Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 7 of 50

Yachtsman INAMAR®
Recreational Marine Insurance
Policy One of the ACE Group of Companies
NEW
Policy Number: YKR Y08326836
Agency Code, Name & Address
409027
BROWN & BROWN INC. OF FT LAUDERDALE
5900 N. ANDREWS AVENUE SUITE 300
FORT LAUDERDALE, FL 33309

This is your Yachtsman

Policy's Declarations Page. Please read carefully. It gives you important facts about your
coverage.
The Company Providing This Insurance
ACE AMERICA/si /NSURANCE COMPANY
436 Walnut Street, P.O. Box 1000
Phila, PA 19106-3703
The Named Insured Under This
Policy: (NAME)

Elaine LaCarubba

Address: 3249 NE 31 Avenue

Lighthouse Point, FL 33064
-rt. 7
i ite V essei k—overea tsy 1111S Foricy (NAME)

(YEAR BUILT) (LENGTH)

"AVANTI"
(MAKE)
(MODEL) (DOC OR HULL IDENT NO)
2005 37 INTREPID
Open Fisherman IBW37573A505
This policy will take effect on 8/31/2007 and end on 8/31/2008
It will begin and end at 12:01 A.M. standard time, at the place where this
In return for the "Total policy was issued.
Premium, listed below, we agree to provide the insurance
below. coverages for which a premium is shown in the chart

COVERAGE PROVIDED—
AMOUNT DEDUCTIBLE
PARTS COVERAGES OF INSURANCE AMOUNT PREMIUM
A Property Damage 295, 000 11, 500 5, 300
Windstorm Deductible
23, 000 0
Commercial Towing & Assistance
1, 500 0 0
B Liability Coverage 500, 000 0 310
C Medical Payments 5, 000 0 0
D Uninsured Boater 500, 000 0 0
E L&HCA
F
Statutory Limits (included in"B" if any)
Trailer
G
10, 000 250 100
Personal Property 5, 000 250 50
Premium Bearing Endt(s): See Attached Endorsements
Florida Hurricane Catastrophe Fund 0
(FHCF) Assessment S 58
TOTAL PREMIUM 5, 818
LIMITS ON USE: See Navigation Warranty MA- 5Y38
ENDORSEMENTS: ALL20887 ALL21101 CC-1E15 MA-14558a M,A-1X09e MA-3Z58
MA-3Z59a MA-5Y38

Lay-up Warranty It is warranted the vessel will be laid

up for part of the year, the dates are:
From noon:
To noon:
Laid up Ashore If this box is marked, you agree to
LOSS PAYEE: We will make payments for Part A:
lay:up your vessel ashore during the above period.

Property Damage losses to the Assured and

Bank of America
P.O. Box 2759

Jacksonville, FL 32203
Countersigned at
this day of EXHIBIT
MA-7N39i (06/05)
INSURED COPY,9/1412007
II Agent
 Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 8 of 50

TRADE OR ECONOMIC SANCTIONS

ENDORSEMENT
Named Insured
Elaine LaCarubba Endorsement Number

Policy Symbol I Policy Number Policy Period

YKR 1Y08326836
Issued By (Name of Insurance
Company)
I Effective Date of Endorsement

8/31/2007
ACE AMERICAN /NSURANCE COMPANY

Insert the policy ntrnbcr. The remainder of the information

is to be completed only when this endorsement is issued subsequert to the preparation ofthc policy.

THIS ENDORSEMENT CHANGES THE

POLICY. PLEASE READ IT CAREFULLY.

This insurance does not

apply to the extent that trade or economic sanctions or other laws
or regulations
providing insurance, including, but not limited to, the payment of claims. All other tenns and
prohibit us from
conditions of the policy remain
unchanged.

Authorized Agent

ALL-2110I (11/06) Ptd. in U.S.A.

Page 1 of I
 Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 9 of 50

ACE INA PRIVACY STATEMENT

The ACE INA group of companies strongly believes in maintaining the privacy of information we collect about individuals. We
want you to understand how and
why we use and disclose the collected infonnation. The following provides details of our practices
and procedures for protecting the
security of nonpublic personal information that we have collected about individuals. This privacy
statement applies to policies underwritten
by the ACE INA group member companies listed below.

INFORMATION WE COLLECT

The information collect will vary

we
depending on the type of product or service individuals seek or purchase, and may include:

Information we receive from individuals, such their name,

as address, age, phone number, social security number, assets,
income, or beneficiaries;
Information about individuals' transactions with us, with our affiliates, or with others, such as policy coverage, premium,
payment history, motor vehicle records; and

Information we receive from a consumer reporting agency, such as a credit history

INFORMATION WE DISCLOSE

We do not disclose any personal information to

anyone except as is necessary in order to provide our products or services to a
person, or otherwise as we are required or permitted by law.
We may disclose
any of the information that we collect to companies that perform marketing services on our behalf to other
or
financial institutions with whom we have joint
marketing agreements.

THE RIGHT TO VERIFY THE ACCURACY OF

INFORMATION WE COLLECT

Keeping information accurate and up to date is important to us. Individuals may and correct their
collect except for infonnation relating to a claim or a criminal or
see
personal infonnation that we
civil proceeding.

CONFIDENTIALITY AND SECURITY

We restrict access to personal information to

to service the account or in the course of
our
employees, our affiliates' employees, or others who need to know that information
conducting our normal business operations. We maintain physical, electronic, and
procedural safeguards to protect personal information.

Rec, Marine
Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 10 of 50

CONTACTING US

If you have any

questions about this privacy statement would like to learn more about how we protect
or
at ACE INA Customer privacy, please write to us
Services, P.O. Box 1000, 436 Walnut Street, WAO4F, Philadelphia, PA 19106. Please include the
number on any correspondence with us. policy

ACE American Insurance

Company
ACE Fire Underwriters Insurance
Company
ACE Indemnity Insurance
Company
ACE Property and Casualty Insurance
Company
Atlantic Employers Insurance Company
Bankers Standard Fire and Marine
Company
Bankers Standard Insurance Company

Century Indemnity Company

Illinois Union Insurance Company

Indemnity Insurance Company of North America

Insurance Company of North America
Pacific Employers Insurance Company
Westchester Fire Insurance Company
Westchester Surplus Lines Insurance
Company
ESIS, Inc.
Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 11 of 50

Signatures

The only signatures applicable to this policy are those representing the company named on the first page of the
declarations.

