SERFF Tracking Number: OHMG State: Ohio Filing Company: Ohio Mutual Insurance Company State Tracking Number: OHMG

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PDF Pipeline for SERFF Tracking Number OHMG-127847315 Generated 02/27/2012 10:22 AM

SERFF Tracking Number: OHMG-127847315 State: Ohio

Filing Company: Ohio Mutual Insurance Company State Tracking Number: OHMG-127847315 Company Tracking Number: OTC01012012OH

TOI: 33.0 Other Lines of Business Sub-TOI: 33.0001 Other Personal Lines

Product Name: Ohio Mutual Town & Country Project Name/Number: OTC Product Review/OTC01012012OH

Filing at a Glance

Company: Ohio Mutual Insurance Company

Product Name: Ohio Mutual Town & Country SERFF Tr Num: OHMG-127847315State: Ohio

TOI: 33.0 Other Lines of Business SERFF Status: Closed-FILED State Tr Num: OHMG-127847315 Sub-TOI: 33.0001 Other Personal Lines Co Tr Num: OTC01012012OH State Status: FILED

Filing Type: Form/Rule Reviewer(s): Valerie Baader

Authors: Rick Hartschuh, Amy Roe, Angie Wyss, Judy Perrin, Hua Zou

Disposition Date: 01/05/2012

Date Submitted: 12/05/2011 Disposition Status: FILED Effective Date Requested (New): 01/01/2012 Effective Date (New): 01/01/2012 Effective Date Requested (Renewal): 02/01/2012 Effective Date (Renewal):

02/01/2012

General Information

Project Name: OTC Product Review Status of Filing in Domicile:

Project Number: OTC01012012OH Domicile Status Comments:

Reference Organization: Reference Number:

Reference Title: Advisory Org. Circular:

Filing Status Changed: 01/05/2012

State Status Changed: 01/05/2012 Deemer Date:

Created By: Angie Wyss Submitted By: Angie Wyss

Corresponding Filing Tracking Number:

State TOI: 33.0 Other Lines of Business State Sub-TOI: 33.0001 Other Personal Lines Filing Description:

Filing description has been included in our Filing Memorandum made a part of this filing.

Company and Contact

Filing Contact Information

Angie Wyss, Product Manager awyss@omig.com

P O Box 111 419-563-0943 [Phone]

Bucyrus, OH 44820 877-219-9073 [FAX]

Filing Company Information

Ohio Mutual Insurance Company CoCode: 10202 State of Domicile: Ohio

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P O Box 111 Group Code: 963 Company Type: Property &

Casualty

Bucyrus, OH 44820 Group Name: State ID Number:

(419) 562-3011 ext. [Phone] FEIN Number: 34-4320350 ---

Filing Fees

Fee Required? Yes

Fee Amount: $50.00

Retaliatory? No

Fee Explanation:

Per Company: Yes

COMPANY AMOUNT DATE PROCESSED TRANSACTION #

Ohio Mutual Insurance Company $50.00 12/05/2011 54249406

State Specific

Statistical Reporting Agent (AAIS, ISO, ISSI, NCIS, NISS, SFAA, etc) REQUIRED on NEW Programs or NEW Lines of Business: N/A

MANDATORY FIELD: PUBLIC RECORD - Acknowledge that EVERYTHING in this filing will become Public Record per ORC 3935.04(A) or ORC 3937.03(A): Yes- acknowledged

IMPORTANT CHANGE -- EFT IS MANDATORY FOR ALL FILINGS SUBMITTED ON OR AFTER 01/01/2011. See Bulletin 2010-08 attached to our General Instructions in SERFF.: Yes- acknowledged

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Correspondence Summary

Dispositions

Status Created By Created On Date Submitted

FILED Valerie Baader 01/05/2012 01/05/2012

Filing Notes

Subject Note Type Created By Created

On

Date Submitted

EFT ok Reviewer Note Laura Schimpf 12/06/2011

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Disposition

Disposition Date: 01/05/2012 Effective Date (New): 01/01/2012 Effective Date (Renewal): 02/01/2012 Status: FILED

Comment:

* * * * * * * * * * * * * * * * * * * * * * * * * * IMPORTANT CHANGE * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

EFT BECAME MANDATORY EFFECTIVE 01/01/2011 FOR ALL FILINGS SUBMITTED ON OR AFTER THAT DATE. See Bulletin 2010-08 attached to our General Instructions in SERFF.

This filing, as submitted or as amended herein, is Approved under Chapter 3935, or Accepted under Chapter 3937, of the Ohio Revised Code.

IMPORTANT NOTICE: Our records indicate the implementation of this filing on the Effective Date(s) shown herein. If the effective date(s) is/are incorrect or you need to revise the effective date(s), submit a Note to Reviewer through SERFF with the requested change.

