XL CATLINBrookfield Place200 Liberty Street, 22nd FloorNew York, NY 10281USAPhone 1 212-915-7000Fax 1 212-945-0820www.xlcatlin.comJuly 29, 2017Ms. SouWei FordWillis Insurance Services of Georgia, Inc.Concourse Corporate Ctr. Five18th FloorAtlanta, GA 30328RE:STATE OF GEORGIA, GTAPolicy Number : MTP9034923Dear SouWei:We are pleased to enclose an original and one (1) copy of the above captioned policy.Thank you for placing your insurance coverage with XL Catlin. We at XL Catlin feel that a keyelement of service to our brokers and insureds is efficient claims handling.Enclosed please find instructions that should be followed in the event of a claim. Should anyproblems or questions arise concerning claims reporting procedures, you may contact XL CatlinClaims Administrators, Inc. at 1-800-432-2481.Thank you for considering our office.Sincerely,Rich SchulzSenior UnderwriterXL CatlinEnclosuresWINS ACCOUNT # 0005242073
Claims Reporting InformationXL CATLINPlease be advised of the following claims reporting address:via email:email@example.comORvia regular mail:XL Catlinc/o XeroxPO Box 614002Orlando, FL 32861-4002POLLRPT 1015 2015 X.L. America, Inc. All Rights Reserved.May not be copied without permission.Page 1 of 1
INSURANCECYBER &TechnologyThank you for choosing XL Catlin for your cyber liability insurance. We value your business and look forward toworking with you.Use the information below for contacting the XL Catlin Data Breach Hotline and for accessing XL Catlin’s new onlineresource – CyberRiskIQ.com that provides easily accessible support for cybersecurity readiness and incidentresponse services.XL Catlin Data Breach HotlineShould you experience a data breach event, call our data breach hotline at 1-855-566-4724 for immediate triageassistance. Please be aware that contacting the data breach hotline does NOT satisfy the claim notificationrequirements of your policy. For claims notification requirements, refer to your policy.CyberRiskIQ.comAs an XL Catlin policyholder, your company has access to XL Catlin’s new online resource – CyberRiskIQ.com,containing information and technical resources that can assist you in the prevention of network attacks, cyber andprivacy losses, and support you in the timely reporting and recovery of losses if an incident occurs. Through asecure login on CyberRiskIQ.com, you can access:To register and access Cyber Liability Library: latest cyber risk articles and videos, as well as productcontent on XL Catlin’sand policy information from our XL Catlin cyber team.CyberRiskIQ.com Incident Roadmap: suggested steps to take following a network or data breach Go to www.CyberRiskIQ.comincident. Complete the registration form and Vendor Partner Resources: a directory to help clients gain quick access to ourinclude your access code. Yourrecently expanded, pre-qualified network of third-party resources with expertise inaccess code is 10448.pre- and post-breach disciplines, including network vulnerability testing, IT risk Once registered, you can accessassessments, incident response planning, security awareness training, PCIthe portal immediately with the Usercompliance, security incident response planning, data breach tabletops, and more.ID and password you established Meet the Team: includes XL Catlin Cyber/Tech team contact informationduring registration. News Center: articles and commentary discussing trends, major breach events,security awareness strategies and, risk management guidance and helpful industrylinks. Risk Manager’s Toolbox: includes a cyber-risk assessment survey, breach notification guides, what-if modeling tools toestimate the cost of a breach, research tools to monitor the type, frequency and severity of incidents occurring in yourbusiness sector, as well as privacy awareness training videos.Please note the following: CyberRiskIQ.com is a private site for customers of XL Catlin only. Do not share portal access instructions with anyoneoutside your organization. You are responsible for maintaining the confidentiality of the Access Code provided to you. Up to three individuals from your organization may register and use the portal. Ideal candidates include yourcompany’s Risk Manager, Compliance Manager, Privacy Officer, IT Operations Manager or Legal Counsel. This portal contains a directory of experienced providers of cyber risk management and breach recovery services.XL Catlin does not endorse these companies or their respective services. Before you engage any of these companies,we urge you to conduct your own due diligence to ensure the companies and their services meet your needs. Unlessotherwise indicated or approved, payment for services provided by these companies is your responsibility.POLLRPT 1015 2015 X.L. America, Inc. All Rights Reserved.May not be copied without permission.Page 1 of 1
