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S9 * 04/11/2022 * GLP 3961460 01 GREAT AMERICAN ASSURANCE COMPANY <br />*D/B* 072977484 262428 <br />CG 82 82 (Ed. 12/09) <br />Policy No. GLP 3961460 01 <br />ABUSE OR MOLESTATION COVERAGE FORM <br />DECLARATIONS PAGE <br />NAMED INSURED: BACKHAUS DANCE POLICY PERIOD: <br />06/03/2022 to 06/03/2023 <br />LIMITS OF INSURANCE: <br />Aggregate Limit $ 2,000,000 Each Abuse Limit $ 1,000,000 <br />DESCRIPTION OF BUSINESS: <br />Form of Business CORPORATION <br />READ YOUR POLICY CAREFULLY, OPTIONAL COVERAGES ARE PROVIDED BY PREMIUM INSERTION <br />Abuse or Molestation Coverage <br />Premium <br />3M <br />TOTAL ADVANCE PREMIUM $ 788 <br />Premium shown is payable: $ at inception; <br />FORMS AND ENDORSEMENTS Applicable to this Coverage Part and made part of this Policy at time of issue are <br />listed on the attached Forms and Endorsements Schedule CG 88 01 (11/85). <br />.,.,, RbkMwgveoe OhiY <br />penEvim6/M,rxo+®Brr. <br />CG 82 82 (Ed. 12/09) (Page 1 of 1) <br />