Rate data does NOT apply to filing.

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Schedule Schedule Item Schedule Item Status Public Access

Supporting Document Filing Requirements Summary - P&C Filed Yes

Form Amendment of Injury Agreement - Known

Injury or Damage

Filed Yes

Form Limited Pollution Liability Coverage Filed Yes

Form Farm Employer's Liability-Ohio Filed Yes

Form Exotic Animals Exclusion Filed Yes

Rate OTC Manual - Rules - Multistate Filed Yes

Rate OTC Manual - Rates - OH Filed Yes

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Reviewer Note

Created By:

Laura Schimpf on 12/06/2011 10:43 AM Last Edited By:

Filing Rules Migration Submitted On: 01/01/2012 02:05 AM Subject:

EFT ok Comments: x

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Form Schedule

Schedule Item Status

Form Name Form # Edition Date

Form Type Action Action Specific Data

Readability Attachment

Filed 01/05/2012

Amendment of Injury Agreement - Known Injury or Damage

ML-50 05-11 Endorseme nt/Amendm ent/Conditi ons

Replaced Replaced Form #: ML-50 (04-10) Previous Filing #: OHMG-

126958875

ML-50 (05- 11)

Amendment of Injury Agreement - Known Injury or Damage (UOF-OFO only eff. 7-1- 11).pdf Compare ML-50(04- 10) to ML- 50(05- 11).pdf Filed

01/05/2012

Limited Pollution Liability Coverage

TNC-102 01-12 Endorseme nt/Amendm ent/Conditi ons

Replaced Replaced Form #: ML-102 (05-11) Previous Filing #: OHMG-

126958875

Compare ML-102(04- 10) to TNC- 102(01- 12).pdf TNC-102 _01-12_ Limited Pollution Liability Coverage.pd f

Filed 01/05/2012

Farm Employer's Liability-Ohio

TNC-310 01-12 Endorseme nt/Amendm ent/Conditi ons

Replaced Replaced Form #: FO-310 (05-11) Previous Filing #: PCD 165656

TNC-310 (01-12) Farm Employer's Liability Coverage -

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Ohio.pdf Compare FO-310(10- 95) to TNC- 310(01- 12).pdf Filed

01/05/2012

Exotic Animals Exclusion

IL-UO-27 01-12 Endorseme nt/Amendm ent/Conditi ons

New IL UO 27

(01-12) Exotic Animals Exclusion (BP,CPP,FO ,FUM,HO,P UM,TNC).pd f

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ML-50 (05-11)

Page 1 of 2

ML- 50 (05-11).DOC

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

AMENDMENT OF INSURING AGREEMENT -

KNOWN INJURY OR DAMAGE

When Form ML 00 09 is attached to this policy, regardless of edition date, this endorsement modifies insurance provided under the following:

SECTION II - LIABILITY COVERAGES

Coverage L - Bodily Injury Liability and Property Damage Liability is replaced by the following:

Coverage L - Bodily Injury Liability and Property Damage Liability

A. We pay, up to our limit, all sums for which an insured is liable by law because of bodily injury or property damage caused by an occurrence to which this coverage applies. We will defend a suit seeking damages if the suit resulted from bodily injury or property damage not excluded under this coverage. We may make investiga- tions and settle claims or suits that we decide are appropriate. We do not have to provide a defense after we have paid an amount equal to our limit as a result of a judgment or written settlement.

B. This insurance applies to bodily injury and property damage only if:

1. the bodily injury or property damage is caused by an occurrence;

2. the bodily injury or property damage occurs during the policy period; and

3. prior to the policy period, no insured knew that the bodily injury or property damage had occurred, in whole or in part. If an insured knew, prior to the policy period, that the bodily injury or property damage occurred, 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 prior to the policy period.

C. Bodily injury or property damage which occurs during the policy period and was not known to have occurred by any insured prior to the policy period, includes any continuation, change, or resumption of that bodily injury or property damage after the end of the policy period.

D. Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured:

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.

When Form TNC-9, or TNC-10 is attached to this policy, regardless of edition date, this endorsement modifies insurance provided under the following:

Coverage L - Personal Liability is replaced by the following:

SECTION II - LIABILITY COVERAGES Coverage L - Personal Liability

A. We pay, up to our limit, all sums for which an insured is liable by law because of bodily injury or property damage caused by an occurrence to which this coverage applies. We will defend a suit seeking damages if the suit resulted from

bodily injury or property damage not excluded under this coverage. We may make investiga- tions and settle claims or suits that we decide are appropriate. We do not have to provide a defense after we have paid an amount equal to our limit as a result of a judgment or written settlement.

