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Item P5
P5 BOARD OF COUNTY COMMISSIONERS COUNTY of MONROE �� i Mayor Holly Merrill Raschein,District 5 The Florida Keys Mayor Pro Tern James K.Scholl,District 3 Craig Cates,District 1 Michelle Lincoln,District 2 ' David Rice,District 4 Board of County Commissioners Meeting May 15, 2024 Agenda Item Number: P5 2023-2464 BULK ITEM: No DEPARTMENT: Fire Rescue TIME APPROXIMATE: STAFF CONTACT: Andrea Thompson, Division Chief of Trauma Star/EMS AGENDA ITEM WORDING: Approval of a Class A Certificate of Public Convenience and Necessity (COPCN) to the Key Largo Volunteer Fire Department, Inc. for the operation of an ALS Non-Transport Service provided through their Fire Engine firefighters for the period May 16, 2024, through May 15, 2026. ITEM BACKGROUND: The Key Largo Volunteer Fire Department, Inc. (KLVFD) has requested this COPCN due to the increase in call volume within the Key Largo area enabling the KLVFD to enhance the level of ALS services. The Key Largo Volunteer Fire Department Inc. has submitted an initial application for BOCC approval of a Class A COPCN which would become effective May 16, 2024, and expire on May 15, 2026. PREVIOUS RELEVANT BOCC ACTION: None. INSURANCE REQUIRED: Yes CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATION: Approval. DOCUMENTATION: Key Largo Volunteer Fire Department Inc. Completed Class A COPCN Application_Redacted.pdf Key Largo Volunteer Fire Department Inc. COPCN Expires 05.15.2026.pdf 4036 2024 04 Schedule Insurance signed exp 10 1 2024.pdf FINANCIAL IMPACT: Effective Date: 05/16/2024 Expiration Date: 05/15/2026 Total Dollar Value of Contract: N/A Total Cost to County: N/A Current Year Portion: N/A Budgeted: N/A Source of Funds: N/A CPI: N/A Indirect Costs: N/A Estimated Ongoing Costs Not Included in above dollar amounts: N/A Revenue Producing: N/A If yes, amount: N/A Grant: N/A County Match: N/A Insurance Required: Yes, per COPCN Class A application. Additional Details: N/A 4037 00 M C) MONROE COUNTY, FLORIDA Iq APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY (COPCN) CLASS A EMERGENCY MEDICAL SERVICE (PRINT OR TYPE) INITIAL APPLICATION-$950.00 El RENEWAL APPLICATION-$475.00 IF RENEWAL,PLEASE LIST NUMBER OF PREVIOUS CERTIFICATE:4 I® NAME OF SERVICE Key Largo Volunteer Fire Department Inc. BUSINESS MAILING ADDRESS 1 East Drive, Key Largo, FL 33037 BUSINESS PHONE NUMBER 305-451-2700 EMERGENCY PHONE NUMBER 305-393-2403 2. TYPE OF OWNERSHIP(i.e.,Sole Proprietor, Partnership,Corporation,etc.) Non-profit Corporation DATE OF INCORPORATION OR FORMATION OF THE BUSINESS ASSOCIATION May 27, 2013 3. LIST ALL OFFICERS,DIRECTORS,AND SHAREHOLDERS(Use separate sheet if necessary): ............................................11................................................................ ................................11.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... NAME AGE ADDRESS TELEPHONE# POSITION M............T L E................ ....................................................................................................................................................................................................... .................................................................................................................................................................................................................................................................................................. .................................................................... Jason Mumper President .................................................................................................11............................................................................. .................I............................................................................................................................................................................................................................................................................11....................................................................................... .............. ......................................................................................................... Donald Conord ........................... �ice Pres ....................................................................................................1.1.11....................................................................................................................... ........................................................................................................................................................................................................................................................................................................... .................................................................................................................- Travis Wilson I Treasurer ..................................................................................I.................................................................................................... ...................................................................... ............................................. ....................................... .......................................I.............................. ............................................................ ...........................................I...... .................................... Mike Jenkins Director ....................................................I..........................................................................................................I,.,..............................I...................................................................... .... I................................... ................................................................................................................................I....................................................................................................................................................................................................................................................................... ............................................................................................................................................................................................................................................................................................................................................................................11...................................................................................................................................................................................................................................................................................................................................................... ................................................................................................................................................I..........................................................................I...............................................................................................................................................................I.-............................................................................... .................................................................................................................................................................................................................................................................. ...........................................................................................I ...........................................................................................".."..................... ........................................................................................................................................................................................................ ....... ........................................... ............................................1..................... ............................................................................................................................-........................................................................................................................................................................................................................................................................................................................... . LEVEL OF CARE TO BE PROVIDED: BLS or IN ALS IF ALS: Ll TRANSPORT or N NON TRANSPORT fl; DESCRIBE THE ZONES(S)THAT YOUR SERVICE DESIRES To SERVE(Use separate sheet if necessary): From Lobster Lane & South Bay Harbor Drive (mile Marker 95) as the southern edge ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... to County Line Marina (mile marker 113). Also CR905 north to mile marker CR10. .......................................................I..........................................................................................I.....................................................................................................................-..........................................................................................11.................................................................................................................................................................................................................................................................................................. ................................................................................................I.............................................................................................................I.........................................................................................I.........................I..........................................................................................................................................................I I......................................................................................................................................................................... ...................I I..........................................................................................................................................................................-.......................I................................................................................................................................................................................................................................. -.............................................."I.................................................................................................I............................ 6. LIST THE ADDRESS AND/OR DESCRIBE THE LOCATION OF YOUR BASE STATION AND ALL SUB- STATIONS(Use separate sheet if necessary): BASE STATION 1 East Drive, Key Largo, FL 33037 (Fire Station 24) SUB-STATION 220 Reef Drive, Key Largo, FL 33037 (Fire Station 25) ............ . ................................ ....................... ............................. -.......................................................................................... ................................... .................................................................................................................................................... ..................... .........................................................-.................................................................................................... ................................................................................................ .........'..............__...............I.,................... ............... .................. .....................................-............................. Nip a U6 M O 7. DESCRIBE YOUR COMMUNICATION SYSTEM (Attach copy®fall FCC licenses)® d aw_____ ___ _�.___ ____ _________ ___________________________ UEN . .... .... 1 CES EXLL NUMBERS OF MOBILES PORTABLES ....... ...... .. .... Monroe County Fore Rescue Frequendes E24, T2 „ S 4, 4 E25 L2 VSeveral n _____ _____„_ ,--- _w___u_________. _____.-aw _________ _-.. ______ __..-aw__ _________ ________. ___ ------aw______-------------------- --------------------- : LIST THE NAMES AND ADDRESSES ( ) U.S.CITIZENS WHO WILL ACT AS REFERENCES FOR YOUR SERVICE. NAME...................................... .......... .. ............. .......................... ........ ....... .............. .. ...SS ......... ..... ................. .......... Dawn l rgo FL 33037 w .._,_,_,_,_,_,_. ....1�..,____________, _,_,_,_ ,_aw___ _______- .............-- _,_,_._.aw °_. .,_,_,_,_'_,_,_,_,_,-aw_____________—,----_........................... Morrisonvi Largo,_____ _._ �.___w____.w_______ _ _______�.w______ _________ °________�_________. . it 1 v i . ATTACH A SCHEDULE OF RATES WHICH YOUR SERVICE CHARGE . 10. PROVIDEIC U INSURANCE N CN PERIOD. 11. ATTACH A COPY OF YOUR SERVICE'S CONTRACT WITH A MEDICALDIRECTOR. 1 . ATTACH A COPY OF ALL STANDING ORDERS AS ISSUED BY YOUR MEDICAL DIRECTOR. 1 . ATTACH A CHECK OR MONEY ORDER IN THE APPROPRIATE AMOUNT, APAYABLE MONROE COUNTY A COUNTY SS N S. ,THE UNDERSIGNEDS TA V ABOVE SERVICE,DO HEREBYATTEST YSERVICE MEETS ALL OFTHE REQUIREMENTS FOR OPERATIONAN EMERGENCY MEDICAL SERVICE COUNTY AND THE STATE FLORIDA. I FURTHER ATTEST A ALL THE INFORMATIONCONTAINED THIS APPLICATION, THE BESTY KNOWLEDGE, IS TRUE AND CORRECT. NA°I'L" E 1<APLIC N6T~ED REPRESENTATIVE t Il HH 3 NO ® A WMS ' 2 TA 'IGNA DATE C) Iq C) Iq PERSONNEL-PARAMEDICS ............................................. ............................................................................................................ ................................ ............................................................. NAME PARAMEDIC CERTIFICATIOR-, Rivet UMA1. ast SOCIAL SECURITY# CERTIFICATION# EXPIRATION DATE ........................................................................... .................. Enrique Abiller1ra ------ PMD 531835 12/01/2024 ............ ................................................... ...... .................................................... ........... (01 Jaime Arana ........ ............. PMD 513116 12/01/2024 ............................................................................................................................................................ ................................................................. ........................................................-................ Don Bock PMD 008122 12/01/2024 ............................... ............................. . ............I.,.,.,.,.,.,...................... ...................................................==................................................................... -.1.1.1.1...,.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.111..'I..................—1 Andrew Bohl PMD 533521 12/01/2024 .............................................................................................................. ...................................................................................................................................................................................... .......................................................................... ......................... .................... -— PMD 539380 12/01/2024 ..... ... ............................................................I.,.,.,.,..,.......................... .................................................................................................................................... ... ....................... ................................ ............................................. .............................. Pedro Fernandez --------------------- PMD 530562 12/01/2024 ............. .................................... ...................... ................................................................................... ........................................................................................................................................................................... Bradly Galvin PMD 534400 12/01/2024 —.......................................................................................................... ..................................................... ............ .................................... ...................................................... Fernando Garcia PMD 530770 12/01/2024 ............................................................................................................... ................................................................................................................................................ Sergio T. Garcia, Jr. PMD 530690 12/01/2024 ....................... .............-1..................................................... —1........................................................ ....................................I.,............................... ..........................—11-111............. .......... David Garrido -------- PMD 526992 12/01/2024 .............. .................. .............................-.—....................................... Christopher Jones ................. PMD 519528 12/01/2024 ............................... ...... ...................................... ................ ...................... ........ - -—------------- - ------ Thomas Mirabella PMD 542524 12/01/2024 ................................................................................. .........................................- . Z. ........................................... r............................ ...........................................................................I.,.,............................................ ......I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.1............ Jason Mumper ........ PMD 526457 12/01/2024 ............................................................................................................................................................ .1.1.1.1.1.1.1.1.1.1.1.1.1=:==� .................................................................................................................. ................. . ...........................- -------------------- ................I................--.—.................... ................................................ . ......................... ---------------------------........... ..................... .......................................................................... .............................................................................I.............................. ..................... ................ ............................................. ......................... .............................................................................................................. ................................................ ..................................................................................................................................... ....................................... ........................... ............................................I.,...................................................--17 .............. ...... ..............................................—1................................................................................ .................... ....................... ---------------------- .............................................................................................................................................................................- : �� .................... . ....................................................... .........................................I.............................................. ............................................. ....... .................... .............................. ............................... ................ ....... .............................. ......................................... ................. .............................................................. ....................................................................................................................................................................................................... .....................................................................I.,.,.,.,,,.,.,..................................................11.................. ........ .............................................. ...........................................-.1.11............................................—11................ ............. ............................... .................................................................--'................ .................................................................................I...................................................................... ...................... .............. ..................................... ............... ...............................................................I................................................................................... ........................................................................... ....................................... -----------"'.. ................ ............................................................. ................................................................... ................................. .............................................................................. EfEF 11..................... .... .................................................................................................................—.1........................................................ ................................. ......................... .................................................................................. ....................................................................................................................................................................... . ................................................................. ......................................................—.......... ...................... ...................... .1.11�............... ................... ....................... ...................... --------------—------ ..... ................. ..................... ......................... ..................................................................................................................... .................... ....................................................................................................................... ...............................................................1.1.111.1......................................... .................. ..... .................-.-..............................................—.............................. ......... ....... ....................................... ...................... .............. Page 3 of 6 d 0 MEDICALPERSONNEL—EMERGENCY A 7— T CERTIFICATION First,Middle,Last SOCIAL SECURITY# CERTIFICATION# EXPIRATIONA Michael Baez EMT 542799 12/01/2024 Carlosr it ...._m___........m.". EMT 534281 1 / 11 2024 .. Christopheris "m. EMT 571728 1 / Andres2024 i12/01/2024 GonzalesMarcos 12/01/2024 SamuelJoseph Hanna j �.._W..Ty .m.. 1 / Mathew 1 12/01/2024 Curtisc 7 12/01/2024 Travis J. Wilson EMT 582747 12/01/2024 .... rv. N d' O d' PERSONNEL DRIVERS .... ,,, .... mw NAME STATE First,,ll1 dle,bast SOCIAL SECURITY# DA"I'E OF BIRTH DRIVER LICENSE# OF ISSLVAI�C E FXPIRA'TTON DATE ,,,,,, m mmmmmmmm... m.mm ....... . ,. Not Applicable-non-transport sve8. _w.. mm.. m .... .. .. C DO H EREBY ATTEST,TO THE BEST OF MY KNOW LE GE,THAT ALL OFTHE A BOVE NANIED RIVERS DO M EET A LL OF TH E REQUIR EM E TS OF C HA1vrER 401.281 F.S.AND CHAPTER 64E 2.012 FAC:FOR AMBUIANCE DRIVERS. NO`I"ARY SEA Notary State of e NOTARY SIG Co HH M d' O d' VEHICLES F r Each Ambulance Operated BX Your Service Please PE2vide the Following.,knfunnation Use Se crate Sheet If NeceusaI LICENSE .. VEHICLE .... ...SPECIFY TRANSPORT or AMBULANCE TYPE m D YEAR MILEAGE CH ASSISASSIS N TAG NUMBS P1 O A or m.m NO I N O T llJ N/AWnon-transport tra saft mm _ ........ ... _.. . . ........ .. _... . y" BOARD OF COUNTY COMMISSIONERS County of Monroe ''��`;�� Mayor Holly Merrill Raschein,District 5 The Florida Keys Mayor Pro Tem James K. Scholl,District 3 Craig Cates,District t Michelle Lincoln,District 2 David Rice,District 4 Monroe County Fire Rescue '; ������� 490 63Td Street Ocean Marathon,FL 33050 Phone(305)289-6004 " MEMORANDUM TO: Nicole Lyons FROM: Cara Johnson SUBJECT: Check for Deposit- COPCN DATE: February 23, 2024 ...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Attached please find Check_ dated February 19, 2024, in the amount of$950.00 per check to be deposited in revenue account 141-342000-RC 00345. This check has been issued for the initial application of a Class A Certificate of Public Convenience for Key Largo Volunteer Fire Department Inc. Thank you, Ca4.2, �6� Cara Johnson 4044 '+ww.RmaIMMwa+wn=S Q� .. . w w�"'''° o a 1 O i:;y of a oBr m I"i * � 'A t9 n rib . 41 41 t � f M LO a j N 190 4� w° E n L 41 CL 0 ���5 41 N m 1 C co Q LL 2 3 Q ' rL YLU O o co f OW O00 V a cc w 4045 9vov NO Piretox al r.- bI C) Iq AGREEMENT FOR MEDICAL DIRECTOR SERVICES This Agreement for Medical Director Services is made and entered into as of the date lag written below, by and between the Key Largo Fire Rescue and Emergency Medical Services District ("DISTRICI"), and TOM Medical Corp, 102901 Overseas Highway, Key Largo, FL 33037 C'DOCTOR"), licensed to practice medicine in the State of Florida with a principle location Monroe County. In exchange for good and valuable consideration,die receipt and sufficiency of which are hereby acknowledged,the parties hereto agree as follows; WITNESSETH: rovi_aoa f�ervice, DISTRICT provides emergency services in -the Key Largo area through its DISTRICT charter under Florida Law, DOCTOR is a medical doctor licensed and insured to practice medicine in the State of Florida, DISTRICT desires to enter into this Agreement with DOCTOR to serve as Medical Director and provide medical supervision and control for the DISTRICT, Key Largo Volunteer Ambulance Corps, and Key Largo Volunteer Fire Department, in Key Largo Florida, and DOCTOR is willing to accept such engagement upon the terms set forth in this AgreemenL 2. By execution hereof, DISTRICT hereby designates DOCTOR as the Medical Director for DISTRICT' operations within DISTRICT'S jurisdiction. In that capacity, DOCTOR will be responsible to provide all necessary and appropriate medical authority and direction for the Medical reams operating in die area, DOCTOR shall be responsible for all iriedical aspects of, and all medical decisions and directions relating to, Basic Life Support, Advanced Life Support, and immunizations, DOCTOR shall meel at least once each month with the DISTRICT and appropriate Medical 'ream(s)personnel on site to review,among other things,patient records for appropriaieness of transport, patient care, and other areas of quality Page I of 8 of 7A 7/2020,735 AM aE�-bl C) improvement. DOCTOR or appropriate designee shall at Minimum provide monthly education, DOCTOR. shall meet all standards of the Florida Department of HeWth and the Commission on the Accreditation of Medical Transport Systems (CAMTS) for a Medical Director, DOCTOR will also be responsible for compliance with federal, state and other Bove err requirements pertaining to the operation and provision of the emergency medical care services. DOCTOR shall also serve as liaison between DISTRICT and the various health care facilities or other health care providers for whom DISTRICT provides service in the area covered by this Agreement. Such liaison shall include coordinating the medical operations of DISTRICT to comply with the by-laws, policies, rules and regulations applicable to any such health care facility or health care provider for whom DISTRICT is providing services, DOCTOR shall also assist in evaluating the technical medical aspects of DISTRICT medical personnel working for DISTRICT who may assist in providing emergency medical assistance, 3 a. Insurance Reouire stets. The Parties shall provide,during the to of this Agreement, the following minimum insurance coverage and provide appropriate certificates of insurance to the other Party: L DISTRICT will provide all risk insurance,as provided herein, fi, DIST`RJCT has liability insurance and to the extent that its existing, policy will allow it will provide coverage to DOCTOR, iii. DISTRICT will provide liability insurance to DOCTOR acting within the scope of his duties to the extent that its present policy a]lows, iv, Both Parties agree to provide workers' compensation insurance for their employees as required by law, f_ommokations zri me , DISTRICT will provide all necessary communication equipment, upon approval of written request(s) presented to DISTRICT for review, including but not firinted to.cellular phone,two-way radio,or pager° Page 2 of 8 7/17/2020,7:35 AM Firefox ab 0) PIE C) 4. 1Ud§-m-mS-Jc-aAo—n. DISTRICT shall indemnify and hold DOCTOR and his employees and agents hamidess from and against claims, damages, liabilities and expenses (including reasonable attorneys' fees and costs) (collectively, "Losses') arising directly from DISTRICT'S performance of emergency services to the extent such Losses arise out of negligent or intentional act of omission of DISTRICT or its officers,directors,employees or agents,except and to the extent such Losses directly result from DOCTOR'S failure to perforrn his duties as outlined in this agreement. DOCTOR shall indemnify and hold DISTRICT and its officers, directors, employees and agents harmless from and against Losses arising directly from DOCTOR'S performance of services hereunder to the extent such Losses arise out of negligent or intentional acts or omissions of DOCTOR, except and to the extent such Losses directly result from DISTRICT'S failure to comply with DOCTOR' directives hereunder, DISTRICT and DOCTOR shall promptly notify the other of any event or circumstance that may lead to a request for indemnification hereunder,provided that,no failure to provide such notice shall prevent either party from obtaining indemnification hereunder unless and only to extent that the indemnifying party was demonstrably prejudiced by such failure to provide notice. 44 Bela-ti-onshi of dle parties, The relationship between DISTRICT and DOCTOR will be that of contractor and independent contractor, Nothing in this Agreement is intended or shall be construed as creating any kind of partnership,joint venture, employer-employee relationship or any other agency relationship between DOCTOR and DISTRICT. The parties shall be solely responsible for the method and manner in which they or their respective employees carry out the duties imposed by this Agreement, and neither party shall exercise any control or direction over the methods by which the other party performs their respective functions hereunder, except as may otherwise be provided in this Agreement. DOCTOR specifically acknowledges that he is not an employee of DISTIUCT, Page 3 of 8 of 8 7/17/2020,7-3 5 AM Firefox atm Ila LO C) 6. ComRensation for Medical Directpr-Services. DISTRICT agrees to pay to DOCTOR the sum of$18,000 per year during the to of this Agreement. A cost of living adjustment of no greater than 4 (four)percent as determined by dbe DISTRICT will be added to the annual fee each year at the beginning of the respective budget year. Payment shall be made biweekly. 7. ftyment of Expenses. DISTRICT agrees to reimburse DOCTOR for DOCTOR's reasonable and necessary travel and business expenses in accordance with state and federal law,and further,pursuant to any DISTRICT travel policies. Any conflict between requirements set out by law and a DJSTRJCT travel policy shall result in the provisions created by law controlling resolution of the conflict. A copy of any DISTRICT travel policy, whenever created if not already in existence at the time of this Agreement,%vill be provided to DOCTOR, DOCTOR may also be reimbursed for expenditures made on behalf of the DISTRICT program, with the prior approval of the DISTRICT. Bills or invoices for fees or compensation under this Agreement shall be submitted in detail sufficient for a proper pre-audit and post-audit thereof, 8. lTmMnL2ofLASEgernerat. This Agreement shall commence on February 1, 2020 and shall continue for a period of three(3)years,and will automatically renew an additional three (3) years, unless terminated by either party as contained in this paragraph. This Agreement may be terminated by either party by giving ninety(90)days written notice to the other party, termination effective upon the other party's receipt of the notice of termination, said receipt of the notice being documented by a return receipt other than via electronic inail. DOCTOR shall be entitled to compensation through the effective date of termination of this Agreement, provided services continue to be provided through such date as contained herein. Page 4 of 8 of 8 7/1712020,7:35 AM Fire fox ab V"da LO C) 9. In no event,whether as a result of contract,tort,strict liability or otherwise, shall either Party be liable to the other for any punitive, special, indirect, incidental or consequential dwages, including without Hil-itation, loss of profits, loss of use or loss of contract, 10. Sexes bill In the event that any provision of this Agreement is determined to be urdawfW or contrary to public policy, such provision shall be severed herefrom and Shall bedeemed null and void, but shall in no way affect the remainhig provisions outlined herein. 11. !;9mg lets-A&L eement. This Agreement sets forth the complete understanding of the _ parties hereto and any modification of the terms hereof must be in a writing signed by both parties hereto. 12, Q2-y-e—m-in-g—Law, The terms of this Agreement shall be governed by and interpreted in accordance with the laws of the Stale of Florida, with venue agreeably set in Monroe County,Florida, 11 Contract Records Rete-" . DOCTOR agrees to comply with all state and federal regulations governing contracts with public entities, including but not limited to cooperation with public records requests as provided by law, and cooperation with comptrollers and auditors as provided by low. 14. Waiver. Any act or lack thereof that is deterniined to be a waiver by either party of a breach or failure to perform hereunder shall not constitute a waiver of any subsequent breach or failure to perform. Page 5 of 9 of 7/17/2020,7:35 AM Firefox a c.4 C) DOCTOR represents and wan-ants to DISTRICT, upon execution and throughout the to of this Agreement that- a) DOCTOR is not bound by any contract or arrangement which would preclude him from entering into, or from fully performing the services required under this Agreement; b) None of DOCTOR'S agents, employees or officers have ever had his or her professional license or certification in the State of Florida, or of any other jurisdiction, denied, suspended, revoked,terminated and/or voluntarily relinquished under threat of disciplinary action,or restricted in any way; c) DOCTOR has not been convicted of a public entity crime as provided in F.S. §287,133;and d) DOCTOR and DOCTOR'S agents,employees and officers have,and shall maintain throughout the term of this Agreement, all appropriate licenses, certifications and insurance coverage that arc required in order for DOCTOR to perform the functions assigned to him in connection with the provisions of this Agreement. 16. Assignment. Neither DJSTFJCT'nor DOCTOR may assign or transfer any interest in this Agreement without the prior written consent of both parties. Should an assignment occur upon mutual written consent, this Agreement shall in to the benefit of and be binding upon the parties hereto and their respective heirs,representatives,successors and assigns. Page 6 of 8 7/17/2020,7:33 AM Firefox ab-�;Sla LO C) 17a Notice,& All notices required by this Agreemen ess otherwise provided herein, by either party to the other shall be in writing,delivered personally, by certified or registered mail, return receipt requested, or by Federal Express or Express Man, and shall be deemed to have been duly given when delivered personally or when deposited in the United States mail®postage prepaid,addressed as follows: rare Key Largo Fire Rescue&Emergency Medical Services District P.O.Box 371023 Key Largo,Florida 33037-1023 Attention:District Clerk DOCTOR: TGM Medical Corporation c/o I'homas Morrison,M,D. 102901 Overseas Highway Key Largo, FL 33037 EREMAINDER OF PAGE LEFT INTENTIONALLY HLANKI Page 7 of 8 "of�8 7/1712020,7:35 AM Firefox ab -')Ig C) N WITNESS WHEREOF, the parties hereto have executed this agreement, as of the day and year first%witten above. Key Largo Fire Rescue and E inergency TGM Medical Corp. Medic e r at.- al S '"a- 'Se By- RY................... a L A_! A y Allen Pring hommos orrison,MD Chairman Dated: Dated; &geDDi cc strictCC rint: Vik�Fay Fay d® ie App�r ov ds amid suffiiciency- DisAriot al ounsel Lrint:Gaclamor P.Jones Dated: Page 8 of 8 of 8 7/17/2020,735 AM /•�/f1i l�l "I"able of Contents Forward I. General Procedural Protocols A. Scene and Patient Assessment Protocol B. Airway Management------------------------------------------------------------------------------------- C. Emergency Incident Rehabilitation II. Altered Mental Status and Unconsciousness A. Unconscious person ...................................................................................... B. Seizure ............................................................................................................ C. Diabetic Emergencies------------------------------------------------------------------------------------ D. Confusion, Agitation------------------------------------------------------------------------------------ III. Acute Respiratory Distress A. Asthma ......................................................................................................... B. COPD (Chronic Bronchitis and/or Emphysema) ---------------------------------------- C. Hyperventilation IV. Behavioral Emergencies-----------------------------------------------------------------------------. V. Burns VI.Cardiac Emergencies.................................................................................... A. Chest Pain (Angina, Acute Coronary Syndrome)......................................... B. Cardiac Arrest VII. Childbirth and Newborn Care A. Uncomplicated Delivery............................................................................... B. Complicated Delivery.................................................................................... C. Newborn Care ............................................................................................... Vill. Environmental Emergencies A. Dehydration Page 2 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4056 B. Drowning— Near Drowning.......................................................................... C. Heat-related Illness (Hyperthermia)____________________________________________________________ D. Diving-related Emergencies.......................................................................... E. Envenomation's ............................................................................................. F. Marine Bites and Stings................................................................................. IX. Trauma ........................................................................................................... A. Extremity wound hemorrhage................................................................... B. Amputations C. Multi-system Trauma D. Chest and Abdominal Injuries____________________________________________________________________. E. Spinal Cord Injuries...................................................................................... F. Selective Spinal Immobilization G. Electrical Burns and Lightning Injuries H. Orthopedic Bone and Joint Injuries............................................................ I. Head, Neck and Facial Injuries____________________________________________________________________ X. Other Medical Emergencies......................................................................... A. Allergic Reaction B. Hypertensive Crisis C. Epistaxis........................................................................................................ D. Nausea/Vomiting......................................................................................... E. GI Bleeding................................................................................................... F. Abdominal Pain ............................................................................................ G. Poisoning/Overdose .................................................................................... H. Stroke, TIA I. Shock ............................................................................................................ XI. Specialty Skills.............................................................................................. A. i-Gel Procedures B. Intranasal Administration Technique (Narcan)____________________________________________ C. Combat Application Tourniquet................................................................... D. Full Spinal Immobilization Technique E. Glasgow Coma Scales F. APGAR Score Page 3 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4057 G. Summary of BLS Maneuvers for Infants, Children, and Adults H. Pediatric Vital Signs Normal Ranges............................................................ I. Rule of Nines ................................................................................................... J. Adult Trauma Scorecard Methodology......................................................... K. Pediatric Trauma Scorecard Methodology__________________________________________________ Page 4 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4058 Foreword The following protocols outline the care that emergency medical technicians should administer to patients. The protocols should be implemented under the approval of a local or agency medical director. For a practicing provider to be proficient with these protocols, he/she must be certified and licensed at the appropriate level and demonstrate and document all the skills and knowledge the protocols require. The protocols in this set use the following format: • A Review of Injury/Illness that provides an overview of the condition and any special issues that should be considered • Signs and Symptoms presented in a bullet list • Management for Basic Life Support (BLS) Page 5 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4059 Am Scene and (Patient Assessment Protocol Scene Size-Up Conduct safety assessment of scene for hazards to EMS personnel. If scene is unsafe and cannot be made safe, DO NOT enter. Patient Assessment BLS 1. Institute appropriate measures for prevention of infectious exposure. 2. If appropriate, begin triage and initiate Mass Casualty Incident (MCI) procedures as outlined in Protocol I.G. 3. Determine mechanisms of injury (MOI), nature of illness, and number of patients. 4. Perform primary assessment (airway, breathing, circulation).Then control serious bleeding and assess level of consciousness with "AVPU"—Alert and aware, Verbal stimuli, Painful stimuli, and Unresponsive—and the Glasgow Coma Scale (Refer to Protocol XII.F.). 5. Initiate BLS measures as outlined by the American Heart Association, including CPR, and use of automated electrical defibrillator (AED), for cardiac arrest. (Refer to Protocol VI.D.) 6. Be prepared to assist ventilations with a bag valve. 7. Administer oxygen at the appropriate flow rate via endotracheal tube (ETT) if inserted by paramedic on scene, bag valve mask, non-rebreathing mask, or nasal cannula if indicated; 8. Apply pulse oximeter if available. 9. Correct other life-threatening problems if possible and according to protocol. 10. Monitor and repeat vital signs at 15-minute intervals for stable patients, and 5-minute intervals for unstable patients. 11. Consider cervical immobilization if appropriate (see "Selective Spine Immobilization"). 12. Obtain full patient history in SAMPLE &OPQRST format. Page 6 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4060 S—Signs/Symptoms O—Onset A—Allergies P— Provocation/Palliative M — Medications Q— Quality P— Past Med Hx/Past Surgical Hx R— Region/Radiation/Referral L— Last Oral Intake S—Severity 13. Perform focused exam. 14. Continue assessment employing (DCAPBTLS). a. D— Deformities b. C—Contusions c. A—Abrasions d. P— Punctures e. B— Burns f. T—Tenderness g. L— Laceration h. S—Swelling 15. Determine the patient's transport priority and whether paramedic care is required. Priority conditions include: a. Unable to obtain or maintain open airway. b. Clinical deterioration or death appears imminent. c. Altered mental status, includes not following commands. d. Difficulty breathing/inadequate ventilation and oxygenation. e. Hypoperfusion (Shock). f. Complicated childbirth. g. Chest pain with Systolic BP < 100 mm Hg. h. Uncontrolled bleeding. i. Severe pain. 16. Treat according to applicable protocols; transport, if capable. 17. Consider the need for additional resources. Page 7 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4061 18. Document all findings and medical interventions on patient care report. 19. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatrics 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH Page 8 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4062 B. ii it a ay Mainageirneint Review of Injury/Illness The obstruction or compromise of an airway can be caused by: (1) a variety of injuries and illnesses that result in narrowed air passages or excessive secretions or (2) the presence of solid foreign bodies that block air fl ow to the lungs. Signs and Symptoms * Wheezing * Stridor * Gasping - (when ineffective, sometimes called agonal respirations) * "Tripoding" or other positioning * Anxious * Skin color changes (cyanosis) * Nasal flaring, accessory muscle use, diminished or absent breath sounds * Difficulty swallowing—swollen tongue, and lips, drooling * Inability to breathe—weak respirations * Inability to speak * Abnormal respiratory rate * Rapid heart rate * Altered mental status Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. If choking, attempt Heimlich maneuver. 5. Assess adequacy of airway and ventilatory effort: a. Ability to speak Page 9 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4063 b. Color (note pallor or cyanosis) c. Vigor of cough/cry d. Rate and depth of respirations e. Unusual breath sounds on auscultation, including rales, wheezing, stridor f. Accessory muscle use and/or nasal flaring 7. For respiratory distress, apply pulse oximeter and administer 100% oxygen via non-rebreathing mask at high flow rate. 8. Assist ventilations with bag valve mask (BVM) as required. 9. Complete vital signs and determine likely cause of airway difficulty, such as: a. Potential aspiration of small objects or food b. Fever or cough c. Chest pain d. History of asthma, COPD, CHF e. In infants, a history of prematurity 10. Place patient in position of comfort. 12. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 10 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4064 II., Altered III ental Status and Unconsciousness Review of Injury/Illness The term "altered mental status" (AMS) indicates a dysfunction of the central nervous system. Common causes of altered mental status in the field include seizures, shock, diabetic emergencies, drug or alcohol intoxication, medication overdose, stroke, infection, environmental exposure (heat or cold), and traumatic brain injuries. AMS may present anywhere on the spectrum from minimal impairment to unconsciousness. Signs and Symptoms * Slurring or other change in speech * Memory loss (inability to recall recent events) * Unsteady gait * Seizure activity * Impaired judgment * Inability to verbally respond or follow commands (unresponsiveness) * Unconsciousness A. Unconscious person Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Determine need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Attempt to determine cause of altered mental status (e.g., overdose, intoxication, stroke, diabetes, trauma). 6. Check for hypoxia and provide supplemental oxygen via non-rebreathing mask at high concentration. Page 11 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4065 7. Check blood sugar level with a glucometer, if available and part of the scope of practice: a. If hypoglycemic (blood sugar< 60 mg/dL) and conscious, administer glucose paste (10-15 gm) between cheek and teeth. May repeat x1 after 10 minutes, if no response. DO NOT give glucose paste to patients who are unconscious and/or do not have the capacity to swallow. Be cautious of vomiting/aspiration after administration and protect the airway. b. Recheck blood sugar after all interventions, every 30 minutes during transport, and with any change in mental status. 8. Check temperature, if a thermometer is available. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. 10. If unconscious, or with depressed respiratory function, consider narcotic overdose and administer naloxone 1mg (1ml) IN each nostril quickly. See Section XI.G Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size 2. See Section XI.G and XLH Page 12 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4066 B. Seizure Review of Injury/Illness: Seizures are caused by abnormal electrical bursts in the brain. Partial, or focal, seizures may cause uncontrolled movements of one or more limbs or the face, though patients typically remain conscious during focal seizure activity. Generalized seizures, sometimes referred to as "fits" or"convulsions," involve both sides of the brain, and therefore typically produce unconsciousness. Generalized seizures may involve tonic (rigid stretching of the body and limbs) and/or clonic (rhythmic jerking of the limbs and/or head) activity. Many, but not all, patients experience an "aura" of symptoms that warn them of a coming seizure, allowing them to sit or lie down to prevent injury. Others have no warning, and may be seriously injured by falls, blunt trauma, motor vehicle accidents, near drowning, or other incidents caused by their sudden loss of consciousness and body control. Seizures may be caused by head trauma, low blood sugar, infections, fevers, tumors, hypoxia, environmental exposure, toxic chemical exposure (e.g., a nerve agent, insecticide), or other metabolic abnormalities. They may also occur periodically in individuals without evidence of one of these causes—a condition called "epilepsy," which typically is controlled to some extent by medication. Febrile seizures in children do not predict underlying epilepsy and seldom last long enough to require treatment in the field, but should always be evaluated by a physician when they occur. Epileptic seizures generally last from 30 seconds to a couple of minutes, and may be followed by a postictal state of deep sleep or agitation lasting from a few minutes to several hours. Generalized seizures that last for 5 minutes or more are considered "prolonged seizures."These may require treatment to be stopped, and the patient should be transported as expeditiously as possible. Continuous or recurrent generalized seizures without regaining consciousness over a period of 30 minutes is called "status epilepticus" or "status seizure." This is a true medical emergency, with the potential for permanent brain damage. Signs and Symptoms Focal seizures * Uncontrolled, rhythmic jerking of one or more limbs or facial muscles * Abnormal, but stereotyped behavior or sensations such as smells not related to the environment Page 13 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4067 * Patients typically remain awake and may be variably responsive during focal seizures Generalized seizures * May be preceded by an aura * Patients are unconscious * Tonic/clonic muscle activity * Likely to have associated injuries Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Determine need for ALS care and/or transport to hospital for further evaluation and treatment. 5. For generalized (typically tonic-clonic) seizure, monitor airway: a. DO NOT attempt to restrain a patient that is actively seizing. b. DO NOT force any device into the patient's mouth, if the patient is still seizing. c. Position patient to maintain open airway; turn onto side if patient is at risk for aspirating excess secretions or is vomiting. 6. For prolonged seizures or status epilepticus (status seizure), request ALS support for medication, and/or transport to hospital ASAP. 7. When seizure activity has stopped: a. Identify and treat injuries. b. If patient is a known diabetic, and patient is awake/able to control airway, glucose paste (10-15 gm) should be administered between the gum and cheek. Consider a single additional dose of glucose paste if condition does not improve after 10 minutes. 8. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 14 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4068 Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size 2. See Section XLG and XLH Page 15 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4069 C. Diabetic Emergencies Review of Illness/Injury Diabetes mellitus is a group of conditions in which the body does not produce enough or cannot properly use insulin. Insulin shock (hypoglycemia or low blood sugar) occurs when a patient has received more insulin than was needed. This causes low blood sugar levels, so metabolically active cells (e.g., brain) do not have enough energy to function normally. Altered mental status, including unconsciousness, may occur and is treated by administering glucose. Diabetic coma (hyperglycemia, diabetic ketoacidosis, and hyperosmolar coma) occurs when insulin is insufficient or not working. This results in excessive sugar circulating in the bloodstream, and other metabolic changes. Signs and Symptoms Insulin Shock * Rapid respirations and/or heartbeat * Dizziness * Sweating * Headache * Confusion * May progress to unresponsiveness Diabetic Coma * Drowsiness * Confusion * Thirst, dehydration * Change in level of consciousness * Sweet or fruity-smelling breath Page 16 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4070 Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Determine need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Determine blood sugar level using a glucometer, if available and usage permitted by local protocols. 6. If hypoglycemic (blood sugar< 60 mg/dL) and conscious, administer glucose paste (10-15 gm) between cheek and teeth. May repeat x1 after 10 minutes, if no response. DO NOT give glucose paste to patients who are unconscious and/or do not have the capacity to swallow. Be cautious of vomiting/aspiration after administration and protect the airway. 7. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XLH Page 17 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4071 D. Confusion, Agitation Review of Injury/Illness "Confusion" is a state in which a patient has difficulty both understanding his surroundings and ascertaining a response. "Agitation" suggests heightened anxiety and frequently includes combative behavior. There are many causes for acute onset of confusion and/or agitation. These include but are not limited to behavioral emergencies, metabolic emergencies including hypoxia and hypoglycemia, hypo/hyperthermia intoxication or over-medication, and head injury. All these conditions are covered elsewhere in these protocols, and all require transportation for full medical evaluation and treatment. Signs and Symptoms This protocol pertains to patients who are awake and alert, but present with an acute change from their normal mental status. It is important to establish and convey to the receiving facility whether the patient is oriented (knows who and where he/she is and the day and date). This can only be established by asking these questions. Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Check for hypoxia and provide supplemental oxygen via non-rebreathing mask at high concentration if present. 5. Assess patient for possible closed head injury and follow trauma protocol if appropriate. 6. Check blood sugar level. a. If hypoglycemic (blood sugar less than 60 mg/dQ, administer glucose paste. (Refer to Protocol II.C.) b. Recheck blood sugar after all interventions, every 30 minutes during transport, if indicated, and with any change in mental status Page 18 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4072 7. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size 2. See Section XLG and XLH Page 19 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4073 M., Acute IlRespiratory Distress General Review A variety of conditions can cause acute difficulty breathing or inadequate oxygenation. Examples include asthma (including allergic reactions involving the airway or allergic bronchospasm), chronic obstructive pulmonary disease (including emphysema), congestive heart failure, respiratory tract infections, pulmonary emboli, and others. Any of these processes can lead to respiratory failure, or loss of the ability to inhale oxygen and exhale carbon dioxide. A. Asthma Review of Injury/Illness Asthma is a chronic lung disease that causes inflammation and narrows the air passages (bronchospasm). It affects people of all ages but usually begins in childhood. In the field, all causes of acute bronchospasm are treated essentially the same. Signs and Symptoms * Coughing * Wheezing * Difficulty exhaling * Shortness of breath * Chest tightness * Retractions and nasal flaring in pediatric patients Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Provide supplemental oxygen. 5. Be prepared to assist ventilations with a bag valve mask (BVM), if necessary. 6. Allow patient to assume position of comfort. Page 20 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4074 7. If patient has prescribed inhaler available, assist the patient to administer; repeat once in a 30-minute period, if difficulty breathing persists. 8. If patient's asthma is historically precipitated by allergies, and he/she has an EpiPen° prescribed by a physician for that purpose, assistance may be offered for administration. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care Pediatric BLS 1. Follow BLS guidelines, adjusting to patient age/size. 2. See Section XI.G and XLH Page 21 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4075 B. COPD (Chronic Bronchitis and/or Emphysema) Review of Injury/Illness Chronic obstructive pulmonary disease (COPD) comprises several problems that impede the fl ow of gases through the airways and gas exchange in the lungs. Most, but not all, cases result from smoking or long-time asthma. Acute exacerbations of COPD are frequently caused by bronchospasm, which may in turn be triggered by infections, changes in air quality, or other environmental factors. Signs and Symptoms * Shortness of breath * Wheezing, rhonchi, or sometimes severely decreased breath sounds * Chronic cough with large amounts of mucus * Frequent respiratory infections Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 5. Provide supplemental oxygen. a. Administer oxygen at high-fl ow rate to all patients in severe respiratory distress. b. COPD patients not in respiratory distress should be given oxygen to maintain adequate 02 saturation (e.g., > 90%). 6. Be prepared to assist ventilations if necessary, with a bag valve mask. 7. Allow patient to assume position of comfort. 8. If patient has a prescribed inhaler available, assist the patient to administer. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 22 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4076 Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH Page 23 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4077 C. Hyperventilation Review of Injury/Illness Hyperventilation is rapid, deep breathing. It may be seen in panic or anxiety attacks. Signs and Symptoms * Agitation * Weakness * Dizziness * Confusion * Numbness or paresthesia of fingers and around the mouth * Syncope Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Allow patient to assume position of comfort. 5. Administer oxygen via non-rebreathing mask, if needed. 6. Coach patient to slow breathing with a calm demeanor. 7. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Confirm patient is not hypoxic with pulse oximetry, and coach to slow breathing. 3. See Section XI.G and XLH Pagel 24 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4078 l ., Behavioral Emergencies Review of Injury/Illness Many factors can influence a person's behavior. A pattern of disruptive behavior can become an emergency at any time. Behavioral emergencies may be psychiatric or medical. Always search for underlying medical causes such as head trauma, hypoxia, drug overdose, postictal following a seizure, or hypoglycemia. Signs and Symptoms * Talking to imaginary person or object * Agitation * Threat of suicide or homicide * Inability to care for self * Threatening or violent behavior Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. CONSIDER LAW ENFORCEMENT 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Maintain calm demeanor and respect the dignity of the patient. 5. Move slowly and deliberately. 6. Assess for underlying medical issues. 7. Check blood sugar and monitor pulse oximetry, if possible. 8. If the patient is spitting, cover his/her face with a surgical mask or non- rebreathing mask (NRBM) with high fl ow oxygen. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 25 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4079 Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH 3. Attempt to locate parent or guardian, if not on scene. Page 26 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4080 V., Burns Review of Injury/Illness A burn injury can result from direct or indirect contact with any heat source, including a flame, electrical, chemical, lightning, flammable liquid, fl ashes, radiation, or scalding liquids. Injuries can range from minor (1st and 2nd degree) to life-threatening (3rd and 4th degree burns). Signs and Symptoms Inhalation (airway burns) * Difficulty breathing and/or swallowing * Hoarseness * Stridor * Wheezing * Soot/singed hairs * May or may not exhibit facial burns First degree (superficial thickness burn to skin) * Redness * Pain * Swelling Second degree (partial thickness burns to skin) * Redness * Pain * Swelling * Blistering Third degree (full thickness burns to skin) * May be white, leathery or charred appearance * Swelling * Underlying tissue is damaged * May or may not have pain Page 27 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4081 Fourth degree (full thickness burns to skin; not universally used term) * Burns extend through skin and muscle, sometimes into bone Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Provision of supplemental oxygen is crucial to patients with smoke inhalation due to possible carbon monoxide poisoning. Start with 100% 02 by non- rebreathing mask (NRBM) if patient has altered mental status. 5. Be prepared to assist ventilations with a bag-valve-mask, if necessary. 6. For singed nasal hair or burns around the mouth or nose, request ALS support and transport as quickly as possible, as airway burns, and edema can result in rapid loss of airway. 7. Evaluate burn surface area (BSA) using the "Rule of Nines" or estimate using the patient's palm as 1%. Measuring BSA does not predict severity of injury for electrical burns. 8. Determine if there is any associated traumatic injury. 9. Remove jewelry and any clothing that is not stuck to the wound. 10. Cool burned skin with room temperature saline, do not apply ice to burned tissues. 11. Cover burns with dry, sterile dressing if irrigation is discontinued prior to hospital arrival. 12. Keep patient warm to protect against hypothermia. 13. For a chemical burn, wear protective equipment as needed, and consider field decontaminant. Remove contaminated clothing and irrigate areas with copious amounts of water. If dry/powdered chemical, brush off prior to any irrigation. Page 28 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4082 16. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. 17. See Section XI.I Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH 3. Adjust estimates of involved BSA for pediatric patients using the Lurd- Broaden chart for age-adjusted Rule of Nines. a. For patients< 1 year, head = 18% and each leg is 15%. b. Add 0.5%to each leg and subtract 1%from head for each year over age 1. 4. Suspect child abuse when injuries and/or story are inconsistent. Page 29 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4083 Im Cardiac i:'nieurgenc°vies A. Chest Pain (Angina, Acute Coronary Syndrome) Review of Injury/Illness In addition to cardiac ischemia, chest pain may be caused by inflammation of the lungs or pleural linings, pneumothorax, pulmonary embolus, indigestion, gastric reflux, and other problems. It is sometimes difficult to distinguish cardiac chest pain from these other problems. "Acute coronary" syndrome (ACS) refers to a set of symptoms resulting from inadequate blood fl ow to the heart muscle. The blood supply for the myocardium is provided by the coronary arteries, and when one or more of the coronaries is narrowed or blocked, ACS results. ACS includes angina pectoris, or chest pain, indicating inadequate blood fl ow to the myocardium. Myocardial infarction (MI) occurs when the muscle has been deprived of blood and oxygen long enough for it to be permanently damaged. Electrocardiograms (ECG) of patients having acute MI may show elevation of the ST segment in leads corresponding to the part of the heart that is being damaged. This is called ST elevation, MI, or STEMI. NOTE: Many patients who are having acute MI do not show ST elevations. Signs and Symptoms * Chest pain/discomfort that may radiate to the left or right arm, shoulders, jaw, or back * Frequently described as pressure or a crushing pain * Shortness of breath, sweating, nausea, or vomiting * Diaphoresis * Women, elderly, and diabetic patients have a higher incidence of atypical presentations such as generalized weakness or fatigue, nausea, and epigastric pain Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. Page 30 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4084 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Determine need for ALS care and/or transport to hospital for further evaluation and treatment. 4. Provide supplemental oxygen: a. 2.0-6.0 L/min via nasal cannula, if pulse oximetry is normal and patient is not short of breath. b. 100% by non- rebreathing mask if 02 saturation is < 90% or if patient is subjectively short of breath. 5. Be prepared to assist ventilations with a bag valve mask (BVM), if necessary. 6. Allow patient to assume position of comfort. 7. If the patient has prescribed nitroglycerin, and there are no contraindications, assist the patient to administer nitroglycerin 0.4 mg sublingual (SL); may repeat every 5 minutes up to a maximum of 3 doses, provided Systolic BP >_ 100 mm Hg and chest pain persists. a. Contraindications to first dose of SL nitroglycerin: • Use of erectile dysfunction medications in previous 24 hours • Systolic BP < 100 mm Hg 8. Continue to assess pain level. 9. Assess and treat for hypotension or shock, if indicated. (Refer to Protocol X.I.) 10. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 31 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4085 B. Cardiac Arrest Review of Injury/Illness BLS protocols to resuscitate patients in cardiac arrest should be based on the most recent American Heart Association guidelines and approved by local medical direction. The protocols below require that all BLS providers be trained to use and have access to automatic or semi-automatic defibrillators (AED). Signs and Symptoms * Unresponsive * No palpable pulse * Electrical activity on ECG is absent or shows course/fi ne ventricular fibrillation or ventricular tachycardia * No respirations (possible agonal gasping in initial stage) Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Determine need for ALS care and/or transport to hospital for further evaluation and treatment. 5. If witnessed arrest: Defibrillate one time prior to starting CPR. (Refer to step 6.) 6. If unwitnessed arrest: Start CPR according to current American Heart Association (AHA) guidelines. a. Resume 5 cycles of CPR (2 minutes) with minimal interruption (< 10 seconds). • Push hard and fast (chest compression of 2 inches at a ratio of 30:2 with a rate of 100 compressions/min. (DO NOT wait to check rhythm or pulses.) Apply an AED as soon as possible. Page 32 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4086 • Change compressors every 2 minutes. • Ensure complete chest recoil during CPR. b. Defibrillate one time, ASAP, if indicated; resume 5 cycles of CPR (2 minutes) with minimal interruption (< 10 seconds). c. Re-check rhythm on AED or cardiac monitor and check pulses. d. Defibrillate one time, ASAP, if indicated; resume 5 cycles of CPR (2 minutes) with minimal interruption (< 10 seconds). e. Re-check rhythm and pulses. f. Defibrillate one time, ASAP, if indicated; resume 5 cycles of CPR (2 minutes) with minimal interruption (< 10 seconds). g. Re-check rhythm and pulses. 7. Manually ventilate with a bag valve mask (BVM) and high fl ow 02 every 6-8 seconds with minimal interruption (< 10 seconds) ASAP. Avoid excessive ventilation. 8. Continue CPR until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XI.H 3. Start CPR according to current American Heart Association (AHA) guidelines (30:2 with one rescuer [15:2 with two rescuers]): a. Compress chest at a rate of 100 compressions/min. • Neonates< 28 days: Compress lower third of the sternum 1/3 of the anterior-posterior diameter of the chest. • Infants 28 days-1 year: Compress chest 1% inches. • Children 1-8 years: Compress chest 2 inches. b. Manually ventilate with appropriate-sized bag valve mask (BVM), if available. If not, use a mouth-to-mask/barrier device. Administer supplemental oxygen. Page 33 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4087 c. Defibrillate one time, if a shockable rhythm (VF/VT) develops; resume 5 cycles of CPR (2 minutes) with minimal interruption (< 10 seconds); if possible, use AED with pediatric pads. d. Defibrillate one time, if a shockable rhythm (VF/VT) develops; resume 5 cycles of CPR (2 minutes) with minimal interruption (< 10 seconds). Page 34 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4088 Ilm Childbirth and Newborn Care A. Uncomplicated Delivery Review of Injury/Illness Full-term gestation lasts 40 weeks. Babies may be born at any time before or after 40 weeks, but the earlier the birth occurs in the gestation process, the likelier it is that complications, including fetal demise, will arise. Signs and Symptoms * Abdominal, pelvic pain * Low back pain * Vaginal discharge—this may be the mucus plug or it may be a large volume of clear liquid from the amniotic sac * Urge to defecate Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Time the duration of contractions and the length of the interval between them. 5. Obtain pre-natal history, including number of previous pregnancies and births. 6. Assess for crowning. 7. If crowning is not present, allow patient to assume position of comfort. 8. If crowning is present, delivery is imminent. 9. In addition to gloves, don splash protection garments, if possible, to assist delivery. 10. Alert medical direction and/or receiving hospital of procedure in progress if possible. Page 35 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4089 11. Assist delivery: a. Apply gentle pressure to the baby's head to prevent tearing of perineum. b. Once head is delivered, suction mouth and nose with bulb syringe. c. Check to see if the umbilical cord is wrapped around the baby's neck. d. Apply gentle pressure downward while supporting baby's head to ease delivery of superior (upper position) shoulder. e. Once superior shoulder is delivered, apply gentle pressure upward to ease delivery of inferior (lower) shoulder. f. Upon delivery of both shoulders, the rest of the baby should follow quickly. g. Keep the baby at the level of the vagina until the cord is clamped and cut. h. Once fully delivered, clamp the umbilical cord at 8" and 10" from baby, and cut the cord between the two clamps. i. After clamping and cutting the cord, wrap the baby in a warm blanket, place the baby on the mother's abdomen, and allow for delivery of placenta. j. Record time of delivery. k. Refer to "Newborn Care Protocol" (Protocol VII.C). I. Watch for excessive bleeding; perform uterine massage and apply pressure to any lacerations that may be bleeding. m. Encourage mother to breastfeed to help control hemorrhage. 12. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 36 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4090 B. Complicated Delivery Review of Injury/Illness Labor and delivery can be complicated by abnormal presentation of the fetus, including: • Breech presentation • Prolapsed cord • Multiple births • Vaginal hemorrhage None of these is optimally handled in the field, and every attempt must be made to move the patient to a higher level of care. Breech Delivery Signs and Symptoms * Fetal buttocks visible at vaginal opening (breech presentation) * Prolapsed umbilical cord Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Provide supplemental oxygen. 5. Support the baby's body as it is delivered. 6. If the head delivers normally, refer to Protocol VII.A. 7. If the head does not deliver within 2 minutes, insert gloved hand into the vagina, keeping palm toward the baby's face and forming a "V" with your fingers. Push the vaginal wall away from the baby's face to allow room for an airway. 8. Maintain this airway until the baby is delivered or turned over to higher level of care. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 37 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4091 Limb Presentation Signs and Symptoms * Fetal arm or foot visible at vaginal opening Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Determine need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Administer oxygen and monitor pulse oximetry. 6. Place mother in the Trendelenburg position. 7. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 38 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4092 Prolapsed Cord Signs and Symptoms * Cord presents first at vaginal opening Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Administer oxygen and monitor pulse oximetry. 5. Place the mother in the knee-to-chest position. 6. Wrap the cord in gauze moistened with saline. 7. Check the cord for a pulse. 8. If no pulse present, insert gloved hand into the vagina and push up on the baby until a pulse returns to the cord. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 39 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4093 Multiple Births Review of Injury/Illness Most patients can report whether the impending delivery involves twins or multiple births. Signs and Symptoms * Ongoing labor after first newborn delivered Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Administer oxygen and monitor pulse oximetry. 5. Follow normal delivery protocol for each neonate as it presents. (Refer to Protocol VI I.A.) 6. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 40 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4094 Vaginal Hemorrhage Review of Injury/Illness Vaginal hemorrhage can be a sign of miscarriage or can be a pre- or post-partum complication. Signs and Symptoms * Unusually heavy vaginal bleeding * May be hypotensive Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Administer oxygen and monitor pulse oximetry. 5. Apply bandages/dressings appropriate for bleeding control in the vaginal area. 6. If pre-delivery, place mother in the left lateral recumbent position for third trimester. Prior to third trimester, place in shock position. 7. If before 20 weeks gestation and baby delivers without vital signs, do not begin resuscitation. If> 20 weeks gestation and baby deliver without vital signs, begin CPR. If unsure of gestational age, begin CPR. (Refer to Protocol VI.D.) 8. If post-partum, begin fi rm uterine massage. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 41 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4095 C. Newborn Care Review of Injury/Illness EMS care for a newborn follows a delivery at which the providers have just assisted or may be initiated on arrival at the scene of a recent out-of-hospital birth. Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Warm and dry the newborn. 5. Stimulate breathing by tapping the heels of the feet or rubbing the newborn's back. 6. If breathing does not begin, or is labored, suction the airway with a bulb syringe to remove mucus and secretions. 7. If no spontaneous respirations occur: Begin manual respirations, as needed, with an appropriate-sized bag valve mask (BVM) at 40-60 breaths per minute with 100% 02. 8. Assess heart rate. 9. If heart rate is absent or< 60 bpm at 30 seconds, after assisted respirations and supplemental oxygen, begin resuscitation according to current American Heart Association (AHA) Neonatal Resuscitation guidelines. 10. Assess APGAR score at 1 minute and 5 minutes post birth. (Refer to chart.) 11. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 42 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4096 APGAR Scores Appearance Blue, pale Body pink, extremities Completely pink (color) Blue or pale Grimace No response Grimace Crying Respirations (respiratory Absent Slow, irregular effort) Point total Infant's Condition Treatment Consideration 7-9 Good Re-assess 0-3 Poor Requires CPR Pagel 43 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4097 Ill., Environmental Emergencies, A. Dehydration Review of Injury/Illness Dehydration can be caused by inadequate fluid intake, inapparent loss of fluids through sweating and evaporation, obvious fluid loss such as vomiting, diarrhea, excessive urination due to diuretic medication, or a combination of these factors. There is increased risk of dehydration in both hot and cold climates and at high altitudes. Signs and Symptoms * Dry mucosa * Decreased urine output * Headache * Loss of coordination * Altered mental status * Decreased blood pressure, increased heart rate * May progress to shock Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. If dehydration is associated with heat exposure, move patient to a cool shaded area. 5. Loosen patient's clothing. 6. If possible, take orthostatic vital signs. If mental status or blood pressure are abnormal with the patient lying down, DO NOT attempt to take an orthostatic set of vital signs. 7. Inquire about patient medical history, including urine output and color, fluid consumption, and recent alcohol or drug use. 8. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 44 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4098 B. Drowning— Near Drowning Review of Injury/Illness Drowning and near drowning involve respiratory impairment due to submersion or immersion in liquid. Hypothermia and/or cervical spine injury are frequently associated with drowning and near drowning and should be considered when caring for such patients. Signs and Symptoms * Respiratory distress/arrest * Hypoxia * Cough with clear or frothy pink sputum * Decreased level or loss of consciousness * Decreased or absent pulses Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Administer oxygen and monitor pulse oximetry. 5. Assist respirations if necessary, with a bag valve mask and high-fl ow 02. 6. Position patient on side to prevent aspiration if coughing/choking, with or without assisted ventilations. Otherwise, allow patient to assume position of comfort. 7. Protect from hypothermia. 8. Evaluate for additional illness or injury including c-spine injury, diabetes, seizure, cardiac event, or stroke. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 45 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4099 Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size 2. See Section XLG and XLH Page 46 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4100 C. Heat-related Illness (Hyperthermia) Review of Injury/Illness Heat-related illness is a group of acute conditions in which the body produces or absorbs more heat than it can effectively dissipate into the environment, causing a dangerous increase in core body temperature. The two most common forms of heat- related illness that require EMS treatment are heat exhaustion and heat stroke. These conditions may be associated with dehydration and electrolyte abnormalities, rarely including life-threatening hypernatremia. Signs and Symptoms Heat exhaustion * Nausea * Clammy skin * Dizziness * Muscle cramps * Elevated core temperature Heat stroke * Altered mental status * Elevated core temperature (> 1050 F) * Skin may be hot and dry or sweaty * Dilated pupils * Rapid heart rate (sometimes with arrhythmia) Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Have patient stop doing any work or physical exertion. Page 47 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4101 5. Remove as much clothing from patient as possible. 6. Have patient rest in shaded or cooler area. 7. Aggressively cool patient with tepid or cool (not cold or iced) water and/or towels soaked with tepid water; the more skin surface actively cooled, the better. a. Increase airflow over the moist skin to increase evaporation. b. Avoid inducing shivering, which is one of the body's mechanisms for warming itself. c. Monitor mental status and core body temperature (rectal) temperature to avoid over-cooling, if possible. d. Watch for rebound hyperthermia when measures are discontinued after initial cooling, and restart if core body temperature exceeds 101° F. e. Provide supplemental oxygen to keep 02 saturation at a minimum of 94%. 8. Monitor core body temperature, oxygen saturation, lung sounds, and mental status. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for age/size of patient. 2. See Section XI.G and XI.H 3. Pediatric patients are more susceptible to heat extremes than adults. 4. Monitor core body temperature. Page 48 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4102 D. Diving-related Emergencies Review of Injury/Illness The most common dive-related medical presentations involve minor ear disorders, but systemic and life-threatening emergencies occur every year. These include arterial gas emboli (AGE), decompression sickness (DCS), and barotraumas to the ears and other locations. 1. When dealing with a diving-related incident, it is important to transport the diver's equipment with him during evacuation, so it can be inspected and possibly analyzed. DO NOT clear patient's dive computer. The dive history obtained from a patient by an EMS provider should include at a minimum: the times, duration and depth of dives (includes bottom time), as well as the number of dives over the previous 3 days, surface intervals, activity performed while diving, and whether the dive(s) were complicated by events such as entrapment, running out of air, or rapid ascent. It is also important to record the time and rapidity of onset of symptoms. Page 49 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4103 E. Decompression Sickness (DCS) Review of Injury/Illness DCS, commonly known as "the Bends," is an emergency condition requiring treatment in a decompression chamber. DCS most often occurs within the first 1-6 hours after diving; further deterioration is unlikely to occur after 24 hours. The onset of symptoms is directly related to the severity of the DCS; in severe cases, symptoms occur more rapidly. Several forms of DCS primarily affect the nervous system, muscles,joints, skin, inner ear and cardiopulmonary system. At depth and under pressure (P), gas is absorbed into the tissues proportionate to depth and exposure time. Significant absorption most likely occurs following dives to depths> 33 feet of sea water (FSW). DCS results from the formation of bubbles of inert gas (e.g., nitrogen) within the intravascular and extravascular spaces as the diver ascends to the surface, when the ascent is too rapid to allow nitrogen to be released that is absorbed in the tissues during the dive. Signs and Symptoms Depending on the distribution of gas bubbles throughout the body, DCS may create a variety of symptoms: * Pruritus (early symptom), skin rash * Unusual fatigue * Joint pain, abdominal or thoracic pain ("girdling" pain) * Shortness of breath, frothy sputum, hemoptysis * Dizziness, vertigo, tinnitus, paresthesia, paralysis, seizures, tremors, staggering * Altered mental status, confusion, amnesia, behavioral changes Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Primary treatment is recompression in a hyperbaric chamber. Page 50 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4104 5. Keep patient supine. 6. Administer oxygen, if available: 10-15 L/min by non-rebreathing mask to keep 02 saturation at a minimum of 94%. 7. Diver's equipment must be taken with patient during evacuation for inspection and possible analysis. DO NOT clear patient's dive computer. Page 51 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4105 F. Envenomation's Snakes and Spiders Review of Injury/Illness Snake and spider bites can cause damage to body tissue at the location of the bite and, if venomous, can cause both local tissue injury and systemic reactions. A snakebite, whether from a venomous or non-venomous snake, may cause severe fright reactions (e.g., nausea, tachycardia, diaphoresis), which may be difficult to distinguish from systemic manifestations of envenomation. Non -venomous snakebites cause only local injury, usually pain and 2-4 rows of scratches from the snake's upper jaw at the bite site. It is important to know and recognize all species of venomous snakes that are indigenous to areas of operation. Spiders are identified by location and markings. Black widow spiders live outdoors in protected spaces (e.g., rock piles, firewood cords, hay bales, outhouses) and have a red or orange hourglass marking on the ventral (upper side) abdomen. Brown recluse spiders live indoors in protected spaces (e.g., in clothing, behind furniture, under baseboards) and have a fiddle- or violin-like marking from the eyes to the abdomen. This marking may be difficult to recognize even in the intact spider. Signs and Symptoms * Local bite wound * Swelling, severe allergic reaction * Bleeding * Ecchymosis at site * Localized pain * Weakness * Tachycardia * Nausea * Shortness of breath * Respiratory arrest * Dim vision * Vomiting and/or shock Page 52 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4106 Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure the patient. 5. Assess and treat for anaphylaxis. (Refer to Protocol X.A.) 6. Secure and maintain airway and administer supplemental oxygen via non- rebreathing mask (NRBM), as needed. 7. Assess and treat for shock. (Refer to Protocol X.I.) 8. Prepare for immediate transport. (DO NOT delay transport for any first aid/treatment measures or wait for signs of envenomation to occur.) 9. DO NOT apply any constricting bands, ice, or suction to the bite. 10. Remove ALL watches, rings and jewelry, not just from affected limb. 11. Mark the proximal edge of any discoloration or swelling in ink and write the time on the line. If signs increase during treatment, make new marks with the times, if possible. 12. Dress the wound and immobilize the extremity. 13. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XI.H Page 53 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4107 G. Marine Bites and Stings Corals and Jellyfish Review of Injury/Illness Most marine bites and stings are at least transiently painful, while some involve envenomation as well. All create wounds at risk of infection with marine organisms. The most common encounters are with a class of marine animals called Cnidaria and they include the following: • Corals • Sea anemones • Jellyfish (e.g., sea nettles) • Hydroids (e.g., Portuguese man-of-war) Cnidaria are responsible for more envenomation's than any other marine animal. However, of the 9,000 species, only about 100 are toxic to humans. The multiple, highly developed stinging units (nematocysts) on Cnidaria tentacles can penetrate human skin; one tentacle may fi re thousands of nematocysts into the skin on contact. Signs and Symptoms * Lesions vary with the type of Cnidaria. * Usually, lesions initially appear as small, linear, papular eruptions that develop rapidly in one or several discontinuous lines, at times surrounded by a raised erythematous zone. * Pain is immediate and may be severe; itching is common. * The papules may blister and proceed to formation of painful, raised pustules, hemorrhage, and eventual peeling of the skin. * Systemic manifestations include weakness, nausea, headache, muscle pain and spasms, tearing of the eyes and nasal discharge, increased perspiration, changes in pulse rate, and pleuritic chest pain. * Uncommonly,fatal injuries have been inflicted by the Portuguese man-of-war in North American waters and by the box jellyfish (sea wasp, Chironex fleckeri), in Indo- Pacific waters. Page 54 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4108 Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure the patient. 5. Assess and treat for anaphylaxis. (Refer to Protocol X.A.) 6. Secure and maintain airway and administer supplemental oxygen via non- rebreathing mask (NRBM), as needed. 7. Assess and treat for shock. (Refer to Protocol X.I.) 8. For pain relief due to stings, administer hot water or cold packs (whichever feels better). 9. Pain caused by jelly fish, usually short-lived, can be relieved with baking soda in a 50:50 slurry applied to the skin, or by papain (meat tenderizer) applied as a paste for a period not to exceed 15 minutes. 10. Jellyfish-type sting treatment includes removal of adherent tentacles with a forceps (preferably) or fingers (double-gloved if possible) and liberal rinsing to remove invisible stinging cells (nematocysts). The type of rinse varies by the stinging organism: a. For jellyfish stings sustained in non-tropical waters and for coral stings, seawater rinse can be used. b. For jellyfish stings sustained in tropical waters,vinegar rinse followed by seawater rinse should be used. Fresh water should not be used because it can activate undischarged nematocysts. c. For box jellyfish stings, vinegar inhibits nematocyst firing and is used as the initial rinse if available, followed by seawater rinse. Fresh water should not be used because it can activate undischarged nematocysts. Notify on-line medical direction of the situation so that antivenins can be obtained. (Antivenin is only available for C. fleckeri species.) d. For Portuguese man-of-war stings, saltwater rinse can be used. Vinegar should not be used because it can activate undischarged nematocysts. Page 55 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4109 I ., Trauma The following patients should be transported to a Trauma Center: • Trauma patients with unstable or abnormal vital signs • Patients with major and/or multiple system trauma • Complex or extensive injury to hands, tissues, and nerves of low extremity • Contraindication for Referral to Pediatric or Adult Trauma Center— Patients with toe amputation (partial or complete) A. Extremity wound hemorrhage Review of Injury/Illness Uncontrolled bleeding from an extremity wound, especially one involving major or deep arteries, can result in life threatening blood loss. Massive, rapid swelling of an extremity following blunt trauma with or without bruising or discoloration may suggest bleeding even without obvious surface laceration. Personnel engaged in military and law enforcement operations are at increased risk for penetrating trauma and exsanguinating wounds. Tourniquets are sometimes the best way to manage life-threatening bleeding from an extremity. Tourniquets placed on conscious patients can be painful and pain management should be considered. Signs and Symptoms * Obvious bleeding at the site of wound * Deep scraping of extremity area (e.g., road rash from a motorcycle accident) with substantial, oozing blood * Swelling of the extremity, usually with obvious bruising * Altered mental status from blood loss and ensuing shock Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. Page 56 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4110 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway and administer supplemental oxygen, as needed. 6. Assess and treat for shock. (Refer to Protocol X.I.) 7. Check for obvious glass or foreign body that could cause further injury, if pressed into wound. 8. Wrap bleeding area with trauma pads or dressing appropriate for the size and location of the wound. 9. Apply direct pressure and elevate until bleeding is controlled, if possible. If the patient is able, have him/her apply direct pressure after dressing the wound. 10. If bleeding CANNOT be controlled by direct pressure: a. Apply a tourniquet proximal to the wound. • Use the Combat Application Tourniquet (CAT), 2-4 inches proximal to the wound. • DO NOT apply tourniquet directly over a joint. • Once placement of CAT is correctly, tighten the omni-tape band then secure it onto itself with the Velcro. b. Place injured extremity through the loop of the omni-tape band. c. Twist the windlass rod no more than 3 times, then insert it into the windlass clip. d. If you can twist the windlass rod more than 3 times, repeat the previous step and pull the omni-tape band tighter. wkndlass „lip Wiindlasfis Page 57 4111 B. Amputations Review of Injury/Illness Patients with severe bone and/or soft tissue injury at or distal to the level of the mid-humerus, including complete or incomplete amputations of the hand, crush or degloving injuries, and other trauma resulting in loss of perfusion or suspected nerve injury (e.g., compartment syndrome) should be referred to a designated Hand Center or the nearest Trauma Center if: • They are stable with an isolated upper extremity injury at or below the mid-humerus • They have complete/incomplete hand or upper extremity amputation • There is partial/complete finger or thumb amputation • There is degloving, crushing, or devascularization injuries of hand or upper extremity • There is high-pressure injection injury to hand or upper extremity •There is complicated nerve,vessel,or compartment syndrome (excessive swelling and pain of extremity with possible evolving nerve deficit) injury of the forearm and hand Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway and administer supplemental oxygen, as needed. 6. Assess and treat for shock. (Refer to Protocol X.I.) 8. Control extremity wound hemorrhage. (Refer to Protocol IX.A.) 9. Package amputated extremity in sealed plastic bag (keep dry) and place on top of ice to keep cool. DO NOT submerge in water or freeze amputated part. Page 58 4112 10. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH Page 59 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4113 C. Multi-system Trauma Review of Injury/Illness Multi-system trauma refers to injuries involving more than one organ system and/or more than one area of the body.A patient with limb fracture(s)and significant head/neck injury, or one with trauma to both the chest and abdomen are examples of multi-system trauma. It is associated with an injury severity score > 17 and increased likelihood of death or a complicated clinical course and protracted time to recovery. It is important that EMS providers report scene findings that help estimate the severity of the injury. Signs and Symptoms * Hypovolemic or neurogenic shock * Pain, bruising, bleeding * Hypertension * Rapid or slow heart rate * Shallow or absent respirations * Decreased distal pulses * Decreased motor and sensory function in extremities * Deformities or obvious fractures/lacerations * Altered mental states or unconsciousness * Intercranial herniation • Posturing (decerebrate or decorticate) • Unequal pupils • Paralysis • Decreasing Glasgow Coma Scale Scores Page 60 4114 Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway and administer supplemental oxygen via non-rebreathing mask (NRBM) at high concentration. Assist ventilations with a bag valve mask (BVM) device, as needed. 6. If patient exhibits signs of intercranial herniation, hyperventilate at 20 breaths/minute, after consulting on-line medical direction. 7. Control extremity wound hemorrhage. (Refer to Protocol IX.A.) 8. Assess and treat for shock. (Refer to Protocol X.I.) 9. Maintain appropriate spine immobilization, according to Protocol XLD (Any trauma patient with suspected spinal injuries based on mechanism of injury should have full body spinal immobilization.) 10. Consider pelvic stabilization, if indicated. 11. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XLH Page 61 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4115 D. Chest and Abdominal Injuries Review of Injury/Illness Chest and abdominal injuries are caused by penetrating or blunt forces applied to the torso. Respiratory distress may indicate pneumothorax; hypotension suggests tension pneumothorax or internal bleeding, both of which can cause rapid death if not treated promptly. Signs and Symptoms * Pain, bruising, deformity of chest/abdomen following rapid deceleration (impact) injuries * Evidence of penetrating wound to the chest/abdomen by knife, bullet, or sharp object * Difficulty breathing and/or hypotension/shock Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Perform airway management for unconscious patient — Chin lift or jaw thrust maneuver NP or OP airway and ventilate if necessary. 6. Secure and maintain airway and administer supplemental oxygen via non- rebreathing mask (NRBM) at high concentration. Assist ventilations with a bag valve mask (BVM) device, as needed. 7. All open and/or sucking chest wounds should be treated by immediately applying an occlusive dressing to cover the defect. Release dressing if respiratory distress Page 62 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4116 occurs. Monitor lung sounds and trachea position for development of tension pneumothorax. 8. Control extremity wound hemorrhage. (Refer to Protocol IX.A) 9. Assess and treat for shock. (Refer to Protocol X.I.) 10. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow the BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH Page 63 4117 E. Spinal Cord Injuries Review of Injury/Illness EMS responders are most likely to see spinal cord injuries, resulting from motor vehicle crashes, diving accidents, and falls. Young children and the elderly are especially vulnerable. Signs and Symptoms * Paralysis, numbness, or tingling sensation in one or more extremities * Obvious head or facial trauma * Loss of consciousness (may or may not be present) Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway and administer supplemental oxygen via non- rebreathing mask (NRBM) at high concentration. Assist ventilations with a bag valve mask (BVM) device, as needed. 6. Maintain appropriate spine immobilization, according to Protocol IX.E. (Any trauma patient with suspected spinal injuries based on mechanism of injury should have full body spinal immobilization.) 7. Consider pelvic stabilization, if indicated. 8. Assess and treat for shock. (Refer to Protocol X.I.) 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow the BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XI.H Page 64 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4118 F. Electrical Burns and Lightning Injuries Review of Injury/Illness Electrical burns may be associated with other traumatic injuries, due to being thrown clear of the source and severe muscle contraction, especially following high voltage DC contact. Longer exposure to lower energy current results in skin and deep tissue burns. Signs and Symptoms * "Entry" and "exit" site burns * Confusion and/or amnesia, with or without temporary loss of consciousness * Ear drum rupture * Fractures * Cardiac dysrhythmias/arrest Lightning injuries can range from minor wounds to serious traumatic injuries that can result in death. Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway and administer supplemental oxygen, if necessary. Assist ventilations with a bag valve mask (BVM) device, as needed. 6. Maintain appropriate spine immobilization, according to Protocol XI.D. 7. Splint any fractures. 8. Dress any open wounds and/or burns. (Refer to Protocol V.) 9. Assess and treat for shock. (Refer to Protocol X.I.) 10. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 65 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4119 Pediatric BLS 1. Follow the BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH Page 66 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4120 G. Orthopedic Bone and Joint Injuries Review of Injury/Illness These injuries are a result of a traumatic direct force or twisting action on a bone or joint. Other than neck or back injuries involving the spinal cord, orthopedic injuries are often not life threatening. Signs and Symptoms * Pain near injury * Swelling and/or bruising near injury * Obvious bony deformity * Limited range of motion Identify any life-threatening injuries. Pelvic and femur fractures can cause severe internal and external hemorrhaging that can lead to death. Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway and administer supplemental oxygen, as needed. 6. Control extremity wound hemorrhage. (Refer to Protocol IX.A.) 7. Apply ice or cold packs to sites of swelling/deformity. 8. Splint obvious fractures and dislocations after checking for pulses distal to the fracture site: a. Splint the joints above and below the fracture site. b. If fracture/dislocation is open (compound), cover the open area with sterile dressing. DO NOT push bone back in if it is protruding. c. If fracture is angulated and the distal limb is pulseless, attempt to realign to neutral position using mild traction. If significant resistance is met, stop immediately and splint in position found. Page 67 4121 d. If fracture/dislocation is angulated with pulse, splint in position found. e. Reassess distal circulation before and after splinting. 9. Treat cervical injury, if indicated. (Refer to Protocol XI.D.) 10. Treat clavicle injury by "sling and swathe" with the patient's arm in a position of comfort. 11. Assess and treat for shock. (Refer to Protocol X.I.) 12. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XLH Page 68 4122 H. Head, Neck and Facial Injuries Review of Injury/Illness Head, neck, and facial injuries can also cause Traumatic Brain Injury (TBI), which can be life-threatening. TBIs can present with loss of consciousness or changes in mental status ranging from confusion and combativeness to lethargy. Signs and Symptoms Head * Visible Wounds * AMS * Unequal Pupils * "Raccoon Eyes" * CSF or blood drainage from ear, nose, throat * Convulsions/seizures * Paralysis * Bruising behind the ear Neck * Hemorrhage * AMS * Hoarseness * Dyspnea, strider * Head fixed in an abnormal position * Vomiting/spitting blood * Paralysis, weakness, or abnormal sensation in upper or lower extremities Facial * Lacerated gums * Misaligned/broken teeth * Nose bleed * Limited eye movements * Massive hemorrhage even with minor wounds * Facial asymmetry * Difficulty swallowing Page 69 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4123 * CSF drainage from nose and ear Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway and administer supplemental oxygen, if necessary. Assist ventilations with a bag valve mask (BVM) device, as needed. 6. Maintain appropriate spine immobilization, according to Protocol IX.E. 7. Assess and treat for shock. (Refer to Protocol X.I.) 8. If a penetrating eye injury is noted or suspected: a. Leave object in eye. b. Perform a rapid field test of visual acuity. c. If object is protruding from the eye socket, stabilize object with bulky dressings and tape; then surround object with cup to prevent jarring. d. If object is not protruding, cover eye with soft patch that does not touch eye. e. Protruding Globe — DO NOT put eye back in socket — Apply bulky dressing around eye, moist gauze over globe, and cover with a cup. f. If CSF is found, do not pack or suction nose/ear and transport in upright position. g. Use extreme caution with head injury and esophageal injury. 9. In cases of nasal injury, DO NOT tilt head back to control bleeding. Pinch the patient's nostrils and apply ice to the bridge of nose. 10. If CNS injury, perform and record full neurological assessment, including the Glasgow Coma Scales. Repeat and record every 5-10 min. (Refer to Protocol XLE.) 11. Resuscitation for victims of a blast or penetrating trauma who have no pulse, no respirations, and no other signs of life should not be initiated. Page 70 4124 12. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH Page 71 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4125 X. Other Medical Emergencies A. Allergic Reaction Review of Injury/Illness The body's immune system normally helps it to recognize, inactivate and eliminate threats such as bacterial or viral infections. Sometimes the components of that system are activated by foods, medications, or environmental elements like pets, latex, or other chemicals causing allergic reactions. Allergic reactions range from mild cold-like symptoms and rashes to life-threatening airway emergencies and shock (acute anaphylaxis). Signs and Symptoms * Itching, Hives * Swelling * Difficulty breathing (hoarseness, stridor) * Difficulty swallowing * Chest pain * Weakness * Flushing/redness * Wheezing * Unconsciousness Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Acute Anaphylaxis: a. If patient has signs of cardiovascular or respiratory compromise (e.g., difficulty breathing, stridor, hypotension) and has a prescribed epinephrine auto-injector Page 72 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4126 (EpiPen°), assistance may be offered for administration; may repeat x1 after 3-5 minutes. b. If patient is wheezing, and has a prescribed MIDI, assistance may be offered for administration. c. Continue to monitor vital signs, including pulse oximetry, if available. 6. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XLH 3. If pediatric patient is in anaphylaxis, and has a prescribed EpiPen,° assistance may be offered for administration. a. Patients weighing < 30 kg may have been prescribed EpiPen Jr° (0.15 mg of epinephrine) for IM administration; may repeat x1. b. Patients weighing > 30 kg may have been prescribed an adult dose EpiPen° (0.3 mg of epinephrine); may repeat x1. Page 73 4127 B. Hypertensive Crisis Review of Illness/Injury A severe increase in blood pressure accompanied by evidence of end organ damage that can lead to a stroke or another neurological manifestation Signs and Symptoms * Systolic BP usually> 180 mm Hg * Headache with or without AMS * Chest pain/ECG changes * Pulmonary edema * Neurologic changes consistent with stroke Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Determine need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Calm and reassure patient. 6. Secure and maintain airway and administer supplemental oxygen, if necessary. Assist ventilations with a bag valve mask (BVM) device, as needed. 7. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XLH Page 74 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4128 C. Epistaxis Review of Injury/Illness It is important to recognize when nose bleeds result from head or face trauma. (Refer to Protocol IX.I.) Signs and Symptoms * Bleeding from one or both nares Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway and administer supplemental oxygen, as needed. 6. Assess and treat for shock. (Refer to Protocol X.I.) 7. With patient in seated position, and head neutral, squeeze nostrils together with a dressing. If patient is able, he/she can hold compression on the nostrils; monitor for compliance and assist as needed (Must hold constant pressure for a minimum of 5 minutes.) 8. Apply cold pack to forehead/nose bridge area, if possible. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 75 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4129 D. Nausea/Vomiting Review of Injury/Illness Patients can present with nausea and/or vomiting due to underlying injury, medical condition, active motion sickness, or medication side effect/complication. Sometimes, vomiting or intense nausea can complicate the existing injury or medical condition (e.g., penetrating eye injury, high risk for aspiration, side effects of narcotic administration). Signs and Symptoms * Vomiting or sensation of imminent vomiting * Inability to tolerate food or liquids * Retching or "dry heaves" Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway. 6. Place patient either in position of comfort or in left lateral position to prevent aspiration, if not contraindicated by spinal immobilization or packaging. 7. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XLH Page 76 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4130 E. GI Bleeding Review of Injury/Illness Upper or lower GI bleeding can rapidly become a life-threatening medical emergency because of substantial blood loss with hypotension and shock. There are many potential sources of GI bleeding; most commonly: • Upper • Lower • Peptic ulcer disease • Infectious diarrhea •Esophageal varices • Colon cancer • Esophageal tears due to vomiting • Diverticulitis • Rectal varices • Hemorrhoids Signs and Symptoms * Vomiting bright red blood or material that resembles coffee grounds * Bloody diarrhea (may be infectious) * Blood visible on the outside of formed stool or noticed on toilet paper after wiping * Black, "tarry" stools (typically indicates upper GI source of bleed) * Occult blood loss— May present with fatigue, general weakness, or syncope due to bleeding into the GI tract which is only found after testing for occult fecal blood Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Bloody vomiting: Page 77 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4131 a. DO NOT allow patient to eat or drink anything. b. Administer supplemental oxygen, as needed. c. Ensure airway is not threatened by severe vomiting; use advanced airway to prevent aspiration, if needed. 5. If possible, take orthostatic vital signs. If mental status or blood pressure are abnormal with the patient lying down, DO NOT attempt to take an orthostatic set of vital signs. 6. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XLH Page 78 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4132 F. Abdominal Pain Abdominal pain can indicate many different conditions such as ulcers, appendicitis, colitis, inflammation of the gall bladder or pancreas, kidney stone and internal masses that causes obstruction. Any of these conditions generate moderate or severe abdominal pain. The acute (surgical) abdomen indicates an intra-abdominal emergency that requires urgent transport for immediate surgical intervention. Signs and Symptoms Peritoneal Inflammation * Abdominal pain, with or without vomiting * Tenderness with guarding * Rebound/percussive tenderness * "Rigid" abdomen * Patient lying perfectly still (movement causes severe pain) Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. DO NOT allow patient to eat or drink anything. 6. Ensure airway is not threatened by severe vomiting; use advanced airway to prevent aspiration, if needed. 7. Administer supplemental oxygen, if needed. 8. For suspected GI bleeding, refer to Protocol X.E. 9. Assess and treat for shock. (Refer to Protocol X.I.) Page 79 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4133 10. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH Page 80 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4134 G. Poisoning/Overdose Review of Illness/Injury Depression and other serious mental illness may cause a suicide attempt by overdose. Poisoning may occur by exposure to toxic substances via inhalation, injection, ingestion, or skin absorption. Children may be accidentally poisoned by medications, alcohol or household cleaners left unsecured. Poisoning may occur in the setting of a hazardous materials incident. Acute or chronic poisoning may also be a result of criminal and/or terrorist activity. Signs and Symptoms * Altered mental status (AMS) - Lethargy or unconsciousness vs. hyper-excitability * Vomiting and/or diarrhea * Tachycardia or bradycardia * Sweating * Dilated or constricted pupils * Difficulty breathing, with or without increased bronchial secretion * Cardiac dysrhythmias/arrest Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Remove patient from the toxic environment, using appropriately trained personnel wearing proper level PPE, if necessary; decontaminate as appropriate. 5. In case of ingestion, identify the source, substance, medication and/or amount ingested or inhaled. 6. Administer supplemental oxygen and monitor pulse oximetry, as needed. 7. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 81 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4135 Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH Page 82 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4136 H. Stroke,TIA Review of Injury/Illness A stroke is a loss of brain function due to insufficient blood fl ow and decreased oxygen reaching the affected area, usually caused by obstruction or rupture of one or more blood vessels in the brain.ATIA or Transient Ischemic Attack is a temporary disruption of function with stroke-like symptoms that typically resolves completely within 24 hours of onset. A TIA is generally considered a warning that a stroke could occur in the same distribution in the near future. Signs and Symptoms * Slurred speech * Facial droop * Unequal grips/arms drift or other extremity weakness * Change in mental status—as documented by friend or family member * Sudden change in vision * Sudden severe or unexplained headache * Syncope/vertigo * Ataxia Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure the patient. 5. Secure and maintain airway and administer supplemental oxygen, as needed. 6. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 7. Establish and relay time of symptom onset to transporting service. 9. Continue supportive care and monitor vital signs until patient is turned over to a higher level of medical care. Page 83 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4137 Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XI.G and XLH 3. Evaluate for overdose (e.g., cocaine, methamphetamine, street drugs). If suspected, refer to Protocol X.G. Page 84 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4138 I. Shock Review of Injury/Illness The body responds in various ways when blood flow cannot meet the oxygen demands of the cells, depending on the severity and duration of the decreased blood fl ow/oxygen delivery. Some of the common causes of shock include gastrointestinal bleeding, sepsis, severe dehydration, cardiac dysfunction, or blunt/penetrating trauma. Signs and Symptoms * General weakness * Cool, clammy skin (diaphoresis) * Dilated pupils * Rapid, weak pulse * Shallow, labored respirations * Decreasing pulse pressure * Altered mental status * Multi-system organ failure Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol 1.13, and as indicated by the patient's condition. 4. Calm and reassure patient. 5. Secure and maintain airway and administer supplemental oxygen via non- rebreathing mask (NRBM) at high concentration. Assist ventilations with a bag valve mask (BVM) device, as needed. 6. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 9. Control extremity wound hemorrhage, if necessary. (Refer to Protocol IX.A.) Page 85 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4139 10. Maintain appropriate spine immobilization,according to Protocol IKE, if indicated. (Any trauma patient with suspected spinal injuries based on mechanism of injury should have full-body spinal immobilization.) Pediatric The pediatric patient may present hemodynamically unstable or with hypoperfusion as evidenced by altered mental status, delayed capillary refill (> 2 seconds), pallor, peripheral cyanosis, hypotension. Hypotension is defined as a Systolic BP < 60 mm Hg in neonates (patients < 28 days old), < 70 mm Hg in infants (patients < 1 year old), < [70+ (2 x years) = Systolic BP] for patients > 1 year old. BLS 1. Follow BLS guidelines, adjusting for patient age/size. 2. See Section XLG and XLH Page 86 ...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... 4140 L Specialty Skills A. i-Gel Airway Device Procedure The i-Gel is a supraglottic airway management device used as an alternate means of establishing an airway. I-Gel has a soft, gel-like, non-inflatable cuff, designed to provide an anatomical, impression fit over the laryngeal inlet. Indication 1. Unconscious patient who is not breathing without a gag reflex. 2. Apneic patient without a gag reflex. 3. A difficult airway is anticipated: a. Small mouth which obstructs visualization b. Short neck c. Mallampatti or Cormack-Lehane score > 3 d. Any obstruction that could impair visualization of the glottic opening. e. Impaired neck mobility. 4. Access to the airway is impeded (entrapment, helicopter cabin etc.) Contraindications 1. Patient has a gag reflex. 2. Esophageal tissue damage from trauma, chemical ingestion or thermal injury. 3. Esophageal or airway obstruction. 4. Airway burns or chemical inhalation injury. Procedure Equipment 1. Appropriate i-Gel Size (SEE CHART BELOW) 2. Water based lubricant (surgilube) 3. Suction 4. Sp02 Monitor Insertion Technique 1. Open and maintain the airway. Ventilate with 100% oxygen before attempting of the i-Gel. 2. Select the appropriately sized i-Gel based on weight. Open i-Gel package and take i-Gel out of the protective cradle. 3. Lubricate the back, sides, and front of the cuff by rubbing it on the smooth surface of the protective cradle containing the water-based lubricant. Page 87 4141 /a /r er. WV It NOW 4. Remove dentures or removable plates from the mouth prior insertion. 5. Grasp the lubricated i-Gel firmly along the integral bite block. Position the device so that the i-Gel cuff is facing towards the chin of the patient. the device so that the i-Gel cuff outlet is facing towards the chin of the patient. 6. Grasp the lubricated i-Gel firmly along the integral bite block. Position the device so that the i-Gel cuff outlet is facing towards the chin of patient. 7. Maintain the head in a neutral position for trauma patients. For non- traumatic patients, the patient's head should be in the "sniffing" position with the head extended and neck flexed. The chin should be gently pressed down before proceeding to insert the i-Gel. O, 8. Introduce the leading soft tip into the mouth of the patient in a direction towards the hard palate. 9. Glide the device downward and backward along the hard palate with continuous but gentle push until a definitive resistance is felt. 10. The front teeth should be resting on the integral bite block. (The black lineon the i-Gel). Page 88 4142 11. Attach the End tidal CO2 Device to the i-Gel and BVM, and confirm placement. � iruU� Hr�air�SrG�i ir!�r9u4ih�tiGnrm4�r�� irk '"„ m � _....m„, .....mo „. Securing the Device 1. Secure the i-Gel with the airway support strap provided. NG Tube Use a #12 NG tube for  I-Gel, a #14 NG tube for a J45 i-Gel —NEW _—NINNIEW 3 Small Adult 30-60 4 Medium Adult 50-90 5 Large Adult+ 90+ Page 89 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4143 ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... B. Intranasal Administration Technique (Narcan) CLASS Synthetic opioid antagonist DOSAGES Vial has 2mg of Naloxone in 2mL • Give 1mg (1ml) in each nostril, quickly • Medication is atomized and absorbed through vessels in the nasal cavity ACTIONS The mechanism of action is not fully understood. It does appear that Naloxone antagonizes the effects of opiates by competing at same receptor sites. When given IV, the action is apparent within two minutes. IM or SC administration is slightly slower. INDICATIONS Naloxone is indicated for the complete or partial reversal of opiate narcotic depression and respiratory depression secondary to opiate narcotics or related drugs. look for the Signs Overdose on opioids typically: • Unconscious • Slow or not breathing (<10/min) • Small "pinpoint" pupils (miosis) • Pulse variable CONTRAINDICATIONS Naloxone is contraindicated in patients known to be hypersensitive to it. Use with extreme caution in narcotic-dependent patients who may experience withdrawal syndrome (including neonates of narcotic-dependent mothers). Page 90 ...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4144 ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... SIDE EFFECTS CNS: Tremor, agitation, belligerence, papillary dilation, seizures, increased tear production, sweating, seizures secondary to withdrawal. Cardio: Hypertension, hypotension, ventricular tachycardia, pulmonary edema, ventricular fibrillation. GI: Nausea, vomiting. WARNINGS Use caution during administration as patient may become violent as level of consciousness increases. Intranasal Administration Technique • The tip of the syringe should be placed near or just inside the nostril • Placement of the syringe too far inside the nasal cavity may traumatize the nasal passage or cause epistaxis 7,7, Page 191 ...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4145 HOW TO GIVE NASAL SPRAY NARCAN ��i,rmi m ni m ni,��dmani m ni,��,m ni d,ni,��,m ni and��,m ni m nid���, �U ouin, 1. rr ry uv�uv✓ry ry vw�ruvWb ii �, ,,, a�, ,.... wa w » �� rokww irk; -------------------------------------------- al io�i�i io�ior rio�io� oio�i�i yoi oo 000i ooi , Page 92 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4146 B. Combat Application Tourniquet The Combat Application Tourniquet (CAT) is an effective tool to help control severe blood loss from body's extremities. If used correctly, the CAT can save lives. A general misconception of the CAT is that it will result in the patient requiring amputation of their extremity, THIS IS FALSE. Amputation is more often required as a result of the injury itself, not because of the tourniquet. The CAT as well as any other type of tourniquet should be as a LAST RESORT for blood control management. Applying direct pressure to the injury and elevating the extremity above the heart should be attempted prior to utilizing the CAT. M-1- 0 a. Apply a tourniquet proximal to the wound. b. Place injured extremity through the loop of the omni-tape band. • Use the Combat Application Tourniquet (CAT), 2-4 inches proximal to the wound. • DO NOT apply tourniquet directly over a joint. • Once placement of CAT is correctly, tighten the omni-tape band then secure it onto itself with the Velcro. c. Twist the windlass rod no more than 3 times, then insert it into the windlass clip. d. If you can twist the windlass rod more than 3 times, repeat the previous step and pull the omni-tape band tighter. Page 93 4147 C. Full Spinal Immobilization Technique Equipment Needed: Long backboard,3 immobilization straps, head stabilization device and cervical collar Adults • Determine need for spinal precautions • Assure and maintain manual c-spine immobilization • Assess pulses, motor and sensation of extremities • Apply appropriate sized C-collar and long backboard • Fill voids with padddings/towels as needed • Apply X4 straps using the chest cross-strap technique • Apply head stabilizing device • Reassess pulses, motor and sensation after immobilizing patient • DO NOT strap the patient directly over the abdomen Strap the IlDafi .^Int to the backboard BEFORE.S(.0 RlI'lIlg th(. I:afiIeInts Ahead host of tho body weight i between the shoutdors, and the Iplp r th i hs, li l~ the straps, accordingly Use tape to secure the forehead nd the chins, area to the iba li iaoaard Page 94 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4148 Pediatrics • Apply appropriate size c-collar • Pad under the shoulders using pillowcases or towels to prevent flexion of spine • Secure to long backboard Pregnant Patients • Immobilize as above and tilt the backboard Left Lateral recumbent to a 20- degree angle • Assure patient comfort Page 95 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4149 E. Glasgow Coma Scales Glasgow Coma, Scale Eye/ opening Spontaneously response, To speech 3 To pain 2 No resportse Iveirbal 0riented to time,,place,acid iperson response Confused 4, Inappropriate w Incomprehensible sound 2 No riesponse Rest moues Obeys,corner cornmands, 61 rep in S R , Iw Abnormal I ,flexion Abnormal extension ee 2 No response a l °nor responseest � corrWtosechent i Page 96 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4150 F. APGAR Scores Appearance Blue, pale Body pink, extremities Completely pink (color) Blue or pale RAM Grimace No response Grimace Crying Respirations (respiratory Absent Slow, irregular effort) Point total Infant's Condition Treatment Consideration 7-9 Good Re-assess 0-3 Poor Requires CPR Pagel 97 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4151 G. BLS Maneuvers Maneuver Adult Child Infant Lay rescuer: >8yrs Lay rescuer: 1 to 8yrs Under 1 year of age HCP: Adolescent and HCP: 1 year to older adolescent Airway Head tilt-chin lift(HCP: suspected trauma, use jaw thrust) Breathing Initial 2 breaths at 1 sec/ 2 effective breaths at 1 sec/ breath breath HCP: Rescue breathing 10 to 12 breaths/ min 12 to 20 breaths/ min (Approximate) without chest (Approximate) compressions HCP: Rescue breaths for CPR with advance 8 to 10 breaths/ min (Approximate) airway Foreign- body airway Back slaps and chest obstruction Abdominal thrusts compressions Circulation HCP: Pulse Carotid Brachial or femoral check(< 10sec) Compression Lower half of sternum, between nipples Just below nipple line landmarks (lower half of sternum) Compression method Heel of one hand, Heel of one hand or as 2 or 3 fingers Push hard and fast other hand on top for adults HCP (2 rescuers): Allow complete recoil 2 thumb-encircling hands Compression depth 1 %to 2 inches Approximately one third to one half the depth of the chest Compression rate Approximately 100/min Compression- 30:2 (one or two 30:2 (single rescuer) ventilation ratio rescuers) HCP: 15:2 (2 rescuers) Defibrillation AED Use adult pads Use AED after 5 cycles No recommendation Do Not use child pads of CPR for infants Use pediatric system < 1 year of age for child 1 to 8 yrs. if available HCP: For sudden collapse/witnessed arrest use AED as soon as possible Note: Maneuvers used by only Healthcare Providers are indicated by"HCP". Page 98 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4152 H. Pediatric Vital Signs Normal Ranges Pediatric Vital Signs Normal Ranges Newborn 30-50 120- 160 50-70 2 -3 4.5—7 Infant (1 - 12 months) 20-30 80- 140 70- 100 4- 10 9—22 Toddler(1 -3yrs.) 20-30 80- 130 80- 110 10- 14 22-31 Preschooler(3 -5 yrs.) 20-30 80- 120 80- 110 14- 18 31-40 School Age (6—12 yrs.) 20-30 70- 110 80- 120 20-42 41-92 Adolescent(13 +yrs.) 12 -20 55 - 105 110- 120 >50 >110 Page 99 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4153 .......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... I. Rule of Nines Rule of Nines Im s'i, 4 M9 k I 8*AA 4 Sw 45% "I I IM to ISAA�, V/ Amv, (Q MR ChOd Page 100 ....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................415 1 4 .......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... J. Adult Trauma Scorecard Methodology Red, any one (1), transport as trauma alert; Blue, any two (2), transport as trauma alert Component Airway • Sustained respiratory rate �t 30 • Acfive iflirway ass stance (1) Circulation • Sustained heart rate A 120 No radial pUse and a susWuW -IR 120 or SystcflHc< 90 rnrnHg Best Motor Response (BMR) • BIVIR=5 a GCS A 12 a BMR = 4 or hss Presence o lDairirllysls SUSlD d()111 of sp nifl cord 111iLfl'y Loss of sensatkm Cutaneous • Soft tissue loss (2) a 2- or 3- burns to 15% or urnore BSA AnTutaUmn pvArnaho W wrist or anWe 11111� AnyIlDenefirafing in(U-y t()th(. head, necl, or tm-so (3) Long bone Fracture (4) • Sign or symptoms of a single a Sign or spaptmas of a frrm= fracture site due to MVC or Fall o1: two oir Iluuoire IIoII ig Ilnou ie "otes"' 10' or more Age • �t 55 years or older(7) Mechanism of Injury • Ejection from motor vehicle (5) • Steering wheel deformity(6) Judgement hII or II'airaine c d;fiscLLLL�^�1( I Airway assistance beyond administration of oxygen; 2 Degloving injuries, major flap avulsion (>5"); 3 Excluding superficial wounds in which the depth can be easily determined; 4 Long bone including humerus, radius/ulna, femur, tibia/fibula; 5 Excludes: motorcycles, mopeds, ATVs, bicycles or open body of a pick-up truck; 6 Only applies to driver of vehicle; 7 Blunt head, chest, or abdominal trauma on blood thinners with high risk of bleeding or with history of a bleeding disorder; 8 If patient does not meet any of the criteria listed above and the on scene EMT, Paramedic believes the patient may benefit from Trauma Alert criteria due to extenuating circumstances surrounding the incident, the patient may be classified as a "Trauma Alert". Page 101 ....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... 4155 ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... K. Pediatric Trauma Scorecard Methodology Red, any one (1,),transport as trauma alert; Blue, any two (2) transport as trauma alert, Gin,eri follow local protocols Size u > 20kg (,f;G u C 2-20kg (22-4 i lbs') Weight< 111kg (<22 lbs.) bs') e Length <33 inches on pediatric length-based tape Airway a 1\4on,na� Oxyg("."Irl e Asslsted (1) 111tUbated Consciousness P�v� (a Ainninesia Nteire��l neritall status (2) e ILoss of consciOUsness Coina Ireserice c�:: ja14ysIs Su spldcri c�::spur4l ccin�l rjuiry o ss c�::serisaticri Circulation s C]";o o d Carotid or feinnorA e Fiflint or ucon. Diflpi)Ue carotid or e 1, -1erfal pulses palpable but lack of f&171011-ifl IlAflS(:n u S S S > radial or pedal pulse 0 SP <! 50 'T11Tfl-1g 90 rn rn g SIBIP<90 inn inn lHg Fracture s I\IOre S(,,eri 01, Sign or Symptom of e Open Ilong Idnbne fil'i)CWIT SUSIraectecl single closed long bone 0 WflfilDk. fi-i)CWIT Slit(.^S fracture (3)(4) 0 Wflfiple 6sk)cafions (3)(4) Cutaneous V \IO \/ISlbk' b q t�j S 0"1 Mi)�()11'SCAt fiSSUe 6SI'U �fi011 (5) 11-1 J u I,Y P, i,as ori e 2- or 3 Idnulrurc tO 10% BSA ArTilDUti&()111 (6) Any Denetrafing 111)Lfl'y tO head, ineck C)II,torch) (7) Judgement e EM i oir Pararne&c &screfic)n (8) I Airway assistance includes manual jaw thrust, continuing suctioning, or use of adjuncts to assist ventilator efforts; 2 Altered mental status includes drowsiness, lethargy, inability to follow commands, unresponsiveness to voice,total unresponsive; 3 Long bone including humerus, radius/ ulna, femur, tibia/fibula; 4 Long bone fractures do not include isolated wrist or ankle fractures or dislocations; 5 Degloving injuries, major flap avulsions, or major soft tissue disruption; 6 Proximal to wrist or ankle; 7 Excluding superficial wounds in which the depth can be easily determined; 8 If the patient does not meet any of the criteria listed above and the on scene EMT, Paramedic believes the patient may benefit from Trauma Alert criteria due to extenuating circumstances surrounding the incident, the patient may be classified as a Trauma Alert". 