By signing and delivering the policy to you, we state that it is a valid contract when countersigned by our authorized
representative.

GEORGE D. MULLIGAN, Secretary

JOHN J. LUPICA, President

Insurance Company of North America ACE American Insurance Company

Philadelphia, Pennsylvania Philadelphia, Pennsylvania
Indemnity Insurance Company of North America ACE Fire Underwriters Insurance Company
Philadelphia, Pennsylvania Philadelphia, Pennsylvania

MA-1X09e (05/05)
Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 12 of 50

ATLANTIC COAST NAVIGATION WARRANTY

Named Insured
Elaine LaCarubba Endorsement Numb er

Vessel 1
Policy Symb ol Policy Number Policy Period Effective Date ofEndorsement
YKR Y08326836 8/31/2007 TO 8/31/2008 8131/2007 I

insert tne
policy ntanser. lee remainder ot the Information is to be completed only when this endorsement is issued subsequent to the preparation of the

Warranted confined to Atlantic and Gulf coastwise and inland

tributary waters of the United States between Morehead City,
North Carolina and Carrabelle, Florida, including the waters of the Bahamas.

ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.

Authorized Agent

I JO kyi yo) riu.

 Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 13 of 50

Named Insured
Elaine LaCarubba Endorsement Number
Vessel 1
Policy Symbol Policy Number Policy Period Effective Date of Endorsement
YKR Y08326836 8/31/2007 TO 8/31/2008 8/31/2007
Issued By (Name of Insurance Company)

ACE AMERICAN INSURANCE COMPANY

Insert the policy number. The remainder of the infoimation is to bc completed only when this endorsement is issued subsequent to the preparation of the policy.

THEFT DEDUCTIBLE

In the event
of a theft of your insured vessel and/or
any of its equipment, the
amount of
insurance provided under Part A: Property Damage Coverage shall be
reduced by 10% or subject to a minimum deductible of $29,
500, whichever is
greater. This deductible will be the only deductible
applied if there is a theft
to your vessel and/or equipment, and will be applied even in the event of a Total
or Constructive Total Loss.

ALL OTHER TERMS AND CONDITIONS REMA/N UNCHANGED.

Authorized Agent

rriwi Afrl ;r1TTC A

 Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 14 of 50

UNSCHEDULED DINGHY TENDER ENDORSEMENT

Named Insured
Elaine LaCarubba Endorsemen

Vessel
Policy Symbol Policy Number Policy Period Effective Date of Endorse
YKR Y08326836 8/31/2007
Issued By (Name of Insurance
TO 8/31/2008 8/31/2007
Company)
ACE AMERICAN INSURANCE COMPANY
Insert the policy ntanber. The remainder of the infonnation is to be completed only when this endorsement is issued subsequent to thc preparation ofthe policy

In consideration of the premium

charged, covered losses to a dinghy/tender (including propulsion unit) included as Insured
Property under this policy shall be subject to a $250.00
deductible, providing the overall length of the dinghy/tender shall not
exceed 17' and the maximum horsepower for
any propulsion unit shall not exceed 40 hp.

The most we will pay for any dinghy/tender and/or propulsion unit is their actual cash value, which is defined as replacement cost
less depreciation.

Should a covered loss to both the dinghy/tender and the insured

yacht shown in the Declarations Page exceed the Part A: Property
Damage Deductible Amount, the $250.00 deductible
applicable to the dinghy/tender shall not apply.

ALL OTHER TERMS AND CONDITIONS REMAIN

UNCHANGED.

Authorized Agent

MA-3Z58 (7/00) Ptd. in U.S.A.

 Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 15 of 50

HURRICANE HAULOUT COVERAGE

Named Insured
Elaine LaCarubba Endorsement Numb er

Policy Symb ol Vessel 1

Policy Number Policy Period Effective Date of Endorsement
YKR Y08326836 8/31/2007 TO 8/31/2008 1 8/31/2007

Insert the policy number. Thc remainder of the information is to be completed only whcn this endorsement issued
is subsequent to thc preparation of the policy.

In consideration of the premium

charged it is understood and agreed that coverage under Part A: Property Damage Coverage is
extended to cover the
following:
If the National Weather Service issues a hunicane
watch or warning for the where your vessel is
area
located, we will share
equally (50%) with you for the reasonable expenses
you incur to:

1. have your insured vessel hauled out of the

water, stored until the watch or warning has ended and then launched in the
same general area; or

2. have your insured vessel moved to safe

a harbor, including any docking or mooring fees.
Expenses for the acquisition of lines, anchors and additional
equipment to secure your insured vessel are not included in this
coverage.

The most we will pay for

any one hurricane is $500, and for any
Deductible Amount does not
one policy period is $1, 000. The Part A.
Property Damage
apply to this coverage

ALL OTHER TERMS AND CONDITIONS

REMAIN UNCHANGED.

Authorized Agent

MA-3Z59a (02/05) Ptd. in U.S.A.

 Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 16 of 50

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Cise 1:09-cv-61 -48-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 1-7 of 501

YACHTSMAN WINDJAMMER BOATSMAN POLICY

QUICK REFERENCE
DECLARATIONS PAGE
Your Name and Address PART E:
1 FEDERAL LONGSHOREMEN'S AND
Your Insured
Property 1 HARBOR WORKERS'
Policy Period
1
Coverages COMPENSATION INSURANCE 6
1
Amounts of Insurance
1 PART F:
Deductible
1 VESSEL TRAILER COVERAGE
Lay-Up Warranty 1 Perils Insured
Limits on Use Against 6
1 Exclusions
Loss Payee 7
1 Deductible Amount
7
Loss Settlement
AGREEMENT AND DEFINITIONS 7
Agreement 3
Definitions PART G:
3 PERSONAL PROPERTY COVERAGE
PART A: Property Covered 7
PROPERTY DAMAGE COVERAGE Exclusions
7
Perils Insured
Against Mysterious Disappearance and/or Theft7
3 Causes of Loss Which
Overland Transport are Covered 7
3 Deductible
Exclusions 7
4 Loss Settlement
Equipment on Shore 4 7
Deductible Amount
4 GENERAL CONDITIONS AND EXCLUSIONS
Loss Settlement
4
Property Subject to Depreciation Policy Period 8
4 Extension of Coverage
Salvage Charges 4 8
Commercial Towing and Assistance Broadening Coverage 8
5
Policy Premium and Renewal 8
PART B: Changes in Policy 8
LIABILITY COVERAGE Conformity To State Law 8
Perils Insured Against Cancelling the Policy 8
5 Return Premiums
Exclusions 8
5
Limits of Liability Operating Other Vessel 8
5 Use of Vessel
9
PART C: Transfer of Interest
9
MEDICAL PAYMENTS COVERAGE Concealment, Misrepresentation or Fraud9
Perils Insured Against Dishonest, Illegal or Intentional Acts 9
5 No Benefits to Others
Exclusions 9
5 War, Confiscation
Loss Settlement and Contamination 9
5
Medical Payments Proof-of-Loss
6 GENERAL PROVISIONS IN
Additional Requirements
6 THE EVENT OF LOSS
Admission of Liability
6 Protection Against Loss
9
PART D: Abandonment 9
UNINSURED BOATER COVERAGE Notice of Loss
9
Perils Insured Against Proof-of-Loss 9
6 Claim of Suit Against You
Exclusions 10
6 Assistance and Cooperation..
Loss Settlement. 10
6
Payment of Loss 10
OurRight to Recover 10
Salvage 10
Suit Against Us
10
Other Insurance
10
--"ose 218-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page ft'Orar

DECLARATIONS PAGE
(Attach Here)

This is not a complete and valid insurance policy without

an
accompanying Declarations Page.

MA-14558 (12/03)
Page 1 of 12
 Ll •JJL 3“).

Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page r9" oT5t1'

This page intentionally left blank.

MA-14558 (12/03) 2 of 12
Page
Case Document 1 Entered on FLSD Docket 08/27/2009 Page 260'6'd'
YACH SMAN WINDJAMMEH BOATSMAN
POLICY

AGREEMENT AND DEFINITIONS

AGREEMENT
This is a legal contract between you and us. We will provide the insurance
coverage described in this policy in
return for the premium and the compliance by all covered persons with all
applicable provisions of this policy.
DEFINITIONS
Throughout this policy, you and your refer to the named insured as shown on the Declarations
we, us and our refer to the
Page, and
company providing this insurance. In addition, certain words and phrases are
defined as follows:

Insured Property
is defined as:
a. the vessel(s) shown on the Declarations
Page, including spars, sails, machinery, furniture, dinghies/
tenders, outboard motors, fittings and other equipment
maintenance of the vessel; personal watercraft,
normally required for the operation or
mooring and cradles are excluded;
b. any vessel that you acquire ownership of during the Policy Period;
however, you must notify us within 30
days of the time you acquire the vessel and pay any additional premium required; in the event of loss
during this period, we will pay no more than its cost to you subject to a deductible of one
the hull value or $250., whichever is (1%) percent of
greater.

Covered Person is defined as you or

any person or legal entity operating your vessel(s) as shown on the
Declarations Page for private pleasure use with
your direct and prior permission. It does not include any
person or legal entity employed by, or the agent of a marina, boat
repair yard, yacht club, sales agency, boat
service station or other similar organization.
However, we will cover your liability for bodily injury or property
damage caused by any of these persons or organizations.

Horsepower is defined as that amount stated the manufacturer

by as peak-developed horsepower as
measured at the flywheel.

Dinghy/Tender is defined as a small craft owned by you which is used to service and maintain the insured
vessel.

Personal Watercraft is defined as a vessel less than 13' in

length upon which the owner sits or stands astride,
and is powered by an internal water
jet propulsion.
Latent Defect is a flaw in the material which is
existing at the time of the building of the vessel or her
machinery and which is not discoverable by the insured through ordinary methods of testing.
Tropical Depressions, Tropical Storms and Hurricanes are defined as those the National
Weather Service and/or the National Hurricane Center.
so designated by

Uninsured Boater and Uninsured

Owner-Operator means any owner or operator of a vessel, other than the
vessel named in this policy, who is
legally responsible for the accident and:
a. to whom no liability policy applies;
b. who cannot be identified, such as a hit-and-run
operator.
PART A: PROPERTY DAMAGE COVERAGE

PERILS INSURED AGAINST: We will provide

coverage for accidental, direct physical foss or damage to
your insured vessel
as well as
salvage charges, except as specifically excluded in this policy.
OVERLAND TRANSPORT: We will provide
coverage while your vessel is being transported overland,
including loading and unloading, provided the distance is 250 miles or
less. Distances greater than 250 miles
require our prior written permission unless the means of conveyance is a trailer owned
by you.
MA-14558 (12/03)
Page 3 of 12
6-6'sWi:b6=c^;=6i 348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page DV8T"

EXCLUSIONS: We do not provide coverage under Part A: Property Damage Coverage against loss or
resulting damage from:
a. wear and tear, gradual deterioration, weathering, insects, mold, animals or marine life; however,
coverage
is provided for accidental damage resulting from zebra mussels, but only applies to engines, generators,
and pumps that are attached to the insured vessel;
b. marring, scratching or denting:
c. osmosis or blistering;
d. manufacturer's defects or defects in designs;
e. the cost of replacing or repairing any item having a latent defect that causes damage to your insured
property, however, resulting damage would be covered;
f. corrosion, except electrolytic (stray current) corrosion.

EQUIPMENT ON SHORE: We will provide coverage for all insured property removed temporarily from
your
vessel for storage
on shore. The amount of insurance on the vessel will be reduced
by the amount covered on
shore.