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ML-50 (05-11)

Page 2 of 2

ML- 50 (05-11).DOC

AMENDMENT OF EXCLUSIONS

Under Exclusions That Apply To Coverages L And M, Item 2., Additional Exclusions That Apply to Coverage L, Item d. is deleted and replaced by:

d. damage to property rented to; occupied by; used by; or in the care, custody, or control of an insured including any costs or expenses incurred by an insured, or any other person, organization, or entity for repair, replace-

ment, enhancement, restoration, or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property;

Exclusion (2.d.) does not apply to property damage to property that is rented to; occupied by; used by; or in the care, custody, or control of an insured caused by fire, smoke, or explosion.

When Form TNC-9 or TNC-10 is attached to this policy, regardless of edition date, this endorsement modifies insurance under the following:

Coverage L - Farm Personal Liability Coverage L - Personal Liability

Under Additional Exclusions That Apply Only to Coverage L, Item 4. is deleted and replaced by: 4. damage to property rented to; occupied by; used

by; or in the care, custody, or control of an insured including any costs or expenses incurred by an insured, or any other person,

organization or entity, for repair, replacement, enhancement, restoration, or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property;

Exclusion (4.) does not apply to property damage to property that is rented to; occupied by; used by; or in the care, custody, or control of an insured caused by fire, smoke, or explosion.

All other terms of this policy apply.

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Text Comparison

Documents Compared

ML-50 (04-10) Amendment of Injury Agreement - Known Injury or Damage

(SFO only eff. 7-1-11).pdf - Adobe Acrobat Professional

ML-50 (05-11) Amendment of Injury Agreement - Known Injury or Damage

(UOF-OFO only eff. 7-1-11).pdf

Summary

439 word(s) added

51 word(s) deleted

686 word(s) matched

11 block(s) matched

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To see where the changes are, scroll down.

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ML-50 (04-10)

Page 1 of 2

ML- 50 (04-10).DOC

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

AMENDMENT OF INSURING AGREEMENT -

KNOWN INJURY OR DAMAGE

When Form ML-2, ML-3, ML-4, TNC-9, or TNC-10 is attached to this policy, regardless of edition date, this endorsement modifies insurance provided under the following:

1. The bodily injury or property damage is caused by an occurrence;

2. The bodily injury or property damage occurs during the policy period; and

3. Prior to the policy period, no insured knew that the bodily injury or property damage

had occurred, in whole or in part. If an insured knew, prior to the policy period, that the bodily injury or property damage occurred, 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 prior to the policy period.

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.

AMENDMENT OF EXCLUSIONS

When Form ML-2, ML-3, or ML-4, is attached to this policy, regardless of edition date, this endorsement modifies insurance provided under the following:

Under Item 2., Additional Exclusions That Apply to Coverage L, Item d. is deleted and replaced by:

d. damage to property rented to; occupied by; used by; or in the care, custody, or control of an insured including any costs or expenses incurred by an insured, or any other person, organization, or entity for repair, replacement, enhancement, restoration, or main-

tenance of such property for any reason, including prevention of injury to a person or damage to another's property;

ML-50 (04-10) Amendment of Injury Agreement - Known Injury or Damage (SFO only eff. 7-1-11).pdf - Adobe Acrobat Professional

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ML-50 (05-11)

Page 1 of 2

ML- 50 (05-11).DOC

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

AMENDMENT OF INSURING AGREEMENT -

KNOWN INJURY OR DAMAGE

Coverage L - Bodily Injury Liability and Property Damage Liability is replaced by the following:

Coverage L - Bodily Injury Liability and Property Damage Liability

When Form TNC-9, or TNC-10 is attached to this policy, regardless of edition date, this endorsement modifies insurance provided under the following:

A. We pay, up to our limit, all sums for which an insured is liable by law because of bodily injury or property damage caused by an occurrence to which this coverage applies. We will defend a suit seeking damages if the suit resulted from

bodily injury or property damage not excluded under this coverage. We may make investiga- tions and settle claims or suits that we decide are appropriate. We do not have to provide a defense after we have paid an amount equal to our limit as a result of a judgment or written settlement.

