Pro Liability Campaign collateral pieces

INCIDENT AFTERMATH INFORMATION 2022/2023 DAN.org/Liability DAN.org/Liability

INCIDENT AFTERMATH:

WHAT TO DO AND WHAT NOT TO DO Every divemaster and instructor knows that if they are present at the scene of a dive accident, they may be exposed to financial liability or, at a minimum, involvement in a lawsuit — just for being there. Whether you’re training or supervising as a dive professional or you’re just out on a recreational dive, once an accident happens, you’re involved.

WHAT TO DO (OVERVIEW) 1. Assess the seriousness of the situation and

render first aid as appropriate.

2. Contact and assist emergency medical

services and law enforcement.

3. Record the name and contact information of every

person present when the accident occurred.

of a verbal or written statement of an intention to hold the insured responsible for an event (incident). If an event (incident) involves a fatality or serious bodily injury, immediate notice (within 24 hours) should be given to the Underwriter.

PHYSICAL EVIDENCE

NOTIFICATION

Collect, catalog, and safeguard all dive equipment and other physical evidence as is. Do not tamper with or disassemble dive gear unless directed by a person with appropriate authority (law enforcement), and do not release the equipment to anyone other than law enforcement. If the equipment is released to law enforcement, make sure you know how you will be able to locate it in the future.

Provide this information and your list of physical evidence to DAN RRG.

Report any accident or incident involving people you are training, supervising or diving with for pleasure to the following:

Physical evidence includes the original waiver and release forms completed by the injured person. Photocopies should be provided to DAN RRG.

4. Notify all relevant parties. See NOTIFICATION below.

5. Secure all dive gear and any other physical evidence

exactly as it is.

6. As soon as you are able, write down your recollection

of the events leading up to, during and immediately following the accident.

Your employer The injured party’s family

DOCUMENTATION

Your certification agency

Contemporaneous notes including observers’ statements are important because it can be difficult to recall many details later on. Include in your notes anything unusual or relevant about the state of the injured person’s scuba equipment. The existence of any such notes should be disclosed only to the liability insurance company and its attorney. This measure will greatly assist the investigation and potential defense in the event of a claim.

Your liability insurance carrier and any other insurance

carrier through which coverage may be available (auto, property, marine, etc.)

Others (dive site owner, rental gear provider, etc.)

Be sure to comply with the notice requirements of your professional liability policy. If your coverage is with DAN RRG, the DAN RRG policy provides as follows: 1. The insured shall immediately give written notice to the

Underwriter of any claim made against the insured, including but not limited to, any verbal demand or written demand, notice, summons or other process received by the insured or his or her representative.

2. The insured must notify the Underwriter as soon as

practicable of any event (incident) likely to give rise to a claim hereunder, or of the receipt from any person

DAN.org/Liability

LEGAL PROTECTION OF COMMUNICATIONS The members of the DAN RRG Incident Response Team are all licensed attorneys. Information provided to the team will be protected by attorney-client privilege.

DAN RRG’s incident response team (IRT) includes the DAN RRG general counsel, the director of claims operations for DAN Services, and outside investigators and attorneys.

WHAT NOT TO DO (OVERVIEW) 1. Do not speculate or provide your opinion on

the incident 2. Do not speak with anyone until you consult

and attorney 3. Do not tamper with or disassemble dive gear

DON’T TAMPER WITH OR DISSASSEMBLE DIVE GEAR Place the dive gear in a secure area in exactly the same condition it was in when removed from the injured diver. Do not close the value or do anything else that would change the condition of the gear at the time of the incident.

unless directed by law enforcement

DON’T SPECULATE ON THE FACTS Do not speculate about or volunteer to anyone an opinion as to why the accident occurred or what led to the injury or death. Limit your statements to the facts as you know them. Do not make conjectures, and do not attempt to assign blame on anyone. Do not say, “It’s all my fault,” or words to that effect. Even if you have feelings of guilt, do not discuss them with others.

DON’T DELAY SPEAKING TO AN ATTORNEY Do not discuss the incident with anyone (other dive professionals, people at the scene, friends, family, etc.) until you have spoken with an attorney. Remember that anything you say can be repeated and used in a legal proceedings against you. If you discuss the incident with anyone, these individuals may be called as witnesses.

Your interest in minimizing adverse legal consequences in the wake of an accident need not be viewed as unfeeling or selfish. Ultimately the issue of fault revolves around the events leading up to the accident and the instructor’s conduct in the context of these events. An instructor should not risk inadvertently doing anything after the accident that could lead to interpretation of wrongdoing by the instructor.

These measures of self-protection are exercised in all business activities, and, in this context, scuba instruction is no different. Further, these realistic concerns need not be incompatible with any sincere feelings of concern, support and comfort that may need to be heard by the family of the injured person.

DAN.org/Liability

WHEN DOES AN INCIDENT BECOME A CLAIM? It is important to understand exactly what a claim is. A claim can be an oral or written notice to the instructor or their insurance company alleging the instructor’s responsibility for injury to a diver and claiming monetary damages.

A claim can consist of a letter from a lawyer or the service of legal papers showing that a lawsuit has been filed.

Although the instructor is required to notify the insurance company of a student injury, this notification is not technically considered a claim.

For practical purposes, however, the insurance company may consider a claim to be in effect if it is determined than an occurrence justifies further investigation.

SUBMITTING REPORTS TO DAN RRG All DAN RRG insureds are required to report an accident or incident via one of the following means: Phone DAN RRG Incident Response Hotline: +1-919-682-9111 Fax

+1-919-490-2935

Email LiabilityClaims@DAN.org If you have any questions about reporting an accident or incident to DAN RRG, or if you have knowledge of an accident or incident at which you were present, call +1-800-446-2671 (toll free in the U.S.) or +1-919-684-2948 (if outside the U.S.), 8:30 a.m. – 5:00 p.m. ET.

LIABILITY

INSURANCE FOR DIVE PROS PROS CHOOSE DAN Professional | Group Professional | General Liability

COST/BENEFITS COMPARISON CHARTS DAN.org/Liability

OUR UNWAVERING COMMITMENT TO DIVE PROFESSIONALS Even during unprecedented times, DAN RRG has maintained its steadfast commitment to helping dive professionals and businesses succeed. This season, we have held liability insurance premiums constant while other providers have increased premium rates.

Isn’t it time you switch to DAN RRG and save?

STANDINGS

COMPETITOR

DAN

Financial Rating

A-rated, Excellent, from AM Best

A-rated, Exceptional, from Demotech, Inc.

Prior Acts

Prior acts are not automatically covered and will be charged an additional premium if included in the policy.

Protection against prior acts with continuous coverage

Cost

Premiums up to 2X the cost of DAN RRG’s

DAN RRG provides dive pros and dive businesses with affordable, low-cost premiums, 30% to 50% lower than the competitor

Other

Over 40 years of providing coverage for specialty risks

In-house medical, legal, and risk management support teams

Profitability

Privately-owned, for-profit organization, a division of HUB International

Supported by DAN, a not-for-profit organization that has reinvested more than $100 million in dive safety and boasts a history of helping divers for over 40 years

Auto-renewal

Additional insureds NOT automatically renewed

?? I assume DAN RRG does??

Coverage

US$1,000,000 per claim/ US$2,000,000 aggregate or US$ 500,000 per claim/ US$1,000,000 aggregate

US$1,000,000 per claim/ US$2,000,000 aggregate

Payment plan

Policy must be paid in full to begin coverage

Premium financing available.

Contact DAN Liability Insurance at LiabilityInsurance@DAN.org or call 1-919-684-2948 for more information.

THE LOWEST LIABILITY INSURANCE PREMIUMS FROM A NAME YOU TRUST DAN’s professional liability insurance premiums are the lowest in the industry. Plus, our split payment program allows you to pay just 25% up front and the balance within 90 days, making it easier to maintain continuous coverage. So what are you waiting for? Isn’t it time you switch to DAN RRG and save?

PROFESSIONAL LIABILITY INSURANCE POLICY TYPE

COMPETITOR’S PREMIUM

* DAN RRG PREMIUM

Instructor (Scuba)

$ 1851

$ 829*

$ 1022

(55%)

Assistant Instructor/Instructor In Training (Scuba)

$ 1331

$ 529*

$ 802

(60%)

Divemaster/Divemaster In Training (Scuba)

$ 1331

$ 529*

$ 802

(60%)

Freediving Instructor

$ 1331

$ 529*

$ 802

(60%)

Mermaiding Instructor

$ 1331

$ 479*

$ 519

(64%)

Swimming Instructor

$ 1016

$ 479*

$ 537

(52%)

Tail Coverage (Retired Scuba Instructor)

$ 1331

$ 529*

$ 802

(60%)

Tail Coverage (Retired Divemaster)

$ 1016

$ 299*

$

(70%)

INCLUDED COVERAGE FOR QUALIFIED PROFESSIONALS

COMPETITOR’S PREMIUM

Technical

Individually underwritten & rated.

Must submit proof of certification.

Included

Rebreather

Individually underwritten & rated.

Must submit proof of certification.

Included

OPTIONAL ENDORSEMENTS

COMPETITOR’S PREMIUM

* DAN RRG PREMIUM

AAUS

NA

$

Tour & Travel Agent Liability

NA

$ 150

Equipment Liability

Individually underwritten & rated.

$ 399

Cylinder Inspection Instruction

Individually underwritten & rated.

Submit proof of certification.

$ 399

Excess Liability ($2M/$3M)

Individually underwritten & rated.

Submit proof of certification.

$ 669

SAVINGS WITH DAN RRG

71

* DAN RRG PREMIUM

0

FAQs DIVE BUSINESS AND PROFESSIONAL INSURANCE 2022/2023 DAN.org/Liability

FAQs

DAN/DAN RISK RETENTION GROUP Professional, Group Professional, and General Liability Insurance Boat & Vessel and Commercial Property Insurance 2022/2023 ELIGIBILITY & ENROLLMENT

Is there a maximum age limitation for DAN RRG liability insurance?

Who is eligible to purchase coverage?

All qualified dive professionals are eligible for coverage under the DAN RRG policy provided they meet any age requirements of their training agency. DAN RRG does not place limitations on the training standards developed by the training agencies and closely follows the recommended guidelines established by these agencies.

Currently, DAN RRG can only enroll (i) dive professionals who reside in the U.S. and hold credentials from an approved training agency, and (ii) U.S. based dive businesses. For service members posted overseas with an APO/FPO address, and certain countries/islands in the Caribbean, you may enroll with DAN’s affiliated carrier, DAN World Insurance Group SP at World.DAN.org/Liability.

DAN is working with other carriers to offer liability coverage in other countries and territories, so please check back for updates.

Can I purchase general liability insurance if I am not set up as a business?

DAN RRG general liability insurance can be purchased only by entities that are legally established as a business.

An independent instructor would be eligible to purchase general liability insurance if operating as an LLC or corporation. Documentation must be provided to DAN RRG to confirm eligibility. A physical address for the business is necessary, but there is no requirement that the business have a retail (brick and mortar) establishment for serving customers.

What training agencies recognize DAN RRG liability insurance?

DAN RRG liability insurance is accepted by all major training agencies. This includes PADI, NAUI, SDI, SSI, TDI, IANTD, PDIC, PFI, PSS, RAID, NASE, AIDA, SEI and others. If your training agency is not listed, contact a liability insurance specialist to learn about coverage.

Can a dive club purchase a general liability policy through DAN RRG?

Does DAN RRG liability insurance meet training agency requirements for coverage?

Unless a dive club is operating as a business, they are not eligible to purchase a DAN RRG general liability policy.

Yes. The DAN RRG policy meets the insurance requirements of all dive training agencies.

How do I apply for liability coverage?

Can I purchase liability coverage as a free diving or swimming instructor?

You must complete the application found at DAN.org/Liability.

Yes, the professional liability insurance (individual and group) provide options for those who do not teach scuba but are qualified to teach freediving, RSSA (Recreational SurfacedSupplied Air) diving, swimming, skin diving and snorkeling.

How quickly can I get a quote?

DAN.org/Liability

You can get an instant quote on DAN.org/Liability.

Once the application is approved and payment confirmed, confirmation is sent via email with a link that will take you to the policy documents.

1

How long does it take to process an application?

I own additional shop locations.

Do I need a separate liability policy for each insured?

Most applications are processed the day they are received.

However, underwriting may require 24 to 48 hours.

No, additional locations of the insured are covered at no additional cost provided they are listed with their physical addresses on the application.

My shop revenues are higher than the listed amounts. Can I still purchase liability coverage?

How many staff members can be covered under my group professional liability policy?

Yes, please call +1-800-446-2671 or +1-919-684-2948 and speak with one of the customer service representatives for the DAN liability program, or email LiabilityInsurance@DAN.org.

Currently, there is no limit to the number of staff members that can be covered under your group professional liability policy. But remember, all staff members share the single policy limit.

Is DAN RRG liability insurance available to residents of Canada?

No, DAN RRG liability insurance is not currently available to residents of Canada. Check back for updates.

COVERAGE/LIMITS What insurance products do you offer for dive professionals?

Is DAN liability insurance available to residents of Puerto Rico?

What about other U.S. territories?

DAN RRG offers professional liability (individual and group) and commercial general liability insurance. Dive pros may also purchase DAN-sponsored dive accident or trip/travel insurance, and may enroll students in DAN’s complementary insurance for entry-level students.

Yes, through DAN World Insurance Group SP.

Can a business purchase group professional liability by itself?

When will my policy become effective?

Yes. DAN offers professional and group professional liability insurance (through DAN World Insurance Group SP).

The effective date is generally 12:01 a.m. on the day after you submit your application, however approval may take up to 48 hours. If you prefer a later effective date, you may choose the date you would like coverage to begin. To avoid a lapse in coverage, please submit your application prior to the expiration date. There is no grace period.

I help plan trips for my customers.

Can I be held responsible?

Each case will be subject to state law and fact dependent, but understand that a plaintiff can file suit against you regardless, and place the burden of proof upon you to defend. To protect you, a Tour and Travel Agent Liability endorsement is available with both the individual professional and the commercial general liability policies. This endorsement requires the payment of an additional premium.

Do I need to carry both liability insurance and DAN dive accident insurance?

Yes. It is wise to have both types of insurance because each product provides different benefits. Professional, group professional and general liability insurance protects you when a student or customer is injured and files a claim against you or your business. DAN dive accident insurance protects you against hyperbaric chamber costs, physician and hospital fees, and ambulance charges incurred in the event of a diving injury. Liability insurance and dive accident insurance are not interchangeable, and the benefits do not overlap.

If I teach at a quarry, is this property automatically covered?

If you own the quarry (also applies to a lake), coverage requires the purchase of a separate endorsement and payment of an additional premium. If you do not own the lake or quarry, but just use it for training, you do not need to add this endorsement.

DAN.org/Liability

2

Do you offer short-term policies less than 12 months?

Are instructors who teach public safety classes covered by the professional liability insurance?

We do not offer short-term policies. Our policies have a term of 12 months.

All professional liability policies (individual and group) cover the insured for teaching public safety diving. However, the insured would not be covered while working as a public safety diver.

Is my liability policy a claims-made or occurrence-based policy?

Does DAN RRG liability professional liability insurance cover training that takes place in a national park?

The professional liability policy (both individual and group) is a claims-made policy, meaning that coverage is triggered when a claim is made against the insured and it is reported to the underwriter while the policy is in force. If a claim is made while the policy is not in force, there is no coverage for that claim.

Yes, the professional liability policies (individual and group) covers the insured when training in a national park. However, some parks will not accept the DAN RRG coverage due to the lack of an A.M. Best rating. If you plan to operate within a national park, please contact a liability insurance specialist to confirm that DAN RRG coverage will be accepted.

The commercial general liability policy is an occurrence­ based policy, meaning that coverage is triggered on the date the bodily injury or property damage occurs. The claim may be made after the expiration of the policy term, provided the event occurred during the policy term.

Does DAN RRG liability insurance protect me against claims arising from COVID-19?

Where am I covered when I teach or supervise divers?

The professional liability policy (both individual and group) offers worldwide coverage.

No, DAN RRG liability insurance does not protect you or your business from claims arising from or related to COVID-19. Infectious diseases are excluded from the policy; this is common with most liability insurance policies in the industry.

Does the professional liability insurance cover non-diving courses such as gas blending and visual cylinder inspection courses?

An endorsement for cylinder inspection instruction is available, but gas blending is not covered. Please refer to the endorsement for details. There is an additional premium for this coverage. If you are not teaching cylinder inspection, coverage for activities such as gas blending and cylinder inspection are covered by the general liability insurance policy.

Is there a pandemic exclusion in the policy?

The professional (individual and group) and general liability insurance policies do not include a specific pandemic exclusion. However, all policies contain an exclusion for losses arising from a communicable disease, which would include pandemic.

Does the general liability insurance cover equipment service and repair?

Am I covered to teach rebreathers or technical diving?

Yes, coverage includes losses related to negligent equipment service and repair, including rebreathers.

Yes, but you must carry the appropriate certifications and ratings for the equipment used for coverage to be valid.

DAN.org/Liability

3

Does DAN RRG professional liability insurance cover mermaids and other underwater performers?

If I teach for more than one dive training agency, can I be covered under one group liability insurance policy?

Yes, the professional (individual and group) liability policy covers professionals when engaged in water-based performances. See endorsement for details.

Yes, the group professional liability policy is designed to cover a professional for services provided under the guidelines of any of the approved training agencies.

However, with a group policy the professional services must be provided to customers of the insured dive business.

Does the professional liability insurance include prior acts coverage?

Professional services you provide outside the scope of your responsibilities as an employee or independent contractor of the dive business are not covered under a group policy.

Yes, this is a claims-made policy and covers all claims made during the policy term, provided the incident/loss occurred subsequent to the earliest date from which you have had continuous professional liability insurance coverage. That coverage could have been with another insurance carrier, but it must have been continuous.

If you experienced a gap in coverage or if this is new coverage, there is no prior acts coverage.

Are defense costs included in the policy limits or are they outside the limits?

Defense costs are included in the aggregate policy limit of both the professional liability (individual and group) and the commercial general liability policies.

How does coverage work under a group professional liability policy?

BOAT & VESSEL INSURANCE

Coverage is the same as under an individual policy, but note the following:

Can you cover my boat?

Yes. DAN now offers boat and vessel insurance.

Go to DAN.org/Membership-Insurance/Liability/ Boat-Insurance/ for details.

1. All staff listed under a group policy share a single limit of

liability ($1 million/$2 million aggregate) and that limit is reduced each time a claim is made.

2. Coverage only applies to professional services

provided by your staff to the store’s customers. If a dive professional teaches or leads a dive trip with someone who is not a customer of the dive shop, the dive professional has no coverage.

PROPERTY INSURANCE Can you insure the contents of my shop?

Yes. DAN now offers commercial property insurance.

Go to DAN.org/Membership-insurance/Liability/ Commercial-property-insurance/ for details.

What limits are available?

Both the professional liability (individual and group) and general liability insurance policies have a limit of $1 million per claim/$2 million aggregate. You may increase this limit to $2 million per claim and $3 million aggregate by purchasing the excess liability endorsement.

ENDORSEMENTS/ CHANGES TO POLICY

Am I exposed to liability whether or not I choose to render aid?

Can I add an endorsement after I purchase my policy?

Each case will be subject to state law and fact dependent, but understand that a plaintiff can file suit against you regardless, and place the burden of proof upon you to defend.

Yes, you can add any endorsement later and pay the prorated amount for the remainder of your policy term.

DAN.org/Liability

4

Is excess cover above the standard $1 million per claim/$2 million aggregate available?

I won’t be teaching again for a while, why should I renew my coverage?

Yes, you may add the excess liability endorsement, which will increase your policy limits from $1 million per claim/$2 million aggregate to $2 million per claim/$3 million aggregate.

There is an additional premium for the higher limits.

Since professional liability insurance is a claims-made policy, it requires you to have coverage at the time the claim is made. If a claim is made and your coverage has lapsed, you will not be covered. You should purchase tail coverage to be protected.

Are there fees to add additional insured? What about fees for policy upgrades?

Does DAN RRG offer tail coverage?

Yes, tail coverage is available to protect you against claims that are made after you have retired. After a few years (the length of time depends on the state), the ability of an injured diver to bring a claim expires and tail coverage is no longer needed.

There is no additional cost to add additional insureds or teaching staff. There are no additional fees for upgrades, but there may be an additional premium depending on what’s added to the policy.

Who can be an additional insured?

Does DAN RRG offer automatic renewal on its liability insurance policies?

Additional insureds are third parties who can be added to the policy at no additional cost. The listed additional insureds are then protected under your policy and have coverage against claims that result from professional services you (the named insured) provide as a dive leader, instructor or business owner. Instructors or divemasters may not be added as additional insureds; they must have their own professional liability coverage or be listed as insured staff members under a group policy.

Automatic renewal is not currently available for professional (individual and group) or general liability insurance policies.

Each policy must be renewed manually each year. You will receive a renewal notice in advance of the renewal date.

PREMIUMS/PAYMENT Must the premium be paid all at once, or can I pay over time?

Can I add endorsements, change approved teaching staff, or add additional insureds after I purchase my policy?

All policies require payment in full at the time of enrollment.

All premiums are fully earned, and there are no refunds.

Yes, changes can be made at any time. You can add or purchase endorsements or riders, add/remove staff or add/remove additional named insureds. Contact a liability representative for assistance.

Is premium financing available?

Yes, a third-party finance company provides premium financing for the group professional liability and general liability products. This requires a separate application. If approved, there is a 25% deposit and the balance is paid in 9 installments. The interest rate is set by the finance company and does not benefit DAN. There is no financing available for the purchase of individual professional liability insurance.

RENEWALS When do I need to renew my liability policy?

If you want continuous coverage, you need to renew no later than the day before your existing policy expires. Renewal notices will be sent to remind you; however, you can renew as late as the day before your policy is due to expire to keep your coverage without lapsing. There is no grace period.

DAN.org/Liability

5

I am a DAN member; do I get a discount?

How do I access my proof of liability coverage?

Yes, as a DAN member, you are eligible to receive a discount on each of the policies sold by DAN RRG. If you need to renew your DAN membership or sign up, you can do so at DAN.org/Join. To receive the DAN member discount rate on group professional liability, all dive professionals under the policy must have an active individual/family DAN membership.

Upon payment of your premium, your liability documents will be sent to the email address on your application. You will be provided with a Declarations Page which describes the coverage you have purchased. If you have listed additional insureds, they will be provided with a separate certificate of insurance. Once your policy goes into effect, you can also log in to your account at DAN.org/Liability to print your declaration page and insurance card at any time.

SUPPORT

How do I file a liability claim?

What risk mitigation programs, products or services do you offer?

Complete an incident report to gather the relevant information. Once this is done, call +1-800-446-2671 or +1-919-684-2948 and speak with one of the customer service representative for the DAN liability program, or email the report to LiabilityClaims@DAN.org. If the incident involves a fatality or serious bodily injury, please contact a DAN representative immediately at +1-800-684-9111 so that we can take steps to protect your interests.

A variety of risk mitigation programs are available, including the following: 1. Brochures and other materials on diving safety,

available in print and digital 2. Hazard Identification and Risk Assessment

(HIRA) – 3 levels (2 are self-assessments) 3. Prepared Diver Course (e-learning program which

Whom do I contact if I have questions?

reminds divers of the causes of diving accidents) 4. Complementary student insurance (to offset the

For liability insurance questions, contact a member of our liability insurance team by phone at +1-919-490-2934 or by email at Liabilitylnsurance@DAN.org.

cost of an injury to your student) 5. DIDS Boards (to count divers on the boat) 6. Oxygen and first aid kits, and training, to respond

For boat & vessel or commercial property insurance questions, contact Sam Ryan at JKJ, +1-215-579-6419.

to injuries

Will my training agency be notified that I have purchased a liability insurance policy?

Yes, all designated training agencies will be notified about your purchase of liability insurance; no action is required by you. However, additional insureds will only be notified at your request.

DAN.org/Liability

6

CUSTOMER SERVICE

INCIDENTS AND CLAIMS

DAN RRG’s Liability Insurance team is ready to help you protect yourself or your business.

Collect all relevant information and send it to DAN RRG. If the incident involves a fatality or serious bodily injury, contact us immediately.

Monday–Friday, 8:30 a.m.–5 p.m. ET +1 (800) 446-2671 FAX: +1 (919) 490-2935

Monday–Friday, 8:30 a.m.–5 p.m. ET +1 (800) 446-2671

EMAIL: LiabilityInsurance@DAN.org

EMAIL: LiabilityClaims@DAN.org

Subject to the terms, conditions, and limitations of DAN Risk Retention Group Policy PL109 (May 1, 2022), GL109 (May 1, 2022) and GPL109 (May 1, 2022).

Coverage may vary and may not be available in all states, countries, or territories. Financing subject to loan approval. RRG-05012022-SPO

PROFESSIONAL LIABILITY INSURANCE FOR PROFESSIONALS UNDER A GROUP POLICY 2022/2023 APPLICATION DAN.org/Liability

1

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION

APPLICATION INSTRUCTIONS DAN PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY

STEP 1.

Fill out this application completely. All individuals seeking Professional Liability under a Group Policy must fill out this application, including the policyholder. Professionals must have an affiliation with the policyholder.

STEP 2.

