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38 EXHIBIT G -2 Lease Number: 09065 Equipment Schedule: 01 QUESTIONNAIRE FOR SELF - INSURANCE TO MASTER LEASE AGREEMENT In connection with the Master Lease Agreement (the "Agreement"), dated as of June 3, 2013, made and entered into by and between SUNTRUST EQUIPMENT FINANCE & LEASING CORP., as Lessor (the "Lessor "), and the lessee identified below, as Lessee (the "Lessee "), Lessee warrants and represents to Lessor the following information. The terms capitalized herein but not defined herein shall have the meanings assigned to them in the Agreement. 1. Property Insurance. a. Lessee is self - insured for damage or destruction to the Equipment. YES NO (circle one) If yes, the dollar amount limit for property damage to the Equipment under Lessee's self - insurance program is $ Lessee maintains an umbrella insurance policy for claims in excess of Lessee's self - insurance limits for property damage to the Equipment as indicated above. YES NO (circle one) If yes, the umbrella policy provides coverage for all risk property damage. YES NO (circle one) If yes, the dollar limit for property damage to the Equipment under such umbrella policy is $ 2. Liability Insurance. a. Lessee is self - insured for liability for injury or death of any person or damage or loss of property arising out of or relating to the condition or operation of the Equipment. YES NO (circle one) If yes, the dollar limit for such liability claims under Lessee's self - insurance program is $ b. Lessee maintains an umbrella insurance policy for claims in excess of Lessee's self - insurance limits for liability including injury or death of persons or damage to property as indicated above. YES NO (circle one) If yes, the umbrella policy provides coverage for liabilities for injury and death to persons as well as damage or loss of property arising out of or relating to the condition or operation of the Equipment. YES NO (circle one) If yes, the dollar amount of the umbrella policy's limits for such liability coverage is $ 3A. Selflnsurance Fund. a. Lessee maintains a self - insurance fund. YES NO (circle one) If yes, please complete the following: Monies in the self - insurance fund are subject to annual budgeting. YES NO (circle one) The total amount maintained in the self - insurance fund to cover Lessee's self - insurance liabilities is $ b. Amounts paid from Lessee's self - insurance fund are subject to limitations for each claim. YES NO (circle one) If yes, the dollar amount of limit per claim is $ 37 5/16/ 2013: BQ- ESCfamtem.D0C /rev.01 /04.st1