Laserfiche WebLink
PI-CXL-002 (05/19) <br />POLICY NUMBER: PHUB807012 <br />PREMIUM SUBTOTAL $ 1,400.00 <br />STATE TAXES, FEES, SURCHARGES (if applicable) Not Applicable <br />PREMIUM TOTAL including Taxes, Fees, Surcharges) $ 1,400.00 <br />AUDIT PERIOD: I ® NOTAPPLICABLE 111 ANNUALLY ❑ SEMI-ANNUALLY I ❑ QUARTERLY1 ❑ MONTHLY <br />SINESS <br />FORM OF BUSINESS: CORPORATION <br />BUSINESS DESCRIPTION: Non -Profit Umbrella <br />PI-CXL-002 (05/19) <br />Page 2 of 5 <br />Includes copyrighted material of Insurance Services Office, Inc., with per <br />RiskManaganetDMalm <br />REVIEWED & APPROVED BY: <br />�. <br />- Risk Management Specials[ <br />