S1

Section S – Standard Endorsement Forms

Ontario – August 2001

FACILITY ASSOCIATION

Ontario Policy Change Form (OPCF) Number and Title

2 Providing Coverage when Named Persons Drive Other AutomobilesThe purpose of this endorsement is to extend the “drive otherautomobiles” Liability and Accident Benefits coverage topersons other than the Insured and spouse.

3 Drive Government AutomobilesThe purpose of this endorsement is to cover the Insured’slegal liability arising from the custody and use of a vehicleowned by the federal or a provincial government, includingliability for the loss of or damage to the vehicle arising fromCollision and/or Comprehensive or Specified Perils. TheInsured must specify the types of vehicle that may be in hiscustody and, in regard to the “Physical Damage” coverages,must indicate the required limit per occurrence.

4A Permission to Carry Explosives

4B Permission to Carry Radioactive Materials

5 Permission to Rent or Lease Automobiles andExtending Coverage to the Specified Lessee(s)Applicable to leases exceeding 30days.

Rates to be charged

Net Annual Premium depending on Liability limit on vehicle:

$200 $300 $500

7 8 9 10Plus $1 for Accident Benefits.

Calculate the coverage premiums applicable to the highest ratedgovernment vehicle that may be in the insured’s custody as if heowned such a vehicle. Take into account Driving Record as well asthe type and use of the vehicle and the coverage deductibles; usethe limit per occurrence as the vehicle’s value for determining therating group and, in respect of a commercial vehicle, assume themodel year to be the current year. The charge for each coverage isthe under-noted percentage of the calculated premium.

Liability and DCPD: . . . . . . . . . . . . . . . . . . . . . .20%Accident Benefits, Uninsured Automobile: . . . . .50%Physical Damage: . . . . . . . . . . . . . . . . . . . . . . . .100%

If main cargo, rate vehicle as Class 48, 51B or 61B plus specialfactors. If incidental, net annual $50.See Rule 39 in Section A of this Manual.

If main cargo, rate vehicle as Class 48, 51B or 61B plus specialfactors.If incidental, net annual $50.See Rule 40 in Section A of this Manual.

No charge; vehicle rated as if owned by lessee.See Rule 36 in Section A of this Manual.

Notes:1.No endorsements, no special wordings and no changes to standard forms are permissible except as approved by or on

behalf of the Superintendent(s) of Insurance.2.This Manual (in this section and elsewhere) provides certain details of approved Endorsement forms. The descriptions

are necessarily very brief and reference must be made to the actual wordings of the Endorsements to ascertain the fullprovisions and restrictions.

3.In certain cases a copy of the Endorsement must be signed by the Applicant and filed with the Servicing Carrier. Theinsurance will not be continued or the policy re-rated if this requirement is not met.

SUB-SECTION 1ENDORSEMENTS APPLICABLE TO

ONTARIO POLICY CHANGE FORM (OPCF)Liability (or TPL) means B.I. and P.D. Tort; DCPD means Direct Compensation - Property Damage;

Physical Damage means Optional Coverages - Loss or Damage (All Perils, Collision, Comprehensive, Specified Perils.)

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Section S – Standard Endorsement Forms

Ontario – August 2001

FACILITY ASSOCIATION

Ontario Policy Change Form (OPCF)Number and Title

5C Permission to Rent or Lease(unspecified lessees - short term leases only)Applicable to leases not exceeding 30 days.

5D Conversion Coverage (rented orleased automobiles)

6A Permission to Carry Paying PassengersWhen appropriate, this endorsement is used to modify thepolicy forms restrictions in regard to the use of the vehiclefor the carriage of passengers. The actual use of the vehiclemust be specified in the endorsement. See Section C (PrivatePassenger Vehicles) and Section E (Public Vehicles): the useof the endorsement is not permissible in respect of othervehicles. Also see OPCF 22.

Rates to be charged

The following premiums apply to the policy and are not specif-ically for the endorsement:

1. Liability, DCPD and All Perils, Collision, Comprehensive, Specified Perils:

Private Passenger . . . . . . . . . . . . . . . . . . . .250% of 07/0

Commercial VehiclesLight Trucks . . . . . . . . . . . . . . . . . . . . . . .200% of 43/0Heavy Trucks . . . . . . . . . . . . . . . . . . . . . . .200% of 45/0Tractor/Trailers . . . . . . . . . . . . . . . . . . . . .175% of 51/0

Private Trailersa. Liability, DCPD . . . . . . . . . . . . . . . . . . . . . . .add $15b. Physical Damage . . . . . . . . . . . . . . . .250% of normal

MotorHomes & Camper Unitsa. Liability, DCPD . . . . . . . . . . . . . . . . . . .250% of 07/0b. Physical Damage . . . . . . . . . . . . . . . .250% of normalMotorcycles & Mopeds . . . . . .250% of DR 0 for age 16Snowmobiles and ATVs . . . . . . . . . . . . .250% of normal

2. Accident Benefits, Uninsured Automobile

All Vehicles . . . . . . . . . . . . . . . . . . . . . . .100% of DR 0

See Rule 35 in Section A of this Manual.

