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Renewal

Commercial Lines Policy Declaration

Customer Number: 0111061583 Policy Period: 06/27/2016 to 06/27/2017


Policy Number: 2112633 02 at 12:01 AM Standard Time at Your Mailing Address Shown Below

Named Insured and Address: Agency Name and Address: 12398


A&T Security, LLC HAUSMAN-KUNKEL INC
420 Clinton Pl 40 S PROSPECT
River Forest, IL 60305 ROSELLE, IL 60172-0290
630-894-7510

In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the
insurance as stated in this policy.
This policy consists of the following coverage parts for which a premium is indicated. This premium may be subject to
adjustment.

Coverage Part Premium

Commercial General Liability Coverage $1,356.00

Total Premium: $1,356.00

Total Including Taxes, Fees and Surcharges: $1,356.00

This is not a bill. A billing invoice will be sent separately.

See attached schedule for forms applicable to all coverage parts.

Countersignature Date
(Authorized Representative)

DCP 01 04 14 04/29/2016 11:09:02


Renewal

Commercial Lines Policy Declaration

Customer Number: 0111061583 Policy Period: 06/27/2016 to 06/27/2017


Policy Number: 2112633 02 at 12:01 AM Standard Time at Your Mailing Address Shown Below

Named Insured and Address: Agency Name and Address: 12398


A&T Security, LLC HAUSMAN-KUNKEL INC
420 Clinton Pl 40 S PROSPECT
River Forest, IL 60305 ROSELLE, IL 60172-0290
630-894-7510

Named Insured Schedule

A&T Security, LLC

DCP 02 04 14 04/29/2016 11:09:02


Renewal

Commercial Lines Policy Declarations

Customer Number: 0111061583 Policy Period: 06/27/2016 to 06/27/2017


Policy Number: 2112633 02 at 12:01 AM Standard Time at Your Mailing Address Shown Below

Named Insured and Address: Agency Name and Address: 12398


A&T Security, LLC HAUSMAN-KUNKEL INC
420 Clinton Pl 40 S PROSPECT
River Forest, IL 60305 ROSELLE, IL 60172-0290
630-894-7510

Location Schedule

Loc Address City County State Zip

1 420 Clinton Pl River Forest Cook IL 60305

DCP 03 04 14 04/29/2016 11:09:02


Renewal

Commercial Lines Policy Declarations

Customer Number: 0111061583 Policy Period: 06/27/2016 to 06/27/2017


Policy Number: 2112633 02 at 12:01 AM Standard Time at Your Mailing Address Shown Below

Named Insured and Address: Agency Name and Address: 12398


A&T Security, LLC HAUSMAN-KUNKEL INC
420 Clinton Pl 40 S PROSPECT
River Forest, IL 60305 ROSELLE, IL 60172-0290
630-894-7510

Forms Schedule
Number Edition Description
IL0017Z 1198 COMMON POLICY CONDITIONS
IL0021 0908 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD FORM)
WB214A 0309 MEMBERSHIP AND VOTING NOTICE
IL0985Z 0115 DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT
WB660 0109 TWO OR MORE COVERAGE FORMS OR POLICIES ISSUED BY US
IL0162 0908 ILLINOIS CHANGES - DEFENSE COSTS
IL0147Z 0911 ILLINOIS CHANGES - CIVIL UNION

DCP 04 04 14 04/29/2016 11:09:02


Renewal

Commercial General Liability Coverage Declarations

Customer Number: 0111061583 Policy Period: 06/27/2016 to 06/27/2017


Policy Number: 2112633 02 at 12:01 AM Standard Time at Your Mailing Address Shown Below

Named Insured and Address: Agency Name and Address: 12398


A&T Security, LLC HAUSMAN-KUNKEL INC
420 Clinton Pl 40 S PROSPECT
River Forest, IL 60305-2211 ROSELLE, IL 60172-0290
630-894-7510

Insured is a(n) Limited Liability Company

Limits of Insurance

General Aggregate Limit (other than Products/Completed Operations) $2,000,000

Products/Completed Operations Aggregate Limit $2,000,000

Each Occurrence Limit $1,000,000

Personal and Advertising Injury Liability Limit $1,000,000

Damage to Premises Rented to You Limit $100,000

Medical Expense Limit, Any One Person Excluded

See attached Forms Schedule for forms and endorsements applicable to this coverage.

