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DECLARATIONS <br />ASPEN AMERICAN INSURANCE COMPANY <br />(A stock insurance company herein called the "Company") <br />175 Capitol Blvd. Suite 100 <br />Rocky Hill, CT 06067 <br />Date Issued Policy Number Previous Policy Number <br />05/22/2015 AAI001251-01 <br />THIS IS A CLAIMS MADE AND REPORTED POLICY. COVERAGE IS LIMITED TO LIABILITY FOR ONLY THOSE <br />CLAI_MS THAT ARE FIRST MADE AGAINST THE INSURED DURING THE POLICY PERIOD AND THEN REPORT- <br />ED TO THE COMPANY IN WRITING NO LATER THAN SIXTY (60) DAYS AFTER EXPIRATION OR TERMINATION <br />OF THIS POLICY, OR DURING THE EXTENDED REPORTING PERIOD, IF APPLICABLE, FOR A WRONGFUL <br />ACT COMMITTED ON OR AFTER THE RETROACTIVE DATE AND BEFORE THE END OF THE POLICY <br />PERIOD. PLEASE READ THE POLICY CAREFULLY. <br />Item <br />1. Customer ID: 141963 <br />Named Insured: <br />KILEY COMPANY <br />ELIZABETH M. KILEY INC. <br />Elizabeth M. Kiley <br />2681 Dow Avenue, Suite E <br />Tustin, CA 92780 <br />2. Policy Period: From: 06/20/2015 To: 06/20/2016 <br />12:01 A.M. Standard Time at the address stated in I above. <br />3. Deductible: $1,000 Each Claim <br />4. Retroactive Date: 06/20/1.997 <br />5. Inception Date: 06/20/2015 <br />6. Limits of Liability: A. $1,000,000 Eaeh Claim <br />B. $1,000,000 Aggregate <br />7. Mail all notices, including notice of Claim, to: <br />LIA Administrators & Insurance Services <br />1600 Anacapa Street <br />Santa Barbara, California 93101 <br />(800)334-0652; Fax: (805)962-0652 <br />8. Annual Premium: $3,187.00 <br />9. Forms attached at issue: LIA002 (12/14) ASPCO002 0110 LLA CA (1.1/1.4) LIA012 (12/14) <br />LIA013 (1.0/1.4) LIA025A (1'1/14) LIA103 (1.0/14) <br />This Declarations Page, together with the completed and signed Policy Application including all attachments and exhibits thereto, and <br />the Policy shall constitute the contract between the Named Insured and the om zany. <br />05/22/2015 By <br />Date Authorized Sig attire <br />LIA-001 (12/14) <br />Aspen American Insurance Company <br />