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To: Page 3 of 4 2013-09-10 22:'13:04 (GMT) 18882679960 From: Tim C) lI n y <br /> ORTHEAST Excess and Surplus Lines Division ` <br /> TAPCO Insurance Services <br /> 3060 S.MChurAGENCIES' INC, P.O.Box 286ch Street <br /> www.NEAgencies.com <br /> Burlington,NC 27216-0286 <br /> Phone:(866)682-7726 <br /> Binder Summary Sheet <br /> Insured: Producer: <br /> Nina Wyman 3800001 <br /> 5351 Giovanni Court Northeast Agency Insurance Services <br /> Linden, CA 95236 6467 Main Street-Suite 104 <br /> Williamsville,NY 14221 <br /> Producing Agent:John Garcia <br /> Insurer: Effective/Expiration Date: 10/31/2013 to 11/1/2013 <br /> Burlington Insurance Company Term:One Day <br /> Binder ID: ISMWT-Q State:CA <br /> Percent Earned: 100% <br /> In accordance with your instructions,we have bound the following General Liability coverage; provided we receive a <br /> properly completed application within 12 days of the effective date shown above. <br /> General Liability: <br /> $ 2,000,000 General Aggregate <br /> $ Included Products/Completed Operations Aggregate <br /> $ 1,000,000 Personal Injury/Advertising injury <br /> $ 1,000,000 Each Occurrence Limit <br /> $ 50,000 Damage to Premises Rented to You <br /> $ 1,000 Medical Payments <br /> $ "0 BI/PD Deductible Per Claimant i <br /> 39041 - Exhibitions-Educational-outside <br /> Days 1 <br /> IL0017 Common Policy Conditions; D-2 California Surplus Lines Notice; IFG-1-402 Service of Suit Amendment; <br /> IFG-1-0408 California Service of Suit Amendment; IFG-G-0060 Amendment—Aircraft,Auto or Watercraft <br /> Exclusion; IFG-G-0062 Personal and Advertising Injury Amended; BG-G-005 Exclusion-Punitive Damages; <br /> BG-G-007 Exclusion-Asbestos,Silica or Other Toxic Substances; BG-G-039a Amendment of Premium <br /> Conditions; BG-G-064 Contractual Liability Amendment; BG-G-446ST Amendment-Section I Insuring <br /> Agreement; BG-G­487 Amendment-Employer's Liability Exclusion; IL0021 Nuclear Energy Liability Exclusion; <br /> CG0001 Commercial General Liability Coverage Form; CGO068 Recording and Distribution of Material or <br /> Information in Violation of Law Exclusion; CG2147 Employment Related Practices; CG2149 Total Pollution <br /> Exclusion Endorsement; CG2167 Fungi or Bacterial Exclusion; CG2173 Exclusion of Certified Acts of: I <br /> Terrorism; CG3234 California Changes; CG0300 Deductible Liability Insurance.This list is for informational <br /> purposes only and does not intend to represent the entire list of forms and/or endorsements that may be attached j <br /> to any policy issued as a result of this quotation. <br /> BG-G487 Amendment-Employer's Liability Exclusion;BG-G-007 Exclusion-Asbestos,Silica or other Toxic <br /> Substances <br /> 4 <br /> Location 1:Giovanni Court,Linden,CA 95236 <br /> Code:39041, Exhibitions-Educational-outside <br /> Coverage Type Basis User Adj. Rate <br /> GL $1 165.0000 <br /> 5 <br /> 9 <br />