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SUSNESS LASTUY CCWERAGE FORM
<br />Val drdemnles an amhkct
<br />engmeer sw,veyo�, k)r 0 n ury cv,
<br />deniage an&g cul of
<br />(a) Frepayiy�q, or fa1 knq k)
<br />xopare o; approve rnaps, shop
<br />dravifngs, irl,) wmns, i f�, p r:> r '!S
<br />swv"v HeU ords, JwTe
<br />ordefs, de&gns or dr awinqs ar)(i
<br />qMahnown or
<br />(b) Gong dJoect�orrs Or krSt1U(Ji(Mi',,
<br />or Admg to gRe ten A W 0 the
<br />pnirnaly cau',i, oN the ir%Iwjy o�
<br />dama, or
<br />2) Undej� which the insured, If an
<br />an,,hil,ecl, engineer Or surveyw,
<br />as;s,jmes hat-,,�Ikty lor an injury or
<br />damage ahshq oW A &a maweds
<br />renderVng or faflure to render
<br />prcft- ssionat sEa ndces tlnckxJing 'hose
<br />ksted In (1) a,'0DOvr, and SupwWary,
<br />inspecfion, an-Jtiitectuirat or
<br />e iginee ing actvitues
<br />11 leased v✓orke�r` mre,"ans a G,Jersor) eased tc,
<br />p,-,ru by a ahor ieas rrg firm under as�
<br />qpnernent between you mid Me labor Jeaskg
<br />ffr!n, to perform dutJes n,,Wed to the [',onduct -4
<br />"Leased Ac0i,cr` does not
<br />ncl,,de a 'tenp,)rairy v,/r rker"
<br />IC Toadrig or unbwWj" mearm am ANUg of
<br />pr0pCTQ
<br />8, After f4 !s nroved trot the pla,,-,,ewhere� 0: is
<br />aLcepted for nvrvem nt Wo or oirtcr an
<br />haak WMvCMR UIWAQ
<br />lb, Vjhde it ie in 0 or I an alr-,n-afl, Natercr��Itll, m
<br />ARan or
<br />c. Whde it Ns bekig incr wxJ from an an craft,
<br />wawmmN a OWN to he pam Here A is
<br />QWy dekvemd;
<br />buf 'b&Jmg rx urk)adirrg" tJoes n¢)t the,
<br />nv�)verircnt,,,)f xopeirly tt,,, rn,,-,�mG r.tt ru 4'necha6f,,4
<br />deyr e, other itI•n a hand Truck Uiaf lap not
<br />av,ache(l Vo air(,,,.raft,),i(aiercraA rx `autc',
<br />1 %hAde eqwpoww" mwws ap of the fodcivvia Ig
<br />Vyp es of ;and wart hes, Ilst,l,asdwg ary aflachi(iad
<br />maddriel or equpmei it.
<br />a. BWUozws,fxm maNwey WhAs and
<br />oh err veNdes dengned ITY use phrrcipahy
<br />A puhn rca=
<br />b."ehrdes nwhiM&W for use soWy mi or
<br />next Vr Pr enrises you own w ient,
<br />C, Vehic,[es 01W tr,,avep on crairder "'ezvjs�
<br />(L Vehdes v hethe, sO p „,-c,,pc0ed or not, (�m
<br />,qvN,,.-,h ,a,re pr, rmaner6y n-,ounted
<br />Page 22 of 24 E N r Y,R- -F--, 1?.,
<br />Z p 9
<br />71
<br />BY':
<br />u1) P o,,,w' ,, 1 ; ";V ane i loaders
<br />ft ggers or drHA or
<br />(2) Road !x i, S i r c t r - t or reisui fa.crr-g
<br />eTApnerV ash an Wadem.saapws
<br />W ldcm�
<br />e, Vehicles m,,A described 0n a., b, c, o ri,
<br />atime Wt mB W seTpmpded wx! are
<br />rnalfitaineri primardy N� prrrv�de mobthty to
<br />perma)eritly attached equjpryrero of the
<br />fidhwuig lype&
<br />(1) Aif = ri;!ir eissors, pumps and
<br />generatc)rs, sprayNrIg,
<br />,oi,eldcng, cIeanoq
<br />geopysical exphrahon, HjUg and
<br />AS sw0mg eqlpment w
<br />(2) Cherry pckers and simdar de-Aces
<br />used to rate or bwer wo*=
<br />f. Vehttes not desi.,nbed m a, b- c, or ct,
<br />aLH:we wawla�mx' pr,mxdy purp4>S(ei
<br />c1her Man the Tansporahon of persais or
<br />Camo
<br />Hcvvevei, scdf propefled aehic�es imth
<br />fir)Ho,A.m)g iyp,,s of perrinanionNy a4PavJled
<br />eqWpme;1 we nW "moife epomeM" Wit
<br />vii I p bc, consilderef.1 "autos,”
<br />(1) Equpnent, at 9east 1 000 p.,n�wnds
<br />qmss veh0e i,rveight, le,!Spled
<br />phWaNy loo
<br />(i) rerroiiaf,
<br />(b) Road rnawlcn,annx,,a, but ri(A
<br />(.`oi�" tiucbon m'rosurfac, ng (.,)r
<br />JX) Welcummig:
<br />(2) Cherry prc:kes and sirtiHar de,Jcies
<br />mcnoved on auSimW or Inuck
<br />chassis and, US(3rl 10 rasc, oir ow,,,r
<br />mWery ard
<br />(3) X (u:�rnpPessai,,3, pun"ps WIC,
<br />q e "') e, r a t C) I, S ir)CkAm") s Ij i a)"" I rr g,
<br />Wd --fldmq, buh(Dng ke a n I 0 I g,
<br />ga,opht,s a' expkd ,oakioi,, lit;: ,Arng and
<br />%,,vefl sen,,lmrrg equipment
<br />rlleans, an ac(Jdent, fnduddng
<br />( onihm,lulus cb repeated cxposure ki substantiafly
<br />Ifiesarne genr'qefl harrrifO
<br />17. 'Personaf and advess"ig iQury" meww,Nury,
<br />snc)udn g ,onsequcntW `bo�Jdy �npay`, ansRng
<br />nu, 1 or nrare of Ore k,�iivnwq ortl'enses
<br />a detejr�jon or ffrpVr-,',O iTAN]C
<br />Pa pmsemhorr;
<br />Fomi SS 00 08 04 05
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