Party Discovery: Lucas Gilpin, as Trustee for the Heirs and next-of-kin of Laura Gilpin, Deceased vs Ben Shinn Trucking, Inc., an Iowa Corporation, Thomas Duane Gilpin

On April 05, 2013 a Party Discovery was filed involving a dispute between and for Wrongful Death in the District Court of Jackson County.

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UVVSCEVUSHAU RUE ENA EAU SEU ESTA

JOHNSON & LINDBERG, P.A.

September 3, 2013

Mr. Eric Hageman
PRITZKER OLSEN, P.A.
2950 Plaza VII Office Tower
45 South Seventh Street
Minneapolis, MN 55402

Re: Lucas Gilpin, as trustee for the heirs and next-of-kin of

SEETAPEUDARELTEAYAU ATU SEH

(nia

WNT

NAHM AHUE

Laura Gilpin, deceased, v. Ben Shinn Trucking, Inc.,
an Jowa corporation, and Thomas Duane Gilpin

Our File No.: 230.14962

Dear Mr. Hageman:

Enclosed and served upon you by mail please find a copy of Ben Shinn Trucking’s
insurance policy with Sparta Insurance with the premium information redacted.

Jie Paaped

JOHNSON & LINDBERG, P.A.

IRC/pjd
Enclosure

oa n-clO QI IS KD

ANDIST

RICT COURT, JACKSON CO., MN
COMISE BELGARD, COURT ADMINISTRATOR:

ARELLAANTM TL

SEP 04 208
Arroangys at Law

780 Northland Plaza

3800 Amencan Boulevard West
Minceapolis, MN 55431-4459
‘Telephone: (952) 851-0700
Facsimile: (952) 951-0900
www johnsonieadberg com

Joun R. CeawrorpD

peau fordiiy

Diecee (952) 956.6207

Admamed a Menesots, Wisconan

NBT A Ceeufied Corl Trai Advorste
MSBA Cemised Gril Tes! Spenserse

~~ LL by

ARTA Insurance Company, a Stock Insurance 7Our President and Secretary have signed this policy. Declaratio
bans couubenigund iy air Oo Mleesat aca ” cee

SPPJ 01 0508Policy Number
024TU 00135

SCPAR TA COMMON POLICY DECLARATIONS Renewal Of:
ARSURASES O24TU 00006
SPARTA INSURANCE COMPANY

CITYPLACE ff, 185 ASYLUM STREET, HARTFORD, CT 06103

Ben Shinn trucking, o gna Butler
6001 Palmer Avenue 800 Main Street
Eddyville IA 52553 PO BOX 28

Dubuque TA 52004

Tiem2 Policy Period From: 05-01-2010 To: 05-01-2011

ai 12:01 AM, Standard Time at n

tem 4. Touma for Sie Say a ae ere co SA Bs A EU DE OL Ree ee AOS HON to
provide the insurance ss stated in this policy. a

Ths consists of the following coverage for which a premium is indicated. Where no premium is shown,
ee See mn prea Say Ee ocagoak Sean “ .

THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S), TOGETHER W5TH THE COMMION POLICY CONDITIONS,
(COVERAGE PART(S}, COVERAGE FORM(S} AND FORMS AND ENDORSEMENTS, ff ANY, COMPLETE THE ABOVE NUMBERED POLICY.

CO-DEC (07/01)Policy Number
024TU 00135

SEPARTA sommuzorrome mo anonsemee

PSURARES
SPARTA INSURANCE COMPANY

Named insured §=Ben Shinn Trucking, Inc - Effective Date: 05-01-10
12:01 A.M, Standard Time

No. 00018

POLICY JACKET
one POLICY DECLARATIONS
‘DULE OF AND

ONS
NUCLEAR ENERGY LIABILITY EXCLUSION ENDT
IOWA CHANGES-CANC & NONRENL

COVERAGE FORM
BLE ete COVERAGE
ADDL INSD-LESSOR

SILICA/: tt Ge ea EXCL FOR COVED AU
CALCULATION OF PREM: OST RATES)

TR PART DECLARA’
econ AND/OR PENDING LITIGATION EXCL.
WAIVER OF TRANSFER OF RIGHTS OP RECOVERY

IOWA CHANGES
FELLOW EMPLOYEE COV FOR DESIG EMPLOYEES
TRUCKERS INTERMODAL INTERCHANGE ENDT
AUTO MEDICAL PAYMENTS

POLLUTION LIAB BROAD COV FOR COV AUTO
COVERED ae eCar cee aea Oe SYMBOL
ENDORSEMENT FOR CARRIER POLICIESSPARTA Insurance Company CO 23 01 0208
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
CANCELLATION NOTICE — EXTENSION

This endorsement modifies insurance provided under the following:
COMMON POLICY CONDITIONS

A Sb. of be Cone ona
Js replaced by the following:

b, 6 before the effective dete of cancella-
flon E we cancel for any other reason.

