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4. Civil Rights <br />Insurance. Company <br />Does your error and ommission policy provide <br />Yes No <br />Federal Civil Rights Coverage <br />States Civil Rights Coverage <br />Does -either your Comprehensive General Liability <br />or Errors and Omm'_ssions coverage provide <br />unqualifie3 assualt :.ind/or battery coveray�. <br />S. Automobile t.iahility <br />Ins1Jr�nr.•z noln,�any <br />Limits of Liability _ _ _ _ <br />CSL <br />_ <br />Bodily Injury <br />Property Damage <br />Is coverage afforded for: <br />Yes No <br />(a) Owned non -owned and hired autos <br />(b) Is basic no fault included <br />(c) Is uninsured and underinsured motorists <br />coverage afforded at basic limits <br />(d) Is the fellow servant exclusion removed <br />(e) Is full automatic coverage for additional <br />vehicles afforded <br />6. Umbrella Liability <br />Insurance Company <br />..imit of Liability ------------------------------- <br />Self insured Retention <br />(a) Is defense coverage afforded on retention <br />(b) Is errors and omissions covered on a follow <br />form basis <br />(c) Is riot or mob exclusion removed <br />(d) Is coverage afforded on an agree -to -pay <br />basis <br />(e) Is the premium on a flat charge basis <br />- I s- <br />