ࡱ> XZWE@ @bjbj %D8L4L,&zzzzz6l`9% M%$&R4)Dq%uzzq%zz%0zz.z `=%60N%0,&&x+x+.x+. L6N,z$q%q%D  Michigan Department of Environmental Quality, Waste and Hazardous Materials DivisionHAZARDOUS WASTE MANAGEMENT FACILITY AMENDATORY ENDORSEMENT POLLUTION LEGAL LIABILITY - NON-SUDDEN ACCIDENTAL This endorsement (the Endorsement) changes the Pollution Legal Liability Policy (the Policy) effective on the inception date of the Policy. This Endorsement is attached to the Policy to fulfill the insurance requirements of Section 11123 of the State of Michigan Natural Resources and Environmental Protection Act, 1994 PA 451, as amended, and R299.9710 of the Michigan Administrative Code (MAC). INSURER:  FORMTEXT      INSURED:  FORMTEXT      INSURER S ADDRESS:  FORMTEXT      INSURED S ADDRESS: CITY:  FORMTEXT      STATE:  FORMTEXT      ZIP CODE:  FORMTEXT      CITY:  FORMTEXT      STATE:  FORMTEXT      ZIP CODE:  FORMTEXT      POLICY NUMBER:  FORMTEXT       POLICY PERIOD: FROM: FORMTEXT       TO: FORMTEXT      COVERED FACILITY: (Attach additional page if necessary to list multiple Facilities covered)FACILITY NAME:  FORMTEXT      FACILITY ADDRESS:  FORMTEXT      CITY:  FORMTEXT      STATE:  FORMTEXT      ZIP CODE:  FORMTEXT      EPA ID NUMBER:  FORMTEXT       DEFINITIONS As used in this Endorsement: The term Contaminant means any hazardous waste defined in MAC R299.9203, and any hazardous waste or hazardous constituent listed in Appendix VIII of Part 261 or Appendix IX of Part 264 of Title 40 of the Code of Federal Regulations; and The term Non-Sudden Accidental Occurrence means the unintentional and unexpected discharge, dispersal, release, or escape of a contaminant in a continuous and repetitive manner, into or upon the land, the atmosphere, or any watercourse or body of water, which results in bodily injury or property damage. DECLARATIONS The insurance afforded with respect to Non-Sudden Accidental Occurrences is subject to all of the terms and conditions of the Policy provided however that any provisions of the Policy inconsistent with Sections A through F of this Endorsement are hereby amended to conform with Sections A through F. The limits of liability as respects bodily injury and property damage are provided in an amount not less than $3,000,000.00 per occurrence with an annual aggregate of not less than $6,000,000.00, exclusive of legal defense costs. The Insurer is liable for the payment of amounts within any deductible applicable to the Policy, with a right of reimbursement by the Insured for any such payment made by the Insurer. A Notice of Violation or Order issued by the MDEQ or other environmental agency shall not be deemed in and of itself sufficient evidence of an insureds intentional, knowing, willful, or deliberate noncompliance with a legal requirement so as to preclude coverage under this Policy. The Insurer will provide the Waste Management Division at the address below with at least 30 days advance written notice of cancellation, termination, or material change to the Policy which affects the coverage required by MAC R299.9710. Such notices shall be