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Philadelphia Indemnity Insurance Company <br />i- <br />E COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS <br />i <br />i <br />Policy Number: EV20434 <br />Agent # 107790 <br />See Supplemental Schedule <br />€ LIMITS OF INSURANCE <br />I <br />$ 3 , 000 ,000 General Aggregate Limit (Other Than Products — Completed Operations) <br />$ 3,000, 000 Products/Completed Operations Aggregate Limit (Any One Person Or Organization) <br />m $ 1, 000, 000 Personal and Advertising Injury Limit <br />$ 1, 000, 000 Each Occurrence Limit <br />$ 100,000 Rented To You Limit <br />$ 0 Medical Expense Limit (Any One Person) <br />FORM OF BUSINESS: Non Profit Organization <br />Business Description: Special Events <br />Location of All Premises You Own, Rent or Occupy: SEE SCHEDULE ATTACHED <br />AUDIT PERIOD, ANNUAL, UNLESS OTHERWISE STATED: This policy is not subject to premium audit. <br />Rates Advanced Premiums <br />I <br />Prod.lCom p. Prod./Comp. <br />Classifications Code No. Premium Basis Prem.lOps. O s. Prem.lQps Ops. <br />p -- <br />SEE SCHEDULE ATTACHED <br />[ TOTAL PREMIUM FOR THIS COVERAGE PART: $175.00 $ <br />i <br />RETROACTIVE DATE (CG 00 02 ONLY) <br />f <br />f <br />This insurance does not apply to "Bodily Injury", "Property Damage", or "Personal and Advertising Injury" which actors before the <br />retroactive date, if any, shown below. <br />E Retroactive pate: <br />FORM (S) AND ENDORSEMENT (5) APPLICABLE TO THIS COVERAGE PART: Refer To Forms Schedule <br />Countersignature Date <br />Authorized Representative <br />