DEDUCTIBLE AMOUNT
a. we will
adjusteach claim separately for a covered loss to your insured property; the amount of each
adjusted claim will be automatically reduced by the Deductible Amount shown on the Declarations Page;
no deductible will be applied in the event of a total loss to
your vessel, except for conditions outlined in
paragraph b below; for deductible purposes, we will treat any two or more covered losses resulting from
the same accident or occurrence as one claim;
b. if a Windstorm Deductible Amount is shown on the Declarations Page, we will apply that deductible to
covered losses caused by wind, rain, wave or hail when those losses are the result of either a Tropical
Depression, Tropical Storm or Hurricane. This deductible will be in lieu of the Part A: Deductible Amount
shown on the Declarations Page and will be applied to the amount of each loss. It will be applicable to all
partial, total or constructive total losses.

LOSS SETTLEMENT: In the event of loss or damage to your insured property, we will pay the lowest of the
following amounts:
a. the Part A: Property Damage Coverage limit as shown on the Declarations Page;
b. the cost of replacement;
c. the cost to repair with no deduction for depreciation, except as specified in Part A:
Property Damage
Coverage and as shown in the Property Subject to Depreciation section.
We will pay for a total loss to your vessel and other covered property only if:
a. the vessel is completely lost or destroyed;
b. the cost of recovering and/or repairing the vessel is greater than the amount of insurance shown on the
Declarations Page.
The cost of repairs shall be determined by yacht repair yards, equipment repairers or surveyors agreeable to
us.

The amount we will pay for a total loss shall be reduced by the amount paid for repairs of prior covered
damage not completed at the time of the total loss.

PROPERTY SUBJECT TO DEPRECIATION: In the event of loss or damage to your insured plastic or
canvas coverings, inclusive
of all-weather bridge and cockpit enclosures, and dodgers, sails, outboard motors
or outdrive units,
machinery inside the vessel which is over seven (7) years old, or components of any of the
preceding items which requires replacement or repair, we will pay the lesser of:
a. the actual cash value at the time of loss;
b. the cost to repair subject to depreciation;
c. the cost of replacement.

SALVAGE CHARGES: We will pay for salvage charges you incur arising from a covered loss.
Payments for
will be in addition to any other payments we make for losses covered
salvage charges by this policy. However,
the most we will pay for salvage charges is the Part A:
Property Damage Coverage limit shown on the
Declarations Page. The Part A: Property Damage
Coverage Deductible Amount does not apply to this
coverage.

MA-14558 (12/03) 4 of 12
Page
Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 2-2-6f

COMMERCIAL TOWING AND ASSISTANCE: We will provide additional protection in the event there is
an emergency situation where you and your vessel are not in imminent danger. The coverage shall be
deemed excess over all other valid and collectible towing assistance benefits. We will reimburse you for the
reasonable costs you incur, not to exceed the Commercial Towing And Assistance Amount of Insurance
shown on the Declarations Page, resulting from the following services to your vessel if help is not available

and you must obtain commercial assistance:

a. towing to the nearest place where necessary repairs can be made;
b. delivery of fuel, oil, parts or loaned battery (excluding the cost of these items themselves) and emergency
labor, while away from safe harbor.

Neither the policy deductible nor the OTHER INSURANCE paragraph under GENERAL PROVISIONS IN THE
EVENT OF LOSS apply to this coverage.

PART B: LIABILITY COVERAGE

PERILS INSURED AGAINST: We will pay sums that you or a covered person become legally obligated to
pay as a result of the ownership, operation or maintenance of your insured vessel because of:
a. attempted or actual raising, removal or destruction of the wreck of your insured property;
b. failure to raise, remove or destroy the wreck of your insured property;
c. bodily injury or loss of life;
d. your liability to paid crew as defined in the Jones Act or under general Maritime Law;
e. loss or damage to any property;
f. pollution or contamination of any kind.

EXCLUSIONS: We do not provide coverage under Part B: Liability Coverage for:

a. liability of other covered persons to you, your spouse, or other persons who reside in your household;
b. your liability to your spouse, or other persons who reside in your household;
c. liability assumed by you under any contract or agreement;
d. liability that arises while your insured property is being conveyed except at the point the vessel is hauled
out of the water or launched;
e. fines or other penalties that any government unit requires you to pay;
f. punitive damages.
LIMITS OF LIABILITY: We will pay no more than the amount of insurance shown on the Declarations Page
for all damage or losses from:
resulting
a. any one accident or occurrence; with respect to pollution or contamination of any kind, we will pay up to
the Part B: Liability Coverage limit shown on the Declarations Page, or $500, 000, whichever is greater;
b. any series of accidents or occurrences arising out of the same event; this is the most we will pay
regardless of the number of covered persons involved, claims made, vessels or premiums shown on the
Declarations Page or the number of vessels involved.

PART C: MEDICAL PAYMENTS COVERAGE

PERILS INSURED AGAINST: We will pay for reasonable medical, ambulance, hospital, professional
nursing and funeral costs that become necessary due to accidental bodily injury to persons injured while in,
upon, boarding, leaving or towed behind your insured vessel. We will pay only for those costs incurred within
one year of the date of accident.

EXCLUSIONS: We do not provide coverage under Part C: Medical Payments Coverage for:
a. any employee of yours injured while in the course of emploxment or while using, maintaining
or repairing
your insured property;
b. any responsibility for payment assumed by you under contract or agreement;
c. anyone who is injured while your insured property is being conveyed, hauled out or launched;
d. anyone to or for whom benefits are payable under any state or federal compensation law or act.

LOSS SETTLEMENT: We will pay no more than the amount of insurance shown for Part C: Medical
on the Declarations Page for all covered costs of each person injured as a result of any
Payments Coverage
one accident or series of accidents arising out of the same event.