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Page 104 ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4158 Our records indicate the Mailing Address for this Insured is as follows: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC 1 EAST DRIVE KEY LARGO, FL 33037-0000 Please note the address of your actual location may be reflected on the declaration page. 4159 DearValued Client: Thankyou for insuring your memberswith theVFISAccident and Sickness (A&S) Program.We share your interest in providing financial securityto emergency responders who are injured in the line of duty. As required, we are providing you with the Glatfelter Insurance Group (GIG)and AIG privacy notices. VFIS,a division of GIG, has underwritten emergency service organizationsfor over 50 years. Emergency responders are at risk of injury on every call,training and department activity. National events have created awarenessin our local communities about these dangers.VFIS remains committed to education and training pro0ramsthatwill prevent or reducethe frequency of these incidents. Please visit www.vOs.comto access the following resources: * Beneficiary Forms—members should review annually to update clueto any life changing events. Current beneficiary formsshould be retained on file with the department.A copy of ourA&S beneficiary form can be found here: * Claim reports and Attending PhysicimnStmtmrmmnts —toreportinjuryori||nesscanbefound here: * Education,Training and Risk Control programs—utilize for risk reduction, loss prevention and educational and training programs foryour members and department.They can be found here: VFIS * Posters and Literature—to create awarenessand promote safetyculture. Contact Glatfelter Purchasing at8OO'233'1957, extension 7291or fulfillment s.com * Responder Help ( —Sample Po|iciesand Articles with valuable information on current topics and events Our Member FamilyAssistance Program(MFAP)supportsthe health and wellness of first responders whether employeesor volunteers in the workplace.Counseling services help enable personnel to resolve persona|andvvork're|atedissuestomaintainindividua|productivity, hea|thandvve||ness.On|ineso|utions allow easy and secure access anywhere,anytime. Clinical response is fast and available 24-7 and counseling is short-term and so|ution-focused.You can find more information here: Thank you for responding to the call for service. We appreciate your business and thank you for insuring with VFIS. For more information please contact your local agent or VFIS at 1-800-233-1957. Sincerely, Troy Marke|,[|[ [RM Michael Baker,[P[U[RM PresidentVF|S Director,VF|S[|ientRiskSo|utions Aairn/"/"l°reabp Volunteer r/Fern°"'"|"°.ira rice Services,|"=.a/k/a VHS,"/k/"vp|s |naorvmw,3erv�pa.5/n CA, CA|ospirancanndixo,u'ense#0a39073,Yolvnww,p/ireman'^ |"""ra°cese=/ces, "=./"a"A=eri"a"|"tF,"m/o"=|�ro"p,Inc.(mK3)c"mpa"v 11114160 Glatfelter INSURANCE GROUP° u , INSURANCEU�° An AIG company Notice of Privacy Policies& Practices* flud Iglud �� Financial companies choose howthey share your personal information. Federal and state laws give consumers the right to limit some but not al sharing. Federal and state laws also require us to tell you how we collect,share and protect your personal information. Please read this notice carefully to understand whatwe do. The types of personal information we collect and share depend on the productor service you have with us. This information can include: ■ Name,address,age,Social Security number,marital status,assets,income,credit history,demographic information,IP address,browser 01 information ■ Products or services purchased,account balances and paymenthistory,employment Information,motor vehicle re orts,medicalinformation Financial companies need to share customers'personal information to run their everyday business. In the section below,we list the reasons financial companies can share their customers' ersonalinformation;thereasonsGIGchoosestoshare;andwhether youcan limit this sharing. Reasons we can share your nonpublic personal information Does GIG Can you limit share? sharing? For our everyday business purposes — as permitted or required by law, such as to process your transactions, marntarn your account(s), conduct research including data analytics, respond to court Yes No orders/legal investi ations, or report to credit bureaus For our marketing purposes—to offer ou r p roducts an d services to you Yes No For joint marketing with other financial companies Yes No For our affiliates'everyday business purposes—information about your transactions and experiences Yes No For our affiliates'everyday business purposes—information about your creditworthiness Yes Yes Fornonaffiliatesto marketto you We No don't share Call us at(800)233-1957 and ask for the Privacy Coordinator or Legal Department. I Please note: When you are no longer a customer,we continueto share your information as described in this notice. However,you can contact us at anytime to limit our sharing. Who we are / Companies to which this notice applies This notice applies to,and is being provided on behalf of,thefollowing Glatfelter Insurance Group affiliates: Arthu rJ.Glatfelter Agency,Inc.,Glatfelter Brokerage Services, Glatfelter Claims Management,Inc.,Glatfelter Commercial Ambulance,Glatfelter Healthcare Practice,Glatfelter Insurance Services,Glatfelter Program Managers,Glatfelter Public Practice,Glatfelter Religious Practice,Glatfelter Underwriting Services,Inc.,Susquehanna Agents Alliance,LLC,The Glatfelter Agency, Inc.,VFIS,VFIS Claims Management,anclVolunteerFiremen'sInsuranceServices,Inc. To protect your personal information from unauthorized access and use,we use security measures that comply with federal law. How does GIG protect These measures include physical,electronic,and procedural safeguards. Werequireand train our employees to comply with our my personal information? rivac standardsand policies,which are designed to protectcustomer information. How does GIG collectmy We collect your personal information,for example when you: visit ourwebsites,apply for insurance or pay insurance premiurrs, file an insurance claim or give us your income information,provide employment information. We also collect your personal personal information? information from others,such as credit bureaus,affiliates,or othercom anies. Federal law gives you the right to limit only: sharing for affiliates' everyday business purposes— information about your Why can't 1 creditworthiness,affiliates from usingyour information to market to you,sharingfor nonaffiliatesto market toyou. Statelaws limit all sharing? may ive you additional rights to limit sharing. See below for more on your rights understate law. Affiliates Companies related by common ownership or control. They can be financial and nonfinancial companies. ■ Our affiliates are companies with which we share common ownership and which offer P&C,lie and health,and certain benefit products. Companies not related by common ownership or control. They can be financial and nonfinancial companies. Nonaffiliates GIG does not share with nonaffiliates so they can market to you. A formal agreement between nonaffiliated financial companies that together market financial products or services to you. Joint marketing Our joint marketing anners include insurance companies and other companies that Provide financial products and services. m - CA and VT Residents:We will not share your information except for our everyday business purposes,for marketing our products and services to you,as required by law,or with your consent. For VT Residents,we also will not share yourcredit information to ouraffiliates without yourconsent. NV Residents: We are providingthis noticeto you pursuant to NV statelaw. To stop marketing calls from us follow the directions in thesection "To limit oursharing." NV law requires that we also provide you with the following contact information:Bureau of Consumer Protection,Office of the Nevada Attorney General, 555 E. Washington Street,Suite 3900,Las Vegas,NV 89101;Phone#.702-486-3 132;email: bcpinfo@ag.state.nv.us. For more information.contact Glatfelter Insurance Group,Attn:Privacy Coordinator,P.O. Box 2726,York,Pennsylvania 17406,(7 17)74 1-091 1,or visit www. latfelters.com/ rivac - olic This privacy pa eon ourwebsite includes a Goo le Analytics opt-out link. *Rev.01/2021 4161 HIPAA PRIVACY NOTICE This HIPAA Privacy Notice is effective as of January 18, 2021. 1. Statement of Our Duties. We are committed to protectingthe privacy of your protected health information(PHI).PHI is your individually identifiable health information,including demographic information,collected from you or created or received by a healthcare provider,a health plan, your employer,or healthcare clearinghouse which is then provided to us and that relates to:(i)your past,present or future physical or mental health or condition; (ii)the provision of health care to you; or (iii)the past, present or future payment for the provision of health care to you.We are required by law to maintain the privacy of your PHI and to provide you with this notice of our privacy practices and legal duties.We are required to abide by the terms of this notice. WE RESERVE THE RIGHT TO CHANGE THE TERMS OF THIS NOTICE AND MAKE ANY NEW PROVISIONS EFFECTIVE TO ALL OF THE PHI WE MAINTAIN ABOUT YOU.IF WE CHANGE OUR NOTICE,WE WILL POST IT ON OURWEBSITE AND SEND YOU A COPY IN OUR ANNUAL MAILING, OR YOU MAY OBTAIN A COPY OF THE REVISED NOTICE BY CONTACTING OUR PRIVACY COORDINATOR USING THE INFORMATION IN PARAGRAPH 9. 2. Statement of Your Rights. You have a right to know how we may use or disclose your PHI. This notice informs you of those uses and disclosures.There are certain uses and disclosures of your PHI that we are permitted or required to make by law without your permission.For all other uses and disclosures,we first must obtain your permission orwritten authorization.In addition,you have the following rights: • The right to request, in writing,that we place additional restrictions on our uses and disclosures of your PHI. However,we are not obligated to agree to impose any such additional restrictions. • The right to access,inspect and copy the protected information pertainingto you that we maintain in our files about you,and the right to have us corrector amend any information that we create in error.Requests to access or amend your PHI must be made in writingand sentto the contact person and address provided in paragraph 9. • The rightto receive an accounting of the disclosures of your PHI that we make for purposes otherthan activities related to yourtreatment,or our payment functions or other health care operations.You must request an accounting in writing by contacting us at the address in paragraph 9.Your request may be for disclosures made up to 6 years before the date of your request,but in no event,for disclosures made before April 14,2003. • The right to request,in writing,that you receive communications aboutyour PHI in a confidential manner,for example,by alternative means or an alternative location,such as your work address or work email. • The rightto request an amendmentto your PHI if you believe thatyour PHI is incorrect or incomplete.Your request must be in writingand explain why the PHI should be amended. • The right to obtain a paper copy of this notice from us on request. 3. Information We Collect About You. In order to administeryour health benefit programs effectively,we collect the following categories of PHI about you from the following sources: • PHI that we obtain directlyfrom you, in conversations or on applications or otherforms that you fill out. • PHI that we obtain as a result of our transactions with you. • PHI that we obtain from your medical records orfrom medical professionals,which is provided by you orto us with your permission. • PHI that we obtain from other entities,such as health care providers or other insurance companies,in order to service your policy or carry out other insurance-related needs. 4. Uses and Disclosures of Protected Information. A. For Treatment Paymentand Operations. In order to administer your health benefit programs effectively,we use and disclose PHI for certain of ouractivities,including: • To Carry Out Treatment Functions.We may use or disclose your PHI without your permission to enable health care providers to provide you with treatment. • To Carry Out Payment Functions. We may use or disclose your PHI withoutyour permission to carry out activities relatingto reimbursingyou for the provision of health care, obtaining premiums, determining coverage, and providing benefits under the policy of insurance that you are purchasing,such as enablinga health care providerto make payment arrangements.Such functions may include reviewing health care services with respectto medical necessity,coverage underthe policy,appropriateness of care,orjustification of charges. • To Carry Out Certain Operations Relating To Your Benefit Plan.We also may use or disclose your PHI without your permission to carry out certain limited activities relatingto your health insurance benefits,including reviewingthe competence or qualifications of health care professionals, placing contracts for stop-loss insurance and conducting quality assessment activities. • To facilitate the underwriting of insurance; however,we are prohibited from using or disclosing your genetic information for the purpose of underwriting insurance. B. Uses and Disclosures of PHI to Other Entities. We also may use and disclose PHI to other covered entities, business associates or other individuals (as permitted by the HIPAA Privacy rule) who assist us in administering your benefit plan and delivering services to its members. In connection with our payment and operations activities,we may contact individuals and other entities ("Business Associates")to perform various functions on our behalf or to provide certain types of services(such as enrollment or member service support).To perform these functions,Business Associates must agree in writi ng to contract terms designed to appropriately safeguard your PHI. C. Other Possible Uses and Disclosures of PHI. We may use and disclose your PHI without your written permission forthe following purposes: *Rev.01/2021 4162 • To plan sponsors of your group health plan to permit the plan sponsor to perform administrative functions,such as to address member questions, concerns or issue regarding claims,benefits,services,coverage,etc.,and summary health information about enrollees inthe plan to obtain premium bids for health insurance coverage offered through the group health plan or to modify,amend or terminate your group plan. • To the extent that federal or state law requires the use or disclosure, such as to Health and Human services upon request for purposes of determining compliance with federal privacy laws,as required by law enforcement officials or pursuantto a court order or subpoena. • As authorized by and to the extent necessary to comply with workers' compensation or other similar programs that provide benefits for work- related injuries or illnesses. • As authorized by law and to the extent necessary to service insurance policies and benefits that are exempt benefits, such as in connection with servicing life,disability,property and casualty,accident and sickness,workers'compensation and auto insurance or other similar insurance coverage under which benefits for medical care are secondary or incidental to other insurance benefits. • To a public health authority for purposes of public health activities as permitted or required by law. • To a coroner/medical examiner for purposes of identifying a deceased person, determining cause of death or for such official to perform other duties authorized by law.Also to funeral directors so they may carry outtheir duties,and to organizations that handle organ,eye or tissue donation or transplantation. • To a government authority, including a social service or protective services agency,authorized to receive reports of abuse, neglect or domestic violence orto prevent a serious threatto the health or safety of the public. D. For Any Purposes to Which You Have Not Objected. Unless you object,we may disclose your PHI to a friend or family member that you have identified as being involved in your health care.We also may disclose your PHI to an entity to assist in disaster relief efforts and so that your family can be notified about your condition, status and location. If you are not present or able to agree to these disclosures of your PHI, then we may determine whetherthe disclosure is in your best interest. E. As Permitted By Plan Documents. In certain limited circumstances where we may be acting as a third party administrator,we may disclose your PHI to plan sponsors pursuantto the restrictions imposed onthe plan sponsor in the sponsor's plan documents. 5. Required Disclosures of Your PHI. We are required to disclose your PHI to the Secretary of the U.S. Department of Health and Human Services when the Secretary is investigating or determining compliance with the HIPAA Privacy Rule.We are required to disclose to you most of your PHI that is in a"designated record set"when you request access to this information.We are also required to provide, upon written request,an accounting of any disclosures of PHI that are for reasons otherthan payment or health benefits operations. 6. Other Uses and Disclosures of Your PHI. Sometimes we are required to obtain written authorization for use and disclosure of your health information.The uses and disclosures that require an authorization under45 C.F.R.§I64.508(a)are:(i)for marketing purposes;(ii)if we intend to sell your PHI; or(i i i)for psychotherapy notes.We do not and will not sell or share your PHI with any non-affiliated third party for any purpose unless you authorize it or it is otherwise permitted by law. Other uses and disclosures of your PHI that are not described above will be made only with your written, permission,and any permission that you give us may be revoked by you at any time. However,the revocation will not be effective for informationthat we already have used ordisclosed,relyingonthe authorization. 7. Questions and Complaints About Use of PHI. If you want more information about our privacy policies or practices or have any questions or concerns,please contact us usingthe information in paragraph 9.You may submit awritten complaint either directly to us or to the U.S.Department of Health and Human Services(HHS)if you believe that your rights with respectto our protection of your PHI have been violated.We will provide you with the address to file your complaint with HHS upon request.To file a complaint with us,you may submit a complaint in writing that includes as many details(such as names and dates)as possible to our Privacy Officer at the address in Paragraph 9.We support your right to protect the privacy of your PHI.You will not be retaliated against in anyway for filing a complaint. 8. Our Practices Re ag rding Confidentiality and Security. We restrict access to PHI about you to those employees who need to know that information in order to provide products or services to you. We maintain physical, electronic,and procedural safeguards that comply with federal regulations to guard your PHI.We do not engaged in fundraising activities using PHI, however,if we did engage in such activity,then you would have the opportunity to opt out of receiving fundraising communications. Subject to applicable regulatory reporting requirements, exceptions and safe harbors,we will notifyaffected individuals followinga breach of their unsecured PHI. 9. Contact Person For Filing Complaint or Obtaining Further Information: GLATFELTER INSURANCE GROUP ATTN:PRIVACY COORDINATOR /LEGAL DEPARTMENT 183 Leader Heights Road,P.O. Box 2726,York, PA 17405 (717)741-091 1 www.,elatfeIters.com/r)rivacy-c)oIicy Our Policy Regarding Dispute Resolution. Any controversyor claim arisingout of or relatingto our privacy policy,orthe breach thereof,shall be settled by arbitration in accordance with the rules of the American Arbitration Association,and judgment upon the award rendered by the arbitrator(s)may be entered in any court having jurisdiction thereof. *Rev.01/2021 4163 4164 Rev 8/2022 WHAT DOES AMERICAN INTERNATIONAL GROUP, INC. (AIG) DO WITH YOUR FACTS PERSONAL INFORMATION? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you how we collect,share,and protect your personal information. Please read this notice carefully to understand what we do. The types of personal information we collect and share depend on the product or service you have with us. This information can include: • Social Security number and Medical Information • Income and Credit History • Payment History and Employment Information When you are no longerour customer, we continue to share your information as described in this notice. All financial companies need to share customers'personal information to run their everyday business. In the section below,we list the reasons financial companies can share their customers'personal information;the reasons AIG chooses to share; and whether you can limit this sharing. Reasons we can share your personal information DoesAIG share? Can you limit this sharing? For our everyday business purposes—such as to process your transactions,maintain your account(s),respond to court orders Yes No and legal investigations,conduct research including data analytics, or report to credit bureaus For our marketing purposes—to offer our products Yes and services to you No For joint marketing with other financial companies Yes No For our affiliates' everyday business purposes— Yes information about your transactions and experiences No For our affil iates' everyday business purposes— No information about your creditworthiness W e don't share For nonaffiliatesto market to you No We don't share For AIG Insurance Companies: Call 866-244-4786; Fax: 212-458-7081 orE-Mail: • CIPrivac ai ®co For Pet insurance sold by AIG Insurance Companies: Call 866-937-7387 or E-Mail: CiPrivacvDaia.com For LiveTravel,Inc.,Travel Guard Group,Inc.orAIG Travel Assist, Inc.: Call 866-244-4786 or E-Mail: CiPrivacvDaia.com AGLC105774-GB-STF Rev0822 4165 Page 2 Rev 8/2022 • Who is providingthis notice? The insurance company subsidiaries of American International Group, Inc. (AIG) underwriting property-casualty, accident& health, life insurance and related services and certain marketing subsidiaries of AIG listed below. • • How doesAlG protect my To protect your personal information from unauthorized access and use, we use personal information? security measures that comply with federal law. These measures include administrative, technical, and physical safeguards. We restrict access to employees, representatives, agents, or selected third parties who have been trained to handle nonpublic personal information. How doesAlG collect my We collect your personal information from you, for example,when you personal information? -apply for insurance or pay insurance premiums -file an insurance claim or give us your income information -provide employment information We also collect your personal information from others, such as credit bureaus, affiliates, or other companies. Why can't I limit all sharing? Federal law gives you the right to limit only -sharing for affiliates' everyday business purposes—information about your creditworthiness -affiliates from using your information to market to you -sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing. See below for more on your rights under state law. Definitions Affiliates Companies related by common ownership or control.They can be financial and nonfinancial companies. •Ouraffiliates include the membercompaniesof American International Group, Inc., such as National Union Fire Insurance Company of Pittsburgh, Pa. Nonaffiliates Companies not related by common ownership or control. They can be financial and nonfinancial companies. -AIG does not share with nonaffiliatesso they can market to you. Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you. •Our joint marketing partners include companies with which we jointly offer insurance products,such as a bank. Other important • • Thisnoticeisprovidedby American Home Assurance Company;AIG Assurance Company;AIG Property Casualty Company;AIG Specialty Insurance Company;Commerce and Industry Insurance Company;Granite State Insurance Company;Illinois National Insurance Co.;Lexington Insurance Company;AIU Insurance Company;National Union Fire Insurance Company of Pittsburgh,Pa.;National Union Fire Insurance Company of Vermont;New Hampshire Insurance Company;The Insurance Company of the State of Pennsylvania;(collectively the"AIG Insurance Companies"). Thisnotice isalso provided by certain marketing subsidiariesof AIG,including Morefar Marketing,Inc.,LLC,Travel Guard Group,Inc.,AIG Travel Assist, Inc.and LiveTravel,Inc.who market insurance ornon-insurance productsand servicesto consumers. For Vermont Residents only. We will not disclose information about yourcreditworthinessto our affiliatesand will not disclose your personal information,financial information,credit report,or health information to nonaffiliated third partiesto market to you, otherthan as permitted by Vermont law,unless you authorize usto make those disclosures. Additional information concerning ourprivacy policiescan be found using the contact information above for Questions. For California Residents only.We will not share informationwe collect aboutyou with nonaffiliated third parties,except aspermittedby California law, such asto process yourtransactionsorto maintain youraccount. For Nevada Residents Only.We are providing thisnotice pursuantto Nevada state law. You may elect to be placed on our internal Do Not Call list by contacting usaslisted above. Nevada law requiresthat we also provide you with the following contact information:Bureau of Consumer Protection, Office of the Nevada Attorney General,555 E.Washington Street,Suite 3900,LasVegas,NV 89101;Phone number:702-486-3132;email: aginfo@ag.nv.gov. You may contactthe applicable customer service department using the contact infiormation above or by writing to usat Privacy Officer, 1271 Ave of the Americas,FL 37,New York,NY 10020-1304. You have the rightto see and,if necessary,correct personal data.Thisrequiresa written request,both to see yourpersonal dataand to request correction.We do not have to change our recordsifwe do not agree with yourcorrection,butwe will place yourstatement in ourfile.If you would like a more detailed description ofourinformationpracticesand yourrights,please write to usat:Privacy Officer,CIPrivacy@aig.com. AGLC105774-GB-STF Rev0822 4166 NOTICE OF AVAILABILITY OF HIPAA NOTICE OF PRIVACY PRACTICES THIS NOTICE IS PROVIDED TO YOU FOR INFORMATIONAL PURPOSES ONLY. YOU ARE NOT REQUIRED TO CALL OR TAKE ANY ACTION IN RESPONSE TO THIS NOTICE. The Notice applies to the insurance products that provide payment for the cost of medical care as issued by the following companies(the"Company"): American General Life Insurance Company i T he United States Life Insurance Comp any in the City of New York National Union Fire Insurance Company of Pittsburgh,Pa. In accordance with the HIPAA(Health Insurance Portability and Accountability Act of 1996)Privacy Rule, we are required to notify y on of the availability of our HIPAA Notice of Privacy Practices. If you would like to receive a p ap er copy of the HIPAA Notice of Privacy Practices,please contact us at: HIPAA Privacy Officer 2919 Allen Parkway L3-20 Houston,TX 77019 hipaaquestions0)a4,,.com Phone Numbers: American General Life Insurance Company 1-800-888-2452 (AGL)and The United States Life Insurance Company in the City of New York(US Life) AIG's Group Benefits 1-800-346-7692 please follow prompt for claims Long Term Care 1-888-565-3769 National Union Fire Insurance Company of 1-866-244-4786 Pittsburgh,Pa. i This Company does not solicit business in New York. AGLC 100605-NT C Rev0222 4167 1� Naltional Union, Fire Insurance Complany of Pittsburgh, Pa. Admi6orcfNvv Officc 12,71 Ave of 6*Arv�eriws,,Ft 37 1 Ns"w'Yc,,A,P,VY 10020 � MA58,5000 ,a orIPOO %,Iock comp"o'ny"1w,"Ma (2s the, C_c,'WIJwWWY) SCHEDULE OF COVERAGE -VOLUNTEER Policy Number- VFP-4310-7210E-6 Policyholder- KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC (Name and Address) 1 EAST DRIVE KEY LARGO, FL 33037-0000 Policy Effective Date- 10/11/2023 Term- 1 Year Policy Termination Date- 10/11/2024 Premium- $6,080 This Schedule of Coverage provides only those benefits that have a specified amount entered opposite the name of the benefit. Benefits that are followed by the word "none" are not provided under this policy. PART COVERAGE I. Loss of Life Benefits A. Accidental Death Benefits (1) Accidental Death Benefit Amount.................................................................................$50,000 (2) Seat Belt Benefit Amount............................................................................................. $12,500 (3) Safety Vest Benefit Amount...................................................................................$12,500 (4) Military Death Benefit Amount......................................................................................$15,000 B. Dependent Child and Education Benefit Amount................................................................ $30,000 C. Spousal Support and Education Benefit Amount.................................................................$15,000 D. Memorial Benefit Amount....................................................................................................$57000 E. Dependent Elder Benefit Amount.........................................................................................$57000 F. Repatriation Benefit Amount................................................................................................$27500 111. Lump Sum Living Benefits A. Accidental Dismemberment and Paralysis Benefit Principal Sum.........................................$507000 B. Vision Impairment Benefit Principal Sum............................................................................$507000 C. Injury Permanent Impairment Benefit Principal Sum............................................................$507000 D. Heart Permanent Impairment Benefit Principal Sum ........................................................... $507000 E. Illness Permanent Impairment Benefit Principal Sum .......................................................... $507000 F. Cosmetic Disfigurement Resulting From Burns Benefit Principal Sum..................................$507000 G. HIV Positive Lump Sum Living Benefit Principal Sum.......................................................... $507000 V50000NUFIC-FL (Rev. 9/17) 1 VFIS 4168 III. WeeklyIncome Benefits A. Total Disability Benefits (1)Total Disability Weekly Amount (first 28 days) .................................................................$600 (2)Total Disability Maximum Weekly Amount(after 28 days).................................................$600 (3)Total Disability Minimum Weekly Amount.........................................................................$150 B. Partial Disability Benefits (1) Partial Disability Weekly Amount(first 28 days)................................................................$300 (2) Partial Disability Maximum Weekly Amount(after 28 days)...............................................$300 (3) Partial Disability Minimum Weekly Amount.........................................................................$75 C. Disability Benefits General IV. Occupational Retraining Benefit Maximum Amount.......................................................... $20,000 V. Weekly Injury Permanent Impairment Benefit............................................................®Yes ❑No VI. Medical Expense Benefits A. Medical Expense Benefit Maximum Amount.........................................................................$5,000 Medical Expense Benefit Options (1) Excess of Workers' Compensation or No-Fault Auto Insurance Benefits...................................1Z (2) Primary Medical Expense Benefit..........................................................................................❑ B. Cosmetic Plastic Surgery Maximum Amount......................................................................$257000 C. Post-Traumatic Stress Disorder Maximum Amount............................................................. $257000 D. Critical Incident Stress Management Maximum Amount .....................................................$257000 E. Family Expense Benefit Amount (per day)...............................................................................$100 F. Family Bereavement and Trauma Counseling Benefit Amount (per person)........................$17000 VII. Transition Benefit......................................................................................................®Yes ❑No Vill. Felonious Assault Benefit Amount.....................................................................................$257000 IX. Home Alteration and Vehicle Modification Benefit Maximum Amount.............................. $507000 X. Optional Benefits A. Weekly Hospital Benefit Amount........................................................................................... NONE B. First Week Total Disability Benefit Amount............................................................................ NONE C. Coordinated 28 Day Total Disability Benefit Amount............................................................ NONE D. Extended Total Disability Benefit.............................................................................❑Yes ®No E. Long-Term Total Disability Benefit...........................................................................❑Yes ®No F. Cost Of Living Adjustment(COLA) Benefits (1) Weekly Injury Permanent Impairment COLA.....................................................®Yes ❑No (2) Long-Term Total Disability COLA......................................................................❑Yes ®No G. Extra Expense Benefit Extra Expense Benefit Monthly Amount...........................................................................$500 Extra Expense Benefit Maximum Amount...................................................................$127000 H. 24-Hour Accident Benefit Amount......................................................................................... NONE I. Off-Duty Accident Benefit Amount........................................................................................ NONE V50000NUFIC-FL (Rev. 9/17) 2 VFIS 4169 SCHEDULE OF FORMS AND RIDERS POLICY FORMS ATTACHED AT ISSUANCE: V50000NUFIC-FL Schedule of Coverage -Volunteer V50004NUFIC-FL Blanket Accident and Sickness Insurance Policy -Volunteer Members V50007NUFIC-FL Career Personnel Rider V50036NUFIC-FL Mandatory Quarantine Rider 89644 (07-05) Coverage Territory Endorsement OFAC Notice Office of Foreign Assets Control Notice V50000NUFIC-FL (Rev. 9/17) 3 VFIS 4170 PAYM ENT/INSTALLM ENT SCHEDULE THE TOTAL POLICY PREMIUM FOR THIS POLICY IS $6,080, PAYABLE IN INSTALLMENTS AS FOLLOWS: 10/1/2023 $3,040 4/1/2024 $3,040 V50000NUFIC-FL (Rev. 9/17) 4 VFIS 4171 National Union Fire Insurance Comp�any of Pittsburgh, Pa. XdrnpnkM,,;?6v,P,Officc Q,7tl Ave of she Arrmico),,,F1 17 ) �,Jww Vk, ,, NY MUD � 212,458,5000 (0 0:`1rW,4,d VkKlk C01'00,xirvy,hermn f0erreJ wo o&0'ie('.ornpemy,) For inquiries, information about coverage or for assistance in resolving complaints, contact: National Union Fire Insurance Company of Pittsburgh,Pa.: 1-800-551-0824. NOTICE This is not comprehensive health insurance coverage. It does not satisfy the requirements of minimum essential coverage under the Affordable Care Act. BLANKET ACCIDENT AND SICKNESS INSURANCE POLICY VOLUNTEER MEMBERS This policy is a legal contract between the Policyholder and/or Participating Organization named in the application and Us. We agree to insure certain persons(herein called Insured Persons) against loss covered by this policy subject to its provisions, benefits, limitations and exclusions. The persons eligible to be insured are all persons described in this policy as Insured Persons. This policy provides accident and sickness insurance to Insured Persons while they are participating in a Covered Activity. CONSIDERATION — TERM This policy is issued in consideration of the payment of the required premium when due as shown in the Schedule. We agree to provide the benefits shown in the Schedule to Insured Persons in accordance with the provisions and conditions of this policy. This policy maybe changed or terminated without consent of or notice to each Insured Person. The term of this policy begins on the policy Effective Date and continues in effect until the policy Termination Date, both of which are shown in the Schedule, as long as premiums are paid when due, unless otherwise terminated as further provided in this policy. If this policy is terminated, insurance ends on the date to which premiums have been paid. All periods of insurance will begin and end at 12.01 AM Standard Time at the address of the Policyholder and/or Participating Organization. RENEWAL After the policy Termination Date shown in the Schedule, this policy may be renewed for additional periods of time by mutual written consent of Us and the Policyholder and/or Participating Organization at the premium rates set by Us for the renewal period. If this policy is not renewed, We shall provide the Policyholder and/or Participating Organization with 45 days advance written notice which states the reason for the non-renewal and, insurance will stop on the date to which premiums have been paid subject to the Grace Period provision. Such notice shall be mailed to the Policyholder's and/or Participating Organization's last known address as shown in Our records. V50004NUFIC-FL 1 VFIS 4172 POLICY EFFECTIVE AND TERMINATION DATES Effective Date. This policy begins on the policy Effective Date shown in the Schedule at 12.01 AM Standard Time at the address of the Policyholder and/or Participating Organization where this policy is delivered. Termination Date. We may terminate this policy by giving 45 days advance notice in writing to the Policyholder and/or Participating Organization, such notice shall state the reason for the termination and be mailed to the Policyholder and/or Participating Organization's last known address as shown in Our records. This policy may, at any time, be terminated by mutual written consent of Us and the Policyholder and/or Participating Organization. Termination takes effect at 12:01 AM at the Policyholder and/or Parti ci pati ng Organization's address on the date of termination. INDIVIDUAL EFFECTIVE AND TERMINATION DATES Coverage for an Insured Person will take effect on the later of: (1)the policy Effective Date shown in the Schedule; or(2)the date he or she becomes an Insured Person as defined in this policy. Coverage for an Insured Person will end on the earliest of: (1)the date this policy terminates;(2)the date he or she is no longer an Insured Person as defined in this policy; or (3) the date the Policyholder and/or Participating Organization's coverage ends. Termination of coveragewill not affect any loss resulting from participation in a Covered Activity when such participation occurred prior to the date of termination. PREM IUM Premiums. Premiums are payable to Us at the rates described in the Premium section of the Schedule. We may change the required premiums as a condition of any renewal of this policy by giving the Policyholder and/or Participating Organization 45 days advance written notice, such notice shall be mailed to the Policyholder's and/or Participating Organization's last known address as shown in Our records. We may also change the required premiums at any time when any change in coverage affecting premiums is made in this policy. Return of Premium on Cancellation. In the event of cancellation, We will promptly return the unearned portion of any premium paid. The earned premium shall be computed pro rata. Cancellation shall be without prejudice to any claim started before the effective date of cancellation. This policy is governed by the laws of Florida. The President and Secretary of National Union Fire Insurance Company of Pittsburgh, Pa. witness this policy: 404 114e� President Secretary PLEASE READ THIS POLICY CAREFULLY. V50004NUFIC-FL 2 VFIS 4173 TABLE OF CONTENTS Page Number Definitions.......................................................................................................................................................4 Benefits Lossof Life Benefits...........................................................................................................................10 LumpSum Living Benefits..................................................................................................................12 WeeklyIncome Benefits.....................................................................................................................18 Occupational Retraining Benefit..........................................................................................................19 Weekly Injury Permanent Impairment Benefit.......................................................................................19 MedicalExpense Benefits...................................................................................................................20 TransitionBenefit...............................................................................................................................22 Felonious Assault Benefit....................................................................................................................22 Home Alteration and Vehicle Modification Benefit.................................................................................22 OptionalBenefits................................................................................................................................23 Exclusions....................................................................................................................................................27 OtherCoverage With Us................................................................. ..................................................27 GeneralProvisions........................................................................................................................................27 V50004NUFIC-FL 3 VFIS 4174 DEFINITIONS (Additional defined terms can be found throughout this policy) Any term in capitals and quotations or any term in bold type in the policy, application, riders, endorsements, amendments or other attached papers are to be given the meanings as ascribed in this section or as later defined. Administrative Personnel — means a person who works an average of 25 hours or more per week while acting within the scope of his or her employment for the Policyholder and/or Participating Organization, which does not include any emergency response or any emergency response training as listed in items(1), (2), (3) or(4) under Covered Activities. Average Weekly Wage—means an average weekly wage determined by the greater of: (1) the weekly average of the total of wages, salaries, tips, or unemployment compensation for the calendar year immediately preceding the year in which the loss occurred; (2) the weekly average of wages earned in the 12 months preceding the loss; (3) the weekly average of the annualized weekly wage earned in the three months preceding the loss; or (4) for the self-employed, the weekly average of the amount taken from Schedule C, E, or F which is reported on IRS Form 1040 as net taxable income, excluding rental, investment or passive income. The Average Weekly Wage will be verified by the Insured Person's employer and/or tax records. Consumer Price Index—means the consumer price index published by the United States Department of Labor's Bureau of Labor Statistics for All Urban Consumers,All Items(CPI-U). Covered Activity— means any activity, including travel directly to and from such activity, which is a normal duty of an Insured Person, including any- (1) emergency response for fire suppression and rescue or emergency medical activity; (2) training exercise which simulates an emergency and where active physical participation is required; (3) Fire matic Events or Contests; (4) class room training; (5) fund-raising activities including athletic activities solely for the purpose of raising funds for the Policyholder and/or Participating Organization or other non-profitorganization when such fund- raising is performed as an activity of the Policyholder and/or Participating Organization, except any form of football, hockey, lacrosse, soccer, boxing, rugby or martial arts; (6) official functions attended primarily by members of the Policyholder and/or Participating Organization for which the purpose is to further the business of the Policyholder and/or Participating Organization (i.e. installation dinners,banquets, etc.); (7) official conventions, conferences or meetings of emergency fire, rescue or medical personnel attended by the Insured Person on behalf of the Policyholder and/or Participating Organization including personal travel and activities related to attend ng such convention, conference or meeting; (8) participation in pre-approved covered athletic events or programs conducted on the premises of the Policyholder and/or Participating Organization; (9) authorized public safety education events; and (10)administrative or maintenance duties. Under no circumstance is there coverage for participation in the athletic events listed in Exclusion number 9. V50004NUFIC-FL 4 VFIS 4175 The Covered Activity must be performed at the direction, or with the knowledge, of an officer of the Policyholder and/or Participating Organization, unless immediate action is required of the Insured Pe rson at the scene of an emergency not on behalf of the Policyholder and/or Participating Organization or any other organization. Covered Person - means all members who are listed on the Policyholder and/or Participating Organization's roster. The roster will be maintained and periodically updated by the Policyholder and/or Participating Organization. The roster will be kept on file by the Policyholder and/or Participating Organization. Dependent Child- means any child of the Insured Person who was dependent upon the Insured Pe rson and either claimed on the Insured Person's most recent or final federal tax return, or was dependent as a result of a legally enforceable agreementfiled with a court or other administrative body. Fire matic Events or Contests—means practice or participation in an organized event intended to enhance the Insured Person's skills or emergency reaction times. These events include departmental or interdepartmental- (1) apparatus pumping contests; (2) battle of the barrel; (3) antique pumping- (4) hose rolling contests; (5) equipment donning contests; (6) bucket brigades; (7) ladder climbs; (8) tug of war contests; and (9) apparatus operation rodeos. Gainful Occupation —means a job for which an Insured Person is qualified by reason of education, training or experience, that has a reasonable expectation to provide more than 85%of pre-disability earnings. Hemiplegia- means the complete and irreversible paralysis of the upperand lower limbs of the same side of the body. Hospital - means a facility which- (1) is operated according to lawfor the care and treatment of injured and sick people; (2) has organized facilities for diagnosis and surgery on its premises or in facilities available to it on a prearranged basis; (3) has 24 hour nursing service by registered nurses (R.N.'s); and (4) is supervised by one or more Physicians. A Hospital does not include- (1) a nursing, convalescent or geriatric unit of a hospital when a patient is confined mainly to receive nursing care; or (2) a facility which is, other than incidentally, a rest home, nursing home, convalescent home or home for the aged; nor does it include any ward, room,wing, or other section of the hospital that is used for such purposes. V50004NUFIC-FL 5 VFIS 4176 However, a facility which is accredited as a hospital by the Joint Commission on the Accreditation of Hospitals, the American Osteopathic Association, or the Commission on the Accreditation of Rehabilitative Facilities shall be considered a Hospital even though the facility lacks major surgical facilities or is primarily of a rehabilitative nature, if such rehabilitation is specifically for treatment of physical disability. Illness(es)—means any disease, sickness, or infection of an Insured Person while coverage under this policy is in force as to the Insured Person. The Illness must- (1) manifest itself during a specific Covered Activity with the result that the Insured Person interrupts his or her participation in such Covered Activity in order to receive immediate Medical Treatment; or (2) directly result from participation in a Covered Activity and also result in the Insured Person receiving Medical Treatment within 48 hours of participation in such Covered Activity. The requirement that Medical Treatment be received within 48 hours is waived for Infectious Diseases. Immediate Family Member—means the Insured Person's spouse, child, parent, brother or sister. Infectious Disease(s) — means an easily transmitted, potentially life-threatening disease resulting from bacterial, viral, fungal, or protozoan infection. Injury(ies)—means accidental bodily injury sustained by the Insured Person- (1) during and resulting from an Insured Person's participation in a specific Covered Activity while coverage under this policy is in force as to the Insured Person; (2) which directly(independent of sickness, disease, mental incapacity or any other cause) causes a loss to the Insured Person; and (3) which is not otherwise defined as an Illness. The term Injury, for the purposes of this policy, will not include human immunodeficiency virus(HIV), acquired immune deficiency syndrome (AIDS) or AIDS related complex(ARC), or any heart or circula tory malfunction. Insured Person(s) — means any officially designated member of the Policyholder and/or Participating Organization while acting as: (1) a volunteer member for the Policyholder and/or Participating Organization; (2) anyjunior member or member in training; (3) any commissioner, director, trustee or othersimilar position associated with the Policyholder and/or Participating Organization; (4) any bystander deputized at the time of the emergency by an official of the Policyholder and/or Participating Organization to assist in an emergency, but only during the actual emergency; (5) any auxiliary member; (6) any non-member who is requested to participate by the auxiliary or Policyholder and/or Participating Organization; (7) any member who receives remuneration for on-call duty or out of pocket expenses and (8) Administrative Personnel; Subject to the following: An Insured Person will not include a Paid Employee while acting within the scope of his or her employment unless the policy is specifically endorsed to provide coverage for career members, except for Administrative Personnel. V50004NUFIC-FL 6 VFIS 4177 Limb(s) - means entire arm or entire leg. Long-Term Total Disability-means- (1) For an Insured Person with an occupation producing wages as described in the defi nition of Av a rage Weekly Wage at the time Total Disability benefits become payable, Long-Term Total Disability means the inability to perform all of the material and substantial duties of any Gainful Occupation. (2) For an Insured Person who does not have an occupation producing wages as described in the definition of Average Weekly Wage at the time Total Disability benefits become payable, Long-Term Total Disability means: (a) the inability to perform all of the material and substantial duties of an occupation for which the Insured Person is qualified by reason of education, training,or experience;or (b) the inability to perform any two of six activities of daily living of the Insured Person. Activities of daily living include mobility, eating, elimination, cognition, personal hygiene, and dressing. The Insured Person must be underthe regular care of a Physician during Long-Term Total Disability. Medical Treatment - means treatment by a Physician or at a Hospital for the Illness. Other Valid and Collectible Insurance—means any- (1) group plan, program, or insurance policy; (2) other group hospital, surgical or medical benefit plan- (3) union welfare plans or group employer or employee benefitprograms; (4) no-fault automobile insurance plan or similar law; or (5) regular or disability benefits paid under a Retirement Program after the commencement of Partial Disability or Total Disability benefits under this policy. Other Valid and Collectible Insurance will not include benefits provided by the United States Social Security Act or any individual disability insurance plans. Out-Patient Physical Therapy—means rehabilitative physical therapy which is: (1) received without being confined overnight in a Hospital as a registered bed patient; (2) an approved therapy program- (3) necessary for the rehabilitation of an Insured Person from an Injury or an Illness for which he or she was confined in a Hospital for treatment- (4) administered by a licensed physical therapist; and (5) monitored by a Physician. Paid Employee(s)—means a person who receives compensation and works an average of 25 hours or more per week for the Policyholder and/or Participating Organization. The time frame used to determine the average hours or the salaried schedule will be the same time frame used to calculate the Average Weekly Wage. Paid Employee does not include Administrative Personnel. Paraplegia -means the complete and irreversible paralysis of both lower Limbs. Partial Disability, Partially Disabled—means, (1) For an Insured Person with an occupation producing wages as described in the definition of Av a rage Wee kly Wage, the inability to perform one or more, but not all, of the material and substantial duties of his or her own occupation. V50004NUFIC-FL 7 VFIS 4178 (2) If the Insured Person does not have an occupation producing wages as described in the definition of Average Weekly Wage, Partial Disability, Partially Disabled means: (a) the inability to perform one or more, but not all, of the material and substantial duties of an occupation for which the Insured Person is qualified by reason of education, training, or experience; or (b) the inability to perform one or more, but not all, of the regular activities of the Insured Person prior to the covered Injury or Illness. The Insured Person must be underthe regular care of a Physician during Partial Disability. Participating Organization(s) —means a non-profit emergency service organization, municipality or political subdivision that elects coverage under this policy and pays the required premium. The Participating Organization is named in the Schedule and/or the Schedule of Policyholders/Participating Organizations. Coverage for such Participating Organization will be in force at 12.01 A.M. on the policy Effective Date shown in the Schedule subject to paymentof the required premium. Coverage is limited to Insured Pe rsons of any fire, emergency, rescue, or ambulance department of the municipality or political subdivision. Permanent Impairment - means a medical condition which is a physical or functional abnormality or loss, which remains after the maximum medical rehabilitation has been achieved, and which is considered stable or non-progressive by the Physician at the time an evaluation is made. Physician(s)—means any duly licensed medical practitioner: (1) who is acting within the scope of his or her license; and (2) who is not the Insured Person or an Immediate Family Member. Policyholder—means a non-profitemergency service organization, municipality or political subdivision that elects coverage under this policy and pays the required premium. The Policyholder is named in the Schedule. Coverage for such Policyholder will be in force at 12-01 A.M. on the policy Effective Date shown in the Schedule subject to payment of the required premium. Coverage is limited to Insured Persons of any fire, emergency, rescue,or ambulance department of the municipality or political subdivision. Post-Traumatic Stress Disorder — means emotional distress resulting from a Traumatic Incident experienced by an Insured Person which adversely affects the psychological and physical well-being of the Insured Person. Quadriplegia -means the complete and irreversible paralysis of both upper and both lower Limbs. Reasonable and Customary Expe nse—means an expense which- (1) is the lesser of (a) the actual charge; (b) the usual charge made by a Physician or other health care provider; (c) the negotiated rate,if any; or (d) the prevailing charges made for covered services in a "geographic area"; (2) is charged for treatment, supplies or medical services medically necessary to treat the Insured Person's condition; (3) does not include charges that would not have been made if no insurance existed. "Geographic area" - means the three digit zip code in which the services, procedures, devices, drugs, treatment or supplies are provided or a greater area, if necessary, to obtain a representative cross-section of charges for a like treatment, service, procedure,device, drug or supply. V50004NUFIC-FL 8 VFIS 4179 Retirement Program- means any normal, early, or disability retirement benefit, provided by the Policyholder and/or Participating Organization, State, Union or other entity where eligibility and/or benefits are based on employment with the Policyholder and/or Participating Organization. Schedule—means the Schedule of Coverage which is attached to this policy. Total Disability, Totally Disabled —means, (1) For an Insured Person with an occupation producing wages as described in the definition of Average Weekly Wage, the inability to perform all of the material and substantial duties of his or her own occupation. (2) If the Insured Person does not have an occupation producingwages as described in the definition of Average Weekly Wage, Total Disability, Totally Disabled means: (a) the inability to perform all of the material and substantial duties of an occupation for which the Insured Person is qualified by reason of education, training,or experience;or (b) the inability to perform all of the regular activities of the Insured Person prior to the covered I n j ury or Illness. The Insured Person must be underthe regular care of a Physician during Total Disability. Traumatic Incident — means an abnormal experience, outside the range of usual human experiences and includes- (1) line-of-duty death or serious injury to other Insured Persons; (2) a single incident having multiple casualties; (3) death or serious injury of a child; and (4) dealing with victims known to the Insured Person. Uniplegia - means the complete and irreversible paralysis of one Limb. We, Us, or Our refers to National Union Fire Insurance Company of Pittsburgh, Pa. V50004NUFIC-FL 9 VFIS 4180 PART I. LOSS OF LIFE BENEFITS A. ACCIDENTAL DEATH BENEFITS (1) Accidental Death Benefit. We will pay the Accidental Death Benefit Amount shown in the Sche du le if an Insured Person dies as a result of any Injury or any disease, sickness,or infection that: (a) occurs during a specific Covered Activity; or (b) occurs due to a covered sickness as a result of participation in a specific Covered Activity; or (c) occurs due to a heart attack or stroke within 48 hours of participating in (i) an emergency response for fire suppression and rescue or emergency medical activity; or (ii) a training exercise which simulates an emergency and where active physical participation is required. Either death or Medical Treatment for the sickness must occur within 48 hours of the Covered Activity. The requirement that death or Medical Treatment for the sickness be within 48 hours is waived for Infectious Disease. In the event that an Accidental Death Benefit and an Accidental Dismemberment Benefit and/or a Vision Impairment Benefit are payable under this policy as a result of any Injury sustained while participating in the same Covered Activity, only one benefit, the largest, will be paid. No Accidental Death Benefit will be payable if, as a direct result of participation in the same Covered Activity, an HIV Positive Lump Sum Living Benefitwas paid to the Insured Person underthe policy. (2) Seat Belt Benefit. If an Accidental Death Benefit is payable under this policy and the accident which caused the Insured Person's accidental death occurred while the Insured Person was wearing a properly fastened automotive seat belt or other vehicle occupant restraint, such as an ambulance harness or tether,We will pay an additional amount equal to the Seat Belt Benefit Amount shown in the Schedule. (3) Safety Vest Benefit. If an Accidental Death Benefit is payable underthis policy and death results from being struck as a pedestrian while on the scene of a motor vehicle accident or while directing trafficand the Insured Person was wearing an approved American National Standards Institute, Inc. (ANSI)/ Manual on Uniform Traffic Control Devices(MUTCD) "Safety Vest", We will pay an additional amount equal to the Safety Vest Benefit Amount shown in the Schedule. "Safety Vest"- means a vest approved in the MUTCD as published by the ANSI. (4) Military Death Benefit. If bodily injury sustained while serving or training on behalf of the United States Military or respective Guard or Reserve Unit results in a Covered Person's death, We will pay the Military Death Benefit shown in the Schedule. Death must occur within 12 months of the bodily injury. Exclusions 4 and 8 do not apply to this benefit. No Military Death Benefit is payable if an Accidental Death Benefit is payable under this policy. B. DEPENDENT CHILD AND EDUCATION BENEFIT If an Accidental Death Benefit is payable under the policy, We will pay the Dependent Child and Education Benefit Amount shown in the Schedule for each Dependent Child. We may make payment directly to the Dependent Child's: V50004NUFIC-FL 10 VFIS 4181 (1) guardian; or (2) to an individual or institution with custody of the De pendent Child if; (a) the Dependent Child is a minor or is not competentto give a valid receiptfor payment due him or her; and (b) no request for payment has been received by Us from a duly appointed guardian or other legally appointed representative. Payment made in this manner will release Us from all liability to the extent of any payment made. C. SPOUSAL SUPPORT AND EDUCATION BENEFIT If an Accidental Death Benefit is payable under the policy, We will pay the Spousal Support and Education Benefit Amount shown in the Schedule to the Insured Person's surviving spouse. In no event will more than one Spousal Support and Education BenefitAmount be paid. D. MEMORIAL BENEFIT If an Accidental Death Benefit is payable underthe policy foreach such death,We will also pay the Memorial Benefit Amount shown in the Schedule to the Policyholder and/or Participating Organization. E. DEPENDENT ELDER BENEFIT If an Accidental Death Benefit is payable under the policy, We will pay the Dependent Elder Benefit Amount shown in the Schedule for each "Dependent Elder". We may make payment directly to the "Dependent Elder". Payment made in this manner will release Us from all liability to the extent of any payment made. "Dependent Elder"-means any parent, parent-in-law, grandparent,grandparent-in-law, great grandparent or great grand parent-in-law of the Insured Person who was dependent upon the Insured Person and claimed on the Insured Person's final federal taxreturn. F. REPATRIATION BENEFIT If an Accidental Death Benefit is payable under this policy and the Insured Person was beyond a 30 mile radius from his or her current place of primary residence at the time of death, We will pay for reasonable expenses incurred to transport his or her body to the local vicinity of their current place of primary residence. We will not pay more than the Repatriation Benefit Amount shown in the Schedule per Insured Person. V50004NUFIC-FL 11 VFIS 4182 PART II. LUMP SUM LIVING BENEFITS A. ACCIDENTAL DISM EM BERMENT AND PARALYSIS BENEFIT If Injury to an Insured Person results in a"Loss"listed below, We will pay the indicated percentage of the Accidental Dismemberment and Paralysis Principal Sum shown in the Schedule forthe "Loss"suffered. If the Insured Person suffers more than one "Loss" as a result of anyone Injury, only one amount,the largest, will be paid. Accidental Dismemberment and Paralysis Chart For Loss of: % of Principal Sum Payable Quadriplegia...... ......................................... ....................................200% Paraplegia..................................................................................200% Hemiplegia.................................................................................200% Uniplegia....................................................................................100% Both Hands or Both Feet ......................................... ...........................100% One Hand and One Foot..........................................................................100% Entire Sight of Both Eyes.........................................................................100% One Hand and Entire Sight of One Eye....................................................100% One Foot and Entire Sight of One Eye .....................................................100% Speech and/or Hearing ...........................................................................100% One Arm or One Leg ...............................................................................100% One Hand or One Foot..............................................................................50% Entire Sight of One Eye .............................................................................50% BothThumbs ............................................................................................50% OneThumb...............................................................................................25% Each Joint of a Finger or Toe.....................................................................10% "Loss" - means Quadriplegia, Paraplegia, Hemiplegia, Uniplegia, or with reference to the foot, a complete severance through or above the anklejoint;with reference to the hand, the complete severance of the distal, proximal or medial phalanx of four fingers; with reference to the arm or leg, the complete severance through or above the elbow or knee joint; with reference to the thumb, the complete severance at the metacarpophalangeal joint; and with reference to a joint of a finge r or toe, the complete severance of a distal, proximal or(where applicable) medial phalanx. "Loss"of speech or hearing means the total and irrecoverable loss of speech and/or hearing. "Loss" of sight means the total and irrecoverable loss of sight. In the event that an Accidental Dismemberment Benefit and an Accidental Death Indemnity Benefit are payable under this policy as a result of any Injury sustained while participating in the same Covered Activity, only one benefit, the largest,will be paid. B. VISION IMPAIRMENT BENEFIT If Injury to an Insured Person results in "Permanent Damage"to the Insured Person's eyesight, We will pay the indicated percentage of the Vision Impairment Benefit Principal Sum shown in the Schedule, for each impaired eye, based on the degree of vision impairment according to the Vision Impairment Chart shown below. This benefit chart will apply separately to each eye. V50004NUFIC-FL 12 VFIS 4183 Vision Impairment Chart % of Vision Impairment Benefit Vision Impairment Payable Per Each Eye 20/20 0.00% 20/30 2.75% 20/40 5.50% 20/50 8.25% 20/60 11.00% 20/80 16.50% 20/100 22.00% 20/120 28.00% 20/150 36.00% 20/180 44.50% 20/200 or poorer 50.00% If the sight of an eye is lessthan 20/20 beforethe "Permanent Damage",We will pay a benefit based only upon the additional impairmentdueto the Injury. In no eventwill We payboth an Accidental Dismemberment and Paralysis Benefitfora loss of sightand a Vision Impairment Benefit for Injuryto the same eye sustained while participating in the same Covered Activity. If a Vision Impairment Benefit is payable, it will be in addition to any Accidental Dismemberment and Paralysis Benefit payable for any non-vision related Injury sustained while participating in the same Cove red Activity. However, in no event will the total amount of benefits payable as a result of any one Injury exceed 100%of the largest Principal Sum shown in the Schedule forthese benefits. "Permanent Damage" - means with reference to the eyes, irreparable Injury which results in permanently impaired vision, but not in total and irrecoverable loss of sight. C. INJURY PERMANENT IMPAIRMENT BENEFIT If an Insured Person suffers a Permanent Impairment due to an Injury and the Insured Person participates in an approved physical rehabilitation program if his or her physical condition so warrants, We will pay the impairment rating percentage of the Injury Permanent Impairment Benefit Principal Sum shown in the Schedule. In no event will an Injury Permanent Impairment Benefit be payable if the Heart Permanent Impairment Benefit or an Illness Permanent Impairment Benefit is payable for any one Injury or Illness sustained while participating in the same Covered Activity. To Determine the Benefit Payable The Insured Person's Permanent Impairment, due to an Injury,will be assigned an impairment value by an examining Physician. This value will be expressed as a percentage in relation to the whole person. The impairment rating will be determined by the most current edition of the American Medical Association's (AMA) "Guides to the Evaluation of Permanent Impairment". This percentage rating will be applied to the Injury Permanent Impairment Benefit Principal Sum shown in the Schedule to determine the Injury Permanent Impairment Benefit amount payable underthis policy. If an Injury results in Uniplegia, We will pay 100% of the Injury Permanent Impairment Principal Sum shown in the Schedule. If, due to an Injury, the Insured Person has a Permanent Impairment rating of 90% or higher, the Insured Person will receive 125%of the Injury Permanent Impairment Benefit Principal Sum. V50004NUFIC-FL 13 VFIS 4184 For example- (1) if a knee Injury resulted in an AMA guideline lower extremity impairment rating of 38%, which eq uates to 15% of the whole body, the benefit would be 15% of the Injury Permanent Impairment Benefit Principal Sum; or (2) if a combination of leg and back Injuries result in an AMA guideline whole person impairment rating of 12%and 17%, respectively,which equates to a combined whole person impairment rating of 27%, the benefit would be 27%of the Injury Permanent Impairment Benefit Principal Sum; or (3) if a fracture at the second cervical vertebra causes incomplete Quadriplegia with an AMA guideline whole person impairment rating of 93%, the benefit would be increased to 125% of the Injury Permanent Impairment Benefit Principal Sum since the impairment rating is 90%or higher. Any Injury Permanent Impairment Benefit payable under this policy will be in addition to any Accidental Dismemberment and Paralysis Benefit or Vision Impairment Benefit payable under this policy. However, in no event will the total amount of benefit payable as the result of any one Injury exceed 100%of the largest Principal Sum shown in the Schedule, unless; (1) the Permanent Impairment rating for an Injury is 90%or higher in which case We will pay 125% of the Injury Permanent Impairment Principal Sum; or (2) an Injury results in Quadriplegia, Paraplegia or Hemiplegia in which case We will pay 200% of the Injury Permanent Impairment Principal Sum. If the Insured Person is impaired prior to the time of Injury, the impairment rating that represents the pre- existing condition will be deducted from the Permanent Impairment evaluation due to the Injury as described above. D. HEART PERMANENT IM PAIRMENT BENEFIT If the Insured Person has a"Heart Permanent Impairment" due to a heart condition that results in at least 26 weeks of Total Disability, based upon the degree of heart impairment according to the Heart Permanent Impairment Benefit Chart shown below, We will pay the indicated percentage of the Heart Permanent Impairment Benefit Principal Sum shown in the Schedule. To Determine the Benefit Payable No more than nine months after the Covered Activity, the Insured Person's highest "Left Ventricular Ejection Fraction" and lowest"New York Heart Association Functional Classification"will be obtained and compared to the Heart Permanent Impairment Benefit Principal Sum shown in the Schedule. The ratings must result from evaluations performed after the Covered Activity date. If the Insured Person had a "Left Ventricular Ejection Fraction" of 35% or lower prior to the Covered Activity date, no Heart Permanent Impairment Benefit is due. V50004NUFIC-FL 14 VFIS 4185 Heart Permanent Impairment Benefit Chart Left Ventricular Ejection NewYork Heart Association Heart Permanent Impairment Fraction Functional Classification Benefit Due 26 to 30% function Class II 25% 26 to 30% function Class III or IV 50% 21 to 25% function Class II or III 50% 21 to 25% function Class IV 75% Less than 21%function Class II or III 75% Less than 21%function Class IV 100% The benefit due is calculated by multiplying the percentage due and the Principal Sum. The benefit is further modified by the Insured Person's age on the date of the heart impairment, according to the following table: • Age 40 or less - 125%of amount payable • Age 41 to 65 - 75%of amount payable • Age 66 or over - 50%of amount payable For example- (1) if a 30 year old (on the date of heart impairment) has a"Left Ventricular Ejection Fraction"of 17%and a "New York Heart Association Functional Classification"of Class IV, the benefit would be 100%of the Heart Permanent Impairment Benefit times 125%since the age is less than 40, f or a total benefit of 125%of the Heart Permanent Impairment Benefit; or, (2) if a 55 year old (on the date of heart impairment) has a"Left Ventricular Ejection Fraction"of 19%and a "New York Heart Association Functional Classification" of Class IV, the ben efit would be 100% of the Heart Permanent Impairment Benefit times 75% since the age is between 41 and 65, for a total benefit of 75% of the Heart Permanent Impairment Benefit; or, (3) if a 68 year old (on the date of heart impairment) has a"Left Ventricular Ejection Fraction"of 18%and a "New York Heart Association Functional" Classification of Class IV, the benefit would be 100% of the Heart Permanent Impairment Benefit times 50% since the age is 66 or over, for a total benefit of 50%of the Heart Permanent Impairment Benefit. "Heart Permanent Impairment" - means a medical condition which is a physical and functional abnormality or loss as a consequence of an Insured Person sustaining a heart impairment as a result of a Covered Activity, resulting in: (1)a"Left Ventricular Ejection Fraction" of 30%or less; and (2)a "New York Heart Association Functional Classification" of 11, III, or IV; and (3) at least 26 weeks of Total Disability. "Left Ventricular Ejection Fraction"- means a clinically used measure of the percentage of blood the heart is able to eject from the left ventricle. "NewYork Heart Association Functional Classification" is a standard measurement of how heart function affects activities of daily living. Below is a summary of the New York Heart Association Classification: I. No symptoms and no limitation in ordinary physical activity. 11. Mild symptoms and slight limitation during ordinary activity. Comfortable at rest. 111. Marked limitation in activity due to symptoms, even during less-than-ordinary activity. Comfortable only at rest. IV. Severe limitations. Experiences symptoms even while at rest. V50004NUFIC-FL 15 VFIS 4186 E. ILLNESS PERMANENT IMPAIRMENT BENEFIT If Illness to an Insured Person results in five years(260 weeks) of Total Disability Benefits, We will pay the indicated percentage of the Illness Permanent Impairment Benefit Principal Sum shown in the Schedule. To Determine the Benefit Payable If the Insured Person is unable to return to his or her occupation after five years (260 weeks) of Total Disability Benefits, 50%of the Illness Permanent Impairment Benefit Principal Sum shown in the Schedule is payable. If the Insured Person is unable to return to any Gainful Occupation after five years (260 weeks) of Total Disability Benefits, 75%of the Illness Permanent Impairment Benefit Principal Sum shown in the Schedule is payable. If the Insured Person has been approved for Social Security disability benefits or, if not eligible for Social Security disability benefits, otherwise meets the eligibility criteria for Social Security disability benefits, 125% of the Illness Permanent Impairment Benefit Principal Sum as shown in the Schedule is payable. The five year(260 week) period of Total Disability does not need to be consecutive weeks but must be payable as a result of one Illness sustained while participating in the same Covered Activity. If an Insured Person has received a Heart Permanent Impairment Benefit and later becomes eligible for payment under this benefit for the same condition, the amount payable under this benefit is the indicated percentage of the Illness Permanent Impairment Principal Sum shown in the Schedule, less the amount previously paid under the Heart Permanent Impairment Benefit. The indicated percentage described in the first paragraph of this section will also apply to the total amount payable. F. COSMETIC DISFIGUREMENT RESULTING FROM BURNS BENEFIT If, as the result of Injury, an Insured Person suffers a cosmetic disfigurement due to a burn that is classified as a full thickness or third degree burn, We will pay the indicated percentage of the Cosmetic Disfigurement Resulting From Burns Principal Sum shown in the Schedule. To Determine the Benefit Payable Any Cosmetic Disfigurement Resulting From Burns Benefit payable under this benefit will be based on a percentage of the Cosmetic Disfigurement Resulting From Burns Principal Sum shown in the Schedule and depend on the area of the body which was burned. The benefit payable for any one loss is determined by the following formula- (1) First the area of the body that was burned is assigned an area classification factor by using the chart shown below. Each body part is assigned a classification relative to its visible exposure (i.e., the more visible the exposure the higher the classification); (2) This area classification factor is multiplied by the percentage of body surface actually burned. The attending Physician will determine the percentage applicable to each burn. The chart below lists the maximum allowance percentage for body surface burned for each area classification., (3) Steps 1 and 2 will produce a numerical factor that will be multiplied by the Cosmetic Disfigurement Resulting From Burns Principal Sum to determine the percentage of the Cosmetic Disfigurement Resulting From Burns Principal Sum payable under this benefit. V50004NUFIC-FL 16 VFIS 4187 For example, by using the Cosmetic Burn Chart shown below: (a) if 100%of the surface of the right hand and forearm were burned the benefitwou Id be 5 x 4.5% _ 22.5%of the Cosmetic Disfigurement Resulting From Burns Principal Sum payable; or (b) if 50% of the surface of the right hand and forearm were burned the benefit would be 5 x 2.25% (which is 50% of 4.5) = 11.25%of the Cosmetic Disfigurement Resulting From Burns Principal Sum payable. The following is a burn chart from which benefits can be determined. This chart represents the maximum percentage of the Cosmetic Disfigurement Resulting From Burns Principal Sum payable for a covered cosmetic disfigurement Injury. If the Insured Person suffers burns in more than one area as a result of any one Injury, benefits will not exceed more than 100% of the Cosmetic Disfigurement Resulting From Burns Principal Sum. Cosmetic Burn Chart Maximum Allowable Maximum % of Cosmetic Area % for Area Surface Disfigurement Resulting Body Part Classification Burned from Burns Principal Sum Face, Neck, Head 11 9.0% 100.0% Hand & Forearm (Right) 5 4.5% 22.5% Hand & Forearm (Left) 5 4.5% 22.5% Upper Arm (Right) 3 4.5% 13.5% Upper Arm (Left) 3 4.5% 13.5% Torso (Front) 2 18.0% 36.0% Torso (Back) 2 18.0% 36.0% Thigh (Right) 1 9.0% 9.0% Thigh (Left) 1 9.0% 9.0% Lower Leg (Right) (below knee) 3 9.0% 27.0% Lower Leg (Left) (below knee) 3 9.0% 27.0% The percentage shown is based on 100% of the Body Part identified being burned. Please refer to the Schedule for the amount of the Cosmetic Disfigurement Resulting From Burns Principal Sum. Any Cosmetic Disfigurement Resulting From Burns Benefit payable under this policy will be in addition to any Accidental Dismemberment and Paralysis Benefit, Vision Impairment Benefit, Injury Permanent Impairment Benefit, Heart Permanent Impairment Benefit, or Illness Permanent Impairment Benefit payable under this policy. However, in no event will the total amount of benefits payable as a result of any one Injury exceed 100%of the largest Principal Sum shown in the Schedule forthese benefits. G. HIV POSITIVE LUM P SUM LIVING BENEFIT If, as a direct result of participation in a specific Covered Activity, an Insured Person tests"HIV Positive", We will pay the HIV Positive Lump Sum Living Benefit Principal Sum shown in the Schedule. In the event that an HIV Positive Lump Sum Living Benefit and (1) an illness death or (2) an Illness Permanent Impairment Benefit are both payable underth is policy as a result of any one illness sustained while participating in the same Covered Activity, only one benefit,the largest,will be paid. "AIDS" - means acquired immune deficiency syndrome. "HIV"- means human immunodeficiency virus identified as the causative agent of"AIDS". V50004NUFIC-FL 17 VFIS 4188 "HIV Positive" - means the presence of HIV antibodies in the blood of an Insured Person as substantiated through both a positive screening test(enzyme-linked immunosorbent assay (ELISA) and a positive supplemental test such as Western Blot. All such tests must be approved by the Food and Drug Administration (FDA)with the interpretation of positivity as specified by the manufacturer(s). PART III. WEEKLY INCOME BENEFITS A. TOTAL DISABILITY BENEFITS (1) If Injury or Illness to an Insured Person results in Total Disability,We will pay the Total Disability Weekly Amount shown in the Schedule for the first 28 days of Total Disability. (2) If Total Disability continues beyond 28 days, We will pay 100%of the difference between the Insured Person's Average Weekly Wage and the sum of any disability income benefits paid or payable to the Insured Person from any Workers' Compensation act or similar Iawand OtherValid and Collectible Insurance, not to exceed the Total Disability Maximum Weekly Amount shown in the Schedule, for each week the Insured Person is Totally Disabled up to a maximum of five years(260 weeks). (3) The minimum benefit payable for Total Disability will be the Total Disability Minimum Weekly Amount shown in the Schedule. If, after Total Disability commences, benefits are payable under a Retirement Program, the Total Disability Minimum Weekly Benefit does not apply. B. PARTIAL DISABILITY BENEFITS (1) If Injury or Illness to an Insured Person results in Partial Disability,We will pay the Partial Disability Weekly Amount shown in the Schedule for the first 28 days of Partial Disability. (2) If Partial Disability continues beyond 28 days, We will pay 50%of the difference between the Insured Person's Average Weekly Wage, and the sum of any earned income, disability income benefits paid or payable to the Insured Person from any Workers' Compensation act or similar Iawand Other Valid and Collectible Insurance,not to exceed the Partial Disability Maximum Weekly Amount shown in the Schedule, for each week the Insured Person is Partially Disabled up to a maximum of 52 weeks. (3) The minimum benefit payable for Partial Disability will be the Partial Disability Minimum Weekly Amount shown in the Schedule. C. DISABILITY BENEFITS GENERAL If an Insured Person is Totally Disabled or Partially Disabled for less than a week, We will pay 1/7 of the benefit otherwise payable for each full day the Insured Person is disabled. The amount of Total Disability Benefits or Partial Disability Benefits payable to an Insured Person who is Totally Disabled or Partially Disabled will be increased after Total Disability Benefits or Partial Disability Benefits have been paid to the Insured Person for at least 52 consecutive weeks. Any increased benefit will become effective on July 1, following the first 52 week benefit period. Successive annual increases will be compounded on July 1 of each subsequent year. The increase will equal a minimum of 5% or the percentage increase in the Consumer Price Index for the preceding calendar year,whichever is greater, to a maximum of 10%. The increase will applyto eitherthe Insured Person'sAverage Weekly Wage at the time of the Covered Activity which caused the Injuryor Illness, orto the Total Disability Benefit or Partial Disability Benefit,whichever results in the higher benefit to the Insured Person. V50004NUFIC-FL 18 VFIS 4189 In the event that benefits are payable for both Total Disability and Partial Disability resulting from Injury or Illness sustained while participating in the same Covered Activity, the maximum benefit period for all benefits is five years(260 weeks). Periods of Total Disability or Partial Disability separated by less than five years (260 weeks) will be considered one period of disability unless due to separate and unrelated causes. PART IV. OCCUPATIONAL RETRAINING BENEFIT If, as a result of Injury or Illness, an Insured Person is not able to remain or continue in a Gainful Occupation and chooses to enroll in an institution of higher learning or professional or trade training program, We will pay for "Covered Retraining Expenses", up to the Occupational Retraining Benefit Maximum Amount shown in the Schedule. The objective of any professional or trade training program must be to return the Insured Person to work in an occupation to which he or she is suited. The professional or trade training program must be agreed upon by Us and the Insured Person. We will pay any"Covered Retraining Expenses" incurred by an Insured Person in excess of benefits paid or payable under any Workers' Compensation act or similar law, no fault automobile insurance or similar law, and any Other Valid and Collectible Insurance. "Covered Retraining Expenses" includes expenses fortuition, books, and any other training materials required by the institution of higher learning or professional or trade training program. PART V. WEEKLY INJURY PERMANENT IM PAIRM ENT BENEFIT If Injury to an Insured Person results in a Permanent Impairment and, due to a covered Injury, it is determined thatthe Insured Person has a whole person Permanent Impairment percentage value of 50% or greater for purposes of the Injury Permanent Impairment Benefit, We will pay a Weekly Injury Permanent Impairment Benefit. This Weekly Injury Permanent Impairment Benefitwill begin on the 261 st week (or 521 st week if the Extended Total Disability Benefit is selected)from the date of participation in the Cove red Activity which caused the Injury and will continue to be paid for the remainder of the Insured Person's lifetime. The Weekly Injury Permanent Impairment Benefit will be determined by multiplying the Weekly Income Benefit amount payable on the 29th day of Total Disability, as determined under the Weekly Income Benefits section of this policy, by the percentage value of the Insured Person's Permanent Impairment. For example: If the Total Disability Weekly Income Benefit payable on the 29th day of Total Disability is $600.00 and the Insured Person's Permanent Impairment,due to an Injury, percentage va I u e is 70%, the lifetime Weekly Injury Permanent Impairment Benefit would be $420 per week($600 x 70%_ $420). The Permanent Impairment rating due to an Injury used to determine the Weekly Injury Permanent Impairment Benefit is final upon initiation of Weekly Injury Permanent Impairment Benefits. Subsequent changes in the Permanent Impairment rating due to an Injurywill not affect the Weekly Injury Permanent Impairment Benefits payable. Weekly Injury Permanent Impairment Benefits will be paid in addition to any benefits payable under this policy. V50004NUFIC-FL 19 VFIS 4190 PART VI. MEDICAL EXPENSE BENEFITS A. MEDICAL EXPENSE BENEFIT If, as a result of a covered Injury or Illness, an Insured Person incurs medical expenses, We will pay the Reasonable and Customary Expenses for necessary: (1) medical, Hospital or surgical treatment; (2) "Home Health Care"; (3) nursing services prescribed and monitored by a Physician; (4) Post-exposure Prophylaxis Protocol (PEP) treatment, when such treatment is advised by the attending Physician; (5) Infectious Disease screening test(s); (6) Post-exposure preventive inoculations as a result of participation in a Covered Activity or; (7) services performed in an "Ambulatory Surgical Center", provided such service would have been covered under the terms of the policy. We will pay the medical expense benefits subject to the Policyholder and/or Participating Organization's choice of 1 or 2 below: (1) If 1" in the Schedule is marked with an "K, We will pay any covered medical expenses incurred by an Insured Person in excess of benefits paid or payable underany Workers' Compensation act or similar law, or no fault automobile insurance plan or similar law. If benefits are not payable under the applicable Workers' Compensation act or similar law, but are covered under th is policy, We wi I I pay such benefits. (2) If"2" in the Schedule is marked with an "K, We will pay any covered medical expenses incurred by an Insured Person on a primary basis regardless of benefits paid or payable under any Workers' Compensation act or similar law, no fault automobile insurance plan or similar law, or any Other Valid and Collectible Insurance. We will not pay more than the Medical Expense Benefit Maximum Amount shown in the Schedule for any one Injury or Illness. "Ambulatory Surgical Center" - means a licensed facility providing surgical treatment, in which the patient is admitted to and discharged from such facility within the same working day and is not permitted to stay overnight and which is not part of a hospital. It does not include a Hospital, clinic or Physician's office. "Home Health Care" -means those nursing and other home health care services provided to an Insured Person in his or her place of residence. "Home Health Care" must be: (1) performed by a "Home Health Care Practitioner'; (2) in lieu of confinement in a Hospital or nursing facility; and (3) pursuant to the orders of the attending Physician. Such attending Physician's orders must be written and include a plan of care which must be reviewed and approved by the Physician. "Home Health Care Practitioner" - means a nurse, medical social worker, home health aide, physical therapist, or other medical practitioner. However, no provider will be considered a "Home Health Care Practitioner" unless such practitioner is: V50004NUFIC-FL 20 VFIS 4191 (1) duly licensed and/or certified in compliance with all applicable laws and regulations to provide the care received; and (2) not an Insured Person or an Immediate Family Member. B. COSMETIC PLASTIC SURGERY BENEFIT If an Insured Person requires skin grafting or plastic surgery due to an Injuryfor which Medical Expense Benefits are payable, We will pay the Reasonable and Customary Expense(s) incurred. We will not pay more than the Cosmetic Plastic Surgery Maximum Amount shown in the Schedule for any one Injury. C. POST-TRAUMATIC STRESS DISORDER BENEFIT If, as the result of participation in a specific Covered Activity in which a Traumatic Incident occurred while coverage under this policy is in force, an Insured Person requires Medical Treatment for a Post- Traumatic Stress Disorder, We will pay the Reasonable and Customary Expense(s) incurred. Treatment must be prescribed and monitored by a Physician. We will not pay more than the Post- Traumatic Stress Disorder Maximum Amount shown in the Schedule for each Insured Person for any one Covered Activity. D. CRITICAL INCIDENT STRESS MANAGEMENT BENEFIT If a "Critical Incident Stress Management Team" is requested andauthorized bythe Policyholder and/or Participating Organization and is required as a result of the Insured Person's participation in a specific Covered Activity in which a Traumatic Incident occurred while coverage underthis policy is in force, We will pay the reasonable expenses incurred by a "Critical Incident Stress Management Team". Covered expenses include the cost of necessary transportation, meals, and lodging. We will not pay more than the Critical Incident Stress Management Maximum Amountwhich is shown in the Schedule regardless of the number of Insured Persons treated. "Critical Incident Stress Management Team (CISMT)" - means a formally organized group of mental health professionals and peer support individuals trained to provide support services to emergency service personnel. Such support services include stress debriefing, defusing, demobilization, stress education, spousal support, one-on-one interviews, or on the scene support. E. FAMILY EXPENSE BENEFIT If an Insured Person is admitted to the Hospital as an inpatient due to a covered Injury or Illness,We will pay the Family Expense Benefit shown in the Schedule for each day of such Hospital confinement. After such Hospital confinement, We will also pay 50% of the Family Expense Benefit shown in the Schedule for each day an Insured Person participates in Out-Patient Physical Therapy as a result of such Injury or Illness. The Family Expense Benefit will be payable for a combined maximum of 26 weeks for any one Injury or Illness regardless of whether it is paid at 100%or 50%. F. FAMILY BEREAVEM ENT AND TRAUM A COUNSELING BENEFIT If an Accidental Death Benefit is payable under this policy or if an Insured Person's participation in a specific Covered Activity in which a Traumatic Incident occurred while coverage under this policy is in force and a Dependent Child or"Resident"Immediate Family Member, of an Insured Person requires counseling, We will pay the reasonable expense(s) incurred for counseling. Treatment must be prescribed V50004NUFIC-FL 21 VFIS 4192 and monitored by a Physician. We will not pay more than the Family Bereavement and Trauma Counseling Benefit Maximum Amount shown in the Schedule for each Dependent Child or "Resident" Immediate Family Member for any one Covered Activity. "Resident"-means that the Immediate Family Member's domicile is at the home of the Insured Person. A domicile is where the Immediate Family Member's permanent home is located or the place the Immediate Family Member intends to return to after a short-term absence, such as vacation, business assignment, college, military assignment. PART VII. TRANSITION BENEFIT If, while the Insured Person is receiving Total Disability benefits underthis policy, he or she is involuntarily terminated from his or her regular employment and so remains unemployed after his or her Total Disability benefits end under this policy, and the Transition Benefit is indicated in the Schedule,We will pay a weekly Transition Benefit equivalent to the last Total Disability Weekly Amount. We will pay this Transition Benefit as long as the Insured Person remains unemployed up to a maximum of 26 weeks. PART Vill. FELONIOUS ASSAULT BENEFIT If an Insured Person suffers a covered Injury or Illness as a result of a "Felonious Assault" that is directed at the Insured Person while he or she is participating in a Covered Activity, and one or more of the following are payable: Accidental Death Benefit, Accidental Dismemberment and Paralysis Benefit, Vision Impairment Benefit, Injury Permanent Impairment Benefit, Heart Permanent Impairment Benefit, Illness Permanent Impairment Benefit, Cosmetic Disfigurement Resulting from Burns Benefit, or HIV Positive Lump Sum Living Benefit as provided by this policy, and the Felonious Assault Benefit is indicated in the Schedule,We will pay the Felonious Assault Benefit Amount. We will not pay more than the Felonious Assault Benefit Amount shown in the Schedule per Insured Person. "Felonious Assault"will not apply to a Police Officerwhile acting within the scope of his or her employment. "Felonious Assault" -means anywillful or unlawful use of force upon the Insured Person- (1) with the intent to cause bodily injury to the Insured Person; and (2) that results in bodily harm to the Insured Person; and (3) that is a felony or a misdemeanor in the jurisdiction in which it occurs. PART IX. HOMEALTERATION AND VEHICLE MODIFICATION BENEFIT If an Insured Person: (1) suffers an Injury or Illness that is payable under this policy and which results in a permanent and irrevocable loss; (2) did not, prior to the date of the Covered Activity, require alterationsto the home and/or modifications to the vehicle; and (3) as a direct result of such Injury or Illness is now required to make alterations to the home and/or modifications to the vehicle; V50004NUFIC-FL 22 VFIS 4193 We will pay the Home Alteration and Vehicle Modification Benefit for "Home Alteration and Vehicle Modification Expenses" that are incurred within three years after the date of the Injury or Illness,up to the Home Alteration and Vehicle Modification Maximum Amount shown in the Schedule, for all such losses caused by the same Injury or Illness. We will pay any"Home Alteration and Vehicle Modification Expenses" incurred by an Insured Person in excess of benefits paid or payable under any Workers' Compensation act or similar law, no fault automobile insurance plan or similar law, and any Other Valid and Collectible Insurance. "Home Alte ration and Ve hicle M odification Expenses" - means one-time expenses that- (1) are charged for: (a) alterations to the Insured Person's residence that are necessaryto make the residence accessible and habitable for an impaired individual; and (b) modifications to a motor vehicle owned or leased by the Insured Person or modifications to a motor vehicle newly purchased for the Insured Person that are necessary to make the vehicle accessible to and/or drivable by the Insured Person; and (2) do not include charges that would not have been made if no insurance existed; and (3) do not exceed the usual level of charges for similar alterations and modifications in the locality where the expense is incurred; but only if the alterations to the Insured Person's residence and the modifications to his or her motor vehicle are- (1) made on behalf of the Insured Person- (2) in compliance with any applicable laws or requirements for approval by the appropriate government authorities; and (3) agreed to and approved by Us. PART X. OPTIONAL BENEFITS A. WEEKLY HOSPITAL BENEFIT If Weekly Income Benefits are payable under th is policy and the Weekly Hospital Benefit is indicated in the Schedule, We will also pay the Weekly Hospital Benefit shown in the Schedule if the Insured Person eligible to receive the Weekly Income Benefits requires Hospital confinement or Out-Patient Physical Therapy for the same Injury or Illness. The Weekly Hospital Benefit starts on the first day the Insured Person is confined to a Hospital or begins Out-Patient Physical Therapy. If benefits are payable for less than a full week, We will pay 1/7 of the Weekly Hospital Benefit shown in the Schedule for each day the Insured Person is confined in the Hospital or receives Out-Patient Physical Therapy. This benefit will be limited to a maximum of 104 weeks for all Injuries or Illnesses resulting from the same Covered Activity. If the Insured Person is in an intensive, cardiacor critical care unit, the Weekly Hospital Benefit Amount shown in the Schedule is doubled. V50004NUFIC-FL 23 VFIS 4194 B. FIRST WEEK TOTAL DISABILITY BENEFIT If an Insured Person becomes Totally Disabled and is eligible for Total Disability Benefits under this policy and the First Week Total Disability Benefit is indicated in the Schedule, We will pay a one-time additional weekly benefit equal to the First Week Total Disability Benefit Amount shown in the Schedule for the first week the Insured Person is Totally Disabled. If the Insured Person is Totally Disabled for less than one week, We will pay 1/7 of the First Week Total Disability Benefit Amount for each full day of Total Disability. We will pay the First Week Total Disability Benefit Amount in addition to any other weekly benefit payable under this policy. C. COORDINATED 28 DAY TOTAL DISABILITY BENEFIT If an Insured Person becomes Totally Disabled and is eligible for Total Disability Benefits under this policy and the Coordinated 28 Day Total Disability Benefit is indicated in the Schedule,We will pay 100% of the difference between the Insured Person's Average Weekly Wage and the sum of the Total Disability Weekly Amount (first 28 days) payable under this policy and any disability income benefits received by the Insured Person from any Workers' Compensation act or similar law not to exceed the Coordinated 28 Day Total Disability Benefit Maximum Amount shown in the Schedule,foreach week the Insured Person is Totally Disabled. This benefit is payable forthe first 28 days of Total Disability. If the Insured Person is Totally Disabled for less than one week, We will pay 1/7 of the Coordinated 28 Day Total Disability Benefit for each full day of Total Disability. D. EXTENDED TOTAL DISABILITY BENEFIT If an Insured Person is Totally Disabled and the Extended Total Disability Benefit is indicated in the Schedule,We will increase the maximum benefit period as indicated under the Total Disability Benefit from five years (260 weeks)to 10 years(520 weeks). E. LONG-TERM TOTAL DISABILITY BENEFIT If an Insured Person meets the definition of Long-Term Total Disability and the Long-Term Total Disability Benefit is indicated in the Schedule,We will increase the maximum benefit period as indicated under the Extended Total Disability Benefit from 10 years(520 weeks)to age 70. The Long-Term Total Disability Benefit amount payable will be based on the Weekly Income Benefit Amount payable on the 29th day of Total Disability, plus annual compounded increases, offset by any Weekly Injury Permanent Impairment Benefit payable for the same loss. The following paragraph is hereby added under Disability Benefits General as follows: If an Insured Person becomes able to return to their regular occupation or becomes otherwise employed, benefits under Long-Term Total Disability will cease. F. COST OF LIVING ADJUSTMENT(COLA) BENEFITS (1) Weekly Injury Permanent ImpairmentCOLA (2) Long-Term Total Disability COLA If Weekly Injury Permanent Impairment COLA or Long-Term Total Disability COLA Benefit is indicated in the Schedule and the Weekly Injury Permanent Impairment Benefit or the Long-Term Total Disability Benefit becomes payable under this policy, the amount payable will be increased annually after benefits V50004NUFIC-FL 24 VFIS 4195 have been paid for at least 52 consecutive weeks. Any increased benefit will become effective on July 1 , following the first 52 week benefit period. Successive annual increases will be compounded on July 1 of each subsequent year. The increase will equal a minimum of 5% or the percentage increase in the Consumer Price Index for the preceding calendar year,whichever is greater, to a maximum of 10%. G. EXTRA EXPENSE BENEFIT After 26 weeks of an Insured Person's Total Disability due to a covered Injuryor Illness, We will pay the Extra Expense Benefit Monthly Amount shown in the Schedule. This benefit will cease when the Insured Person is no longer Totally Disabled. We will not pay more than the Extra Expense Benefit Maximum Amount shown in the Schedule. If an Insured Person is Totally Disabled for less than a month, We will pay 1/28 of the benefit otherwise payable for each full day the Insured Person is disabled. H. 24-HOUR ACCIDENT BENEFIT—INJURY ONLY 24-Hour Accidental Death Benefit. We will pay the 24—Hour Accident Benefit Amount shown in the Schedule if bodily injury to a Covered Person results in the Covered Person's death. 24-Hour Accidental Dismemberment and Paralysis or Vision Impairment Benefit. In the event of dismemberment, paralysis or vision impairment the amount payable under this benefit will be calculated based on the 24-Hour Accident Benefit Amount indicated in the Schedule and the percentage indicated on the Accidental Dismemberment and Paralysis Chart or the Vision Impairment Chart. We will pay the 24-Hour Accident Benefit Amount, as described above,when a Covered Pe rson suffers a bodily injury at any time,whether during a Covered Activity or not, that results in the Covered Pe rson's accidental death, dismemberment, paralysis or vision impairment. Any 24-Hour Accident Benefit payable is in addition to any Accidental Death Benefit,Accidental Dismemberment and Paralysis Benefit or Vision Impairment Benefit payable underthis policy. In no event will the total amount of benefits payable as a result of any one bodily injury exceed 100%of the largest Benefit Amount for a24-Hour Accidental Death, and/or a 24-Hour Accidental Dismemberment and Paralysis and/or a Vision Impairment. We will not pay more than 100% of the 24-Hour Accident Benefit Amount shown in the Schedule, or the indicated percentage on the Accidental Death, Dismemberment and Paralysis Chart per Covered Person,whichever is greater. In no event will both, a 24-Hour Benefit and an Off-Duty Accident Benefit be provided under this policy. I. OFF-DUTY ACCIDENT BENEFIT - INJURY ONLY Off-Duty Accidental Death Benefit. We will pay the Off-Duty Accident Benefit Amount shown in the Schedule if bodily injury to a Covered Person results in the Covered Person's death. Off-Duty Accidental Dismemberment and Paralysis or Vision Impairment Benefit. In the event of dismemberment, paralysis or vision impairment the amount payable under this benefit will be calculated based on the Off-Duty Accident Benefit Amount indicated in the Schedule and the percentage indicated on the Accidental Dismemberment and Paralysis Chart or the Vision Impairment Chart. V50004NUFIC-FL 25 VFIS 4196 We will pay the Off-Duty Accident Benefit, as described above,when a Covered Person suffers a bodily injury that does not occur during a Covered Activity,that results in the Covered Person's accidental death, dismemberment, paralysis or vision impairment. In no event will the total amount of benefits payable as a result of any one bodily injury exceed 100%of the largest Benefit Amount for an Off-Duty Accidental Death, and/or an Off-Duty Accidental Dismemberment and Paralysis and/or a Vision Impairment. We will not pay more than 100% of the Off-Duty Accident Benefit Amount shown in the Schedule, or the indicated percentage on the Accidental Death, Dismemberment and Paralysis Chart per Covered Person,whichever is greater. In no event will both, an Off-Duty Benefit and a 24-Hour Accident Benefit be provided under this policy. V50004NUFIC-FL 26 VFIS 4197 EXCLUSIONS We will not cover any loss caused by or resulting from: (1) suicide or any attempt at it; or intentionally self-inflicted injuries; (2) injuries that happen while flying except; (a) as a passenger on a commercial aircraft; (b) as a passenger on any aircraft while taking part in a Covered Activity; (3) injuries that happen while flying as a crew member, or during parachute jumps from the aircraft; (4) war or any act of war, whether declared or undeclared; (5) mental or emotional disorders, except as specifically provided for covered Post-Traumatic Stress Disorder; (6) treatment of alcoholism or drug addiction and any complications arising from it, except loss caused by Injury sustained during and resulting from a Covered Activity; (7) illness, except as provided by this policy; (8) military service of any state or country; (9) any form of football, hockey, lacrosse, soccer, boxing, rugby and martial arts; (10) any league sports event, except as covered underthe Organized Team Sports Rider or (11) "Cancer". "Cancer" - means any disease in which abnormal, unregulated cell growth forms malignant tumors and/or invades nearby tissues. This includes: carcinoma, sarcoma, leukemia, lymphoma and multiple myeloma, and central nervous system cancers. OTHER COVERAGE WITH US If the Insured Person is covered under more than one similar policy issued by Us, the total benefits payable will not exceed those payable under the policy which provides the largest benefit. GENERAL PROVISIONS Entire Contract;Changes: The policy,application(s), riders, endorsements, amendments, or other attached papers make up the entire contract between the Policyholder and/or Participating Organization and Us. No change in this policy will be valid until approved by one of Our executive officers. Such approval must be noted on or attached to the policy . No agent may change or waive any of the provisions of the policy. Statements: In the absence of fraud, all statements made by the Policyholder and/or Participating Organization or any Insured Person will be considered representations and not warranties. No statement will be used to void the insurance or reduce benefits unless they appear in a written instrument signed by the Policyholder and/or Participating Organization and unless a copy of the statement is furnished to the Insured Person, his or her beneficiary or personal representative. Incontestability: The validity of this policy will not be contested after it has been in force for two year(s) from the policy Effective Date shown in the Schedule, except as to nonpayment of premiums. Grace Period: This policy has a 31 day grace period. This means if the premium is not paid on or before the date it is due, it may be paid during the following 31 days. During the grace period th is policy will remain in force. V50004NUFIC-FL 27 VFIS 4198 Notice of Claim: Written notice of claim must be given to Us within 30 days after a covered loss occurs, or as soon after as reasonably possible. The notice can be given by or on behalf of the Insured Person to Us at Our executive offices or to one of Our authorized agents with sufficient information to identify the Insured Person,will be deemed notice to Us. Claim Forms: When We receive the written notice of claim, We will send the claimant forms for filing proof of loss. If these forms are not furnished within 15 days after receipt of such notice, the claimant will need to meet the proof of loss requirements by giving Us written proof of the occurrence, the nature, and the extent of the loss within the time limit stated in the "Proof of Loss" Section. The notice should include the Insured Person's name, the Policyholder and/or Participating Organization's name, and the Policy Number. Proof of Loss: Proof must be given as soon as reasonably possible. If this policy provides for periodic payment for a continuing loss, We must be given written proof within 90 days after the end of each period for which We are liable. For any other loss, We must be given written proof within 90 days after that loss. If it was not reasonably possible to give written proof in the time required, We will not reduce or deny the claim forth is reason, if the proof is filed as soon as reasonably possible. Time of Payment of Claims: When We receive written proof of loss, We will pay any benefits due. Benefits that provide for periodic payment will be paid at least monthly. When Our liability ends, We will pay any remaining balance as soon as We receive written proof of loss. Payment of Claims: Any Loss of Life Benefitwill be paid in accordance with the beneficiary designation on record with Us or the Policyholder and/or Participating Organization. If no beneficiary is named, Loss of Life Benefits will be paid to the first surviving class of the following classes: the Insured Person's (1) spouse; (2)child(ren); (3) parents; or(4) brothers or sisters. Otherwise, We wil I pay benefits to the Insured Person's estate. All other benefits are payable to the Insured Person, unless otherwise indicated in this policy. We may pay all or a part of any benefits for health care services directly to the provider. We cannot require that the service be given by a certain provider. If the Policyholder and/or Participating Organization requests, We may(at Our option)pay benefits to the Policyholder and/or Participating Organization. The Policyholder and/or Participating Organization will then pay the Insured Person or beneficiary entitled to receive the benefits. Any payment We make in good faith will end Our liability to the extent of the payment. Physical Examination and Autopsy: We, at Our expense, have the right to have the Insured Person examined as often as reasonably necessarywhile a claim is pending under this policy. We may also have an autopsy performed unless prohibited by law. Legal Actions: No legal action may be brought to recover on th is policy within 60 days after written proof of loss has been given as required by this policy. No such action may be brought after expiration of the applicable statute of limitations from the time written proof of loss is required to be given. Change of Beneficiary: The Insured Person can change the beneficiary at anytime by sending a written notice to the Policyholder and/or Participating Organization. The beneficiary's consent is not required for this or any other change in this policy, unless the designation of the beneficiary is irrevocable. V50004NUFIC-FL 28 VFIS 4199 Conformity with State Statutes: Any provision of this policy,which, on its effective date, is in conflict with the laws of the state in which the Insured Person resides on that date, is amended to conform to the minimum requirements of such laws. Clerical Error: The insurance of any Insured Person will not be affected by a clerical error made by the Policyholder and/or Participating Organization or Us. An error will not continue the insurance of an Insured Pe rson beyond the date it would end under the policy terms if the error had not been m ade. Examination and Audit: We will be permitted to examine and audit a Policyholder and/or Participating Organization's records relating to this policy at: (1) any reasonable time during the policy term; and (2)within two years after the expiration of the policy or until all claims have been settled or adjusted,whichever is later. New Entrants: New eligible persons added from time to time to the group of Insured Persons originally insured under this plan will be automatically covered under th is policy. Dutyto Cooperate: The Policyholder, Participating Organization and the Insured Person will cooperate with Us and assist Us, as We request, in the investigation of any claim reported under th is policy. Neither the Policyholder,Participating Organization nor the Insured Person will voluntarily make payments, assume obligations, or incur expenses, except at the cost of the Policyholder, Participating Organization or the Insured Person. Not In Lieu Of Workers' Compensation: This policy is not a Workers' Compensation policy. It does not provide Workers' Compensation Benefits. Noncompliance with Policy Requirements: Any express waiver by Us of any requirements of this policy will not constitute a continuing waiver of such requirements. Any failure by Us to insist upon compliance with any policy provision will not operate as a waiver or amendment of that provision. Misstatement of Age: If the benefits for which the Insured Person is insured are based on age and the Insured Person has misstated his or her age,there will be an adjustment of said benefit based on his or her true age. We may require satisfactory proof of age before paying any claim. Assignment: This policy is non-assignable. An Insured Person may not assign any of his or her rights, privileges or benefits under this policy. V50004NUFIC-FL 29 VFIS 4200 I ittsburgh., PaI. National Union, fire Insurance Company of N AchrrcnislrqaNvo 011,Fpco 0271 Ave of 6e Anwica%Ft 37 1 t4o,,wv Yf�x+, NY 10,020 � 212,458,50010 (0 ir,,rIPOO�v)ock compamy, harie n iraferrrved Io cis thok Cotnprvlyk Policyholder- KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Policy Number- VFP-4310-7210E-6 Effective Date- 10/11/2023 For inquiries, information about coverage or for assistance in resolving complaints, contact: National Union Fire Insurance Company of Pittsburgh,Pa.: 1-800-551-0824. CAREER PERSONNEL RIDER This rider is attached to and made apart of the above mentioned policy. It applies only with respect to Injuries or Illnesses that occur on or after the effective date shown above. Any changes in premium apply as of the effective date of this rider. This rider is subject to all of the provisions, benefits, limitations and exclusions of the policy except as they are specifically modified by this rider. If there is a conflict between the policy and this rider, the terms of this rider will govern. This rider amends the policy in the following manner: 1. The Schedule is amended to extend the following benefits to Paid Employees as indicated below- V. Weekly Injury Permanent Impairment Benefit...............................................E]Yes ®No V1111. Transition Benefit.........................................................................................E]Yes ®No X. Optional Benefits D. Extended Total Disability Benefit ................................................................E]Yes ER No E. Long-Term Total Disability Benefit...............................................................E]Yes [Z No F. Cost Of Living Adjustment(COLA) Benefits (1)Weekly Injury Permanent Impairment COLA..........................................E]Yes ER No (2)Long-Term Total Disability COLA..........................................................E]Yes [Z No G. Extra Expense Benefit Extra Expense Benefit Monthly Amount.................................................................. NONE Extra Expense Maximum Amount........................................................................... NONE 2. The DEFINITIONS section is modified as follows: The definition of Insured Pe rson(s) is amended to include those Paid Employees of the Policyholder that is primarily staffed by volunteers. 3. In no event will coverage provided to such Insured Persons by way of this rider be in lieu of any Workers' Compensation actor similar law. The President and Secretary of National Union Fire Insurance Company of Pittsburgh, Pa. witness this rider: President Secretary V50007NUFIC-FL 1 VFIS 4201 1� Naltional Union, Fire Insurance Complany of Pittsburgh, Pa. Admi6orcfNvv Officc 12,71 Ave of 6*Arv�ericas,,Ft 37 1 Ns"v'Yc,,rk',P,VY 10020 � MA58,5000 (0 oi"'IPOO %Iock comp"amy"lu'"Ma (n the, C-c"WIJwWWY) Policyholder- KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Policy Number- VFP-4310-7210E-6 Effective Date- 10/11/2023 For inquiries, information about coverage or for assistance in resolving complaints, contact: National Union Fire Insurance Company of Pittsburgh.Pa.: 1-800-551-0824. MANDATORY QUARANTINE RIDER This rider is attached to and made apart of the above mentioned policy. It applies only with respect to Injuries or Illnesses that occur on or after the effective date shown above. Any changes in premium apply as of the effective date of this rider. This rider is subject to all of the provisions, benefits, limitations and exclusions of the policy except as they are specifically modified by this rider. If there is a conflict between the policy and this rider, the terms of this rider will govern. This rider amends the policy in the following manner. 1. The DEFINITIONS section is modified as follows: The following is added to the definition of Illness: (3) Illness also includes the Mandatory Quarantine of an Insured Person. The following definition is added: Mandatory Quarantine - means period of isolation intended to limit the spread of an Infectious Disease. The Mandatory Quarantine of an Insured Person must be ordered by appropriate medical officials while acting under the authority of the local, state or federal government. The President and Secretary of National Union Fire Insurance Company of Pittsburgh, Pa. witness this rider: President Secretary V50036NUFIC-FL 1 VFIS 4202 NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBUIRGH, PA. Executive Offices: 175 Water Street, 15" Floor, New York, NY 10038 (212) 458-5000 (a capital stock company, herein referred to as the Company) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement, effective 12:01 AM. 10/1/2023 forms a part of Policy No. VFP-4310-7210E_6 issued to KEYLARGO VOLUNTEER FIRE DEPARTMENT,INC by National Union Fire Insurance Company of Pittsburgh, PA COVERAGE TERRITORY ENDORSEMENT This endorsement modifies insurance provided under the following: Payment of loss under this policy shall only be made in full compliance with all United States of America economic or trade sanction laws or regulations, including, but not limited to, sanctions, laws and regulations administered and enforced by the U.S. Treasury Department's Office of Foreign Assets Control("OFAC"). 004 44* President Secretary 89644 (7-05) 4203 IMPORTANT NOTICE TO OUR CUSTOMERS REGARDING THE OFFICE OF FOREIGN ASSETS CONTROL ("OFAC") Your rights as a policyholder and payments to you, any insured, additional insured, loss payee, mortgagee, or claimant,for loss under this policy may be affected by the administration and enforcement of U.S. economic embargoes and trade sanctions by the OFFICE OF FOREIGN ASSETS CONTROL ("OFAC). The United States imposes economic sanctions against countries, groups and individuals, such as terrorists and narcotics traffickers. These sanctions prohibit US persons from dealing with these sanctioned parties. The purpose of this notice is to inform youthatwe cannotviolate US sanctions by engaging with sanctioned countries or people. WHAT IS OFAC? OFAC is an office of the Department of the Treasury and acts under presidential wartime and national emergency powers, as well as authority granted by specific legislation,to impose controls on transactions and freeze foreign assets under U.S.jurisdiction. OFAC administers and enforces economic embargoes and trade sanctions primarily against: • Targeted foreign countries and their agents • Terrorism sponsoring agencies and organizations • International narcotics traffickers • Proliferators of Weapons of Mass Destruction PROHIBITED ACTIVITY • OFAC enforces certain embargoes and sanctions against designated countries. No U.S. business or person may enter into transactions involving designated "sanctioned" countries. • OFAC publishes on its website a list known as the"Specially Designated Nationals and Blocked Persons" ("SDNBP")list. No U.S. business or person may enter into transactions involving any person or entity named on the SDNBP list. Additional information about OFAC Sanctions Programs and Countries can be found at: hope//www.treasu rv.gov/resource-center/sanctions/Programs/Pa es/Programs.aspx OBLIGATIONS PLACED ON US BY OFAC If we determine that you or any insured, additional insured, loss payee, mortgagee, or claimant are on the SDNBP list or are connected to a sanctioned country as described in the regulations, we must block or "freeze" property and payment of any funds transfers or transactions. POTENTIAL ACTIONS BY US 1. We shall not be deemed to provide cover when it would violate any applicable sanction, prohi bition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations ofthe European Union or the United States of America. You will not receive a return premium unless approved by OFAC. All funds will be placed in an interest bearing blocked account established on the books of a U.S. financial institution. 2. We will not pay a claim or provide any benefit to the extent that such cover, payment ofsuch claim or provision of such benefit would violate any trade or economic sanctions, laws or regulations of the United States of America and we will not defend or provide any other benefits under your policy to individuals, entities or companies to the extent that it would violate any trade or economic sanctions, laws or regulations of the United States of America. YOUR RIGHTS AS A POLICYHOLDER If funds are blocked or frozen by us in conjunction with the OFFICE OF FOREIGN ASSETS CO NTRO L, you may complete an "APPLICATION FOR THE RELEASE OF BLOCKED FUNDS" and apply for a specific license to request their release. Forms are available for download at the OFAC website.See hops://www.tre�sury.�r�v/resr�urce-center/s�nctir�ns/Pees/farms-index.�spx Edition Date:5/2016 4204 POLICYHOLDER NOTICE Thank you for purchasing insurance from a member company of American International Group, Inc. (AIG). The AIG member companies generally pay compensation to brokers and independent agents, and may have paid compensation in connection with your policy. You can review and obtain information about the nature and range of compensation paid by AIG member companies to brokers and independent agents in the United States by visiting our website at www.aig.com/producer-compensation or by calling 1-800-706- 3102. 91222 (9/16) 4205 W 0 N d' Portfolio of Coverage Especially Designed For: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC 1 EAST DRIVE KEY LARGO, FL 33037-0000 i *4 ov :)if F I SO Underwritten by National Union Fire Insurance Company of Pittsburgh, PA. VPJ100(01-20) rPek, 46,,)� V F I SOD National Union Fire Insurance Company of Pittsburgh, PA. RISK CONTROL POLICYHOLDER NOTICE Dear VFIS Client, Safety and health is a major concern in emergency service organizations today. These issues are important because of the major impact that accidents can have on an organization. Morale can often be affected as well as an organization's finances, Insurance rarely covers all the expenses associated with accidents. There are often hidden costs that the organization must bear such as time spent reporting, documenting and investigating the accident, time spent training the replacement staff and time to replace the vehicles and equipment. Risk Control Guidelines Provided by VFIS As a valuable service to you, VFIS provides risk control guidelines and programs to your organization in an effort to help you prevent and/or reduce the impact of accidents. Implementing VFIS risk control measures could benefit your organization by reducing or eliminating the hidden costs of accidents while helping your organization to continue to serve your community. VFIS provides a number of programs and services to help you in your risk control effort. While most of these services are available to our clients at no additional cost, some may require a fee based on the scope of the service requested. Some of the services and programs that we provide to our clients include: • On-site risk control consultations • Recommendations to control identifiable hazards • Loss experience analysis • Consultation on specific risk control-related problems • Sample standard operating guidelines for vehicle operations • Accident investigation procedures and forms • Health and Safety Audit of NFPA 1500 Risk Control Publications VFIS has many resources that you can access at no charge on our Web site. These include Communiqu6s,which are a one-page fact sheet,that presents a specific hazard and provides procedures for controlling the hazard. VFIS also provides numerous training programs that you can access through the Client Education and Training Resource Catalog. Please visit www.vfis.com to view and order these resources. Inquire About Our Risk Control Services If you would like information about some of the above services and publications, please call VFIS Client Risk Solutions at (800) 233-1957. p VPJ100(01-20) N 0 4 00 0 N d' National Union Fire Insurance Company of Pittsburgh, Pa. (o capitol stock company) Administrative Office:1271 Ave of the Americas,FL 37 New York,NY 10020 1212 458.5000 )VF1S Administered by.- r46, * VFIS 1183 leader Heights Road'York,PA 17402 800 233.1957 I vfis.com COMMON POLICY DECLARATIONS Named Insured and Mailing Address. KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC 1 EAST DRIVE KEY LARGO, FL 33037-0000 Policy Number. VFN U-TR-0019768-03/000 Policy Period-. From 10-01-2023 To 10-01-2024 12:01 AM Standard Time at your mailing address shown above. Type of Entity: CORPORATION Business Description: EMERGENCY SERVICE ORGANIZATION This policy consists of the following coverage parts: Premium Property $46,4%00 Crime $166,00 Portable Equipment $1,246.00 Auto $13,966.00 General Liability $2,1%00 Management Liability $4,085.00 Excess Liability $1,900.00 Taxes/Fees/Surcharges:: $1,010.05 Estimated Total Premium;: $70,982.05 The policy premium is payable on the dates and in the amounts shown below: See Installment Schedule. TR1000(01-20) 10-03-2023 Named Insured: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Policy Number: Policy Period: From 10-01-2023 VFN U-TR-00 19768-03/000 To 10-01-2024 COMMON FORMS See Schedule of Forms and Endorsements. In return for payment of the premium,, and subject to all the terms of this policy,we agree with you to provide the insurance as stated in the policy. The policy consists of the coverage parts where a premium is shown on page 1 of these Common Policy Declarations. In addition to any common forms, each coverage part consists of a Coverage Part Declarations and any coverage forms and endorsements listed on the Coverage Part Declarations or elsewhere in the policy. 10-03-2023 Authorized representative (countersignature,where required) Date The Company has caused this policy to be signed by its President and Secretary r1�„ . 1 .004 40* President Secretary TR1000(01 20) 10-03 2023 P N O O 0 N d' FLORIDA ADDENDUM TO THE DECLARATIONS If you have questions about your insurance policy, or questions about claims relating to your insurance policy, please contact our insurer at the following: AIG 1271 Ave of the Americas FL 37 New York, NY 10020-1304 (212) 458-5000 74825 (01/22) Policy Number VFN U-T R-0019768-03/000 SCHEDULE OF FORMS AND ENDORSEMENTS Named Insured KEY LARGO VOLUNTEER FIRE Effective Date: 10-01-23 DEPARTMENT, INC 12:01 A.M., Standard Time Agency Name V F I S COMMON POLICY FORMS AND ENDORSEMENTS 89644 06-13 ECONOMIC SANCTIONS ENDORSEMENT VC0300 01-20 COMMON POLICY CONDITIONS CG 21 70 01-15 CAP ON LOSSES FROM CERTIFIED ACTS OF TER IL 00 21 09-08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDT IL 09 52 01-15 CAP ON LOSSES FROM CERT ACTS/TERRORISM VCOFL1 01-20 FLORIDA CHANGES -CANCELLATION AND NONREN VCOFL2 01-20 FLORIDA CHANGES -LEGAL ACTION AGAINST US PROPERTY FORMS AND ENDORSEMENTS VPR101 01-20 ESO PROPERTY COVERAGE FORM VPR312 01-20 WIND/HAIL/FLOOD PERCENT DED-NAMED STORMS VPR314 01-20 LIMITATION OF ORDINANCE COVERAGE - WINDS VPR319 01-20 CRISIS INCIDENT RESPONSE COVERAGE VPR322 01-20 AMENDATORY ENDORSEMENT VPRFL1 07-22 FLORIDA CHANGES CRIME FORMS AND ENDORSEMENTS VCRI05 01-20 EMPLOYEE DISHONESTY COVERAGE FORM (COVER VCR 00 01-20 CRIME GENERAL PROVISIONS VCR109 01-20 ADDITIONAL COVERAGES COMPUTER AND FUNDS VCR110 01-20 IDENTITY FRAUD EXPENSE COVERAGE FORM PORTABLE EQUIPMENT FORMS AND ENDORSEMENTS CP 00 90 07-88 COMMERCIAL PROPERTY CONDITIONS PE1001 01-20 EMERGENCY SERVICE ORGANIZATION PORTABLE PE1003 01-20 WATERCRAFT EXTENSION PE1009 01-20 AMENDATORY ENDORSEMENT PORTABLE EQUIPMEN PE1012 01-20 UNMANNED AIRCRAFT EXTENSION PEFLO1 10-23 FLORIDA CHANGES AUTOMOBILE FORMS AND ENDORSEMENTS AU1001 01-20 AUTO PHYSICAL DAMAGE EXTENSION ENDORSEME AU1002 01-20 AGREED VALUE ENDORSEMENT AU1005 01-20 WAIVER OF GOVERNMENTAL OR CHARITABLE IMM AU1006 01-20 CARE, CUSTODY OR CONTROL EXCLUSION ENDOR AU1007 01-20 COMMANDEERED AUTO DEFINITION ENDORSEMENT AU1009 01-20 INCIDENTAL GARAGE OPERATIONS AU1017 01-20 AUTO PHYSICAL DAMAGE EXTENSION ENDORSEME AU1023 01-20 AUTO LIABILITY EXTENSION ENDORSEMENT EME CA 00 01 10-13 BUSINESS AUTO COVERAGE FORM CA 01 28 01-21 FLORIDA CHANGES CA 02 67 01-21 FL C14ANGES -® CANCELLATION AND NONRENEWAL CA 21 72 06-17 FL UNINSURED MOTORISTS COV -- NON STACKED CA 22 10 01-21 FL PERSONAL INJURY PROTECTION CA 20 02 10-13 SOUND RECEIVING EQUIP COVG -FIRE, POLICE CA 20 18 10-13 PROFESSIONAL SERVICES NOT COVERED CA 99 03 10-13 AUTO MEDICAL PAYMENTS COVERAGE CA 99 48 10-13 POLLUTION LIAR BROAD COV FOR COV AUTO GENERAL LIABILITY FORMS AND ENDORSEMENTS VGL101 01-20 EMERGENCY SERVICE ORGANIZATION GENERAL L VGL212 01-20 EXCLUSION ELECTRONIC INFORMATION SECURIT I7GL213 03-21 AMENDMENT TO POLLUTION EXCLUSION N T_ N d' Policy 9768-03/000 SCHEDULE OF FORMS AND ENDORSEMENTS Named Insured KEY LARGO VOLUNTEER FIRE Effective Date: 10-01-23 DEPARTMENT, INC 1 :01 A.M., Standard Time Agency Name VFIS VGL317 01-20 LINE OF DUTY ACCIDENTAL DEATH BENEFITS VGL320 01-20 UNMANNED AIRCRAFT COVERAGE VGLFLI 01-20 FLORIDA CHANGES GGL330 01-20 MOBILE EQUIPMENT SUBJECT TO MOTOR VEHICL MANAGEMENT LIABILITY FORMS AND ENDORSEMENTS VL101 01-20 EMERGENCY SERVICE ORGANIZATION MANAGEMEN VL306 01-20 CYBER LIABILITY AND PRIVACY CRISIS MANAG VL310 01-20 AMENDATORY ENDORSEMENT MANAGEMENT LIAB EXCESS FORMS AND ENDORSEMENTS CX0001 04-13 COMMERCIAL EXCESS LIABILITY COVRG FORM CX0209 03-12 FL CHANGES - CANCELLATION AND NONRENEAL CX2101 09-08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDO CX2700 12-19 UNDERLYING CLAIMS-MADE COVERAGE CXE0112 01-20 PER LOCATION AGGREGATE LIMIT OF INSURANC CXE0172 01-20 FIREWORKS OR PYROTECHNICS EXCLUSION CXE0279 01-20 SUBLIMITED COVERAGES ENDORSEMENT CXE0286 01-20 ERISA EXCLUSION CXE0328 01-20 PRODUCTS-COMPLETED OPERATIONS AGGREGATE CXEFL1101 01-20 FLORIDA FUNGI OR BACTERIA EXCLUSION CXEG0287 01-20 EMERGENCY SERVICE ORGANIZATION AMENDATOR CXEG0297 01-20 OTHER VALID AND COLLECTIBLE INSURANCE AM CXEG0329 01-20 UNMANNED AIRCRAFT LIABILITY COVERAGE SUB CX2130 01-15 CAP ON LOSSES FROM CERTFD ACTS OF TERROR POLICYHOLDER NOTICES 118477 03-15 POLICYHOLDER NOTICE - TAXES, ASSESSMENTS 91222 09-16 POLICYHOLDER NOTICE AGLC105774 01-22 AIG PRIVACY NOTICE Policy Number V F N U-T R-0019768-03/000 INSTALLMENT SCHEDULE Named Insured KEY LARGO VOLUNTEER FIRE DEPARTMENT, Effective Date: 10-01-23 INC 12:01 A.M., Standard Time Agency Name VFIS IT IS HEREBY AGREED AND UNDERSTOOD THAT THIS POLICY IS PAYABLE ON INSTALLMENTS AS FOLLOWS: DUE PREMIUM SURCHARGE REVISED INSTALLMENT TOTAL DEPOSIT 10/01/2023 $69,972 00 $1,010.05 $70,982.05 Failure to pay the Installment Premium by the Date Due shown shall constitute non-payment of premium for which we may cancel this policy. .p N w d N d' ENDORSEMENT This endorsement, effective 12:01 A.M. forms a part of policy No. VFNU-TR-0019768-03/000 issued to KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC By AMERICAN INTERNATIONAL GROUP, INC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ECONOMIC SANCTIONS ENDORSEMENT This endorsement modes insurance provid ed underthe following: ALL COVERAGE PARTS The Insurer shall not be deemed to provide cover and the Insurer shall not be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover; payment of such claim or provision of such benefit would expose the Insurer, its parent company or its ultimate controlling entity to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union or the United States of America. AUTHORIZED REPRESENTATIVE 89644(6/13) Policy Number VFN U-TR-0019768-03/000 SCHEDULE OF TAXES,SURCHARGES OR FEES Named Insured KEY LARGO VOLUNTEER FIRE DEPARTMENT, Effective Date: 10-01-2023 INC 12:01 A.M., Standard Time Agency Name V F I TAXES / SURCHARGES DETAILED BREAKDOWN FL-INSURANCE REMIUM SURCHARGE $ 4 . 