Return the completed application to: Email: LiabilityInsurance@DAN.org Fax: 1-919-490-2935 Mail: Divers Alert Network

Attn: Risk Retention Group

6 W. Colony Pl.

Durham, NC 27705

FOR APPLICATION ASSISTANCE Email: LiabilityInsurance@DAN.org Phone: +1-919-684-2948

2

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION

PERSONAL INFORMATION: (PRINT OR TYPE) Dive Operator/Center Name Training Agency

Training Agency ID#

Legal First Name

Last Name

Street Address City

State/Province

Zip/Postal

Home Phone

Country

Cell Phone/Other

E-mail Personal DAN Member# Please send a copy of your dive professional certification to LiabilityInsurance@DAN.org or by fax to +1-919-490-2935

COVERAGES: (CHECK THOSE THAT APPLY) Please send a copy of your dive professional certification to LiabilityInsurance@DAN.org or by fax to +1 (919) 490-2935 HIGHEST LEVEL OF CERTIFICATION

 Instructor

 Divemaster In Training

 Retired Divemaster

 Assistant Instructor

 Skin Diving

 Skin Diving Instructor

 Instructor In Training

 Swimming Instructor

 Assistant Instructor (Tail Coverage)

 Divemaster

 Retired (Inactive Instructor)

 Freedive Instructor

OPTIONAL TRAINING MUST ALSO BE SELECTED BY POLICY OWNER FOR COVERAGE TO APPLY

 Technical Dive Training Manufacturer Name

 Rebreather Model

Certification #

Training Agency

3

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION

KNOWN CLAIM DECLARATION Each Applicant must complete and sign one of the following claims declarations. Read carefully and complete either 1 (No Claims Declaration) or 2 (Disclosure of Known Claim), not both.

NO CLAIMS DECLARATION/INCIDENT I,

, have no knowledge of any incident, accident, occurrence, act, error, or omission

(collectively “Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any

known Event to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the under¬writers any information pertinent to the investigation of any Event, legal action or claim.

Signed

Date:

(dd/mm/yyyy)

DISCLOSURE OF KNOWN CLAIM/INCIDENT I,

, have knowledge of an incident, accident, occurrence, act, error, or omission (collectively

“Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any

known Event to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the under¬writers any information pertinent to the investigation of any Event, legal action or claim.

Signed

Date:

Name of Any Person Injured:

(dd/mm/yyyy)

Name of Dive Professional: Date of Incident:

Incident Report Filed: Yes No

If yes, how can DAN Services obtain a copy Fatality: Yes No

Serious Injury: Yes No

Amount of Loss (with defense cost)

In Training: Yes No Insurance Carrier

Location of Incident Brief Summary of Incident

Signed Date:

Please send supporting claim/incident documentation to: liabilityinsurance@DAN.org or fax to 919-490-2935 4

(dd/mm/yyyy

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION

DECLARATION SECTION Applicant must complete and sign this Declaration Section. Read carefully, check the boxes next to those statements and sign where indicated.

The information you disclose and the answers given by you to the specific questions in the Application form will be treated by the Underwriters as applying to each person or legal entity seeking coverage, including each principal, partner or director.

Please confirm the following with a check.

I declare and warrant that I have read and understood the Application and that after full examination, all statements and particulars contained in the Application and any attachments are true and correct and that no information whatsoever has been withheld that might increase the risk of the Underwriters or influence the acceptance of this Application and should the above particulars change in any way, I will advise the Underwriters immediately.

I declare and warrant that I have read and understand the Application and that after full examination, all statements and particulars contained in the Application and any attachments are true and correct and that no information whatsoever has been withheld that might increase the risk of the Underwriters or influence the acceptance of this Application and should the above particulars change in any way, I will advise the Underwriters immediately.

I understand that failure to disclose any material facts, which would be likely to influence the acceptance and assessment of the Application, may result in the Underwriters refusing to provide indemnity or cancelling the policy in every respect.

I hereby agree and accept that this Declaration and the other parts of this Application shall be the basis of the contract between both parties if entered into and shall become a part of the contract of insurance.

I hereby agree and accept that this is a Claims Made policy and that I am required to provide immediate written notice to the party designated in the policy of any incident, accident, occurrence, act, error, or omission that might lead to a claim, and that failure to provide such written notice may result in a denial of coverage under the policy.

I acknowledge and accept that this coverage is provided by DAN Risk Retention Group, INC. and understand that the carrier is not required to be licensed in our State of domicile, but is allow to do business in our State on a non-admitted and unlicensed basis.

I hereby acknowledge and declare that I have never been declined professional liability insurance, have never had a policy cancelled or non-renewed, and have never had special terms imposed.

I hereby acknowledge and declare that I have never had my membership or credentials suspended, annulled or removed by any dive instructor association or training agency and I understand that coverage will only be effective as long as my professional membership is current or I am in training with a recognized dive instructor association or training agency.

I acknowledge and accept that I am covered only for incidents/claims that arise from providing Professional Services I provide on behalf of the Named Insured.

I acknowledge and declare that I have read, understand and accept the Fraud Warning as set forth on page 6 of the Application.

I acknowledge and declare that I have read, understand and accept the Exclusions as set forth on page 7–14 of the Application. **NOTICE** This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for your risk retention group.

Full Name of Applicant

Signed

Date:

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First Name

Last Name

Date of Birth

(dd/mm/yyyy)

PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION

FRAUD WARNING GENERAL STATEMENT: Any person who, with the intent to defraud or knowingly facilitates a fraud against an insurer, submits an ap- plication or files a claim containing a false or deceptive statement, or conceals information for the purpose of misleading may be guilty of insurance fraud and subject to criminal and/or civil penalties.

AK, AL, AR, CA, CT, DC, DE, GA, IA, ID, IN, IL, MA, MO, MS, MT, NC, ND, NE, NJ, NH, NM, ND, OK, PA, RI, TN, TX, WI (GROUP) - Fraud Warning: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, is guilty of insurance fraud, which is a felony and subject to criminal and/or civil penalties MD, ME, WA, NY, MN, SD, UT (INDEPENDENTLY) – Fraud Warning: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, maybe guilty of insurance fraud, which is a felony and maybe subject to criminal and/or civil penalties.

Notice to Colorado: It is unlawful to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policy holder or claim- ant for the purpose of defrauding or attempting to defraud the policy holder or claimant with regard to a settlement or aware payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.

Notice to Florida: Any person who knowingly and with intent to injure, defraud or deceive any insurer, files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.

Notice to Hawaii: For your protection, Hawaii law requires you to be informed that presenting a fraudulent claim for payment of a loss or benefit is a crime punishable by fines or imprisonment or both.

Notice to Idaho: Any person who knowingly and with intent to defraud or deceive any insurance company, files a statement or claim containing a false, incomplete or misleading information is guilty of a felony.

Notice to Indiana: Any person who knowingly makes any false or fraudulent statement or presentation in or with reference to any application for life insurance or for the purpose of obtaining any fee, omission, money or benefit from or in any company transacting business under this article, commits a class A misdemeanor.

Notice to Kentucky: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

Notice to Louisiana: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false infor- mation in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

Notice to New York: Any person who knowingly and with intent to defraud an insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.

Notice to Ohio: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

Notice to Oklahoma: Any person who knowingly, and with intent to injure, defraud or deceive any insurer makes any claim for the proceeds of an insurance policy containing any false, incomplete, or misleading information is guilty of a felony.

Notice to Oregon: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, may be guilty of insurance fraud, which may be a crime and may be subject to criminal and/or civil penalties.

Notice to Pennsylvania: Any person who knowingly and with intent to defraud any insurance company or other person files an application for in- surance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

Notice to Virginia: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of de-frauding the company. Penalties include imprisonment, fines and denial of insurance benefits.

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First Name

Last Name

Date of Birth

(dd/mm/yyyy)

PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION

EXCLUSIONS EXCLUSIONS RELATED TO PROFESSIONAL STANDARDS AND CONDUCT No coverage is provided for any CLAIM: 1. Arising out of any EVENT involving any swimming or diving activities in which the INSURED was not an active member in good standing with the applicable certification agency or agencies through which the training or supervision was offered at the time of the EVENT; 2. Arising out of any EVENT involving any training or supervisory dive or swim activity conducted by the INSURED that fails to meet the standards of the applicable certification training agency or agencies through which the training or supervision was offered, provided that the failure to meet the standard was a contributing cause of the EVENT, and specifically including but not limited to the following; a. any EVENT involving a training dive where an INSURED intentionally left or permitted any uncertified student to be unsupervised, however, this exclusion does not apply to a navigation exercise on the second or subsequent training dives after the INSURED has evaluated the student’s required skills, or a situation where the INSURED is responding to an emergency situation; or b. any EVENT involving a training dive for anyone under the age of 10, except those courses that are taught in confined water only (e.g. swimming pools) and such may be offered to anyone age 7 and older; or c. any EVENT involving an introductory/discover scuba experience (any program designed to introduce uncertified divers to SCUBA diving via a supervised, controlled open water experience) that was not within the standards of either the Recreational SCUBA Training Council (RSTC) or the certification agency under which the introductory experience was offered; 3. Arising out of any diving activity that is not planned as a RECREATIONAL DIVE (defined as dives planned to 130 feet or shallower, planned without mandatory stage decompression, and made using compressed air or oxygen enriched air ‘nitrox’ only), however this exclusion shall not apply to an INSURED who is engaged in the instruction or supervision of technical diving, provided the INSURED (i) has disclosed to the Underwriter that he or she is a technical diver, (ii) has been properly trained in technical diving and the equipment being used, (iii) has credentials to teach or supervise technical diving on the type of equipment being used at the time of the EVENT, and (iv) is engaged in a dive planned to a depth less than 330’ using air, nitrox, helium or trimix.

4. Involving an INSURED who does not have appropriate training and/or all appropriate certifications (including first aid training, when required) to teach the course or supervise the dive or swim activity which resulted in the EVENT, specifically including but not limited to an EVENT involving technical training and/or technical training dives where the INSURED is not a technically certified professional or where the INSURED is a technically certified professional but exceeds the depths for which the INSURED is trained and certified to teach and/or supervise.

5. Where the INSURED a. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed medical history form prior to in-water training; or b. allows a person to participate where the medical history form of that PARTICIPANT reveals a medical condition that is contraindicated for safe participation in any in-water activities and the PARTICIPANT has not provided a medical release from a physician or other licensed medical professional qualified to provide such a release (who is not the PARTICIPANT or the parent and/or legal guardian of a PARTICIPANT) approving the proposed in-water activity prior to any in-water training or supervision; or c. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed and signed written release of liability and assumption of risk in a form approved by the certification agency through which the training or supervision was offered and naming the INSURED as a released party; or d. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed and signed written release of liability and assumption of risk which acknowledges that some dive sites are remote, that a recompression chamber may not be readily available, and that the PARTICIPANT still wants to continue their training or diving and assume the risk in the absence of a recompression chamber; or e. fails to retain teaching records for each PARTICIPANT for a minimum of five (5) years, including records reporting the PARTICIPANT’s progress and results of knowledge tests for the purpose of evaluating the PARTICIPANT’s understanding of the instructional material.

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First Name

Last Name

Date of Birth

(dd/mm/yyyy)

PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION

EXCLUSIONS FOR ASBESTOS, LEAD, SILICA, POLLUTION, HAZARDOUS SUBSTANCES, RADIATION, AND NUCLEAR MATERIAL 1. Asbestos. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY in any way arising out of the use by any person or organization of or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; b. PROPERTY DAMAGE to real or personal property arising out of the use by any person or organization of asbestos, asbestos products, asbestos fibers or asbestos dust, including, without limitation, the costs incurred with respect to the removal or abatement of asbestos, asbestos products, asbestos fibers or asbestos dust from or in such real or personal property; c. Any obligation of the INSURED to indemnify any party because of damage arising out of such PROPERTY DAMAGE, BODILY INJURY, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury, arising out of the manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; or d. Any obligation to defend any suit or CLAIM against the INSURED alleging BODILY INJURY, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury or PROPERTY DAMAGE resulting from or contributed to, by any and all manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust.

2. Lead. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY or PROPERTY DAMAGE, arising in whole or in part, either directly or indirectly, out of the manufacture, distribution, sale, resale, re-branding, installation, repair, removal, encapsulation, abatement, replacement or handling of, explore to, ingestion of or testing for, lead whether or not the lead is or was at any time airborne as a particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatsoever; b. The costs of clean up or removal of lead or products and materials containing lead; c. The costs of such actions as may be necessary to monitor, assess and evaluate the release or threat of same, or lead or products and material containing lead; d. The cost of disposal of lead substances or the taking of such other action as may be necessary to temporarily or permanently prevent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; e. The cost of compliance with any law or regulation regarding lead.

3. Silica. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY or PROPERTY DAMAGE or any other loss, cost or expense arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form; or b. Any obligation of the INSURED to defend and/or indemnify any party because of damages arising out of such BODILY INJURY or PROPERTY DAMAGE arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form.

4. Pollution and Hazardous Substances. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY, PROPERTY DAMAGE, or any other loss, damage, cost or expense, or b. any increase in insured loss, damage, cost or expense, or c. any loss, damage, cost, expense, fine or penalty, which is incurred, sustained or imposed by order, direction, instruction or request of, or by any agreement with, any court, government agency or any public, civil or military authority; or threat thereof, (and whether or not as a result of public or private litigation), which arises from: i. any kind of seepage or any kind of pollution and/or contamination, or threat thereof, whether or not caused by or resulting from a peril insured, or from steps or measures taken in connection with the avoidance, prevention, abatement, mitigation, remediation, clean-up or removal of such seepage or pollution and/or contamination or threat thereof; or ii. relates to the actual, alleged or threatened discharge, dispersal, release or escape of POLLUTANTS, however caused or whenever or wherever happening; or

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Date of Birth

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PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION iii. any request, demand or liability to test for, monitor, clean-up, remove, contain, treat, detoxify or neutralize POLLUTANTS, whether or not any of the foregoing are or should be performed by the INSURED or by another.

The term ‘any kind of seepage or any kind of pollution and/or contamination’ as used herein includes, but is not limited to: i. seepage of, or pollution and/or contamination by, anything, including but not limited to, any material designated as a ‘hazardous substance’ by the United States Environmental Protection Agency or as a ‘hazardous material’ by the United States Department of Transportation, or defined as a ‘toxic substance’ by the Canadian Environmental Protection Act for the purposes of Part II of that Act, or any substance designated or defined as toxic, dangerous, hazardous or deleterious to persons or the environment under any other Federal, State, Provincial, Municipal or other law, ordinance or regulation; and, ii. the presence, existence, or release of anything which endangers or threatens to endanger the health, safety or welfare of persons or the environment.

The term “Pollutants” as used herein includes but is not limited to, any electromagnetic transmissions or fields, or any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals, and waste, including medical waste. Waste also includes materials to be recycled, reconditioned or reclaimed.

5. Pathogens or Harmful Biological or Chemical Materials. No coverage is provided for any CLAIM arising out of BODILY INJURY, PROPERTY DAMAGE, or any other loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or arising in connection with the actual or suspected presence of pathogenic or harmful biological or chemical materials, including bacteria, fungi, viruses and proteins, regardless of any other cause or event contributing concurrently or in any other sequence thereto.

6. Radiation and Nuclear Material. This policy does not apply: a. To claims under any Coverage that are in any way caused or contributed to by nuclear reaction, nuclear radiation or radioactive contamination. b. Under any Liability Coverage, to BODILY INJURY, PROPERTY DAMAGE or any other injury, sickness, disease, death or destruction: i. with respect to which an INSURED under the policy is also an insured under a nuclear energy liability policy issued

by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insurance Association of Canada, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or ii. resulting from the hazardous properties of nuclear material and with respect to which (1) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (2) the INSURED is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any person or organization. c. Under any Medical Payments Coverage, or under any Supplementary Payments Provision relating to immediate medical or surgical relief, to expenses incurred with respect to bodily injury, sickness, disease or death resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. d. Under any Liability Coverage, to injury, sickness, disease, death or destruction resulting from the hazardous properties of nuclear material, if: i. the nuclear material (1) is at any nuclear facility owned by, or operated by or on behalf of, an INSURED or (2) has been discharged or dispersed therefrom; ii. the nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed, stored, transported or disposed of by or on behalf of an INSURED; or iii. the injury, sickness, disease, death or destruction arises out of the furnishing by an INSURED of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility, but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (c) applies only to injury to or destruction of property at such nuclear facility.

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PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION e. To (i) any loss or destruction of or damage to any property whatsoever or any loss or expense whatsoever resulting or arising therefrom or any consequential loss; or, (ii) any legal liability of whatsoever nature directly or indirectly caused by or contributed to by or arising out of: i. ionizing radiations or contamination by radioactivity form any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel; or ii. ithe radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof. f. In relation to liability arising outside the U.S.A., its Territories or Possessions, Puerto Rico or the Canal Zone, this policy does not cover liability of whatsoever nature directly or indirectly caused by or contributed to by or arising out of ionizing radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel.

As used in this section: “hazardous properties” include radioactive, toxic or explosive properties; “nuclear material” means source material, special nuclear material or by-product material; “source material”, “special nuclear material”, and “by-product material” have the meanings given them in the Atomic Energy Act 1954 or in any law amendatory thereof; “spent fuel” means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor; “waste” means any waste material (1) containing by-product material and resulting from the operation by any person or organization of any nuclear facility included within the definition of nuclear facility under paragraph (i) or (ii) thereof; “nuclear facility” means: i. any nuclear reactor, ii. iany equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing spent fuel, or (3) handling, processing or packaging waste, iii. iiany equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the INSURED at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235, iv. any structure, basin, excavation, premises or place prepared or used for the storage or disposal of waste, and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations; “nuclear reactor” means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material. With respect to injury to or destruction of property, the word “injury” or “destruction” includes all forms of radioactive contamination of property.

7. Communicable Disease. No coverage is provided for any CLAIM arising out of BODILY INJURY, PROPERTY DAMAGE or any other actual or alleged loss, liability, damage, compensation, injury, sickness, disease, death, medical payment, defense cost, cost, expense or any other amount, directly or indirectly and regardless of any other cause contributing concurrently or in any sequence, originating from, caused by, arising out of, contributed to by, resulting from, or otherwise in connection with a COMMUNICABLE DISEASE or the fear or threat (whether actual or perceived) of a COMMUNICABLE DISEASE. A COMMUNICABLE DISEASE means any disease which can be transmitted by means of any substance or agent from any organism to another organism where: a. the substance or agent includes, but is not limited to, a virus, bacterium, fungus, parasite or other organism or any variation thereof, whether deemed living or not; and b. the method of transmission, whether direct or indirect, includes but is not limited to, airborne transmission, bodily fluid transmission, transmission from or to any surface or object, solid, liquid or gas or any other means of transmission between organisms; and c. the disease, substance or agent can cause or threaten BODILY INJURY, including but not limited to illness, emotional distress, or damage to human health or welfare, or PROPERTY DAMAGE.

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PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION

EXCLUSIONS FOR VIOLATION OF CIVIL AND CRIMINAL LAWS, RULES AND REGULATIONS No coverage is provided for any CLAIM: 1. Arising out of invasion of privacy, libel, slander or defamation of character, false arrest, detention or imprisonment, assault or battery, or wrongful entry or eviction, including any allegation that the violation of any civil right caused or contributed to such CLAIM. 2. Directly or indirectly attributed to any failure to comply with any applicable statute, regulation, ordinance, directive or order, provided that the failure to comply is an intentional, willful or deliberate act or omission of the INSURED. 3. Arising out of discrimination by the INSURED, including but not limited to discrimination on the basis of age, color, race, sex, sexual orientation, creed, national origin, marital status or mental or physical disability, however, this exclusion does not apply if services are denied for valid safety reasons, including but not limited to, concern over medical history, disability, or belief by the INSURED that a potential PARTICIPANT lacks the physical ability or mental aptitude to engage in swim or dive activities.

4. Arising out of infringement of trademark, trade dress, trade name, patent, copyright or other intellectual property rights.

5. Arising out of a criminal act.

6. Arising out of BODILY INJURY or PROPERTY DAMAGE caused by an INSURED while under the influence of alcohol, intoxicants, narcotics or any mind-altering substance.

7. Arising out of abuse or molestation, where “abuse or molestation” means: a. Actual or threatened abuse or molestation or licentious, immoral or sexual behavior whether or not intended to lead to, or culminating in any sexual act, whether caused by, or at the instigation of, or at the direction of, or omission by, the INSURED, an INSURED’s employee, or any other person, or b. Charges or allegations of negligent hiring, employment, investigation, supervision, reporting to the proper authorities, or failure to so report; or retention of a person for whom the INSURED is or ever was legally responsible and whose conduct could be described by a. above.

Abuse or Molestation includes, but is not limited to, negligent or intentional infliction or physical, emotional or psychological injury/harm; harassment of any type; lewd, immoral or sexual behavior, whether or not any such act is intended to lead to, or culminate in, any sexual act, whether caused by, at the instigation of, at the direction of, or as a result of any act or omission by the INSURED, his/her employees, patrons, PARTICIPANTS, or from any cause whatsoever.

8. involving any liability as respects access or disclosure of confidential or personal information or data-related liability, which shall mean damages, or loss, defense costs, other costs or expenses because of BODILY INJURY or PROPERTY DAMAGE arising directly or indirectly out of: a. Any access to or disclosure of any person’s or organization’s confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or b. The loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data.

This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, costs or expenses incurred by the INSURED or others arising out of that which is described in paragraph a. or b. above. Further, as used in this exclusion, “electronic data” means information, facts or programs stored as or on, created or used on, transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment.

9. Arising out of BODILY INJURY or PROPERTY DAMAGE arising out of any action or omission that violates or is alleged to violate: a. The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; b. The CAN-SPAM Act of 2003, including any amendment of or addition to such law;

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PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION c. The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transaction Act (FACTA); or d. Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information.

EXCLUSIONS FOR WAR AND TERRORISM No coverage is provided for any: 1. Liability directly or indirectly occasioned by, happening through, in consequence of or arising out of war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalization or requisition or destruction of or damage to property by or under the order of any government or public or local authority; or 2. Loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with, or arising out of any act of Terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss; or 3. Loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of Terrorism.

“Terrorism” means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or governments(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear. If the Underwriter alleges that due to Terrorism any loss, damage, cost or expense is not covered, the burden of proving the contrary shall be upon the INSURED. In the event any portion of this section on Terrorism is found to be invalid or unenforceable, the remainder shall remain in full force and effect.

