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* S1 * 0521523 <br />GREAT AMERICAN ALLIANCE INSURANCE COMPANY <br />*D/B* 058909113 253316 <br />(2) The "insured's" name and address; and <br />(3) To the extent possible, the names and addresses of any injured persons and witnesses. <br />SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph A.2.b(2) is deleted and replaced with the <br />following: <br />(2) As soon as practicable send us copies of any request, demand, order, notice, summons or legal <br />paper received concerning the claim or "suit" after the claim or "suit" is known to you (if you <br />are an individual), one of your partners (if you are a partnership), or one of your officers or any <br />personnel responsible for insurance, risk management, or loss prevention (if you are a <br />corporation). <br />T. BLANKET WAIVER OF SUBROGATION BY WRITTEN CONTRACT <br />SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph A.5 is amended to add the following: <br />However, we waive any right of recovery we may have against any person or organization to the <br />extent required of you by a written contract or written agreement signed by all parties prior to any <br />"accident" or "loss", provided that the "accident" or "loss" arises out of the operations contemplated <br />by such written contract or written agreement. The waiver applies only to the person or <br />organization designated in such written contract or written agreement. <br />U. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS <br />SECTION IV - BUSINESS AUTO CONDITIONS, B.2. is amended to add the following: <br />Failure of the "Insured" to disclose all exposures or hazards existing as of the effective date of this <br />Coverage Form will not invalidate or adversely affect coverage for such exposure or hazard, <br />provided such failure is not intentional on the part of the "Insured". However, you must report the <br />undisclosed exposure or hazard to us as soon as practicable after you discover the exposure or <br />hazard. <br />V. MENTAL ANGUISH <br />The definition of "Bodily Injury" in SECTION V - DEFINITIONS is replaced by the following: <br />"Bodily Injury" means physical injury, sickness or disease sustained by a person including death <br />resulting from any of these. "Bodily Injury" also means mental injury, mental anguish, humiliation or <br />shock if directly resulting from physical injury, sickness or disease to that person. <br />CA 86 20 (Ed. 05/16) (Page 9 of 9) <br />TtlnleM�ugnnmtDhdeinn w5 <br />REv e&m 6 APPROAD BY <br />' A� A�walo <br />v—ftkk Management Specialist <br />