00 FL-ADDL 2022 FICA Assessment Surcharge $ 560. 06 FL-2023 FICA Assessment Surcharge $ 392 . 04 FL - Commercial Property Surcharge $ 53 . 95 --------------------- TOTAL TAXES / SURCHARGES $ 1, 010. 05 N to ct, N d' COMMON POLICY CONDITIONS All coverage parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. 30 days before the effective date of cancellation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. a. Notice of cancellation will state the effective date of cancellation The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be sufficient proof of notice. 7. If this Condition conflicts with your state's requirements regarding cancellation or non-renewal, the provisions of any state-specific form attached to this policy will supersede this Condition to the extent of such conflict. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination of Your Books and Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections and Surveys 1. We have the right to: a. Make inspections and surveys at any time; b. Give you reports on the conditions we find; and c. Recommend changes. VC0300 (01-20) Copyright,American International Group,Inc_2019.. Page 1 of 2 COMMON All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. 2. We are not obligated to make any inspections, surveys„ reports or recommendations and any such actions we do undertake rebate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public, And we do not warrant that conditions a. Are safe or healthful-,or b. Comply with laws, regulations,codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us,„ but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations on our behalf. 4. Paragraph 2, of this condition does not apply to any inspections, surveys, reports or recommendations we may make relative to certification, under state or municipal statutes, ordinances or regulations,of boilers, pressure vessels or elevators. E. Liberalization If we revise any coverage included in this policy„ and if such revision does not require a premium charge, your policy will automatically provide the additional coverage as of the date the revision is effective in your state. F. Premiums The first Named Insured shown in the Declarations;. 1. Is responsible for the payment of all premiums-I and 2. Will be the payee for any return premiums we pay, G. Titles Throughout this policy, tithes are intended for ease of reference only, They do not extend or restrict any coverage beyond what is specifically stated in the policy had no titles been used.. H. Transfer of Your Rights and Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent. VC0300 (01-20) Copyright,American International Group,Inc,,,2019, Page 2 of 2 COMMON All rights reserved..Includes copyrighted material of the Insurance Servaces Office;,Inc.,with its permission P IV 00 T- N d' COMMERCIAL GENERAL LIABILITY CG 2170 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 GENERAL LIABILITY COVERAGE PART GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART HOSPICE AND HOME HEALTH CARE LIABILITY COVERAGE PART HOSPICE AND HOME HEALTH CARE NOT FOR PROFIT ORGANIZATION DIRECTORS AND OFFICERS LIABILITY POLICY LIABILITY COVERAGE PART MANAGEMENT LIABILITY COVERAGE PART PUBLIC OFFICIALS AND MANAGEMENT LIABILITY COVERAGE PART EDUCATORS LEGAL LIABILITY COVERAGE PART HEALTHCARE PROFESSIONAL LIABILITY AND HEALTHCARE GENERAL LIABILITY RELIGIOUS ORGANIZATION MANAGEMENT LIABILITY COVERAGE PART RELIGIOUS ORGANIZATION MANAGEMENT LIABILITY COVERAGE PART(CLAIMS MADE) A. If aggregate insured losses attributable to terrorist 2. The act is a violent act or an act that is acts certified under the federal Terrorism Risk dangerous to human life, property or Insurance Act exceed $100 billion in a calendar infrastructure and is committed by an individual year and we have met our insurer deductible or individuals as part of an effort to coerce the under the Terrorism Risk Insurance Act, we shall civilian population of the United States or to not be liable for the payment of any portion of the influence the policy or affect the conduct of the amount of such losses that exceeds $100 billion, United States Government by coercion. and in such case insured losses up to that amount B. The terms and limitations of any terrorism are subject to pro rata allocation in accordance exclusion, or the inapplicability or omission of a with procedures established by the Secretary of terrorism exclusion, do not serve to create the Treasury. coverage for injury or damage that is otherwise "Certified act of terrorism" means an act that is excluded under this Coverage Part. certified by the Secretary of the Treasury, in accordance with the provisions of the federal Terrorism Risk Insurance Act, to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a"certified act of terrorism"include the following: 1. The act resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act;and CG 2170 0115 C)Insurance Services Office, Inc.,2015 Page 1 of 1 IL00210908 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (Broad Form) This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply: C. Under any Liability Coverage, to "bodily injury" A Under any Liability Coverage, to "bodily injury" or"property damage"resulting from"hazardous or"property damage": properties"of"nuclear material", if: (1) With respect to which an "insured" under (1) The 'nuclear material" (a) is at any "nuclear the policy is also an insured under a nu- facility" owned by, or operated by or on be- clear energy liability policy issued by Nu- half of, an 'Insured" or (b) has been dis- clear Energy Liability Insurance Association, charged or dispersed therefrom; Mutual Atomic Energy Liability Underwrit- (2) The 'nuclear material"is contained in "spent ers, Nuclear Insurance Association of Can- fuel"or 'Waste" at any time possessed, han- ada or any of their successors, or would be dled, used, processed, stored, transported an insured under any such policy but for its or disposed of, by or on behalf of an 'In- termination upon exhaustion of its limit of li- sured"; or ability; or (3) The "bodily injury" or "property damage" (2) Resulting from the "hazardous properties" arises out of the furnishing by an 'insured" of 'nuclear material" and with respect to of services, materials, parts or equipment in which (a) any person or organization is re- connection with the planning, construction, quired to maintain financial protection pur- maintenance, operation or use of any 'nu- suant to the Atomic Energy Act of 1954, or clear facility", but if such facility is located any law amendatory thereof, or (b) the'In- within the United States of America, its terri- sured"is, or had this policy not been issued tories or possessions or Canada, this ex- would be, entitled to indemnity from the clusion (3) applies only to "property dam- United States of America, or any agency age" to such "nuclear facility" and any thereof, under any agreement entered into property thereat. by the United States of America, or any 2. As used in this endorsement: agency thereof, with any person or organi- zation. "Hazardous properties" includes radioactive, toxic or explosive properties. B. Under any Medical Payments coverage, to expenses incurred with respect to 'bodily in- "Nuclear material"means ''source material", "special jury" resulting from the 'Hazardous properties" nuclear material"or"by-product material". of 'nuclear material" and arising out of the op- eration of a "nuclear facility" by any person or organization. IL 00 2109 08 ®ISO Properties, Inc., 2007 Page 1 of 2 N W 0 N N d' "Source material", ''special nuclear material", and (c) Any equipment or device used for the proc- "by-product material" have the meanings given essing, fabricating or alloying of "special them in the Atomic Energy Act of 1954 or in any nuclear material" if at any time the total law amendatory thereof. amount of such material in the custody of "Spent fuel" means any fuel element or fuel com- the 'Insured" at the premises where such ponent, solid or liquid, which has been used or equipment or device is located consists of exposed to radiation in a"nuclear reactor". or contains more than 25 grams of pluto- nium or uranium 233 or any combination 'Waste' means any waste material (a) containing thereof, or more than 250 grams of uranium 'by-product material" other than the tailings or 235; wastes produced by the extraction or concentra- (d) Any structure, basin, excavation, premises tion of uranium or thorium from any ore processed primarily for its "source material" content, and (b) or place prepared or used for the storage or resulting from the operation by any person or or- ganizationof'Waste",of any "nuclear facility" included under and includes the site on which any of the forego- the first two paragraphs of the definition of "nu- ing is located, all operations conducted on such clear facility". site and all premises used for such operations. 'Nuclear facility"means: "Nuclear reactor" means any apparatus designed (a) Any"nuclear reactor"; or used to sustain nuclear fission in a self- supporting chain reaction or to contain a critical (b) Any equipment or device designed or used mass of fissionable material. for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing "Property damage"includes all forms of radioactive "spent fuel", or (3) handling, processing or contamination of property. packaging 'Waste"; Page 2 of 2 0 ISO Properties, Inc., 2007 IL 00 2109 08 0 IL 09 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: BOILER AND MACHINERY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART STANDARD PROPERTY POLICY INLAND MARINE COVERAGE PART PROPERTY COVERAGE PART PORTABLE EQUIPMENT COVERAGE PART A. Cap On Certified Terrorism Losses If aggregate insured losses attributable to terrorist "'Certified act of terrorism" means an act that is acts certified under the Terrorism Risk Insurance certified by the Secretary of the Treasury,,, in Act exceed $100 billlion in a calendar year and we accordance with the provisions of the federal have met our insurer deductible under the Terrorism Risk Insurance Act, to be an act of Terrorism Risk Insurance Act,, we shall not be terrorism pursuant to such Act. The criteria iliablNe for the payment of any portion of the amount contained in the Terrorism Risk Insurance Act for of such losses that exceeds $100 billion, and in a "certified act of terrorism" include the following: such case insured losses up to that amount are subject to pro rata allocation in accordance with 1. The act resulted in insured losses in excess of procedures established by the Secretary of the $5 million in the aggregate, attributable to alll Treasury. types of insurance subject to the Terrorism Risk Insurance Act; and B. Application Of Exclusions 2. The act is a violent act or an act that its The terms and limitations of any terrorism dangerous to human life„ property or exclusion, or the inapplicability or omission of a infrastructure and is committed by an individual terrorism excllusion, do not serve to create or individuals as part of an effort to coerce the coverage for any (loss which would otherwise be civilian population of the United States or to excluded under this Coverage Part or Policy, such influence the policy or affect the conduct of the as losses excluded by the Nucllear Hazard United States Government by coercion. Exclusion or the War And Military Action Exclusion. IL 09 52 01 15 0,Insurance Services Office, Inc,, 2015 Page i of 1 N N N N N d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CRIME COVERAGE PART GENERAL LIABILITY COVERAGE PART INLAND MARINE COVERAGE PART MANAGEMENT LIABILITY COVERAGE PART PORTABLE EQUIPMENT COVERAGE PART PROPERTY COVERAGE PART A. Paragraph 2.of the Cancellation Common Policy Condition is replaced by the following 2. Cancellation of Policies In Effect 90 Days or Less a. If this policy has been in effect for 90 days or less, we may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation, accompanied by the specific reasons for cancellation, at least: (1) 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or (2) 20 days before the effective date of cancellation if we cancel for any other reason„ except we may cancel immediately if there has been: (a) A material misstatement or misrepresentation; or (b) A failure to comply with underwriting requirements established by the insurer. b,. We may not cancel: (1) On the basis of property insurance claims that are the result of an act of God, unless we can demonstrate, by claims frequency or otherwise, that you have failed to take action reasonably necessary as requested by us to prevent recurrence of damage to the insured property; or (2) Solely on the basis of a single property insurance claim which is the result of water damage, unless we can demonstrate that you have failed to take action reasonably requested by us to prevent a future similar occurrence of damage to the insured property. B. Paragraph 5.of the Cancellation Common Policy Condition is replaced by the following: S. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. If the return premium is not refunded with the notice of cancellation or when this policy is returned to us, we will mail the refund within 15 working days after the date cancellation takes effect, unless this is an audit policy. If this is an audit policy, then, subject to your full cooperation with us or our agent in securing the necessary data for audit, we will return any premium refund due within 90 days of the date cancellation takes effect. If our audit is not completed within this time limitation, then we shall accept your own audit, and any premium refund due shall be mailed within 10 working days of receipt of your audit.. The cancellation will be effective even if we have not made or offered a refund. VCOFLI (01-20) Copyright,American International Group,Inc.,2019. Page 1 of 3 COMMON All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. C. The following is added to the Cancellation Common Policy Condition., 7. Cancellation of Policies In Effect for More Than 90 Days a. If this policy has been in effect for more than 90 days, we may cancel this policy only for one or more of the following reasons; (1) Nonpayment of premium; (2) The policy was obtained by a material misstatement; (3) In the event of failure to comply, within 90 days after the effective date of coverage„ with underwriting requirements established by us before the effective date of coverage; (4) There has been a substantial change in the risk covered by the policy; (5) The cancellation is for all insureds under such policies for a given class of insureds; (6) On the basis of property insurance claims that are the result of an act of God, if we can demonstrate, by claims frequency or otherwise, that you have failed to take action reasonably necessary as requested by us to prevent recurrence of damage to the insured property; (7) On the basis of a single property insurance claim which is the result of water damage, if we can demonstrate that you have failed to take action reasonably requested by us to prevent a future similar occurrence of damage to the insured property; or (8) The cancellation of some or all of our policies is necessary to protect the best interests of the public or policyholders and such cancellation is approved by the Florida Office of Insurance Regulation, b. If we cancel this policy for any of these reasons„ we will mail or deliver to the first Named Insured written notice of cancellation, accompanied by the specific reasons for cancellation, at least. (1) 10 days before the effective date of cancellation if cancellation is for nonpayment of premium; (2) 45 days before the effective date of cancellation if: (a) Cancellation is for one or more of the reasons stated in 7.a.(2) through 7.a.(7) above; and this policy does not cover a residential structure or its contents;, or (b) Cancellation is based on the reason stated in Paragraph 7.a.(8)above; (3) 120 days before the effective date of cancellation if: (a) Cancellation is for one or more of the reasons stated in Paragraphs 7.a.(2) through 7.a.(7)above; and (b) This policy covers a residential structure or its contents. c. If thus policy has been in effect for more than 90 days and covers a residential structure or its contents, we may not cancel this policy based on credit information available in public records. D. The following is added: NONRENEWAL 1. If we decide not to renew this policy we will mail or deliver to the first Named Insured written notice of nonrenewal, accompanied by the specific reason for nonrenewal, at least:: a. 45 days prior to the expiration of the policy if this policy does not cover a residential structure or its contents; or if nonrenewal is for the reason stated in Paragraph D.S.; or b. 120 days prior to the expiration of the policy if this policy covers a residential structure or its contents, 2. Any notice of nonrenewal will be mailed or delivered to the first Named Insured's last mailing address known to us. If notice is mailed, proof of mailing will be sufficient proof of notice. 3. We may not refuse to renew this policy: VCOFLI (01-20), Copyright.American International Group,Inc.,2019. Page 2 of COMMON Al rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission.. P IV IV W dq N N d' a. On the basis of property insurance claims that are the result of an act of God, unless we can demonstrate, by claims frequency or otherwise, that you have failed to take action reasonably necessary as requested by us to prevent recurrence of damage to the insured property; b. On the basis of filing of claims for"sinkhole loss". However, we may refuse to renew this policy if: (1) The total of such property insurance claim payments for this policy equals or exceeds the policy limits in effect on the date of loss for property damage to the covered building; or (2) You have failed to repair the structure in accordance with the engineering recommendations upon which any loss payment or policy proceeds were based; or c. Solely on the basis of a single property insurance claim which is the result of water damage, unless we can demonstrate that you have failed to take action reasonably requested by us to prevent a future similar occurrence of damage to the insured property. 4. Notwithstanding the provisions of Paragraph D.3.,we may refuse to renew this policy if this policy includes "sinkhole loss" coverage. If we nonrenew this policy for purposes of removing "sinkhole loss" coverage, pursuant to section 627.706, Florida Statutes, we will offer you a policy that includes catastrophic ground cover collapse coverage. 5. Notwithstanding the provisions of Paragraph D.3.,we may refuse to renew this policy if nonrenewal of some or all of our policies is necessary to protect the best interests of the public or policyholders and such nonrenewal is approved by the Florida Office of Insurance Regulation, E. Limitations On Cancellation And Nonrenewal In The Event Of Hurricane Or Wind Loss — Residential Property: 1. The following provisions apply to a policy covering a residential structure or its contents, if such property has sustained damage as a result of a hurricane or windstorm that is the subject of a declaration of emergency by the Governor and filing of an order by the Commissioner of Insurance Regulation: a. Except as provided in E.1.b., we may not cancel or nonrenew the policy until at least 90 days after repairs to the residential structure or its contents have been substantially completed so that it is restored to the extent that it is insurable by another insurer writing policies in Florida.. If we elect to not renew the policy, we will provide at least 100 days' notice that we intend to nonrenew 90 days after the substantial completion of repairs. b. We may cancel or nonrenew the policy prior to restoration of the structure or its contents for any of the following reasons: (1) Nonpayment of premium; (2) Material misstatement or fraud related to the claim; (3) We determine that you have unreasonably caused a delay in the repair of the structure;. or (4) We have paid the policy limits. If we cancel or nonrenew for nonpayment of premium, we will give you 10 days' notice. If we cancel or nonrenew for a reason listed in b.(2), b.(3)or b.(4), we will give you 45 days'notice, 2. With respect to a policy covering a residential structure or its contents, any cancellation or nonrenewal that would otherwise take effect during the duration of a hurricane will not take effect until the end of the duration of such hurricane, unless a replacement policy has been obtained and is in effect for a claim occurring during the duration of the hurricane. We may collect premium for the period of time for which the policy period is extended. 3. With respect to E.2., a hurricane is a storm system that has been declared to be a hurricane by the National Hurricane Center of the National Weather Service (hereafter referred to as NHC).. The hurricane occurrence begins at the time a hurricane watch or hurricane warning is issued for any part of Florida by the NHC, and ends 72 hours after the termination of the last hurricane watch or hurricane warning issued for any part of Florida by the NHC. VCOFL1 (01-20) Copyright,American International Group,Inc.,2019 Page 3 of 3 COMMON All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission.. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA CHANGES - LEGAL ACTION AGAINST US This endorsement modifies insurance provided under the following: CRIME COVERAGE PART INLAND MARINE COVERAGE PART PORTABLE EQUIPMENT COVERAGE PART PROPERTY COVERAGE PART With respect to the CRIME COVERAGE PART,, the Legal Action Against Us Condition is replaced by the following: You may not bring any legal action against us involving loss: 1. Unless you have complied with all the terms of this poky; 2. Until 90 days after you have filed proof of loss with us; and 3. Unless brought within 5 years from the date you discover the loss. With respect to the INLAND MARINE COVERAGE PART, PORTABLE EQUIPMENT COVERAGE PART and PROPERTY COVERAGE PART, the following replaces the second paragraph of the Legal Action Against Us Condition: Legal action against us involving direct physical foss or damage to property must be brought within 5 years from the date the loss occurs, VCOFL2(01-20) Copyright,American International Group,Inc.,2019. Page 1 of 1 COMMON AA rights reserved.Includes copyrighted material of the Insurance Services Office,Inc,with its permission. P IV IV tJ1 W N N E ed: Policy Number: VFNU-TR-0019768-03/000 O VOLUNTEER FIRE Policy Period: From 10-01-2023 NT, INC To 10- 1- 24 k$ r w.',w b Isn;.m w�r>ra a �: t o 4 r ru w u A>•ti r e w...0 ro / w / u fi anw w», a 5 j w r V E m omu un dh 4G� G. dIJ $ C '/ ! .. EI, �/Yl I$ I;NI rft /)m,➢S LE V,�tdl.a=lG /✓,r;"l.;x/N U/6,G",v;i14 JkU V{/V.l,. hl. fA/tr M9 N%4/�Y N 5 Jy�, UY / /f!( /41 Q1 " D°q t 2 L 4 ,ai M S i s R-� � �� � r�" a Wl ,L I A J9 � 4 b b b 4 IY 4 2 1�! 1 1 yr Vh{` :,4' rvrvpp h'Y��TF � 1 U -.� f J/9 �Jn q: U�fl rd d1/ Y Ill/ /C 6.V 1?1%i DIY f IN �fYv 11 ( �' Y� w i,w;nwr,.!'VAIN✓+:�n h✓%x iW�f„+dud+,aagwi u..::F.4,.V D:C:w16.v!U W-rfi rdow�Va,iu��B,I�aFdV�,a.,W SU�f:�N V ��AiP nu,y, "8 ro,u,,..a .wuy„n FwV,�n,o�G r,4rv,&n'M J iw.,,W ryn:✓i�,(f✓'✓."'b.un. 4/E CnE,�.v rpwN�ml,m'I.Unyuuru,,,,6 Jmr a wwr.:u%ir AWb���,.✓rwr,� v✓vl�.Unr,wn✓ Proeedy Schedule Summary Premises Item Number Number Address Occupancy Real Pro Limit Personal Propaq Limit 1 1 1 EAST DR, KEY LARGO, k'L FI RL SIATUA, $2,809,4'R3 See Blanket Sumary 33037 2 1 220 REEF, KEY 1ARG0, FL ^kAT�OIZ $3,7u 45,46,5 »pep Bweanket $wmaxy 33037 Estimated Coverage Part Premium: $ 46, 459. 00 Taxes, Fees and Surcharges: $ 840.26 Total Premium: $ 4 7 2 9 9.2 6 VPR100(01!20) 10-03.2023 Named Insured: Policy Number: VFNU—TR— 019768— 3/0 0 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 u c iid fl fa /YU V" u ✓ k,� 7 �c, IVu u 4 d CA 1u C,�k t[� r��u,r "' o r`✓'� Y ol'' YA mu `yi 000N i Vuyr eM II r>" { }, t�yjv r � 'p ✓�i � !� �,� �rcu ;,,,,+,r„�„ ,,,,dr✓,,,,,, „�r,!';;,,�✓ ' d I,�r„�,r.✓�V„9��',a;�� ,� ,;�.,,.r„ �V,:r� ,�, rV�...rl ro Val 'viu ° a u 6 a rr rrn i� L Sri 6 Schedule of Property Coverage 'C ➢I '.:�',v.MwO b .J �!��� �', m'Y'.:,b' &�.+..u4=+.�0✓.R tv wWw4�aa...y,.aam bd b,d�f.L.: Address: Occupancy, 1 EAST DR FIRE STATION KEY LARGO, FL 33037 Coverages Limit of Insurance Inflation Guard A. Real Property $2, 809, 473 4% B. Personal Property See Blanket Summar.:'y 4" C. Loss of Income 24 Months Actual Loss Sustained D. Extra Expense 24 Months Actual Loss Sustained Mine Subsidence Net Covered Coverage Details Valuation Method Coinsurance Real Property RC Replacement Cost. N/A Personal Property RC Replacement Cost N/A Deductible Details Policy Deductible 5, 000 Per Occurrence Earthquake Deductible 155, 276 Per Item Flood Deductible 1, 000 Per Premises Mine Subsidence Deductible Per Premises VPR100 tau 20) 10-03-2023 .p N N 4 00 N N d' I jNamed Insured: Policy Number: VFNU-TR-0019768-03/000 j KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 Y DEPARTMENT, INC To 10-01-2024 II s z r i„V lq.,•,fy., r Pu .wr 4 ,ur unarmk* µM y i r,; N � " h« /��i M1 �p�r�i r�rr�/,+'�v r�Edcl m^,� a .u.r.. a �,r•�I ovr a a r fl n.W 4 d o.�rb<.,.wu. f,,,,;rl Y" sn J w: mfro �9 fl F Y rir,i uw RV ,nvwi RI Y'Itw ✓.. ( t ^.f 11 ««t^1 wY 9 :,.n:G p f,d s,.r. (J rr.. g„l„a '.✓n ✓-:. ..(> f�f,rd rY.,..,.:J G ,r fN r">Y. �I.�O,,,�r � tloyl YBG Rrr� ,r� Yw�ullnitYy�uJ�l<�y I�Y�&rrui�n��¢;,uU� u( a�Kl �r�:w Schedule of Property Coverage i �u t � uruv�u"�� «Vr i^g n ti J f��yln 1 y n p'd„r say a� r i u Rio i 8 lei nl✓c day Fula',4� f e n ' y I d �umwr uu,",�n;,r a w,. .n,,rd ui�✓wv ru,u n,nv,o a v 21" Vn vas A w c va,r�. Address: Occupancy: 220 REEF FIRE STATION KEY LARGO, FL 33037 Coverages Limit of Insurance Inflation Guard A. Real Property $3, 7 4 5, 9 6 5 4% B. Personal Property See Blanket Summary 4 C. Loss of Income 24 Months Actual Loss Sustained D. Extra Expense 24 Months Actual Loss Sustained Mine Subsidence Not Covered Coverage Details Valuation Method Coinsurance Real Property RC Replacement Cost N/A Personal Property RC Replacement Cost N/A Deductible Details Policy Deductible 5, 000 Per Occurrence Earthquake Deductible 198, 770 Per Item Flood Deductible 1, 000 Per Premises Mine Subsidence Deductible Per Premises I d I Named Insured: Policy Number: KEY LARGO VOLUNTEER FIRE VFNU-TR-0019768- 3/000 DEPARTMENT", INC Policy Period: From 1 -01-2023 To 10- 1-2024 i d r �� ��t�l i ' OV " R �� G 8 h u11 ii i 4 Blanket Summary The following limit applies to all coverages denoted above as "See Blanket Summary". Coverage Limit of Insurance Personal Property $ 525, 488 Money and Securities Coverage Limit of Insurance Mo ney and Securities 3 0, 0 0 0 Software Coverage Limit of Insurance Software $ 250, 000 s I s !XI YA V See Schedule of Forms and Endorsements. VPR1oo(01120) 10-03-2023 N N W 0 M N d' EMERGENCY SERVICE ORGANIZATION PROPERTY COVERAGE FORM Various provisions in this coverage part restrict coverage. Read the entire coverage part carefully to determine rights, duties, and what is and is not covered. Throughout this coverage part the words "you" and "your" refer to the Named Insured shown in the Declarations. The words"we,""us"and"our" refer to the Company providing this insurance. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION VI. DEFINITIONS. SECTION I. COVERAGES Coverage A. Real Property We will pay for direct physical loss or damage to 'real property" at a "premises" caused by or resulting from any "covered cause of loss". The most we will pay is described under SECTION IV. WHAT WE WILL PAY. Coverage B. Personal Property We will pay for direct physical loss or damage to "personal property" at a "premises" caused by or resulting from any"covered cause of loss". The most we will pay is described under SECTION IV.WHAT WE WILL PAY. Coverage C. Loss of Income We will pay for the actual "loss of income" you sustain during the "period of restoration", if your "operations" are interrupted as a result of direct physical loss or damage to "real property" or "personal property" at a "premises" caused by or resulting from any "covered cause of loss". The most we will pay is described under SECTION IV.WHAT WE WILL PAY. Coverage D. Extra Expense We will pay the necessary"extra expense"you incur during the"period of restoration", if your"operations" are interrupted as a result of direct physical loss or damage to"real property" or"personal property" at a "premises" caused by or resulting from any "covered cause of loss". The most we will pay is described under SECTION IV.WHAT WE WILL PAY. VPR101 (01-20) Copyright,American International Group,Inc,2019 Page 1 of 34 PROPERTY All rights reserved, Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. SECTION II. COVERAGE EXTENSIONS This section adds to or extends the coverage under SECTION I. COVERAGES. Each separately numbered provision is referred to as an extension. Except to the extent specifically stated otherwise in an extension: 1 Each extension is limited to direct physical loss or damage caused by or resulting from any "covered cause of loss"; 2. The limits in each extension are in addition to the limits applicable to SECTION I. COVERAGES; and 3, All other applicable terms and conditions of this coverage form apply to each extension. 1. Ordinance Coverage When either"replacement cost" or guaranteed "replacement cost" is indicated in the Declarations as applicable to Coverage A, we will pay: a. For loss to any undamaged portion of your"real property"' caused by the enforcement of any law or ordinance that; (1) Requires the demolition of parts of your"real property" not damaged by a "covered cause of loss"; (2) Regulates the construction or repair of buildings or establishes zoning or land use requirements at a"premises"; and (3) Is in force at the time of loss. b. The cost to demolish and clear the site of the undamaged part of the property caused by enforcement of a building, zoning or land use ordinance or law; and c. The increased cost to repair, rebuild or construct the"'real property" caused by the enforcement of a building, zoning or land use ordinance or law, in addition to the "replacement cost" of the "real property"suffering the loss or damage. The total paid for any "item" under paragraph a. above shall be included within the Coverage A Limit of Insurance applicable to that "'item" and shall not increase that limit. The most we wilil pay under paragraphs b. and c. above shall not exceed 100% of the amount paid under this coverage part for the initial direct physical loss or damage to that"item". Under this extension, we will not pay any costs: (a) Due to an ordinance or law that was in effect before the loss or damage occurred, and with which you failed to comply even though you were required to do so; (b) Associated with "remediation expenses'; or (c) Due to"fungus", wet rot„ dry rot or bacteria. 2. Debris Removal Expenses We will pay your debris removal expenses if they are reported to us within 180 days after the date of direct physical loss or damaged. Debris removals expense means expense you incur in removing debris of covered "real property" or covered "personal property" from a "premises" after direct physical) doss or damage caused by or resulting from any "'covered cause of loss". Debris removal VPR101 (01-20) Copyright,American International Group,Inc.,,2019. Page 2 of 34 PROPERTY All rights reserved Includes copyrghted material of the Insurance Services Office,Inc„with its permission, P N W N M N d' expense does not include "remediation expenses" or any expense related to the removal of"fungus", wet rot, dry rot, bacteria or asbestos. 3. Supplementary Provisions for Coverage C. Loss of Income and Coverage D. Extra Expense a. Coverages C and D will apply if you have direct physical loss or damage covered under Coverage A or B to new buildings, additions or alterations to existing buildings, or associated equipment and supplies at a "premises". If a direct physical lass or damage delays the start of your "operations" at the new building, addition, or alteration, Coverages C and D will be determined from the date your "operations" would have begun if the direct physical loss or damage had not occurred. b. Coverages C and D will apply if your fund-raising activities are interrupted as a result of direct physical loss or damage to "real property" or "personal property" not owned by you from a "covered cause of loss"at any site used for your fund-raising activities. c. 1f property not at a "premises" is damaged by a "covered cause of loss", and as a result, a government agency prohibits you from using a "premises", Coverages C and D will apply for up to two weeks from the date that the loss occurred. d. The following will be disregarded in determining the amount of"loss of income": (1) Donations and contributions which are a direct result of the interruption of your "operations" and are received by you during the period of interruption; and (2) Proceeds from fund-raising drives or solicitations which are for your sole benefit and occur as a result of the interruption of your"operations". e. If a regularly scheduled fund-raising drive for your sole benefit occurs during the period of interruption, the revenue produced by such drive will not be considered as income unless the results of the drive fail, because of the interruption of your"operations", to produce an amount at least equal to the same drive in prior solicitations. If the regularly scheduled fund-raising drive is canceled or postponed, such loss of revenue will not be considered as a"loss of income". f. If Coverage C or D applies, we will extend Coverage C or D up to 30 consecutive days after the damaged property is repaired or replaced or to the date you could restore your"operations", with reasonable speed, to the condition that would have existed if no direct physical loss or damage occurred, whichever comes first. 4. Preservation of Property If it is necessary to move "real property" or"personal property"from a "premises" to preserve it from direct physical loss or damage by a "covered cause of lass", we will pay for any direct physical loss or damage to that property: a. While it is being moved or while temporarily stored at another location; and b. Only if loss or damage occurs within 90 days after the property is first moved. VPR101 (01-20) Copyright,American International Group, Inc.,,20119 Page 3 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services office, Inc.,with its permission. 5. Personal Property Off Your Premises a. If there is a direct physical loss or damage to your covered "personal property"' while it is away from your"premises", we will pay that covered loss. The most we will pay in any one occurrence is the greater of: (1) The highest Limit of Insurance for Coverage B shown in the Declarations„ or (2) $25,000, b, Any amount we pay is included in and is not in addition to the Coverage B limit shown in the Declarations, except to the extent the amount under a.(2) exceeds the Coverage B limit c. This extension does not apply to any portable equipment.. Portable equipment means portable firefighting, ambulance, or rescue rebated equipment„ including portable communications equipment, commonly used in fire and rescue operations away from your"premises". 6. Newly Acquired or Under Construction Real Property and Related Personal Property a. "Real property" you buy„ lease, rent„ or construct, inc'tuding temporary structures such as scaffoldiing, construction forms„ falsework, or cribbing at the job site, will be covered under Coverage A as provided in this extension. "Personal property"you acquire in connection with the "real property"described above wiilll be covered under Coverage B as provided in this extension. b Coverage A or B applies only if your newly acquired or under construction ""real property" is intended for similar use as an "'item" described in the Declarations and you acquired it or began construction of it after this policy pe60d began. c. The most we with pay under this extension iis: (1) $2,500,000 in any one occurrence under Coverage A; and (2) $500,000 in any one occurrence under Coverage B. d. In addition to the limit available for "real property" under construction, we will also pay up to $10,000 for loss or damage to construction materials and equipment that will become a permanent part of the project, while such property is held temporarily away from the construction site, or while in transit or awaiting delivery to the construction site.. This property may be your property or, at your option„ the property of others for which you are responsible. e. You agree to notify us as soon as possible of the value of: (1) Your newly acquired or under construction "real property""and to pay additional premium from the date you acquired or began construction of it;, and (2) "Personal property" at the site of newly acquired or under construction "real property" and to pay additional premium from the date you place such "personal property" at the site of newly acquired or under construction "real property". Coverage provided under this extension will cease at the later of 90 days after you acquire the property or begun construction, or the end of the policy period. However„ coverage will cease when this coverage part is cancelled or nonrenewed. VPR101 (01-20) Copyright,American International Group„Inc.,2019 Page 4 of 34 PROPERTY AN rights reserved. Includes copyrighted material of the Insurance Services office,Inc„with its permission P N W W d M N d' 7. Trees, Shrubs, Plants and Lawns We will pay for direct physical loss or damage to trees, shrubs, plants, and lawns at a"premises"on a replacement cost basis, only if they are damaged or destroyed by fire, lightning, explosion, riot or civil commotion, aircraft, "vehicles", or vandalism and malicious mischief. Replacement of trees, shrubs or plants shall be with trees, shrubs or plants of comparable size and kind, but shall not exceed the cost of replacing them with the largest commonly available transplantable like species of tree, shrub or plant that is usually available or listed in catalogs by nurseries or suppliers for the region in which the covered loss occurred and which can be legally transported on public roads without special permits. The costs of removing the existing tree, shrub or plant and associated cleanup is also included. Diminution of "real property" or "personal property" values resulting from the loss of trees shall not be recoverable as part of the loss settlement. 8. Personal Effects a. At your request, we will pay for direct physical loss or damage to "personal effects" caused by or resulting from any"covered cause of loss", provided the"personal effects"are at a"premises". b. The most we will pay under this extension in any one occurrence is: (1) The actual "replacement cost" for the "personal effects" of any of your volunteers, "employees", directors, officers, or trustees; or (2) For all other persons, $1,500 for the"personal effects"of any one person. c. This coverage is primary and will apply regardless of any other insurance coverage which may be available to the owner of the"personal effects". d. No deductible applies to this extension. 9. Pollution Remediation Expenses a. We will pay "remediation expenses" you incur as a result of the actual„ alleged, or threatened presence of "pollution conditions" on or from a "premises" described in the policy declarations" but only if the "pollution conditions" result from a "covered cause of loss" occurring during the policy period. However, we will not pay for any expense related to the removal of "fungus", wet rot, dry rot, bacteria or asbestos. (1) You must notify us within 180 days after the date of the"covered cause of loss", (2) The most we will pay under paragraph a. of this extension in any policy period is$251,000. b. We will pay "remediation expenses" you incur as a result of the actual,,, alleged, or threatened presence of "pollution conditions" on or from a "premises" described in the policy declarations, but only if the "pollution conditions" result from a "specified cause of loss" occurring during the policy period. However, we will not pay for any expense related to the removal of"fungus wet rot, dry rot, bacteria or asbestos. (1) You must notify us within 180 days after the date of the"specified cause of loss" (2) Subject to paragraph a. (2) the most we will pay under paragraph a.. and paragraph b of this extension in any policy period is$100,000, VPR101 (01-20) Copyright,American International Group,Inc.,2019. Page 5 of 34 PROPERTY All rights reserved,Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. 10. Sirens and Antennas Your"real property", "'loss of income" and "extra expense" coverages are extended to include sirens, antennas, towers and similar structures and their associated equipment and structures located away from your "premises"', However, this extension applies only to sirens, antennas, towers and similar structures associated with a "premises". 11. Commandeered Property a. At your request, we willl pay for direct physical loss or damage to commandeered property caused by or resulting from any "covered cause of loss". Commandeered property means the following property belonging to someone else: (1) "Read property" (2) "'Personal property"; (3) "'Watercraft' (4) Anil terrain vehicles; (5) Snowmobiles;; (6) Golf carts; (7) Aircraft or its parts, accessories and equipment; and (8) Animals; that you commandeer, seize, borrow or take over for official use to manage an "emergency situation"` b Coverage for direct physical loss or damage to commandeered property applies only for the time you officially use the commandeered property to manage an "emergency situation" plus the reasonable time necessary to return the property. This extension will not apply to direct physical loss or damage occurring after the policy period. c. At your request, if there is direct physical loss or damage to commandeered property during the policy period that is payable under this extension„ we will also pay any resulting loss of use of commandeered property arising during: (1) The time subsequent to the direct physical loss or damage during which you officially use or retain the commandeered property to manage an "emergency situation" plus the reasonable time necessary to return the property; and (2) The time after return of the commandeered property reasonably necessary to repair or replace the commandeered property, not to exceed 180 days. These times may extend beyond the policy period stated in the Declarations so long as the direct physical loss or damage to the commandeered property occurred during the policy period stated in the Declarations. d. The most we will pay under this extension in any one occurrence is the"replacement cost" of the commandeered property, plus loss of use covered by this extension, e. No deductible will apply to commandeered property belonging to a volunteer, "employee", director, officer or trustee, VPR101 (01-20) Copyright,,American International Group,Inc,,2019 Page 6 of 34 PROPERTY All rights reserved, Includes copyrighted material of the insurance SeMces Office„Inc„with its permission P N W tJ1 cfl M N d' 12. Software a. We will pay the following when caused by or resulting from any"covered cause of loss", or from a "computer virus", or from mechanical breakdown of"hardware": (1) The cost of restoring, researching, replacing, or reproducing "software" or the media upon which "software" is magnetically or optically recorded; (2) "Loss of income" if your"operations"are interrupted because of loss or damage to"software"; (3) "Extra expense" if your"operations"are interrupted because of loss or damage to"software"; (4) The following costs incurred because of loss or damage to"software": (a) Expenses you actually incur in recharging an automatic fire suppression system due to an accidental discharge, whether or not the discharge was caused by a "covered cause of loss"; (b) Fees payable to professional accountants or auditors; (c) Costs of conducting investigations by consulting engineers or programmers; and (d) Modification of"hardware" or replacement of data in order to achieve compatibility with replacement"hardware"or"software". b. To the extent that electronic data is not replaced or restored, we will pay the cost of replacement of the media on which the data was stored or recorded, with blank media of substantially identical type. c. Coverage provided under this extension is not restricted to your"premises". d. The most we will pay under this extension is$250,000 in any one occurrence. 13. Valuable Papers and Records a. We will pay the costs you incur in restoring, researching,, replacing, or reproducing your"valuable papers and records" that suffer direct physical loss or damage caused by or resulting from any "covered cause of loss". b. We will not pay for: (1) Irreplaceable "valuable papers and records" unless they are specifically described in the Declarations or in an endorsement made a part of this coverage part, and a limit for them is shown there; (2) Any cost that results directly from processing or copying the records; (3) Any cost that results directly from work performed on papers or records, such as filing or binding; (4) Loss or damage to computer-based records arising from loss or damage to "software", or from a"computer virus", or from mechanical breakdown of"hardware'; or (5) Loss or damage to"software". c. Coverage provided under this extension is not restricted to your"premises". VPR101 (01-20) Copyright,American International Group,Inc.,2019. Page 7 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office.Inc,„with its permission. 14. Accounts Receivable a. We will pay for"accounts receiivable costs"you incur as a result of direct physical loss or damage to your accounts receivable records caused by or resulting from any "covered cause of loss", including those arising from loss or damage to "software", or from a "computer virus", or from mechanical breakdown of"hardware"' b. We will not pay for: (1) Any loss or cost that results from mistakes made in bookkeeping, accounting, or billing; (2) Any loss or cost if its existence can be shown only by an inventory count or an audit. However, if the existence of a loss can be shown by other means, you may use an inventory count or audit to support your claim for that loss; (3) Any loss or cost resulting from any dishonest act or omission of either you or your volunteers or "employees", or anyone authorized to act for you. But we will cover loss that results if someone falsifies, alters or destroys your accounts receivable records in order to conceal any such action; (4) Any loss arising out of bad debts; or (5) Any loss arising out of aged accounts receivables greater than 180 days.. c. If you recover any amounts after we have paid you for a loss, you have to turn the recoveries over to us until we have been repaid. If you recover more than the amount we paid you,, the excess over our payment is yours, Also, you must help us collect amounts customers owe you, if we request your help. d. Coverage provided under this extension is not restricted to your"premises". 15. Money and Securities a. We will pay for loss of your "money"" or your "'securities" or of"money" or "securities" of others that you hold in any capacity„ or for which you are responsible, resulting from theft, disappearance or destruction, provided the loss occurs: (1) At your"premises (2) Away from your"premises" (whether inside or outside the"policy territory")while the"money" or"securities"are in the possession of your volunteers or"employees", or (3) Away from your "'premises" while the "money" or "'securities" are in the custody of a depository or an armored vehicle company. b. We will not pay for any loss of"money"or"securities"arising from: (1) "War"; (2) "Nuclear activity"; (3) "Government activity"; (4) Fraudulent; dishonest or criminal acts committed by a director, officer, trustee, volunteer or "employee"of your organization,whether acting alone or in collusion with others; (5) A sale, exchange, or purchase transaction, including internet transactions; or (6) Accounting, mathematical or record-keeping errors. VPR101 (01-20) Copyright,American International Group, Inc,,,2019 Page 8 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,.inc.,with its permission. P N W 4 00 M N d' c. The amount we will pay for any loss of "securities" is the market value of the "securities" at the end of the last business day before the loss was discovered. We will not pay for any "loss of income", including interest or dividends, that occurs as a result of a loss we do cover. d. The most we will pay for any loss of"money" or"securities" in the custody of a depository or an armored vehicle company is the portion of the loss that exceeds any amount you recover from: (1) The depository or armored vehicle company; (2) Insurance carried by the depository or armored vehicle company; or (3) Insurance carried by any other person or organization for the benefit of users of the depository's or armored vehicle company's services. e. The most we will pay under this extension is$30,000 in anyone occurrence. 16. Equipment Breakdown a. We will pay for loss caused by or resulting from an accident to covered equipment. Accident means direct physical loss as follows: (1) Mechanical breakdown, including rupture or bursting caused by centrifugal force, but excluding the mechanical breakdown of"hardware"; and (2) Explosion, rapture or bursting of steam boilers, steam pipes, steam turbines, steam engines or rotating parts of machinery that you own or lease, or that are operated under your control, but excluding loss or damage caused by a hydrostatic, pneumatic, or gas pressure test of any boiler or pressure vessel; and (3) Loss or damage to steam boilers, steam pipes, steam engines, steam turbines, hot water boilers or other water heating equipment caused by or resulting from any condition or event inside such boilers or equipment. If an initial accident causes other accidents, all will be considered one accident. All accidents that are the result of the same event will be considered one accident. Covered equipment means "real property" or "personal property" built to operate under vacuum or pressure, other than weight of contents, or used for the generation, transmission or utilization of energy. However, none of the following are covered equipment: (a) Insulating or refractory material; (b) Sewer piping, underground vessels or piping, piping forming part of a "sprinkler system" or water piping other than boiler feedwater piping, boiler condensate return piping or water piping forming part of a refrigerating or air conditioning system; (c) "Vehicles", excavation or construction equipment; or (d) Any structure,foundation or cabinet supporting or housing covered equipment. b. The following coverages also apply to loss caused by or resulting from an accident to covered equipment: (1) Expediting Expenses With respect to damaged "real property" or "personal property", we will pay the reasonable extra costs to: (a) Make temporary repairs; and (b) Expedite permanent repairs or replacement. VPR101 (01-20) Copyright,American International Group,Inc.,2019 Page 9 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inca with its permission. (2) Perishable Goods We will pay the following (a) Loss of perishable goods due to spoilage. (b) Loss of perishable goods due to contamination from the release of a refrigerant, including but not limited to ammonia, (c) Any necessary expenses you incur to reduce the amount of loss under this extension. We will pay for such expenses to the extent that they do not exceed the amount of loss that otherwise wound have been payable under this extension. However, we will not pay for loss or damage caused by or resulting from your failure to use all reasonable means to protect the perishable goods from damage following an accident. Perishable goods means "personal property", maintained under controlled conditions for its preservation, that is susceptible to loss, damage, or spoilage if the controlled conditions change. (3) Hazardous Substances We will pay for the additional costs to repair or replace "real property" or "personal property" because of contamination by a hazardous substance, including the additional costs to clean up or dispose of such property. Additional costs means those beyond what would have been required had no hazardous substance been involved, The most we will pay for loss or damage under the Hazardous Substances coverage, including the actual "loss of income" you sustain, the necessary "extra expense" you incur, and the loss of or damage to perishable goods due to contamination from a hazardous substance is$25„000 per accident Hazardous substance means any substance other than ammonia that has been declared to be hazardous to health by a governmental agency. (4) Service Interruption The insurance provided for "loss of income", "extra expense", and perishable goods is extended to apply to loss caused by or resulting from an accident to equipment that is owned by a utility„, 'landlord or other supplier with whom you have a contract to provide you with any of the following services: electrical power, communications, waste disposal, Wr conditioning, refrigeration, cleating, gas, air, water or steam. (5) Off-"Premises"'Accidents Coverage is extended to apply to an accident to the following types of equipment anywhere in the"policy territory": (a) Mobile cascade units; (b) Mobile internal combustion engines used solely as part of an emergency generating unit; (c) Electrical generators used solely as part of an emergency generating unit; (d) Portable pumping units; and (e) Portable extrication devices, such as jaws-of-life, whether hydraulic or air powered. c, Conditions (1) Suspension When any covered equipment is found to be in, or exposed to, a dangerous condition, any of our representatives may immediately suspend the insurance against loss from an accident to that covered equipment. We can do this by mailing or delivering a written notice of VPR101 (01-20) Copyright,American International Group„Inc,2019. Page 10 of 34 PROPERTY A'GI rights reserved.Includes copyrighted material of the insurance Services Office,Inc.,with its permission. P N W W 0 Iq N d' suspension to your address as shown in the Declarations, or at the address where the equipment is located. Once suspended in this way, your insurance can be reinstated only by written notice from us. If we suspend your insurance, you will get a pro-rata refund of premium. But the suspension will be effective even if we have not yet made or offered a refund. We will not consider firefighting or other emergency service activities, or training related to such activities, as a dangerous condition within the context of this provision. (2) Jurisdictional Inspections If any property that is covered equipment under this extension requires inspection to comply with state or municipal boiler and pressure vessel regulations, we agree to perform such inspections on your behalf. d. Except for the Hazardous Substances limit specified above, the most we will pay for loss or damage under this extension is the applicable Limit of Insurance shown in the Declarations. 17. Fire Extinguishing Equipment Recharge Costs a. We will pay the necessary and reasonable cost to recharge or refill your fire extinguishing equipment, including both hand-held extinguishers and fixed automatic extinguishing systems, as a result of: (1) Their discharge as a result of a"covered cause of loss'; or (2) Their accidental discharge in the absence of a"covered cause of loss". b. This extension applies regardless of whether the fire extinguishing equipment itself is damaged. c. The fire extinguishing equipment must be for the protection of and located at a"premises". d. No deductible applies to this extension. 18. Limited Coverage for Fungus,Wet Rot, Dry Rot and Bacteria a. The coverage described in 18.b and 18.e. of this extension applies only when the "fungus", wet rot, dry rot or bacteria is the result of one or more of the following causes that occurs during the policy period and only if all reasonable means were used to save and preserve the property from further damage at the time of and after that occurrence: (1) A"specified cause of loss"other than fire or lightning; or (2) "Flood", except if the Flood Exclusion endorsement is attached. b. We will pay for loss or damage by"fungus",wet rot, dry rot or bacteria. As used in this extension, the term loss or damage means: (1) Direct physical loss or damage to covered "real property" or covered "personal property" caused by"fungus", wet rot, dry rot or bacteria, including the cost of removal of the"fungus", wet rot, dry rot or bacteria; (2) The cost to tear out and replace any part of the building or other property as needed to gain access to the"fungus",wet rot, dry rot or bacteria; and (3) The cost of testing performed after removal, repair, replacement or restoration of the damaged property is completed, provided there is reason to believe that"fungus",wet rot, dry rot or bacteria are present. VPR101 (01-20) Copyright,American International Group,Inc..2019 Page 11 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. c, The coverage described under 18.b. of this extension is limited to $25,000. Regardless of the number of claims, this INimit is the most we will pay for total of all loss or damage arising out of all occurrences of"specified causes of(loss" (other than hire or lightning)and"flood"which take place in a 12 month period (starting with the beginning of the present annual policy period). With respect to a particular occurrence of loss which results in"fungus"', wet rot, dry rot or bacteria, we will not pay more than a total of$25,000 even if the"fungus"', wet rot, dry rot or bacteria continues to be present or active,or recurs, in a (later policy period. d. The coverage provided under this extension does not increase the applicable Limit of Insurance on any covered "real property" or covered "personal property". If a particular occurrence results in loss or damage by "fungus", wet rot, dry rot or bacteria, and other loss or damage, we will not pay more, for the total of all loss or damage, than the applicable Limit of Insurance on the affected covered"real property"or covered"personall property". If there is covered loss or damage to covered "'real property"' or covered "personal property" not caused by "fungus", wet rot, dry rot or bacteria, loss payment wild not be (limited by the terms of this extension except to the extent that "fungus"", wet rot, dry rot or bacteria causes an increase in the loss. Any such increase in the loss will be subject to the terms of this extension. e, Under Coverage C, "Loss of Income"or Coverage D. "Extra Expense": (1) If the loss which resulted in "fungus"„ wet rot, dry rot or bacteria does not in itself necessitate an interruption of 'operations", but such interruption is necessary due to loss or damage to property caused by"'fungus", wet rot, dry rot or bacteria, then our payment under Coverage C and/or Coverage D is limiited to the amount of "Boss of income" and/or "extra expense" sustained in a period of not more than 30 days. The days need not be consecutive. (2) If a covered interruption of "operations" was caused by Boss or damage other than "fungus wet rot,, dry rot or bacteria but remediation of"fungus",wet rot, dry rot or bacteria prolongs the "period of restoration", we will pay for "loss of income" and/or "'extra expense" sustained during the delay (regardless of when such a delay occurs during the "period of restoration"), but such coverage is limited to 30 days The days need not be consecutive, 19. Arson Fire Information Reward We will reimburse you for the payment of rewards that you actually incur which provide information related to arson fire. For the purposes of this extension,,covered property means property covered by this coverage part or any other coverage part issued to you by this company. This reimbursement is subject to compliance with all of the following conditions:. a. Conditions (1) Your covered property at a "premises" is damaged or destroyed by a fire that is declared to be an arson fire by the appropriate ciivil authority; (2) You pay reward(s) for information about the causes of such arson fire to persons who would not normally make reports and who did not make such report before the potential of a reward was announced; (3) Such information its presented to the investigative authorities within 90 days after the start of the arson fire; (4) Such reported information for which you paid a reward contributes directly and significantly to the arrest and conviction of those causing the arson fire; and VPR101 (01-20) Copyright,American international Group Inc,",2019. Page 12 of 34 PROPERTY All rights reserved. Includes copyrighted material of the Insurance Services Office, Inc.,with its permission. P tV P N d' N d' (5) Your intention to pay such reward or your payment of such reward is reported to us within 15 days of the date on which the appropriate arson fire investigative authority receives the information. b, Regardless of the number of people who provide information about the arson fire, the most we will pay for all reward payments related to any one arson fire, or series of related arson fires committed by the same arsonist(s), is$25,000 per lass. c. No deductible applies to this extension. Our reimbursement to you for the arson fire information rewards that you pay does not limit in any way your ability to offer or not offer and pay or not pay rewards for arson fire information related to covered property, 20. Fine Arts a. We will pay for direct physical loss or damage caused by or resulting from a "covered cause of loss"to "fine arts"owned by you and for which you have secured a certified appraisal prior to the loss. (1) The value of"fine arts"will be the least of the following amounts: (a) The fair market value of the object at the time of loss; (b) The cost of reasonably restoring the object to its condition immediately before floss; or (c) The cost of replacing the object with a substantially identical object, (2) The most we will pay for loss under paragraph a.(1) is$50,000 in any one occurrence. b. We will also pay for direct physical loss or damage caused by or resulting from a"covered cause of loss"to"fine arts"for which you have not secured a certified appraisal prior to the loss. (1) The value of"fine arts"will be the least of the following amounts: (a) The fair market value of the object at the time of loss; (b) The cost of reasonably restoring the object to its condition immediately before loss; (c) The cost of replacing the object with a substantially identical object; or (d) $1 1,500 per item. (2) The most we will pay for loss under paragraph b.(1) is $25,000 in any one occurrence. This limit of insurance is in addition to the amount provided under Paragraph a.(2) above. As used in this extension„ fair market value means the cash value that the object of"fine arts" would bring in an open and unrestricted market between a willing buyer and a willing seller who are both knowledgeable,, informed and prudent, and who are acting independently of each other. 21. Lock and Key Replacement a, We will pay the necessary expense you incur to replace locks, lock cylinders and keys, electronic or otherwise, necessitated by: (1) A covered theft of your covered property, or (2) Damage to the hock as a result of a"covered cause of loss". For the purposes of this extension, covered property means property covered by this coverage part or any other coverage part issued to you by this company. Coverage applies if there is a VPR101 (01,20) Copyright,American International Group„Inc.,2019, Page 13 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. loss of covered property by a covered theft even if the keys are not known to be missing or copied b. Additional Conditions (1) You must notify us and the appropriate law enforcement authority of the theft as soon as practicable; (2) Locks, lock cylinders and keys must be replaced within 72 hours of the discovery of the theft, or as soon as practicable; and (3) Coverage under this extension applies to disappearance of keys only if other covered property is stolen or missing. c. Coverage under this extension applies only to locks, lock cylinders and keys located at a "premises"described in the declarations. d. We will pay to replace the locks, lock cylinders and keys with property of the same kind and quality without deduction for deterioration or depreciation. e. The most we will pay in any one occurrence for coverage under this extension is$25,000. f. No deductible applies to this extension. 22. Member's Property a. We will pay for direct physical loss or damage, resulting from a "covered cause of (loss", to property while at your"premises"that is owned by your volunteer, "employee", director, officer or trustee. b. The most we will pay in any one occurrence for coverage under this extension is$5,000. c. This coverage is primary and will apply regardless of any other insurance coverage which may be available to the owner of the property. d„ No deductible applies to this extension. As used in this extension, member's property includes, but is not limited to computers, game consoles and associated software, all-terrain vehicles, snowmobiles, golf carts, "watercraft", personal watercraft, tools and firearms. Member's property does not include: 1. "Personal effects' 2. "Money"and "securities"; 3. "Fine arts' 4. Animals; 5. Aircraft or its parts, accessories and equipment; or 6. "Vehicles". 23. Member's Real Property Deductible Reimbursement a We will reimburse your volunteer, "employee", director, officer or trustee for the amount of the deductible applied under their personal insurance for direct physical loss or damage to owned "real property" at their residence premises due to a"covered cause of loss". The loss must occur while the volunteer, "employee", director, officer or trustee is enroute to, engaged in, or returning VPR101 (01-20) Copyright,American International Group,Inc.,2019. Page 14 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission, .P N .P W dq dq N d' from an "emergency situation" at the direction and knowledge of an officer of the insured organization. b. The most we will pay per member in any one occurrence for coverage under this extension is $1,000. c. No deductible applies to this extension. 24. Permanently Installed Outdoor Property a. We will pay up to the "replacement cost" for direct physical loss or damage to your outdoor property caused by or resulting from a"covered cause of loss". b. The most we will pay in anyone occurrence for coverage under this extension is $125,000. As used in this extension, outdoor property means property that is permanently installed away from your"premises"and includes, but is not limited to the following: traffic control devices, signs, statues, monuments and fire hydrants. Outdoor property does not include "real property" or "personal property". 25. Unintentional Omission of Real Property a. If you unintentionally omit"real property"from an application for insurance or unintentionally fail to report all "real property" prior to the beginning of the policy period, we will pay for direct physical loss or damage by a "covered cause of loss" to such "real property" that qualifies as "real property" but is not shown in the Declarations due to such unintentional omission or failure to report. b. You agree to pay the additional premium for the "'real property" as of the effective date of the policy. c. The most we will pay in any one occurrence for coverage under this extension is$500,000. 26. Vehicle Stock a. We will pay for direct physical loss or damage caused by or resulting from a "covered cause of loss"to"vehicle stock"owned by you and stored inside a building or at a"premises". b. The most we will pay for coverage under this extension in anyone occurrence is$25,000. 27. Utility Service Interruption Coverage a. Coverage Your coverage for"loss of income" and "extra expense" is extended to apply to a suspension of "operations" at your "premises" caused by an interruption in utility service to that "premises" during the"period of restoration". The interruption in utility service must result from direct physical loss or damage by a"covered cause of loss"to the property described in Paragraph c. VPR101 (01•20) Copyright,American International Group,Inc„2019. Page 15 of 34 PROPERTY Al rights reserved includes copyrighted material of the Insurance Services Office,Inc.,with its permission. b. Exception Coverage under this endorsement does not apply to "loss of income" or "extra expense" related to interruption in utility service which causes loss or damage to "software", including destruction or corruption of"software". c. Utility Service (1) Water Supply Service, meaning the following types of property suppliying water to your "premises": (a) Pumping stations; and (b) Water mains. (2) Communication Supply Service, meaning property supplying communication services, including telephone, radio, microwave or television services, to your"'premises", such as: (a) Communication transmission lines, including optic fiber transmission lines; (b) Coaxial cables; and (c) Microwave radio repays except satellites. (3) Wastewater Removal Property, meaning a utility system for removing wastewater and sewage from the described premises, other than a system designed primarily for draining storm water. The utility property includes sewer mains, pumping stations and similar equipment for moving the effluent to a holding, treatment or disposal facility, and includes such facilities. Coverage under this extension does not apply to interruption in service caused by or resulting from a discharge of water or sewage due to heavy raWalll or flooding. (4) Power Supply Service, meaning the following types of property supplying electricity, steam or gas to your"premises": (a) Utility generating plants; (b) Switching stations; (c) Substations; (d) Transformers; and (e) Transmi!ssion lines. d. For the purposes of this extension only, the definition of"period of restoration" is replaced by the following: "Period of restoration" means the period of time after direct physical) loss or damage to the property described in Paragraph c. that: (1) Begins: (a) 72 hours after the initial interruption in Utility Services for"Boss of income"; or (b) Immediately after the initial interruption in Utility Services for"extra expense"°; and (2) Ends when the Utility Service is restored. "Period of restoration" does not include any increased period required due to the enforcement of any ordinance or law that: (a) Requires any insured or others to incur"remediation expenses""; or (b) Pertains to"fungus", wet rot, dry rot, bacteria, or asbestos. VPR101 (01-20) Copyright.American International Group,Inc.,2019, Page 16 of 34 PROPERTY All rights reserved. Includes copyrighted material of the ,insurance Services Office,Inc.,with its permission. P N P tJ1 cfl dq N d' The expiration date of this policy will not cut short the"period of restoration". f. No deductible applies to this extension. SECTION III. COVERED CAUSES OF LOSS "Covered cause of loss" means any cause of direct physical loss or damage except as excluded below, Exclusions We will not pay for loss or damage caused by or resulting directly or indirectly from the following causes, or occurring in the following situations. Such loss or damage is excluded regardless of any other cause or event that contributes concurrently with or before, during, or after the loss or damage. But we will cover resulting fire or explosion, meaning a fire or explosion that results from any cause of loss other than "war",whether or not that cause of loss itself is covered under this coverage part. 1. "War" 2. "Nuclear Activity" 3. "Government Activity" 4. Nesting or Infestation Nesting or infestation, or the discharge or release of waste products or secretions, caused by any insects, birds, rodents or other animals. 5. Neglect Neglect meaning your failure to take all reasonable steps to protect your property when it is threatened with loss or damage and to take all reasonable steps to protect your property from further loss after loss or damage occurs. 6. Earth Movement Earth movement meaning any sinking, rising, shifting, freezing, thawing, erosion, compaction or expansion of the earth, including mine subsidence. But we will cover"earthquake", "volcanic action", landslide or"sinkhole collapse". 7. Building Settlement Settling, shrinking, cracking, bulging or expansion of any pavement, building or structure. 8. Dishonesty Dishonest acts or omissions of you or your volunteers or"employees", or anyone authorized to act for you, or anyone to whom you entrust property, whether an individual is acting alone or in collusion with others. 9. Vacancy Freezing, leakage or overflow from plumbing, heating, air conditioning or any other equipment or appliance in a"vacant" or unoccupied building unless: a. You have taken reasonable steps to maintain heat in the building; or b. Water was drained from the system or appliance involved, and the water supply was shut off while the building was"vacant"or unoccupied. VPR101 (01-20) Copyright,American International Group,Inc.,2019. Page W of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. Also, we will not cover damage to plumbing systems located outside the perimeter of building walls or off the"premises"that results from freezing. 10. Delay, Loss of Use Delay and loss of use or because you can no longer sell or use property, except as specifically provided in Coverage C, 11. Mysterious Disappearance Mysterious disappearance of property or an inventory shortage. 12. Wear and Tear Wear and tear, deterioration, rust, corrosion, marring or scratching, erosion, decomposition, and decay. However, we will cover resulting loss or damage not otherwise excluded caused by"vehicles"' or aircraft, "sprinkler leakage water damage, freezing, collapse of a building or falling objects. 13, Fungus,Wet Rot, Dry Rot and Bacteria The presence, growth„ proliferation, spread or any activity of "fungus"', wet or dry rot or bacteria, including loss, damage or "remediation expenses" resulting from any of these. But if"fungus"', wet rot, dry rot or bacteria results in a"specified cause of loss", we will pay for the loss or damage caused by that"specified cause of loss". This exclusion does not apply: a. When "fungus",wet rot„ dry rot or bacteria results from fire or lightning; or b, To the extent coverage is provided in the Limited Coverage for Fungus, Wet Rot, Dry Rot or Bacteria coverage extension 14, "Pollution Conditions", except to the extent coverage is provided in the Pollution Remediation Expenses coverage extension. 15. Remediation Expenses "Remediation expenses" except to the extent coverage is provided in the Pollution Remediation Expenses coverage extension. 16. Asbestos Asbestos, including loss, damage or "remediation expenses" resulting from asbestos or asbestos- containing materials. 17. Mechanical Breakdown Mechanical breakdown, but this exclusion does not apply to "hardware" or to any coverage provided in the Equipment Breakdown coverage extension. 18. Steam Vessels Rupture, bursting or explosion of steam boilers, steam pipes, steam turbines or steam engines except to the extent coverage is provided in the Equipment Breakdown coverage extension. 19. Inherent Vice Inherent vice meaning a natural condition of property that causes it to deteriorate or become damaged. Examples of inherent vice are the yellowing and cracking of old paper, patina that forms on old bronze and the swelling of wood under moist conditions. 20. Latent Defects Latent defects meaning faults or weaknesses in property itself. 21. Faulty Design and Workmanship VPR101 (01-20) Copyright,American International Group,Inc.,2019. Page 18 of 34 PROPERTY All rights reserved Includes copyrighted material of the Insurance Services Office,line,,with its permission. .P N P 4 00 dq N d' Faulty design, workmanship and material including the cost of correcting any faulty design, workmanship, material, manufacture or installation, alteration, repair or work on covered "real property" or "personal property". But we will cover loss or damage that results from any of these, if the loss or damage occurs in connection with any cause of loss not otherwise excluded by this coverage part. This exclusion does not apply to"hardware". 22, Vandalism and Malicious Mischief Vandalism and malicious mischief if the building involved has been "vacant" for more than 60 consecutive days immediately before the loss. 23. Loss of Contractor Strike "Loss of income"or"extra expense" resulting from: a. Loss of contract, meaning a loss that results from the expiration, suspension or cancellation of any contract, lease or order, or b. Strike, meaning interference by strikers or other persons with your"operations", or with the repair, rebuilding or replacement of property at the location of the repair, rebuilding or replacement, or with the resumption of your"operations". 24. Seepage or Leakage of Water Continuous or repeated seepage or leakage of water, or the presence or condensation of humidity, moisture or vapor,that occurs over a period of 14 days or more. SECTION IV. WHAT WE WILL PAY A. Limits of Insurance 1. The most we will pay for loss or damage in any one occurrence is the applicable Limit of Insurance shown in the Declarations, except as provided in the guaranteed 'replacement cost" provision. 2. If we pay the limit for any one occurrence, that will not reduce the applicable limit for any future covered loss resulting from an unrelated occurrence. 3. All "earthquakes" or "volcanic actions" that occur within a continuous 168 hour period will constitute a single occurrence under this coverage part. 4. All "floods" that occur within a continuous 168 hour period will constitute a single occurrence under this coverage part. B. Valuation—Coverage A. Real Property 1. If 'replacement cost" valuation for Coverage A is indicated in the Declarations or in an endorsement attached to this coverage part, we will not pay more than the Coverage A limit applicable to the lost or damaged 'real property". Subject to that limit, we will pay the "replacement cost" of any loss or damage to "real property", less any deductible that applies, so long as: a. The loss or damage to'real property"is actually repaired or replaced; b. The repairs to or replacement of the "real property" are made within one year of the loss or damage; c. The repairs or replacements restore the"real property"to the same use; and VPR101 (01-20) Copyright,American International Group,Inc.,2019. Page 19 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission, d. The repairs to or replacement of the "real property" are of the same kind and quality and at the same"premises"'as the"'real property"suffering the loss or damage, however: (1) You may substitute property of a different kind or quallity, but we won't pay more than what it would cost to repair or repllace the doss or damage to the "real property" with property of comparable kind and quality; and (2) You may replace the "'real property" suffering the loss or damage at a different location, but we won't pay more than what it would cost to replace the loss or damage to the"real property" at the original)"premises". 2. a, Subject to the provisions of subparagraphs a. - d. of paragraph 1. above, if guaranteed "replacement cost" valuation for Coverage A is indicated in the Declarations or in an endorsement attached to this coverage part, and the cost to replace loss or damage to"real property" is more than the Coverage A )limit accepted by us, we will nevertheless pay the entire"replacement cost"'less any deductible that applies. b, This guaranteed"replacement cost" provision for Coverage A is contingent on: (1) Your purchasing an amount of insurance accepted and kept on file by us; (2) Your promptly advising us of any changes made to your "real property" which would change the cost to replace it, and adjusting the amount of insurance accordingly; and (3) Your purchasing an amount of insurance on each policy anniversary equal to an adjusted cost figure. This adjusted cost figure wRl be calculated from the original amount plus any changes made to your "real property"" and will be modified by an automatic inflation adjustment factor applicable to your"real property". C. Valuation—Coverage B. Personal Property 1. If "replacement cost" valuation for Coverage B is indicated in the Declarations or in an endorsement attached to this coverage part, we will not pay more than the Coverage B limit applicable to the lost or damaged "personal property' Subject to that limit, we will pay the "replacement cost" of any loss or damage to "personal property", less any deductible that applies, so long as: a. The loss or damage to"personal property" is actually repaired or replaced; b. The repairs to or replacement of the "personal property" are made within one year after the loss or damage; c. The repairs or replacements restore the"personal property"to the same use; and d. The repairs to or replacement of the "personal property" are of the same kind and quality as the"personal property"suffering the loss or damage. 2. a. Subject to the provisions of subparagraphs a. - d. of paragraph 1. above, cif guaranteed "replacement cost" valluation for Coverage B is indicated in the Declarations or in an endorsement attached to this coverage part, and the cost to replace loss or damage to "personal property" its more than the Coverage B limit accepted by us, we will nevertheless pay the entire"replacement cost" (less any deductible that applies. b. This guaranteed"replacement cost" provision for Coverage B is contingent on: (1) Your purchasing an amount of insurance accepted and kept on file by us; (2) Your promptly advising us of any changes made to your"personal property"which would change the cost to replace it, and adjusting the amount of insurance accordingly; and VPR101 (01-20) Copyright,American InternationM Group,,,Ilnc.,2019 Page 20 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,.Inc,with its permission. P N P W 0 L0 N d' (3) Your purchasing an amount of insurance on each policy anniversary equal to an adjusted cost figure. This adjusted cost figure will be calculated from the original amount plus any changes to the "personal property", and will be modified by an automatic inflation adjustment factor applicable to your"personal property". 3. When guaranteed "replacement cost" applies to Coverage B, "personal property" does not include portable equipment. Portable equipment means portable firefighting, ambulance, or rescue related equipment, including portable communications equipment, commonly used in fire and rescue operations away from your"premises". D. Valuation—Coverage C. Loss of Income and Coverage D. Extra Expense 1. The amount of the"loss of income"you sustain due to necessary suspension of your"operations" during the"period of restoration"will be based on: a. Your net income before the direct physical loss or damage occurred; b. Your likely net income if no loss or damage occurred; c. The operating expenses, including payroll expenses, necessary to resume your"operations" with the same quality of service that existed just before the direct physical loss or damage; and d. Other relevant sources of information, including: (1) Your financial records and accounting procedures; (2) Bills, invoices and other vouchers; and (3) Deeds, liens or contracts. e. We will reduce the amount of your "loss of income" to the extent you can resume your "operations" in whole or in part by using damaged or undamaged property (including merchandise or"stock") at the"premises"or elsewhere. 2. The amount of"extra expense"will be determined based on: a. All expenses that exceed the normal operating expenses that would have been incurred by your "operations" during the "period of restoration" if no direct physical loss or damage had occurred. We will deduct from the total of such expenses: (1) The salvage value that remains of any property bought for temporary use during the "period of restoration", once your"operations"are resumed; and (2) Any "extra expense" that is paid for by other insurance, except for insurance that is written subject to the same plan,terms, conditions and provisions as this insurance; and b. All necessary expenses that reduce the "loss of income" that otherwise would have been incurred. c. We will reduce the amount of your "extra expense" loss to the extent you can return your "operations"to normal and discontinue such "extra expense". 3. If you do not resume your "operations", or do not resume your "operations" as quickly as possible, we will pay based on the length of time it would have taken to resume your"operations" as soon as possible. 4. If this policy expires before we have paid you all the"loss of income" or"extra expense"to which you are entitled for direct physical loss or damage that occurred during the policy period, we will continue to make payments after the expiration date. VPR101 (01,20) Copyright,American International Group,Inc.,2019, Page 21 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission, E. Valuation—COVERAGE EXTENSIONS 1. "Replacement cost" applies to all SECTION II. COVERAGE EXTENSIONS unless stated otherwise in the extension, so long as: a. The requirements in SECTION IV. B. 1. are met if "real property" is (lost or damaged; or b. The requirements in SECTION IV. C. 1. are met if"personal property" is (lost or damaged. F. Deductible 1. We will not pay for loss or damage in any one occurrence until the amount of doss or damage exceeds the applicable deductible. We will then pay the amount of loss or damage in excess of the deductible, up to the appllicable Limit of Insurance, after any applicable deduction required by a coinsurance provision. Z The deductible shown in the Declarations applies to Mosses under the folliowing coverages except as otherwise specifically indicated: a. "Real property"; b. "Personal property"; c. "Loss of income"; d. "Extra expense"; and e. All coverages provided under SECTION II. COVERAGE EXTENSIONS. 3, If more than one coverage (other than coverage for "earthquake" or "flood") applies to any one occurrence, we will) subtract the deductible amount only once If more than one deductible applies„ we will subtract the largest applicable deductible unless indicated otherwise in this coverage part.. 4, Earthquake Deductible. A special deductible applies to losses caused by or resulting from '"earthquake Refer to the Declarations. When a percentage deductible is shown as applicable to "'earthquake", that percentage wild be applied to the sum of the "real property" and "personal property"" limits shown in the Declarations for each affected "item", if blanket coverage applies, we will determine this sum based on the most recent amounts on file with us for each affected "item" The deductibles determined in accordance with this paragraph shall apply separately to each affected "item". 5. Flood Deductible. A special deductible applies to each occurrence caused by or resulting from "flood" Refer to the Declarations. The deductible shown will apply separately to each affected "premises"' 6. Deductible Waiver. If a loss covered under this coverage part also involves a loss under an Emergency Service Organization Auto, Portable Equipment or other Inland Marine coverage issued to you by us„ only one deductible, the largest„ wiilli be applied. The deductible under the other policies or coverage parts with be waived. 7. Glass Deductible Waiver. If a doss covered under this coverage part is limited to damage to glass that is part of a building and no other property is included in the loss, the policy deductible will be waived. VPR101 (01-20) Copyright,Amencan International Group,Inc..2019 Page 22 of 34 PROPERTY All rights reserved.Includes copyrughted material of the insurance Services Office,Inc..with its permifssion.. P N U1 N N d' G. Automatic Inflation Adjustment 1. We will automatically increase your Coverage A and Coverage B limits to keep pace with inflation. We will increase the limits by the annual percentage shown in the Declarations for each "item". 2. The amount of increase will be: a. The limit that applied on the most recent of the policy inception date, the policy anniversary date, or any change amending the Limit of Insurance, multiplied by b. The percentage of annual increase shown in the Declarations, multiplied by c. The number of days since the beginning of the current policy year or the effective date of the most recent policy change amending the Limit of Insurance, divided by 365. 3. Where there is a blanket limit for Coverages A and B, the most recent values we used to calculate your premium will be used to separate "real property" and "personal property" values, the separate values will be increased as if they were separate limits, and the results will be added to determine the increase in the blanket limit. H. Other Conditions Affecting Property Losses This sub-section explains special rules that apply to valuing some of the property covered by this coverage part. It also gives you important information about payment for losses. 1. Improvements by a Tenant. If you are a tenant at a "premises" and property improvements for which you paid are lost or damaged by a "covered cause of loss" at the "premises", we will reimburse you for repairing or replacing them.. We will pay their "replacement cost" if you repair or replace them within a reasonable time after the loss at the "premises". But we will not cover repairs or replacements which were made for your use at someone else's expense. a. If you do not repair or replace the covered improvements within a reasonable time at the "premises", we will pay a portion of their original cost, This will be the ratio between: (1) The length of time remaining on your lease at the time of the loss; and (2) The length of time between the making of the improvements and the expiration of the lease. b. If your lease contains a renewal option, the expiration of the renewal option period will replace the expiration of the lease. c. If you purchased the interest in the use of improvements made by a previous tenant, we will cover them as if you had paid for them. 2. Property in Sets. The loss of an article which is part of a set will not be considered a loss of the entire set. Therefore, if there is loss or damage to property which is part of a set, we will pay a fair portion of the total value of the set. 3. Parts. If the loss or damage is to a part of property that consists of several parts, we will pay for only the lost or damaged part. 4. Exhibitions and Displays. The most we will pay for exhibitions and displays is the amount that they cost you. VPR101 (01-20) Copyright,American International Group,Iinc.,2019. Page 23 of 34 PROPERTY All rights reserved. Includes copyrighted material of the Insurance Services Office,inc.,with its permission. 5. Stock. "Stock" you have sold but not delivered will) be valued at no more than the selling price less discounts and expenses you otherwise wound have had. 6. Glass. Glass will be valued at the cost of replacement with safety glazing material if required by law. SECTION V.CONDITIONS The following apply in addition to the Common Policy Conditions. 1. Abandonment There can be no abandonment of any property to us.. 2. Appraisal If we cannot agree with you on the amount of the loss, either of us can demand that the following procedure be used to settle the amount. a. You or we will request in writing that the dispute be submitted to appraisal within 60 days from the time we receive your proof of loss Each will then select an appraiser and notify the other of that choice within 20 days of the iinitial request. b. The appraisers will select an Impartial umpire, If they cannot agree on an umpire within 15 days, either you or we can ask that an umpire be appointed by a judge of the court of record in the county where the property is (located c, The appraisers will appraise each item for its value at the time of loss and the amount of loss, If they can't agree, they will submit any differences to the umpiire. An agreement in writing by any two of these three widll determine the amount of the loss d. You w0l pay your appraiser and we will pay ours. Each will share equally any other costs of the appraisal and the umpire. e. We will not surrender our rights by any act we take relating to an appraisail,. 3. Concealment, Misrepresentation or Fraud This coverage part is void in any case of fraud by you as it relates to this coverage part at any time.. It is also void if you or any other insured„ at any time, intentionally conceal or misrepresent a material fact concerning: a. This coverage part; b. The covered property; c. Your interest in the covered property; or d. A claim under this coverage part. 4. Control of Property Any act or neglect of any person other than you, beyond your direction or control, will not affect this insurance. The breach of any condition of this coverage part at any one or more locations will not affect coverage at any (location where, at the time of loss or damage, the breach of condition does not exist. VPR101 (01-20) Copyright,American International Group,,Inc„2019. Page 24 of 34 PROPERTY All rights reserved.Includes copyrighted matenare of the Insurance Services Office,Inc.,with its permission P N tJ1 W dq W) N d' 5. Duties in the Event of Loss or Damage a. You must see that the following are done in the event of loss or damage to property insured under this coverage part: (1) Notify the police if a law may have been broken. (2) Give us prompt notice of the loss or damage. Include a description of the property involved. (3) As soon as possible, give us a description of how, when and where the loss or damage occurred. (4) Take all reasonable steps to protect the property from further damage by a "covered cause of loss". If feasible, set the damaged property aside and in the best possible order for examination. Also keep a record of your expenses for emergency and temporary repairs, for consideration in the settlement of the claim. This will not increase the Limit of Insurance. (5) At our request, give us complete inventories of the damaged and undamaged property, Include quantities, costs, values, and amount of loss claimed. However, if the total claim for any loss is less than $10,000, you are not required to provide an inventory of the undamaged property. (6) As often as may be reasonably required, permit us to inspect the property proving the loss or damage and examine your books and records. Also permit us to take samples of damaged and undamaged property for inspection, testing and analysis, and permit us to make copies from your books and records. (7) Send us a signed, sworn proof of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. (8) Cooperate with us in the investigation or settlement of the claim. (9) If you intend to continue your"operations", you must resume all or part of them as quickly as possible. If you do not resume your "operations", or do not resume your "operations" as quickly as possible, we will pay based on the length of time it would have taken to resume your"operations"as soon as possible. b. We may examine any insured under oath, while not in the presence of any other insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, including an insured's books and records. In the event of an examination, an insured's answers must be signed. 6. Insurance Under Two or More Coverages If two or more coverages of this coverage part apply to the same loss or damage, we will not pay more than the actual amount of the loss or damage. 7. Legal Action Against Us No one may bring a legal action against us under this coverage part unless: a. There has been full compliance with all of the terms of this coverage part; and b. The action is brought within 2 years after the date on which the direct physical loss or damage occurred. VPR101 (01-20) Copyright,American International Group,Inc,,2019 Page 25 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. 8.. loss Payment a. In the event of loss or damage covered by this coverage part, at our option,„we will either: (1) Pay the value of lost or damaged property; (2) Pay the cost of repairing or replacing the lost or damaged property; (3) Take all or any part of the property at an agreed or appraised value; or (4) Repair, rebuild or replace the property with other property of like kind and quality. b We will give notice of our intentions within 30 days after we receive the sworn proof of loss. c. We will not pay you more than your financial interest in the property. d. We may adjust losses with the owners of lost or damaged property if other than you. If we pay the owners, such payments will satisfy your claims against us for the owners' property. We will not pay the owners more than their financial interest in the property. e„ We may elect to defend you against suits arising from claims of owners of property. We will do this at our expense. f We will pay for covered loss or damage within 30 days after we receive the sworn proof of loss if: (1) You have complied with all of the terms of this coverage part; and (2) We have reached agreement with you on the amount of loss, or an appraisal award has been made. 9. Mortgage Holders a. The term mortgage holder includes trustee. b, We will pay for covered loss of or damage to buildings or structures to each mortgage holder shown in the Declarations in their order of precedence, as interests may appear. c, The mortgage holder has the right to receive loss payment even if the mortgage holder has started foreclosure or similar action on the building or structure. d If we deny your claim because of your acts or because you have failed to comply with the terms of this coverage part, the mortgage holder will still have the right to receive loss payment if the mortgage holder: (1) Pays any premium due under this coverage part at our request if you have failed to do so; (2) Submits a signed, sworn statement of loss within 60 days after receiving notice from us of your failure to do so; and (3) Has notified us of any change in ownership, occupancy or substantial change in risk known to the mortgage holder. All of the terms of this coverage part will then apply directly to the mortgage holder.. e. If we pay the mortgage holder for any loss or damage and deny payment to you because of your acts or because you have failed to comply with the terms of this coverage part: (1) The mortgage holder's rights under the mortgage will be transferred to us to the extent of the amount we pay; and (2) The mortgage holder's right to recover the full amount of the mortgage holder's claim will not be impaired. At our option we may pay to the mortgage holder the whole principal on the mortgage plus any accrued interest. In this event, your mortgage and note will be transferred to us and you will pay your remaining mortgage debt to us. VPR101 (01.20) Copyright,.American International Group,Inc,,2019 Page 26 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc-with its permission. .P W U1 U1 (D rn N d' �'. if we cancel this coverage part., we will give written notice to the mortgage holder at'least: (1) 10 days before the effective date of cancellation if we cancel for your nonpayment of premuum;,or (2) 30 days before the effective date of cancellation if we cancel for any other reason. gi. If we elect not to renew this coverage part, we will give written notice to the mortgage holder at least 10 days before the expiration date of this policy. 101. No Benefit to Bailee No person or organization, other than you, having custody of covered property will benefit from this insurance, 11. Other Insurance a. You may have other insurance subject to the same plan, terms„ conditions and proviisions as the insurance under this coverage part. If you do,, we will pay our share of the covered loss or damage. Our share is the proportion that the applicable Limit of Insurance under this coverage part bears to the Limits of Insurance of all insurance covering on the same basis. b, If there is other insurance covering the same loss or damage, other than that described in a, above„ we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance, whether you can collect it or not. But we will not pay more than the applicable Limit of Insurance. 12. Policy Period, Policy Territory We wilt cover loss or damage commencing: a. During the policy period shown in the Declarations; and b,. Within the"policy territory". 13. Recovered Property If either you or we recover any property after loss settlement, that party must give the other prompt notice. At your option, the property will be returned to you. You must then return to us the amount we paid to you for the property. We will pay recovery expenses and the expenses to repair the recovered property, subject to the Limit of Insurance. 14. Transfer of Rights of Recovery Against Others To Us If any person or organization to or for whom we make payment under this coverage part has rights to recover damages from another, those rights are transferred to us to the extent of our payment. That person or organization must do everything necessary to secure our rights and must do nothing after loss to impair them. But you may waive your rights against another party in writing: a. Prior to a loss to your covered property or covered income; b. After a loss to your covered property or covered income only if, at time of loss, that party is one of the following: (1) Someone insured by this insurance; (2) An organization owned by or controlled by you; VPR101 (01-20) Copyright„American International Group,Inc.,2019. Page 27 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. (3) An organization that owns you or controls you; or (4) Your tenant. This will not restrict your insurance.. 15. Coinsurance If a coinsurance percentage its shown in the Declarations, or in an endorsement attached to this coverage part, for any of your"real property"or"'personal property", the following condition applies. a.. We will not pay the full amount of any loss if the value of the property at the time of loss, multiplied by the coinsurance percentage shown for it, is greater than the Limit of Insurance for the property. Instead, we will determine the most we will pay using the following steps: 1. Muiltiply the value of the property at the time of loss by the coinsurance percentage; 2. Divide the Limit of Insurance of the property by the figure determined in step 1.; 3, Muilt'iply the total amount of (loss, before the application of any deductible, by the figure determined in step 2.; and 4, Subtract the deductible from the figure determined in step 3. We will pay the amount determined in step 4 or the Limit of Insurance, whichever is less. For the remainder, you will either have to rely on other insurance or absorb the loss yourself. b, Example (Undehnsurance): The value of the property is $250,000. The coinsurance percentage for it its 90%, The Limit of Insurance for it is $100,000, The deductible its $500. The amount of loss is$40,000. 11, Step (1): $250,000 x 90'% =$225,000 (this is the minimum amount of insurance needed to meet your coinsurance requirement) 2, Step (2): $100,000 + $225,000 = A4 3. Step (3): $40,000 x .44 = $17,600 4.. Step (4): $17,600 - $500 = $17,100 We will pay no more than $17,100. The remaining $22„900 is not covered. c You agree to keep the property insured for a portion of its value. That portion is the coinsurance percentage shown in the Declarations or in an endorsement attached to this coverage part. In computing this amount, we use the property's ""replacement cost" or its "actual cash value", whichever is indicated. d. We compute the minimum amount of insurance you are required to carry based on the property's value at the time a loss occurs. In determining the property's value for this coinsurance agreement,we do not include the following 1, The value of property covered under SECTION II.COVERAGE EXTENSIONS; 2 The value of excavations, or 3, The value of brick,, stone or concrete foundations, including foundations of machinery or boilers, which are bellow the surface of the building's basement floor.. If the building has no basement, we don't include the value of brick, stone, or concrete below the surface of the ground and inside the foundation walls when we compute the value of the building.. Nor do we include the value of underground flues, pipes or drains. e. If your property is insured for the minimum amount required, this coinsurance agreement won't have any effect on what we will pay for a covered loss. We will pay up to the applicable coverage VPR101 (01-20) Copyright„American International Group,Inc,.2019, Page 28 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office„Inc.,math its permission. P N tJ1 4 00 N d' limit. But if your property is insured for less than the minimum amount required, we will only pay part of your loss and you must pay the rest. f. When coinsurance applies, it will apply separately to each coverage limit for "real property" or "personal property" covered under this policy, unless specifically amended. However, coinsurance will not apply to losses which are less than $10,000. g. When "actual cash value" is indicated as the valuation basis for "real property" or "personal property" in the Declarations or in an endorsement attached to this coverage part, the most we will pay for loss or damage is the smallest of the following: 1. the coverage limit which applies to that property; 2. the"actual cash value"of the lost or damaged property; or 3. the amount which you actually spend to repair or replace the lost or damaged property with property of comparable kind or quality. You may substitute property of a different kind or quality, but we won't pay more than what it would cost to replace the lost or damaged property with property of comparable kind and quality. h. When "real property" is insured on a "replacement cost" basis, coinsurance shall apply to paragraph a., but not to paragraphs b. or c., of Extension 1. Ordinance Coverage. SECTION VI. DEFINITIONS 1. "Accounts receivable costs" mean: a. Accounts receivable due to you but which you can't collect; b. Extra collection costs you incur to collect accounts receivable due to you; c. Interest charges on loans you have been required to obtain to compensate for accounts receivable you can't collect when due; and d. Reasonable costs of replacing your accounts receivable records. "Accounts receivable costs" also include losses or costs you incur if you have to remove accounts receivable records from a "premises"to a place of safety in order to protect them from the threat of a "covered cause of loss". Accounts receivable are amounts owed to you by those with whom you deal. 2. "Actual cash value" is calculated as the amount it would cost to repair or replace the damaged or destroyed property, at the time of loss or damage, with material of like kind and quality, subject to a deduction for deterioration, depreciation and obsolescence. "Actual cash value" applies to the valuation of property regardless of whether that property has sustained partial or total loss or damage. The "actual cash value" of such property may be significantly less than its "replacement cost". 3. "Computer virus" means a computer program or computer code which is entered into your computer system without your knowledge, and which causes a disruption of normal program or computer system operation, but it does not mean an error in design or a programming error. 4. "Covered cause of loss" is defined in SECTION Ill. COVERED CAUSES OF LOSS. 5. "Earthquake" means all earthquake shocks that commence after the inception of this insurance, but "earthquake"does not include the cost of restoring or remediating land. 6. "Emergency situation" means an unexpected situation demanding an immediate official action during an emergency response. VPR101 (01-20) Copyright,American International Group,Inc..2019. Page 29 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc,,with its permission. 7. "Employees" are people who work for you in the conduct of your ordinary activities, in return for a salary, wages or commissions. In order to be considered an "employee"', a person must be subject to your exclusive direction in the performance of his or her activities. Contractors and agents are not considered to be"employees". 8. "Extra expense" means expense you incur during the "period of restoration" over and above your ordinary expenses,which are necessary to avoid or minimize the suspension of your"operations"and return to your normal "operations" after direct physical loss or damage to "real property" or"personal property" at a "premises". "Extra expenses" include expenses you incur to continue your normal "operations" at a temporary location or with substitute equipment. The most we w0ll pay is described under SECTION IV.WHAT WE WILL PAY. 9. "Fine arts" means property that is rare or that has historic or artistic value, including antiques, rare articles, etchings, pictures, statuary, marbles, bronzes, porcelains and similar property. 10. "Flood" means a general and temporary condition of partial or complete inundation of normally dry land areas due to: a. The overflow of inland or tidal waters; or b. The unusual or rapid accumulation or runoff of surface waters from any source. Flooding must commence after the inception of this insurance. If the"flood" is due to the overflow of inland or tidal waters, the"flood" is considered to begin when the water first overflows its banks. With respect to"flood", we will not pay for loss or damage caused by or resulting from the destabilization of land arising from the accumulation of water in subsurface land areas. 11. "Fungus" means any type or form of fungus, including mold or mildew, and any mycotoxiins, spores, scents or by-products produced or released by fungi. 12, "Government activity" means: a. The seizure or destruction of property by any government body, including any customs or quarantine action; or b.. Confiscation or destruction of property by order of any government or public authority, except an order to destroy property to prevent the spread of fire or explosion. 13. "Hardware" means computers and their electronic data processing parts and equipment which accept„ utilize and process raw information for conversion to machine readable form. 14. "Item" means a building or structure at a "premises". 15. "Loss of income" including rental value means the net income (net profit or (Noss before income taxes) that would have been earned in your"operations" during the "period of restoration". "Loss of income" includes continuing normal operating expenses incurred, including payroll. 16. "Money"' means currency, coins, bank notes, bullion, travelers checks, registered checks and money orders held for sale. 17. "Nuclear activity" means loss from nuclear reaction, nuclear radiation or radioactive contamination, whether deliberate or accidental, controlled or uncontrolled, and whether or not the loss is direct or indirect, proximate or remote, or is contributed to or aggravated by a "covered cause of loss"". But it does not include explosion, fire or smoke. 18, "Operations" means: a. Your official activities as an emergency service organization, and b.. The tenantability of a"premises", if coverage for"loss of income" applies to rental value. 19, "Period of restoration" means the period of time that: VPR101 (01-20) Copyright,American International Group...Inc.,,2019. Page 30 of 34 PROPERTY All rights reserved.Includes copyrighted maternal of the Insurance Services Office,Inc.,with its permission, P N tJ1 0 (D N d' a. Begins with the date of direct physical loss or damage caused by or resulting from any "covered cause of loss"at a"premises"; and b. Ends at the earliest of: (1) The date when the property is actually repaired or replaced using reasonable speed and similar quality, design, functionality and materials; or (2) The date when the property could have been repaired and your"operations"could have been resumed, if the damaged property had been repaired using similar quality, design„ functionality and materials; or (3) Twenty-four consecutive months after the direct physical loss or damage. "Period of restoration" does not include any increased period required due to the enforcement of any ordinance or law that: (1) Requires any insured or others to incur"remediation expenses'; or (2) Pertains to"fungus",wet rot, dry rot or bacteria. The expiration of this policy will not cut short the period of restoration. 20, "Personal effects" means property that belongs to an individual and is devoted primarily to that individual's personal use; for example, clothing, eyeglasses, or individually owned portable firefighting, ambulance, or rescue related equipment. "Personal effects"does not include: a. "Money"and"securities"; b. "Fine arts"; c. Animals; d. Aircraft or its parts, accessories and equipment; e. "Watercraft'; or f. "Vehicles". 21. "Personal property" means all property used in your"operations", other than"real property", including but not limited to furnishings and equipment, building contents, "hardware", communication systems, base stations and dispatching systems, provided the property is on your "premises" and also provided: a. You own the property; or b. The property is in your custody or control, and you are responsible for it, even though it belongs to someone else. "Personal property" also includes the value of your right to use improvements made as a tenant, if you have paid for alterations or additions to any building or structure you don't own. However, these improvements must be at a"premises". "Personal property"does not include: (1) "Personal effects"belonging to you or your volunteers or"employees"; (2) Animals; (3) "Money"and"securities"; (4) "Valuable papers and records"; (5) "Accounts receivable costs'; (6) "Software"; (7) "Fine arts"or jewelry; VPR101 (01-20) Copyright,American International Group,Inc.,2019 Page 31 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office.Inc.,with its permission. (8) Aircraft or its parts, accessories and equipment; (9) "Watercraft"; or (10) "Vehicles". 22. "Policy territory"means the United States, its territories and possessions, Puerto Rico and Canada. 23, "Pollution conditions" means the discharge, dispersal, release, seepage, migration, or escape of smoke, vapors, soot, fumes, acids, alkalis, toxic chemicals, liquids or gases, hazardous materials, waste materials (including medical, infectious and pathological wastes) or electromagnetic fields into or upon land or any structures thereon, the atmosphere, or any watercourse or body of water including groundwater. 24. "Premises" means a location described in the Declarations that is owned or legally occupied by you and used to conduct your"operations". 25. "Reall property"means buildings or structures described in the Declarations as"items", including: a. All appurtenant buildings or structures; b. Completed additions; c. Additions under construction; d. Alterations and repairs to the buildings or structures; e. Permanently installed fixtures, machinery, and equipment; f. Outdoor fixtures; g. "'Personal property" used for the maintenance and service of buildings or structures, inclluding tools, lawn care equipment, and free standing appliances for refrigerating, ventilating, cooking, dishwashing and laundering; h. Materials, equipment, supplies and temporary structures you own or for which you are responsible, on the "premises" or in the open (including property inside "'vehicles") within 1,000 feet of the "premises", used for making additions, alterations or repairs to buildings or structures at the"premises"; I. Paved surfaces such as sidewalks, patios or parking lots; j. Air cascade units that acre not designed to be used off"premises"; and k. Exterior signs, meaning neon„ automatic, mechanical, electric or other signs either attached to the outside of a building or structure, or standing free in the open. "Real property"does not incllude: (1) Land; (2) Water; (3) Excavations, grading, or filling; or (4) Trees, shrubs, plants and pawns except as described in SECTION H. COVERAGE EXTENSIONS. 26 "Remediation expenses"are expenses incurred for or in connection with the 'investigation, monitoring, removal], disposal, treatment, or neutralization of"pollution conditions" to the extent required by: a. Federal, state or local haws, regulations or statutes, or any subsequent amendments thereof, enacted to address"pollution conditions",- or b. A legally executed state voluntary program governing the cleanup of"pollution conditions". VPR101 (01-20) Copyright,American Internatlonall Group„Inc;,2019, Page 32 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,,with its permission. P N d7 N tG N d' 27. "Replacement cost" is the amount it would take, following direct physical loss or damage, to replace property with property of the same kind and quality, determined at the time of loss, without deduction for deterioration, depreciation or obsolescence. But: a. "Replacement cost"does not include costs arising out of the enforcement of any ordinance or law regulating the construction, use or repair of any property, or requiring the tearing down of any property, or the cost of removing its debris; and b. "Replacement cost"does not apply to"stock". 28, "Securities" means negotiable and non-negotiable instruments or contracts that represent property or obligations to pay "money". Stamps, including revenue stamps, are "securities"; so are tokens and tickets. However, stamps are covered only for their face value. "Money" is not considered to be "securities". 29. "Sinkhole collapse" means sudden sinking or collapse of land into underground empty space created by the action of water on limestone or similar rock formations. "Sinkhole collapse" does not include the cost of filling sinkholes. 30, "Software" includes all forms of computer programs, computer code, and computer readable data employed in your "operations". It also includes the media on which computer programs, computer code, or computer readable data are electronically or optically recorded such as magnetic tapes, hard disks, floppy disks, compact disks or digital video disks. 31, "Specified cause of loss" means fire, lightning, windstorm or hail, explosion, riot or civil commotion, "vehicles" or aircraft, smoke, sonic boom, vandalism and malicious mischief, "sprinkler leakage", "sinkhole collapse", "volcanic action", falling objects, weight of ice, snow or sleet, or water damage. Water damage means only accidental discharge or leakage of water or steam as the direct result of the breaking or cracking of any part of a system or appliance containing water or steam. "Specified cause of loss" does not include "remediation expenses" resulting from the spilling or dripping of gasoline, diesel fuel or other pollutants while being delivered by "vehicles" into storage tanks or other repositories, and/or when"vehicles"are being fueled. 32. "Sprinkler leakage" means leakage or discharge of any substance from an automatic "sprinkler system". It includes the collapse or fall of a tank that is part of a plumbing or an automatic "sprinkler system". It also includes damage caused by breakage or freezing to parts of an automatic"sprinkler system"installed in a building, if"sprinkler leakage" results from such damage. 33. "Sprinkler system" means an automatic fire protection system. Sprinkler heads, discharge nozzles and ducts, pipes, valves, fittings, tanks, tank parts and supports, pumps„ and private fire protection systems which are connected to the "sprinkler system" are considered to be part of the system, So are non-automatic fire protection systems, hydrants, standpipes, and hose outlets supplied from the automatic fire protection"sprinkler system". 34. "Stock" means merchandise held in storage or for sale, raw materials, and in-process or finished goods, including supplies used in their packing or shipping. 35. "Vacant" when referring to a building means that the building doesn't contain the "personal property"' used in the operations ordinarily conducted there. 36. "Valuable papers and records" are documents that are written, printed, or otherwise inscribed These include: a. Books, manuscripts, abstracts, maps and drawings; b. Film and other photographically produced records, such as slides and microfilm; and c. Legal and financial agreements such as deeds and mortgages. But"valuable papers and records"do not include"money"or"securities". VPR101 (01-20) Copyright,American International Group Inc.,2019, Page 33 of 34 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission, 37. 'Vehicle" means vehicles or their parts, accessories, and equipment if the vehicles are required by law to be licensed for highway use. 38. 'Vehicle stock" means parts and accessories used for your"vehicles "Vehicle stock" inclludes but is not limited to tires, batteries, light bars, mobile radios„ and auto parts used for"veh'iclle" maintenance. "Vehicle stock" does not include portable firefighting, ambulance, or rescue related equipment, including portable communications equipment, commonly used in fire and rescue operations away from your"premises"' 39. "Volcanic action" means direct loss or damage resulting from the eruption of a volcano when the loss or damage is caused by: a„ Airborne volcanic blast or airborne shock waves; b. Ash, dust or particulate matter; or c. Lava flow.. But"volcanic action" does not 'include the cost to remove ash, dust or particulate matter that does not cause direct physical loss or damage to covered property, 40. "War"means any of the following,. a. War, including undeclared or civil war; b. Warlike action by a miliitary force, including action in hindering or defending against an actual or expected attack, by any government,, sovereign or other authority using military personnel or other agents„ or c, Insurrection,,, rebellion, revolution, usurped power, or action taken by governmental authority in hinderiing or defending against any of these, 41. "Watercraft"" means any watercraft, including iits motor, parts„ accessories and equipment„ except for rowboats and canoes that are out of the water and on your"premises". VPR10i (01-20) Copyright„American International Group„Inc.,2019. Page 34 of 34 PROPERTY All nights reserved.Includes copyrighted material of the Insurance Services Office,Inc,with its permission. P N d7 W dq to N d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WINDSTORM, HAIL AND/OR "FLOOD" PERCENTAGE DEDUCTIBLE - "NAMED STORMS" ONLY This endorsement modifies insurance provided under the following; PROPERTY COVERAGE PART SCHEDULE "Premises" "Item" Deductible Number Number Address Percentage 1 1 1 EAST DR KEY LARGO FL 33037 5% 2 ±:71 220 REEF KEY LARGO FL 33037 5% [Information required to complete this schedule, if not shown on this endorsement,will be shown in the Declarations.] The deductible shown in the schedule applies to loss or damage to covered property caused by or resulting from windstorm, hail and/or"flood" resulting from a "named storm". Loss or damage caused by windstorm, hail and/or"flood" not resulting from a"named storm", or loss or damage caused by any other "covered cause of loss", is not affected by this endorsement. "Named storm"' means a weather condition that: a. Has sustained windspeeds of at least 39 miles per hour; and b. Has been declared to be a hurricane or a tropical storm by the National Hurricane Center of the National Oceanic and Atmospheric Administration's National Weather Service. For the purpose of this endorsement,the occurrence of a"named storm"; C. Begins when the National Hurricane Center issues a tropical storm or hurricane watch or warning for any part of the state in which covered property is located; and d. Ends 72 hours after the National Hurricane Center terminates the last tropical storm or hurricane watch or warning for any part of the state in which covered property is located. A. Windstorm, Hail and/or"Flood" Deductible Clause for"Named Storms"Only 1. A deductible is calculated separately for, and applies separately to, each affected "item". This is done by multiplying the deductible percentage appearing in the schedule to the sum of the "real property" and "personal property" limits shown in the Declarations for each affected "item". If blanket coverage applies, we will determine this sum based on the most recent amounts on file with us for each affected "item". 2. We will not pay for loss or damage until the amount of loss or damage exceeds the applicable deductible. We will then pay the amount of loss or damage in excess of that deductible, up to the applicable Limit of Insurance, after any reduction required by any applicable coinsurance provision. 3. When property is covered under Extension 6. Newly Acquired or Under Construction "Real Property" and Related "Personal Property" of SECTION II. COVERAGE EXTENSIONS, we will calculate the deductible amount for each "item" in the schedule according to paragraph 1. above, and apply the largest deductible so calculated to the property covered by Extension 6. VPR312(01-20) Copyright,American international Group,Inc-2019 Page 1 of 2 PROPERTY All rights reserved Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. B. Examples Example#1 —Scheduled "Real Property" and "Personal Property"!No Coinsurance The amounts of loss to damaged property at an affected "item" are $60,000 to the building and $40,000 to personal property"'as a result of high winds from a tropical storm.. The Liimit of Insurance on the damaged building at the time of loss is $100,000. The Limit of Insurance on the "personal property" in the building is $80,000. No coinsurance provision applies The deductible is 5%. Step (1) : The sum of the"real property"and"personal property'"limits is$180,000. Step(2) : $180,000 X 5%=$9,000 Step(3) : The sum of the"real property"and""personal property" loss amounts is$100,000. Step(4) : $100,000-$9,000 =$91,000, The most we will pay is $91„000 That portion of the loss not reimbursed due to application of the deductible is$9,000. Example#2—Blanket"Personal Property"1 No Coinsurance The insured is a tenant at two locations, The blanket limit for "personal property" is $350,000, This is the sum of the value of the "personal property'" at "item" 91 ($250„000) and the 'personal property" at "'item" #2 ($100,000)," as used to calculate the most recent renewal premium. No coinsurance provision applies, The "personal property" housed at "item' #1 sustains damage of$100,000 as the result of storm surge ("flood") caused by a hurricane. There is only minor "flood" damage of $2„000 to the `personal property"at"item'#2. The deductible is 3%. "Personal Property"at"Item"#1 Step(1) : $250",000 X 3%= $7,500 Step(2) : $100,,000-$7,500 =$92,500 "Personal Property" at"Item"#2 Step (1) : $100„000 X 3% =$3,000 (the$2,000 loss does not exceed the deductible) The most we will pay is $92,500. The remainder of the loss ($9,500) will not be paid due to the separate application of the deductible at the two locations. Example#3—Scheduled "Real Property' /Coinsurance Applies The roof of the insured's only building is badly damaged by wind and hail during a hurricane and needs to be replaced. The amount of the loss is $40,000. There is no damage to "personal property". The value of the building at the time of loss is $150,000. The coinsurance percentage on the Declarations is 80%, so the insured would need to carry at least $120,000 of insurance on the building to meet the coinsurance requirement (80% of $150,000). However, the amount carried on the building is only$100,000. The"personal property" limit is$20,000. The deductible is 5%. Step(1) : $100,000 +$120,000= .83 Step(2) : $40,000 X .83 =$33,200 Step (3) : $120,000 X 5%= $6,000 Step (4) : $33„200-$6,000 = $27,200 The most we will pay is $27,200. The remainder of the loss ($12,800)will not be reimbursed due to the application of the coinsurance penalty [steps (1) and (2)] and the deductible [steps (3) and (4)1. VPR312(01-20) Copyright,American International Group,Inc.,2019, Page 2 of 2 PROPERTY Aili rights reserved.Includes copyrighted material of the Insurance Services Office, Inc,,with its permission. P N d7 tJ1 cfl cfl N d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITATION OF ORDINANCE COVERAGE - WINDSTORM, HAIL AND/OR "FLOOD" RESULTING FROM "NAMED STORMS" ONLY This endorsement modifies insurance provided under the following:. PROPERTY COVERAGE PART With respect only to loss or damage caused directly by windstorm, hail and/or "flood" resulting from a "named storm", Extension I. Ordinance Coverage of SECTION ll. COVERAGE EXTENSIONS is deleted and replaced by the following.