.MAKE YOUR WORLD GOxlcatlin.comXL Catlin is the global brand used by XL Group plc’s insurance subsidiaries. In the US, theinsurance companies of XL Group plc are: Catlin Indemnity Company, CatlinInsurance Company, Inc., Catlin Specialty Insurance Company, GreenwichInsurance Company, Indian Harbor Insurance Company, XL Insurance America, Inc.,XL Insurance Company of New York, Inc., and XL Specialty Insurance Company. Not allof the insurers do business in all jurisdictions, nor is coverage available in all jurisdictions.Information and ratings (if listed) accurate as of December, 2015
Transactions – We will maintain records of all transactions with us, our affiliates, and our third party serviceproviders, including your insurance coverage selections, premiums, billing and payment information, claimshistory, and other information related to your account;Claims – If you obtain insurance from us, we will maintain records related to any claims that may be madeunder your policies. The investigation of a claim necessarily involves collection of a broad range of informationabout many issues, some of which does not directly involve you. We will share with you any facts that wecollect about your claim unless we are prohibited by law from doing so. The process of claim investigation,evaluation, and settlement also involves, however, the collection of advice, opinions, and comments from manypeople, including attorneys and experts, to aid the claim specialist in determining how best to handle your claim.In order to protect the legal and transactional confidentiality and privileges associated with such opinions,comments and advice, we will not disclose this information to you; andCredit and Financial Reports – We may receive information about you and your business regarding your credit.We use this information to verify information you provide during the submission and quote processes and tohelp underwrite and provide to you the most accurate and cost-effective insurance quote we can provide.Retention and Correction of Personal InformationWe retain personal information only as long as required by our business practices and applicable law. If we becomeaware that an item of personal information may be materially inaccurate, we will make reasonable effort to re-verifyits accuracy and correct any error as appropriate.Storage of Personal InformationWe have in place safeguards to protect data and paper files containing personal information.Sharing/Disclosing of Personal InformationWe maintain procedures to assure that we do not share personal information with an unaffiliated third party formarketing purposes unless such sharing is permitted by law. Personal information may be disclosed to anunaffiliated third party for necessary servicing of the product or service or for other normal business transactions aspermitted by law.We do not disclose personal information to an unaffiliated third party for servicing purposes or joint marketingpurposes unless a contract containing a confidentiality/non-disclosure provision has been signed by us and the thirdparty. Unless a consumer consents, we do not disclose “consumer credit report” type information obtained from anapplication or a credit report regarding a customer who applies for a financial product to any unaffiliated third partyfor the purpose of serving as a factor in establishing a consumer’s eligibility for credit, insurance or employment.“Consumer credit report type information” means such things as net worth, credit worthiness, lifestyle information(piloting, skydiving, etc.) solvency, etc. We also do not disclose to any unaffiliated third party a policy or accountnumber for use in marketing. We may share with our affiliated companies information that relates to our experienceand transactions with the customer.Policy for Personal Information Relating to Nonpublic Personal Health InformationWe do not disclose nonpublic personal health information about a customer unless an authorization is obtained fromthe customer whose nonpublic personal information is sought to be disclosed. However, an authorization shall notbe prohibited, restricted or required for the disclosure of certain insurance functions, including, but not limited to,claims administration, claims adjustment and management, detection, investigation or reporting of actual orpotential fraud, misrepresentation or criminal activity, underwriting, policy placement or issuance, loss control and/orauditing.PN CW 02 1015SULC 07/29/2017Page 2 of 3 2015 X.L. America, Inc. All Rights Reserved.May not be copied without permission.
