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POLICY NUMBER: PHUB777844 <br />Watercraft Liability <br />Company: <br />Policy Number: <br />Policy Period: <br />Retroactive Date: <br />Minimum Applicable Limits <br />PI-CXL-002 (05/19) <br />El Occurrence ❑Claims -Made <br />Other Coverages Not Included in Above ❑ Occurrence ❑ Claims -Made <br />Company: <br />Policy Number: <br />Policy Period: <br />Retroactive Date: <br />Minimum Applicable Limits <br />THESE DECLARATIONS, TOGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE <br />FORM(S) AND ANY ENDORSEMENT(S), COMPLETE THE ABOVE NUMBERED POLICY. <br />Countersigned: ey: <br />(Date) (Authorized Representative) <br />IN WITNESS WHEREOF, we have caused this policy to be executed and attested, and, if <br />required by state law, this policy shall not be valid unless countersigned by our authorized <br />representative. <br />V4� <br />John W. Glomb, Jr. Secretary <br />President & CEO <br />whr�m.ge�ron;om <br />,.5w Ren6 &Arvxw® <br />,Br: <br />PI-CXL-002 (05/19) rs�kn a=�, aR iaae <br />Page 5 of 5 <br />Includes copyrighted material of Insurance Services Office, Inc., with permission. <br />