Not offered

For Private Passenger Vehicles used in car pools: add 10% ofLiability and DCPD premium.

Volunteers:A volunteer transports persons to medical appointments and the like, and is reimbursed for their reasonable driving expenses,including gas, vehicle wear and tear and meals. END 6a is notrequired and there is no additional premium charge.

Other Private Passenger Vehicles used to transport passengers:

i) If transportation of non-paying passengers is part of insured’s job and employer reimburses employee for expenses- then 07 rates apply.

ii) If transportation is very occasional (no more than once a week - non-paying passengers) then 02 or 03 rates can apply.

iii) All others, then appropriate taxi, limousine or bus rates are applicable.

OPCF 6a endorsement would be attached, however, only if thevehicle is used in a car pool would the 10% surcharge apply.For Public Vehicles: rate vehicle accordingly. See Public VehicleSection of the Manual.

Ontario Policy Change Form (OPCF)Number and Titles

6B School BusThis endorsement is used in respect of School Buses and, inregard to Passenger Hazard, provides either (a) separatelimits of liability in respect of (i) bodily injury to any oneperson, (ii) bodily injury to all persons, and (iii) passengers’property or (b) a combined limit in respect of all passengers’bodily injury and property damage.

6C Public Passenger Vehicles - Combined LimitsThis endorsement is used in respect of buses other thanSchool Buses and, in regard to Passenger Hazard, provideseither (a) separate limits of liability in respect of (i) bodilyinjury to any one person, (ii) bodily injury to all persons, and(iii) damage to property carried in the automobile, or (b) acombined limit in respect of all passengers’bodily injury andproperty.

6D Driver Training SchoolThis endorsement gives permission for the vehicle to be usedfor Driver Training School purposes and extends theLiability section of the policy to provide coverage in respectof the Insured’s liability for bodily injury to studentdrivers/observers. The Liability limit provided in respect ofRoad Hazard is to be repeated in the endorsement againstboth “any one person” and “two or more persons”.Also See OPCF 22.

6F Public Passenger VehiclesThis endorsement is used instead of OPCF 6C when acombined Road & Passenger Hazard Limit (B.I. & P.D.) is tobe provided.

7 Separate Limits (Liability)This endorsement is used only when proof of insurance isfiled in respect of a vehicle and the authority concernedrequires that, in respect of Road Hazard, the insuranceprovide separate Liability limits for (i) bodily injury to anyone person, (ii) bodily injury to all persons, and (iii) damageto property.

8 Property Damage Reimbursement

9 Marine Use ExcludedThis endorsement specifies that insurance is not providedwhile the vehicle is in or upon water or being launched orlanded. The use of the endorsement is mandatory in respectof vehicles designed for use on both land and water(amphibious vehicles, all terrain vehicles, swamp buggies).

Rates to be changed

Rate Vehicle according to Public Vehicle Section of the Manual.

Rate vehicle according to Public Vehicle Section of the Manual.

Rate vehicle according to Rule 37 in the Manual.

Rate vehicle according to Public Vehicle Section of the Manual.

Premium is that applicable to an inclusive limit equal to the sum ofthe limits for B.I. to any one person/any one accident.

Not offered.

No charge.

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Section S – Standard Endorsement Forms

Ontario – August 2001

FACILITY ASSOCIATION

S4

Section S – Standard Endorsement Forms

Ontario – August 2001

FACILITY ASSOCIATION

Ontario Policy Change Form (OPCF)Number and Title

13C Restricting Glass CoverageThis endorsement amends the Comprehensive coverage bydeleting coverage for damage to glass unless caused by ahazard included in Specified Perils coverage.

16 Suspension of Coverage

17 Reinstatement of Coverage

19 Limiting the Amount Paid for Loss or Damage CoverageThis endorsement provides that, in the event of loss ordamage, the maximum amount of insurance under thePhysical Damage sections of the policy is the actual cashvalue of the vehicle or the specified dollar amount (selectedby the Insured), whichever is less.The use of the endorsement is mandatory in respect ofMotorcycles and Mopeds and all vehicles for which thePhysical Damage premiums are based on the estimated orappraised current value.

19A Agreed Value of Automobiles

20 Coverage for Transportation ReplacementThis endorsement provides coverage to pay for other meansof transportation because of loss or damage to a describedvehicle covered by END 20 caused by an insured peril andwhere the amount of loss or damage exceeds the deductible.