NOTICE TO POLICYHOLDERSU.S. TREASURY DEPARTMENT’S OFFICE OF FOREIGN ASSETS CONTROL(“OFAC”)No coverage is provided by this Policyholder Notice nor can it be construed to replace any provisions ofyour policy. You should read your policy and review your Declarations page for complete information onthe coverages you are provided.This Policyholder Notice provides information concerning possible impact on your insurance coveragedue to directives issued by OFAC and possibly the U.S. Department of State. Please read thisPolicyholder Notice carefully.OFAC administers and enforces sanctions policy based on Presidential declarations of "nationalemergency". OFAC has identified and listed numerous Foreign agentsFront organizationsTerroristsTerrorist organizationsNarcotics traffickersas Specially Designated Nationals and Blocked Persons.This list can be found on theU.S. Department of the Treasury’s web site - http//www.treas.gov/ofac.The Secretary of the Treasury also has identified a number of entities in the insurance, petroleum, andpetrochemicals industries determined to be owned or controlled by the Iranian government. Businesstransactions with any of these entities are expressly prohibited. These entities have been added toOFAC’s list of Financial Institutions Determined To Be Owned or Controlled by the Government of Iran.This list can be found on the U.S. Department of the Treasury’s web site Programs/Pages/iran.aspx, see List of CISADA andNDAA Prohibitions or ConditionsIn accordance with OFAC regulations, or any applicable regulation promulgated by the U.S. Departmentof State, if it is determined that you or any other insured, or any person or entity claiming the benefits ofthis insurance has violated U.S. sanctions law or is a Specially Designated National and Blocked Person,as identified by OFAC, this insurance will be considered a blocked or frozen contract and all provisionsof this insurance will be immediately subject to OFAC. When an insurance policy is considered to besuch a blocked or frozen contract, neither payments nor premium refunds may be made withoutauthorization from OFAC. Other limitations on the premiums and payments also apply.PN CW 05 0914 2014 X.L. America, Inc. All rights reserved. May not be copied without permission.Includes copyrighted material of Insurance Services Office, Inc., with its permission.SULC 07/29/2017
NOTICE TO POLICYHOLDERSFRAUD NOTICEArkansasColoradoDistrict andNew JerseyPN CW 01 0915SULC 07/29/2017Any person who knowingly presents a false or fraudulent claim for payment of a loss orbenefit or knowingly presents false information in an application for insurance is guilty ofa crime and may be subject to fines and confinement in prison.It is unlawful to knowingly provide false, incomplete, or misleading facts orinformation to an insurance company for the purpose of defrauding or attemptingto defraud the company. Penalties may include imprisonment, fines, denial ofinsurance, and civil damages. Any insurance company or agent of an insurancecompany who knowingly provides false, incomplete, or misleading facts orinformation to a policyholder or claimant for the purpose of defrauding orattempting to defraud the policyholder or claimant with regard to a settlement oraward payable for insurance proceeds shall be reported to the Colorado Divisionof Insurance within the Department of Regulatory Agencies.WARNING: It is a crime to provide false or misleading information to an insurer for thepurpose of defrauding the insurer or any other person. Penalties include imprisonmentand/or fines. In addition, an insurer may deny insurance benefits if false informationmaterially related to a claim was provided by the applicant.Any person who knowingly and with intent to injure, defraud, or deceive any insurer filesa statement of claim or an application containing any false, incomplete, or misleadinginformation is guilty of a felony of the third degree.A "fraudulent insurance act" means an act committed by any person who, knowinglyand with intent to defraud, presents, causes to be presented or prepares withknowledge or belief that it will be presented to or by an insurer, purported insurer,broker or any agent thereof, any written, electronic, electronic impulse, facsimile,magnetic, oral, or telephonic communication or statement as part of, or in support of, anapplication for the issuance of, or the rating of an insurance policy for personal orcommercial insurance, or a claim for payment or other benefit pursuant to an insurancepolicy for commercial or personal insurance which such person knows to containmaterially false information concerning any fact material thereto; or conceals, for thepurpose of misleading, information concerning any fact material thereto.Any person who knowingly and with intent to defraud any insurance company or otherperson files an application for insurance containing any materially false information orconceals, for the purpose of misleading, information concerning any fact materialthereto commits a fraudulent insurance act, which is a crime.Any person who knowingly presents a false or fraudulent claim for payment of a loss orbenefit or knowingly presents false information in an application for insurance is guilty ofa crime and may be subject to fines and confinement in prison.It is a crime to knowingly provide false, incomplete or misleading information to aninsurance company for the purpose of defrauding the company. Penalties may includeimprisonment, fines, or denial of insurance benefits.Any person who knowingly or willfully presents a false or fraudulent claim for payment ofa loss or benefit or who knowingly or willfully presents false information in an applicationfor insurance is guilty of a crime and may be subject to fines and confinement in prison.Any person who includes any false or misleading information on an application for aninsurance policy is subject to criminal and civil penalties.Page 1 of 3 2015 X.L. America, Inc. All Rights Reserved.May not be copied without permission.