- When either"replacement cost" or guaranteed 'replacement cost" is indicated in the Declarations as applicable to Coverage A, we will pay: a. For loss to any undamaged portion of your"'real property" caused by the enforcement of any law or ordinance that: (1) Requires the demolition of parts of your"real property"not damaged by a"covered cause of loss"; (2) Regulates the construction or repair of buildings or establishes zoning or land use requirements at a"premises`; and (3) Is in force at the time of loss. b. The cost to demolish and clear the site of the undamaged part of the property caused by enforcement of a building„zoning or land use ordinance or law; and c. The increased cost to repair„ rebuild or construct the "real property" caused by the enforcement of a building, zoning or land use ordinance or law, in addition to the "replacement cost" of the"real property"suffering the loss or damage. The total paid for any "item" under paragraph a. above shall be included within the Coverage A Limit of Insurance applicable to that "item" and shall not increase that limit. The most we will pay under paragraphs b. and c. above shall not exceed 25% of the amount paid under this coverage part for the initial direct physical loss or damage to that"item". Under this extension, we will not pay any costs: (a) Due to an ordinance or law that was in effect before the loss or damage occurred, and with which you failed to comply even though you were required to do so; (b) Due to an ordinance or law enacted to apply retroactively; (c) Associated with "remediation expenses"; or (d) Due to"fungus", wet rot, dry rot or bacteria. "Named storm"means a weather condition that: (i) Has sustained windspeeds of at least 39 miles per hour; and (ii) Has been declared to be a hurricane or a tropical storm by the National Hurricane Center of the National Oceanic and Atmospheric Administration's National Weather Service. For the purpose of this endorsement, the occurrence of a"named storm": (iii) Begins when the National Hurricane Center issues a tropical storm or hurricane watch or warning for any part of the state in which covered property is located; and (iv) Ends 72 hours after the National Hurricane Center terminates the last tropical storm or hurricane watch or warning for any part of the state in which covered property is located. Loss or damage arising out of other"covered causes of loss" is not affected by this endorsement. VPR314(01-20) Copyright,American International Group,Inc.;2019. Page 1 of 1 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission„ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CRISIS INCIDENT RESPONSE COVERAGE This endorsement modifies insurance provided under the following: PROPERTY COVERAGE PART SCHEDULE Crisis Incident Limit of Insurance: $ 26,000 Any One Crisis Incident A. Crisis Response Management Expense We will pay "crisis response management expense" incurred by you as a result of a covered "crisis incident" B. Post-Crisis Counseling Services We will pay expenses incurred by you for "post-crisiis counseling services"' provided to your "member(s)"following a covered "chsis incident". C. Loss Payment The most we will pay in any one"'crisis incident"' is the lesser of. 1. The actual cost you incur for all "crisis response management expense" and "post-crisis counseling services"; or 2. The Crisis Incident Limit of Insurance shown in the Schedule above. The "crisis response management expense" and the cost for "post-crisis counseling services must be incurred and submitted within 12 months of the first published news media report. The expiration of this policy will not reduce the 12 month period. D. Deductible No deductible applies to this coverage. E. Definitions 1. "Crisis incident" means any of the following acts that result in significant "news media coverage"' of the named insured: a. An actual, attempted, or threatened violent act occurring at a "premises" committed with mali6ous intent to cause "serious bodily injury" or death to a person or person(s); the abduction or kidnapping of a person from a"premises'; or a sexual assault at a"premises". b. A criminal act which is alleged to have been committed by a "member" of your organization, including but not limited to arson„theft, or sexual assault. c. The performance of your"operations" in response to an"emergency situation"', All related acts committed by one or more individual(s) shall be considered one"crisis incident."" VPR319(01-20) Copyright„American International Group,Inc.,2019. Page 1 of 2 PROPERTY All rights reserved. Includes copyrvghted materW of the Insurance Services office.Inc."with its permission. P N d7 4 00 W N d' 2. "Crisis response management expense" means the reasonable and necessary expense charged by an independent public relations or other crisis communications firm to restore your public image that has been damaged by a covered"crisis incident". 3. "Member"means a volunteer or"employee"of the Named insured. 4. "News media coverage" means an oral or written publication, in any manner, by a news organization. 5. "Post-crisis counseling services" means the reasonable and necessary expense you incur for independent professional counseling or pastoral services provided to your "member($)' as a result of emotional strain due to a covered "crisis incident" involving one of the following: a. the death or"serious bodily injury" of another"member"or"member's"family member; b. three or more deaths; or c. the death or"serious bodily injury" of a child. "Post-crisis counseling services" will not be provided to any "member" who was responsible for, or participated in acts described in Ca.or 1.b.above. 6. "Serious bodily injury" means any injury to a person that creates substantial risk of death, serious permanent disfigurement, or protracted loss or impairment of the function of any bodily member or organ. F. Other Provisions The coverage provided by this endorsement is separate from any other property coverage provided by the coverage part to which it is attached. However, Section V. Conditions and Section VI. Definitions of the Property Coverage Form will apply. VPR319(01-20) Copyright,American International Group,Inc.,2019, Page 2 of 2 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission.. THIS ENDORSEMENT CHANGES THE POLIICY. PLEASE READ IT CAREFULLY. AMENDATORY ENDORSEMENT This endorsement modifies insurance provided under the following:. PROPERTY COVERAGE FORM Section II. Coverage Extensions, 16.b.(5) Off-"Premises" Accidents, is deleted and replaced by the following: (5) Off-"Premises"Accidents Coverage is extended to apply to an accident to the following types of equipment, whether mobile/portable or permanently mounted on a"vehicle anywhere in the"pollicy territory": (a) Mobile cascade units (b) Mobile electrical generators; (c) Portable pumping units,;and (d) Portable extrication devices, such as jaws-of-life, whether hydraulic or air powered. This additional coverage is not subject to the definition of 'covered equipment" (Section II. Coverage Extensions, 16.a.(c)) to the extent that the definition conflicts with the coverage provided for Off- "Premises" Accidents. However, in no event will we pay for an accident to a "vehicle's" drivetrain, driveline,or fire pump. VPR322(01-20) Copyright.American international]Group,Inc.,2019 Page 1 of 1 PROPERTY AIU rights reserved Includes copyrighted material of the Insurance Services Office,Inc with its permission. .P N W 0 ti N d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA CHANGES This endorsement modifies insurance provided under the following: PROPERTY COVERAGE PART A. The following provision applies when a coinsurance percentage is shown in the Declarations: Florida law states as follows: Coinsurance contract: The rate charged in this policy is based upon the use of the coinsurance clause attached to this policy, with the consent of the insured. B. The following is added: If loss or damage to covered property is caused by or results from windstorm, the following exclusion applies in: 1. Broward County; 2. Dade County; 3. Martin County; 4. Monroe County; 5. Palm Beach County; and 6. All the areas east of the west bank of the Intracoastal Waterway in the counties of: a. Indian River; and b. St. Lucie. Windstorm Exterior Paint and Waterproofing Exclusion We will not pay for loss or damage to: 1. Paint; or 2. Waterproofing material; applied to the exterior of buildings unless the building to which such loss or damage occurs also sustains other loss or damage by windstorm in the course of the same storm event. But such coverage applies only if windstorm is a"covered cause of loss". When loss or damage to exterior paint or waterproofing material is excluded, we will not include the value of paint or waterproofing material to determine; a. The amount of the windstorm or hail deductible; or b. The value of covered property when applying the coinsurance condition. C. Paragraph f. of Condition 8. Loss Payment of SECTION V is replaced by the following: f. Provided you have complied with all the terms of this coverage part, we will pay for covered loss or damage upon the earliest of the following: (1) Within 20 days after we receive the sworn proof of loss and reach written agreement with you; (2) Within 30 days after we receive the sworn proof of loss and: (a) There is an entry of a final judgment; or (b) There is a filing of an appraisal award with us; or VPRFLI (07-22) Copyright,American International Group,Inc.,2022, Page i of 5 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. (3) Within 90 days of receiving notice of an initial, reopened or supplemental claim, unless we deny the claim during that time or factors beyond our control reasonably prevent such payment. If a portion of the claim is denied, then the 90 day time period for payment of claim relates to the portion of the claim that is not denied.. Paragraph (3)applies only to the following: (a) A claim under a policy covering residential property; (b) A claim for building or contents coverage if the insured structure is 10,000 square feet or less and the policy covers only locations in Florida; or (c) A claim for contents coverage under a tenant's policy if the rented premises are 10,000 square feet or less and the policy covers only locations in Florida. D, The Legal Action Against Us Condition is replaced by the following: No action can be brought against us unless there has been full compliance with all of the terms of this coverage part and the action is started within 5 years after the date of loss; except that the time for filing suit is extended for a period of 60 days following the conclusion of the neutral evaluation process or 5 years," whichever is later. All other provisions of this policy apply. E. The following provisions are added to the Duties In The Event Of Loss Or Damage Loss Condition: c. A claim or reopened claim for loss or damage caused by any peril is barred unless notice of claim is given to us in accordance with the terms of this policy within two years after the date of loss. A reopened claim means a claim that we have previously closed but that has been reopened upon your request for additional costs for loss or damage previously disclosed to us. A supplemental claim is barred unless notice of the supplemental claim was given to us in accordance with the terms of the policy within three years after the date of loss. A supplemental claim means a claim for additional loss or damage from the same peril which we have previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. For claims resulting from hurricanes, tornadoes, windstorms, severe rain or other weather- related events, the date of loss is the date that the hurricane made (landfall or the tornado, windstorm, severe rain or other weather-related event is verified by the National Oceanic and Atmospheric Administration. This provision concerning time for submission of claim, supplemental claim or reopened claim does not affect any limitation for legal action against us as provided in this policy under the Legal:Action Against Us Condition, including any amendment to that condition. d Any inspection or survey by us, or on our behalf, of property that is the subject of a claim, will be conducted with at least 48 hours' notice to you.. The 48-hour notice may be waived by you. e. A claim for"sinkhole loss", including but not limited to initial, supplemental and reopened claims is barred unless notice of claim is provided to us in accordance with the terms of this policy within two years after you knew or reasonably should have known about the"sinkhole loss". F. "Sinkhole Loss" Provisions a. All references to'sinkhole collapse"mean "sinkhole loss"defined as follows: ""'Sinkhole loss", meaning loss or damage to covered property when"'structural damage"to the building, including the foundation, is caused by settlement or systematic weakening of the earth supporting the building, only when such settlement or systematic weakening results from movement or raveling of soils, sediments, or rock materials into subterranean voids created by the effect of water on a limestone or similar rock formation, VPRFL1 (07.22) Copyright,American International Group,Inc.,2022, Page 2 of 5 PROPERTY All rights reserved.(includes copyrighted material of the Insurance Services Office,(Inc.,,with its permission .P W 4 N ti N d' Coverage for"sinkhole loss" includes stabilization of the building (including land stabilization) and repair to the foundation, provided such work is in accordance with the requirements of Florida Insurance Law and in accordance with the recommendation of a professional engineer and with notice to you. The professional engineer must be selected or approved by us. However, until you enter into a contract for performance of building stabilization or foundation repair in accordance with the recommendations of the professional engineer as set forth in a report from us: 1. We will not pay for underpinning or grouting or any other repair technique performed below the existing foundation of the building; and 2. Our payment for"sinkhole loss"to covered property maybe limited to the actual cash value of the loss to such property. You must enter into a contract for the performance of building stabilization and/or foundation repair in accordance with the aforementioned recommendations,within 90 days after we notify you that there is coverage for your"sinkhole loss". After you have entered into such contract, we will pay the amounts necessary to begin and perform such repairs as the work is performed and the expenses are incurred. However, if the professional engineer determines, prior to your entering into the aforementioned contract or prior to the start of repair work, that the repairs will exceed the applicable Limit of Insurance, we must either complete the recommended repairs or pay that Limit of Insurance upon such determination. If the aforementioned determination is made during the course of repair work and we have begun making payments for the work performed„ we must either complete the recommended repairs or pay only the remaining portion of the applicable Limit of Insurance upon such determination. The most we will pay for the total of all "sinkhole loss", including building and land stabilization and foundation repair, is the applicable Limit of Insurance on the affected building. The stabilization and all other repairs to the covered property must be completed within 12 months after entering into the contract for the performance of these repairs, unless: 1. There is a mutual agreement between you and us; 2. The claim is involved with the neutral evaluation process; 3. The claim is in litigation; or 4. The claim is under appraisal or mediation. b. "Sinkhole loss"does not include: 1. Sinking or collapse of land into man-made underground cavities; or 2. Earthquake. c. With respect to coverage provided by this endorsement, the Earth Movement Exclusion does not apply. d. With respect to a claim for alleged"sinkhole loss", the following provision is added: Following receipt by us of a report from a professional engineer or professional geologist on the cause of loss and recommendations for land stabilization and repair of property, or if we deny your claim, we will notify you of your right to participate in a neutral evaluation program administered by the Florida Department of Financial Services (hereinafter referred to as the Department). For alleged "sinkhole loss" to commercial residential properties, this program applies instead of any mediation procedure set forth elsewhere in this policy, but does not invalidate the Appraisal Condition. VPRFL1 (07-22) Copyright,American International Group„Inc.,2022. Page 3 of 5 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc„with its permission. You or we may file a request with the Department for neutral evaluation; the other party must comply with such request.We will pay reasonable costs associated with the neutral evaluation, regardless of which party makes the request. But if a party chooses to hire a court reporter or stenographer to contemporaneously record and document the neutral evaluation, that party must bear the costs of those services. The neutral evaluator will be selected from a list maintained by the Department.The recommendation of the neutral evaluator will not be binding on you or us. Participation in the neutral evaluation program does not change your right to file suit against us in accordance with the Legal Action Against Us Condition in this policy, except that the time for filing suit is extended for a period of 60 days following the conclusion of the neutral evaluation process or five years,whichever is later. e. Coverage for"sinkhole loss" does not increase the applicable Limit of Insurance. Even if loss or damage qualifies under, or includes, both catastrophic ground cover collapse (addressed elsewhere in this endorsement) and "sinkhole loss", only one Limit of Insurance will apply to such loss or damage. f. If we deny your claim for "sinkhole loss" without performing testing under section 627.7072, Florida Statutes, you may demand testing by communicating such demand to us in writing within 60 days after you receive our denial) of the claim. You are responsible for 50% of the testing costs, or$2,500, whichever is less. If our professional engineer or geologist provides written certification, pursuant to section 627.7073, that there is "sinkhole loss", we will reimburse you for the testing costs. g. You may not accept a rebate from any person performing repairs for "sinkhole loss" covered under this endorsement. If you receive a rebate, coverage under this endorsement is void and you must refund the amount of the rebate to us. h. If we deny your claim for"sinkhole Moss" upon receipt of written certification from a professional engineer or geologist, pursuant to section 627.7073, that there is no"sinkhole loss" or that the cause of the damage was not sinkhole activity, and if the sinkhole claim was submitted without good faith grounds for submitting such claim, you shall reimburse us for 50%of the actual costs of the analyses and services provided under sections 627.7072 and 627,7073, or $2,500, whichever Is less. You are not required to pay such reimbursement unless you requested the analysis and services and we, before ordering the analysis, informed you in writing of the potential for reimbursement and gave you the opportunity to withdraw the claim. J. As a precondition to accepting payment for"sinkhole loss", you must file with the county clerk of court, a copy of any sinkhole report regarding your property which was prepared on behalf or at your request, You will bear the cost of filing and recording the sinkhole report. G. Catastrophic Ground Cover Collapse The following is added to this Coverage Part as a"covered cause of loss": We willl pay for direct physical loss or damage to covered property caused by or resulting from catastrophic ground cover collapse, meaning geological activity that results in all of the following: 1. The abrupt collapse of the ground cover; 2. A depression in the ground cover clearly visible to the naked eye; 3. "Structural damage"to the building, including the foundation; and 4. The insured structure being condemned and ordered to be vacated by the governmental agency authorized by law to issue such an order for that structure. However, damage consisting merely of the settling or cracking of a foundation, structure or building does not constitute loss or damage resulting from catastrophic ground cover collapse. The earth movement exclusion does not apply to catastrophic ground cover collapse. VPRFLI (07-22) Copyright,American International Group,Inc.2022 Page 4 of 5 PROPERTY All rights reserved.Includes copyr,ghted material of the Insurance Services Office,Inc„with its permiission P N 4 W d ti N d' Coverage for catastrophic ground cover collapse does not increase the applicable Limit of Insurance. Regardless of whether loss or damage attributable to catastrophic ground cover collapse also qualifies as"sinkhole loss"or earthquake(if either or both of those causes of loss are covered under this Coverage Part), only one Limit of Insurance will apply to such loss or damage. K The following definitions are added with respect to the coverage provided under this endorsement:. 1. "Structural damage" means a covered building, regardless of the date of its construction, has experienced the following: a. interior floor displacement or deflection in excess of acceptable variances as defined in ACI 117-90 or the Florida Building Code,which results in settlement related damage to the interior such that the interior building structure or members become unfit for service or represent a safety hazard as defined within the Florida Building Code; b. Foundation displacement or deflection in excess of acceptable variances as defined in ACI 318-95 or the Florida Building Code, which results in settlement related damage to the primary structural members or primary structural systems that prevents those members or systems from supporting the loads and forces they were designed to support to the extent that stresses in those primary structural members or primary structural systems exceed one and one-third the nominal strength allowed under the Florida Building Code for new buildings of similar structure, purpose, or location; c. Damage that results in listing, leaning,or buckling of the exterior load bearing walls or other vertical primary structural members to such an extent that a plumb line passing through the center of gravity does not fall inside the middle one-third of the base as defined within the Florida Building Code; d. Damage that results in the building, or any portion of the building containing primary structural members or primary structural systems, being significantly likely to imminently collapse because of the movement or instability of the ground within the influence zone of the supporting ground within the sheer plane necessary for the purpose of supporting such building as defined within the Florida Building Code; or e. Damage occurring on or after October 15, 2005, that qualifies as substantial "structural damage"as defined in the Florida Building Code. 2. 'Primary structural member" means a structural element designed to provide support andstability for the vertical or lateral loads of the overall structure. 3. 'Primary structural system" means an assemblage of"primary structural members". VPRFLI (07-22) Copyright,American International Group,Inc.,2022„ Page 5 of 5 PROPERTY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inca with its permission. Named Insured: Policy Number: VFNU—TR-0019768-03/000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 4y u r iv rV J1., 11 r b P U r7 m w 1 P,' t r .y y r Her u k z r l ✓: G,� Rt Y RAC AR D E GLARA 101. � v c-'� ny tin 111k,�G,✓...,eu�, ,.B,ti"r��,GO G��[,.Ftia a"rug„ ,„i,�l�,'.-w„U ,,,,, .b ,��� � i Estimated Coverage Part Premium: $ 166. 00 Taxes, Fees and Surcharges: $ 2 . 82 Total Premium: $ 168 . 82 See Schedule of Forms and Endorsements. VCR100(01120) 10-03-2023 N 4 Ul cfl ti N d' Named Insured: Policy Number: VFNU-TR-0019768-03/000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 I, p wru ri �� a i a t i ,11, r Gr vv r rtr va a d a pn c r f; r r v r Y a 9r GrC' i G G fire IJ YI /;flr!N 'L � Y tl .sp dus it r 4 '/ r F i d' C;cllrvx i�ryi�ilQl,", rub i Y °" ° � iil 'a ;{ is a t�l4i I(EY�t ,ri'Ga�l� 3v�r(cy?vinl�r� v t r U �lr� is,N°d°"rex nY rr/ "(u(rr e v r tr rW; ltrJ � ,.,.,. rr*•,a„n ,,,,.,i,e, ,rig. ..........: .. ......� „i,w..�.s ro= i!w +it .ii,�.k, a,+, u/l it .,.r,. N', 7 ,Pr a.yy1G„, s.Z 7��!( ,E(."". Employee Dishonesty —Blanket Covered Entity: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Limit of Insurance Deductible Faithful Performance $ 100, 000 None No SPECIFIC EXCESS LIMIT OF INSURANCE-NAME SCHEDULE Excess Limit of Insurance Each Faithful Names of Covered "Employees" 'Employee" Performance SPECIFIC EXCESS LIMIT OF INSURANCE-POSITION SCHEDULE Number of Excess Limit of Titles of Positions 1 "Employees" in Insurance Each Faithful Name of Covered Entities Each Position 'Employee" Performance VCR100(01/20) 10-03-2023 NarredInsured: Policy Number: VFNU—TR-0019768-03/000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 I G Y Yq JIN kt iG I f,' 1M1 I dU t rb GI P U w� //w�1�J / I'6 1 ,rdt VYYJ E V d b Yb 4 ru NII y ✓ @p I �Yl � jAir € G/td u r r u a w✓�i, t b✓ ��R ME �R m� / i ° i i d y € ✓u Y^o✓r dde us r u.� ✓ a '.b7. t✓ y Y V t,. II 'a E Nun, Computer Fraud Covered Entity: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Limit of Insurance Deductible $ 50, 000 None VCR100(ov2o) 10-03-2023 N 4 00 ti .� N Named Insured: Policy Number: VFNU-TR-0019768-031000 KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Policy Period: From 10-01-2023 To 10-01-2024 CRIME COVERAGE PART DECLARATIONS' Fraudulent Impersonation Coverage ....... ........ ........ ......,,, Covered Entity: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Limit of Insurance Deductible $50,000 None ......-._ ........ ......... ......... VCR100(01120) 10-03-2023 Named Insured: Policy Number: VFNU—TR-0019768-03/000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 -mJD . rw�iru /�► /�ar r r 9 w rt8 p m r d u & r rN � I i Rwr �wR"1�1► �� . I ` 3 3�} J ` r a e u r s r e r s zro �i r au� iu w i u"� o ¢ n r r ' �. s,' I ,ol �wl � .�^A°." .r. �� t ..3 m� a ui Identity Fraud Expense Covered Entity: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Limit of Insurance Deductible 25, 000 None Persons Not Covered VCR1oa(Oii20) 10-03-2023 .p N 4 co 0 00 N d' EMPLOYEE DISHONESTY COVERAGE FORM (Coverage Form A - Blanket) A. COVERAGE We will pay for loss of, and loss from damage to, covered property resulting directly from the covered cause of loss. 1. Covered Property. "Money", "securities"and"property other than money and securities". 2. Covered Cause of Loss: "Employee dishonesty". 3. Coverage Extension Employees Temporarily Outside Coverage Territory: We will pay for loss caused by any "employee"while temporarily outside the territory specified in General Condition B.16. for a period not more than 120 days. B. LIMIT OF INSURANCE The most we will pay for loss in any one "occurrence" is the applicable Limit of Insurance shown in the Declarations. C. DEDUCTIBLE 1. We will not pay for loss in any one"occurrence" unless the amount of loss exceeds the deductible amount shown in the Declarations. We will then pay the amount of loss in excess of the deductible amount, up to the Limit of Insurance. 2. You must: a. Give us notice as soon as possible of any loss of the type insured under this coverage form even though it falls entirely within the deductible amount, and b. Upon our request, give us a statement describing the loss. D. ADDITIONAL EXCLUSIONS, CONDITION AND DEFINITIONS In addition to the Crime General Provisions,this coverage form is subject to the following: 1. Additional Exclusions: We will not pay for loss as specified below: a. Employee Cancelled Under Prior Insurance: Loss caused by any "employee" of yours, or predecessor in interest of yours, for whom similar prior insurance has been cancelled and not reinstated since the last such cancellation. b. Inventory Shortages: Loss, or that part of any loss,the proof of which as to its existence or amount is dependent upon: (1) An inventory computation; or (2) A profit and loss computation. But if you can prove in the absence of such computations that you have sustained a covered loss, you may offer your inventory records and actual physical count of inventory in support of other evidence as to the amount of loss claimed. VCR 105(01-20) Copyright,American International Group,Inc.,20% Page 1 of 2 CRIME All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc...,,with its permission. 2, Additional Condition Cancellation As To Any Employee: This insurance is cancelled as to any"employee": a, Immediately upon discovery by you of any dishonest act committed by that "emplioyee" whether before or after becoming employed by you; or b, On the date specified in a notice mailed to you. That date will! be at least 30 days after the date of mailing. The mailing of notice to you at the last mailing address known to us wfl$ be sufficient proof of notice. Delivery of notice is the same as mailing. 3. Additional Definitions a. "'Employee dishonesty" in paragraph A.2. means only dishonest acts committed by an "'employee," whether identified or not, acting alone or in collusion with other persons, with the manifest intent to: (1) Cause you, or the rightful owners of any covered property included in paragraph B.12. Ownership of Property; Interests Covered of the Crime General) Provisions, to sustain loss; and also (2) Obtain financial benefit (other than employee benefits known to you, approved by you, and earned in the normal course of employment, including salaries, commissions, fees, bonuses, promotions„awards, profit sharing or pensions)for: (a) The"employee"; or (b) Any person or organization intended by the"employee"to receive that benefit, b, "Occurrence" means all loss caused by, or involving, one or more "employees", whether the result of a single act or a series of acts. VCR105(01.20) Copyright,American International Group,Inc.,2019. Page 2 of 2 CRIME All rights reserved.Includes copyrighted material of the Insurance Services Office, Inc.,with its permission. .P W 00 N 00 N d' CRIME GENERAL PROVISIONS Various provisions in this coverage part restrict coverage. Read the entire coverage part carefully to determine rights, duties and what is or is not covered. Throughout this coverage part the words "you" and "your" refer to the Named Insured shown in the Declarations. The words"we,""us" and "our" refer to the Company providing this insurance. Various provisions of this coverage part refer to knowledge held or obtained by you, or discovery made by you. Under these provisions, knowledge or discovery by you means knowledge held or obtained, or discovery made, by any natural person who is: 1. An officer of any corporation which is a Named Insured under this policy; 2. An elected or appointed official of any governmental entity, including an official or employee of any unnamed govemmental entity authorized to manage, govern or control your"employees"; or 3. An officer, official, director, trustee, commissioner, board member or administrator of any plan, trust, union, association, club, auxilliary or other organization which is a Named Insured under this policy. Words and phrases in quotation marks are defined in this coverage part. Unless stated otherwise in any Crime coverage form, declarations or endorsement, the following General Exclusions, General Conditions and General Definitions apply to all Crime coverage fortis making up this coverage part. A. GENERAL EXCLUSIONS We will not pay for loss as specified below: 1. Acts Committed by You: Loss resulting from any dishonest or criminal act committed by you whether acting alone or in collusion with other persons. 2. Governmental Action: Loss resulting from seizure or destruction of property by order of governmental authority. 3. Indirect Loss: Loss that is an indirect result of any act or"occurrence"covered by this insurance including, but not limited to, loss resulting from: a. Your inability to realize income that you would have realized had there been no loss of, or loss from damage to, covered property, b. Payment of damages of any type for which you are legally liable. But we will pay compensatory damages arising directly from a loss covered under this insurance. c. Payment of costs, fees or other expenses you incur in establishing either the existence or the amount of loss under this insurance. 4. Legal Expenses: Expenses related to any legal action. 5. Nuclear: Loss resulting from nuclear reaction, nuclear radiation or radioactive contamination, or any related act or incident. 6. War and Similar Actions: Loss resulting from war, whether or not declared, warlike action, insurrection, rebellion or revolution, or any related act or incident. VCR300(01-20) Copyright,American International Group„Inc.,,2019. Page 1 of 6 CRIME All rights reserved,Includes copyrighted material of the Insurance Services Office„Inc.,with its perrrrission. B. GENERAL CONDITIONS 1. Concealment, Misrepresentation or Fraud: This insurance is void in any case of fraud by you as it relates to this insurance at any time. It is also void if you or any other insured, at any time, intentionally conceal or misrepresent a material fact concerning: a. This insurance; b. The covered property; c. Your interest in the covered property; or d. A claim under this insurance 2. Consolidation - Merger: If through consolidation or merger with, or purchase or acquisition of assets or liabilities of, some other entity; a. Any additional persons become"employees"; or b. You acquire the use and control of any additional premises; any insurance afforded for"employees" or premises also applies to those additional "employees" and premises for a period of 60 days after the effective date of such consolidation, merger, or purchase or acquisition of assets or liabilities. You must give us written notice within this 60 day period and obtain our written consent to extend this insurance to such additional "emplloyees" or premises. Upon obtaining our written consent, you must pay us an additional premium. If you fail to notify us in writing within this 60 day period, then this insurance shall automatically terminate as to such additional "employees" or premises. Such automatic termination shall be retroactive to the effective date of such consolidation, merger, or purchase or acquisition of assets or liabilities. 3. Coverage Extensions: Unless stated otherwise in the coverage form, our liability under any Coverage Extension is part of, not in addition to, the Limit of Insurance applying to the coverage or coverage section. 4. Duties in the Event of Loss: After you discover a loss or a situation that may result in loss of, or loss from damage to, covered property you must: a„ Notify us as soon as possible. b. Submit to examination under oath at our request and give us a signed statement of your answers., c. Give us a detailed, sworn proof of Voss within 120 days: d. Cooperate with us in the investigation and settlement of any claim. 5. Extended Period to Discover Loss: We will pay for covered loss discovered no later than one year from the end of the policy period. However, if: a. You obtain replacement insurance not issued by us or any affiliate; and b. Such'loss is covered by your replacement insurance; and c. Your replacement insurance provides an extended period to discover loss of less than one year or does not provide an extended period to discover loss; we will pay only for covered loss discovered no later than the number of days equal to any extended period to discover loss provided by such replacement insurance. If such replacement insurance does not provide an extended period to discover loss, we will not provide this Extended Period to Discover Loss, 6. Joint Insured a, If more than one insured is named in the Declarations, the first Named Insured will act for itself and for every other insured for all purposes of this insurance. If the first Named Insured ceases to be covered„ then the next Named Insured will become the first Named Insured. VCR300(01-20) Copyright,American'4;nternationai Group,Inc,,2019. Page 2 of 6 CRIME Alt,rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,,,with its permission. .P W CD W dq 00 N d' b. If any insured or officer of that insured has knowledge of any information relevant to this insurance, that knowledge is considered knowledge of every insured. c. An"employee"of any insured is considered to be an"employee" of every insured. d. If this insurance or any of its coverages is cancelled or terminated as to any insured, loss sustained by that insured is covered only if discovered no later than one year from the date of that cancellation or termination. e. We will not pay more for loss sustained by more than one insured than the amount we would pay if all the loss had been sustained by one insured. 7. Legal Action Against Us: You may not bring any legal action against us involving loss: a. Unless you have complied with all the terms of this insurance; and b. Until 90 days after you have filed proof of loss with us; and c. Unless brought within 2 years from the date you discover the loss. 8. Loss Covered Under More Than One Coverage of This Insurance: If two or more coverages of this insurance apply to the same loss,we will pay the lesser of: a. The actual amount of loss; or b. The sum of the limits of insurance applicable to those coverages. 9. Loss Covered Under This Insurance and/or Prior Insurance a. If any loss is covered: (1) Partly by this insurance; and (2) Partly by any prior cancelled or terminated insurance that we or any affiliate had issued to you or any predecessor in interest; the most we will pay is the larger of the amount recoverable under this insurance or the prior insurance. b. If any loss is covered: (1) Partly by this insurance; and (2) Partly by any prior cancelled or terminated insurance issued to you or any predecessor in interest by any carrier other than us or any affiliate: (a) Any deductible amount applicable to such loss will be reduced by any deductible amount applicable or sustained by you under the prior insurance; and (b) The Limit of Insurance applicable to such loss will be reduced by any amount paid or payable to you under the prior insurance. c. If you or any predecessor in interest sustained loss during the period of any prior insurance, and you or the predecessor in interest could have recovered under that insurance except that the time within which to discover loss had expired, we will pay for it under this insurance, provided: (1) This insurance became effective at the time of cancellation or termination of the prior insurance; and (2) The loss would have been covered by this insurance had it been in effect when the acts or events causing the loss were committed or occurred. The insurance under this paragraph c. is part of, not in addition to,, the Limits of Insurance applying to this insurance and is limited to the lesser of the amount recoverable under this insurance as of its effective date, or the prior insurance had it remained in effect. 10. Non-Cumulation of Limit of Insurance: Regardless of the number of years this insurance remains in force, the number of premiums paid or the duration of any loss, no Limit of Insurance or deductible amount applicable to any coverage of this insurance cumulates from year to year or period to period. VCR300(01-20) Copyright,American International Group,Inc.,2019, Page 3 of 6 CRIME All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. 11 Other Insurance: This insurance does not apply to loss recoverable or recovered under other insurance or indemnity. However, if the limit of the other insurance or indemnity is insufficient to cover the entire amount of the loss, this insurance will apply to that part of the loss, other than that falling within any deductible amount, not recoverable or recovered under the other insurance or indemnity. But this insurance will not apply to the amount of loss that is more than the applicable Limit of Insurance shown in the Declarations, 12, Ownership of Property; Interests Covered: The property covered under this insurance is limited to property: a. That you own or hold; or b. For which you are legally liable. However, this insurance is for your benefit only, It provides no rights or benefits to any other person or organization. 13. Policy Period a, The policy period is shown in the Declarations b. Except as provided by the Loss Covered Under This Insurance and/or Prior Insurance General Condition, we will pay only for loss that you sustain through acts committed or events occurring during the policy period. 14. Records: You must keep records of all covered property so we can verify the amount of any loss. 15. Recoveries a, Any recoveries, less the cost of obtaining them, made after settlement of loss covered by this insurance will be distributed as follows: (1) To you, until you are reimbursed for any loss that you sustain that would be covered under this insurance„ but that exceeds the Limit of Insurance and the deductible amount, if any; (2) Then to us, until we are reimbursed for the settlement made; (3) Then to you, until you are reimbursed for that part of the loss equal to the deductible amount,„ if any. b. Recoveries do not include any recovery: (1) From insurance, suretyship, reinsurance, security or indemnity taken for our benefit; or (2) Of original"securities"after duplicates of them have been issued. 16. Territory: This insurance covers only acts committed or events occurring within the United States of America, ji,ts territories and possessions, Puerto Rico or Canada. 17. Transfer of Your Rights of Recovery Against Others to Us: You must transfer to us all your rights of recovery against any person or organization for any loss you sustained and for which we have paid or settled. You must also do everything necessary to secure those rights and do nothing after loss to impair them. 18. Valuation-Settlement a, Subject to the applicable Limit of Insurance provision we will pay for: (1) Loss of 'money" but only up to and including its face value. We may, at our option, pay for loss of""money" issued by any country other than the United States of America: (a) At face value in the"money" issued by that country; or (b) In the United States of America dollar equivalent determined by the rate of exchange on the day the loss was discovered. VCR300(01-20) Copynght„American International Group,Inc-2019. Page 4 of 6 CRIME All rights reserved 'Includes copyrighted material of the Insurance Services Office, Inc.with its permission. .P W CD Ul W 00 N d' (2) Loss of"securities" but only up to and including their value at the close of business on the day the loss was discovered. We may, at our option: (a) Pay the value of such "securities" or replace them in kind, in which event you must assign to us all your rights,title and interest in and to those"securities"; or (b) Pay the cost of any Lost Securities Bond required in connection with issuing duplicates of the "securities". However, we will be liable only for the payment of so much of the cost of the bond as would be charged for a bond having a penalty not exceeding the lesser of: i. The value of the "securities" at the close of business on the day the loss was discovered; or ii. The Limit of Insurance. (3) Loss of, or loss from damage to, "property other than money and securities" or loss from damage to the premises for not more than the: (a) Actual cash value of the property on the day the loss was discovered; (b) Cost of repairing the property or premises;or (c) Cost of replacing the property with property of like kind and quality. We may, at our option, pay the actual cash value of the property or repair or replace it. If we cannot agree with you upon the actual cash value or the cost of repair or replacement, the value or cost will be determined by arbitration. b. We may, at our option, pay for loss of, or loss from damage to, property other than "money": (1) In the"money"of the country in which the loss occurred;,or (2) In the United States of America dollar equivalent of the "money" of the country in which the loss occurred determined by the rate of exchange on the day the loss was discovered. c. Any property that we pay for or replace becomes our property. C. GENERAL DEFINITIONS 1. "Employee"means: a. Any natural person: (1) While in your service(and for 30 days after termination of service);; and (2) Whom you compensate directly by salary, wages or commissions,„ and (3) Whom you have the right to direct and control while performing services for you; or b. Any natural person employed by an employment contractor while that person is subject to your direction and control and performing services for you; or c. Any natural person who is a non-compensated officer or any other volunteer of any volunteer fire, ambulance, or other emergency service or auxiliary organization which is a Named Insured under this policy, while such officer or volunteer is subject to your direction and control and performing services for you; or d. Any natural person who is an elected or appointed supervisory official of any governmentally operated fire, ambulance or other emergency service organization which is a Named Insured under this policy,while such official is performing services for you; or e. Any natural person who is a director, trustee, commissioner or board member of any organization which is a Named Insured under this policy„ while such director, trustee„ commissioner or board member is performing services for you. VCR300(01-20) Copyright,American International Group,Inc.,2019. page 5 of 6 CRIME All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission, But"employee"does not mean any: (1) Agent, broker, factor„ commission merchant, consignee, independent contractor or representative of the same general character;; or (2) Director, trustee, commissioner or board member. (a) With respect to his or her official duties as your director, trustee, commissioner or board member; or (b) While executing specific acts mandated or authorized by a resolution of your board of directors, board of trustees or board of commissioners, 2. "Money" means: a. Currency,coins and bank notes in current use and having a face value; and b. Travelers checks, register checks and money orders held for sale to the publlic. 3. "Property other than money and securities" means any tangible property other than "money" and "securities"that has intrinsic value but does not include any property listed in any Crime coverage form as Property Not Covered. 4. "Securities" means negotiable and nonnegotiable instruments or contracts representing either "money" or other property and inciludes;. a. Tokens, tickets, revenue and other stamps (whether represented by actual stamps or unused value in a meter) in current use,- and b. Evidences of debt issued iin connection with credit or charge cards, which cards are not issued by you; but"securities"does not include"'money' VCR300(01-20) Copyright,,American International Group,Inc.,,2019. Page 6 of CRIME All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc,with its permission.. P N 00 4 00 00 N d' ADDITIONAL COVERAGES COMPUTER AND FUNDS TRANSFER FRAUD AND FRAUDULENT IMPERSONATION SCHEDULE Coverage Limit of Insurance Deductible Amount Computer and Funds Transfer Fraud $ per Occurrence $ per Occurrence Fraudulent Impersonation $ perOccurrence $ per Occurrence Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. COMPUTER AND FUNDS TRANSFER FRAUD COVERAGE 1. We will pay for loss you sustain arising directly out of the loss of or damage to "money", "securities" and"property other than money and securities" resulting directly from: a. A fraudulent: (1) Entry of"electronic data"or"computer program" into; or (2) Change of"electronic data"or"computer program"within; any "computer system" owned, leased or operated by you, provided the fraudulent entry or fraudulent change causes, with regard to Paragraphs A.1.a.(1)and A.1.a.(2)above: (a) "Money", "securities" or"property other than money and securities"to be transferred, paid or delivered; or (b) Your account at a"financial institution"to be debited or deleted. b. A "fraudulent instruction" directing a "financial institution" to debit your"transfer account" and transfer, pay or deliver"money" or"securities"from that account. 2. As used in Paragraph A.1.a., fraudulent entry or fraudulent change of "electronic data" or "computer program" shall include such entry or change made by an "employee" acting, in good faith, upon a "fraudulent instruction" received from a computer software contractor who has a written agreement with you to design, implement or service "computer programs"for a"computer system"covered under this Coverage. B. FRAUDULENT IMPERSONATION COVERAGE 1. We will pay for loss you sustain arising directly from your having, in good faith, transferred "money", "securities" or "other property" in reliance upon a "transfer instruction" purportedly issued by an "employee", "customer" or"vendor" but which "transfer instruction" proves to have been fraudulently issued by an imposter without the knowledge or consent of the "employee", "customer"or"vendor". 2. Verification If the Limit of Insurance for Fraudulent Impersonation shown in the Schedule on this endorsement is$100,000 or greater, the following is a precondition to coverage under this endorsement: You shall verify all "transfer instructions" for amounts greater than or equal to $25,000. This verification will be in accordance with a pre-arranged callback or other established verification procedure before acting upon any such "transfer instruction". VCR109(01-20) Copyright,American International Group,Inc.,2019, Page 1 of 5 CRIME All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,,,with its permission. C. LIMIT OF INSURANCE 1. The most we will pay for loss in any one "occurrence" for Computer and Funds Transfer Fraud Coverage is the applicable Limit of Insurance shown in the Schedule. 2.. The most we will pay for loss iin any one "occurrence" for Fraudulent Impersonation Coverage is the applicable Limit of Insurance shown in the Schedule. If any (loss is covered under more than one Coverage, the most we will pay for such loss shall not exceed the largest Limit of Insurance available under any one of those Coverages. D. DEDUCTIBLE We will not pay for loss in any one "occurrence" unless the amount of loss exceeds the deductible amount shown in the Schedule on this endorsement. We will then pay the amount of loss in excess of the deductible amount, up to the Limit of Insurance. E. EXCLUSIONS, CONDITIONS AND DEFINITIONS In addition to the Crime General Provisions, this coverage form is subject to the following: 1, Additional Exclusions appllicablie to A. Computer and Funds Transfer Fraud Coverage and B. Fraudulent Impersonation Coverage: We will not pay for loss as specified below: a Acts of Employees, Directors, or Trustees: We wild not pay for loss resulting from any dishonest or criminal act committed by any of your "employees", directors, trustees, or authorized representatives (1) Whether acting alone or in collusion with other persons; or (2) Whether while performing services for you or otherwise. b. Authorized Access Loss resulting from a fraudulent: (1) Entry of"electronic data" or"computer program" into, or (2) Change of"electronic data"or"computer program"'within; any "computer system" owned, leased or operated by you by a person or organization with authorized access to that"computer system", except when covered under Paragraph A.2. c. Confidential Or Personal Information Loss resulting from: (1) The disclosure of your or another person's or organization's confidential or personal information including, but not limited to, patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or (2) The use of another person's or organization's confidential or personal information including,, but not limited to, patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic Information.. d. Data Security Breach Fees, costs, fines, penalties and other expenses incurred by you which are related to the access to or disclosure of another person's or organization's confidential or personal information including, but not limited to, patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information. VCR109(01-20) Copyright,American International Group,Inc.,,2019. Page 2 of 5 CRIME Al rights reserved. Includes copyrighted material of the Insurance Services Office„Inc.,with its permission. .P W 00 0 0) N d' 2. Additional Exclusions applicable to A.Computer and Funds Transfer Fraud Coverage: We will not pay for loss as specified below: a. Authorized Access Loss resulting from a fraudulent: (1) Entry of"electronic data"or"computer program" into; or (2) Change of"electronic data"or"computer program"within; any "computer system" owned, leased or operated by you by a person or organization with authorized access to that"computer system", except when covered under Paragraph A.2. b. Credit Card Transactions Loss resulting from the use or purported use of credit, debit, charge, access, convenience, identification, stored-value or other cards or the information contained on such cards. c Exchanges Or Purchases Loss resulting from the giving or surrendering of property in any exchange or purchase. d. Fraudulent Instructions Loss resulting from an"employee"or"financial institution"acting upon any instruction to: (1) Transfer, pay or deliver "money", "securities" or "property other than money and securities"; or (2) Debit or delete your account; which instruction proves to be fraudulent, except when covered under Paragraph A.1.b, or A.2. e. Inventory Shortages Loss, or that part of any loss, the proof of which as to its existence or amount is dependent upon: (1) An inventory computation; or (2) A profit and loss computation. 3. The Territory Condition, under Section E. Conditions, is replaced by the following as respects B. Fraudulent Instruction Coverage: Territory We will cover loss that you sustain resulting directly from an 'occurrence" taking place anywhere in the world. 4. Additional Definitions a. "Computer program" means a set of related electronic instructions,which direct the operation and function of a computer or devices connected to it, which enable the computer or devices to receive, process, store or send"electronic data". b. "Computer system" means: (1) Computers, including Personal Digital Assistants (PDAs) and other transportable or handheld devices, electronic storage devices and related peripheral components; (2) Systems and applications software; and (3) Related communications networks; by which"electronic data" is collected, transmitted, processed, stored or retrieved. c. "Customer" means an entity or individual to whom you sell goods or provide services under a written contract. VCR109(01-20) Copyright,American International Group,Inc.,2019. Page 3 of 5 CRIME All rights reserved.Includes copyrighted material of the Insurance Services Office.Inc.,with its permission. d. "Electronic data"means information, facts, images or sounds stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software) on data storage devices, including hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment e. "Financial institution"means: (1) A bank, savings bank, savings and loan association, trust company, credit union or similar depository institution; (2) An insurance company; or (3) A stock brokerage firm or investment company. f, "Fraudulent instruction"means: (1) With regard to Paragraph A.1.(b): (a) A computer, telefacsimile, telephone or other electronic instruction directing a "financial institution" to debit your "transfer account" and to transfer, pay or deliver °'"money" or "securities" from that "transfer account", which instruction purports to have been issued by you, but which in fact was fraudulently issued by someone else without your knowledge or consent; or (b) A written instruction (other than those covered under Paragraph A.2. issued to a "financial institution" directing the"financial institution"to debit your"transfer account" and to transfer, pay or deliver "money" or "securities" from that "transfer account", through an electronic funds transfer system at specified times or under specified conditions, which instruction purports to have been issued by you, but which in fact was issued,forged or altered by someone else without your knowledge or consent. (2) With regard to Paragraph A.2.: A computer, telefacsimile, telephone or other electronic, written or voice instruction directing an "employee" to enter or change "electronic data" or "computer programs" within a "computer system" covered under A. Computer and Funds Transfer Fraud Coverage, which instruction in fact was fraudulently issued by your computer software contractor. g. "Occurrence" means (1) An individual act or event; (2)The combined total of all separate acts or events whether or not related;, or (3) A series of acts or events whether or not related,- committed by a person acting alone or in collusion with others, or not committed by any person, during the Policy Period shown in the Declarations, except as provided under the Crime General Provisions, General Condition 9. h. "Transfer account" means an account maintained by you at a financial institution from which you can initiate the transfer, payment or delivery of'money"'and securities: (1) By means of computer, telefacsimile, telephone or other electronic instructions; or (2) By means of written instructions (other than a check,, draft, promissory note, or similar written promise, order or direction to pay a sum certain in "money') establishing the conditions under which such transfers are to be initiated by such "financial institution" through an electronic funds transfer system. i„ "Transfer instruction" means an instruction directing you to transfer "money", "securities' or "other property". j. "Vendor" means an entity or individual from whom you purchase goods or receive services under a written contract 5. Revised Definitions: VCR109(01.20) Copyright,American International Group Inc.,2019. Page 4 of 5 CRIME AIII nghls reserved.Includes copyrighted material of the Insurance SeMces Office.Inc,with its permission.. .P W W N 0) N d' a. With regard to A. Computer and Funds Transfer Fraud Coverage, the following is added to the definition of"money" in the General Crime Provisions: 3. Deposits in your account at a"financial institution" as defined in Paragraph E.4.e. b. As respects the coverage provided by this endorsement, the following is added to the definition of"property other than money and securities"in the General Crime Provisions: "Property other than money and securities" does not include "computer programs", "electronic data"or any property specifically excluded under this insurance. VCR109(01-20) Copyright,American International Group,Inc.,2019. Page 5 of 5 CRIME All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission IDENTITY FRAUD EXPENSE COVERAGE FORM .. ... ......................_ SCHEDULE Limit of Insurance: Deductible: Persons Not Covered: Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. COVERAGE We will pay for"expenses"you sustain incurred by: 1. You; or 2. Any"employee'; resulting directly from"identity fraud. B. LIMIT OF INSURANCE The most we will pay for your"expenses" resulting directly from "identity fraud' its the applicable Limit of Insurance shown in the Schedule. C. DEDUCTIBLE We will not pay for "expenses" unless the amount of "expenses" exceeds the deductible amount shown in the Schedule. We will then pay the amount of "expenses" in excess of the deductible amount, up to the Limit of Insurance. D. EXCLUSIONS,CONDITIONS AND DEFINITIONS In addition to the Crime General Provisions, this coverage form is subject to the following: 1. Additional Exclusion: "Expenses" due to"theft", "identity fraud"or any other dishonest act committed by: 1. You; 2. Any"employee"; or 3. Any person shown in the Schedule; whether acting alone or in collusion with other persons. 2. Revised Exclusion: The Legal Expenses Exclusion is replaced by the following: Expenses incurred by you which are related to any legal action, except when covered under this Coverage Form. VCR110(01-20) Copyright,American International Group,Inc..2019.. Page 1 of 2 CRIME All rights reserved.Includes copyrighted material of the Insurance Services Orrice.Inc-with its permission P N W W d N d' 3. Revised Condition: The following is added to the Duties In The Event Of Loss Condition: You must send to us, within 60 days after our request, receipts,, bills or other records that support any claim for"expenses"covered under this Coverage Form. 4. Additional Definitions: a. "Expenses"means: (1) Advertising and public relations expenses incurred by you to restore your business reputation as a result of an"identity fraud% (2) Costs incurred by you or any "employee" for notarizing affidavits or similar documents attesting to fraud required by financial institutions or similar credit grantors or credit agencies; (3) Costs incurred by you or any "employee" for certified mail to law enforcement agencies, credit agencies, financial institutions or similar credit grantors; (4) Costs incurred by you or any"employee"for obtaining credit reports; (5) Lost income incurred by you or any "employee" resulting from time taken off work to complete fraud affidavits, meet with or talk to law enforcement agencies, credit agencies and/or legal counsel, up to a maximum payment of $250 per day. Total payment for lost income is not to exceed $10,000 or the Limit of Insurance shown in the Schedule, whichever is less; (6) Loan application fees, incurred by you or any "employee" for reapplying for a loan when the original application is rejected solely because the lender received incorrect credit information; (7) Reasonable attorney fees to: (a) Defend lawsuits brought against you by merchants, vendors, suppliers, financial institutions or their collection agencies; (b) Remove any criminal or civil judgments wrongly entered against you; and (c) Challenge the accuracy or completeness of any information in a consumer credit report for you; (8) Charges incurred by you or any "employee" for long distance telephone calls to merchants, vendors, suppliers, customers, law enforcement agencies, financial institutions or similar credit grantors, or credit agencies to report or discuss an actual "identity fraud"; and (9) Any other reasonable expenses incurred by you or any "employee" with our written consent. b. "Identity fraud" means the act of knowingly transferring or using, without lawful authority, a means of identification of: (1) Your business as shown in the Declarations; or (2) Any"employee"; with the intent to commit, or to aid or abet another to commit, any unlawful activity that constitutes a violation of federal law or a felony under any applicable state or local law. c. "Theft" means the unlawful taking of property to the deprivation of the Insured. VCR110(01-20) Copyright,American International Group,Inc.,2019, Page 2 of 2 CRIME All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. Named Insured: Policy Number: VFN -TR-0019768-03/00 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 QRTLE UIPIHENT COYExE PkRT„JCL`ARAT1QI , e,.�. ,.. ., .. . Schedule of Portable Equipment Coverage Coverage Limit of Insurance Deductible Coverage A Blanket Guaranteed Replacement Cost $ 500 Coverage B Scheduled NONE NONE f r Estimated Coverage Part Premium: 1, 246. 00 Taxes, Fees and Surcharges: 22 . 43 Total Premium: 1 268 . 43 ►Qab�e Equip@mot ' r " wr See Schedule of Forms and Endorsements it i i I PE1000(01120) 10-03-2023 W W Ul cfl N d' COMMERCIAL PROPERTY COMMERCIAL PROPERTY CONDITIONS This Coverage Part is subject to the following conditions, the Common Policy Conditions and applicable Loss Conditions and Additional Conditions in Commercial Property Coverage Forms. A CONCEALMENT, MISREPRESENTATION OR F. NO BENEFIT TO BAILEE FRAUD No person or organization, other than you,having This Coverage Part is void in any case of fraud by custody of Covered Property will benefit from this you as it relates to this Coverage Part at any time. insurance. It is also void if you or any other insured, at any G. OTHER INSURANCE time, intentionally conceal or misrepresent a mate- rial fact concerning: 1. You may have other insurance subject to the 1. This Coverage Part; same plan, terms, conditions and provisions as the insurance under this Coverage Part. If you 2. The Covered Property; do, we will pay our share of the covered loss or 3. Your interest in the Covered Property; or damage. Our share is the proportion that the applicable Limit of Insurance under this Cover- 4 A claim under this Coverage Part. age Part bears to the Limits of Insurance of all B. CONTROL OF PROPERTY insurance covering on the same basis. Any act or neglect of any person other than you 2 If there is other insurance covering the same beyond your direction or control will not affect this loss or damage, other than that described in 1. insurance. above, we will pay only for the amount of cov- The breach of any condition of this Coverage Part ered loss or damage in excess of the amount at any one or more locations will not affect cover- due from that other insurance, whether you age at any location where, at the time of loss or can collect on it or not. But we will not pay damage,the breach of condition does not exist. more than the applicable Limit of Insurance. C. INSURANCE UNDER TWO OR MORE H. POLICY PERIOD, COVERAGE TERRITORY COVERAGES Under this Coverage Part: If two or more of this policy's coverages apply to 1. We cover loss or damage commencing: the same loss or damage, we will not pay more a During the policy period shown in the Dec- than the actual amount of the loss or damage. larations; and D. LEGAL ACTION AGAINST US b. Within the coverage territory. No one may bring a legal action against us under 2. The coverage territory is: this Coverage Part unless: a The United States of America (including its 1. There has been full compliance with all of the territories and possessions); terms of this Coverage Part; and b. Puerto Pico;and 2. The action is brought within 2 years after the date on which the direct physical loss or dam- c. Canada. age occurred. E. LIBERALIZATION If we adopt any revision that would broaden the coverage under this Coverage Part without addi- tional premium within 45 days prior to or during the policy period, the broadened coverage will im- mediately apply to this Coverage Part. CP 00 90 07 88 Copyright, ISO Commercial Pisk Services, Inc., 1983, 1987 Page 1 of 2 I. TRANSFER OF RIGHTS OF RECOVERY AGAINST 1. Prior to a loss to your Covered Property or OTHERS TO US Covered Income. If any person or organization to or for whom we 2. After a loss to your Covered Property or Cov- make payment under this Coverage Part has rights ered Income only if, at time of loss, that party is to recover damages from another, those rights are one of the following: transferred to us to the extent of our payment. a. Someone insured by this insurance; That person or organization must do everything necessary to secure our rights and must do noth- b. A business firm: ing after loss to impair them. But you may waive (1) Owned or controlled by you; or your rights against another party in writing: (2) That owns or controls you; or c. Your tenant. This will not restrict your insurance. Page 2 of 2 Copyright, ISO Commercial Risk Services, Inc., 1983, 1987 CP 00 90 07 88 13 N co 4 00 0) N d' EMERGENCY SERVICE ORGANIZATION PORTABLE EQUIPMENT COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties, and what is and is not covered. Throughout this policy the words"you"and"your"refer to the Named Insured shown in the Declarations, The words"we,""us"and"our" refer to the Company providing this insurance. Other words and phrases that appear in quotation marks have special meaning. SECTION I. YOUR PORTABLE EQUIPMENT COVERAGE Coverage A. Blanket "Portable Equipment." We will pay for direct physical loss or damage caused by or resulting from any"covered cause of loss"to "portable equipment"owned by you or furnished to you for your regular use. The most we will pay is described under WHAT WE WILL PAY. Coverage B. Scheduled "Portable Equipment." We will pay for direct physical loss or damage caused by or resulting from any"covered cause of loss"to "portable equipment"owned by you or furnished to you for your regular use, that is specifically listed in the Declarations or in a schedule attached to this coverage form. The most we will pay is described under WHAT WE WILL PAY. SECTION II. EXTENSIONS OF PORTABLE EQUIPMENT COVERAGE This section adds to or extends the coverage under YOUR PORTABLE EQUIPMENT COVERAGE. Each separately numbered provision is referred to as an extension. Except to the extent specifically stated otherwise in an extension: (1) each extension is limited to direct physical loss or damage caused by or resulting from any"covered cause of loss;" (2) the limits in each extension are in addition to the limits applicable to YOUR PORTABLE EQUIPMENT COVERAGE; (3) the limits in each extension apply separately for each occurrence; and (4) all other applicable terms and conditions of this coverage form apply to each extension. Extension 1. "Debris Removal Expenses." We will pay your"debris removal expenses" if they are reported to us within 180 days after the date of the direct physical loss or damage. The most we will pay in any one occurrence is the greater of: (1) 25% of the amount we pay for direct physical loss or damage under Coverage A or Coverage B, before the application of any deductible; or (2) $5,000. PE1001 (01-20) Copyright,American International Group,Inc.,2019. Page i of 11 PORTABLE EQUIPMENT All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission Extension 2. "Personal Effects." a We will pay for direct physical loss or damage to"personal effects' belonging to your volunteers, "employees,"directors, officers or trustees while enroute to, during, and returning from any official duty authorized by you. b. We will pay up to the"replacement cost"for host or damaged "personal effects"bellonging to any one volunteer, "'employee,"director, officer or trustee under this extension, but not more than the smalller of the following: (1) the amount which is actually spent to repair or replace the lost or damaged "personal) effects"of comparable kind and quality; or (2) the'replacement cost"of the lost or damaged "personal effects." The volunteer, "employee,"director, officer or trustee may substitute"personal effects" of a different kind or quality and still comply with the"replacement cost"provision, but we won't pay more than the cost to repair or replace the lost or damaged"personal effects"with "personal effects"of comparable kind and quality. c, This coverage is primary and MCI apply regardless of any other insurance coverage which may be available to the owner of the"personall effects." d. No deductible will apply. Extension 3. Non-Owned "Portable Equipment." a, We will pay for direct physical loss or damage to"portable equipment"not owned by you and not furnished to you for your reguliar use, but that is temporarily in your possession, caused by or resulting from any"covered cause of loss,"' b The most we will pay under this extension in any one occurrence is $50,000. Extension 4. "Valuable Papers and Records." a, We will pay the costs you incur in restoring„ researching, replacing, or reproducing the"valuable papers and records"associated with your firefighting, ambulance or rescue related activities, when the"valuable papers and records' suffer direct physical loss or damage from a"covered cause of loss,„"away from your premises. b. We will not pay for: (1) irreplaceable"valuable papers and records," unless they are specifically described in an endorsement and a limit its shown there; (2) any cost that results directly from processing or copying records; (3) any cost that results from work performed on papers or records, such as filing or binding; (4) loss or damage to computer-based records arising from Voss or damage to"software,"or from a "computer virus" or from mechanical breakdown of"hardware"; or (5) loss or damage to"software." PE1001(01.20) Copynght,American'International!Group,Inc„2019. Page 2 of 11 PORTABLE EQUIPMENT All rights reserved. Includes copyrighted material of the Insurance Services Office, Inc,,,with its permission. P IV 0 0 M d' Extension 5. "Watercraft." a. If Coverage A is indicated in the Declarations, we will pay for direct physical loss or damage to "watercraft"or"personal watercraft" owned by you or furnished to you for your regular use, resulting from a"covered cause of loss." b. This extension applies to all such "personal watercraft". C. This extension applies only to"watercraft"that are either: (1) not powered by a motor or engine; or (2) powered by a motor or combination of motors of 100 horsepower or less, regardless of whether the motor is inboard, outboard, or inboard/outboard. Extension 6. Newly Acquired "Portable Equipment." a. Under Coverage B, Scheduled"Portable Equipment,"we will pay for the direct physical loss or damage caused by or resulting from any"covered cause of loss"to newly acquired "portable equipment"similar to that listed in the Declarations or schedule attached to this coverage form. b. This automatic extension of coverage will apply for a period of 30 days from the date of acquisition, on a"replacement cost" basis, not to exceed the purchase price of the newly acquired "portable equipment." SECTION III. COVERED CAUSES OF LOSS "Covered cause of loss" means any cause of direct physical loss or damage except as excluded below. Exclusions This policy does not apply to loss or damage caused by or resulting directly or indirectly from the following causes, or occurring in the following situations. Such loss or damage is excluded regardless of any other cause or event that contributes concurrently with or before, during, or after the loss or damage.. But we will cover"resulting fire or explosion"arising out of any of these excluded causes except"war." 1. "War." 2. "Nuclear activity." 3. "Neglect"except when your"portable equipment"is in use in an"emergency situation." 4. Dishonest acts or omissions of you or your"employees"or volunteers, or anyone authorized to act for you. 5. Mysterious disappearance of property or an inventory shortage. 6. "Wear and tear,"deterioration, rust, corrosion, marring or scratching, erosion, wet or dry rot, and mold. 7. Mechanical breakdown. 8. "Inherent vice."Examples of"inherent vice"are the yellowing and cracking of old paper, patina that forms on old bronze and the swelling of wood under moist conditions. PE1001 (01-20) Copyright,American International Group,Inc.,.2019. Page 3 of 11 PORTABLE EQUIPMENT All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. 9. "Latent defects." 10. Faulty design,workmanship and material including the cost of correcting any faulty design, workmanship, material, manufacture or installation, alteration, repair or work on covered"portable equipment." But we will cover loss or damage that results from any of these, if the loss or damage occurs in connection with any cause of loss not otherwise excluded by this policy. 11. Asbestos, including loss„damage or"'clean-up"resulting from asbestos or asbestos-containing materials unless the damage from asbestos is caused by or results from your"emergency operations" conducted away from premises owned or occupied by you. 12, Pollution or contamination including the actual, alleged or threatened presence, discharge, seepage, migration, release, escape or"clean-up" of"pollutants" unless caused by a"specified cause of loss"or by your"training operations,"or by your"emergency operations"conducted away from premises owned or occupied by you. SECTION IV. WHAT WE WILL PAY A. Limits of Insurance 1: The most we will pay for loss or damage in any one occurrence is the guaranteed replacement cost for Coverage A, or for Coverage B the applicable Limit of Insurance shown in the Declarations or in an attached schedule. 2. If we pay the limit for any one occurrence, that will not reduce the applicable limit for any future covered loss resulting from an unrelated occurrence. 3. Except to the extent specifically stated otherwise in an extension,the (limits in each extension are in addition to the limits applicable to YOUR PORTABLE EQUIPMENT COVERAGE. B. Deductible 1. We will not pay for loss or damage in any one occurrence until the amount of loss or damage exceeds the applicable deductible. We wflil then pay the amount of loss or damage in excess of the deductible, up to the applicable Limit of Insurance. 2. Deductible Waiver. If a loss covered under this policy also involves a loss under an Emergency Service Organization Commercial Property or Business Auto Policy issued to you by us, only one deductible,the(largest,will be applied. The deductible under the other policy or policies will be waived, C. Coverage A Valuation - Guaranteed Replacement Cost In the event of loss or damage,we will determine the value of property on a guaranteed replacement cost basis, as follows: 1. We will pay the entire"replacement cost" of the lost or damaged "portable equipment,"or the cost to repair or replace the damaged"portable equipment,"whichever is smaller, in excess of the deductible, provided you accurately report to us at policy inception and within 30 days after acquisition,, the number and"types of vehicles"which carry"portable equipment"owned by you or furnished to you for your regular use. PE1001 (01-20) Copyright,American International Group Inc.,2019. Page 4 of 11 PORTABLE EQUIPMENT All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with 4s permission. P W O N O M d' 2. You may substitute"portable equipment"of a different kind or quality, but we won't pay more than the cost to repair or replace the lost or damaged "portable equipment"with "portable equipment" of comparable kind and quality. 3. Our estimated value of the total"replacement cost"of all"portable equipment" is based on the number and"types of vehicles" reported by you which carry"portable equipment"owned by you or furnished to you for your regular use. 4. If you do not accurately report the number and "types of vehicles"set forth in paragraph 1. above, we will determine the most we will pay using the following steps: (a) Calculate the estimated value of your"portable equipment" based on the number and "types of vehicles"you reported to us. (b) Calculate the estimated value of your"portable equipment"had the number and"types of vehicles"been accurately reported to us. (c) Divide the amount calculated in step (a) by the amount calculated in step (b). (d) Multiply the resulting proportion by the total amount of loss. (e) Subtract the applicable deductible. We will pay the amount determined in step(e). For the remainder of any loss, you will have to rely on other insurance or absorb the loss. D. Coverage B Valuation - Replacement Cost In the event of loss or damage,we will determine the value of property under Coverage B as follows: 1. We will pay the"replacement cost" of the lost or damaged"portable equipment"in excess of the deductible, but not more than the smallest of the following: (a) the amount which you actually spend to repair or replace the lost or damaged "portable equipment"with "portable equipment"of comparable kind and quality; (b) the"replacement cost"of the lost or damaged "portable equipment;"or (c) the limit shown in the schedule for each item. 2. You may substitute"portable equipment"of a different kind or quality and still comply with the "replacement cost" provision, but we won't pay more than the cost to repair or replace the lost or damaged"portable equipment"with"portable equipment"of comparable kind and quality. SECTION V. LOSS CONDITIONS The following conditions apply in addition to the Common Policy Conditions and the Commercial Property Conditions. 1. Abandonment There can be no abandonment of any property to us. PE1001 (01-20) Copyright,American International Group,Inc.,,2019. Page 5 of 11 PORTABLE EQUIPMENT All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission 2. Appraisal If we cannot agree with you on the amount of the loss, either of us can demand that the following procedure be used to settle the amount. a. You or we will request in writing that the dispute be submitted to appraisal within 60 days from the time we receive your proof of loss. Each will then select an appraiser and notify the other of that choice within 20 days of the iinitial request.. b. The appraisers will select an impartial umpire, If they cannot agree on an umpire within 15 days, either you or we can ask that an umpire be appointed by a judge of the court of record in the county where the property is located, c The appraisers will appraise each item for its value at the time of loss and the amount of loss. If they can't agree,they will submit any differences to the umpire. An agreement in writing by any two of these three will determine the amount of the loss. d You will pay your appraiser and we will pay ours. Each will share equally any other costs of the appraisal and the umpire. e., We will not surrender our rights by any act we take relating to an appraisal. 3. Duties In The Event Of Loss Or Damage a. You must see that the following are done in the event of loss or damage to property insured under this policy; (1) Notify the police if a law may have been broken. (2) Give us prompt notice of the loss or damage. Include a description of the property involved. (3) As soon as possible, give us a description of how, when and where the loss or damage occurred. (4) Take all reasonable steps to protect the property from further damage by a"covered cause of loss." If feasible, set the damaged property aside and in the best possible order for examination. Also keep a record of your expenses for emergency and temporary repairs, for consideration in the settlement of the claim. THs will not increase the Limit of Insurance. (5) As often as may be reasonably required, permit us to inspect the property proving the loss or damage and examine your books and records. Also permit us to take samples of damaged and undamaged property for inspection, testing and analysis, and permit us to make copies from your books and records. (6) Send us a signed, sworn proof of doss containing the information we request to investigate the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. (7) Cooperate with us in the investigation or settlement of the claim. PE1001(01-20) Copyright,American International Group,Inc.,2019. Page 6 of 11 PORTABLE EQUOPMENT All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. P W O W dq 0 M d' b. We may examine any insured under oath,while not in the presence of any other insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, including an insured's books and records. In the event of an examination, an insured's answers must be signed. 4. Loss Payment a. In the event of loss or damage covered by this policy, at our option, we will either: (1) Pay the value of lost or damaged property; (2) Pay the cost of repairing or replacing the lost or damaged property; (3) Take all or any part of the property at an agreed or appraised value; or (4) Repair, rebuild or replace the property with other property of like kind and quality. b. We will give notice of our intentions within 30 days after we receive the sworn proof of loss. C. We will not pay you more than your financial interest in the property. d. We may adjust losses with the owners of lost or damaged property if other than you. If we pay the owners, such payments will satisfy your claims against us for the owners' property. We will not pay the owners more than their financial interest in the property. e. We may elect to defend you against suits arising from claims of owners of property. We will do this at our expense. f. We will pay for covered loss or damage within 30 days after we receive the sworn proof of loss if: (1) You have complied with all of the terms of this Coverage Part; and (2) (a) We have reached agreement with you on the amount of loss; or (b) An appraisal award has been made. 5. Recovered Property If either you or we recover any property after loss settlement, that party must give the other prompt notice. At your option, the property will be returned to you. You must then return to us the amount we paid to you for the property. We will pay recovery expenses and the expenses to repair the recovered property, subject to the Limit of Insurance. SECTION VI. PORTABLE EQUIPMENT COVERAGE DEFINITIONS "Aircraft" means aircraft except those that are: (1) on the ground for display or instructional purposes; (2) not self-propelled; and (3) not certified for flight. PE1001 (01-20) Copyright,American International Group,Inc.,2019. Page 7 of 11 PORTABLE EQUIPMENT Ail rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. However,this does not include detached aircraft engines,, parts, accessories and equipment. "Clean-up"includes testing, monitoring, removal, containment„treatment, detoxification or neutralization, or assessing the effects of"'pollutants." "Computer virus" means a computer program or computer code which is entered into your computer system without your knowledge, and which causes a disruption of normal program or computer system operation„ but it does not mean an error in design or programming error.. "Covered cause of loss" is defined in the section titled COVERED CAUSES OF LOSS. "'Debris removal expense"'means expenses you incur in removing debris of"portable equipment"covered by this policy after direct physical loss or damage caused by or resulting from any"covered cause of doss. "Emergency operations" means actions; 1) Which are urgent responses for protection of property, human life, health or safety; and, 2) Which result from the performing or attempting to perform fire fighting services, hazardous materials unit services, first aid, ambulance or rescue squad services, or related services, including the stabilizing or securing of an emergency scene; and, 3) Which are sanctioned by (i)a fire department, hazardous materials unit, or first aid, ambulance or rescue squad qualifying as an insured under this pollicy, or (ii) an officer, "'employee""or volunteer member of such organization. "Emergency situation" means an unexpected situation demanding immediate official action, but does not include response to situations which are your normal or routine activities. "Employees" means people who work for you in the conduct of your ordinary activities, in return for a salary,wages or commissions. In order to be considered an employee, a person must be subject to your exclusive direction in the performance of his or her activities. Contractors and agents are not considered to be employees. "Fine arts""means property that is rare or that has historic or artistic value, including antiques, rare articles, etchings, pictures, statuary, marbles, bronzes, porcelains and bric-a-brac. "Hardware" means computers and their electronic data processing parts and equipment which accept, utilize and process raw information for conversion to machine readable form. "Inherent vice" means a natural condition of property that causes it to deteriorate or become damaged. "'Latent defects" are faults or weaknesses in property itself. "'Named insured" means the person(s)or organization(s) named in the Declarations. "Neglect"means your failure to take All reasonable steps to protect your property when it is threatened with loss or damage and to take all reasonable steps to protect your property from further loss after loss or damage occurs. "'Nuclear activity" means loss from nuclear reaction, nuclear radiation or radioactive contamination, whether deliberate or accidental, controlled or uncontrolled, and whether or not the loss is direct or PE1001 (01 20) Copyright,American International Group,Inc.,2019, Page 8 of 11 PORTABLE EQUIPMENT A I rights reserved. Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. P W O tJ1 W 0 M d' indirect, proximate or remote, or is contributed to or aggravated by a"covered cause of loss." But it does not include explosion, fire or smoke. "Permanently attached equipment"means equipment that is welded, bolted or permanently screwed to the dashboard,firewall or body of the"vehicle." Equipment inserted on permanently installed slide brackets with or without the use of setscrews or tension, or portable firefighting and rescue related equipment, shall not be construed as permanently attached equipment "Personal effects"means property that belongs to an individual and is devoted primarily to that individual's personal use; for example, clothing, eyeglasses, or individually owned portable firefighting, ambulance, or rescue related equipment. Personal effects does not include: (1) money and securities; (2) "fine arts" (3) "aircraft" (4) "watercraft,"except as provided for in Extension 5. for Coverage A, or in an attached schedule for Coverage B; or (5) "vehicles." "Personal watercraft" means a vessel which uses an inboard motor powering a water jet pump as its primary source of motive power, and which is designed to be operated by a person sitting, standing, or kneeling on the vessel, rather than the conventional manner of sitting or standing inside the vessel. "Portable equipment" means portable firefighting, ambulance, or rescue related equipment and portable communications equipment commonly used in fire and rescue operations away from your premises. Portable equipment also includes equipment specific to firefighting and rescue related activities, such as training videos, manuals and mannequins, and any trailer whose primary purpose is to transport covered portable equipment. But portable equipment does not include: (1) "personal effects"belonging to you or your volunteers or"employees,"other than individually owned portable firefighting, ambulance, or rescue related equipment; (2) personal property including contents, building fixtures, or building maintenance equipment such as lawn mowers or tractors; (3) money and securities; (4) "valuable papers and records;" (5) televisions, video cassette recorders, and other audio-visual equipment except when such equipment is intended for use off your premises in actual"emergency situations" or in training for"emergency situations;" (6) computer hardware or software or other electronic data processing equipment except when such equipment is intended for use off your premises in actual"emergency situations"or in training for"emergency situations;" (7) "fine arts;" (8) jewelry (except watches); PE1001 (01-20) Copyright,American International Group,Inc.,2019. Page 9 of 11 PORTABLE EQUIPMENT All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. (9) "aircraft;" (10) "'watercraft,"except as provided for in Extension 5. for Coverage A or in an attached schedule for Coverage B; or (11) "vehicles."' "Pollutants" means any solid" liquid, gaseous or thermal irritant or contaminant, including vapor,fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. "Replacement cost" its the amount it wound take to replace property with property of the same kind and quality, determined at the time of loss, without deduction for depreciation. "Resulting fire or explosion"'means a fire or explosion that results from any cause of loss other than"war," whether or not that cause of loss itself is covered under this policy. "Software" includes all forms of computer programs, computer code, and computer readable data employed in your operations. It includes the media on which computer programs, computer code, or computer readable data are electronicallly or optically recorded, such as magnetic tapes, hard disks, floppy disks, or compact disks. "Specified cause of loss" means fire, lightning,windstorm or hail, explosion, riot or civil commotion, "vehicles"or"'aircraft,"smoke, sonic boom, vandalism and malicious mischief, sprinkler leakage, sinkhole colllapse or volcanic action. "Training operations" means activities used to prepare, train, or instruct members of a fire department, hazardous materials unit, or first aid, ambulance or rescue squad in accepted and recognized emergency procedures, including municipal„ state and federal standards, "'Types of vehicles" means various categories of vehicles commonly used in firefighting„ ambulance or rescue operations, such as pumpers, brush trucks, aerial devices, rescue trucks, or advanced life support ambulances. "Valuable papers and records" are documents that are written, printed, or otherwise inscribed. These include: (1) books, manuscripts, abstracts, maps and drawings; (2) film and other photographically produced records, such as slides and microfilm; and (3) schematics, pre-plans, and haz mat manuals. "Vehicle"'means a land motor vehicle,trailer or semi-trailer, including "permanently attached equipment," designed for travel on public roads, but does not include mobile equipment or trailers whose primary purpose is to transport covered "portable equipment." "War" means any of the following: (1) Hostile or belligerent action, including action in hindering, combating or defending against an actual, impending or expected attack by: (a) any government or sovereign power(de jure or de facto); PE1001 (01.20) Copyright,American international Group,Inc.,2019. Page 10 of 11 PORTABLE EQUIPMENT All rights reserved.Includes copyrighted material of the insurance Services Office,Inc.,with its permission. P W O 4 00 0 M d' (b) any military, naval, air or nuclear forces; or (c) any agent of such government, power, authority or forces. (2) Insurrection, invasion, rebellion, revolution, civil war, usurped power or action taken by governmental authority in hindering, combating or defending against such an event. "Watercraft"means any watercraft used in your firefighting, ambulance or rescue related activities, including its motor, parts, accessories and equipment, but does not include"personal watercraft". "Wear and tear" includes wear, deterioration, rust, corrosion, marring or scratching, erosion, wet or dry rot, and mold. PE1001 (01-20) Copyright,American International Group,Inc.,2019. Page 11 of 11 PORTABLE EQUIPMENT WI rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WATERCRAFT EXTENSION This endorsement modifies insurance provided under the following: PORTABLE EQUIPMENT COVERAGE PART With respect to"watercraft" (including its motor, parts, accessories and equipment) insured under this coverage form, all exclusions in Section III. COVERED CAUSES OF LOSS apply except as amended below: 4. Dishonest acts or omissions done by you, your"employees", volunteers or anyone authorized to act for you, but this exclusion does not apply to a dishonest act or omission done by the captain or crew of your"watercraft"for a fraudulent or dishonest purpose contrary to their duty to you. 7. This exclusion is deleted in its entirety. 9. "Latent defects". We will not pay the cost of replacing or repairing an item having a "latent defect"that causes damage to your insured property; however, resulting damage would be covered.. 12. Pollution and contamination, which means the presence, release, discharge or dispersal of"'pollutants"' unless the damage is itself caused by or results from (1)the use of the "watercraft"' in an emergency or(2)the activities of governmental authorities acting for the public welfare to prevent or mitigate a pollution incident, or the threat of a pollution incident. All other exclusions remain unchanged, PE1003(01-20) Copyright,American International Group,Inc.,2019. Page 1 of 1 PORTABLE EQUIPMENT Ail rights reserved. Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. .P W O W 0 M d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDATORY ENDORSEMENT PORTABLE EQUIPMENT This endorsement modifies insurance provided under the following: PORTABLE EQUIPMENT COVERAGE PART The following revisions are made to the Portable Equipment Coverage Form: 1. Coveraae for Replacement Chargers for Portable Eauipment The following paragraph is added to Section IV What We Will Pay, Paragraph C. Coverage A Valuation - Guaranteed Replacement Cost and Paragraph D. Coverage B Valuation - Replacement Cost: When "portable equipment" is replaced and the undamaged associated mobile or stationary chargers for such "portable equipment" are incompatible with the replacement "portable equipment"„ we will pay to replace the mobile or stationary chargers with chargers that are compatible with the replacement"portable equipment". 2. Member Theft of Portable Equipment The following extension is added: Member Theft of"Portable Equipment" a. At your request, we will pay up to$5,000 in the event that: (1) Your "portable equipment" that was assigned to a volunteer or"employee" who is no longer affiliated with or employed by you, has been taken by the volunteer or"employee'; (2) You are unable to repossess such "portable equipment"; and (3) You now consider such "portable equipment"to be stolen. b. This payment is subject to the following conditions in addition to the policy provisions: (1) You must provide the identity and last known contact information of the volunteer or "employee"suspected of the theft of the"portable equipment". (2) You must provide us with reasonable documentation of your effort to re-claim the "portable equipment". (3) You have notified the police that a law may have been broken. (4) The volunteer or "employee" must have been affiliated with you or employed by you during the policy period. c. The most we will pay in any one policy period, regardless of the number of volunteers or "employees"who do not return the"portable equipment"assigned to them is$10,000, PE1009(01-20) Copyright,American International Group,Inc., 2019, Page 1 of 1 PORTABLE EQUIPMENT All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNMANNED AIRCRAFT EXTENSION This endorsement modifies insurance provided under the folllowiing PORTABLE EQUIPMENT COVERAGE FORM A. The following extension is added to Section II. Extensions of Portable Equipment Coverage: "Unmanned Aircraft" a We will pay for direct physical loss or damage to "unmanned aircraft" owned by you or furnished to you for your regular use, resulting from a"covered cause of loss". b. Coverage is not provided; (1) While "'unmanned aircraft" is rented„ leased, or loaned to others without an operator who is your"employee"or voltunteer; or (2) While being used in any professional or organized racing or demoliitiion contest or stunting activity„ or while practicing or preparing for such contest or activity;or (3) While not used in the insured's"operations", c. Subject to the limit shown in d., below, we will pay the"'replacement cost"' of the lost or damaged "unmanned ailrcraft"in excess of the deductible, but not more than the lesser of: (1) The amount which you actually spend to repair or replace the lost or damaged "'unmanned aircraft"with "unmanned aircraft" of comparable kind and quality', or (2) The"replacement cost" of the lost or damaged""'unmanned aircraft" d. The most we will pay under this extension in any one occurrence is$25,000. e. A$500 deductible applies to this extension. B. The following changes are made to Section VI. Portable Equipment Coverage Definitions: 1. The definition of"aircraft"is replaced with the following: "Aircraft" means aircraft, other than"unmanned aircraft', except those that are: (1) on the ground for 6splay or instructional purposes; (2) not self-propelled; and (3) not certified for flight. However,this does not include detached aircraft engines, parts, accessories and equipment. 2. The following definition is added: "Unmanned aircraft" means an aircraft weighing 15 pounds or less, that is not: a. Designed; b. Manufactured; or c. Modified after manufacture; to be controlled directly by a person from within or on the aircraft. "Unmanned aircraft" includes equipment used with such "unmanned aircraft", provided such equipment is attached to or essential for its operation. Payload (camera) is included only when in connection to, stored with, or in use with the drone. PE1012(01-20) Copyright,American international Group,Inc.,2019. Page 1 of 2 PORTABLE EQUIPMENT All rights reserved. Includes copyrighted material of the Insurance Services Office„Inc.,with its permission. P W N M d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 3. Item (3) under the definition of"personal effects" is replaced by the following: (3) "aircraft"or"unmanned aircraft". 4. Item (9) under the definition of"portable equipment"is replaced by the following: (9) "aircraft"or"unmanned aircraft", except as provided for in the"Unmanned Aircraft"extension. PE1012(01-20) Copyright,American International Group,Inc.,2019. Page 2 of 2 PORTABLE EQUIPMENT All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY FLORIDA CHANGES This endorsement modifies insurance provided under the following: EMERGENCY SERVICE ORGANIZATION PORTABLE EQUIPMENT COVERAGE. FORM The following provisions are added to the Duties In The Event Of Loss Or Damage Condition under Section V-Conditions: c. A claim or reopened claim for loss or damage caused by any peril is barred unless notice of claim is given to us in accordance with the terms of this policy within one year after the date of loss. A reopened claim means a claim that we have previously closed but that has been reopened upon your request for additional costs for loss or damage previous disclosed to us. A supplemental claim is barred unless notice of the supplemental claim was given to us in accordance with the terms of the policy within 18 months after the date of loss. A supplemental claim means a claim for additional loss or damage from the same peril which we have previously adjusted or for which costs have been incurred while completing repairs or replacement pursuant to an open claim for which timely notice was previously provided to us. For claims resulting from hurricanes, tornadoes, windstorms, severe rain or other weather-related events, the date of loss is the date that the hurricane made landfall) or the tornado, windstorm, severe rain or other weather-related event is verified by the National Oceanic and Atmospheric Administration, This provision concerning time for submission of claim, supplemental claim or reopened claim does not affect any limitation for legal action against us as provided in this policy under the Legal Action Against Us Condition, including any amendment to that condition.. d. Any inspection or survey by us, or on our behalf,„ of property that is the subject of a claim, will be conducted with at least 48 hours' notice to you The 48-hour notice may be waived by you PEFL01 (10-23) Copyright,American'international Group.Inc,,,2023. Page 1 of 1 AR rights reserved. Includes copyrighted material of the Insurance Servaces Office, Inc.,with its permission. P W W d M d' Named Insured: Policy Number:VFNU-TR-0019768-031000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 AUTO COVERAGE PART DECLARATIONS ITEM ONE. Named Insured-Refer to the Common or Auto Policy Declarations ITEM TWO; Coverage and Covered Autos This coverage part provides only those coverages activated by a Covered Auto Symbol or a Premium shown below° Coverage Covered Limit of Insurance Premium Auto (this is the most we will pay for Symbols any one accident or loss) Covered Autos Liability 1 $1,000,000 $2,863 (combined single limit) each accident Personal Injury Protection (PIP) 5 Refer to ITEM THREE and each PIP or $31 (orequivalent no-fault coverage) added PIP endorsement Added Personal Injury Protection N/A Separately stated in each added PIP (or equivalent added no-fault coverage) endorsement Property Protection Insurance NIA Separately stated in the P.P.I. endorsement (Michigan Only) minus Ded. for each accident Auto Medical Payments 7 $5,000 Each Insured $13 Medical Expense and Income Loss Separately stated in each Medical Expense Benefits NIA and Income Loss Benefits (Virginia anl ) endorsement Uninsured Motorists (UM) 2 8 9 Refer to ITEM THREE and the Uninsured $2,086 Motorists endorsement Underinsured Motorists (UIM) 2 8 9 Refer to ITEM THREE and the Underinsured INCL (when not included in UM coverage) Motorists endorsement Physical Damage—Comprehensive 7.8 Refer to ITEM THREE and $2 951 Physical Damage—Specified ITEM FOUR(if applicable) Causes of Loss NIA Physical Damage—Collision 7,8 $6,022 Physical Damage—Towing and N/A Refer to ITEM THREE Labor Other Auto Coverages Estimated Coverage Part Premium: $13,966.00 Taxes, Fees and Surcharges: Total Premium: $13,966�00 AU1000(01-20) Page: 1 10-03-2023 Named Insured: Policy Number: VFNU-TR-0019768-031000 KEY LARGO VOLUNTEER FIRE Policy Period'. From 10-01-2023 DEPARTMENT„ INC To 10-01-2024 ITEM THREE: Schedule of Your Auto Coverage Auto Schedule Summary Veh. Year Make Model PIE V.Q.N. Value Num. Code 2213 5q^IRRARA V.'UMFER 11,111H 1pC,°H 4�44°CF1T4282B39'Z22424 „G2i2,31,,0810 20112 2"312,II) SEV¢:V'34w;E OTH IFIDA,F36F152EB3t'c°I84:3 ACV 4 2441r4 FREI:ro➢B".VpV:V^VER TAIhtll°ER T V3'"V G 51 CYfBViRB,FVP 51.,2 5291P,9135 2014 5'E3d:F.ARA AB^,";RIAL AlD q44';:4'T42B61E'W'Z22!50R $16107,5,3'B 2 i@'.1.P E_4"pN E PUMPER "L"AJk;N KE R 111111111 q IFB'IN 6ah.Ak4 kl IER U 110 Cd'A 12"B $4b3 0,'.C.IP4"4 6 2i3I,.5 E—(MqE; PUMPER TA,Ik;NpCtllR 45"pwV&A.AAl:.B1{34'.3002031 $5 p3 .1196 � "�4�22: F'�C34'Gll:b ll'�IX3 i2'tl3 ail� 11:4q'r.� AC Ak"I("4�'IFI,`5G �4�NV�i�i2'�2'S5o2�8 '4"';716,"4�42 AU1000(01-20) Page: 2 10-03-2023 �P W tJ1 cfl M d' Named Insured: Policy Number: VFNU-TR-0019768-03I000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 Vehicle# 1 Insured's#: SQ-24 Insured Entity: Year: 2013 Use.- Make: FERRARA Class Code 790900 Model: PUMPER LDH State: FL V.I.N.: 44KFT4282BVVZ22424 Territory: 132 Valuation:Agreed Value Coverages: Limit of Insurance Deductible Premium Covered Autos Liability(combined single limit) $1,000,000 $279 Personal Injury Protection (PIP) See Endorsement $4 Added Personal Injury Protection Property Protection Insurance(MI only) Auto Medical Payments $5,000 $2 Medical Exp.And Income Loss Benefits(VA only) Uninsured Motorists (UM) $500,000 $298 Underinsured Motorists(UIM) $500,000 INCL Physical Damage—Comprehensive $401,080 $250 $376 Physical Damage—Specified Causes of loss Physical Damage—Collision $401,080 $500 $639 Physical Damage—Towing and Labor Other Auto Coverages Total: $1„598 Vehicle#2 Insured's#:A-25 Insured Entity: Year. 2002 Use: Service Make: FORD Class Code: 014990 Model: SERVICE State: FL V.I.N.: 1 FDAF56F52EB97843 Territory: 132 Valuation: Actual Cash Value Coverages: Limit of Insurance Deductible Premium Covered Autos Liability(combined single limit) $1,000,000 $222 Personal Injury Protection (PIP) See Endorsement $7 Added Personal Injury Protection Property Protection Insurance(MI only) Auto Medical Payments $5,000 $1 Medical Exp.And Income Loss Benefits(VA only) Uninsured Motorists(UM) $500,000 $298 Underinsured Motorists(UIM) $500,000 INCL Physical Damage—Comprehensive ACV $250 $139 Physical Damage—Specified Causes of Loss Physical Damage—Collision ACV $500 $169 Physical Damage—Towing and Labor Other Auto Coverages Total: $836 AU1000(01-20) Page: 3 10-03-2023 Named Insured: Policy Number; VFNU-TR-0019768-031000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 Vehicle#3 Insured's#: T-24 Insured Entity: Year: 2014 Use: Make: FREIGHTLINER Class Code: 790900 Modell: TANKER State: FL V I N.: 1 FVHG5CY8EHFV7512 Territory:: 132 Valuation: Agreed Value Coverages: Limit of Insurance Deductible Premium Covered Autos Liability(combined single limit) $1,000,000 $279 Personals(Injury Protection (PIP) See Endorsement $4 Added Personal Injury Protection Property Protection Insurance(MI onlly) Auto Medical Payments $5„000 $2 Medical Exp.And Income Loss Benefits(VA only) Uninsured Motorists(UM) $500,000 $298 Underinsured Motorists(UIM) $5001,000 INCL Physical)Damage—Comprehensive $297,985 $250 $412 Physical Damage—Specified Causes of Loss Physical)Damage—Collision $297,985 $500 $808 Physical)Damage—Towing and Labor Other Auto Coverages Total: $1,803 �eh'jcle � ........ #4 Insured's#. L 25 Insured Entity: Year: 2014 Use: Make: FERRARA Class Code: 790900 Modell, AERIAL State; FL V.III.N.: 44KFT4286EVC22508 Territory: 132 Valluatiion:Agreed Value Coverages: Limit of Insurance Deductible Premium Covered Autos Liability(combined single limit) $1,000,000 $279 Personal Injury Protection (PIP) See Endorsement $4 Added Personal Injury Protection Property Protection Insurance(MI only) Auto Medical Payments $5„000 $2 Medical Exp.And Income Loss Benefits(VA only) Uninsured Motorists(UM) $500,000 $298 Underinsured Motorists (UIM) $500,000 INCL Physical Damage—Comprehensive $607,„847 $250 $566 Physical Damage—Specified Causes of Loss Physical Damage—Collision $607„847 $500 $1,138 Physical Damage—Towing and Labor Other Auto Coverages Total: 2 287 AU1000(01-20) Page: 4 10-03-2023 P W 00 M d' Named Insured: Policy Number:VFNU-TR-0019768-03I000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 Vehicle#5 Insured's#: E-25 Insured Entity: Year: 2017 Use: Make: E-ONE Class Code: 790900 Model: PUMPER TANKER State: FL V.I.N.: 4EN6AAA88H1001128 Territory: 132 Valuation: Agreed Value Coverages: Limit of Insurance Deductible Premium Covered Autos Liability(combined single limit} $1,000,000 $279 Personal Injury Protection (PIP) See Endorsement $4 Added Personal Injury Protection Property Protection Insurance (MI only) Auto Medical Payments $5,000 $2 Medical Exp.And Income Loss Benefits(VA only) Uninsured Motorists(UM) $500,000 $298 Underinsured Motorists(UIM) $500,000 INCL Physical Damage—Comprehensive $530,187 $250 $534 Physical Damage—Specified Causes of Loss Physical Damage—Collision $530,187 $500 $1,061 Physical Damage—Towing and Labor Other Auto Coverages Total: $2,178 Vehicle#6 Insured's#: E-24 Insured Entity: Year: 2019 Use: Make: E-ONE Class Code: 790900 Model: PUMPER TANKER State: FL V.I.N.:4EN6AAA8XK1002031 Territory: 132 Valuation: Agreed Value Coverages: Limit of Insurance Deductible Premium Covered Autos Liability(combined single limit) $1,000,000 $279 Personal Injury Protection (PIP) See Endorsement $4 Added Personal Injury Protection Property Protection Insurance(MI only) Auto Medical Payments $5,000 $2 Medical Exp.And Income Loss Benefits(VA only) Uninsured Motorists(UM) $500,000 $298 Underinsured Motorists(UIM) $500,000 INCL Physical Damage—Comprehensive $573,796 $250 $553 Physical Damage—Specified Causes of Loss Physical Damage—Collision $573,796 $500 $1,378 Physical Damage—Towing and Labor Other Auto Coverages Total: $2,514 AU1000(01-20) Page: 5 10.03-2023 Named Insured: Policy Number: VFNU-TR-0019768-031000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 Vehicle#7 Insured's#: Insured Entity: Year: 2022 Use.: Make: FORD Class Code: 790900 Model:AIR CASCADE State: FL V.I,N.: 1 FDOW5GT7NEC35528 Territory: 132 Valuation.- Agreed Value Coverages: Limit of Insurance Deductible Premium Covered Autos Liability(combined single limit) $1,000,000 $279 Personal Injury Protection (PIP) See Endorsement $4 Added Personal Injury Protection Property Protection Insurance(MI only) Auto Medical Payments $5,000 $2 Medical Exp,And Income Loss Benefits(VA only) Uninsured Motorists (UM) $500,,000 $298 Underinsured Motorists(UIM) $500,000 INCL Physical Damage-.-Comprehensive $176,748 $250 $346 Physical Damage—Specified Qauses of Loss Physical Damage—Collision $176„748 $500 $804 Physilcal Damage—Towing and Labor Other Auto Coverages Total: $1,733 Vehicle# Insured's#: Insured Entity.- Year, Use: Make: Class Code. Model: State: p V.1 N.: Territory: Valuation: Coverages: Limit of Insurance Deductible Premium Covered Autos Liability(combined single limit) Personal) Injury Protection (PIP) Added Personal Injury Protection Property Protection Insurance(MI only) Auto Medical Payments Medical Exp. And Income Loss Benefits (VA only) Uninsured Motorists (UM) Underinsured Motorists(UIM) Physical Damage—Comprehensive Physical Damage—Specified Causes of Loss Physical Damage—Collision Physical Damage--Towing and Labor Other Auto Coverages Total: AU1000(01-20) Page: 6 10-03-2023 .P W W 0 N M d' Named Insured: Policy Number: VFNU-TR-0019768-031000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 ITEM FOUR: Hired, Borrowed, and Commandeered Coverage (if applicable) Covered Autos Liability Coverage Rating Basis, Cost of Hire State Estimated Cost of Rate Per Each Factor(If Liability Premium Hire for Each State $100 Cost of Hire Coverage is Prima FL IF ANY $4.264 $97 TOTAL HIRED AUTO PREMIUM: $97 Covered Autos Liability Coverage Rating Basis, Number of Days- (For Mobile or Farm Equipment—Rental Period Basis) State Estimated Number of Base Premium Factor Premium Days Equipment Will Be Rented TOTAL HIRED AUTO PREMIUM: State: FL Physical Damage Cove ra a Valuation and Deductible Estimated Cost of Hire Premium Comprehensive Actual cash value or the cost of IF ANY $25 repair, whichever is less, minus a $50 deductible for each covered auto Collision Actual cash value or the cost of IF ANY $25 repair, whichever is less, minus a $100 deductible for each covered auto Such insurance as is afforded by hired auto physical damage coverage also applies to autos you Commandeer. AU1000(01-20) Page: 7 10-03-2023 Named Insured: Policy Number: VFNU-TR-0019768-03/000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 ITEM FIVE: Non-Ownership`Liability Named Insured's Business Rating Basis Number Premium EMERGENCY SERVICE ORGANIZATION Number of 43 $870 volunteers/employees Extended coverage INCL Auto Forms See Schedule of Forms and Endorsements AU1000(01-20) Page: 8 10-03-2023 P W N N N M d' THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. AUTO PHYSICAL DAMAGE EXTENSION ENDORSEMENT BUSINESS AUTO COVERAGE FORM The following revisions are made to Section III -Physical Damage Coverage: TOWING Coverage A.2.,, Towing,, is replaced by the following: For any 'auto" listed in Item Three of the Auto Coverage Part Declarations for which a premium charge has been made for Comprehensive Coverage: a. We will pay reasonable labor costs incurred to make necessary repairs to the"auto" so it can be driven from the scene of disablement.. This Labor must be performed at a scene of disablement other than your normal garaging location for such"auto"; or b. We willi pay for all reasonable towing costs incurred for towing the disabled "auto" from the scene of disablement to an appropriate repair facility. This includes the costs to tow the disabled "auto"'to multiple facilities as necessary,,prior to delivery to the final repair facility. The most we will pay for each"auto"'under this extension is$2,500. GLASS BREAKAGE Coverage A.3., Glass Breakage—Hitting a Bird or Animal—Falling Objects or Missiles, replaced by the fallowing; If you carry Comprehensive Coverage for the damaged covered "auto we will pay for the following under Comprehensive Coverage: a. Full window glass breakage, without deductible; b. "Loss"caused by hitting a bird or animal; and C. "Loss"caused by falling objects or missiles. DEDUCTIBLE WAIVER The following is added to paragraph D. Deductible: If a "loss" covered under this policy also involves a "loss" under an Emergency Service Organization Portable Equipment, Inland Marine or Property coverage part issued by us, only one deductible, the largest, will be applied. The deductible under the other coverage parts will be waived. AU1001 (01-20) Copyright,American International Group,Inc.,2019 Page 1 of 1 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY AGREED VALUE ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM For covered"autos" designated in the schedule as being insured on an agreed value basis, the following provisions of SECTION III -PHYSICAL DAMAGE COVERAGE, are changed: A. COVERAGE The first sentence is deleted and repllaced with the following: 1. We will pay for"loss"to a covered"auto"or its"permanently attached equiipmenC Lander: C. LIMIT OF INSURANCE The most we will pay for"Boss"to any one covered "'auto" in any one accident is the least of: 1. the cost of repairing the damaged property; or 2. the cost to replace a part or parts of the damaged property as of the time of the "loss" with a part or parts of like kind and quality, without deduction for depreciation; or 3. the cost to replace the entire covered "auto"and its"'permanently attached equipment"as of the time of the "floss" with a comparablle new "auto" and "permanently attached equipment" manufactured to current specifications or standards set by nationally recognized organizations such as NFPA or the U.S. Department of Transportation; or 4, the limit stated in the Declarations as applicable to the damaged or stolen property. In addition to the costs of repairs or replacements as referenced in paragraphs C.1., or C.2., above„ we will pay up to an additional 25% of the "loss" for the actual costs you incur to render the post or damaged parts of the covered "auto" in compliance with the latest safety or equipment standards mandated by governmental agencies or other nationally recognized standards setting organizations. If, as a result of a covered cause of "loss", an agency or organization requires recertification of the repllaced, lost or damaged parts,we shall also pay those costs. In the event the estimated costs to repair a damaged covered "auto" exceed 75% of the limit shown in the schedule of vehicles as the agreed value, and you choose not to accept payment under paragraphs C.1. or C.2. above, we will pay the lesser of the amounts due you under paragraphs C.3. or CA. above„ Should we make settlement under C.3. or CA., we shall have the rights to all recovery and salvage. AIII other provisions of SECTION III -PHYSICAL DAMAGE COVERAGE-are unchanged. Additional)definitions applicable to this endorsement: ■ "'Auto" shall include its equipment other than portable firefighting and rescue related equipment. ■ "Permanently attached equipment" means equipment that its welded, bolted or permanently screwed to the dashboard, firewall or body of the "auto." Equipment inserted on permanently installed slide brackets with or without the use of setscrews or tension, or portable firefighting and rescue related equipment, shall not be construed as"permanently attached equipment." AU1002 (01-20) Copyright.Amer0can International Group,Inc.,2019. Page 1 of 2 All rights reserved Includes copyrighted material of the Insurance Services Office, lint,with its permission. W N W dq N M d' The following is added to item B. OWNED AUTOS YOU ACQUIRE AFTER THE POLICY BEGINS of Section I—COVERED AUTOS: 3. If symbols 2, 7 or 8 are entered next to a coverage in Item Two of the Declarations, for owned"autos" or "autos" you lease for a period of six months or more, acquired after the policy begins and not described in the Declarations, we will pay under the Comprehensive or Collision coverages the least of the following: a. the cost of repairing the damaged property; or b. the cost to replace a part or parts of the damaged property as of the time of the "loss" with a part or parts of like kind and quality,without deduction for depreciation; or c. the actual cash value of the newly acquired "auto" or your actual cost of purchase of the newly acquired"auto,"whichever is more; provided that the newly acquired "auto" is an emergency vehicle and you agree to notify us as soon as possible. This coverage will cease at the end of the policy period during which the "auto" was acquired. AU1002 (01-20) Copyright,American International Group, Inc.,2019, Page 2 of 2 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY WAIVER OF GOVERNMENTAL OR CHARITABLE IMMUNITY ENDORSEMENT - PROPERTY DAMAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM We will waive, both in the adjustment of claims and in the defense of any"property damage"suit against the"insured", any charitable or governmental immunity of the"insured", unless the"insured" requests in writing that we not do so. Waiver of immunity as a defense wilt not subject us to(liability for any portion of a claim or judgment in excess of the applicable limit of insurance. AU1005(01-20) Copyright„American International Group,Inc.,2019 Page 1 of 1 All rights reserved.Includes copyrtighted material of the Insurance Services Office„Inc.,with its permission P W N Ul to N M d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CARE, CUSTODY OR CONTROL EXCLUSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM LIABILITY COVERAGE is changed as follows: B. Exclusion 6., CARE CUSTODY OR CONTROL, is deleted and replaced by: 6. CARE, CUSTODY OR CONTROL This insurance does not apply to"property damage"to or"covered pollution cost or expense" involving property owned, transported by, or in the care, custody or control of the Named Insured, The exclusion does not apply to"property damage"to a building and its contents or garage and its contents rented to, used by,or in the care, custody or control of the Named Insured. This exclusion also does not apply to property owned by an"insured"other than the Named Insured or to property transported by or in the care, custody or control of an "insured," The amount payable for"property damage"to a building and its contents or garage and its contents, rented to, used by, or in the care, custody or control of the Named Insured will be subject to a$250 deductible. This exclusion does not apply to liability assumed under a sidetrack agreement. The provisions of this endorsement are subject to item B,5., OTHER INSURANCE, included as a part of BUSINESS AUTO CONDITIONS. Authorized Agent AU1006(01-20) Copyright,American International Group, Mine,,2019 Page 1 of 1 All rights reserved.Includes copyrighted materiaii of the Insurance Services Office,Inc,,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMANDEERED AUTO DEFINITION ENDORSEMENT Named Insured KEY LARUO V=TEER FIRE DLVAK Endorsement Number Policy Number - - - Endorsement Effective 10/01/23 Countersigned by Authorized Representative) The above is reg0red to be completed only Men this endorsement is!issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided underthe following: BUSINESS AUTO COVERAGE FORM SECTION V-DEFINITIONS The following definition is added: "Commandeered auto"means an'auto"belonging to someone else that you seize, confiscate or take arbitrarily by force, into your temporary care,custody or control while using it as part of an"emergency situation."'"Commandeered auto"does not include an"auto"owned by or available to an employee or volunteer of your organization from whom you have tacit approval to use the"auto". 'Emergency Situation"means an unexpected situation demanding immediate official action. AU1007(01-20) Copyright,American International Group, Inc.,2019. Page 1 of 1 All rights reserved. Includes copyrighted material of the Insurance Serwces Office,Inc.,with its permission. .P W IV 4 00 N M d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INCIDENTAL GARAGE OPERATIONS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE LIABILITY The following paragraph is hereby inserted following the first paragraph of item A.COVERAGE of SECTION II—LIABILITY COVERAGE: Any"auto"you do not own, lease, hire, rent or borrow that is used in connection with your"garage operations" is considered a covered"auto". This includes"autos" used by your volunteers or employees, or members of their households, while used in your"garage operations". With respect only to the coverage provided by the above paragraph: • item 10. COMPLETED OPERATIONS of B. EXCLUSIONS is deleted; and • item b.(3)of 1.WHO IS AN INSURED of A.COVERAGE is deleted. GARAGEKEEPERS INSURANCE The following Coverage Extension is hereby added under item A.COVERAGE of SECTION III— PHYSICAL DAMAGE COVERAGE: We will pay for"loss"to any"autos"while left with your"garage operations". Coverage under this extension is provided only to the extent indicated below. COVERAGE DEDUCTIBLE LIMIT PER"LOSS" Comprehensive rima basis $250 $50 000 Collision (prima v basis $500 $50,000 For the purpose of this endorsement,"garage operations" means your use of one or more locations for the service, repair„ parking or storage of"autos"other than your own, including all operations necessary or incidental thereto. Parking or storage of"autos" is a"garage operation"only when the"autos" are parked by you and are in your care, custody or control, AU1009(01-20) Copyright,American International Group,Inc„2019. Page 1 of 1 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc„with its permission, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO PHYSICAL DAMAGE EXTENSION ENDORSEMENT - PUBLIC ENTITY AND EMERGENCY SERVICE ORGANIZATIONS This endorsement modifies insurance provided under the folllowing: BUSINESS AUTO COVERAGE FORM 1. The following coverages are added to Section III - Physical Damage Coverage, Paragraph A. Coverage: PHYSICAL DAMAGE TO VOLUNTEERS'OR EMPLOYEES' PERSONAL AUTOS 5. Physical Damage to Personal Autos a. At your request, we will pay up to the actual cash value for an"auto" not covered for physical damage: or the amount of the deductible under any policy covering an "auto" owned or used by a volunteer or"emplloyee" of your insured law enforcement, firefighting, ambulance and/or rescue organization for°'"Moss"that occurs: (1) While enroute to,,during and returning directly from an emergency; or (2) While enroute to, during and returning from activities that are performed at the direction and knowledge of an officer of the insured flaw enforcement, firefighting,, ambulance and/or rescue organization. b. At your request, we will pay the lesser of $1,000, or the amount of the deductible under any policy covering an "auto" owned or used by your elected or appointed official, officer, volunteer or "employee" of your organization, other than your insured law enforcement, freighting, ambulance and/or rescue organization, for "loss" that occurs whiCe enroute to, during and returning from activities that are performed at the direction and knowledge of your elected or appointed official or officer.. c. At your request,we will pay the rental) reimbursement expenses incurred by your volunteer or "employee" for the rental of an "auto" because of"loss" sustained under Paragraph a.(1) to their owned"auto". The most we wiill pay is$30 per day for a maximum of 30 days. d. Proof of statutory limits of financial responsibility as of the date of"floss" for an "'auto" that is covered under this extension must be provided before payment is made for"loss"" under this extension. e. In no event will we pay for any "loss" under this coverage to any "auto"" owned, hired or borrowed by your organization. AU1017(01-20) Copyright,American intemational Group,Inc,,2019, Page 1 of AIII rights reserved. includes copyrighted material of the .p Insurance Services Office.Inc.,with ilts permission. W N W C) M M d' RENTAL REIMBURSEMENT COVERAGE FOR FIREFIGHTINGIRESCUE VEHICLES 6. Rental Reimbursement Coverage for Firefighting/Rescue Vehicles (1) This extension only applies to covered "autos" listed in Item Three of the Auto Coverage Part Declarations that are used for firefighting/rescue purposes, which are designated with a 7909 class code in the Declarations. The coverage provided under this extension does not apply to any other covered"autos"on the schedule. (2) We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of"loss"to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductible applies to this coverage. (3) We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto". If"loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto"and return it to you. (b) 40 days. (4) Our payment is limited to the lesser of the following amounts: (a) Necessary and actual expenses incurred. (b) $250 for any one day. (5) This coverage does not apply while there are spare or reserve "autos" available to you for your operations. TEMPORARY SUBSTITUTE FIREFIGHTING OR RESCUE AUTO 7. Temporary Substitute Firefighting or Rescue Autos a. We will provide coverage for temporary substitute firefighting and rescue "autos" you do not own. The temporary substitute "auto" must replace a covered "auto" for which a premium charge has been made for Comprehensive and/or Collision coverage. The replaced "auto" must be out of service for a period of less than six months because of its: (1) Breakdown; (2) Repair; (3) Servicing; (4) "Loss'; or (5) Destruction. b. For temporary substitute firefighting and rescue "autos" you do not own described in paragraph a.above, Paragraph C. Limit Of Insurance is replaced by the following: C. Limit Of Insurance 1. If the owner has physical damage coverage on the temporary substitute "auto", the most we will pay for"loss" in any one"accident" is the lesser of: a. The amount that would have been paid by the owner's insurance policy insuring the temporary substitute firefighting or rescue"autos'; or b. $1,000,000. 2. If the owner does not have physical damage coverage on the temporary substitute "auto", the most we will pay for"loss" in any one"accident" is the least of: a. The actual cash value of the damaged or stolen property as of the time of the "loss"; or b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality; or c. $1,000,000. c. The deductible assigned to the temporary substitute "auto'will be the same as the firefighting or rescue covered "auto"that is being replaced. AU1017(01-20) Copyright,American international Group,Inc.,2019. Page 2 of 4 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. d. For the purpose of this coverage, Paragraph d. of B.S., Other Insurance, is deleted. The temporary substitute ""auto"" is deemed to be a covered "auto" you own and with no consideration of or contribution from other valid and collectible insurance for the"auto". FORESTRY VEHICLES AND FORESTRY EQUIPMENT 8 Any "auto" that is a "forestry vehicle" and is not scheduled for physical damage is a covered "'auto". Any equipment that is "forestry equipment'and is installed on a covered "auto" is covered equipment. For the purpose of this extension, forestry vehicle"' means an "auto" you don't own, used for firefighting purposes„ that is on loan to you from a state agency under the Federal Excess Personal Property program or any similar program. 'Forestry equipment" means any firefighting equipment you don't own that is on loan to you from a state agency under the Federal Excess Personal Property program or any similar program and is installed on an "auto" you own or on a "forestry vehicle The folllowing replaces paragraph C. Limit of Insurance: The most we will) pay for"loss"'to a"forestry vehicle" or"forestry equipment" in any one"accident" is the lesser of: a. The actual cash value of the damaged or stolen property as of the time of the"'loss"; or b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total "floss", No payment whit be made under this extension unless the damaged or stolen property its actually repaired or replaced. Repairs to or replacement of the damaged or stolen property with the same kind of property must be done within a year of the date of "loss". If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment For any Comprehensive °""losses" covered by this extension, we will use the smallest Comprehensive deductible applying to any of your scheduled "autos". For any Collision "losses" covered by this extension, we will use the smallest Colt'ision deductible applying to any of your scheduled "autos". We shall have no salvage rights to any"forestry vehicle" or"forestry equipment". 2. The following revisions are made to Section III -Physical Damage Coverage:. AIRBAG COVERAGE a. The exclusion for "loss" caused by mechanical breakdown in sub-paragraph 3.a. of B. Exclusions does not appll'y to the accidental discharge of an airbag FREEZING COVERAGE ON EMERGENCY VEHICLES b. The exclusion for "loss" caused by freezing in sub-paragraph 3.a. of B. Exclusions does not apply to permanently attached special equipment common to a firefighting or rescue vehicle caused by freezing, unlless the "loss" is caused by your failure to properly maintain such equipment. Such equipment shall include but is not limited to pumps, gauges and tanks. In no event will the"loss"to a vehicle's engine caused by freezing be covered by this policy. CUSTOMIZED VEHICLE EXTENSION c. For scheduled customized covered "autos" not covered on an agreed value basis that are owned by your law enforcement, firefighting, ambulance and/or rescue organization, the following is added to paragraph C. Limit Of Insurance 5. We wild pay the additional repair or replacement costs necessary to customize the damaged '°'auto"' with permanently installed equipment of like kind and quality, without deduction for depreciation. We will also include the cost of installation onto a replacement "auto" if the covered "auto" is not repairable. Permanently installed means equipment that is permanently installed in the covered "auto" at the time of the "loss"or equipment that is removable from a AU1017(01�20) Copyright„American International Group"Inc,,2019, Page 3 of 4 All rights reserved.