ML-50 (05-11) Amendment of Injury Agreement - Known Injury or Damage (UOF-OFO only eff. 7-1-11).pdf

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ML-50 (04-10)

Page 2 of 2

ML- 50 (04-10).DOC

ML-50 (04-10) Amendment of Injury Agreement - Known Injury or Damage (SFO only eff. 7-1-11).pdf - Adobe Acrobat Professional

(16)

ML-50 (05-11)

Page 2 of 2

ML- 50 (05-11).DOC

AMENDMENT OF EXCLUSIONS

Under Exclusions That Apply To Coverages L And M, Item 2., Additional Exclusions That Apply to Coverage L, Item d. is deleted and replaced by:

d. damage to property rented to; occupied by; used by; or in the care, custody, or control of an insured including any costs or expenses incurred by an insured, or any other person, organization, or entity for repair, replace-

ment, enhancement, restoration, or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property;

ML-50 (05-11) Amendment of Injury Agreement - Known Injury or Damage (UOF-OFO only eff. 7-1-11).pdf

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Text Comparison

Documents Compared

ML-102 (04-10) Limited Pollution Liability Coverage (UOF-OFO) chg. 8-6-10.pdf

TNC-102 _01-12_ Limited Pollution Liability Coverage.pdf - Adobe Acrobat

Professional

Summary

674 word(s) added

171 word(s) deleted

446 word(s) matched

14 block(s) matched

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To see where the changes are, scroll down.

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ML-102 (04-10)

Page 1 of 1

ML-102 (04-10).DOC

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

LIMITED POLLUTION LIABILITY COVERAGE

Part I.

A. The following applies when Form ML-2, ML-3, and ML-4 is attached to this policy, regardless of edition date:

Under Section II - Liability Coverages of Form ML-2, ML-3, and ML-4, Exclusions 1.p. and 1.q. are deleted and replaced by Part II below.

B. The following applies when Form TNC-9 or TNC-10, is attached to this policy, regardless of edition date:

Under Form TNC-9 or TNC-10, Exclusions That Apply to Coverages L and M, Exclusion 11. is deleted and replaced by Part II below.

Part II.

We do not pay for a loss if one or more of the following excluded events apply to the loss, regardless of other causes or events that contribute to or aggravate the loss, whether such causes or events act to produce the loss before, at the same time as, or after the excluded event.

Exclusions that apply to Coverages L and M and Limited Pollution Liability Coverage endorsement:

This policy does not apply to bodily injury or property damage which results directly or indirectly from the actual, alleged, or threatened discharge, dispersal, seepage, migration, release, or escape of pollutants into or upon land, water, or air. However, this exclusion does not apply to a discharge, dispersal, release, or escape of pollutants that:

(1) is both sudden and accidental; and (2) does not:

(a) emanate from any underground tank; or

(b) arise out of the ownership, operation, maintenance, use, or plugging of oil or gas wells, unless such discharge, dispersal, release, or escape of pollutants is caused by heat, smoke, or fumes of a hostile fire.

As used in this exclusion:

(i) Underground tank means any storage tank or other container, ducts, or piping which is below or partially below the surface of the ground or water or which, at

any time, has been buried under the surface of the ground or water and then subsequently exposed by erosion, excavation, or any other means.

(ii) Hostile fire means one that becomes uncontrollable or breaks out from where it was intended to be.

We will not pay more than the Each Occurrence Sublimit shown in the Declarations for Limited Pollution Liability Coverage for any one loss nor more than the Annual Aggregate Sublimit shown in the Declarations for all losses for Limited Pollution Liability Coverage during the policy period.

The Each Occurrence Sublimit shown in the Declarations for Limited Pollution Liability Coverage does not increase the Personal Liability Each Occurrence Limit or the Farm Personal Liability Each Occurrence Limit shown in the Declarations regardless of the number of:

a. insureds under this policy;

b. persons or organizations who sustain injury or damage; or

c. claims made or suits brought.

The Limited Pollution Liability Coverage Annual Aggregate Sublimit is the most we will pay during the policy period for damages due to bodily injury and property damage that arise out of coverage provided by this endorsement.

The Limited Pollution Liability Coverage Annual Aggregate Sublimit applies separately to each consecutive 12-month period beginning with the inception date shown in the Declarations for this policy.

The Limited Pollution Liability Coverage Annual Aggregate Sublimit also applies separately to any remaining policy period of less than 12 months, unless this policy has been extended after it was written. In that case, the additional period will be considered part of the last preceding period for the purpose of determining the annual aggregate limit.

ML-102 (04-10) Limited Pollution Liability Coverage (UOF-OFO) chg. 8-6-10.pdf

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TNC-102 (01-12)

Page 1 of 2

TNC-102 (01-12).DOC

THIS ENDORSEMENT CHANGES THE LIABILITY COVERAGES.

LIMITED POLLUTION LIABILITY COVERAGE

The following applies when Form TNC-9 or TNC-10, is attached to this policy, regardless of edition date: Under Form TNC-9 or TNC-10, Exclusions That Apply to Coverages L and M, Exclusions 16. and 17. are deleted and replaced by the following.