NOTICE TO POLICYHOLDERSNew MexicoNew YorkANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIMFOR PAYMENT OF A LOSS OR BENEFIT OR KNOWINGLY PRESENTS FALSEINFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A CRIMEAND MAY BE SUBJECT TO CIVIL FINES AND CRIMINAL PENALTIES.General: All applications for commercial insurance, other than automobileinsurance: Any person who knowingly and with intent to defraud any insurancecompany or other person files an application for insurance or statement of claimcontaining 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 thousanddollars and the stated value of the claim for each such violation.All applications for automobile insurance and all claim forms: Any person whoknowingly makes or knowingly assists, abets, solicits or conspires with another to makea false report of the theft, destruction, damage or conversion of any motor vehicle to alaw enforcement agency, the department of motor vehicles or an insurance company,commits a fraudulent insurance act, which is a crime, and shall also be subject to a civilpenalty not to exceed five thousand dollars and the value of the subject motor vehicle orstated claim for each violation.Fire: Any person who knowingly and with intent to defraud any insurance company orother person files an application for insurance containing any false information, orconceals for the purpose of misleading, information concerning any fact materialthereto, commits a fraudulent insurance act, which is a crime.OhioOklahomaPennsylvaniaThe proposed insured affirms that the foregoing information is true and agrees thatthese applications shall constitute a part of any policy issued whether attached or notand that any willful concealment or misrepresentation of a material fact orcircumstances shall be grounds to rescind the insurance policy.Any person who, with intent to defraud or knowing that he is facilitating a fraud againstan insurer, submits an application or files a claim containing a false or deceptivestatement is guilty of insurance fraud.WARNING: Any person who knowingly, and with intent to injure, defraud or deceiveany insurer, makes any claim for the proceeds of an insurance policy containing anyfalse, incomplete or misleading information is guilty of a felony.All Commercial Insurance, Except As Provided for Automobile Insurance:Any person who knowingly and with intent to defraud any insurance company or otherperson files an application for insurance or statement of claim containing any materiallyfalse information or conceals for the purpose of misleading, information concerning anyfact material thereto commits a fraudulent insurance act, which is a crime and subjectssuch person to criminal and civil penalties.Automobile Insurance: Any person who knowingly and with intent to injure or defraudany insurer files an application or claim containing any false, incomplete or misleadinginformation shall, upon conviction, be subject to imprisonment for up to seven years andthe payment of a fine of up to 15,000.PN CW 01 0915SULC 07/29/2017Page 2 of 3 2015 X.L. America, Inc. All Rights Reserved.May not be copied without permission.
NOTICE TO POLICYHOLDERSPuerto RicoRhode IslandTennesseeUtahVirginiaWashingtonWest VirginiaAll Other StatesPN CW 01 0915SULC 07/29/2017Any person who knowingly and with the intention of defrauding presents falseinformation in an insurance application, or presents, helps, or causes thepresentation of a fraudulent claim for the payment of a loss or any other benefit,or presents more than one claim for the same damage or loss, shall incur a felonyand, upon conviction, shall be sanctioned for each violation by a fine of not lessthan five thousand dollars ( 5,000) and not more than ten thousand dollars( 10,000), or a fixed term of imprisonment for three (3) years, or both penalties.Should aggravating circumstances [be] present, the penalty thus establishedmay be increased to a maximum of five (5) years, if extenuating circumstancesare present, it may be reduced to a minimum of two (2) years.Any person who knowingly presents a false or fraudulent claim for payment of a loss orbenefit or knowingly presents false information in an application for insurance is guilty ofa crime and may be subject to fines and confinement in prison.All Commercial Insurance, Except As Provided for Workers’ Compensation It is acrime to knowingly provide false, incomplete or misleading information to an insurancecompany for the purpose of defrauding the company. Penalties include imprisonment,fines and denial of insurance benefits.Workers’ Compensation: It is a crime to knowingly provide false, incomplete ormisleading information to any party to a workers’ compensation transaction for thepurpose of committing fraud. Penalties include imprisonment, fines and denial ofinsurance benefits.Workers’ Compensation: Any person who knowingly presents false or fraudulentunderwriting information, files or causes to be filed a false or fraudulent claim fordisability compensation or medical benefits, or submits a false or fraudulent report orbilling for health care fees or other professional services is guilty of a crime and may besubject to fines and confinement in state prison.It is a crime to knowingly provide false, incomplete or misleading information to aninsurance company for the purpose of defrauding the company. Penalties includeimprisonment, fines and denial of insurance benefits.It is a crime to knowingly provide false, incomplete or misleading information to aninsurance company for the purpose of defrauding the company. Penalties includeimprisonment, fines and denial of insurance benefits.Any person who knowingly presents a false or fraudulent claim for payment of a loss orbenefit or knowingly presents false information in an application for insurance is guilty ofa crime and may be subject to fines and confinement in prison.Any person who knowingly and willfully presents false information in an application forinsurance may be guilty of insurance fraud and subject to fines and confinement inprison. (In Oregon, the aforementioned actions may constitute a fraudulent insuranceact which may be a crime and may subject the person to penalties).Page 3 of 3 2015 X.L. America, Inc. All Rights Reserved.May not be copied without permission.