CO 21010208 Includes copyright material of Insurance Services Oifice, Inc, with its permission, Pago 1 of 1
EDPOLICY NUMBER: 024TU 00135
SPARTA Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL CONDITION

This endorsement modifies insurance provided under the following:
BUSINESSOWNERS POLICY
CAPITI
(SOA. AMTOMOBLE COVEMGE PAT

INTERLINE
CO 21 a20503

STANDARD PROPERTY POLICY
SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY NEW YORK DEPARTMENT OF
TRANSPORTATION
UNDERGROUND STORAGE TANK POLICY
A. The coverage provided under this policy does not B, The coverage provided undar this policy shall not be
apply to any insured involved in any occurrence, deemed excess Over coverage provided under the
acckdent, claim or foes for which coverage & following Policy / Policies:
granted under the following Policy / Policies: SPARTA Insurance Commercial
——SEARTA Insurance Commercia) __ 012.
Auto Policy #024AU00123

CO 21020509 Includes copyright material of Insurance Services Office, inc. with its permission. Page 1 of 1
arpTL, 00 17 1198

O17 1198
COMMON POLICY CONDITIONS
All Coverage Parts included in this policy are subject to the following conditions.
A. Cuncellaten b. Give you reports on the condition: we find;
1. The first Named Insured shown in the Dectara- ont :
tions may cancel this policy by or de- Recommend changes,

livering to us advance written notice of cancel-
Istion.

2, We may cance! this policy by mailing or deliv.
ering to the first Named Insared written notice
of cancellation at least:

a. 10 days before the effective date of cancel-
lation if we cancel for nonpayment of pre-
imu; or

Ik 30 days before the effective date of cancel-
lation if we cancel for any other reason.

3. We will mail or detiver our notice to the first
Named Insured’s last mailing address known to

i
i
i
i
F

even if we bave aot made or offered a refend.

6. Tf notice is mailed, proof of mailing will be suf-
ficient proof of notice,

& Make iaspections and surveys at amy time:

4, Paragraph 2, of this condition does nt apply to

‘The first Named Insured shown in the Declarations:
1 Recpapoutibte Gerdes payment tol prorat

2, Will be the payee for any return premiums we
pay.
‘Trensfer Of Your Rights And Duties Under This

‘Your rights and duties under this policy may not be
transferred without our written consent except in
the case of death of an individual named izsured,

Tf you die, your rights and duties will be transferred

eat i

( tty wrod tye ead

(Broad Form)

#2 Sa38 83 ett as if
bs ;
i Ht aa

thy al iw

a Hanae

NUCLEAR ENERGY LIABILITY EXCLUSION
ENDORSEMENT

:
|

This endorsement modifies insurance provided under the following:wai
4

i a

i feo or
“Nuclear facility” means:
. na paneuan alll

Lo2ec oO

Page2of 2IL P PGD1 07 08

PRODUCER COMPENSATION DISCLOSURE
ADVISORY NOTICE TO POLICYHOLDERS

SPARTA Insurance Company ("SPARTA") sells fs products and services through indepandont

This Notica provides an overview of the types of compensation that SPARTA may pay its producers,
SPARTA may pay the producers one or more of these types of compensation,

‘The producer may receive addilional commission ‘upon the producer's cortaln
goals upon the profitability of the business undersrition over a period of
‘time. Profitability Is measured the premiums on the policies which the producer places with

which the producer places with SPARTA. This percentage may vary dépending upon the line of business
and the level at which the producer achieves the pre-established performance goals.

