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DS 70 21 11 16 <br />10/25/19 57048355 POLSVCS 290 NCXFPPNO INSURED COPY CO2 <br />'A Coverage Is Provided In: Policy Number: <br />Liberty Ohio Security Insurance Company - a stock company BKS (20) 57 04 83 55 <br />MUtUdl- 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 1 R.I.C. INSURANCE GENERAL AGENCY <br />DEL MAR, CA 92014 PO BOX 12279 <br />SANTA ROSA. CA 95406-2279 <br />POLICY FORMS AND ENDORSEMENTS - CONTINUED <br />This section lists all of the Forms and Endorsements for your policy. Refer to these documents as needed for <br />detailed information concerning your coverage. <br />FORM NUMBER TITLE <br />CG 21 67 12 04 <br />Fungi or Bacteria Exclusion <br />CG 21 7001 15 <br />Cap on Losses from Certified Acts- of Terrorism <br />CG 21 7601 15 <br />Exclusion of Punitive Damages Related to a Certified Act of Terrorism <br />CG 24 2604 13 <br />Amendment of Insured Contract Definition <br />CG 80 61 05 11 <br />Amendment of Cancellation Provisions <br />CO 84 9901 12 <br />Non -Cumulation Of Liability Limits Same Occurrence <br />E CG 85 15 0903 <br />Exclusion - Professional Services <br />CG 88 1004 13 <br />Commercial General Liability Extension <br />CG 88 60 12 08 <br />Each Location General Aggregate Limit <br />CO 88 61 12 08 <br />Property Damage - Customers' Goods <br />CG 88 66 1208 <br />Property Damage - Burrowed Equipment <br />CG 88 77 12 08 <br />Medical Expense At Your Request Endorsement <br />CG 88 86 1208 <br />Exclusion - Asbestos Liability <br />CG 90 41 01 13 <br />Amendment Of Coverage B Personal And Advertising Injury <br />CP 00 10 04 02 <br />Building and Personal Property Coverage Form <br />CP 0090 07 88 <br />Commercial Property Conditions <br />CP Ol 40 0706 <br />Exclusion of Loss Due to Virus or Bacteria <br />CP 04 49 1205 <br />California Changes - Replacement Cost <br />s CP 1030 0402 <br />Causes of Loss - Special Form <br />CP 10 32 08 08 <br />Water Exclusion Endorsement <br />CP 72 97 0402 <br />Equipment Breakdown Enhancement Endorsement - Special Form <br />CP 88 04 03 10 <br />Removal Permit <br />CP 88 17 08 12 <br />California Custom Protector - Extended Period of Indemnity <br />CP 90 40 08 12 <br />Office / Lessors Custom Protectors Endorsement <br />To report a claim, call your Agent or 1-844-325.2467 <br />Ride Management Diuisian <br />REVIEWED&APPROVED By: <br />Risk Management Analyst <br />