Oregon Mutual Insurance Company Washington General Liability (GL)
Sample Contract & Support Forms

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Basic Policy
M2358 (5-15)

Asbestos And Lead Exclusion Endorsement

IL 00 03 09 08

Calculation Of Premium

CG 00 01 04 13 Commercial General Liability Coverage Form
M2072L (9-08) Commercial General Liability Coverage Part Declarations
M2034 (12-89) Commercial General Liability Schedule
M2070 (1-04) Common Policy Declarations
CG 21 47 12 07 Employment - Related Practices Exclusion - Commercial GL Coverage Part
CG 00 67 03 05 Exclusion - Violation of Statues That Govern E - Mails, Fax, Phone Calls Or Other Methods of Sending Material Or Information
CG 21 62 09 98 Exclusion - Year 2000 Computer-Related And Other Electronic Problems
CG 21 86 12 04 Exterior Insulation And Finish System (EIFS) Exclusion
M2071 (2-98) Forms And Endorsements List
CG 21 67 12 04 Fungi Or Bacteria Exclusion - Commercial General Liability
M2432 (7-99) Mutual Policy Conditions
M2125L (9-08) Owners and Contractors Protective Liability Declarations - Oregon, Washington, Idaho, California
CG 33 70 03 05 Silica Or Silica - Related Dust Exclusion (OCP - PROD)
CG 04 50 05 08 Washington Changes - Who is an Insured
Terrorism
CG 21 73 01 08 Exclusion of Certified Acts of Terrorism
CG 21 75 01 15

Exclusion of Certified Acts of Terrorism and Exclusion of Other Acts of Terrorism Committed Outside the United States

CG 21 84 01 15

Exclusion of Certified Nuclear, Biological, Chemical or Radiological Acts of Terrorism; Cap on Losses from Certified Acts of Terrorism

Supplements
M2755L (3-06)

Bakery Errors And Omissions

M2793 (5-07)

Barbers and Beauticians Professional Liability

M2769L (5-07)

Bed And Breakfast Supplemental Coverages - Washington

M2757L (3-06) Florists Errors And Omissions
M2299 (9-08) Funeral Directors, Morticians And Cemeteries Professional Liability
M2756L (3-06) Mail Services Errors And Omissions
M2752L (3-06) Motels
M2753L (3-06) Motels - Liability For Guests Property
M2759L (3-06) Printers Errors And Omissions
M2768L (9-08) Veterinarians Consent To Settle
M2761L (3-06) Veterinarians Professional
M2754L (3-06) Wake Up Calls Errors And Omissions
Other Endorsements
M2867L (1-14)

Additional Insured - Blanket Vendors

CG 20 20 11 85

Additional Insured - Charitable Institutions

CG 20 22 10 01

Additional Insured - Church Members, Officers And Volunteer Workers

CG 20 02 11 85

Additional Insured - Club Members

CG 20 27 04 13

Additional Insured - Co-Owner Of Insured Premises

CG 20 03 04 13

Additional Insured - Concessionaires Trading Under Your Name

CG 20 04 11 85

Additional Insured - Condominium Unit Owners

CG 20 05 04 13

Additional Insured - Controlling Interest

CG 20 26 04 13

Additional Insured - Designated Person Or Organization

CG 20 25 11 85

Additional Insured - Elective Or Appointive

CG 20 31 04 13

Additional Insured - Engineers, Architects Or Surveyors

CG 20 32 04 13

Additional Insured - Engineers, Architects Or Surveyors Not Engaged by the Insured

CG 20 07 04 13

Additional Insured - Engineers, Architects, Or Surveyors

CG 20 23 04 13

Additional Insured - Executors, Administrators, Trustees Or Beneficiaries

CG 20 29 04 13

Additional Insured - Grantor Of Franchise

CG 20 36 04 13

Additional Insured - Grantor Of Licenses

CG 20 35 04 13

Additional Insured - Grantor Of Licenses - Automatic Status When Required By Licensor

CG 20 28 04 13

Additional Insured - Lessor Of Leased Equipment

CG 20 34 04 13

Additional Insured - Lessor Of Leased Equipment - Automatic Status When Required In Lease Agreement With You