Ns producer compensation for services which the fenders or obtains trom
but not fimited to, loss control, premium audit, Oversight, and underwriting or

SPARTA pay
vendors,iL 02760306

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ If CAREFULLY.
IOWA CHANGES — CANCELLATION AND NONRENEWAL

‘This endorsement modifies insurance provided under the following:

FARM COVERAGE

MEDICAL LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART

PROOUCTS/| OPERATIONS LIABILITY COVERAGE PART
A Cencellation Polley Condition ts

teplaced by the following:

IL 0276 05 08

i
“i
i!

a
ri
Hi
in
eet
73 os

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(8) You have acted in & manner which you
knew or should have known was in vio-

3 i ips
bisa ai,

Hoy ity

i H tell
mitieniel
ated
nL titls

Lenmooe a

i. CA 00 120306
TRUCKERS COVERAGE FORM
Suates acs Se
duties and what is anc te Renee ee ee ae eens The

The words "we", "us" and “our” refer to the Company Coverage on the Declarations designate the only
providing this insurance, ‘taken’ tet re cowed "molar

Other words and ‘that in A. Description Of Covered Auto Designation Symbols
Cate toe Gnald eomied fom to vw-

Detinitions.

‘Owned “Autos” Only the “autos” you own (and for Lisblty any

Only senate tps tak es Ta as dais Uonee nce
ownership of after the policy beg

Owned Com- Only those trucks, tractors and "Wailers" you own (and for Liability Coverage any

mesclal "Awios” "railers" you don’t own while connected to a power unit own). This includes

‘Onily those trucks, tractors and "ralers" you acquire of after the policy ba-
gin

Gwned hates” Only those "autos" you own that, because of the law in the sta where they ee
Hee ee IE Onn cunanh, Ws rensued te Bee end cans ——
insured Motor- polley begine provided they are subject to the seme stvle uninsured motorist te-

Tired "autos" Only those
Only vate passenger
household,is

Hl
Hh

you own SECTION lI —LIABILITY COVERAGE

=
i

lie af

$5895

B if
i

all

ie al

‘are also cov
2,000 pounds
carried or

igned primarty for travel on public

‘Substitute Autos

if tb

Form, the

Cee aoe ior Lae
“Trailers” with a load
or less desi
roads.

2 “Mobile

C. Certain Trailers, Mobile Equipment And Temporary
of
Coverage:

equipment while

towed by a covered "auto".

CA@i20@068 O

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cAMR@o Oo

Page 4 of 14CA 00 12.03 06

7. Handling Of Property
dente eras heey.
@ Betore it is moved from the place where itis

socepted by the ‘ingured” for movernent Into
covered "auto" or

b. After It is moved trom the covered “auto” to
the place where it is finally dolivered by tho
"Wsured”.

ot os OOK Om ae unless the
9. Operations ;
“Bodily injury” rover damage! at out
of te operation of me
& Any equipment listed in 6b.
and 6.c. of the definition of equip-
ment"; or

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Me
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Page Sof 14thi, HG fii hie
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CAw@i20006 O

Page 6 of 14‘6. Al interest on the full amount of any SECTION WW —PHYSICAL DAMAGE COVERAGE
tant tat accrue aftr entry of he A. Comrege
ae AO ey ey Cet ones 4. We wil pay for “loss"to a covered “auto" or its
posited in cout the pert of the frsgment equipment under:
that's within our Limit of Insurance. @ Comprehensive Coverage
‘These payments will not reduce the Limit of In- From ary cause excapt:
surance.
‘The covered “auto's” collision with an-
B. Exclusions Se meteor
1. Woe will not pay for “loss” caused by or resulting (2) The covered "auto's" overturn,
of the following. Such “loss* Is ex- :
of any other cause or event b. Specified Causes Of Loss Coverage
that or in any se- ‘Caused by:
quence to the “loss*. (1) Fire, Sghtning or explosion;
8. Nuclear Hazard (2) Thett;
(1) The of
) nae eae ee
09 econ renee oeene are” @ Mi oe or

(® The sinking, burning, collision or derail-
ment of conveyance transporting

(1) Vir, including undeclared or clvil war; the covered

(2) VWaarlike action by a military force, includ: ¢. Collision Coverage
ai clone oneal ‘attack, be Caused by:
Sy govevweent or offer ‘au- (1) The covered “auto's™ cofision with an-
thority using milftary personnel or other or

soo (2) The covered "auto's" overtum.
Insurraction, 2 Towing ~Privale Passenger Auios
emmental suthory iderng oe. We will pay Up fo the limit shown in the Decia-
fending against any of these. rations for towing and labor costs incurred

2, We will not pay for loss of use.
3. We will not pay for “oes* caused by or resulting

from of the unless caused by ~ eo

other oes" thet fa by this Insurances: x Fuoco tee at

@& Wear and tear, freezing, mechanical or olec- Mt you cary for the
ical breakdown. damaged covered “auto”, we will pay for the fol-

b. ‘Loss* caused by hitting 2 bird or enimal;
oes for "loss" to any one “rallec”
amounts minus any

[= : pe tedesditase an

1, The actual cash value of the damaged of stolen auge consed by w coered sma cian

property at the tino of the “oss, or a "loss" Collision
32, The onet of epeltng or suetacing fhe dessa

or stolen with other property of
Kind end ay.

