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PI-GLD-HS (10/11) <br /> <br />Page 1 of 12 <br />Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />© 2011 Philadelphia Indemnity Insurance Company <br /> <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY . <br /> <br />GENERAL LIABILITY DELUXE ENDORSEMENT: <br />HUMAN SERVICES <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE <br /> <br />It is understood and agreed that the following extensions only apply in the event that no other specific coverage for <br />the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and <br />limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on <br />this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this <br />endorsement. For complete details on specific coverages, consult the policy contract wording. <br /> <br />Coverage Applicable Limit of Insurance Page # <br />Extended Property Damage Included 2 <br />Limited Rental Lease Agreement Contractual Liability $50,000 limit 2 <br />Non-Owned Watercraft Less than 58 feet 2 <br />Damage to Property You Own, Rent, or Occupy $30,000 limit 2 <br />Damage to Premises Rented to You $1,000,000 3 <br />HIPAA Clarification 4 <br />Medical Payments $20,000 5 <br />Medical Payments Extended Reporting Period 3 years 5 <br />Athletic Activities Amended 5 <br />Supplementary Payments Bail Bonds $5,000 5 <br />Supplementary Payment Loss of Earnings $1,000 per day 5 <br />Employee Indemnification Defense Coverage $25,000 5 <br />Key and Lock Replacement Janitorial Services Client Coverage $10,000 limit 6 <br />Additional Insured Newly Acquired Time Period Amended 6 <br />Additional Insured Medical Directors and Administrators Included 7 <br />Additional Insured Managers and Supervisors (with Fellow <br />Employee Coverage) <br />Included 7 <br />Additional Insured Broadened Named Insured Included 7 <br />Additional Insured Funding Source Included 7 <br />Additional Insured Home Care Providers Included 7 <br />Additional Insured Managers, Landlords, or Lessors of Premises Included 7 <br />Additional Insured Lessor of Leased Equipment Included 7 <br />Additional Insured Grantor of Permits Included 8 <br />Additional Insured Vendor Included 8 <br />Additional Insured Franchisor Included 9 <br />Additional Insured When Required by Contract Included 9 <br />Additional Insured Owners, Lessees, or Contractors Included 9 <br />Additional Insured State or Political Subdivisions Included 10 <br />Docusign Envelope ID: 253B9B42-52AB-4A7C-A5E0-4833CDBBA731