to, to, arising
arising or or (2) To
(2) any obligation
To any obligation to to share damages
share damages
with
with or repay someone
or repay someone else else whowho
alleged to
alleged to have
have arisen
arisen out out of any
of any
use, exposure, existence, detection,
detection, must pay
must pay damages
damages because because of of the
the
use, exposure, existence,
removal, elimination,
elimination, avoidance,
avoidance, act, act, injury.
injury.
removal,
error, omission,
error, omission, failure
failure to to disclose
disclose or or n. Based
n. Based in in equity,
equity, including
including but but notnot limited
limited
warn of of the presence of
the presence of radon
radon or or to injunctive relief.
to injunctive relief.
any other
any other radioactive
radioactive emissions
emissions or or o. For
o. For anyany construction
construction or development
or development
any other
any duty involving
other duty involving radon radon or or activities or
activities operations performed
or operations performed by by oror
other radioactive
other radioactive emissions.
emissions. on behalf
on behalf of of the developer/sponsorof
the developer/sponsor of
l.I. For:
For: your association's
your association’s property,property, including
including but but
not limited
not limited to, to, loss
loss or damage arising
or damage arising outout
(1) Any
(1) Any injury
injury or damage arising
or damage arising out out ofof construction, construction materials,
actual, alleged
alleged or of construction,
of construction materials,
the actual,
the or threatened
threatened
discharge, dispersal,
discharge, dispersal, seepage,
seepage, landscape, design,
landscape, design, surveys,
surveys, or or
engineering services
engineering performed by
services performed by or
or on
on
migration, release
migration, release or escape of
or escape of
“pollutants” at
"pollutants" any time.
at any time. behalf of
behalf of such developer/sponsor.
such developer/sponsor.
(2) Any
(2) loss, cost
Any loss, cost or expense arising
or expense arising out out B. LIMITS
B. LIMITS OF OF INSURANCE
INSURANCE
any:
of any:
of Directors and
1. Directors and Officers Liability Aggregate
Officers Liability Aggregate
(a) Request,
(a) Request, demand,demand, order order or or Limit
Limit
statutory or
statutory regulatory
or regulatory The Limit
The Limit OfOf Insurance
Insurance stated stated in in the
the
requirement that
requirement that anyany insured
insured” Declarations as
Declarations aggregate is
as aggregate is the
the mostmost we we
or others
or others test for, monitor,
test for, monitor, clean clean will pay for
will pay for all
all loss
loss covered
covered under under
remove, contain,
up, remove,
up, contain, treat,
treat, DIRECTORS AND
DIRECTORS AND OFFICERS
OFFICERS LIABILITY. LIABILITY.
detoxify or
detoxify neutralize, or
or neutralize, or inin any
any 2. Directors
2. Directors and and Officers Liability Wrongful
Officers Liability Wrongful
way respond to,
way respond to, oror assess
assess the the Act Limit
Act Limit
effects of,
effects of, "pollutants";
“pollutants; or or
Subject to
Subject to 1. Above, the
1. Above, the Limit
Limit Of Of Insurance
Insurance
(b) “Claim” or “suit” by or on behalf of a
(b) stated in
stated in the
the Declarations
Declarations as applicable to
as applicable to
governmental authority
governmental authority for for each wrongful act” is
each is the
the most
most we will pay
we will pay
damages because
damages because of testing for,
of testing for, for all
for all loss
loss incurred
incurred on on account
account of any one
of any one
monitoring, cleaning
monitoring, cleaning up, up, removing,
removing, “wrongful act” covered covered under under DIRECTORS
DIRECTORS
containing, treating,
containing, treating, detoxifying
detoxifying or or AND OFFICERS
AND OFFICERS LIABILITY. LIABILITY.
neutralizing, or
neutralizing, or inin any
any wayway
responding to,
responding to, or assessing the
or assessing the 3. All “claims” or “suits” arising out of the same
3.
effect of pollutants”. “wrongful act” shall be considered as arising arising
out of
out one wrongful
of one wrongful act act”..
m. For:
m. For:
4. The inclusion of more than one “insured”
4.
(1) Refusal
(1) Refusal to employ;
to employ; shall not
shall operate to
not operate to increase
increase the the Limits
Limits Of Of
(2) Termination
(2) Termination of employment;
of employment; Insurance. Our
Insurance. Our maximum
maximum liability will not
liability will not
(3) Employment-related
(3) Employment-related practices,
practices, policies,
policies, exceed the
exceed the limits
limits stated
stated in in the
the Declarations.
Declarations.
acts or
acts omissions, such
or omissions, such as coercion,
as coercion, 5. The
5. The Limits
Limits of of Insurance
Insurance for for DIRECTORS
DIRECTORS
demotion, evaluation,
demotion, evaluation, reassignment,
reassignment, AND OFFICERS
AND OFFICERS LIABILITY LIABILITY stated stated in in the
the
Declarations apply
Declarations apply separately
separately to to each
each
PB 41
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Page 33 of
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PB 41
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consecutive annual
consecutive annual periodperiod and
and to any
to any Spouses of current or former “directors”
e. Spouses
e.
remaining period
remaining period of of less
less than
than 12 months,
12 months, or “officers” and legally recognized
and legally recognized
starting with
starting with the beginning of
the beginning of the policy
the policy domestic partners of
domestic partners of current
current or
or former
former
period shown
period shown in in the Declarations, unless
the Declarations, unless the the or “officers”,
directors” or
directors officers but only for
policy period
policy period isis extended
extended after after issuance
issuance for for “claims” arising out
claims arising out of
of “claims” against
claims against
an additional
an period of
additional period of less
less than
than 12 12 months.
months. those “directors”
d or oofficers” and only
and only
In that
In case, the
that case, the additional period will
additional period be
will be while acting at
while acting direction, or
your direction,
at your or the
the
deemed part
deemed part of
of the
the last preceding period
last preceding period forfor direction of your directors” or “officers”,
purposes of
purposes determining the
of determining the Limits
Limits ofof and within
and scope of
the scope
within the of their
their duties
duties for
for
Insurance.
Insurance. you.
you.
C. AMENDED CONDITION
C. AMENDED CONDITION f.
f. Any other
Any other natural person, and
natural person, and their
their
Under Section
Under Section IV.IV. LIABILITY CONDITIONS, the
LIABILITY CONDITIONS, the estate, guardian
estate, guardian or legal representative,
or legal representative,
following is
following is added
added to to Condition
Condition 2. 2. Duties
Duties inin the
the who isis no
no longer your director” or
longer your
Event of
Event Occurrence, Offense,
of Occurrence, Offense, ClaimClaim or Suit,
or Suit, “officer” at
at the
the time
time of discovery of
of discovery of aa
paragraph a.:
paragraph a.: wrongful act”, but who was a director”
You and any other “insured” must must also
also see
see toto itit or “officer” at the time the wrongful act”
that we are
that are notified
notified as as soon
soon as practicable of
as practicable of aa was committed.
committed.
“wrongful act” that may result in a “claim”. 4. "Officer"
4. “Officer” means person holding
means aa person holding any any of
of the
the
D. ADDITIONAL
D. ADDITIONAL DEFINITIONS
DEFINITIONS officer positions created
officer positions created by by your charter,
your charter,
constitution, by-laws
constitution, by-laws or any other
or any other similar
similar
The following additional
The following additional definitions
definitions are
are added
added toto governing document.
governing document.
Section V.
Section V. DEFINITIONS:
DEFINITIONS:
5. With
5. respect only
With respect only toto the coverage provided
the coverage provided
1. “Claim” means
1. means aa demand
demand for damages.
for damages. by this endorsement, the definition of “suit” is
However, claim
However, claim shall
shall notnot include
include court
court cost
cost replaced by:
replaced by:
or attorney fees
or attorney fees when
when otherother than monetary
than monetary
damages are
damages sought.
are sought. “Suit’ means
means aa civil proceeding in
civil proceeding in which
which
damages be
damages because of any wrongful act” to
2. “Director” means
2. means aa director
director of
of the
the Named
Named which this insurance
which this applies are
insurance applies alleged.
are alleged.
Insureds shown
Insureds shown onon thethe Declarations.
Declarations. “Suit” includes:
"Suit" includes:
3. With
3. respect only
With respect only to
to the coverage provided
the coverage provided a. An
a. An arbitration proceeding in
arbitration proceeding in which
which such
such
by this
by this endorsement
endorsement and superseding any
and superseding any damages are
damages are claimed
claimed and and to to which the
which the
other meaning:
other meaning: insured” must
insured must submit
submit or or does
does submit
submit
“Insured” means:means: with consent; or
our consent;
with our or
a. You;
a. You; b. Any other
b. Any other alternative dispute resolution
alternative dispute resolution
b. Your “directors” or officers”,, but
b. Your only
but only proceeding in
proceeding in which such damages are
such damages are
respect to
with respect to their
their duties
duties for you;
for you; claimed and
claimed and toto which
which thethe “insured’
insured
c. Your
c. Your current
current or former;
or former; submits with our
submits our consent.
consent.
(1) Employees;
(1) Employees; 6. “Wrongful act” means
6. means any any actual
actual or or
alleged negligent:
alleged negligent:
(2) Committee
(2) members;
Committee members;
Act;
a. Act;
a.
(3) Board
(3) members;
Board members;
Error;
b. Error;
b.
Volunteers;
(4) Volunteers;
(4)
Omission;
c. Omission;
c.
only while acting
but only
but acting atat your direction, or
your direction, or
Mistake;
d. Mistake;
d.
the direction
the direction of your “directors” or
of your
“officers”,, and
and within the scope of
the scope of their
their e. Misstatement;
e. Misstatement;
duties for
duties you.
for you. f. Misleading
f. Misleading statement
statement or; or;
d. Your
d. property or
Your property or real
real estate manager;
estate manager; g. Breach
g. Breach of duty;
of duty;
only while acting
but only
but acting atat your direction, or
your direction, or committed by
committed by or
or at
at the
the direction
direction of of aa
the direction
the direction of your “directors” or
of your “director” or officer” while acting within within the
the
“officers”,, and
and within the scope of
the scope of their
their scope or
scope or their duties, individually
their duties, individually or or
duties for
duties you.
for you. collectively
collectively
HOWEVER, your
HOWEVER, your property
property or
or real
real estate
estate
manager is not an “insured” for “claims”
ma
or “suits” brought against them by you.
Page 44 of
Page of 44 All terms
All and conditions
terms and conditions of
modified by endorsement.
this endorsement. PB 41
PB 41 00
000515
05 15
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INSURED COPY 24
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03735
BUSINESSOWNERS
BUSINESSOWNERS
PB 90
PB 90450515
45 05 15
THE POLICY.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
VIRGINIA AMENDATORY ENDORSEMENT