3. The Limit of Insurance shown in the Dectara-

CA00 1203.06

‘© (SO Properties, Inc., 2006

Page 7 of 14fe i iit} Ail fu
i Hi Mae it |

itt Hh
el i

aS, Hau MAT BE

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oes j oeF
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Heb i “a i

(ich linn i

52233 ie lial

ib. The cost of repairing or the dam-
oe cee rey other property

2 An for depreciation and physical
San am be toack hr tanning nat
cash value in the event of a total “loss”,

we or , we wil not pay for the
amount of the
D. Deductible
Oo a ree at oe fo pay for,
felurn or replace or stolen prop-
ery wil be reduced by tho deductible
shown in the Declarations. Comprehensive

CA00 120306

oe oe ee concerming tho
or .
Cooperate with us In the Investigation
Ant anne or dalonse
against the "suit",

Page 9 of 14piel rtial 5, HE jie
pide itty tt tea i
Tne Gade dt Ba bel
titty atime ELL it ie

k i HO Lanett ABE

LA a a || gL
Hine eG AERAU Tt ead
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Ho Hi a Halle Lil

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Ht etl ip ul bli i Wh fill
ili i Pa

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CA00 1206 06

HEHE Unita i iy alle
azine 228r5 og ity ; i ul i ity]
i i ain ete ahi ae a
Te a ep SEE ay ie Gy eb Eh
ba HL a
iii Ht ly fit th inkl iti Wik
it alte Heli a HEE i fit i ie
seit eta thi bah iii

cAMIG@O OO

Poge 12 of 144. “Insured Contract" means:
1. A lease of promises;
2 Asidatrack agreement;
3. Any easement or license in
with construction or demolition op-
erations on or within 50 feet of a raiiroad;
4 An obligation, as ordinance, to in-
a meat Wearaaien

Pertaining to your business (including an in-
demnificalion of a municipality

with work performed for a under
which you assume the tort flability of another to
ey Pat aay Dey coe tox
third or . Tort means
a that would be imposed by law in the
absence of any contract or agreement;

6 That part of ary contract or agreement, entered

<9488G Ute
fay te
feat
pay
it et
ta ti

into, a8 part of your business, pertaining to the maintained primarty to provide to per
Foul ec bana, ty you or ory tl twer tartar: manontly ‘qulbmant of Be teeny
See tie bi eee eee Air compressors, generators,
contact" to the extent that it you oF * hn spray weing can
any of your sae ieared tenet ing, and
damage” to rented or by you welt equipment; or
or ary of your employes” b. Cherry pickers and similar devices used to
An “insured conact” does not Include that part of ralee or ‘workers.
any contact or agreement: 6. Vehicles not described in a
ee eres ee bey Near connie Peary or =
‘or “property oul con- persons
srcaney donates within 50 cargo. However, sal propoted vehicles with
my rabeed btige or Nests, Naka, oad equipment te fot mabe equipment bi wil
any or . are nai
Save Ea untorpase Or cede be considered “autos”:
b. That pertains to the loan, lease or rontal of @. Equipment designed primarily for:
oer toe cee eee oe taliaaee
a driver; or “ fae en
Thet holds a person or organization en- remnfacing;
© caged in the bestnees of transporting prop- (3 Strest cleaning;
erty by “auto” for hire harmless for your use b. Cherry pickers and sim@ar devices
of @ covered “huto” over a route or territory automobile or ruck chassis and used to
that person or organization is authorized to raise or lower workers;
serve by public authority,
CA 001203 06 @ ISO Properties, inc., 2005 Page 13 of 14gis ah ar is
i ia fi i
Hl tt

‘ih i hy hh :

Ui if

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Vili Hut
ry

Goteal encore.

lf
g

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erty

1. Damages because of “bodily Injury" or "prop-

use of tangitie property.
0. "Suit" moans a chil proceeding in which:

canned Oo

Page 14 of 14POLICY NUMBER: O24TU 00135

AUTO
CA 03 0203 06

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DEDUCTIBLE LIABILITY COVERAGE
‘This endorsement modifies Insurance provided under the following:

BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM

With to by this endorsement, the of the Form unless
eye coverage provided Provisions Coverage apy

This endorsement changes the policy effective on the inception date of the policy unless another date Is indicated

below.