(includes copyrighted material of the .p Insurance Services Office„Inc.,with its permission. W W N M M d' housing unit which is permanently installed in the covered"auto"at the time of the"loss", and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto". This customization will include, but is not limited to,the following: a. custom painting and gold leaf lettering, b. light bars and sirens, c. permanently installed communications equipment, Global Positioning Systems (GPS), traffic signal control systems, electronic license plate readers, and radar equipment, and d. computer or electronic equipment that receives or transmits audio,visual or data signals. In addition, we will pay for property owned by you that is permanently installed in an "auto" not owned by you. DEDUCTIBLE WAIVER d. The following is added to paragraph D. Deductible: Regardless of the number of covered"autos" suffering a physical damage"loss"while engaged in a single law enforcement, firefighting, ambulance and/or rescue emergency, only one deductible, the largest, shall apply to the entire event. AU1017(01-20) Copyright,American International Group,Inc., 2019. Page 4 of 4 All rights reserved.includes copyrighted material of the Insurance Services Office,Inc.,with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY AUTO LIABILITY EXTENSION ENDORSEMENT EMERGENCY SERVICE ORGANIZATIONS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM 1. The following revisions are made to Section II -Covered Autos Liability Coverage and Section IV -Business Auto Conditions: VOLUNTEERS EMPLOYEES AND ELECTED OR APPOINTED OFFICIALS AS INSUREDS - NON-OWNED AUTO LIABILITY COVERAGE -PRIMARY BASIS a. Coverage A.1., Who Is An Insured, under Section II - Covered Autos Liability Coverage is modified by the addition of paragraphs d., e. and f., as follows: d. Any volunteer or "employee" of yours while using a covered "auto" you don't own, hire or borrow, while performing duties related to the conduct of your business. Anyone else who furnished that"'auto"is ailso an"'insured". e. Your elected or appointed officials while using a covered "auto' you don't own, hire or borrow, whiffle performing duties related to the conduct of your business. Anyone else who furnished that""'auto" is also an"insured". f. Your commissions, authorities, boards or agencies, their commissioners, officers and members whiffle using a covered "auto" you don't own, hire or borrow, but only while acting within the authority granted by you and only while performing duties related to the conduct of your business, Anyone else who furnished that"auto"is also an "insured". b. The follllowing paragraph is added to B.5., Other Insurance of Section IV - Business Auto Conditions: e. Notwithstanding condition 5.a. and 5.d. above, for any covered "auto" you or any other emergency service organization or public entity don't own, hire or borrow, which is being used by a person, commission, authority, board or agency as described under paragraph d., e. or f. of Section II - Covered Autos Liability Coverage, Coverage A.1., Who Is An Insured, this Coverage Form provides primary insurance with no consideration of or contribution from any other insurance for such"auto". OWNER OF TEMPORARY SUBSTITUTE AUTO AS AN INSURED-PRIMARY BASIS c. Coverage A.1., Who Is An Insured, under Section II - Covered Autos Liability Coverage is modified by the addition of paragraph g., as follows: g. The owner or anyone else from whom you rent, lease or borrow a substitute "auto" is an "insured", but only for that covered "auto". The substitute must be for a similar scheduled "auto" which is out of normal use because of its breakdown, repair, servicing, loss or destruction d. The following paragraph its added to B.5., Other Insurance of Section IV - Business Auto Conditions: f. Notwithstanding condition 5.a. and 5.d. above, a substitute "auto" as described under paragraph g. of Section 11 -Covered Autos Liability Coverage, Coverage A.1.,Who Is An Insured, is deemed a covered "auto" you own. This Coverage Form provides primary insurance with no consideration of or contribution from other insurance for such"auto". AU1023(01-20) Copyright,American International Group,Inc.,2019. Page 1 of 3 All rights reserved.Includes copyrighted material of the Insurance Services Office, Inc,with its permission. P W W W d M M d' OWNER OF COMMANDEERED AUTO AS AN INSURED-PRIMARY BASIS e. Coverage A.1., Who Is An Insured, under Section II - Covered Autos Liability Coverage is modified by the addition of paragraph h., as follows: h. The owner of a "commandeered auto" is an "insured" while the "auto" is in your temporary care, custody or control and is being used as part of an"emergency situation". f. The following paragraph is added to B.S., Other Insurance of Section IV - Business Auto Conditions: g. Notwithstanding condition 5.a. and 5.d. above, a"commandeered auto" is deemed a covered "auto" you own. This Coverage Form provides primary insurance with no consideration of or contribution from other insurance for such"auto". 2. The following revisions are made to Section II -Covered Autos Liability Coverage: ADDITIONAL INSURED-AUTOMATIC STATUS a. Coverage A.1.,Who Is An Insured, is modified by the addition of paragraph i.,as follows: i. Any person or organization for whom you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional "insured" on your policy, but only to the extent that person or organization qualifies as an "insured" under Coverage A.1.,Who Is An Insured. Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional "insured" whether primary, excess, contingent or on any other basis unless a written contract or agreement specifically requires that this insurance be primary in which case any other insurance available to the additional "insured" shall be considered excess and non-contributing. ADDITIONAL EXPENSES YOU INCUR AT OUR REQUEST b. Coverage A.2.a.(4), Coverage Extensions, Supplementary Payments, is replaced by the following: (4) All reasonable expenses incurred by the "iinsured" at our request, including actual loss of earnings up to$300 a day because of time off from work. EXPECTED OR INTENDED INJURY c. Exclusion B.1., Expected Or Intended Injury, is replaced by the following: "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to expected or intended "bodily injury" or "property damage' resulting from actions taken to protect persons or property and arising out of the use of a covered "auto". BODILY INJURY TO VOLUNTEER EMERGENCY SERVICE PROVIDERS d. Exclusion. BA., Employee Indemnification And Employer's Liability„ is amended by the addition of paragraphs c.and d., as follows: c. Any volunteer, if you provide or are required to provide any benefits for such volunteer under any Workers'Compensation or disability benefits claw or under any similar law. d. The spouse, child, parent, brother or sister of that volunteer as a consequence of paragraph c. above. BODILY INJURY TO FELLOW VOLUNTEERS OR EMPLOYEES e. Exclusion B.S., Fellow Employee, is deleted.. AU1023(01-20) Copyright,American International Group,Inc.,2019. Page 2 of 3 Alt rights reserved, Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. 3. The following revision is made to Section IV-Business Auto Conditions: KNOWLEDGE OF ACCIDENT The following paragraph is added to Paragraph A.2. Duties In The Event Of Accident, Claim, Suit Or Loss: d. The failure of any agent„ volunteer or '"employee of the "insured", other than an "employee" authorized by you to give or receive notice of an "accident", claiim, "suit" or"loss", to notify us of any "accident" of which he or she has knowledge, shall not invalidate insurance afforded by this policy. AU1023(01-20) Copyright„American International Group,Inc.,2019. Page 3 of 3 All rights reserved Includes copyrighted material of the 7;nsurance Services office,lint with its permission. P W W tJ1 cfl M M d' COMMERCIAL AUTO CA00011013 BUSINESS AUTO COVERAGE FORM Various provisions in this policy restrict coverage. SECTION I—COVERED AUTOS Read the entire policy carefully to determine rights, Item Two of the Declarations shows the "autos" that duties and what is and is not covered. are covered "autos" for each of your coverages. The Throughout this policy the words "you" and "your' following numerical symbols describe the "autos" that refer to the Named Insured shown in the Declarations. may be covered "autos". The symbols entered next to The words "we", "us" and "our' refer to the company a coverage on the Declarations designate the only providing this insurance. "autos"that are covered"autos". Other words and phrases that appear in quotation A. Description Of Covered Auto Designation marks have special meaning. Refer to Section V — Symbols Definitions. Symbol Description Of Covered Auto Designation Symbols 1 An "Auto" 2 Owned"Autos" Only those"autos"you own (and for Covered Autos Liability Coverage any Only "trailers"you don't own while attached to power units you own). This includes those"autos"you acquire ownership of after the policy begins. 3 Owned Private Only the private passenger"autos"you own. This includes those private Passenger passenger"autos"you acquire ownership of after the policy begins. "Autos"Only 4 Owned Only those"autos"you own that are not of the private passenger type(and for "Autos"Other Covered Autos Liability Coverage any"trailers"you don't own while attached to Than Private power units you own). This includes those"autos" not of the private passenger Passenger type you acquire ownership of after the policy begins. "Autos"Only 5 Owned"Autos" Only those"autos"you own that are required to have no-fault benefits in the state Subject To where they are licensed or principally garaged. This includes those"autos"you No-fault acquire ownership of after the policy begins provided they are required to have no- fault benefits in the state where they are licensed or principally garaged. 6 Owned"Autos" Only those"autos"you own that because of the law in the state where they are Subject To A licensed or principally garaged are required to have and cannot reject Uninsured Compulsory Motorists Coverage. This includes those"autos"you acquire ownership of after the Uninsured policy begins provided they are subject to the same state uninsured motorists Motorists Law requirement. 7 Specifically Only those"autos"described in Item Three of the Declarations for which a Described premium charge is shown (and for Covered Autos Liability Coverage any"trailers" "Autos" you don't own while attached to any power unit described in Item Three). S Hired"Autos" Only those"autos"you lease, hire, rent or borrow. This does not include any"auto" Only you lease, hire, rent or borrow from any of your"employees", partners (if you are a partnership), members(if you are a limited liability company) or members of their households. 9 Non-owned Only those"autos"you do not own, lease, hire, rent or borrow that are used in "Autos"Only connection with your business. This includes"autos"owned by your"employees", partners(if you are a partnership), members(if you are a limited liability company) or members of their households but only while used in your business or your personal affairs. CA 00 01 1013 cp insurance Services Office, Inc.,, 2011 Page 1 of 12 19 Mobile Only those"autos"that are land vehicles and that would qualify under the definition Equipment of"mobille equipment"under this policy if they were not subject to a compulsory or Subject To financials responsibility law or other motor vehicle insurance law where they are Compulsory Or licensed or principally garaged. Financial Responsibility Or Other Motor Vehicle Insurance Law Only B. Owned Autos You Acquire After The Policy SECTION II—COVERED AUTOS LIABILITY Begins COVERAGE 1. If Symbols 1, 2, 3, 4, 6, 6 or 19 are entered A. Coverage next to a coverage in Item Two of the We with pay all sums an "insured" legally must pay Declarations, then you have coverage for as damages because of"'bodily injury" or"property "autos""' that you acquire of the type described damage" to which this insurance applies, caused for the remainder of the policy period. by an "accident"and resulting from the ownership, 2. But, if Symbol 7 is entered next to a coverage maintenance or use of a covered"auto". in Item Two of the Declarations, an "auto" you We will also pay all sums an "insured" legally must acquire will be a covered "auto"' for that pay as a "covered pollution cost or expense" to coverage only if: which this insurance applies, caused by an a. We already cover all "autos" that you own "'accident" and resulting from the ownership, for that coverage or it replaces an "auto" maintenance or use of covered "autos". However, you previously owned that had that we will only pay for the "covered pollution cost or coverage;l and expense" if there its either "bodily injury" or b. You tell us within 30 days after you acquire "property damage""to which this insurance applies it that you want us to cover it for that that is caused by the same"accident". coverage. We have the night and duty to defend any C. Certain Trailers, Mobile Equipment And "insured" against a "suit"' asking for such damages Temporary Substitute Autos or a""covered pollution cost or expense"'. However, we have no duty to defend any "insured" against a If Covered Autos Liability Coverage is provided by I..suit"' seeking damages for "'bodily injury" or this Coverage Form, the following types of °'property damage"' or a "covered pollution cost or vehicles are also covered "autos" for Covered expense" to which this insurance does not apply. Autos Liability Coverage: We may investigate and settle any claim or "suit" 1. "Tr0ers" with a load capacity of 2,000 pounds as we consider appropriate. Our duty to defend or or less designed primarily for travel on public settle ends when the Covered Autos Liability roads. Coverage Limit of Insurance has been exhausted 2. "Mobilie equipment" while being carried or by payment of judgments or settlements. towed by a covered"auto". 1. Who Is An Insured 3. Any "auto" you do not own while used with the The following are"insureds": permission of its owner as a temporary a. You for any covered "auto". substitute for a covered "auto" you own that is out of service because of its: b. Anyone else while using with your permission a covered "auto" you own, hire a. Breakdown; or borrow except: b. Repair; (1) The owner or anyone else from whom c. Servicing; you hire or borrow a covered"auto". d. "Loss'; or This exception does not apply if the e. Destruction. covered "'auto" is a"trainer" connected to a covered"auto"you own. Page 2 of 12 0 insurance Services Office, Inc., 2011 CA 00 01 10 13 w w 4 00 M M d' (2) Your"'employee" if the covered "auto"' is These payments will not reduce the Limit of owned by that "employee" or a member Insurance. of his or her household. b. Out-of-state Coverage Extensions (3) Someone using a covered "auto"" while While a covered "auto" is away from the he or she is working in a business of state where it is licensed,we will: selling, servicing, repairing, parking or storing "'autos" unless that business is (1) Increase the Limit of Insurance for yours. Covered Autos Liability Coverage to (4) Anyone other than your "employees", meet the limits specified by acompulsory or financial responsibility partners (if you are a partnership)„ law of the jurisdiction where the covered members (if you are a limited liability "auto" is being used. This extension company) or a lessee or borrower or does not apply to the limit or limits any of their "'employees", while moving specified by any law governing motor property to or from a covered "auto"'. carriers of passengers or property. (6) A partner (if you are a partnership) or a (2) Provide the minimum amounts and member (if you are a limited liability types of other coverages, such as no- company)for a covered"auto"'owned by faullt, required of out-of-state vehicles by him or her or a member of his or her the jurisdiction where the covered "auto" household. is being used. c. Anyone liable for the conduct of an We will not pay anyone more than once for "insured" described above but only to the the same elements of loss because of extent of that Viability, these extensions. 2. Coverage Extensions B. Exclusions a. Supplementary Payments This insurance does not apply to any of the We will pay for the"insured":: following: (1) All expenses we incur. 1. Expected Or Intended Injury (2) Up to $2„000 for cost of bail bonds "Bodily injury" or "property damage" expected (including bonds for related traffic law or intended from the standpoint of the violations) required because of an "insured". "accident" we cover. We do not have to 2. Contractual furnish these bonds. (3) The cost of bond„suit against the s to release Liability assumed under any contract or attachments in any agreement. "insured" we defend, but only for bond But this exclusion does not apply to liability for amounts within our Limit of Insurance. damages: (4) All reasonable expenses incurred by the a. Assumed in a contract or agreement that is "insured"at our request, including actual an "insured contract", provided the "bodily loss of earnings up to $250 a day injury" or "property damage" occurs because of time off from work. subsequent to the execution of the contract (5) All court costs taxed against the or agreement; or "insured" in any "suit" against the b. That the "insured" would have in the "insured" we defend. However, these absence of the contract or agreement. payments do not include attorneys' fees 3. Workers'Compensation or attorneys'expenses taxed against the Any obligation for which the "insured" or the "insured". "insured's" insurer may be held liable under (6) All interest on the full amount of any any workers' compensation, disability benefits judgment that accrues after entry of the or unemployment compensation law or any judgment in any "suit" against the similar law. "insured"we defend, but our duty to pay interest ends when we have paid, offered to pay or deposited in court the part of the judgment that is within our Limit of Insurance. CA 00 01 1013 0 Insurance Services Office, Inc., 2011 Page 3 of 12 4. Employee Indemnification And Employer's b. After it is moved from the covered "'auto"to Liability the pace where it is fiinally deliivered by the "Bodily injury"to: "insured a. An "employee" of the "insured" arising out 8• Movement Of Property By Mechanical of and in the course of: Device (1) Employment by the"'insured'; or "Bodily injury"' or "'property damage'" resulting from the movement of property by a (2) Performing the duties related to the mechanical) device (other than a hand truck) conduct of the'"'insured's"business; or unless the device its attached to the covered b. The spouse, child, parent, brother or sister "`auto", of that "employee" as a consequence of g, Operations Paragraph a.above "Bodily injury""or"property damage" arising out This exclusion applies: of the operation of (1) Whether the "insured" may be liable as a. Any equipment listed in Paragraphs 6.b. an employer or in any other capacity;, and 6.c. of the definition of "mobile and equipment" or (2) To any obligation to share damages with b. Machinery or equipment that is on, attached or repay someone else who must pay to or past of a land vehicle that would damages because of the injury. qualify under the definition of "mobile But this exclusion does not apply to "bodily equipment"' if it were not subject to a injury" to domestic "employees" not entitled to compulsory or financial responsibility law or workers' compensation benefits or to liability other motor vehicle insurance law where it assumed by the "insured"' under an "insured is licensed or principally garaged. contract", For the purposes of the Coverage 10. Completed Operations Form, a domestic "employee" is a person "" engaged in household or domestic work 'Bodily injury" or"property damage"' arising out performed principally in connection with a of your work after that work has been residence premises. completed or abandoned. 5. Fellow Employee In this exclusion, your work means: "Bodily injury"to: a. Work or operations performed by you or on a. Any fellow "employee" of the "insured" your behalf; and arising out of and in the course of the fellow b. Materials, parts or equipment furnished in "employee's" employment or while connection with such work or operations. performing duties related to the conduct of Your work includes warranties or your business; or representations made at any time with respect b. The spouse, child, parent„ brother or sister to the fitness, quality, durability or performance of that fellow"employee" as a consequence of any of the items included in Paragraph a. or of Paragraph a. above. b.above. 6. Care, Custody Or Control Your work will be deemed completed at the "Property damage"to or"covered pollution cost earliest of the following times: or expense" involving property owned or (1) When all of the work called for in your transported by the "insured" or in the contract has been completed; "insured's" care, custody or control. But this (2) When alNl of the work to be done at the exclusion does not apply to liability assumed site has been completed if your contract under a sidetrack agreement. calls for work at more than one site; or 7. Handling Of Property (3) When that part of the work done at a job , "Bodily injury"' or property damage" resulting site has been put to its intended use by from the handling of property: any person or organization other than another contractor or subcontractor a. Before it is moved from the place where it is working on the same project. accepted by the "insured"' for movement into or onto the covered"auto"'; or Page 4 of 12 0 Insurance Services Office, Inc.,2011 CA 00 01 10 13 w w W 0 M d' Work that may need service, maintenance, Paragraphs b. and c. above of this exclusion correction, repair or replacement, but which is do not apply to "accidents" that occur away otherwise complete, will be treated as from premises owned by or rented to an completed. "insured" with respect to "pollutants" not in or 11. Pollution upon a covered "auto"if: "Bodily injury" or"property damage"arising out (a) The "pollutants" or any property in of the actual, alleged or threatened discharge, which the "pollutants" are contained dispersal, seepage, migration, release or are upset, overturned or damaged as escape of"pollutants": a result of the maintenance or use of a. That are, or that are contained in any a covered "auto"; and property that is: (b) The discharge, dispersal, seepage, migration, release or escape of the (1) Being transported or towed by, handled "pollutants" is caused directly by or handled for movement into, onto or such upset, overturn or damage. from the covered "auto'; 12. War (2) Otherwise in the course of transit by or on behalf of the"insured"; or 'Bodily injury" or "property damage" arising directly or indirectly out of: (3) Being stored, disposed of, treated or processed in or upon the covered a. War, including undeclared or civil war; "auto'; b. Warlike action by a military force, including b. Before the "pollutants" or any property in action in hindering or defending against an which the "pollutants" are contained are actual or expected attack, by any moved from the place where they are government, sovereign or other authority accepted by the "insured" for movement using military personnel or other agents; or into or onto the covered"auto"; or c. Insurrection, rebellion, revolution, usurped c. After the "pollutants" or any property in power or action taken by governmental which the "pollutants" are contained are authority in hindering or defending against moved from the covered "auto" to the place any of these. where they are finally delivered, disposed of 13. Racing or abandoned by the"insured". Covered "autos"while used in any professional Paragraph a. above does not apply to fuels, or organized racing or demolition contest or lubricants, fluids, exhaust gases or other stunting activity, or while practicing for such similar"pollutants" that are needed for or result contest or activity. This insurance also does from the normal electrical, hydraulic or not apply while that covered "auto" is being mechanical functioning of the covered "auto"or prepared for such a contest or activity. its parts if: C. Limit Of Insurance (1) The "pollutants" escape, seep, migrate Regardless of the number of covered "autos",. or are discharged, dispersed or released "insureds", premiums paid, claims made or directly from an "auto" part designed by vehicles involved in the "accident", the most we its manufacturer to hold, store, receive will pay for the total of all damages and "covered or dispose of such"pollutants"; and pollution cost or expense"combined resulting from (2) The"bodily injury", "property damage"or any one "accident" is the Limit Of Insurance for "covered pollution cost or expense" Covered Autos Liability Coverage shown in the does not arise out of the operation of Declarations. any equipment listed in Paragraphs 6.b. and 6.c. of the definition of "mobile equipment". CA 00 01 10 13 ©Insurance Services Office, Inc., 2011 Page 6 of 12 All"bodily injury", "property damage" and "covered 3. Glass Breakage—Hitting A Bird Or Animal— pollution cost or expense" resulting from Falling Objects Or Missiles continuous or repeated exposure to substantially If you carry Comprehensive Coverage for the the same conditions will be considered as damaged covered "auto", we will pay for the resulting from one"accident", following under Comprehensive Coverage No one will be entitled to receive duplicate a. Grass breakage; payments for the same elements of "'loss" under this Coverage Form and any Medical Payments b. "Loss"' caused by hutting a bird or animal; Coverage endorsement, Uninsured Motorists Coverage endorsement or Underinsured Motorists c. "'Loss""caused by falling objects or missiles. Coverage endorsement attached to this Coverage However, you have the option of having glass Part, breakage caused by a covered "auto's" SECTION III—PHYSICAL DAMAGE COVERAGE collusion or overturn considered a "'loss" under A. Coverage Collusion Coverage. 1. We will pay for"loss" to a covered "auto" or its 4. Coverage Extensions equipment under: a. Transportation Expenses a. Comprehensive Coverage We will pay up to $20 per day„ to a From any cause except: maximum of $600, for temporary (1) The covered "auto's"" collision with transportation expense incurred by you because of the total theft of a covered another object;,or I"auto"" of the private passenger type. We (2) The covered "auto's"overturn, will pay only for those covered "autos" for b. Specified Causes Of Loss Coverage which you carry either Comprehensive or Specified Causes Of Loss Coverage.. We Caused by; will pay for temporary transportation (1) Fire, lightning or explosion; expenses incurred during the period (2) Theft;, beginning 48 hours after the theft and ending, regardless of the policy's expiration, (3) Windstorm, hail)or earthquake; when the covered "auto" is returned to use (4) Flood; or we pay for fits"loss". (5) Mischief or vandalism; or b. Loss Of Use Expenses (6) The sinking, burning collision or For Hired Auto Physical Damage, we will derailment of any conveyance pay expenses for which an "insured" transporting the covered "'auto", becomes legally responsible to pay for loss c. Collision Coverage of use of a vehicle rented or hired without a driver under a written rental contract or Caused by: agreement. We will pay for loss of use (1) The covered "auto's" collision with expenses if caused by: another object; or (1) Other than collision only if the (2) The covered "auto's"overturn. Declarations indicates that 2. Towing Comprehensive Coverage is provided for any covered "auto'; We will pay up to the limit shown in the (2) Specified Causes Of Loss only if the Declarations for towing and labor costs Declarations indicates that Specified incurred each time a covered "'auto" of the Causes Of Loss Coverage is provided private passenger type is disabled. However, for any covered"auto'; or the labor must be performed at the place of disablement. Page 6 of 12 0 Insurance Services Office, Inc., 2011 CA 00 01 10 13 w .p N d' M d' (3) Collision only if the Declarations b. Any device designed or used to detect indicates that Collision Coverage is speed-measuring equipment, such as radar provided for any covered "auto". or laser detectors, and any jamming However, the most we will pay for any apparatus intended to elude or disrupt expenses for loss of use is $20 per day, to speed-measuring equipment. a maximum of$600. c. Any electronic equipment, without regard to B. Exclusions whether this equipment is permanently installed, that reproduces, receives or 1. We will not pay for"loss"caused by or resulting transmits audio, visual or data signals. from any of the following. Such "loss" is d. Any accessories used with the electronic excluded regardless of any other cause or equipment described in Paragraph c. event that contributes concurrently or in any sequence to the"loss". above. a. Nuclear Hazard 6. Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by (1) The explosion of any weapon employing use of the power from the "auto's" electrical atomic fission or fusion; or system that, at the time of"loss", is: (2) Nuclear reaction or radiation„ or a. Permanently installed in or upon the radioactive contamination, however covered "auto"; caused. b. Removable from a housing unit which is b. War Or Military Action permanently installed in or upon the (1) War, including undeclared or civil war; covered "auto'; (2) Warlike action by a military force, c. An integral part of the same unit housing including action in hindering or any electronic equipment described in defending against an actual or expected Paragraphs a.and b. above; or attack, by any government, sovereign or d. Necessary for the normal operation of the other authority using military personnel covered "auto" or the monitoring of the or other agents; or covered "auto's"operating system. (3) Insurrection, rebellion„ revolution, 6. We will not pay for "loss" to a covered "auto" usurped power or action taken by due to"diminution in value". governmental authority in hindering or defending against any of these. C. Limits Of Insurance 2. We will not pay for"loss"to any covered "auto" 1. The most we will pay for: while used in any professional or organized a. "Loss" to any one covered "auto" is the racing or demolition contest or stunting activity, lesser of: or while practicing for such contest or activity. (1) The actual cash value of the damaged We will also not pay for "loss" to any covered or stolen property as of the time of the "auto" while that covered "auto" is being "loss"; or prepared for such a contest or activity, (2) The cost of repairing or replacing the 3. We will not pay for"loss"due and confined to: damaged or stolen property with other a. Wear and tear,., freezing, mechanical or property of like kind and quality. electrical breakdown. b. All electronic equipment that reproduces, b. Blowouts, punctures or other road damage receives or transmits audio, visual or data to tires. signals in any one"loss" is$1,000, if, at the This exclusion does not apply to such "loss" time of"loss", such electronic equipment is: resulting from the total theft of a covered (1) Permanently installed in or upon the "auto". covered "auto" in a housing, opening or 4. We will not pay for "loss" to any of the other location that is not normally used following: by the "auto" manufacturer for the a. Tapes, records,, discs or other similar audio, installation of such equipment; visual or data electronic devices designed for use with audio, visual or data electronic equipment. CA 00 01 1013 0 Insurance Services Office,,, Inc,,,2011 Page 7 of 12 (2) Removable from a permanently installed (2) The"insured's" name and address; and housing unit as described in Paragraph (3) To the extent possible, the names and b.(1)above; or addresses of any injured persons and (3) An integral part of such equipment as witnesses. described in Paragraphs b.(1) and b.(2) b. Additionally, you and any other involved above, "insured"must: 2. An adjustment for depreciation and physical (1) Assume no obligation, make no condition will be made in determining actual payment or incur no expense without cash value in the event of a total"floss". our consent, except at the "insured's" 3. If a repair or replacement results in better than own cost. like kind or quality, we will not pay for the (2) Immediately send us copies of any amount of the betterment. request, demand, order, notice, D. Deductible summons or legal paper received For each covered "auto", our obligation to pay for, concerning the claim or"suit". repair, return or replace damaged or stolen (3) Cooperate with us in the investigation or property will be reduced by the applicable settlement of the claim or defense deductible shown in the Declarations. Any against the"suit"' Comprehensive Coverage deductible shown in the (4) Authorize us to obtain medical records Declarations does not apply to "loss" caused by or other pertinent information. fire or lightning. SECTION IV—BUSINESS AUTO CONDITIONS (8) Submit examination, at our expense, by physicians of our choice, as often as The following conditions apply in addition to the we reasonably require. Common Policy Conditions: c. If there is "loss"' to a covered "auto" or its A. Loss Conditions equipment, you must also do the following: 1. Appraisal For Physical Damage Loss (1) Promptly notify the police if the covered If you and we disagree on the amount of"loss", "auto"or any of its equipment its stolen. either may demand an appraisal of the "loss". (2) Take all reasonable steps to protect the In this event, each party will select a competent covered "auto" from further damage. appraiser. The two appraisers wilili select a Also keep a record of your expenses for competent and impartial umpire. The consideration in the settlement of the appraisers will state separately the actual! cash claim. value and amount of"loss". If they fail to agree, (3) Permit us to inspect the covered "auto" they will submit their differences to the umpire. and records proving the "'loss" before its A decision agreed to by any two will be repair or disposition. binding. Each party will: a. Pa its chosen appraiser; and (4) Agree to examinations under oath at our Y pp request and give us a signed statement b. Bear the other expenses of the appraisal of your answers. and umpire equally. 3. Legal Action Against Us If we submit to an appraisall, we will still retain No one may bring a legal action against us our right to deny the claim. under this Coverage Form until: 2. Duties In The Event Of Accident,Claim, Suit a. There has been full compliance with all the Or Loss terms of this Coverage Form;; and We have no duty to provide coverage under b. Under Covered Autos Liability Coverage, this policy unless there has been full we agree in writing that the "insured" has an compliance with the Following duties: obligation to pay or until the amount of that a. In the event of "accident", claim, "suit" or obligation has finallly been determined by "floss", you must give us or our authorized Judgment after triall, No one has the right representative prompt notice of the under this policy to bring us into an action "accident"or"loss". Include: to determine the"insured's" liability. (1) How, when and where the "accident" or "loss"occurred; Page 8 of 12 Insurance Services Office, Inc.„2011 CA 00 01 10 13 w .p w dq d M d' 4. Loss Payment—Physical Damage 5. Other Insurance Coverages a. For any covered "auto" you own, this At our option,we may: Coverage Form provides primary a. Pay for, repair or replace damaged or insurance. For any covered "auto"you don't stolen property; own, the insurance provided by this Coverage Form is excess over any other b. Return the stolen property, at our expense. collectible insurance. However, while a We will pay for any damage that results to covered "auto' which is a "trailer" is the"auto"from the theft; or connected to another vehicle, the Covered c. Take all or any part of the damaged or Autos Liability Coverage this Coverage stolen property at an agreed or appraised Form provides for the"trailer" is: value. (1) Excess while it is connected to a motor If we pay for the "loss", our payment will vehicle you do not own; or include the applicable sales tax for the (2) Primary while it is connected to a damaged or stolen property. covered"auto"you own. 5. Transfer Of Rights Of Recovery Against b. For Hired Auto Physical Damage Coverage, Others To Us any covered "auto" you lease, hire, rent or If any person or organization to or for whom we borrow is deemed to be a covered "auto" make payment under this Coverage Form has you own. However, any "auto" that is rights to recover damages from another, those leased, hired, rented or borrowed with a rights are transferred to us. That person or driver is not a covered "auto". organization must do everything necessary to c. Regardless of the provisions of Paragraph secure our rights and must do nothing after a. above, this Coverage Form's Covered "accident"or"loss"to impair them. Autos Liability Coverage is primary for any B. General Conditions liability assumed under an "insured 1. Bankruptcy contract". Bankruptcy or insolvency of the"insured"or the d. When this Coverage Form and any other "insured's" estate will not relieve us of any Coverage Form or policy covers on the obligations under this Coverage Form. same basis, either excess or primary, we will pay only our share. Our share is the 2. Concealment, Misrepresentation Or Fraud proportion that the Limit of Insurance of our This Coverage Form its void in any case of Coverage Form bears to the total of the fraud by you at any time as it relates to this limits of all the Coverage Forms and Coverage Form. It is also void if you or any policies covering on the same basis. other "insured", at any time, intentionally 6. Premium Audit conceals or misrepresents a material fact a. The estimated premium for this Coverage concerning: Form is based on the exposures you told us a. This Coverage Form; you would have when this policy began. We b. The covered "auto will compute the final premium due when c. Your interest in the covered"auto or we determine your actual exposures. The estimated total premium will be credited d. A claim under this Coverage Form. against the final premium due and the first 3. Liberalization Named Insured will be billed for the If we revise this Coverage Form to provide balance, if any. The due date for the final more coverage without additional premium premium or retrospective premium is the charge, your policy will automatically provide date shown as the due date on the bill. If the estimated total premium exceeds the the additional coverage a the day the final premium due, the first Named Insured revision is effective in your state. will get a refund. 4. No Benefit To Bailee—Physical Damage b. If this policy is issued for more than one Coverages year, the premium for this Coverage Form We will not recognize any assignment or grant will be computed annually based on our any coverage for the benefit of any person or rates or premiums in effect at the beginning organization holding, storing or transporting of each year of the policy. property for a fee regardless of any other provision of this Coverage Form. CA 00 01 10 13 Insurance Services Office„ Inc,, 2011 Page 9 of 12 7. Policy Period,Coverage Territory 2. Any other land vehicle that is subject to a Under thus Coverage Form, we cover compulsory or financial responsibility law or "accidents"and"losses"occurring: other motor vehicle insurance law where it is a. During the policy period shown in the licensed or principally garaged. Declarations; and However, "auto" does not include "mobile b. Within the coverage territory. equipment". C. "Bodily injury" means bodily injury, sickness or The coverage territory is: disease sustained by a person, including death (1) The United States of America; resulting from any of these. (2) The territories and possessions of the D. "Covered pollution cost or expense" means any United States of America; cost or expense arising out of: (3) Puerto Rico; 1. Any request, demand, order or statutory or (4) Canada; and regulatory requirement that any "insured" or others test for, monitor, clean up, remove, (5) Anywhere in the world if a covered contain, treat, detoxify or neutralize, or in any "auto"' of the private passenger type is way respond to, or assess the effects of, leased, hired, rented or borrowed "pollutants"; or without a driver for a period of 30 days 2. Any claim or "suit" by or on behalf of a or less, governmental authority for damages because provided that the "insured's" responsibility to of testing for, monitoring, cleaning up, pay damages is determined in a "suit" on the removing, containing, treating, detoxifying or merits, in the United States of America, the neutralizing, or in any way responding to, or territories and possessions of the United States assessing the effects of, "pollutants". of America, Puerto Rico or Canada, or in a "Covered pollution cost or expense" does not settlement we agree to. incilude any cost or expense arising out of the We also cover "loss" to, or "accidents" actual, alleged or threatened discharge, dispersal, involving, a covered "auto" while being seepage, migration, release or escape of transported between any of these places. ..pollutants": 8. Two Or More Coverage Forms Or Policies a. That are, or that are contained in any Issued By Us property that is: If this Coverage Form and any other Coverage (1) Being transported or towed by, handled Form or policy issued to you by us or any or handled for movement into, onto or company affiliated with us applies to the same from the covered"auto"; '"accident", the aggregate maximum Limit of (2) Otherwise in the course of transit by or Insurance under all the Coverage Forms or on behalf of the"insured'; or policies shall not exceed the highest applicable Limit of Insurance under any one Coverage (3) Being stored, disposed of, treated or Form or policy. This condition does not apply to processed in or upon the covered any Coverage Form or policy issued by us or "auto"; an affiliated company specifically to apply as b. Before the "pollutants" or any property in excess insurance over this Coverage Form. which the "pollutants" are contained are SECTION V—DEFINITIONS moved from the place where they are A. "Accident" includes continuous or repeated accepted by the "insured" for movement exposure to the same conditions resulting in into or onto the covered "auto"; or "bodily 'injury"or"property damage". c. After the "pollutants" or any property in B. "Auto" means; which the "pollutants" are contained are moved from the covered auto" to the place 1. A land motor vehicle, "trailer' or semitrailer where they are finally delivered, disposed of designed for travel on public roads; or or abandoned by the"insured". Page 10 of 12 10, Insurance Services Office, Inc., 2011 CA 00 01 10 13 w .p v, cfl d M d' Paragraph a. above does not apply to fuels, 5. That part of any other contract or agreement lubricants, Fluids, exhaust gases or other pertaining to your business (including an similar"pollutants" that are needed for or result indemnification of a municipality in connection from the normal electrical, hydraulic or with work performed for a municipality) under mechanical functioning of the covered "auto" or which you assume the tort liability of another to its parts, if: pay for"bodily injury"or"property damage"to a (1) The "pollutants" escape, seep, migrate third party or organization. Tort liability means or are discharged, dispersed or released a liability that would be imposed by law in the directly from an "auto" part designed by absence of any contract or agreement; or its manufacturer to hold, store, receive 6. That part of any contract or agreement entered or dispose of such"pollutants"; and into, as part of your business, pertaining to the (2) The"bodily injury", "property damage"or rental or lease, by you or any of your "covered pollution cost or expense" "employees", of any "auto". However, such does not arise out of the operation of contract or agreement shall not be considered any equipment listed in Paragraph 6.b. an "insured contract" to the extent that it or 6.c. of the definition of "mobile obligates you or any of your "employees" to equipment". pay for"property damage" to any"auto" rented or leased by you or any of your"employees". "accidents" that occur away from premises Paragraphs and c. above not apply to An "insured contract" does not include that part of r owned by or rented to an insured'with respect any contract or agreement: to "pollutants" not in or upon a covered "auto" a. That indemnifies a railroad for"bodily injury" if: or "property damage" arising out of (a) The "pollutants" or any property in construction or demolition operations, within which the "pollutants" are contained 50 feet of any railroad property and are upset, overturned or damaged as affecting any railroad bridge or trestle, a result of the maintenance or use of tracks, roadbeds, tunnel, underpass or a covered"auto"; and crossing; (b) The discharge, dispersal, seepage, b. That pertains to the loan, lease or rental of an "auto" to o your migration, release or escape of the e pollutants is caused directly by mployees", if the�auto'ris onanedf leased such upset, overturn or damage. or rented with a driver; or E. "Diminution in value" means the actual or c. That holds a person or organization perceived loss in market value or resale value engaged in the business of transporting which results from a direct and accidental"loss". property by"auto"for hire harmless for your use of a covered "auto" over a route or F. "Employee" includes a "leased worker". territory that person or organization is "Employee" does not include a "temporary authorized to serve by public authority. worker". I. "Leased worker" means a person leased to you by G. "Insured" means any person or organization a labor leasing firm under an agreement between qualifying as an insured in the Who Is An Insured you and the labor leasing firm to perform duties provision of the applicable coverage. Except with related to the conduct of your business. "Leased respect to the Limit of Insurance, the coverage worker"does not include a"temporary worker". afforded applies separately to each insured who is seeking coverage or against whom a claim or J. "Lass" means direct and accidental loss or "suit"is brought. damage. H. "Insured contract"means: K. "Mobile equipment" means any of the following types of land vehicles, including any attached 1. A lease of premises; machinery or equipment: 2. A sidetrack agreement; 1. Bulldozers, farm machinery, forklifts and other 3. Any easement or license agreement, except in vehicles designed for use principally off public connection with construction or demolition roads; operations on or within 50 feet of a railroad; 2. Vehicles maintained for use solely on or next to 4. An obligation, as required by ordinance, to premises you own or rent; indemnify a municipality, except in connection 3. Vehicles that travel on crawler treads; with work for a municipality; CA 00 01 1013 ©insurance Services Office, Inc,, 2011 Page 11 of 12 4. Vehicles, whether self-propelled or not, However, °"moNlle equipment" does not incllude maintained primarily to provide mobility to land vehicles that are subject to a compulsory or permanently mounted: financial responsibility law or other motor vehicle a. Power cranes,, shovels, loaders, diggers or insurance law where it is licensed or principally drills; or garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle b. Road construction or resurfacing equipment insurance law are considered"autos". such as graders, scrapers or rollers; L. "'Pollutants" means any solid, liquid, gaseous or 5. Vehicles not described in Paragraph 1., 2., 3. thermal irritant or contaminant, including smoke, or 4. above that are not self-propelled and are vapor, soot, fumes, acids, alkalis, chemicals and maintained primarily to provide mobility to waste. Waste includes materials to be recycled, permanently attached equipment of the reconditioned or reclaimed. folllowing types;. a. Air compressors, pumps and generators, M. "Property damage" means damage to or loss of p p p g use of tangible property. including spraying, welding, building cleaning, geophysical exploration, lighting "Suit""means a civil proceeding in which: and well-servicing equipment; or 1. Damages because of "bodily injury" or b. Cherry pickers and similar devices used to "property damage"; or raise or lower workers;; or 2. A"covered pollution cost or expense' 6. Vehicles not described in Paragraph 1., 2., 3. to which this insurance applies, are allleged. or 4. above maintained primarily for purposes "Suit"includes: other than the transportation of persons or cargo. However, self-propelled vehicles with a. An arbitration proceeding in which such the following types of permanently attached damages or "covered pollution costs or equipment are not "mobile equipment" but will expenses" are claimed and to which the be considered "autos": "insured" must submit or does submit with a. Equipment designed primarily for: our consent; or (1) Snow removal, b. Any other alternative dispute resolution proceeding in which such damages or (2) Road maintenance, but not construction "covered pollution costs or expenses" are or resurfacing, or claimed and to which the insured submits (3) Street cleaning, with our consent. b. Cherry pickers and similar devices mounted O. "Temporary worker" means a person who is on automobile or truck chassis and used to furnished to you to substitute for a permanent raise or lower workers; and "employee" on leave or to meet seasonal or short- term workload conditions. c. Air compressors, pumps and generators, including spraying, welding, building P. "Trailer"includes semitrailer. cleaning, geophysical exploration, lighting or well-servicing equipment. Page 12 of 12 0 Insurance Services Office, Inc.., 2011 CA 00 01 1013 .p w .p 4 00 d M d' COMMERCIAL AUTO CA 0128 01 21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA CHANGES For a covered "auto" licensed or principally garaged in, or "auto dealer operations" conducted in, Florida, this endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Covered Autos Liability Coverage is changed as C. Paragraph 1. of Loss Conditions, Appraisal For follows: Physical Damage toss, is replaced by the Paragraph (5) of a. Supplementary Payments following: under Coverage Extensions in the Auto Dealers, 1. Appraisal For Physical Damage Loss Business Auto and Motor Carrier Coverage Forms is replaced by the following: If you and we disagree on the amount of"loss,,, either may demand an appraisal of the "loss We will pay for the"insured": Upon notice of a demand for appraisal, the (6) All court costs taxed against the opposing party may, prior to appraisal, demand "insured" in any "suit" against the mediation Mediation of he dispute i contained accorncelwith the "insured" we defend. However, theseprovision is payments do not include attorneys' fees endorsement. The mediation must be or attorneys'expenses taxed against the completed before a demand for appraisal can "insured". be made. In this event, each party will select a B. Physical Damage Coverage is changed as competent appraiser. The two appraisers will Y 9 9 9 select a competent and impartial umpire. The follows: appraisers will state separately the actual cash 1. No deductible applies under Specified Causes value and amount of"loss". If they fail to agree, Of Loss or Comprehensive Coverage for"loss" they will submit their differences to the umpire. to glass used in the windshield. A decision agreed to by any two will be 2. All other Physical Damage Coverage binding. Each party will: provisions will apply. a. Pay its chosen appraiser; and CA 0128 0121 0 Insurance Services Office, Inc., 2020 Page 11 of 3 b. Bear the other expenses of the appraisal then the Coverage Form or policy issued to and umpire equally. the service customer described in If we submit to an appraisal, we wild still retain Paragraph D.1.1b.(1) is primary over any our right to deny the claim. insurance available to an entity described in D. The General Conditions are amended as follows: D.1.b.(2) if: 1. The followingis added to the Other Insurance (1) The vehicle is provided without charge or at a reasonable daily charge; Condition in the Auto Dealers and Business Auto Coverage Forms, and Other Insurance— (2} There is no negligence criminal Primary And Excess Provisions Condition in wrongdoing on the part e the e vehicle r the Motor Carrier Coverage For dealer, or its leaning or rental affiliate; m and a. When this Coverage Form and any other Coverage Form or policy providing liability i[3) The vehicle deader or its leasing or coverage applies t an auto"and: rental affiliate executes a written rental or use agreement and obtains from the (1) One provides coverage to a lessor of person receiving the temporary ""autos"for rent or Ilease�; and replacement a copy of the person's (2) The other provides coverage to a driver (license and insurance information person not described in Paragraph reflecting at least the minimum motor D.1.a.(1); vehicle insurance coverage provided in then the Coverage Form or policy issued to the state. the lessor described in Paragraph DA.a.(1) 2. The following condition is added to the Auto is excess over any insurance available to a DealNers, Business Auto and Motor Carrier person described in D.1.a.(2) if the face of Coverage Forms:: the lease or rental agreement contains, in Mediation at least 10 point type, the following language: 1. In any claim filled by an "'insured"' with us for: The valid and collectible liability a. "Bodily 'u in an amount of $10,000 insurance and personal injury protection y injury"'ry,„ insurance of any authorized rental or or less, arising out of the ownership„ leasing driver is primary for the limits of operation, use or maintenance of a liability and personal injury protection covered "'"auto"; coverage required by FIA. STAT. b. "Property damage" in any amount, SECTION 324,021(7) and FIA. STAT. arising out of the ownership, operation, SECTION 627.736. maintenance or use of a covered "auto"; b. When this Coverage Form and any other or Coverage Form or policy providing liability c. "'Loss" to a covered "auto" or its coverage applies to an "auto" being used equipment, in any amount,; as a temporary substitute for a service either party may make a written demand for customer's auto that is being held by a mediation of the claim prior to the institution motor vehicle deader, or a motor vehicle of litigation. dealer's leasing or rental affiliate for repair, service or adjustment; and: 2. A written request for mediation must be filed with the Florida Department of (1) One provides coverage to the service Financial Services on an approved form, customer;and which may be obtained from the Florida (2) The other provides coverage to a motor Department of Financial Services. vehicle dealer, or a motor vehicle dealer's leasing or rental affiliate; Page 2 of 3 0 Insurance Services Office,„ Inc,, 2020 CA 0128 0121 w .p to 0 M d' 3. The request must state: 5. Only one mediation may be requested for a. Why mediation is being requested. each claim unless all parties agree to further mediation. A party demanding b. The issues in dispute, which are to be mediation shall not be entitled to demand or mediated. request mediation after a suit is filed 4. The Florida Department of Financial relating to the same facts already mediated. Services will randomly select mediators. 6. The mediation shall be conducted as an Each party may reject one mediator, either informal process and formal rules of before or after the opposing side has evidence and procedures need not be rejected a mediator. The mediator will notify observed. the parties of the date, time and place of the mediation conference. The mediation conference will be held within 45 days of the request for mediation. The conference will be held by telephone if feasible. Participants in the mediation conference must have the authority to make a binding decision, and must mediate in good faith. Each party will bear the expenses of the mediation equally, unless the mediator determines that one party has not mediated in good faith. CA 0128 0121 0 Insurance Services Office, Inc., 2020 Page 3 of 3 COMMERCIAL AUTO CA02670121 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Paragraph A.2.b. of the Common Policy If this is an audit policy, then, subject to your Conditions, Cancellation, is replaced by the full cooperation with us or our agent in securing folllowing: the necessary data for audit, we will return any b. 45 days before the effective date of premium refund due within 90 days of the date cancelllation if we cancel for any other cancellation takes effect. If our audit is not reason. completed within this time limitation, then we shall accept your own audit, and any premium B. Paragraphs A.4. and A.S. of the Common Poliicy refund due shall be mauled within 10 working Conditions, Cancellation, are replaced by the days of receipt of your audit. following: The cancelllation will be effective even if we 4. Notice of cancellation will state the effective have not made or offered a refund. date of, and reason(s) for, the cancellation. The policy period will end on that date. C. The following is added to Paragraph A. of the Common Policy Conditions, Cancellation: S. If this Policy is cancelled, we will send the first T. If this Policy provides Personal Injury Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Protection, Property Damage Liability Named Insured cancels, the refund may be Coverage or both and: less than pro rata.. If the return premium is not a. It is a new or renewal policy, it may not be refunded with the notice of cancellation or cancelled by the first Named Insured during when this Policy is returned to us, we will mail the first 60 days immediately following the the refund within 15 working days after the effective date of the Policy or renewal, date cancellation takes effect, unless this is an except for one of the following reasons: audit policy. (1) The covered "auto" is completelly destroyed such that it is no longer operable, CA 02 67 01 21 0 Insurance Services Office, Inc., 2020 Page 1 of 2 w v, N M d' (2) Ownership of the covered "auto" is 2. If we fail to mail proper notice of nonrenewal transferred; or and you obtain other insurance, this Policy will (3) The Named Insured has purchased end on the effective date of that insurance. another policy covering the motor 3. Notice of nonrenewal will state the reason(s) vehicle insured under this Policy. for the nonrenewal and the effective date of b. It is a new policy, we may not cancel it nonrenewal. The policy period will end on that during the first 30 days immediately date. following the effective date of the Policy for nonpayment of premium unless a check used to pay us is dishonored for any reason or any other type of premium payment is subsequently determined to be rejected or invalid. D. The following condition is added: Nonrenewal 1. If we decide not to renew or continue this Policy, we will mail you notice at least 45 days before the end of the policy period. If we offer to renew or continue and you do not accept, this Policy will terminate at the end of the current policy period. Failure to pay the required renewal or continuation premium when due shall mean that you have not accepted our offer. Page 2 of 2 0 Insurance Services Office, Inc;, 2020 CA 02 67 01 21 POLICY NUMBER:VFNU-TR-0019768-031000 COMMERCIAL AUTO CA 21 72 06 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA UNINSURED MOTORISTS COVERAGE - NONSTACKED For a covered "'auto" licensed or principally garaged in,, or "auto dealer operations" conducted in, Florida, this endorsement modifies insurance provided under the following. AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the Policy effective on the inception date of the Policy unless another date is indicated below. Named Insured: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Endorsement Effective Date: 10/01/2023 SCHEDULE Limit Of Insurance: $500,000 Each "Accident" Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Coverage b. A tentative settlement has been made 1. We will pay all sums the "insured" is (legally between an "insured" and the insurer of the entitled to recover as compensatory damages "underinsured motor vehicle"and we: from the owner or driver of an"uninsured motor (1) Have been given prompt written notice vehicle". The damages must result from "bodily of such tentative settlement; and injury" sustained by the "insured" caused by an (2) Advance payment to the "insured"" in an "accident". The owner's or driver's liability for amount equal to the tentative settlement these damages must result from the within 30 days after receipt of ownership, maintenance or use of the notification. ""'uninsured motor vehicle"'. 3. Any judgment for damages arising out of a 2. With respect to damages resulting from an "suit" brought without our written consent is not "'accident" with a vehicle described in binding on us. Paragraph b. of the definition of "uninsured motor vehicle", we will pay under this coverage B. Who Is An Insured only if Paragraph a. or b.below applies: If the Named Insured is designated in the a. The limit of any applicable liability bonds or Declarations as: policies has been exhausted by payment of 1. An individual, then the following are"insureds": judgments or settlements; or a. The Named Insured and any ""family members". CA 21 72 06 17 V Insurance Services Office, Inc., 2016 Page 1 of 6 w v, w dq W) M d' b. Anyone else "occupying" a covered "auto" d. Any "insured" with respect to damages for or a temporary substitute for a covered pain, suffering, mental anguish or "auto". The covered "auto" must be out of inconvenience unless the "bodily injury" service because of its breakdown, repair, consists in whole or in part of: servicing, "loss"or destruction. (1) Significant and permanent loss of an c. Anyone for damages he or she is entitled to important bodily function; recover because of"bodily injury" sustained (2) Permanent injury within a reasonable by another"insured". degree of medical probability, other than 2. A partnership, limited liability company, scarring or disfigurement; corporation or any other form of organization, (3) Significant and permanent scarring or then the following are"insureds": disfigurement; or a. Anyone "occupying" a covered "auto" or a (4) Death. temporary substitute for a covered "auto". The covered "auto" must be out of service 5. Punitive or exemplary damages. because of its breakdown, repair, servicing, 6. "Bodily injury" arising directly or indirectly out "loss"or destruction. of: b. Anyone for damages he or she is entitled to a. War, including undeclared or civil war; recover because of"bodily injury"sustained b. Warlike action by a military force, including by another"insured". action in hindering or defending against an C. Exclusions actual or expected attack, by any This insurance does not apply to: government, sovereign or other authority 1. Any claim settled or judgment reached without using military personnel or other agents; or our consent, unless our right to recover c. Insurrection, rebellion, revolution, usurped payment has not been prejudiced by such power, or action taken by governmental settlement or judgment. However, this authority in hindering or defending against exclusion does not apply to a settlement made any of these. with the insurer of a vehicle described in D. Limit Of Insurance Paragraph b. of the definition of an "uninsured 1. Regardless of the number of covered "autos", motor vehicle". "insureds", premiums paid, claims made or 2. The direct or indirect benefit of any insurer or vehicles involved in the"accident", the most we self-insurer under any workers' compensation, will pay for all damages resulting from any one disability benefits or similar law. "accident" is the limit of Uninsured Motorists 3. Anyone using a vehicle without a reasonable Coverage shown in the Schedule or belief that the person is entitled to do so. Declarations. 4. "Bodily injury"sustained by: 2. No one will be entitled to receive duplicate a. An individual Named Insured while payments for the same elements of "loss" "occupying" or when struck by a vehicle under this coverage form and any Liability owned by that individual Named Insured Coverage form, No-fault Coverage that is not a covered "auto" for Uninsured endorsement, Medical Payments Coverage Motorists Coverage under this coverage endorsement, or Uninsured Motorists form; Coverage endorsement attached to this Coverage Part. b. Any "family member" while "occupying" or 3. We will not make a duplicate payment under when struck by any vehicle owned by that this coverage for any element of "loss" for "family member"that is not a covered"auto" which payment has been made by or for for Uninsured Motorists Coverage under anyone who is legally responsible. this coverage form; c. Any "family member" while "occupying" or 4. We will not pay for any element of "loss" if a when struck by any vehicle owned by the person is entitled to receive payment for the Named Insured that is insured for same element of "loss" under any workers Uninsured Motorists Coverage on a primary compensation, disability benefits or similar law. basis under any other coverage form or policy; or Page 2 of 5 ©insurance Services Office, Inc., 2016 CA 2172 06 17 E. Changes In Conditions c. if the coverage under this coverage form is The Conditions are changed for Uninsured provided: Motorists Coverage Nonstacked as follows: (1) On a primary basis, we will pay only our 1. Other Insurance in the Auto Dealers and share of the 'Boss that must be paid Business Auto Coverage Forms and Other under insurance providing coverage on Insurance — Primary And Excess Insurance a primary basis. Our share is the Provisions in the Motor Carrier Coverage proportion that our limit of liability bears Form are replaced by the following: to the total of all applicable limits of a. If there is other applicable insurance liabillity for coverage on a primary basis. available under one or more coverage (2) On an excess basis, we will pay only our forms, policites or provisions of coverage, share of the loss that must be paid any recovery for damages sustained by an under insurance providing coverage on individual Named Insured or any "family an excess basis. Our share is the member': proportion that our limit of liability bears to the total of all applicable limits of (1) While "occupying" a vehicle owned by liability for coverage on an excess basis.. that Named Insured or any "family member"may equal, but not exceed, the 2• Duties In The Event Of Accident, Claim, Suit limit of insurance for Uninsured Or Loss is changed by adding the following: Motorists Coverage applicable to that a. Promptly notify the police if a hit-and-run vehicle. driver is involved; and (2) While "occupying" a vehicle not owned b. Promptly send us copies of the legal papers by that Named Insured or any "family if a"suit" is brought, member" may equal,,. but not exceed,; the c. A person seeking Uninsured Motorists sum of: Coverage must also promptly notify us in (a) The limit of insurance for Uninsured writing by certified or registered mail of a Motorists Coverage applicable to the tentative settlement between the "insured" vehicle such Named Insured or any and the insurer of the vehicle described in "family member" was "occupying" at Paragraph b. of the definition of an the time of the"accident and "'uniinsured motor vehicle" and alllow us 30 (b) The highest limit of insurance for days to advance payment to that "'insured" Uninsured Motorists Coverage in an amount equal to the tentative applicable to any one vehicle under settlement to preserve our rights against any one policy affording coverage to the insurer, owner or operator of such such Named Insured or any "family vehicle described in Paragraph b. of the member'. definition of an"uninsured motor vehicle (3) While not "occupying" any vehicle may 3. Transfer Of Rights Of Recovery Against equal„ but not exceed, the highest limit Others To Us is changed by adding the of 'insurance for Uninsured Motorists following: Coverage applicable to any one vehicle If we make any payment and the "insured" under any one policy affording coverage recovers from another party, the "insured" shall to an individual Named Insured or any hold the proceeds in trust for us and pay us "family member"'. back the amount we have paid. b. Any insurance we provide with respect to a Our rights do not apply under this provision vehicle the Named Insured does not own with respect to Uninsured Motorists Coverage shall be excess over any collectible if we: uninsured motorists insurance providing a. Have been given prompt written notice of a coverage on a primary basis. tentative settlement between an "insured" and the insurer of a vehicle described in Paragraph b. of the definition of an "uninsured motor vehicle and CA 2172 06 17 0 Insurance Services Office„ Inc., 2016 Page 3 of 5 w v, v, cfl M d' b. Fail to advance payment to the "insured" in c. Mediation an amount equal to the tentative settlement (1) In any claim filed by an "insured"with us within 30 days after receipt of notification. for: If we advance payment to the "insured" in an (a) "Bodily injury" in an amount of amount equal to the tentative settlement within $10,000 or less, arising out of the 30 days after receipt of notification: ownership, operation, use or a. That payment will be separate from any maintenance of a covered"auto"; amount the "insured" is entitled to recover (b) 'Property damage" in any amount, under the provisions of Uninsured Motorists arising out of the ownership, Coverage; and operation, maintenance or use of a b. We also have a right to recover the covered "auto", or advanced payment. (c) "Loss" to a covered "auto" or its 4. The following condition is added: equipment, in any amount; a. Arbitration either party may make a written demand (1) If we and an "insured"do not agree: for mediation of the claim prior to the (a) Whether that person is legally institution of litigation. entitled to recover damages under (2) A written request for mediation must be this endorsement; or filed with the Florida Department of Financial Services on an approved form, (b) As to the amount of damages that which may be obtained from the Florida are recoverable by that person; Department of Financial Services. then the matter may be mediated, in (3) The request must state: accordance with the Mediation Provision contained in General Conditions, if the (a) Why mediation is being requested. damages resulting from "bodily injury" (b) The issues in dispute, which are to are for $10,000 or less, or arbitrated. be mediated. However, disputes concerning coverage (4) The Florida Department of Financial under this endorsement may not be Services will randomly select mediators. arbitrated. Both parties must agree to Each party may reject one mediator„ arbitration. In this event, each party will either before or after the opposing side select an arbitrator. The two arbitrators has rejected a mediator. The mediator will select a third. If they cannot agree will notify the parties of the date, time within 30 days, either may request that and place of the mediation conference. selection be made by a judge of a court The mediation conference will be held having jurisdiction. within 45 days of the request for (2) Each party will pay the expenses it mediation. The conference will be held incurs and bear the expenses of the by telephone, if feasible. Participants in third arbitrator equally. the mediation conference must have the (3) Unless both parties agree otherwise, authority to make a binding decision„ arbitration will take place in the county in and must mediate in good faith. Each which the "insured" lives. Local rules of party will bear the expenses of the law as to arbitration procedure and mediation equally, unless the mediator evidence will apply. A decision agreed determines that one party has not to by two of the arbitrators will be mediated in good faith. binding. (5) Only one mediation may be requested b. Florida Arbitration Act for each claim unless all parties agree to further mediation. A party demanding If we and an "insured" agree to arbitration, mediation shall not be entitled to the Florida Arbitration Act will not apply. demand or request mediation after a suit is filed relating to the same facts already mediated. Page 4 of 5 0 Insurance Services Office, Inc., 2016 CA 2172 06 17 (6) The mediation shall be conducted as an (2) Cause an "accident" resulting in "bodily informal process and formal rules of injury""to an individual Named Insured or evidence and procedures need not be any "famiily member' without hitting that observed. Named Insured, any "family member", a F. Additional Definitions covered ""auto" or a vehicle such Named Insured or any "family member is As used in this endorsement: "occupying". 1. "'Family member" means a person related to an If there is no physical contact with the land individual Named Insured by blood, marriage motor vehicle or "trailer", the facts of the or adoption who is a resident of such Named '"accident" must be proved. We will only Ilnsured's household, including a ward or foster accept competent evidence other than the child. testimony of a person making claims under 2. "Occupying"'means in, upon, getting in, on, out this or any similar coverage. or off. However, "uninsured motor vehicle" does not 3. "Uninsured motor vehicle" means a land motor include any vehicle: vehicle or"trailer": a. Owned by a governmental unit or agency; a. For which no (liability bond or policy applies b. Designed for use mainly off public roads at the time of an"accident"; while not on public roads; or b. That is an underinsured motor vehiclle. An c. Owned by or furnished or available for the underinsured motor vehicle is a land motor regular use of the Named Insured, or if the vehicle or"trailer"for which a "bodily injury" Named Insured is an individual, any "family liability bond or policy applies at the time of member" unless it is a covered "auto" to an "accident" but the amount paid under which the coverage form's Liability that bond or policy to an ""insured" is not Coverage applies and liability coverage is enough to pay the full amount the "insured" excluded for any person or organization is legally entitled to recover as damages other than the Named Insured, or if the caused by the"accident'; Named Insured is an individual, any "familly c. For which an insuring or bonding company member', denies coverage or is or becomes insolvent; or d. For which neither the driver nor owner can be identified. The land motor vehicle or "trawler"must: (1) Hit an individual Named Insured or any ""family member", a covered "auto" or a vehicle such Named Insured or any "family member"is"occupyiing"; or CA 21 72 0617 ©Insurance Services Office, Inc., 2016 Page 5 of 5 .p w v, 4 00 M d' POLICY NUMBER:VFNU-TR-0019768-031000 COMMERCIAL AUTO CA 22 10 01 21 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA PERSONAL INJURY PROTECTION For a covered "auto" licensed or principally garaged in, or "auto dealer operations" conducted in, Florida, this endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the Policy effective on the inception date of the Policy unless another date is indicated below. Named Insured: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Endorsement Effective Date: 10/01/2023 We agree with the"named insured", subject to all the provisions of this endorsement and to all of the provisions of the Policy except as modified herein, as follows that: SCHEDULE Any Personal Injury Protection deductible shown in the Declarations of is applicable to ❑ the following "named insured"only: ❑ each "'named insured"'and each dependent"'family member". ❑ Work loss for"named insured"'does not apply,. ❑ Work loss for"named insured"and dependent"family member"does not apply. Benefits Limit Per Person Total Aggregate Limit for all Personal Injury $10"000 Protection Benefits„ except Death Benefits Death Benefits $5,000 Medical Expenses 80%,of medical expenses subject to the total aggregate limit and the provisions of Paragraphs D.2.a. and b. under Limit Of Insurance. Work Loss 60%,of work loss subject to the total aggregate limit Replacement Services Expenses subject to the total aggregat2 limit Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CA 2210 0121 0 Insurance Services Office, Inc., 2020 Page 1 of 8 A. Coverage (4) An entity wholly owned by one or more We will pay Personal Injury Protection benefits in licensed physicians, osteopathic accordance with the Florida Motor Vehicle No-fault physicians, chiropractic physicians, Law to or for an "insured" who sustains "bodily advanced practice registered nurses or injury" in an "accident" arising out of the dentists; or by such practitioners and the ownership, maintenance or use of a "motor spouse, parent, child, or sibling of such vehicle". Subject to the limits shown in the practitioners; Schedule,„ these Personal) Injury Protection (5) An entity that owns or is wholly owned, benefits consist of the following; directly or indirectly, by a hospital or 1. Medical Expenses hospitals; a. All reasonable "medically necessary" (6) A licensed physical therapist, based expenses for medical, surgical, X-ray, upon referral by a provider described in dental„ ambulance, hospital), professional Paragraph A.1.b.; or nursing and rehabilitative services, (7) A health care clinic licensed under the including prosthetic devices. However, we Florida Health Care Clinic Act: will pay for these benefits only if the (a) Which is accredited by the Joint "'insured" receives initial services and care Commission on Accreditation of within 14 days after the "motor vehicle" Healthcare Organizations, the "accident""that are: American Osteopathic Association, (1) Lawfully provided, supervised, ordered the Commission on Accreditation of or prescribed by a licensed physician, Rehabilitation Facilities or the dentist, chiropractic physician or an Accreditation Association for advanced practice registered nurse; Ambulatory Health Care, Inc.; or (2) Provided in a hospital or in a facility that (b) Which; owns,, or is wholly owned by, a hospital; (i) Has a licensed medical director, or 3 Provided b a person or entity licensed (ii) Has been continuously licensed) O Y P Y for more than three years or is a to provide emergency transportation and publicly traded corporation that treatment; issues securities traded on an as authorized by the Florida Motor Vehicle exchange registered with the No-fault Law. United States Securities and b. Upon referral by a licensed health care Exchange Commission as a provider described in Paragraph A.1.a.(1), national)securities exchange; and (2) or (3), follow-up services and care (iii) Provides at least four of the consistent with the underlying medical following medical specialties: diagnosis rendered pursuant to Paragraph i. General medicine; A.1.a., if provided, supervised, ordered or prescribed only by a licensed: lii. Radiography; (1) Physician, osteopathic physician, iii. Orthopedic medicine; chiropractic physician,; dentist or iv. Physical medicine;, advanced practice registered nurse; or v. Physical therapy; (2) Physician assistant or advanced A. Physical)rehabilitation; registered nurse practitioner, under the supervision of such physician, vii. Prescribing or dispensing osteopathic physician, chiropractic outpatient prescription physician or dentist; medication; or as authorized by the Florida Motor Vehicle viili. Laboratory services,°; No-fault Law. as authorized by the Florida Motor Vehicle Follow-up services and care may also be No-fault Law. provided by: (3) A licensed hospital) or ambulatory surgical center; Page 2 of 8 0 Insurance Services Office, Inc., 2020 CA 22 10 0121 w v, to 0 cc M d' However, with respect to Paragraph A.1., 6. To any person, other than the "named medical expenses do not include massage or insured", if that person is the "owner" of a acupuncture, regardless of the person, entity or "motor vehicle" for which security is required licensee providing the massage or under the Florida Motor Vehicle No-fault Law; acupuncture; 7. To any person, other than the "named 2. Replacement Services Expenses insured", or any "family member", who is With respect to the period of disability of the entitled to personal injury protection benefits injured person, all expenses reasonably from the owner of a"motor vehicle"that is not a incurred in obtaining from others ordinary and covered"motor vehicle" under this insurance or necessary services in lieu of those that, but for from the"owner's"insurer;or such injury, the injured person would have 8. To any person who sustains "bodily injury" performed without income for the benefit of his while "occupying" a "motor vehicle" located for or her household; use as a residence or premises. 3. Work Loss D. Limit Of Insurance With respect to the period of disability of the 1. Regardless of the number of persons insured, injured person, any loss of income and earning policies or bonds applicable, premiums paid, capacity from inability to work proximately vehicles involved or claims made, the total caused by the injury sustained by the injured aggregate limit of personal injury protection person; and benefits, available under the Florida Motor 4. Death Benefits Vehicle No-fault Law from all sources combined, including this Policy,for or on behalf B. Who Is An Insured of any one person who sustains "bodily injury" 1. The"named insured". as the result of any one"accident", shall be: 2. If the "named insured" is an individual, any a. $10,000 for medical expenses, work loss "family member". and replacement services; and 3. Any other person while "occupying" a covered b. $5,000 for death benefits. "motor vehicle" with the "named insured's" 2. Subject to Paragraph D.1.a.,we will pay: consent. a. Up to $10,000 for medical expenses, if a 4. A "pedestrian" if the "accident" involves the licensed physician, dentist, physician covered "motor vehicle". assistant or an advanced registered nurse C. Exclusions practitioner authorized by the Florida Motor We will not pay Personal Injury Protection benefits Vehicle No-fault Law has determined that for"bodily injury": the insured had an emergency medical condition"; or 1. Sustained by the "named insured" or any "family member" while "occupying" any "motor b. he It care$2,5 p for medical expenses, if any vehicle" owned by the "named insured" that is health care provider described in Paragraph not a covered"motor vehicle"; A.1.a. or A.1.b. has determined that the "insured" did not have an "emergency 2. Sustained by any person while operating the medical condition". covered "motor vehicle" without the "named 3. Any amount paid under this coverage will be insured's"expressed or implied consent; reduced by the amount of benefits an injured 3. Sustained by any person, if such person's person has been paid or is entitled to be paid conduct contributed to his or her"bodily injury" for the same elements of "loss" under any under any of the following circumstances: workers'compensation law. a. Causing "bodily injury" to himself or herself 4. If personal injury protection benefits, under the intentionally; or Florida Motor Vehicle No-fault Law, have been b. While committing a felony; received from any insurer for the same 4. To the "named insured" or any "family elements of loss and expense benefits member" for work loss if an entry in the available under this Policy, we will not make Schedule or Declarations indicates that duplicate payments to or for the benefit of the coverage for work loss does not apply; injured person. The insurer paying the benefits shall be entitled to recover from us its pro rata 5. To any "pedestrian", other than the "named share of the benefits paid and expenses insured" or any "family member", not a legal incurred in handling the claim. resident of the state of Florida; CA 2210 0121 0 Insurance Services Office, Inc., 2020 Page 3 of 8 5. The deductible amount shown in the Schedule A person seeking personal injury protection will be deducted from the total amount of benefits must submit to an examination under expenses and losses listed in Paragraphs A.1., oath. The scope of questioning during the A.2. and A.3. of this endorsement before the examination under oath is limited to relevant application of any percentage limitation for information or information that could each "'insured" to whom the deductible applies. reasonably be expected to lead to relevant The deductible does not apply to the death information. benefit. 2. Legal Action Against Us is replaced by the 6. Any amount paid under this coverage for following: medical expenses shall be limited by the Legal Action Against Us medical fee schedule prescribed by the Florida Motor Vehicle No-fault Law. a. No legal action may be brought against us E. Changes In Conditions until there has been full compliance with all g terms of this Pollucy. In addition, no legal The Conditions are changed for Personal Injury action may be brought against us Protection as follows; (1) Until the claim for benefits is overdue in 1. Duties In The Event Of Accident,Claim, Suit accordance with Paragraph F.2. of this Or Loss is replaced by the following: endorsement; and Compliance with the following duties is a (2) Until we are provided with a demand condition precedent to receiving benefits:: letter in accordance with the Florida In the event of an "accident", the "'named Motor Vehicle No-fault Law sent to us insured" must give us or our authorized via U.S, certified or registered mail; and representative prompt written notice of the (3) With respect to the overdue claim "'accident", specified in the demand letter„ if, within If any injured person or his or her legal 30 days of receipt of the demand letter, representative institutes a legal action to we: recover damages for "bodily ;injury" against a (a) Pay the overdue chain or third party, a copy of the summons, complaint (b) Agree to pay for future treatment not or other process served in connection with that yet rendered; legal action must be forwarded to us as soon as possible by the injured person or his or her in accordance with the requirements of legal representative. the Florida Motor Vehicle No-fault Law.. A person seeking personal injury protection b. If legal action is brought against us, all/ benefits must, as soon as possible, give us claims related to the same health care written proof of claim, under oath if required, provider or facility shall be brought in a containing full particulars concerning the single action, unless good cause can be injuries and treatment received and/or shown why such claims should be brought contemplated, and send us any other separately. information that will assist us in determining the amount due and payable. Page 4 of 8 0,Insurance Services Office, Inc,, 2020 CA 22 10 0121 w rn N tG M d' 3. Transfer Of Rights Of Recovery Against 4. Concealment, Misrepresentation Or Fraud is Others To Us is replaced by the following: replaced by the following: Transfer Of Rights Of Recovery Against Concealment, Misrepresentation Or Fraud Others To Us We do not provide coverage under this Unless prohibited by the Florida Motor Vehicle endorsement for an "insured" if that "insured" No-fault Law, in the event of payment to or for has committed, by a material act or omission, the benefit of any injured person under this insurance fraud relating to personal injury coverage: protection coverage under this form, if fraud is a. We will be reimbursed for those payments, admitted to in a swom statement by the not including reasonable attorneys' fees "insured"or if the fraud is established in a court and other reasonable expenses, from the of competent jurisdiction. Any insurance fraud proceeds of any settlement or judgment voids all personal injury protection coverage resulting from any right of recovery of the arising from the claim with respect to the injured person against any person or "insured" who committed the fraud. Any organization legally responsible for the benefits paid prior to the discovery of the fraud "bodily injury" from which the payment are recoverable from that"insured". arises. We will also have a lien on those 5. Policy Period,Coverage Territory is replaced proceeds. by the following: b. If any person to or for whom we pay Policy Period, Coverage Territory benefits has rights to recover benefits from The insurance under this section applies only another, those rights are transferred to us. to "accidents" which occur during the policy That person must do everything necessary period: to secure our rights and must do nothing after loss to impair them. a. In the state of Florida; c. The insurer providing personal injury b. As respects the "named insured" or any protection benefits on a private passenger "family member", while "occupying" the "motor vehicle", as defined in the Florida covered "motor vehicle" outside the state of Motor Vehicle No-fault Law, shall be Florida but within the United States of entitled to reimbursement to the extent of America, its territories or possessions or the payment of personal injury protection Canada; and benefits from the "'owner" or the insurer of c. As respects the "named insured", while the "owner" of a commercial "motor "occupying" a "motor vehicle" of which a vehicle", as defined in the Florida Motor "family member" is the "owner" and for Vehicle No-fault Law, if such injured person which security is maintained under the sustained the injury while "occupying", or Florida Motor Vehicle No-fault Law outside while a "pedestrian"' through being struck the state of Florida but within the United by, such commercial "'motor vehicle". States of America, its territories or However, such insurer's right of possessions or Canada. reimbursement under this Paragraph c. does not apply to an "owner"or registrant of a"motor vehicle" used as a taxicab. CA 2210 01 21 O Insurance Services Office, Inc., 2020 Page 5 of 8 F. Additional Conditions f. The mediation shall be conducted as an The following conditions are added; informal process and formal rules of 1. Mediation evidence and procedures need not be observed. a. In any claim filed by an "insured" with us 2. Payment Of Benefits for; Personal injury protection benefits payable (1) "Bodily injury" in an amount of $10,000 under this Coverage Form, whether the full or or less„ arising out of the ownership, partial amount, may be overdue if not paid operation, use or maintenance of a within 30 days after we are furnished with covered "auto"; written notice of the covered loss and the (2) "Property damage" in any amount, amount of the covered loss in accordance with arising out of the ownership, operation, the Florida Motor Vehicle No-fault Law. maintenance or use of a covered "auto"; However, if we have a reasonable belief that a or fraudulent insurance act has been committed (3) "'Loss" to a covered "auto" or its rebating to personal) injury protection coverage equipment, in any amount, under this Coverage Form, we wibl notify the either party may make a written demand for "insured" in writing, within 30 days after the mediation of the claim prior to the institution submission of the claim, that the claim is being of litigation. investigated for suspected fraud. No later than 90 days after the submission of the claim, we 5. A written request for mediation must be will either deny or pay the claim, in accordance filed with the Floriida Department of with the Florida Motor Vehicle No-fault Law. Financial Services on an approved form, if we pay only a portion of a claim or reject a which may be obtained from the Floriida claim due to an alleged error in the claim, we, Department of Financial Services. at the time of the partial payment or rejection, c. The request must state'; will proviide an itemized specification or (1) Why mediation is being requested. explanation of benefits due to the specified (2) The issues in dispute, which are to be error. Upon receiving the specification or mediated. explanation, the person making the claim, at the person's option and without waiving any d. The Florida Department of Financial other legal remedy for payment,,, has 15 days to Services will randomly sellect mediators, submit a revised claim, which will be Each parry may reject one mediator, either considered a timely submission of written before or after the opposing side has notice of a claim, rejected a mediator,. The mediator will notify 3. Modification Of Policy Coverages the parties of the date„ time and pliace of the mediation conference.. The mediation Any Automobile Medical Payments Coverage conference will be held within 45 days of and any Uninsured Motorists Coverage the request for mediation The conference afforded by the Policy shall be excess over any will be held by telephone, if feasible. personal injury protection benefits paid or Participants in the mediation conference payable. must have the authority to make a binding Regardless of whether the full amount of decision, and must mediate in good faith. personal injury protection benefits has been Each party will bear the expenses of the exhausted, any Medical Payments Coverage mediation equally„ unless the mediator afforded by the Policy shall pay the portion of determines that one party has not mediated any claim for personal injury protection medical in good faith, expenses which are otherwise covered but not e. Only one mediation may be requested for payable due to the limitation of 80% of medical each claim unless all parties agree to expense benefits but shall not be payable for further mediation, A party demanding the amount of the deductible selected, mediation shall not be entitled to demand or request mediation after a suit is filed relating to the same facts already mediated. Page 6 of 8 Q Insurance Services Office, Inc,, 2020 CA 22 10 01 21 w rn w d cfl M d' 4. Medical Reports And Examinations; 6. Special Provisions For Rented Or Leased Payment Of Claim Withheld Vehicles As soon as practicable, the person making the Notwithstanding any provision of this coverage claim shall submit to mental and physical to the contrary, if a person is injured while examinations at our expense when and as "occupying", or through being struck by, a often as we may reasonably require and a "motor vehicle" rented or leased under a rental copy of the medical report shall be forwarded or lease agreement which does not specify to such person if requested. If the person otherwise in language required by FLA. STAT. unreasonably refuses to submit to, or fails to SECTION 627.7263(2) in at least 10-point type appear at, an examination, we will not be liable on the face of the agreement, the personal for subsequent personal injury protection injury protection benefits available under the benefits. Such person's refusal to submit to, or Florida Motor Vehicle No-fault Law and failure to appear at, two examinations, raises a afforded under the lessor's policy shall be rebuttable presumption that such person's primary. refusal or failure was unreasonable. 7. Insured's Right To Personal Injury Whenever a person making a claim as a result Protection Information of an injury sustained while committing a felony a. In a dispute between us and an "insured", is charged with committing that felony, we shall or between us and an assignee of the withhold benefits until, at the trial level, the "insured's" personal injury protection prosecution makes a formal entry on the record benefits, we will, upon request, notify such that it will not prosecute the case against the "insured" or assignee that the limits for person, the charge is dismissed or the person Personal Injury Protection have been is acquitted. reached. We will provide such information 5. Provisional Premium within 15 days after the limits for Personal In the event of any change in the rules, rates, Injury Protection have been reached. rating plan, premiums or minimum premiums b. If legal action is commenced, we will, upon applicable to the insurance afforded, because request, provide an "insured"with a copy of of an adverse judicial finding as to the a log of personal injury protection benefits constitutionality of any provisions of the Florida paid by us on behalf of the "insured". We Motor Vehicle No-fault Law providing for the will provide such information within 30 days exemption of persons from tort liability, the of receipt of the request for the log from the premium stated in the Declarations for any "insured". Liability, Medical Payments and Uninsured G. Additional Definitions Motorists insurance shall be deemed provisional and subject to recomputation. If this As used in this endorsement: Policy is a renewal policy, such recomputation 1. "Emergency medical condition" means a shall also include a determination of the medical condition manifesting itself by acute amount of any return premium previously symptoms of sufficient severity, which may credited or refunded to the "named insured" include severe pain, such that the absence of pursuant to the Florida Motor Vehicle No-fault immediate medical attention could reasonably Law with respect to insurance afforded under a be expected to result in any of the following: previous policy. a. Serious jeopardy to"insured's" health; If the final premium thus recomputed exceeds b. Serious impairment to bodily functions; or the premium shown in the Declarations, the "named insured" shall pay to us the excess as c. Serious dysfunction of any bodily organ well as the amount of any return premium part• previously credited or refunded. CA 2210 0121 ©Insurance Services Office, inc., 2020 Page 7 of 8 2. "Motor vehicle" means any self-propelled b. A lessee having the right to possession, in vehicle with four or more wheels which is of a the event a "motor vehicle" is the subject of type both designed and required to be licensed a lease with option to purchase and such for use on the highways of Florida and any lease agreement is for a period of six trailer or semitrailer designed for use with such months or more; and vehicle. c. A lessee having the right to possession, in However, "motor vehicle"does not include: the event a "motor vehicle" iis the subject of a. A mobile home; a lease without option to purchase„ and such lease is for a period of she months or b. Any "motor vehicle" which is used in mass more, and the pease agreement provides transit, other than public school that the lessee shall l be responsible for transportation, and designed to transport securing insurance. more than five passengers exclusive of the operator of the motor vehicle and which is 7• ""Pedestrian" means a person whine not an owned by a municipality, a transit authority occupant of any self-propelled vehicle. or a political subdivision of the state. 8. "Medically necessary" refers to a medical 3. "'Family member' means a person related to service or supply that a prudent physician the "named insured" by blood, marriage or wound provide for the purpose of preventing, adoption, including a ward or foster child, who diagnosing or treating an illness, injury, is a resident of the same household as the disease or symptom in a manner that is: "named insured". a. in accordance with generallly accepted 4. "Named insured" means the person or standards of medical)practice; organization named in the Declarations of the b. Clinically appropriate in terms of type, Policy and, if an individual, shall include the frequency, extent, site and duration; and spouse if a resident of the same household, c. Not primarily for the convenience of the 5. "Occupying" means in or upon or entering into patient„ physician or other health care or allighting from. provider.. 6. "Owner" means a person or organization who holds the legal tithe to a "motor vehicle" and also includes: a. A debtor having the right to possession, in the event a ""motor vehicle" is the subject of a security agreement; Page 8 of 8 0 Insurance Services Office, Inc., 2020 CA 22 10 0121 w rn v, to cfl M d' COMMERCIAL AUTO CA 20 02 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE - FIRE, POLICE AND EMERGENCY VEHICLES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Physical Damage Coverage is changed as follows: 3. Equipped as an emergency vehicle and owned A. The exclusion relating to audio, visual and data by a volunteer fire department„ volunteer electronic equipment in Paragraphs 113.4.c. and rescue squad or volunteer ambulance corps. B.4.d. does not apply to any equipment that is B. For covered "autos" described above,: the Limits installed in or upon a covered "auto"'which is: Of Insurance provision in Paragraph CA.b. does 1. Owned by a police or fire department; not apply. 2. Equipped as an emergency vehicle and owned by a political body or any of its agencies; or CA 20 02 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1 COMMERCIAL AUTO CA20181013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PROFESSIONAL SERVICES NOT COVERED This endorsement modifies insurance provided under the following: BUSIINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement, Covered Autos Liability Coverage is changed by 2. "'Bodily injury" resulting from food or drink adding the following exclusions: furnished with these services. This insurance does not apply W 3. "Bodily injury" or "property damage" resulting 1. "'Bodily injury" resulting from the providing or from the handling of corpses. the failure to provide any medical or other professional services, CA 20 18 10 13 ,' Insurance Services Office, Inc., 2011 Page 1 of 1 w rn 4 00 to M d' COMMERCIAL AUTO CA99031013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO MEDICAL PAYMENTS COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Coverage 3. "'Bodily injury" sustained by any "family We will pay reasonabVe expenses incurred for member" while "occupying" or struck by any necessary medical and funeral services to or for vehicle (other than a covered "auto") owned by an "insured"' who sustains "bodily injury' caused or furnished or available for the regular use of by "accident We will pay onily those expenses any"family member". incurred, for services rendered within three years 4. "'Bodily injury"to your"employee" arising out of from the date of the"accident"". and in the course of employment by you. B. Who Is An Insured However, we will cover "bodily injury" to your domestic"employees" if not entitled to workers' 1. You whine "'occupying"' or, while a pedestrian, compensation benefits. For the purposes of when struck by any"auto", this endorsement, a domestic "employee" is a 2. If you are an individual, any "family member" person engaged in household or domestic while "occupying" or, while a pedestrian, when work performed principally in connection with a struck by any"auto'. residence premises. 3. Anyone else "occupying" a covered "auto" or a 5. "Bodily injury" to an "insured" while working in temporary substitute for a covered "auto". The a business of selling, servicing, repairing or covered "auto" must be out of service because parking"autos" unless that business is yours. of its breakdown, repair, servicing, loss or 6. "Bodily injury" arising directly or indirectly out destruction. of: C. Exclusions a. War, including undeclared or civil war; This insurance does not apply to any of the b. Warlike action by a military force, including following: action in hindering or defending against an 1. "Bodily injury" sustained by an "insured" while actual or expected attack, by any "occupying" a vehicle located for use as a government, sovereign or other authority premises. using military personnel or other agents; or 2. "Bodily injury" sustained by you or any "family c. Insurrection, rebellion, revolution, usurped member' while "occupying" or struck by any power, or action taken by governmental vehicle (other than a covered "auto") owned by authority in hindering or defending against you or furnished or available for your regular any of these. use. CA 99 03 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 2 7. "Bodily injury"' to anyone using a vehicle E. Changes In Conditions without a reasonable belief that the person is The Conditions are changed for Auto Medical entitled to do so. Payments Coverage as follows: 8. "Bodily Injury" sustained by an "insured" while 1, The Transfer Of Rights Of Recovery Against "occupyiing" any covered "auto" while used in Others To Us Condiition does not apply. any professional racing or demolition contest or stunting activity, or while practicing for such 2• The reference in Other Insurance in the Auto contest or activity, This insurance also does Dealers and Business Auto Coverage Forms not apply to any "bodily injury" sustained by an and Other Insurance — Primary And Excess "insured"while the "'auto" is being prepared for Insurance Provisions in the Motor Carrier such a contest or activity., Coverage Form to "other collectible insurance" D. Limit Of Insurance applies only to other collectible auto medical payments insurance. Regardless of the number of covered "autos", F. Additional Definitions "insureds", premiums paid, claims made or vehicles involved in the "accident", the most we As used in this endorsement: will pay for"bodily injury for each "insured"' injured 1. "Famiily member" means a person related to in any one "accident' is the Limit Of Insurance for you by blood„ marriage or adoption who is a Auto Medical Payments Coverage shown in the resident of your household, including a ward or Declarations. foster child. No one will be entitled to receive duplicate 2. "'Occupying" means in, upon, getting in, on, out payments for the same elements of "loss" under or off. this coverage and any Liability Coverage Form, Uninsured Motorists Coverage Endorsement or Underinsured Motorists Coverage Endorsement attached to this Coverage Part, Page 2 of 2 0 Insurance Services Office, Inc., 2011 CA 99 03 10 13 .p w rn to 0 ti M d' COMMERCIAL AUTO CA99481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLLUTION LIABILITY - BROADENED COVERAGE FOR COVERED AUTOS - BUSINESS AUTO AND MOTOR CARRIER COVERAGE FORMS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Covered Autos Liability Coverage is changed as "Covered pollution cost or expense" does not follows: include any cost or expense arising out of the 1. Paragraph a. of the Pollution Exclusion actual, alleged or threatened discharge, applies only to liability assumed under a dispersal, seepage, migration, release or contract or agreement, escape of"pollutants": 2. With respect to the coverage afforded by a. Before the"pollutants" or any property in Paragraph A.I. above, Exclusion B.6. Care, which the "pollutants" are contained are Custody Or Control does not apply: moved from the place where they are accepted by the "insured" for movement B. Changes In Definitions into or onto the covered"auto'; or For the purposes of this endorsement, Paragraph b. After the "pollutants" or any property in D. of the Definitions Section is replaced by the which the "pollutants" are contained are following: moved from the covered "auto" to the D. "Covered pollution cost or expense"means any place where they are finally delivered, cost or expense arising out of: disposed of or abandoned by the 1. Any request, demand, order or statutory or "insured". regulatory requirement that any "insured" or Paragraphs a. and b. above do not apply to others test for, monitor, clean up, remove, "accidents" that occur away from premises contain, treat, detoxify or neutralize, or in owned by or rented to an "insured" with any way respond to, or assess the effects respect to "pollutants" not in or upon a of"pollutants"; or covered "auto"if: 2. Any claim or "suit" by or on behalf of a (1) The "pollutants" or any property in governmental authority for damages which the "pollutants" are contained because of testing for, monitoring, cleaning are upset, overturned or damaged as up, removing, containing, treating, a result of the maintenance or use of detoxifying or neutralizing, or in any way a covered"auto'; and responding to or assessing the effects of (2) The discharge, dispersal, seepage, "pollutants". migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage. CA 99 48 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1 Named Insured: Policy Number:VFNU—TR-0019768-03/000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 �r Ji v' d Vdr eu fr v �r'. s at c Je i iy rlir e r -L r r uX o h }�Yy iIId �p ii /�r�• 2 t T `�Lf��i w� � ' � � rF.¢r ,tr Vi 6 e� w'Tv is rr 44, ,.w .. . .... ... .... �E,,,. .�, 4.�., Limits of Insurance Each Occurrence or Medical Incident $ 1, 000, 000 Medical Expense $ 5, 000 Any One Person Personal & Advertising Injury $ 1, 000, 000 General Aggregate $ 2, 0 0 0, 0 0 0 Products -Completed Operations Aggregate $ 2, 0 0 0, 0 0 0 Products-Completed Operations are subject to the General Aggregate limit unless indicated otherwise Employers' Liability NOT COVERED Bodily Injury by Accident $ Each Accident Bodily Injury by Disease $ Policy Limit Bodily Injury by Disease $ Each Employee or Volunteer Estimated Coverage Part Premium: $ 2, 150 . 00 Taxes, Fees and Surcharges: $ 38 . 70 Total Premium: $ 2, 188 . 70 " i 1 ✓ " h i M^v r ° u r v r P S U V �' R .✓ P ! Y 4 fyu'��. 1 dN Y- �' rlYI/I KI UM Ja Y See Schedule of Farms and Endorsements. VGL100(01/20) 10-03�2023 w 4 N ti M d' EMERGENCY SERVICE ORGANIZATION GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this coverage part the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this coverage part. The words "we", "us" and "our" refer to the company providing this insurance. The word "insured" means any person or organization qualifying as such under SECTION II. WHO IS AN INSURED. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION V. DEFINITIONS. SECTION I. COVERAGES Coverage A. Bodily Injury and Property Damage Liability 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of"bodily injury" or"property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "bodily injury" or "property damage" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence"and settle any claim or"suit"that may result, But;. (1) The amount we will pay for damages is limited as described in SECTION III. LIMITS OF INSURANCE; and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under COVERAGES A, B or C or medical expenses under COVERAGE D. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under SUPPLEMENTARY PAYMENTS—COVERAGES A, B AND C. b. This insurance applies to"bodily injury"and"property damage"only if: (1) The "bodily injury" or"property damage" is caused by an "occurrence"that takes place in the "coverage territory"; (2) The"bodily injury"or"property damage"occurs during the policy period; and (3) Prior to the policy period, no officer, director, commissioner or trustee, and no volunteer or "employee" authorized by you to give or receive notice of an "occurrence" or claim, knew or had reason to know that the"bodily injury" or"property damage" had occurred, in whole or in part. If any such persons knew or had reason to know, prior to the policy period, that the "bodily injury" or "property damage" occurred in whole or in part, then any continuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known to have occurred prior to the policy period. c. "Bodily injury" or "property damage" which occurs during the policy period and was not, prior to the policy period, known to have occurred by any insured listed in paragraph b.(3) above, includes any continuation, change or resumption of that"bodily injury"or"property damage" after the end of the policy period. VGL101 (01-20) Copyright,American International Group„Inc,,2019. Page 1 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. d, "Bodily injury" or"property damage"will be deemed to have been known to have occurred at the earliest time when any insured listed in paragraph b.(3)above: (1) Reports all, or any part, of the"'bodily injury"or"property damage"to us or any other insurer; (2) Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property damage"; or (3) Becomes aware by any other means that"bodily injury"or"'property damage"'has occurred or has begun to occur. e, Damages because of"bodily injury"' include damages claimed by any person or organization for care, loss of services or death resulting at any time from the"bodily injury". 2. Exclusions Applicable to Coverage A This insurance does not apply to: a, Expected or Intended Injury "Bodily injury" or"property damage""expected or intended from the standpoint of the insured. This exclusion does not apply to expected or intended "bodily injury" or "property damage" resulting from reasonable actions taken to protect persons or property. b, Contractual Liability "Bodily injury"or"property damage"'for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contract or agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the"bodily injury"' or "property damage"' occurs subsequent to the execution of the contract or agreement. Solely for the purposes of(liability assumed in an "insured contract", reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of"bodily injury"or"property damage", provided: (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same"insured contract"; and (b) Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Workers' Compensation and Similar Laws Any obligation of the insured under a workers'compensation, disability benefits or unemployment compensation law, or any similar law. d. Employer's Liability "Bodily injury"to: (1) An "employee" of the insured arising out of and in the course of employment by the insured, or performing duties related to the conduct of the insured's business; or (2) Any volunteer, if you provide or are required to provide any benefits for such volunteer under any workers'compensation law, disability benefits law, or any similar law:or (3) The spouse, child, parent, brother or sister of that employee or"volunteer" as a consequence of paragraph (1)or(2) above. This exclusion applies: (a) Whether the insured may be liable as an employer or in any other capacity; and (b) To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an "insured contract". VGL101(01-20) Copyright,American International Group"Inc.,2019. Page 2 of 19 GENERAL LIABILITY Ali rights reserved.Includes copyrighted material of the Insurance Services Office„Inc.,with its permission, P W 4 W d ti M d' e. Pollution Any injury, damage, expense, cost, loss, liability or legal obligation arising out of or in any way related to pollution, however caused. Pollution includes the actual, alleged, or potential presence in or introduction into the environment of any substance d such substance has, or is alleged to have, the effect of making the environment impure, harmful or dangerous. Environment includes any air, land, structure (or the air therein), watercourse or other body of water, including underground water. This exclusion does not apply to: (1) "Emergency operations"conducted away from premises owned by or rented to you or any fire department, hazardous materials unit, first aid squad, ambulance squad or rescue squad qualifying as an insured under this coverage part; or (2) "Training operations"; or (3) Water runoff from the cleaning of equipment used in"emergency operations"; or (4) "Bodily injury" if sustained within a building and caused by smoke, fumes, vapor or soot from equipment used to heat that building; or (5) 'Bodily injury" or"property damage" caused by heat, smoke or fumes from a"hostile fire": (a) At or from premises you own, rent or occupy; or (b) At or from any site or"location" in connection with operations described in (1), (2) or (3) above. f. Asbestos Any injury, damage, expense, cost, loss, liability or legal obligation arising out of or in any way related to asbestos or asbestos-containing materials, or exposure thereto, or for the costs of abatement, mitigation, removal, elimination or disposal of any of them. This exclusion does not apply to: (1) "Bodily injury"or"property damage" arising from; or (2) The costs of abatement, removal or disposal of: asbestos released as a result of "emergency operations" or "training operations" away from premises which are either owned by, rented to, or occupied by any insured. g. Lead, Electromagnetic Radiation, Nuclear (1) Any injury, damage, expense, cost, loss, liability or legal obligation arising out of or in any way related to: (a) The toxic properties of lead, or any material or substance containing lead;,or (b) Electromagnetic radiation; or exposure thereto, or for the costs of abatement, mitigation, removal, elimination or disposal of any of them. (2) Any loss, cost or expense arising out of any actual, alleged or threatened injury or damage to any person or property from any radioactive matter or nuclear material, h. Aircraft,Auto or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is not being used to carry persons or property for a charge; (3) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; (4) 'Bodily injury"or"property damage"arising out of the operation of any of the equipment listed in paragraph f.(2)or f.(3)of the definition of"mobile equipment; or (5) A watercraft you own that is: (a) Powered by a motor or combination of motors of 100 horsepower or less; or (b) Not powered by a motor; or (c) A"personal watercraft". VGL101(01-20) Copyright,American International Group,Inc.,2019, Page 3 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. i. Mobile Equipment "Bodily injury" or"property damage"arising out of: (1) The transportation of "mobile equipment" by an "'auto" owned or operated by or rented or loaned to any insured; or (2) The use of "mobile equipment" in, or while in practice for, or while being prepared for, any prearranged racing, speed, demolition, or stunting activity. j. War "Bodily injury"or"property damage", however caused, arising directly or indirectly out of: (1) War, including undeclared or civil war; or (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. k. Damage To Property "'Property damage"to: (1) Property you or any insured owns, rents, or occupies; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you or any insured; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage"arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because"your work"was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not applNy to "property damage" (other than damage by fire)to premises, including the contents of such premises, rented or loaned to you for a period of 30 or fewer consecutive days. The Each Occurrence or Medical Incident Limit shown in the Declarations will apply to this coverage. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (4) of this exclusion does not apply to "property damage" to personal property belonging to anyone receiving service from any insured because of loss by theft, physical damage or disappearance of such property during the period when volunteers or"employees" of the insured arrive on the scene or while they are rendering service to others and ending when they either leave the scene, complete their service, or transfer care of a transported patient to others. This insurance does not apply to that portion of any loss for which the Named Insured has other vapid and collectible insurance. The limit of the company's liability is the Each Occurrence or Medical Incident Limit stated in the Declarations, subject to a $100 deductible each "occurrence". Paragraphs (5) and (6) of this exclusion do not apply to "property damage" resulting from actions taken to protect persons or property. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products- completed operations hazard". N. Personal and Advertising Injury "Bodily injury"arising out of"personal and advertising injury". VGL101 (01-20) Copyright„American international Group,Inc.,2019- Page 4 of 19 GENERAL LIABILITY All rights reserved. includes copyrighted material of the Insurance Services Office,inc.,with its permission, P W 4 U1 cfl ti M d' m. Sexual Abuse "Bodily injury" arising out of the "sexual abuse" of any person. However, this exclusion shall not apply to the Named Insured if no officer, director, commissioner or trustee of the Named Insured knew or had reason to know of the "sexual abuse". Also, we will defend an insured for covered civil action subject to the other terms of this coverage part until either a judgment or final adjudication establishes such an act, or the insured confirms such act. n. Professional Health Care Services Damages arising or allegedly arising out of providing or failing to provide"professional health care services". o. Employment Practices "Bodily injury"or"property damage" arising out of your"employment practices". p. Product Recall Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (1) "Your product'; (2) "Your work"; or (3) "Impaired property"; if such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. Exclusions c. through p. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. The Each Occurrence or Medical Incident Limit shown in the Declarations will apply to this coverage. Coverage B. Personal and Advertising Injury Liability 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "personail and advertising injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "personal and advertising injury"to which this insurance does not apply. We may, at our discretion, investigate any offense and settle any claim or"suit"that may result. But: (1) The amount we will pay for damages is limited as described in SECTION III — LIMITS OF INSURANCE, and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under COVERAGES A, B or C or medical expenses under COVERAGE D. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under SUPPLEMENTARY PAYMENTS—COVERAGES A, B AND C. b. This insurance applies to "personal and advertising injury"' caused by an offense arising out of your business but only if the offense was committed in the "coverage territory" during the policy period. VGL101 (01-20) Copyright,American International Group,Inc.,2019 Page 5 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc,with its permission. 2. Exclusions Applicable to Coverage B This insurance does not apply to: a. Knowing Violation of the Rights of Another "Personal and advertising injury" caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict"personal and advertising injury". b. Material Published with Knowledge of Its Falsity "Personal and advertising injury" arising out of oral or written publication of material, if done by or at the direction of the insured with knowledge of its falsity. c. Material Published Prior to the Policy Period "Personal and advertising injury"' arising out of oral or written publication of material whose first publication took place before the beginning of the policy period. d. Criminal Acts "Personal and advertising iinjury'" arising out of a criminal act committed by or at the direction of any insured. e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement, f. Breach of Contract "Personal and advertising injury" arising out of a breach of contract, except an implied contract to use another's advertising idea in your"advertisement". g. Quality or Performance of Goods "Personal and advertising injury" arising out of the failure of goods, products or services to conform with any statement of quality or performance made in your"advertisement". h. Wrong Description of Prices "Personal and advertising injury" arising out of the wrong description of the price of goods, products or services stated in your"advertisement"'. i. Infringement of Copyright, Patent, Trademark or Trade Secret "Personal and advertising injury" arising out of the infringement of copyright, patent, trademark, trade secret or other intellectual property rights. However„ this exclusion does not apply to infringement, In your"advertisement", of copyright„trade dress or slogan. j. Pollution "Personal and advertising injury" arising out of or in any way related to pollution„ however caused. Pollution includes the actual, alleged, or potential presence in or introduction into the environment of any substance if such substance has, or is alleged to have, the effect of making the environment impure, harmful or dangerous. Environment includes any air, land, structure (or the air therein), watercourse or other body of water, including underground water. k. Professional Health Care Services "Personal and advertising injury" arising or allegedly arising out of providing or failing to provide "professional health care services". I. Employment Practices "Personal and advertising injury" arising out of your"employment practices".. VGL101(01,20) Copyright,American InlernaLonall Group,Inc,,.2019 Page 6 of 19 GENERAL ILIIABUTY All rights reserved.Includes copyrighted material of the Insurance Services Office„Inc.,with its permission. P W 4 00 ti M d' m. Asbestos Any injury, expense, cost, loss, liability or legal obligation arising out of or in any way related to asbestos or asbestos-containing materials. n. Lead, Electromagnetic Radiation, Nuclear (1) Any injury, expense, cost, loss, liability or legal obligation arising out of or in any way related to: (a) The toxic properties of lead, or any material or substance containing lead; or (b) Electromagnetic radiation; or exposure thereto, or for the costs of abatement, mitigation, removal, elimination or disposal of any of them. (2) Any loss, cost or expense arising out of any actual, alleged or threatened injury to any person or property from any radioactive matter or nuclear material. o. War "Personal and advertising injury", however caused, arising directly or indirectly out of: (1) War, including undeclared or civil war; or (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. p. Sexual Abuse "Personal and advertising injury"arising out of the"sexual abuse"of any person. Coverage C. Professional Health Care Liability 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of injury arising out of a"medical incident". We will have the right and duty to defend any claim or "suit" seeking those damages. We may at our discretion investigate any *rr icai incident" and settle any claim or"suit"that may result. But: (1) The amount we will pay for damages is limited as described in SECTION III. LIMITS OF INSURANCE; and (2) Our right and duty to defend end when we have used up the applicable (limit of insurance in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided under SUPPLEMENTARY PAYMENTS — COVERAGES A, B AND C or medical expenses under COVERAGE D. b. This insurance applies only if the damages are caused by a"medical incident"that takes place: (1) During the policy period; and (2) In the"coverage territory". 2. Exclusions Applicable to Coverage C All exclusions under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY apply to this COVERAGE C, except that exclusion n. Professional Health Care Services under COVERAGE A shall not apply. All exclusions under COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY apply to this COVERAGE C, except that exclusion k. Professional Health Care Services under COVERAGE B shall not apply. VGL101 (01-20) Copyright,American International Group,Inc.,2019. Paige 7 of"lg GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. In addition, this insurance does not apply to a. Medical Command via Telecommunications Device Any physician providing or failing to provide on-line medical direction or medical command via telecommunication to emergency medical personnel. b. Criminal Acts Injury arising out of a criminal act(except for"sexual abuse")committed by the insured or anyone for whom the insured is legally responsible. However, we will defend the insured for covered civil action subject to the other terms of this coverage part until either a judgment or final adjudication establishes such act, or the insured confirms such act. Coverage D. Medical Expense 1. Insuring Agreement a. We will pay medical expenses as described below for""bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (a) The accident takes place in the"'coverage territory"and during the policy period; (b) The expenses are incurred and reported to us within one year of the date of the accident; and (c) The injured person submits to examination„ at our expense, by physicians of our choice as often as we reasonably require, b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We w0l pay reasonable expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, x-ray and dental services, including prosthetic devices; and (3) Necessary ambulance, hospital, professional nursling and funeral services. 2, Exclusions Applicable to Coverage D We will not pay expenses for"bodily injury": a. Any Insured To any insured. b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c, Injury on Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d Workers'Compensation and Similar Laws To a person, whether or not an "employee" of any insured, if benefits for the "bodily injury" are payable or must be provided under a workers' compensation or disability benefits law or a similar law, e. Athletic Activities To a person injured while taking part in athletics. f. Products—Completed Operations Hazard VGL101(01 20) Copyright,American International Group,Inc.,2019. Page 8 of 19 GENERAL t„,IABILIITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. .P W 4 W 0 00 M d' Included within the"products-completed operations hazard". g. Professional Health Care Services To any person for"professional health care services" provided by you. h. Coverage A Excluded under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY. Supplementary Payments— Coverages A, B and C 1. We will pay, with respect to any claim we investigate or settle, or any "suit" against an insured we defend: a. All expenses we incur. b. Up to$250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or"suit", including actual loss of earnings up to $300 a day because of time off from work. e. All costs taxed against the insured in the"suit". f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance. 2. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the"suit", we will defend that indemnitee if all of the following conditions are met; a. The"suit" against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an"insured contract"; b. This insurance applies to such liability assumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same"insured contract"; d. The allegations in the"suit"and the information we know about the"occurrence"are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee; e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and f. The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investigation, settlement or defense of the"suit"; (b) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the"suit' (c) Notify any other insurer whose coverage is available to the indemnitee„ and (d) Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee; and (2) Provides us with written authorization to: (a) Obtain records and other information related to the"suit"; and (b) Conduct and control the defense of the indemnitee in such "suit". VGL101 (01-20) Copyright,American International Group.Inc.,2019.. Page 9 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc,„with its permission, So long as the above conditions are met, attorneys" fees incurred by us in the defense of that indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as SUPPLEMENTARY PAYMENTS. Notwithstanding the provisions of paragraph 2.b.(2) of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, such payments will not be deemed to be damages for "bodily injury" and "property damage"and will not reduce the limits of insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation expenses as SUPPLEMENTARY PAYMENTS ends when: a We have used up the applicable limit of insurance in the payment of judgments or settlements; or b. The conditions set forth above, or the terms of the agreement described in paragraph f. above, are no longer met. SECTION II. WHO IS AN INSURED 1. If you are: a. An organization other than a partnership„ joint venture or limited liability company, you are an insured b A partnership or joint venture, you are an insured. Your members and your partners are also insureds, but only within the course and scope of your operations. c. A limited liability company, you are an insured. Your members are also insureds, but only within the course and scope of your operations. Your managers are insureds, but only within the course and scope of your operations. 2, In addition to you, each of the following is an insured: a, Volunteers and Employees. Your volunteers, "employees°",, elected or appointed officers, &rectors commissioners or trustees", but only for acts within this course and scope of their employment by you, membership with you or authorized duties on your behalf. b. Medical Directors. Physicians who are your medical directors, but only for acts within the course and scope of their medical director duties on your behalf. c. Good Samaritans. Your volunteers, "employees", elected or appointed officers; directors, commissioners or trustees while acting as a Good Samaritan independently of his or her activities on your behalf", but only when he or she encounters the scene of an emergency requiring sudden action. Iln no event will such person who responds to the scene of an emergency with or for any other emergency service organization be an insured d. Owners of Commandeered Equipment. The owner of commandeered equipment other than an `auto" is an insured while the equipment is in your temporary care, custody or control and is being used as part of an "emergency operation". e. Real Estate Managers. Any person or any organization while acting as your real estate manager. f. Blanket Additional Insureds. Any person or organization required to be an additional insured under an "Insured contract", if agreed to by you prior to the "bodily injury", "property damage", "'personal and advertising injury", or"medical incident", but only with respect to liability arising out of your premises or operations. 