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di MARKEL INSURANCE COMPANY <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />• DECLARATIONS <br />Polis No: MTK70002501-00 Effective Date: 05/27%2013 <br />Policy 17-rIl A AA gtanrtarrl Times <br />General Aggregate Limit (Other Than Products -Completed Operations) $2,000,000 <br />Products -Completed Operations Aggregate Limit $2,000,000 <br />Personal and Advertising injury Limit $1,000,000 <br />Each Occurrence Limit $1,000,()00 <br />Damage To Premises Rented To You Limit SEE MGL 1215 Any One Premises <br />SEE MGL 1215 Any One Person <br />Medical Expense Limit <br />Coverage A of this Insurance does not apply to 'bodily injury' or 'property damage' which occurs before the Retroactive Date, if <br />any, shown here: <br />(Ertee Dare a'Nme' N no Rsroactlre Date aPpfi'S) <br />DESCRIPTION AND LOCA <br />Form of Business: corporation <br />SusineSs Description: Ambulance Service <br />t Location of All Premises You Own, Rent or Occupy: <br />SEE ATTACHED "EXTENSION OF DECLARATIONS" <br />PREMIUM <br />Advance <br />Classification Code No. Premium Basis _ Rate Premium <br />SEE ATTACHED "EXTENSION OF DECLARATIONS" <br />Total Advance Premium. $12, 379 <br />FORMS AND ENDORSEMENTS (otherthan applicable Forms and Endorsements shown elsewhere in the policy) <br />Forms and Endorsements applying to this Coverage Fart and made part Oithis policy at time of issue: <br />SEP "SCHEDULE OF FORMS AND ENDORSEMENTS" <br />THESE DECLARATIONS 70GETHER W114T4E COMMON POLICY CONDITIO NS, COVERAGE PART DECLARATIONS, COVERAGE PART COVERAGE FORMS) <br />AND FO RMS AND EW)ORSEMFWS, IF ANY, ISSUED TO FORMA PART THE REOR COMPLET€ THE ABOVE NUMBERED POL ICY., <br />MD011 (9/99) ncW06 GOW19Ma0 m,tolo, a nuv ce serA­ omGo, mc,. wrih it. P— Page 1 of 4 <br />