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Prepared on December 29. 202C Page 2 of 4 <br />Nationwide <br />Is an your side <br />For coverage definitions and descriptions, <br />visit nationwide.com <br />Your Policy Declarations <br />Personal Umbrella Liability Policy <br />Policy Period: Jan 31, 2021 - Jan 31. 2022 <br />Policy Number: 72041U043950 <br />Schedule of Required Underlying Insurances <br />Named Insured agrees to maintain the following Required Underlying Insurance Coverages and <br />minimum limits during this policy's term, <br />Coverages Minimum Underlying Limits Required <br />Automobile, Recreational Motor Vehicle or $250,000/500,000 <br />300000//3Property a0'0,O00 Bodily Injury <br />Motorcycle Liability <br />Personal Liability I $300.000 <br />Current exposures with underlying insurance coverage in force: <br />Underlying Current Underlying Company Name And <br />Insurance Coverages Insurance Limits Policy Number <br />Automobile, Motorcycle Bodily Injury $250,000 / $500.000 7204J 241301 Nationwide <br />and Other Vehicles Property Damage $100,000 <br />Licensed for Road Use <br />Liability <br />Personal Injury Liability $500,000 7204HR201675 Nationwide <br />Personal Liability for $500,000 7204HR201675 Nationwide <br />Bodily Injury and Property <br />Damage <br />Total Policy Premium $ 280.15 <br />Policy Form and Endorsements <br />P 5900 07 16 Your Nationwide Umbrella Policy <br />P 6004 04 18 Special Provisions - California <br />Rlek Mrmaganatt DiMsIm <br />REVI &APPROVED BY: <br />ilk' F a+u.e 2. V:iG4.d <br />®' Risk Management Malys <br />