This endorsement
the following:
PREMIER BUSINESSOWNERS COMMON
COMMON POLICY
POLICY CONDITIONS
CONDITIONS
PREMIER BUSINESSOWNERS PROPERTY
PROPERTY COVERAGE
COVERAGE FORM
FORM
FORM
A. In
A. In the
the COMMON
COMMON POLICY CONDITIONS,
POLICY CONDITIONS, (2) Because
(2) Because you you no longer has
no longer has aa
condition A.
condition A. CANCELLATION
CANCELLATION is replaced by
is replaced by the
the financial or
financial or insurable
insurable interest
interest in in the
the
following:
following: property or
property or business operation that
business operation that
CANCELLATION
CANCELLATION is the
is subject of
the subject insurance; or
of insurance; or
1. The
1. The first
first Named
Named InsuredInsured shownshown in in the
the (3) And
(3) And is is rewritten
rewritten in in the
the same
same
Declarations may
Declarations may cancel
cancel this policy by
this policy by company or
company group.
or group.
mailing or
mailing delivering to
or delivering to us
us advance
advance written
written b. When
b. When this policy is
this policy is cancelled
cancelled at your
at your
notice of
notice of cancellation.
cancellation. request (except
request (except when paragraphs (2)
when paragraphs (2) oror
2. We
2. We maymay cancel
cancel this policy by
this policy by mailing
mailing or or (3) apply),
(3) apply), we will return
we will return 90% 90% of of the
the propro
delivering to
delivering to the
the first
first Named
Named Insured
Insured written
written rata unearned
rata premium, rounded
unearned premium, rounded to to the
the
notice of
notice cancellation, stating
of cancellation, stating the
the reason
reason for for next higher whole
next higher whole dollar.
dollar.
cancellation, at
cancellation, at least:
least: 6. IfIf notice
6. notice is mailed, proof
is mailed, proof of mailing will
of mailing will bebe
a. 15
a. 1 5 days
days before
before the the effective
effective datedate of of sufficient proof
sufficient proof of of notice.
notice.
cancellation ifif we
cancellation we cancel
cancel forfor B. The
B. following conditions
The following conditions are are added
added to to the
the
nonpayment of
nonpayment premium; or
of premium; or COMMON POLICY
COMMON POLICY CONDITIONS:
CONDITIONS:
b. 45
b. days before
45 days before the the effective
effective datedate of of NON REN EWAL
NONRENEWAL
cancellation ifif we
cancellation we cancel
cancel for any other
for any other 1. IfIf we elect
1. elect notnot toto renew
renew this policy, we will
this policy, will
reason.
reason. mail or
mail or deliver
deliver aa noticenotice of of nonrenewal
nonrenewal to to the
the
3. We
3. We will mail or
will mail or deliver
deliver written
written notice
notice to to the
the first Named
first Insured, stating
Named Insured, stating the the reason
reason for for
first Named
first Named Insured’s
Insured’s last mailing address
last mailing address nonrenewal, at
nonrenewal, at least:
least:
known to
known us. IfIf notice
to us. notice is mailed, itit will
is mailed, will be
be a. 15
a. 1 5 days
days before
before the expiration date
the expiration date ifif the
the
sent by
sent by ordinary
ordinary mail mail forfor which
which a a certificate
certificate nonrenewal is
nonrenewal is due
due to nonpayment of
to nonpayment of
of mailing has
of mailing has been obtained, or
been obtained, by
or by premium; or
premium; or
registered or
registered or certified
certified mail.mail.
b. 45
b. days before
45 days before the expiration date
the expiration date ifif the
the
4. Our
4. Our notice will state
notice will state thethe effective
effective datedate of of nonrenewal is
nonrenewal is for any other
for any other reason.
reason.
cancellation. The
cancellation. The policy period will
policy period end on
will end on
2. We
2. We will mail or
will mail or deliver
deliver written notice of
written notice of
that date.
that date.
nonrenewal to
nonrenewal to the
the first
first Named
Named Insured’s
Insured’s last last
5. IfIf this
5. policy is
this policy cancelled, we
is cancelled, we will send the
will send the mailing address
mailing address known known to us. IfIf notice
to us. notice is is
first Named
first Named Insured
Insured any any premium
premium refund refund mailed, itit will
mailed, will be
be sent
sent by by ordinary
ordinary mail mail forfor
due. The
due. The cancellation
cancellation will will be
be effective even ifif
effective even which aa Certificate
Certificate of Mailing has
of Mailing has been
been
we have
have notnot made
made or or offered
offered aa refund.
refund. The The obtained, or
obtained, by registered
or by registered or or certified mail. IfIf
certified mail.
following provisions
following provisions govern govern calculation
calculation of of notice is
notice mailed, proof
is mailed, proof of mailing will
of mailing will be
be
return premium.
return premium. sufficient proof
sufficient proof of of notice.
notice.
a. We
a. We will compute the
will compute the return premium pro
return premium pro
rata and
rata and round
round to to the
the next higher whole
next higher
dollar when
dollar when this policy is
this policy is cancelled:
cancelled:
(1) At
(1) Atourrequest;
our request;
PB 90
PB 90 45
45 05
05 15
15
Includes copyrighted material
Includes copyrighted material of
of Insurance
its permission.
with its Page 11 of
Page of 55
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PB 90
PB 90450515
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C. In the
C. In the COMMON
COMMON POLICY CONDITIONS, under
POLICY CONDITIONS, under (2) The
(2) The service
service charge charge is is not
not made
made in in
Condition H.
Condition H. OTHER
OTHER INSURANCE, INSURANCE, paragraph paragraph response to
response to aa call
call outside
outside of of the
the volunteer
volunteer
1. is
1. replaced by
is replaced by the following:
the following: department’s fire
fire department’s
fire fire protection district, city
protection district, city
or municipality pursuant
or municipality pursuant to to aa contract.
contract.
1. Under
1. Under any any property
property coveragecoverage provided
provided by by
this policy, ifif there
this policy, there is is other
other insurance
insurance c. No
c. No deductible
deductible applies applies to to this
this Additional
Additional
covering the
covering the same
same loss loss or damage, we
or damage, we willwill Coverage.
Coverage.
pay our
pay our share
share of of the
the covered
covered loss loss or or 2. Under
2. Under Section
Section E. E. PROPERTY
PROPERTY LOSS LOSS
damage. Our
damage. Our shareshare is is the proportion that
the proportion that thethe CONDITIONS, paragraph
CONDITIONS, paragraph 2. 2. Appraisal
Appraisal is is
applicable Limit
applicable Limit of of Insurance
Insurance under under this this replaced by
replaced by the following:
the following:
policy bears
policy bears to to the
the Limits
Limits of of Insurance
Insurance of of all
all
Appraisal
Appraisal
insurance covering
insurance covering on on the
the same
same basis.basis. But But
we will
will notnot paypay more more than than the applicable
the applicable IfIf we and
and you you disagree
disagree on on thethe value
value of of the
the
Limit of
Limit of Insurance.
Insurance. property or
property or the
the amount
amount of loss, either
of loss, either maymay
D. AMENDMENTS
D. AMENDMENTS TO TO THE THE PROPERTY
PROPERTY make written
make written demand demand for for an appraisal of
an appraisal of the
the
loss. In
loss. In this event, each
this event, party will
each party select aa
will select
COVERAGE FORM
COVERAGE FORM
1. Under COVERAGES, The
A. COVERAGES, competent and
competent impartial appraiser.
and impartial appraiser. You You and and
1. Under Section
Section A. The Fire Fire
Department Service
Department Service Charge Charge Additional
Additional we must notify the
must notify the other
other of of the appraiser
the appraiser
selected within
selected within 20 days of
20 days of the
the written
written demand
demand
Coverage is
Coverage replaced by
the following:
for appraisal. The
for appraisal. The two appraisers will
two appraisers will select
select
Fire Department Service
Fire Department Service Charge Charge umpire. IfIf the
an umpire.
an appraisers do
the appraisers do not agree on
not agree on
a. When
a. When the the fire department is
fire department is called
called to to save
save the selection
the selection of of an umpire within
an umpire within 15 days, the
15 days, the
or protect Covered
or protect Covered Property Property fromfrom aa Covered
Covered insured or
insured or the
the insurer
insurer may may applyapply in in writing, for for
Cause of
Cause Loss, we
of Loss, we will pay up
will pay up to $2,500 for
to $2,500 for appointment of
the appointment
the of an umpire, to
an umpire, the judge
to the judge of of
service at
service at each premises described
each premises described in in the
the the circuit
the circuit court
court of of the county or
the county city in
or city in which
which
Declarations, unless
Declarations, unless aa different
different limit
limit is is damaged or
the damaged
the destroyed property
or destroyed property was was
shown in
shown in the
the Declarations.
Declarations. Such Such limitlimit is is the
the located at
located at the
the time
time of of loss.
loss. The appraisers will
The appraisers will
most we will
most pay regardless
will pay regardless of of the
the number
number of of state separately the
state separately the value
value of of the property and
the property and
responding fire
responding departments or
fire departments or fire units,
fire units, amount of
amount loss. IfIf the
of loss. appraisers submit
the appraisers submit aa
report of
written report of an agreement to
an agreement us, the
to us, the
and regardless of
and regardless of the
the number
number or type of
or type of
amount agreed
amount agreed upon upon will be the
will be the amount
amount of of
services performed.
services performed. loss. IfIf they
loss. they fail fail to agree, they
to agree, they willwill submit
submit theirtheir
This Additional
This Additional Coverage Coverage applies applies to your
to your differences to
differences to the umpire. A
the umpire. A decision
decision agreedagreed
liability for
liability for fire department service
fire department charges:
service charges: to by
to by any
any two two setset the the amount
amount of of loss.
loss. AnyAny
outcome of
outcome of the appraisal will
the appraisal will be binding on
be binding on
(1) Assumed
(1) Assumed by by contract
contract or agreement prior
or agreement prior both parties. IfIf you
both parties. you makemake aa written
written demand
demand
to loss; or
to loss; or loss, each
for an
for appraisal of
an appraisal of the
the loss, each party will:
party will:
(2) Required
(2) Required by by local
local ordinance.
ordinance. a. Pay
a. Pay its its own appraiser; and
own appraiser; and
b. IfIf the
b. the fire department service
fire department charge is
service charge is not
not b. Bear
b. Bear the the other expenses of
other expenses of the
the
covered under
covered under the the terms
terms of Paragraph a.,
of Paragraph a., appraisal and
appraisal umpire equally.
and umpire equally.
then the
then following applies:
the following applies: However, ifif we make
However, make written
written demand
demand for for anan
When aa volunteer
When volunteer fire department is
fire department is called
called appraisal of
appraisal of the loss, we
the loss, will reimburse
we will reimburse you you
to save
to save or protect the
or protect the Covered Property from
Covered Property from for the
for the reasonable
reasonable cost cost of your chosen
of your chosen
aa Covered
Covered Cause Cause of Loss, we
of Loss, will pay
we will pay thethe appraiser, and
appraiser, and for your portion
for your portion of of the
the cost
cost ofof
amount billed
amount billed to you, up
to you, up to $250, unless
to $250, unless aa the umpire.
the umpire.
different limit
different limit is is shown
shown in in the
the Declarations
Declarations IfIf there
there is is an appraisal, we
an appraisal, we willwill still
still retain
retain our our
for volunteer fire
for department services
fire department services right to
right deny the
to deny the claim.
claim.
charges.
charges. 3. Under
3. Under Section
PROPERTY LOSS LOSS
This Additional
This Additional Coverage Coverage applies applies to your
to your CONDITIONS, 3.
CONDITIONS, 3. Duties
Duties In In The
The Event
Event Of Of Loss
Loss
liability for
liability for service
service charges charges billed
billed to you by
to you by Or Damage, paragraph
Or Damage, paragraph a.(1) a.(1) does
does not apply.
not apply.
aa volunteer fire department, provided
fire department, provided that: that: 4. Under
4. Under Section
PROPERTY LOSS LOSS
(1)-The
(1) The volunteer fire department is
fire department is not fully
not fully CONDITIONS, 5.
CONDITIONS, 5. Loss Payment, paragraph
Loss Payment, paragraph
funded by
funded by real
real estate
estate taxes taxes or or other
other e.(1 )(b) is
e.(1)(b) replaced by
the following:
property taxes:
property taxes: and and
Page 22 of
Page of 55 copyrighted material
of Insurance
its permission.
with its PB 90
PB 90 45
45 05
05 15
15
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INSURED COPY 24
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03737
PB 90
PB 90450515
45 05 15
(c) You
(c) You may may makemake an an initial
initial claim
claim for for loss
loss or or c.
c. We renew
We renew or replace the
or replace policy to
the policy to
damage covered
damage covered by by this
this insurance
insurance on on which this
this endorsement
endorsement is is attached
attached
an actual
an actual cash
cash value basis basis instead
instead of of on
on with insurance
insurance that:
that:
a replacement cost
a replacement cost basis.
basis. In In the
the event
event (1) Has
(1) Has aa Retroactive
Retroactive Date Date later
later
you elect
you elect toto have
have loss
loss or damage settled
or damage settled than the
than the date
date shown
shown in in the
the
on an
on an actual
actual cashcash value basis, you
value basis, you maymay Declarations; or
Declarations; or
still make
still make aa claimclaim on replacement cost
on aa replacement cost act, error
basis ifif you
basis you notify
notify usus of your intent
of your intent to to do
do (2) Does
(2) Does not apply to
not apply to an
an act, error oror
omission on
omission on aa claims-made
claims-made
so within
so within 6 6 months
months of of the
the later
later of of the
the
following dates: basis.
basis.
following dates:
HOWEVER, this
HOWEVER, right to
this right purchase an
to purchase an
i.i. The
The last
last date
date onon which you you received
received
value; or Extended Reporting Period
Extended Reporting Period doesdoes notnot
a payment for
a payment for actual
actual cash cash value; or
apply ifif cancellation
apply cancellation or or nonrenewal
nonrenewal is is
ii. The
ii. The date
date of entry of
of entry of aa final
final order
order of of aa due to
due non-payment of
to non-payment premium, failure
of premium, failure
court of
court competent jurisdiction
of competent jurisdiction to comply with
to comply terms or
with terms or conditions
conditions of of the
the
declaring your
declaring your right
right toto full
full policy, or
policy, or fraud.
fraud.
replacement cost.
replacement cost.
3. IfIf the
3. the DIRECTORS
DIRECTORS AND AND OFFICERS
OFFICERS
E. AMENDMENTS
E. AMENDMENTS TO TO ENDORSEMENTS
ENDORSEMENTS LIABILITY endorsement, form
LIABILITY endorsement, PB41 00, is
form PB4100, is aa
1. IfIf the
1. the CONDOMINIUM
CONDOMINIUM COMMERCIAL COMMERCIAL part of
part of this policy, then
this policy, then under
under Section
Section A., A.,
UNIT-OWNERS OPTIONAL
UNIT-OWNERS OPTIONAL COVERAGE COVERAGE paragraph 2.
paragraph 2. SUPPLEMENTAL
SUPPLEMENTAL EXTENDED EXTENDED
endorsement, form
endorsement, PB1 703, is
form PB1703, part of
is aa part of this
this REPORTING PERIOD
REPORTING PERIOD is replaced by
is replaced by the
the
policy, then
policy, then under
under B. B. MISCELLANEOUS
MISCELLANEOUS following:
following:
REAL PROPERTY
REAL PROPERTY COVERAGE COVERAGE in in that
that
endorsement, paragraph paragraph 2. 2. does apply. SUPPLEMENTAL EXTENDED
SUPPLEMENTAL EXTENDED
endorsement, does not not apply.
REPORTING PERIOD
REPORTING PERIOD
2. IfIf the
2. the EMPLOYEE
EMPLOYEE BENFITS BEN FITS LIABILITY
LIABILITY
endorsement, form PB0498, is a. If:
a. If:
COVERAGE endorsement,
COVERAGE form PB0498, is
part of
a part
a of this policy:
this policy: (1) The
(1) policy to
The policy to which
which thisthis
DIRECTORS AND
DIRECTORS AND OFFICERS
OFFICERS
a. Paragraph C.3.
a. Paragraph C.3. inin that
that endorsement
endorsement is is
replaced by by the following: LIABILITY endorsement
LIABILITY endorsement is is attached
attached
replaced the following: renewed;
is canceled
is canceled or or not
not renewed;
Any organization
Any organization you you newly
newly acquire acquire or or
(2) We
(2) We renew
renew or replace the
or replace policy but
the policy but
form other
form other than partnership, joint
than aa partnership, joint
liability company,
company, and remove the
remove the DIRECTORS
DIRECTORS AND AND
venture
venture or or limited
limited liability and
LIABILITY
OFFICERS LIABILITY
OFFICERS
over which
over which you you maintain ownership or
maintain ownership or endorsement; or
interest, will endorsement; or
majority interest,
majority will qualify
qualify as as anan
Insured ifif no
Insured no other
other similar
similar insurance
insurance (3) We
(3) We renew
or replace policy to
the policy to
applies to
applies to that organization
that organization which this
this endorsement
endorsement is is attached
attached
with insurance that:
with insurance that:
b. Under
b. Under Section
Section G. EXTENDED
G. EXTENDED
REPORTING PERIOD
REPORTING PERIOD in in that
that (a) Has
(a) Has aa Retroactive
Retroactive Date Date later
later
endorsement, paragraph
endorsement, paragraph 1. 1. is replaced
is replaced than the
than the date
date shown
shown in in the
the
by the
by following:
the following: Declarations; or
Declarations; or
EXTENDED REPORTING
EXTENDED REPORTING PERIOD PERIOD (b) Does
(b) Does not apply to
not apply to an act, error
an act, error
1. You or omission
or omission on on aa claims-made
claims-made
1. You will have the
will have right to
the right purchase an
to purchase an basis;
Period, as basis;
Extended Reporting Period,
Extended Reporting as
described below,
described below, if:if: you have
you have the option to
the option to extend
extend the the
reporting period
reporting period of of this
this endorsement
endorsementfor for
a. The
a. policy to
The policy to which
which this this
two years upon
two years upon payment
payment of of an
an addition
addition
endorsement is
endorsement is attached
attached is is
canceled or
canceled or not renewed;
not renewed; premium. Other
premium. reporting period
Other reporting period options
options
are available.
are available.
b. We
b. We renew
or replace policy but
the policy but HOWEVER,
b. HOWEVER,
b.
remove the
remove the EMPLOYEE
EMPLOYEE BENEFITS BENEFITS
LIABILITY COVERAGE
LIABILITY COVERAGE (1) This
(1) option to
This option purchase an
to purchase an
endorsement; or
endorsement; or Extended Reporting Period
Extended Reporting Period does does not
not
apply ifif cancellation
apply cancellation or or nonrenewal
nonrenewal
is due
is due to non-payment of
to non-payment premium,
of premium,
PB 90
PB 904505 15
45 05 15 Includes copyrighted material
of Insurance
its permission.
with its Page 33 of
Page of 55
ACP BPHM2482951730
INSURED COPY 24
24 03738
03738
PB 90
PB 90450515
45 05 15
failure to
failure comply with
to comply terms or
with terms or business data,
business data, propagation
propagation of of malware
malware or or
conditions of
conditions of the policy, or
the policy, or fraud.
fraud. denial of
denial of service
service attack occurring before
attack occurring before the the
(2) This
(2) supplemental extended
This supplemental extended end of
end of the coverage period
the coverage period for for this
this
reporting period
reporting period applies:applies: CyberOne coverage
CyberOne coverage and and whichwhich is is otherwise
otherwise
covered by
covered by this CyberOne coverage
this CyberOne coverage and and
(a) Only
(a) Only to “wrongful act”
to aa “wrongful act” which
which in addition to, and of, the
shall be
shall be in addition to, and not part of,
not part the
occurred during
occurred during the Coverage
the Coverage
Period; and Network Security Liability
Network Security Liability LimitLimit for for the
the
Period; and preceding coverage
preceding coverage period. period.
(b) Only
(b) if
Only if this option is
this option is exercised
exercised CONDITIONS; B.
ADDITIONAL CONDITIONS;
ADDITIONAL B. Duties
Duties in in
within sixty sixty (60)(60) days
days after after thethe the Event
the Event of of aa “Network
“Network Security Security Liability
Liability
expiration date
expiration date of of the policy or
the policy or Suit”, paragraph 1 .b. is
Suit”, paragraph 1.b. replaced with the
is replaced the
this endorsement.
this endorsement. following:
following:
4. IfIf DATA
4. COMPROMISE, form
DATA COMPROMISE, form PB PB 58 58 05, 05, isis aa notice, as
b. Provide
b. Provide us us with
with written
written notice, as soon
soon
part of
part of this policy, then
this policy, coverage provided
then coverage provided in no
as practicable, but
as practicable, but in no event
event more more
on that
on that form
form is is amended
amended as as follows:
follows:
than 60
than days after
60 days after thethe date
date the the “network
“network
EXCLUSIONS, ADDITIONAL
EXCLUSIONS, ADDITIONAL CONDITIONS CONDITIONS security liability
security liability suit”
suit” is is first
first received
received by by
AND DEFINITIONS
AND DEFINITIONS APPLICABLE APPLICABLE TO TO you. Failure
you. Failure to give notice
to give notice within the the
BOTH SECTION
BOTH SECTION 11 AND AND SECTION
SECTION 2; 2; prescribed time
prescribed time shall
shall not not invalidate
invalidate any any
Additional Conditions; B.
Additional Conditions; B. Duties
Duties in in the
the Event
Event claim ifif itit shall
claim shall be be shown
shown not not to to have
have
of aa “Data
of Compromise Suit”;
“Data Compromise Suit”; Paragraph
Paragraph reasonably possible
been reasonably
been possible to give such
to give such
1 .b. is
1.b. is deleted
deleted and replaced with
and replaced with the the notice within
notice within the prescribed time
the prescribed frame,
time frame,
following:
following: that notice
that notice was given as
was given as soon
soon as as
b. Provide
b. Provide us us with
with written notice, as
written notice, as soon
soon reasonably possible
reasonably possible and and thatthat thethe insurer
insurer
as practicable, but
as practicable, but in in no
no event
event more more was not prejudiced by
not prejudiced by the
the failure
failure to give
to give
than 60
than days after
60 days after the the date
date the the “data
“data notice within
the prescribed frame;
time frame;
compromise suit”
compromise suit” is is first
first received
received by by ADDITIONAL CONDITIONS;
ADDITIONAL CONDITIONS; C. C. Extended
Extended
you. Failure
you. Failure to to givegive notice
notice within the the Periods, Paragraph
Reporting Periods,
Reporting Paragraph 2.b. 2.b. is is deleted
deleted
prescribed time
prescribed time shall shall not not invalidate
invalidate any any replaced with
and replaced
and with the following:
the following:
claim ifif itit shall
claim shall be be shown
shown not not to to have
have Upon payment
payment of premium
b. Upon
b. of an
an additional
additional premium
reasonably possible
been reasonably
been possible to give such
to give such
frame, of 200%
of 200% of of the
the full
full annual premium
annual premium
notice within
the prescribed time frame, applicable to
applicable to this CyberOne coverage,
this CyberOne coverage, aa
that notice
that notice was was given given as as soon
soon as as Supplemental Extended
Supplemental Extended Reporting Reporting
reasonably possible
reasonably possible and and that
that the the insurer
insurer
Period of
Period of 22 year
year immediately
immediately following following
was
was not prejudiced by
not prejudiced by the
the failure
failure to give
to give
frame; the effective
the effective date date of of the
the event
event described
described
notice within
the prescribed time frame; in paragraph
in paragraph 11 above, above, or or the
the exclusion
exclusion
5. IfIf CYBERONE
5. CYBERONE COVERAGE, COVERAGE, form form PB PB 58 07,
58 07, or removal
or removal of of an existing coverage
an existing coverage in in
is part of
is aa part of this policy, then
this policy, coverage
then coverage which
which to give to
to give to us
us written
written noticenotice of of aa
provided on
provided on that
that form
form is is amended
amended as as “network security
“network security liability
liability suit”
suit” of of which
follows:
follows: you first
you first receive
receive notice
notice duringduring said said
SECTION 22 – LIMIT;
SECTION —LIMIT; the the fourth paragraph is
fourth paragraph is Supplemental Extended
Supplemental Extended Reporting Reporting
deleted and
deleted replaced with
and replaced with the following:
the following: Period for
Period any propagation
for any propagation of malware,
of malware,
Notwithstanding the
Notwithstanding foregoing, in
the foregoing, in the
the event
event denial of
denial of service attack, or
service attack, loss, release
or loss, release
that you
that you purchase
purchase the Supplemental
the Supplemental or disclosure
or disclosure of of business
business data occurring
data occurring
Extended Reporting
Extended Reporting Period pursuant to
Period pursuant to the
the before the
before the end
end of of the coverage period
the coverage period
terms of
terms of Additional
Additional Conditions
Conditions C.2.b C.2.b the the limit
limit for this
for CyberOne coverage
this CyberOne coverage and and which
which
of liability for
of liability for the Supplemental Extended
the Supplemental Extended is otherwise
is otherwise coveredcovered by by this CyberOne
this CyberOne
Reporting Period
Reporting Period (if (if applicable)
applicable) shall shall be be coverage.
coverage.
equal to
equal to the
the Network
Network SecuritySecurity Liability
Liability Limit.Limit. The limit
The limit of liability for
of liability for the Supplemental
the Supplemental
The limit
The limit of liability for
of liability for the Supplemental
the Supplemental Extended Reporting Period
Extended Reporting Period shall shall be be as
as set
set
Extended Reporting
Extended Reporting Period, Period, ifif purchased,
purchased, forth in
forth in Section
Section 22 – Limits,
— Limits, paragraph
paragraph 44 of of
shall be
shall solely for
be solely for “network
“network securitysecurity liability
liability this CyberOne Coverage.
this CyberOne Coverage.
suits” of
suits” of which
which you you first first receive
receive noticenotice duringduring IfIf any
any existing
existing coverage
coverage is is excluded
excluded or or
said Supplemental Extended
said Supplemental Extended Reporting Reporting removed under
removed under this CyberOne Coverage
this CyberOne Coverage
Period for
Period for any loss, release
any loss, release or or disclosure
disclosure of of and this
and CyberOne Coverage
this CyberOne Coverage remains remains in in
Page 44 of
Page of 55 copyrighted material
of Insurance
its permission.
with its PB 90
PB 9045 05 15
45 05 15
ACP BPHM2482951730
INSURED COPY 24
24 03739
03739
90450515
PB 90 45 05 15
effect or
effect or is renewed, we
is renewed, we shall
shall offer
offer aa insurance, provided
This insurance,
This provided during
during thethe
Supplemental Extended
Supplemental Reporting Period
Extended Reporting Period Supplemental Extended
Supplemental Period, is
Reporting Period,
Extended Reporting is
solely for
solely for such
such excluded coverage.
excluded coverage. excess over
excess over anyany other
other valid and and collectible
collectible
To obtain
To obtain the Supplemental Extended
the Supplemental Extended insurance that
insurance begins or
that begins or continues
continues in in effect
effect
Reporting Period, you
Reporting Period, you must request itit in
must request in after the
after Supplemental Extended
the Supplemental Reporting
Extended Reporting
writing pay the
and pay
writing and the additional premium due,
additional premium due, Period becomes
Period effective, whether
becomes effective, whether the the other
other
within 30 days of
30 days of the
the effective
effective datedate of:of: applies on
insurance applies
insurance on aa primary, excess,
primary, excess,
contingent, or
contingent, any other
or any other basis.
basis.
(1) the
(1) the event
event described
described in in paragraph
paragraph 11
above; or
above; or 6. IfIf SUPPLEMENTAL
6. SUPPLEMENTAL EXTENDED EXTENDED REPORTINGREPORTING
PERIOD ENDORSEMENT, form
PERIOD ENDORSEMENT, form PB PB 4343 50 50 for
for
(2) the
(2) the exclusion
exclusion or or removal
removal of of an
an CYBERONE COVERAGE, is
CYBERONE COVERAGE, part of
is aa part of this
this
existing coverage.
existing coverage. policy, then
policy, coverage provided
then coverage provided on on that
that form
form isis
The additional
The premium for
additional premium for the
the amended as
amended follows:Paragraph 11 is
as follows:Paragraph replaced as
is replaced as
Supplemental Reporting Period
Extended Reporting Period follows:
follows:
shall be
shall fully earned
be fully earned at at the inception of
the inception of the
the 1. You
1. You shall
shall have period of
have aa period of 22 years
years following
following
Supplemental Period. IfIf
Reporting Period.
Extended Reporting Supplemental Extended
the Supplemental
the Reporting
Extended Reporting
we do not
we do not receive
receive thethe written request as
written request as Period Effective
Period Effective Date (shown in
Date (shown in the
the above
above
required, you
required, you may
may not not exercise
exercise this right at
this right at aa Schedule) in
Schedule) in which
which to give written
to give notice to
written notice to
later date.
later date. us of
us of aa “network security liability
“network security liability suit”
suit” of
of
This Condition
This Condition C C and
and the rights contained
the rights contained which you first
which you first receive
receive notice during said
notice during said 22
herein shall
herein shall not apply to
not apply any cancellation
to any cancellation or or year period
year period forfor any loss, release
any loss, release or or
non-renewal resulting from
non-renewal resulting non-payment of
from non-payment of disclosure of
disclosure of business data, propagation
business data, propagation of of
premium, failure
premium, failure to comply with
to comply with thethe terms
terms malware or
malware or denial
denial of
of service
service attack occurring
attack occurring
and conditions
and conditions of of the policy or
the policy or fraud.
fraud. on or
on prior to
or prior to the Supplemental Extended
the Supplemental Extended
Reporting Period
Reporting Period Effective
Effective DateDate andand
otherwise covered
otherwise covered by by this CyberOne
this CyberOne
coverage.
coverage.
terms and
All terms
All and conditions
conditions of
modified by this endorsement.
endorsement.
PB 90
PB 90450515
45 05 15 Includes copyrighted material
of Insurance
its permission.
with its Page 55 of
Page of 55
ACP BPHM2482951730
INSURED COPY 24
24 03740
03740
COMMERCIAL UMBRELLA (NATIONWIDE MUTUAL FIRE)
w
0
C
IIz
C
C
Im
m
0003741
24
24-8-2951730
ACP
INSURED COPY
N
78GJ
TABPAGE (07-02)00
FIRE INS CO
NATIONWIDE MUTUAL FIRE
Named Insured:
Named Insured: HOLLY GLEN A CONDO ASSOC INC
Address: 4605 PEMBROKE LAKE CIR STE 302
Address:
BEACH
VA
IMPORTANT INSURANCE INFORMATION *********
IMPORTANT NOTICE RENEWAL POLICIES