CG 20 11 04 13

Additional Insured - Managers Or Lessors Of Premises

CG 20 18 04 13

Additional Insured - Mortgagee, Assignee, Or Receiver

CG 20 24 04 13

Additional Insured - Owners Or Other Interests From Whom Land Has Been Leased

CG 20 38 04 13 Additional Insured - Owners, Lessees or Contractors - Automatic Status For Other Parties When Required in Written Construction Agreement
CG 20 33 04 13 Additional Insured - Owners, Lessees or Contractors - Automatic Status When Required in Construction Agreement With You
CG 20 37 04 13 Additional Insured - Owners, Lessees or Contractors - Completed Operations
M2666L (9-04)

Additional Insured - Owners, Lessees Or Contractors - Scheduled Person Or Organization

CG 20 12 04 13

Additional Insured - State Or Political Subdivisions - Permits

CG 29 35 04 13

Additional Insured - State Or Political Subdivisions - Permits

CG 20 13 04 13

Additional Insured - State Or Political Subdivisions - Permits Relating To Premises

CG 20 17 10 93

Additional Insured - Townhouse Associations

CG 20 08 04 13

Additional Insured - Users Of Golf-mobiles

CG 20 14 11 85

Additional Insured - Users Of Teams, Draft or Saddle Animals

CG 20 15 04 13

Additional Insured - Vendors

CG 22 28 12 04

Amendment - Travel Agency Tours (Limitation Of Coverage)

CG 22 74 10 01

Amendment Of Contractual Liability Exclusion For Personal Injury

CG 24 23 04 13

Amendment Of Coverage Territory - Additional Scheduled Countries

CG 24 22 04 13

Amendment Of Coverage Territory - Worldwide Coverage

CG 24 24 04 13

Amendment Of Coverage Territory - Worldwide Coverage With Specified Exceptions

CG 24 26 04 13 Amendment Of Insured Contract - Washington, Idaho, California, Nevada
CG 25 02 07 98

Amendment Of Limits Of Insurance

CG 24 13 04 13

Amendment Of Personal & Advertising Injury Definition

M2662L (9-04)

Americans With Disabilities Act Exclusion - Oregon, Washington, Idaho

M2293 (9-94)

Blank Endorsement

M2868L (1-14)

Blanket Additional Insured

CG 24 12 11 85

Boats

CG 31 98 12 04 Calculation of Premium (EDL PROD Withdrawal)
CG 24 16 12 07 Canoes or Rowboats
M2887L (12-16) Cluster Endorsement - General Liability
CG 22 72 04 13 Colleges Or Schools
CG 22 71 04 13 Colleges Or Schools (Limited Form)
M2282 (9-94) Commercial Policy Change

IL 01 46

08 10

Common Policy Conditions - Washington

M2758L

(5-07)

