Restriction of Individual Policies – North Carolina

POLICY NUMBER: HOMEOWNERS HO 32 29 01 13 RESTRICTION OF INDIVIDUAL POLICIES – NORTH CAROLINA SCHEDULE At the request of the Named Insured, it is agreed that the policy is restricted in the following respects: The following Exclusions have been added to SECTION II – EXCLUSIONS, under E. Coverage E – Personal Liability And Coverage F – Medical Payments To Others: E. Coverage E – Personal Liability And Coverage F – Medical Payments To Others This insurance will not provide coverage or payments for indemnity or expense costs under any part of this policy for any “occurrence” arising wholly or in part, out of or in connection with: Swimming Pools or Spas 1. Pool slides; 2. Diving boards; 3. Unkempt swimming pool or spa; or 4. Empty or unprotected swimming pool or spa: Unprotected swimming pool is defined as a swimming pool that is not completely enclosed by a permanent barrier, such as a wall or fence, at least 4 feet high, or screen enclosure. Unprotected spa is defined as a spa that does not have locking cover or a permanent barrier such as a wall, fence, or screen enclosure; Animals 1. Any prohibited breeds dogs; 2. Any exotic, wild, farm, or saddle animal; 3. Any animal deemed dangerous, vicious, or potentially dangerous, under state statute; 4. Any animal with prior history of biting or attacking persons, property, or other animals; or 5. Any animal that has been trained to guard or attack; This Exclusion applies whether the “bodily injury” or “property damage” occurs on the “residence premises” or elsewhere. Exotic, wild, farm, or saddle animals, include, but are not limited to: hoofed animals, livestock, reptiles, primates, and fowl. Prohibited breeds of dogs include: Akitas Inu, Alaskan Malamute, American Bull Dog, American Staffordshire Terrier, American Pit Bull Terrier, Beauceron, Boerboel, Bull Mastiff / American Bandogge / Bully Kutta (any other Mastiff breed), Cane Corso, Caucasian Ovcharka (Mountain Dogs), Chow Chow, Doberman Pinscher (miniature Dobermans acceptable), Dogo Argentino, English Bull Terrier, Fila Brasileiro (aka Brazilian Mastiff), German Shepherds, Giant Schnauzer, Great Dane, Gull Dong (aka Pakistani Bull Dog), Gull Terrier, Husky or Siberian Husky, Japanese Tosa / Tosa Inu / Tosa Ken, Korean Jindo, Perro de Presa Canario, “Pit Bull”, Rhodesian Ridgeback, Rottweiler, Staffordshire Bull Terrier, Thai Ridgeback Wolf or Wolf hybrid, and any mixed breed dog containing any of the aforementioned breeds. Liability Hazards 1. Trampolines; 2. Skateboards ramps; 3. Bicycle ramps; 4. Bounce houses or similar apparatus; 5. Zip lines; or 6. Tree houses; HO 32 29 01 13 Copyright, North Carolina Rate Bureau, 2012 Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. This Exclusion applies whether the “bodily injury” or “property damage” occurs on the “residence premises” or elsewhere. Recreational Vehicles Coverage E and F do not apply to any ownership, maintenance, or use of any motor vehicle or other motorized land conveyances designed for recreational use off public roads or which is not subject to motor vehicle registration. This Exclusion does not apply to: 1. Vehicles used exclusively to service the premises; 2. Vehicles designed to assist the disabled; or 3. Golf carts; The Section II – Exclusions above should be interpreted as excluding negligence arising from or resulting in the excluded cause of loss, including, but not limited to, the negligent hiring, employment, placement, training, supervision, investigation, reporting to the proper authorities, or failure to so report, retention of a person for whom any insured is or ever was legally responsible and whose conduct would be excluded by E. Coverage E – Personal Liability And Coverage F – Medical Payments To Others: Signature Of Named Insured Insurance Company By: Title HO 32 29 01 13 Copyright, North Carolina Rate Bureau, 2012 Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. .

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