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Master Policy Number 103 GL 0212472 01 <br /> Member Endorsement Number 24012363 <br /> Date 10/15/2024 <br /> Forms and Endorsements(Continued): <br /> Number Title <br /> T5531-0119 Exclusion-Designated Activities <br /> T5532-0119 Additional Insured-Designated Person or Organization <br /> T5533-0119 Additional Insured-Managers or Lessors of Premises <br /> T8022-0820 Alaska Policyholder Notice <br /> 0002A-0916 Minimum Earned Premium <br /> • <br /> U009-0310 Aircraft Products and Grounding Exclusion <br /> U016-0310 Athletic or Sports Participants Exclusion <br /> U018-0520 Exclusion-Communicable Disease,Virus or Bacteria <br /> U048-0310 Employment-Related Practices Exclusion <br /> U1010-0819 Exclusion-Cyber Injury,Electronic Data,and Confidential or Personal Information <br /> U173AS-0708 Cancellation <br /> U175-0608 Multiple Coverages Limitation <br /> U232-0104 Exclusion-Punitive, Exemplary or Multiple Damages <br /> U266-0510 Exclusion-USL&H,Jones Act or Other Maritime Laws <br /> U276-0310 Exclusion-Breach of Contract <br /> U466-0212 Exclusion-Lead <br /> U467-0212 Exclusion-Asbestos <br /> U684-0511 Exclusion-Abuse or Molestation <br /> U018-0713 Exclusion-Communicable Disease <br /> State Surplus Lines Notification <br /> CALIFORNIA DISCLOSURE <br /> Amwins Insurance Brokerage LLC may be charging you a brokerage fee for providing the basic services set forth herein.The amount of <br /> the mutually agreed upon brokerage fee,if any,is the amount included on our invoice.The general brokerage services we perform <br /> include,but are not limited to,searching our relevant market(s)for appropriate combination(s)of price,coverage and security for a <br /> particular risk.Amwins may also be entitled to receive compensation,directly or indirectly,from the insurer that accepted and bound your <br /> business,even when you have been charged a brokerage fee. <br /> The above disclosures are required by Section 1623 of the Insurance Code of the State of California when a wholesale intermediary <br /> broker transacts insurance with,but not on behalf of,an admitted insurer.Amwins,in the interest of transparency,includes this disclosure <br /> on transactions with both admitted and non-admitted carriers where brokerage fees are involved. <br /> Please review the above quotation/binder carefully;terms and/or conditions may differ from those requested in your submission.In <br /> addition to the above mentioned exclusions,the policy contains other standard exclusions;specimen policies are available upon request. <br /> Terms herein are summarized for use by a licensed broker and should not be submitted in this format to the applicant.Please call with <br /> any questions. <br /> This quotation/binder is subject to all terms and conditions of the policy to be issued.The quotation/binder shall be terminated and voided <br /> by delivery of a policy to either the insured,his agent or representative.The coverage will remain in effect for the term indicated unless <br /> cancelled by the insured,Amwins or the Company,via written notice. <br /> This quotation/binder is a privileged document and shall not be released or assigned in whole or in part to any other person or entity <br /> without the written consent of Amwins,endorsed hereon. <br /> APPROVED <br /> By Cynthia Mora at 12:00 pm, Oct 30, 2024 <br />