CA 0302.03 06 @ ISO Properties, Inc., 2005 Page 1 of 2de,

aim of "suit" we wil pay all or any

of: Potany deducttie shown te You

pa tn dese Se eaoeeany or Bee parte
the dedvotile we pal

Page 2 of 2 © 150 Proportios, Inc., 2005 CABOMOs O

LTPOLICY NUMBER: 024TU 00135 AUTO
CA 2001 0306

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LESSOR — ADDITIONAL INSURED AND LOSS PAYEE

This endorsement modifies insurance provided under the folowing:

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-
fled by the endorsemont.
‘This endorsement changes the policy effective on the inception date of the policy unless another dato Is indicated

CAMO1 G06 © ISO Properties, Inc,, 2005 Pageiof3 Oa TT

Address: 6001 i Avenue
$2553-

pao Per Certificates of Insurance on file
800 Main St.
Dubuque, IA USA 52001

chal Cash Value Or Goat Of Repel Whichover Ig Less, Minus
NO COVERAGE Deductible For Each Covered "Leased Auto”

man eh, Ceeinn echt
Deductible For Each Covered “Leased Auto"CA2001 03 06

‘© (SO Properties, inc., 2005

. The lessor ts not fable for payment of your premi-
ume.

Page3ot3COMMERCIAL AUTO
CA23 940306

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SILICA OR SILICA-RELATED DUST EXCLUSION FOR

COVERED AUTOS EXPOSURE
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS FORM
With this the of the Form uniess modi-
eS oven eee endorsernent, the provisions Coverage apply
A Tha tlonieg exctanton (patted to a See cee ee oe eaperens heb, i wis or

Exclusions of Section & SN eet tePolicy Number

Z O24TU 00135
SPARTA CALCULATION OF PREMIUM ~ COMPOSITE RATE(S)
° ° SPARTA INSURANCE COMPANY

Efieotive Date: 05-01-10
1201 A.M, Standard Time
00018

Namedinsued Ben Shinn Trucking, Inc

ielioas auto “Liability andi eagtaatne any surcharges
and assessments (Policy #024AU00123) plus truckers policy
surcharges and assessmentsSPARTA INSURANCE COMPANY
TRUCKERS DECLARATIONS
POLICY NO.; 024TU 00155

NAMED INSURED: Ben Shinn Trucking, Inc
MAILING ADDRESS: 6001 Palmer Avenve
Eddyville, IA 52553

POLICY PERIOD: From 05-01-2010 to _05-0}-2011
at 1201 AM. Standard Time at your mailing address. show above.
PREVIOUS POLICY NUMBER: 024TU 00006 _

FORM OF BUSINESS:
(2 ]corporation {_Jumrrep uasitiry COMPANY (_Jwomouat
[_]partwersHip C_Jomer

N_RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBS 70 AL THE TER OF 7180 FOLIOY,
WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.

ENDORSEMENTS ATTACHED TO THIS POLICY:
1.00 17 —Common Poly Conditions (IL. 01 45 In Washington)
{L 00 21 —Broud Form Nuclear Exclusion (Not Applicable in Now York)

i
(Date) (Authorized Representative)
OFFICERS’ FACSIMILE SIGNATURES MAY BE INSERTED HERE, ON THE POLICY COVER OR ELSEWHERE
AT THE COMPANY'S OPTION,

COUNTERSIGNED BY
NOTEINTHEPPI.

REACI

“This policy meaty be subject to final audi.

TR-DEC C/W 03 06

Page 2SCHEDULE OF COVERED AUTOS YOU OWN

‘Yoor, Model, Trade
wane

(2003, 2003, OM FILE

aC a atTTT TE a_i rath
a
TL pm Wa th

Pes [| fosena

2006, 2006, OM PLE
2007, 2007, ca FtEE
Business
‘Use
janaericn
r= rete
c= commercial |
ee ea
/__
is
2)
ie

[lee BO WN

Page 4

TR-DEC C/W 03 06é
3
i
.

