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DEDUCTIBLES OR SELF-INSURED RETENTIONS <br />Commercial General Liability: <br />Contractors Pollution Liability: <br />Site Pollution Liability: <br />Professional Liability: <br />RETROACTIVE DATES <br />Site Pollution Liability: <br />Professional Liability: <br />PREMIUM AND RATE <br />Pay Plan: <br />See bass quote for total premium <br />Terrorism Premium (additional premium): <br />Minimum Earned Premium: <br />Policy Fee: <br />Premium Basis: <br />Rate Type: <br />TERMS AND CONDITIONS <br />N/A Each Occurrence <br />$5,000 Each Pollution Condition <br />N/A Each Pollution Condition <br />N/A Each Claim <br />N/A <br />N/A <br />Agency Bill - Annual <br />$150 <br />100.00% <br />$50 <br />$2,000,000 Gross Revenue <br />Non Auditable <br />This proposal is offered by a non -admitted carrier. <br />This proposal is valid for 30 days following the listed date. <br />Please review this proposal carefully. Terms and conditions may differ from those requested by you or in your <br />submission or proposals previously. <br />We reserve the right to amend this proposal following analysis of submission information or further underwriting <br />criteria. <br />The proposed premium is not inclusive of taxes or fees. The producer is responsible for collecting and paying all <br />taxes or fees where applicable. <br />SUBJECTIVITIES <br />• PRIOR TO BINDING, Subject to review of five (5) years acceptable, currently valued loss runs. <br />• Signed and dated copy of Producer Surplus Lines Certification within 10 days of binding. <br />• Signed and dated Policy Disclosure Notice of Terrorism Insurance Coverage if TRIA Coverage is rejected. <br />• Subject to currently signed and dated copy of the previously submitted supplemental application. <br />Forms and Endorsements: <br />See Forms Schedule <br />MG -PROPOSAL -PATE 03/2022 <br />