Comprehensive Personal Liability Coverage - Oregon, Washington, Idaho, Nevada

CG 21 39 10 93 Contractual Liability Limitation
CG 22 67 10 93 Corporal Punishment
CG 31 72 12 04 Coverage Extension - Coverage A - Product Restoration Expense
CG 04 24 10 93 Coverage For Injury To Leased Workers (For Use With CGL, Liquor, OCP, Pollution And Products Policies)
M2875 (4-15) CyberOne Coverage - Computer Attack & Network Security Liability - $50,000 Limit
M2876 (4-15) CyberOne Coverage - Computer Attack & Network Security Liability - $100,000 Limit
M2877L (4-15) Data Compromise Coverage - Response Expenses & Defense & Liability - $50,000 Limit
M2878L (4-15) Data Compromise Coverage - Response Expenses & Defense & Liability - $100,000 Limit
M2879L (4-15) Data Compromise Coverage - Response Expenses & Defense & Liability - $250,000 Limit
CG 03 00 01 96 Deductible Liability Insurance (CGL & Products Policies)
CG 03 05 01 96 Deductible Liability Insurance (Liquor Liability Policies)
CG 25 03 05 09 Designated Construction Project(s) General Aggregate Limit
CG 25 04 05 09 Designated Location(s) General Aggregate Limit
CG 22 69 04 13 Druggists
CG 02 24 10 93 Earlier Notice of Cancellation Provided by Us
CG 04 35 12 07 Employee Benefits Liability Coverage
M2894W 12-15 Employment Practices Liability Insurance Coverage Endorsement
M2187 12-15 Employment Practices Liability Insurance Coverage Supplemental Declaration
CG 24 10 07 98 Excess Provision - Vendors
CG 21 07 05 14 Exclusion - Access or Disclosure of Confidential or Personal Information and Data-Related Liability - Limited Bodily Injury Exception Not Included
CG 33 59 05 14 Exclusion - Access or Disclosure of Confidential or Personal Information and Data-Related Liability - Limited Bodily Injury Exception Not Included
CG 22 87 04 13 Exclusion - Adult Day Care Centers
CG 21 00 07 98 Exclusion - All Hazards In Connection With Designated Premises
CG 21 01 11 85 Exclusion - Athletic Or Sports Participants
CG 22 39 04 13 Exclusion - Camp Or Campgrounds
CG 22 34 04 13 Exclusion - Construction Management Errors And Omissions
CG 22 79 04 13 Exclusion - Contractors-Professional Liability
CG 22 30 07 98 Exclusion - Corporal Punishment
CG 21 57 04 13 Exclusion - Counseling Services
CG 31 68 12 07 Exclusion - Coverage A - Product Withdrawal Expense
CG 31 69 12 04 Exclusion - Coverage B - Product Withdrawal Liability
CG 21 35 10 01 Exclusion - Coverage C-Medical Payments
CG 21 45 07 98 Exclusion - Damage To Premises Rented To You
CG 22 94 10 01 Exclusion - Damage To Work Performed By Subcontractors On Your Behalf
CG 22 95 10 01 Exclusion - Damage To Work Performed By Subcontractors On Your Behalf - Designated Sites Or Operations
CG 22 58 11 85 Exclusion - Described Hazards (Carnivals, Circuses And Fairs)
CG 21 53 01 96 Exclusion - Designated Ongoing Operations
CG 21 54 01 96 Exclusion - Designated Operations Covered By A Consolidated (Wrap-Up)
CG 21 33 11 85 Exclusion - Designated Products
CG 21 16 04 13 Exclusion - Designated Professional Services
CG 21 34 01 87 Exclusion - Designated Work
CG 21 59 04 13 Exclusion - Diagnostic Testing Laboratories
CG 21 37 06 15 Exclusion - Employees As Insureds
CG 22 43 04 13 Exclusion - Engineers, Architects Or Surveyors Professional Liability
CG 22 81 01 96 Exclusion - Erroneous Delivery Or Mixture And Resulting Failure Of Seed To Germinate - Seed Merchants
CG 22 42 11 85 Exclusion - Existence Or Maintenance Of Streets, Roads, Highways Or Bridges
CG 21 42 12 04 Exclusion - Explosion, Collapse And Underground Property Damage Hazard (Specified Operations)
CG 21 43 12 04 Exclusion - Explosion, Collapse And Underground Property Damage Hazard (Specified Operations Excepted)
CG 31 66 12 04 Exclusion - Exterior Insulation And Finish Systems (OCP)
CG 22 50 04 13 Exclusion - Failure To Supply
CG 22 38 07 98 Exclusion - Financial Institutions (Exclusion Of Fiduciary Liability)
CG 21 52 04 13 Exclusion - Financial Services
CG 21 56 04 13 Exclusion - Funeral Services
CG 22 41 10 01 Exclusion - Housing Projects Sites
CG 22 56 07 98 Exclusion - Injury To Volunteer Firefighters
CG 22 24 04 13 Exclusion - Inspection, Appraisal And Survey Companies
CG 22 48 04 13 Exclusion - Insurance And Related Operations
CG 21 41 11 85 Exclusion - Intercompany Products Suits
CG 22 98 04 13 Exclusion - Internet Service Providers And Internet Access Providers Errors And Omissions
CG 22 53 11 85 Exclusion - Laundry And Dry Cleaning Damage
CG 22 51 07 98 Exclusion - Law Enforcement Activities
CG 22 54 11 85 Exclusion - Logging And Lumbering Operations
CG 22 40 01 96 Exclusion - Medical Payments - Day Care Centers
CG 22 52 10 93 Exclusion - Medical Payments Coverage (Inmates, Patients Or Prisoners)
CG 21 17 07 98 Exclusion - Movement Of Buildings Or Structures
CG 21 36 03 05 Exclusion - New Entities
CG 22 73 07 98