NOTICE FOR RENEWAL POLICIES
In an
In an effort
effort to keep your
to keep your insurance premium as
insurance premium as low
low as possible, we
as possible, have streamlined
we have your renewal
streamlined your policy. We
renewal policy. We have
have
not included
not printed copies
included printed copies of policy forms
of policy forms and
and endorsements
endorsements thatthat have
have not changed from
not changed your expiring
from your expiring policy
policy unless
unless
they include
they include variable
variable information
information that
that is unique to
is unique you. Please
to you. Please refer
refer to your prior
to your prior policies
policies for printed copies
for printed copies of
of these
these
forms. IfIf you
forms. you desire copies, they
desire copies, they are
are available upon request
available upon request from your agent.
from your agent.
(05-93)
IN 5017 (05-93)
IN
DIRECT BILL
DIRECT BILL LENL 15310
LENL 15310 INSURED
INSURED ACP CAF
ACP CAF 2482951730
2482951730 24
24 0003742
0003742
UMB 1 (12-98)
DECLARATIONS
COMMERCIAL UMBRELLA LIABILITY
RENEWAL INSURANCE POLICY UMB 1 (12-98)
NATIONWIDE MUTUAL FIRE INS CO
DECLARATIONS ONE NATIONWIDE PLAZA
COLUMBUS OHUMBRELLA LIABILITY
COMMERCIAL 432152220
RENEWAL INSURANCE POLICY
Policy Number: ACP CAF 2482951730 ONE NATIONWIDE PLAZA
COLUMBUS OH 432152220
ITEM 1
Named Insured: ACP
Policy Number: HOLLY
CAFGLEN A CONDO ASSOC INC
2482951730
ITEM 2
Address:
ITEM 1 4605 PEMBROKE LAKE CIR STE 302
Named Insured: HOLLY GLEN A CONDO ASSOC INC
ITEMAgent:
2 Wilson Insurance Agency Inc
Address: VIRGINIA
Address: BEACH VA LAKE CIR STE23452
4605 PEMBROKE 302 24 45 80455 0001
VIRGINIA
PRODUCER: WILSON BEACH INC.
INS. AGENCY, VA 234556448
ITEMAgent:
3 Wilson Insurance Agency Inc
Policy : From 12:01
Period VIRGINIA
Address: A.M.,VA01/01/16 to 12:0123452
BEACH A.M., 01/01/17
24 45 80455 0001
PRODUCER: WILSON INS. AGENCY, INC.
ITEM 34
Schedule
Policy of Underlying
Period Insurance:
: From 12:01 See Endorsement
A.M., 01/01/16 No.01/01/17
to 12:01 A.M., UMB 00 01
ITEM 45
Retained Limit
Schedule Aggregate:
of Underlying NONE See Endorsement No. UMB 00 01
Insurance:
ITEM 56
Limit Aggregate: NONE a) $1 ,000,000 Each Occurrence
Limits of Insurance:
Retained
b) $1 ,000,000 Products - Completed Operations Aggregate
ITEM 6 c) $1 ,000,000 Other Aggregate
Limits of Insurance: a) $ 1 , 0 0 0 , 0 0 0 Each Occurrence
ITEM 7 b) $ 1 , 0 0 0 , 0 0 0 Products - Completed Operations Aggregate
Coverage 1X A -c)Excess
$ 1 , 0 0Follow OtherLiability
0 , 0 0 0Form AggregateInsurance
1X B - Umbrella Liability Insurance
ITEM 7
ITEM 8
Coverage ¹X A - Excess Follow Form Liability Insurance
Premium : Amount
¹X B - Umbrella Liability Insurance
$490.00
ITEM 8
Premium : Amount
ITEM 9 $490.00
Endorsements: UMBOO52 0115 UMB4502 0214 EN7281 0706 UMB0001 0309 UMB0002 0413
13614 1185 UMBOO28 0413 UMBOO5O 1102 UMB7O1O 0514
ITEM 9
Endorsements: UMB0052 0115 UMB4502 0214 EN7281 0706 UMB0001 0309 UMB0002 0413
13614 1185 UMB0028 0413 UMB0050 1102 UMB7010 0514
Renewal or Replacement No. ACP CAF 2472951730
Renewal or Replacement No. ACP CAF 2472951730

