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Type of Policy <br />Automobile Liability <br />Recreational Motor Vehicle Liability <br />Including Passenger Bodily Injury <br />Personal Residential Liability <br />Watercraft Liability <br />Office Premises Liability <br />NOTICE TO POLICYHOLDER: <br />CONTINUED FROM FRONT <br />Required Underlying Insurance <br />(Terms in Bold in this section are defined in the policy) <br />Minimum Underlying Limits <br />Combined Limits <br />(Bodily Injury and Property Damage) or <br />* 3 0 0, 0 0 0 Bodily Injury - <br />Property Dainage- <br />9 3 0 0, 0 0 0 Bodily Injury - <br />Property Damage - <br />5100,000 <br />S100,000 <br />Split Limits <br />5 1 0 0, 0 0 0 <br />5 <br />Per Person <br />* 3 0 0, 0 0 0 <br />Per Accident <br />5 2 5, 0 0 0 <br />Per Accident <br />$100,000 <br />Per Person <br />$300 000 <br />Per Accident <br />* 2 5, 0 0 0 <br />Per Accident <br />30 0, 0 0 0 Bodily Injury- *300 , 000 Per Person <br />* 3 0 0, 0 0 0 Per Accident <br />Property Damage- 5 5 0, 0 0 0 Per Accident <br />Policy changes requested before the "Date Prepared", which appear on this notice, are effective on the Effective Date of this <br />policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage forms attached <br />to this notice are also effective on the Effective Date of this policy. <br />Policy changes requested after the "Dale Prepared" will be sent to you as an amended declarations or as an endorsement to <br />your policy. Billing for any additional premium for such changes will be mailed at a later date. <br />Please keep this with your policy <br />303 Rev. 08-Ot -2006 (o1 ra092a) <br />