MA-14558 (12/03) Page 5 of 12

Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 23'of 50

MEDICAL PAYMENTS PROOF-OF-LOSS: A written, sworn proof-of-loss must be filed with us by any
person seeking payment by us under Part C: Medical Payments Coverage, or by someone on their behalf. This
proof-of-loss must include:
a. the nameand address of each person and organization performing covered services;
b. the nature, extent and dates of these services; and
c. itemized charges and any sums already paid.
This proof-of-loss must be filed:
a. as soon as reasonably possible after completion of services;
b. as soon as reasonably possible after the cost of services being provided equals the amount of our liability
under Part C: Medical Payments Coverage on the Declarations Page;
c. within one year of the date of the accident, whichever of the above occurs first.

ADDITIONAL REQUIREMENTS: Each person seeking payment by us under Part C: Medical Payments
Coverage must:
a. submit to a physical examination by a physician selected
by us when and as often as we reasonably
require; we will pay for the cost of the examination; and
b. provide us with written authorization for release to us of copies of pertinent medical reports and records.

ADMISSION OF LIABILITY: Any payment made under this section is not an admission of liability by you or
us.

PART D: UNINSURED BOATER COVERAGE

PERILS INSURED AGAINST: We will pay for the damages which, because of bodily injury received aboard
your vessel, you are legally entitled to recover from the uninsured owner or operator of another vessel.

EXCLUSIONS: We do not provide coverage under Part D: Uninsured Boater Coverage:

a. for claims settled without our written consent;
b. if the uninsured vessel is owned by a government agency or unit;
c. for vessels owned by or furnished for your regular use, or the use of a member of your immediate family or
any person insured by this policy;
d. for an insured person using a vessel without permission;
e. where no evidence of physical contact exists between your vessel and an unidentified vessel, or where no
evidence of physical contact exists between your vessel and an uninsured vessel.

LOSS SETTLEMENT: The amount shown for Part D: Uninsured Boater Coverage on the Declarations Page
is the most we will pay under Part D, regardless of the number of insured persons, claims made or vessels
involved in any one accident or series of accidents arising out of the same event. This coverage will not apply
directly or indirectly to the benefit of any insured under any state or federal compensation law or act. Payment
made for this coverage to or for an insured person will reduce the amount that person is entitled to recover
from the Part B: Liability Coverage of this policy.

PART E: FEDERAL LONGSHOREMEN'S AND HARBOR WORKERS'

COMPENSATION INSURANCE

When insurance is provided under Part B: Liability Coverage, insurance is also provided under this section. We
will provide coverage for any liability which you, as owner of the insured property, incur during the term of the
policy under Part E: Federal Longshoremen's and Harbor Workers' Compensation Insurance.

PART F: VESSEL TRAILER COVERAGE

PERILS INSURED AGAINST: We will provide coverage for all accidental, direct physical loss or damage to
any trailer listed the Declarations Page, but only:
on
a. if used exclusively for transporting the vessel; and
b. while located in the continental United States including Alaska, Hawaii, Puerto Rico or Canada.

MA-14558 (12/03) Page 6 of 12

ase 1:09-cv=61-48-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 2-4-Of

EXCLUSIONS: We do not provide coverage for wear and tear, gradual deterioration or manufacturer's
defects.

DEDUCTIBLE AMOUNT: We will adjust each claim

separately for a covered loss to your insured property.
The amount of adjusted claim will be
automatically reduced by the Deductible Amount shown on the
Declarations Page. We will treat each covered loss as a
separate claim. For deductible purposes, we will treat
two or more covered losses resulting from the same accident or occurrence as one
claim.

LOSS SETTLEMENT: In the event of loss or damage to the vessel trailer, we will pay the lowest of the
following amounts:
a. the Part F: Vessel Trailer Coverage limit as shown on the Declarations Page;
b. the actual cash value at the time of loss;
c. the cost to repair subject to depreciation;
d. the cost of replacement.

PART G: PERSONAL PROPERTY COVERAGE

PROPERTY COVERED: We will cover clothing, personal effects,

fishing gear and sports equipment that
belong to you members of your family while these items are on board
or
your vessel, or are being loaded or
unloaded. If you choose, we will provide the same
coverage to guests and unpaid crew members. We will not
cover money, jewelry, traveler's checks or
any other valuable papers or documents.

EXCLUSIONS: We do not provide coverage under Part G: Personal Property Coverage against loss or
resulting damage from:
a. wear and tear, mechanical breakdown, gradual deterioration, weathering, insects, mold, animals, marine
life, ice, freezing or extremes of temperature;
b. marring, scratching or
denting;
c. osmosis, blistering, electrolysis or corrosion;
d. manufacturer's defects, defects in designs or latent defects.

MYSTERIOUS DISAPPEARANCE AND/OR THEFT: The

coverages provided herein do not insure the
mysterious disappearance and/or theft of any covered property unless:
a. there is visible evidence of forcible
entry into the cabin of the insured vessel;
b. there is visible evidence of forcible removal of covered
properties from the insured vessel;
c. there is a theft of the entire vessel.

CAUSES OF LOSS WHICH ARE COVERED: We will direct loss

cover physical or damage from any
external cause, except as specifically excluded in this policy.
DEDUCTIBLE: We will adjust each claim separately for a covered loss to
your insured property. The amount
of adjusted claim will be
automatically reduced by the Deductible Amount shown on the Declarations Page.
We will treat each covered loss as a
separate claim. For deductible purposes, we will treat two or more
covered losses resulting from the same accident or occurrence as one
claim.

LOSS SETTLEMENT: In the event of loss or damage to

your insured property, we will pay the lowest of the
following amounts:
a. the Part G: Personal Property
Coverage limit as shown on the Declarations Page;
b. the actual cash value at the time of loss;
c. the cost to repair subject to depreciation;
d. the cost of replacement.

The OTHER INSURANCE paragraph under GENERAL PROVISIONS IN

THE EVENT OF LOSS does not apply
to PART G: PERSONAL PROPERTY COVERAGE.

