Forma Construction Company 9/20/2017 Amendment 1

PROPEL INSURANCE PAGE 13 OF 16 (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered"auto"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered"auto". However, the most we will pay for any expenses for loss of use is$100 per day,to a maximum of$3000. I. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Coverage a. We will pay up to$750 for"loss"to personal effects which are: (1) Personal property owned by an"insured"; and (2) In or on a covered"auto". b. Subject to Paragraph a.above,the amount to be paid for"loss"to personal effects will be based on the lesser of: (1) The reasonable cost to replace;or (2) The actual cash value. c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for"loss"to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value. (2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones. (3) Paintings, statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same"loss". J. Tapes,Records and Discs Coverage 1. The Exclusion in Paragraph B.4.a. of Section III — Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.2.c. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage Form does not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for "loss"to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio,visual or data electronic devices: (a) Are the property of an"insured"; and (b) Are in a covered"auto"at the time of"loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such"loss". U-CA-424-F CW(04-14) Page 3 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission.