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ADDITIONAL COVERAGES Ref# Description Coverage Code Form No. Edition Date PAESL PAESL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000 $172.00 Ref# Description Coverage Code Form No. Edition Date Employment Practices Liability Insurance EPLI Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 10,000 Ref# Description Coverage Code Form No. Edition Date Uninsured motorist combined single limit UMCSL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 Ref# Description Coverage Code Form No. Edition Date Umbrella(C) CUMBR Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 2,000,000 2,000,000 10,000 Ref# Description Coverage Code Form No. Edition Date Adjst.to reconcile-exp mod.premium AREM Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$2,045.00 Ref# Description Coverage Code Form No. Edition Date Schedule rate adjustment SRA Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$2,577.00 Ref# Description Coverage Code Form No. Edition Date Add'I for policy minimum premium APMP Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $144.00 Ref# Description Coverage Code Form No. Edition Date Uninsured Employee Benefits Trust Fund UEBTF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $4.00 Ref# Description Coverage Code Form No. Edition Date Increased employer's liability INEL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref# Description Coverage Code Form No. Edition Date Merit Surcharge MERIT Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$6.00 Ref# Description Coverage Code Form No. Edition Date LECF LECF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $62.00 LOFADTLCV APPROVED Copyright 2001,AMS Services,Inc. By Cynthia Mora at 5:30 pm, Dec 02, 2024