A. We do not pay for a loss if one or more of the following excluded events apply to the loss, regardless of other causes or events that contribute to or aggravate the loss, whether such causes or events act to produce the loss before, at the same time as, or after the excluded event. Exclusions that apply to Coverages L and M and Limited Pollution Liability Coverage endorsement: 1. This policy does not apply to bodily injury or

property damage which arises out of the actual, alleged, or threatened discharge, dispersal, seepage, migration, release, or escape of pollutants into or upon land, water, or air:

a. at or from any premises, site, or location which is or was at any time owned by, occupied by, rented to, or loaned to any insured, unless the bodily injury or property damage arises from the heat, smoke, or fumes of a fire which:

(1) becomes uncontrollable or breaks out from where it was intended to be located and does not arise out of the ownership operation, maintenance, use, or plugging of oil or gas wells; or

(2) is set by the insured on the insured premises for the purpose of burning off crop stubble or other vegetation consistent with normal and usual farming practices, and is not in violation of any ordinances or laws; b. at or from any premises, site, or location

which is or was at any time used by or for any insured or others, for the handling, storage, disposal, processing, or treatment of waste;

c. which are or were at any time transported, handled, stored, treated, disposed of, or processed as waste by or for any insured or any person or organization for whom any insured may be legally responsible; or

d. which arises at or from any premises, site, or location where any insured or any contractor or subcontractor, directly or indirectly under your control, is working: (1) if the pollutants are brought on or to

the premises, site, or location in connection with such work by such insured, unless the bodily injury or property damage arises from the heat, smoke, or fumes of a fire which becomes uncontrollable or breaks out from where it was intended to be located and does not arise out of the ownership, operation, maintenance, use, or plugging of oil or gas wells; or

(2) if the work is to test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, or in any way respond to or assess the effect of pollutants;

However, this exclusion does not apply to a discharge, dispersal, release, or escape of pollutants that:

a. is both sudden and accidental; and b. does not:

(1) emanate from any underground tank; or

(2) arise out of the ownership, operation, maintenance, use, or plugging of oil or gas wells, unless such discharge, dispersal, release, or escape of pollutants is from an exempt well and is caused by heat, smoke, or fumes of a hostile fire. As used in this exclusion:

(a) Underground tank means any storage tank or other container, ducts, or piping which is below or partially below the surface of the ground or water or which, at any time, has been buried under the surface of the ground or water and then subsequently exposed by erosion, excavation, or any other means.

(b) Hostile fire means one that becomes uncontrollable or breaks out from where it was intended to be.

TNC-102 _01-12_ Limited Pollution Liability Coverage.pdf - Adobe Acrobat Professional

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TNC-102 (01-12)

Page 2 of 2

TNC-102 (01-12).DOC

(c) Exempt well means an exempt Mississippean well or exempt domestic well as defined by Chapter 1509, Section 1509.01 of the Ohio Revised Code including any amendments. Exempt well does not include any well retrofit, or subject to retrofitting, for commercial production purposes, including wells subject to hydraulic fracturing, or similar extraction method.

2. This policy does not apply to any loss, cost, or expenses arising out of any:

a. request, demand, or order that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, or in any way respond to or assess the effects of pollutants; or

b. claim or suit by or on behalf of any governmental authority relating to testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutral- izing, or in any way responding to or assessing the effects of pollutants; However, this exclusion does not apply to liability for damages because of property damage that the insured would have in the absence of such request, demand, or order or such claim or suit by or on behalf of a governmental authority.

B. We will not pay more than the Each Occurrence Sublimit shown in the Declarations for Limited Pollution Liability Coverage arising out of one occurrence otherwise insured herein.

The Each Occurrence Sublimit shown in the Declarations for Limited Pollution Liability Coverage does not increase the Personal Liability Each Occurrence Limit or the Farm Personal Liability Each Occurrence Limit shown in the Declarations regardless of the number of:

1. insureds under this policy;

2. persons or organizations who sustain injury or damage; or

3. claims made or suits brought.

The Limited Pollution Liability Coverage Annual Aggregate Sublimit is the most we will pay for all losses which occur during the policy period for damages due to bodily injury and property damage that arise out of coverage provided by this endorsement.

The Limited Pollution Liability Coverage Annual Aggregate Sublimit applies separately to each consecutive 12-month period beginning with the inception date shown in the Declarations for this policy.

The Limited Pollution Liability Coverage Annual Aggregate Sublimit also applies separately to any remaining policy period of less than 12 months, unless this policy has been extended after it was written. In that case, the additional period will be considered part of the last preceding period for the purpose of determining the annual aggregate limit.

C. Policy Conditions

If this policy and any other insurance policy issued to you or another entity by us, or a member Company of the Ohio Mutual Insurance Group, applies to the same occurrence, the maximum limit of our liability under all the policies shall not exceed the highest applicable limit of liability under any one policy.