Countersigned By
Authorized Representative
Countersigned By
Authorized Representative
UMB 1 (12-98)
DIRECT BILL LENL 15310 INSURED 01 24 03743
UMB 1 (12-98)
DIRECT BILL LENL 15310 INSURED 01 24 03743
MUTUAL COMPANY CONDITIONS ENDORSEMENT
POLICYHOLDER MEMBERSHIP IN THE COMPANY
(Applicable Only toMUTUAL COMPANY
Policies Issued by Nationwide CONDITIONS ENDORSEMENT
Mutual Fire Insurance Company in States Other than the State
of Texas)
POLICYHOLDER
Because this policyMEMBERSHIP IN THE COMPANY
is issued by Nationwide Mutual Fire Insurance Company (the “Company”), the first named
(Applicable Only to Policies Issued
insured listed on the declarations page by Nationwide Mutual Fire
(“named insured”) InsuranceofCompany
is a member in States
the Company Other
issuing the than
policythe State
while
of Texas)
this or any other policy issued by the Company is in force. While a member, the named insured is entitled to one
Because
vote only this policy is issued
– regardless by Nationwide
of the number Mutual
of policies FiretoInsurance
issued the namedCompany
insured –(the “Company”),
either in person the firstproxy
or by named
at
insured listed
meetings on the declarations
of members page (“named insured”) is a member of the Company issuing the policy while
of the Company.
this or
The any other
annual policy
meeting issued by of
of members Company
thethe Company in force.
is will While
be held a member,
each theHome
year at the named insured
Office is entitled
of the Company to in
one
vote only —
regardless of the number of policies issued to the named insured either
—
in person or
Columbus, Ohio, at 9:30 a.m. on the first Thursday of April. If the Board of Directors of Nationwide Mutual Fireby proxy at
meetings ofCompany
Insurance membersshould Company.
of the elect to change the time or place of that meeting, the Company will mail notice of the
The annual
change meeting
to the of members
member’s of the
last known address. The will
Company be heldwill
Company mailyear
each thisatnotice
the Home Office
at least of theinCompany
10 days in the
advance of
Columbus,
meeting Ohio, at 9:30 a.m. on the first Thursday of April. If the Board of Directors of Nationwide Mutual Fire
date.
This policyCompany
Insurance should elect
is non-assessable, to change
meaning that the
the time
namedor place of is
insured notmeeting,
that Company
theany
subject to will mail
assessment noticetheof the
beyond
change to the member’s last known address.
premiums required for each policy term. The Company will mail this notice at least 1 0 days in advance of the
meeting date.
This policy is non-assessable, meaning that the named insured is not subject to any assessment beyond the
premiums
The namedrequired
insuredfor each policy
is entitled term.
to any Dividends which are declared by the Board of Directors of the Company in
accordance with law and which are applicable to coverages provided in this policy.
The named insured is entitled to any Dividends which are declared by the Board of Directors of the Company in
accordance with law
POLICYHOLDER and which areINapplicable
MEMBERSHIP to coverages
THE COMPANY provided in this policy.
IN TEXAS
(Applicable Only to Policies Issued by Nationwide Mutual Fire Insurance Company in the State of Texas)
1. MUTUALS – MEMBERSHIP AND VOTING NOTICE. The named insured is notified that, by virtue of this
POLICYHOLDER
policy, MEMBERSHIP
the named insured is a memberIN THE COMPANY
of the NationwideIN Mutual
TEXASFire Insurance Company of Columbus, Ohio,
(Applicable Only to Policies Issued by Nationwide Mutual
(the “Company”) and is entitled, as is lawfully provided in the Firecharter,
Insurance Companyand
constitution, in the State to
by-laws Texas)
of vote either in
1. MUTUALS
person MEMBERSHIP
or by proxy
—
AND VOTING
in any or all meetings of saidNOTICE.
Company. The named
Each insured
member is notified
is entitled that,one
to only by virtue of this
vote regardless
policy,
of the named
the number insuredowned.
of policies is a member of the meetings
The annual Nationwideof the Mutual Fire Insurance
members Company
of the Company Columbus,
areofheld Ohio,
in the Home
(the “Company”)
Office, is entitled,
and Ohio,
at Columbus, is lawfully
on theasfirst Thursday of April,in inthe
provided charter,
each year,constitution,
at 9:30 o’clock by-laws to vote either in
anda.m.
person
2. or by proxy
MUTUALS in any or all meetings
– PARTICIPATION CLAUSE of said Company.
WITHOUT Each member
CONTINGENT LIABILITY. to only
is entitledNo one vote
Contingent regardless
Liability: This
of the number of policies owned. The annual meetings of the members of the Company
policy is non-assessable. The named insured is a member of the Company and shall participate, to the Home
are held in the extent and
Office, at conditions
upon the
Columbus,fixed
Ohio,and the first Thursday
on determined by the of April,ofinDirectors
Board each year, at 9:30 o’clock
in accordance witha.m.
the provisions of law, in
2. MUTUALS
the distribution ofPARTICIPATION
— dividends so fixedCLAUSE WITHOUT CONTINGENT LIABILITY. No Contingent Liability: This
and determined.
the distribution of dividends so fixed and determined.
IN WITNESS WHEREOF: Nationwide Mutual Fire Insurance Company has caused this policy to be signed by its
President and Secretary, and countersigned by a duly authorized representative of the
IN WITNESS WHEREOF: Nationwide Mutual Fire Insurance Company has caused this policy to be signed by its
President and Secretary, and countersigned by a duly authorized representative of the
/
Secretary President
Nationwide Mutual Fire Insurance Company
Secretary President
Nationwide Mutual Fire Insurance Company
SP 00 29 01 08 Page 1 of 1
ACP CAF 2482951730 INSURED 24 0003744
5P00290108 Pagelofi
ACP CAF 2482951730 INSURED 24 0003744

