Lloyd's Certificate

This Insurance

is effected with certain Underwriters at Lloyd's,

London (not incorporated).

This Certificate

is issued in accordance with the limited

authorization granted to the Correspondent by certain Underwriters at Lloyd's,
London whose names and the proportions underwritten by them can be
ascertained from the office of said Correspondent (such Underwriters being
hereinafter called "Underwriters") and in consideration of the premium
specified herein, Underwriters do hereby bind themselves each for his own
pa rt , and not one for another , th eir h eirs , ex ecuto rs and
administrators.

The Assured

is requested to read this certificate, and if not correct,

return it immediately to the Correspondent for appropriate alteration.
In the event of a claim under this certificate, please notify the following
correspondent:

Hays Affinity Solutions

A Member of Hays Companies

1025 Thomas Jefferson Street, NW

Suite 425W
Washington, DC 20007

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Evidence of Insurance
For the Specified Members of the Allied Health Professionals Purchasing Group
THIS EVIDENCE OF INSURANCE IS ISSUED TO THE SPECIFIED MEMBER PURSUANT AND
SUBJECT TO THE MASTER POLICY ISSUED TO THE MASTER POLICYHOLDER. THIS
EVIDENCE OF INSURANCE IS NOT THE POLICY, BUT MUST BE READ TOGETHER WITH THE
MASTER POLICY, ANY ENDORSEMENTS ISSUED TO THE SPECIFIED MEMBER AND ANY
OTHER ATTACHMENTS, APPLICATIONS, OR ADDITIONS TO THIS EVIDENCE OF INSURANCE,
ALL OF WHICH SHALL FORM THE POLICY ISSUED TO THE SPECIFIED MEMBER BY CERTAIN
UNDERWRITERS AT LLOYD'S, LONDON AND COLLECTIVELY SET FORTH THE INSURANCE
COVERAGE AFFORDED.
This document is to notify the Specified Member named below that the following insurance has been
effected with certain Underwriters at Lloyd's, London (not incorporated) (the "Underwriters") for the
Period of Insurance specified below under the Master Policy specified below (the "Master Policy")
issued to the Master Policyholder.
The insurance is provided under the Master Policy and is in accordance with the terms of the Master
Policy, a copy of which is attached hereto. The Original Master Policy may be inspected at the offices
of the Master Policyholder. The respective names of and proportions underwritten by Underwriters
can be ascertained from the office of the Master Policyholder.

Previous #: 1407YA005903

Auth Ref #: NA12HY05

Policy #: 1507YA005903

1. NAME AND ADDRESS OF THE SPECIFIED MEMBER

Patricia Raffa McKenna
191 Sea Oats Lane, Southern Shores, NC, 27949
2. PERIOD OF INSURANCE
EFFECTIVE FROM 07/07/2015

to 07/07/2016

both days at 12:01 a.m. standard time

3. Insurance is effective with certain UNDERWRITERS AT LLOYD'S, LONDON Percentage: 100%

4. Covered Allied Healthcare Profession: Registered Yoga Teacher (RYT)
5. LIMITS OF LIABILITY AND DEDUCTIBLE
A.

Professional Liability:

B.

Other Specified Liability Coverages

1. General Liability:

$ 2,000,000 Each Claim

$ 4,000,000 Aggregate for All Claims

$ 2,000,000 Each Claim

$ 4,000,000 Aggregate for all Claims
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2. Host Liquor Liability

$ 25,000 Aggregate for all Bodily Injury and

Property Damage

3. Fire/Water Damage Legal Liability:

$ 100,000 Each Claim

4. Medical Expense Payments:

$ 2,500 All Medical Expenses for Each Person

$ 50,000 Aggregate for all Medical Expenses for
All Persons

5. Defendants Expense:

$ 250 Each Day

$ 5,000 Aggregate for all Days

6. Deposition Fees and Expenses:

$ 10,000 Each Deposition

$ 25,000 Aggregate for all Depositions

7. Damage to Property of Others:

$OO'DPDJHWR3URSHUW\RI2WKHUV
UHVXOWLQJIURP(DFK2FFXUUHQFH
$JJUHJDWHIRUDOO'DPDJHto
Property of Others resulting from all
Occurrences

8. HIPAA/HITECH Fines and Penalties

$ 5,000 Aggregate for all HIPAA/

HITECH Fines and Penalties

9. First Aid Expense

$ 5,000 Aggregate for all First Aid Expense

10. Sexual Misconduct

$ 50,000 Aggregate for all Sexual

Misconduct Incidents

11. Reimbursement for Uninsured Medical

Expenses and Damage to the Insureds
Personal Property Incurred due to Assault

$ 2,500 Each Person

$ 5,000 Aggregate for all Claims

12. License and Disciplinary Proceedings

$ 5,000 Each Proceeding

$ 25,000 Aggregate for All Proceedings

13. Products / Completed Operations:

$ 1,000,000 Each Claim

$ 2,000,000 Aggregate for all Claims

C.

