Location Summary Policy Number: WA0200212404-00 Location Summary Loc # Complex Name Street Address City State Zip Code 1 34 Amherst NH 03031 LOC-SUM 06 12 Page 1 of 1
Billing Number: 410061142 Businessowners Policy Declarations Policy Period Optional Coverages From: 01/01/2018 To: 01/01/2019 12:01 A.M., Standard Time s of Insurance WORLDS APART Advantage Endorsement Equipment Breakdown Building Automatic Increase 3% CAPsure Community Coverage (All In) Employee Dishonesty $25,000 Property Management Agent As An Employee Covered For "Employee Dishonesty" Only Employee Dishonesty for Designated Community Officers And Directors Forgery and Alteration $25,000 Extended Business Income 90 Days Hired Non-Owned Auto Liability $1,000,000 Aggregate s of Insurance Per Location Policy Forms and Endorsements attached at issuance: See Schedule of Forms and Endorsements THIS POLICY DECLARATION TOGETHER WITH THE COVERAGE FORM(S), FORMS AND ENDORSEMENTS, IF ANY, COMPLETE THE ABOVE NUMBERED POLICY. To report a claim after hours, call 1-800-225-2533 AWA DS 03 06 12 Page 2 of 2
Schedule of Forms and Endorsements Schedule of Forms and Endorsements Form Number Title IL N 070 09-03 New Hampshire Fraud Statement PRIV 01-17 Privacy Statement PNWA 01 08-16 WORLDS APART Businessowners Program Notice To Policyowners AWA DS 03 06-12 Worlds Apart Declarations AWA 68 51 01-17 Mutual Conditions FORM-SCHED 06-12 Schedule of Forms and Endorsements LOC-SUM 06-12 Summary of Locations BLANKET 06-14 Schedule of Building and Personal Property Blanket s LOC-BLDG 06-12 AWA 66 14 02-17 Worlds Apart Advantage Endorsement BP 00 03 01-10 Businessowners Coverage Form BP IN 01 01-10 Businessowners Coverage Form Index AIL 10 08 06-06 Exclusion - Tanning Beds And Tanning Bed Operations AIL 10 11 06-06 Punitive Damages Exclusion AIL 10 12 06-06 Equipment Breakdown Coverage AWA 05 15 01-16 Disclosure Pursuant To Terrorism Risk Insurance Act AWA 66 80 01-12 - Building(s) AWA 67 01 06-12 CAPsure Community Coverage AWA 67 08 06-12 Employee Dishonesty Coverage For Designated Community Officers And Directors AWA 68 23 05-15 Ice Dam Deductible - Per Unit AWA 68 27 02-16 ation Of Coverage To Designated Premises With Special Events Exception BP 01 13 01-11 New Hampshire Changes BP 01 22 03-11 New Hampshire Businessowners Standard Fire Policy BP 04 04 01-10 Hired & Nonowned Auto BP 04 17 01-10 Employment-Related Practices Exclusion BP 04 39 07-02 Abuse or Molestation Exclusion BP 05 01 07-02 Calculation of Premium BP 05 26 01-15 Cap On Losses From Certified Acts Of Terrorism BP 05 65 01-15 Conditional ation Of Coverage For Terrorism - Sub- On Annual Aggregate Basis (Relating To Disposition Of Federal Terrorism Risk Insurance Act) BP 05 77 01-06 Fungi or Bacteria Exclusion (Liability) BP 10 05 07-02 Exclusion - Year 2000 Computer-Related and other Electronic Problems BP 12 24 10-10 New Hampshire Effective Time Changes - Replacement Of 12 Noon FORM-SCHED 06 12 Page 1 of 1
Schedule of Named Insured(s) Policy Number: WA0200212404-00 Schedule of Building and Business Personal Property s Location Blanket Buildings listed in the for this location Loc # Not included in Blanket 1 $5,179,432 All For locations and buildings not included in a blanket limit, see the for the specific limits. BLANKET 06 14 Page 1 of 1
Location 1 Policy Number: WA0200212404-00 Loc #1 Amherst, NH 03031 Bldg #1 Bldg #2 Bldg #3 Bldg #4 Bldg #5 LOC-BLDG 06 12 Page 1 of 5
Bldg #6 Bldg #7 Bldg #8 Bldg #9 LOC-BLDG 06 12 Page 2 of 5
Bldg #10 Bldg #11 Bldg #12 Bldg #13 Bldg #14 LOC-BLDG 06 12 Page 3 of 5
Bldg #15 Bldg #16 Bldg #17 Bldg #18 LOC-BLDG 06 12 Page 4 of 5
Bldg #19 LOC-BLDG 06 12 Page 5 of 5