FORMS AND ENDORSEMENTS SUMMARY
NATIONWIDE MUTUAL FIRE INS CO Period:
Number: ACP CAF 2482951730 From 01/01/16 To 01/01/17
FORM/ENDORSEMENT DATE TITLE
FORMS AND ENDORSEMENTS SUMMARY Period:
EN7281
Number: ACP CAF 0706
2482951730 IMPORTANT INFORMATION REGARDING YOUR From
INSURANCE
01/01/16 To 01/01/17
UMB0001
FORM/ENDORSEMENT 0309
DATE SCHEDULE OF UNDERLYING INSURANCE
TITLE
UMB0002
EN7281 0413
0706 IMPORTANT UMBRELLA LIABILITY
COMMERCIAL INFORMATION POLICY
REGARDING YOUR INSURANCE
UMBOO28
UMB0001 0413
0309 LIMITATIONOFOF
SCHEDULE COVERAGE INSURANCE
UNDERLYING TO DESIGNATED PREMISES -
COVERAGE B
UMBOO5O
UMB0002 1102
0413 DISCRIMINATION
COMMERCIAL EXCLUSION
UMBRELLA LIABIL
-
Y POLICY B
I TCOVERAGE
UMBOO52
UMB0028 0115
0413 CAP ON LOSSES
LIMITATION FROM CERTIFIED
OF COVERAGE ACTS OF PREMISES
TO DESIGNATED TERRORISM - COVERAGE B
UMB4502
UMB0050 0214
1102 VIRGINIA AMENDATORY
DISCRIMINATION ENDORSEMENT
EXCLUSION - COVERAGE B
UMB7O1O
UMB0052 0514
0115 EXCLUSION-ACCESS
CAP OR CERTIFIED
ON LOSSES FROM DISCLOSURE OF OF
ACTS TERRORISM OR PERSONAL I
CONFIDENTIAL
13614
UMB4502 1185
0214 SPECIAL CONTINUATION
VIRGINIA PROVISION
AMENDATORY ENDORSEMENT
UMB7010 0514 EXCLUSION-ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL I
13614 1185 SPECIAL CONTINUATION PROVISION
17206 (07-98)
LENL 16001 INSURED 24 03745
LENL 16001 INSURED 24 03745