TNC-102 _01-12_ Limited Pollution Liability Coverage.pdf - Adobe Acrobat Professional

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TNC-102 (01-12)

Page 1 of 2

TNC-102 (01-12).DOC

THIS ENDORSEMENT CHANGES THE LIABILITY COVERAGES.

LIMITED POLLUTION LIABILITY COVERAGE

The following applies when Form TNC-9 or TNC-10, is attached to this policy, regardless of edition date: Under Form TNC-9 or TNC-10, Exclusions That Apply to Coverages L and M, Exclusions 16. and 17. are deleted and replaced by the following.

A. We do not pay for a loss if one or more of the following excluded events apply to the loss, regardless of other causes or events that contribute to or aggravate the loss, whether such causes or events act to produce the loss before, at the same time as, or after the excluded event. Exclusions that apply to Coverages L and M and Limited Pollution Liability Coverage endorsement: 1. This policy does not apply to bodily injury or

property damage which arises out of the actual, alleged, or threatened discharge, dispersal, seepage, migration, release, or escape of pollutants into or upon land, water, or air:

a. at or from any premises, site, or location which is or was at any time owned by, occupied by, rented to, or loaned to any insured, unless the bodily injury or property damage arises from the heat, smoke, or fumes of a fire which:

(1) becomes uncontrollable or breaks out from where it was intended to be located and does not arise out of the ownership, operation, maintenance, use, or plugging of oil or gas wells; or

(2) is set by the insured on the insured premises for the purpose of burning off crop stubble or other vegetation consistent with normal and usual farming practices, and is not in violation of any ordinances or laws; b. at or from any premises, site, or location

which is or was at any time used by or for any insured or others, for the handling, storage, disposal, processing, or treatment of waste;

c. which are or were at any time transported, handled, stored, treated, disposed of, or processed as waste by or for any insured or any person or organization for whom any insured may be legally responsible; or

d. which arises at or from any premises, site, or location where any insured or any contractor or subcontractor, directly or indirectly under your control, is working: (1) if the pollutants are brought on or to

the premises, site, or location in connection with such work by such insured, unless the bodily injury or property damage arises from the heat, smoke, or fumes of a fire which becomes uncontrollable or breaks out from where it was intended to be located and does not arise out of the ownership, operation, maintenance, use, or plugging of oil or gas wells; or

(2) if the work is to test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, or in any way respond to or assess the effect of pollutants;

However, this exclusion does not apply to a discharge, dispersal, release, or escape of pollutants that:

a. is both sudden and accidental; and b. does not:

(1) emanate from any underground tank; or

(2) arise out of the ownership, operation, maintenance, use, or plugging of oil or gas wells, unless such discharge, dispersal, release, or escape of pollutants is from an exempt well and is caused by heat, smoke, or fumes of a hostile fire. As used in this exclusion:

(a) Underground tank means any storage tank or other container, ducts, or piping which is below or partially below the surface of the ground or water or which, at any time, has been buried under the surface of the ground or water and then subsequently exposed by erosion, excavation, or any other means.

(b) Hostile fire means one that becomes uncontrollable or breaks out from where it was intended to be.

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TNC-102 (01-12)

Page 2 of 2

TNC-102 (01-12).DOC

(c) Exempt well means an exempt Mississippean well or exempt domestic well as defined by Chapter 1509, Section 1509.01 of the Ohio Revised Code including any amendments. Exempt well does not include any well retrofit, or subject to retrofitting, for commercial production purposes, including wells subject to hydraulic fracturing, or similar extraction method.

2. This policy does not apply to any loss, cost, or expenses arising out of any:

a. request, demand, or order that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, or in any way respond to or assess the effects of pollutants; or

b. claim or suit by or on behalf of any governmental authority relating to testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutral- izing, or in any way responding to or assessing the effects of pollutants; However, this exclusion does not apply to liability for damages because of property damage that the insured would have in the absence of such request, demand, or order or such claim or suit by or on behalf of a governmental authority.

B. We will not pay more than the Each Occurrence Sublimit shown in the Declarations for Limited Pollution Liability Coverage arising out of one occurrence otherwise insured herein.

The Each Occurrence Sublimit shown in the Declarations for Limited Pollution Liability Coverage does not increase the Personal Liability Each Occurrence Limit or the Farm Personal Liability Each Occurrence Limit shown in the Declarations regardless of the number of:

1. insureds under this policy;

2. persons or organizations who sustain injury or damage; or

3. claims made or suits brought.

The Limited Pollution Liability Coverage Annual Aggregate Sublimit is the most we will pay for all losses which occur during the policy period for damages due to bodily injury and property damage that arise out of coverage provided by this endorsement.