EXCLUSION FOR EXPOSURE TO SANCTIONS No coverage is provided and no liability shall exist to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose the Underwriter or the reinsurers to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

ADDITIONAL EXCLUSIONS No coverage is provided for any CLAIM: 1. by an INSURED against another INSURED, however this exclusion does not apply to a CLAIM brought by an INSURED who was a PARTICIPANT during the EVENT that gave rise to the CLAIM; 2. arising out of BODILY INJURY to any employee of the INSURED arising out of and in the course of his/her employment by the INSURED, including any obligation to indemnify another in whole or in part for such BODILY INJURY, however this exclusion does not apply to any CLAIM brought by an employee who was a PARTICIPANT during the EVENT that gave rise to the CLAIM; 3. by an employer against an INSURED who is employed by or representing such employer; 4. arising out of liability assumed by an INSURED under any contract or agreement; 5. arising out of an EVENT occurring prior to the POLICY PERIOD, if prior to the effective date of the policy, the INSURED had a reasonable basis to foresee that a CLAIM would be made against them; 12

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Date of Birth

(dd/mm/yyyy)

PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION 6. arising out of an EVENT for which notice of the EVENT or a CLAIM was provided to another insurer prior to the start of the POLICY PERIOD; 7. arising out of an EVENT commencing prior to the POLICY PERIOD for which coverage is available under an occurrence based liability policy issued by the Underwriter or any other insurer; 8. arising out of any obligation for which the INSURED or any carrier as his/her insurer may be held liable under any worker’s compensation law, unemployment compensation or disability benefits law, or under any similar or related law (including occupational disease and cumulative trauma) including but not limited to the Jones Act, the Longshoremen and Harbor Workers Act, the Americans with Disabilities Act, and any civil rights laws or legislation; 9. arising out of any obligation for which the INSURED or any carrier as his/her insurer may be held liable under any employers’ liability law; 10. arising out of BODILY INJURY or PROPERTY DAMAGE expected or intended from the standpoint of the INSURED, however this exclusion does not apply to BODILY INJURY or PROPERTY DAMAGE resulting from the use of reasonable force to protect persons or property; 11. for any obligation to pay fines, judicial sanctions, penalties, punitive and/or exemplary damages, or multiples of compensatory damages, whether at common law or by statute; 12. based on the insolvency or bankruptcy of any person, firm or organization; 13. arising out of the function or failure of any product, including but not limited to RSSA, SCUBA, SNUBA and snorkeling equipment, regardless if owned, borrowed, rented or lent by an INSURED; 14. in any way involving potential or actual transmission of or exposure to Human Immunodeficiency Virus (HIV), hepatitis, or any other infectious disease or any complex or syndrome related thereto, or to any CLAIM in any way relating to the use or misuse or confidentiality of any information relating to HIV disease, hepatitis, or any other infectious disease, including the failure to disclose the health status of the INSURED; 15. directly or indirectly caused by, arising out of, resulting from or in connection with: a. any actual, alleged, or threat of infectious disease, including but not limited to diseases arising out of coronavirus, regardless of any other cause or event contributing concurrently or in any other sequence to the loss; b. any action taken or failure to take action in controlling, preventing, suppressing or in any way responding to such actual, alleged or threat of infectious disease; 16. arising out of any commercial or industrial diving activities, including but not limited to welding, construction, salvage, repair, maintenance, and inspection or fishing activities; however, this exclusion does not apply to public safety diving or scientific research activities; 17. arising out of navigation, towing, repair, storage, conversion, cleaning, demolition, wrecking, up righting, or salvage of any commercial vessel or oil rig, ship building and boat manufacturing, stevedoring, ship repair yards and dry docks; 18. arising out of off-shore and subaqueous work (other than PROFESSIONAL SERVICES provided by the INSURED); 19. arising out of the ownership, maintenance or use of the following premises or any property located on such premises: camps, campgrounds, recreational vehicle parks, or paintball fields; 20. arising out of premises or operations involving: (a) amusement parks or devices, carnivals or circuses, sports or other entertainment events, professional sports organizations, zoos, casinos, race tracks, or any theater, hall, arena, grandstand or stadium; (b) oil or gas pipelines, wells, or drilling operations; (c) all mining and quarrying operations; (d) bridges, tunnels, dams or reservoirs; (e) waste treatment, storage or disposal facilities, dumps or dumpsites, landfills; surface impoundments; waste lagoons; or waste sites;

13

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

PROFESSIONAL LIABILITY FOR PROFESSIONALS UNDER A GROUP POLICY APPLICATION 21. arising out of the ownership, maintenance, operation, use, loading or unloading or entrustment to others of any automobile, aircraft or watercraft, including alleged negligence or other wrongdoing in the supervision, employment, training or monitoring of others by the INSURED; however, this exclusion does not apply to the ingress and/or egress from any watercraft while any PARTICIPANT is under the INSURED’s supervision or instruction, or involving the operation of a kayak or paddleboard; 22. for PROPERTY DAMAGE to: a. property owned or occupied by or rented to the INSURED; b. Property used by the INSURED; or c. Property in the care, custody or control of the INSURED or property over which the INSURED is for any purpose exercising physical control (this exclusion does not apply to swimming pools rented by, used by, or occupied by the INSURED); or, 23. for BODILY INJURY or PROPERTY DAMAGE arising out of the ownership, maintenance, packing, handling, transportation, storage, igniting, operation, sponsorship, set-up or take-down or other use of: a. Firearms, including handguns, revolvers, pistols, rifles, shotguns, air guns, semi-automatic weapons and similar devices; b. Fireworks, including firecrackers, Roman Candles, flash powder, explosive compositions or combustible substances, pinwheels, skyrockets, ground displays, flares, smoke bombs, and similar devices that produce, when ignited or activated, sound, smoke, motion or a combination of these; c. Explosives, caps, primers, detonators, ammunitions, fuses, arms, magnesium, ammonium nitrate, nitroglycerin, celluloid, pyroxylin or other substances intended for use as an explosive; by the INSURED or by any person for which the INSURED may be held liable in any capacity, and no coverage is provided for any obligation of the INSURED to indemnify, defend or contribute jointly or severally with another because of BODILY INJURY or PROPERTY DAMAGE arising out of any of the activities specified paragraphs a., b. or c. above; or, 24. arising out of a CYBER LOSS. CYBER LOSS means any actual or alleged loss, damage, liability, injury, compensation, sickness, disease, death, medical payment, claim, cost, defense cost, expense or any other amount incurred by or accruing to the INSURED, including but not limited to any mitigation cost or statutory fine or penalty, directly or indirectly caused by, contributed to by, resulting from, arising out of or in connection with any CYBER INCIDENT. CYBER INCIDENT means: a. an unauthorized or malicious act or series of related unauthorized or malicious acts, regardless of time and place, or the threat or hoax thereof; or b. a failure to act, any error or omission or accident or series of related failures to act, errors or omissions or accidents; or c. a breach of duty, statutory duty or regulatory duty or trust or series of related breaches of duty, statutory duty or regulatory duty or trust;involving access to, processing of, use of or operation of any COMPUTER SYSTEM or any data by any person or group(s) of persons.

COMPUTER SYSTEM means any computer, hardware, software, information technology or communications system or electronic device, including any similar system or any configuration of the aforementioned and including any associated input, output or data storage device, networking equipment or backup facility.

25. arising out of any incident involving CYLINDER INSPECTION INSTRUCTION. CYLINDER INSPECTION INSTRUCTION means training given by a certified instructor in the performance of CYLINDER INSPECTION SERVICES. CYLINDER INSPECTONI SERVICES means any of the following activities: (a) visual or hydrostatic testing of high pressure cylinders; (b) oxygen cylinder cleaning; (c) eddy current testing; (d) cylinder valve repair; (e) HAZMAT handling of SCUBA or SCBA Cylinders; or (f) Operation of a cylinder fill station.

14

WHAT NOT TO DO (OVERVIEW) 1. Do not speculate or provide your opinion on

the incident 2. Do not speak with anyone until you consult

and attorney 3. Do not tamper with or disassemble dive gear

DON’T TAMPER WITH OR DISSASSEMBLE DIVE GEAR Place the dive gear in a secure area in exactly the same condition it was in when removed from the injured diver. Do not close the value or do anything else that would change the condition of the gear at the time of the incident.

unless directed by law enforcement

DON’T SPECULATE ON THE FACTS Do not speculate about or volunteer to anyone an opinion as to why the accident occurred or what led to the injury or death. Limit your statements to the facts as you know them. Do not make conjectures, and do not attempt to assign blame on anyone. Do not say, “It’s all my fault,” or words to that effect. Even if you have feelings of guilt, do not discuss them with others.

DON’T DELAY SPEAKING TO AN ATTORNEY Do not discuss the incident with anyone (other dive professionals, people at the scene, friends, family, etc.) until you have spoken with an attorney. Remember that anything you say can be repeated and used in a legal proceedings against you. If you discuss the incident with anyone, these individuals may be called as witnesses.

Your interest in minimizing adverse legal consequences in the wake of an accident need not be viewed as unfeeling or selfish. Ultimately the issue of fault revolves around the events leading up to the accident and the instructor’s conduct in the context of these events. An instructor should not risk inadvertently doing anything after the accident that could lead to interpretation of wrongdoing by the instructor.

These measures of self-protection are exercised in all business activities, and, in this context, scuba instruction is no different. Further, these realistic concerns need not be incompatible with any sincere feelings of concern, support and comfort that may need to be heard by the family of the injured person.

DAN.org/Liability

WHEN DOES AN INCIDENT BECOME A CLAIM? It is important to understand exactly what a claim is. A claim can be an oral or written notice to the instructor or their insurance company alleging the instructor’s responsibility for injury to a diver and claiming monetary damages.

A claim can consist of a letter from a lawyer or the service of legal papers showing that a lawsuit has been filed.

Although the instructor is required to notify the insurance company of a student injury, this notification is not technically considered a claim.

For practical purposes, however, the insurance company may consider a claim to be in effect if it is determined than an occurrence justifies further investigation.

SUBMITTING REPORTS TO DAN RRG All DAN RRG insureds are required to report an accident or incident via one of the following means: Phone DAN RRG Incident Response Hotline: +1-919-682-9111 Fax

+1-919-490-2935

Email LiabilityClaims@DAN.org If you have any questions about reporting an accident or incident to DAN RRG, or if you have knowledge of an accident or incident at which you were present, call +1-800-446-2671 (toll free in the U.S.) or +1-919-684-2948 (if outside the U.S.), 8:30 a.m. – 5:00 p.m. ET.

PROFESSIONAL LIABILITY INSURANCE 2022/2023 APPLICATION World.DAN.org/Liability

1

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION

DAN WORLD INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION Return the completed application to: Email: LiabilityInsurance@DAN.org Fax: 1-919-490-2935 Mail:

DAN Liability Insurance Attn: DAN World Insurance Group SP 6 W. Colony PL. Durham, NC 27705

For application assistance, please email LiabilityInsurance@DAN.org or phone 919-684-2948 Renewal?

Yes

No

PERSONAL INFORMATION: (PRINT OR TYPE) Training Agency

Training Agency ID#

Training Agency

Training Agency ID#

Legal First Name

Last Name

DAN Member

Street Address City

State/Province

Zip/Postal

Home Phone

Cell Phone/Other

Country

E-mail

Please send a copy of your dive professional certification to LiabilityInsurance@DAN.org or by fax to +1-919-490-2935

2

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION

COVERAGES: (CHECK THOSE THAT APPLY) PRICE

DAN MEMBER COST

NONMEMBER COST

$829

$869

$529

$569

$529

$569

$529

$569

$479

$519

$529

$569

$299

$339

$0

$0

$0

$0

 Instructor (Scuba)  Assistant Instructor/Instructor In Training (Scuba)  Divemaster/Divemaster In Training (Scuba)  Freediving Instructor  Mermaiding/Swimming Instructor  Tail Coverage (Retired Scuba Instructor)  Tail Coverage (Retired Divemaster) OPTIONS

 AAUS DO YOU PARTICIPATE IN THE FOLLOWING ACTIVITIES?

 Technical  Rebreather

$0

$0

Manufacturer Name

Model

Certification #

Training Agency Cost of insurance includes Premium, Filing Fees and Applicable Taxes, each of which will be itemized on the Declarations page provided to each insured. All Premium, Filing Fees and Taxes are fully earned.

Please indicate the preferred effective date (dd/mm/yyyy)

PAYMENT INFORMATION Credit Card Card Holder Information: (Print or Type) Card Type: (Check only one)  MasterCard

 VISA

 AMEX

 Discover

Card Holder Name

Billing Address City

State/Province

Card #

Expires:

Zip/Postal

Country

(Month/Year)

Card Holder Signature

CVS Code

There is no refund of premium, fees or taxes if an insured wishes to cancel coverage.

3

Total (USD) $

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION

KNOWN CLAIM DECLARATION Each Applicant must complete and sign one of the following claims declarations. Read carefully and complete either 1 (No Claims Declaration) or 2 (Disclosure of Known Claim), not both.

NO CLAIMS DECLARATION/INCIDENT I,

, have no knowledge of any incident, accident, occurrence, act, error, or omission

(collectively “Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any

known Event to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the under¬writers any information pertinent to the investigation of any Event, legal action or claim.

Signed

Date: (dd/mm/yyyy)

DISCLOSURE OF KNOWN CLAIM/INCIDENT I,

, have knowledge of an incident, accident, occurrence, act, error, or omission (collectively

“Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any

known Event to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the under¬writers any information pertinent to the investigation of any Event, legal action or claim.

Signed

Date: (dd/mm/yyyy)

Name of Any Person Injured:

Name of Dive Professional: Date of Incident:

Incident Report Filed: Yes No

If yes, how can DAN Services obtain a copy Fatality: Yes No

Serious Injury: Yes No

Amount of Loss (with defense cost)

In Training: Yes No Insurance Carrier

Location of Incident Brief Summary of Incident

Signed Date:

Please send supporting claim/incident documentation to: liabilityinsurance@DAN.org or fax to 919-490-2935 4

(dd/mm/yyyy

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION

SCHEDULE OF ADDITIONAL INSUREDS Each person or organization identified in this schedule is an additional INSURED, subject to the following: The coverage afforded to these additional INSUREDS is limited solely to “vicarious liability” of the additional INSURED that

is a specific and direct result of a negligent act, error or omission by the NAMED INSURED in rendering or failing to render PROFESSIONAL SERVICES. “Vicarious liability” as used in this endorsement means liability that is imposed on the additional INSURED solely by virtue of its relationship with the NAMED INSURED, and not due to any act, error or omission of the additional INSURED. This policy does not apply to any BODILY INJURY or PROPERTY DAMAGE arising from the act, error or omission of any

additional INSURED, when such act, error or omission is the sole or a contributing cause of the loss.

The additional INSURED is entitled to a defense under this policy only if the CLAIM against the additional INSURED relates

exclusively to the additional INSURED’s vicarious liability for the negligent act, error or omission of the NAMED INSURED in rendering or failing to render PROFESSIONAL SERVICES. If the CLAIM also includes allegations of negligent acts, errors, or omissions on the part of the additional INSURED or other third parties, this policy will cover only that portion of the total defense costs that can be directly attributable to matters that might lead to an award of damages under this policy.

In no event is the coverage provided to an additional INSURED broader than the underlying coverage provided to the NAMED

INSURED. Coverage is provided for an additional INSURED’s vicarious liability only if the negligent act, error or omission resulting in vicarious liability is covered under this policy.

In accordance with the terms and conditions of the policy and as more fully explained in the policy, as soon as practicable, each

INSURED must give us prompt notice of any occurrence which may result in a CLAIM, forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with all of the policy’s terms and conditions. Failure to comply with this provision may, at our option, result in the claim or “suit” being denied.

All INSUREDs share the Limits of Liability established by this policy. The provision of coverage to an additional INSURED does

not change or increase the Limits of Liability.

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

5

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

6

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION

DECLARATION SECTION Applicant must complete and sign this Declaration Section. Read carefully, check the boxes next to those statements and sign where indicated.

The information you disclose and the answers given by you to the specific questions in the Application form will be treated by the Underwriters as applying to each person or legal entity seeking coverage, including each principal, partner or director.

Please confirm the following with a check.

I declare and warrant that I have read and understood the Application and that after full examination, all statements and particulars contained in the Application and any attachments are true and correct and that no information whatsoever has been withheld that might increase the risk of the Underwriters or influence the acceptance of this Application and should the above particulars change in any way, I will advise the Underwriters immediately.

I understand that failure to disclose any material facts, which would be likely to influence the acceptance and assessment of the Application, may result in the Underwriters refusing to provide indemnity or cancelling the policy in every respect.

I hereby agree and accept that this Declaration and the other parts of this Application shall be the basis of the contract between both parties if entered into and shall become a part of the contract of insurance.

I hereby agree and accept that the Individual and the Group Professional Liability policies are Claims Made policies and that under both policies I am required to provide immediate written notice to the party designated in the policy of any incident, accident, occurrence, act, error, or omission that might lead to a claim, and that failure to provide such written notice may result in a denial of coverage under the policy.

I acknowledge and accept that this coverage is provided on an Excess and Surplus lines basis where the carrier is not required to be licensed in our domicile, but is allowed to do business on a non-admitted and unlicensed basis.

I hereby acknowledge and declare that I have never been declined professional liability insurance, have never had a policy cancelled or non-renewed, and have never had special terms imposed.

I hereby acknowledge and declare that I have never had my membership or credentials suspended, annulled or removed by any dive instructor association or training agency and I understand that coverage will only be effective as long as my professional membership is current or I am in training with a recognized dive instructor association or training agency.

I acknowledge and declare that I have read, understand and accept the Fraud Warning as set forth on page 8 of the Application.

I acknowledge and declare that I have read, understand and accept the Exclusions as set forth on pages 8–15 of the Application.

I acknowledge and accept that it is the duty of the Named Insured to timely notify all additional Insureds of ANY notice or change they receive from DAN World Insurance Group SP. All documents sent solely to the Named Insured are deemed by us as having been sent to all additional Insureds.

I acknowledge and accept that the coverage afforded additional INSUREDS is limited solely to “vicarious liability” of the additional INSURED that is a specific and direct result of a negligent act, error or omission by the NAMED INSURED or a member of the NAMED INSURED’s professional staff who qualifies as an INSURED in rendering or failing to render PROFESSIONAL SERVICES

Full Name of Applicant

Signed

Date:

7

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION

FRAUD WARNING GENERAL STATEMENT: Any person who, with the intent to defraud or knowingly facilitates a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement, or conceals information for the purpose of misleading may be guilty of insurance fraud and subject to criminal and/or civil penalties.

EXCLUSIONS EXCLUSIONS RELATED TO PROFESSIONAL STANDARDS AND CONDUCT No coverage is provided for any CLAIM: 1. Arising out of any EVENT involving any swimming or diving activities in which the INSURED was not an active member in good standing with the applicable certification agency or agencies through which the training or supervision was offered at the time of the EVENT; 2. Arising out of any EVENT involving any training or supervisory dive or swim activity conducted by the INSURED that fails to meet the standards of the applicable certification training agency or agencies through which the training or supervision was offered, provided that the failure to meet the standard was a contributing cause of the EVENT, and specifically including but not limited to the following; a. any EVENT involving a training dive where an INSURED intentionally left or permitted any uncertified student to be unsupervised, however, this exclusion does not apply to a navigation exercise on the second or subsequent training dives after the INSURED has evaluated the student’s required skills, or a situation where the INSURED is responding to an emergency situation; or b. any EVENT involving a training dive for anyone under the age of 10, except those courses that are taught in confined water only (e.g. swimming pools) and such may be offered to anyone age 7 and older; or c. any EVENT involving an introductory/discover scuba experience (any program designed to introduce uncertified divers to SCUBA diving via a supervised, controlled open water experience) that was not within the standards of either the Recreational SCUBA Training Council (RSTC) or the certification agency under which the introductory experience was offered; 3. Arising out of any diving activity that is not planned as a RECREATIONAL DIVE (defined as dives planned to 130 feet or shallower, planned without mandatory stage decompression, and made using compressed air or oxygen enriched air ‘nitrox’ only), however this exclusion shall not apply to an INSURED who is engaged in the instruction or supervision of technical diving, provided the INSURED (i) has disclosed to the Underwriter that he or she is a technical diver, (ii) has been properly trained in technical diving and the equipment being used, (iii) has credentials to teach or supervise technical diving on the type of equipment being used at the time of the EVENT, and (iv) is engaged in a dive planned to a depth less than 330’ using air, nitrox, helium or trimix.

4. Involving an INSURED who does not have appropriate training and/or all appropriate certifications (including first aid training, when required) to teach the course or supervise the dive or swim activity which resulted in the EVENT, specifically including but not limited to an EVENT involving technical training and/or technical training dives where the INSURED is not a technically certified professional or where the INSURED is a technically certified professional but exceeds the depths for which the INSURED is trained and certified to teach and/or supervise.

5. Where the INSURED a. fails to obtain from the PARTICIPANT(or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed medical history form prior to in-water training; or b. allows a person to participate where the medical history form of that PARTICIPANT reveals a medical condition that is contraindicated for safe participation in any in-water activities and the PARTICIPANT has not provided a medical release from a physician or other licensed medical professional qualified to provide such a release (who is not the PARTICIPANT or the parent and/or legal guardian of a PARTICIPANT) approving the proposed in-water activity prior to any in-water training or supervision; or c. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed and signed written release of liability and assumption of risk in a form approved by the certification agency through which the training or supervision was offered and naming the INSURED as a released party; or

8

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION d. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed and signed written release of liability and assumption of risk which acknowledges that some dive sites are remote, that a recompression chamber may not be readily available, and that the PARTICIPANT still wants to continue their training or diving and assume the risk in the absence of a recompression chamber; or e. fails to retain teaching records for each PARTICIPANT for a minimum of five (5) years, including records reporting the PARTICIPANT’s progress and results of knowledge tests for the purpose of evaluating the PARTICIPANT’s understanding of the instructional material.

EXCLUSIONS FOR ASBESTOS, LEAD, SILICA, POLLUTION, HAZARDOUS SUBSTANCES, RADIATION, AND NUCLEAR MATERIAL 1. Asbestos. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY in any way arising out of the use by any person or organization of or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; b. PROPERTY DAMAGE to real or personal property arising out of the use by any person or organization of asbestos, asbestos products, asbestos fibers or asbestos dust, including, without limitation, the costs incurred with respect to the removal or abatement of asbestos, asbestos products, asbestos fibers or asbestos dust from or in such real or personal property; c. Any obligation of the INSURED to indemnify any party because of damage arising out of such PROPERTY DAMAGE, BODILY INJURY, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury, arising out of the manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; or d. Any obligation to defend any suit or CLAIM against the INSURED alleging BODILY INJURY, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury or PROPERTY DAMAGE resulting from or contributed to, by any and all manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust.

2. Lead. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY or PROPERTY DAMAGE, arising in whole or in part, either directly or indirectly, out of the manufacture, distribution, sale, resale, re-branding, installation, repair, removal, encapsulation, abatement, replacement or handling of, explore to, ingestion of or testing for, lead whether or not the lead is or was at any time airborne as a particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatsoever; b. The costs of clean up or removal of lead or products and materials containing lead; c. The costs of such actions as may be necessary to monitor, assess and evaluate the release or threat of same, or lead or products and material containing lead; d. The cost of disposal of lead substances or the taking of such other action as may be necessary to temporarily or permanently prevent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; e. The cost of compliance with any law or regulation regarding lead.

3. Silica. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY or PROPERTY DAMAGE or any other loss, cost or expense arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form; or b. Any obligation of the INSURED to defend and/or indemnify any party because of damages arising out of such BODILY INJURY or PROPERTY DAMAGE arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form.

4. Pollution and Hazardous Substances. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY, PROPERTY DAMAGE, or any other loss, damage, cost or expense, or b. any increase in insured loss, damage, cost or expense, or

9

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION c. any loss, damage, cost, expense, fine or penalty, which is incurred, sustained or imposed by order, direction, instruction or request of, or by any agreement with, any court, government agency or any public, civil or military authority; or threat thereof, (and whether or not as a result of public or private litigation), which arises from: i. any kind of seepage or any kind of pollution and/or contamination, or threat thereof, whether or not caused by or resulting from a peril insured, or from steps or measures taken in connection with the avoidance, prevention, abatement, mitigation, remediation, clean-up or removal of such seepage or pollution and/or contamination or threat thereof; or ii. relates to the actual, alleged or threatened discharge, dispersal, release or escape of POLLUTANTS, however caused or whenever or wherever happening; or iii. any request, demand or liability to test for, monitor, clean-up, remove, contain, treat, detoxify or neutralize POLLUTANTS, whether or not any of the foregoing are or should be performed by the INSURED or by another.

The term ‘any kind of seepage or any kind of pollution and/or contamination’ as used herein includes, but is not limited to: i. seepage of, or pollution and/or contamination by, anything, including but not limited to, any material designated as a ‘hazardous substance’ by the United States Environmental Protection Agency or as a ‘hazardous material’ by the United States Department of Transportation, or defined as a ‘toxic substance’ by the Canadian Environmental Protection Act for the purposes of Part II of that Act, or any substance designated or defined as toxic, dangerous, hazardous or deleterious to persons or the environment under any other Federal, State, Provincial, Municipal or other law, ordinance or regulation; and, ii. the presence, existence, or release of anything which endangers or threatens to endanger the health, safety or welfare of persons or the environment.

The term “Pollutants” as used herein includes but is not limited to, any electromagnetic transmissions or fields, or any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals, and waste, including medical waste. Waste also includes materials to be recycled, reconditioned or reclaimed.

5. Pathogens or Harmful Biological or Chemical Materials. No coverage is provided for any CLAIM arising out of BODILY INJURY, PROPERTY DAMAGE, or any other loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or arising in connection with the actual or suspected presence of pathogenic or harmful biological or chemical materials, including bacteria, fungi, viruses and proteins, regardless of any other cause or event contributing concurrently or in any other sequence thereto.

6. Radiation and Nuclear Material. This policy does not apply: a. To claims under any Coverage that are in any way caused or contributed to by nuclear reaction, nuclear radiation or radioactive contamination. b. Under any Liability Coverage, to BODILY INJURY, PROPERTY DAMAGE or any other injury, sickness, disease, death or destruction: i. with respect to which an INSURED under the policy is also an insured under a nuclear energy liability policy issued

by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insurance Association of Canada, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or ii. resulting from the hazardous properties of nuclear material and with respect to which (1) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (2) the INSURED is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any person or organization. c. Under any Medical Payments Coverage, or under any Supplementary Payments Provision relating to immediate medical or surgical relief, to expenses incurred with respect to bodily injury, sickness, disease or death resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. d. Under any Liability Coverage, to injury, sickness, disease, death or destruction resulting from the hazardous properties of nuclear material, if: i. the nuclear material (1) is at any nuclear facility owned by, or operated by or on behalf of, an INSURED or (2) has been discharged or dispersed therefrom; 10

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION ii. the nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed, stored, transported or disposed of by or on behalf of an INSURED; or iii. the injury, sickness, disease, death or destruction arises out of the furnishing by an INSURED of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility, but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (c) applies only to injury to or destruction of property at such nuclear facility. e. To (i) any loss or destruction of or damage to any property whatsoever or any loss or expense whatsoever resulting or arising therefrom or any consequential loss; or, (ii) any legal liability of whatsoever nature directly or indirectly caused by or contributed to by or arising out of: i. ionizing radiations or contamination by radioactivity form any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel; or ii. the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof. f. In relation to liability arising outside the U.S.A., its Territories or Possessions, Puerto Rico or the Canal Zone, this policy does not cover liability of whatsoever nature directly or indirectly caused by or contributed to by or arising out of ionizing radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel.

As used in this section: “hazardous properties” include radioactive, toxic or explosive properties; “nuclear material” means source material, special nuclear material or by-product material; “source material”, “special nuclear material”, and “by-product material” have the meanings given them in the Atomic Energy Act 1954 or in any law amendatory thereof; “spent fuel” means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor; “waste” means any waste material (1) containing by-product material and resulting from the operation by any person or organization of any nuclear facility included within the definition of nuclear facility under paragraph (i) or (ii) thereof; “nuclear facility” means: i. any nuclear reactor, ii. any equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing spent fuel, or (3) handling, processing or packaging waste, iii. any equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the INSURED at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235, iv. any structure, basin, excavation, premises or place prepared or used for the storage or disposal of waste, and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations; “nuclear reactor” means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material. With respect to injury to or destruction of property, the word “injury” or “destruction” includes all forms of radioactive contamination of property.

