# Deductible Coverage Endorsement

## SCHEDULE

### Part 1. POLICIES TO WHICH DEDUCTIBLE APPLIES

This Endorsement applies to the policy to which this endorsement is attached and to the policies described by policy number in the table below.

| Type of Insurance | Policy Numbers |
|-------------------|----------------|
| General Liability  | RMGL 612-27-08 |

### Part 2. COVERAGES TO WHICH DEDUCTIBLE APPLIES

#### A. This Part 2A. applies to all coverages OTHER THAN Business Auto, Garage, Truckers or Motor Carriers Auto Insurance.

The Deductible Amount of ______ applies on a combined basis to all coverages selected by "X" in the table below, except for such coverages (if any) for which a separate Deductible is shown below.

| Selected | Coverage | Deductible Amount | Per Occurrence | Per Claim |
|----------|----------|------------------|----------------|-----------|
| ☑        | Bodily Injury – Other than Products or Completed Operations | $5,000,000 | ☑ | ☐ |
| ☑        | Property Damage - Other than Products or Completed Operations | $5,000,000 | ☑ | ☐ |
| ☑        | Bodily Injury – Products or Completed Operations Only | $5,000,000 | ☑ | ☐ |
| ☑        | Property Damage – Products or Completed Operations Only | $5,000,000 | ☑ | ☐ |
| ☑        | Personal Injury | $5,000,000 | Each person or organization | ☐ |
| ☑        | Advertising Injury | $5,000,000 | Each person or organization | ☐ |
| ☑        | Employee Benefits Liability | $5,000,000 | Each Claim | ☐ |
| ☐        | All Other | ☐ | ☐ | ☐ |

As respects this deductible schedule, "Occurrence" means each occurrence, offense, professional incident, or common cause. "Claim" means each person, claim or suit.

#### B. This Part 2B. applies ONLY to Business Auto, Garage, Truckers Or Motor Carrier Auto Insurance.

The Deductible Amount of ______ applies on a combined basis to all coverages selected in the table below, except for such coverages (if any) for which a separate Deductible is shown below.

| Selected | Coverage | Deductible Amount per Accident |
|----------|----------|--------------------------------|
| ☐        | All Coverages | |
| ☐        | Bodily Injury | |
| ☐        | Property Damage | |
| ☐        | Personal Injury Protection | |
| ☐        | Added Personal Injury Protection | |
| ☐        | Uninsured Motorist | |
| ☐        | Underinsured Motorist | |

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