DCGL 01 04 14 04/29/2016 11:09:02


Renewal

Commercial General Liability Classification Schedule

Customer Number: 0111061583 Policy Period: 06/27/2016 to 06/27/2017


Policy Number: 2112633 02 at 12:01 AM Standard Time at Your Mailing Address Shown Below

Named Insured and Address: Agency Name and Address: 12398


A&T Security, LLC HAUSMAN-KUNKEL INC
420 Clinton Pl 40 S PROSPECT
River Forest, IL 60305-2211 ROSELLE, IL 60172-0290
630-894-7510

Commercial General Liability Classifications

Class
Loc Code Description Exposure Premium Basis Rate Premium Coverage

1 70070 SECURITY PATROL - 49,000 Payroll 18.890 $926 Prem/Ops


WITHOUTFIREARMS Included Included Prod/Co

1 91591 Contractors - 70,000 TotalCost 1.454 $102 Prem/Ops


subcontracted work - other 1.004 $70 Prod/Co
than construction-related
work

DCGL 02 04 14 04/29/2016 11:09:02


Renewal

Commercial General Liability Endorsements and Miscellaneous Premiums

Customer Number: 0111061583 Policy Period: 06/27/2016 to 06/27/2017


Policy Number: 2112633 02 at 12:01 AM Standard Time at Your Mailing Address Shown Below

Named Insured and Address: Agency Name and Address: 12398


A&T Security, LLC HAUSMAN-KUNKEL INC
420 Clinton Pl 40 S PROSPECT
River Forest, IL 60305-2211 ROSELLE, IL 60172-0290
630-894-7510

Miscellaneous Premiums

Description Form Number Premium

Terrorism Risk Insurance Act $4

Additional Premium to Meet Coverage Minimum Prod/Co: $254

Total General Liability Premium: $1,356

DCGL 03 04 14 04/29/2016 11:09:02


Renewal

Commercial General Liability Forms Schedule

Customer Number: 0111061583 Policy Period: 06/27/2016 to 06/27/2017


Policy Number: 2112633 02 at 12:01 AM Standard Time at Your Mailing Address Shown Below

Named Insured and Address: Agency Name and Address: 12398


A&T Security, LLC HAUSMAN-KUNKEL INC
420 Clinton Pl 40 S PROSPECT
River Forest, IL 60305-2211 ROSELLE, IL 60172-0290
630-894-7510

Forms Schedule
Number Edition Description
CG0001 1207 COMMERCIAL GENERAL LIABILITY COVERAGE FORM (OCCURRENCE VERSION)
CG0068 0509 RECORDING AND DISTRIBUTION OF MATERIAL OR INFORMATION IN VIOLATION OF
LAW EXCLUSION
CG2135 1001 EXCLUSION - COVERAGE C - MEDICAL PAYMENTS
CG2144 0798 LIMITATION OF COVERAGE TO DESIGNATED PREMISES OR PROJECT
CG2147 1207 EMPLOYMENT-RELATED PRACTICES EXCLUSION
CG2170 0115 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM
CG2229 1185 EXCLUSION - PROPERTY ENTRUSTED
NS0003GL 0414 EXCLUSION - THEFT-DETECTIVE, SECURITY AND PATROL OPERATIONS
NS0007GL 0414 EXCLUSION-DESIGNATED OPERATIONS-DETECTIVE, SECURITY AND PATROL
AGENCIES
NS0029GL 0414 EXCLUSION - DISCRIMINATION
NS0076GL 0414 TOTAL LIQUOR LIABILITY EXCLUSION
NS0077GL 0414 EXCLUSION - NONCOMPENSATORY DAMAGES
NS0078GL 0414 EXCLUSION - FIREARMS-DESCRIBED HAZARDS
NS0273 0708 LIMITED FUNGI COVERAGE
WB1468GL 0414 EXCLUSION - ASBESTOS OR ASBESTOS PRODUCTS