Exclusion - Oil Or Gas Producing Operations - Oregon, Washington, Idaho

CG 21 38 11 85 Exclusion - Personal And Advertising Injury
CG 31 71 12 04 Exclusion - Product Replacement, Repair Or Repurchase
CG 31 70 12 04 Exclusion - Product Tampering
CG 21 04 11 85 Exclusion - Products - Completed Operations Hazard
CG 22 36 04 13 Exclusion - Products And Professional Services (Druggists)
CG 22 37 04 13 Exclusion - Products And Professional Services (Optical And Hearing Aid Establishments)
CG 22 32 04 13 Exclusion - Professional Services - Blood Banks
CG 21 58 04 13 Exclusion - Professional Veterinarian Services
CG 22 29 11 85 Exclusion - Property Entrusted
CG 23 01 04 13 Exclusion - Real Estate Agents Or Brokers Errors Or Omissions
CG 22 31 07 98 Exclusion - Riot, Civil Commotion Or Mob Action - Governmental Subdivisions
CG 22 46 11 85 Exclusion - Rolling Stock - Railroad Construction
CG 22 47 11 85 Exclusion - Saline Substances Contamination
CG 22 44 04 13 Exclusion - Services Furnished By Health Care Providers
CG 22 45 04 13 Exclusion - Specified Therapeutic Or Cosmetic Services
M2303L (12-16) Exclusion - Subsidence Of Land
CG 22 91 04 13 Exclusion - Telecommunication Equipment Or Service Providers Errors And Omissions
CG 22 33 04 13 Exclusion - Testing Or Consulting Errors And Omissions
CG 22 57 01 96 Exclusion - Underground Resources And Equipment
CG 21 09 06 15 Exclusion - Unmanned Aircraft
CG 29 60 06 15 Exclusion - Unmanned Aircraft
CG 21 66 06 15 Exclusion - Volunteer Workers
CG 31 74 12 04 Exclusion of Newly Acquired Organizations as Insureds
CG 27 05 01 96 Exclusion Of Specific Accidents, Products, Work Or Location (Claims Made)
CG 31 73 12 04 Extended Reporting Period Endorsement For Electronic Data Liability Coverage
CG 27 15 12 07 Extended Reporting Period Endorsement For Employee Benefits Liability Coverage
CG 24 11 12 04 Fiduciaries - Fiduciary Interest
CG 24 05 12 04 Financial Institutions - Fiduciary Interest Only
M2299L (9-08) Funeral Directors, Morticians And Cemeteries Professional Liability
M2295 (3-04) General Change Endorsement
CG 24 09 07 98 Governmental Subdivisions
CG 22 93 04 13 Lawn Care Services - Limited Pollution Coverage
CG 22 60 12 07 Limitation Of Coverage - Real Estate Operations
CG 21 44 07 98 Limitation Of Coverage To Designated Premises or Project
CG 28 06 01 96 Limitation Of Coverage To Insured Premises (Liquor Liability)
CG 22 80 04 13 Limited Exclusion - Contractors - Professional Liability
CG 22 96 04 13 Limited Exclusion - Personal And Advertising Injury - Lawyers
CG 31 32 12 04

Limited Fungi Or Bacteria Coverage

CG 04 36 12 04 Limited Product Withdrawal Expense Endorsement
CG 24 08 10 93 Liquor Liability
CG 00 33 04 13 Liquor Liability Coverage Form
CG 22 66 11 85 Miss-delivery Of Liquid Products Coverage
CG 99 01 11 85

Motor Vehicle Laws - Oregon, Washington, Idaho

M2665L (12-16) Multi-Unit Residential Construction Exclusion
M2663L (2-05)