7. Communicable Disease. No coverage is provided for any CLAIM arising out of BODILY INJURY, PROPERTY DAMAGE or any other actual or alleged loss, liability, damage, compensation, injury, sickness, disease, death, medical payment, defense cost, cost, expense or any other amount, directly or indirectly and regardless of any other cause contributing concurrently or in any sequence, originating from, caused by, arising out of, contributed to by, resulting from, or otherwise in connection with a COMMUNICABLE DISEASE or the fear or threat (whether actual or perceived) of a COMMUNICABLE DISEASE. A COMMUNICABLE DISEASE means any disease which can be transmitted by means of any substance or agent from any organism to another organism where: a. the substance or agent includes, but is not limited to, a virus, bacterium, fungus, parasite or other organism or any variation thereof, whether deemed living or not; and b. the method of transmission, whether direct or indirect, includes but is not limited to, airborne transmission, bodily fluid transmission, transmission from or to any surface or object, solid, liquid or gas or any other means of transmission between organisms; and c. the disease, substance or agent can cause or threaten BODILY INJURY, including but not limited to illness, emotional distress, or damage to human health or welfare, or PROPERTY DAMAGE. 11

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION

EXCLUSIONS FOR VIOLATION OF CIVIL AND CRIMINAL LAWS, RULES AND REGULATIONS No coverage is provided for any CLAIM: 1. Arising out of invasion of privacy, libel, slander or defamation of character, false arrest, detention or imprisonment, assault or battery, or wrongful entry or eviction, including any allegation that the violation of any civil right caused or contributed to such CLAIM. 2. Directly or indirectly attributed to any failure to comply with any applicable statute, regulation, ordinance, directive or order, provided that the failure to comply is an intentional, willful or deliberate act or omission of the INSURED. 3. Arising out of discrimination by the INSURED, including but not limited to discrimination on the basis of age, color, race, sex, sexual orientation, creed, national origin, marital status or mental or physical disability, however, this exclusion does not apply if services are denied for valid safety reasons, including but not limited to, concern over medical history, disability, or belief by the INSURED that a potential PARTICIPANT lacks the physical ability or mental aptitude to engage in swim or dive activities.

4. Arising out of infringement of trademark, trade dress, trade name, patent, copyright or other intellectual property rights.

5. Arising out of a criminal act.

6. Arising out of BODILY INJURY or PROPERTY DAMAGE caused by an INSURED while under the influence of alcohol, intoxicants, narcotics or any mind-altering substance.

7. Arising out of abuse or molestation, where “abuse or molestation” means: a. Actual or threatened abuse or molestation or licentious, immoral or sexual behavior whether or not intended to lead to, or culminating in any sexual act, whether caused by, or at the instigation of, or at the direction of, or omission by, the INSURED, an INSURED’s employee, or any other person, or b. Charges or allegations of negligent hiring, employment, investigation, supervision, reporting to the proper authorities, or failure to so report; or retention of a person for whom the INSURED is or ever was legally responsible and whose conduct could be described by a. above.

Abuse or Molestation includes, but is not limited to, negligent or intentional infliction or physical, emotional or psychological injury/ harm; harassment of any type; lewd, immoral or sexual behavior, whether or not any such act is intended to lead to, or culminate in, any sexual act, whether caused by, at the instigation of, at the direction of, or as a result of any act or omission by the INSURED, his/her employees, patrons, PARTICIPANTS, or from any cause whatsoever.

8. involving any liability as respects access or disclosure of confidential or personal information or data-related liability, which shall mean damages, or loss, defense costs, other costs or expenses because of BODILY INJURY or PROPERTY DAMAGE arising directly or indirectly out of: a. Any access to or disclosure of any person’s or organization’s confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or b. The loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data.

This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, costs or expenses incurred by the INSURED or others arising out of that which is described in paragraph a. or b. above. Further, as used in this exclusion, “electronic data” means information, facts or programs stored as or on, created or used on, transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment.

9. Arising out of BODILY INJURY or PROPERTY DAMAGE arising out of any action or omission that violates or is alleged to violate: a. The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; b. The CAN-SPAM Act of 2003, including any amendment of or addition to such law; c. The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transaction Act (FACTA); or 12

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION d. Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information.

EXCLUSIONS FOR WAR AND TERRORISM No coverage is provided for any: 1. Liability directly or indirectly occasioned by, happening through, in consequence of or arising out of war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalization or requisition or destruction of or damage to property by or under the order of any government or public or local authority; or 2. Loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with, or arising out of any act of Terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss; or 3. Loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of Terrorism.

“Terrorism” means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or governments(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear. If the Underwriter alleges that due to Terrorism any loss, damage, cost or expense is not covered, the burden of proving the contrary shall be upon the INSURED. In the event any portion of this section on Terrorism is found to be invalid or unenforceable, the remainder shall remain in full force and effect.

EXCLUSION FOR EXPOSURE TO SANCTIONS No coverage is provided and no liability shall exist to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose the Underwriter or the reinsurers to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

ADDITIONAL EXCLUSIONS No coverage is provided for any CLAIM: 1. by an INSURED against another INSURED, however this exclusion does not apply to a CLAIM brought by an INSURED who was a PARTICIPANT during the EVENT that gave rise to the CLAIM; 2. arising out of BODILY INJURY to any employee of the INSURED arising out of and in the course of his/her employment by the INSURED, including any obligation to indemnify another in whole or in part for such BODILY INJURY, however this exclusion does not apply to any CLAIM brought by an employee who was a PARTICIPANT during the EVENT that gave rise to the CLAIM; 3. by an employer against an INSURED who is employed by or representing such employer; 4. arising out of liability assumed by an INSURED under any contract or agreement; 5. arising out of an EVENT occurring prior to the POLICY PERIOD, if prior to the effective date of the policy, the INSURED had a reasonable basis to foresee that a CLAIM would be made against them; 6. arising out of an EVENT for which notice of the EVENT or a CLAIM was provided to another insurer prior to the start of the POLICY PERIOD; 7. arising out of an EVENT commencing prior to the POLICY PERIOD for which coverage is available under an occurrence based liability policy issued by the Underwriter or any other insurer; 13

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION 8. arising out of any obligation for which the INSURED or any carrier as his/her insurer may be held liable under any worker’s compensation law, unemployment compensation or disability benefits law, or under any similar or related law (including occupational disease and cumulative trauma) including but not limited to the Jones Act, the Longshoremen and Harbor Workers Act, the Americans with Disabilities Act, and any civil rights laws or legislation; 9. arising out of any obligation for which the INSURED or any carrier as his/her insurer may be held liable under any employers’ liability law; 10. arising out of BODILY INJURY or PROPERTY DAMAGE expected or intended from the standpoint of the INSURED, however this exclusion does not apply to BODILY INJURY or PROPERTY DAMAGE resulting from the use of reasonable force to protect persons or property; 11. for any obligation to pay fines, judicial sanctions, penalties, punitive and/or exemplary damages, or multiples of compensatory damages, whether at common law or by statute; 12. based on the insolvency or bankruptcy of any person, firm or organization; 13. arising out of the function or failure of any product, including but not limited to RSSA, SCUBA, SNUBA and snorkeling equipment, regardless if owned, borrowed, rented or lent by an INSURED; 14. in any way involving potential or actual transmission of or exposure to Human Immunodeficiency Virus (HIV), hepatitis, or any other infectious disease or any complex or syndrome related thereto, or to any CLAIM in any way relating to the use or misuse or confidentiality of any information relating to HIV disease, hepatitis, or any other infectious disease, including the failure to disclose the health status of the INSURED; 15. directly or indirectly caused by, arising out of, resulting from or in connection with: a. any actual, alleged, or threat of infectious disease, including but not limited to diseases arising out of coronavirus, regardless of any other cause or event contributing concurrently or in any other sequence to the loss; b. any action taken or failure to take action in controlling, preventing, suppressing or in any way responding to such actual, alleged or threat of infectious disease; 16. arising out of any commercial or industrial diving activities, including but not limited to welding, construction, salvage, repair, maintenance, and inspection or fishing activities; however, this exclusion does not apply to public safety diving or scientific research activities; 17. arising out of navigation, towing, repair, storage, conversion, cleaning, demolition, wrecking, up righting, or salvage of any commercial vessel or oil rig, ship building and boat manufacturing, stevedoring, ship repair yards and dry docks; 18. arising out of off-shore and subaqueous work (other than PROFESSIONAL SERVICES provided by the INSURED); 19. arising out of the ownership, maintenance or use of the following premises or any property located on such premises: camps, campgrounds, recreational vehicle parks, or paintball fields; 20. arising out of premises or operations involving: (a) amusement parks or devices, carnivals or circuses, sports or other entertainment events, professional sports organizations, zoos, casinos, race tracks, or any theater, hall, arena, grandstand or stadium; (b) oil or gas pipelines, wells, or drilling operations; (c) all mining and quarrying operations; (d) bridges, tunnels, dams or reservoirs; (e) waste treatment, storage or disposal facilities, dumps or dumpsites, landfills; surface impoundments; waste lagoons; or waste sites; 21. arising out of the ownership, maintenance, operation, use, loading or unloading or entrustment to others of any automobile, aircraft or watercraft, including alleged negligence or other wrongdoing in the supervision, employment, training or monitoring of others by the INSURED; however, this exclusion does not apply to the ingress and/or egress from any watercraft while any PARTICIPANT is under the INSURED’s supervision or instruction, or involving the operation of a kayak or paddleboard; 22. for PROPERTY DAMAGE to: a. property owned or occupied by or rented to the INSURED; b. Property used by the INSURED; or c. Property in the care, custody or control of the INSURED or property over which the INSURED is for any purpose exercising physical control (this exclusion does not apply to swimming pools rented by, used by, or occupied by the INSURED); or, 14

First Name

Last Name

Date of Birth

(dd/mm/yyyy)

INDIVIDUAL PROFESSIONAL LIABILITY APPLICATION 23. for BODILY INJURY or PROPERTY DAMAGE arising out of the ownership, maintenance, packing, handling, transportation, storage, igniting, operation, sponsorship, set-up or take-down or other use of: a. Firearms, including handguns, revolvers, pistols, rifles, shotguns, air guns, semi-automatic weapons and similar devices; b. Fireworks, including firecrackers, Roman Candles, flash powder, explosive compositions or combustible substances, pinwheels, skyrockets, ground displays, flares, smoke bombs, and similar devices that produce, when ignited or activated, sound, smoke, motion or a combination of these; c. Explosives, caps, primers, detonators, ammunitions, fuses, arms, magnesium, ammonium nitrate, nitroglycerin, celluloid, pyroxylin or other substances intended for use as an explosive; by the INSURED or by any person for which the INSURED may be held liable in any capacity, and no coverage is provided for any obligation of the INSURED to indemnify, defend or contribute jointly or severally with another because of BODILY INJURY or PROPERTY DAMAGE arising out of any of the activities specified paragraphs a., b. or c. above; or, 24. arising out of a CYBER LOSS. CYBER LOSS means any actual or alleged loss, damage, liability, injury, compensation, sickness, disease, death, medical payment, claim, cost, defense cost, expense or any other amount incurred by or accruing to the INSURED, including but not limited to any mitigation cost or statutory fine or penalty, directly or indirectly caused by, contributed to by, resulting from, arising out of or in connection with any CYBER INCIDENT. CYBER INCIDENT means: a. an unauthorized or malicious act or series of related unauthorized or malicious acts, regardless of time and place, or the threat or hoax thereof; or b. a failure to act, any error or omission or accident or series of related failures to act, errors or omissions or accidents; or c. a breach of duty, statutory duty or regulatory duty or trust or series of related breaches of duty, statutory duty or regulatory duty or trust; involving access to, processing of, use of or operation of any COMPUTER SYSTEM or any data by any person or group(s) of persons.

COMPUTER SYSTEM means any computer, hardware, software, information technology or communications system or electronic device, including any similar system or any configuration of the aforementioned and including any associated input, output or data storage device, networking equipment or backup facility.

25. arising out of any incident involving CYLINDER INSPECTION INSTRUCTION. CYLINDER INSPECTION INSTRUCTION means training given by a certified instructor in the performance of CYLINDER INSPECTION SERVICES. CYLINDER INSPECTONI SERVICES means any of the following activities: (a) visual or hydrostatic testing of high pressure cylinders; (b) oxygen cylinder cleaning; (c) eddy current testing; (d) cylinder valve repair; (e) HAZMAT handling of SCUBA or SCBA Cylinders; or (f) Operation of a cylinder fill station.

15

Photo by Kat DeStefano

GROUP PROFESSIONAL LIABILITY INSURANCE FOR YACHT CREW 2022/2023 APPLICATION DAN.org/Liability 1

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

DAN GROUP PROFESSIONAL LIABILITY APPLICATION Return the completed application to: Email: LiabilityInsurance@DAN.org Fax: 1-919-490-2935 Mail: DAN Liability Insurance

Attn: Risk Retention Group

6 W. Colony PL.

Durham, NC 27705 For help, please email DAN LiabilityInsurance at LiabilityInsurance@DAN.org or phone 919-684-2948 Renewal?

 Yes

No

BUSINESS INFORMATION: (PRINT OR TYPE) Primary Training Agency

Training Agency ID#

Legal Business Name Doing Business As DAN Business Member # Business Mailing Address City

State/Province

Zip/Postal

Country

Business Physical Address City

State/Province

Zip/Postal

Country

Cell

Business Phone 1

Business Fax

WEB Address

Maximum number of staff members working on each excursion PRIMARY CONTACT Legal Name

Family Name

Title

Email Phone #

Is owner of Business?

Yes

Nickname

No

SECONDARY CONTACT Legal Name

Family Name

Title

Email Phone #

Is owner of Business?

Yes

No

How long in business?

Business Type:

Nickname

 Corporation

Email Phone #  Partnership

LLC Proprietorship

2

Non-Profit

Other

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

GROUP POLICY DIVING ACTIVITIES PRIMARY ACTIVITY OF YOUR BUSINESS  Dive Shop

 Liveaboard

 Resort

Charter Boat

Other

Yacht/Boat Name: Average # of Charters/Year: 7 night

10 night

Maximum # of Guests per Charter

Typical Charter description: # nights

# days diving

# dives offered/day

Number of Dive Professionals (Instructors) (Dive Masters) Primary Area of Operation Type of Diving – Shore Diving Conditions:

%  Warm Water

Current

Visibility

Tender

%

Yacht

%

 Cold Water  <1 knot

 1-3 knot

 >3 knot

 <30 feet

 30’-100’

 >100’

Average Distance/Time From Dive Site to Local Medical Care:

minutes

SUPERVISED DIVING DEPTHS How many dives are done annually for each depth? < 100 ft Is Nitrox used in any of your recreational diving activities?

 Yes

distance

101–120 ft

> 120 ft

 No

TECHNICAL DIVING Does your business offer technical dive training?

 Yes

 No

Do you offer technical diving (decompression and mixed gas) activities outside of training?

 Yes

 No

REBREATHER DIVING Does your business offer rebreather training?

 Yes

 No

Do you offer rebreather diving activities outside of training?

 Yes

 No

DIVING ACCIDENT PROTECTION Do you require student medical coverage for all open water students?

Do you require dive accident insurance for divers?

 Yes

Do you require your dive professionals to be trained in:

 Yes

 No

 No

 Yes

 No

Who do you use for your first aid training?

PAST YEAR REVENUES Diving Activities $

3

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

SCHEDULE OF PROFESSIONAL STAFF Total number of professional staff included in your group liability policy: In this section you will add members of your instructional and/or supervisional staff to be included in your group policy. This may include dive instructors, dive masters, and swim instructors. Staff may be defined as those employed exclusively by your organization(i.e. and employee or an independent contractor that provides professional services to your customers on behalf of your business.

Please note that each professional staff member listed on the group policy, including the policyholder, will receive an electronic application that must be completed before being added to the group policy.

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

*Use another sheet if necessary.

4

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

SCHEDULE OF ADDITIONAL INSUREDS Each person or organization identified in this schedule is an additional INSURED, subject to the following: The coverage afforded to these additional INSUREDS is limited solely to “vicarious liability” of the additional INSURED that

is a specific and direct result of a negligent act, error or omission by the NAMED INSURED in rendering or failing to render PROFESSIONAL SERVICES. “Vicarious liability” as used in this endorsement means liability that is imposed on the additional INSURED solely by virtue of its relationship with the NAMED INSURED, and not due to any act, error or omission of the additional INSURED. This policy does not apply to any BODILY INJURY or PROPERTY DAMAGE arising from the act, error or omission of any

additional INSURED, when such act, error or omission is the sole or a contributing cause of the loss.

The additional INSURED is entitled to a defense under this policy only if the CLAIM against the additional INSURED relates

exclusively to the additional INSURED’s vicarious liability for the negligent act, error or omission of the NAMED INSURED in rendering or failing to render PROFESSIONAL SERVICES. If the CLAIM also includes allegations of negligent acts, errors, or omissions on the part of the additional INSURED or other third parties, this policy will cover only that portion of the total defense costs that can be directly attributable to matters that might lead to an award of damages under this policy.

In no event is the coverage provided to an additional INSURED broader than the underlying coverage provided to the NAMED

INSURED. Coverage is provided for an additional INSURED’s vicarious liability only if the negligent act, error or omission resulting in vicarious liability is covered under this policy.

In accordance with the terms and conditions of the policy and as more fully explained in the policy, as soon as practicable, each

INSURED must give us prompt notice of any occurrence which may result in a CLAIM, forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with all of the policy’s terms and conditions. Failure to comply with this provision may, at our option, result in the claim or “suit” being denied.

All INSUREDs share the Limits of Liability established by this policy. The provision of coverage to an additional INSURED does

not change or increase the Limits of Liability.

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

5

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

6

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

KNOWN CLAIM DECLARATION Each Applicant must complete and sign one of the following claims declarations. Read carefully and complete either 1 (No Claims Declaration) or 2 (Disclosure of Known Claim), not both.

NO CLAIMS DECLARATION/INCIDENT I,

, have no knowledge of any incident, accident, occurrence, act, error, or omission (collectively

“Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any known Event

to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the underwriters any information pertinent to the investigation of any Event, legal action or claim.

Signed

Date: (dd/mm/yyyy)

DISCLOSURE OF KNOWN CLAIM/INCIDENT I,

, have knowledge of an incident, accident, occurrence, act, error, or omission (collectively

“Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any known Event

to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the underwriters any information pertinent to the investigation of any Event, legal action or claim.

Signed

Date: (dd/mm/yyyy)

Name of Any Person Injured:

Name of Dive Professional: Date of Incident:

Incident Report Filed: Yes No

If yes, how can DAN Services obtain a copy Fatality: Yes No

Serious Injury: Yes No

Amount of Loss (with defense cost)

In Training: Yes No Insurance Carrier

Location of Incident Brief Summary of Incident

Signed Date:

Please send supporting claim/incident documentation to: liabilityinsurance@DAN.org or fax to 919-490-2935 7

(dd/mm/yyyy

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

DECLARATION SECTION Applicant must complete and sign this Declaration Section. Read carefully, check the boxes next to those statements and sign where indicated.

Your duty of disclosure information and the answers given by you to the specific questions in the Application form will be treated by the Underwriters as applying to each person or legal entity seeking coverage, including each principal, partner or director.

Please confirm the following with a check.

I declare and warrant that I have read and understood the Application and that after full examination, all statements and particulars contained in the Application and any attachments are true and correct and that no information whatsoever has been withheld that might increase the risk of the Underwriters or influence the acceptance of this Application and should the above particulars change in any way, I will advise the Underwriters immediately.

I understand that failure to disclose any material facts, which would be likely to influence the acceptance and assessment of the Application, may result in the Underwriters refusing to provide indemnity or cancelling the policy in every respect.

I hereby agree and accept that this Declaration and the other parts of this Application shall be the basis of the contract between both parties if entered into and shall become a part of the contract of insurance.

I hereby agree and accept that the Group Professional Liability policy is a Claims Made policy and that under the policy I am required to provide immediate written notice to the party designated in the policy of any incident, accident, occurrence, act, error, or omission that might lead to a claim, and that failure to provide such written notice may result in a denial of coverage under the policy.

I acknowledge and accept that this coverage is provided on an Excess and Surplus lines basis where the carrier is not required to be licensed in our State of domicile, but is allowed to do business in your State on a non-admitted and unlicensed basis.

I hereby acknowledge and declare that I have never been declined professional or general liability insurance, have never had a policy cancelled or non-renewed, and have never had special terms imposed.

I hereby acknowledge and declare that I have never had my membership or credentials suspended, annulled or removed by any dive instructor association or training agency and I understand that coverage will only be effective as long as my professional membership is current or I am in training with a recognized dive instructor association or training agency.

I acknowledge and declare that I have read, understand and accept the Fraud Warning as set forth on page 11 of the Application.

I acknowledge and declare that I have read, understand and accept the Exclusions as set forth on page 12–19 of the Application.

I acknowledge and accept that it is the duty of the Named Insured to timely notify all additional Insureds of ANY notice or change they receive from DAN Risk Retention Group. All documents sent solely to the Named Insured are deemed by us as having been sent to all additional Insureds.

I acknowledge and accept that the coverage afforded additional INSUREDS is limited solely to “vicarious liability” of the additional INSURED that is a specific and direct result of a negligent act, error or omission by the NAMED INSURED or a member of the NAMED INSURED’s professional staff who qualifies as an INSURED in rendering or failing to render PROFESSIONAL SERVICES I acknowledge and declare that I have read, understand and accept the Proxy on page 20 of this application as a condition of eligibility for coverage under the DAN RRG program.

I acknowledge and declare that I have read, understand and accept the Shareholders Agreement on page 21 of this application as a condition of eligibility for coverage under the DAN RRG program. **NOTICE** This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for your risk retention group.

Full Name of Applicant

Signed

Date:

8

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

COSTS AND FEES Cost of insurance includes Premium and Processing Fees, each of which will be itemized on the Declarations page provided to each insured. All Premium, Processing Fees and Taxes are fully earned.

There is no refund of fees and taxes if an insured wishes to cancel coverage.

All Instructors, Assistant Instructors, Divemasters and Retired Instructors included under a Group Professional Liability policy must complete a separate application. *Please visit the website to download application.

PREMIUM TOTALS Group Liability Premium

$

Total Premium (USD)

$

Please indicate the preferred effective date (dd/mm/yyyy):

PAYMENT OPTIONS  Check or Money Order # Make checks payable to: DAN Services.

Send to: DAN Liability Insurance, 6 W. Colony Place, Durham, NC 27705-9030  Premium Financing Federal Tax ID # or FEIN # Contact DAN Liability Insurance at LiabilityInsurance@DAN.org or 1-919-684-2948 for more information.

Credit card information is mandatory before finance agreement can be sent.  Credit Card Card Holder Information: (Print or Type) Card Type: (Check only one)

 MasterCard

 VISA

 AMEX

 Discover

Card Holder Name Billing Address City

State/Province

Card #

Expires:

Zip/Postal

Country

(Month/Year)

Card Holder Signature

CVS Code

9

Total (USD) $

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

FRAUD WARNING GENERAL STATEMENT: Any person who, with the intent to defraud or knowingly facilitates a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement, or conceals information for the purpose of misleading may be guilty of insurance fraud and subject to criminal and/or civil penalties.

AK, AL, AR, CA, CT, DC, DE, GA, IA, ID, IN, IL, MA, MO, MS, MT, NC, ND, NE, NJ, NH, NM, ND, OK, PA, RI, TN, TX, WI (GROUP) - Fraud Warning: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, is guilty of insurance fraud, which is a felony and subject to criminal and/or civil penalties MD, ME, WA, NY, MN, SD, UT (INDEPENDENTLY) – Fraud Warning: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, maybe guilty of insurance fraud, which is a felony and maybe subject to criminal and/or civil penalties.

Notice to Colorado: It is unlawful to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policy holder or claim- ant for the purpose of defrauding or attempting to defraud the policy holder or claimant with regard to a settlement or aware payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.

Notice to Florida: Any person who knowingly and with intent to injure, defraud or deceive any insurer, files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.

Notice to Hawaii: For your protection, Hawaii law requires you to be informed that presenting a fraudulent claim for payment of a loss or benefit is a crime punishable by fines or imprisonment or both.

Notice to Idaho: Any person who knowingly and with intent to defraud or deceive any insurance company, files a statement or claim containing a false, incomplete or misleading information is guilty of a felony.

Notice to Indiana: Any person who knowingly makes any false or fraudulent statement or presentation in or with reference to any application for life insurance or for the purpose of obtaining any fee, omission, money or benefit from or in any company transacting business under this article, commits a class A misdemeanor.

Notice to Kentucky: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

Notice to Louisiana: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false infor- mation in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

Notice to New York: Any person who knowingly and with intent to defraud an insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.

Notice to Ohio: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

Notice to Oklahoma: Any person who knowingly, and with intent to injure, defraud or deceive any insurer makes any claim for the proceeds of an insurance policy containing any false, incomplete, or misleading information is guilty of a felony.

Notice to Oregon: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, may be guilty of insurance fraud, which may be a crime and may be subject to criminal and/or civil penalties.

Notice to Pennsylvania: Any person who knowingly and with intent to defraud any insurance company or other person files an application for in- surance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

Notice to Virginia: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of de-frauding the company. Penalties include imprisonment, fines and denial of insurance benefits.