21A Monthly reporting basis fleet (applicable to Ontariolicensed vehicles)

21B Blanket Fleet Coverage for Ontario Licensed Automobiles

22 Damage to Property of PassengersThis endorsement is used to insure the Passenger PropertyDamage hazard when either (a) OPCF 6a or 6d is attached tothe policy.

Rate to be charged

Private Passenger Vehicles, Motor Homes and “Light”Commercial Vehicles (excluding Trailers).Premium charged for reduced coverage is Specified Perils plus10% of Comprehensive except for deductibles of $500 or overwhere there is no discount from the full applicableComprehensive premium.Note: For the purposes of the Automobile Statistical Plan, thereduced coverage is reported as Comprehensive Coverage.Other Vehicles:Not offered.

If there is only one vehicle on the policy, percentage of unearnedpremium for remainder of term to be refunded: Liability - 90%;A.B. - 75%; DCPD - 90%; Coll. - 100%. If two or more vehicleson policy and one retains Liability and Accident Benefitscoverages, the percentages are Liability - 90%; A.B. - 100%;DCPD - 90%; Coll. - 100%. No refund for suspensions of lessthan 45 days.See Rule 30 in Section A of this Manual.

Used in connection with OPCF 16.See Rule 30 in Section A of this Manual.

Base Physical Damage premiums on estimated or appraisedcurrent value.

Not offered.

Private PassengerVehicles (Classes 01-19):$50 net per annum - for amount payable not exceeding $50 forany one day nor total more than $900.

Other Vehicles:Not offered.

See Rule 114A in Section B of the Manual.

Not offered.

Not offered.

Premium is the Passenger Hazard Property Damage premiumfor the class of vehicle.See Public Vehicle Section of the Manual.

Ontario Policy Change Form (OPCF)Number and Title

23A Lienholder ProtectionThis endorsement records the joint interest of a lienholder.

23B Mortgage (Broad Form)This endorsement is broader than OPCF 23a in that itprovides additional protection to the lienholder.

24 Fire ApparatusThis endorsement excludes Physical Damage coverage inrespect of equipment removed from the vehicle while at thelocation of a fire. Use of the endorsement is mandatorywhen the insurance applies to a fire-fighting vehicle

25 Alteration

27 Liability for Damage to Non-Owned Automobile(s) and providing Other Coverageswhen Insured Persons Drive Other AutomobilesThe purpose of the endorsement is to cover the Insured’slegal liability for loss of or damage to a non-ownedvehicle/trailer (not owned by or licensed in the name of theInsured or any other person residing in the same premises)arising from Collision and/or Comprehensive or SpecifiedPerils. The Insured must specify the types of vehicle/trailerthat may be in his custody.In addition, this endorsement extends the “drive otherautomobiles” Liability and Accident Benefits coverage topersons other than the Insured and spouse.

27B Business Operations - Liability for Damage to Non-Owned Automobile(s) in your Care, Custody orControlThe purpose of the endorsement is to cover the Insured’slegal liability for loss of or damage to a non-ownedvehicle/trailer (not owned by or licensed in the name of theInsured or any other person residing in the same premises)arising from Collision and/or Comprehensive or SpecifiedPerils. The Insured must specify the types of vehicle/trailerthat may be in his custody and indicate the required limitper occurrence.

28 Reducing Coverage for Named PersonsThis endorsement is used if the coverages provided by thepolicy are to be restricted when certain named operators aredriving the vehicle.

28A Excluded DriverThis endorsement is used to exclude coverage when theperson named in the endorsement drives the automobile.Both the excluded person and the insured must sign theendorsement. The endorsement must be signed annually.

Rate to be charged

No charge.If an OPCF 23a/b is issued showing the coverages provided, theapplicability of any restrictive endorsement (such as OPCF19/28/40) is also to be recorded.

10% of total Physical Damage premium; minimum net annual $25.If an OPCF 23a/b is issued showing the coverages provided, theapplicability of any restrictive endorsement (such as OPCF19/28/40) is also to be recorded.

No charge.

No charge; minimum additional premium of $5 for addition ofcoverage or vehicle, increase in Liability limit, or decrease indeductible amount.

Private Passenger Vehicles:

Premium: $50 per annum.

Peril: All Perils onlyLimit: $40,000Deductible: $250

Restriction: Coverage offered only to risks carrying both Collision and Comprehensive, or All Perils on the vehicle described in the policy.

Other Vehicles: Not offered.

Coverage premiums charged are those applicable to the highest ratedvehicle as if the insured owned such a vehicle; the limit peroccurrence is used to calculate rate group; model year is assumed tobe the current year.

No premium reduction

Premium: No charge to add endorsement.Rate vehicle as if excluded driver was not in the household. Uponremoval of the END 28A, all accidents and convictions will beconsidered chargeable. See Rule 31.