MA-14558 (12/03)
Page 7 of 12
 1°:019-64-6'it148-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 26'Or6"6"

GENERAL CONDITIONS AND EXCLUSIONS

POLICY PERIOD: This policy applies

only in the event of an accident or loss which occurs
during the
Period
as shown on the Declarations Policy
Page.
EXTENSION OF COVERAGE: If the
Navigation Warranty included in this policy, or the Lay-Up
shown on the Declarations
Page, are breached due to matters beyond your control, the Warranty
effect, but only if you give us written notice of the breach policy will remain in
within ten (10) days after the breach and
additional premiums due for this extension pay any
of coverage. If the
breached voluntarily there shall be no Navigation Warranty or Lay-Up
Warranty are
coverage under this policy without both prior
notice to us and
by us. approval

BROADENING COVERAGE: If, during the Policy Period, we make any revision to this policy which
broadens the coverage without additional
premium, the broadened coverage will apply as of the effective date
of such revision.

POLICY PREMIUM AND RENEWAL: The

premium shown on the Declarations
Page is the initial premium
for this policy. If we agree to renew orcontinue the policy, then at the time of each
renewal or continuation of,
on the
policy anniversary date, the premium for the renewal or continuation will be computed
to our premium rules, forms and guidelines then in use. by us according

CHANGES IN POLICY: This policy contains all of the

agreements between you and us. Its terms may not
be changed or waived except by an endorsement issued by us. If a
we will change requires a premium adjustment,
adjust the premium as of the effective date of the policy
change.
CONFORMITY TO STATE LAW: When a provision of this
state in which this
policy is in conflict with the applicable law of the
policy is issued, then the law of the state shall apply.
CANCELLING THE POLICY: You may cancel this
policy by returning it to us or our authorized agent, or
by advising us or our authorized agent in writing, the future date you want it to be cancelled. We
cancel this policy by delivering or
stating may
mailing to you at your last address shown on our records, written notice
stating when, not less than 15 days after
mailing, the policy will be cancelled. Delivery or mailing of this notice
to you shall be sufficient proof that notice
of cancellation was given. The date of the
notice shall become the end of the cancellation stated in the
Policy Period.
RETURN PREMIUMS: If this
policy is cancelled, you may be entitled to a premium refund. If we cancel the
policy, any
return premium will be computed on a
pro-rata basis. If you cancel the policy, any return
will be computed on a 90% premium
pro-rata basis. No premiums will be returned to if we have
orconstructive total loss of the vessel insured under this you paid you for a total
soon as possible after the cancellation.
policy. Any return premium will be paid to you as

OPERATING OTHER VESSELS: We will extend the

liability coverage provided by Part B: Liability
Coverage
if you are operating another vessel with the permission of its owner. In
addition, if there is a covered
property loss, we will pay at the time of the loss up to the amount of
insurance shown on Part A:
Damage Coverage of the Declarations Page. Both amounts are Property
there is any other insurance subject to the deductible amount as shown. If
against a loss covered by this provision, we will provide
over such other insurance. We
do not provide any
coverage only as excess
coverage while you operate other vessels if:
a. the vessel is owned
wholly or in part by you;
b. the vessel is rented or under charter to
you, or being used for purposes other than private
c. the vessel is furnished for pleasure use;
your regular use;
d. the vessel length exceeds that of the
insured vessel by at least five
e.the vessel is designed for, or (5) feet;
capable of, speeds in excess of 55 miles per hour;
f. the vessel is a personal watercraft.

MA-14558 (12/03)
Page 8 of 12
a-as-a -1-:09--CV--6:I348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 2-8 of 56

USE OF VESSEL: We do not provide any coverage while your insured property is used for any type of
charter, to carry passengers for hire, to carry property for a fee or for any other commercial use. We will
provide coverage while you are attempting to aid other vessels in distress, provided there is no consideration
for your services.

TRANSFER OF INTEREST: All coverage provided by us will terminate upon the sale, assignment,
transfer or pledge of the insured property or of this contract unless prior written consent has been obtained
from us.

CONCEALMENT, MISREPRESENTATION OR FRAUD: All coverage provided by us will be voided

from the beginning of the Policy Period if you intentionally conceal or misrepresent any material fact or
circumstance relating to this contract of insurance, or the application for such insurance, whether before or
after a loss.

DISHONEST, ILLEGAL OR INTENTIONAL ACTS: We do not pay for loss or damage caused by the
dishonest, illegal intentional acts of any covered person, or any person to whom your insured property is
or
entrusted, regardless of whether or not such person is convicted of such an act by a criminal court.

NO BENEFIT TO OTHERS: No person or organization which has custody of your insured property and is
to be paid for services will benefit from this insurance.

WAR, CONFISCATION AND CONTAMINATION: We do not provide any coverage for loss, damage,
liability or expense due to:
a. war, including undeclared war, civil war, insurrection, rebellion, revolution, warlike act by military force or
military personnel, destruction or seizure for military purpose and including any consequence of these;
b. the lawful or unlawful capture, seizure, confiscation, requisition or detainment of your vessel by a civil or
military authority or an attempt at any of these;
c. radioactive, chemical, biological, bio-chemical or electromagnetic contamination.

GENERAL PROVISIONS IN THE EVENT OF LOSS

PROTECTION AGAINST LOSS: If your vessel or other property covered by this policy is damaged, you
must take all reasonable steps to protect it from further damage. We will reimburse you for reasonable
expenses for protecting the property from further damage. Payments for protecting damaged property will be
in addition to any other payments we make for losses covered by this policy. However, the most we will pay
for protecting damaged property is the coverage limit which to that applies property.
ABANDONMENT: If we take any steps to protect
damaged property, this does not mean we are accepting
an abandonment of the property. And, if you take steps to protect damaged property, this does not mean
you are waiving any rights you have to abandon the property.

NOTICE OF LOSS: You must report in writing to us, or our authorized agent, as soon as possible after the
occurrence of any accident, loss, damage or expense that may be covered under this policy. This notice
should state when, where and how the event occurred, and should include the names and addresses of any
witnesses. You are also required to
notify the police and file a police report as soon as you are aware that
your property has been stolen or vandalized. If you do not provide the notice to us as required by this
section as soon as possible, any claim for such loss under this will be voided.
policy
PROOF-OF-LOSS: You must file with us authorized agent, as soon as possible after our written
or our
request, a detailed proof-of-loss signed and sworn to
by you setting forth to the best of your knowledge, the
facts of the loss. We may also require you to submit to an examination under oath. See Part C: Medical
Payments Coverage for special proof-of-loss requirements for medical payments claims.

