Fill and Sign the Common Insurance Terms in Mobile Alabama and Mississippi Form

14.04 Insurance Policy Summary Information Worksheet Analysis of Insurance PolicyPolicy: Policy Number: Date of Policy: Underwriter: Agent: Contact Information: NAME INSURED [Name of principal policy holders]INSURED PERSONS [Insured persons can include more than the policy holder. Describe any covered individual, corporation, partnership, employee, subsidiary or other relevant party. Also describe the relationship between the policy holder and the insured persons.] Individual-if the named insured is shown in the Declarations as an individual, the Named insured is an Insured only for the conduct of a business of which the Named Insured is the sole owner. Corporation-If the Named insured is shown in the Declarations as a corporation or organization other than a partnership or joint venture, the Named Insured and any Subsidiary which is identified in the Declarations or by endorsement to this policy are Insureds. Partnerships-If the Named Insured in the Declarations is a partnership or joint venture, the Named Insured is an Insured. The Named Insured's partners are also Insureds but only for the conduct of the Named Insured's business. However, no person or organization is covered for the conduct of any current or past partnership not named in the Declarations. Employee-Employees of the Named Insured and of any covered Subsidiary are Insureds but only for the conduct of the Named Insured's or the covered Subsidiary's business within the scope of their employment. Subsidiaries-Notwithstanding the foregoing, any covered Subsidiary and any director, officer or employee who is an Insured by virtue of his or her affiliation with a covered Subsidiary, is an Insured only with respect to claims based solely on employment practices wrongful acts occurring wholly subsequent to the date on which the covered Subsidiary became a Subsidiary. TYPES OF CLAIMS COVERED [Describe nature of the policy] COINSURANCE [Usually expressed as a percentage]DISCOVERY PERIOD [Usually expressed as a number of years] Election Of Discovery Period [Usually expressed as a number of days of effective date of the policy's expiration] CANCELLATION PROVISION No cancelable except for non-paying of premium [Describe any rights that insured has to cancel/Usually should only be for non- payment.] NON-RENEWAL PROVISION [Describe-also confirm compliance with applicable state law] PAYMENT OBLIGATIONS Limit [Describe coverage limits/Usually expressed in dollars]Deductible [Describe deductible/Usually expressed in dollars]Annual Premium Indication [Describe annual cost/Usually expressed in dollars] Annual Aggregate Limit [If applicable, describe/Usually expressed in dollars] Advancement of Funds [Will the insurer advance settlement and other payments?] DAMAGES, PENALTIES, ETC. Punitive [Included/Excluded?] Exemplary [Included/Excluded?] Multiplied Awards [Included/Excluded?]Fines and Penalties [Included/Excluded?] Taxes [Included/Excluded?]Grand Jury/Criminal Proceedings [Included/Excluded?] Matters Deemed Uninsurable By Law [Included/Excluded?] DEFENSE and SETTLEMENT PROVISIONS Duty to Defend [Describe who has the obligation to defend any claim; who has investigation rights; and what settlement consents are required.] Settlement [Does insured have a right to refuse consent to settle? If so, what consequences?] Yes-If the Insureds refuse to consent to a settlement acceptable to the claimant in accordance with the Underwriter's recommendation, the Underwriter's liability for such Claim will not exceed the amount for which the Claim could have been settled plus any Defense Expenses incurred with the Underwriter's consent up to the date the Insureds refuse to settle such Claim. NOTIFICATION OF RIGHTS PROVISION Claim [Who must provide notification to the underwriter and by what means and on what timetable?] ARBITRATION PROVISION [Yes/No. If so, describe when applicable and in what forum; binding/non-binding?] SUBSIDIARY COVERAGE PROVISION Created and Acquired Subsidiaries [Are they covered? If so, must they meet any definitional tests?] Prior Acts Covered [Yes/No? What are relevant dates?] Divested Subsidiary [Yes/No? What are relevant dates?] CHANGE OF CONTROL PROVISION [Yes/No? Describe limitations concerning who survives, ownership interest requirements, etc.] EXCLUSIONS Bankruptcy/ Insolvency [Yes/No?] Bodily Injury/ Property Damage [Yes/No?] Contractual Liability [Yes/No?] Malicious Intentional Acts [Yes/No?]Non-Monetary/ Injunctive Relief [Yes/No?] Defense Cost [Yes/No?]Pending and Prior Litigation [Yes/No?] Prior Acts [Yes/No?] Prior Knowledge [Yes/No?]