New Residential Construction Exclusion - Oregon, Washington, Idaho

IL 01 98 09 08 Nuclear Energy Liability Exclusion Endorsement - Washington
CG 22 68 09 97 Operation Of Customers Autos On Particular Premises
CG 22 65 09 99 Optical And Hearing Aid Establishments
CG 00 09 04 13 Owners And Contractors Protective Liability Coverage Form - Coverage For Operations Of Designated Contractor
CG 28 05 10 01 Personal Injury Liability (OCP)
CG 22 64 04 13 Pesticide Or Herbicide Applicator - Limited Pollution Coverage
CG 04 29 12 04 Pollution Exclusion - Limited Exception For A Short - Term Pollution Event
CG 04 30 09 99 Pollution Exclusion - Limited Exception For Designated Pollutant(s)
CG 04 28 12 04 Pollution Exclusion - Named Peril Limited Exception For A Short - Term Pollution Event
CG 00 39 12 04 Pollution Liability Coverage Form Designated Sites
CG 00 40 12 04 Pollution Liability Limited Coverage From Designated Sites
CG 20 01 04 13 Primary & Noncontributory - Other Insurance Conditions
CG 28 07 04 13 Principals Protective Liability Coverage
CG 00 66 04 13 Product Withdrawal Coverage Form
CG 24 07 01 96 Products/Completed Operations Hazard Redefined
CG 00 37 12 04 Products/Completed Operations Liability Coverage Form
CG 00 38 12 04 Products/Completed Operations Liability Coverage Form (Claims Made)
CG 22 75 04 13 Professional Liability Exclusion - Computer Software
CG 22 77 04 13 Professional Liability Exclusion - Electronic Data Processing
CG 22 88 04 13 Professional Liability Exclusion - Electronic Data Processing Services And Computer Consulting Or Programming Services
CG 22 76 04 13 Professional Liability Exclusion - Health Or Exercise Clubs Or Commercially Operated Health Or Exercise Facilities
CG 22 90 04 13 Professional Liability Exclusion - Spa Or Personal Enhancement Facilities
CG 22 99 04 13 Professional Liability Exclusion - Web-Site Designers
CG 22 70 04 13 Real Estate Property Managed
M2289 (3-89) Renewal Certificate
IL 09 17 11 85 Resident Agent Countersignature Endorsement
CG 24 19 09 99 Seed Merchants - Coverage For Erroneous Delivery Or Mixture (Resulting Failure Of Seed To Germinate Not Included)
CG 24 18 09 99 Seed Merchants - Coverage For Erroneous Delivery Or Mixture And Resulting Failure Of Seed To Germinate
CG 22 92 12 07 Snow Plow Operations Coverage
M2385L (9-08) Special Events Exclusion Endorsement
M2763L (3-06) Stacking of Limits
CG 22 63 01 96 Stevedoring Operations Limited Completed Operations Coverage

CG 04 42

11 03

Stop Gap - Employers Liability Coverage Endorsement - Washington

CG 21 49 09 99 Total Pollution Exclusion Endorsement
CG 21 65 12 04 Total Pollution Exclusion With A Building Heating Equipment Exception And A Hostile Fire Exception
CG 21 55 09 99 Total Pollution Exclusion With A Hostile Fire Exception
M2827L (9-08) Travel Agency Exclusion Endorsement
CG 00 42 12 04 Underground Storage Tank Policy Designated Tanks
CG 24 03 11 85 Waiver Of Charitable Immunity (For Use With CGL And Products Policies)
CG 24 14 04 13 Waiver of Governmental Immunity
CG 24 04 05 09 Waiver Of Transfer Of Rights Of Recovery Against Others To Us
CG 29 88 10 93 Waiver Of Transfer Of Rights Of Recovery Against Others To Us (For Use With OCP Policy)

CG 26 77

12 04

Washington - Fungi Or Bacteria Exclusion (CGL)

CG 26 78

12 04

Washington - Limited Fungi Or Bacteria Coverage

CG 01 81

05 08

Washington Changes

CG 26 01

04 13

Washington Changes - Amendment Of Liquor Liability Exclusion

CG 29 62

03 90

Washington Changes - Amendment of Liquor Liability Exclusion

CG 26 02

04 13

Washington Changes - Amendment Of Liquor Liability Exclusion (Exception For Scheduled Activities)

CG 29 63

03 90

WashingtonChanges - Amendment of Liquor Liability Exclusion (Exception For Scheduled Activities)

CG 26 26

03 93

Washington Changes - Condominiums

IL 01 23

11 13

Washington Changes - Defense Costs

CG 29 08

09 99

Washington Changes - Department of Transportation Projects (OCP)

CG 01 97

12 07

Washington Changes - Employment Related Practices Exclusion

CG 29 54

12 07

Washington Changes - Employment Related Practices Exclusion (OCP And Products)

CG 28 99

01 96

Washington Changes (Liquor Liability Coverage Part)

CG 28 53

08 10

Washington Changes (OCP)

CG 28 98

11 89

Washington Changes (OCP)

CG 29 57

01 96

Washington Changes (Products/Completed Operations Liability Coverage Part - Pollution Liability Coverage Part)

CG 31 49

12 04

Washington Fungi Or Bacteria Exclusion (OCP/Products)

CG 31 50

12 04

Washington Limited Fungi Or Bacteria Coverage

CG 04 32 04 98 Year 2000 Computer - Related And Other Electronic Problems - Limited Coverage Options
CG 04 31 09 98 Year 2000 Computer - Related And Other Electronic Problems - Limited Coverage Options
 
 

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