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10�Coverage is Provided In: Policy Number: <br />Lgb1E:'"1 Ohio Security Insurance Company - a stack company BKS (16) 55 96 34! 27 <br />�VIT. Z71. Policy Period: <br />INSURANCE From 05/31/2015'To 05/31/2016 <br />12:01 am Standard Time <br />at Insured Whiling Location <br />Common Policy Declarations <br />Named Insured <br />AVT INC <br />SUMMARY OF LOCATIONS <br />(626)300-9000 <br />NEW CENTURY INSURANCE SVS INC <br />This policy provides coverage for the following under one or more coverage parts. Please refer to the individual <br />Coverage Declarations Schedules, or, the individual Coverage Forms for locations or territory definition for that <br />specific Coverage Part, <br />0001 341 Bonnie Cir Ste 102, Corona, CA 92880-2895 <br />0002 341 Bonnie Cir Ste 101-A, Corona, CA 92880-2895 <br />0003 231 N Sherman Ave, Corona, CA 92882-1844 <br />0004 119 N Maple St Ste P„ Corona, CA 92880-6998 <br />This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed <br />information concerning your coverage. <br />FORM NUMBER TITLE <br />CG 00 01 04 1.3 <br />Commercial General Liability Coverage Form - Occurrence <br />CG 04 36 04 13 <br />Limited Product 'Withdrawal Expense Endorsement <br />CG 20 11 04 1.3 <br />Additional Insured - Managers Or Lessors Of Premises <br />CG 20 28 04 13 <br />Additional Insured - Lessor Of Leased Equipment. <br />CG 21 06 05 1.4 <br />Exclusion - Access Or Disclosure Of Confidential Or Personal Information And <br />Data -Related. Liability - With Limited Bodily Injury Exception <br />CG 21 47 1207 <br />Employment -Related Practices Exclusion <br />CG 21 65 12 04 <br />Total Pollution Exclusion with a Building Heating, Cooling and Dehumidifying <br />Equipment Exception and a Hostile Fire Exception <br />CG 21 67 12 04 <br />Fungi or Bacteria. Exclusion <br />CG 21 70 01 08 <br />Cap on Losses From Certified Acts of Terrorism <br />CG 21 76 01 08 <br />Exclusion of Punitive Damages Related to a. Certified Act of Terrorism <br />In witness whereof, we have caused this policy to be signed by our authorized officers. <br />I r a <br />0"504.w.m <br />Dexter Legg Paul Condrin(' <br />Secretary President <br />To report a claim, call your Agent or 1-800 362-0000 <br />DS 70 21 01 08 <br />05101115 55963427 N0197371 275 GCXOPPNO INSURED COPY 000496 PAGE 28 OF 2,12 <br />