MA-14558 (12/03) Page 9 of 12

uzleAP09C^;26ii`48-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page Ilud§51-4

CLAIM OR SUIT AGAINST YOU: If a claim is made or suit is

brought against you or a Covered person
for liability that may be covered under this
policy, you must immediately
notify us and send us
every
demand, notice, other legal papers received
summons or
by you or your representative. We will pay the
ensuing cost of the suit. We will also have the option of naming attorneys to represent you. Payments for the
cost of your legal defense will be in addition to
payments we make under your coverage for liability claims
against you.

ASSISTANCE AND COOPERATION: Any person

making a claim must:
a. cooperate with in the
us
investigation, settlement or defense of any claim or suit under this policy:
b. assist us in the enforcement of any right of contribution or
indemnity against any person or organization
which may be liable to any covered
person;
c. allow us to inspect and appraise all
damaged property, not stolen or otherwise unrecoverable, before it
is repaired or disposed of;
d. sign awritten authorization permitting us to obtain medical files
and other pertinent records;
e. submit, at our expense and as often as we
reasonably require, to a physical examination by
we select and at the time and place we select;
physicians
f. not assume any obligation or admit any fault or liability that you or we may be liable for without first
obtaining written
our consent; and
g. not incur any expenses that we
may be liable for without first obtaining our written consent; the only
expenses you may incur without obtaining our written consent are those covered under Part C: Medical
Payments Coverage of this policy, or as described in General Provisions In The Event Of Loss in the
Protection Against Loss section.

PAYMENT OF LOSS: Unless a claim has been

paid by others, we will pay for any loss covered under this
policy within thirty (30) days after both the detailed sworn proof-of-loss and
proof of your interest in the
insured property are given to us. However, should a covered loss to
your insured vessel result in a total or
constructive total loss, the policy premium shall be paid in full prior to the final claim
payment.
OUR RIGHT TO RECOVER:
If we make
a payment under this
policy and the person to or for whom payment was made recovers or has
the right to recover from another for the covered loss, we will be
subrogated to that right; however, our right
to recover is subordinate to the insured's
right to be fully compensated.
SALVAGE: If we have made
payment under this policy for loss or damage, and if there is salvage or
recovery as a result of that loss or damage, we have the
right to recover that salvage or recovery to the
extent of our payment.

SUIT AGAINST US: You may not bring a suit

against us unless you have complied with all terms and
conditions of this policy. In addition:
a. with respect to any claim or loss to insured
property, any suit against us must commence within one (1)
year of the date of loss or damage;
b. with respect to any other claim for loss, no suit
may be brought against us until the amount of the
covered person's obligation to pay has been determined
by final judgments after trial or by written
agreement signed by you, us and the claimant; any such legal action against us must commence within
one year of the date of
judgment or written agreement;
c. no one shall have
any right to join us as a party to any action against a covered person;
d. if any time limitations of this
policy are prohibited or invalid under the law, then legal action against us
must commence within the shortest limitation of
time permitted such law. by
OTHER INSURANCE: If any covered person has
any other insurance against a property damage loss
covered under this
policy, we will not pay for any greater proportion of the loss than our applicable amount
of insurance stated the Declarations Page bears to the total amount of insurance
on
to
covering the loss. With
respect liability,
medical payments and/or uninsured boater
a
loss, any insurance provided by this
contract shall be deemed excess over all other valid
and collectible insurance.

MA-14558 (12/03) Page 10 of 12

eas`e—T:04-CV-61-S48-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 8 of 50

SIGNATURES
The only signatures applicable to this policy are those representing the company named on the
Declarations Page.

By signing and delivering the policy to you, we state that it is a valid contract when countersigned by our
authorized representative.

GEORGE D. RIZGA7S:::::61 SUSAN RNERA. Presklent

Insurance Company of North America ACE American Insurance Company

Philadelphia, Pennsylvania Philadelphia, Pennsylvania

MA-14558 (12/03) Page 11 of 12

Caw 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 49 of 50

ace usa

Sincerely,

Conor. urray

Marine Claims Adjuster

ACE American Insurance Company

Cc: Chip Birthisel via facsimile

Brown & Brown Inc. of Ft. Lauderdale via fax (w/o attachments)

Page 7/7
 Case 1:09-cv-61348-JIC Document 1 Entered on FLSD Docket 08/27/2009 Page 50 of 50

JS 44 (Rev. 2/08) CIVIL COVER SHEET

The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of
pleadings or other papers as required by law, except as provided
by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the purpose of initiating
the civil docket sheet. (SEE INSTRUCTIONS ON THE REVERSE OF THE FORM.) NOTICE: MUST Indicate All Re-filed Cases Below. Attorneys
I. (a) PLAINTIFFS DEFENDANTS

Ace American Insurance Company Paul S. Lacarubba, Personal Representative of the Estate of Elaine
R. Lacarubba, deceased, and Paul S. Lacarubba, individually, 181
(b) County of Residence of First Listed Plaintiff Philadelphia County, PA County of Residence of First Listed Defendant Broward
(EXCEPT IN U.S. PLAINTIFF CASES) (IN U.S. PLAINTIFF CASES ONLY)
(C) Attorney's (Firm Name, Address, and Telephone Number) NO fE• IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE TRACT

LAND INVOLVED.
Robert B. Birthisel,
Esquire, Hamilton, Miller & Birthisel, LLP
Ashley Drive, Suite 1210
100 S. Attorneys (If Known)
Tampa, FL 33602 (813-223-1900)