The Limited Pollution Liability Coverage Annual Aggregate Sublimit applies separately to each consecutive 12-month period beginning with the inception date shown in the Declarations for this policy.

The Limited Pollution Liability Coverage Annual Aggregate Sublimit also applies separately to any remaining policy period of less than 12 months, unless this policy has been extended after it was written. In that case, the additional period will be considered part of the last preceding period for the purpose of determining the annual aggregate limit.

C. Policy Conditions

If this policy and any other insurance policy issued to you or another entity by us, or a member Company of the Ohio Mutual Insurance Group, applies to the same occurrence, the maximum limit of our liability under all the policies shall not exceed the highest applicable limit of liability under any one policy.

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THIS ENDORSEMENT CHANGES THE LIABILITY COVERAGES.

FARM EMPLOYER’S LIABILITY COVERAGE - OHIO

SCHEDULE

(The information required below may be shown on a separate schedule or in the Declarations.) LIMIT - each occurrence $

A. The following is added:

COVERAGE - FARM EMPLOYER'S LIABILITY 1. Insuring Agreement

a. We will pay those sums that the insured becomes legally obligated by Ohio Law to pay as damages because of bodily injury by accident or bodily injury by disease to your employee 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 to which this insurance does not apply. We may, at our discretion, investigate any accident and settle any claim or suit that may result. But:

(1) the amount we will pay for damages is limited as described in Para- graph D - 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 this coverage.

No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments.

b. This insurance applies to bodily injury by accident or bodily injury by disease only if:

(1) The:

(a) bodily injury by accident or bodily injury by disease takes place in the coverage territory; (b) bodily injury by accident or

bodily injury by disease arises out of and in the course of the injured employee's employment by you; and

(c) employee, at the time of the injury, was covered under a worker's compensation policy and subject to a workers' compensation law of Ohio; and

(2) The:

(a) bodily injury by accident is caused by an accident that occurs during the policy period; or

(b) bodily injury by disease is caused by or aggravated by conditions of employment by you and the injured em- ployee's last day of last exposure to the conditions causing or aggravating such bodily injury by disease occurs during the policy period. c. The damages we will pay, where

recovery is permitted by law, include damages:

(1) For:

(a) which you are liable to a third party by reason of a claim or suit against you by that third party to recover the damages claimed against such third party as a result of injury to your employee;

(b) care and loss of services; and (c) consequential bodily injury by

accident or bodily injury by disease to a spouse, child, parent, brother, or sister of the injured employee;

provided that these damages are the direct consequence of bodily injury by accident or bodily injury by disease that arises out of and in the course of the injured employee's employment by you; and

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(2) because of bodily injury by acci- dent or bodily injury by disease to your employee that arises out of and in the course of employment, claimed against you in a capacity other than as employer.

2. Additional Exclusions That Apply To Cov- erage L

This insurance does not apply to: a. Intentional Injury

Bodily injury by accident or bodily injury by disease intentionally caused or aggravated by you, or bodily injury by accident or bodily injury by disease resulting from an act which is determined to have been committed by you if it was reasonable to believe that an injury is substantially certain to occur.

b. Fines Or Penalties

Any assessment, penalty, or fine levied by any regulatory inspection agency or authority.

c. Statutory Obligations

Any obligation of the insured under a workers' compensation, disability benefits, or unemployment compensation law or any similar law.

d. Contractual Liability

Liability assumed by you under any contract or agreement.

e. Violation Of Law

Bodily injury by accident or bodily injury by disease suffered or caused by any employee while employed in violation of law with your actual knowledge or the actual knowledge of any of your executive officers.

f. Termination, Coercion, Or Discrimination

Damages arising out of coercion, criticism, demotion, evaluation, reassign- ment, discipline, defamation, harassment, humiliation, discrimination against, or termination of any employee, or arising out of other employment or personnel decisions concerning the insured.

g. Failure To Comply With Workers Compensation Law

Bodily injury by accident or bodily injury by disease to an employee when you are:

(1) deprived of common law defenses; or

(2) otherwise subject to penalty;

because of your failure to secure your obligations or other failure to comply with any workers compensation law.

h. Violation Of Age Laws Or Employment Of Minors

Bodily injury by accident or bodily injury by disease suffered or caused by any person:

(1) knowingly employed by you in viola- tion of any law as to age; or

(2) under the age of 14 years, regardless of any such law.

i. Federal Laws

Any premium, assessment, penalty, fine, benefit, liability, or other obligation imposed by or granted pursuant to:

(1) the Federal Employer's Liability Act (45 USC Section 51-60);

