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INSURANCE, <br />UupuI COMPANY <br />COMMERCIAL EXCESS LIABILITY 13OLICY DECLARATIONS <br />Policy Number: 8271-30u2~EX <br />Policy Period: 04/04/2821-04/04/2022 <br />LIMITS OELNSU.RANCE <br />Each Occurrence Limit <br />General Aggregate Limit <br />BUSINESS INFORMATION <br />JPWCommunications LLC <br />Form of Business <br />Limited Liability Company <br />Location* Address of All Premises (inc. Zip Code) that You Own, Rent or Occupy <br />001 %7l0Luker Avenue oy#J00 Cwtohud CA9ZVlV <br />POLICY PREMIUM <br />$1200.00 <br />Total Advance Premium $ 1200.00 <br />RATING BASIS: EXCESS OVER UNDERLYING COVERAGBG): <br />Hiscox Insurance Company UDC-2220435-BOP Occurrence Form <br />UDC~2220435`EO Claims Made Form <br />PREMIUM BASIS: PRO -RATED <br />FOB —MS AND ENDORSEMENTS <br />Forms and Endorsements applying b)this Coverage Part and made part ufthis policy u1time cf issue: <br />Per Forms Schedule <br />These Declarations, together with Common Policy Conditions and Coverage Form(s) and any <br />Endorsements, complete the above numbered policy. <br />41.11.,2/ <br />_� R <br />Authorized Representative <br />