0001
UMB 00 0309
01 03 09
Policy Number:
Policy Number: ACP CAF 2482951730
Policy Period:
Policy Period: 01/01/16
01/01/16 to 01/01/17
to 01/01/17
ITEM 4.
ITEM 4.
Schedule Of
Schedule Underlying Insurance
Of Underlying (as identified
Insurance (as by the
identified by entry of
the entry of aa company name, policy
company name, number, policy
policy number, policy period
period and
and
limits):
limits):
Commercial General
Commercial Liability or
General Liability or ($)
Limits ($)
Limits
XBusinessowners
X Liability
Businessowners Liability 2000000
2000000 General Aggregate
General Aggregate
NATIONWIDE MUTUAL INS CO Co 2000000
2000000 Products-Completed Operations
Products-Completed Operations Aggregate
Aggregate
Policy Number:
Policy Number: ACP BPHMBPHM 2482951730 1000000
1000000 Personal and
Personal Advertising Injury
and Advertising Injury
Policy Period:
Policy Period: 01/01/16
01/01/16 to 01/01/17
to 01/01/17 1000000
1000000 Each Occurrence
Each Occurrence
Commercial Auto
Commercial Liability
Auto Liability ($)
Limits ($)
Limits
Each Accident
Each Accident
Policy Number:
Policy Number:
Policy Period:
Policy Period: to
to
Employers Liability
Employer's Liability or
or ($)
Limits ($)
Limits
Stop Gap
Stop Gap Liability
Liability
Bodily Injury
Bodily Injury by
by Accident
Accident - Each
-
Each Accident
Accident
Policy Number:
Policy Number: Bodily Injury
Bodily Injury by
by Disease
Disease – Each
—
Employee
Each Employee
Policy Period:
Policy Period: to
to Bodily Injury
Bodily Injury by
by Disease Policy Limit
Disease – Policy
—
Limit
($)
Limits ($)
Limits
Policy Number:
Policy Number:
Policy Period:
Policy Period: to
to
($)
Limits ($)
Limits
Policy Number:
Policy Number:
Policy Period:
Policy Period: to
to
($)
Limits ($)
Limits
Policy Number:
Policy Number:
Policy Period:
Policy Period: to
to
($)
Limits ($)
Limits
Policy Number:
Policy Number:
Policy Period:
Policy Period: to
to
IMPORTANT NOTICE:
IMPORTANT RESTRICTIONS, LIMITATIONS
NOTICE: RESTRICTIONS, AND EXCLUSIONS
LIMITATIONS AND EXCLUSIONS TO THE ABOVE
TO THE ABOVE SCHEDULED
SCHEDULED
UNDERLYING INSURANCE
UNDERLYING INSURANCE (OR ANY REPLACEMENTS
(OR ANY REPLACEMENTS THEREOF) WILL ACT
THEREOF) WILL ACT AS RESTRICTIONS,
AS RESTRICTIONS,
LIMITATIONS AND EXCLUSIONS
LIMITATIONS AND EXCLUSIONS TO
TO COVERAGE
COVERAGE A A OF
OF THIS
THIS POLICY.
POLICY.
UMB 00
UMB 00 01
01 03
0309
09 Page
Page of
of
ACP CAF
ACP CAF 2482951730
2482951730 INSURED
INSURED 24
24 0003746
0003746
UMB 00 52 01 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM

