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Burns <br />Wilcox <br />101 California Street, Suite 975, San Franc <br />Phone: (415) 421.4244 OR (800) 759-4855 Fax: <br />DATE: 4/7/2021 INSURANCE BINDER <br />LIMITS / DEDUCTIBLES: <br />o, CA 94111 <br />15)421-0620 <br />Page 2 of 4 <br />Lac Sub Coverage Limit(s) Deductible(s) Co Ins <br />1 General Aggregate $2,000,000 <br />1 Products and Completed Operations $2,000,000 <br />1 Each Occurrence $1,000,000 $500 Per Claim BI/PD <br />1 Personal and Advertising Injury $1,000,000 <br />1 Medical Expense / Any One Person $5,000 <br />1 Damage to Premises Rented to You / Each Occurrence $100,000 <br />TOTAL CHARGES: <br />Premium: $ <br />Fee: $ <br />Tax: $ <br />Tax: $ <br />TOTAL: $ <br />EXCLUSIONS: <br />600,00 Commercial General Liability <br />200.00 Brokerage Fee (Fully Earned) <br />1.50 Stamping Tax <br />18.00 Surplus Lines Tax - GenLiab <br />819.50 <br />SEE "ENDORSEMENTS' SECTION BELOW / NEXT PAGE <br />ENDORSEMENTS: <br />100% MINIMUM & DEPOSIT <br />MINIMUM RETAINED PREMIUM: <br />100.00 % EARNED <br />MINIMUM PREMIUM = $600,00 <br />asei a„t Riek Mutagemnrt0lWsfmt <br />REVIEWED & APPROVED 13P <br />OWr�1�� ,'�c� r 1A.hGvhZ Iv. V+4LMS� <br />Ruk Management Analyst <br />