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91 <br />Evanston Insurance Company <br />COMMON POLICY DECLARATIONS <br />Promotion, Event and Prize Purchasing Group <br />POLICY NUMBER: 3DS5468-M2704116 <br />Named Insured and Mailing Address: <br />M.A.i3.I.C. INC. James Stapleton c/o Anita Harvey 700. W. 3RD ST, Santa Ana, CA 92701 <br />Policy Period: rrom 09/28/19 to 09/29/19 at 12:01 A.M. Standard Time at your mailing address (shown above). <br />IN RETURN FORTHE PAYMENT OF THE PREADUM, AND SUBJECT TO ALL <br />THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO .PROVIDE THE <br />INSURANCE AS STATED IN THIS POLICY. <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS <br />LIMITS OF INSURANCE <br />General Aggregate Limit (other titan Products/Completed Operations) <br />$ 2,000,000 <br />Products/Completed Operations Aggregate Limit <br />$ 1,000,000 <br />Personal and. Adve.rtising Injury Limit <br />$ 1,000,000 <br />Each Occurence Limit <br />$ 1.000,000 <br />Damage to Premises Rented to You Limit <br />$ 100,000 <br />Medical Expense Limit <br />Any One Promises <br />$ 5,000 <br />Any One Persmt <br />These declarations, together with the Common Policy Conditions and Coverage Forms) and any <br />Enclorsement(s), complete the above numbered nolicv. <br />FORMS AND ENDORSEMENTS <br />SEE FORMS SCHEDULE A9'DIL 1001 <br />rrociucor Number, Name and Mailing Address <br />East Main Street Insurance Services, Inc. <br />Will Maddox <br />PO Box 1298 <br />Grass Valley, CA 95945 <br />Premium: $240,00 <br />Surplus Tax: $7•20 <br />Stamping Pee: $0.48 <br />Countersigned: 09/12/ 19 By: <br />AiDIL 7000 OS 17 1�f�e <br />1 ate AUTHORIZED REPRESENTATIVE <br />Page 1 of 1 <br />0 <br />