Regulatory Office505 Eagleview Blvd., Ste. 100Dept: RegulatoryExton, PA 19341-1120(800) 688-1840Indian Harbor Insurance CompanyCompany Providing Coverage:Cyber and Technology Liability PolicyDECLARATIONSNOTICE: THIS CONTRACT IS REGISTERED AND DELIVERED AS A SURPLUS LINE COVERAGEUNDER THE SURPLUS LINE INSURANCE LAW, O.C.G.A. CHAPTER 33-5.POLICY NUMBER:RENEWAL OF:MTP9034923New PolicyITEM 1.NAMED INSURED:Address:ITEM 2.POLICY PERIOD:Effective Date: July 1, 2017Expiration Date: July 1, 201812:01 A.M. Standard Time at the address of the Named Insured as stated herein.ITEM 3.PREMIUM:ITEM 4.NOTICE OF A CLAIM: STATE OF GEORGIA, GTA200 PIEDMONT AVENUE SEATLANTA, GA 30334400,000By email: firstname.lastname@example.org; orBy certified post mail: XL Catlin, P.O. Box 614002, Orlando, Florida 32861-4002.ITEM 5.XL BREACH HOTLINE:ITEM 6.PROFESSIONAL SERVICES:1.855.566.4724N/ATCD 000 0715 2015 X.L. America, Inc. All Rights Reserved. May not be copied without permission.Page 1
ITEM 7.COVERAGE SCHEDULE:LIMIT OF LIABILITY ELECTIONCombined LimitsCombined PolicyAggregate Limit10,000,000COVERAGESInsuring AgreementsThird Party Liability CoveragesPrivacy and Cyber SecurityPrivacy Regulatory Defense,Awards and FinesSeparate LimitsData Breach Responseand Crisis ManagementAggregate LimitN/AThird and First PartyAggregate LimitN/ASublimitsRetentionRetro /01/2016First Party CoveragesBusiness Interruption andExtra ExpenseData Recovery10,000,00010 000250,000N/A250,000N/AData Breach Response and Crisis Management CoverageData Breach Response and10,000,000Crisis ManagementTCD 000 0715 2015 X.L. America, Inc. All Rights Reserved. May not be copied without permission.Page 2
XL Catlin is the global brand used by XL Group plc's insurance subsidiaries. In the US, the insurance companies of XL Group plc are: Catlin Indemnity Company, Catlin Insurance Company, Inc., Catlin Specialty Insurance Company, Greenwich Insurance Company, Indian Harbor Insurance Company, XL Insurance America, Inc.,
Catlin Park North Catlin Park North is a future park located on Russi Road. The park site is approximately 9.2 aces, but only two acres will be developed. A multi-use turf area with small group · picnic shelter, restroom, an
Gilbert Stuart George Washington, Lansdowne Portrait, 1796 Thomas Jefferson et al. Declaration of . George Washington Crossing the Delaware. 1851. Guilty Eradication: The Portrayal of . George Catlin. Catlin Painting the Portrait of Mah-to-toh-pa-Mandan (
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Objective 1: Knows physical, human, and environmental geography of Georgia . The beginning Geography teacher: A. Knows the physical geography of Georgia B. Knows the human geography of Georgia C. Knows the regions and places in Georgia D. Knows the environmental geography of Georgia E. Knows the natural resource debates in Georgia
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Apr 29, 2013 · Georgia Institute of Technology Laboratory Safety Manual 9 1. Introduction and General Administration Laboratory Safety at the Georgia Institute of Technology (Georgia Tech) is a multi faceted program managed by Georgia Tech Environmental Health and Safety (EHS) and includes programs in Biological Safety, Chemical Safety, Hazardous MaterialsFile Size: 1MB
DCH At-a-Glance Board of Community Health Governor Georgia Department of Community Health Executive Assistant Commissioner Georgia Board for Physician Workforce Georgia Composite . Georgia Children* Served by the Department of Community Health in FY 2013 Accomplishments. Georgia Department of Community
analisis akuntansi persediaan barang dagang berdasarkan psak no 14 (studi kasus pada pt enseval putera megatrading tbk) kementerian riset teknologi dan pendidikan tinggi politeknik negeri manado – jurusan akuntansi program studi sarjana terapan akuntansi keuangan tahun 2015 oleh: novita sari ransun nim: 11042014