DCGL 04 04 14 04/29/2016 11:09:02


Renewal

Commercial General Liability Forms Schedule

Customer Number: 0111061583 Policy Period: 06/27/2016 to 06/27/2017


Policy Number: 2112633 02 at 12:01 AM Standard Time at Your Mailing Address Shown Below

Named Insured and Address: Agency Name and Address: 12398


A&T Security, LLC HAUSMAN-KUNKEL INC
420 Clinton Pl 40 S PROSPECT
River Forest, IL 60305-2211 ROSELLE, IL 60172-0290
630-894-7510

Forms Schedule
Number Edition Description
WB1958GL 0414 EXCLUSION - LEAD LIABILITY
CG0200 1207 ILLINOIS CHANGES - CANCELLATION AND NONRENEWAL
NS0002IL 0414 DETECTIVE/SECURITY GUARD PROFESSIONAL LIABILITY COVERAGE
NS0028GLIL 0414 EXCLUSION - DESCRIBED HAZARDS - GUARD DOGS

DCGL 04 04 14 04/29/2016 11:09:02


POLICY NUMBER: 2112633 COMMERCIAL GENERAL LIABILITY
CG 21 35 10 01

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EXCLUSION COVERAGE C MEDICAL PAYMENTS


This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Description And Location Of Premises Or Classification:


All Locations and Operations

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)

With respect to any premises or classification shown 2. The following is added to Section I Supple-
in the Schedule: mentary Payments:
1. Section I Coverage C Medical Payments h. Expenses incurred by the insured for first
does not apply and none of the references to it aid administered to others at the time of an
in the Coverage Part apply: and accident for "bodily injury" to which this in-
surance applies.

CG 21 35 10 01 ISO Properties, Inc., 2000 Page 1 of 1 


POLICY NUMBER: 2112633 COMMERCIAL GENERAL LIABILITY
CG 21 44 07 98

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

LIMITATION OF COVERAGE TO DESIGNATED


PREMISES OR PROJECT
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Premises:

Project:
Security Guard Operations

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)

This insurance applies only to "bodily injury", "property damage", "personal and advertising injury" and medical
expenses arising out of:
1. The ownership, maintenance or use of the premises shown in the Schedule and operations necessary or
incidental to those premises; or
2. The project shown in the Schedule.

CG 21 44 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1 o


THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

LIMITED FUNGI COVERAGE


This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Fungi Liability
Each Occurrence Limit $$50,000
Aggregate Limit $$100,000

Coverage under this endorsement is subject to the Fungi Each Occurrence and Aggregate Limits shown
in the schedule. Our obligation to pay any claim or judgment, or to defend any suit, ends after these lim-
its have been exhausted by payment of judgments or settlements, or after we have offered for settlement
our limit of liability.

A. The following exclusion is added to Paragraph 2., C. The following are added to Section III Limits of
Exclusions of Section I Coverage B Personal Insurance:
And Advertising Injury Liability: 1. Subject to Paragraphs 2. and 3. of Section
2. Exclusions III Limits of Insurance, as applicable, the
This insurance does not apply to: Fungi Liability Aggregate Limit shown in the
Schedule of this endorsement is the most
a. "Personal and advertising injury" arising out we will pay under Coverage A for all "bodily
of a "fungi incident". injury" or "property damage" and Coverage
b. Any loss, cost or expense arising out of the C. for Medical Payments arising out of one
abating, testing for, monitoring, cleaning up, or more "fungi incidents". This provision C.1.
removing, containing, treating, detoxifying, does not apply to any "fungi" that are, are
neutralizing, remediating or disposing of, or on, or are contained in, a good or product in-
in any way responding to, or assessing the tended for bodily consumption.
effects of, "fungi" by any insured or by any 2. Paragraph 5., the Each Occurrence Limit,
other person or entity. Paragraph 6., the Damage To Premises
B. Coverage provided by this insurance for "bodily Rented To You Limit, and Paragraph 7., the
injury" or "property damage", arising out of a "fungi Medical Expense Limit, Of Section III - Lim-
incident", is subject to the Fungi Liability Each Oc- its Of Insurance continue to apply to bodily
currence and Aggregate Limit as described in injury or property damage arising out of a
Paragraph C. of this endorsement. This provision fungi incident but only if, and to the extent
B. does not apply to any "fungi" that are, are on, or that, limits are available under the Fungi Li-
are contained in, a good or product intended for ability Aggregate Limit.
bodily consumption.