3. Mobile Equipment. With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is an insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the equipment„ and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to "property damage" to property owned by,, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. VGL101(01-20) Copyright„American International Group,inc.,2019. Page 10 of 19 GENERAL LIABILITY All rights reserved,includes copyrighted material of the Insurance Services office,Inc,with its permission, .P W 00 N 00 M d' 4. New Organizations. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period,whichever is earlier; b. COVERAGE A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; c, COVERAGE B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization; and d. COVERAGE C does not apply to a "medical incident" that took place before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION III. LIMITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or"suits"brought; or c. Persons or organizations making claims or bringing"suits". 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under COVERAGE D; b. Damages under COVERAGE A, except damages because of"bodily injury" or"property damage" included in the"products-completed operations hazard"; c. Damages under COVERAGE B; and d. Damages under COVERAGE C; for each Named Insured shown in the Declarations and each "location" owned by or rented to you. 3. The Products - Completed Operations Aggregate Limit is the most we will pay under COVERAGE A for damages because of"bodily injury" and "property damage" included in the "products-completed operations hazard", for each Named Insured shown in the Declarations. 4. Subject to 2. above, the Personal and Advertising Injury Limit is the most we will pay under COVERAGE B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization. 5. Subject to 2. or 3. above, whichever applies, the Each Occurrence or Medical Incident Limit is the most we will pay for the sum of: a. Damages under COVERAGES A and C; and b. Medical expenses under COVERAGE D; because of all "bodily injury" and "property damage" arising out of any one "occurrence" and all damages arising out of any one"medical incident". B. Subject to 5. above, the Each Occurrence or Medical Incident Limit is the most we will pay under COVERAGE A for damages because of"property damage"to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to 5. above, the Medical Expense Limit is the most we will pay under COVERAGE D for all medical expenses because of"bodily injury"sustained by any one person. VGL101 (01-20) Copyright,American International Group,Ina_,2019, Page 11 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission.. The Limits of Insurance of this coverage part apply separately to each consecutive annual period and to any remaining period of less than 12 months, startling with the beginning of the policy period shown in the Declarations„ unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV. CONDITIONS The following conditions apply in addition to the Common Policy Conditions.. 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this coverage part 2, Duties in the Event of an Occurrence,Offense, Medical Incident, Claim or Suit a. You must see to it that we are notified as soon as practicable of an "occurrence", offense or "medical incident" which may result in a claim or "suit", To the extent possible, notice should include: (1) How,when and where the"occurrence"', offense or"medical incident"took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arisiing out of the "'occurrence offense or .medicall incident"', b. If a claim is made or"suit" is brought against any insured,you must. (1) Immediately record the specifics of the claim or"suit"and the date received; and (2) Notify us as soon as practicable.. You must see to it that we receive written notice of the claim or"suit"as soon as practicable. c, You and any other involved insured must (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or"suit", (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the"suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost„ voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid,without our consent. e. If you report an "occurrence"„ offense or "medical incident" to an insurer providing other than General Liability insurance" which later develops into a General Liability claim covered under this coverage part, failure to report such ""occurrence"„, offense or 'medical incident" to us at the time of the "occurrence", offense or "medical incident" shall not be deemed in violation of these conditions. However, you shall give notification to us,; as soon as is reasonably possible, that the "occurrence", offense or"medical incident" is a General Liability claim. f. Knowledge of an "occurrence", offense or"medical incident" by any of your agents, volunteers or `"'employees" shall not constitute knowledge by you unless one of your officers or anyone responsible for administering your insurance program has received a notification from the agent, volunteer or"employee". VGL101(01-20) Copyright,American International Group,Inc.,2019 Page 12 of 19 GENERAL LIABILITY AIII rights reserved.Includes copyrighted material of the ➢nsurance Services Office,Inc.,,with its permission. P W CD W dq 00 M d' 3. Legal Action Against Us No person or organization has a right under this coverage part: a. To join us as a party or otherwise bring us into a"suit"asking for damages from an insured; or b. To sue us on this coverage part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this coverage part or that are in excess of the applicable limit of insurance.An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured volunteer, "employee", elected or appointed officer, director, commissioner, trustee, medical director or owner of commandeered equipment for a loss we cover under COVERAGES A, B or C of this form, our insurance is primary, with no consideration or contribution with other insurance, except with respect to any medical malpractice liability insurance available to a physician who is acting on your behalf by providing on- site medical treatment of a person. With respect to said medical malpractice liability insurance, our insurance is excess over that coverage. If other valid and collectible insurance is available to the insured, other than volunteers, "employees", elected or appointed officers, directors, commissioners, trustees, medical directors or owners of commandeered equipment, for a loss we cover under COVERAGES A, B or C of this form, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance,whether primary, excess, contingent or on any other basis: (a) That is fire, extended coverage, builder's risk, installation risk or similar coverage for "your work"; (b) That is fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage"to premises rented to you or temporarily occupied by you with permission of the owner; (d) That is insurance covering your liability for"bodily injury"or"property damage"arising out of the providing, serving or selling of alcoholic beverages to others; (e) That is insurance covering your liability for"bodily injury" or"property damage"arising out of the igniting or discharging of fireworks, including but not limited to firecrackers, aerial or ground displays, in conjunction with any demonstration or show conducted or sponsored by you. However, this coverage shall not be excess should the "bodily injury" or"property damage" result from an emergency response you provide in response to an emergency arising out of fireworks; or (f) If the loss arises out of the maintenance or use of aircraft or watercraft to the extent not subject to exclusion h. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY. VGL101 (01-20) Copyright,American International Group,Inc.,2019. Page 13 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office, Inc.,with its permission. (2) Any other primary insurance, including poops or self-insurance, covering your liability for damages arising out of the premises or operations for which you have been added as an additional)insured. When this insurance is excess, we will have no duty under COVERAGES A, B or C to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this excess insurance provision and was not bought specifically to apply in excess of the limits of insurance shown in the Declarations of this coverage part. c. Method Of Shaving If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. Ilf any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Representations By accepting this policy, you agree: a. The information in the Declarations is accurate and complete; b. The information is based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. Your failure to disclose all hazards existing as of the inception date of the policy shall not prejudice you with respect to the coverage afforded, provided such failure or omission is not intentional. This coverage part is void if any material fact or circumstance relating to this insurance is intentionallly omitted or misrepresented. 6. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this coverage part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim its made or"suit"is brought. 7. Transfer of Rights of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this coverage part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring"suit"or transfer those rights to us and help us enforce them. VGL101(01-20) Copyright„American International Group,Inc.,,2019, Page 14 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office; Inc.,with its permission. P W CD Ul W 00 M d' 8. When We Do Not Renew If we decide not to renew this coverage part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V. DEFINITIONS 1. "Advertisement"means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. 2. "Auto" means a land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or equipment. But"auto"does not include"mobile equipment". 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. 4 "Coverage territory"means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada;, b. International waters or airspace, provided the injury or damage does not occur in the course of travel or transportation to or from any place not included in a. above; or c. All other parts of the world if: (1) The injury or damage arises out of: (a) Goods or products made or sold by you in the territory described in a. above;or (b) The activities of a person whose home is in the territory described in a. above, but is away for a short time on your business; and (2) The insured's responsibility to pay damages is determined in a "suit" on the merits, in the territory described in a. above or in a settlement we agree to, 5. "Emergency operations"means actions: a. Which are urgent responses for protection of property, human life, health or safety; and b. Which result from the performing or attempting to perform firefighting services, hazardous materials unit services, first aid, ambulance or rescue squad services,, or related services, including the stabilizing or securing of an emergency scene; and Which are sanctioned by: (1) A fire department, hazardous materials unit, or first aid, ambulance or rescue squad qualifying as an insured under this coverage part„or (2) An officer, volunteer member or"`employee"of such organization. 6. "Employee" includes a"'leased worker". "Employee"does not include a"temporary worker". 7. "Employment practices' means an actual or alleged improper employment related practice, policy, act or omission involving an actual, prospective, or former volunteer or"employee", including; a- Failing to hire or refusing to hire; b.. Wrongful dismissal, discharge, or termination of employment or membership, whether actual or constructive; c. Wrongful deprivation of a career opportunity, or failure to promote;; d. Wrongful discipline of volunteers or"employees"; e. Negligent evaluation of volunteers or"employees'; f. Retaliation against volunteers or"employees" for the exercise of any legally protected right or for engaging in any legally protected activity„ g. Failure to adopt adequate workplace or employment-related policies and procedures,; h. Harassment, including "sexual harassment"; or VGL101 (01-20) Copyright,American International Group,Inc.,2019. Page 15 of 19 GENERAL LIABILITY All rights reserved.Inctudes copyrighted material of the insurance Services Office„Inc,with its permission. i. Violation of any federal, state or local laws (whether common law or statutory) concerning employment or discrimination in employment. & "Hostile fire" means one which becomes uncontrollable or breaks out from where it was intended to be. 9. "Impaired property" means tangible property, other than "your product" or"your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work"' that is known or thought to be defective, deficient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by: (1) The repair, replacement, adjustment or removal of"your product"or"your work'; or (2) Your fulfilling the terms of the contract or agreement. 10. "Insured contract"means: a. A contract for a lease of premises. However, that portion of the contract for a pease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort Viability of another party to pay for"bodily injury" or"property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for"bodily injury"'or"property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, inclluding those listed in (2) above and supervisory, inspection, architectural or engineering activities. 11. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker"does not include a"temporary workerr". 12. "Loading or unloading"means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or"auto'; b. While it fs in or on an aircraft,watercraft or"auto'; or c. While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered; VGL101 (01-20) Copyright„American International Group,Inc.,2019. Page 16 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office Inc,,with uts permission. P W CD 4 00 00 M d' but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft,watercraft or"auto". 13. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 14. "Medical incident" means any act, error or omission in the rendering of or failure to render "professional health care services" by you or by anyone for whose"professional health care services" you are legally responsible. Any such act, error or omission, together with all related acts, errors or omissions in the furnishing of such services to any one person, shall be considered one "medical incident". 15. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads; b. Vehicles maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders„ scrapers or rollers; e. Vehicles not described in a., b., c. or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: (1) Air compressors, pumps and generators, including spraying, welding, building cleaning" geophysical exploration, lighting and well servicing equipment;or (2) Cherry pickers and similar devices used to raise or lower workers;. f. Vehicles not described in a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment"but will be considered "autos": (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. 16. "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 17. "Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, or any other interference with real property rights; d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral or written publication in any manner of material that violates a person's right of privacy; f. The use of another's advertising idea in your"advertisement'; or g. Infringing upon another's copyright,trade dress or slogan in your"advertisement". VGL101(01-20) Copyright,American International Group,Inc.,2019. Page 17 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. 18. "Personal watercraft" means a vessel which uses an inboard motor powering a water jet pump as its primary source of motive power, and which is designed to be operated by a person sitting, standing, or kneeling on the vessel, rather than the conventional manner of sitting or standing inside the vessel, 19 "Products-completed operations hazard": a. Includes all "bodily injury"' and "property damage" occurring away from premises you own or rent and arising out of"your product"or"your work" except. (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed, (b) When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. (c) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. b. Does not include"bodily injury""or"property damage"arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading"of that vehicle by any insured;, (2) The existence of tools, uniinstalled equipment or abandoned or unused materials; or (3) Products or operations for which the classification, listed in the Declarations or in a policy schedule, states that products-completed operations are subject to the General Aggregate Limit. 20, "Professional health care services" means; a. Providing medical or nursing services; b. Providing professional services of any other health care professional, including emergency medical technicians and paramedics; c, Furnishing or dispensing drugs or medical, surgical or dental supplies or appliances; d. Handling of patient&. (1) From the place where they are accepted for movement into or onto the means of transport, (2) During transport, and (3) From the means of transport to the place where they are finally delivered; e. Dispatching of,, including the failure or refusal to dispatch, personnel to provide any of the above services; f. Serving on, or carrying out the orders of, a health care accreditation board or similar professional board or committee; and g. Establishing medical protocol, creating medical training curricula, providing medical training, conducting medical)quallity assurance programs, and carrying out similar duties. 21. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured.All such (loss of use shall be deemed to occur at the time of the"occurrence"that caused it. 22. "Sexual abuse" means any actual, attempted or alleged sexual conduct by a person, or by persons acting in concert, which causes injury. "Sexual abuse" includes sexual molestation, sexual assault, sexual)exploitation, or sexual injury, but does not include"sexual harassment". VGL101(01-20) Copyright,American International Group.Inc 2019, Page 18 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the insurance Services Office,Inc,with its permission. P W CD W 0 M d' 23. "Sexual harassment" means any actual, attempted or alleged unwelcome sexual advances, requests for sexual favors, or other conduct of a sexual nature by a person, or by persons acting in concert, which causes injury. "Sexual harassment" includes: a. The above conduct when submission to or rejection of such conduct is made either explicitly or implicitly a condition of a person's employment, or a basis for employment decisions affecting a person; or b. The above conduct when such conduct has the purpose or effect of unreasonably interfering with a person's work performance or creating an intimidating, hostile or offensive work environment. 24. "Suit" means a civil proceeding in which damages because of "bodily injury", "property damage", "personal and advertising injury", or injury arising out of a "medical incident" to which this insurance applies are alleged. "Suit"includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. But "suit" does not mean any ethical conduct review or enforcement action, or disciplinary review or enforcement action. 25. "Temporary worker' means a person who is furnished to you to substitute for a permanent "employee"on leave or to meet seasonal or short-term workload conditions. 26. "Training operations" means activities used to prepare, train, or instruct members of a fire department, hazardous materials unit, or a first aid, ambulance or rescue squad in accepted and recognized emergency procedures, including municipal, state and federal standards. 27. "Your product"means: a. Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (1) You; (2) Others trading under your name; or (3) A person or organization whose business or assets you have acquired; and b. Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. "Your product"includes: (a) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of"your product'; and (b) The providing of or failure to provide warnings or instructions. "Your product" does not include vending machines or other property rented to or located for the use of others but not sold. 28. "Your work"means: a. Work or operations performed by you or on your behalf; and b. Materials, parts or equipment furnished in connection with such work or operations. "Your work" includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of"your work"; and (2) The providing of or failure to provide warnings or instructions. VGL101(01-20) Copyright,American International Group,Inc.,2019. Page 19 of 19 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office„Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION ELECTRONIC INFORMATION SECURITY EVENT This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE PART 1. The following exclusion applies to Coverage A. Bodily Injury And Property Damage Liability, Coverage B. Personal and Advertising Injury Liability, Coverage C. Professional Heath Care Liability,and any additional coverage that is provided under this General Liability Coverage Part: This insurance does not appliy to Any injury, damage„ expense, cost, loss, liability, or IegaiU obligation arising out of or in any way related to an "electronic information security event. 2. The following definitions are added: "'Electronic information security event" means: (1) Transmission of malware from your"computer system"to a third party, (2) The inability of an authorized user to access your web site or your "computer system" because of a de6ia'6 of service attack (3) A "personal identity event", but this is limited to information that is obtained or released directly from: (a) Your"computer system"; or (b) The "computer system" of an entity that has such information under a formal agreement with you.. (4) A"corporate privacy event", but this is limited to information that is obtained or released directly from: (a) Your"computer system"; or (b) The "computer system" of an entity that has such Information under a formal agreement with you. As used in this definition, a denial of service attack means an intentional attack on a web site or a computer network that prevents or slows down access to the web site or computer network. "Computer system" means the following: (1) Computers, including Personal Digital Assistants (PDAs) and other transportable or hand held devices, electronic storage devices and related peripheral components; (2) Systems and applications software; (3) Communications networks (including the internet, iintranets„ extranets or virtual private networks)to the extent used by the items in (1)and(2)above,- by which "electronic data" is collected,transmitted, processed, stored or retrieved; and (4) "Computer system" includes"electronic data" that is: (1) Stored on any of the items described in item(1)above; or (2) Temporarily outside of the "computer system" for use by an insured or an employee of an entity that has such (information under a formal agreement with you. VGL212(01-20) Copyright.American International Group,'inc,2019 Page 1 of 2 GENERAL LIABILITY All rights reserved. (includes copyrighted material of the Insurance Services Office,Inc, with its permssion. P W W N M M d' "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. This includes such information, facts or programs only while they are in an electronic format. "Personal identity event" means: (1) Unauthorized disclosure by you of "personally identifiable information" or your failure to protect"personally identifiable information"from misappropriation. (2) Failure by you to disclose or warn of an actual or potential disclosure or misappropriation of"personally identifiable information", but only if this policy applies to such disclosure or misappropriation and it resulted directly from (1)above; or (3) Violation of any federal or state privacy statute addressing disclosure or misappropriation of"personally identifiable information", but only if: (a) This policy applies to such disclosure or misappropriation and it resulted directly from (1)or(2)above; and (b) The violation is not willful. "Personally identifiable information" means any of the following in your care, custody or control: (1) Information from which an individual may be uniquely and reliably identified or contacted, including an individual's name, telephone number, social security number, drivers license number, state identification number, account relationships, account numbers, account balances, account histories, access codes, and passwords; (2) Information concerning an individual that would be considered nonpublic personal information within the meaning of Title V of the Gramm-Leach Bliley Act of 1999 as implemented and amended; and (3) Information concerning an individual that would be considered protected health information within the Health Insurance Portability and Accountability Act of 1996 as implemented and amended. "Corporate privacy event" means: (1) Unauthorized disclosure by you of "confidential corporate information" or your failure to protect"confidential corporate information"from misappropriation; (2) Failure by you to disclose or warn of an actual or potential disclosure or misappropriation of"confidential corporate information", but only if this policy applies to such disclosure or misappropriation and it resulted directly from(1)above; or (3) Violation of any federal or state privacy statute addressing disclosure or misappropriation of"confidential corporate information", but only if: (a) This policy applies to such disclosure or misappropriation and it resulted directly from (1)or(2)above; and (b) The violation is not willful. "Confidential corporate information" means any commercial trade secret, data, design, interpretation, forecast, formula, method, practice, process record, report or other item of information of a non-insured third party, and which is: (1) In your care, custody or control; (2) Not available to the general public; and (3) (a) Provided to you under a mutually agreed to written confidentiality/non-disclosure agreement; or (b) Marked confidential or otherwise specifically designated in writing as confidential by such third party. VGL212(01-20) Copyright,American International Group,Inc.,2019. Page 2 of 2 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT TO POLLUTION EXCLUSION - CLASS B FIREFIGHTING FOAM This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE PART The following changes are made to SECTION V--DEFINITIONS: 1, The following is added to the definition of"emergency operations`: "Emergency operations" does not include the use of a Class B firefighting foam containing any "PFAS" unless such use meets all standards of any statute, ordinance,; regulation or license requirement of any federal, state or local government having application to those operations, 2. The following is added to the definition of"training operations": "Training operations"does not include the use of a Class B firefighting foam containing any"PFAS". 3 For the purposes of this endorsement, "PFAS"means: Any product containing per- and polyfluoroalkyl substances (PFAS) or other perfiuorinated compounds (PFC) including but not limited to, perfluorooctanic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perflluorononanoc acid (PFNA), perfluorobutyric acid (PFBA), perftuorobutane sulfonic acid (PFBS), perfluoropentanoic acid (PFPeA), perfluorohexane sulfonic acid (PFHxS), perfluorohexonoic acid (PFHxA), perfluoroheptanoic acid (PFHpA), perflurooctane sulfonamide (PFSOA), perfluorodecanoic acid (PFDA), perfluorodecane sulfonate (PFDS), perfiuoroundecan6c acid (PFUnA), perfluorododecanoic acid (PFDoA), perfluorotri�decanoic acid (PFTrDA), perFluorotetradecanotc acid (PFTeDA), or 6:2 Fluorotelomer sulfonate (6:2 FTS). VGL213 (03-21) Copyright,American International Group,inc.,2020. Page 1 of 1 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office, Inc.,with its permission, P W W W d M THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY LINE OF DUTY ACCIDENTAL DEATH BENEFIT This endorsement modifies insurance provided under the following endorsement: GENERAL LIABILITY COVERAGE FORM Schedule Coverage Limit of Insurance Line of Duty Accidental Death Benefit $10,000 each person A. The following coverage is added to Section I. Coverages, Coverage A - Bodily Injury and Property Damage Liability: 1. We will reimburse you for your voluntary payment made to the family or members of the household of an insured whose accidental death results directly from injury due to participation in your "emergency operation". The most we will pay for any one Line of Duty Accidental Death is the Limit of Insurance shown in the Schedule above. The death must result within one year from the date of participation in the"emergency operation"which resulted in injury. For the purpose of this endorsement, a death that results from a stroke or heart attack which occurs within 48 hours after participation in an"emergency operation" is considered an accidental death. 2. For the purpose of this endorsement, paragraph 2. Exclusions Applicable to Coverage A Lander Section 1.Coverages is replaced by: 2. Exclusions This insurance does not apply if death results from the following: a. Suicide; b. Performing an"emergency operation" under the influence of alcohol or drugs; c. Injuries caused intentionally by the immediate family or members of the household who would be the beneficiary of this benefit; d. Flying in an aircraft; or e. Heart attack or stroke which occurs more than 48 hours after participation in an "emergency operation". B. The following is added to paragraph 2. Duties in the Event of an Occurrence, Offense, Medical Incident,Claim or Suit in Section IV.Conditions: g. You must provide us with written notice of a covered death as soon as practicable after the death occurs and submit a request for us to reimburse the Limit of Insurance shown in the Schedule and documentation of your voluntary payment. Your notice must include the identification of the deceased and a description of the"emergency operation"that resulted in the death of the insured. VGL317(01-20) Copyright,American International Group,Inc.,2019. Page 1 of 1 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Once,;Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNMANNED AIRCRAFT COVERAGE This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE PART A. The first paragraph of Exclusion 2.h. Aircraft, Auto Or Watercraft under Section I. Coverages, Coverage A. Bodily Injury and Property Damage Liability is replaced by the following: "Bodily injury" or '"property damage"' arising out of the ownership,„ maintenance, use or entrustment to others of any aircraft(other than "unmanned aircraft"), "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and"loading or unloading This exclusion does not apply to B. The following exclusion is added to Section I. Coverages, Coverage A. Bodily Injury and Property Damage Liability, Exclusions Applicable to Coverage A: Unmanned Aircraft "Bodily injury" or"property damage" arising out of the ownership, maintenance or use of an"unmanned aircraft" while: (1) Rented, leased or loaned to others without an operatorwho is your"employee" or "volunteer worker"; (2) Used in any professional or organized racing or demolition contest or stunting activity, or while practicing or preparing for such contest or activity;or (3) Not used in the insured's operations. C. The following definition its added to Section V. Definitions: "Unmanned aircraft" means an aircraft weighing 15 pounds or I ss that is not. a. Designed; b. Manufactured; or c. Modified after manufacture; to be controlled directly by a person from within or on the aircraft. "Unmanned aircraft" includes equipment used with such "'unmanned aircraft"', provided such equipment is attached to or essential for its operation. VGL320 (01-20) Copyright,,American International Group,Inc.,2019. Page 1 of 1 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc."with its permission. P W W Ul cfl M d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA CHANGES This endorsement modifies insurance prodded under the following: GENERAL LIABILITY COVERAGE PART The following is added to Paragragh 1.a Insuring Agreement of COVERAGE C. PROFESSIONAL HEALTH CARE LIABILITY: We may determine, make and conclude, without the permission of the insured, any offer: (a) Of settlement or of judgment; or (b) Of admission of liability and for arbitration of damages pursuant to Florida Statutes Section 776106; if the offer is within the limits described in SECTION III. LIMITS OF INSURANCE. The insured will cooperate in the review process established by Ch. 766„ Florida Statutes. VGLFL1 (01-20) Copyright,American International Group,Inc.,2019 Page 1 of 1 GENERAL LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MOBILE EQUIPMENT SUBJECT TO MOTOR VEHICLE INSURANCE LAWS This endorsement modifies insurance provided under the folllowing: GENERAL LIABILITY COVERAGE PART LIABILITY COVERAGE PART PUBLIC ENTITY LIABILITY COVERAGE PART The DEFINITIONS Section is amended as follows: 1. The definition of"auto" is replaced by the following: "Auto" means: a. Any land motor vehicle„, trailer or semitrailer designed for travel on public roads; or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However, "auto" does not include"mobile equipment"', 2. The following is added to the definition of"mobile equipment": However, "mobile equipment" does not include land vehicles that are subject to a compulsory or financial responsibility law or other motor vehiclle insurance law where it is Incensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered "'autos". GGL330(01-20) Copyright,American International Group,Inc.,2019 Page 1 of 1 GENERAL LIABILITY All rights reserved Includes copyrighted material of the Insurance Services Office,!Inc„with its permission. .P W W 4 00 M d' Named Insured: Policy Number: VFNU—TR-0019768-03/000 KEY LARGO VOLUNTEER FTR� , Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 m q r a n n ry r a,r ti 3 a nr m zm +n mz t : r s w t W rr,��,cnw�a"a ��"x t ar� r m svz ce r� n�� ¢ cetV�r tt r ;y�r �av�.9[aa z�r ry`�ty d rP L✓r sz to{[71f7.'1� ENT i itl � �': �� � �u� e'�I.�z��'�':''ia 'R�' �O[�S t Duce wY lyAl�G 3 r r a lu 'rru c fi r 'p r zs rEv t :r v pl1 p. a§s « rr .V 7 > > t r ayaa r 1 or rev rm art n udm s. r s n¢M „.,..� ,,��, .. �„ro a„� .r ..,.�w;;m.C�✓n,1.�,p ��a.�,.� .....,��.4.,«".. .�, .w r Awa.a ..a t& ,. �..rnu,.9 ,.t.« ..w ru* awu�ww,�,u�,a ..1e «uod..w.aa.Y..�av,.aQmuao-��v..r,errv.rur THIS IS CLAIMS MADE COVERAGE. PLEASE READ THE POLICY CAREFULLY. Limits of Insurance Aggregate Limit $2, 0 0 0, 0 0 0 Coverage A and B Combined Coverage A $ 1, 0 0 0, 0 0 0 Each Wrongful Act or Offense Coverage B $ 50, 000 Each Action for Injunctive Relief Deductible(Coverage A only) $ 0 Each Wrongful Act or Offense Estimated Coverage Part Premium: $ 4, 0 8 5 . 0 Taxes, Fees and Surcharges: $ 73 . 15 4 Total Premium: $ 4, 158 . 54 .1„pJ 30�a,r;lr:,.A r trSg-,.Ilf 4/Vw e:u 3 Mm tmLa rv,z ukuG ce.:26r Ct'4V V...N:A d t'r;a Nd4ub eL. ,N �✓t~ UL A'P!W v!',„„.b '1��'n.9!aK/�eE'wk /P✓V»wY rv+YG Ylrµ r'lyt v,a+++a UI 2AX ra /y1MY rawly Im4Y dWe tl-�hP Wwm f II v2, 2 4r r t i "',..� ,�'^'+ye d VY V IV'� i ¢ N ✓ .YG /N 4u.!J+1 zl m [v :rNlY4Z 1 u r u,a ✓b G,P"I.Y k r &G54.-1� wr¢ E YI. 44 t 0 Y7d // f tl ,'�¢n!5 Ikr rtr a IIlir r• a 8��M1 dr 'turd v H 1 aid d Y d rm r 1 �7r!" mail m w r r�:gin yy� w. � y.. �y�yy7�c�r� r[v wa rqr rn✓u d rut vc.nr�$yz nn � fI r° d vM. n d,wr,t t r wt m o u u m:F v G r¢ a s rr u,n !"[W117' `� IE�[ltli rp r r ma' nut ar m..r e v o ft •,.1� Y1 !.:!%�� V LEE, 2b1� kJkG Xr G�, d6mfdld",,P J7i WS r L,wa if ,�.xd IY/ oil o &F ( w +✓ �A//( ✓' rvVF Y,r,fnd; ¢lil rQe,,,�", v r�,v„gym,° i r lr ,.�.,,�i z r�,�f ,"�u,�,ui gJ�4T'?"Y, >�t,itl, �� :W.IY n� pun it r¢d"rir)Y,"l:'n��", <, ua krV.91,9 , f " D�a r ,ce7aa a�uix 0w al.hJ,.s See Schedule of Forms and Endorsements VML100(01120) 10-03-2023 EMERGENCY SERVICE ORGANIZATION MANAGEMENT LIABILITY COVERAGE FORM CLAIMS MADE Various provisions in this policy restrict coverage. Read the entire policy carefullly to determine rights, duties and what is and is not covered. We have no duty to provide coverage unless there has been full complliance with all the SECTION V.CONDITIONS contained in this coverage part. Throughout this coverage part the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this coverage part. The words "we," "us" and "our' refer to the company providing this insurance. The word "insured" means any person or organization qualifying as such under SECTION III.WHO IS AN INSURED. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION VII. DEFINITIONS. SECTION I. COVERAGES Coverage A. Insuring Agreement - Liability for Monetary Damages 1. We will pay those sums that the insured becomes legally obligated to pay as monetary damages arising out of an "employment practices'offense,,, an offense in the"administration" of your"employee benefit pllans% or other"wrongful act"to which this insurance applies. We will have the night and duty to defend any"suit" seeking those damages. We may, at our discretion, investigate any such offense or'Wrongful act"and settle any""claim"or"suit""that may result. However: a. The amount we will pay for damages is limited as described in SECTION IV. LIMITS OF INSURANCE; and b. Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A and B. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for below under Supplementary Payments. However„we may, prior to any "claim"or"suit" and at our sole discretion and expense, help you with an Equal Employment Opportunity Commission investigation, or an equivalent state or local agency investigation, If we choose to help you with an investigation, our help will be strictly voluntary, and we may discontinue it at any time- You agree that our help does not admit, confirm, waive, estop, or in any way represent a determination of coverage of any alleged employment related violation. 2. This insurance applies to offenses or"wrongful acts"only if: a. The offense or "wrongful act" takes place in the "coverage territory" and before the end of the policy period; and b. A "claim" pis first made against any insured in accordance with paragraph 3 below, during the policy period or any Extended Reporting Period we provide according to SECTION VI, 3. A"claim"will be deemed to have been made at the earliest of the following times: VML101 A01-20) Copyright,American international Group, Inc.,2019, Page 1 of 13 MANAGEMENT LIABILITY All rights reserved. Includes copyrighted material of the insurance Services Office,Inc,with its permission. P W W W 0 0 Iq Iq a. When notice of such "claim" is received and recorded by any insured or by us, whichever comes fi rst; b. When we make settlement in accordance with paragraph I. above; or c. When you become aware of an offense or "wrongful act" which may subsequently give rise to a "claim" being made against any insured, and you give written notice to us, as described in SECTION V.CONDITIONS, of such circumstances as soon as practicable but no later than: (1) The end of the policy period; or (2) The end of any applicable Extended Reporting Period. All "claims" based on or arising out of the same or related offenses or"wrongful acts" by one or more insureds shall be considered first made when the first of such "claims" is made. Related offenses or "wrongful acts" shall include offenses or"wrongful acts"which are the same, related or continuous, or which arise from a common nucleus of facts. Coverage A. Supplementary Payments We will pay, with respect to any "claim" we investigate or settle, or any "suit" against an insured we defend: 1. All expenses we incur. 2. The cost of bonds to release attachments, but only for bond amounts within the applicable Limit of Insurance. We do not have to furnish these bonds. 3. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the "claim"or"suit", including actual loss of earnings up to$300 a day because of time off from work. 4. All costs taxed against the insured in the"suit". 5. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. 6. All interest earned on that part of any judgment within our limit of insurance after entry of the judgment and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable Limit of Insurance. These payments will not reduce the limits of insurance. Coverage B. Insuring Agreement - Defense Expense for Injunctive Relief 1. We will pay those reasonable sums the insured incurs as "defense expense" to defend against an action for "injunctive relief' because of an "employment practices" offense, an offense in the "administration" of your "employee benefit plans", or other "wrongful act" to which this insurance applies. However: a. The amount we will pay for"defense expense"is limited as described in SECTION IV. LIMITS OF INSURANCE; and b. We have no obligation to arrange or provide the defense for any action for"injunctive relief'. No other obligation or liability to pay sums or perform acts or services is covered. VML101 (01-20) Copyright,American International Group,Inc.,2019, Page 2 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission.. 2. This!insurance applies only if: a. The action seeking "injunctive relief' is brought in a legally authorized court or agency of the United States, any of its states or commonweailths, or any governmental subdivision of any of them; b, Such action is filed during the pollicy period,; and c The insured (1) First notifies us as soon as practicable after retaining counsel to respond to such action but in no case later than 60 days after the end of the policy period;and (2) Is reasonably expedient in requesting us to pay the"defense expense' 3. All actions based on or arising out of the same or related offenses or "wrongful acts' shall be considered one actilon for"injunctive relief' regardless of the number of. a. Insureds; b.. Plaintiffs; c, Demands asserted;; or d Injunctions, temporary restraining orders or prohibitive writs. Related offenses or "'wrongful acts" shallll include offenses or "'wrongful acts" which are the same, related or continuous„ or which arise from a common nucleus of facts. SECTION II. EXCLUSIONS This insurance does not apply under either Coverage A or Coverage B to; a, Other Applicable Coverage Any offense or"°'wrongfull act"which is insured by any other policy or policies except. (1) A policy purchased to apply in excess of this coverage part; or (2) That portion of monetary damages otherwise covered by this coverage part which exceeds the limits of liability of such other policy or policies, subject to the Other Insurance condition in SECTION V.CONDITIONS. b Known Prior Acts Any offense or"wrongful act"which takes place prior to the inception date of this coverage part if the insured knew or reasonably should have foreseen that such offense or "wrongful act" would give rise to a "claim'. c. Prior Litigation Damages, loss or expense based upon, attributed to, arising out of, in consequence of, or in any way related to litigation or administrative or regulatory proceedings otherwise covered by this coverage part if such litigation or administrative or regulatory proceedings were initiated prior to or were pending on the inception date of this coverage part. d, Bodily Injury, Property Damage, Personal and Advertising Injury "Bodily injury", "property damage", or"personal and advertising injury" except when resulting from a covered`employment practices" offense. e. Workers' Compensation and Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law, or any similar law. f. Professional Health Care VML1 01 (01-20) Copyright„American Ilnternational Group,Inc.,2019.. Page 3 of 13 MANAGEMENT LIABILITY Ali rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. P P O N O d' d' Providing or failing to provide"professional health care services". g. Fines Fines, penalties and taxes„ including those imposed by the Internal Revenue Service code or any similar state or Iocat code. h. Bonds Any obligation related to a fidelity bond or a surety bond. i. Contracts Any amount actually or allegedly due under the terms of any contract for the purchase of goods or services or any payment or performance contract, other than an employment contract. j. Employment Contracts Any amount actually or allegedly due under the terms of any contract of employment for a definite term, or as severance pay under any contract of employment. k. Wage and Hour taws Back wages, overtime or similar damages if specified by the Fair Labor Standards Act of 1938, as amended, or any other wage or hour law. I. Failure to Maintain Insurance The failure to effect or maintain: (1) Insurance of any kind, including adequate limits of insurance; or (2) Suretyship or bonds. This exclusion does not apply to the extent coverage is provided for the "administration" of "employee benefit plans". m. Performance of Employee Benefit Plans Any "employment practices" offense or any offense in the "administration" of "employee benefit plans"arising out of: (1) Failure of any investment program, individual securities or savings program to perform as held forth by or represented by an insured; (2) Advice given by an insured in connection with participation or non-participation in stock subscription plans, savings programs or any other"employee benefit plan"; (3) Errors in providing information or failing to provide information on past performance of investment vehicles; (4) Failure of the insured or any insurer, fiduciary, trustee or fiscal agent to perform any of their duties or obligations or to fulfill any of their guarantees with respect to the payment of benefits under"employee benefit plans"or the providing, handling or investment of funds; (5) The liability of others which is assumed by the insured under a contract or agreement, except to the extent the insured would have been liable in the absence of the contract or agreement; (6) Any claim for the return of compensation paid by the insured if a court determines that the payment was illegal; or (7) Any claim for benefits that are lawfully paid or payable to a beneficiary from the funds of an "employee benefit plan". n. Claims Against Other Insureds Any actions for"injunctive relief or"claims": (1) By a Named Insured against any other insured,„ or (2) By one Named Insured against another Named Insured. VML101 (01-20) Copyright,,American Intemational Group,Inc_,2019. Page 4 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the insurance Services Office„Inc.,with As permission. o. Criminal Acts Damages, loss or expense arising out of or contributed to by any fraudulent„ dishonest, criminal or malicious act of the insured (except for "sexual abuse"), or the willful violation of any statute, ordinance or regulation committed by or with the knowledge of the insured. However; we will defend the insured for covered civil action subject to the other terms of this coverage part until either a judgment or final adjudication establishes such an act, or the insured confirms such act. p. Sexual Abuse (1) "Sexual abuse" of any person; or (2) The negligent: (a) Employment,; (b) lnvestigation;; (c) Supervision; (d) Reporting to the proper authorities, or failing to so report; or (e) Retention; of a person for whom any insured is or ever was legally responsible and whose conduct would be excluded by paragraph (1) above, q. Profit, Advantage or Remuneration Any loss, cost or expense based upon or attributable to the insured gaining any profit; advantage or remuneration to which the insured is not legally entitled„ r.. ERISA, COBRA and WARN Act Liability Damages, loss or expense arising out of or contributed to by any insured's oblligations under: (1) the Employee Retirement (income Security Act of 1974 (ERISA); (2) the Comprehensive Omnibus Budget Reconciliation Act(COBRA);. (3) the Worker Adjustment and Retraining Notification Act (WARN)„ or (4) any similar federal, state, or local laws or regulations; including subsequent amendments or any regulations promulgated thereunder, s. Compliance with ADA Requirements Costs or expenses incurred as a result of physical modifications made to accommodate persons with disabilities as required by: (1) the Americans with Disabilities Act of 1990; or (2) any federal, state, or local disability discrimination or accommodation laws or regulations; including subsequent amendments or any regulations promulgated thereunder. t. Strikes Damages, loss or expense arising out of or contributed to by any lockout, strike, picket (line, replacement or other similar actions resulting from (labor disputes or labor negotiations. u. Tax Assessments Damages, loss or expense arising out of or contributed to by any tax assessments or adjustments, or the collection, refund, disbursement or application of any taxes. This exclusion does not apply to the use or prioritization of your operating funds. v. Debt Financing Damages, loss or expense arising out of or contributed to by any debt financing, including but not limited to bonds, notes, debentures and guarantees of debt. VML101 (01-20) Copyright,American International Group,Inc„20119. Page 5 of 13 MANAGEMENT LIABILITY All rights reserved. Includes copyrighted material of the Insurance Services Office,Inc,,with uts permission. P P O W dq 0 Iq Iq w. Pollution Any injury, damage, expense, cost, loss, liability or legal obligation arising out of or in any way related to pollution, however caused. Pollution includes the actual, alleged, or potential presence in or introduction into the environment of any substance if such substance has, or is alleged to have, the effect of making the environment impure, harmful or dangerous. Environment includes any air, land, structure (or the air therein), watercourse or other body of water, including underground water. This exclusion does not apply if: (1) There is no allegation that you are liable for, the cause of, or responsible in whole or in part for any pollution; and (2) You are alleged to be liable solely as a result of ordering an evacuation, a business or building closure, or other similar action to protect persons or property, provided you are authorized by law to take such actions. x. Asbestos, Lead, Electromagnetic Radiation, Nuclear (1) Any injury, damage, expense, cost, loss, liability or legal obligation arising out of or in any way related to asbestos or asbestos-containing materials. (2) Any injury, damage, expense, cost, loss, liability or legal obligation arising out of or in any way related to: (a) The toxic properties of lead, or any material or substance containing lead;or (b) Electromagnetic radiation; or exposure thereto, or for the costs of abatement, mitigation, removal, elimination or disposal of any of them. (3) Any loss, cost or expense arising out of any actual, alleged or threatened injury or damage to any person or property from any radioactive matter or nuclear material. y. Fungi or Bacteria (1) Any liability, loss, injury or damage which would not have occurred or taken place, in whole or in part, but for the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence of, or presence of, any "fungi" or bacteria on or within a building or structure, including its contents, regardless of whether any other cause, event, material or product contributed concurrently or in any sequence to such injury or damage. (2) Any loss, cost or expenses arising out of the abating, testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, remediating or disposing of, or in any way responding to, or assessing the effects of, "fungi" or bacteria, by any insured or by any other person or entity. z. Attorney Fees and Court Costs Any award of costs or fees which arises out of an action for"injunctive relief'. SECTION III. WHO IS AN INSURED 1. If you are: a. An organization other than a partnership, joint venture or limited liability company, you are an insured. b. A partnership or joint venture, you are an insured. Your members and your partners are also insureds, but only within the course and scope of your operations. c. A limited liability company, you are an insured. Your members are also insureds, but only within the course and scope of your operations. Your managers are insureds, but only within the course and scope of your operations. VML101 (01-20) Copyright,American International Group,Inc.,2019, Page 6 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc,,with its permission, 2. In addition to you, each of the following is an unsure& a. Volunteers and Employees. Volunteers and employees, including any elected or appointed officers, directors, commissioners or trustees, but only for acts within the course and scope of their employment by you, membership with you or authorized duties on your behalf. b. Medical Directors. Physicians who are your medical directors, but only for acts within the course and scope of their medical director duties on your behMf, c. Mutual Aid Agreements. Any persons or organizations providing service to you under any mutual aid or similar agreement. d. Blanket Additional Insureds. Any person or organization (liable for your"employment practices" offenses, offenses arising out of the "administration" of your "employee benefit plans", or other "wrongful acts':' committed or alleged to have been committed by you is an insured under this coverage part, but only to the extent of that(liability. 3. Outside Directorship Extension. Your volunteers, employees, officers, directors, commissioners, or trustees„while acting independently and not on behalf of your organization, are insureds whiille they serve on the board of directors of an outside organization as specified herein- a. The outside organization was establiished and is currently chartered as not-for-profit; and b. The organization is a separate and distinct entity not subject to your direction and control; and c. The organization exists for the purpose of supporting and furthering the efforts and welfare of the organizations or individuals who provide fire service, emergency medical response or rescue services„ This coverage shall be excess of and not contribute with: (1) Any insurance available, whether primary or excess; and (2) Any corporate indemnification agreements afforded by the outside organization. In no event will this insurance inure to the benefit of the outside organization or to any of its officers, directors„ commissioners, trustees, volunteers or employees„ except to the extent that coverage is provided to an insured as set forth above. 4„ Any organization you newly acquire or form, other than a partnership or joint venture; and over which you maintain ownership or majority interest,will qualify as a Named Insured if there is no other similar insurance available to the organization. However: a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period„whichever is earlier; and b. Coverage does not apply to any"employment practices"offense, offense in the"administration"of your "employee benefit plans", or other "wrongful act' that occurred before you acquired or formed the organization or of which you had notice or knowledge. No organization is an insured with respect to the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. SECTION IV. LIMITS OF INSURANCE 1, The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a, Insureds; b. "Claims"made or"suits"brought; or c. Persons or organizations making "claims"or bringing "suits". 2. The Aggregate Limit is the most we will pay for the sum of: a. Monetary damages under Coverage A; and b. "Defense expense" under Coverage B; for each Named Insured shown in the Declarations. VML101 (01 20) Copyright„American InternationW Group Inc.,2019. Page 7 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc„with its permission, P P O tJ1 (D 0 Iq Iq 3. Subject to 2. above, the Each "Wrongful Act" or Offense limit is the most we will pay under Coverage A for the sum of all monetary damages arising out of the same or related offenses or"wrongful acts". 4. Subject to 2. above, the Each Action for "Injunctive Relief' limit is the most we will pay under Coverage B for all "defense expense" arising out of all actions or proceedings for "injunctive relief' arising out of the same or related offenses or"wrongful acts". 5. The Aggregate Limits of this coverage part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. 6. Our obligations under this coverage part end when the applicable Limit of Insurance available is exhausted. If we pay amounts for monetary damages or"defense expense" in excess of that Limit of Insurance, you agree to reimburse us for such amounts. SECTION V. CONDITIONS The following conditions apply in addition to the Common Policy Conditions. 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this coverage part. 2. Duties in the Event of an Offense, "Wrongful Act", "Claim" or"Suit" a. You must see to it that we are notified as soon as practicable of an offense or '"wrongful act" which may result in a"claim"or"suit". To the extent possible, notice should include (1) How,when and where the offense or"wrongful act"took place; and (2) The names and addresses of any persons seeking damages or of any witnesses. b. If a"claim" is made or"suit" is brought against any insured, you must.- (1) Immediately record the specifics of the"claim"or"suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the"claim"or"suit"as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the"claim" or"suit' (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation, settlement or defense of the"claim"or"suit";and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of damages to which this insurance may also apply. d. No insureds will, except at their own cost, voluntarily make a payment, assume any obligation, or incur any expense without our written consent. e. Notice shall be deemed given as soon as practicable if it is given by the person to whom you have delegated such responsibility as soon as practicable after they become aware of an offense or"wrongful act". 3. Duties in the Event of a Request to Pay "Defense Expense"for"Injunctive Relief" VML101 (01-20) Copyright,American International Group„Inc,2019, Page 8 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its penmtssion_ a. You must see to it that we are notified as soon as practicable of an action or proceeding which may give rise to a request for us to respond for"'defense expense". To the extent possible, notice should include: (1) The plaintiff in the action; (2) The court or agency involved; (3) The relief being sought; and (4) The date of the action and any underlying demand. b. You and any other involved insured must: (1) Immediately send us copies of any legal papers received in connection with the action and any underlying demand; (2) Cooperate with us in the determination of any "defense expense"' which may be covered by this insurance; and (3) Submit a request for us to pay any covered "defense expense". 4. Legal Action Against Us No person or organization has a right under this coverage part: a. To join us as a party or otherwise bring us into a "'suit" asking for damages or"defense expense" from an insured; or b. To sue us on this coverage part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages or"defense expenses"that are not payable under the terms of this coverage part or that are lin excess of the applicable Limit of Insurance. Under Coverage A, an agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 5. Other Insurance If other valid and collectible insurance is available to the insured volunteer, employee, elected or appointed officer, director„ commissioner, trustee or medical director for a loss or "defense expense" we cover under this coverage part, our insurance Is priimary, with no consideration or contribution with such other insurance. However,, this does not apply to such insureds when serving on outside directorships as described in the Outside Directorship Extension of SECTION III. WHO IS AN INSURED. If other vapid and collectible insurance is available to insureds other than volunteers, employees, elected or appointed officers, directors, commissioners, trustees or medical directors for a loss or "defense expense' we cover under this coverage part, this insurance is excess over any of the other insurance and its deductible or self-insured retention provisions, whether primary, excess, contingent or on any other basis. 6. Representations By accepting this policy, you agree:. a. The information in the Declarations is accurate and complete, b. That information is based upon representations you made to us in the application for this insurance. This application forms the basis of our obligations under this coverage part.. c, This coverage part is void if any material fact or circumstance relating to this insurance is intentionally omitted or misrepresented in the application for this insurance, 7. Separation of Insureds VML101 (01-20) Copyright.American International Group,,Inc.,2019. Page 9 of 13 MANAGEMENT LIABILITY AIII rights reserved Includes copyrighted material of the Insurance Services Office,Inc„with its permission P P O 4 tb 0 Iq Iq Except with respect to the Limit of Insurance as described in SECTION IV, and any rights or duties specifically assigned to the first Named Insured,this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom"claim" is made or"suit"is brought. 8. Transfer of Rights of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this coverage part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring"suit"or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this coverage part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of such non-renewal not less than 30 days before the expiration date. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. If notice is mailed, proof of mailing will be sufficient proof of notice. 10. Your Right to Claim Information Upon request, we will provide the first Named Insured shown in the Declarations the following information relating to this and any preceding coverage part we have issued to you during the previous three years: a. A list or other record of each "wrongful act" or other offense not previously reported to any other insurer, of which we were notified in accordance with paragraph 2.a. or paragraph 3.a. of this section. We will include the date and a brief description of such "wrongful act" or offense if that information was in the notice we received. b. A summary, by policy year, of payments made and amounts reserved. Amounts reserved are based on our judgment. They are subject to change and should not be regarded as ultimate settlement values. You must not disclose this information to any claimant or any claimant's representative without our consent. We compile claim and related information for our own business purposes and exercise reasonable care in doing so. In providing this information to the first Named Insured, we make no representations or warranties to insureds, insurers, or others to whom this information is furnished by or on behalf of any insured. Cancellation or non-renewal will be effective even if we inadvertently provide inaccurate information. SECTION VI. EXTENDED REPORTING PERIODS (COVERAGE A ONLY) With respect to Coverage A only: 1. We will provide one or more Extended Reporting Periods, as described in items 3. and 4. below, if: a. This coverage part is cancelled or not renewed; or b. We renew or replace this coverage part with insurance that does not apply to offenses or "wrongful acts"on a claims made basis. 2. Extended Reporting Periods do not extend the policy period or change the scope of coverage provided. They apply only to"claims" arising out of offenses or"wrongful acts"that take place before the end of the policy period. Once in effect, Extended Reporting Periods may not be cancelled. VML101 (01-20) Copyright,American International Group,Inc.,2019, Page 10 of 13 MANAGEMENT LIABILITY All rights reserved. Includes copyrighted material of the Insurance Services Office,Inc.,with its permission, 3. A Basic Extended Reporting Period is automatically provided without additional) charge. This period starts with the end of the policy period and lasts for sixty days. The Basic Extended Reporting Period does not apply to "claims'" that are covered under any subsequent insurance you purchase, or that would be covered but for exhaustion of the amount of insurance applicable to such"claims", 4. A Supplemental Extended Reporting Period of unlimited duration is available, but only by an endorsement and for an extra charge. This supplemental period starts when the Basic Extended Reporting Period ends. You must give us a written request for the endorsement within 60 days after the end of the policy period. The Supplemental Extended Reporting Period will not go into effect unless you pay the additional premium promptly when due„ We will determine the additional premium in accordance with our rules and rates, In doing so, we will take into account the following:: a. The exposures insured; b. Previous types and amounts of insurance; c Limit of Insurance available under this coverage part; and d. Other related factors. The additional premium will not exceed 200% of the annual premium for this coverage part. This endorsement shall set forth the terms, not inconsistent with this section, applicable to the Supplemental Extended Reporting Period, including a provision to the effect that the insurance afforded for ""claims" received durng such period is excess over any other valid and collectible insurance available under policies in force after the Supplemental Extended Reporting Period starts. 5. The Basic Extended Reporting Period does not reinstate or increase the Limit of Insurance. 6. If the Supplemental Extended Reporting Period is in effect, we will provide the separate Aggregate Limit of Insurance described below, but only for "claims" first received and recorded during the Supplemental Extended Reporting Period. The separate Aggregate Limit of Insurance will be equal to the dollar amount shown in the Declarations in effect at the end of the policy period for the Aggregate limit. The applicable Each "Wrongful Act"or Offense limit will continue to apply. SECTION VII. DEFINITIONS 1. "Administration"' means any of the following acts that you do or authorize a person to do: a.. Counseling volunteers or employees, other than giving legal advice, on"employee benefit plans"; b. Interpreting your"employee benefit plans"; c. Handling records for your"employee benefit plans"; and d. Effecting enrollment, termination or cancellation of volunteers or employees under your "employee benefit plans". 2. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. VML101 (01-20) Copyright,American International Group,Inc.,2019, Page 11 of 13 MANAGEMENT LIABILITY All rights reserved Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. P P O O 0 Iq Iq 3. "Claim" means a written or oral notice, including "suit", from any party that it is their intention to hold the insured responsible for damages arising out of an offense or"wrongful act" by the insured. 4. "Coverage territory" means the United States of America (including its territories and possessions), Puerto Rico and Canada. 5. "Defense expense" means under Coverage B, fees or expenses incurred by the insured for: a. Legal fees charged by the insured's attorney; b. Court costs; c. Expert witnesses; and d. The cost of court bonds, but we do not have to furnish these bonds. "Defense expense"does not include: (1) Any salaries, charges or fees for any insured, insured's volunteers or employees, or former volunteers or employees; or (2) Any expenses other than a., b., c. and d. above. 6. "Employee benefit plans" mean group life insurance, group accident or health insurance, profit sharing plans, pension plans, employee stock subscription plans, employee travel, vacation, or savings plans, workers compensation, unemployment insurance, social security and disability benefits insurance, and any other similar benefit program applying to volunteers or employees. 7. "Employment practices" means an actual or alleged improper employment related practice, policy, act or omission involving an actual, prospective, or former volunteer or employee, including: a. Failing to hire or refusing to hire; b. Wrongful dismissal, discharge, or termination of employment or membership, whether actual or constructive; c. Wrongful deprivation of a career opportunity, or failure to promote; d. Wrongful discipline of volunteers or employees; e. Negligent evaluation of volunteers or employees; f. Retaliation against volunteers or employees for the exercise of any legally protected right or for engaging in any legally protected activity; g. Failure to adopt adequate workplace or employment-related policies and procedures;; h. Harassment, including"sexual harassment"; or i. Violation of any federal, state or local laws (whether common law or statutory) concerning employment or discrimination in employment. 8. "Fungi" means any type or form of fungus, including mold or mildew and any mycotoxins„ spores, scents or by-products produced or released by"fungi". 9. "Injunctive relief' means equitable relief sought through the demand for the issuance of a permanent, preliminary or temporary injunction, restraining order, or similar prohibitive writ against, or order for specific performance by, an insured provided such action is filed during the policy period. 10. "Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, or any other interference with real property rights; d. Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral or written publication in any manner of material that violates a person's right of privacy; VML101 (01-20) Copyright,American International Group.Inc.,2019 Page 12 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission„ f. The use of another's advertising idea in your advertisement; or g. Infringing upon another's copyright, trade dress or slogan in your advertisement. 11. "Professional health care services"means: a. Providing medical or nursing services; b. Providing professionall services of any other health care professional, including emergency medicail technicians and paramedics; c. Furnishing or dispensing drugs or medical, surgical or dental supplies or appliances; d. Handling of patients; (1) From the place where they are accepted for movement into or onto the means of transport, (2) During transport, and (3) From the means of transport to the place where they are finally delivered; e. Dispatching of,, including the failure or refusal to dispatch, personnel to provide any of the above services, f. Serving on, or carrying out the orders of, a health care accreditation board or similar professional board or committee; and g. Establishing medical protocol, creating medical training curricula, providing medical training, conducting medical)quality assurance programs, and carrying out similar duties. 12. "Property damage" means a. Physical injury to tangible property, including all resulting loss of use of that property; and b. Loss of use of tangible property that is not physically injured but results from a. above. 13. "Sexual abuse" means any actual, attempted or alleged sexual conduct by a person, or by persons acting in concert, which causes injury. "Sexual abuse" includes sexual molestation, sexual assault, sexual exploitation or sexual injury, but does not include"sexual harassment". 14. "Sexual harassment" means any actual„ attempted or alleged unwelcome sexual advances, requests for sexual favors, or other conduct of a sexual nature by a person" or by persons acting in concert, which causes injury. "Sexuat harassment"iinclludes; a. 'I he above conduct when submission to or rejection of such conduct is made either explicitly or implicitly a condition of a person"s employment, or a basis for employment decisions affecting a person; or b. The above conduct when such conduct has the purpose or effect of unreasonably interfering with a person's work performance or creating an intimidating, hostile or offensive work environment. 15. "Suit" means a civil proceeding in which damages arising out of an offense or"wrongful act"to which this insurance applies are alleged. "Suit" includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. But "suit" does not mean any ethical conduct review or enforcement action, or disciplinary review or enforcement action. 16, "Wrongful act" means any actual or alleged error, act, omission, misstatement, misleading statement, neglect or breaches of duty committed by you or on behalf of you in the performance of your operations, including misfeasance, mallfeasance, or nonfeasance in the discharge of duties, individually or collectively that results directly but unexpectedly and unintentionally in damages to others. VML101 (01-20) Copyright,American International Group,Inc.,2019. Page 13 of 13 MANAGEMENT LIABILITY All rights reserved. Includes copyrighted material of the Insurance Serv�ces Office,Inc,with its permission. P P N T- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLYIq CYBER LIABILITY AND PRIVACY CRISIS MANAGEMENT EXPENSE COVERAGE C AND COVERAGE D ARE FOR EVENTS DISCOVERED DURING THE POLICY PERIOD PLEASE READ THE ENTIRE FORM CAREFULLY This endorsement modifies insurance provided under the following, MANAGEMENT LIABILITY COVERAGE PART Schedule Coverage C Cyber Liability Cyber Liability Each Event Limit: $1,000;,000 each"electronic information security event" Cyber Liabiillity Retroactive Date', NONE Coverage D Privacy Crisis Management Expense Privacy Crisis Management $50,000 each"privacy event Expense Each Event Limit: Privacy Crisis Management NONE Expense Retroactive Date Deductible for Coverage D Privacy $0 each "privacy event" Crisis Management Expense Coverage E Cyber Extortion Expense Cyber Extortion Expense $20,000 each "cyber extortion threat" Each Event Limit: Deductible for Coverage E Cyber $0 each "cyber extortion threat" Extortion Expense: Coverage D and Coverage E Aggregate Limit of Insurance Privacy Crisis Management $50,000 aggregate Expense and Cyber Extortion Expense Aggregate Limit: VML306(01-20) Copyright.American International Group,Inc.,2019, Page 1 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission, A. COVERAGES The following coverages are added to Section I. Coverages. All other terms and conditions remain as is unless otherwise stated in this endorsement: 1. COVERAGE C CYBER LIABILITY-Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as monetary damages because of an "electronic information security event" to which this insurance applies We will have the right and duty to defend the insured against any"suit" seeking those damages.. However, we will have no duty to defend the insured against any "suit" seeking damages for an"epectronic information security event"to which this insurance does not apply. We may, at our discretion, investigate any "electronic information security event" and settle any'*claim"or"suit"that may result. But: (1) The amount we pay for damages is limited as described in Section C. Limits of Insurance; and (2) Our right and duty to defend end when we have used up the applicable liirrI4 of insurance in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Coverage A Supplementary Payments. b. This insurance applies.to an"electronic information security event"only if: (1) The "electronic information security event"takes place in the "coverage territory" and any responsibility to pay damages is determined in a"suit"on the merits brought in the United States of America (inclluding its territories and possessions), Puerto Rico or Canada or in a settlement we agree to; (2) The "electronic information security event" does not result from an act, error or omission that occurred before the Cyber Liability Retroactive Date or after the end of the policy period' (3) The electronic information security event" is first discovered in accordance with Paragraph c. below during the policy period or any Extended Reporting Period we provide according to Section E. Extended Reporting Period; and (4) Written notice of the "electronic information security event" is received by us within 60 days of its first discovery or before the end of any Extended Reporting Period, whichever is earlier. c. First Discovery And Related Events And Acts (1) First Discovery An "electronic information security event'will be deemed to have been discovered at the earliest of the following times: t (a) When such "electronic information security event" is discovered and recorded by any insured or by us,whichever comes first; or (b) When you become aware of an act, error or omission that may subsequently result in an "electronic information security event", and you give written notice to us, as described in Section V. Conditions, of such circumstances as soon as practicable but no later than: (1) 60 days after becoming aware; or (ii) The end of any applicable Extended Reporting Period; whichever is earlier. (2) Related Events All related "electronic information security events" will be considered one event and will be considered first discovered when the first of such related events is discovered. Related "electronic information security events" include all"electronic information security events" that are the same„ related or continuous, or that arise from a common nucleus of facts, circumstances, events or acts. VML306(01-20) Copyright„American International Group.Inc,,2019. Page 2 of 13 MANAGEMENT LIABILITY All rights reserved-Inclludes copyrighted material of the Insurance Services Office,Inc.,,,with its permission. P P W d d d (3) Related Acts All acts, errors or omissions that result in the same or related "electronic information security events" will be considered one act, error or omission and will be considered to have occurred when the first of such related acts, errors or omissions occurred. 2. COVERAGE D PRIVACY CRISIS MANAGEMENT EXPENSE -Insuring Agreement a. We will pay applicable "privacy crisis management expenses" incurred on behalf of the insured because of a "privacy event" to which this insurance applies. But the amount we will pay is limited as described in Section C. Limits of Insurance. No other obligation or liability to pay sums or perform acts or services is covered. b. This insurance applies to a"privacy event"only if: (1) The "privacy event" takes place in the "coverage territory" and any responsibility to pay damages is determined in a "suit" on the merits brought in the United States of America (including its territories and possessions), Puerto Rico or Canada or in a settlement we agree to; (2) The "privacy event" does not result from an act, error or omission that occurred before the Privacy Crisis Management Expense Retroactive Date or after the end of the policy period; (3) The"privacy event" is first discovered in accordance with Paragraph c. below during the policy period or any Extended Reporting Period we provide according to Section E. Extended Reporting Period; and (4) Written notice of the"privacy event" is received by us within 60 days of its first discovery or before the end of any Extended Reporting Period,whichever is earlier. c. First Discovery And Related Events And Acts (1) First Discovery A "privacy event' will be deemed to have been discovered at the earliest of the following times: (a) When such "privacy event" is discovered and recorded by any insured or by us, whichever comes first; or (b) When you become aware of an act, error or omission that may subsequently result in a "privacy event", and you give written notice to us, as described in Section V. Conditions, of such circumstances as soon as practicable but no later than: (1) 60 days after becoming aware; or (ii) The end of any applicable Extended Reporting Period; whichever is earlier. (2) Related Events All related "privacy events" will be considered one event and will be considered first discovered when the first of such related events is discovered. Related "privacy events" include all "privacy events" that are the same, related or continuous, or that arise from a common nucleus of facts, circumstances, events or acts. (3) Related Acts All acts, errors or omissions that result in the same or related "privacy events" will be considered one act, error or omission and will be considered to have occurred when the first of such related acts, errors or omissions occurred. VML306(01-20) Copyright,American International Group„Inc,201g. Page 3 of 13 MANAGEMENT LIABILITY All rights reserved Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. d. This insurance applies to"privacy crisis management expenses"only if: (1) The"privacy crisis management expenses"are because of a "privacy event'to which this insurance applies; (2) The ""'privacy crisis management expenses" are incurred within 6 months from the date the "privacy event" was first discovered in accordance with Paragraph c. above or within 12 months as respects costs included in Section F. Definitions, Paragraph 3.j.(1)(e) Services for Individuals Affected by Personal Identity Event in the definition of "privacy crisis management expenses'; and (3) Any consultants, vendors or suppliers providing the materials or services included in "privacy crisis management expenses" are approved by us. 3. COVERAGE E CYBER EXTORTION EXPENSE -Insuring Agreement a. We will reimburse you for"cyber extortion expenses" that you have paid because of a"cyber extortion threat" to which this insurance applies. But the amount we will pay is limited as described in Section C. Limits of Insurance. No other obligation to pay sums or perform acts or services is covered. b. This insurance applies to a "cyber extortion threat"only if the"cyber extortion threat"": (1) Takes place in the"coverage territory"; (2) Is first made against you during the policy period and; (3) Is reported to us as soon as practicable, but in no event more than 60 days after the date it is first made against you. c. Related Cyber Extortion Threat Events All related "cyber extortion threats" will be considered one "cyber extortion threat" event and will be considered first made when the first"cyber extortion threat' its received. Related cyber extortion threat" events include alll "cyber extortion threats' that are the same, rellated or continuous„ or that arise from a common nucleus of facts, circumstances„ events or acts. d. This insurance applies to"cyber extortion expenses"only if. (1) The "cyber extortion expenses" are because of a "'cyber extortion threat" to which this insurance applies, and (2) The "cyber extortion expenses are incurred within 6 months from the date the "cyber extortion threat"was first received by you in accordance with Paragraph b. above. 4. Exclusions a. Exclusions Applicable To Management Liability The following exclusion is added to Section Il. Exclusions: This insurance does not apply under either Coverage A or Coverage B to: Electronic Information Security Event Damages, loss or expense arising directly or iin&ectlly from an "electronic information security event". b. Management Liability Exclusions Applicable to Cyber Liability, Privacy Crisis Management Expense And Cyber Extortion Expense All exclusions under Section II. Exclusions apply to Coverage C Cyber Liability, Coverage D Privacy Crisis Management Expense and Coverage E Cyber Extortion Expense„except; (1) The Electronic Information Security Event exclusion in 4.a. above does not apply to this Cyber Liability And Privacy Crisis Management Expense endorsement,- (2) As respects Coverage D Privacy Crisis Management Expense, Exclusion 1. Other Applicable Coverage does not apply; and VML306(01-20) Copyright„American International Group,Inc-,2019, Page 4 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,..Inc.„with its permission, P P tJ1 rfl d d (3) As respects Coverage D Privacy Crisis Management Expense and Coverage E Cyber Extortion Expense, exclusion d. Bodily Injury, Property Damage or Personal and Advertising Injury (in form VML101) or exclusion b. Bodily Injury, Property Damage or Personal and Advertising Injury (in form VML102), as applicable, do not apply to: (a) Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; or (b) Oral or written publication in any manner of material that violates a person's right of privacy. c. Exclusions Applicable To Coverage C Cyber Liability The following exclusion applies to Coverage C Cyber Liability: This insurance does not apply to: 1. General Liability Damages, loss or expense that your General Liability Coverage Form applies to. This includes any damages, loss or expense that your General Liability Coverage Form would apply to except for the exhaustion of its limits, its cancellation prior to the end of its policy period or your failure to fulfill its requirements. d. Exclusions Applicable to Cyber Liability, Privacy Crisis Management Expense, And Cyber Extortion Expense The following exclusions apply to Coverage C Cyber Liability, Coverage D Privacy Crisis Management Expense and Coverage E Cyber Extortion Expense: This insurance does not apply to: 1. Failure to Follow Risk Management Procedures and Inadequacy of Software Damages, loss, or expense arising directly or indirectly from: a. Any shortcoming in security that you knew about prior to the inception of this policy and for which you failed to take corrective action within a reasonable time, not to exceed 60 days; b. Your failure to comply with all data security standards issued by credit card issuers or financial institutions with whom you transact business, if you process, store or handle credit card information; c. Your reckless disregard for the security of "personally identifiable information" and "confidential corporate information"; or d. The inability to use, or the lack of performance of, software: (1) Due to the expiration, cancellation, or withdrawal of such software; (2) That has not yet been released from its development stage; or (3) That has not passed all test runs or proven successful in applicable daily operations. 2. Unauthorized Collection of Personal Information Damages, loss or expense arising directly or indirectly from: a. The illegal, unauthorized or wrongful collection of"personally identifiable information", including collection of"personally identifiable information" using cookies or malware, if committed by or with the knowledge of the insured; or b. The failure to provide required notice that such "personally identifiable information" is being collected. VML306(01-20) Copyright,American International Group,Inc.,2019., Page 5 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc,with its permission, 3. Governmental Seizure of Computer System Damages, loss or expense arising directly or indirectly from the seizure, confiscation, expropriation, nationalization„ or destruction of a "computer system" by order of any governmental authority. 4. Known Prior Acts Any "electronic information security event" or "privacy event" that results from an act, error or omission that takes place prior to the inception date of this coverage part if the insured knew or reasonably should have foreseen that such act, error or omission would give rise to a"claim"or"privacy crisis management expenses", S. Prior Litigation Damages, loss or expense based upon, attributed to, arising out of, in consequence of, or in any way related to litigation or administrative or regulatory proceedings otherwise covered by this coverage part if such litigation or administrative or regulatory proceedings were initiated prior to or were pending on the inception date of this coverage part. B. SUPPLEMENTARY PAYMENTS For the purposes of the coverage provided by this endorsement. All references to Supplementary Payments under Section I. Coverages are replaced by Supplementary Payments -Coverages A and C.. C. LIMITS OF INSURANCE 1. For the purposes of the coverage provided by Coverage C Cyber Liability of this endorsement the f6lowing revisions are made to Section IV. Limits Of Insurance; a. Paragraph 2. is replaced by the following 2. The Aggregate Limit is the most we will pay for the sum of: a. Monetary damages under Coverage A; b. "Defense expense" under Coverage B; and c. Monetary damages under Coverage C; for each Named Insured shown in the Declarations. b. The following paragraph is added Subject to 2. above, the Cyber Liability Each Event Limit shown in the Schedule of this endorsement is the most we will pay under Coverage C for the sum of all monetary damages arising out of any one or all rebated"electronic information security event(s)". 2. For the purposes of the coverage provided by Coverage D Privacy Crisis Management Expense and Coverage E Cyber Extortion Expense of this endorsement, the following is added to Section IV. Limits Of Insurance: Privacy Crisis Management Expense and Cyber Extortion Expense Limits of Insurance 1. The Privacy Crisis Management Expense and Cyber Extortion Expense Aggregate Limit shown in the Schedule of this endorsement is the most we will pay for the sum of"privacy crisis management expenses" under Coverage D and "cyber extortion expenses" under Coverage E, regardless of the number of persons, "privacy events", "cyber extortion threats" or entities covered by this policy. 2. Subject to the Privacy Crisis Management Expense and Cyber Extortion Expense Aggregate Limit, the Privacy Crisis Management Expense Each Event Limit is the most we will pay under Coverage D for the sum of all "privacy crisis management expenses"arising out of any one or alil related "privacy event(s)". VML306(01-20) Copyright,American international Group,Inc.,2019, Page 6 of 13 MANAGEMENT LIABILITY Alp rights reserved. Includes copyrighted material of the Insurance Services office, Inc,with its permission, P P 00 V_ dq d 3. Subject to the Privacy Crisis Management Expense and Cyber Extortion Expense Aggregate Limit, the Cyber Extortion Expense Each Event Limit is the most we will pay under Coverage E for the sum of all "cyber extortion expenses" arising out of any one or all related "cyber extortion threat"event(s). 4. The Privacy Crisis Management Expense and Cyber Extortion Expense Aggregate Limit applies separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the preceding period for the purposes of determining the Limit of Insurance. D. CONDITIONS 1. For the purposes of the coverage provided by Coverage C of this endorsement: a. In Condition 2.the following is added: You must cooperate with us and our designated representatives in the provision of the services described in"privacy crisis management expense". b. The following condition is added: 11. Deductible-Coverage C No deductible applies to Coverage C. 2. For the purposes of the coverage provided by Coverage D and Coverage E of this endorsement, the following conditions are added: 12. Duties in the Event of a Privacy Event or a Cyber Extortion Threat a. You must notify us as soon as practicable of a"privacy event" or"cyber extortion threat", but in no event later than 60 days after you incur"privacy crisis management expenses" or "cyber extortion expenses" for which coverage will be requested under this endorsement. b. With respect to a "privacy event", you must notify us in writing as soon as practicable but no later than sixty days after the first discovery of the"privacy event' by you. Notice must include: (1) How, when and where the"privacy event"took place; (2) A description of the"privacy event"; (3) The number of individuals and type of personal identification involved in a "personal identity event": and (4) Upon request by us, the names and addresses of individuals affected by a "personal identity event". c. With respect to a "cyber extortion threat", you must notify us in writing as soon as practicable but no later than sixty days after the first"cyber extortion threat" is received by you. Notice must include: (1) How,when and where the"cyber extortion threat"took place; (2) A description of the"cyber extortion threat"; and (3) Names and addresses of the negotiator or investigator retained by you in connection with a"cyber extortion threat". d. You must provide us all information and assistance that we request and cooperate with us and our designated representatives in the: (1) Investigation of any"privacy event" or any acts, errors or omissions that may result in a"privacy event"; and (2) Provision of the services described in "privacy crisis management expense". VML306(01-20) Copyright,American International Group,Inc..2019. Page 7 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. 13. Deductible-Coverage D and Coverage E Our obligation to pay "privacy crisis management expenses" or"cyber extortion expenses" on your behalf applies only to the amount of such expense in excess of any deductible amount shown in the above schedule. This deductible applies to each occurrence of a "privacy event"or a"cyber extortion threat" event. 14. Your Right to Claim Information Upon request, we will provide the first Named Insured shown in the Declarations the following information relating to this and any preceding coverage part we have issued to you during the previous three years: a. A list or other record of each "electronic information security event"or"privacy event", not previously reported to any other insurer, of which we were notified in accordance with Paragraph 2.a. or Paragraph 12. of this section. We will include the date and a brief description of such "electronic information security event" or "privacy event" if that information was in the notice we received. b. A summary, by policy year, of payments made and amounts reserved. Amounts reserved are based on our judgment. They are subject to change and should not be regarded as ultimate settlement values. You must not disclose this information to any claimant or any claimant's representative without our consent. We compile claim and related information for our own business purposes and exercise reasonable care in doing so. In providing this information to the first Named Insured, we make no representations or warranties to insureds, insurers, or others to whom this Information is furnished by or on behalf of any Insured. Cancellation or non-renewal) will be effective even if we inadvertently provide inaccurate information. 3. For the purposes of the coverage provided by Coverage C, D and Coverage E of this endorsement the following is added to Condition S. Other Insurance: However, if the insured has another policy„ coverage part or endorsement issued by us or one of our affiliated companies that applies to a loss or expense we cover under this Cyber Liability And Privacy Crisis Management Expense endorsement„ the most we will pay in total) is the single largest applicable limit. This does not apply to a pollicy bought specifically to apply in excess of this policy, E. EXTENDED REPORTING PERIODS—Applicable to Coverage C--Cyber Liability and Coverage D—Privacy Crisis Management Expense i. We will provide one or more Extended Reporting Periods, as described in items 3. and 4. below, if; a. The policy or coverage part to which this endorsement is attached is cancelled or not renewed; b. This endorsement is removed; or c. We renew or replace this endorsement with insurance that does not apply to an "electronic information security event" and/or a"privacy event on a first discovered and reported basis. 2. Extended Reporting Periods do not extend the policy period or change the scope of coverage provided. They apply only to; a. "Claims"arising out of an `61ectronic information security event"; or b. "Privacy crisis management expenses" incurred as a result of a"privacy event that is caused by an act, error or omission that occurred on or after the Cyber Liability Retroactive Date or Privacy Crisis Management Expense Retroactive Date, as applicable, and before the end of the policy period. Once iin effect, Extended Reporting Periods may not be cancelled. VML306(0120) Copyright;American International Group„lint„2019. Page 8 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted materiall of the Insurance Services Office,Inc„with its permission. .P .P W 0 N d' d' 3. A Basic Extended Reporting Period is automatically provided without additional charge. This period starts with the end of the policy period and lasts for sixty days. The Basic Extended Reporting Period does not apply to "electronic information security events" and/or "privacy events" that are covered under any subsequent insurance you purchase, or that would be covered but for exhaustion of the amount of insurance applicable to such "electronic information security events"and/or"privacy events". A Basic Extended Reporting Period does not reinstate or increase the Limit of Insurance. 4. A Supplemental Extended Reporting Period of five years is available, but only by an endorsement and for an extra charge. This supplemental period starts when the Basic Extended Reporting Period ends. You must give us a written request for the endorsement within 60 days after the end of the policy period. The Supplemental Extended Reporting Period will not go into effect unless you pay the additional premium promptly when due. We will determine the additional premium in accordance with our rules and rates. In doing so, we will take into account the following: a. The exposures insured; b. Previous types and amounts of insurance; c. Limit of Insurance available under this coverage; and d. Other related factors. The additional premium will not exceed 200% of the annual premium for this coverage. This endorsement shall set forth the terms, not inconsistent with this section, applicable to the Supplemental Extended Reporting Period, including a provision to the effect that the insurance afforded for"electronic information security events" and/or"privacy events"first discovered during such period is excess over any other valid and collectible insurance available under policies in force after the Supplemental Extended Reporting Period starts. 6. If this Supplemental Extended Reporting Period is in effect, we will provide the separate Aggregate Limit of Insurance described below, but only for"electronic information security events" first discovered during the Supplemental Extended Reporting Period. The separate Aggregate Limit of Insurance will be equal to the dollar amount shown in the Declarations in effect at the end of the policy period for the Aggregate Limit. The applicable Cyber Liability Each Event Limit will continue to apply. If there is a Supplemental Extended Reporting Period in force for any other coverage under this policy that was subject to the original Aggregate Limit, this separate Aggregate Limit ins shared with that other coverage. Any payments made under a Supplemental Extended Reporting Period for those other coverages will reduce this separate Aggregate Limit. 6. If this Supplemental Extended Reporting Period is in effect, we will provide the separate Privacy Crisis Management Expense Aggregate Limit of Insurance described below, but only for"privacy events"first discovered during the Supplemental Extended Reporting Period, The separate Privacy Crisis Management Expense Aggregate Limit will be equal l to the dollar amount shown in the Schedule in effect at the end of the policy period for the Privacy Crisis Management Expense Aggregate Limit. The applicable Privacy Crisis Management Expense Each Event Limit will continue to apply. VML306(01-20) Copyright,American International Group,Inc.,2019, Page 9 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc„with its permission. F. DEFINITIONS For the purposes of the coverage provided by this endorsement, the following changes are made to Section Vill. Definitions: 1. The following definition is amended: a. Definition 16."wrongful act' ins amended to include the following: "Wrongful act"also means an"electronic information security event". 2. The following definitions are replaced: a. Definition 4. "coverage territory" is replaced by the following: 4. "Coverage territory" means worldwide, but the "electronic information security event', "privacy event" or"cyber extortion threat" must take place in the United States of America (including its territories and possessions), Puerto Rico or Canada. b. Definition 12."property damage" is replaced by the following: 12. "Property damage" means: a. Physical injury to tangible property, including all resulting Voss of use of that property; and b. Loss of use of tangible property that is not physically injured but results from a. above. For the purposes of this insurance, "electronic data" is not tangible property. 3. The following definitions are added: a. "Computer system" means the following: (1) Computers, including Personal Digital Assistants (PDAs) and other transportable or hand held devices, electronic storage devices and related peripheral)components; (2) Systems and applications software; and (3) Communications networks (including the internet, intranets, extranets, virtual private networks, or cloud computing environments)to the extent used by the items in (1) and (2) above; by which"electronic data" is collected, transmitted, processed, stored or retrieved; and (4) "Computer system" includes'electronic data"that is (a) Stored on any of the items described in item (1)above; or (b) Temporarily outside of the "computer system" for use by an insured or an employee of an entity that has such iinformation under a formal agreement with you. b. ""Confidential corporate information" means any commercial trade secret, data, design, interpretation, forecast, formula, method, practice, process record, report or other item of information of a non-insured third party, and which is: (1) In your care, custody or control; (2) Not available to the general public; and (3) (a) Provided to you under a mutually agreed upon written confidentiality/non-disclosure agreement; or (b) Marked confidential or otherwise specifically designated in writing as confidential by such third party. c. "Corporate privacy event' means; (1) Unauthorized disclosure by you of "confidential corporate informatiion" or your failure to protect'confidential corporate information"from misappropriation; (2) Failure by you to disclose or warn of an actual or potential disclosure or misappropriation of"confidential corporate information", but only if this policy applies to such disclosure or misappropriation and it resulted directly from(1)above; or VML306(01-20) Copyright,American International Group,Inc.,2019. Page 10 of 13 MANAGEMENT LIABILITY All rights reserved. Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. .P .P IV N N d' d' (3) Violation of any federal or state privacy statute addressing disclosure or misappropriation of"confidential corporate information", but only if: (a) This policy applies to such disclosure or misappropriation and it resulted directly from (1)or(2)above; and (b) The violation is not willful. d. "Cyber extortion expenses"means: (1) The reasonable and necessary expenses paid by you in response to a "cyber extortion threat" to the party that made the "cyber extortion threat" for the purposes of eliminating the"cyber extortion threat"; and (2) The expense you incur to complete the mandatory transaction in (1). e. "Cyber extortion threat" means a demand for monetary payment from you based on a credible threat, or series of related credible threats to: (1) Launch a denial of service attack against your "computer system" for the purpose of denying you or authorized third party users access to your services provided through the "computer system" via the internet. A denial of service attack which affects the internet at large and prevents access by you or authorized third party users to your services provided through the"computer system" is not a"cyber extortion threat'; (2) Gain access to your "computer system" and use that access to steal, release or publish "personally identifiable information", or"confidential corporate information"; (3) Alter, damage or destroy"electronic data"that is stored within your"computer system"; (4) Launch a computer attack against your "computer system" in order to alter, damage or destroy "electronic data" while such "electronic data" is stored within your "computer system"; or (5) Cause you to transfer, pay or deliver any funds or property using a "computer system" without your authorization. "Cyber extortion threat" does not mean or include any threat made in connection with a legitimate commercial dispute. f. "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. g. "Electronic information security event"means: (1) Transmission of malware from your"computer system"to a third party; (2) The inability of an authorized user to access your web site or your "computer system" because of a denial of service attack; (3) A "personal identity event", but this is limited to information that is obtained or released directly from (a) Your"computer system"; or (b) The "computer system" of an entity that has such information under a formal agreement with you; or (4) A "corporate privacy event", but this is limited to information that is obtained or released directly from your"computer system". As used in this definition, a denial of service attack means an intentional attack directly on your "computer system" that prevents or slows down access to your web site or your computer network. However, a denial of service attack which affects the internet at large and is not directed at your"computer system" is not an "electronic information security event". h. "Personally identifiable information" means any of the following in your care, custody or control: VML306(01-20) Copyright,American International Group,Inc.,2019. Page 11 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. (1) Information from which an individual may be uniquely and reliably identified or contacted, including an individual's name, telephone number, social security number, drivers (license number, state identification number, account relationships, account numbers, account balances„ account histories, access codes, and passwords; (2) Information concerning an individual that would be considered nonpublic personal information within the meaning of Title V of the Gramm-Leach Bliley Act of 1999 as implemented and amended; and (3) Information concerning an individual that would be considered protected health information within the Health Insurance Portability and Accountability Act of 1996 as implemented and amended. I. "Personal identity event" means: (1) Unauthorized disclosure by you of "personallly identifiable information" or your fa4ure to protect"personally identifiable information"from misappropriation. (2) Failure by you to disclose or warn of an actual or potential disclosure or misappropriation of"personally identifiable information", but only if this policy applies to such disclosure of misappropriation and it resulted &ectiy from(1)above; or (3) Violation of any federal or state privacy statute addressing disclosure or misappropriation of"personally identifiable information", but only if: (a) This policy applies to such disclosure or misappropriation and it resulted directly from (1)or(2)above; and (b) The violation is not willful. j. "Privacy crisis management expense" means: (1) Reasonable and necessary fees and expenses for: (a) Computer Forensic Analysis An approved outside vendor to conduct a computer forensic analysis with reasonable alllocation of time and resources to investigate your "computer system" to determine the cause and extent of the"privacy event"; (b) Crisis Management Review and Advice The approved crisis management or legal firm to review the "privacy event" and advise you on the appropriate response; (c) Travel Expenses Travel by directors, "executive officers", partners, or "employees" of the insured, that is done to mitigate the damage from the"privacy event"; (d) Notification to Affected Parties Printing, advertising, mailing of materials or other costs to provide notice to affected parties of the "privacy event" for the purposes of maintaining goodwill or compliance with any notification requirements imposed by law; and (e) Services for Individuals Affected by Personal Identity Event The following services provided to any individual whose personal identification is the subject of a "personal identity event", but only if the primary purpose of such services is mitigating the effect of the"personal identity event": (i) Call Center Services Reasonable fees and expenses to establish, maintain and provide call center services; (ii) Credit Monitoring Services Credit file monitoring services; or (Ili)Other Services VML306(01-20) Copyright,American International Group,Inc.,2019, Page 12 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. P P IV W dq N d' d' Reasonable fees and expenses for any other service specifically approved by us in writing. (2) However, "privacy crisis management expenses"shall not include: (a) Compensation, fees, benefits or overhead of any insured or "employee" of any insured; (b) Costs or expenses that would have been incurred in the absence of the "privacy event"; (c) Costs or expenses associated with upgrading, maintaining, improving, repairing or remediating any"computer system"as a result of a"privacy event"; or (d) Costs or expenses associated with upgrading, maintaining, improving, repairing or remediating any procedures, services or property as a result of a"privacy event". k. "Privacy event" means any one of the following events: (1) A"corporate privacy event"; or (2) A"personal identity event". VML306(01-20) Copyright,American International Group,Inc.,2019. Page 13 of 13 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDATORY ENDORSEMENT MANAGEMENT LIABILITY This endorsement modifies insurance provided under the following: MANAGEMENT LIABILITY COVERAGE PART The following revisions are made to the Management Liability Coverage Form; 1. HIPAA Fines and Penalties HIPAA Fines and Penalties Schedule Limit of Insurance $100,000 Each HIPAA Claim $100,000 Aggregate The exclusion for Fines in Section 11. Exclusions is replaced by the following: Fines Fines, penalties and taxes, including those imposed by the Internal) Revenue Service code or any similar state or local code Except for violations due to willful neglect as defined by the Health Insurance Portability and Accountability Act (HIPAA), this exclusion does not apply to the payment of fines and penalties assessed for HIPAA violations up to the limit of insurance shown in the above HIPAA Fines and Penalties Schedule for the coverage provided under Coverage A. The Each HIPAA Claim Limit of Insurance is part of and not in addition to the Each Wrongful) Act Limit shown on the Declarations. The Aggregate Limit of insurance is part of and not in addition to the Aggregate Limit shown in the Declarations. 2. FLSA Suit Defense Only Coverage FLSA Defense Costs Schedule Limit of Insurance $100,000 Each FLSA Claim $100,000 Aggregate a. The exclusion for Wage and Hour Laws in Section II. Exclusions is replaced by the following: Wage and Hour Laws Back wages, overtime or similar damages if specified by the Fair tabor Standards Act (FLSA) of 1938, as amended, or any other wage or hour laws, However., this exclusion does not apply to"defense costs' as a result of a"suit"for such back wages, overtime or similar damages, Our duty to defend ends upon payment of the Each FLSA Claim Limit of Insurance shown in the above FLSA Defense Costs Schedule for"defense costs" for such "suit". The Aggregate Limit of Insurance is the most we will pay for FLSA Suit Defense Only Coverage arising out of all "suits" in any one policy period. VML310(01.20) Copyright„American International Group,Inc.,2019. Page 1 of 2 MANAGEMENT LIA813 ITY AR rights reserved,Indudes copyrighted material of the Insurance Services Office,'Inc.,with sits permission. .P .P IV tJ1 to THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Iq Iq b. The following definitions only apply to this FLSA Suit Defense Only Coverage: "Defense costs"means fees or expenses for: (1) Legal fees; (2) Court costs; (3) Expert witnesses; and (4) The cost of court bonds, but we do not have to furnish these bonds. "Suit" means a civil proceeding in which damages arising out of an offense or"wrongful act" are alleged. "Suit' includes: (1) An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or (2) Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. But"suit" does not mean any ethical conduct review or enforcement action, or disciplinary review or enforcement action. 3. Spouses, Estates, Heirs,and Legal Representatives added as Insureds The following additions are made to Paragraph 2. Of Section Ill.Who Is An Insured: e. Spouses. The spouse of an insured but only for claims arising solely out of his or her status as such. f. Estates, Heirs and Legal Representatives. If an insured is deceased, the estates, heirs, legal representatives, and assigns, but only for claims arising solely out of their status as such. In the event of the incompetency, insolvency or bankruptcy of an insured, the legal representative of such insured, but only for claims arising solely out of their status as legal representative. VML310(01-20) Copyright.American International Group,Inc.,2019, Page 2 of 2 MANAGEMENT LIABILITY All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc„with its permission, Named Insured: Policy Number. VFNU—TR-0019768-03/000 KEY LARGO VOLUNTEER FIRE Policy Period: From 10-01-2023 DEPARTMENT, INC To 10-01-2024 W4 C 41Y tYa V k (!E t Y 1 4 t V ':q '4 �'Y � �. tl I N d 4 e Y d r d U ,d1� tt1Ai�� El + SS�t� 1T1� �GVIE GE�� ry w n mn a �a r�r v u t s s tiT r '� e t If V �� 6� 11 Y C/C:1<Y Y Y a Y Y 9¢ Id 7 U V E „il�.�►_ �yy W 41i► ir-7 ?r u l i pv v�u v 7J✓ E a,�tv.�.�rtH'•„ n �rv'ti �x i.r.v at� Sv �� :. ;v y�l a a r,�fe4 a ari v dud sYo Alin v r ilu Yu�,4„r� THIS COVERAGE PART CONTAINS CLAIMS MADE COVERAGE. PLEASE READ IT CAREFULLY. 1 1 Y�'9i d r ad� r 8 r r S Y ,Ci Y V VIM �Qu h l r II C r p T y iVY G ¢ y 1 4r 1 d k'1 C IM dflhi ,a.,r d,n^4,G�.'�� a xu� �.✓,C ns.i,',;e a,.,,�r ,.�N,,, ,x�ay.,l .� .,_C,,i, nor, ,,CAB,. ,�r,<,,, ai,:r� Pli,6,i,u�u�, 4w ,�»° -�u, ,,tr. d Each Occurrence Limit $ 11000, 000 Products-Completed Operations Aggregate Limit $ 2, 000, 000 (where applicable) Aggregate Limit $ 2, 000, 000 Retroactive Date See Schedule of Controlling (applicable to Claims Made coverages) Underlying Insurance I Estimated Coverage Part Premium: 1, 90 . 0 0 Taxes, Fees and Surcharges: 32 . 30 Total Premium: $ 1, 932 . 30 revu n ulr r i.; T t i ,:�MY i� a ✓. �`.✓r. rl/r,Y,'4,vM!1 CWrti-V ioP.4 Fre Yin. 2,. See Schedule of Forms and Endorsements. This coverage part consists of these declarations, the schedule of controlling underlying insurance, the schedule of forms and endorsements,and any forms and endorsements we may later attach to reflect changes. EXD100(0t®20) 9 0-n2023 iv 4 00 N d' d' Named Insured: Policy Number: VFNU-TR-0019768-031000 KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Policy Period: From 10-01-2023 To 10-01-2024 SCHEDULE OF CONTROLLING UNDERLYING INSURANCE Controlling Underlying Insurer Type of Coverage Limits of Insurance Automobile Liability Name: NATIONAL UNION FIRE INS.CO. OF PITTSBURGH,,PA. Bodily Injury Liability—Each Person Bodily Injury Liability—Each Accident Policy Number: VFNUTR0019768-03 Property Damage Liability—Each Accident Policy Period: or 10/01/2023 to 10/0112024 $1,000,000 Combined Single Limit General Liability Name: NATIONAL UNION FIRE INS.CO. OF PITTSBURGH, PA, $1,000,000 Each Occurrence $1,000,000 Personal&Advertising Injury Policy Number: VFNUTR0019768-03 $2,000,000 General Aggregate $2,000,000 Products—Completed Operations Aggregate Policy Period: 10/01/2023 to 10/01/2024 [ X ] Occurrence [ ] Claims Made Management Liability Name: NATIONAL UNION FIRE INS.CO. OF PITTSBURGH, PA. $1,000,000 Each Wrongful Act or Offense Policy Number: $2,000,000 Aggregate VFNUTR0019768-03 NONE Retroactive Date Policy Period: 10101l2023 to 10/01/2024 [ ] Occurrence [ X ] Claims Made EXS100(01-20) 10-03-2023 11 Named Insured: Policy Number: VFNU-TR-0019768-03l000 KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC Policy Period: From 10-01-2023 To 10-01-2024 SCHEDULE OF CONTROLLING UNDERLYING INSURANCE Controlling Underlying Insurer Type of Coverage Limits of Insurance Employer's Liability Name SEE CONTROLLING UNDERLYING INSURANCE $100,000 Bodily(Injury by Accident—Each Accident Policy Number: $500,000 Bodily Injury by Disease—Policy Limit $100,000 Bodily Injury by Disease—Each Employee Policy Period: to EXS100(01-20) 10-03-2023 P P IV W 0 M d' d' COMMERCIAL EXCESS LIABILITY CX 2130 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 EXCESS LIABILITY COVERAGE PART A. Any endorsement addressing acts of terrorism "Certified act of terrorism" means an act that is (however defined) in any "controlling underlying certified by the Secretary of the Treasury, in insurance" does not apply to this excess accordance with the provisions of the federal insurance. The following provisions addressing Terrorism Risk Insurance Act, to be an act of acts of terrorism apply with respect to this excess terrorism pursuant to such Act. The criteria insurance: contained in the Terrorism Risk Insurance Act for If aggregate insured losses attributable to terrorist a"certified act of terrorism" include the following: acts certified under the federal Terrorism Risk 1. The act resulted in insured losses in excess of Insurance Act exceed $100 billion in a calendar $5 million in the aggregate, attributable to all year and we have met our insurer deductible types of insurance subject to the Terrorism under the Terrorism Risk Insurance Act, we shall Risk Insurance Act; and not be liable for the payment of any portion of the 2. The act is a violent act or an act that is amount of such losses that exceeds $100 billion, dangerous to human life, property or and in such case insured losses up to that amount infrastructure and is committed by an individual are subject to pro rata allocation in accordance or individuals as part of an effort to coerce the with procedures established by the Secretary of civilian population of the United States or to the Treasury. influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclusion, or the inapplicability or omission of a terrorism exclusion, do not serve to create coverage for "injury or damage" that is otherwise excluded under this Coverage Part. CX 2130 01 16 0 Insurance Services Office, Inc., 2015 Page 1 of 1 COMMERCIAL EXCESS LIABILITY CX 00 01 0413 COMMERCIAL EXCESS LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. When we have no duty to defend, we will have Read the entire policy carefully to determine rights, the right to defend, or to participate in the duties and what is and is not covered. defense of, the insured against any other suit Throughout this policy the words "you' and "your" seeking damages for "injury or damage". refer to the Named Insured shown in the Declarations, However, we will have no duty to defend the and any other person or organization qualifying as a insured against any suit seeking damages for Named Insured under this policy. The words "we", which insurance under this policy does not "us' and 'our" refer to the company providing this apply. insurance. The word "insured" means any person or At our discretion, we may investigate any organization qualifying as such under the"controlling "event' that may invOve this insurance and underlying insurance". settle any resultant claim or suit, for which we Other words and phrases that appear in quotation have the duty to defend. marks in this Coverage Part have special meaning. But: Refer to Section IV — Definitions. Other words and phrases that are not defined under this Coverage Part (1) The amount we will pay for "ultimate net but defined in the 'controlling underlying insurance" loss" is limited as described in Section II— wiil have the meaning described in the policy of Limits Of Insurance;and "controlling underlying insurance". (2) Our right and duty to defend ends when we The insurance provided under this Coverage Part will have used up the applicable limit of follow the same provisions, exclusions and limitations insurance in the payment of judgments or that are contained in the applicable "controlling settlements under this Coverage Part. underlying insurance", unless otherwise directed by However, if the policy of "controlling this insurance. To the extent such provisions differ or underlying insurance" specifies that limits conflict, the provisions of this Coverage Part will are reduced by defense expenses, our right apply. However, the coverage provided under this and duty to defend ends when we have Coverage Part will not be broader than that provided used up the applicable limit of insurance in by the applicable"controlling underlying insurance". the payment of defense expenses, There may be more than one "controlling underlying judgments or settlements under this insurance"listed In the Declarations and provisions in Coverage Part. those policies conflict, and which are not superseded b. This insurance applies to "injury or damage" by the provisions of this Coverage Part. In such a that is subject to an applicable "retained limit". case, the provisions, exclusions and limitations of the If any other limit, such as, a sublimit, is "controlling underlying insurance" applicable to the specified in the 'controlling underlying particular "event' for which a claim is made or suit is insurance", this insurance does not apply to brought will apply. "injury or damage"arising out of that exposure SECTION I—COVERAGES unless that limit is specified in the Declarations under the Schedule of "controlling underlying 1. Insuring Agreement insurance". a. We will pay on behalf of the insured the c. If the "controlling underlying insurance" "ultimate net loss" in excess of the "retained requires, for a particular claim, that the 'injury limit" because of "injury or damage" to which or damage" occur during its policy period in insurance provided under this Coverage Part order for that coverage to apply, then this applies. insurance will only apply to that 'injury or We will have the right and duty to defend the damage" if it occurs during the policy period of insured against any suit seeking damages for this Coverage Part. If the "controlling such "injury or damage' when the applicable underlying insurance" requires that the `event limits of "controlling underlying insurance" causing the particular injury or damage takes have been exhausted in accordance with the place during its policy period in order for that provisions of such 'controlling underlying coverage to apply, then this, insurance will apply to the claim only if the event causing insurance". that "injury or damage" takes place during the policy period of this Coverage Part. CX 00 01 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 5 w N M d' d' d. Any additional insured under any policy of (a) Request, demand, order or statutory or "controlling underlying insurance" will regulatory requirement that any insured automatically be an additional insured under or others test for, monitor, clean up, this insurance. If coverage provided to the remove, contain, treat, detoxify or additional insured is required by a contract or neutralize, or in any way respond to, or agreement, the most we will pay on behalf of assess the effects of, pollutants; or the additional insured is the amount of (b) Claim or suit by or on behalf of a insurance required by the contract, less any governmental authority for damages amounts payable by any "controlling because of testing for, monitoring, underlying insurance". cleaning up, removing, containing, Additional insured coverage provided by this treating, detoxifying or neutralizing, or in insurance will not be broader than coverage any way responding to, or assessing the provided by the "controlling underlying effects of, pollutants. insurance". This exclusion does not apply to the extent that 2. Exclusions valid "controlling underlying insurance" for the pollution liability risks described above exists The following exclusions, and any other or would have existed but for the exhaustion of exclusions added by endorsement, apply to this underlying limits for"injury or damage". Coverage Part. In addition, the exclusions d IMorkers'Condensation And 51 Laws applicable to any controlling underlying . insurance" apply to this insurance unless Any obligation of the Insured under a workers' superseded by the following exclusions, or compensation, disability benefits or superseded by any other exclusions added by unemployment compensation law or any similar endorsement to this Coverage Part. law. Insurance provided under this Coverage Part does SECTION II —LIMITS OF INSURANCE not apply to: 1. The Limits of Insurance shown in the Declarations, a. Medical Payments and the rules below fix the most we will pay Medical payments coverage or expenses that regardless of the number of: are provided without regard to fault, whether or a. Insureds; not provided by the applicable "controlling b. Claims made or suits brought, or number of underlying insurance". vehicles involved; b• AutiD c. Persons or organizations making claims or Any loss, cost or expense payable under or bringing suits; or resulting from any of the following auto d. Limits available under any "controlling coverages: underlying insurance". (1) First-party physical damage coverage; 2, The Limits of Insurance of this Coverage Part will (2) No-fault coverage; apply as follows: (3) Personal injury protection or auto medical a. This insurance only applies in excess of the payments coverage; or "retained limit". (4) Uninsured or underinsured motorists b. The Aggregate Limit is the most we will pay for coverage. the sum of all 'ultimate net loss', for all 'injury c. Pollution or damage covered under this Coverage Part. (1) "Injury or damage" which would not have However, this Aggregate Limit only applies to occurred, in whole or in part, but for the "Injury or damage" that is subject to an actual, alleged or threatened discharge, aggregate limit of insurance under the dispersal, seepage, migration, release or controlling underlying insurance . escape of pollutants at any time. c. Subject to Paragraph 2.b. above, the Each (2) Any loss, cost or expense arising out of Occurrence Limit is the most we will pay for the sum of all "ultimate net loss" under this any: insurance because of all "injury or damage" arising out of any one"event". Page 2 of 5 0 Insurance Services Office, Inc.,2012 CX 00 01 0413 d. If the Limits of Insurance of the "controlling 3. Duties In The Event Of An Event, Claim Or Suit underlying insurance" are reduced by defense expenses by the terms of that policy, any a. You must see to it that we are notified as soon payments for defense expenses we make will as practicable of an "event", regardless of the reduce our applicable Limits of Insurance in the amount, which may result in a claim under this same manner. insurance. To the extent possible, notice 3. If any 'controlling underlying insurance' has a should include: policy period that is different from the policy period (1) How, when and where the "event" took of this Coverage Part then, for the purposes of place; this insurance, the 'retained limit" will only be (2) The names and addresses of any injured reduced or exhausted by payments made for persons and witnesses;and "injury or damage"covered under this insurance. (3) The nature and location of any "injury or The Aggregate Limit of this Coverage Part applies damage"arising out of the"event'. separately to each consecutive annual period of this b. If a claim is made or suit is brought against any Coverage Part and to any remaining period of this insured,you must: Coverage Part of less than 12 months, starting with the beginning of the policy period shown in the (1) Immediately record the specifics of the claim Declarations, unless the policy period is extended or suit and the date received; and after issuance for an additional period of less than 12 (2) Notify us as soon as practicable. months. In that case, the additional period will be deemed part of the last preceding period for purposes You must see l it that we receive written c of determining the Limits of Insurance. notice of the claim or suit as soon as practicable. SECTION III —CONDITIONS c. You and any other insured involved must: The following conditions apply. In addition, the (1) Immediately send us copies of any conditions applicable to any "controlling underlying demands, notices, summonses or legal insurance" are also applicable to the coverage provided under this insurance unless superseded by papers received in connection with the claim or suit; the following conditions. 1 Apl�s (2) Authorize us to obtain records and other information; If the "controlling underlying insurer' or insured elects not to appeal a judgment in excess of the (3) Cooperate with us in the investigation or amount of the "retained limit", we may do so at our settlement of the claim or defense against own expense. We will also pay for taxable court the suit; and costs, pre- and postjudgment interest and (4) Assist us, upon our request, in the disbursements associated with such appeal. In no enforcement of any right against any event will this provision increase our liability person or organization which may be liable beyond the applicable Limits of Insurance to the insured because of "injury or described in Section II —Limits Of Insurance. damage' to which this insurance may also 2. Bankruptcy apply. a. Bankruptcy Of Insured d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any Bankruptcy or insolvency of the insured or of obligation, or incur any expense, other than for the insured's estate will not relieve us of our first aid, without our consent. obligations under this Coverage Part. 4. First Named Insured Duties b. Bankruptcy Of Controlling Underlying Insurer The first Named Insured is the person or Bankruptcy or insolvency of the "controlling organization first named In the Declarations and is underlying insurer" will not relieve us of our responsible for the payment of all premiums. The obligations under this Coverage Part. first Named Insured will act on behalf of all other However, insurance provided under this Coverage Named Insureds for giving and receiving of notice Part will not replace any "controlling underlying of cancellation or the receipt of any return insurance" in the event of bankruptcy or premium that may become payable. insolvency of the 'controlling underlying insurer". The insurance provided under this Coverage Part will apply as if the "controlling underlying insurance"were in full effect and recoverable. p CX 00 01 0413 ®Insurance Services Office, Inc., 2012 Page 3 of 5 .p w w d M d' d' At our request, the first Named Insured will furnish Such exhaustion or reduction is not a failure to us, as soon as practicable, with a complete copy maintain 'controlling underlying insurance". of any `controlling underlying insurance" and any Failure to maintain 'controlling underlying subsequently issued endorsements or policies insurance" will not invalidate insurance provided which may in any way affect the insurance under this Coverage Part, but insurance provided provided under this Coverage Part. under this Coverage Part will apply as if the 5. Cancellation controlling underlying insurance" were in full ,effect. a. The first Named Insured shown in the Declarations may cancel this policy by mailing The first Named Insured must notify us in writing, or delivering to us advance written notice of as soon as practicable, if any "controlling cancellation. underlying insurance" is cancelled, not renewed, replaced or otherwise terminated, or if the limits or b. We may cancel this policy by mailing or scope of coverage of any "controlling underlying delivering to the first Named Insured written insurance"is changed. notice of cancellation at least: 5' Other insurance (1) 10 days before the effective date of cancellation if we cancel for nonpayment of a. This insurance is excess over, and shall not premium; or contribute with any of the other insurance, whether primary, excess, contingent or on any (2) 30 days before the effective date of other basis. This condition will not apply to cancellation if we cancel for any other insurance specifically written as excess over reason. this Coverage Part. c. We will mail or deliver our notice to the first When this insurance is excess, if no other Named Insured's last mailing address known to insurer defends, we may undertake to do so, US. but we will be entitled to the insured's rights d. Notice of cancellation will state the effective against all those other insurers. date of cancellation. The policy period will end b. When this insurance is excess over other on that date. insurance, we will pay only our share of the e. If this policy is cancelled, we will send the first "ultimate net loss"that exceeds the sum of: Named Insured any premium refund due. If we (1) The total amount that all such other cancel, the refund will be pro rate. If the first insurance would pay for the loss in the Named Insured cancels,the refund may be less absence of the insurance provided under than pro rata. The cancellation will be effective this Coverage Part;and even if we have not made or offered a refund. (2) The total of all deductible and self-insured f. If notice is mailed, proof of mailing will be amounts under all that other insurance. sufficient proof of notice. 