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CapSpecialty CAPITOL SPECIALTY INSURANCE CORPORATION A Stock Company <br />Especially nov,_ <br />Policy Coverage Part Form Schedule <br />Policy No.: BR20221803-01 <br />First Named Insured: Temecula Carriage Company LLC <br />Form Number <br />D-2 <br />Title . ,. <br />CALIFORNIA- NOTICE <br />N-200 (09/16) <br />WHATTO DO IF YOU HAVE A CLAIM OR POTENTIAL CLAIM OR INCIDENT <br />CGE 1000 06 20 <br />Common Policy Declarations <br />CGE 100106 20 <br />Locations Schedule <br />It 00 17 1198 <br />Common Policy Conditions <br />CGE 2630315 <br />Policyholder Audit Information <br />E-90005 (04/21) <br />Service of Suit <br />IL P 0010104 <br />U.S. Treasury Department's Office of Foreign Assets Control ("OFAC") Advisory Notice to Policyholders <br />CG 32 34 0105 <br />California Changes <br />CGE 126 05 20 <br />Minimum Earned Premium <br />CGE 5170918 <br />Auditable Policy with Minimum Premium <br />CG 20 0112 19 <br />Primary and Noncontributory - Other Insurance Condition <br />CG 24 04 12 19 <br />Waiver of Transfer of Rights of Recovery Against Others to Us (Waiver of Subrogation) <br />IL 00 2109 08 <br />Nuclear Energy Liability Exclusion Endorsement (Broad Form) <br />CG 2173 0115 <br />Exclusion of Certified Acts of Terrorism <br />CG 2187 0115 <br />Conditional Exclusion of Terrorism (Relating to Disposition of Federal Terrorism Risk Insurance Act) <br />- liek Mw�agemmt DiW.vian <br />R6 EWEDf,APPRovm8y: <br />1L A, ju AczP44 <br />Risk Management Specialist <br />CGE 1002 (06-20) 0 2020 CapSpecialty, Inc. All rights reserved. Page 1 of 1 <br />