10

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

EXCLUSIONS EXCLUSIONS RELATED TO PROFESSIONAL STANDARDS AND CONDUCT No coverage is provided for any CLAIM: 1. Arising out of any EVENT involving any swimming or diving activities in which the INSURED was not an active member in good standing with the applicable certification agency or agencies through which the training or supervision was offered at the time of the EVENT; 2. Arising out of any EVENT involving any training or supervisory dive or swim activity conducted by the INSURED that fails to meet the standards of the applicable certification training agency or agencies through which the training or supervision was offered, provided that the failure to meet the standard was a contributing cause of the EVENT, and specifically including but not limited to the following; a. any EVENT involving a training dive where an INSURED intentionally left or permitted any uncertified student to be unsupervised, however, this exclusion does not apply to a navigation exercise on the second or subsequent training dives after the INSURED has evaluated the student’s required skills, or a situation where the INSURED is responding to an emergency situation; or b. any EVENT involving a training dive for anyone under the age of 10, except those courses that are taught in confined water only (e.g. swimming pools) and such may be offered to anyone age 7 and older; or c. any EVENT involving an introductory/discover scuba experience (any program designed to introduce uncertified divers to SCUBA diving via a supervised, controlled open water experience) that was not within the standards of either the Recreational SCUBA Training Council (RSTC) or the certification agency under which the introductory experience was offered; 3. Arising out of any diving activity that is not planned as a RECREATIONAL DIVE (defined as dives planned to 130 feet or shallower, planned without mandatory stage decompression, and made using compressed air or oxygen enriched air ‘nitrox’ only), however this exclusion shall not apply to an INSURED who is engaged in the instruction or supervision of technical diving, provided the INSURED (i) has disclosed to the Underwriter that he or she is a technical diver, (ii) has been properly trained in technical diving and the equipment being used, (iii) has credentials to teach or supervise technical diving on the type of equipment being used at the time of the EVENT, and (iv) is engaged in a dive planned to a depth less than 330’ using air, nitrox, helium or trimix.

4. Involving an INSURED who does not have appropriate training and/or all appropriate certifications (including first aid training, when required) to teach the course or supervise the dive or swim activity which resulted in the EVENT, specifically including but not limited to an EVENT involving technical training and/or technical training dives where the INSURED is not a technically certified professional or where the INSURED is a technically certified professional but exceeds the depths for which the INSURED is trained and certified to teach and/or supervise.

5. Where the INSURED a. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed medical history form prior to in-water training; or b. allows a person to participate where the medical history form of that PARTICIPANT reveals a medical condition that is contraindicated for safe participation in any in-water activities and the PARTICIPANT has not provided a medical release from a physician or other licensed medical professional qualified to provide such a release (who is not the PARTICIPANT or the parent and/or legal guardian of a PARTICIPANT) approving the proposed in-water activity prior to any in-water training or supervision; or c. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed and signed written release of liability and assumption of risk in a form approved by the certification agency through which the training or supervision was offered and naming the INSURED as a released party; or d. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed and signed written release of liability and assumption of risk which acknowledges that some dive sites are remote, that a recompression chamber may not be readily available, and that the PARTICIPANT still wants to continue their training or diving and assume the risk in the absence of a recompression chamber; or e. fails to retain teaching records for each PARTICIPANT for a minimum of five (5) years, including records reporting the PARTICIPANT’s progress and results of knowledge tests for the purpose of evaluating the PARTICIPANT’s understanding of the instructional material.

11

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

EXCLUSIONS FOR ASBESTOS, LEAD, SILICA, POLLUTION, HAZARDOUS SUBSTANCES,RADIATION, AND NUCLEAR MATERIAL 1. Asbestos. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY in any way arising out of the use by any person or organization of or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; b. PROPERTY DAMAGE to real or personal property arising out of the use by any person or organization of asbestos, asbestos products, asbestos fibers or asbestos dust, including, without limitation, the costs incurred with respect to the removal or abatement of asbestos, asbestos products, asbestos fibers or asbestos dust from or in such real or personal property; c. Any obligation of the INSURED to indemnify any party because of damage arising out of such PROPERTY DAMAGE, BODILY INJURY, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury, arising out of the manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; or d. Any obligation to defend any suit or CLAIM against the INSURED alleging BODILY INJURY, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury or PROPERTY DAMAGE resulting from or contributed to, by any and all manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust.

2. Lead. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY or PROPERTY DAMAGE, arising in whole or in part, either directly or indirectly, out of the manufacture, distribution, sale, resale, re-branding, installation, repair, removal, encapsulation, abatement, replacement or handling of, explore to, ingestion of or testing for, lead whether or not the lead is or was at any time airborne as a particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatsoever; b. The costs of clean up or removal of lead or products and materials containing lead; c. The costs of such actions as may be necessary to monitor, assess and evaluate the release or threat of same, or lead or products and material containing lead; d. The cost of disposal of lead substances or the taking of such other action as may be necessary to temporarily or permanently prevent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; e. The cost of compliance with any law or regulation regarding lead.

3. Silica. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY or PROPERTY DAMAGE or any other loss, cost or expense arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form; or b. Any obligation of the INSURED to defend and/or indemnify any party because of damages arising out of such BODILY INJURY or PROPERTY DAMAGE arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form.

4. Pollution and Hazardous Substances. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY, PROPERTY DAMAGE, or any other loss, damage, cost or expense, or b. any increase in insured loss, damage, cost or expense, or c. any loss, damage, cost, expense, fine or penalty, which is incurred, sustained or imposed by order, direction, instruction or request of, or by any agreement with, any court, government agency or any public, civil or military authority; or threat thereof, (and whether or not as a result of public or private litigation), which arises from: i. any kind of seepage or any kind of pollution and/or contamination, or threat thereof, whether or not caused by or resulting from a peril insured, or from steps or measures taken in connection with the avoidance, prevention, abatement, mitigation, remediation, clean-up or removal of such seepage or pollution and/or contamination or threat thereof; or ii. relates to the actual, alleged or threatened discharge, dispersal, release or escape of POLLUTANTS, however caused or whenever or wherever happening; or iii. any request, demand or liability to test for, monitor, clean-up, remove, contain, treat, detoxify or neutralize POLLUTANTS, whether or not any of the foregoing are or should be performed by the INSURED or by another.

12

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

The term ‘any kind of seepage or any kind of pollution and/or contamination’ as used herein includes, but is not limited to: i. seepage of, or pollution and/or contamination by, anything, including but not limited to, any material designated as a ‘hazardous substance’ by the United States Environmental Protection Agency or as a ‘hazardous material’ by the United States Department of Transportation, or defined as a ‘toxic substance’ by the Canadian Environmental Protection Act for the purposes of Part II of that Act, or any substance designated or defined as toxic, dangerous, hazardous or deleterious to persons or the environment under any other Federal, State, Provincial, Municipal or other law, ordinance or regulation; and, ii. the presence, existence, or release of anything which endangers or threatens to endanger the health, safety or welfare of persons or the environment.

The term “Pollutants” as used herein includes but is not limited to, any electromagnetic transmissions or fields, or any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals, and waste, including medical waste. Waste also includes materials to be recycled, reconditioned or reclaimed.

5. Pathogens or Harmful Biological or Chemical Materials. No coverage is provided for any CLAIM arising out of BODILY INJURY, PROPERTY DAMAGE, or any other loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or arising in connection with the actual or suspected presence of pathogenic or harmful biological or chemical materials, including bacteria, fungi, viruses and proteins, regardless of any other cause or event contributing concurrently or in any other sequence thereto.

6. Radiation and Nuclear Material. This policy does not apply: a. To claims under any Coverage that are in any way caused or contributed to by nuclear reaction, nuclear radiation or radioactive contamination. b. Under any Liability Coverage, to BODILY INJURY, PROPERTY DAMAGE or any other injury, sickness, disease, death or destruction: i. with respect to which an INSURED under the policy is also an insured under a nuclear energy liability policy issued

by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insurance Association of Canada, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or ii. resulting from the hazardous properties of nuclear material and with respect to which (1) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (2) the INSURED is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any person or organization. c. Under any Medical Payments Coverage, or under any Supplementary Payments Provision relating to immediate medical or surgical relief, to expenses incurred with respect to bodily injury, sickness, disease or death resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. d. Under any Liability Coverage, to injury, sickness, disease, death or destruction resulting from the hazardous properties of nuclear material, if: i. the nuclear material (1) is at any nuclear facility owned by, or operated by or on behalf of, an INSURED or (2) has been discharged or dispersed therefrom; ii. the nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed, stored, transported or disposed of by or on behalf of an INSURED; or iii. the injury, sickness, disease, death or destruction arises out of the furnishing by an INSURED of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility, but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (c) applies only to injury to or destruction of property at such nuclear facility. e. To (i) any loss or destruction of or damage to any property whatsoever or any loss or expense whatsoever resulting or arising therefrom or any consequential loss; or, (ii) any legal liability of whatsoever nature directly or indirectly caused by or contributed to by or arising out of: i. ionizing radiations or contamination by radioactivity form any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel; or ii. ithe radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.

13

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

f. In relation to liability arising outside the U.S.A., its Territories or Possessions, Puerto Rico or the Canal Zone, this policy does not cover liability of whatsoever nature directly or indirectly caused by or contributed to by or arising out of ionizing radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel.

As used in this section: “hazardous properties” include radioactive, toxic or explosive properties; “nuclear material” means source material, special nuclear material or by-product material; “source material”, “special nuclear material”, and “by-product material” have the meanings given them in the Atomic Energy Act 1954 or in any law amendatory thereof; “spent fuel” means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor; “waste” means any waste material (1) containing by-product material and resulting from the operation by any person or organization of any nuclear facility included within the definition of nuclear facility under paragraph (i) or (ii) thereof; “nuclear facility” means: i. any nuclear reactor, ii. iany equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing spent fuel, or (3) handling, processing or packaging waste, iii. iiany equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the INSURED at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235, iv. any structure, basin, excavation, premises or place prepared or used for the storage or disposal of waste, and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations; “nuclear reactor” means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material. With respect to injury to or destruction of property, the word “injury” or “destruction” includes all forms of radioactive contamination of property.

7. Communicable Disease. No coverage is provided for any CLAIM arising out of BODILY INJURY, PROPERTY DAMAGE or any other actual or alleged loss, liability, damage, compensation, injury, sickness, disease, death, medical payment, defense cost, cost, expense or any other amount, directly or indirectly and regardless of any other cause contributing concurrently or in any sequence, originating from, caused by, arising out of, contributed to by, resulting from, or otherwise in connection with a COMMUNICABLE DISEASE or the fear or threat (whether actual or perceived) of a COMMUNICABLE DISEASE. A COMMUNICABLE DISEASE means any disease which can be transmitted by means of any substance or agent from any organism to another organism where: a. the substance or agent includes, but is not limited to, a virus, bacterium, fungus, parasite or other organism or any variation thereof, whether deemed living or not; and b. the method of transmission, whether direct or indirect, includes but is not limited to, airborne transmission, bodily fluid transmission, transmission from or to any surface or object, solid, liquid or gas or any other means of transmission between organisms; and c. the disease, substance or agent can cause or threaten BODILY INJURY, including but not limited to illness, emotional distress, or damage to human health or welfare, or PROPERTY DAMAGE.

EXCLUSIONS FOR VIOLATION OF CIVIL AND CRIMINAL LAWS, RULES AND REGULATIONS No coverage is provided for any CLAIM: 1. Arising out of invasion of privacy, libel, slander or defamation of character, false arrest, detention or imprisonment, assault or battery, or wrongful entry or eviction, including any allegation that the violation of any civil right caused or contributed to such CLAIM. 2. Directly or indirectly attributed to any failure to comply with any applicable statute, regulation, ordinance, directive or order, provided that the failure to comply is an intentional, willful or deliberate act or omission of the INSURED.

14

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

3. Arising out of discrimination by the INSURED, including but not limited to discrimination on the basis of age, color, race, sex, sexual orientation, creed, national origin, marital status or mental or physical disability, however, this exclusion does not apply if services are denied for valid safety reasons, including but not limited to, concern over medical history, disability, or belief by the INSURED that a potential PARTICIPANT lacks the physical ability or mental aptitude to engage in swim or dive activities.

4. Arising out of infringement of trademark, trade dress, trade name, patent, copyright or other intellectual property rights.

5. Arising out of a criminal act.

6. Arising out of BODILY INJURY or PROPERTY DAMAGE caused by an INSURED while under the influence of alcohol, intoxicants, narcotics or any mind-altering substance.

7. Arising out of abuse or molestation, where “abuse or molestation” means: a. Actual or threatened abuse or molestation or licentious, immoral or sexual behavior whether or not intended to lead to, or culminating in any sexual act, whether caused by, or at the instigation of, or at the direction of, or omission by, the INSURED, an INSURED’s employee, or any other person, or b. Charges or allegations of negligent hiring, employment, investigation, supervision, reporting to the proper authorities, or failure to so report; or retention of a person for whom the INSURED is or ever was legally responsible and whose conduct could be described by a. above.

Abuse or Molestation includes, but is not limited to, negligent or intentional infliction or physical, emotional or psychological injury/harm; harassment of any type; lewd, immoral or sexual behavior, whether or not any such act is intended to lead to, or culminate in, any sexual act, whether caused by, at the instigation of, at the direction of, or as a result of any act or omission by the INSURED, his/her employees, patrons, PARTICIPANTS, or from any cause whatsoever.

8. involving any liability as respects access or disclosure of confidential or personal information or data-related liability, which shall mean damages, or loss, defense costs, other costs or expenses because of BODILY INJURY or PROPERTY DAMAGE arising directly or indirectly out of: a. Any access to or disclosure of any person’s or organization’s confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or b. The loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data.

This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, costs or expenses incurred by the INSURED or others arising out of that which is described in paragraph a. or b. above. Further, as used in this exclusion, “electronic data” means information, facts or programs stored as or on, created or used on, transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment.

9. Arising out of BODILY INJURY or PROPERTY DAMAGE arising out of any action or omission that violates or is alleged to violate: a. The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; b. The CAN-SPAM Act of 2003, including any amendment of or addition to such law; c. The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transaction Act (FACTA); or d. Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information.

15

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

EXCLUSIONS FOR WAR AND TERRORISM No coverage is provided for any: 1. Liability directly or indirectly occasioned by, happening through, in consequence of or arising out of war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalization or requisition or destruction of or damage to property by or under the order of any government or public or local authority; or 2. Loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with, or arising out of any act of Terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss; or 3. Loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of Terrorism.

“Terrorism” means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or governments(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear. If the Underwriter alleges that due to Terrorism any loss, damage, cost or expense is not covered, the burden of proving the contrary shall be upon the INSURED. In the event any portion of this section on Terrorism is found to be invalid or unenforceable, the remainder shall remain in full force and effect.

EXCLUSION FOR EXPOSURE TO SANCTIONS No coverage is provided and no liability shall exist to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose the Underwriter or the reinsurers to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

ADDITIONAL EXCLUSIONS No coverage is provided for any CLAIM: 1. by an INSURED against another INSURED, however this exclusion does not apply to a CLAIM brought by an INSURED who was a PARTICIPANT during the EVENT that gave rise to the CLAIM; 2. arising out of BODILY INJURY to any employee of the INSURED arising out of and in the course of his/her employment by the INSURED, including any obligation to indemnify another in whole or in part for such BODILY INJURY, however this exclusion does not apply to any CLAIM brought by an employee who was a PARTICIPANT during the EVENT that gave rise to the CLAIM; 3. by an employer against an INSURED who is employed by or representing such employer; 4. arising out of liability assumed by an INSURED under any contract or agreement; 5. arising out of an EVENT occurring prior to the POLICY PERIOD, if prior to the effective date of the policy, the INSURED had a reasonable basis to foresee that a CLAIM would be made against them; 6. arising out of an EVENT for which notice of the EVENT or a CLAIM was provided to another insurer prior to the start of the POLICY PERIOD; 7. arising out of an EVENT commencing prior to the POLICY PERIOD for which coverage is available under an occurrence based liability policy issued by the Underwriter or any other insurer; 8. arising out of any obligation for which the INSURED or any carrier as his/her insurer may be held liable under any worker’s compensation law, unemployment compensation or disability benefits law, or under any similar or related law (including occupational disease and cumulative trauma) including but not limited to the Jones Act, the Longshoremen and Harbor Workers Act, the Americans with Disabilities Act, and any civil rights laws or legislation; 16

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

9. arising out of any obligation for which the INSURED or any carrier as his/her insurer may be held liable under any employers’ liability law; 10. arising out of BODILY INJURY or PROPERTY DAMAGE expected or intended from the standpoint of the INSURED, however this exclusion does not apply to BODILY INJURY or PROPERTY DAMAGE resulting from the use of reasonable force to protect persons or property; 11. for any obligation to pay fines, judicial sanctions, penalties, punitive and/or exemplary damages, or multiples of compensatory damages, whether at common law or by statute; 12. based on the insolvency or bankruptcy of any person, firm or organization; 13. arising out of the function or failure of any product, including but not limited to RSSA, SCUBA, SNUBA and snorkeling equipment, regardless if owned, borrowed, rented or lent by an INSURED; 14. in any way involving potential or actual transmission of or exposure to Human Immunodeficiency Virus (HIV), hepatitis, or any other infectious disease or any complex or syndrome related thereto, or to any CLAIM in any way relating to the use or misuse or confidentiality of any information relating to HIV disease, hepatitis, or any other infectious disease, including the failure to disclose the health status of the INSURED; 15. directly or indirectly caused by, arising out of, resulting from or in connection with: a. any actual, alleged, or threat of infectious disease, including but not limited to diseases arising out of coronavirus, regardless of any other cause or event contributing concurrently or in any other sequence to the loss; b. any action taken or failure to take action in controlling, preventing, suppressing or in any way responding to such actual, alleged or threat of infectious disease; 16. arising out of any commercial or industrial diving activities, including but not limited to welding, construction, salvage, repair, maintenance, and inspection or fishing activities; however, this exclusion does not apply to public safety diving or scientific research activities; 17. arising out of navigation, towing, repair, storage, conversion, cleaning, demolition, wrecking, up righting, or salvage of any commercial vessel or oil rig, ship building and boat manufacturing, stevedoring, ship repair yards and dry docks; 18. arising out of off-shore and subaqueous work (other than PROFESSIONAL SERVICES provided by the INSURED); 19. arising out of the ownership, maintenance or use of the following premises or any property located on such premises: camps, campgrounds, recreational vehicle parks, or paintball fields; 20. arising out of premises or operations involving: (a) amusement parks or devices, carnivals or circuses, sports or other entertainment events, professional sports organizations, zoos, casinos, race tracks, or any theater, hall, arena, grandstand or stadium; (b) oil or gas pipelines, wells, or drilling operations; (c) all mining and quarrying operations; (d) bridges, tunnels, dams or reservoirs; (e) waste treatment, storage or disposal facilities, dumps or dumpsites, landfills; surface impoundments; waste lagoons; or waste sites; 21. arising out of the ownership, maintenance, operation, use, loading or unloading or entrustment to others of any automobile, aircraft or watercraft, including alleged negligence or other wrongdoing in the supervision, employment, training or monitoring of others by the INSURED; however, this exclusion does not apply to the ingress and/or egress from any watercraft while any PARTICIPANT is under the INSURED’s supervision or instruction, or involving the operation of a kayak or paddleboard; 22. for PROPERTY DAMAGE to: a. property owned or occupied by or rented to the INSURED; b. Property used by the INSURED; or c. Property in the care, custody or control of the INSURED or property over which the INSURED is for any purpose exercising physical control (this exclusion does not apply to swimming pools rented by, used by, or occupied by the INSURED); or, 23. for BODILY INJURY or PROPERTY DAMAGE arising out of the ownership, maintenance, packing, handling, transportation, storage, igniting, operation, sponsorship, set-up or take-down or other use of: a. Firearms, including handguns, revolvers, pistols, rifles, shotguns, air guns, semi-automatic weapons and similar devices; 17

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

b. Fireworks, including firecrackers, Roman Candles, flash powder, explosive compositions or combustible substances, pinwheels, skyrockets, ground displays, flares, smoke bombs, and similar devices that produce, when ignited or activated, sound, smoke, motion or a combination of these; c. Explosives, caps, primers, detonators, ammunitions, fuses, arms, magnesium, ammonium nitrate, nitroglycerin, celluloid, pyroxylin or other substances intended for use as an explosive; by the INSURED or by any person for which the INSURED may be held liable in any capacity, and no coverage is provided for any obligation of the INSURED to indemnify, defend or contribute jointly or severally with another because of BODILY INJURY or PROPERTY DAMAGE arising out of any of the activities specified paragraphs a., b. or c. above; or, 24. arising out of a CYBER LOSS. CYBER LOSS means any actual or alleged loss, damage, liability, injury, compensation, sickness, disease, death, medical payment, claim, cost, defense cost, expense or any other amount incurred by or accruing to the INSURED, including but not limited to any mitigation cost or statutory fine or penalty, directly or indirectly caused by, contributed to by, resulting from, arising out of or in connection with any CYBER INCIDENT. CYBER INCIDENT means: a. an unauthorized or malicious act or series of related unauthorized or malicious acts, regardless of time and place, or the threat or hoax thereof; or b. a failure to act, any error or omission or accident or series of related failures to act, errors or omissions or accidents; or c. a breach of duty, statutory duty or regulatory duty or trust or series of related breaches of duty, statutory duty or regulatory duty or trust;involving access to, processing of, use of or operation of any COMPUTER SYSTEM or any data by any person or group(s) of persons.

COMPUTER SYSTEM means any computer, hardware, software, information technology or communications system or electronic device, including any similar system or any configuration of the aforementioned and including any associated input, output or data storage device, networking equipment or backup facility.

25. arising out of any incident involving CYLINDER INSPECTION INSTRUCTION. CYLINDER INSPECTION INSTRUCTION means training given by a certified instructor in the performance of CYLINDER INSPECTION SERVICES. CYLINDER INSPECTONI SERVICES means any of the following activities: (a) visual or hydrostatic testing of high pressure cylinders; (b) oxygen cylinder cleaning; (c) eddy current testing; (d) cylinder valve repair; (e) HAZMAT handling of SCUBA or SCBA Cylinders; or (f) Operation of a cylinder fill station.

18

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

DAN RISK RETENTION GROUP, INC. c/o Artex Risk Solutions 1180 Sam Rittenberg Blvd., Suite 235 Charleston, South Carolina 29407

SHAREHOLDER PROXY In consideration of the issuance of insurance to the Applicant, the Applicant hereby constitutes and appoints the President of DAN Risk Retention Group, Inc. (“DAN RRG”) as the Applicant’s proxy to attend all meetings of the members of DAN RRG, with full power to vote as proxy for the Applicant and act in the Applicant’s name, place and stead, in the same manner, to the same extent, and with the same effect that the Applicant might if personally present, giving to the President full power of substitution. This grant of proxy is effective as of the date it is executed below. This grant of a proxy shall continue in force until either (1) the Applicant ceases to be a policyholder of DAN RRG or (2) the Applicant revokes the proxy.

THE APPLICANT MAY REVOKE THIS PROXY AT ANY TIME BY ATTENDING A MEETING OF THE MEMBERS OF DAN RRG OR BY SENDING DAN RRG A WRITTEN NOTICE REVOKING THE PROXY.

19

Business Name

Training Agency ID#

GROUP PROFESSIONAL LIABILITY APPLICATION—YACHTS

DAN RISK RETENTION GROUP, INC. c/o Artex Risk Solutions 1180 Sam Rittenberg Blvd., Suite 235 Charleston, South Carolina 29407

SHAREHOLDERS AGREEMENT By applying for insurance and indicating your acceptance of this Shareholder Agreement, you agree to purchase one share of the common stock of DAN Risk Retention Group, Inc. (“DAN RRG”) for each policy of insurance issued to you. The purchase price is one dollar ($1.00) per share.

Your shares are not transferable. They may not be sold, exchanged, assigned, transferred, gifted, pledged, encumbered, hypothecated or otherwise disposed of in any manner, whether voluntarily or by operation of law.

As a shareholder, you agree to abide by the provisions of this Shareholders Agreement, the Articles of Incorporation and Bylaws of DAN RRG and any guidelines and standards adopted by the Board of Directors of DAN RRG, including any risk management and underwriting standards.

Your shares are subject to mandatory redemption if (a) you no longer are insured by DAN RRG or are only insured under an extended reporting period or tail coverage, (b) your business undergoes dissolution, winding up or liquidation or you die (if the insurance is issued to you personally), or (c) you fail to satisfy any of your obligations or the eligibility requirements for membership in DAN RRG. If your shares are subject to mandatory redemption, DAN RRG will repurchase the shares from you for one dollar ($1.00) per share.

This Shareholders Agreement is governed by and will be construed in accordance with the laws of South Carolina, without regard to choice of law principles.

20

GROUP PROFESSIONAL LIABILITY INSURANCE 2022/2023 APPLICATION World.DAN.org/Liability

1

DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION Return the completed application to: Email: LiabilityInsurance@DAN.org Fax: 1-919-490-2935 Mail:

DAN Liability Insurance Attn: DAN World Insurance Group SP 6 W. Colony PL. Durham, NC 27705

For application assistance, please email LiabilityInsurance@DAN.org or phone 919-684-2948 Renewal?

Yes

 No

BUSINESS INFORMATION: (PRINT OR TYPE) DAN Business Member # Primary Training Agency Affiliation

Training Agency ID#

Legal Business Name Doing Business As How long in business?