6. Changes a• Premium Audit a. We will compute all premiums for this Coverage This Coverage Part contains all the agreements Part in accordance with our rules and rates. between you and us concerning the insurance afforded. The first Named Insured is authorized by b• If this policy is auditable, the premium shown in all other insureds to make changes in the terms of this Coverage Part as advance premium is a this Coverage Part with our consent. This deposit premium only. At the close of each Coverage Part's terms can be amended or waived audit period, we will compute the earned only by endorsement. premium for that period and send notice to the first Named Insured. The due date for audit 7. Maintenance Of/ To Controlling premium is the date shown as the due date on Underlying Insurance the bill. If the sum of the advance and audit Any 'controlling underlying insurance" must be premiums paid for the policy period is greater maintained in full effect without reduction of than the earned premium, we will return the coverage or limits except for the reduction of excess to the first Named Insured. aggregate limits in accordance with the provisions c. The first Named Insured must keep records of of such 'controlling underlying insurance" that the information we need for premium results from 'injury or damage" to which this computation, and send us copies at such times insurance applies. as we may request. Page 4 of 6 0 Insurance Services Office, Inc., 20112 CX 00 01 0413 10.Loss Payable We will cooperate in the transfer of control of Liability under this Coverage Part does not apply defense to any insurer specifically written as to a given claim unless and until: excess over this Coverage Part of any outstanding claims or suits seeking damages to a. The insured or insured's "controlling which this insurance applies and which would underlying insurer' has become obligated to have been covered by the "controlling pay the"retained (limit";and underlying insurance" had the applicable limit b. The obligation of the insured to pay the not been exhausted. "ultimate net loss" in excess of the "retained In the event that there is no insurance written limit" has been determined by a final settlement as excess over this Coverage Part, we will or judgment or written agreement among the cooperate in the transfer of control to the insured, claimant, "controlling underlying insured and its designated representative. insurer" (or a representative of one or more of these)and us. 13.When We Do Not Renew 11.Legal Action Against Us If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured No person or organization has a right under this shown in the Declarations written notice of the Coverage Part: nonrenewal not less than 30 days before the a. To join us as a party or otherwise bring us into expiration date. a suit asking for damages from an insured; or If notice is mailed, proof of mailing will be sufficient b. To sue us on this Coverage Part unless all of proof of notice. its terms have been fully complied with. SECTION IV—DEFINITIONS A person or organization may sue us to recover The definitions applicable to any "controlling on an agreed settlement or on a final judgment underlying insurance" also apply to this insurance. In against an insured; but we will not be liable for addition,the following definitions apply. damages that are not payable under the terms of this Coverage Part or that are in excess of the 1. "Controlling underlying insurance' means any applicable limit of insurance. An agreed settlement policy of insurance or self-insurance listed in the means a settlement and release of liability signed Declarations under the Schedule of "controlling by us, the insured, 'controlling underlying insurer" underlying insurance". and the claimant or the claimant's legal 2. "Controlling underlying insurer" means any insurer representative. who provides any policy of insurance listed in the 12.Transfer Of Defense Declarations under the Schedule of "controlling underlying insurance . a. Defense Transferred To Us 3, "Event" means an occurrence, offense, accident, When the limits of "controlling underlying act, or other event, to which the applicable insurance" have been exhausted, in "controlling underlying insurance"applies. accordance with the provisions of "controlling underlying insurance', we may elect to have � "Injury or damage" means any injury or damage, the defense transferred to us. We will covered in the applicable "controlling underlying cooperate in the transfer of control to us of any insurance"arising from an "event'. outstanding claims or suits seeking damages to 5. "Retained limit" means the available limits of which this insurance applies and which would "controlling underlying insurance" applicable to have been covered by the "controlling the claim. underlying insurance" had the applicable limit 6. "Ultimate net loss" means the total sum, after not been exhausted. reduction for recoveries, or salvages collectible, b. Defense Transferred By Us that the insured becomes legally obligated to pay When our limits of insurance have been as damages by reason of: exhausted our duty to provide a defense will a. Settlements,judgments, binding arbitration; or cease. b. Other binding alternate dispute resolution proceeding entered into with our consent. "Ultimate net loss" includes defense expenses if the "controlling underlying insurance" specifies that limits are reduced by defense expenses. p CX 00 01 0413 ®Insurance Services Office, Inc.„ 2012 Page 5 of 5 .p w cn cfl M d' d' COMMERCIAL EXCESS LIABILITY CX 02 09 0312 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA CHANGES - CAN C ELLATI ON AN D N ON REN EWAL This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART A. Paragraphs &b. and c. of the Cancellation If we cancel this policy for any of these Provisions of Section III —Conditions are replaced reasons, we will mail or deliver to the by the following: first Named Insured written notice of b. Cancellation Of Policies In Effect cancellation, accompanied by the (1) For 90 Days Or Less reasons for cancellation,at least: (1) 10 days before the effective date If this policy has been in effect for 90 of cancellation if we cancel for days or less, we may cancel this policy nonpayment of premium; or by mailing or delivering to the first (IQ 45 days before the effective date Named Insured written notice of cancellation, accompanied by the of cancellation if we cancel for reasons for cancellation,at least: any of the other reasons stated in (a) 10 days before the effective date of Paragraph b.(2). cancellation if we cancel for c. We will mail or deliver our notice to the first nonpayment of premium; or Named Insured at the last mailing address known to us. (b) 45 days before the effective date of cancellation if we cancel for any B. Paragraph &e. of the Cancellation Provisions of other reason, except we may cancel Section III — Conditions is replaced by the immediately if there has been: following: (i) A material misstatement or e. If this policy is cancelled, we will send the misrepresentation; or first Named Insured any premium refund due. If we cancel, the refund will be pro {i) A failure to comply with the rata. If the first Named Insured cancels, the underwriting requirements refund may be less than pro rata. If the established by the insurer. return premium is not refunded with the (2) For More Than 90 Days notice of cancellation or when this policy is If this policy has been in effect for more returned to us, we will mail the refund within than 90 days, we may cancel this policy 15 working days after the date cancellation only for one or more of the following takes effect, unless this is an audit policy. reasons: If this is an audit policy, then, subject to your full cooperation with us or our agent in {a) Nonpayment of premium; securing the necessary data for audit, we (b) The policy was obtained by a material will return any premium refund due within misstatement; 90 days of the date cancellation takes effect. (c) Failure to comply with underwriting If our audit is not completed within this time requirements established by the limitation, then we shall accept your own insurer within 90 days of the effective audit, and any premium refund due shall be date of coverage; mailed within 10 working days of receipt of (d) A substantial change in the risk your audit. covered by the policy; or The cancellation will be effective even if we (a) The cancellation is for all insureds have not made or offered a refund. under such policies for a given class of insureds. CX02 09 0312 0 Insurance Services Office, Inc., 2011 Page 1 of 2 C. Paragraph 13. When We Do Not Renew of Section 2. Any notice of nonrenewal will be mailed or III—Conditions is replaced by the following: delivered to the first Named Insured at the last 1. If we decide not to renew this policy, we will mailing address known to us. If notice is mail or deliver to the first Named Insured mailed, proof of mailing will be sufficient proof written notice of nonrenewal, accompanied by of notice. the reason for nonrenewal, at least 45 days prior to the expiration of this policy. p Page 2 of 2 ®Insurance Services Office, Inc., 2011 CX 02 09 03 12 w 4 00 M d' d' COMMERCIAL EXCESS LIABILITY CX 21 0109 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. N UC LEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD FORM) This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2., Exclusions: (2) The 'nuclear material"is contained in 'spent 2. Exclusions fuel"or"waste"at any time possessed, han- NUCLEAR ENERGY LIABILITY dled, used, processed, stored, transported or disposed of, by or on behalf of an in- a. Under any Liability Coverage, to "injury or sured; or damage": (3) The "injury or damage" arises out of the (1) With respect to which an insured under the furnishing by an insured of services, mate- policy is also an insured under a nuclear rials, parts or equipment in connection with energy liability policy issued by Nuclear En- the planning, construction, maintenance, ergy Liability Insurance Association, Mutual operation or use of any "nuclear facility", Atomic Energy Liability Underwriters, Nu- but if such facility is located within the clear Insurance Association of Canada or United States of America, its territories or any of their successors, or would be an in- possessions or Canada, this Exclusion (3) sured under any such policy but for its ter- applies only to property damage to such mination upon exhaustion of its limit of li- "nuclear facility'and any properly thereat. ability; or c. As used in this endorsement: (2) Resulting from the "hazardous properties" "Hazardous properties" includes radioactive, of "nuclear material" and with respect to which (a) any person or organization is re- quired to maintain financial protection pur- "Nuclear material" means 'source material", suant to the Atomic Energy Act of 1954, or "special nuclear material" or "by-product mate- any law amendatory thereof, or (b) the in- rial". sured is, or had this policy not been issued "Source material", 'special nuclear material", would be, entitled to indemnity from the and "by-product material" have the meanings United States of America, or any agency given them in the Atomic Energy Act of 1954 or thereof, under any agreement entered into in any law amendatory thereof. by the United States of America, or any agency thereof, with any person or organk "Spent fuel' means any fuel element or fuel zation. component, solid or liquid, which has been b. Under any Liability Coverage, to "injury or used or exposed to radiation in a"nuclear reao- damage" resulting from 'hazardous properties" tor". of"nuclear material", if: "Waste' means any waste material (a) contain- (1) The "nuclear material"(a) is at any 'nuclear ing "by-product material" other than the tailings or wastes produced by the extraction or con- facility" owned by, or operated by or on be- half of, an insured or has been die- centration of uranium or thorium from any ore charged a dispersed therefrom; processed primarily for its source material" content, and (b) resulting from the operation by any person or organization of any 'nuclear facility" included under the first two paragraphs of the definition of"nuclear facility". CX 210109 08 0 ISO Properties, Inc., 2007 Page 1 of 2 0 "Nuclear facility" means: (a) Any"nuclear reactor"; (b) Any equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing 'spent fuel", or (3) handling, processing or packaging "waste"; (c) Any equipment or device used for the processing, fabricating or alloying of "special nuclear material" if at any time the total amount of such material in the custody of the"insured"at the premises where such equipment or device is lo- cated consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; (d) Any structure, basin, excavation, prerr} ises or place prepared or used for the storage or disposal of"waste"; and includes the site on which any of the fore- going is located, all operations conducted on such site and all premises used for such opera- tions. "Nuclear reactor" means any apparatus de- signed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material. "Injury or damage" includes all forms of radio- active contamination of property. p Page 2 of 2 ®ISO Properties, Inc., 2007 CX 21 01 09 08 ❑ .p w co 0 Iq Iq Iq POLICY NUMBER:VFNU-TR-0019768-031000 COMMERCIAL EXCESS LIABILITY CX 27 0012 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNDERLYING CLAIMS-MADE COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART SCHEDULE Retroactive Date: Enter Date Or"NONE" If No Retroactive Date Applies.) Information required to complete this Schedule, if not shown above, will be shown in the Declarations. If any"controlling underlying insurance" is written on a A claim for damages for such "injury or claims-made basis, the following applies to the damage" must be first made against the insurance provided by this Coverage Part which is insured during this policy period or any excess over that underlying insurance: extended reporting period provided under A. Paragraph 1.c. under Section I — Coverages is this Coverage Part. A claim will be replaced by the following: considered first made under this Coverage Part: c. If the "controlling underlying insurance" requires, for a particular claim, that the (1) When notice of such claim is received "injury or damage" occur on or after the and recorded by any insured or by us,. Retroactive Date shown in the Declarations whichever comes first, if the "controlling of that insurance in order for that coverage underlying insurance" is written on a to apply, then this insurance will only apply claims-made and recorded basis; or to that"injury or damage"which occurs on or (2) When notice of such claim, after being after the Retroactive Date shown in the received by any insured, is reported to us Schedule of this endorsement but before the in writing, if the "controlling underlying end of the policy period of this Coverage insurance"is written on any other claims- Part. If the"controlling underlying insurance" made basis. requires, fora particular claim, that the B. The following is added to Section II — Limits Of "event" causing the particular "injury or Insurance: damage" takes place on or after the Retroactive Date shown in the Declarations The "retained limit" will only be reduced or of that insurance in order for that coverage exhausted by payments made for: to apply, then this insurance will apply to the (1) Claims made during the policy period or claim only if the "event" causing that "injury any Extended Reporting Period of this or damage" takes place on or after the Coverage Part; or Retroactive Date shown in the Schedule of (2) Defense expenses if the limits of this endorsement but before the end of the "controlling underlying insurance" are policy period of this Coverage Part. reduced by defense expenses for that insurance. CX 27 00 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 2 C. The following section is added: 4. You must give us a written request for the Claims-made Extended Reporting Period Extended Reporting Period endorsement under this Coverage Part no later than the time 1. Any provisions under the"controlling underlying aillowed to purchase such endorsement under insurance" relating to an Extended Reporting the "controlliing underlying insurance"'. The Period for which a separate premium charge is Extended Reporting Period will not go into effect made do not apply to this insurance, unless an unless you pay the additional premium promptly Extended Reporting Period is purchased under when due. this insurance. 5. We will determine the additional premium in 2. An Extended Reporting Period„ consistent with accordance with our rules and rates. In doing the terms, conditions and duration of any so,we may take into account the following: Extended Reporting Period available in accordance with the terms of any "controllling a. The exposures insured; underlying insurance", will be available for this b. Previous types and amounts of insurance; Coverage Part by endorsement, for an c. Limits of Insurance available under this additional charge, if: Policy for future payment of damages; and a. This Policy is cancelled or not renewed; or d. Other related factors. b. This Policy is renewed or replaced with 6. If the provisions of the Extended Reporting insurance that: Period in any "'controlling underlying insurance" (1) Has a Retroactive Date later than the provide for supplemental aggregate limits of date shown in the Schedule of this insurance when the Extended Reporting Period endorsement; or is purchased, a supplementary aggregate Ilimit (2) Does not apply to "injury or damage"' on of insurance„ equal to the Aggregate Limit a claims-made basis. shown in the Declarations of this Coverage Part, wild apply to claims first made during the 3. If this Policy and the "controlling underlying Extended Reporting Period if the Extended insurance"are cancelled or not renewed and an Reporting Period is purchased for this Extended Reporting Period has been provided insurance. under the "controlling underlying insurance"„ then an Extended Reporting Period will be available for this Coverage Part. The Extended Reporting Period available under this Coverage Part will be consistent with the terms, conditions and duration of any Extended Reporting Period provided in accordance with the terms of the "controlling underlying insurance". Page 2 of 2 0 Insurance Services Office, Inc., 2018 CX 27 00 12 19 N d' d' d' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PER LOCATION AGGREGATE LIMIT OF INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART Paragraph 2.b. under Section II —Limits Of Insurance is deleted and replaced by the following: 2.b. The Aggregate Limit is the most we will pay for the sum of all "ultimate net loss", for all "injury or damage"covered under this Coverage Part. However, this Aggregate Limit only applies to "injury or damage"that is subject to an aggregate limit of insurance under the"controlling underlying insurance". The above described Aggregate Limit applies separately to each location owned by or rented to or managed by the named insured. As used herein, location means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway,waterway or right-of-way of a railroad. CXE0112(01 20) Copyright,American International Group,I,nc.,2019. Page 1 of 1 All rights reserved.Includes copyrighted material of the Insurance services Office,Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FIREWORKS OR PYROTECHNICS EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. Exclusions of Section I -Coverages:. This insurance does not apply to any"injury or damage"caused directly or indirectly by fireworks, pyrotechnics or any similar explosive material. CXE0172(01-20) Copyright,American International Group,Inc.,2019. Page 1 of 1 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. P P P W dq dq dq dq THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SUBLIMITED COVERAGES ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART The following is added to Paragraph 1.b. under Insuring Agreement in Section I—Coverages: As described in Paragraph 1.b., any limits or sublimits of insurance must be: (1) Specifically listed under the Schedule of"controlling underlying insurance"; or (2) Subject to the applicable available limits of "controlling underlying insurance" listed under the Schedule of "controlling underlying insurance"; in order for this insurance to apply. CXE0279(01-20) Copyright,American International Group,Inc.,2019. Page 1 of 1 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ERISA EXCLUSION This endorsement modifies insurance provided under the following; COMMERCIAL EXCESS LIABILITY COVERAGE PART The following exclusion its added to Paragraphh 2. Exclusions of Section I -Coverages'; This insurance does not apply to any "injury or damage arising out of or associated with any obligation of the insured under the Employee Retirement Income Security Act of 1974 (ERISA)„ and any amendments thereto or any similar federal, state or local statute. CXE0286(01-20) Copyright,American International Group,inc.,2019. Page 1 of 1 All rights reserved.Includes copyrighted material of the p Insurance Services Office,Inc.,with its permission. P P tJ1 cfl d d d THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRODUCTS-COMPLETED OPERATIONS AGGREGATE LIMIT OF INSURANCE This endorsement modifies insurance provided under the folltowing; COMMERCIAL EXCESS LIABILITY COVERAGE PART SCHEDULE Products-completed Operations Aggregate Limit: i Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Section II _, Limits Of Insurance is replaced by the c. The Products-completed Operations Aggregate following: Limit shown in the Schedule of this 1. The Limits of Insurance shown in the Declarations, endorsement is the most we will pay for the and the Schedule of this endorsement, and the sum of all "ultimate net loss" under this following rutes fix the most we widiU pay regardless insurance because of all "injury or damage of the number of: included in a products-completed operations hazard. a. Insureds; d. Subject to Paragraph b. or c. of this b. Claims made or suits brought, or number of endorsement, whichever applies,.. the Each vehicles involved; Occurrence Limit is the most we will pay for the c. Persons or organizations making claims or sum of all "ultimate net loss" under this bringing suits; or insurance because of all "injury or damage"' d. Limits available under any "controlling arising out of any one"event". underlying insurance". e. If the Limits of Insurance of the "controlling 2. The Limits of Insurance will apply as follows: underlying insurance" are reduced by defense expenses by the terms of that policy, any a. This insurance only applies in excess of the payments for defense expenses we make will "retained limit". reduce our applicable Limits of Insurance in the b. The Aggregate Limit is the most we will pay for same manner. the sum of all "ultimate net loss", for all "injury 3. If any "controlling underlying insurance" has a or damage" covered under this Coverage Part, policy period that is different from the policy period except "ultimate net loss" because of"injury or of this Coverage Part then, for the purposes of this damage": insurance, the "retained limit" will only be reduced (1) That is not subject to an aggregate limit of or exhausted by payments made for "injury or insurance under the "controlling underlying damage"covered under this insurance.. insurance"; or The Aggregate Limits, as described in Paragraphs b. (2) Included in the products-completed and c. above, apply separately to each consecutive operations hazard. annual period of this Coverage Part and to any remaining period of this Coverage Part of less than 12 months„ starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months, In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. CXE0328(01-20) Copyright,American International Croup,Inc.,2019 Page 1 of 1 All rights reserved. Includes copyrighted material,of the Insurance Services Office,l,nc.,with fits permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA FUNGI OR BACTERIA EXCLUSION This endorsement modes insurance provided under the following; COMMERCIAL EXCESS LIABILITY COVERAGE PART A. The folllowiing exclusion is added to Paragraph 2.Exclusions of Section I-Coverages: 2. Exclusions This insurance does not apply to: FUNGI OR BACTERIA a. "'Injury or damage" which would not have occurred, in whole or in part, but for the actual, alleged or threatened inhalation of, ingestion of,, contact with, exposure to, existence of, or presence of, any"fungi" or bacteria on or within a building or structure, including its contents, regardless of whether any other cause, event, material or product contributed concurrently or in any sequence to such "injury or damage"'. b. Any loss, cost or expenses arising out of the abating, testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing„ remediating or disposing of, or in any way responding to, or assessing the effects of,"fungi"or bacteria„by any insured or by any other person or entity. This exclusion does not apply to any"injury or damage arising out of"fungi,"'or bacteria that are,are on, or are contained in,a good or product intended for bodily consumption, B. For the purposes of this exclusion, the following definition is added to Section IV-Definitions "Fungi" means any type or form of fungus, including mold or mildew and any mycotoxins, spores, scents or byproducts produced or released by fungi, CXEFL1101 (01-20) Copyright,American International Group,Inc-2019. Page 1 of 1 All rights reserved.Includes copyrighted material of the .P. Insurance Services Office„Inc..,with its permission. .P .P 4 00 dq dq dq THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EMERGENCY SERVICE ORGANIZATION AMENDATORY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART I. The following is added to Paragraph 1.a. Insuring Agreement under Section I—Coverages: When we have the right and duty to defend the insured against any suit seeking damages for "injury or damage" to which this insurance applies and when the applicable limits of"controlling underlying insurance" have been exhausted, we will pay the insured's expenses incurred at our request, including actual loss of earnings not to exceed$300 per day. We will assume such charge only if such expense was not included in the"controlling underlying insurance". When we assume such charge, we will pay in addition to the applicable limit of insurance only if the policy of "controlling underlying insurance" specifies that limits are not reduced by any defense expenses. 111, Paragraph 3. Duties In The Event Of An Event, Claim or Suit under Section III -- Conditions is deleted and replaced by the following: a. You must see to it that we are notified as soon as possible of an "event", regardless of the amount, which may result in a claim under this insurance. To the extent possible, notice should include: (1) How, when and where the"event"took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any"injury or damage"arising out of the"event". b. If a claim is made or suit is brought against any insured,,you must, (1) Immediately record the specifics of the claim or suit and the date received; and (2) Notify us as soon as possible. You must see to it that we receive written notice of the claim or suit as soon as possible. c. You and any other insured involved must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or suit; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the suit; and (4) Assist us„ upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of"injury or damage"to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent.. CXEG0287(01 20) Copyright,American International Group,Inc.,2019. Page 1 of 1 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER VALID AND COLLECTABLE INSURANCE AMENDMENT - EMERGENCY SERVICE ORGANIZATIONS This endorsement modifies insurance provided under the Following: COMMERCIAL EXCESS LIABILITY COVERAGE PART The following its added to Paragraph 8. Other Insurance of Section III Conditions; However„ in the event other insurance exists for the following: (1) An auto the Named Insured doesn't own„ Mire or borrow which is being used by a person, commission, authority, board or agency as described under paragraphs d.., e., and f of Section li -Liability Coverage, Coverage A.1.,Who Is An Insured of the BUSINESS AUTO COVERAGE FORM of the"controlling underlying insurance", (2) A substitute auto as described under paragraph g. of Secb)on li - Liability Coverage, Coverage A.1. Who Is An Insured of the BUSINESS AUTO COVERAGE FORM of the"controlling underlying insurance'; (3) A commandeered auto as described under paragraph h, of Section II - Liability Coverage, Coverage A.1. Who Is An Insured of the BUSINESS AUTO COVERAGE FORM of the"controlling underlying insurance"; or (4) Commandeered equipment other than an auto as described under paragraph d. of Section II - Who Is An Insured of the EMERGENCY SERVICE ORGANIZATION GENERAL LIABILITY COVERAGE FORM of the "controlling underlying insurance'; This insurance will be excess over the applicable "controlling underlying insurance" and will not take into consideration nor will seek contribution from the applicable other insurance, described in paragraphs (1) through (4)above. CXEG0297(01-20) Copyright,American International Group,Inc.,2019. Page 1 of 1 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. P P P 0 W) Iq Iq THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UNMANNED AIRCRAFT LIABILITY COVERAGE SUBLIMIT This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY COVERAGE PART SCHEDULE Unmanned Aircraft Liability Each Occurrence Limit Of Insurance: $1,000,000 Unmanned Aircraft Liability Aggregate Limit Of Insurance: $1,000,000 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. This insurance applies to "injury or damage" attributable to "unmanned aircraft" only to the extent that valid "controlling underlying insurance" for such "unmanned aircraft" exists or would have existed but for the exhaustion of underlying limits. Coverage provided will follow the provisions and exclusions of the applicable "controlling underlying insurance"unless otherwise directed by this insurance. B. The following is added to Section II—Limits Of Insurance: (1) The Unmanned Aircraft Liability Aggregate Limit of Insurance shown in the Schedule of this endorsement is the most we will pay for the sum of all "ultimate net loss" for all "injury or damage" attributable to "unmanned aircraft"" covered under this Coverage Part. (2) Subject to Paragraph B.(1) above, the Unmanned Aircraft Liability Each Occurrence Limit of Insurance shown in the Schedule of this endorsement is the most we will pay for the sum of all "ultimate net loss" under this insurance because of all "injury or damage" arising out of any one "event" attributable to "unmanned aircraft"covered under this Coverage Part. The above described limits of insurance in paragraphs B.(1) and B.(2) are subject to, and not in addition to, the Aggregate Limit or Products-Completed Operations Aggregate Limit shown in the Declarations page of this policy. Any payments under the Unmanned Aircraft Liability Aggregate Limit of Insurance and Unmanned Aircraft Liability Each Occurrence Limit of Insurance will erode the Aggregate Limit or Products-Completed Operations Aggregate Limit. C. The following definition is added to the Section IV-Definitions: "Unmanned aircraft" means an aircraft weighing 15 pounds or less that is not: 1. Designed; 2. Manufactured; or 3. Modified after manufacture; to be controlled directly by a person from within or on the aircraft. "Unmanned aircraft" includes equipment used with such "unmanned aircraft", provided such equipment is attached to or essential for its operation. CXEG0329(01-20) Copyright,American International Group,Inc.,2019 Page i of 1 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission. r96MI 46,�IbV F ISO CLAIM REPORTING Successful claim handling begins with prompt notification. Incidents that will or might give rise to a claim should be immediately reported to your agent. The agent will relay pertinent information to Glatfelter Claims Management, Inc. (GCM). Minimum information needed is: • Name and telephone number of insured contact person. • Date, time and location of the accident or incident. • Description of how the incident occurred- • Description of the vehicle or property involved. • Description of the damage and/or injuries. • Description of any other automobiles, property, persons and witnesses involved, including addresses and telephone numbers, if available. • If known, the name and Incident report number of the responding police department or other authority. Do not delay reporting an incident to your agent waiting on information such as a police report, repair estimate, or other claim details. When additional information is obtained, it should be promptly reported to your agent or the claim handler assigned by GCM. Should a claim arise, some important points to remember are: • Provide assistance to injured persons.. • Protect property from further damage... • Do not divulge information to anyone other than the assigned claim handler or GCM's authorized representative. • If a lawsuit is filed, contact your agent immediately who will transmit copies to GCM. If an after-hours emergency should arise, please contact our office for assistance. Glatfelter Claims Management, Inc. P.O. Box 5126 York, PA 17405 Telephone: (800) 233-1957 Claims Fax: (717) 747-7051 E-Mail:claimsO-alatfelters.com License Number: 2D89880 (California only) Glatfelter Claims Management, Inc,,a diviisio!n of Gllatfelter Insurance Group„,is a wholly owned„third-party claims administrator charged with the handling of claims for VI IS, on behalf of National Union Fire Insurance Company of Pittsburgh„ Pa .p VPJ100(01-20) .P tJ1 N LO d' d' 0410M MIA :III F Isw (800) 233-1967 www.vfis.com Volunteer Firemen's Insurance Services, Inc.(2) VFISO,VFIS®with design and Volunteer Firemen's Insurance Services„InGA are all registered service marks of the same PA Corporation. VPJ100(01-20) ENDORSEMENT This endorsement,effective 10/01/2023 12:01 A.M., Forms a part of Policy No.: VFNU-TR-0019768-03/000 Issued to: KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC By: NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA. FEDERAL SHARE OF COMPENSATION UNDER TRIA AND CAP ON LOSSES ENDORSEMENT This endorsement modifies insurance provided by this Policy: DISCLOSURE You should know that where coverage is provided by this Policy for losses resulting from"Certified Acts of Terrorism" (as defined by Section 102 (1) of United States Terrorism Risk Insurance Act), such losses may be partially reimbursed by the United States Government under a formula established by federal law. However, your Policy may contain other exclusions which might affect your coverage such as, an exclusion for nuclear events. Under the formula, the Uniited States Government generally reimburses 80% beginning on January 1, 2020, of covered terrorism fosses exceeding the statutorily established deductible paid by the insurance company providing the coverage. You should also know that the Terrorism Risk Insurance Act, as amended, contains a $100 billion cap that limits United States Government reimbursement as well as insurers' liability for losses resulting from "Certified Acts of Terrorism" when the amount of such losses in any one calendar year exceeds $100 billion. If the aggregate insured losses for all insurers exceed $100 billion in a calendar year and if we have met our insurer deductible, we are not liable for the payment of any portion of the amount of such losses that exceeds $100 billllion; and for aggregate insured losses up to $100 b0lion, we will only pay a pro rata share of such insured losses as determined by the Secretary of the Treasury. All other terms and conditions of the Policy remain the same. Authorized Representative 125595(03120) @American International Group,Inc. Page 1 of 1 All Rights Reserved. P P tJ1 W dq Uj dq d POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE (COVERAGE INCLUDED) Coverage for acts of terrorism is included in your policy. You are hereby notified that under the Terrorism Risk Insurance Act, as amended in 2015, the definition of act of terrorism has changed. As defined in Section l 02(1)of the Act: The term"act of terrorism"means any act that is certified by the Secretary of the Treasury—,in consultation with the Secretary of Homeland Security,and the Attorney General of the United States. to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Under your coverage, any losses resulting from certified acts of terrorism may be partially reimbursed by the United States Government under a formula established by the Terrorism Risk Insurance Act,as amended.However, your policy may contain other exclusions which might affect your coverage,such as an exclusion for nuclear events. Under the formula, the United States Government generally reimburses 80%beginning on January 1, 2020 of covered terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. The Terrorism Risk Insurance Act, as amended, contains a $100 billion cap that limits U.S. Government reimbursement as well as insurers' liability for losses resulting from certified acts of terrorism when the amount of such losses exceeds $100 billion in any one calendar year. If the aggregate insured losses for all insurers exceed $100 billion, your coverage may be reduced. The portion of your annual premium that is attributable to coverage for acts of terrorism is $ 0 , and does not include any charges for the portion of losses covered by the United States government under the Act. 96556(3120)0 0 2020 National Association of Insurance Commissioners FLORIDA UNINSURED MOTORIST COVERAGE SELECTION/REJECTION YOU ARE ELECTING NOT TO PURCHASE CERTAIN VALUABLE COVERAGE WHICH PROTECTS YOU AND YOUR FAMILY OR YOU ARE PURCHASING UNINSURED MOTORIST LIMITS LESS THAN YOUR BODILY INJURY LIABILITY LIMITS WHEN YOU SIGN THIS FORM. PLEASE READ CAREFULLY. SELECT FROM THE FOLLOWING AND COMPLETE SECTIONS A AND C, OR B, AS INDICATED: ❑ POLICY WILL INCLUDE SPECIFICALLY INSURED OR IDENTIFIED MOTOR VEHICLE(S) REGISTERED OR PRINCIPALLY GARAGED IN FLORIDA. SECTION A BELOW AND SECTION C.ON PAGE 3, MUST BE COMPLETED. ❑ UNINSURED MOTORIST COVERAGE IS DESIRED FOR OTHER THAN SPECIFICALLY INSURED OR IDENTIFIED MOTOR VEHICLE(S) REGISTERED OR PRINCIPALLY GARAGED IN FLORIDA. COMPLETE SECTION B ON PAGE 2. NON-STACKED COVERAGE WILL AUTOMATICALLY BE APPLIED, SECTION A Uninsured Motorist coverage provides for payment of certain benefits for damages caused by owners or operators of uninsured motor vehicles because of bodily injury or death resulting therefrom. Such benefits may include payments for certain medical expenses, lost wages, and pain and suffering, subject to limitations and conditions contained in the policy. For the purpose of this coverage, an uninsured motor vehicle may include a motor vehicle for which the Bodily Injury Liability Limits or Combined Single Limit for Liability Coverage are less than your damages. Florida law requires that automobile policies include Uninsured Motorist coverage at limits equal to the Bodily Injury Liability Limits (Split Limits) or Combined Single Limit for Liability Coverage in your policy unless you select lower limits offered by the company, or reject Uninsured Motorist coverage entirely. Please indicate below whether you desire to entirely reject Uninsured Motorist coverage, whether you desire this coverage at limits equal to your Bodily Injury Liability Limits or Combined Single Limit for Liability Coverage, or whether you desire this coverage at limits lower than the Bodily Injury Liability Limits or Combined Single Limit for Liability Coverage of your policy: NEW CUSTOMERS- IF YOU DO NOT ELECT ANY OF THE BELOW,YOUR POLICY WILL INCLUDE UNINSURED MOTORIST LIMITS EQUAL TO YOUR BODILY INJURY LIABILITY LIMITS OR COMBINED SINGLE LIMIT FOR LIABILITY COVERAGE. RENEWAL/EXISTING CLIENTS-IF YOU HAVE PREVIOUSLY COMPLETED AND SIGNED AN ELECTION OF COVERAGE FORM AND DO NOT WISH TO CHANGE YOUR ELECTION, NO FURTHER ACTION IS REQUIRED AND SUCH ELECTION WILL BE REFLECTED ON YOUR MOST CURRENT DECLARATIONS PAGE($). IF YOU CHANGE YOUR BODILY INJURY LIABILITY LIMITS OR COMBINED SINGLE LIMIT FOR LIABILITY COVERAGE, WE MUST MATCH YOUR UNINSURED MOTORIST LIMITS TO YOUR BODILY INJURY LIABILITY LIMITS OR COMBINED SINGLE LIMIT FOR LIABILITY COVERAGE UNTIL YOU MAKE ANOTHER SELECTION ON THIS FORM. IF YOU WOULD LIKE TO AMEND YOUR REJECTION OR PREVIOUS SELECTION, PLEASE INDICATE BELOW AND SUBMIT THIS FORM WITH THE DESIRED CHANGES. VLFL05(01-20) Copyright,American International Group,,unc.,20% Page 1 of 3 All rights reserved.Includes copyrighted material of the Insurance Services office,Inc_with its permission. P P tJ1 tJ1 cfl w � d d ❑ I reject Uninsured Motorist coverage entirely. ❑ I select Uninsured Motorist limits equal to my Bodily Injury Liability Limits or Combined Single Limit for Liability Coverage. (If you select this option disregard the bold statement at the heading of this form unless the named insured is designated as an individual and elects the non-stacked option on page 3.) ❑ I select the following Uninsured Motorist coverage limit(s) listed below which are lower than my Bodily Injury Liability Limits or Combined Single Limit for Liability Coverage. Please check with your agent or carrier for the limits offered by your company. Please indicate limits below. SPLIT LIMITS COMBINED SINGLE LIMIT O $10,000 per person/$20,000 per accident O $20,000 per accident O $25,000 per person/$50,000 per accident O $50,000 per accident O $50,000 per person/$100,000 per accident O $100,000 per accident O $100,000 per person/$300,000 per accident O $250,000 per accident O $250,000 per person/$500,000 per accident O $300,000 per accident O $500,000 per person/$1,000,000 per accident O $500,000 per accident O $1,000,000 per accident I understand and agree the selection of any of the above options applies to my liability insurance policy and future renewals or replacements of such policy which are issued at the same Bodily Injury Liability Limits or Combined Single Limit for Liability Coverage. If I decide to select another option at some future time, I must let the Insurance Company or my agent know in writing. Applicant's Signature Date Effective Date SECTION B NEW CUSTOMERS -IF YOU DO NOT ELECT ANY OF THE BELOW, YOUR POLICY WILL NOT INCLUDE UNINSURED MOTORIST COVERAGE. RENEWAL/EXISTING CLIENTS- IF YOU HAVE PREVIOUSLY COMPLETED AND SIGNED AN ELECTION OF COVERAGE FORM AND DO NOT WISH TO CHANGE YOUR ELECTION, NO FURTHER ACTION IS REQUIRED AND SUCH ELECTION WILL BE REFLECTED ON YOUR MOST CURRENT DECLARATIONS PAGE(S). IF YOU WOULD LIKE TO AMEND YOUR REJECTION OR PREVIOUS SELECTION, PLEASE INDICATE BELOW AND SUBMIT THIS FORM WITH THE DESIRED CHANGES. ❑ I select the following Uninsured Motorist Coverage limit(s). Please check with your agent or carrier for the limits offered by your company. ❑ Combined Single Limit $ ❑ Bodily Injury Liability Limits $ each Person $ each Accident ❑ I reject Uninsured Motorist Coverage entirely and understand that my policy will not include this coverage Applicant's Signature Date Effective Date VLFLO5(01.20) Copyright,American International Group,Inc.,2019. Page 2 of 3 All rights reserved.Includes copyrighted material of the Insurance Services Office,Inc.,with its permission, SECTION C ELECTION OF NON-STACKED OR STACKED* UNINSURED MOTORIST COVERAGE (Do not complete if you have rejected Uninsured Motorist Coverage) If the named insured is designated as an individual, you have the option to purchase,, at a reduced rate, the non-stacked (limited) type of Uninsured Motorist Coverage.. If you are designated as other than an individual, your policy will include non-stacked Uninsured Motorist Coverage unless you reject Uninsured Motorist Coverage entirely. Under this coverage, if iinjury occurs in a vehicle owned or leased by you or any family member who resides with you, this policy will apply only to the extent of coverage, if any, which applies to that vehicle in this policy. If an injury occurs while occupying someone else's vehicle, or you are struck as a pedestrian, you are entitled to select the highest limits of Uninsured Motorist Coverage available on any one vehicle for which you are a named insured, insured family member, or insured resident of the named insured's household, This policy will not apply if you select the coverage available under any other policy issued to you or the policy of any other family member who resides with you. If you do not elect to purchase non-stacked coverage, your policy limit(s) for each motor vehicle are added together (stacked`) for all covered injuries. Thus„ your policy limit(s) would automatically change during the policy term if you increase or decrease the number of autos covered under your policy.. NEW CUSTOMERS - IF YOU DO NOT ELECT ANY OF THE BELOW, YOUR POLICY WILL INCLUDE STACKED* UNINSURED MOTORIST COVERAGE, RENEWAL I EXISTING CLIENTS - IF YOU HAVE PREVIOUSLY COMPLETED AND SIGNED AN ELECTION OF COVERAGE FORM AND DO NOT WISH TO CHANGE YOUR ELECTION, NO FURTHER ACTION IS REQUIRED AND SUCH ELECTION WILL BE REFLECTED ON YOUR MOST CURRENT DECLARATIONS PAGE(S). IF YOU CHANGE YOUR BODILY INJURY LIABILITY LIMITS OR COMBINED SINGLE LIMIT FOR LIABILITY COVERAGE, WE WILL STACK* YOUR UNINSURED MOTORIST COVERAGE UNTIL YOU MAKE ANOTHER ELECTION ON THIS FORM, IF YOU WOULD LIKE TO AMEND YOUR REJECTION OR PREVIOUS ELECTION, PLEASE INDICATE BELOW AND SUBMIT THIS FORM WITH THE DESIRED CHANGES, ❑ 1 hereby elect the non-stacked form of Uninsured Motorist coverage. ❑ I hereby elect the stacked* form of Uninsured Motorist coverage. (If you elect this option, disregard the bold statement on page 1 at the heading of the form, unless you selected Uninsured Motorists limits less than your Bodily Injury Liability Limits or Combined Single Limit for Liability Coverage on page 1 of this form) I understand and agree that selection of any of the above options applies to my liability insurance policy and future renewals or replacements of such policy which are issued at the same Bodily Injury Liability Limits or Combined Single Limit for Liability Coverage.. If I decide to select another option at some future time, I must let the Insurance Company or my agent know in writing, Applicant's/Named Insured's Signature Date If you have any questions„ please contact your independent iinsurance advisor.. *If you are not an individual, stacking of Uninsured Motorist coverage is not available. VL.FL05,(01 20) Copyright,American Intemational Group„inc,„2019, Page 3 of 3 Ali,rights reserved.Includes copyrighted maternal of the Insurance Services Office,Inc.,with its perm8ssion. .P .P Ul 4 00 dq dq POLICYHOLDER NOTICE Taxes. Assessments and/or Surcharces The taxes, assessments and/or surcharges shown on the declarations page or any premium schedule are collected on behalf of the applicable State(s) and in accordance with such State's laws and regulations. The payment of these taxes, assessments and/or surcharges is the responsibility of the Named Insured. In the event the applicable State implements a new tax, assessment and/or surcharge or increases such tax, assessment and/or surcharge during the term of this policy, the Named Insured shall remain responsible for the payment of all amounts due under the policy, including those newly implemented or increased taxes, assessments and/or surcharges. Any newly implemented or increased taxes, assessments and/or surcharges shall apply on the effective date dictated by the applicable State regardless: 1. Of when the Insurance Company implements the new or increased tax, assessment or surcharge into its systems; or 2. If the Insurance Company recalculates the Named Insured's premium in accordance with the policy's terms and conditions as part of a premium audit after the end of the policy period. 118477 (3/15) POLICYHOLDER NOTICE Thank you for purchasing insurance from a member company of American International Group, Inc. (AIG). The AIG member companies generally pay compensation to brokers and independent agents, and may have paid compensation in connection with your policy. You can review and obtain information about the nature and range of compensation paid by AIG member companies to brokers and independent agents in the United States by visiting our website at www.aig.como`producer-comt�ensation or by calling 1-800-706- 3102, 91222 (9/16) to to 0 cfl Iq Rev 8/2021 WHAT DOES AMERICAN INTERNATIONAL GROUP, INC. (AIG) DO WITH YOUR FACTS PERSONAL INFORMATION? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you how we collect,share, and protect your personal information. Please read this notice carefully to understand what we do. The types of personal information we collect and share depend on the product or service you have with us.This information can include: •Social Security number and Medical Information • Income and Credit History • Payment History and Employment Information When you are no longer our customer,we continue to share your information as described in this notice. All financial companies need to share customers'personal information to run their everyday business. In the section below,we list the reasons financial companies can share their customers'personal information;the reasons AIG chooses to share;and whether you can limit this sharing. ReasonsDoes AIG share? Can you limit this sharing? For our everyday business purposes—such as to process your transactions,maintain your account(s), respond to court orders Yes No and legal investigations,conduct research including data analytics, or report to credit bureaus For our marketing purposes—to offer our products Yes No and services to you For joint marketing with other financial companies Yes No For our affiliates'everyday business purposes— Yes information about your transactions and experiences No For our affiliates'everyday business purposes— No information about your creditworthiness We don't share i6i ket to you No We don't share For AIG Insurance Companies: Call 866-244-4786; Fax: 212-458-7481 or E-Mail: ClPrivacyCcaaia.com For Pet insurance sold by AIG Insurance Companies: Call 866-937-7387 or E-Mail: ClPrivacy(Maim com For LiveTravel,Inc.,Travel Guard Group,Inc.or AIG Travel Assist,Inc.:Call 866-244-4786 or E-Mail: CIPrivacy0aia.com AGLC105774NUFIC(01-2022) Rev 8/2021 • - - Who is providing this notice? The insurance company subsidiaries of American International Group, Inc. (AIG) underwriting property-casualty, accident& health, life insurance and related services and certain marketing subsidiaries of AIG listed below. How does AIG protect my To protect your personal information from unauthorized access and use,we use personal information? security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. We restrict access to employees, representatives, agents, or selected third parties who have been trained to handle nonpublic personal information. How does AIG collect my We collect your personal information, for example,when you personal information? -apply for insurance or pay insurance premiums -file an insurance claim or give us your income information -provide employment information We also confect your personal information from others, such as credit bureaus, affiliates, or other companies. Why can't I limit all sharing? Federal law gives you the right to limit only •sharing for affiliates' everyday business purposes—information about your creditworthiness -affiliates from using your information to market to you -sharing for nonafFiliates to market to you State laws and individual companies may give you additional tights to limit sharing. See below for more on your tights under state law. Definitions Affiliates Companies related by common ownership or control. They can be financial and nonfinancial companies. -Our affiliates include the member companies of American International Group, Inc., such as National Union Fire Insurance Company of Pittsburgh, Pa. Nonaffiliates Companies not related by common ownership or control. They can be financial and nonfinancial companies. -AIG does not share with nonaffiliates so they can market to you. Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you. •Our joint marketing partners include companies with which we jointly offer insurance products, such as a bank. Other important • • This notice is provided by American Home Assurance Company;AIG Assurance Company;AIIG Property Casualty Company;AIG Specialty Insurance Company,Commerce and Industry Insurance Company;Granite State Insurance Company;Illinois National Insurance Co.;Lexington Insurance Company;AIU'Insurance Company:,National Union Fire Insurance Company of Pittsburgh,Pa.:National Union Fire Insurance Company of Vermont;New Hampshire Insurance Company;"l he Insurance Company of the State of Pennsylvania;(collectively the"AIG Insurance Companies'). 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AGLC105774NUFIC(01-2022) �P �P rn w m ,I 4 2 ivi 111111101 III IIIIII�� 1°°°�°1III!!!IIIIIN, i� IIliiii��'a'�'! arils '( '�IIIP hm mW '" ,,i I Imll II uul . .p .p cn m m 25 1 Fast Drive, Key Largo, Ftori a 33037 hone® 05® 1- 7 Fax-- r 51® MEDICAL4699 These protocols havee approved the Key Largo Fire Department Medicat Director and are effective as of the date indicated to . r Dr. Tomas Morrison .p .p 00 cm Iq "able of Contents Foreword 1. General ProceduralA. Scene and Patient Assessment ProtocoL _ _. . .. B.Airway as a en _ 3 C. Emergency Incident Rehabilitation .Altered Mental Status and Unconsciousness1 A. Unconscious person 14 B.Seizure _ 17 C. Diabetic Emergencies, 2 D.Confusion,Agitation 23 III.Acute Respiratoryi r sA. 2 Asthma _.. 2 B. COPD(Chronic Bronchitis and/or Emphysema) 27 C. Hyperventilation Behavioralcis _ _ 1 V. Burns Cardiac i 3 Chest Pain (Angina,Acute Coronary Syndrome) 37 B. Cardiogenic Shock, 3 C. Congestive Heart Failure(Pulmonary Edema) 41 D. CardiacArrest 4 E. Other Cardiac Arrhythmias _ 49 Childbirth r _58 A. Uncomplicated liver 5 B. Complicated __ 60 C. Newborn Care __64 Vill. Environmental Emergencies 67 A. Dehydration _ _67 B. Drowning—Near Drowning C. Heat-related Illness(Hyperthermia) 70 D. Hypothermia _ 73 E. Diving-related Emergencies 76 F. Decompression Sickness(DCS) 76 G.Arterial Gas Emboli (AGE) _ 78 H. Barotrauma of the Ear, 79 I. Envenomation 81 J. Marine Bites and Stings ... _.84 IX.Trauma... 89 A. Extremity wound hemorrhage -89 B.Amputations 91 C. Multi-system Trauma 92 D. Chest and Abdominal Injuries _95 E.Spinal Cord Injuries 97 F.Selective Spinal Immobilization 98 G. Electrical Burns and Lightning Injuries 99 H. Orthopedic Bone and Joint Injuries 101 I. Head, Neck and Facial Injuries _ ___103 X.Other Medical Emergencies A.Allergic Reaction _ 107 B. Hypertensive Crisis 109 C. Epistaxis 111 .p .p c� 0 ti Iq D. Nauseallomiting 112 E. IBleeding _.. 13 F. Abdominal Pain G. Poison in / ver asa _ 117 H.Stroke,TI __ _. 1 1. Shock 120 ® Special Medical/Legat14 A. Documentation Requirements 124 B. use/ e tact . 125 C.Withholding r Terminating es scita ion(Non-trauma) .. .. .... .. 12 D.Withholdingor Terminating Resuscitatio (Trauma) 128 E. c Not Resuscitate ( ) __ _ 129 F. Refusal of are or Transport 130 ®Specialty Skills 13 A. 10 Procedures .... 13 B. ral Endotracheal Intu a ion, _.. _134 C. i®Gel Device Procedure _ 135 D. Intranasal Administration Technique{ arcan} 13 E. Combat p licationTourniquet 1 0 F. Futt Spinal Immobilization Technique 141 G.APGAR Scores 142 H. e of Nines . 143 I.Adult Trauma Scorecard Methodology 144 J. Pediatric Trauma Scorecard Methodology .145 K. ® 57 Pulse C Ci eer _ -_ 4 L. Glasgow Coma Scales _ ___ 149 M. Pediatric Vital Signs 150 N. ETCO2 Waveforms 151 0. 12 Lead Quick Reference Guide. 152 P.Synchronized Cardioversion 153 Q.Transcutaneous External Pacing _ ,153 XIII.Appendix A.Approved Drug List _ _ 1-2 .p 4 . i C%4 I- Fore word The following protocols outline the caret t emergency medical technicians and paramedics should administer to patients. These protocols are implemented under two conditions: (1)with the approval of our medical director®and (2)as part of a comprehensive medical oversight program. Fora practicing provider to be proficient with these protocols, he/she must be certified and Licensed at the appropriate Level and demonstrate and document all the skills and knowledge the protocols require.A provider's scope of practice may expand (e.g., administration of intravenous therapy by Basic Life Support providers) only with additional training and confirmation of competency by a medical director.The protocols in this set use the following format: ®A Review of Injury/Ittness that provides an overview of the condition and any special issues that should be considered ®Signs and Symptoms presented in a bullet list • Management divided into Basic Life Support (BLS)and Advanced Life Support(ALS) It is all-too common to discover that a patient's clinical presentation does not obviously conform to any of the available EMS protocoLs. In such cases, a provider is encouraged to consult online medical direction for additional guidance. Opportunities to review patient presentations and treatment options with local medical directors and/or other supervisory staff will be available to all providers as needed. Foreword KLFD BLS&ALS PROTOCOLS ti 1. General Procedural Protocols A. Scene Size-Up Patient Assessment scmiffaJizem-up Conduct safety assessment of scene for hazards to EMS personnel. If the scene is unsafe and cannot be made safe, DO NOT enter. Patient 1. Institute appropriate measures for prevention of infectious exposure as outlined i Protocol I.A. . If appropriate, begin triage and initiate Mass Casualty Incident(MCI). 3, Determine mechanisms of injury( I), nature of illness,and number of patients. 4. Perform primary assessment(airway, breathing, circulation).Then control serious bleedingand assess level of consciousness with"AVPU"—Alert andaware,Verbal stimuli, Painful stimuli, and Unresponsive—and the Glasgow Coma Scale(Refer to Protocol XII.L.). . Initiate BILS measures as outlined by the American Heart Association, including , and use of automated electrical defibrillator(A ), for cardiac arrest. (Refer to Protocol 1/I® .) 6. Be prepared to assist ventilation with a bagvaive or mechanical ventilator 7.Administer oxygen at the appropriate to rate via en otrac ea tube ( ) if inserted y paramedic on scene, bag valve mask, non-rebreathing mask, or nasal cannula if indicated-, 8. Apply pulse oxi eter if available. 9. Correct other life-threatening problems if possible and according to protocol. 10. Monitor and repeat vital signs at 15® inue intervals for stable patients, and 5 minutes intervals for unstable patients. 11. Consider cervical immobilization if appropriate (see"Selective Spine Immobilization"). 1 . Obtain full patient history in SAMPLE &OPQRST format. I I General Procedural Protocols KLFD BLS&ALS PROTOCOLS 2. S-Signs/Symptoms O-Onset A-Allergies P-Provocation/Palliative M-Medications Q-Quality P-Past Med Hx/Past Surgical Hx R-Region/Radiation/Referral L-Last Oral Intake S-Severity E-Precipitating Events T-Timing 13. Perform focused exam. 14.Continue assessment employing(DCAPBTLS). a. D-Deformities b. C-Contusions c.A-Abrasions d. P-Punctures e. B-Burns f.T-Tenderness g. L-Laceration h. S-Swe[Ling 15. Determine the patient's transport priority and whether paramedic care is required. Priority conditions include: i a. Unable to obtain or maintain open airway. b. Clinical deterioration or death appears imminent. c.Altered mental status, includes not following commands. d. Difficulty breathing/inadequate ventilation and oxygenation. e. Hypoperfusion (Shock). f. Complicated childbirth. g. Chest pain with Systolic BP<100 mm Hg. h. Uncontrolled bleeding. I y General Procedural Protocols KLFD BLS&ALS PROTOCOLS .p ti I. Severe pain. 16.Treat according to applicable protocols;transport, if capable. 17. Determine the need for ALS care, ground transport. 18.Consider the need fora itional resources. 19. Document all findings and medical interventions on patient care report. 20. Continue supportive care and monitorvital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm completion of BLS steps 1-19. 2.Assess the need fora vance airway management. (Refer to Protocol I.B.). 3. Institute ALS measures for resuscitation as outlined in the most recent guidetines for Advanced Cardiac Life Support(ACLS) by the American Heart Association. 4. Obtain 12-Lead ECG and maintain cardiac monitoring, if appropriate. 5. Initiate fluid line of 0.9% Normal Saline IWIO at KVO or saline lock or as required by Local protocol. 6.Administer medications as required by local protocol.ALWAYS ask about allergies to medication before administering any drug to a patient. 7. Continue supportive care and monitor vital signs until the patient is turned over to a higher level of medical care. Consider the need for Aeromedical evacuation to the nearest Trauma Center. -pediatfics 1. Follow BILS guidelines,adjusting for patient age/size. 2.Adjust medication dosage, as appropriate,for patient agelsize. (Referto Protocol XIII.E.) B.Airway Management Remiew.of lnjurytfte-si I 'General Procedural Protocols KLFD BLS&ALS PROTOCOLS i 4 I The obstruction or compromise of an airway can be caused by: (1)a variety of injuries and illnesses that result in narrowed air passages or excessive secretions or(2)the presence of solid foreign bodies that block air flow to the lungs. Signs and Symptoms *Wheezing *Stridor *Gasping-(when ineffective, sometimes called agonal respirations) *"Tripoding"or other positioning *Anxious *Skin color changes(cyanosis) * Nasal flaring, accessory muscle use,diminished or absent breath sounds *Difficulty swallowing-swollen tongue,and lips,drooling *Inability to breathe-weak respirations *Inability to speak *Abnormal respiratory rate *Rapid heart rate *Altered mental status Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI)measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A., and as indicated bythe patient's condition. 4. If choking,attempt Heimlich maneuver. 5. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. I General Procedural Protocols KLFD BLS&ALS PROTOCOLS .p 00 ti Iq 5 6.Assess adequacy of airway and ventilatory effort: a.ability to speak. . Color(note pallor or cyanosis) c.Vigor of cough/cry o Rate and depth of respirations e. Unusual breath sounds on auscultation, including rales,wheezing, stridor f.Accessory muscle use and/or nasal flaring 7. For respiratory distress,apply pulse oxi eter and administer 1 %oxygen via non- rebreathing mask at high flow rate. 8. Assist ventilations with ba valve mask( V )as required. 9. Complete vital signs and determine likely cause of airway diff icul y, such as: a. Potential aspiration of small objects or food . Fever or cough c.Chest pain . History of asthma,COPID, CHF e. In infants, a history of prematurity 10. Place patient in a position of comfort. 11. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. it til i 1. Confirm completion of BLSsteps 1-11.These guidelines should be followed for all attempts at advanced airway management, or when assuming responsibility for an airway already established y another agency or provider. .The ter "advanced airway"refers to endotracheal tube and devices such as the supra to is i® elAirwa . Securing an airwaywith these devices is a lifesaving eas re at has the potential for devastating harm if not performed or maintained correctly. .Advanced airways may be used ONLY by paramedics who have received training and been certified by local medical direction.Advanced airways should be attempted LY if BLS ventilatory support and oxygen are insufficient to sustain respirations. I I General Procedural Protocols KLFD BLS&ALS PROTOCOL 6 4. i-Gel airway devices may be deployed as either preferred or"rescue" methods for airway control only after all providers have been trained on them according to the manufacturer's instructions and certified as"competent" in the technique by local medical direction. 5. Forceps(e.g., Magill)should be available during laryngoscopy of a choking patient so that a solid object obstructing the airway can be mechanically removed. If unable to remove an object obstructing airway using forceps, immediately consider surgical airway. 6. Mobile or portable suction devices should be available during placement of advanced airways to clear airway secretions present in the tube or oral pharynx. i-Gel Airways Indication 1. Unconscious patient who is not breathing without a gag reflex. 2.Apneic patient without a gag reflex 3.A difficult airway is anticipated: a.Small mouth which obstructs visualizatiion b.Short neck c. Mallampati or Cormack- Lehane score?..3 d.Any obstruction that could impair visualization of the glottic opening. e. Impaired neck mobility f.Access to the airway is impeded(entrapment, helicopter cabin etc.) Contraindications 1. Responsive patients with an intact gag reflex 2. Esophageal tissue damage from trauma, chemical ingestion or thermal injury 3. Known esophageal disease or ingestion of caustic substances Procedure BLSBLS/ALS 1.Select appropriate size: a.#1 (Pink): Patient 2-5kg*No gastric Channel I General Procedural Protocols KLFD BLS&ALS PROTOCOLS .P co 0 00 Iq 7 b.#1, (Blue): Patients ®12 g NG Tube Size 10 Fr c.#2 (Grey): Patients 10-25kg NG Tube Size 10® 2 Fr d. 2. (Wh ite): Patients 5-35kg N G Tube Size ® 2 Fr e.## (Yellow): Patients 30-60kg NG Tube Size 1 -12 Fr f. ## (Green): Patients 50-80kg NG Tube Size 12 Fr g. ## (Orange): Patients +kg NG Tube Size 12-14 Fr 2, ®pen and maintain the airway.Ventilate with 100%oxygen before attempting the i® el. 3 pen i® el package and take i®Gel out of the protective cradle. 4. Lubricate the back,sides, and front of the cuff by rubbing it on the smooth surface oft e protective cradle containing thewater- based lubricant. a Remove dentures or removable plates from the mouth prior insertions 6.Grasp the lubricate i® el firmly along the integral bite block. Position the device so that the i® el is facing towards the chin oft e patient. 7e Maintain the head in i i trauma patients. For non-traumatic patients,the patient°s head should be in the"sniffing"position it the head extended an neck flexed.The chin should e gently press.d do n before proceeding to insert the i® eL S® Introduce the leading soft tip into the mouth of the patient in a direction towards the hard elate. 9® Glide the device downward and backward along the hard palate with continuous but gentle push until a definitive resistance is felt. 10.Attach the End-tidal CO2 device tot e i® el and BVM and confirm placement. I I General Procedural Protocols KLFD BLS&AL i PROTOCOLS Location of bite block "tracheal opening 4 ` ' i�IIIIIIIIIVu11"w //// -r ir���'��Y�rVowwwwuuwwoJoiW �t�lli Oesophageal opening Confirming Secure AirWAY 1. Confirmation of objective methods for tube placement(quantitative electronic capnography)must be used to continuously ensure that an advanced airway is positioned correctly. 2.The following steps are designed to assist the paramedic in verifying initial airway placement and maintaining the airway until the emergency department(ED)staff assumes patient care. a.The paramedic who initially establishes an advanced airway is responsible for maintaining it until the patient is transferred to transport paramedic.While mechanical ventilation may be delegated to another provider,the paramedic is responsible for all aspects of tube placement(lung sounds,capnography,and pulse oximetry). •The transporting paramedic should re-confirm tube placement before assuming responsibility for the patient. b.Quantitative ETCO2 confirmation and continuous monitoring are required for all field intubations(adult and pediatric and suprag(ottic devices). •Quantitative capnography should include continuous display of the ETCO2 waveform and numerical value(normal=35-40 mm Hg). Documentation Documentation is a key component in protecting an EMT against claims of a misplaced airway device or inadequate respiratory care.The documentation should include initial and final assessment of airway placement, regardless of transportation decision(hospital transport or field termination). Documentation should also reflect a reassessment performed after each patient's movement and should be included in the patient care report. I I General Procedural Protocols KLFD BLS&ALS PROTOCOLS .p 00 i N 00 Iq 9 f C. Emergency Incident Rehabilitation This protocol describes the roles of Fire Department personnel in the process of rehabilitating firefighters. Rehab is designed to prevent,detect,and treat such conditions as heat exhaustion, hyperthermia, and dehydration among the workforce, and to remove operational personnel from duty if they cannot safely rotate back into emergency response eff orts° m An Emergency IncidentRehabilitation area: a.Should be designated by the incident commander(IC)or designated sector officer. I should be in a safe location, and upwind and uphill from the hot zone if the incident involves airborne or waterborne threats. b. e specific incident will dictate the type and configuration of the rehab area to be established. For example, if hazardous materials are involved, a decontamination corridor must separate the hot zone from the rehab area. 2. Responsibilities: a. Incident Commander:The incident commander has discretion as to how to implement formal e erg° cy incident rehabilitation( I ). The IC should consider the circumstances of each incident and make adequate provisions early in the incident for the rest an rehabilitation of all members operating at the scene.These provisions may include physical and mentalrest;fluid and food replenishment; relief from extreme climatic conditions and other environmental parameters of the incident; and medical evaluation,treatment, an monitoring. b® Rehab Officer:An EMT- , EMT- , old/may be assigned to the rehab area,and, i appropriate, may be designated bythe IC as the Rehab Off icer( ). If available and practical, it is preferable that AL-Level.personnel and equipment e present, as indicated in NFPA 1500. Rehab sector medical personnel and other assets should be dedicated to support of firefighters and other operational emergency responders andshould be assigned no other responsibilities, c, Rehab Team:Should include sufficient personnel to perform rehab sector functions for the maximum number of personnel anticipated t®be in the Rehab Area at any given time. ratio of one Rehab Team member for every 10 personnel on scene is recommended.The tears should include sufficient EMS personnel to perform medical monitoring tasks but may include non-EMS personnel also. I I General Procedural Protocols KLFD BLS&ALS PROTOCOLS 10 d.Supervisors/Company Officers:All supervisors and company officers should maintain their awareness of the condition of all personnel operating within their span of control and ensure that adequate steps are taken to provide for each member"s safety and health.The ICS structure should be used to request relief and/or reassignment of fatigued crews. e. Personnel:Any member who believes that fatigue or exposure to heat or cold is approaching a level that could affect his performance or the operation in which he/she is involved should advise his supervisor or company officer. Personnel should also remain aware of the health and safety of other members of the crew. 3. Establishing the Rehabilitation Sector: a.The IC should establish a Rehab Sector or Group when conditions indicate that rest and rehabilitation is needed for personnel operating at an incident scene or training exercise. This determination should be made based upon the anticipated duration of the operation, level of physical exertion, and environmental conditions, including temperature, humidity, and windchill. Guidelines to consider include: • Heat stress index>901 F •Wind chill index<100 F i • Personnel have completed (or will complete) exertional work with second 30-minute SCBA cylinder, if firefighting involved • Personnel have used (or will use)SCBA or other protective breathing devices for>45 minutes of physical exertion • It is recommended that an EMS vehicle, not otherwise involved in emergency operations at the scene, be positioned at the Rehab Area. If required,an additional ambulance should be requested to the scene for this purpose. Except under extreme circumstances,this ambulance should not be used for transport of civilian patients. b.The location of the Rehab Area will be designated by the IC and/or the RO,and should: • Be far enough from the scene to allow personnel to safely remove(and leave outside the area)SCBA and/or PPE, and remove personnel from the imminent dangers the scene presents,yet close enough to allow prompt re-entry completion Provide adequate protection from environmental conditions and exhaust fumes • Be easily accessible by EMS units • Be large enough to accommodate several crew members. I General Procedural Protocols KLFD BLS&ALS PROTOCOLS .p 00 w Iq 00 Iq 11 For extreme heat conditions, have shaded areas, misting systems and/or fans, and an area to sit down For extreme cold and/or wet conditions, have dry, protected, heated areas, and dry clothing e integrated ith departmental system for personnel accountability, using a single entry and exit point when feasible. Sites that have been used include a nearby building, ara e, or lobby; a school bus or Large van; and an open, shaded area. Operations:4. Rehab a. Resources:The RO should secure,through the IC or Logistics fficer, all necessary resources to properly supply the sector.These may include oral fluids,foods, medical supplies, paperwork, Lighting, heaters,funs, a means of access to toilet facilities,and other assets as appropriate tot e incident. b. Rotation of ersonnel/ ccount ility:Working units will be assigned tote Rehab Sector by the IC or his designee(e.g.,Operations Off icer)e When possible,the entire unit should be assigned to the Rehab Sector as a group.The crew designation, names of members, times of entry and exit,and appropriate medical information should e documented by the Rehab Off icer or designee on a PCR form or similar document. Personnel rotated to the Rehab Sector should not leave until directed by the P . If any member requires transport to a medical facility,the IC shall be notified immediateLy. c. Hydration: During exertional activity, in both hot and cold weather, personnelshould consume at least one quart per hour of water, activity beverage, or combination. Carbonated and caffeinated beverages should be avoided. During a typical 20- inute rehab cycle, 12-32 ounces of fluids are recommended. d. Nutrition: Food should be provided whenever operations exceed 3 hours. Fatty and salty i foods should be avoided. 5. Medical Evaluation: a,Ask members arriving at the Rehab Area if they have any symptoms of dehydration, eat/cold stress, physical exhaustion, cardiopulmonary abnormalities, or emotional/mental stress. b.Complete a medical evaluation, and appropriate treatment and/or transport,for all members who report such symptoms. ca A medical evaluation,with appropriate treatment and/or transport, should also be completed for any member meeting any oft e following criteria: I I General Procedural Protocols KLFD BLS&ALS PROTOCOLS 12 The RO or Rehab Sector EMS staff observes evidence of one of the above conditions displayed by a member. •Another member,officer,or supervisor indicates he/she does not appear well. •The member had to leave an evolution for reasons of excessive fatigue or symptoms. d.Consider the possibility of toxic exposure in ill or injured responders at fi re, hazmat, and certain law enforcement operational scenes. e.Carbon monoxide levels can be determined non-invasively when pulse oximetry with this capability(CO-oximetry)is available. Management RLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. For personnel with signs or symptoms of dehydration or fatigue, check for toxic exposure, heat-related illness,chest pain,and/or change in mental status.These are medical emergencies;obtain ALS treatment if available and transport to a hospital emergency department. 6. For symptomatic personnel with no evidence of the conditions listed in step 5 and vital signs within the following ranges: I a.Systolic BP>90 and<200 mm Hg b. Pulse rate>50 and <100 bpm c. Respirations> 12 and <24 per minute d.Temperature< 100.50 F Then manage them in rehab as follows: a. Remove as much clothing as possible and minimize exposure to sun and wind. I I General Procedural Protocols KLFD BLS&ALS PROTOCOLS .p 00 cm 00 Iq 13 . Limit as much energy exertion as possible. c. Oral hydration may be administered using a carbohydrate/electrolyte drink, diluted with water. d. Place members in cool place and apply evaporative measures.Avoid shivering as this may raise the core temperature. (Apply cool—not cold—water-soaked towels to as much exposed skin as possible.) e.Administer oxygen and apply pulse oxi etry. . Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit, ALS . Confirm the completion of BLS steps 1-6. m Initiate 0.9%Normal Saline via IWIC at 10 mUk / r®, up to a maximum of 3 L if the patient is severely dehydrated. If the patient's condition does not improve or worsens at any time during the trial of re y ration, he/she should be transported tote hospital. Oral hydration may be administered using a carbohydrate/electrolyte drink,diluted 1:4 with water. 3e Continue to monitor vital signs,administer oxygen, and pulse oxi etry® 4. Continue cold packs and maintain a cool environment.Avoid shivering, as this may raise body core temperature. 5. Obtain 1 ®lead ECG to check for myocardial isc ernia and monitor cardiac rhythm, as necessary, 6. If elevated carbon monoxide levels are documented or suspected,ensure that the patient is on high flow oxygen via non®rebrea in mask( )and IV access is established. 7e If cyanide exposure is suspected advise on-tine medical direction of the situation. 8. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit, I I General Procedural Protocols KLFD BLS&AILS PROTOCOLS .p 4 00 00 Iq I 4 IIL Attleii,eld Met Ral Status miid Uniconsicioiii0siness Review of Injury/l[Iness The term"altered mental status"(AMS) indicates a dysfunction of the central nervous system. Common causes of altered mental status in the field include seizures, shock, diabetic emergencies, drug or alcohol intoxication, medication overdose, stroke, infection, environmental exposure(heat or cold), and traumatic brain injuries. AMS may present anywhere on the spectrum from minimal impairment to unconsciousness. Slurring or other change in speech Memory toss(inabitity to recaft recent events) Unsteady gait*Seizure activity Impaired judgment Inability to verbatly respond or fol.tow commands(u nresponsiveness) Unconsciousness A. Unconscious person BIS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI)measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the atient®s condition. 4. Determine the need for AL S care treatment. 5.Attempt to determine cause of altered mental status(e.g., overdose, intoxication, stroke,diabetes,trauma). 6. Check for hypoxia and provide supplemental oxygen via non-rebreathing mask at high concentration 7. Check blood sugar level with a gLucometer, if available and part of the scope of practice: a. If hypoglycernic(blood sugar<60 mg/dL)and conscious, administer glucose paste(110- 15 gm) between cheek and teeth. May repeat x1 after 10 minutes, if no response. DO NOT III Altered Mental Status and Unconsciousness KLFD BLS&ALS PROTOCOLS awl' give glucose paste to patients who are unconscious and/or do not have the capacity to swallow. Be cautious of vomiting/aspiration after administration and protect the airway. i b. Recheck blood sugar after all interventions,every 30 minutes during transport,and with any change in mental status. 8.Check temperature, if a thermometer is available. 9. Continue supportive care and monitor vital signs until the patient is turned over to a higher level of medical care. ALS 1.Confirm completion of BLS steps 1-8. 2. Provide advanced airway support, if necessary. (Refer to Protocol I.B.). 3. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock. If hypotensive, administer a fluid bolus at 20 ml/kg of 0.9% Normal Saline via IV/IO. 4. If hypoglycemic, administer D50W 50 ml(25 gm)slow IV push. a. Important to have free flowing IV access due to risk of vein sclerosis. 5. If unconscious,or with depressed respiratory function, consider narcotic overdose and administer naloxone 0.4-2.0 mg IV/IO/IM every 2-3 minutes as needed, up to a maximum of 6 mg. 6. Obtain 12-lead ECG and treat dysrhythmias, as appropriate. Continue monitoring cardiac rhythm. Pediatric 1. Follow BLS guidelines. 2.Assess for possible closed head injury. 3. If hypoglycemic:Administer glucose paste(10-15 gm)between cheek and teeth, if awake and able to swallow. ALS 1. Follow BLS guidelines. 2. If hypoglycemic: II 1 Altered Mental Status and Unconsciousness KLFD BLS&ALS PROTOCOLS .p 00 cD C) 0) 1 16 a. Newborn-2 months: D1 OW 2.0-4.0 mL/kg IWIO. b. 2 months-2 years: D25W 2.0-4.0 mi/kg IV110. c. >2 years: D50W 1.0-2.0 ml/kg to max of 50 ml IV/10. 3. If overdose of narcotic is suspected, administer one dose of natoxone 0.1 mWkg up to 2.0 mg IWIM/10. 4. If hypo perfusing, initiate 0.9% Normal Saline fluid therapy 20 mUkg bolus IWIO, except in votume-sensitive children. Titrate to a systolic pressure of 100 mm Hg. a.Volume-sensitive children:Administer an initial fluid bolus of 10 mtlkg 0.9%Normal Saline via IV/10. If patient's condition does not improve, administer the second bolus of fluid at 10 mL/kg 0.9% Normal Saline via IWIO.Volume-sensitive children include neonates (0-28 days)and children with congenital heart disease, chronic lung disease,or chronic renal failure. b, If the patient's condition does not improve,and the lung sounds clear, administer the second bolus of fluid at 20 ml/kg 0.9% Normal Saline via IV/10. c.Administer third (ands e uent)fluid boluses at 10 mL/kg IV110,white monitoring lung sounds. d. Consider additional fluid administration, up to a maximum of 3,000 m(,without consulting on-tine medical directions. 5. Consider obtaining a blood sample, using a closed system. 6. If a patient has constricted pupils and respiratory depression, or is unresponsive, consider narcotic overdose. a.Administer naLoxone 0.4-2.0 mg stow IWIM/10/lntranasaL(if delivery device is available). Titrate to adequate respiratory effort. b. If there is no improvement in respiratory function or level of consciousness, consider an additional dose of naLoxone, every 2®3 minutes as needed, up to a maximum of 6 mg. 7. Continue supportive care and monitor vital signs untilthe patient is turned over to a higher level of medical care. 111 Altered Mental Status and Unconsciousness KLFD BLS&AL PROTOCOLS 1 B.Seizure Review of Iniiury/Illness: Seizures are caused by abnormal electrical bursts in the brain. Partial, or focal, seizures may cause uncontrolled movements of one or more limbs or the face, though patients typically remain conscious during focal seizure activity.Generalized seizures, sometimes referred to as"fits"or"convulsions,"involve both sides of the brain,and therefore typically produce unconsciousness.Generalized seizures may involve tonic(rigid stretching of the body and limbs)and/or clonic(rhythmic jerking of the limbs and/or head)activity. Many, but not all, patients experience an"aura"of symptoms that warn there of a coming seizure, allowing them to sit or lie down to prevent injury.Others have no warning, and may be seriously injured by falls, blunt trauma, motor vehicle accidents, near drowning, or other incidents caused bytheir sudden loss of consciousness and body control. Seizures may be caused by head trauma, low blood sugar, infections,fevers,tumors, hypoxia,environmental exposure,toxic chemical exposure(e.g., a nerve agent, insecticide), or other metabolic abnormalities.They may also occur periodically in individuals without evidence of one of these causes—a condition called"epilepsy;'which typically is controlled to some extent by medication. Febrile seizures in children do not predict underlying epilepsy and seldom last long enough to require treatment in the field but should always be evaluated by a physician when they occur. Epileptic seizures generally last from 30 seconds to a couple of minutes and may be followed by a postictal state of deep sleep or agitation lasting from a few minutes to several hours. Generalized seizures that last for 5 minutes,or more are considered"prolonged seizures"These may require treatment to be stopped,and the patient should be transported as expeditiously as possible. Continuous or recurrent generalized seizures without regaining consciousness over a period of 30 minutes is called "status epilepticus" or"status seizure."This is a true medical emergency,with the potential for permanent brain damage. Signs and Symptoms Focal seizures *Uncontrolled, rhythmic jerking of one or more limbs or facial muscles *Abnormal, but stereotyped behavior or sensations such as smells not related to the environment *Patients typically remain awake and may be variably responsive during focal seizures ll f Altered Mental Status and Unconsciousness KLFD BLS&ALS PROTOCOLS .p cc i C%4 0) Iq Generalized seizures May be preceded by an aura Patients are unconscious *Tonic/ctonic muscle activity *Likely to have associated injuries Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universat Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. For generalized (typically tonic-clonic)seizure, monitor airway: a. DO NOT attempt to restrain a patient that is actively seizing. b. DO NOT force any device into the patient's mouth, if the patient is still seizing. c. Position patient to maintain open airway;turn onto side if patient is at risk for aspirating excess secretions or is vomiting. 6. For prolonged seizures or status epilepticus(status seizure), request AL S support for medication, and/or transport to hospital ASAR 7. When seizure activity has stopped: a. Identify and treat injuries. b. If the patient is a known diabetic, and patient is awake/able to control airway,glucose paste(10-15 gm) should be administered between the gum and cheek. Consider a single additional dose of glucose paste if condition does not improve after 10 minutes. 8. Continue supportive care and monitor vital signs until the patient is turned over to a higher level of medical care. V I Altered Mental Status and Unconsciousness KLFD BLS&ALS PROTOCOLS i 19 ALS 1. Confirm completion of BLS steps 1-7. 2. initiate 0.9% Normal Saline via IV/10 at KVO or saline lock. 3. Check blood sugar. 4. For prolonged seizure or status epilepticus,treat with the IV/10 benzodiazepine, according to local protocols: a. Midazolam: 5.0 mg IV/10,administer over 1-2 min b. Patients z 69 years: Reduce any of these medications by 50%. c. If IV is unavailable,check with on-line medical direction for alternative route and dosing. 5. Pregnant women require on-line medical consultation prior to the administration of any benzodiazepines. (Refer to Protocols VII.A and VII.B.) 6.Continue supportive care and monitor vital signs until the patient is turned over to a higher level of medical care. Pediatric 1. Follow BLS guidelines,adjusting for patient age/size. ALS 1. Follow BLS guidelines,adjusting for patient age/size. 2. Initiate 0.9%Normal Saline via IV/10 at KVO or saline lock. 3.Check blood sugar. 4. For prolonged seizure or status epilepticus,treat with the IV/10 benzodiazepine, according to local protocols: a. Midazolam: Administer 1.0-5.0 mg(0.05 mg/kg) IV/IOAM; repeat every 5 minutes, up to a maximum of 0.1 mg/kg, if needed. b. If medications are administered, monitor cardiac rhythm and pulse oximetry. 111 Altered Mental Status and Unconsciousness KLFD BLS&ALS PROTOCOLS .p cc w 20 C. Diabetic Emergencies BM-ew-of-Ill easfinilwy Diabetes mellitus is a group of conditions in which the body does not produce enough or cannot property use insulin. Insulin shock(hypoglycemia or low blood sugar)occurs when a patient has received more insulin than was needed.This causes to blood sugar Levels, so metabolically active cells (e.g., brain)do not have enough energy to function normally.An altered mental status, including unconsciousness, may occur and is treated by administering glucose. Diabetic coma (hypergLycemia, diabetic ketoacidosis, and hyperosmotar coma)occurs when insulin is insufficient or not working.This results in excessive sugar circulating in the bloodstream, and other metabolic changes. nd-Zymptoms Insulin Shock •Rapid respirations and/or heartbeat •Dizziness *Sweating *Headache *Confusion *May progress to unresponsiveness Diabetic Coma •Drowsiness •Confusion *Thirst,dehydration *Change in level of consciousness *Sweet or fruity-smeLLing breath mnt 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 111 Altered Mental Status and Unconsciousness KLFD BLS&AL S PROTOCOLS 21 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Determine blood sugar level using a glucometer, if available and usage permitted by local protocols. 6. If hypoglycemic(blood sugar<60 mg/dQ and conscious,administer glucose paste(10- 15 gm) between cheek and teeth. May repeat x1 after 10 minutes, if no response. DO NOT give glucose paste to patients who are unconscious and/or do not have the capacity to swallow. Be cautious of vomiting/aspiration after administration and protect the airway. 7. If a patient's condition improves,and he/she does not wish further evaluation, no medical direction is required, if all the following are present: a.This was an acute hypoglycemic event in a diabetic patient and he/she has returned to an alert and oriented mental status. b.Oral glucose was administered. c.The current glucose reading is>80 mg/dL. d.A responsible adult is present. e. Further caloric intake is assured.f.There are no clinical findings consistent with acute illness. 8.Continue supportive care and monitor vital signs until the patient is turned over to a higher level of medical care. Patients on oral hypoglycemic agents who have a hypoglycemic's episode must be transported for further monitoring. ALS 1.Confirm completion of BLS steps 1-8. 2. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock. 3. If hypoglycemic(blood sugar<60 mg/dL):Administer Dextrose(D50W)50 ml of 50% solution slow IV push. a. If unable to obtain IWIO access,administer Glucagon(1.0 mg) IM. II 1 Altered Mental Status and Unconsciousness KLFD BLS&ALS PROTOCOLS .p 11 cc 22 b. Patients on oral hypoglycemic agents who have a hypogtycemic's episode must be transported for further monitoring. 4. If hypergtycemic(blood sugar>400 mg/dL): Run IV 0.9% Normal Saline or open. a. Reassess bilateral lung sounds and pulse oximetry after each 250 mt of fluid. b. Do not exceed 2 L of IV fluid without consulting on-Line medical direction. 5. Re-check glucometer reading every 30 minutes, or for altered mental status, during transport. 6. Refer to"Refusal of Further Evaluation"in this section, if patient does not is further evaluation or transport. Pediatric 1. Follow BLS guidelines, adjusting for patient age/size. 2. Re-check glucometer reading: a. If hypoglycemic(bloc d sugar<60 mg/dL):Administer glucose paste(10®1 gm) between cheek and teeth. May repeat x1 after 10 minutes, if no response. DO NOT give glucose paste to patients who are unconscious and/or do not have the capacity to swallow. Be cautious of vomiting/aspi ration after administration and protect the airway. hyperglycemic(blood sugar>400 mg/dL):Contact on-tine medical direction. I Ref u at of Further Evatuation 1. If a patient's condition improves,and he/she does not wish further evaluation, no assistance from on-line medical direction is required if aRthe following are present: a.This was an acute hypog Lyon mic event in a diabetic patient and he/she has returned to an alert and oriented mental status. b. Oral glucose was administered, c.The current glucose reading is>80 mg/dL. d.A responsible adult is present. e. Further caloric intake is assured. f.There are no clinical findings consistent with acute illness. 111 Altered Mental Status and Unconsciousness KLFD SLS&ALS PROTOCOLS ,23 g.The patient is not using prescribed oral hypoglycemic agents. D.Confusion,Agitation Review of Injury/ItLness "Confusion"is a state in which a patient has difficulty both understanding his surroundings and ascertaining a response. "Agitation"suggests heightened anxiety and frequently includes combative behavior.There are many causes for acute onset of confusion and/or agitation.These include but are not limited to behavioral emergencies, metabolic emergencies including hypoxia and hypoglycemia, hypo/hyperthermia intoxication or over- medication, and head injury.All these conditions are covered elsewhere in these protocols, and all require transportation for full medical evaluation and treatment. Signs and Symptoms This protocol pertains to patients who are awake and alert, but present with an acute change from their normal mental status. It is important to establish and convey to the transport unit whether the patient is oriented (knows who and where he/she is and the day and date).This can only be established by asking these questions. Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment.a. Restrain only if necessary for patient and staff safety,following local protocols for methods of restraint and documentation requirements. 5.Check for hypoxia and provide supplemental oxygen via a non-rebreathing mask at high concentration if present. 6.Assess patient for possible closed head injury and follow trauma protocol if appropriate. 7.Check blood sugar level. a. If hypoglycemic (blood sugar less than 60 mg/dQ, administer glucose paste. (Refer to Protocol I I.C.) III Altered Mental Status and Unconsciousness KLFD BLS&ALS PROTOCOLS .p cc 4 00 0) Iq 24 b. Recheck blood sugar after all interventions. B. Check for signs of dehydration and provide oral or IV re hydration, (Refer to Protocol Vill-A.) 9. Continue supportive care and monitor vital signs until the patient is turned over to a higher Level of medical care. AU 1. Confirm completion of BILS Steps 1® (above). 2. Initiate 0.9% Normal Saline via IWIO at KVO or saline Lock. If hypotensive, administer a fluid bolus at 20 ml/kg of 0.9%Normal Saline via IWO. 3. If hypoglycemic, refer to Protocol II.C. 4. If a patient has constricted pupils and respiratory depression,or is unresponsive, consider narcotic overdose. a®Administer nalaxone 0.4-2.0 mg slow IWIM/10/intranasal(if delivery device is available). Titrate to adequate respiratory effort. b. If there is no improvement in respiratory function or level of consciousness,consider an additional dose of natoxone, every 2®3 minutes as needed, up to a maximum of 5. Obtain 12-lead ECG and treat dysrhythmias, as appropriate. Continue monitoring cardiac rhythm. Meaalric DIS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Assess for possible closed head injury. 3. If hypoglycemic:Administer glucose paste(1 ®1 gm) between cheek and gum, if awake and able to swallow. ALS 1. Follow BILS guidelines® adjusting for patient age/size III Altered Mental Status and Unconsciousness KLFD BLS&ALS PROTOCOLS .p c� C) C) L0 1111.Acute Respiratory Distress General Review A variety of conditions can cause acute difficulty breathing or inadequate oxygenation. Examples include asthma (including allergic reactions involving the airway or allergic bronchospasm), chronic obstructive pulmonary disease(including emphysema), congestive heart failure, respiratory tract infections, pulmonary emboti, and others.Any of these processes can lead to respiratory failure➢ or loss of the ability to inhale oxygen and exhale carbon dioxide. EMS care of patients in acute respiratory distress should determine what is causingthe difficulty breathing and use the appropriate protocols to improve ventilation and oxygenation in the fi el d environment. A.Asthma Review of luryffiness Asthma is a chronic lung disease that causes inflammation and narrows the air passages {bronchus pasm), It affects people of all ages but usually begins in childhood. In the fi eLd, all causes of acute bronchospasm are treated essentially the same. SWWmandJ9YmpWms *Coughing *Wheezing *Diff icutty exhaling *Shortness of breath *Chest tightness *Retractions and nasal flaring in pediatric patients 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe, 2. Institute appropriate Body Substance Isolation(BSI) measures/Universat Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated byte patient's condition. 1111 Acute Respiratory Distress KLFD BLS&AL PROTOCOLS 4. Determine need for ALS care and/or transport to hospital for further evaluation 5. Provide supplemental oxygen. 6. Be prepared to assist ventilations with a bag valve mask(BVM), if necessary. 7.Allow patient to assume position of comfort. 8. If the patient has prescribed inhaler available, assist the patient to administer; repeat once in a 30-minute period, if difficulty breathing persists. 9. If a patient's asthma is historically precipitated by allergies, and he/she has an EpiPen`" prescribed by a physician for that purpose, assistance may be offered for administration. 10. Continue supportive care and monitor vital signs until the patient is turned over to a higher level of medical care. ALS 1.Confirm the completion of BLS steps 1-9. 2.Administer Albuterol 2.5 mg in 3 ml 0.9% Normal Saline via nebulizer. Repeat nebulizer treatments,with Albuterol only,every 5 minutes as needed. 3. If ventilatory support is needed,continue nebulized Albuterol treatment via BVM or while assisting respirations through advanced airway. NOTE:Although sometimes needed, intubation further narrows the airway restriction in a severe asthma exacerbation, and this may worsen some cases.Aggressive use of bronchodilators is generally the most important therapy for severe asthma exacerbation. 4. Initiate 0.9% Normal Saline via IV/IO at KVO or saline lock. 5.Administer epinephrine 0.3-0.5 mg of 1:1,000 solution SQ, may repeat x1 in patients<40 years old with no history of cardiac disease, if there is no improvement with nebulizer treatment or if in extreme respiratory distress. Pediatric )ES 1. Follow BLS guidelines,adjusting to patient age/size. 1111 Acute Respiratory Distress KLFD BLS&ALS PROTOCOLS .P C i C%4 C) Ul) 27 AU 1. Follow BLSguidelines, adjusting to patient age/size. 2. Initiate 0.9%Normal Saline via IWIO at KVO or saline Lock. 3.Administer ALbuterot adjusting for patient age/size,via nebuLizer. Repeat nebuLizer treatments,with ALbuterol only, every 5 minutes as needed. 4. Epinephrine: 0.01 mg/kg SQ, up to a maximum of 0.5 mg. S.COPD(Chronic Bronchitis and/or Emphysema) Review of Inimy/lUnan Chronic obstructive pulmonary disease (COPD)comprises several problems that impede the flow of gases through the airways and gas exchange in the Lungs. Most, but not all, cases result from smoking or Long-time asthma.Acute exacerbations of COPD are frequently caused by bronchospasm,which may in turn be triggered by infections, changes in air quality, or other environmental factors. *Shortness of breath *Wheezing, rhonchi,or sometimes severely decreased breath sounds *Chronic cough with Large amounts of mucus *Frequent respiratory infections managamant BI.S. 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Provide supplemental oxygen. 1H Acute Respiratory Distress KLFD BLS&ALS PROTOCOLS i 28 a.Administer oxygen at a high-flow rate to all patients in severe respiratory distress. b.COPD patients not in respiratory distress should be given oxygen to maintain adequate 02 saturation(e.g., >90%). 6. Be prepared to assist ventilation, if necessary,with a bag valve mask. 7.Allow patient to assume position of comfort. 8. If the patient has a prescribed inhaler available, assist the patient to administer. 9. Continue supportive care and monitor vital signs until patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-8. 2. Initiate 0.9% Normal Saline via IV/IO at KVO or saline lock. 3. Administer Albuteral adjusting for patient age/size,via nebulizer. Repeat nebulizer treatments,with Albuterol only,every 5 minutes as needed. 4. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 5.Obtain 12-lead ECG and treat dysrhythmias, as appropriate. Continue monitoring cardiac rhythm. 7. Monitor pulse oximetry. Pediatric BU 1. Follow BLS guidelines,adjusting for patient age/size. ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 3. Epinephrine:Administer 0.01 mg/kg SQ, up to a maximum of 0.5 mg. 4. Monitor cardiac rhythm and pulse oximetry. 1111 Acute Respiratory Distress KLFD BLS&ALS PROTOCOLS .p o w Iq C) Ul) 29 C. Hyperventilation Reyje-w-- /llt Hyperventilation is rapid, deep breathing. It may be seen in panic or anxiety attacks. •Agitation •Weakness *Dizziness *Confusion •Numbness or parasthesia of fingers and around the mouth *Syncope Managomw 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I A. 3. Perform patient assessment and initiate routine BLS care, as outline d in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for PALS care and/or transport to hospital for further evaluation and treatment. 5.Allow patients to assume a position of comfort, 6.Administer oxygen via non-rebreathing mask, if needed. 7. Coach patient to stow breathing with a calm demeanor. 8. Continue supportive care and monitor vita[signs until the patient is turned over to an ALS transport unit. "L 1. Confirm the completion of BLS steps 1-8. 2. Initiate 0.9% or al Saline via IWIO at KVO or saline lock. 3. Confirm patient is not hypoxic with pulse oximetry, and coach to stow breathing. INN Acute Respiratory Distress KLFD BLS&ALS PROTOCOLS 4. Consider any of the following sedatives as a last resort: a. Midazolam: 2.0 mg IWIO, up to maximum of 4.0 mg; repeat once, if needed. b. If medications are administered, place them on cardiac monitor. Pediatric BLS/ALS 1. Follow BLS guidelines,adjusting for patient age/size. 2. Confirm patient is not hypoxic with pulse oximetry, and coach to slow breathing. 1111 Acute Respiratory Distress KLFD BLS&ALS PROTOCOLS I .p o _ cn (D C) Ul) 31 IV. lBehaviorat Emergencies Many factors can influence a person's behavior.A pattern of disruptive behavior can become an emergency at any time. Behavioral emergencies may be psychiatric or medical. Always search for underlying medical causes such as head trauma, hypoxia, drug overdose, postictal following a seizure, or hypogLycemia. *Talking to imaginary person or object *Agitation *Threat of suicide or homicide *Inability to care for self *Threatening or violent behavior 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. REQUEST LAW ENFORCEMENT. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. S. Maintain calm demeanor and respect the dignity of the patient. 6. Move slowly and deliberately. 7. Assess underlying medical issues. 8. Check blood sugar and monitor pulse oximetry, if possible. 9. If the patient is spitting,cover his/her face with a surgical mask or non-rebreating mask (NRBM)with high flow oxygen. 10. Continue supportive care and monitor vital signs until the patient is turned over to an ALS trans port unit. IV I Behavioral Emergencies KLFID BLS&ALS PROTOCOLS 32 AU 1.Confirm the completion of BLS steps 1-10. 2. Establish IW10 of 0.9% Normal Saline via IV/10 at KVO or saline lock, if appropriate. 3. If patient remains combative, belligerent, or uncontrollable,consider any of the following sedatives as a last resort, according to local protocols: a. Midazolam:Administer 2.0 mg IV/10; repeat once, up to maximum of 4.0 mg. b. If medications are administered,place the patient on a cardiac monitor. Monitor cardiac rhythm and pulse oximetry. Pediatric i� 1. Follow BLS guidelines,adjusting for patient age/size. 2.Attempt to locate parent or guardian, if not on scene.ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Establish IWO of 0.9%Normal Saline via IV/10 at KVO or saline lock, if appropriate. 3. If patient remains combative, belligerent, or uncontrollable, consider any of the following sedatives as a last resort,according to local protocols: a. Midazolam:Administer 1.0-5.0 mg(0.05 mg/kg) IV/10/IM; repeat every 5 minutes, up to a maximum of 0.1 mg/kg, if needed. b. If medications are administered,place the patient on a cardiac monitor. Monitor cardiac rhythm and pulse oximetry. IV I Behavioral Emergencies KLFD BLS&ALS PROTOCOLS .p cn 0 4 00 0 L0 3 V. Burns IniurytIM931 urn injury can result from irec r indirect contact with any heat source, including flame, electrical, chemical, lightning,flammable Uquid,flashes, radiation,or scalding liquids. Injuries can range fromminor(1 st and 2nd degree)to Life-threatening(3rd and 4th degree urns),(Also referto Protocol XG-Electrical Burns and Lightning Injuries.) _ ins and Symptoms Inhalationit *Diff icuLty breathing / swallowing •Hoarseness •Stridor *Wheezing Soot/singed• it •May or may not exhibit facial First (superficial thickness skin) *Redness i Swelling Second degree(partial thicskin) *Pain Swelling *Blistering Third (fuLL thicknessskin) *May be white,Leathery or charred •Swelling *Underlying tissue is damaged *May or may not have pain V I Burns KLFD BLS&ALS PROTOCOLS 34 Fourth degree(full thickness burn to skin;not universally used term) *Burns extend through skin and muscle,sometimes into bone. Management BU 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Provision of supplemental oxygen is crucial to patients with smoke inhalation due to possible carbon monoxide poisoning.Start with 100%02 by non-rebreathing mask(NRBM) if patient has altered mental status. 6. Be prepared to assist ventilation with a bag-valve-mask, if necessary. 7. For singed nasal hair or burns around the mouth or nose, request ALS support and transport as quickly as possible, as airway burns, and edema can result in rapid loss of airway. 8. Evaluate burn surface area (BSA) using the"Rule of Nines"or estimate using the patient's palm as 1%. Measuring BSA does not predict severity of injury for electrical burns. 9. Determine if there is any associated traumatic injury. 10. Remove jewelry and any clothing that is not stuck to the wound. 11. Cool burned skin with room temperature saline, do not apply ice to burned tissues. 12. Cover burns with dry, sterile dressing if irrigation is discontinued. 13. Keep patient warm to protect against hypothermia. 14. For a chemical burn,wear protective equipment as needed,and consider fi eld decontaminant. Remove contaminated clothing and irrigate areas with copious amounts of water. If dry/powdered chemical, brush off prior to any irrigation. V i Burns KLFD BLS&ALS PROTOCOLS .P 0 co 0 r Lf'> 35 ALS 1. Confirm the completion of BLS steps 1-15. . Continue high flow 100%02 by non®re reat in ask( )if CO poisoningis possible or if it is documented by CO-oximetry. 3. Monitor airway as airway edema may progress rapidly to complete obstruction. Provide advanced airway support, if necessary. (Refer to Protocol I. .) . Initiate 0.9% Normal Saline via IWIO through unburned skim, if possible. If BSA>2 % second degree or higher burns,administer fluid bolus with 500 ml of 0.9% Normal Saline via IWI . a. Check lure sounds after each 250 ml fluid bolus. b. If hypotensive, repeat fluid bolus, as needed. c. Use caution with IV fluids to avoid hypothermia and fluid overload. d. Calculate IV fluid resuscitation using Parktand formula. •Total IV fluid for first 24 hours =4 x%BSA x Weight(kg) • Deliver first half of IV fluids in the first 8 hours, second half in the following 16 hours. 5®Obtain 12®led ECG andmonitor cardiac rhythm. Pe-djaUbc . Follow BLS guidelines, adjusting for patient age/size. 2.Adjust estimates of involved BSA for pediatric patients using the Lurd® roaden chart for age-adjusted age-adjusted Pule of Nines. a. For patients< 1 year, head = 18%and each leg is 1 %. b.Add Oafs to each leg and subtract 1%from head for each year over age 1. 3.Suspect child abuse when injuries and/or story are inconsistent. Report to authorities, s required by state or local laws. 4. ConsiderAero edical evacuation to a Pediatric Trauma Center or Burn Center. V I Burns KLFO BLS&AL;PROTOCOLS ,6 ALS I 1. Follow BLS guidelines,adjusting for patient age/size. 2.Adjust estimates of involved BSA for pediatric patients using the Lurd-Broaden chart for age-adjusted Rule of Nines. a. For patients< 1 year, head =18%and each leg is 15%. b.Add 0.5%to each leg and subtract 1%from head for each year over age 1. 3. Initiate 0.9% Normal Saline IWIO through unburned skin, if possible. If BSA>20% second degree or higher burns,administer fluid bolus with 20 ml/kg of 0.9% Normal Saline via IV/IQ. a.Check lung sounds after each fluid bolus. b. If hypotensive, repeat fluid bolus 20 ml/kg,as needed. c. Use caution with IV fluids to avoid hypothermia and fluid overload. •Total IV fluid for first 24 hours=4 x% BSA x Weight(kg) • Deliver first half of IV fluids in the first 8 hours, second half in the following 16 hours. 4. Suspect child abuse when injuries and/or story are inconsistent. Report to authorities as required by state or local laws. 5. Consider the need for Aeromedical evacuation to the nearest Burn Center or Pediatric Trauma Center. i i V i Burns KLFD BLS&ALS PROTOCOLS .p cn _ i i C%4 37' V1.Cardiac Emergencies A.Chest Pain (Angina,Acute Coronary Syndrome) Revi ew-offnfuryfillnem Inaddition to cardiac ischernia, chest pain may be caused by inflammation oft a lungs or pleural linings, pneumothorax, pulmonary embolus, indigestion,gastric reftux, and other problems. It is sometimes difficult to distinguish cardiac chest pain from these other problems. "Acute coronary"syndrome (ACS)refers to a set of symptoms resulting from inadequate blood flow to the heart muscle.The blood supplyforthe myocardium is provided by the coronary arteries,and when one or more of the coronaries is narrowed or blocked,ACS results.ACS includes angina pectoris, or chest pain, indicating inadequate blood to to the myocardium. Myocardial infarction (MI)occurs when the muscle has been deprived of blood and oxygen to enough for it to be permanently damaged. Electrocardiograms (ECG)of patients having acute MI may show elevation oft e ST segment in leads corresponding to the part of the heart that is being damaged.This is called ST elevation, MI, or STEMI. NOTE: any patients who are having acute MI do not show ST elevations, Chest pain/dIscomf ort that may radiate to the left or right arm, shoulders,jaw,or back Frequently described as pressure or a crushing pain Shortness of breath,sweating, nausea,or vomiting Diaphoresis Women,elderly,and diabetic patients have a higher incidence of atypical presentations such as generalized weakness or fatigue, nausea,and epigastric pain MAIM190MBM 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol LA. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I. and as indicated by the patient's condition. V1 I Cardiac Emergencies KLFD BLS&PALS PROTOCOLS 38 4. Determine need for ALS care and/or transport to hospital for further evaluation and treatment 5. Provide supplemental oxygen: a. 2.0-6.0 L/min via nasal cannula, if pulse oximetry is normal and the patient is not short of breath. b. 100% by non-rebreathing mask if 02 saturation is<90% or if patient is subjectively short of breath. 6. Be prepared to assist ventilations with a bag valve mask(BVM), if necessary. 7.Allow patient to assume position of comfort. 8. If the patient has prescribed nitroglycerin,and there are no contraindications, assist the patient to administer nitroglycerin 0.4 mg sublingual(SL); may repeat every 5 minutes up to a maximum of 3 doses, provided Systolic BP;? 100 mm Hg and chest pain persists. a. Contraindications to first dose of SL nitroglycerin: • Use of erectile dysfunction medications in previous 72 hours • Systolic BP< 100 mm Hg 9. For chest pain consistent with ACS,administer aspirin 162-324 mg,after confirming the following: a. No history of ulcers or gastrointestinal bleeding b. No history of allergy or sensitivity to aspirin 10. Continue to assess pain level. 11.Assess and treat for hypotension or shock, if indicated. (Refer to Protocol X.I.) 12. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-12. 2. Initiate 0.9%Normal Saline via IV/IO at KVO or saline lock. 3. Obtain a 124ead ECG and monitor cardiac rhythm. VI Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p i W 39 4®Administer aspirin (162-324 mg)orally, if patient is awake, able to swallow, and denies aspirin allergy. 5. If patient does not have a prescription or previous history of nitroglycerin use: a. Establish a 0.9% Normal Saline via IWIO at KVO prior to administration. b.Administer nitroglycerin 0.4 mg sub Lin gual(SL); may repeat every 5 minutes up to a maximum of 3 doses, provided Systolic BP 2, 100 mm Hg and chest in persists. c. If I O or saline lock cannot be established, consult on-tine medical direction before nitroglycerin use. 6.Withhold administration of nitroglycerin if the patient has an obvious inferior M I (> 1 mm ST segment elevation in at[east 2 of the inferior Leads 11, 111,AVF)or with ECG evidence of a right ventricular infarct. 7. If Systolic BP< 90 mm Hg, place patient insupine position with Legs elevated and administer 250 mt fluid bolus of 0.9% Normal Saline via IWIO. 8. Consider repeating ECG every 15 minutes,as indicated by changes in chest pain. 9. Monitor cardiac rhythm and treat any dysrhythmia according to current AHAIACLS guidelines. B.Cardiogenic Shock ReAem_DJi ®Illu Cardiogenic shock indicates failure of the heart's pump function. Like other forms of shock, it presents with to blood pressure and evidence of inadequate perfusion of the brain and other vital organs. It is caused by profound weakness of the Left ventricular muscle, most often due to a large area of myocardial ischemia or infarct, or to a severe inflammatory process(myocarditis). In cardiogenic shock,the tow blood pressure is due entirely to Loss of pump function, notto hypovolemia.Therefore, patients are often in congestive heart failure with distended neck veins and pulmonary edema despite the hypotension. Other processes that impede cardiac pump function (e.g.,tension pneumothorax,cardiac tamponade) may cause patient presentations similar to car diogenic shock. * Distended neck veins * Pulmonary edema(rates on auscultation) V1 I Cardiac Emergencies KLFD BLS&ALS PROTOCOLS 40, *Decreased heart sounds *Hypotension *Tachycardia *Electrocardiographic changes consistent with current or recent Mi *Sudden deterioration in condition(respiratory failure,decreased mentation) Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/ortransport to hospital forfurther evaluation and treatment. 5. Provide supplemental oxygen(100%by non-rebreathing mask[NRBM]). 6. Be prepared to assist ventilation, if necessary,with a bag valve mask. 7.Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1.Confirm the completion of BLS steps 1-6. 2. Initiate 0.9%Normal Saline via IWIO at KVO or saline lock;titrate to achieve a Systolic BP a100mmHg. 3. If Systolic BP<90 mm Hg, administer 250 ml fluid bolus with 0.9%Normal Saline via IWIO, and reassess both BP and lung sounds. If lung sounds are clear, repeat with a second 250 ml fluid bolus with 0.9%Normal Saline via IWIO. 4.Consider other causes of the patient's shock. 5.Obtain 12-lead ECG and monitor cardiac rhythm. 6. Provide advanced airway support, if necessary. (Referto Protocol I.B.) VI I Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p i V1 41 C.Congestive Heart Failure(Pulmonary Edema) Review of IniMIRtness Congestive heart failure(CHF) occurs when the heart is not strong enough to pump the blood that returns to it via the venous system out to the rest of the body against the resistance produced by tearteries.This causes the body to retain fluid as it tries to build up enough"head pressure"to compensate for the faiLing pump. Eventually,the combination of increased circulating volume and ineffective pumping action causes fluid to build up in the Limbs and abdomen (right-sided CHF), and the lungs (teft-sided CHF, pulmonary edema). Patients may present it biventricular, or both right and Left-sided CHF.This protocol deals prim aril ywith puLmonaryedema,a life-threatening emergency. The pump failure of CHF can be caused by Long-standing hypertension, damage to the heart's valves, and toss of myocardial muscle strength due to inflammation or infarct. •Edema, most often in Legs and ankles •Fatigue •Diff icutty breathing on exertion or when Lying down •Pulmonary edema causes severe shortness of breath and hypoxia at rest;may be improved by sitting upright Frothy sputum, may be pink-tinged 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Provide supplemental oxygen (100%by non-rebreathing mask[NRBM]). R.Assist ventilations with a bag valve as (BVM), if necessary. V1 I Cardiac Ernergencies KLFD BLS&ALS PROTOCOLS 42 7. If the patient has prescribed nitroglycerin,and there are no contraindications, assist the patient to administer nitroglycerin 0.4 mg sublingual(SL); may repeat every 5 minutes up to a maximum of 3 doses, provided Systolic BP a 100 mm Hg and chest pain persists. a. Contraindications to first dose of SL nitroglycerin: • Use of erectile dysfunction medications in previous 24 hours •Systolic BP< 100 mm Hg 8. Continue to monitor vital signs, including pulse oximetry, if available. 9.Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1.Confirm the completion of BLS steps 1.8. 2. Initiate 0.9% Normal Saline via IV/IO at KVO or saline Lock. 3.Obtain a 12-lead ECG and monitor cardiac rhythm. Pediatric 1. Follow BLS guidelines, adjusting for patient age/size. 2. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 3.Administer Albuterol 2.5 mg in 3.0 ml Normal Saline. 4. Monitor cardiac status and pulse oximetry. D. Cardiac Arrest Ventricular Fibrillation,Non-Perfusing Ventricular Tachycardia,Asystole, Pulseless Electrical Activity VI I Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .P i 00 43 Review of IniMlIltness BLS and ALS protocols to resuscitate patients in cardiac arrest should be based on the most recent American Heart Association guidelines and approved by local medical direction.The protocols below require that all BLS providers be trained to use and have access to automatic or semi-automatic defibrillators(AED). •Unresponsive •No palpable pulse •ELectricat activity on ECG is absent or shows course/fi ne ventricutar fibrillation or ventricutar tachycardia No respirations(possible agonat gasping in initial stage ement 131-S 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/UniversaL Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I A., and as indicated byte atient➢s condition. 4. Determine the need for ALS care and/or trans port to hospital for further evaluation and treatment. 5. If witnessed arrest: Defibrillate,one time for to starting CPR. (Refer to step 6.) & If unwitnessed arrest:Start CPR according to current American Heart Association (AHA)guidelines. a. Resume 5 cycles of CPR(2 minutes)with minimal interruption(<10 seconds). Push hard and fast(chest compression of 2 inches at a ratio of 30:2 with a rate of 100 compressions/min.(DO NOT wait to check rhythm or pulses.)Apply an AED as soon as possible. • Change compressors every 2 minutes. • Ensure complete chest recoil during CPR Vi Q Cardiac Emergencies KLFD BLS&ALS PROTOCOLS 44 b. Defibrillate one time,ASAP, if indicated; resume 5 cycles of CPR(2 minutes)with minimal interruption (< 10 seconds). c. Re-check rhythm on AED or cardiac monitor and check pulses. d. Defibrillate one time,ASAP, if indicated; resume 5 cycles of CPR(2 minutes)with minimal interruption(<10 seconds). e. Re-check rhythm and pulses. f. Defibrillate one time,ASAP, if indicated; resume 5 cycles of CPR(2 minutes)with minimal interruption(<10 seconds). g. Re-check rhythm and pulses. 7. Manually ventilate with a bag valve mask(BVM)and high flow 02 every 6-8 seconds with minimal interruption (< 10 seconds)ASAP.Avoid excessive ventilation. 8. Continue CPR until the patient is turned over to an ALS transport unit. 9. If there is no return of spontaneous circulation, refer to Protocol XI.C. ALS(VE Pulseless VT-Adult) 1.Confirm the completion of BLS steps 1-6. 2. Resume CPR,administer supplemental oxygen,attach manual defibrillator, and verify that VF/VT is present on the monitor. 3. Defibrillate one time. If a shockable rhythm(VF/VT)develops, resume 5 cycles of CPR (2 minutes)with minimal interruption (< 10 seconds). 4. Initiate intubation, or provide advanced airway support,and verify correct placement with capnography with minimal interruption of CPR(< 10 seconds). 5. Initiate 0.9%Normal Saline via IV/10 at KVO or saline lock with minimal interruption of CPR(<10 seconds). 6.Administer epinephrine 1.0 mg IV/IO/ET, every 3 5 minutes,with minimal interruption of CPR(< 10 seconds). 7. Defibrillate one time. If a shockable rhythm(VF/VT)develops, resume 5 cycles of CPR (2 minutes)with minimal interruption (< 10 seconds). 8. If refractory VF/VT:Administer Amiodarone 300 mg bolus IV/10; may repeat x1 at 150 mg bolus IV/10. VI I Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p cn i C) C%4 Ul) 45 9. Defib rill ate onetime. If a shockable rhythm(VF/VT)develops, resume 5 cycles of CPR (2 minutes)with minimal interruption (< 10 seconds). 10. Identify and treat reversible causes; • HypovoLemia • Hypoxia • Hydrogen Ion(acidosis) • Hypo/hyperkaLemia • Hypothermia *Tamponade, cardiac *Tension Pneumothorax Thrombosis, coronary Thrombosis, pulmonary Toxins 13. If spontaneous circulation returns, monitor vital signs, support airway and breathing per Local protocols. 14. If there is no return of spontaneous circulation, refer to Protocol I.C. ALSIARYWWWREA.-Adult) 1.Confirm the completion of BLS steps 1-6. 2. Resume 5 cycles of CPR(2 minutes)with minimal interruption(<10 seconds). 3.Administer supplemental oxygen,attach manual defibrillator,and verify that Asystole is present on the monitor. 4. Continue to monitor cardiac rhythms. 5. Def ibr ill ate one time,if a shockable rhythm(VF/VT)develops. Follow the guidelines for"ALS(VF, PutseLess VT-Adult)." 6. Initiate intubation, or provide advanced airway support,and verify correct placement with capnography with minimal interruption of CPR(<10 seconds). 7. Initiate 0.9% Normal Saline or via I O at KVO or saline lock with minimal interruption of CPR(< 10 seconds). V1 I Cardiac Emergencies KLFD BLS&ALS PROTOCOLS 46 8.Administer epinephrine 1.0 mg IV/IO/ET,every 3-5 minutes,with minimal interruption of CPR(< 10 seconds). 9. Identify and treat reversible causes: • HypovoLemia • Hypoxia • Hydrogen Ion(acidosis) • Hypo/hyperkalemia • Hypothermia •Tamponade,cardiac •Tension Pneumothorax •Thrombosis,coronary •Thrombosis, pulmonary •Toxins 10. Give all medications with minimal interruption of CPR(< 10 seconds). 11. If spontaneous circulation returns, monitor vital signs,support airway and breathing, and provide medications appropriate for BP, heart rate, and rhythm per local protocols. 12. If there is no return of spontaneous circulation, refer to Protocol XI.C. Pediatric DIS 1. Follow BLS guidelines, adjusting for patient age/size. 2.Start CPR according to current American Heart Association (AHA)guidelines(30:2 with one rescuer[15:2 with two rescuers]):a.Compress chest at a rate of 100 compressions/min. • Neonates<28 days:Compress the lower third of the sternum 1/3 of the anterior- posterior diameter of the chest. • Infants 28 days-1 year:Compress chest 11/2 inches. • Children 1-8 years:Compress chest 2 inches. VI I Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p N i C%4 C%4 Ul) 47 b. Manually ventilate with appropriate-sized bag valve mask(BVM), if available. If not, use a mouth-to-mask/ba rrie r device. Administer supplemental oxygen. c. Defibrittate one time, if a shockable rhythm(VFNT)develops; resume 5 cycles of CPR (2 minutes)with minimal interruption (< 10 seconds); if possible, use AED with pediatric pads. d. Defibriltate one time, if a shockable rhythm(VFNT)develops; resume 5 cycles of CPR (2 minutes)with minimal interruption (< 10 seconds) 3. Ifspontaneous circulation returns, monitor vital signs, support airway and breathing per local protocols. 4. If there is no return of spontaneous circulation, refer to Protocol XI.C. ALS(YZRutapLess_VT_-ReAmIdW 1. Follow Ped iatric BLS gu ide lines,adju stirs g for patient age/size. 2.Attach manual defibrillator and verify that VF1VT is present on the monitor. 3. DefibriLlate one time at 2 J/kg. If a shockable rhythm develops; resume 5 cycles of CPR(2 minutes)with minimal interruption (< 10 seconds). 4. Initiate intubation, or provide advanced airway support, and verify correct placement with capnography with minimal interruption of CPR(< 10 seconds). 5. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock with minimal interruption of CPR(< 10 seconds). 6.Administer epinephrine,every ®5 minutes,with minimal interruption of CPR(< 10 seconds): a. 1WI0:0.01 mg/kg(0.1 mL/kg 1:10,000), up to a maximum of 1.0 mg 0.01 mglkg(0.1 mt/kg 1:1,000), up to a maximum of 2.5 mg. Flush with 5 mL of Normal Saline and follow with 5 ventilations, 7. Defibriltate one time at 4 Mg. If a shockable rhythm develops; resume 5 cycles of CPR (2 minutes)with minimal interruption (< 10 seconds). 8. Defibriltate third and subsequent times at 4 J/kg,up to a maximum of 10 J/kg or adult dose. 9. If refractory VF1VT®A inister Amiodarone 5 mg/kg IWIO; may repeat x2 at 15 mg/kg, up to a maximum single dose of 300 mg. V1 I Cardiac Emergencies KLFD BLS&AL PROTOCOLS a 10. Identify and treat reversible causes: • Hypovolemia • Hypoxia • Hydrogen Ion(acidosis) • Hypo/hyperkalemia • Hypothermia •Tamponade,cardiac •Tension Pneumothorax •Thrombosis, coronary •Thrombosis, pulmonary •Toxins 11. Give all medications with minimal interruption of CPR(< 10 seconds). 12. If spontaneous circulation returns, monitor vital signs,support airway and breathing, and provide medications appropriate for BP, heart rate, and rhythm per local protocols. 13. If there is no return of spontaneous circulation, refer to Protocol XI.C. ALS(AWstole/PEA-Pediatric) 1. Follow Pediatric BLS guidelines,adjusting for patient age/size. 2.Attach manual defibrillator and verify that Asystole is present on the monitor. 3. Defibrillate one time at 2 J/kg, if a shockable rhythm develops. Follow the guidelines for "ALS(VF, Pulseless VT- Pediatric)." 4. Initiate intubation, or provide advanced airway support,and verify correct placement with capnography with minimal interruption of CPR(< 10 seconds). 5. Initiate 0.9%Normal Saline via IV/IO at KVO or saline lock with minimal interruption of CPR(< 10 seconds). 6.Administer epinephrine, every 3-5 minutes,with minimal interruption of CPR(< 10 seconds): a. IV/10:0.01 mg/kg(0.1 ml/kg 1:10,000), up to a maximum of 1.0 mg VI j Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p N W Iq C%4 Ul) 49 b. ET:0.01 mg/kg(0.1 ml/kg1:1,000), up to a maximum of 2.5 mg. Flush with 5m(of Normal Saline and follow with 5 ventilations. 7. Identify and treat reversible causes: * HypovoLemia * Hypoxia * Hydrogen Ion (acidosis) • Hypo/hyperkatemia Hypothermia Tamponade, cardiac •Tension Pneurnothorax •Thrombosis, coronary •Thrombosis, pulmonary •Toxins 8. Give all medications with minimal interruption of CPR(< 10 seconds). 9. If spontaneous circulation returns, monitor vital signs, support airway and breathing, and provide medications appropriate for BP, heart rate, and rhythm per local protocols. 10. If there is no return of spontaneous circulation, refer to Protocol XI.C. E. Other Cardiac Arrhythmias Pro mat u Review of Injury/Illness Premature ventricular complexes(PVCs)have three characteristics: •They occur earlier than the expected sinus beat. •They do not start with a positive P wave. •They have an ab normal QRS width(2!0.12 seconds). PVCs in the presence of cardiac symptoms that are and that have the following characteristics are indications for treatment: - Near the"T"wave V1 I Card ac Emergencies KLFD BLS&AL PROTOCOLS • Multi-focal(different shapes on the monitor tracing) •Sequential or closely coupled • Runs of ventricular tachycardia(5 or more consecutive beats) •Ventricular tachycardia with a pulse •Once successful electrical conversion from ventricular tachycardia •Ventricular fibrillation to a supraventricutar rhythm Signs and Symms *Irregular heartbeat of ventricular origin(may or may not be felt by the patient) *Sensation of irregular heartbeats or pounding/fluttering in chest 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Monitor airway, administer supplemental oxygen, if necessary, and monitor pulse oximetry. 6.Assess and treat for shock, if indicated. (Refer to Protocol X.I.) 7.Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-6. 2. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 3. Obtain a 12-lead ECG and monitor cardiac rhythm. 4. Initiate 0.9%Normal Saline via IV/IO at KVO or saline lock. 5. Patients who are symptomatic(e.g., hypotensive, syncope, dizziness): VI I Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p N (D C%4 Ul) 51 a.Administer Am iodarone 150 mg IV mixed in NS50 cc on a macro drip. (Administer over 10 minutes using DiaL-A-Flow set at 300 which yiekds 5cc/min). 6. Continue supportive care, monitoring cardiac status and 02 saturation, and transport. Patients may present with a slow heart rate and chest pain, shortness of breath, decreased Level of consciousness, hypotension, hypoperfusion, pulmonary congestion,congestive heart failure, and/or acute myocardial infarction. It is not unusual for young, healthy athletes to have a resting heart rate below 60 beats per minute. Brady car dia has a number of causes, including damage to the conduction pathways in the heart, medications, hypoxia, and hypothermia. Signs and Symptomq. *Light-headedness *Syncope *Fatigue *Chest pain •Shortness of breath management BUS 1. Evaluate scene safety® DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions. as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5.Assess and treat for shock, if indicated. (Refer to Protocol X.I.) V1 0 Cardiac Emergencies KLFD BLS&AL PROTOCOLS 6. Monitor airway, administer supplemental oxygen, if necessary, and monitor pulse oximetry. 7. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-6. 2.Obtain 12-lead ECG and monitor cardiac rhythm. 3. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock. 4. If hypotensive, and lungs are clear, initiate a 250 ml bolus of 0.9%Normal Saline; repeat to bring Systolic BP>90 mm Hg, as needed. 5. if symptomatic, with heart rate<50 bpm, apply pacer pads and treat any underlying causes. 6. If symptomatic,administer atropine 0.5 mg slow IWIO push; repeat every 3-5 minutes, up to a maximum total dose of 3.0 mg. a. DO NOT administer atropine to patients who have had cardiac transplants. b. Hypothermic patients with a pulse should generally be re-warmed before atropine or pacing is attempted. 7. If the patient is hemodynamically unstable,with NO response to atropine: a.Administer transcutaneous pacing(TCP). 