Page 6

TR-DEC C/W 03 06SCHEDULE OF COVERED AUTOS YOU OWN (Cont'd)

Page 8

TR-DEC C/W 03 06SCHEDULE OF COVERED AUTOS YOU OWN (Cont'd)

Page 10

TR-DEC C/W 03 06Cost of Hire means:
The total doflar amount of incurred for the hire of automobiles (indudes tellers arxi
(0) TeSwrere), and Wot modded terebe,,
04 Te bet eemmeeretone Std ees = drivers helpers, of hired sutomnobiles whether hired with a
driver by lessor of an “employee” of the lessee, or any other third party, and,
{e) The tote dole smount of ary other costa ne rapa, naietenanon, Sot eto.) directly associated with
operating the hired automobiles whether costs aro absorbed by the Insured, pald to the lessor or
owner, or paid to others,

‘TRDEC C/W 63 06 Page 11TR-DEC C/W03 06

anion uae we dia, Wiens
from renting any equipment to any “rucker*.

Page 12SPARTA Insurance Company

This endorsement modifies insurance provided under the following:

claims, costs or expense arising rdifor prior higation.

AU 45060506 = Includes copyright material of Insurance Services Olfice, inc. with iis
permission.

ABILITY
AU 45060606
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRIOR AND/ OR PENDING LITIGATION EXCLUSION

BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM

‘A. The following exclusion ls added to Paragraph B, — C. If the Broadened Coverage — Garages endorse-
Exclusions of Section ti — ‘Coverage: 4s attached, the following exchision le added
B. Exclusions to B. Exclusions of Section | — Personal And Ad-

eer TR ‘This Insurance does not apply to:
o owe eter 7 ‘Personal and adverting Iara in whole oc
pope cee ee pat, from an offence the of any

wo pa the . °
; and/or prior litigation; as wel as ei future clakns,
pending and/or p . For the of this endorsement, prior and/or

Page 1 of 1SPARTA Insurance Company Coma 008
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
COVERAGE
TRUCKERS COVERAGE FORM
Paragragh Seoion IV -BUSINESS AUTO b, However, we waive any tight of recovery we
oo vee : Dtacues wee pou ty a iebaen
& reese: Fights Of Recovery Against cour i
2 any person or organtzaion to or for whom varias posanaal te coh conte.
Sergei t en doce toe mne eo eI een aly, $0 pean ‘er
those rights are transfered to us. That organization designated in such contract.
person of organization must do everything
necessary to secure our rights and must do
nothing after an “accident* or loss" to impair
them,
AU 3 01 05 08 Includes copyright material of Insurance Services Office, ino. with its Page 1 of 1 o
permission.AUTO
AU P 004 04 G9

NOTICE TO POLICYHOLDERS
UPDATE ON TERRORISM ENDORSEMENTS

The federal Terrorism Risk insurance Program (TRIP) has been terminated with respect to commercial auto in-
surance. An exclusion of limitation Is now conteined In your commercial auto policy that governs the treaknont of

Cerefully read your policy, including the endorsements attached to your policy.CAN canes
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
1OWA CHANGES

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM

With to under this the of the Form unless
mip tcc endorsement, the provisions Coverage apply

Changes In Conditions

‘The following Is added to the Legal Action Against Us Condition:

However, a judgment creditor shall have a right to sue us to recover an execution on a judgment returned unsatis-
fied against an “insured” fo the same extent that such “insured” could have enforced the “nsured's” claim

os has a meeered: eld sus DaSGeEERL Re ek be MSE Remager Heat aro be acces of the

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

FELLOW EMPLOYEE COVERAGE FOR DESIGNATED
EMPLOYEES/ POSITIONS

This eedorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM

MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM

With respect to coverage provided by this endorsement, thie provisions of the Coverage Form apply unless modified by the en-

‘Name of Person(s), Job Tide(s) or Pasition(s):
Officers and managers only

A no aggours abow, Information requis 1 complete this endorscenot willbe shown fn the Declaraioes as appli-

‘The Fellow Employee Exclusioncoatained in Sectioo II - ‘Coverage does the .
wo eer hactacd oc Hated in the Sebdule. “ee ge does not apply to the “employee(s)", job udeta)

CA 20 5602 99 Copyright, Insurance Services Office, Inc, 1998 Poge tof 1 OCA23 1703 06

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

TRUCKERS — UNIFORM INTERMODAL INTERCHANGE

COMMERCIAL AUTO

POLICY NUMBER: 024TU 00135

ENDORSEMENT FORM UIIE — 1

This endorsement modifies Insurance provided under the following:

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CA 23 17 03 06eke Hall, ee

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Page 2of 2AUTO
CA 9903.03 06

THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
AUTO MEDICAL PAYMENTS COVERAGE

‘This enclorsement modifies tisurance provided under the following:

ment, the of Coverage Form apply
unless by the endorsement.
A Coverage

qt
i
i
by

i
:
i

uu
Iie
nti |
Hitt f
li

5. "Bodily injury to an “insured” while working in a
peoriens of ean. enn. Epes
Ing “autos” unless that business me
6. ee Se ee Se

