INVOICE TEMPLATE

RISK TYPE - TTS : TRACKS AND TREADS Standard

INSURER TLC Insurance Ltd as Lloyd’s Coverholder

EXCESS AS SHOWN BELOW

( S ) STANDARD COVER

Cover for sudden physical loss, damage or destruction from any cause, subject always to the terms, conditions and exceptions contained within the TLC ‘Tracks & Treads – Standard’ Contractors Mobile Plant policy wording TTS:04 – March 2015.

( T ) SCHEDULE OF PLANT INSURED

( C ) EXCESS

1% of Sum insured – minimum of $500

EXCEPT a minimum Theft excess of $2,000 applies to Machine Accessories whilst detached from a machine

(S) TERRITORY

New Zealand

( S ) STANDARD EXTENSIONS

Additional Costs – Limit $10,000

Additions & Deletions – Limit $250,000 / 3 months

Agreed Value (conditions apply)

Breach of Warranty

Cleaning Up Costs following an Accident – Limit $10,000

Emergency Services

GST in excess of sum insured clause

Hired & Borrowed Plant – Limit $250,000 / 90 days – Subject to Average

Increased Value – Limit 10% of sum insured

Interest Clause

Mutually Acceptable Loss Adjusters

No excess for Fire (conditions apply)

Progress Payments

Proportional Premium Refund – Total Loss

Reinstatement of Amount following Loss

Salvage, Recovery & Resiting Costs – Limit $50,000

Temporary Repairs with Insurer approval – Limit $5,000

Third Party Road Risk – $10,000,000 – $500 excess

Uninsured Third Party Protection – Limit $3,000

Windscreen – Limited to one claim per policy period / to be reported within

60 days / $1,500 limit / Excess: Non Forestry $100 / Forestry $250

( C ) OPTIONAL EXTENSIONS

1. Appreciation (Limit 25% of Sum Insured)

2. Consequential Loss including Loss of Revenue

Weekly Limit - $5,000 (Maximum)

Claim Limit - $50,000 (Maximum)

Policy Limit - $250,000 (Any one Period of Insurance)

Excess – 10% of claim – minimum $2,500

Indemnity Period – 6 Months

Items -

3.  Employee Death by Accident ‘At Work’ / Funeral Expenses

Limit - $50,000 (For Death)

Limit - $5,000 (For Funeral Costs)

Aggregate Limit - $100,000 (For Death) / $10,000 (For Funeral Costs)

-  All Employees

4. Finance Payment Protection

Limit – 6 months

Excess – 10% of loss – minimum $2,500

Items -

5.  Foreign Objects (Excess 10% of loss - minimum $2,500)

Items –

6.  Goods on Hook

Limit $

Excess $

Items -

7.  Hoists & Hydraulic Lifting Equipment

Limit - $5,000 per claim

Excess - $1,000

Items -

8. Laid-Up Cover Discount

Items

8.  Machinery Breakdown

Limit $10,000

Excess 10% of claim – minimum $1,000

Items -

10. Profit Share Clause (15% refund where total loss less than 40%)

11. Rental Machine Cover

Limit - $10,000

Excess - $1,000)

12. Tools & Sundry Equipment

Excess - $500 / $1,000 Burg/Theft)

Limit $

13. Tyre Extension

Limit - $5,000 any one claim

Excess - $500

Items -

14. Windscreen (Forestry/Quarry)

Limit - $5,000

Excess $ as agreed

Items

( S ) PRINCIPAL EXCLUSIONS

Consequential Loss

Depreciation, Wear & Tear

Electronic Data

Failure, defect or fault in design or specification

Intentional loss

Loss arising from ingestion or entry of any foreign object into any machine or any attachment or accessory thereto

Loss caused by an operator under the influence of alcohol or drugs

Loss caused by lawful seizure

Loss caused by nuclear fuel, material etc

Loss caused by war, foreign hostilities or nuclear material

Loss discovered during routine servicing

Loss resulting from explosion or collapse of a pressure vessel

Mechanical breakdown or failure

Outside New Zealand

Theft by any person posing as a prospective purchaser

Theft unless reasonable steps taken to protect property

Tyre Damage

Where left unattended in any watercourse for more than 4 hours

Where operator not licensed to operate machine

Whilst being used for a purpose other than for which a machine was designed

Whilst being used for an illegal purpose

Whilst being used for or in preparation for any race, trial or contest

Whilst being used in an unsafe manner or unroadworthy condition

Whilst being used underground

Whilst undergoing a testing procedure

( C ) REMARKS

( C ) UNDERWRITER COMMENT

Please notify TLC IMMEDIATELY should any of the information contained within this invoice be incorrect and require amendment.

( S ) INSURANCE COMPANY DETAILS

INSURER: Certain Underwriters at Lloyd’s under Agreement Number: SC 3342014219

TLC Insurance Limited as Lloyd’s Coverholder

INSURANCE COMPANIES (RATINGS & INSPECTIONS) ACT 1994

Lloyd’s Standard & Poors A+ (Strong) 15 October 2014

AM Best A (Excellent) 15 October 2014

Fitch AA- (Very Strong) 15 October 2014

INSURANCE COMPANIES DEPOSIT ACT 1953

Access to the Insurers with whom the insurance under this policy is placed is made available through deposits lodged by Lloyd’s in accordance with Section 4B of the Insurance Companies Deposits Act 1953 and such deposit is available as security for the contract of insurance evidenced by this document

The name of the individual Insurer with whom your insurance is placed is available on request

SEVERAL LIABILITY CLAUSE LSW1001

The subscribing Insurers’ obligation under contracts of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual subscriptions. The subscribing insurers are not responsible for the subscription of any co-subscribing insurer who for any reason does not satisfy all or part of its obligation.

TTS:04 March 2015