(d) Check County Where Action Arose: 0 MIAMI- DADE 0 MONROE VI BROWARD 0 PALM BEACH 0 MARTIN 0 ST. LUCIE 0 INDIAN RIVER 0 OKEECHOBEE
HIGHLANDS
II. BASIS OF JURISDICTION (Place an "X" in One Box Only) III. CITIZENSHIP OF PRINCIPAL PARTIES(Place an "X" in One Box for Plaintiff
(For Diversity Cases Only) and One Box for Defendant)
7 I U.S. Government
'0 3 Federal Question PTF DEF PH? DEF
Plaintiff (U.S. Government Not a Party) Citizen of This State 0 1 0 1 Incorporated or Principal Place 0 4 0 4
of Business In This State

O 2 U.S. Government 0 4 Diversity Citizen of Another State 0 2 0 2 Incorporated and Principal Place 1 5 1 5

Defend?) (Indicae Cnhip of Parties in

titizes Item III)
of13usiness In Another State

IV
(9.11)iir e,,,,,,, 4,5,
AT A TITII 17 cm QUIT to--
z47,
Citizen or Subject of a

Foreign Country
0 3 0 3 Foreign Nation 0 6 0 6

I CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES I

.1 110 Insurance PERSONAL INJURY PERSONAL INJURY 0 610 Agriculture 1 422 Appeal 28 USC 158 0 400 State Reapportionment
X 120 Marine 0 310 Airplane 0 362 Personal Injury 1 620 Other Food & Drug 1 423 Withdrawal 0 410 Antitrust
7 130 Miller Act 0 315 Airplane Product Malpractice
Med. 7 625 Drug Related Seizure 28 USC 157 1 430 Banks and Banking
1 Negotiable Instrument
140 Liability 1 365 Personal Injury of Property 21 USC 881 1 450 Commerce
.1 150 Recovery of Overpayment 7 320 Assault, Libel & Product Liability 7 630 Liquor Laws I PROPERTY RIGHTS 0 460 Deportation
& Enforcement ofludgment Slander :1 368 Asbestos Personal 1 640 R.R. & Truck 1 820 Copyrights 1 470 Racketeer Influenced and
O 151 Medicare Act 1 330 Federal Employers' Injury Product 1 650 Airline Regs. 0 830 Patent Corrupt Organizations
7 152 Recovery of Defaulted Liability Liability .7 660 Occupational 1 840 Trademark 0 480 Consumer Credit
Student Loans 0 340 Marine PERSONAL PROPERTY Safety/Health 0 490 Cable/Sat TV
(ExcL Veterans) 1 345 Marine Product 0 370 Other Fraud 0 690 Other 1 810 Selective Service
1 153 Recovery of Overpayment Liability 0 371 Truth in Lending, LABOR SOCIAL SECURITY 0 850 Securities/Commodities/
of Veteran's Benefits 1 350 Motor Vehicle 0 380 Other Personal 7 710 Fair Labor Standards 1 861 H1A(1395ff) Exchange
1 160 Stockholders' Suits 1 355 Motor Vehicle Property Damage Act 0 862 BlackLung (923) 7 875 Customer Challenge
0 190 Other Contract Product Liability 1 385 Property Damage 1 720 Labor/Mgmt. Relations 0 863 DIWC/DIWW (405(g)) 12 USC 3410
il 195 Contract Product Liability 7 360 Other Personal Product Liability 1 730 Labor/Mgmt.Reporting 0 864 SS1D Title XVI,7 890 Other Statutory Actions
O 196 Franchise Injury & Disclosure Act 7 865 RSI (405(g)) 0 891 Agricultural Acts
I REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS 0 740 Railway Labor Act FEDERAL TAX SUITS 0 892 Economic Stabilization Act
O 210 Land Condemnation 0 441 Voting 0 510 Motions to Vacate 0 790 Other Labor Litigation .1 870 Taxes (U.S. Plaintiff 1 893 Environmental M atters
O 220 Foreclosure 1 442 Employment Sentence 1 791 Empl. Ret. Inc. Security Defendant)
or 1 894 Energy Allocation Act
LI 230 Rent Lease & Ejectment 1 443 Housing/ Habeas Corpus: Act 0 871 IRS—Third Party 1
0 240 Torts to Land Accommodations 895 Freedom of Information Act
7 530 General 26 USC 7609
1 245 Tort Product Liability 7 444 Welfare 7 535 Death Penalty I I IMM IGR ATOM 7 900 Appeal of Fee Determination
445 Amer. w/Disabilities 462 Naturalization Under Equal Access to Justice
0 290 All Other Real Property 7 1 540 Mandamus & Other 0
Empioyme.t Application
446 Amer. w/Disabilities 463 Habeas Corpus-Alien
Other
1 550 Civil Rights .1
Detainee

0 440 Other Civil Rights .7 555 Prison Condition 7 465.0ther Immigration 950 Constitutionality of State
Actions 1
Statutes

V. ORIGIN (Place an "X" in One Box Only) District

to

tr 1 Original71 2 Removed from 0 3 Re-filed- Cl 4 Reinstated or 0 5 aTnroantisieferndesdtrfircotm 0 6 Multidistrict 0 7

Afpereal
u
gF from
Proceeding State Court (see VI below) Reopened Litigation Magistrate
(specify) Judgment
a) Re-filed Case 0 YES 473NO b) Related Cases Ci YES
VI. RELATED/RE-FILED 7 NO
(See instructions
CASE(S). second page): JUDGE DOCKET NUMBER

Cite the U.S. Civil Statute under which you are filing and Write a Brief Statement of Cause (Do not cite jurisdictional statutes unless
diversity):
VII. CAUSE OF ACTION 28 USC Section 2201 Admiralty Action seeking Declaratory Relief

I LENGTH OF TRIAL via 3 days estimated (for both sides to try entire case)
VIII. REQUESTED IN 0 CHECK IF THIS IS A CLASS ACTION DEMAND CHECK YES only if demanded in complaint:
A
COMPLAINT: UNDER F.R.C.P. 23 Ut i1/vv
V JURY DEMAND: 0 Yes ri No

ABOVE INFORMATION IS TRUE & CORRECT TO SIGNATURE F ATTO EY 0 ECO

THE BEST OF MY KNOWLEDGE
DATE,,

FOR
91d 616) 4)'..
OFFIC
AMOUNT, tE6NLY RECEIPT FP