Business Type:

Email

 Corporation

 Partnership

Phone # LLC Proprietorship

Non-Profit

Other

Business Mailing Address City

State/Province

Zip/Postal

Country

State/Province

Zip/Postal

Country

Business Physical Address City Business Phone 1

Cell

Business Fax WEB Address

PRIMARY CONTACT Legal Name

Family Name

Nickname

Title

Email

Phone #

Is owner of Business?

Yes

 No

SECONDARY CONTACT Legal Name

Family Name

Nickname

Title

Email

Phone #

Is owner of Business?

Yes

 No

How long in business?

Business Type:

 Corporation

Email  Partnership

Phone # LLC Proprietorship

2

Non-Profit

Other

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

GROUP POLICY DIVING ACTIVITIES OPTIONAL PAGE PRIMARY ACTIVITY OF YOUR BUSINESS Dive Shop

 Liveaboard

 Resort

Charter Boat

Number of Dive Professionals (Instructors)

Other

(Dive Masters)

Number of Dives/Year: (Training) (Supervised)

(Unsupervised)

Frequency of diving — Guest: < 3 per day

%

%

3–5 per day

Frequency of diving Staff: < 3 per day

3–5 per day

> 5 per day

%

> 5 per day

Primary Area of Diving Activities Average Distance/Time From Dive Site to Shore:

miles minutes

Type of Diving Exposures (check all that apply): Quarry

 Boat

Shore

Diving Conditions:

 Warm Water

Current

Visibility

 Liveaboard

Travel Less Than 100 miles

Travel More Than 100 miles

 Cold Water  <1 knot

 1–3 knot

 >3 knot

 <30 feet

 30’–100’

 >100’

SUPERVISED DIVING DEPTHS How many dives are done annually for each depth? < 100 ft

101–120 ft

Is Nitrox used in any of your recreational diving activities?

 No

 Yes

> 120 ft

TECHNICAL DIVING Does your business offer technical dive training?

 Yes

 No

Do you offer technical diving (decompression and mixed gas) activities outside of training?

 Yes

 No

REBREATHER DIVING Does your business offer rebreather training?

 Yes

 No

Do you offer rebreather diving activities outside of training?

 Yes

 No

DIVING ACCIDENT PROTECTION Do you require student medical coverage for all open water students?

Do you require dive accident insurance for divers?

 Yes

Do you require your dive professionals to be trained in:

 Yes

 No

 No

 Yes

 No

Who do you use for your first aid training?

3

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

SCHEDULE OF PROFESSIONAL STAFF Total number of professional staff included in your group liability policy: In this section you will add members of your instructional and/or supervisional staff to be included in your group policy. This may include dive instructors, dive masters, and swim instructors. Staff may be defined as those employed exclusively by your organization(i.e. and employee or an independent contractor that provides professional services to your customers on behalf of your business.

Please note that each professional staff member listed on the group policy, including the policyholder, will receive an electronic application that must be completed before being added to the group policy.

Email address should be unique for each staff member and should match email address on record her at DAN if they are a member.

The staff application link is only valid for 14 days and must be reissued.

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

NAME

NAME

EMAIL

EMAIL

PHONE

PHONE

*Use another sheet if necessary.

4

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

SCHEDULE OF ADDITIONAL INSUREDS Each person or organization identified in this schedule is an additional INSURED, subject to the following: The coverage afforded to these additional INSUREDS is limited solely to “vicarious liability” of the additional INSURED that

is a specific and direct result of a negligent act, error or omission by the NAMED INSURED in rendering or failing to render PROFESSIONAL SERVICES. “Vicarious liability” as used in this endorsement means liability that is imposed on the additional INSURED solely by virtue of its relationship with the NAMED INSURED, and not due to any act, error or omission of the additional INSURED. This policy does not apply to any BODILY INJURY or PROPERTY DAMAGE arising from the act, error or omission of any

additional INSURED, when such act, error or omission is the sole or a contributing cause of the loss.

The additional INSURED is entitled to a defense under this policy only if the CLAIM against the additional INSURED relates

exclusively to the additional INSURED’s vicarious liability for the negligent act, error or omission of the NAMED INSURED in rendering or failing to render PROFESSIONAL SERVICES. If the CLAIM also includes allegations of negligent acts, errors, or omissions on the part of the additional INSURED or other third parties, this policy will cover only that portion of the total defense costs that can be directly attributable to matters that might lead to an award of damages under this policy.

In no event is the coverage provided to an additional INSURED broader than the underlying coverage provided to the NAMED

INSURED. Coverage is provided for an additional INSURED’s vicarious liability only if the negligent act, error or omission resulting in vicarious liability is covered under this policy.

In accordance with the terms and conditions of the policy and as more fully explained in the policy, as soon as practicable, each

INSURED must give us prompt notice of any occurrence which may result in a CLAIM, forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with all of the policy’s terms and conditions. Failure to comply with this provision may, at our option, result in the claim or “suit” being denied.

All INSUREDs share the Limits of Liability established by this policy. The provision of coverage to an additional INSURED does

not change or increase the Limits of Liability.

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

5

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

NAME

NAME

ADDRESS

ADDRESS

CITY/STATE/ZIP

CITY/STATE/ZIP

COUNTRY

COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL OR PHONE

EMAIL OR PHONE

6

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

KNOWN CLAIM DECLARATION Each Applicant must complete and sign one of the following claims declarations. Read carefully and complete either 1 (No Claims Declaration) or 2 (Disclosure of Known Claim), not both.

NO CLAIMS DECLARATION/INCIDENT I,

, have no knowledge of any incident, accident, occurrence, act, error, or omission

(collectively “Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any

known Event to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the underwriters any information pertinent to the investigation of any Event, legal action or claim Date:

Signed

(dd/mm/yyyy)

DISCLOSURE OF KNOWN CLAIM/INCIDENT I,

, have knowledge of an incident, accident, occurrence, act, error, or omission (collectively

“Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any

known Event to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the underwriters any information pertinent to the investigation of any Event, legal action or claim Signed

Date: (dd/mm/yyyy)

Name of Any Person Injured: Name of Dive Professional: Date of Incident:

Incident Report Filed: Yes No

If yes, how can DAN Services obtain a copy Fatality: Yes No

Serious Injury: Yes No

Amount of Loss (with defense cost)

In Training: Yes No Insurance Carrier

Location of Incident Brief Summary of Incident

Signed

Date: (dd/mm/yyyy

Please send supporting claim/incident documentation to: liabilityinsurance@DAN.org or fax to 919-490-2935

7

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

DECLARATION SECTION Applicant must complete and sign this Declaration Section. Read carefully, check the boxes next to those statements and sign where indicated.

Your duty of disclosure information and the answers given by you to the specific questions in the Application form will be treated by the Underwriters as applying to each person or legal entity seeking coverage, including each principal, partner or director.

Please confirm the following with a check.

I declare and warrant that I have read and understood the Application and that after full examination, all statements and particulars contained in the Application and any attachments are true and correct and that no information whatsoever has been withheld that might increase the risk of the Underwriters or influence the acceptance of this Application and should the above particulars change in any way, I will advise the Underwriters immediately.

I understand that failure to disclose any material facts, which would be likely to influence the acceptance and assessment of the Application, may result in the Underwriters refusing to provide indemnity or cancelling the policy in every respect.

I hereby agree and accept that this Declaration and the other parts of this Application shall be the basis of the contract between both parties if entered into and shall become a part of the contract of insurance.

I hereby agree and accept that Individual and Group Professional Liability policies are Claims Made policies and that under both policies I am required to provide immediate written notice to the party designated in the policy of any incident, accident, occurrence, act, error, or omission that might lead to a claim, and that failure to provide such written notice may result in a denial of coverage under the policy.

I acknowledge and accept that this coverage is provided on an Excess and Surplus lines basis where the carrier is not required to be licensed in our jurisdiction, but is allowed to do business in your jurisdiction on a non-admitted and unlicensed basis.

I hereby acknowledge and declare that I have never been declined professional insurance, have never had a policy cancelled or non-renewed, and have never had special terms imposed.

I hereby acknowledge and declare that I have never had my membership or credentials suspended, annulled or removed by any dive instructor association or training agency and I understand that coverage will only be effective as long as my professional membership is current or I am in training with a recognized dive instructor association or training agency.

I acknowledge and declare that I have read, understand and accept the Fraud Warning as set forth on page 11 of the Application.

I acknowledge and declare that I have read, understand and accept the Exclusions as set forth on page 11–18 of the Application.

I acknowledge and accept that it is the duty of the Named Insured to timely notify all additional Insureds of ANY notice or change they receive from DAN World Insurance Group SP. All documents sent solely to the Named Insured are deemed by us as having been sent to all additional Insureds.

I acknowledge and accept that the coverage afforded additional INSUREDS is limited solely to “vicarious liability” of the additional INSURED that is a specific and direct result of a negligent act, error or omission by the NAMED INSURED or a member of the NAMED INSURED’s professional staff who qualifies as an INSURED in rendering or failing to render PROFESSIONAL SERVICES

Full Name of Applicant

Signed

Date:

8

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

PREMIUM CALCULATION INFORMATION FOR GROUP PROFESSIONAL Revenue from Water Instruction and Activities To receive the DAN Member discount rate, all dive professional under the Group Professional Liability policy must have an active individual/family DAN membership.

GROUP PROFESSIONAL LIABILITY

DAN MEMBER COST

NONMEMBER COST

 Revenues less than $25,000

$2,089

$2,201

 Revenues of $25,001 to $50,000

$2,731

$2,920

 Revenues of $50,001 to $100,000

$3,650

$3,858

 Revenues of $100,001 to $150,000

$4,717

$4,970

 Revenues of $150,001 to $200,000

$6,107

$6,402

 Revenues of $200,001 to $300,000

$6,970

$7,325

 Revenues of $300,001 to $400,000

$7,686

$8,045

 Revenues of $400,001 to $500,000

$8,421

$8,828

 Revenues of $500,001 to $600,000

$9,287

$9,695

 Revenues of $600,001 to $700,000

$10,189

$10,650

 Revenues of $700,001 to $800,000

$10,943

$11,447

 Revenues of $800,001 to $900,000

$11,719

$12,269

 Revenues of $900,001 to $1,000,000

$12,567

$13,167

Call

Call

 Technical

$0

$0

 Rebreather

$0

$0

Revenues over $1,000,000 DO YOU PARTICIPATE IN THE FOLLOWING ACTIVITIES?

9

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

COSTS AND FEES Cost of insurance includes Premium and Processing Fees, each of which will be itemized on the Declarations page provided to each insured. All Premium, Processing Fees and Taxes are fully earned.

There is no refund of fees and taxes if an insured wishes to cancel coverage.

All Instructors, Assistant Instructors, Divemasters and Retired Instructors included under a Group Professional Liability policy must complete a separate application.

PREMIUM TOTALS Group Liability Premium

$

Total Premium (USD)

.00

Please indicate the preferred effective date (dd/mm/yyyy):

PAYMENT Credit card information is mandatory before finance agreement can be sent.

 Credit Card Card Holder Information: (Print or Type) Card Type: (Check only one)

 MasterCard

 VISA

 AMEX

 Discover

Card Holder Name Billing Address City

State/Province

Card #

Expires:

Zip/Postal

Country

(Month/Year)

Card Holder Signature

CVS Code

10

Total (USD) $

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

FRAUD WARNING Warning: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, is guilty of insurance fraud, which is a felony and subject to criminal and/or civil penalties

EXCLUSIONS EXCLUSIONS RELATED TO PROFESSIONAL STANDARDS AND CONDUCT No coverage is provided for any CLAIM: 1. Arising out of any EVENT involving any swimming or diving activities in which the INSURED was not an active member in good standing with the applicable certification agency or agencies through which the training or supervision was offered at the time of the EVENT; 2. Arising out of any EVENT involving any training or supervisory dive or swim activity conducted by the INSURED that fails to meet the standards of the applicable certification training agency or agencies through which the training or supervision was offered, provided that the failure to meet the standard was a contributing cause of the EVENT, and specifically including but not limited to the following; a. any EVENT involving a training dive where an INSURED intentionally left or permitted any uncertified student to be unsupervised, however, this exclusion does not apply to a navigation exercise on the second or subsequent training dives after the INSURED has evaluated the student’s required skills, or a situation where the INSURED is responding to an emergency situation; or b. any EVENT involving a training dive for anyone under the age of 10, except those courses that are taught in confined water only (e.g. swimming pools) and such may be offered to anyone age 7 and older; or c. any EVENT involving an introductory/discover scuba experience (any program designed to introduce uncertified divers to SCUBA diving via a supervised, controlled open water experience) that was not within the standards of either the Recreational SCUBA Training Council (RSTC) or the certification agency under which the introductory experience was offered; 3. Arising out of any diving activity that is not planned as a RECREATIONAL DIVE (defined as dives planned to 130 feet or shallower, planned without mandatory stage decompression, and made using compressed air or oxygen enriched air ‘nitrox’ only), however this exclusion shall not apply to an INSURED who is engaged in the instruction or supervision of technical diving, provided the INSURED (i) has disclosed to the Underwriter that he or she is a technical diver, (ii) has been properly trained in technical diving and the equipment being used, (iii) has credentials to teach or supervise technical diving on the type of equipment being used at the time of the EVENT, and (iv) is engaged in a dive planned to a depth less than 330’ using air, nitrox, helium or trimix.

4. Involving an INSURED who does not have appropriate training and/or all appropriate certifications (including first aid training, when required) to teach the course or supervise the dive or swim activity which resulted in the EVENT, specifically including but not limited to an EVENT involving technical training and/or technical training dives where the INSURED is not a technically certified professional or where the INSURED is a technically certified professional but exceeds the depths for which the INSURED is trained and certified to teach and/or supervise.

5. Where the INSURED a. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed medical history form prior to in-water training; or b. allows a person to participate where the medical history form of that PARTICIPANT reveals a medical condition that is contraindicated for safe participation in any in-water activities and the PARTICIPANT has not provided a medical release from a physician or other licensed medical professional qualified to provide such a release (who is not the PARTICIPANT or the parent and/or legal guardian of a PARTICIPANT) approving the proposed in-water activity prior to any in-water training or supervision; or c. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed and signed written release of liability and assumption of risk in a form approved by the certification agency through which the training or supervision was offered and naming the INSURED as a released party; or

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Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

d. fails to obtain from the PARTICIPANT (or the parent(s) and/or legal guardian(s) of the PARTICIPANT if a minor) a completed and signed written release of liability and assumption of risk which acknowledges that some dive sites are remote, that a recompression chamber may not be readily available, and that the PARTICIPANT still wants to continue their training or diving and assume the risk in the absence of a recompression chamber; or e. fails to retain teaching records for each PARTICIPANT for a minimum of five (5) years, including records reporting the PARTICIPANT’s progress and results of knowledge tests for the purpose of evaluating the PARTICIPANT’s understanding of the instructional material.

EXCLUSIONS FOR ASBESTOS, LEAD, SILICA, POLLUTION, HAZARDOUS SUBSTANCES, RADIATION, AND NUCLEAR MATERIAL 1. Asbestos. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY in any way arising out of the use by any person or organization of or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; b. PROPERTY DAMAGE to real or personal property arising out of the use by any person or organization of asbestos, asbestos products, asbestos fibers or asbestos dust, including, without limitation, the costs incurred with respect to the removal or abatement of asbestos, asbestos products, asbestos fibers or asbestos dust from or in such real or personal property; c. Any obligation of the INSURED to indemnify any party because of damage arising out of such PROPERTY DAMAGE, BODILY INJURY, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury, arising out of the manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; or d. Any obligation to defend any suit or CLAIM against the INSURED alleging BODILY INJURY, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury or PROPERTY DAMAGE resulting from or contributed to, by any and all manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust.

2. Lead. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY or PROPERTY DAMAGE, arising in whole or in part, either directly or indirectly, out of the manufacture, distribution, sale, resale, re-branding, installation, repair, removal, encapsulation, abatement, replacement or handling of, explore to, ingestion of or testing for, lead whether or not the lead is or was at any time airborne as a particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatsoever; b. The costs of clean up or removal of lead or products and materials containing lead; c. The costs of such actions as may be necessary to monitor, assess and evaluate the release or threat of same, or lead or products and material containing lead; d. The cost of disposal of lead substances or the taking of such other action as may be necessary to temporarily or permanently prevent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; e. The cost of compliance with any law or regulation regarding lead.

3. Silica. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY or PROPERTY DAMAGE or any other loss, cost or expense arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form; or b. Any obligation of the INSURED to defend and/or indemnify any party because of damages arising out of such BODILY INJURY or PROPERTY DAMAGE arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form.

4. Pollution and Hazardous Substances. No coverage is provided for any CLAIM arising out of: a. BODILY INJURY, PROPERTY DAMAGE, or any other loss, damage, cost or expense, or b. any increase in insured loss, damage, cost or expense, or c. any loss, damage, cost, expense, fine or penalty, which is incurred, sustained or imposed by order, direction, instruction or request of, or by any agreement with, any court, government agency or any public, civil or military authority; or threat thereof, (and whether or not as a result of public or private litigation), 12

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

which arises from: i. any kind of seepage or any kind of pollution and/or contamination, or threat thereof, whether or not caused by or resulting from a peril insured, or from steps or measures taken in connection with the avoidance, prevention, abatement, mitigation, remediation, clean-up or removal of such seepage or pollution and/or contamination or threat thereof; or ii. relates to the actual, alleged or threatened discharge, dispersal, release or escape of POLLUTANTS, however caused or whenever or wherever happening; or iii. any request, demand or liability to test for, monitor, clean-up, remove, contain, treat, detoxify or neutralize POLLUTANTS, whether or not any of the foregoing are or should be performed by the INSURED or by another.

The term ‘any kind of seepage or any kind of pollution and/or contamination’ as used herein includes, but is not limited to: i. seepage of, or pollution and/or contamination by, anything, including but not limited to, any material designated as a ‘hazardous substance’ by the United States Environmental Protection Agency or as a ‘hazardous material’ by the United States Department of Transportation, or defined as a ‘toxic substance’ by the Canadian Environmental Protection Act for the purposes of Part II of that Act, or any substance designated or defined as toxic, dangerous, hazardous or deleterious to persons or the environment under any other Federal, State, Provincial, Municipal or other law, ordinance or regulation; and, ii. the presence, existence, or release of anything which endangers or threatens to endanger the health, safety or welfare of persons or the environment.

The term “Pollutants” as used herein includes but is not limited to, any electromagnetic transmissions or fields, or any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals, and waste, including medical waste. Waste also includes materials to be recycled, reconditioned or reclaimed.

5. Pathogens or Harmful Biological or Chemical Materials. No coverage is provided for any CLAIM arising out of BODILY INJURY, PROPERTY DAMAGE, or any other loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or arising in connection with the actual or suspected presence of pathogenic or harmful biological or chemical materials, including bacteria, fungi, viruses and proteins, regardless of any other cause or event contributing concurrently or in any other sequence thereto.

6. Radiation and Nuclear Material. This policy does not apply: a. To claims under any Coverage that are in any way caused or contributed to by nuclear reaction, nuclear radiation or radioactive contamination. b. Under any Liability Coverage, to BODILY INJURY, PROPERTY DAMAGE or any other injury, sickness, disease, death or destruction: i. with respect to which an INSURED under the policy is also an insured under a nuclear energy liability policy issued

by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insurance Association of Canada, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or ii. resulting from the hazardous properties of nuclear material and with respect to which (1) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (2) the INSURED is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any person or organization. c. Under any Medical Payments Coverage, or under any Supplementary Payments Provision relating to immediate medical or surgical relief, to expenses incurred with respect to bodily injury, sickness, disease or death resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. d. Under any Liability Coverage, to injury, sickness, disease, death or destruction resulting from the hazardous properties of nuclear material, if: i. the nuclear material (1) is at any nuclear facility owned by, or operated by or on behalf of, an INSURED or (2) has been discharged or dispersed therefrom; ii. the nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed, stored, transported or disposed of by or on behalf of an INSURED; or

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Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

iii. the injury, sickness, disease, death or destruction arises out of the furnishing by an INSURED of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility, but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (c) applies only to injury to or destruction of property at such nuclear facility. e. To (i) any loss or destruction of or damage to any property whatsoever or any loss or expense whatsoever resulting or arising therefrom or any consequential loss; or, (ii) any legal liability of whatsoever nature directly or indirectly caused by or contributed to by or arising out of: i. ionizing radiations or contamination by radioactivity form any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel; or ii. ithe radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof. f. In relation to liability arising outside the U.S.A., its Territories or Possessions, Puerto Rico or the Canal Zone, this policy does not cover liability of whatsoever nature directly or indirectly caused by or contributed to by or arising out of ionizing radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel.

As used in this section: “hazardous properties” include radioactive, toxic or explosive properties; “nuclear material” means source material, special nuclear material or by-product material; “source material”, “special nuclear material”, and “by-product material” have the meanings given them in the Atomic Energy Act 1954 or in any law amendatory thereof; “spent fuel” means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor; “waste” means any waste material (1) containing by-product material and resulting from the operation by any person or organization of any nuclear facility included within the definition of nuclear facility under paragraph (i) or (ii) thereof; “nuclear facility” means: i. any nuclear reactor, ii. iany equipment or device designed or used for (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing spent fuel, or (3) handling, processing or packaging waste, iii. iiany equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the INSURED at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235, iv. any structure, basin, excavation, premises or place prepared or used for the storage or disposal of waste, and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations; “nuclear reactor” means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material. With respect to injury to or destruction of property, the word “injury” or “destruction” includes all forms of radioactive contamination of property.

7. Communicable Disease. No coverage is provided for any CLAIM arising out of BODILY INJURY, PROPERTY DAMAGE or any other actual or alleged loss, liability, damage, compensation, injury, sickness, disease, death, medical payment, defense cost, cost, expense or any other amount, directly or indirectly and regardless of any other cause contributing concurrently or in any sequence, originating from, caused by, arising out of, contributed to by, resulting from, or otherwise in connection with a COMMUNICABLE DISEASE or the fear or threat (whether actual or perceived) of a COMMUNICABLE DISEASE. A COMMUNICABLE DISEASE means any disease which can be transmitted by means of any substance or agent from any organism to another organism where: a. the substance or agent includes, but is not limited to, a virus, bacterium, fungus, parasite or other organism or any variation thereof, whether deemed living or not; and b. the method of transmission, whether direct or indirect, includes but is not limited to, airborne transmission, bodily fluid transmission, transmission from or to any surface or object, solid, liquid or gas or any other means of transmission between organisms; and c. the disease, substance or agent can cause or threaten BODILY INJURY, including but not limited to illness, emotional distress, or damage to human health or welfare, or PROPERTY DAMAGE.

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Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

EXCLUSIONS FOR VIOLATION OF CIVIL AND CRIMINAL LAWS, RULES AND REGULATIONS No coverage is provided for any CLAIM: 1. Arising out of invasion of privacy, libel, slander or defamation of character, false arrest, detention or imprisonment, assault or battery, or wrongful entry or eviction, including any allegation that the violation of any civil right caused or contributed to such CLAIM. 2. Directly or indirectly attributed to any failure to comply with any applicable statute, regulation, ordinance, directive or order, provided that the failure to comply is an intentional, willful or deliberate act or omission of the INSURED. 3. Arising out of discrimination by the INSURED, including but not limited to discrimination on the basis of age, color, race, sex, sexual orientation, creed, national origin, marital status or mental or physical disability, however, this exclusion does not apply if services are denied for valid safety reasons, including but not limited to, concern over medical history, disability, or belief by the INSURED that a potential PARTICIPANT lacks the physical ability or mental aptitude to engage in swim or dive activities.

4. Arising out of infringement of trademark, trade dress, trade name, patent, copyright or other intellectual property rights.

5. Arising out of a criminal act.

6. Arising out of BODILY INJURY or PROPERTY DAMAGE caused by an INSURED while under the influence of alcohol, intoxicants, narcotics or any mind-altering substance.

7. Arising out of abuse or molestation, where “abuse or molestation” means: a. Actual or threatened abuse or molestation or licentious, immoral or sexual behavior whether or not intended to lead to, or culminating in any sexual act, whether caused by, or at the instigation of, or at the direction of, or omission by, the INSURED, an INSURED’s employee, or any other person, or b. Charges or allegations of negligent hiring, employment, investigation, supervision, reporting to the proper authorities, or failure to so report; or retention of a person for whom the INSURED is or ever was legally responsible and whose conduct could be described by a. above.

Abuse or Molestation includes, but is not limited to, negligent or intentional infliction or physical, emotional or psychological injury/harm; harassment of any type; lewd, immoral or sexual behavior, whether or not any such act is intended to lead to, or culminate in, any sexual act, whether caused by, at the instigation of, at the direction of, or as a result of any act or omission by the INSURED, his/her employees, patrons, PARTICIPANTS, or from any cause whatsoever.

8. involving any liability as respects access or disclosure of confidential or personal information or data-related liability, which shall mean damages, or loss, defense costs, other costs or expenses because of BODILY INJURY or PROPERTY DAMAGE arising directly or indirectly out of: a. Any access to or disclosure of any person’s or organization’s confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or b. The loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data.

This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, costs or expenses incurred by the INSURED or others arising out of that which is described in paragraph a. or b. above. Further, as used in this exclusion, “electronic data” means information, facts or programs stored as or on, created or used on, transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment.

9. Arising out of BODILY INJURY or PROPERTY DAMAGE arising out of any action or omission that violates or is alleged to violate: a. The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; b. The CAN-SPAM Act of 2003, including any amendment of or addition to such law;

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Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

c. The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transaction Act (FACTA); or d. Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information.