provided no matter which party initiates the cancellation, termination, or material change, and whether or not nonpayment of premium is involved. The following are the only specific pre-existing soil and groundwater conditions (defined in the referenced assessments or reports) that are excluded from coverage under the Policy (Attach additional pages if necessary): FORMTEXT       No condition, provision, stipulation, limitation, or exclusion contained in the Policy, or any other endorsement thereon, or any violation thereof, shall relieve the Insurer from liability or from the payment of any claim, within the stated limits of liability in this Endorsement, for bodily injury and property damage to a third party caused by a Non-Sudden Accidental Occurrence. The Insurer hereby certifies that it has issued the Insured the Policy to provide financial assurance and responsibility for bodily injury and property damage caused by NonXZ      & ( R T h j l v x ƼƲ۲tctRt!j hPCJOJQJU!j hPCJOJQJU&jhPCJOJQJUmHnHu!j hPCJOJQJUjhPCJOJQJUhP6CJOJQJhPCJOJQJhPCJOJQJhP5CJOJQJhPCJOJQJhPCJOJQJhP5CJOJQJjhP5CJOJQJU YZ  * 5 , 50*x0*x0*܎0*,dd$a$Ekd! $$Ifl0$ * f!4 la$If $$Ifa$ @@* , R z  " J ddddi d dddJdJdGkdM $$Ifl 0*r4 la$IfGkdh $$Ifl 0*r4 la x " $ 8 : < F H V X l n p z |  n!jhPCJOJQJU!jhPCJOJQJU!jhPCJOJQJU!j hPCJOJQJU!j2 hPCJOJQJU&jhPCJOJQJUmHnHu!j hPCJOJQJUjhPCJOJQJUhPCJOJQJ+J V ~  8 : X  d ddd*d*de{ d{ d{ d{ dkdv$$Ifl ֈD  $* " 4 la$If   & ( * 4 6 X Z d f z | ~ z zi!j)hPCJOJQJU!jhPCJOJQJUhP5CJOJQJ!j+hPCJOJQJU!jhPCJOJQJUhPCJOJQJ&jhPCJOJQJUmHnHu!j?hPCJOJQJUhPCJOJQJjhPCJOJQJU)X Z |~{ ,{ d{ ,{ ,{ ,{ d*@i/ddd4kdf$$Ifl**4 laZkd$$Ifl F 8*RRR    4 la$If FT|d d dddddddGkd$$Ifl 0*r4 la$If  468BDTVjlnxz NO[\pryyohPCJOJQJhP5CJOJQJhP5CJOJQJ!jrhPCJOJQJU!jhPCJOJQJU!jhPCJOJQJU&jhPCJOJQJUmHnHu!jhPCJOJQJUhPCJOJQJjhPCJOJQJU% *O\o'C0*,0*0*d0*d0*d0*d0*0*d0*d{0*d{0*d{0*d{0*d & Fxx]$a$mkd$$Ifl \2 * |4 la899B9[9\9f9g9: : ::f:h::::::::::J;L;¸«ŒxkZxP«hPCJOJQJ!j3hPCJOJQJUhP56CJOJQJ&jhPCJOJQJUmHnHu!jhPCJOJQJUjhPCJOJQJUhP5CJOJQJUhPCJOJQJhPCJOJQJ&jhPCJOJQJUmHnHujhPCJOJQJU!jhPCJOJQJUKL99)9A9B9[9:::h:0*0*d0*d0*d0*7vjkdq$$Ifl F *v      4 lap $If $$Ifa$ & F & Fxx -Sudden Accidental Occurrences arising from operation of the covered facility(ies), and that the Insurer is licensed to transact the business of insurance, or is eligible to provide insurance as an excess or surplus lines insurer, in the State of Michigan. Filing of this Endorsement is required by Law (MAC R299.9710)Name of Authorized Agent  FORMTEXT       Submit one original signed Endorsement to:Street Address or PO Box  FORMTEXT       HAZARDOUS WASTE SECTION WASTE AND HAZARDOUS MATERIALS DIVISION City, State and Zip Code  FORMTEXT       DEPARTMENT OF ENVIRONMENTAL QUALITY PO BOXh::::::J;L;~;;;;@wiGkd$$Ifl 0*4 laGkd$$Ifl 0*4 la$If L;~;;;;;;;;;;<@H@J@@@@@@@@@@@@@@@@hFb_hPhPCJOJQJ!jhPCJOJQJUUhP5CJOJQJ&jhPCJOJQJUmHnHu!j hPCJOJQJUjhPCJOJQJUhPCJOJQJ 30241 LANSING MI 48909-7741 Signature of Authorized AgentDate  FORMTEXT       EQP 5103-2b (3/05) @H@J@@@@@@@@@@4480*0*Д0*$a$Zkd[$$Ifl0F$*x     4 la$If #0/ =!"#$% ! 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