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10r^�, <br />HISCOX HISCOX INSURANCE COMPANY INC. (A Stock Company) <br />encouragecourage- 104 South Michigan Avenue, Suite 600, Chicago, Illinois 60603 <br />Commercial General Liability Declarations <br />In return for the payment of the premium, and subject to all the terms of this Policy, we agree with you to provide <br />the insurance as stated in this Policy. <br />Declaration effective from: <br />Policy No.: <br />Renewal of: <br />Named Insured: <br />Address: <br />Email Address: <br />Policy period: <br />Form of Business: <br />Each Occurrence Limit: <br />June11,2022 <br />P100.325.866.2 <br />From: I June 11, 2022 To: I <br />June 11, 2023 <br />At 12:01 A.M. (Standard Time) at the address shown above. <br />Damage to Premises Rented to You Limit: <br />Medical Expense Limit: <br />Personal & Advertising Injury Limit: <br />General Aggregate Limit: <br />Products/Completed Operations <br />Aggregate Limit: <br />Supplemental Business Personal Property Floater <br />Coverage Limit: <br />Corporation <br />$1,000,000 <br />$100,000 Any one premises <br />$5,000 Any one person <br />$0 Any one person or organization <br />$2,000,000 <br />$2,000,000 <br />$0 <br />Supplemental Business Personal Property Floater Not Applicable <br />Coverage Deductible: <br />All Premises You Own, Rent or Occupy <br />Premises Number: <br />1 <br />Address: <br />27 Gathering Hill Court <br />Morris Plains, NJ 07950 <br />Total Premium: 420.00 <br />Surcharge: $ 2.52 NJ PLIGA Surcharge <br />Attachments: See attached Forms and Endorsements Schedule. <br />C K tYMd� <br />Y <br />Hd'kMutagem®u C1aic,INde <br />CGL D001 10 18 Includes copyrighted material of Insurance Services Office, Inc., wit - _ - ----_ <br />its permission. 0 ISO Properties, Inc., 2000 <br />