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EVANSTON INSURANCE COMPANY State Transaction Code: MAW COMMERCIAL EXCESS LIABILITY POLICY DECLARATIONS POLICY NUMBER: EZXS3065303 RENEWAL OF POLICY: NEW Named Insured and Mailing Address (No., street, Town or city, county, State, Zip Code) Spineless Wonders Ltd 12160 Scandia Trail North Scandia, MN 55073 Policy Period: From 12/03/2021 to 12/03/2022 at 12:01 A.M. Standard Time at your mailing address shown above. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. Limits Of Insurance Each Occurrence Limit: $ 2,000,000 Aggregate Limit: $ 2,000,000 Retained Limit / Each Occurrence: $ Premium Policy Premium: $ 1,200.00 Terrorism Premium: $ Not Covered Fees (Where Applicable): $ 242.56 Total Premium: $ 1,442.56 Payable At Inception Audit Period: ® Not Applicable ❑ Annual ❑ Semi -Annual ❑ Quarterly ❑ Monthly Rating Basis (If Subject To Audit) Premium Basis: Rate: THIS INSURANCE IS ISSUED PURSUANT TO THE MINNESOTA SURPLUS LINES INSURANCE ACT. THE INSURER IS AN ELIGIBLE .-. TT!"IT TT TT TITTT TC'TT/1T - - Producer Number, Name and Mailing Address L7lll\1 J-UU 1-111Il'Ll 1114Vv1 A'-vi OTHERWISE LICENSED BY THE STATE OF MINNESO IN CASE OF INSOLVENCY, PAYMENT OF CLAIMS IS NOT GUARANTEED. 210496 Burns & Wilcox, Ltd. 150 South Fifth Street Towers Suite 2650 Minneapolis, MN 56402 Endorsements Forms and Endorsements applying to this Coverage Part and made part of this policy at time of issue: Per Forms Schedule Schedule Of Underlying Insurance Per Schedule Of Underlying Insurance These declarations, together with the Coverage Form and any Endorsement(s), complete the above numbered policy. Countersigned: 11/29/2021 DATE NO FLAT CANCELLATIONS MADUB 1000 0417 Samud eciman By: AUTHORIZED REPRESENTATIVE TA. RAMmWmerdDMsiun REVIEWED & APPROVED BY.- ~` .v"° wd --� RFsk janagement Analyst