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PREMIER BUSINESSOWNERS POLICY <br />PREMIER OFFICE <br />LIABILITY DECLARATIONS <br />Policy Period: <br />Policy Number: ACP BPO 7642687509 <br />Included in Liability R Medical Payments Limit <br />From OS -12 -11 To OS -12 -12 <br />Included in Liability &Medical Payments Limit <br />Lessors of Leased Equipment <br />Included in Liability 8. Medical Payments Limit <br />WE PROVIDE INSURANCE ONLY FOR THOSE COVERAGES INDICATED BY A LIMIT OR BY "INCLUDED ". <br />COVERAGES <br />Mortgagee, Assignee or Receiver <br />LIMITS OF INSURANCE <br />Liability and Medical Payments <br />Per Occurrence <br />$1000,000 <br />Medical Payments Coverage Sub Limit <br />Per Person <br />$5,000 <br />Tenants Property Damage Legal Liability Sub Limit <br />Per Covered Loss <br />$300,000 <br />Personal and Advertising Injury <br />Per Person Or Organization <br />$1,000,000 <br />Products - Completed Operations Aggregate <br />All Occurrences <br />$2,000,000 <br />General Aggregate <br />All Occurrences <br />$2,000,000 <br />(Other than Products - Completed Operations) <br />AUTOMATIC ADDITIONAL INSUREDS STATUS <br />The following persons or organizations are automatically insureds when you and they have agreed in a written <br />contract or agreement that such person or organization be added as an additional insured on your policy. <br />Co-Owners of Insured Premises <br />Included in Liability &Medical Payments Limit <br />Controlling Interest <br />Included in Liability R Medical Payments Limit <br />Grantor of Franchise or License <br />Included in Liability &Medical Payments Limit <br />Lessors of Leased Equipment <br />Included in Liability 8. Medical Payments Limit <br />Managers or Lessors of Leased Premises <br />Included in Liability E� Medical Payments Limit <br />Mortgagee, Assignee or Receiver <br />Included in Liability 8� Medical Payments Limit <br />Owners or Other Interest from Whom Land has been Leased <br />Included in Liability &Medical Payments Limit <br />State or Political Subdivisions - Permits Relating to Premises <br />Included in Liability &Medical Payments Limit <br />PROPERTY DAMAGE DEDUCTIBLE <br />NONE <br />OPTIONAL COVERAGES <br />Hired Auto Liability Coverage <br />Nonowned Auto Liability Coverage <br />PB 81 03 (01 -01) <br />DIRECT BILL MACH MAC <br />includBd in Liability & Medical Payacrrts Liait <br />Included in Liability � Medical Pay�ants Limit <br />INSURED COVY APP��TEl13 AS TO Fd�l�i�osz <br />LIE � ORCK <br />j�45i5Eanf 6ity Attorney 3/` <br />