EXCLUSIONS FOR WAR AND TERRORISM No coverage is provided for any: 1. Liability directly or indirectly occasioned by, happening through, in consequence of or arising out of war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalization or requisition or destruction of or damage to property by or under the order of any government or public or local authority; or 2. Loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with, or arising out of any act of Terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss; or 3. Loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of Terrorism.

“Terrorism” means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or governments(s), committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear. If the Underwriter alleges that due to Terrorism any loss, damage, cost or expense is not covered, the burden of proving the contrary shall be upon the INSURED. In the event any portion of this section on Terrorism is found to be invalid or unenforceable, the remainder shall remain in full force and effect.

EXCLUSION FOR EXPOSURE TO SANCTIONS No coverage is provided and no liability shall exist to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would expose the Underwriter or the reinsurers to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

ADDITIONAL EXCLUSIONS No coverage is provided for any CLAIM: 1. by an INSURED against another INSURED, however this exclusion does not apply to a CLAIM brought by an INSURED who was a PARTICIPANT during the EVENT that gave rise to the CLAIM; 2. arising out of BODILY INJURY to any employee of the INSURED arising out of and in the course of his/her employment by the INSURED, including any obligation to indemnify another in whole or in part for such BODILY INJURY, however this exclusion does not apply to any CLAIM brought by an employee who was a PARTICIPANT during the EVENT that gave rise to the CLAIM; 3. by an employer against an INSURED who is employed by or representing such employer; 4. arising out of liability assumed by an INSURED under any contract or agreement;

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Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

5. arising out of an EVENT occurring prior to the POLICY PERIOD, if prior to the effective date of the policy, the INSURED had a reasonable basis to foresee that a CLAIM would be made against them; 6. arising out of an EVENT for which notice of the EVENT or a CLAIM was provided to another insurer prior to the start of the POLICY PERIOD; 7. arising out of an EVENT commencing prior to the POLICY PERIOD for which coverage is available under an occurrence based liability policy issued by the Underwriter or any other insurer; 8. arising out of any obligation for which the INSURED or any carrier as his/her insurer may be held liable under any worker’s compensation law, unemployment compensation or disability benefits law, or under any similar or related law (including occupational disease and cumulative trauma) including but not limited to the Jones Act, the Longshoremen and Harbor Workers Act, the Americans with Disabilities Act, and any civil rights laws or legislation; 9. arising out of any obligation for which the INSURED or any carrier as his/her insurer may be held liable under any employers’ liability law; 10. arising out of BODILY INJURY or PROPERTY DAMAGE expected or intended from the standpoint of the INSURED, however this exclusion does not apply to BODILY INJURY or PROPERTY DAMAGE resulting from the use of reasonable force to protect persons or property; 11. for any obligation to pay fines, judicial sanctions, penalties, punitive and/or exemplary damages, or multiples of compensatory damages, whether at common law or by statute; 12. based on the insolvency or bankruptcy of any person, firm or organization; 13. arising out of the function or failure of any product, including but not limited to RSSA, SCUBA, SNUBA and snorkeling equipment, regardless if owned, borrowed, rented or lent by an INSURED; 14. in any way involving potential or actual transmission of or exposure to Human Immunodeficiency Virus (HIV), hepatitis, or any other infectious disease or any complex or syndrome related thereto, or to any CLAIM in any way relating to the use or misuse or confidentiality of any information relating to HIV disease, hepatitis, or any other infectious disease, including the failure to disclose the health status of the INSURED; 15. directly or indirectly caused by, arising out of, resulting from or in connection with: a. any actual, alleged, or threat of infectious disease, including but not limited to diseases arising out of coronavirus, regardless of any other cause or event contributing concurrently or in any other sequence to the loss; b. any action taken or failure to take action in controlling, preventing, suppressing or in any way responding to such actual, alleged or threat of infectious disease; 16. arising out of any commercial or industrial diving activities, including but not limited to welding, construction, salvage, repair, maintenance, and inspection or fishing activities; however, this exclusion does not apply to public safety diving or scientific research activities; 17. arising out of navigation, towing, repair, storage, conversion, cleaning, demolition, wrecking, up righting, or salvage of any commercial vessel or oil rig, ship building and boat manufacturing, stevedoring, ship repair yards and dry docks; 18. arising out of off-shore and subaqueous work (other than PROFESSIONAL SERVICES provided by the INSURED); 19. arising out of the ownership, maintenance or use of the following premises or any property located on such premises: camps, campgrounds, recreational vehicle parks, or paintball fields; 20. arising out of premises or operations involving: (a) amusement parks or devices, carnivals or circuses, sports or other entertainment events, professional sports organizations, zoos, casinos, race tracks, or any theater, hall, arena, grandstand or stadium; (b) oil or gas pipelines, wells, or drilling operations; (c) all mining and quarrying operations; (d) bridges, tunnels, dams or reservoirs; (e) waste treatment, storage or disposal facilities, dumps or dumpsites, landfills; surface impoundments; waste lagoons; or waste sites; 21. arising out of the ownership, maintenance, operation, use, loading or unloading or entrustment to others of any automobile, 17

Business Name

Training Agency ID# DAN WORLD GROUP PROFESSIONAL LIABILITY APPLICATION

aircraft or watercraft, including alleged negligence or other wrongdoing in the supervision, employment, training or monitoring of others by the INSURED; however, this exclusion does not apply to the ingress and/or egress from any watercraft while any PARTICIPANT is under the INSURED’s supervision or instruction, or involving the operation of a kayak or paddleboard; 22. for PROPERTY DAMAGE to: a. property owned or occupied by or rented to the INSURED; b. Property used by the INSURED; or c. Property in the care, custody or control of the INSURED or property over which the INSURED is for any purpose exercising physical control (this exclusion does not apply to swimming pools rented by, used by, or occupied by the INSURED); or, 23. for BODILY INJURY or PROPERTY DAMAGE arising out of the ownership, maintenance, packing, handling, transportation, storage, igniting, operation, sponsorship, set-up or take-down or other use of: a. Firearms, including handguns, revolvers, pistols, rifles, shotguns, air guns, semi-automatic weapons and similar devices; b. Fireworks, including firecrackers, Roman Candles, flash powder, explosive compositions or combustible substances, pinwheels, skyrockets, ground displays, flares, smoke bombs, and similar devices that produce, when ignited or activated, sound, smoke, motion or a combination of these; c. Explosives, caps, primers, detonators, ammunitions, fuses, arms, magnesium, ammonium nitrate, nitroglycerin, celluloid, pyroxylin or other substances intended for use as an explosive; by the INSURED or by any person for which the INSURED may be held liable in any capacity, and no coverage is provided for any obligation of the INSURED to indemnify, defend or contribute jointly or severally with another because of BODILY INJURY or PROPERTY DAMAGE arising out of any of the activities specified paragraphs a., b. or c. above; or, 24. arising out of a CYBER LOSS. CYBER LOSS means any actual or alleged loss, damage, liability, injury, compensation, sickness, disease, death, medical payment, claim, cost, defense cost, expense or any other amount incurred by or accruing to the INSURED, including but not limited to any mitigation cost or statutory fine or penalty, directly or indirectly caused by, contributed to by, resulting from, arising out of or in connection with any CYBER INCIDENT. CYBER INCIDENT means: a. an unauthorized or malicious act or series of related unauthorized or malicious acts, regardless of time and place, or the threat or hoax thereof; or b. a failure to act, any error or omission or accident or series of related failures to act, errors or omissions or accidents; or c. a breach of duty, statutory duty or regulatory duty or trust or series of related breaches of duty, statutory duty or regulatory duty or trust;involving access to, processing of, use of or operation of any COMPUTER SYSTEM or any data by any person or group(s) of persons.

COMPUTER SYSTEM means any computer, hardware, software, information technology or communications system or electronic device, including any similar system or any configuration of the aforementioned and including any associated input, output or data storage device, networking equipment or backup facility.

25. arising out of any incident involving CYLINDER INSPECTION INSTRUCTION. CYLINDER INSPECTION INSTRUCTION means training given by a certified instructor in the performance of CYLINDER INSPECTION SERVICES. CYLINDER INSPECTONI SERVICES means any of the following activities: (a) visual or hydrostatic testing of high pressure cylinders; (b) oxygen cylinder cleaning; (c) eddy current testing; (d) cylinder valve repair; (e) HAZMAT handling of SCUBA or SCBA Cylinders; or (f) Operation of a cylinder fill station.

18

GENERAL LIABILITY INSURANCE 2022/2023 APPLICATION

DAN.org/Liability

1

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

DAN GENERAL LIABILITY APPLICATION INSTRUCTIONS

STEP 1.

Fill out this application completely.

Incomplete applications will delay processing times.

STEP 2.

Return the completed application to: Email: LiabilityInsurance@DAN.org Fax: 1-919-490-2935 Mail: Divers Alert Network

Attn: Risk Retention Group

6 W. Colony Pl.

Durham, NC 27705

FOR APPLICATION ASSISTANCE Email: LiabilityInsurance@DAN.org Phone: +1-919-684-2948

2

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

Renewal?

Yes

No

BUSINESS INFORMATION: (PRINT OR TYPE) Legal Business Name

DAN Business Member #

Doing Business As

Business Mailing Address City

State/Province

Zip/Postal

Business Phone

Country

Cell

Fax

WEB Address Primary Training Agency Affiliation Training Agency ID # PRIMARY CONTACT Legal First Name

Family Name

Title

Email Phone #

Is owner of Business?

Yes

Nickname

No

SECONDARY CONTACT Legal Name

Family Name

Title

Email Phone #

Is owner of Business?

Yes

No

Nickname

How long in business?

GENERAL INFORMATION SECTION: Business Type:

 Corporation

 Partnership

LLC Proprietorship

 Non-Profit

Other

How long in business?

Owned business location(s) (Use Use another sheet if necessary) 1. Street Address City Is primary location?

State/Province Yes

Location ownership:

Zip/Postal

Country

Commercial Leased

Residential

No Commercial Owned

2. Street Address City Is primary location?

State/Province Yes

Location ownership:

Zip/Postal

Country

Commercial Leased

Residential

No  Commercial Owned

3. Street Address City Is primary location?

Location ownership:

State/Province Yes

Zip/Postal

Country

Commercial Leased

 Residential

 No Commercial Owned

* Use Additional Sheet if necessary.

3

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

BUSINESS ACTIVITIES: (PLEASE CHECK ALL THAT APPLY) Air Fills

Hydrotesting

Rentals

 Repairs

Product Sales

Training

Tank Inspections

Local Trade Shows

Pool on Premises

Travel (more than 100 miles)

Travel (less than 100 miles)

Description of business activities/operations:

Do you sell or rent products “other than scuba?” (Please describe)

4

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

KNOWN CLAIM DECLARATION FOR BUSINESS Applicant must complete and sign one of the following claims/incident declarations. Read carefully and complete either 1 (No Claims/Incident Declaration) or 2 (Disclosure of Known Claim/Incident), not both.

NO CLAIMS DECLARATION/INCIDENT I,

, have no knowledge of any incident, accident, occurrence, act, error, or omission

(collectively “Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any

known Event to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the underwriters any information pertinent to the investigation of any Event, legal action or claim Signed

Date:

(dd/mm/yyyy)

DISCLOSURE OF KNOWN CLAIM/INCIDENT I,

, have knowledge of an incident, accident, occurrence, act, error, or omission (collectively

“Event”) that might lead to, or has already led to, a legal action or claim, except those matters disclosed as part of this application or already reported to DAN Services, Inc. on

, 20

. I understand that I must report any

known Event to my previous insurer and that this policy does not cover any Event known on or before the effective date of this coverage. I also agree and understand that any Event which occurred prior to the effective date of this coverage which becomes a legal action or claim within 90 days of expiration of the previous policy, must first be reported to the underwriter of the previous policy and will be excluded under this policy. By applying for this insurance, I hereby authorize DAN Services, Inc. to release to the underwriters any information pertinent to the investigation of any Event, legal action or claim Signed

Date:

(dd/mm/yyyy)

Name of Any Person Injured: Name of Dive Professional: Date of Incident:

Incident Report Filed: Yes No

If yes, how can DAN Services obtain a copy Fatality: Yes No

Serious Injury: Yes No

In Training: Yes No

Amount of Loss (with defense cost)

Insurance Carrier

Location of Incident Brief Summary of Incident

Signed Date:

Please send supporting claim/incident documentation to: liabilityinsurance@DAN.org or fax to 919-490-2935 5

(dd/mm/yyyy

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

SCHEDULE OF ADDITIONAL INSUREDS It is not required for a party to be listed on this schedule as an additional Insured for that party to be covered under this policy.

Insured shall include any person or organization you are required to include as an additional Insured on this policy by a written contract or written agreement in effect during this policy period and executed prior to the “occurrence” of the “Bodily Injury” or “Property Damage”, and any person or organization to which a certificate of insurance has been issued under this policy. This coverage is limited as follows: It provides Coverage A (Bodily Injury and Property Damage Liability) only.

The person or organization is only an additional Insured with respect to vicarious liability arising out of “your work” or “your

product”.

In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract or

written agreement, the insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract or written agreement. This endorsement shall not increase the Limits of Insurance shown in the Declarations pertaining to the coverage provided herein.

The insurance provided to such an additional Insured does not apply to “Bodily Injury” or “Property Damage” arising out of a

dive professional’s rendering or failing to render professional services.

This insurance does not apply to “Bodily Injury” or “Property Damage” arising out of “your work” or “your product” included

in the “product-completed operations hazard” unless you are required to provide such coverage by written contract or written agreement and then only for the period of time required by the written contract or written agreement and in no event beyond the expiration date of the policy.

Any coverage provided to an additional Insured shall be excess over any other valid and collectible insurance available to the

additional Insured whether primary, excess, contingent or on any other basis In accordance with the terms and conditions of the policy and as more fully explained in the policy, as soon as practicable, each additional Insured must give us prompt notice of any “occurrence” which may result in a claim, forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with all of the policy’s terms and conditions. Failure to comply with this provision may, at our option, result in the claim or Suit being denied.

NAME

NAME

ADDRESS

ADDRESS

CITY/ST(Province)

CITY/ST(Province)

ZIP (Postal)/COUNTRY

ZIP (Postal)/COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL

EMAIL

NAME

NAME

ADDRESS

ADDRESS

CITY/ST(Province)

CITY/ST(Province)

ZIP (Postal)/COUNTRY

ZIP (Postal)/COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL

EMAIL

6

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

SCHEDULE OF ADDITIONAL INSUREDS NAME

NAME

ADDRESS

ADDRESS

CITY/ST(Province)

CITY/ST(Province)

ZIP (Postal)/COUNTRY

ZIP (Postal)/COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL

EMAIL

NAME

NAME

ADDRESS

ADDRESS

CITY/ST(Province)

CITY/ST(Province)

ZIP (Postal)/COUNTRY

ZIP (Postal)/COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL

EMAIL

NAME

NAME

ADDRESS

ADDRESS

CITY/ST(Province)

CITY/ST(Province)

ZIP (Postal)/COUNTRY

ZIP (Postal)/COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL

EMAIL

NAME

NAME

ADDRESS

ADDRESS

CITY/ST(Province)

CITY/ST(Province)

ZIP (Postal)/COUNTRY

ZIP (Postal)/COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL

EMAIL

NAME

NAME

ADDRESS

ADDRESS

CITY/ST(Province)

CITY/ST(Province)

ZIP (Postal)/COUNTRY

ZIP (Postal)/COUNTRY

RELATIONSHIP

RELATIONSHIP

EMAIL

EMAIL

7

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

DECLARATION SECTION Applicant must complete and sign this Declaration Section. Read carefully, check the boxes next to those statements and sign where indicated.

Your duty of disclosure information and the answers given by you to the specific questions in the Application form will be treated by the Underwriters as applying to each person or legal entity seeking coverage, including each principal, partner or director.

Please confirm the following with a check.

I declare and warrant that I have read and understand the Application and that after full examination, all statements and particulars contained in the Application and any attachments are true and correct and that no information whatsoever has been withheld that might increase the risk of the Underwriters or influence the acceptance of this Application and should the above particulars change in any way, I will advise the Underwriters immediately.

I understand that failure to disclose any material facts, which would be likely to influence the acceptance and assessment of the Application, may result in the Underwriters refusing to provide indemnity or cancelling the policy in every respect.

I hereby agree and accept that this Declaration and the other parts of this Application shall be the basis of the contract between both parties if entered into.

I hereby agree and accept that the Commercial General Liability policy is an Occurrence policy that I am required to provide immediate written notice to the party designated in the policy of any incident, accident, occurrence, act, error, or omission that might lead to a claim, and that failure to provide such written notice may result in a denial of coverage under the policy.

I acknowledge and accept that this coverage is provided on an Excess and Surplus lines basis where the carrier is not required to be licensed in our State of domicile, but is allowed to do business in our State on a non-admitted and unlicensed basis.

I hereby acknowledge and declare that I have never been declined general liability insurance, have never had a policy cancelled or non-renewed, and have never had special terms imposed.

I hereby acknowledge and declare that this is a business that provides equipment, training services and/or facilities to the diving community.

I acknowledge and declare that I have read, understand and accept the Fraud Warning as set forth on page 11 of the Application.

I acknowledge and declare that I have read, understand and accept the Exclusions as set forth on page 12–22 of the Application.

I acknowledge and declare that I have read, understand and accept the Proxy on page 23 of this application as a condition of eligibility for coverage under the DAN RRG program.

I acknowledge and declare that I have read, understand and accept the Shareholders Agreement on page 24 of this application as a condition of eligibility for coverage under the DAN RRG program.

**NOTICE** This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for your risk retention group.

Full Name of Applicant

Signed

Date:

8

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

PREMIUM CALCULATION INFORMATION FOR GENERAL LIABILITY GROSS BUSINESS REVENUES (Before Expenses) Average Annual Sales (Excluding Travel, Water Instruction and Activities)

PRICING GENERAL LIABILITY  Revenues less than $50,000

DAN MEMBER COST* $977

NONMEMBER COST $1,021

 Revenues of $50,001 to $100,000

$1,276

$1,337

 Revenues of $100,001 to $200,000

$1,737

$1,822

 Revenues of $200,001 to $300,000

$2,221

$2,332

 Revenues of $300,001 to $400,000

$2,640

$2,773

 Revenues of $400,001 to $500,000

$2,892

$2,038

 Revenues of $500,001 to $750,000

$3,168

$3,329

 Revenues of $750,001 to $1,000,000

$3,397

$3,570

 Revenues of $1,000,001 to $1,500,000

$3,561

$3,742

Call

Call

$0

$0

$69

$73

$164

$174

$3,520

$3,705

$844

$888

 $100,001 to $300,000

$1,577

$1,661

 $300,001 to $750,000

$2,359

$2,483

 750,001 to $1,500,000

$2,850

$3,000

Revenues over $1,500,000 OPTIONS (please select any additional endorsement options)

 Additional Location  Terrorism  Tour and Travel Agent Liability  Lakes and Quarries EXCESS LIABILITY ENDORSEMENT  $0 to $100,000

* In order to receive DAN Member Cost you must have an active business membership.

9

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

COSTS AND FEES Cost of insurance includes Premium and Processing Fees, each of which will be itemized on the Declarations page provided to each Insured. All Premium, Processing Fees and Taxes are fully earned.

There is no refund of earned premium, fees or taxes if an insured wishes to cancel coverage.

PREMIUM TOTALS A. General Liability Premium

$

Liability Options:

a. Additonal Locations

$

b. Terrorism

$

c. Tour and Travel Agent Liability

$

d. Lakes and Quarries

$

e. Excess Liability

$

Total Premium (USD)

$

.00

Please indicate the preferred effective date (dd/mm/yyyy):

PAYMENT OPTIONS  Check or Money Order # Make checks payable to: DAN Services.

Send to: DAN Liability Insurance, 6 W. Colony Place, Durham, NC 27705-9030  Premium Financing Federal Tax ID # or FEIN # Contact DAN Liability Insurance at LiabilityInsurance@DAN.org or 1-919-684-2948 for more information.

Credit card information is mandatory before finance agreement can be sent.  Credit Card Card Holder Information: (Print or Type) Card Type: (Check only one)

 MasterCard

 VISA

 AMEX

 Discover

Card Holder Name Billing Address City

State/Province

Card #

Expires:

Zip/Postal

Country

(Month/Year)

Card Holder Signature

CVS Code 10

Total (USD) $

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

FRAUD WARNING GENERAL STATEMENT: Any person who, with the intent to defraud or knowingly facilitates a fraud against an insurer, submits an ap- plication or files a claim containing a false or deceptive statement, or conceals information for the purpose of misleading may be guilty of insurance fraud and subject to criminal and/or civil penalties.

AK, AL, AR, CA, CT, DC, DE, GA, IA, ID, IN, IL, MA, MO, MS, MT, NC, ND, NE, NJ, NH, NM, ND, OK, PA, RI, TN, TX, WI (GROUP) - Fraud Warning: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, is guilty of insurance fraud, which is a felony and subject to criminal and/or civil penalties MD, ME, WA, NY, MN, SD, UT (INDEPENDENTLY) – Fraud Warning: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, maybe guilty of insurance fraud, which is a felony and maybe subject to criminal and/or civil penalties.

Notice to Colorado: It is unlawful to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policy holder or claim- ant for the purpose of defrauding or attempting to defraud the policy holder or claimant with regard to a settlement or aware payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.

Notice to Florida: Any person who knowingly and with intent to injure, defraud or deceive any insurer, files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.

Notice to Hawaii: For your protection, Hawaii law requires you to be informed that presenting a fraudulent claim for payment of a loss or benefit is a crime punishable by fines or imprisonment or both.

Notice to Idaho: Any person who knowingly and with intent to defraud or deceive any insurance company, files a statement or claim containing a false, incomplete or misleading information is guilty of a felony.

Notice to Indiana: Any person who knowingly makes any false or fraudulent statement or presentation in or with reference to any application for life insurance or for the purpose of obtaining any fee, omission, money or benefit from or in any company transacting business under this article, commits a class A misdemeanor.

Notice to Kentucky: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

Notice to Louisiana: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false infor- mation in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

Notice to New York: Any person who knowingly and with intent to defraud an insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.

Notice to Ohio: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

Notice to Oklahoma: Any person who knowingly, and with intent to injure, defraud or deceive any insurer makes any claim for the proceeds of an insurance policy containing any false, incomplete, or misleading information is guilty of a felony.

Notice to Oregon: Any person who knowingly and with intent, defrauds or deceives any insurance company by submitting an application or filing a claim that contains any false or incomplete information, or conceals information for the purpose of misleading, may be guilty of insurance fraud, which may be a crime and may be subject to criminal and/or civil penalties.

Notice to Pennsylvania: Any person who knowingly and with intent to defraud any insurance company or other person files an application for in- surance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

Notice to Virginia: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of de-frauding the company. Penalties include imprisonment, fines and denial of insurance benefits.

11

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

EXCLUSIONS COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY This insurance does not apply to:: A. Expected or Intended injury Bodily Injury or Property Damage expected of intended from the standpoint of the Insured. This exclusion does not apply to Bodily Injury resulting from the use of reasonable force to protect persons or property.

B. Contractual Liability Bodily Injury or Property Damage for which the Insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: i.

That the Insured would have in the absence of the contract or agreement; or

ii.

Assumed in a contract or agreement that is an Insured Contract, provided the Bodily Injury or Property Damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an Insured Contract, reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an Insured are deemed to be damages because of Bodily Injury or Property Damage, provided: a. Liability to such party for, or for the cost of, that party’s defense has also been assumed in the same Insured Contract; and b. Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged.

C. Liquor Liability Bodily Injury or Property Damage for which any Insured may be held liable by reason of: i.

Causing or contributing to the intoxication of any person;

ii.

The furnishing of alcoholic beverages to a person under the legal drinking age of under the influence of alcohol; or

iii.

Any statute, ordinance or relating to the sale, gift, distribution or use of alcoholic beverages.

This exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages.

D. Workers’ Compensation and Similar Laws Any obligation of the Insured under a workers’ compensation, disability benefits, social security, unemployment compensation or insurance law or under any similar or related law (including occupational disease and cumulative trauma) including but not limited to the Jones Act, the Longshoremen and Harbor Workers Act, the Americans with Disabilities Act, and any civil rights laws or legislation.

E. Employer’s Liability Bodily Injury to: i.

An Employee of the Insured arising out of and in the course of: a. Employment by the Insured; or b. Performing duties related to the conduct of the Insured’s business; or

The spouse, child, parent, brother or sister of that Employee as a consequence of Paragraph i. above.

This exclusion applies: i.

Whether the Insured may be liable as an employer or in any other capacity; and

ii.

To any obligation to share damages with or repay someone else who must pay damages because of the injury.

F. Pollution i.

Bodily Injury or Property Damage which would not have occurred in whole or part but for the actual, alleged or threatened, discharge, dispersal, seepage, migration, release or escape of Pollutants at any time at any location and from any source.

ii.

Any loss, cost or expense arising out of any: 12

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

a. Request, demand or order that any Insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of Pollutants; or b. Claim or Suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of Pollutants.

Pollutants mean any solid, liquid, gaseous, or thermal irritant or contaminant including smoke, vapor, soot, fumes, acid alkalis, chemicals and waste. Waste includes material to be recycled, reconditioned or reclaimed.