NS 0273 07 08 West Bend Mutual Insurance Company Page 1 of 2


West Bend, Wisconsin 53095
D. The following definitions are added to the Defi-
nitions Section:
1. "Fungi" means any type or form of fungus,
including mold or mildew and any mycotoxins,
spores, scents or byproducts produced or re-
leased by fungi.
2. "Fungi incident" means an incident which
would not have occurred, in whole or in part,
but for the actual, alleged or threatened inhala-
tion of, ingestion of, contact with, exposure to,
existence of, or presence of, any "fungi" on or
within a building or structure, including its con-
tents, regardless of whether any other cause,
event, material or product contributed concur-
rently or in any sequence to such injury or
damage.

Page 2 of 2 West Bend Mutual Insurance Company NS0273 07 08


West Bend, Wisconsin 53095
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EXCLUSION DESIGNATED OPERATIONS


DETECTIVE, SECURITY AND PATROL AGENCIES
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Description of Designated Operations:


1. PUBLIC OR PRIVATE SCHOOLS WHEN OPEN TO THE PUBLIC
2. AIRPORT SECURITY
3. RESTAURANTS OR TAVERNS WHEN OPEN TO THE PUBLIC
4. LABOR DISPUTES OR EMPLOYMENT STRIKES
5. TRAFFIC CONTROL

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)

With respect to any designated operations shown in the schedule, this insurance does not apply to "bodily injury",
"property damage", "personal and advertising injury" or medical expenses arising out of "your work".

NS 0007 GL 04 14 West Bend Mutual Insurance Company Page 1 of 1


West Bend, Wisconsin 53095
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EXCLUSION THEFT
DETECTIVE, SECURITY AND PATROL OPERATIONS
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

This insurance does not apply to "bodily injury" or 3. Any liability for loss based on any actual or al-
"property damage" arising out of: leged inventory shortage, or inventory shrinkage,
1. Actual or alleged theft, burglary, robbery, and/or which in any way involves the named insured or
disappearance of any property committed by or an employee or agent of the named insured or
alleged to in any way involve the named insured, any known or unknown third parties.
any employee or agent of the named insured, or 4. Any liability for theft or loss of property assumed
any known or unknown third parties. by any insured under contract, lease or agree-
2. Theft or loss of money, securities, or any other ment, written or otherwise.
property of others, while being transported by the 5. Any illegal, unlawful, fraudulent, deceitful or dis-
named insured or any employee or agent of the honest acts committed by or alleged to involve
named insured, or held at the named insureds or the named insured or any employee or agent of
an employee or agent of the named insureds the named insured or any other known or un-
premises, in any capacity, committed by or al- known third parties.
leged to in any way involve the named insured or
any employee or agent of the named insured or
any known or unknown third parties.

NS 0003 GL 04 14 West Bend Mutual Insurance Company Page 1 of 1


West Bend, Wisconsin 53095
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

EXCLUSION DESCRIBED HAZARDS


GUARD DOGS
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

Customer Number: 0111061583


Policy Number: 2112633
Named Insured: A&T Security, LLC
Agency Name and Code: HAUSMAN-KUNKEL INC 12398

This insurance does not apply to "bodily injury", "property damage", "personal injury", "advertising injury" (or "per-
sonal and advertising injury" if defined as such in your policy) or medical expenses arising out of the use or own-
ership of guard dogs.

Signature of First Named Insured

Date

NS 0028 GL IL 04 14 West Bend Mutual Insurance Company Page 1 of 1


West Bend, Wisconsin 53095

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