This endorsement modifies insurance provided under the following:
COMMERCIAL UMBRELLA LIABILITY POLICY
A. If aggregate insured losses attributable to terrorist 1. The act resulted in insured losses in excess
acts certified under the federal Terrorism Risk of $5 million in the aggregate, attributable to
Insurance act exceed $100 billion in a Calendar all types of insurance subject to the
Year and we have met our insurer deductible Terrorism Risk Insurance Act; and
under the Terrorism Risk Insurance Act, we shall 2. The act is a violent act or an act that is dangerous
not be liable for the payment of any portion of the to human life, property or infrastructure
amount of such losses that exceeds $100 billion, and is committed by an individual or individuals
and in such case insured losses up to that as part of an effort to coerce the
amount are subject to pro rata allocation in accordance civilian population of the United States or to
with procedures established by the influence the policy or affect the conduct of
Secretary of the Treasury. the United States Government by coercion.
‘Certified act of terrorism’ means an act that is B. The terms and limitations of any terrorism exclusion,
certified by the Secretary of the Treasury, in or the inapplicability or omission of a terrorism
accordance with the provisions of the federal exclusion, do not serve to create coverage
Terrorism Risk Insurance Act, to be an act of for injury or damage that is otherwise excluded
terrorism pursuant to the federal Terrorism Risk under the Policy.
Insurance Act. The criteria contained in the
Terrorism Risk Insurance Act for a ‘certified act
of terrorism” included in the following:
All terms and conditions of this policy apply unless modified by this endorsement.
UMB 00 52 01 15 Includes Copyrighted Material of Insurance Services Page 1 of 1

Office, Inc., with its permission.
ACP CAF
ACP CAF 2482951730
2482951730 INSURED
INSURED 24
24 0003747
0003747
Nationwide®
On Your SicIe
56 144 24 PZ
HOLLY GLEN, A CONDOMINIUM ASSOCIATION,

C/O
56 144 PROPERTY
24 PZ MANAGEMENT ASSOCIATES
4605 PEMBROKE LAKE CIR STE 302
VIRGINIA
HOLLY BEACH,
GLEN, VA 23455-6448 ASSOCIATION,
A CONDOMINIUM
C/O PROPERTY MANAGEMENT ASSOCIATES
4605 PEMBROKE LAKE CIR STE 302
VIRGINIA BEACH, VA 23455-6448
Enclosed you will find your Nationwide policy or an amendment to that policy.
We look forward to continuing to provide your insurance protection.
If you have any questions, please contact:
Claims: 1-800-421-3535
Billing Inquiry: 1-888-508-8622
AGENCY -
450014341
Address:
Wilson Insurance Aciencv Inc
3213 VIRGINIA BEACH BLVD
VIRGINIA BEACH VA 23452-5725
Phone: 757-340-0028
Email:
Thank you for placing your trust in us. Nationwide is On Your S1d6SM.
16071 0505
LENL N 110615 INSURED COPY ACP 24-8-2951730 24 0003708
LENL N 110615 INSURED COPY ACP 24-8-2951730 24 0003708

Nationwide®
On Your SicIe
IN 744203 07
******* IMPORTANT INSURANCE INFORMATION *******
provision of your policy. You should read your policy and review your declarations page for complete information
on the coverages you are provided. If there is any conflict between the policy and this notice, the provisions of the
CONSUMER REPORT INQUIRY NOTICE