(2) the Non-appropriated Fund Instru- mentalities Act (5 USC Sections 8171-8173);

(3) the Longshore and Harbor Workers' Compensation Act (33 USC Sections 910-950);

(4) the Outer Continental Shelf Lands Act (43 USC Section 1331-1356); (5) the Defense Base Act (42 USC

Sections 1651-1654);

(6) the Federal Coal Mine Health and Safety Act of 1969 (30 USC Sections 901-942);

(7) the Migrant and Seasonal Agricul- tural Worker Protection Act (29 USC Sections 1801-1872);

(8) any other workers compensation, unemployment compensation or disability laws, or any similar law; or (9) any subsequent amendments to the

laws listed above. j. Crew Members

Bodily injury by accident or bodily injury by disease to a master or member of the crew of any vessel or any member of the flying crew of an aircraft.

B. Paragraph 2. Claims and Defense Costs of Incidental Coverages in the Farm Personal Liability Coverage Form apply to Farm Employer's Liability Coverage.

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C. For the purposes of this endorsement, Insured is replaced by the following:

If you are:

1. an individual, you, and your spouse are insureds, but only with respect to the conduct of a farm operation of which you are the sole owner;

2. a partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of a farm operation; 3. a limited liability company, you are an

insured. Your members are also insureds, but only with respect to the conduct of a farm operation. Your managers are insureds, but only with respect to their duties as your managers; or

4. an organization other than a partnership, joint venture, or limited liability company, you are an insured. Your executive officers and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders.

No person or organization is an insured with respect to the conduct of any current or past part- nership, joint venture, or limited liability company that is not shown as a Named Insured in the Declarations.

D. Limits Of Insurance

For the purposes of this endorsement, limit is replaced by the following:

1. The limit shown in the Schedule of this endorsement 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 most we will pay for all damages covered by this insurance because of bodily injury by accident to one or more employees in any one accident is the limit shown in the Schedule for Farm Employer's Liability Coverage.

3. The most we will pay for all damages covered by this insurance because of bodily injury by disease to any one employee, or to all employees, because of bodily injury by disease in each consecutive annual period is the limit shown in the Schedule for Farm Employer's Liability Coverage.

The limit of the coverage 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 last preceding period for purposes of determining the Limits of Insurance.

E. For the purposes of this endorsement, the following replaces any conditions regarding what must be done is case of loss:

1. Duties In The Event Of Injury, Claim, Or Suit

a. You must see to it that we or our agent are notified as soon as practicable of a bodily injury by accident or bodily injury by disease which may result in a claim. To the extent possible, notice should include:

(1) how, when, and where the bodily injury by accident or bodily injury by disease took place;

(2) the names and addresses of any injured persons and witnesses; and (3) the nature and location of any injury. 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 injury, claim, proceeding, or suit;

(2) authorize us to obtain records and other information;

(3) cooperate with us and assist us, as we may request, in the investigation or settlement of the claim or defense against the suit;

(4) assist us, upon our request, in the enforcement of any right against any person or organization which may be

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liable to the insured because of injury to which this insurance may also apply; and

(5) do nothing after an injury occurs that would interfere with our right to recover from others.

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.

F. For the purposes of this endorsement, coverage territory is defined:

Coverage territory means:

a. the United States of America (including its territories and possessions), Puerto Rico, and Canada;

b. international waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in a. above; or c. all other parts of the world if the injury or

damage arises out of the activities of a person whose home is in the territory described in a. above, but who is away for a short time for your farm operation; provided the insured's responsibility to pay damages is determined in the United States (including its territories and possessions), Puerto Rico, or Canada, in a suit on the merits according to the substantive law in such territory, or in a settlement we agree to. G. The following are added to the Definitions Section

and apply to this coverage endorsement:

1. Bodily injury by accident means bodily injury, sickness, or disease sustained by a person, including death, resulting from an accident. A disease is not bodily injury by accident unless it results directly from bodily injury by accident.

2. Bodily injury by disease means a disease sustained by a person, including death. Bodily injury by disease does not include a disease that results directly from an accident. 3. Employee includes a leased worker.

Employee does not include a temporary worker.

4. Executive officer means a person holding any of the officer positions created by your charter, constitutions, by-laws, or any other similar governing document.

5. 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 farm operation. Leased worker does not include a temporary worker.

6. Occurrence means an accident, including continuous and repeated exposure to substantially the same general harmful conditions.

7. Suit means a civil proceeding in which damages because of bodily injury 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.

8. 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.

9. Workers Compensation Law means the Workers Compensation Law and any Occupational Disease Law of Ohio. This does not include provisions of any law providing non-occupational disability benefits. H. For the purposes of this endorsement, any

definition of bodily injury in the policy does not apply.

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