‘ection in hindering or defending against an
“ insurance does the follow- mad pen Soe: eee. mae
This i not to of
ing: ores military personnel or other agents; or
|. “Bodily injury” sustained “insured” while Insurrection, rebellion, revolution, usurped
5 wT a vadtie loceisd ior ose. © poner, or aston lahen by ‘ath
Sae ing against
injury" sustained Gane.
Se ene ote
a
Footie tera Yo er
CA93 03 03 06 © 1SO Properties, Inc., 2005 Page 1 of 2E. Changes In Conditions
The Conditions ere changed for Auto Medica
Payments

0: "aoe tbr icine “hsured” while Sm .
1. The Transfer Of or Against
Denes oe, whlie used in Caran We Us Govemion tea est eek
of stunting activity, praaticing for such 2, The reference in Other insurance in the Busi-
contast or ‘aso does ness Auto and Coverage Forms and
not ‘sustained by an Other Insurance — And Excess Insur-
Be eee ance Provisions in the Truckers and Motor
such a Cartier Forms to “other cokectible in-
D. Limt Of insurance sameeren. OY 00 ober cote te
Regerdiess of the number of covered “autos”, in- =F additional Definitions
sureds", ee cn th asi ‘As sed In this
each “insured” injured in any one "Family member" means a person related to
iste Limit Of Insurance for Auto Medi a Mariage of adopon who ae
cal Payments Coverage Dectarations. of household, @ werd or
No one wal be entitled to receive pay ie
ments for the same elements of under 2 “Occupying” msans In, upon, getting In, on, out
cones ou) 8 Form, Unin- or off.
sured Endorsement or Under-
insured Motorists Coverage Endorsement attached
to this Coverage Part.
Pago 2 of 2 © ISO Properties, Inc,, 2005 CAMOGOG OAUTO
CA 99 46.03 06
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

POLLUTION LIABILITY - BROADENED COVERAGE
FOR COVERED AUTOS — BUSINESS AUTO
MOTOR CARRIER AND TRUCKERS COVERAGE FORMS

This endorsement modifies insurance provided under the following:

A. Wiabilty Coverage is changed as follows: ame eo ene mae
Paragraph a. of tho Pollution applies include Or expense arising
fabllty assumed under a contract sctual, alleged or threatened discharge, disper-
- * < fa sepage, migration, release or eee of
. AL ‘hove, Guckisbn BS, Core, Cus ae Oe cee Oc ae Cespey b
Poly Soved eos tas place share’ Baye
B, Changes In Defintions socepted by the “insured” for movement
For the purposes of this into or anto the covered “auto”, or
D. of the Definitions Section is replaced by the bi After the *pollutants* or any in
which the “pollutants” are are
‘Covered ‘cost or means any moved from the covered “auto” to the
cost or expense arising out place where they are finally delivered,
1. Any request, demand, order oF or Gente’ of or ‘sbendoned ty Sa Sr
Be comaiten Gacomin Paragraphs a. and b. abovedo not to
contain, treat, detoxify or neutralize, or in "accidents" that occur from
way respond to, or assess the effects owned by of rented to an with re-
ot or eee am ‘ot In oF upon a cov-
2 Any claim oF “sult” by or on behalf of a :
governmental authority for damages be- (1) The “pollutants” or any in
cause of testing for, monitoring, cleaning which the “pollutants” ountthed
up, removing, containing, treating, detoxdfy- are upset, damaged as
Ing oF noutr: or in way respond- 4 result of the maintenance or use of
bo oF mera De of "pollut- acovered "auto and
The
O Miraon, tious & ease a oe
“pollutants” is 4 drealy
such upset, overturn or damage.
CA 99 48 03 06 @1S0 Properties, Inc., 2005 r Paget of 1POLICY NUMBER; COMMERCIAL AUTO
CA 99 54.0797

‘THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ It CAREFULLY.
COVERED AUTO DESIGNATION SYMBOL

‘This eadarsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE PORM

GARAGE COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

TRUCKERS COVERAGE FORM

BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM

‘With respect to coverage provided by this endorsement, the provision: of the Coverage Form apply unless modified by tho
‘This endorsement changes the policy effective oo the inception date of the policy unless another date is indicated below:

