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Burns& <br />Wilcox <br />DATE: 4/7/2021 <br />101 California Street, Suite 975, San Francisco, CA 94111 <br />Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620 <br />INSURANCE BINDER Page 2 of 4 <br />LIMITS / DEDUCTIBLES: <br />Loc Sub Coverage <br />1 General Aggregate <br />1 Products and Completed Operations <br />1 Each Occurrence <br />1 Personal and Advertising Injury <br />1 Medical Expense / Any One Person <br />1 Damage to Premises Rented to You / Each Occurrence <br />TOTAL CHARGES: <br />Premium: $ <br />Fee: $ <br />Tax: $ <br />Tax: $ <br />TOTAL: $ <br />EXCLUSIONS: <br />600.00 Commercial General Liability <br />200.00 Brokerage Fee (Fully Earned) <br />1.50 Stamping Tax <br />18.00 Surplus Lines Tax - GenLiab <br />819.50 <br />SEE "ENDORSEMENTS' SECTION BELOW / NEXT PAGE <br />ENDORSEMENTS: <br />Limit(s) Deduct! <br />$2,000,000 <br />$2,000,000 <br />$1,000,000 $500 <br />$1,000,000 <br />$5,000 <br />$100,000 <br />Per Claim BI/PD <br />100% MINIMUM & DEPOSIT <br />MINIMUM RETAINED PREMIUM: <br />100.00 % EARNED <br />MINIMUM PREMIUM = $600.00 <br />Co Ins <br />&s c RlekMamge LDW!un <br />t? GREVIEWED&APPROVED BY: <br />��� pI �oa+.rM.a P1, V1.4�tnas,E <br />45=- Risk Management Analyst <br />