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Coverage Is Provided In: Policy Number: <br />Liberty Ohio Security Insurance Company - a stock company BNS (20) 57 04 83 55 <br />MUtUd�. Policy Period: <br />INSURANCE From 12/09/2019 To 12/09/2020 <br />12:01 am Standard Time <br />at Insured Mailing Location <br />Common Policy Declarations <br />Named Insured Agent <br />ECONOMICS INC DBA ECAL/NOMICS (800) 962-7132 <br />832 CAMINO DEL MAR STE I R.I.C. INSURANCE GENERAL AGENCY <br />DEL MAR, CA 92014 PO BOX 12279 <br />SANTA ROSA. CA 95406-2279 <br />SUMMARY OF LOCATIONS <br />This policy provides coverage for the following under one or more coverage parts. Please refer to the individual <br />Coverage Declarations Schedules, or, the individual Coverage Forms for locations or territory definition for that <br />specific Coverage Part. <br />0001 832 Camino Del Mar Ste 2, Del Mar, CA 92014-2808 <br />0002 33155 Camino Capistrano Ste E. San luau Capistrano, CA 926754829 <br />0003 206 W 4th St Ste 429, Santa Ana, CA 92701-4678 <br />POLICY FORMS AND ENDORSEMENTS <br />This section lists the Forms and Endorsements for your policy. Refer to these doctunents as needed for detailed <br />information concerning your coverage. <br />FORM NUMBER TITLE <br />CG 00 01 04 13 <br />Commercial General Liability Coverage Form - Occurrence <br />g CG 20 10 04 13 <br />Additional Insured - Owners, Lessees or Contractors - Scheduled Person or <br />s <br />Organization <br />CG 20 37 04 13 <br />Additional Insured - Owners, Lessees or Contractors - Completed Operations <br />CG 21 06 05 14 <br />Exclusion - Access Or Disclosure Of Confidential Or Personal Information And <br />Data -Related Liability - With Limited Bodily Injury Exception <br />CG 21 47 12 07 <br />Employment -Related Practices Exclusion <br />In witness whereof, Gwe(�havecaused this policy to be signed by our authorized officers. <br />Mark Touhey David Long <br />Secretary President <br />To report a claim, call yourAgent or 1.844-325-2467 <br />DS 70 21 11 16 <br />10/25/19 57048355 POLSVCS NO NCXFPPND INSURED COPY WS <br />Rime Managxnlent Diuisian <br />REVIEWED&APPROVED BY: <br />'� <br />Risk Management Analyst <br />