(Authorized Representative)
Section I - Covered Autos is arcaded by adding the following:
[term Two of the Declarations sbows the "autos" that are covered “autos for cach of your coverages. The following numerical
symbols may be used (in addition to the eumerical symbols described in the Coverage Form) to describe the “xutos" that may
Re avated nent, Tie Oeky of oan et Ben eee covernge on the Declarations will designate the anly"satos"
thatare covered . 7

‘Symbol Desxtption Of Covered Auto Designation Synabols
For use with the Business Auto Coverage Form

For use with the Garage Coverage Form

Por use with the Truckers Coverage Form

Si = ANY COMMERCIAL TRUCK, TRACTOR OR TRAILER. EXCLUDES PPT
VERICLES.Symbol Description Of Covered Auto Designation Symbols
For use with the Business Auto Physica! Damage Coverage Form

For use with the Motor Carrler Coverage Form

een MOTOR CARRIER POLICIES OF INSURANCE FOR PUBLIC LIABILITY fom Nonmen
Ter ean UNDER SECTIONS 29 AND 30 OF THE MOTOR CARRIER ACT OF 1960 “ee

tuedio BEN SHINN TRUCKING, INC. @ 6001 AVE EDDYVI I
Qed st Hartford, Connecticut ®% 19th dayo April + 10

Amending Polley Na. O24TU 00135 Bhoctive Dae 05-01-10

Name ot Insurance Gompay SPARTA Insurance
Countersigned by Martin R. Hughes
Authorired Company Represertaive
‘The policy to which this endamement Is attached provides primary or excess Insuranco, a8 Indicated by the "[)]", for the lirelts shown:

(XX) This insurance is primary and the company shall not be fable for amounts in excess of $ 1,009,000 _ for ench accktent.
(C ] Téa inauranoe is excess and the company shall nat be liable for amounts in excess of $ for each accident in

ercess of the underying imitel$ foreach accident,
Whenowerreg the FoderalMoto Carrier tee company agrees tofureistithe FMCSA\ ‘sald and ait
Re eT eee ce erate nale cree amamenearertna FDA eh poloyls breasts

Caccollaiont thisendorsement may be ellocted by the company of the Insured by giving (1) . days naticein writing te the other party (sald 35

dain notice to commencetrom the date Runcticetamalied, proof of maiiing shall Pa ingwrodis subject the FMCSA’S
registration requicemantsunder 49 ULB.C. 12901, providingtirty daysrotice | 20, to commancetromthednts thenctice
iptocled by he FMODA ne fc In setuegto, D.C). = a
DEFINITIONS AS USED IN THIS: ENT
Accided inchydes cordiewouser reported exposure to condiliors or Property Qattagemeans damage to or loss of use of tangible property,
which results in bodily Injury, property damage, or envirormortal
damage Which he insured neither axpeoied ror Intended. edcmasmatniretneneats petites Salsas 0 Gestrection
anaatccenneorating ost Gavedieeni eaten,
(Motor Vehiols means a and vehicle rractine, Weck, tact, Dailer or OF eaeape ine OF upon thatand, ‘body of veatar, of
eemiiriler propelted or drawn by mechanical | ert used on & wy warcporied by a moter casries. This shalt incledethe cost of
Nighwey ir wansporting peoperty, or any removal and the cod of necessary mensures taken to ednimize or
dierage to human henlth, the retural emeicormert, Eh, shotitch anc
Bodily bury moare tan ay, scinaen, oF diana te aay a . wk
=m ‘emvtronmectal resrration, 7 Pel ee
‘The Inturance policy to which tis endorsernect Is attached provides witin Be Himits ci Sability herein described, imespective of the francial
Wraureceand ls amended Wo by condition, of the Insured. However, all Sere,
a mctor card 7, condiniona, ard fraitatonsin the policy to whichite is
with Gections 29 and $0 of the Motor Carder Act of 1980 anc tha rules and shall remain force | dinding betwnen the Insured and fe
muses ot Pall Ms Cosi ey Naaeasenten POS carey Se compu ehesceunts ny eoasonsclan
In combdorsecil he pram sated In Om poy to which Wis breacr ee tea fh poy ane fr Say pyri

at
ercdorssmantis amached, | fe
be inarer Gis organ) carers Pa witin paths bean ebfgaed te mao water's pression! hopetey exceptirMO te22p(01-07),

Foran MICS-00 (4 200%)

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Party Discovery: Lucas Gilpin, as Trustee for the Heirs and next-of-kin of Laura Gilpin, Deceased vs Ben Shinn Trucking, Inc., an Iowa Corporation, Thomas Duane Gilpin

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