Aggregate Limit of Liability

for all Coverages set forth above:

6. DEDUCTIBLE:

$ 4,000,000

$0.00 Each Claim or Occurrence, including Damages and Claims Expenses

7. PREMIUM: $ 140.00

Surplus Lines Tax: $ 2.25%

State Fee: $ 0.03%

8. SPECIAL CONDITIONS
Allied Healthcare Professional Liability, General Liability and Other Specified Coverages
Wording:
(Claims Made and Reported Basis)

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9. NOTICE OF CLAIM, POTENTIAL CLAIM, OR OCCURRENCE

Notice of Claim required to be given to Underwriters pursuant to the Policy shall be sent to the
following address:
Notice of Claim,
Potential Claim, or
Occurrence:

Martin M. Ween, Esq.

Wilson, Elser, Moskowitz, Edelman & Dicker, LLP
150 E. 42nd Street
New York, New York 10017
Copy to:
Hays Affinity Solutions
1025 Thomas Jefferson Street, NW, Suite 425W
Washington, DC 20007

10. Retroactive Date:

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YOGA ALLIANCE ENDORSEMENT

Effective Date: 07/07/2015
Specified Member: Patricia Raffa McKenna

In consideration of the premium paid, and subject to the terms and conditions of the Evidence Of Insurance not
otherwise modified herein, it is hereby understood and agreed that:
ANTI-STACKING OF LIMITS

if any Claim is afforded coverage under this Policy and under any other policies issued by Us through the Allied
Health Professionals Purchasing Group, Our maximum aggregate liability to YOU and to all other persons or
entities insured by US for all Damages and Claims Expenses payable as to such Claim under this Policy and all of
such other policies issued by Us that apply to such Claim shall not exceed the highest single applicable limit of
liability specified among all of such policies, excess of the deductible if any specified in the Policy providing the
highest single applicable limit of liability, which deductible shall be payable by the person or entity named as the
Specified Member in said Policy. The Limits of Liability under this Policy shall be reduced, and may be
exhausted, by payments of Damages and Claims Expenses from the single applicable limit of liability, but, in the
event the single applicable limit of liability is greater than the limit of liability specified in this Policy, YOU and all
other persons and entities insured by US as to such Claim shall be entitled in the aggregate to the benefit of
such higher limit of liability. If the single applicable limit of liability is exhausted by payment of Damages and/or
Claims Expenses for the persons and entities insured under the applicable policies, Underwriters shall have no
further obligation or responsibility to pay any Damages or Claims Expenses for or on behalf of any of the persons
or entities after the exhaustion of said limit of liability.

All other terms and conditions remain unchanged and the above does not increase the limits of liability set forth
in this Policy except as set forth above.

Section I. WHAT THIS POLICY COVERS, B. Other Specified Liability coverages. Is amended to include the
following:
13.

Products
Subject to the Limits of Liability for Products specified in the Declarations, We will pay
those amounts You are required to pay as Damages for a Claim first made against the
Insured and reported to Us during the Policy Period arising from Products furnished or
sold by the Insured for use in, or during the course of, the practice of yoga. We will
not pay under this Section of the Policy for Damages incurred as a result of the
following:

Page 5 of 7

a. any ingestible products or substances, topical solutions or therapeutic agents;

b. any product that is manufactured, designed, created, modified or labeled by the
Insured;
c. any product sold or furnished by the Insured that has been relabeled, repackaged,
repaired or altered in any way; and
d. any advertisement, pamphlet, warning label or other literature not provided by
the manufacturer.

Section II. EXCLUSIONS.

Exclusions 13 and 16 shall not apply to the coverage under this endorsement.
The following exclusions are added to and form part of the Evidence Of Insurance:

V.

32.

The sale of any product you manufacture, assemble, construct, create, sell under your
own name, label, design, or alter or repackage in any way.

33.

The sale of of any type of ingestible substance, including but not limited to herbs,
therapeutic agents, medicines, nutritional supplements, topically applied agents,
whether manufactured by others or by you.

34.

Claims arising out of any advertisement, pamphlet, warning label or any other
notification, disclaimer or disclosure by the manufacturer of a product employed in the
course of Professional Services.

35.

Claims arising out of or relating to any copyright and/or trademark infringement,

improper certification, accreditation and/or licensing, and/or unfair business practice
involving Bikram yoga, hot yoga, or any type of heated yoga.

LIMITS OF LIABILITY
B.

Other Supplemental Coverages Is amended to include the following:

13.

Products

a.

Each Claim
The Each Claim Limit of Liability for Products indicated in the Declarations is the most
We will pay for Claims Expenses and Damages arising out of products and equipment
employed in the course of yoga practice furnished or sold by You, including but not
limited to, blocks, straps, yoga mats, blankets, pillows, and bolsters. All Claims sharing
the same or similar factual nexus shall be deemed to be one Claim and shall be subject
to the Limit of Liability for Each Claim, regardless of the number of Insureds or
claimants involved.

Page 6 of 7

b.

Aggregate
The Aggregate Limit of Liability for Products indicated in the Declarations is the most
We will pay for all Claims Expenses and Damages arising out of all Claims first made
against the Insureds and reported to Us during the Policy Period arising out of the use
of products and equipment employed in the course of yoga practice furnished or sold
by You, including but not limited to, blocks, straps, yoga mats, blankets, pillows, and
bolsters, regardless of the number of Insureds involved, or Claims first made against
the Insureds and reported to Us during the Policy Period.

All other terms and conditions remain unchanged.

Attaching to and forming part of Policy Number 1507YA005903

Date: 05/30/2015

BY:_______________________________________

HAYS AFFINITY SOLUTIONS

A MEMBER OF HAYS COMPANIES

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