8. If patient is hemodynamically stable and in Type il, second-degree AV Block or thirddegree AV Block: a.Consider TCP after consulting on-line medical direction. • If the patient develops discomfort with TCP,and Systolic BP> 110 mm Hg: •Consider midazotam 0.1 mg/kg in 2.0 mg increments slow IWIO push over 1-2 minutes, up to a maximum single dose of 5.0 mg to reduce pain/anxiety of pacing. Reduce dosage by 50%for patients a 69years. Pediatric VI Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p 4 00 C%4 Ul) 53 1. Follow BLS guidelines, adjusting for patient age/size.AL S 1. Follow BLS guidelines, adjusting for patient age/size. 2. Obtain 2-lead ECG and monitor cardiac rhythm. 3. Initiate 0.9% Normal Saline via IV/I at KVO or saline Lock. 4. Identify and treat any reversible causes. 5. If hypotensive, and Lungs are clear, initiate a 20 mg/kg fluid bolus of 0.9% Normal Saline or LR; repeat to bring Systolic BP>90 mm Hg, as needed. 6. If the patient is hemodynamicaLty unstable(with a pulse and poor perfusion): a. Start CPR, if heart rate<60 bpm, with poor perfusion, despite oxygenation and ventilation. b.Administer epinephrine,every 3® minutes,with minimal interruption of CPR(< 10 seconds): • IWIO: 0.01 mg/kg(0.1 mL/kg 1:10,000), up to a maximum of 1.0 mg • ET- 0.01 rng/kg(0.1 ml/kg 1:1,000), up to a maximum of 2.5 mg. Flush with 5 ml of Norma[ Saline and follow with 5 ventilations. c. If symptomatic,administer atropine 0.02 mg/kg IWIO(minimum dose 0.1 mg); may repeat x1, up to a maximum single dose of 0.5 mg. • DO NOT administer atropine to patients who have had cardiac transplants. • Hypothermic patients with a pulse should generally be re-warmed before atropine or pacing is attempted. * If the patient DOES NOT respond to epinephrine and atropine, administer transcutaneous pacing(TCP)after consulting on-line medical direction. Tachnardle Ravi-ew-0.1niuryllUness Tachycardia is defined as a heart rate > 100 bpm. Symptoms and potential hemodynamic compromise typically occur when heart rates> 150 bpm.The most common tachycardia is sinus tach,and it is treated by correcting the underlying causes.Atrial,tachycardias require transport if they produce hypotension. V1 u Cardiac Emergencies KLFD BLS&ALS PROTOCOLS S *Chest pain(mayor may not be felt by the patient) *Shortness of breath *Decreased level of consciousness *Heart failure and/or acute myocardial infarction *Light-headedness *Syncope *Fatigue Management iu 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions.as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Monitor airway, administer supplemental oxygen, if necessary, and monitor pulse oximetry. 6.Assess and treat for shock, if indicated.(Refer to Protocol X.I.) 7.Continue supportive care and monitor vital signs (every 15 minutes, if stable;every 5 minutes, if unstable) until patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-6. 2. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 3.Obtain a 12-lead ECG and monitor cardiac rhythm. identify the rhythm and QRS duration. 4. Initiate 0.9%Normal Saline via IWIO at KVO or saline lock. VI I Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p N C) C") L0 55 5. If no pulse is present,treat it as Asystole PEA. (Refer to Protocol VI.D"ALS [Asystote/PEA -Ad u Lt).") 6. If the patient is hemodynamically stable, identify the rhythm and treat according to current AHA/ACLS guidelines. 7. If patient is hemodynamicatly unstable with a ventricular rate > 150 bpm, identify and treat reversible causes: • Hypovotemia • Hypoxia • Hydrogen Ion (acidosis) • Hypo/hyperkatemia ® Hypothermia •Tamponade,cardiac •Tension Pneum cat horax •Thrombosis,coronary *Thrombosis, pulmonary -Toxins. 8. Consider vagal maneuvers. 9. If the QRS duration is a regular narrow complex: a.Consider administering adenosine 6.0 mg rapid IWIO push and follow with 20 ml Normal Saline flush. b If the rhythm does not convert in 1-2 minutes,administer a second dose at 12 mg IV/10. c. If the rhythm does not convert in 1-2 minutes, administer a third dose at 12 mg IV110. d. If the patient has a history of WPW, a defibrillator must be available when adenosine is administered. 10. Consider the following for sedation prior to synchronized car inversion, after consulting on-tine medical direction. DO NOT delay, if hemodynamically unstable,as Low blood pressure may affect ability to administer sedative. a. MidazoLam(Versed*): 2.0-5.0 mg stow 1WI0 or 0.2 mg/kg I M, if no IV access. Vi p Cardiac Emergencies KLFD BLS&ALS PROTOCOLS �e 11. Synchronized cardioversion doses: a. Narrow regular: 50-100 J b. Narrow irregular: 120-200 J c.Wide regular: 100 J d.Wide irregular: defibrillation dose(NOT synchronized) Pediatric M 1. Follow BLS guidelines, adjusting for patient age/size. ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. If the patient is hemodynamically stable(with a pulse and appears well perfused): a.Administer oxygen to obtain a saturation of 90-100%. b.Attach cardiac monitor and identify rhythm and QRS duration. c. Initiate 0.9%Normal Saline via IV/10 at KVO or saline lock. d. Identify and treat reversible causes. 3. If the patient is hemodynamically unstable(with a pulse and poor perfusion)with a heart rate>220 bpm for an infant, or> 180 bpm for a child: a.Considervagal maneuvers. b. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock. c. If cardiac rhythm is regular and narrow and the QRS durations 0.09 seconds: •Administer Adenosine 0.1 mg/kg rapid IWIO push, up to a maximum of 6.0 mg. Follow with 20 ml Normal Saline flush. • If the rhythm does not convert in 1-2 minutes, administer a second dose at 0.2 mg/kg rapid IWIO, up to a maximum of 12 mg. • If the rhythm does not convert in 1-2 minutes, administer a third dose at 0.2 mg/kg rapid IWIO, up to a maximum of 12 mg. • ET dosage is 2-2.5 times the IWIO dosage. VI I Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p cn ,, w i C%4 57 d. If the patient is not improved with Adenosine, or if IWIO is unavailable, consider immediate synchronized car inversion, a Consider the following for sedation prior to synchronized car inversion, after consulting on-line medical direction. DO NOT delay, if hemodynamically unstable,as to blood pressure may affect ability to administer sedative. - Midazotarn (VersedO): 0.1 mg/kg slow 1110, up to a maximum of 4.0 mg or 0.2 mg/kg IM, up to a maximum of 4.0 mg, if no IV access. Start car inversion with 0.5-1.0 J/kg. If a patient's condition does not improve,or worsens, increase to 2.0 J/kg If a calculated joule setting is lower than the cardioversion device is able to deliver, use the lowest power setting possible or consult on-line medical direction. Be prepared for up to 40 seconds of AsystoLe after cardioversion. V0 Cardiac Emergencies KLFD BLS&ALS PROTOCOLS .p w w L0 VIII.Childbirth and Newborn Care A. Uncomplicated Delivery Fu(L-term gestation lasts 40 weeks. Babies may be born at any time before or after 40 weeks, but the earlier the birth occurs in the gestation process,the likelier it is that complications, including fetal demise,witt arise. SignARMdlymMm *Abdominal, pelvic pain •Low back pain •Vaginal discharge—this may be the mucus plug or it may be a large volume of clear liquid from the amniotic sac *Urge to defecate Management M 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universat Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5.Time the duration of contractions and the length of the interval between them. 6. Obtain pre-natal history, including the number of previous pregnancies and births. 7.Assess for crowning. 8. If crowning is not present, allow patient to assume position of comfort. 9. If crowning is present,delivery is imminent. 10. In addition to gloves, on splash protection garments, if possible,to assist delivery. it 11. Alert medical direction and/or receiving hospital of procedure in progress if possible. V11 I Chit birth and Newborn Care KLFD BLS&ALS PROTOCOLS Ss 12.Assist delivery: a.Apply gentle pressure to the baby's head to prevent tearing of perineum. b.Once the head is delivered,suction mouth and nose with bulb syringe. c.Check to see if the umbilical cord is wrapped around the baby's neck. d.Apply gentle pressure downward while supporting baby's head to ease delivery of superior(upper position)shoulder. e.Once superior shoulder is delivered, apply gentle pressure upward to ease delivery of inferior(lower)shoulder. f. Upon delivery of both shoulders,the rest of the baby should follow quickly. g. Keep the baby at the level of the vagina until the cord is clamped and cut. h.Once fully delivered,clamp the umbilical cord at 8"and 10"from baby, and cut the cord between the two clamps. i.After clamping and cutting the cord,wrap the baby in a warm blanket, place the baby on the mother's abdomen, and allow for delivery of placenta. j. Record time of delivery. k. Refer to"Newborn Care Protocol"(Protoco(VII.C). L.Watch for excessive bleeding; perform uterine massage and apply pressure to any lacerations that may be bleeding. m. Encourage mothers to breastfeed to help control hemorrhage. 13. Continue supportive care and monitor vital signs until the patient is turned overto a higher level of medical care. ALS 1.Confirm the completion of BLS steps 1-12. 2.Administer oxygen and monitor pulse oximetry. 3. Resuscitate neonate, if needed. (Refer to Protocol VII.C). 4. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock. VII I Childbirth and Newborn Care KLFD BLS&ALS PROTOCOLS .P cn , w cn m M 60 B. Complicated Delivery Bayi-aw-of.Injuryffilmess Labor and delivery can be complicated by abnormal presentation of the fetus, incLu in Breech presentation Prolapsed cord Multiple births Vaginal hemorrhage None of these is optimally ane in the fi eld, and every attempt must be made to move e patient to a higher level of care white EMS care is in progress, tiiv i *Fetal buttocksvisible vaginal iipresentation) ProLapsed umbiticat cord anagement BIB 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safes . Institute appropriate o y Substance Isolation (BSI) measures/Universal Precautions,as outlined in Protocol I.A. a Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patients condition. 4. Determine the need for ALS care and/ter transport to hospital for further evaluation and treatment. . Provide supplemental oxygen. . Support the bab 's body as it is delivered, 7. If the head delivers normally, refer to Protocol VI I.A. Se If the head does not deliver within 2 minutes, insert loved hand into the vagina, keeping I palm toward the aby°s face and forminga`gV"with your fingers. Push the vaginal wall away from the baby's face to allow room for an airway. V11 I Childbirth and Newborn Care KLFD BLS&ALS PROTOCOLS 6'1i 9. Maintain this airway until the baby is delivered or turned over to an ALS transport unit. 10.Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-9. 2. Resuscitate neonate, if needed. (Refer to Protocol VII.C). 3. Initiate 0.9%Normal Saline via IWIO at KVO or saline lock. Limb Presentation Signs and Symptoms *Fetal arm or foot visible at vaginal opening Management )tom 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5.Administer oxygen and monitor pulse oximetry. 6. Place mother in the Trendelenburg position. 7. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-6. 2. Initiate 0.9% Normal Saline via IV/IO at KVO or saline lock. VII I Childbirth and Newborn Care KLFD BLS&ALS PROTOCOLS .p 4 00 62 Prolarased Cord t me *Cord presents iirst at vaginat opening 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance isolation (BSI) measures/UniversaL Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for AL care and/or transport to hospital for further evaluation and treatment. 5.Administer oxygen and monitor pulse oximetry. 6. Place the mother in the knee-to-chest position. 7.Wrap the cord in gauze moistened with saline. 8. Check the cord for a pulse. 9. If no pulse resent® insert gloved hand into the vagina and push up on the baby until a pulse returns tothe cord. 10. Continue supportive care and monitor vital signs until the patient is turned over to a higher Level of medical care. ALES 1.Confirm the completion of BLS steps 1-9. 2. Initiate 0.9% Normal Saline via IWIO at KVO or saline Lock. MuftinLe-Birthis ReA ew-0thim-rw1unell Most patients can report whether the impending delivery involves twins or multiple births. V11 I Childbirth and Newborn Care KLFD BLS&ALS PROTOCOLS 63 Signs and Symptoms *Ongoing labor after first newborn delivered Management au 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI)measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5.Administer oxygen and monitor pulse oximetry. 6. Follow normal delivery protocol for each neonate as it presents.(Refer to Protocol VII.A.) 7.Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1.Confirm the completion of BLS steps 1-6. 2. Initiate 0.9%Normal Saline via IV/10 at KVO or saline lock. Vaginal Hemorrhage Review of Injury/Illness Vaginal hemorrhage can be a sign of miscarriage or can be a pre-or post-partum complication. Signs and Symptoms *Unusually heavy vaginal bleeding *May be hypotensive VI1 Childburth and Newborn Care KLFD BLS&ALS PROTOCOLS .p co C) Management 64 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for PAL S care and/or transport to hospital for further evaluation and treatment. 5.Administer oxygen and monitor pulse oximetry. 6.Apply bandages/dressings appropriate for bleeding control in the vaginal area. 7. If pre-detivery, place mother in the left lateral recumbent position for it trimester. Prior to third trimester, place inshock position. 8. If before 20 weeks gestation and baby delivers without vital signs, do not begin resuscitation. If>20 weeks gestation and baby deliver without vital signs, begin CPR. If unsure of gestational age, begin CPR. (Refer to Protocol VI.D.) 9. If post-part um, begin fir uterine massage. 10. Continue supportive care and monitor vital signs until the patient is turned over to an PALS transport unit. AL-3- 1. Confirm the completion of BLS steps 1® . 2. Initiate Normal Saline via IWIO at KVO or saline Lock. 3,Assess and treat for hypotension or shock, if indicated. (Refer to Protocol X.I.) C. Newborn Care Review-0.0uryMn.e.aa EMS care for a newborn follows a delivery at which the providers have just assisted or may be initiated on arrival at the scene of a recent out-of-hospitat birth. V11 I Childbirth and Newborn Care KLFD BLS&ALS PROTOCOLS 65 Management BU 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI)measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A., and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5.Warm and dry the newborn. 6.Stimulate breathing by tapping the heels of the feet or rubbing the newborn's back. 7. If breathing does not begin,or is labored, suction the airway with a bulb syringe to remove mucus and secretions. 8. If no spontaneous respirations occur: Begin manual respirations, as needed,with an appropriate-sized bag valve mask(BVM) at 40-60 breaths per minute with 100%02. 9.Assess heart rate. 10. If heart rate is absent or<60 bpm at 30 seconds,after assisted respirations and supplemental oxygen, begin resuscitation according to current American Heart Association (AHA) Neonatal Resuscitation guidelines. 11.Assess APGAR score at 1 minute and 5 minutes post birth. (Refer to chart.) 12. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-9. 2. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 3. If heart rate remains<60 bpm, despite adequate ventilation with 100%02 and chest compressions, administer epinephrine(1:10,000)0.01-0.03 mg/kg IV/IO or 0.05-0.1 mg/kg ET. 4. Consider hypovolemia and pneumothorax, if condition does not improve. VII I Childbirth and Newborn Care KLFD BLS&ALS PROTOCOLS .p cn .P i N 6 D—MPGAR Score Appearance(Color) Blue,pale Body pink,exMr,., nilies Corn�ple'W,y piink Mue air piny Grimace o resonse ;;Frirraaoe C'ryin, ii r,,r;/,-,/ /p y,rr/% /o, /;/G%I/ r�i//'"/" 1 „u"�irrr/✓ °i/ i � %r/ %,� "// RespirationsAbsent Mow,irrq;,p,Anr Gof,:)d,f;ry+'ing (respiratory effort) ,. .. ,���t %%//� oit total Infant's ii Treat n#Considerations o/i I, ,,, i7, /i i„, // l,yr r��,,Ti �"^/ // ✓ ry �7�'s.;iiln? r rrrr ,ii � ��<,, ,r /� /i//,✓ / /i�,//�i, �/ � of/ ,,o,�/ li//�/ � � /�9� �rvrv,v��:W�(��WW� WWr✓���Wbr�(��� �w������ ������u�� ��lwtvw���a, , a;,�rcu.�r��„!��rZ YYO��W�„/%%.,///�� ��/%�✓� �u�,�,n a��������'G'w ��,/„,,,,,, sess r �!� /fir/ ////1//ri%//%/ ,,,� ,/ „// i%lii �, �/ ,/,//�✓-//, / //0.,9 //�/,,, //� //„//�/// ��rr�r/,���/��/ i���✓w�!�r,��l�r���r r������rr�r����//r����4�/r� "�r�� �� n .,, f1Jl� ��1 i�ft � f�//iii s Poor Recla�ires CPS Vii I Chikdbirlh and Newborn Care KLFD BLS ALS PROTOCOLS .p cn .p w Iq 67 Vill. Environmental Emergencies A. Dehydration Review of I ' littness Dehydration can be caused by inadequate fluid intake, inapparent loss of fluids through sweating and evaporation, obvious fluid loss such as vomiting,diarrhea, excessive urination due to diuretic medication, or a combination oft ese factors.There is an increased risk of dehydration in both hot and cold climates and at high attitudes. vrn ptoms *Dry mucosa *Decreased urine output *Headache *Loss of coordination *Altered mentat status *Decreased blood pressure, increased heart rate *May progress to shock managulenit I 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal,Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol LA, and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. If dehydration is associated with heat exposure, move the patient to a cool shaded area. 6. Loosen patient®s clothing. 7. If possible,take orthostatic vital signs. If mentat status or blood pressure area nor l with the patient lying own® DO NOT attempt to take an orthostatic set of vital signs. MH Env iron rnenta4 E::'Merge=es KLFD BLS&AL S PROTOCOLS 68 8. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-11. 2. Monitor for change in mental status. 3. Initiate 0.9%Normal Saline via IWIO and administer 500 ml fluid bolus. a. If the patient's age is<40, repeat 500 ml bolus as needed up to 3,000 ml. b. If the patient's age is>40, repeat 500 ml bolus as needed up to 2,000 mt. 4.After each bolus, monitor vital signs, including auscultation of lung sounds,and pulse oximetry, if available. 5.Obtain 12-lead ECG and monitor cardiac rhythm. (An electrolyte imbalance may cause dysrhythmia.) Pediatric BU 1. Follow BLS guidelines,adjusting for age/size of patient. Expanded Scope BLS ALS 1. Follow Expanded Scope BLS guidelines, adjusting for age/size of patient. 2. Initiate 0.9% Normal Saline via IWIO. Infuse 20 ml/kg bolus. Reevaluate and repeat 20 ml/kg bolus, up to a maximum total infusion of 40 ml/kg.After each bolus, monitor vital signs, lung sounds,and pulse oximetry, if available. B. Drowning-Near Drowning Review of Injury/Illness Drowning and near drowning involve respiratory impairment due to submersion or immersion in liquid. Hypothermia and/or cervical spine injury are frequently associated with drowning and near drowning and should be considered when caring for such patients. Signs and Symptoms *Respiratory distress/arrest *Hypoxia Vill I Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p .p (D Iq L0 69 •Cough with clear or frothy pink sputum •Decreased level or toss of consciousness •Decreased or absent putses Managam-ent M 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/UniversaL Precautions, as outlined in Protocol I.A. S. Perform patient assessment and initiate routine BLS care, as outlined in Protocol LA, and as indicated by the patient's condition. 4. Determine the need for PALS care and/or transport to hospitat for further evaluation and treatment. 5.Administer oxygen and monitor pulse oximetry. 6.Assist respirations, if necessary,with a bag valve mask and high-flow 02. 7. Position patient on side to prevent aspiration if coughing/choking,with or without assisted ventilations. Otherwise, allow patients to assume a position of comfort. 8. Protect from hypothermia. (Refer to Protocol VIII.D.) 9. Evaluate fora ditional illness or injury including c-spine injury, diabetes, seizure, cardiac event,or stroke. 10. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BILS steps 1-9. 2. Provide advanced airway support, if necessary. (Refer to Protocol 1.B.) S. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock. Use warm fluids, if available. 4. Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (A HA)AC guidelines. 5. Start CPR actor dingto current AHA guidelines, if indicated. VM I Environmental Emergendes KLFD BLS&ALS PROTOCOLS 70 6. If a patient is resuscitated from VF or Asystole cardiac arrest,consider therapeutic hypothermia and have receiving facility continue therapy, if available. 7. Continuously monitor vital signs and pulse oximetry. Pediatriic BIB 1. Follow BLS guidelines, adjusting for patient age/size. ALS 1. Follow BLS guidelines,adjusting for patient age/size. 2. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 3. Initiate 0.9% Normal Saline via IV/IO at KVO or saline lock. Use warm fluids, if available. 4.Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association(AHA)ACLS guidelines. 5.Start CPR according to current AHA guidelines, if indicated. 6. If a patient is resuscitated from VF or Asystole cardiac arrest, consider therapeutic hypothermia and have receiving facility continue therapy, if available. 7.Continuously monitor vital signs and pulse oximetry. C. Heat-related Illness(Hyperthermia) Review of Injury/Illness Heat-related illness is a group of acute conditions in which the body produces or absorbs more heat than it can effectively dissipate into the environment, causing a dangerous increase in core body temperature.The two most common forms of heat-related illness that require EMS treatment are heat exhaustion and heat stroke.These conditions may be associated with dehydration and electrolyte abnormalities, rarely including life-threatening hypernatremia. Signs and Symptoms Heat exhaustion *Nausea *Clammy skin VIII I Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p 4 00 71 •Dizziness •Muscle cramps •Elevated core temperature Heat stroke •Altered mental status •Elevated core temperature(>105-F) •Skin may be hot and dry or sweaty •Dilated pupils •Rapid heart rate(sometimes with arrhythmia) Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe, 2. Institute appropriate Body Substance Isolation(BSI) measures/UniversaL Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I® ® and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Have the patient stop doing any work or physical exertion. 6. Remove as much clothing from patients as possible. 7® Have the patient rest in shaded or cooler area. 8.Aggressively cool patient with tepid or coot(not cold or iced)water and/or towels soaked with tepid water;the more skin surface actively cooled,the better. a. Increase airflow over the moist skin to increase evaporation. b. Avoid inducing shivering,which is one of the body's mechanisms for warming itself. c. Monitor mental status and core body temperature (rectal)temperature to avoid over- cooling, if possible. V10 Enviyonmentak Emergencies KLFD BLS&AL S PROTOCOLS 72 d.Watch for rebound hyperthermia when measures are discontinued after initial coaling, and restart if core body temperature exceeds 1011 F. e. Provide supplemental oxygen to keep 02 saturation at a minimum of 94%. 9. Provide oral hydration with water, diluted fruit juice, or diluted sports drink(50:50 with water), if patient is awake and able to swallow and mental status is intact. 10. For heat stroke,consider ground transportation to the nearest hospital as rapidly as possible. 11. Monitor core body temperature,oxygen saturation, lung sounds,and mental status. 12. Continue supportive care and monitor vital signs until patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-11. 2. Initiate 0.9% Normal Saline via IV/10 at 250 ml/hr., up to a maximum total of 3,000 mt. 3. Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association(AHA)ACLS guidelines. 4. If patient is seizing or combative and Systolic BP...?100 mm Hg,consider Midazolam (Versed):2.0-5.0 mg IV/10, up to a maximum of 10 mg. Pediatric US 1. Follow BLS guidelines,adjusting for age/size of patient. 2. Pediatric patients are more susceptible to heat extremes than adults. 3. Monitor core body temperature. ALS 1. Follow BLS guidelines, adjusting for age/size of patient. 2. Pediatric patients are more susceptible to heat extremes than adults. 3. Monitor core body temperature. 4. Initiate 0.9%Normal Saline via IV/10 at 20 ml/kg fluid bolus, up to a maximum total infusion of 40 ml/kg. VIII I Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p .P c� C) 73 5. Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (A A)AC LS guidelines. 7. If patient is combative, belligerent,or uncontrollable, consider any of the following sedative as a Last resort,according to Local protocols- a. Midazotam:Administer 1.0-5.0 mg(0.05 mg/kg) IWIO1I M; repeat every 5 minutes, up to a maximum of 0.1 mg/kg, if needed. d. If medications are administered, place them on cardiac monitor. Monitor cardiac rhythm and pulse oximetry. D. Hypothermia Review_QtJniurv/ll1Iness Hypothermia results when the body Loses more heat to the environment than it can generate metabolically. Hypothermia is a cold injury of greatest significance. -Signs and Symptoms Mild hypothermia(core body temperature 98.6-920 F) *Shivering •Unable to perform complex tasks with hands *Poor judgment •Amnesia Moderate hypothermia(core body temperature 1® F) •Violent shivering to potential loss of shivering reflex •Dazed consciousness,slurred speech, irrational behavior •Loss of fi ne motor coordination *Dilated pupils* it to moderate hypotension *Diminished respiratory rate and effort Severe hypothermia(core body temperature!g 850 F) *Shivering occurs in waves until it ceases as body tamp drops *Severe altered mental status VM 1I Environimentat Emergencies KLFD BLS&ALS PROTOCOLS 74 *Absent response to pain *Muscle rigidity,skin becomes pale *pupils dilate, pulse rate decreases,breathing becomes erratic *Cardiac abnormalities,hypotension Management Hypothermia 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A, and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Monitor core body temperature. 6.Assess for possible hypoglycemia and treat. (Refer to Protocol II.C.) 7. Move patient to warm place if feasible: a. Handle gently in moderate to severe hypothermia as jostling can precipitate cardiac arrhythmias. b. DO NOT massage or vigorously manipulate the patient. 8. Minimize patient's exposure to weather. 9. Replace wet clothing with dry, if possible. 10. Passive re-warming: a.Wrap in rescue blanket if available. b. Ensure adequate insulation between patient and ground. 11.Active re-warming: a. Hot packs to neck,groin,and armpits, if available. VIII I Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p cn i C%4 75 b. Discourage PO intake if hypothermia is moderate or severe. c.Assist ventilations with BVM and 02. d. Begin CPR if the patient deteriorates and loses spontaneous respiration or pulses. In general, CPR should not be considered unsuccessful and terminated until patient has been warmed (core body temperature>950 F. 12. Continue supportive care and monitor vital signs, including core body temperature (rectal.), until patient is turned over to a higher level of medical care. ALS 1. Confirm the completion of BLS steps 1-11. 2. Initiate 0.9% Normal Saline via IWIO.Administer initial bolus of 250 mt. Use warm fluids, if available. 3. Obtain 1 -lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association(A A)ACLS guidelines. 4. If hypogtycemic: a.Administer D50W- 25 gm IWIO. 5. If there is suspected opiate overdose, administer naloxone 0.4-2.0 mg slow IWIO/IM/intranasal(if delivery device is available), up to a maximum of 6 mg,every ®3 minutes.Titrate to adequate respiratory effort. 6. Continue re-warming and monitoring. Pe-diatft 1. Follow BLS guidelines,adjusting for patient age/size. ALS 1. Follow BLS guidelines, adjustingfor patient agelsize. 2. Initiate 0.9% Normal Saline via IWIO.Administer initial bolus of 20 mL/kg. 3. Obtain 1 -lead ECG and monitor cardiac rhythm and treat any dysmythmia according to current American Heart Association(A A)ACLU guidelines. 4. Continue re-warming and monitoring. VM a Env iron rnn nWt Ernergendes KLFD BLS&ALS PROTOCOLS 76 E.Diving-related Emergencies Review of Injury/Illness The most common dive-related medical presentations involve minor ear disorders, but systemic and life-threatening emergencies occur every year.These include arterial gas emboli (AGE), decompression sickness(DCS), and barotraumas to the ears and other locations. 1.When dealing with a diving-related incident, it is important to transport the diver's equipment with him during evacuation, so it can be inspected and possibly analyzed. DO NOT clear patient's dive computer.The dive history obtained from a patient by an EMS provider should include at a minimum:the times, duration and depth of dives(includes bottom time), as well as the number of dives over the previous 3 days, surface intervals, activity performed while diving, and whether the dive(s)were complicated by events such as entrapment, running out of air,or rapid ascent. It is also important to record the time and rapidity of onset of symptoms. 2. Flying too soon after diving increases the risk of decompression sickness(DCS)and other dive-related problems. (Refer to Protocol VI 11.17, Protocol VIII.G, Protocol VIII.H.) Minimum Flight Delay Dive History 12 hrs Single,no-decompression dive 18 hrs Multi-day,no-decompression dives 24 hrs Decompression required dive(s) 3 days If treated for DCS or arterial emboUs(AGE) F. Decompression Sickness(DCS) Review of Injury/Illness DCS, commonly known as"the Bends,"is an emergency condition requiring treatment in a decompression chamber. DCS most often occurs within the first 1-6 hours after diving; further deterioration is unlikely to occur after 24 hours.The onset of symptoms is directly related to the severity of the DCS; in severe cases, symptoms occur more rapidly.Several forms of DCS primarily affect the nervous system, muscles,joints, skin, inner ear and cardiopulmonary system. At depth and under pressure (P),gas is absorbed into the tissues proportionate to depth and exposure time.Significant absorption most likely occurs following dives to depths> 33 feet of sea water(FSW). DCS results from the formation of bubbles of inert gas(e.g., nitrogen)within the intravascular and extravascular spaces as the diver ascends to the VIII k Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p cn ... cn w Lo 77 surface,when the ascent is too rapid to allow nitrogen to be released that is absorbed in e tissues during the dives i nsMs Depending is ii i f gas bubbLes throughout the body, DCS may create varietysymptoms: •Pruritus i •Unusual fatigue*Joint pain, abdominal or thoracic in("girdling"pain) *Shortness of breath,frothy sputum, hemoptysis *Dizziness,vertigo,tinnitus,parasthesia, paralysis,seizures,tremors, staggering Altered• t ,confusion, i ,behavioral ManagemmA OLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) easures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I. ® and as indicated by thepatient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation an treatment. . Primary treatment is recompression in a by er aric chamber. 6, Keep patient supine. 7.Administer oxygen, if available: 1 -15 LB in by non-rebreathing maskto keep saturation at a minimum o %. 8.Transport diver's equipment it atient during evacuation for inspection and possibLe analysis, DO NOT clear patient's dive computer. ALIS 1. Confirm the completion of BLS steps 1® . . Initiate 0.9% Normal Saline via I BIC at KVO or saline lock. Vill � Environmental Erner er-mies KLFD BLS&ALS PROTOCOLS 3. If seizures develop,consult medical control before administering IV benzodiazepines (e.g., midazolam). G.Arterial Gas Emboli(AGE) Review of Injury/Illness Arterial gas emboli (AGE) is the most common cause of sudden death in diving.Sudden collapse or loss of consciousness immediately or soon after surfacing should always be treated as AGE until proven otherwise.A complication of pulmonary barotrauma(PBT),AGE may cause near-drowning during ascent. It is most commonly seen in panicked or inexperienced divers making a rapid ascent while holding their breath, as the rapidly expanding air ruptures the pulmonary alveoli and allows gas bubbles to enter the blood stream across the capillary membranes.These bubbles may cause sudden loss of perfusion to the brain, heart, and other vital organs. Massive gas loading of the vasculature causes cardiac arrest that is refractory to resuscitation efforts. Signs and Symptoms *Abrupt onset of symptoms occurring during ascent or within 10 minutes after surfacing *Stupor,confusion,vertigo,coma,convulsions *Unilateral or bilateral motor or sensory deficits *Visual disturbances Symptoms may also include: *Aphasia *Headache *Chest pain related to myocardial ischemis *Cardiac arrhythmias,cardiac arrest *Symptoms of other barotrauma and decompression sickness(DCS)may also be present Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. VIII I Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p 79 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BILS care, as outlined in Protocol LA, and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Primary treatment is recompression in a hyperbaric chamber. 6. Keep patient supine, 7.Administer oxygen, if available. 10-15 LB in NRBM to keep 02 saturation at a minimum of 94%. 8. Transport diver equipment with patient during evacuation for inspection and possible analysis. DO NOT cLear patient's dive computer. Urgently transport for decompression. ALS 1. Confirm the completion of BLS steps 1-9. 2. Initiate 0.9%Normal Saline via IWIO at KVO or saline lock. a. DCS patients are often hypovolemic. 3. If seizures develop,consult medical control before administering IV benzodiazepines (e.g., midazotam). H. Barotrauma of the Ear Revi-e-w-Q flit yffidne-sa I There are 3 barotraumas related tot a ear: 1, External ear barotrauma: Also known as barotitis externs media interna or"ear canal squeeze"; caused by air trapped in the external auditory canal(EAC) by: a. erumen impaction. b. Exocytoses(chronic narrowing of the EAC). c.The use of ear plugs or a tight wet suit hood. 2. Middle Ear Barotrauma. a. Barotitis media or"ears ueeze"and"reverse ear squeeze." VM � Environirnenta�Fmergendes KLFD BLS&JAL S PROTOCOLS 80 b. Caused by failure of middle ear to equalize to ambient pressure(P). 3. Inner Ear Barotrauma(IEB): a.Also known as barotitis interna or labyrinthine window rupture. b.Caused by the pressure differential between the inner ear and ambient pressure. c. IEB may cause injury to the cochleovestibular system of the inner ear, may lead to permanent vestibular dysfunction or deafness. d. it is important to distinguish IEB from the dizziness, balance problems, nausea, and vomiting that are also symptoms of decompression sickness(DCS). Signs and Symptoms External Ear Barotrauma *Pain,swelling,and erythema to the EAC *Petechiae or hemorrhagic blebs may be seen on the walls of the EAC Middle Ear Barotrauma * Pain,begins as slight pain and progressively worsens on descent/ascent * Impaired hearing * Nasal congestion *Tympanic membrane(ear drum)rupture •Sudden severe pain e Vertigo,as water enters into the middle ear e Total loss of hearing in the affected ear *Blood may be seen around the mouth and nose as well as in the EAC Inner Ear Barotrauma *Sudden pain, dizziness,vertigo, may be extreme *Nausea and vomiting(vomiting underwater may lead to drowning) "Roaring" hearing loss *Nystagmus,ataxia,facial nerve paralysis *Pallor,diaphoresis, disorientation Vlll I Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p 4 00 81 *Ear may feet"blocked"or patient may relate a feeling of'If utiness"in the ear *Differentiation from inner ear Decompression Sickness(DCS): *If EB is usually associated with ear pain and clearing difficulties upon descent * In IEB, evidence of other barotraumas may be seen on ear exam * In inner ear DCS, symptoms are often noted upon ascent or shortly after surfacing *Other symptoms of decompression sickness are often present with inner ear DCS Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions,as outtined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A, and as indicated by the patient's condition. 4. Determine the need for ALS care and/ortransport to hospital for further evaluation and treatment. 8. Continues ortive care and monitor vital signs until the patient is turned over to an PALS transport unit. ALS 1. Confirm the completion of BLS steps. 2. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock. 1. Envenornations Snake.a..and.-Sp-id-ers.RoviemLofJnjuryLLLLnp-n Snake and spider bites can cause damage to body tissue at the Location of the bite and, if venomous, can cause both local tissue injury and systemic reactions.A snakebite,whether from a venomous or non-venomous snake, may cause severe fright reactions(e.g., nausea, tachycardia,diaphoresis),which may be difficult to distinguish from systemic manifestations of envenomation. on-venomous snakebites cause only Local injury, usually pain and 2®4 rows of scratches from the snake's upper jaw at the bite site. It is VNI 0 Environmental Emergencies KLFD BLS&AL S PROTOCOLS 82 important to know and recognize all species of venomous snakes that are indigenous to areas of operation. Spiders are identified by location and markings. Black widow spiders live outdoors in protected spaces(e.g., rock piles,firewood cords, hay bales,outhouses)and have a red or orange hourglass marking on the ventral(upper side)abdomen. Brown recluse spiders live indoors in protected spaces(e.g., in clothing, behind furniture, under baseboards)and have a fiddle-orviolin-like marking from the eyes to the abdomen.This marking may be difficult to recognize even in the intact spider. Signs and Symptoms *Local bite wound *Swelling,severe allergic reaction *Bleeding*Ecchymosis at site * Localized pain *Weakness *Tachycardia *Nausea *Shortness of breath *Respiratory arrest *Dim vision *Vomiting and/or shock Management BIS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A,and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. VIII I Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p cn cn co C) 83 5. Calm and reassure the patient. 6.Assess and treat for anaphylaxis. (Refer to Protocol X.A.) 7.Secure and maintain airway and administer supplemental oxygen via non-rebreathing mask(NRBM),as needed. 8.Assess and treat for shock. (Referto Protocol X.I.) 9. Prepare for immediate transport. (DO NOT delay transport for any first aid/treatment measures or wait for signs of envenomation to occur.) 9. DO NOT apply any constricting bands, ice,or suction to the bite. 10. Remove ALL watches, rings and jewelry, not just from affected limbs. 11. Mark the proximale ge of any discoloration orswelling in ink and write the time on the Line. If signs increase during treatment, make new marks with the times, if possible. 12. Dress the wound and immobilize the extremity. 13. If the snake or spider is identified in the field, notify receiving facility of type of bite and patient's condition ASAP in case they need to initiate acquisition of antivenin. 14. Notify on-line medical direction of the situation so that antivenins can be obtained. 15. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit, AUS 1. Confirm completion of BILS steps 1-14. 2. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock 3. Monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association(AHA)ACLS guidelines. 1. Follow BLS guidelines,adjusting for patient age/size. ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Initiate 0.9% Normal Saline via IWIO at KVO or saline Lock. Vill I Environmental Emergencies KLFD BLS&ALS PROTOCOLS 84 3. Monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association(AHA)ACLS guidelines. J. Marine Bites and Stings Corals and Jellyfish Review of Injury/Illness Most marine bites and stings are at least transiently painful,while some involve envenomation as well.All create wounds at risk of infection with marine organisms.The most common encounters are with a class of marine animals called Cnidaria and they include the following: • Corals • Sea anemones • Jellyfish (e.g.,sea nettles) • Hydroids(e.g., Portuguese man-of-war) Cnidaria are responsible for more envenomations than any other marine animal. However, of the 9,000 species, only about 100 are toxic to humans.The multiple, highly developed stinging units(nematocysts)on Cnidaria tentacles can penetrate human skin;one tentacle may fi re thousands of nematocysts into the skin on contact. Signs and Symptoms *Lesions vary with the type of Cnidaria. *Usually,lesions initially appear as small,linear, papular eruptions that develop rapidly in one or several discontinuous lines,at times surrounded by a raised erythematous zone. *Pain is immediate and may be severe;itching is common. *The papules may blister and proceed to formation of painful,raised pustules, hemorrhage,and eventual peeling of the skin. *Systemic manifestations include weakness,nausea,headache, muscle pain and spasms,tearing of the eyes and nasal discharge, increased perspiration,changes in pulse rate,and pleuritic chest pain. VIII I Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p i C%4 8CG Uncommonly,fatal injuries have been inflicted by the Portuguese man-of-war in North American waters and by the box jettyf is (sea wasp, Chironex flecked), in Indo- Pacific waters. M-M-ageM&DA 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universat Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A, and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospitaLfor further evaluation and treatment. 5. Calm and reassure the patient. 6.Assess and treat for anaphylaxis, (Refer to Protocol X.A.) 7.Secure and maintain airway and administer supplemental oxygen via non-rebreathing mask(NRBM),as needed. 8.Assess and treat for shock. (Refer to Protocol X.I.) 9. For pain relief due to stings, administer hot water or cold packs(whichever feels better). 10. Pain caused by jellyfish, usually short-lived, can be relieved with baking soda in a 50:50 slurry applied to the skin, or by apain (meat tenderizer) applied as a paste fora period not to exceed 15 minutes. 11.Jellyfish-type sting treatment includes removal of adherent tentacles with forceps (preferably)or fingers(double-gloved if possible)and liberal rinsing to remove invisible stinging calls(nematocysts).The type of rinse varies by the stinging organism: a. For jellyfish stings sustained in non-tropical waters and for coral stings, seawater rinse can be used. b. For jellyfish stings sustained in tropical waters,vinegar rinse followed by seawater rinse should be used. Fresh water should not be used because it can activate undischarged nematocysts. MH I Environmentak Emergencies KLFD BLS&AL S PROTOCOLS 86 c. For box jellyfish stings,vinegar inhibits nematocyst firing and is used as the initial rinse if available,followed by seawater rinse. Fresh water should not be used because it can activate undischarged nematocysts. Notify on-line medical direction of the situation so that antivenins can be obtained.(Antivenin is only available for C.fleckeri species.) d. For Portuguese man-of-war stings,saltwater rinse can be used.Vinegar should not be used because it can activate undischarged nematocysts. 13. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. AUS 1.Confirm the completion of BLS Steps 1-12. 2. Provide advanced airway support, if necessary. (Referto Protocol I.B.) 3. Initiate 0.9%Normal Saline via IWIO at KVO or saline lock. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. ALS 1. Follow BLS guidelines,adjusting for patient age/size. 2. Initiate 0.9%Normal Saline via IV/10 at KVO or saline lock. 3. Monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (AHA)ACLS guidelines. Seabather's Eruption Review of in-Jury/illness This condition affects swimmers in some Atlantic locales(e.g., Florida,Caribbean, Long Island). It is caused by hypersensitivity to stings from the larvae of the sea anemone(e.g., Edwardsiella lineate)or the thimble jellyfish (Linuche unguiculata). Signs and Symptoms *Itchy, stinging rash typically appearing where the bathing suit contacts the skin Management VIII Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p w 87 ALS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A, and as indicated by the patient's condition. 4. Determine the need for ALS care and/ortransport to hospital for further evaluation and treatment. 5. Cal m and reassure the patient. 6.Assess and treat for anaphytaxis. (Refer to Protocol X.A.) 7. Encourage patients to sit in a shaded area and wait for conditions to ease. B. People exposed to these larvae should shower after taking off their bathing suit. 9. Cutaneous manifestations can be treated with hydrocortisone lotion and an oral antihistamine, if needed. 10. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1. Confirm the completion of BLS steps 1-9. 2. Initiate 0.9% Normal Saline via IWIO at KVO or saline Lock, if necessary. Pedialft BUS 1, FoLlow BLS.guidelines, adjusting for patient age/size. ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock, if necessary. VM � EnAronmental Emergencies KLFD BLS&ALS PROTOCOLS I�6 .... ...... ,,,,,-,,.,.,,.,.,.. � ....... ...�„ -�,. ,,,,,,,,.,,.....me.,,,,�,,,,�,,,,,�--.._...... ... .m,„�, m„�„�,,... ,, ,,,,,� „m,,,,,,,,,,�,�,,,,-. w E w �w Brown Recluse Spider Black Widow Spider High,Iy p They have thick tails and thin pincers.Not usually in the Keys. s a , 00w� <,iirrnnnnn� fn II', Non-venomous Wolf Spider Brown Widow Spider Non-venomous Scorpion- They have thin tails and broad,well-developed pincers.Common in the Keys-both black and brown i Vill I Environmental Emergencies KLFD BLS&ALS PROTOCOLS .p cn ca 107 X.Other Medical Emergencies A.Allergic Reaction Review of Iniury/Ittriess The body's immune system normally helps it to recognize, inactivate and eliminate threats such as bacterial or viral infections. Sometimes the components of that system are activated by foods, medications,or environmental elements[Ike pets, latex, or other chemicals causing allergic reactions.Allergic reactions range from mild col -like symptoms and rashes to life-threatening airway emergencies and shock(acute anaphylaxis). *Itching, Hives *Swelling *Diff icutty breathing(hoarseness,stridor) *Diff icutty swallowing *Chest pain *Weakness *Ftushing/redness *Wheezing *Unconsciousness ManagenieM M 1. Evaluate scene safety® DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI)measures/Universat Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol LA, and as indicated by the patient's condition® 4. Determine the need for S care and/or transport to hospital for further evaluation and treatment. X� Other Medical Emergencies KLFD BLS&PALS PROTOCOLS 10 5.Calm and reassure patient 6.Acute Anaphylaxis: a. If a patient has signs of cardiovascular or respiratory compromise(e.g., difficulty breathing, stridor, hypotension)and has a prescribed epinephrine auto-injector(EpiPen ), assistance may be offered for administration; may repeat x1 after 3-5 minutes. b. If the patient is wheezing, and has a prescribed MIDI,assistance may be offered for administration. c.Continue to monitor vital signs, including pulse oximetry, if available. 7. Continue supportive care and monitor vital signs until the patient is turned over to an AILS transport unit. ALS 1.Confirm the completion of BLS steps 1-6. 2.Secure and maintain airway and administer supplemental oxygen, if necessary.Assist ventilations with a bag valve mask(BVM)device,as needed. 3. Provide advanced airway support, if necessary. (Referto Protocol I.B.) 4. Initiate 0.9%Normal Saline via IWIO at KVO or saline lock. 5.Administer epinephrine 0.3-0.5 mg 1:1,000 solution SQ; may repeat x1 after 3-5 minutes with a maximum of 2 doses. 6.Administer diphenhydramine 25-50 mg IV/IO/IM; may repeat x1 after 15-20 minutes. 7. if unresponsive,or with no palpable pulses, administer epinephrine 0.5 mg of 1:10,000 IWIO. Ensure that only the 1:10,000 formula is used for IWIO administration. 8. Initiate 0.9%Normal Saline IWIO 250-500 ml bolus, up to a maximum total infusion of 2,000 ml without consulting on-line medical direction.Titrate to a Systolic BP =100 mm Hg. 9. If patient is wheezing,administer Albuterol 2.5 ml in 5.0 ml 0.9%Normal Saline; nebulized every 15 minutes. 10. Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (AHA)ACLS guidelines. 11. For patients taking beta blockers,who are unresponsive to epinephrine,consider Glucagon 1.0 mg IWIO/IM,every 5 minutes; may repeat x2. X I Other Medical Emergencies KLFD BLS&ALS PROTOCOLS .p cn 4 00 (D itL0 109 Pedlatubc 1. Follow BILS guidelines, adjusting for patient age/size. 2. If pediatric patient is in anaphylaxis,and has a prescribed EpiPen,8 assistance may be offered fora inisraion. a. Patients weighing<30 kg may have been prescribe piPen Jr"�'(0.15 mg of epinephrine) for IM administration; may repeat x1. b. Patients weighing>30 kg may have been prescribed an adult dose EpiPen"'(0.3 mg of epinephrine); may repeat x1. ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Secure and maintain airway and administer supplemental oxygen, if necessary.Assist ventilations with a bag valve mask(BVM) device, as needed. 3. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 4.Administer epinephrine 0.01 mWkg 1-1,000 solution SQ, up to a maximum total dose of 0.5 mg. 5. If patient is wheezing, administer A[buteroL 0.03-0.05 mift in 2.5 mL 0.9% Normal Saline; nebulized every 15 minutes. 6. Initiate 0.9% Normal Saline via IV/10 at 20 mL/kg fluid bolus, up to a maximum total infusion of 40 mt/kg. B. Hypertensive Crisis ReMem-oflUnaiiLinjury A severe increase in blood pressure accompanied by evidence of an organ damage that can lead to a stroke or another neurological manifestation. Signs-m symptoms *Systotic BP usually>180 mm Hg Headache with or without AMS *Chest pain/ECG changes *Putmonary edema X I Other Medical,Emergencies KLFD BLS&ALS PROTOCOLS *Neurologic changes consistent with stroke Management 1. Evaluate scene safety.DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A,and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5.Calm and reassure patient. 6.Secure and maintain airway and administer supplemental oxygen, if necessary.Assist ventilations with a bag valve mask(BVM)device, as needed. 7. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1.Confirm the completion of BLS steps 1-6. 2. Initiate 0.9% Normal Saline via IV/IO at KVO or saline lock. 3. Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (AHA)ACLS guidelines. i 4. If Systolic BP> 180 mm Hg or Diastolic BP z 110 mm Hg, monitor blood pressure every 5 minutes Pediatric 1. Follow BLS guidelines, adjusting for patient age/size. 2.Contact on-line medical direction for further guidance. X I Other Medical Emergencies KLFD BLS&ALS PROTOCOLS .p cc C) ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Initiate 0.9% Normal Saline via IWIO at KVO or saline Lock. 3.Obtain 1261ead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (AHA)ACLS guidelines.Apply pediatric pads. 4. Contact on-tine medical direction for further guidance C. Epistaxis Review-DU- It is important to recognize when nose bleeds result from head or face trauma. (Refer to Protocol IXI.) BLeeding from one or both nares 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) mensures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A, and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Calm and reassure patient. 6.Secure and maintain airway and administer supplemental oxygen, as needed. 7.Assess and treat for shock. (Refer to Protocol X.I.) 8.With patient in seated position,and head neutral, squeeze nostrils together with a dressing. If patient is able, he/she can hold compression on the nostrils; monitor for compliance and assist as needed(Must hold constant pressure fora minimum of 5 minutes.) X I Other Medical Emergencies KLFD BLS&ALS PROTOCOLS i '1 12 9.Apply cold pack to forehead/nose bridge area, if possible. 10. Continue supportive care and monitor vital signs until the patient is turned over to an ALS unit. ALS 1. Confirm the completion of BLS steps 1-9. 2. Initiate 0.9% Normal Saline via IV/IO at KVO or saline lock. 3. DO NOT attempt nasal intubation. D.Nauseallomiting Review of Injury/lUnass Patients can present with nausea and/or vomiting due to underlying injury, medical condition,active motion sickness, or medication side effect/complication.Sometimes, vomiting or intense nausea can complicate the existing injury or medical condition (e.g., penetrating eye injury, high risk for aspiration, side effects of narcotic administration). Signs and Symptoms *Vomiting or sensation of imminent vomiting *Inability to tolerate food or liquids *Retching or"dry heaves" Management y� 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI)measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol LA, and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Calm and reassure patient. 6. Secure and maintain the airway. X I Other Medical Emergencies KLFD BLS&ALS PROTOCOLS .p cn ............... a. C%4 ti 113 7. Place patient either in position of comfort or in Left lateral position to prevent aspiration, if not contraindicated by spinal immobilization or packaging. 8. Continue supportive care and monitor vital signs until the patient is turned over to an ALS unit. ALS 1. Confirm the completion of BLS steps 1-7. 2. Initiate 0.9%Normal Saline via 11//I0 at KVO or saline Lock. Pediatric 1. Follow BLS guidelines, adjusting for patient age/size. ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Initiate 0.9% Normal Saline via IWO at 20 mt/kg fluid bolus, up to a maximum total infusion of 40 mt/kg. E. G1 Weeding .Rem1[emt_Qf..1n1wy/_Un&%a Upper or tower GI bleeding can rapidly become a Life-threatening medical emergency as a result of substantial blood Loss with hypotension and shock.There are any potential sources of GI bleeding➢ most commonly: •_UPPQJ @ Lower • Peptic ulcer disease ® Infectious diarrhea • Esophageat varices *Colon cancer • Esop hmeal tears due to vomiting @ Diverticulitis e Rectatvarices * Hemorrhoids PAOM •Vomiting bright red blood or material that resembles coffee grounds •Bloody diarrhea(may be infectious) X I Other Medical Emergencies KLFD BLS&ALS PROTOCOLS 114 *Blood visible on the outside of formed stool or noticed on toilet paper after wiping *Black,"tarry"stools(typically indicates upper GI source of bleed) *Occult blood loss—May present with fatigue,general weakness,or syncope due to bleeding into the GI tract which is only found after testing for occult fecal blood Management M 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions,as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A, and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Bloody vomiting: a. DO NOT allow patients to eat or drink anything. b.Administer supplemental oxygen, as needed. c. Ensure the airway is not threatened by severe vomiting; use advanced airway to prevent aspiration, if needed. d. If dehydrated, refer to Protocol VI II.A. 6. Bloody diarrhea: a. Provide oral hydration with water, diluted fruit juice, or diluted sports drink(50:50 with water), if patient is awake, able to swallow and mental status is intact. b. If dehydrated, refer to Protocol VIII.A. 7. If possible,take orthostatic vital signs. If mental status or blood pressure are abnormal with the patient lying down, DO NOT attempt to take an orthostatic set of vital signs. 8. Continue supportive care and monitor vital signs until the patient is turned over to an ALS unit. X`Other Medical Emergencies KLFD BLS&ALS PROTOCOLS .p w ti 115 AUS 1. Confirm the completion of BLS steps 1-7. 2. Initiate 0.9%Normal Saline via IW10 250 ml fluid bolus, up to a maximum total infusion of 2,000 ml without consulting on-line medical direction. ReAaArfic 1. Follow BLS guidelines, adjusting for patient age/size. ALS 1. Follow BLS guidetines, adjusting for patient age/size. 2. Initiate 0.9% Normal Saline via IW10 at 20 mL/kg fluid bolus, up to a maximum total infusion of 40 ml/kg. F.Abdominal Pain Abdominal pain can indicate any different conditions such as ulcers, appendicitis, colitis, inflammation of the gall bladder or pancreas, kidney stone and internal masses that cause obstruction.Any of these conditions generate moderate or severe abdominal in. The acute (surgical) abdomen indicates an intra-abdominal emergency that requires urgent transportfor immediate surgical intervention. tM-- Peritoneat Inflammation •Abdominal pain,with or without vomiting *Tenderness with guarding •Rebound/percussive tenderness *"Rigid"abdomen *Patient lying perfectly still(movement causes severe pain) Management BIB 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. X �Otheir Medical Emergencies KLFD BLS&ALS PROTOCOLS 116 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A,and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Calm and reassure patient. 6. DO NOT allow patients to eat or drink anything. 7. Ensure the airway is not threatened by severe vomiting; use advanced airway to prevent aspiration, if needed. 8.Administer supplemental oxygen, if needed. 9. For suspected GI bleeding, refer to Protocol X.E. 10.Assess and treat for shock. (Refer to Protocol X.I.) 11.Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. ALS 1.Confirm completion of BLS steps 1-10. 2. Initiate 0.9%Normal Saline via IWIO 250 ml fluid bolus, up to a maximum total infusion of 2,000 ml without consulting on-line medical direction.Titrate to maintain Systolic BP> 90 mm Hg. 3.Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (AHA)ACLS guidelines. Pediatric W 1. Follow BLS guidelines,adjusting for patient age/size. ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. Initiate 0.9% Normal Saline via IWIO at 20 ml/kg fluid bolus, up to a maximum total infusion of 40 ml/kg. X Other Medical Emergencies KLFD BLS&ALS PROTOCOLS .p LO 117 G. Poison ing/Overdose Reyiew--atlftnessfinWry. Depression and other serious mental illness may cause a suicide attempt by overdose. Poisoning may occur by exposure to toxic substances via inhalation, injection, ingestion, or skin absorption. Children may be accidentally poisoned by medications, alcohol or household cleaners left unsecured. Poisoning may occur in the setting of a hazardous materials incident.Acute or chronic poisoning may also be a result of criminal and/or terrorist activity. Altered mental status(AMS)-Lethargy or unconsciousness vs. hype r-excita b itity Vomiting and/or diarrhea •Tachycardla or bradycardia •Sweating •Dilated or constricted pupils •Diff icutty breathing,with or withoutier s ial secretion •Cardiac dysrhythmias/arrest Managerrivni BU 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol LA, and as indicated by the patient's condition. 4. Determine the need for AL care and/or transport to hospital for further evaluation and treatment. 5. Remove patient from the toxic environment, using appropriately trained personnel wearing proper Level PPE, if necessary; decontaminate as appropriate. 6. In case of ingestion, identify the source, substance, medication and/or amount ingested or inhaled, if possible. X I Other Medical Emwgendes KLFD BLS&ALS PROTOCOLS 7.Administer supplemental oxygen and monitor pulse oximetry, as needed. 8. Contact Poison Control and follow their instructions 1-800-222-1222. 9.Continue supportive care and monitor vital signs until the patient is turned over to an AILS transport unit. ALS 1. Confirm the completion of BLS steps 1-9. 2.Secure and maintain airway and administer supplemental oxygen, as needed. 3. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 4. Initiate 0.9% Normal Saline via 1WIO at KVO or saline lock. 5. Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association(AHA)ACLS guidelines. 6. Maintain contact with the Poison Control Center. Pediatric BLS 1. Follow BLS guidelines, adjusting for patient age/size. ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2.Secure and maintain airway and administer supplemental oxygen, as needed. 3. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 4. Initiate 0.9%Normal Saline via IV/IO at KVO or saline lock. 5. Obtain 12-tead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association(AHA)ACLS guidelines.Apply pediatric pads. 6. Maintain contact with the Poison Control Center. H.Stroke,TIA Review of Injury/lllness A stroke is a loss of brain function due to insufficient blood flow and decreased oxygen reaching the affected area,usually caused by obstruction or rupture of one or more blood X Other Medical Emergencies KLFD BLS&ALS PROTOCOLS .p 00 ti 119 vessels in the brain.A TIA or Transient Ischemic Attack is a temporary disruption of function with stroke-like symptoms that typically resolves completely within 24 hours of onset®A Ti is generally considered a warning that a stroke could occur in the same distribution in the near future. Sig and Svmotoms •Slurred speech •Facial droop •Unequal grips/arms drift or other extremity weakness •Change in mental status-as documented by friend or family member •Sudden change in vision •Sudden severe or unexpLained headache •Syncope/vertigo *Ataxia Management BLS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI)measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol LA, and as indicated byte patient®s condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Calm and reassure the patient. 6. Secure and maintain airway and administer supplemental oxygen, as needed. 7. Provide advanced airway support, if necessary. (Refer to Protocol I. .) 8. Establish and relay time of symptom onset to receiving facility or transporting service. 9. Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit. X 0 Other Medicat Emergencies KLFD BLS&ALS PROTOCOLS 120 ALS 1.Confirm the completion of BLS steps 1-8. 2. Provide advanced airway support, if necessary. (Referto Protocol I.B.) 3. Initiate 0.9%Normal Saline via IWIO at KVO or saline lock. 4.Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (AHA)ACLS guidelines. 5. If seizures occur, treat according to seizure protocol. (Refer to Protocol II.B.) Pediatri-c M 1. Follow BLS guidelines, adjusting for patient age/size. 2. Evaluate for overdose(e.g., cocaine, methamphetamine, street drugs). If suspected, refer to Protocol X.G. ALS 1. Follow BLS guidelines, adjustingfor patient age/size. 2. Evaluate for overdose(e.g.,cocaine, methampheta mine, street drugs). If suspected, refer to Protocol X.G. 3. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 4. Initiate 0.9% Normal Saline via IWIO at KVO or saline lock. 5.Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (AHA)ACLS guidelines.Apply pediatric pads. 6. If seizures occur,treat according to seizure protocol. (Refer to Protocol II.B.) I. Shock Review of Injury/Illness The body responds in various ways when blood flow cannot meet the oxygen demands of the cells,depending on the severity and duration of the decreased blood flow/oxygen delivery. Some of the common causes of shock include gastrointestinal bleeding, sepsis, severe dehydration, cardiac dysfunction,or blunt/penetrating trauma. Signs and Symptoms X I Other Medical Emergencies KLFD BLS&ALS PROTOCOLS .P cn cc C) 00 Ul) 121 •General weakness •Cool,clammy skin(diaphoresis) •Dilated pupils •Rapid,weak pulse •Shallow, Labored respirations •Decreasing pulse pressure •Altered mentaL status •Multi-system organ failure Management 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care,as outlined in Protocol I.A, and as indicated byte patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5.Calm and reassure patient. 6. Secure and maintain airway and administer supplemental oxygen via non-rebreathing mask (NRBM)at high concentration.Assist ventilations with a bagvalve mask(BVM) device, as needed. 7. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 8. Initiate IV fluid resuscitation, if permitted by local protocol. (Refer to Protocol VII I.A.) 9.Control extremity wound hemorrhage, if necessary. (Refer to Protocol IX.A.) 10. Maintain appropriates ine immobilization, according to Protocol IX.E, if indicated. (Any trauma patient with suspected spinal injuries based on mechanism of injury should have full-body spinal immobilization.) 11. Consider pelvic stabilization, if indicated. X Q Other Medical Emergencies KLFD BLS&ALS PROTOCOLS 122 12.Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit.Consider Aeromedical evacuation to the nearest Trauma Center, if available. ALS 1.Confirm the completion of BLS steps 1-11. 2. Provide advanced airway support, if necessary. (Refer to Protocol I.B.) 3. Initiate 0.9%Normal Saline via IV/IO 250 ml fluid bolus, up to a maximum total infusion of 2,000 ml without consulting on-line medical direction.Titrate to maintain Systolic BP> 90 mm Hg. If rates are present, infuse up to 250 mt.Additional fluid requires consulting on- line medical direction. 4.Obtain 12-lead ECG and monitor cardiac rhythm and treat any dysrhythmia according to current American Heart Association (AHA)ACLS guidelines. Pediatric The pediatric patient may present hemodynamicalty unstable or with hypoperfusion as evidenced by altered mental status,delayed capillary refi 11(> 2 seconds), pallor, peripheral cyanosis, hypotension. Hypotension is defined as a Systolic BP<60 mm Hg in neonates (patients<28 days old), < 70 mm Hg in infants (patients< 1 year old), < [70+(2 x years) _ Systolic BP]for patients> 1 year old. M 1. Follow BLS guidelines,adjusting for patient age/size. 2.Consider Aeromedical evacuation to the nearest Trauma Center or Pediatric Trauma Center, if available. BLS Extended Scope/ALS 1. Follow BLS guidelines, adjusting for patient age/size. 2. If age-related vital signs and patient's condition indicate hypoperfusion,administer initial fluid bolus of 20 ml/kg 0.9%Normal Saline via IV/10. (Refer to Protocol VIII.A.) 3. If patient's condition does not improve: a.Administer the second bolus of fluid at 20 ml/kg 0.9%Normal Saline via IV/110. If patient's condition still does not improve, administer third and subsequent fluid boluses at 10 ml/kg. X I Other Medical Emergencies KLFD BLS&ALS PROTOCOLS .p 0 i N 00 123 b. For volume sensitive children(e.g., neonates[0-28 days], children with congenital heart disease, chronic lung disease, or chronic renal failure), administer initial fluid bolus of 10 ml/ 0,9% Normal Saline 1W10. If atient' condition still does not improve, contact on- Line medical direction. 4, Consider Aeromedicat evacuation to the nearest Trauma Center. i I i X Q Other Medical Emeir en6es KLFD BLS&AdL i PROTOCOLS .p cn w Iq 00 Ul) 124 Xi.Special Medical/Legal Protocols A. Documentation Requirements The patient care report(ePCR), or run report, is an official report provided by pre-hospitat personnel.Alt requests for emergency medical services require that an ePCR be completed. Documentation must accurately reflect observations, orders,treatments, and outcomes throughout the patient encounter. Proper documentation is critical to proving adherence to standards of care. 1. Each ePCR should contain the following information: a. to and time of event b. Chief complaint includes: • Patient description of problem • Mechanism of injury if trauma related c. History includes, * Onset-When did symptoms begin? * Provocation/Palliation-What makes them worse?What makes the better? -Quality-What do these symptoms feet Like? ® Radiation-Can it be felt in any other body Location? e Pain Severity- How bad does it hurt?(rate pain using a 0-10 scale) *Time- Is the pain constant or does it come and go?Have you had this occur before?How was it treated? - Pertinent past medical history, related to complaint e Past surgical history 2. Documentation of patient assessment should include a.Scene survey and mechanism of injury if trauma related. b. Initial primary survey,to include signs, symptoms and immediate interventions related to the following: •Airway • Breathing X1 I Special Medical/Legal Protocols KLFD BLS&ALS PROTOCOLS l25 •Circulation • Level of Consciousness •Spinal precautions(if appropriate) 3. Documentation of focused history and physical findings should include signs and symptoms of presenting problem and review of body systems as needed: a.Vital signs, including postural vital signs if indicated. b.Color,temperature,appearance of skin c. Blood pressure, both arms if indicated. d. Capillary refill e. Pupiltary response f. Motor, sensory, circulatory status of extremities, if appropriate g.Orders received,treatment and/or drug therapy initiated and patient response to treatment. h.On-going assessment of patient 4.Transfer summary should include: a.Condition of patient on transfer b. Name and signature of receiving agency/person assuming care of the patient. c.Time of transfer d . Legible signature of EMS provider of record,and names of all personnel who performed care,especiatly if they performed or attempted any procedure. B.Abuse/Neglect Review of Injury/Illness Abuse may involve physical,verbal, sexual mistreatment and/or neglect.Abuse may cause serious injury to the patient's mental and/or physical well-being. Perpetrators will often try to cover up, hide or alter information related to the nature of the injury.Victims may have been coached to give an alternate story about how an injury occurred. Particularly at-risk populations include pediatric, elderly, and pregnant patients. XI I Special MedicaU Legal Protocols KLFD BLS&ALS PROTOCOLS .p cn 00 (D 00 Ul) 126 * Bruising *Burns * Broken bones * Lethargy or other AMS *Dehydration, malnutrition * Injuries inconsistent with the history provided * Delay in seeking medical care * Information passed on byfamilyfriends *Information passed on byte victim's friend(s) Management BILWALS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation (BSI) measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol LA, and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5.Triage and treat patient according to appropriate protocol for injuries sustained. 6. Do not confront suspected abuser. 7. Document all findings incLudingvisual inspection of Location where patient was found, and any interaction between patient and caregiver. 8. Relay all findings upon transfer of care. 9.ALL suspected cases of abuse,exploitation, or neglect should be reported to appropriate Law Enforcement,Adult and/or Child Protective Services according to state and Local laws or regulations. 10. If the individual or caregiver is refusing treatment and transport,authorities and on-line medical direction should be notified prior to clearing the scene. X1 I Speciat Med`ucat/Legal Protocols KLFD BLS&AL S PROTOCOLS 1127 11.Continue supportive care and monitor vital signs until the patient is turned over to an ALS transport unit, if indicated. C.Withholding or Terminating Resuscitation (Non-trauma) Review of InJury/lUness In the pre-hospital setting,there are times when it is appropriate or necessary to consider discontinuing cardiopulmonary resuscitation and other lifesaving interventions. Management BLS/ALS 1. Discontinuation of cardiopulmonary resuscitation and other potentially lifesaving interventions may be considered when ALL of the following criteria have been met a.Arrest was not witnessed by an EMS provider or first responder. b. Adequate CPR has been administered according to current American Heart Association (AHA)guidelines. c.There is no spontaneous circulation (palpable pulse) and no neurological activity(e.g., spontaneous respiration, eye opening, or motor response) present after appropriate BLS resuscitation efforts. d.The patient is at least 18 years of age. e. Core body temperature is at least 95°F for a patient who was hypothermic due to cold exposure(e.g.,submersion). f.All health care providers on scene agree with the decision to cease efforts. g. Family members and others present must be acknowledged and assisted in dealing with this death. h.Contact on-line medical direction prior to termination of efforts. Documentation 1.The following must be legibly documented (e.g., printed) in addition to documentation protocol requirements. (Refer to Protocol XI.A.): a.Time resuscitation was started and discontinued. b. Run Number c.Any procedures performed(e.g., shocks administered by AED,airway management) XI I Special MedicaV Legal Protocols KLFD BLS&ALS PROTOCOLS .P 00 4 00 00 Ul) 128 d. Name, identifying number, and agency of law enforcement official and/or patient's private physician,and/or on-line medical direction contacted, and time of contact® D.Withholding or Terminating Resuscitation(Trauma) ROW ow-"juryllanvusa Early cardiac arrest in trauma patients is usually due to severe hypoxia, neurologic injury, or massive hemorrhage. If a trauma patient is unresponsive, putseLess, and apneic,the prognosis is generally very poor.As outlined below,there are circumstances where it is appropriate not to initiate resuscitation of a trauma patient, as well as criteria for discontinuing unsuccessful efforts in the fi eld. *No response *No pulse *No respirations MAnDament 1. For patients with penetrating trauma(e.g.,stab or gunshot wounds)it is acceptable NOT to attempt resuscitation if the patient has: a. No respirations or respiratory effort; and b. No palpable pulses and no organized electrical activity on AED or ECG; and c. No papillary reflexes; and d. No spontaneous movement. 2. If ANY signs of life are present, or if mechanism of injury indicates blunt trauma,the patient should undergo aggressive attempts at resuscitation. (Refer t® Protocol,IX.C.) a. Continue supportive care and monitor vita[signs until the patient is turned over to an ALS transport unit. Consider the need for Aeromedical evacuation to the nearest Trauma Center. 3. For patients with either blunt or penetrating trauma, it is acceptable NOT to attempt resuscitation if the patient has: X1 I Special MedcaU Legal Protocols KLFD BLS&ALS PROTOCOLS 12s a. Injuries such as decapitation, hemicorporectomy, incineration,or submersion> 12 hours,that are obviously incompatible with life, OR b. Evidence that he/she has been pulseless and apneic for a prolonged period(e.g., dependent lividity, rigor mortis, or decomposition). 4. For patients in cardiac arrest, but without injuries or apparent mechanism of injury to account for death, resuscitate according to current American Heart Association (AHA) guidelines. 5. For patients with either blunt or penetrating trauma, it is acceptable to terminate resuscitation in the field if the patient: a. Remains in cardiac arrest(after 15 minutes of appropriate resuscitation efforts), OR b. Remains in cardiac arrest and is located more than 15 minutes from a trauma center. 6.Always document findings and leave scene under Law Enforcement control after presuming an out-of-hospital death. a. Include name, identifying number, and agency of law enforcement officer. E.Do Not Resuscitate(DNR) Review of injury/illness 1.A DNR or"Do Not Resuscitate Order" is a valid physician's order to forgo resuscitative efforts.The presence of a valid Withholding Care Form allows providers to withhold specified care on patients. 2.When such a document is produced by the patient, patient's guardian, or agent designated to act on the patient's behalf, it should conform to the relevant, state or local requirements.The form must be signed by a physician or medical provider with authority to do so. 3.An Advanced Directive, otherwise known as a livingwill or health care directive, is a letter to a physician from the patient or responsible party outlining what care they wish to receive or not receive in the event they are incapacitated. Management BLS/ALS 1. If presented with a valid DNR form, do not begin resuscitative measures on a patient in or near cardiac or respiratory arrest. XI I Special Medical/Legal Protocols KLFD BLS&ALS PROTOCOLS .p 00 cn cc C) 130 2. If the EMS provider is unsure as tothe validity of the DNR contact medical direction for orders. If unable to contact, resuscitative efforts should be initiated until clarification of the Directive is made by a medical direction authority. 3. Proper law enforcement agencies should be notified upon death of the patient when: a. Resuscitative eff orts are cancelled by a medical direction authority. b.A valid DNR For is presented,and resuscitative efforts are withheld. c.A patient is being left rather than transported after death has occurred. 4. Documentation regarding the validity of a Pre-hospital Medical Care Directive or must be included in the patient care reporting document. 5.Take into consideration the sensitivities of family members,whether or not transporting the patient. Saecj� i i 1. Emergency Medical Services (EMS) personnel are not required to accept or interpret medical care directives, if uncertain of their validity. 2.Authorization forte withholding of resuscitative eff orts DOES NOT include withhold ing other medical interventions(e.g., IV fluids, pain control)prior to cardiac or respiratory arrest. F. Refusal of Care or Transport Review-plinjuryllAtneas An adult patient with normal mental status and intact judgment(competent) has the right to refuse care if properly informed oft e potential consequences of that refusal.A parent or Legal guardian must refuse care on behalf of a minor. mptoms •Patient refusing medical care or transport for litness or injury *Not under the influence of mind-attering substances(e.g.,alcohol, drugs) •Not demented •Oriented x 4(person, place,time, event)Management X1 I Special MedicaU Legal Protocols KLFD BLS&ALS PROTOCOLS 111 BLS/ALS 1. Evaluate scene safety. DO NOT approach patient if scene cannot be rendered safe. 2. Institute appropriate Body Substance Isolation(BSI)measures/Universal Precautions, as outlined in Protocol I.A. 3. Perform patient assessment and initiate routine BLS care, as outlined in Protocol I.A,and as indicated by the patient's condition. 4. Determine the need for ALS care and/or transport to hospital for further evaluation and treatment. 5. Upon determination of illness or injury, if patient is refusing care, has a GCS of 15 is oriented x4,explain the potential risks and dangers of not accepting medical intervention to the patient or other authorized responsible party,that could reasonably be expected to occur(e.g., infection of an open wound, pain, death from heart attack). 6. Have the patient verbalize understanding of the consequences,and then sign REFUSAL OF CARE form or patient care record (PCR)and obtain witness signature(s), if possible. XI Special Medical/Legal Protocols KLFD BLS&ALS PROTOCOLS .P ca i C%4 132 X11.Specialty Skills A. 10 Procedures lnt.r-ao-ssao-us--Inf-usion-f.Z.-10-Insert Lan The administration of fluids and medications via intraosseous infusion has Long been known to be a relatively safe and effective procedure in the treatment of critically M patients. Equipment needed: EZ-10 driver and appropriate needle, Betadine, NS with drip set, 10 cc syringe, EZ-10 connector tubing, pressure infuser and 2-inch tape. tndi-cati-ons Patients in is the following conditions are present: 1. Cardiac arrest, or 2. Profound hypovotemia, or 3. No available vascular access,or 4. Following two unsuccessful peripheral IV attempts for patients with any other life- threatening illness or injury requiring immediate pharmacological or volume intervention, or 5. In pediatric patients in cardiac arrest,go directly to 10 if no peripheral sites are obvious. Contraindicatians 1. Conscious patient with stable vital signs 2. Peripheral vascular access available 3.Suspected or known fractures in the extremity targeted for 10 infusion 4. Previous attempt in the same one 5. Celtulitis at the intended site of procedure 6. Patient with known bone disorder 7. Prior knee or shoulder joint replacement S-aILe-cLa9-p=da1e..na9 d-tp- 1.Adult: >40 kg®there are two lengths: regular and long 2. Pediatric® ®3 kg or patients that fir on the Broselow Tape(if child has excessive tissue, adult needle may be used) X11 I Specialty Skills KLFD BLS&ALS PROTOCOLS 133 Procedure 1. Locate landmarks: identify patella, approximately 2 fingers widths, below is the tibial tuberosity.Then 1 finger width medial is the final landmark. 2. Prepare the skin with antiseptic(Betadine)solution. 3. Select appropriate needle and prepare driver 4.Stabilize leg and power the needle set through the skin at a 90-degree angle to the surface of the bone until you feel the needle set tip encounter the bone itself 5.The 5 mm mark on the catheter(mark closest to the flange)should be visible 6. If 5 mm mark not visible abandon the procedure,the needle is not long enough 7.Apply firm and steady pressure on the driver and power through the cortex(hard, outer surface of the bone),ensuring the driver is maintained at a 90-degree angle 8. Stop when the flange touches the skin or sudden decrease in resistance is felt 9. Remove the driver from needle set and withdraw Stylet from catheter 10. If patient is unable to tolerate pain due to fluid pressure inside the bone,consider administering Lidocaine 25 mg 10, up to 50 mg to reduce the pain 11.Attach primed EZ-10 extension tubing and confirm placement with fluid bolus:failure to flush will result in no flow •Adults: 10 cc fluid bolus • Pediatrics: 5 cc fluid bolus Secure tubing and catheter with tape and document time of insertion as the EZ-10 is good for 24 hours. Pressure infuser may be used to maintain adequate flow rates. XII I Specialty Skills KLFD BLS&ALS PROTOCOLS i .p cn .. w w 134 EZ-10 LANDMARKS w, k „ ,,,, p ' .... .... .... ... ...... ., . ....... ..... .... .. Locate landmark. Clean insertion site. Power driver through the cortex. mm m m. mmmm yti�u�e ,, � it i ill Remove needle. Attach tubing,flush,and Pressure infusion for adequate consider Lido(25 mg to 50 mg f tow rates I for bone pain in conscious patients . . _ .... __...._ . B. Orat Endotracheatl i Equipment Needed:[SPA or NPA, R1/M, oxygen,appropriate size endotracheal tube, detector,suction and taryngscope . Use the ® ®2 rule fort e airway to estimate the Likelihood of success;the first look is the best. re-oxynate gives you the time to gently look. a. Attach pulse oxi eter and have suction readily available b. Perform appropriate L airway manaeuver too en airway c. Head tilt chin lift or jaw maneuver to open airway d. Insert prop aryn eat airway and/or naso haryn eal airway e. Check the integrity of the ET tube by inflating the cuff and deflate f. re-ox hate with BVIVI15 Ipm 02 at a rate of 1 -12 per minute g. Using the taryngoscope, insert ET tube with directvisualization of the vocal cords xii I Specialty Skills KLFD BLS&ALS PROTOCOLS 135 YOU MUST SEE ET TUBE PASS THROUGH THE VOCAL CORDS h. Inflate the cuff on the ET tube i.Auscultate epigastric area to confirm no sounds present j. If breath sounds are absent,withdraw the tube and re-oxynate k. If left breath sounds are absent,withdraw ET tube slightly and asculate again L. If bilateral breath sounds are present, secure ET tube and record cm depth at lips m.Attach ETCO2 detector,square waveforms should appear on the monitor: pulse ox should improve and chest should rise with insuflation n.Secure the patient's neck with C-collar and CID on backboard Basic Airway Management(BAM): is defined as follows: Assisted Ventilations while using basic airway adjuncts(OPA, NPA), i-Gel and a Bag Valve Mask. Advanced Airway Management(AAM): Includes all Basic procedures with the addition of Endotracheal(ET). C..J-Gel Airway Device Procedure The i-Gel is a supraglottic airway management device used as an alternate means of establishing an airway. I-Gel has a soft,gel-like, non-inflatable cuff,designed to provide an anatomical impression fit over the laryngeal inlet. Indication 1. Unconscious patient who is not breathing without a gag reflex. 2.Apneic patient without a gag reflex. 3.A difficult airway is anticipated: a.Small mouth which obstructs visualization b.Short neck c. Mallarnpatti or Cormack-Lehane score 7 3 d.Any obstruction that could impair visualization of the glottic opening. e. Impaired neck mobility. 4.Access to the airway is impeded (entrapment, helicopter cabin etc.) Contraindications 1. Patient has a gag reflex. 2. 2. Esophageal tissue damage from trauma, chemical ingestion or thermal injury. XII I Specialty Skills KLFD BLS&ALS PROTOCOLS .p cc 136 3. Esophageal or airway obstruction. 4.Airway burns or chemical inhalation injury. Procedure Equipment 1.Appropriate i-Gel.Size(SEE CHART BELOW) 2.Water based lubricant(surglLube) 3.Suction 4.Sp02 Monitor 5. ETCO2 detector Insertion Techniaue 1.Open and maintain the airway.Ventilate with 100%oxygen before attempting of the i- Get. 2. Select the appropriately sized i-Get based on weight. Open i-Gel package and take i-Gel out of the protective cradle. 3. Lubricate the back, sides, and front of the cuff by rubbing it on the smooth surface of the protective cradle containing the water-based lubricant. 4. Remove dentures or removable plates from the mouth prior insertion. 5. Grasp the lubricated i-Gel firmly along the integral bite block. Position the device sot at the i-Gel cuff is facing towards the chin of the patient. 6. Maintain the head in a neutral position for trauma patients. For non-traumatic patients, the patient's head should be in the "sniffing" position with the head extended and neck flexed.The chin should be gently pressed down before proceeding to insert the i-Gel. X11 I Specialty Skills KLFD BLS&,BLS PROTOCOLS t7 (JINN/, §r 7. Introduce the leading soft tip into the mouth of the patient in the direction towards the hard palate. 8. Glide the device downward and backward along the hard palate with continuous but gentle push until a definitive resistance is felt. 9.The front teeth should be resting on the integral bite block. (The black lineon the i-Gel). 10.Attach the End tidal CO2 Device to the i-Gel and BVM, and confirm placement. Securing the Device 1.Secure the i-Gel with the airway support strap provided. i-Gel Tube Sizing Chart: 2 Small Pediatric 10-25 ........................._._. � _... 2.5 Large Pediatric 25-35 ..- m ...... ...................... �.._........_�,...,....,.,.,....,.,.............,.�� mmm„rr r�............................_.............. 3 Small adult 30-60 NMI XII Specialty Skills KLFD BLS&ALS PROTOCOLS .p cc 4 00 (7) L0 138 Basic Airway Management(BAM). is defined as follows: Assisted Ventilations while using basic airway adjuncts(OPA, NPA), i-Gel and a Bag Valve Mask. Advanced Airway Management(AAM): Includes all.Basic procedures with the addition of Endotracheal(ET). D. Intranasat Administration Technique(Narcan) OLASS Synthetic opioid antagonist DDSAGES Vial,has 2mg of NaLoxone in 2mL •Give 1 mg(1 ml) in each nostril, quickly • Medication is atomized and absorbed through vessels in the nasal cavity ACILONS The mechanism of action is not fully understood. It does appear that Natoxone antagonizes the effects of opiates by competing at same receptor sites. When given IV,the action is apparent within two minutes. IM or SC administration is slightly sioweL INUD-ADONS Naloxone is indicated for the complete or partial reversal,of opiate narcotic depression and respiratory depression secondary to opiate narcotics or related drugs. Look fr,:v,the Signs.,. Overdose on opioids typically: * Unconscious *Slow or not breathing(<1 0/min) ®Small,"pinpoint"pupils(miosis) * Pulse variable CONTRAINDICATIONS NaLoxone is contraindicated in patients known to be hypersensitive to it. Use with extreme caution in narcotic-dependent patients who may experience withdrawal, syndrome (including neonates of narcotic-dependent mothers). Xi I Specialty Skills KLFD BLS&ALS PROTOCOLS I S SIDE EFFECTS •Tremor •Agitation *Belligerence *Papffiary dilation •Seizures *Increased tear production •Sweating •Seizures it Cardio: *Hypertension *Hypotension •Ventricular tachycardia •pulmonary ede , *Ventricular fibrillation. GI: *Nausea,vomiting. WARNINGS Use caution during administration as patient may become violent as level of consciousness increases. •The tip of the syringe should e placed near or just inside the nostril • Placement of the syringe too far inside the nasal cavity may traumatize the nasal passage or cause epistaxis XII i Specialty Skills KLFD BLS&ALS PROTOCOLS .p cc c� 0 0 cm 4 �t %o i HOW TO GIVE NASAL SPRAY NA C N a ,nwmmxmv �% �,o^ WWIIryry�IW1WVNVIWM0U1 NIP, V%MVM2 Pam CA rM _i0(tlsauiuw w,w.xnwuww ✓N w,k� siuunuw ��rr�, s� to GNPULft to%WWI min nmv ry Pula M a vubw ®F4 eeeer+f�&I 1P�aaaa�le ra I in ism E.Combat Application r f t The Combat Application Tourniquet (CAT) is an effective tool to help control severe blood toss from the body's extremities. If usedcorrectly, the CPT can save lives. A general misconception of the CAT is that it will result in the patient requiring amputation oftheir extremity, THIS IS FALSE. Amputationis more often required as a result of the injury itself, not because oft e tourniquet.The CAT as well as any other type of tourniquet should a as a LAST RESORT for btood control management. Applying direct pressure to the injury an elevating the extremity above the heart should be attempted prior to utiLizing the CAT. i CVO I pecWty SkKs KLFD BLS&ALS PROTOCOLS lit F. Full Spinal Immobilization Technique Equipment Needed: Long backboard,3 immobilization straps,head stabilization device and cervical collar Adults • Determine need for spinal precautions •Assure and maintain manual c-spine immobilization •Assess pulses, motor and sensation of extremities •Apply appropriate sized C-collar and long backboard • Fill voids with padddings/towels as needed •Apply X4 straps using the chest cross-strap technique •Apply head stabilizing device • Reassess pulses, motor and sensation after immobilizing patient • DO NOT strap the patient directly over the abdomen Strap tlhle p atieirit tio the lb ackbioard If;�.11 .1[::: �$ .a.;t:,, ,uring the patients head Most of the body weight is between'the 4V shoulders and the upper thighs, place the straps accordingly i Use tape`to secure;the forehead d the'chin area to the'backboard XII Specialty Skills KLFD BLS&ALS PROTOCOLS .p 0 i C%4 C) (D 142 Pediatrics •Apply appropriate size c-collar • Pad under the shoulders using pillowcases or towels to prevent flexion of spine •Secure to Long backboard emgnftntplafia� • Immobilize as above and tilt the backboard LeftlateraLrecu m bent to a 20-degree an le •Assure patient comfort 0.APGAR Scores ,�/'7, '/�M, IN/ I ONES M I g MMMI/m/m/al"M . ..... Appearance Blue, pate Body pink, extremities completely (color) Blue or pate pink EMS Grimace No response Grimace Crying ME % gig /,h sentPtespiraticns Slow, I regular 7i�1llliel 011/1,111 1/111ME1117 MINE Infant's Conditio Point total Treatment Consideration Good 7-9 Re-assess Poor 0-3 Requires CPR ....................... X11 Specialty Skills KLFD BLS&ALS PROTOCOLS 143, H. Rule of Nines mm via r`, '1 /1 4.5° 4 � r t .5% Want � 6,59a ..d% I I �I L,3 XII Specialty Skills KLFD BLS&ALS PROTOCOLS .p 0 w Iq 0 cm Iq 144 1. It Trauma Scorecard Methodology Read, any one (1),transport as trauma alert, Blue, any two(2), transport as trauma alert Component Airway +Sustained respiratory rate Active airway rarnhsistal ce (J) 30 Circulation Sustained heart rate 120 _... .......,,. o rarad• m � I lilai latrl,SIr,�,alimd a Hi1 > 120 or SystoliIrc 90 rur°r°r Il°f Best .tor...�, ... „�.�.�,.. , M, ... ......._ ._m.... ......... .......... _...__. �,..... . __ . .�.... ...... . . .... ....w: Response • — (,31C t (BMR) BKR=4 tali kr�,,raa-.3 prasciriitFe oil`p ar aliysis aasIpia:.lioni of arapilri at i mn jr.,alkW� M ........m.m.m...M.M.M.M.M.M.M.M.M.M.M�..,.M.M.M.M .M._.. . . .M .M. ..� ... . i..os of seinsr::atir:rra Cutaneous o tissue loss 2 •� NCH ralr lralrroalf I.r JI �II a.�llr ramrarl u BSA Arra;iaratatioln I iroxiim,A to t:liie it i^.at o u, a lrt lk[e Any li:aeratr.kitrtatilrm,g ulajury to thie A°urraad, rnr-cill „ rart�ar aaa ) 1 Lon .... one Fracture 4 Sign or symptoms of _ ipti _._ .. _aw.. ( ) single � fli�,li�n tar�aylrrrlq�at�err7is of ra fracture site due to MVC or frtactwaa of two aar rnorc lrora„ Fall 1 W or more Iraone"si'it'es" e • years or older(7) .... . «.... .�.�. .�.�.««<.�..... .. _m ....__ .._.. ec anism o Injury Ejection from o or vehicle (6) •Steering heel deformity(6) ....... .. .... �....,ri,�..o,,.�. . ._ . Judgement In EMT orlP alrrar.�edlCk,, dliis uetion (H) ®Airway assistance beyond administration of oxygen. 2. egloving injuries, major flap avulsion (>6") ® Excluding superficial wounds in which the depth can be easily determined. ® Long bone including humerus, radius/ulna,femur,tibia/fibulae . Excludes: motorcycles, mopeds,ATVs, bicycles or open body of a pick-up truck. 6. Only applies to driver of vehicle. i XH i Specialty SkMs KLFD BLS ALS PROTOCOLS 145 7. Blunt head,chest, or abdominal trauma on blood thinners with high risk of bleeding or with history of a bleeding disorder 8. If patient does not meet any of the criteria listed above and the on scene EMT, Paramedic believes the patient may benefit from Trauma Alert criteria due to extenuating. circumstances surrounding the incident,the patient may be classified as a "Trauma Alert". J. Pediatric Trauma Scorecard Methodology 1:1 ;rd, any of ne, (1), transport as trauma alert; Blue,anytwo(2)transport as trauma alert; Green—follow local protocols Size 0>20kg 1 -20kg(22-4 lbs.) @Weight< 11 kg(<22 lbs.) p (44+tbs.) 41 Length<33 inches on pediatric length-based tape ______.�._.......... ......... .._ .......,..,, ......... Airway 0 Normal 0 Supplemental 10 Assisted (1) oxygen n1 dinnt.�ul. .. _- ... ....__. Consciousness Awake Amnesia 10,Aftered irienntoil sitatus(2) ` 0 Loss of 0 Coirna consciousness Pre�sb�bnnr ie of Ipara'lys. s I Su�spli6ion ofslpinaL oorld liin)u,ury Loss of sennsa ticarn �.,,,... .____.. ,..,,. .... _ ._ .... .... or n��c�n n II nrnli�_ � .�.. Circulation Good Carotid or femoral Fah-it able carotlid peripheral pulses palpable but or feryioiral,Ipualse pulses;SBP lack of radial or pedal l~P 50 nnin'"rnll l,g 0 mmHg pulse SBP<90 mmHg ......... . ....... ...... �._ ..............................___ ...._... Fracture 0 .None seen •Sign or symptom of 0 Open U)i ng bone fracture, or suspected single closed long 0 MIUL ifnla fra ,tUFC,C c.,lites bone fracture(3)(4) e MultipLe dis'looatliorns (3)(4) k ...,.,.,.. ,w .. _....,..... ._.. .............. ....,...... .._..... .......-................. ........... ........ ..............,. )) Cutaneous 0 No visible 0 Contusion 10 Maim soft firssur�,, disruption (5) injury 0 Abrasion 10 20 or 3o burrns to ''-> 1 11%..l..BSA Arrnprutatiiorn (6) 10 Anny Iperretirrt'lliirnh irnqUryto l°nead, nri ec lk o it to irs r�u (7) -. .............- �......, .. . .....,,m,�_ . .............-._ Judgement l:d " ran Ipararrned c discretion (B) 1.Airway assistance includes manual jaw thrust,continuing suctioning,or use of adjuncts to assist ventilator efforts. XII I Specialty Skills KLFD BLS&ALS PROTOCOLS .p cn (D C) (D i 146 2.Altered mental status includes drowsiness,lethargy, inability to follow commands, unresponsiveness to voice,total unresponsive. 3. Long bone including humerus, radius/ulna,femur,tibia/fibula. ® on bone fractures do not include isolated wrist or ankle fractures or dislocations. ® DegLoving injuries, major flap avulsions, or major soft tissue disruption. ® Proximal to wrist or ankle. 7® Excluding superficial wounds in which the depth can be easily determined. ® If the patient does not meet any of the criteria listed above and the on scene EMT, Paramedic believes the patient may benefit from Trauma Alert criteria due to extenuating circumstances surrounding the incident,the patient may be classified as a Trauma Alert". K. RAD-57 Pulse CO-Oximeter Purp-ose, Carboxyhernoglobin monitoring is used to determine if carbon monoxide levels are present in-firefighters, patients and occupants with possible exposure to carbon monoxide. If levels are present,determine the course of treatment needed., Sp CO readings can be used as an additional screening measure to determine exposure to carbon monoxide. SpCO readings can also be used as a tool of inclusion/exclusion on vague inedicaL complaints to reduce the risk of undiagnosed carbon monoxide poisoning. When Sp CO is used In conjunction with SP02 it gives a higher index of suspicion of hypoxia and indicates a need for aggressive treatment. XlV I Speciatty Skilks KLFD BLS&ALS PROTOCOLS 147 SpCO monitoring shall be indicated for the following conditions: . Post-incident firefighter screening on all fires 2. Firefighter rehabilitation in accordance to NFPA 1554. . Extended time on or near fire-ground. 4. Multiple SCBA bottle use. . Suspected carbon monoxide exposure from ork performed in confined spaces. 6. Carbon monoxide alarms/gas leaks without symptoms in conjunction with gas detectors to determine presence and exposure. 7. Multi-patient presentation. 8. Headache, dizziness, syncope,weakness,altered mental status,and/or lethargy. 9. Shortness of breath,chest pain. 10. Nausea,vomiting, abdominal complaints. 11. Any ill or injured patient with vague complaints. For use during firefighter rehabilitation and as a screening tool on occupants without complaints regardless of whether known or unknown exposure.The following guidelines will be used as a baseline for detecting SpCO levels: 1,0- % Normal, no treatment required 2.3- 12%Yes-signs and symptoms or history of exposure TREAT . 3- 2% No-signs or symptoms, no history of exposure OBSERVE . 1 %and higher TREAT and CONSIDER TRANSPORT Treatment: 1 %oxygen by non-re-breather mask and transport to hospital is highly recommended. 1.Adults with an SpCO level %or higher 2. Pediatrics with an SpCO level 1 %or higher 3. Pregnant females with an SpCO 1 %or higher XII I Specialty Skills KLFD BLS&ALS PROTOCOLS p 0 4 00 0 cm 148 r 1,Appdy probe to p atierit's runiid dds finger or ainy other digit to centeroffingernaill as recommended d by tha device rrn nu fact uirer„ if near strobe Lights,ts, over finger to avoid o nterfer incs and/or rnnove swayfrorn Ughts if p ossiblis. � i .AlIllo lac machine to register percent 6rc udatprng carboxyh"a rnogtobi n. 34 Record Carboxy IHlb procedure in patient care report or on the scams r h alboddt tiion form. AlIso record ao2 frorn RAID 57 i 4 Verify pau.ulhse rate on innach i ne with actualt puwuds of tine patient. n t. . Monitor critical patients coati nuousdy until,sinriinrsd at-the h o slpht da if recording a one-orris reading, n-noiniitor patients nts for a pew rninu.ut s as oxygen saturation can vary.. . Document percent of a�rarlboxyhernu:a dr Wn"a every t1irne vutall signs are recorded and in resp pins to therapy to correct CO exposure. 7. Use-the pups oximetryfeature of than:device as ain added tool[for patient evaLuation. Treat the patient, not the data proviided by the device. 8.'Tlhe pu,udse oximeter reading sh ou W never Ibe used to withnh oW oxyp'en from a patient nt in respiratory distress or do rn it its the standard of care to appudy oxygen despite good pupudse oximetry readings,such as chest pain. 94 Factors which may reduce than r l[iabiippty of the reading hnCtU de: e Poor p eriiph rad curc ud tiio n (Wood vodum , hypotension, hyp oth eirmiis and vasoconstrictors) * Excessive external[al[Lighting, psutiicu,ud rdy strob /f Lashing d'u hats * Excessive puLse oxiinrast r sensor motion * FingernaiL paoUshb (may be reirraoved with acetone pad) irregular heart rhythrirns( aL6ai fiilbiriiU a4uorna SVT, etc,) 9.Jaundu c ; PlIaceiment of BP cuff oin same extremity as putse ox probe -4%raorrra d vsWe 10%allarm wills.sound. High CO exposure and sera treating patient appropru t dy and i consider transport ort to the ose st appropriate h osp itaL. UU V Specially skUUUs KLFD BLS&AL Z PROTOCOL 149, L.Glasgow Coma Scales Spontaneous 4 ....... ........... - To Voice 3 -.............................. ............... ........... To Pain 2 I.................... Epp ............ .................. No Response 71 MEMEMEMEMEM Obeys Command 6 ............................................... Localizes P� ..in 5 ...............................- .....................-- Withdraws to Pain 4 ................. ............ Flexion to Pain 3 ............. ................... Extension to Pain No Response 1 5 YEARS-ADULT Oriented and Converses ............ ...................... Disoriented and Converses 4 .. .. ........................Inappropriate Words 3 . ..........................................—.-... ........ Incomprehensible Sounds 2 .............. No Response ............. .. ............... i 2 YEARS-5 YEARS Appropriate Words 5 ...................... ....................................... Inappropriate Words 4 ......................................... Cries/Screams 3 .......................... ............... Grunts 2 ...............11..........I........... ........ ......................... No Response 1 ........... 2 YEARS Smiles/Coos/Cries S .................. Cries 4 ............. Inappropriate Cries/Screams 3 . ........ .............I........ ................................................. Grunts 2 L_No Response .......................11.1.1............. .................. T-1 ........... ................ Glasgow Coma Score Total XII I Specialty Skills KLFD BLS&ALS PROTOCOLS C) (D 0 r CG 150 M. P III:111MA IIIVITAL•• G __ ____ Age weight fill _ Miniirnu rn Nor mat Heart IRate IN rr ai Respiratory Rat yt¢s4Nue IP _.................... ..... ............................................................................ ................................. �........... ferimi ............................................................................ .......................................................................................................................................... 3.5 ................. ....... .................................................................................. ......... ............................. .......................................... ........................................................................................ I year 72. 1QED-170 30-40 .................................................�.... .................................................................................................................. ........,... ..................... ............... ............................................................................................................ ............................................................. 15 years 20 2 70-"1 1'� 16 ................................................................. .................................................................................................................. 1 years �� � 4� N�9y N�� ........................................_..................................................................................................... _................................................................................................................................ T Ipmc t,BP fin chlidiren 1••••10 years f age:80 ur rnllA (chill''(chilld's age idin years x ) Inifl l 0.5joulles p r kg foltItowed by 1 j uul e/Ik tllie° 2.jou ll kg FoUow M IA reClDrlullneu dat ao s. I i 011 0 SpleciaUySkilfts KLFD BLS& BLS PROTOCOLS L I 71 � N. ETCO2 Waveforms tidal not as Impressive as everything else i Capnography (90 roes) and common Waves. v/q MOMm,ire••IbeoM11l1m a ollw�q deat 2 common waves tnsp�rattonxpatton i u. � -----01-'------------- scocn,spsm ate.. a �a CM DKr"wb5EMh*M Aalwodw k�•a; .ar CU Auto zm pem.o.i.s,r. „7�rotepl�iiacan.. oon.a vwh". Tub��splaoanNnl elaa«aslorHooNan olp�seenA�eeaaaRtTCe2E�ip1+1 BnaU ft wm dH il+erl°h"�b P pram of*a MI&M M vrnwo, �a�,•eearr. a►w�nkq ar gd�bn U Oly in ptnw (Nnolu slopd „rl XII Specialty Skills KLFD BLS&ALS PROTOCOLS I .p i i (%4 CG 0. 12 LEAD QUICK REFERENCE GUIDE •ST elevation in the following leads include: a. Inferior watt MI-11, 111, aVF-Perform V4R on all inferior watt MI(IF VI IS POSITIVE, DO NOT GIVE NITRO TO PT.) b. Lateral all MI -1,aVL,VS thru V6 c.Anterior all MI-V1 thru V6 d.Septat all MI-V1 thru V3 Inverted T waves and ST depression are indications of ischernia when found in aVL and V1 Posteriorwatt MI-ST Depression in VI thru V4 and a tati,R wave;any Rwave in V1 is suspicious a Indications for 12 Lead Include: a.Any suspected cardiac event b. Chest pain c.Abdominal pain d.Syncope e. Poor general appearance f. Hypotension g. Dysthymias h.Weakness i. Unexplained nausea,vomiting or diaphoresis. j, Unexplained arm,jawor back pain ................ ......... ......... XIII Specialty Skills KLFD BLS&ALS PROTOCOLS R SYNCHRONIZED CARDIOVERSION Hemodynamically unstable, unconscious or decreased mental status, hypotension, dyspnea,chest pain. If possible, sedate with Mldazolarn 2.5 mg(up to 10 mg max). Biphasic: •Synchronized cardioversion 100 joules, if unsuccessful •Synchronized cardioversion 200 joules, if unsuccessful •Synchronized cardioversion 300 joules, if unsuccessful repeat subsequent shocks at 360 joules IF patients'rhythm converts,then re-enters dysrhythmias, repeat cardioversion at last joule setting administered. Q.TRANSCUTANEOUS EXTERNAL PACING •Apply Combo pads to patient's chest.Apply the first pad to anterior right chest,just below clavicle and second pad lower left lateral, mid axillary,or anterior/posterior. • Connect the multifunction cable to the extremity leads. •Sedate the patient as needed with MidazoLam 2.5 rng up to 10 mgmax) • Print an EKG rhythm strip prior to pacing •Turn on the external pacer and set the rate at 70 beats per minute •Turn milliamps to lowest amount and slowly increase until electrical capture is noted * Electrical capture is noted when each pacer spike isfollowed by a wide R wave • If electrical capture is achieved,check central pulses at the femoral and carotid *If palpable pulses are present, mechanical capture has been achieved and pacing is successful • If both electrical and mechanical capture have not been achieved, pacing should be discontinued and the need for chest compressions assessed • If pacing has been successful the patient's mental status, perfusion and blood pressure should improve • Maintain pacing until transfer of care is given to an AILS transport unit and fully prepare to assume pacing efforts for the patient rrterut of ads and good con-tact to the I is imperative to have correct place P chest wall to successfully pace. XII I Specialty Skills KLFD BLS&ALS PROTOCOLS .p W r CG I.Appendix APPROVED DRUG LIST This section contains a brief description of drugs used in the protocols. It is intended to supplement other standard references® Drugs are listed alphabetically, based on their generic narnes.Trade names are shown in parenthesis. Adenosineri ( _ Page 1-2 terot(Proventil.6, i ) Page 3® ArniodaroneO) Page 5 Aspirin Page Atropine Sulfate as Cardiac Agent Page 7-8 Dextrose %, ! p) Page -1 p i ( ) Page 11-12 Epinephrine 1 , _ _ _ Page 13 Epinephrine : 10,000 Page 1 Page 1 -1 p ") . Page 1 Natoxonei ) Page 1 -19 Nitroglycerin(NitrostatO, Nitrolinguat", _ Page 20-21 Oral Glucose( ) _ age 22 .p i V1 m r CG .p Adenosine Triphosphate m J � i isA Mechanism f Action P : Slows conduction through AV node and interrupts AV reentry pathways,which restore normal sinus symptoms, Contraindications Hypersensitivity 2nd or 3rd degree Pad'block(except these onpacemakers) Sinus node disease, such as sick sinus syndrome or symptomatic bra ycardia(except in patients with a functioning artificial pacemaker) Adencscan: Contraindicated in broncho constrictive or bronchospastic lure disease (e , asthma) Cautions: Symptomatic brad cardia, cardiac arrest, heart block, heart transplant patients, HT , hypotension, MI, proarrhythmic events, unstable angina denocard:Caution with bronco constrictive or broncespastic lung disease(i.e asthma) IV Administration- Adenocard:given as a rapid injection (1 d3 sec) by peripheral IV route directly into vein or into IV line close (proximal)to patient and is followed by rapid NS flush after each injection (20 mL for adults, 5 mL or more for pediatrics) Place patient in mild reverse Trendelenburg position before giving drug. Record rhythm strip during administration, Adenosine dose Flush 2 •Attach both syringes to IV injection port nearest to patient • Clamp IV tubing above injection port •Avoid drug traveling retrograde • Push adenosine as fast as possible (1-3 sec) •While keeping pressure on adenosine syringe plunger, push NS flush as fast as possible • Unclamp IV tubing .p i 00 r Albutero CG I i ® li Mechanism of Action Beta2 receptor a onist with some betal activity; relaxes bronchial smooth uscle with little effect on hurt rate. Contraindications Hypersensitivity to albuterol Cautions Some inhalers use hydrofluoroalkane(HF )as propellant instead of chlorofluorocarbons (CFCs); otherwise, devices are equivalent. Immediate hypersensitivity reactions may occur after administration of albuterol sulfate, as demonstrated by rare cases of urticaria, an ioedema, rash, bronchospasm, anaphylaxis, and oropharyneat edema. Paradoxical bronchos asm may occur. The need for more doses than usual may be a sign of deterioration of asthma and requires reevaluation of treatment. Adverse ea tion and Side acts: Cardiovascular:Tachycardia, hypertension, and angina. NS: Nervousness,tremor, headache, dizziness, and insomnia. im Drying of oropharynx, nausea® and vomiting, unusual taste. Dosage: Nebulizer solution; If>1 year or<10 kg.-2.5 in 3 mI,of NS( . %) to nebulizer and flow oxygen at 6-8 liters/ min, (premixed) If<1 year or¢ 1 : 1.5 in 3mL of (0.083%)to nebulizer and flow oxygen at 3 liters/ min. (premixed). (2.5) mg divided in half). Delivered in over 5-15 minutes. .p c� i 0 N CG Via. i ��su�IIUII.II ndnrr mc Iw„u Ca row ew uu,c Ilaad. �muwll. Mechanismof Action Class ill antiarrhyth is agent,which inhibits adrenergic stimulation; affects sodium, potassium,and calcium channels; markedly prolongs action potential and repoLarization® decreases AV conduction and sinus node function. Contraindications Hypersensitivity Severe sinus node dysfunction, 21/31 Alf block or bradycardia causing syncope(except with functioning artificial pacemaker), cardiogenic shock. ACLS, PutsetessVentricular Fibrillation/Ventricular Tachycardia 300 rig IV or intraosse pus push after dose epinephrine if no initial response to defibrillation h ay fottow initial dose with 150 mg IV q -5min. Pediatric dosage: Pulseless Arrest: mg/ kg may be repeated once. No single dose greater than 300 mg. 15 rngl kg x) Aspirin (Bayer,® Bufferin) m t%% P °gym Mechanism of Action Aspirin is a salicylate used to treat pain, fever, inflammation, migraines, and reducing the risk of major adverse cardiovascular events. Contraindications: A known allergyto Aspirin(i.e. urticaria, dyspnea,etc.),active GI ulceration or bleeding, hemophilia or other bleeding disorders,during pregnancy, children under 2 years of age. Indications: Aspirin is indicated in Acute Coronary Syndrome setting to prevent further clotting. Adverse Reactions and Side Effects: GI: Nausea,vomiting, heartburn,and stomach pain. OTC:Tinnitus Hypersensitivity: Bronchospasm,tightness in chest, angioedema, urticaria,and anaphylaxis. Dosage: Adult 324 mg(4)81 mg chewable tablets)for Acute Coronary Syndromes .p N i N N CG 7 Atropine Sulfate as Cardiac Agent .I. j' Mechanism Action: Atropine is a potent antic olinergic (parasympathetic bLocker, parasym pato ic)that reduces va al tone and thus increases automatically the SA node and increases AV conduction, Indications: Sinus Bradycardia accompanied by hemo yna is compromise, (i.e. hypotension, confusion,frequent PVCs, pale cold, clammy skin). In children <1year bradycardia of less than 60 beats/ min should be treated if symptomatic even if BP is normal. Contraindications: None in emergency situations Warnings: Too small of a dose(<0.5 mg) or if pushedtoo slowly, may initially cause the heart to decrease,Antihistamines and antidepressants potentiate Atropine.A maximum dose o shout shoutd not be exceeded. For 2Ild degree AV blockType 11 and 3rf degree A block, omit Atropine and go to external pacer® Adverse Reactions and SideEffects: CNS. Restlessness, agitation, confusion, psychotic reaction, pupil dilation, blurred vision, and headache Cardiovascular. Increase heart rate, may worsen ischernia or increase area of infection, ventricular fibrillation,ventric tar tachycardia, angina,flushing of skin GI: Dry mouth, difficulty swa[Lowing Other: Urinary retention. Can worsen pre-existing glaucoma. Dosage: Adult: 0.5-1 mg IV/10, may repeat every 3-5 minutes until improved or total of 2 mg is reached Pediatric: 0.02 mg/kg 1V/10(minimum dose is 01 mg maximum single dose is 0.5 mg child, 1 mg adolescent). May repeat once. .p W Iq N CG I Mechanismctl onosacc ari e,which provides calories for metabolic needs,spare body proteins are loss of electrolytes, Readily excreted by kidneys producing diuresis, Hypertonic solution, Indications • Hypoglycemia •Lorna of unknown origin Contraindications • Intracranial or intraspinat hemorrhage (in a patient with normal L), • Blood glucose Level> 6 /dl. Adversections and Sides Cardiovascular.Thrombosis Sclerosing if given in peripheraLvein. Local:Tissue irritation or necrosis if infiltrates Other:Acidosis, alkalosis, hyperglycemia, and by o ale is Dosage Adult: (>30 g) 50 ml of a 50%solution; (2 ) IV/10. Pediatric(<30 kg) 2 mL/kg slow IW 10 of a 25%solution. Newborn: (< 10 kg or<1 month of age)5 ml/kg IV/10 of 10%solution(dilute D50 4a 1 with ), II�' *Note-Divide 50 by the type of dextrose solution to arrive at rate in ml/kg Adult(D50): 50/50= 1 ml/kg Child (D25): 50/25=2 ml/kg .p N cm N CG INS I i� 116 E ��!r�arlMwlliJ/d Mechanismi ip en y ra ine is an antihistamine with antic oliner is(drying) and sedative side effects. ti ista Ines a pear to compete with histamines for cell receptor sites on effector cells. Diphenhydramine prevents, but does not reverse histamine mediated responses, particularly histamine effects on the smooth sce of the bronchial airways, gastrointestinal tract, uterus, and blood vessels. Indications Allergy symptoms, anaphylaxis Sedation of violet patients. stonic reactions from enot iine overdose(i.e al ol,Compazine,Torazine, and Stetazine) Contraindications • Diphenhydramine is not to be used in newborn or premature infants. • ip enydrarnine is not to be used in patients with acute asthma attack. Warnings In infants and children especially, antihistamines in overdose may cause hallucinations, convulsions,or death.As in adults, antihistamines may diminish mental alertness in children. In young children,they may produce excitation. Diphenhydramine has additive eff ects with alcohol and other C S depressants( yp otics, sedatives,tranquilizers, etc.). Antihistamines are more likely to cause dizziness, sedation,and hypotension in the elderly (60 years or older)patients. �i? Adverse Reactions and Side Effects CNS: Drowsiness,confusion, insomnia, headache,vertigo(especially in the elderly) Cardiovascular: Palpitations,tachycardia, PVCs, and hypotension Respiratory:Thickening of bronchial secretions,tightness of the chest,wheezing, nasal stuffiness. GI: Nausea,vomiting, diarrhea,dry mouth, and constipations GU: Dysuria, urinary retention Dosage Adult: 25-50 mg IV/10 or 50 mg deep IM. Pediatric: 1 mg/kg IV/10 or IM (maximum 25 mg). .p N 4 00 N CG 1 Epinephrine 111,000 � IR' Mechanism i s Epinephrine is a sympathomimetic,which stimulates bath alpha and beta®adener is receptors causing immediate one o nation, increase in heart rate and an increase in the force of cardiac contraction. Subcutaneous dose lasts 5 15 minutes. Indications •Asthma @ Anaphylaxis •Angioneurotic edema 11 puLseLess Arrest Contraindications None in the cardiac arrest situation. Hyperthyroi d ism, hypertension, cerebral arteriosclerosis in asthma. Caution should be used with Epi administration when the patient is older>40 years of age or history of heart disease. Tlihe benefit must Oink ei ltl the risk. IDID II'giD:t administer i if heart is> 150 beats per minute. ReactionsAdverse f C a Anxiety, headache, cere rat hemorrhage. Cardiovascular®Tachycardia,ventricular dysrhythmias, hypertension, angina, palpitations. GI: Nausea and vomiting. Dosage Adult: SQ 0.3 mg( .3 cc). Repeat every ®5 minutes(Asthma/Anaphytaxis may repeat once in 15 minutes). Pediatric:SQ 0.01 mg/kg up to 0. 11 . Epinephrine 1:10,000 y,�//��'iw�.. u� //iin�nmiruuuu�;V�muYY3�lll!'NONrytttir�IWtiw�mr�rf �r Mechanism of Action Epinephrine is a sympathomimetic,which stimulates both Alpha and Beta-receptors.As a result of its effects, myocardial and cerebral blood flow are increased during ventilation and chest compression. Epi increases systemic vascular resistance and thus may enhance defibrillation. Indications •All Pulse Less Arrest • Asystole •Ventricular Fibrillation to defibrillation • PEA •Other pediatric indications: hypotension in patients with circulatory instability, bradycardia(before Atropine). Contraindications None in the cardiac arrest situation. Warnings Epi is inactivated by alkaline solutions-Never Mix with Sodiun'm Bicarbonate Adverse Reactions and Side Effects CNS: Anxiety, headache, cerebral hemorrhage. Cardiovascular:Tachycardia,ventricular dysrhythmias, hypertension, angina, palpitations. GI: Nausea and vomiting. .p c� N 0 M CG 1 Glucagon i I, Mechanismtl Luca on,which is produced naturally in ancreas by the alpha ells of the islets of Langerhans,causes an increase in blood glucose concentrations. It is effective ins all doses, and no evidence of toxicity has been reported with its use. Glucagon acts only on the liver glycogen,converting it to glucose if the patient has adequate lco en reserves. Luca on possesses positive inotro is and c ronotropic properties. Indications Documentedhypoglycemia is a true medical emergency, IM gLucagonshould be administered rapidly if IV access is delayed.Glucagon is indicated fort the treatment of hypo Lyce is when IV cannot be established and oral glucose is contraindicate a It may be effective in a symptomatic eta® loc er overdose. Contraindications • eoc ro octo a • !ns lino a • Known hypersensitivity •Should not be routinely used to replace Dextrose when Ili access has been obtained Warnings Luca on should e administered it caution in patients with history of inslinora and I or pheochromocytoma. ONLY f ruin of Sterile grater should be used for u°,r.c lnstliitt,Itil u°I,, Il Normal alliine cannnot be used as an atterrlatlive. Possible Adverse Reactions and Side Effects Occasional nausea and vomiting Dosage Adult: 1 mg slow IVP/IM (not less than 34 seconds) Pediatric<40 kg: 0.025 mg/kg slow IVP/IM (not as effective in children as in adults) .p i N M CG 1 Midazotam (Versed I' Mechanism of � fly Actions Depresses uscle relaxant, strong sedative, hypnotic, amnesia. Indications Control of seizures, sedation for car ioversion&pacing. Sedation for airway management. Contra indications Respiratory depression Hypotension ETOH and drugs Warnings Monitor patient for respiratory and CNS depression. Monitor vital signs after administration. Adverse Reactions and SideEffects: Retrograde amnesia altered mental status, dizziness. Cardiovascular: Bradycardia, hypotension, PVCs,tachycardia, nodal rhythms. GI: Nausea and vomiting, hiccoughs, coughing Respiratory: Respiratory depression, laryngospasm, bronchospasm. Dosage Adult: 2.5 mg increments up to 10 mg max Pediatric: > 1 years of age( .1 A ) 1 Naloxone Hydrochloride (Narcan°) �����iG�dr�,uq+uamfav�!Iuv� Sumrtm�f�i�i!�i�row'dmrn�ud�un�sr+�,rcumu�V rx Mechanism of Actions Naloxone antagonizes the effects of opiates by competing at the same receptor sites. When given IV,the action is apparent within two minutes. IM or SC is slightly slower. Indications • Heroin •Methadone • Meperidine(Demerol) • Lomotil •Codeine • Hydromorphone(Dilaudid) • Morphine • Pentazocine(Talwin) • Propoxyphene(Darvon) • Percodan • Fentanyl(Sublimize)(Also Known As"White China") Contraindications Known hypersensitivity to Narcan. Warnings Naloxone should be administered cautiously to people including newborns of mothers who are known or suspected to be physically dependent on opiates, it may precipitate an acute abstinence syndrome. If the patient is intubated and the airway is controlled do not administer Narcan(excludes cardiac arrest). May repeat Narcan since duration of action of some narcotics may exceed that of Narcan. Naloxone is not effective against a respiratory depression due to non-opiate drugs. Use caution during administration as patients may become violent as level of consciousness increases. .p a„ m w Iq CG 19 Adverse Reactions and Side Effects CNS: Tremor, agitation, belligerence, pupiUary dilation, seizures, increased tear production, sweating, and seizures secondary to withdrawal Cardiovascular: Hypertension, hypotension®ventricular tachycardia, pulmonary edema, ventricular fibrillation. Gh Nausea and vomiting. Dosage Adult: Initial dose 2 mg may administer 1WIO1IM/If no response after 4 mg,then the condition is probably not due to narcotic. (Fentanyl may require large doses of Naloxone to reverse effects). Pediatric: 0.1 mg/kg 1WIO/IM 20 Nitroglycerin (Nitrostat°, Nitrolingual° Spray) w Mechanism of Actions Nitroglycerin is a direct vasodilator,which acts principally on the venous system although it also produces direct coronary artery vasodilation as well.There is a decrease in venous return,which decreases the workload on the heart and thus,decreases myocardial oxygen demand. Sublingual nitroglycerin is rapidly absorbed. Pain relief occurs within one to two minutes and therapeutic effects can last up to 30 minutes. Indications •Chest pain or discomfort associated with suspected AMI. • Pulmonary edema with hypertension Contraindications • Systolic BP< 100 mmHg •Children under 12 • Patients on erectile dysfunction drugs that fall within time parameters, IIDO NOT administer Nitro if erectile dysfunction drug use <48 hours. • Known hypersensitivity to the drug • Evidence of a positive WR in the setting of an Inferior Wall MI Adverse Reactions and Side Effects CNS: Headache, dizziness,flushing, nausea and vomiting Cardiovascular: Hypotension, reflextachycardia, bradycardia .p cn (D CG 21 Dosage Adult: 0.4 mg(1 tablet or 1 spray sublingual). May repeat up to two additional times ®5 minutes PRN. 2 Oral Glucose (Insta Glucose) Mechanism of Actions Increases blood glucose levels slowly. Indications BS<60 mgdl, patients who are altered but alert enough to take the command to swallow. Contraindications Patients unable to swallow or Stroke symptoms. Precautions None when patient can swallow, risk of aspiration if given improperly. Adverse Reactions and Side Effects Cardiovascular: Unknown' CNS: Unknown GI: Nausea Dosage Adult: 1 tube Pediatric: 1 tube .p 4 co M tG d' Z, N 140 U) CO N U o a U 0 0 a � •� o cop, ° co co co o • Z) Cl) QL) co tmp � H O QL) o~ o o O coU LO W o U QL)QL) Q �L) a) � E Z a -14 cd x a' 2 � C) � N N cdu co c� ul Z - u - � � °SUN o N � � V V w N N � N O � co � U > 4� LO ri co QL) ® Cd � W oUD a x U W U U ° cd W p co U � N .co 2r.� W W O Oco Z) V p O � O O ❑ a ° p :� U pj pj O d' O W z � � �.� w W w w �' co N N N d co p p N O p V ai co O O Cd � W U W U W W0 c •- O '� i�i 1� Naltional Union, Fire Insurance Complany of Pittsburgh, Pa. Admi6orcfNvv Officc 12,71 Ave of 6*Arv�eriws,,Ft 37 1 Ns"w'Yc,,A,P,9'Y 10020 � MA58,5000 ,a orIP00 %,Iock comp"o'ny"1w,"Ma (2s the, C_c,'WIJwWWY) SCHEDULE OF COVERAGE -VOLUNTEER Policy Number- VFP-4310-7210E-6 Policyholder- KEY LARGO VOLUNTEER FIRE DEPARTMENT, INC (Name and Address) 1 EAST DRIVE APPROVED BY RISK MANAGEMENT KEY LARGO, FL 33037-0000 DATE 4/29i2024` Policy Effective Date- 10/11/2023 Term- 1 Year WAIVER NIA—YES— Policy Termination Date- 10/11/2024 Premium- $6,080 This Schedule of Coverage provides only those benefits that have a specified amount entered opposite the name of the benefit. Benefits that are followed by the word "none" are not provided under this policy. PART COVERAGE I. Loss of Life Benefits A. Accidental Death Benefits (1) Accidental Death Benefit Amount.................................................................................$50,000 (2) Seat Belt Benefit Amount............................................................................................. $12,500 (3) Safety Vest Benefit Amount...................................................................................$12,500 (4) Military Death Benefit Amount......................................................................................$15,000 B. Dependent Child and Education Benefit Amount................................................................ $30,000 C. Spousal Support and Education Benefit Amount.................................................................$15,000 D. Memorial Benefit Amount....................................................................................................$57000 E. Dependent Elder Benefit Amount.........................................................................................$57000 F. Repatriation Benefit Amount................................................................................................$27500 111. Lump Sum Living Benefits A. Accidental Dismemberment and Paralysis Benefit Principal Sum.........................................$507000 B. Vision Impairment Benefit Principal Sum............................................................................$507000 C. Injury Permanent Impairment Benefit Principal Sum............................................................$507000 D. Heart Permanent Impairment Benefit Principal Sum ........................................................... $507000 E. Illness Permanent Impairment Benefit Principal Sum .......................................................... $507000 F. Cosmetic Disfigurement Resulting From Burns Benefit Principal Sum..................................$507000 G. HIV Positive Lump Sum Living Benefit Principal Sum.......................................................... $507000 V50000NUFIC-FL (Rev. 9/17) 1 VFIS 4639 III. WeeklyIncome Benefits A. Total Disability Benefits (1)Total Disability Weekly Amount (first 28 days) .................................................................$600 (2)Total Disability Maximum Weekly Amount(after 28 days).................................................$600 (3)Total Disability Minimum Weekly Amount.........................................................................$150 B. Partial Disability Benefits (1) Partial Disability Weekly Amount(first 28 days)................................................................$300 (2) Partial Disability Maximum Weekly Amount(after 28 days)...............................................$300 (3) Partial Disability Minimum Weekly Amount.........................................................................$75 C. Disability Benefits General IV. Occupational Retraining Benefit Maximum Amount.......................................................... $20,000 V. Weekly Injury Permanent Impairment Benefit............................................................®Yes ❑No VI. Medical Expense Benefits A. Medical Expense Benefit Maximum Amount.........................................................................$5,000 Medical Expense Benefit Options (1) Excess of Workers' Compensation or No-Fault Auto Insurance Benefits...................................1Z (2) Primary Medical Expense Benefit..........................................................................................❑ B. Cosmetic Plastic Surgery Maximum Amount......................................................................$257000 C. Post-Traumatic Stress Disorder Maximum Amount............................................................. $257000 D. Critical Incident Stress Management Maximum Amount .....................................................$257000 E. Family Expense Benefit Amount (per day)...............................................................................$100 F. Family Bereavement and Trauma Counseling Benefit Amount (per person)........................$17000 VII. Transition Benefit......................................................................................................®Yes ❑No Vill. Felonious Assault Benefit Amount.....................................................................................$257000 IX. Home Alteration and Vehicle Modification Benefit Maximum Amount.............................. $507000 X. Optional Benefits A. Weekly Hospital Benefit Amount........................................................................................... NONE B. First Week Total Disability Benefit Amount............................................................................ NONE C. Coordinated 28 Day Total Disability Benefit Amount............................................................ NONE D. Extended Total Disability Benefit.............................................................................❑Yes ®No E. Long-Term Total Disability Benefit...........................................................................❑Yes ®No F. Cost Of Living Adjustment(COLA) Benefits (1) Weekly Injury Permanent Impairment COLA.....................................................®Yes ❑No (2) Long-Term Total Disability COLA......................................................................❑Yes ®No G. Extra Expense Benefit Extra Expense Benefit Monthly Amount...........................................................................$500 Extra Expense Benefit Maximum Amount...................................................................$127000 H. 24-Hour Accident Benefit Amount......................................................................................... NONE I. Off-Duty Accident Benefit Amount........................................................................................ NONE V50000NUFIC-FL (Rev. 9/17) 2 VFIS 4640 SCHEDULE OF FORMS AND RIDERS POLICY FORMS ATTACHED AT ISSUANCE: V50000NUFIC-FL Schedule of Coverage -Volunteer V50004NUFIC-FL Blanket Accident and Sickness Insurance Policy -Volunteer Members V50007NUFIC-FL Career Personnel Rider V50036NUFIC-FL Mandatory Quarantine Rider 89644 (07-05) Coverage Territory Endorsement OFAC Notice Office of Foreign Assets Control Notice V50000NUFIC-FL (Rev. 9/17) 3 VFIS 4641 PAYM ENT/INSTALLM ENT SCHEDULE THE TOTAL POLICY PREMIUM FOR THIS POLICY IS $6,080, PAYABLE IN INSTALLMENTS AS FOLLOWS: 10/1/2023 $3,040 4/1/2024 $3,040 V50000NUFIC-FL (Rev. 9/17) 4 VFIS 4642 National Union Fire Insurance Comp�any of Pittsburgh, Pa. XdrnpnkM,,;?6v,P,Officc Q,7tl Ave of she Arrmico),,,F1 17 ) �,Jww Vk, ,, NY MUD � 212,458,5000 (0 0:`1rW,4,d VkKlk C01'00,xirvy,hermn f0erreJ wo o&0'ie('.ornpemy,) For inquiries, information about coverage or for assistance in resolving complaints, contact: National Union Fire Insurance Company of Pittsburgh,Pa.: 1-800-551-0824. NOTICE This is not comprehensive health insurance coverage. It does not satisfy the requirements of minimum essential coverage under the Affordable Care Act. BLANKET ACCIDENT AND SICKNESS INSURANCE POLICY VOLUNTEER MEMBERS This policy is a legal contract between the Policyholder and/or Participating Organization named in the application and Us. We agree to insure certain persons(herein called Insured Persons) against loss covered by this policy subject to its provisions, benefits, limitations and exclusions. The persons eligible to be insured are all persons described in this policy as Insured Persons. This policy provides accident and sickness insurance to Insured Persons while they are participating in a Covered Activity. CONSIDERATION — TERM This policy is issued in consideration of the payment of the required premium when due as shown in the Schedule. We agree to provide the benefits shown in the Schedule to Insured Persons in accordance with the provisions and conditions of this policy. This policy maybe changed or terminated without consent of or notice to each Insured Person. The term of this policy begins on the policy Effective Date and continues in effect until the policy Termination Date, both of which are shown in the Schedule, as long as premiums are paid when due, unless otherwise terminated as further provided in this policy. If this policy is terminated, insurance ends on the date to which premiums have been paid. All periods of insurance will begin and end at 12.01 AM Standard Time at the address of the Policyholder and/or Participating Organization. RENEWAL After the policy Termination Date shown in the Schedule, this policy may be renewed for additional periods of time by mutual written consent of Us and the Policyholder and/or Participating Organization at the premium rates set by Us for the renewal period. If this policy is not renewed, We shall provide the Policyholder and/or Participating Organization with 45 days advance written notice which states the reason for the non-renewal and, insurance will stop on the date to which premiums have been paid subject to the Grace Period provision. Such notice shall be mailed to the Policyholder's and/or Participating Organization's last known address as shown in Our records. V50004NUFIC-FL 1 VFIS 4643