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Section S – Standard Endorsement Forms

Ontario – 15 September 2005

FACILITYASSOCIATION

FACILITYASSOCIATION

Ontario Policy Change Form (OPCF)Number and Title

29 Additional Coverage for Named Persons

30 Removing Coverage for Attached MachineryThis endorsement excludes Liability and Accident Benefitscoverage in respect of the ownership or use of machinery orapparatus mounted on or attached to the vehicle, while at thesite of such use. .

31 Non-Owned EquipmentThis endorsement provides coverage in respect of apparatus,machinery or equipment that is attached to the vehicle but isnot owned by the Insured. Use of the endorsement is notpermissible in respect of a vehicle to which OPCF 30applies. The Physical Damage coverages may only be thesame as those provided in respect of the vehicle. Therequired limit in respect of loss of or damage to theequipment must be specified.

32 Use of Recreational Vehicles by Unlicensed OperatorsThis endorsement permits the use of the insured vehicle, offthe public highway and for recreational purposes only, by anunlicensed and/or unqualified person.

35 Coverage for Emergency Road ServicesThis endorsement provides coverage in respect of towing andemergency service expenses necessitated by disablement ofthe vehicle.

38 Agreed Limit for Automobile Electronic Accessoriesand EquipmentThis endorsement limits theft coverage for electronicaccessories (other than factory installed) to the lesser of theactual value of the equipment or $1,500 unless the equipmentis listed in the endorsement.

40 Fire DeductibleThis endorsement is used when the All-Perils/Comprehensive/Specified Perils deductible is to bemade applicable also to Fire losses.

43 Removing Depreciation Deduction

43A Removing Depreciation Deduction for SpecifiedLessee(s)

Rate to be Charged

Not offered.

No charge.

No specific charge, equipment cost to be included in vehiclevalue.

No charge.

Net annual $5 per vehicle.

$30 per $1,000 or part there of, of the limit of coverage shownon the endorsement.

No charge.

Not offered.

Not offered.

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Section S – Standard Endorsement Forms

Ontario – 15 March 2009

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Section S – Standard Endorsement Forms

Ontario – August 2001

FACILITY ASSOCIATION

O.E.F.No.

90: Limitation to Operation of automobiles by partnersofficers and employees.This endorsement is used when the insurance is to apply only toautomobiles driven by partners, officers and employees (ie., noagents and no “hired automobiles’or automobiles operated undercontract). The classed concerned (A1/A2/B) are to specified in theendorsement.

91: Limitation to operation of automobiles by namedpersonsThis endorsement is used when the insurance is to apply only toautomobiles driven by the persons whose names, occupations andlocations are specified in the edorsement.

92: Limitation to Hired Automobiles and Automobilesoperated under contractThis endorsement is used when the insurance is to apply only to“hired automobiles’and/or automobiles operated under contract.

93: Limitation to automobiles owned by named personsThis endorsement is used when the insurance is to apply only to theoperation of automobiles owned by the persons, firms orcorporations whose names and addresses are specified in theendorsement.

94: Legal Liability for damage to Hired AutomobilesThis endorsement is used when the insurance is to be extended tocover the Insured’s legal liability for damage to hired automobilesarising from All-Perils or from Collision and/orComprehensive/Specified-Perils. See Rule 702.E.3in Section H ofthis manual

95: Limitation to business conducted at specifiedlocations

This endorsement is used when the insurance is to apply only to theuse of automobiles in connection with the Insured’s specifiedbusiness locations.

96: Contractual LiabilityThis endorsement is used when the policy’s exclusion of liabilityassumed under any contract or agreement is to be deleted in respectof specified contracts; the dates of the contracts and the names of thecontraction parties tobe specified. See Rule 702.E.2in Section H ofthis manual

O.E.F.No.

97: Operation by individual named InsuredThis endorsement is used if the named Insured is an individual andcoverage is to be provided in respect of the operation by the Insured,in the business of the insured, of a non-owned automobile to whichthe insurance relates.

The endorsement also extends the coverage provided by S.E.F. No.94. (Until the discrepancy is corrected, the reference in the secondparagraph of S.E.F. No. 97 to “exclusions (a)” should be Exclusion 1.

If the endorsement is required, it is necessary for full details of therisk to be submitted to the Servicing Carrier so that the appropriatepremium(s) may be assessed.

98: Excluding automobiles driven by named personsThis endorsement is used when it is required to exclude coverage inrespect of automobiles driven by specific named persons.

99: Excluding long-term leased vehicleThis endorsement is applicable to insurance in respect of hiredautomobiles and must be used when the automobiles are hiredwithout drivers. See Rule 702.Fin Section H of this manual.

100: AlterationThis form is used by the Servicing Carrier to record a change of theinformation provided on the application form and the change (if any)of the policy premuim.

SUB-SECTION 4ENDORSEMENTS APPLICABLE TO O.P.F. No.6

(NON-OWNED AUTOMOBILE LIABILITY POLICY)