G. Aircraft, Auto or Watercraft Bodily Injury or Property Damage arising out of the ownership, maintenance, use or entrustment to others of any aircraft, Auto or watercraft: a. Owned or operated by or rented or loaned to any Insured; or b. Operated by any Volunteer Worker in the course of his or her employment by the Insured or while performing duties related to the conduct of the Insured’s business.

Use includes the operation and Loading or Unloading.

This exclusion applies even if the claims against the Insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that Insured, if the Occurrence which caused the Bodily Injury or Property Damage involved the ownership, maintenance, use or entrustment to others of any aircraft, Auto or watercraft that is owned or operated by or rented or loaned to any Insured.

This exclusion does not apply to: i.

A watercraft while ashore on premises you own or rent;

ii.

A watercraft you do not own that is: a. Less than 26 feet long: and b. Not being used to carry persons or property for a charge

iii.

Parking an Auto on, or on the ways next to, premises you own or rent, provided the Auto is not owned by or rented or loaned to you, the Insured, any of your Volunteer Workers or any Volunteer Workers of the Insured.

iv.

Liability assumed under any Insured Contract for the ownership, maintenance or use of aircraft or watercraft; or

v.

Bodily Injury or Property Damage arising out of: a. The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of Mobile Equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged; or b. The operation of any machinery or equipment listed in Paragraph f.(ii) or f.(iii) of the definition of Mobile Equipment.

H. Mobile Equipment Bodily Injury or Property Damage arising out of: i.

The transportation of Mobile Equipment by an Auto owned or operated by or rented or loaned to any Insured; or

ii.

The use of Mobile Equipment in, or while in practice for, or while being prepared for, any prearranged racing, speed, demolition, or stunting activity.

I. War Bodily Injury or Property Damage, however caused, arising, directly or indirectly, out of, occasioned by, happening through or in consequence of:War, including undeclared or civil war; i.

Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or

ii.

Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these.

iii.

Invasion, acts of foreign enemies, hostilities, insurrection, rebellion, revolution, military or usurped power or confiscation or nationalization or requisition or destruction of or damage to property by or under the order of any government or public or local authority, or action taken by governmental authority in hindering or defending against any of these.

13

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

J. Damage to Property Property Damage to: i.

Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another’s property.

ii.

Premises you sell, give away or abandon, if the Property Damage arises out of any part of those premises;

iii.

Property loaned to you;

iv.

Personal property in the care, custody or control of the Insured;

v.

That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the Property Damage arises out of those operations; or

That particular part of any property that must be restored, repaired or replaced because Your Work was incorrectly performed on it.

Paragraphs (i), (iii) and iv) of this exclusion do not apply to Property Damage (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage to Premises Rented to You as described in Section III – Limits of Insurance. vi.

Paragraph (ii) of this exclusion does not apply if the premises are Your Work and were never occupied, rented or held for rental by you.

Paragraphs (iii), (iv), (v) and (vi) of this exclusion do not apply to liability assumed under a sidetrack agreement.

Paragraph (vi) of this exclusion does not apply to Property Damage included in the Products-completed Operations Hazard.

K. Damage to Your Product Property Damage to Your Product arising out of it or any part of it.

L. Damage to Your Work Property Damage to Your Work arising out of it or any part of it and included in the Products-completed Operations Hazard.

This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.

M. Damage to Impaired Property or Property Not Physically Injured Property Damage to Impaired Property or property that has not been physically injured, arising out of: i.

A defect deficiency, inadequacy or dangerous condition in Your Product or Your Work; or

ii.

A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms.

This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to Your Product or Your Work after it has been put to its intended use.

N. Recall of Products, Work or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: i.

Your Product,

ii.

Your Work; or

iii.

Impaired Property; If such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it.

Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III – Limits of Insurance.

O. Personal and Advertising Injury Bodily Injury arising out of Personal and Advertising Injury.

14

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

P. Access, Disclosure Or Unauthorized Use Of Data Damages arising out of: i.

Any access to or disclosure of any person’s or organization’s confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or

Theft or unauthorized viewing, copying, use, loss of, loss of use of, damage, corruption, manipulation or deletion, or inability to access or manipulate electronic data.

This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in i. or ii. above. ii.

As used in this exclusion, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment.

Q. Fungi or Bacteria Bodily Injury or Property Damage which would not have occurred, in whole or in part, but for the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence of, or presence of, any Fungi or bacteria on or within a building or structure, including its contents, regardless of whether any other cause, event, material or product contributed concurrently or in any sequence to such injury or damage.

Any loss, cost or expenses arising out of the abating, testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, remediating or disposing of, or in any way responding to, or assessing the effects of, Fungi or bacteria, by an Insured or by any other person or entity.

This exclusion does not apply to any Fungi or bacteria that are, are on, or are contained in, a good or product intended for bodily consumption.

R. Employment Related Practices Bodily Injury to: i.

A person arising out of any: a. Refusal to employ that person; b. Termination of that person’s employment; or c. Employment-related practices, policies, acts or omissions, such as coercion, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination or malicious prosecution directed at that person; or

The spouse, child, parent, brother or sister of that person as a consequence of Bodily Injury to that person at whom any of the employment related practices described in Paragraphs a, b, or c above is directed.

This exclusion applies: ii.

i.

Whether the injury-causing event described in Paragraphs a, b or c above occurs before employment, during employment or after employment of that person;

ii.

Whether the Insured may be liable as an employer or in any other capacity; and

iii.

To any obligation to share damages with or repay someone else who must pay damages because of the injury.

S. Infringement, Misappropriation, Interference with Privacy and Unfair Competition Bodily Injury or Property Damage arising directly or indirectly out of: a. Any infringement upon or dilution of copyright, trademark, patent, title, slogan, service mark, service name, trade name, trade dress, trade secret, or other intellectual property rights; b. Any invasion or infringement of or interference with the right of privacy or publicity including, but not limited to, intrusion, public disclosure or private facts, unwarranted or wrongful publicity, false light or the use of name or likeness for profit; c. Plagiarism or misappropriation of information, trade secrets, ideas or style of doing business;

15

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

d. “Unfair competition” as defined by statute or common law, both state and federal, whether or not pertaining to and alleged in conjunction with a claim of plagiarism, misappropriation of information or ideas, “piracy”, infringement or dilution of copyright, title, slogan, trademark, trade name, trade dress, trade secret, patent, service mark, service name, or other intellectual property rights; e. Any acts of the Insured pertaining to the internet, web site(s), domain name(s), metatag(s), linking, framing or chatrooms the Insured hosts, owns, or over which the Insured exercises control.

T. Professional Liability This insurance does not apply to Bodily Injury or Property Damage or Personal and Advertising Injury that arises out of the rendering of or failure to render any professional services. Professional services include but are not limited to advice, instruction, supervision or direction in connection with a training program for either recreational or certification purposes, including but not limited to instruction or supervision in the activity of water skiing, jet skiing, operation of a boat, parasailing, hang gliding, paragliding, ultra-light flying, kite boarding, kite surfing, snow kiting, surfing, wake boarding, scuba diving, skin diving, swimming or any other recreational activity.

U. Abuse or Molestation This insurance does not apply to Bodily Injury or Property Damage, Personal and Advertising Injury or any injury arising out of: i.

The actual or threatened abuse or molestation or licentious, immoral or sexual behavior whether or not intended to lead to, or culminating in any sexual act, of any person, whether caused by, or at the instigation of, or at the direction of, or omission by, any Insured, his Employees, or any other person, or

ii.

The actual or alleged transmission of any communicable disease, or

Charges or allegations of negligent hiring, employment, investigation, supervision, reporting to the proper authorities, or failure to so report; or retention of a person for whom any Insured is or ever was legally responsible and whose conduct would be excluded by paragraph i. above.

Abuse includes, but is not limited to, negligent or intentional infliction of physical, emotional or psychological injury/harm. iii.

V. Asbestos i.

Bodily Injury in any way arising out of the use by any person or organization of or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust;

ii.

Property Damage to real property arising out of the use by any person or organization of asbestos, asbestos products, asbestos fibers or asbestos dust, including, without limitation, the costs incurred with respect to the removal or abatement of asbestos, asbestos products, asbestos fibers or asbestos dust from or in such real property;

iii.

Any obligation of the Insured to indemnify any party because of damage arising out of such Property Damage, Bodily Injury, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury, at any time as a result of the manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust; or

iv.

Any obligation to defend any Suit or claim against the Insured alleging Bodily Injury, sickness, disease, occupational disease, disability, shock, death, mental anguish or mental injury or Property Damage resulting from or contributed to, by any and all manufacture of, mining of, use of, sale of, removal of, distribution of, or exposure to asbestos, asbestos products, asbestos fibers or asbestos dust.

W. Lead i.

Bodily Injury or Property Damage, for past, present or future claims arising in whole or in part, either directly or indirectly, out of the manufacture, distribution, sale, resale, re-branding, installation, repair, removal, encapsulation, abatement, replacement or handling of, explore to, ingestion of or testing for, lead whether or not the lead is or was at any time airborne as a particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatsoever;

ii.

The costs of clean up or removal of lead or products and materials containing lead;

iii.

The costs of such actions as may be necessary to monitor, assess and evaluate the release or threat of same, or lead or products and material containing lead;

iv.

The cost of disposal of lead substances or the taking of such other action as may be necessary to temporarily or permanently prevent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result;

v.

The cost of compliance with any law or regulation regarding lead.

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Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

X. Securities and Financial Interest i.

Any violation of any securities law or similar law or any regulation promulgated thereunder;

ii.

The purchase, sale, offer of sale or solicitation of any security, debt, insurance policy, bank deposit or financial interest or instrument;

iii.

Any representation made at any time in relation to the price or value of any security, debt, insurance policy, bank deposit or financial interest or instrument; or

iv.

Any depreciation or decline in price or value of any security, debt, insurance policy, bank deposit or financial interest or instrument.

Y. Silica i.

Bodily Injury or Property Damage or any other loss, cost or expense arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form; or.

ii.

Any obligation of the Insured to defend and/or indemnify any party because of damages arising out of such Bodily Injury or Property Damage arising out of the presence, ingestion, inhalation, or absorption, of or exposure to silica products, silica fibers, silica dust or silica in any form.

Z. Violation of Statutes in Connection with Sending, Transmitting, or Communicating Any Material or Information Any loss, injury, damage, claim, Suit, cost or expense arising out of or resulting from, caused directly or indirectly, in whole or in part by, any act that violates any statute, ordinance or regulation of any federal, state or local government including, any amendment of or addition to such laws, that includes, addresses or applies to the sending, transmitting or communicating of any material or information, by any means whatsoever. aa. Nuclear Reaction / Nuclear Radiation or Radioactive Contamination Any loss, injury, damage, claim, Suit, cost or expense arising out of or resulting from, caused directly or indirectly, in whole or in part by, nuclear reaction, nuclear radiation or radioactive contamination. bb. Recording And Distribution Of Material Or Information In Violation Of Law Bodily Injury or Property Damage arising out of any action or omission that violates or is alleged to violate: i.

The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law;

ii.

The CAN-SPAM Act of 2003, including any amendment of or addition to such law;

iii.

The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transaction Act (FACTA); or

iv.

Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information.

cc. Infectious Disease Any liability, loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, arising out of, resulting from or in connection with: i.

any actual, alleged, or threat of infectious disease, including but not limited to diseases arising out of coronaviruses, regardless of any other cause or event contributing concurrently or in any other sequence to the loss;

ii.

any action taken or failure to take action in controlling, preventing, suppressing or in any way responding to such actual, alleged or threat of infectious disease.

dd. Nuclear/Chemical/Biological/Radioactive Terrorism Regardless of any contributory cause(s), this policy does not cover any claim(s) in any way caused or contributed to by an act of terrorism involving the use or release or the threat thereof of any nuclear weapon or device or chemical, biological or radioactive agent, material, device or weapon.

For the purpose of this exclusion, an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or government(s), committed for political, religious, ideological or ethnic purposes or reasons including the intention to influence any government and/or to put the public, or any section of the public, in fear.

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Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

COVERAGE B BODILY INJURY AND PROPERTY DAMAGE LIABILITY This insurance does not apply to: A. Knowing Violation of Rights of Another Personal and Advertising Injury caused by or at the direction of the Insured with the knowledge that the act would violate the rights of another and would inflict Personal and Advertising Injury; B. Material Published with Knowledge of Falsity Personal and Advertising Injury arising out of oral or written publication of material, if done by or at the direction of the Insured with knowledge of its falsity; C. Material Published Prior to Policy Period Personal and Advertising Injury rising out of oral or written publication of material whose first publication took place before the beginning of the Policy Period; D. Criminal Acts Personal and Advertising Injury arising out of a criminal act committed by or at the direction of any Insured; E. Contractual Liability Personal and Advertising Injury for which the Insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the Insured would have in the absence of the contract or agreement; F. Breach of Contract Personal and Advertising Injury arising out of a breach of contract, except an implied contract to use another’s advertising idea in your Advertisement; G. Quality of Performance of Goods – Failure to Conform to Statements Personal and Advertising Injury arising out of the failure of goods, products or services to conform with any statement of quality or performance made in your Advertisement; H. Wrong Description of Prices Personal and Advertising Injury arising out of the wrong description of the price of goods, products or services stated in your Advertisement; I. Infringement of Copyright, Patent, Trademark or Trade Secret Personal and Advertising Injury arising out of the infringement of copyright, patent, trademark, trade secret or other intellectual property rights.

However, this exclusion does not apply to infringement, in your Advertisement, of copyright, trade dress or slogan.

J. Insureds in Media and Internet Type Businesses Personal and Advertising Injury committed by an Insured whose business is: i.

Advertising, broadcasting, publishing or telecasting:

ii.

Designing or determining content of we-sites for others; or

iii.

An Internet search, access, content or service provider.

However, this exclusion does not apply to Paragraphs 15. a., b., and c. of Personal and Advertising Injury under Section V–Definitions.

For the purpose of this exclusion, the placing of frames, borders or links, or advertising, for you or others anywhere on the internet, is not by itself, considered the business of advertising, broadcasting, publishing or telecasting.

K. Electronic Chatrooms or Bulletin Boards Personal and Advertising Injury arising out of an electronic chatroom or bulletin board the Insured hosts, owns, or over which the Insured exercises control.

L. Unauthorized Use of Another’s Name or Product Personal and Advertising Injury arising out of the unauthorized use of another’s name or product in your email address, domain name or metatag, or any other similar tactics to mislead another’s potential customers.

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Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

M. Pollution Personal and Advertising Injury arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of Pollutants at any time.

N. Pollution-Related Any loss, cost or expense arising out of any: i.

Request, demand, order or statutory or regulatory requirement that any Insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, Pollutants, or

ii.

Claim or Suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, Pollutants.

O. War Personal and Advertising Injury, however caused, arising, directly or indirectly, out of, occasioned by, happening through or in consequence of: i.

War, including undeclared or civil war;

ii.

Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or

iii.

Invasion, acts of foreign enemies, hostilities, insurrection, rebellion, revolution, military or usurped power, or confiscation or nationalization or requisition or destruction of or damage to property by or under the order of any government or public or local authority, or action taken by governmental authority in hindering or defending against any of these.

P. Fungi or Bacteria Personal and Advertising Injury which would not have taken place, in whole or in part, but for the actual, alleged or threatened inhalation of, ingestion of, ingestion of, contact with, exposure to, existence of, or presence of any Fungi or bacteria on or within a building or structure, including its contents, regardless of whether any other cause, event, material or product contributed concurrently or in any sequence to such injury.

Any loss, cost or expenses arising out of the abating, testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, remediating or disposing of, or in any way responding to, or assessing the effects of, Fungi or bacteria, by an Insured or by any other person or entity.

Q. Employment Related Practices i.

Personal and Advertising Injury to a person arising out of any: a. Refusal to employ that person; b. Termination of that person’s employment; c. Employment-related practices, policies, acts or omissions, such as coercion, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination or malicious prosecution directed at that person; or d. Claim related in any way to employers’ liability;

ii.

The spouse, child, parent, brother or sister of that person as a consequence of Personal and Advertising Injury to that person at whom any of the employment-related practices described in Paragraphs a, b, or c above is directed.

This exclusion applies: i.

Whether the injury-causing event described in Paragraphs a., b. or c. above occurs before employment, during employment or after employment of that person;

ii.

Whether the Insured may be liable as an employer or in any other capacity; and

iii.

To any obligation to share damages with or repay someone else who must pay damages because of the injury.

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Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

R. Infringement, Misappropriation, Interference with Privacy and Unfair Competition Personal and Advertising Injury arising directly or indirectly out of: a. Any infringement upon or dilution of copyright, trademark, patent, title, slogan, service mark, service name, trade name, trade dress, trade secret, or other intellectual property rights; b. Any invasion or infringement of or interference with the right of privacy or publicity including, but not limited to, intrusion, public disclosure or private facts, unwarranted or wrongful publicity, false light or the use of name or likeness for profit; c. Plagiarism or misappropriation of information, trade secrets, ideas or style of doing business; “Unfair competition” as defined by statute or common law, both state and federal, whether or not pertaining to and alleged in conjunction with a claim of plagiarism, misappropriation of information or ideas, “piracy”, infringement or dilution of copyright, title, slogan, trademark, trade name, trade dress, trade secret, patent, service mark, service name, or other intellectual property rights.

S. Professional Liability This insurance does not apply to Bodily Injury or Property Damage or Personal and Advertising Injury that arises out of the rendering of or failure to render any professional services. Professional services include but are not limited to advice, instruction, supervision or direction in connection with a training program for either recreational or certification purposes, including but not limited to instruction or supervision in the activity of water skiing, jet skiing, operation of a boat, parasailing, hang gliding, paragliding, ultra-light flying, kite boarding, kite surfing, snow kiting, surfing, wake boarding, scuba diving, skin diving, swimming or any other recreational activity.

T. Abuse or Molestation This insurance does not apply to Bodily Injury or Property Damage, personal injury, Personal and Advertising Injury or any injury arising out of: i.

The actual or threatened abuse or molestation or licentious, immoral or sexual behavior whether or not intended to lead to, or culminating in any sexual act, of any person, whether caused by, or at the instigation of, or at the direction of, or omission by, any Insured, his Employees, or any other person, or

ii.

The actual or alleged transmission of any communicable disease, or

Charges or allegations of negligent hiring, employment, investigation, supervision, reporting to the proper authorities, or failure to so report; or retention of a person for whom any Insured is or ever was legally responsible and whose conduct would be excluded by paragraph i. above.

Abuse includes, but is not limited to, negligent or intentional infliction of physical, emotional or psychological injury/harm. iii.

U. Recording And Distribution Of Material Or Information In Violation Of Law Personal or Advertising Injury arising out of any action or omission that violates or is alleged to violate: i.

The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law;

ii.

The CAN-SPAM Act of 2003, including any amendment of or addition to such law;

iii.

The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transaction Act (FACTA); or

iv.

Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information.

V. Access, Disclosure Or Unauthorized Use Of Data Damages arising out of: i.

Any access to or disclosure of any person’s or organization’s confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or

Theft or unauthorized viewing, copying, use, loss of, loss of use of, damage, corruption, manipulation or deletion, or inability to access or manipulate electronic data.

This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in i. or ii. above. ii.

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Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

As used in this exclusion, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment.

W. Employers’ Liability Any liability, loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, arising out of, resulting from or in connection with employers’ liability.

X. Workers’ Compensation and Similar Laws Personal or Advertising Injury arising out of any obligation of the Insured under a workers’ compensation, disability benefits, social security, unemployment compensation or insurance law or under any similar or related law (including occupational disease and cumulative trauma) including but not limited to the Jones Act, the Longshoremen and Harbor Workers Act, the Americans with Disabilities Act, and any civil rights laws or legislation.

Y. Infectious Disease Any liability, loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, arising out of, resulting from or in connection with: i.

any actual, alleged, or threat of infectious disease, including but not limited to diseases arising out of coronaviruses, regardless of any other cause or event contributing concurrently or in any other sequence to the loss;

ii.

any action taken or failure to take action in controlling, preventing, suppressing or in any way responding to such actual, alleged or threat of infectious disease.

Z. Nuclear Reaction / Nuclear Radiation or Radioactive Contamination Any loss, injury, damage, claim, Suit, cost or expense arising out of or resulting from, caused directly or indirectly, in whole or in part by, nuclear reaction, nuclear radiation or radioactive contamination.

AA.Nuclear/Chemical/Biological/Radioactive Terrorism Regardless of any contributory cause(s), this policy does not cover any claim(s) in any way caused or contributed to by an act of terrorism involving the use or release or the threat thereof of any nuclear weapon or device or chemical, biological or radioactive agent, material, device or weapon.

For the purpose of this exclusion, an act of terrorism means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or government(s), committed for political, religious, ideological or ethnic purposes or reasons including the intention to influence any government and/or to put the public, or any section of the public, in fear.

COVERAGE C MEDICAL PAYMENTS EXCLUSIONS This insurance does not apply to: We will not pay expenses for Bodily Injury: A. Any Insured To any Insured.

B. Hired Person To a person hired to do work for or on behalf of any Insured or a tenant of any Insured.

C. Injury on Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies.

D. Worker’s Compensation and Similar Laws To a person, whether or not an Employee of any Insured, if benefits for the Bodily Injury are payable or must be provided under a worker’s compensation law, unemployment compensation insurance, social security, or disability benefits law, or under any similar or related law (including occupational disease and cumulative trauma) including but not limited to the Jones Act, the Longshoremen and Harbor Workers Act, the Americans with Disabilities Act, and any civil rights laws or legislation.

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Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

E. Athletics Activities To a person injured while practicing, instructing or participating in any physical exercises or games, sports, or athletic contests.

F. Products-Completed Operations Hazard Included within the Products-completed Operations Hazard.

G. Coverage A Exclusions Excluded under Coverage A.

ADDITIONAL EXCLUSIONS The following exclusions apply to all sections of this policy.

Notwithstanding anything to the contrary contained herein this policy does not cover the following: 1. any liability or expense arising out of the ownership, maintenance or use of the following premises or any property located on such premises: camps, campgrounds, recreational vehicle parks, or paintball fields; a. unless such use is incidental to the Named Insured’s scuba diving business; 2. any liability or expense arising out of navigation, towing, repair, storage, conversion, cleaning, demolition, wrecking, uprighting, or salvage of any commercial vessel or oil rig, ship building and boat manufacturing, stevedoring, ship repair yards and dry docks; 3. any liability or expense arising out of off-shore and subaqueous work; 4. any liability or expense arising out of premises or operations involving: (a) amusement parks or devices, carnivals or circuses, sports or other entertainment events, professional sports organizations, zoos, casinos, race tracks, or any theater, hall, arena, grandstand or stadium; (b) oil or gas pipelines, wells, or drilling operations; (c) all mining and quarrying operations; (d) bridges, tunnels, dams or reservoirs; (e) waste treatment, storage or disposal facilities, dumps or dumpsites, landfills; surface impoundments; waste lagoons; or waste sites.

22

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

DAN RISK RETENTION GROUP, INC. c/o Artex Risk Solutions 1180 Sam Rittenberg Blvd., Suite 235 Charleston, South Carolina 29407

SHAREHOLDER PROXY In consideration of the issuance of insurance to the Applicant, the Applicant hereby constitutes and appoints the President of DAN Risk Retention Group, Inc. (“DAN RRG”) as the Applicant’s proxy to attend all meetings of the members of DAN RRG, with full power to vote as proxy for the Applicant and act in the Applicant’s name, place and stead, in the same manner, to the same extent, and with the same effect that the Applicant might if personally present, giving to the President full power of substitution. This grant of proxy is effective as of the date it is executed below. This grant of a proxy shall continue in force until either (1) the Applicant ceases to be a policyholder of DAN RRG or (2) the Applicant revokes the proxy.

THE APPLICANT MAY REVOKE THIS PROXY AT ANY TIME BY ATTENDING A MEETING OF THE MEMBERS OF DAN RRG OR BY SENDING DAN RRG A WRITTEN NOTICE REVOKING THE PROXY.

23

Business Name

Training Agency ID# DAN GENERAL LIABILITY APPLICATION

DAN RISK RETENTION GROUP, INC. c/o Artex Risk Solutions 1180 Sam Rittenberg Blvd., Suite 235 Charleston, South Carolina 29407

SHAREHOLDERS AGREEMENT By applying for insurance and indicating your acceptance of this Shareholder Agreement, you agree to purchase one share of the common stock of DAN Risk Retention Group, Inc. (“DAN RRG”) for each policy of insurance issued to you. The purchase price is one dollar ($1.00) per share.

Your shares are not transferable. They may not be sold, exchanged, assigned, transferred, gifted, pledged, encumbered, hypothecated or otherwise disposed of in any manner, whether voluntarily or by operation of law.

As a shareholder, you agree to abide by the provisions of this Shareholders Agreement, the Articles of Incorporation and Bylaws of DAN RRG and any guidelines and standards adopted by the Board of Directors of DAN RRG, including any risk management and underwriting standards.

Your shares are subject to mandatory redemption if (a) you no longer are insured by DAN RRG or are only insured under an extended reporting period or tail coverage, (b) your business undergoes dissolution, winding up or liquidation or you die (if the insurance is issued to you personally), or (c) you fail to satisfy any of your obligations or the eligibility requirements for membership in DAN RRG. If your shares are subject to mandatory redemption, DAN RRG will repurchase the shares from you for one dollar ($1.00) per share.

This Shareholders Agreement is governed by and will be construed in accordance with the laws of South Carolina, without regard to choice of law principles.

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