Consumer reports, including credit history may have been ordered from a consumer reporting agency to
underwrite and/or rate your insurance policy. You have the right to access this information and request correction
of any inaccuracies. Your consumer reports, including your credit history are not affected in any way by our
inquiry.
We are committed to respecting your privacy and safeguarding your personal information.
ACP 24-8-2951730 78GJ 15309 INSURED COPY IN7442030700 0002 24 0003709
1N74420307 Pageloll
ACP 24-8-2951730 78GJ 15309 INSURED COPY 1N7442030700 0002 24 0003709
Nationwide®
On Your Side’
COM-PAK SUMMARY
COM-PAK SUMMARY
PRINTED 11/06/2015
PLAZA
NATIONWIDE PLAZA
ONE NATIONWIDE
COLUMBUS, OH 443215-2220
COLUMBUS, 3215-2220
Number:
Number: ACP
ACP 2482951730
2482951730 Effective from
Effective from 01/01/2016
01/01/2016 to
to 01/01/2017
01/01/2017
Named Insured:
Named Insured: HOLLY GLEN,
HOLLY A CONDOMINIUM
GLEN, A ASSOCIATION, INC.
CONDOMINIUM ASSOCIATION, INC.
C/O PROPERTY
C/O PROPERTY MANAGEMENT
MANAGEMENT ASSOCIATES
ASSOCIATES
Mailing Address:
Mailing Address: LAKE CIR STE 302
4605 PEMBROKE LAKE
VIRGINIA BEACH,
VIRGINIA VA 23455-6448
BEACH, VA 23455-6448
Agency Name:
Agency Name: Wilson Insurance Agency Inc
Insurance Agency Inc 45 80455-001
80455-001 24
24
Agency Address:
Agency Address: VIRGINIA BEACH
VIRGINIA VA 23452-5725
BEACH VA 23452-5725 (757)340-0028
(757)340-0028
Producer:
Producer: INS. AGENCY, INC.
WILSON INS. INC.
Division
Division Program
Program Total Premium
A
A PREMIER BUSINESSOWNERS
PREMIER BUSINESSOWNERS -- HABITATIONAL (NATIONWIDE)
HABITATIONAL (NATIONWIDE) $2,51
$ 2,5188.00
.00
B
B COMMERCIAL UMBRELLA
COMMERCIAL (NATIONWIDE MUTUAL
UMBRELLA (NATIONWIDE FIRE)
MUTUAL FIRE) $490.00
$ 490.00
Not a bill.
Not bill. Your bill separately.
bill is sent separately.
NI
NI
Estimated Total
Estimated Total Premium:
Premium: $
$ 3,008.00
3 ,008.00
This Com-Pak
This Com-Pak is portfolio of
is aa portfolio of individual policies which
individual policies which serves
serves to
to combine
combine
various insurance
various coverages written
insuran ce coverages group of
under aa group
written under separate contracts
of separate contracts
of insurance.
of insurance.
PAKSUM 01
PAKSUM 01 08
08
EAM398
EAM398 78GJ
78GJ 2015309
2015309 INSURED COPY
INSURED COPY ACP
ACP 2482951730
2482951730 24
24 0003710
0003710
IN 72
IN 72390115
39 01 15
NOTICE OF
NOTICE OF TERRORISM
TERRORISM INSURANCE
INSURANCE COVERAGE
COVERAGE
NOTICE – DISCLOSURE
NOTICE DISCLOSURE OF
-
OF PREMIUM
PREMIUM
Applies to
Applies to all
all Commercial Policies, except
Commercial Policies, for Farmowners
except for Multiperil, Business
Farmowners Multiperil, Auto,
Business Auto,
Crime, and
Crime, and Workers Compensation
Workers Compensation
disclosure notice
(This disclosure
(This notice does
does not provide coverage,
not provide coverage, and it does
and it does not replace any
not replace any
provisions of
provisions your policy.
of your policy. You
You should
should read your policy
read your policy for complete information
for complete information onon the
the
coverages you
coverages you are provided. IfIf there
are provided. is any
there is conflict between
any conflict between the policy and
the policy notice,
this notice,
and this
the provisions of
the provisions of the policy shall
the policy prevail.)
shall prevail.)
Coverage for
Coverage for acts
acts of
of terrorism
terrorism is is included
included in your policy.
in your policy. YouYou are hereby notified
are hereby notified that
that under
under the
the
Terrorism Risk Insurance Act, Act, as amended in 201 5, the definition of act of terrorism has
in 2015,
changed. As
changed. As defined
defined inin Section 102(1) of
Section 102(1) of the
the Act:
Act: The
The term
term “act
“act of
of terrorism”
terrorism” means
means anyany act
act
certified by
that is certified by the Secretary
Secretary of the Treasury,
Treasury, in in consultation with the Secretary Secretary of
Homeland Security, and
Homeland Security, and the Attorney General
the Attorney General of of the
the United
United States
States – to
—
to be
be anan act
act of terrorism;
of terrorism;
dangerous to human
to be a violent act or an act that is dangerous human life, property, or infrastructure;
life, property, infrastructure; to have
resulted
resulted in
in damage
damage within the United
within the United States,
States, or outside the United States in
or outside the United States in the
the case
case ofof certain
certain
premises of a United
air carriers or vessels or the premises mission; and to have been
United States mission; been committed
committed
by an
by an individual
individual oror individuals
individuals as part of
as part of an
an effort
effort to
to coerce
coerce the the civilian population of
civilian population of the
the United
United
States or to influence the policy policy or affect the conduct of the United States Government by by
coercion. Under
coercion. your coverage,
Under your coverage, any any losses resulting from
losses resulting from certified
certified acts
acts of
of terrorism
terrorism maymay bebe
partially reimbursed
partially reimbursed by by the United States Government under a formula established by by the
Terrorism Risk
Terrorism Risk Insurance Act, as
Insurance Act, as amended. However, your
amended. However, your policy
policy may
may contain
contain other
other exclusions
exclusions
might affect your
which might your coverage,
coverage, such as an exclusion for nuclear events. formula,
events. Under the formula,
the United
the United States
States Government
Government pays pays the following percentage
the following percentage of of covered
covered terrorism
terrorism losses
losses
exceeding statutorily paid by
exceeding the statutorily established deductible paid by the insurance company providing the company providing
coverage.
coverage.
85%, for
85%, for insured
insured losses occurring before
losses occurring January 1,
before January 1, 2016;
201 6;
84%, for insured
84%, occurring during
insured losses occurring during the 2016 calendar year;
year;
83%, for
83%, for insured
insured losses occurring during
losses occurring during the
the 2017
2017 calendar year;
calendar year;
82%, for insured
82%, occurring during
insured losses occurring during the 2018 calendar year;
year;
81%, for
81%, for insured
insured losses occurring during
losses occurring during the
the 2019
2019 calendar year; and
calendar year; and
80%, for insured
80%, occurring on or after January
insured losses occurring January 1,
1, 2020.
Act, as amended,
Terrorism Risk Insurance Act,
The Terrorism amended, contains a $100 billion cap that limits U.S.
billion cap U.S.
Government reimbursement as well as insurer’s
Government reimbursement as well as insurer’s liability
liability for losses
for losses resulting
resulting from certified acts
from certified acts
of terrorism when the amount of such losses exceeds $100 $1 00 billion
billion in any one calendar year.
in any year. IfIf
the aggregate insured
the aggregate insured losses
losses for
for all
all insurers
insurers exceed
exceed $100 billion, your coverage
billion, your coverage may may bebe
reduced.
reduced.
The portion of
The portion your annual
of your premium that
annual premium that is
is attributable
attributable to coverage for
to coverage for acts
acts of
of terrorism
terrorism is $0,
is $0,
and does not include anyany charges
charges for that portion
portion of losses covered byby the United States
Government under
Government under the
the Act.
Act.
iN72390115
IN 72 39 01 15 Pagelofl
Page 1 of 1
EAM398
EAM398 78GJ
78GJ 2015309
2015309 INSURED COPY
INSURED COPY ACP
ACP 2482951730
2482951730 24
24 0003711
0003711

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DATE(MM/DD/VYYY)

DESCRIPTION 101, Additional

Employee Dishonesty Coverage is provided for under the above mentioned

CERTIFICATE HOLDER CANCELLATION

All rights reserved.

PREMIER BUSINESSOWNERS - HABITATIONAL (NATIONWIDE)

IMPORTANT INSURANCE INFORMATION

FLOOD EXCLUSION NOTICE

The General Assembly of Virginia enacted and amended section 38.2-2125 of

******* IMPORTANT INSURANCE INFORMATION *******

DATA BREACH & IDENTITY RECOVERY SERVICES

data breach incident. Having an incident response plan prepared in advance of a

practices and Red Flag Rules.

management events, and helpful industry links.

To access the eRiskHub®portal:

Identity Recovery Services Information:

ACP BPHM2482951730 INSURED COPY 24 03715

PREMIER BUSINESSOWNERS POLICY

RENEWAL POLICY NOTICE:

Previous Policy Number

ACP BPHM 2472951730

PREMIERSCHEDULE OF NAMED INSUREDS POLICY

regardless of the number of policies issued to the named insured —

Additional Interest: Interest Number: Loan Number:

Additional Interest: Interest Number: Loan Number:

Additional Interest: Interest Number: Loan Number:

Additional Interest: Interest Number: Loan Number:

Additional Interest: Interest Number: Loan Number:

Additional Interest: Interest Number: Loan Number:

Additional Interest: Interest Number: Loan Number:

Additional Interest: Interest Number: Loan Number:

Additional Interest: Interest Number: Loan Number:

ADDITIONAL INSUREDS STATUS

PROPERTY DAMAGE DEDUCTIBLE

ACKNOWLEDGEMENT OF ADDITIONAL INSURED STATUS

Designated Premises (Part Leased to the Named Insured):

Named Insured HOLLY GLEN

Issuing Company: NATIONWIDE MUTUAL

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CAP ON LOSSES FROM CERTIFIED

PREMIER BUSINESSOWNERS PROPERTY COVERAGE FORM

b. Only ifif this

VIRGINIA AMENDATORY ENDORSEMENT

IMPORTANT INSURANCE INFORMATION *********

IMPORTANT NOTICE RENEWAL POLICIES

Renewal or Replacement No. ACP CAF 2472951730

Renewal or Replacement No. ACP CAF 2472951730

COMMERCIAL UMBRELLA LIABILITY

LENL 16001 INSURED 24 03745

LENL 16001 INSURED 24 03745

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM

COMMERCIAL UMBRELLA LIABILITY POLICY

UMB 00 52 01 15 Includes Copyrighted Material of Insurance Services Page 1 of 1

HOLLY GLEN, A CONDOMINIUM ASSOCIATION,

If you have any questions, please contact:

Billing Inquiry: 1-888-508-8622

LENL N 110615 INSURED COPY ACP 24-8-2951730 24 0003708

******* IMPORTANT INSURANCE INFORMATION *******

CONSUMER REPORT INQUIRY NOTICE

ACP 24-8-2951730 78GJ 15309 INSURED COPY IN7442030700 0002 24 0003709

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