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t,average is rrowaea rn: policy Number: <br /> `�'-liberty 'ihio Security Insurance Company BKS(19) 57 91 51 72 <br /> pt. , Miittla Policy Period: <br /> INSURANCE From 07/25/2018 To 07/25/2019 <br /> 12:01 am Standard Time <br /> at Insured Mailing Location <br /> Common Policy Declarations <br /> Named Insured Agent <br /> BRUCE BARSTOW (360) 653-0900 <br /> DBA DOG DAY AFTERNOON MARYSVILLE INSURANCE AGENCY <br /> POLICY FORMS AND ENDORSEMENTS - CONTINUED <br /> This section lists all of the Forms and Endorsements for your policy. Refer to these documents as needed for <br /> detailed information concerning your coverage. <br /> FORM NUMBER TITLE <br /> CG 88 72 12 08 Off Premises Property Damage Including Care, Custody or Control <br /> CG 88 77 12 08 Medical Expense At Your Request Endorsement <br /> CG 89 27 10 09 Washington Exclusion - Asbestos <br /> CL 01 03 03 10 Common Policy Conditions - Washington <br /> CL 06 00 01 15 Certified Terrorism Loss <br /> CL 07 00 10 06 Virus or Bacteria Exclusion <br /> IL 01 23 11 13 Washington Changes - Defense Costs <br /> IL 01 46 08 10 Washington Common Policy Conditions <br /> IL 01 98 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) <br /> IM 20 97 04 04 Amendatory Endorsement - Washington <br /> IM 70 03 04 04 Contractors' Equipment Coverage - Small Tools <br /> • <br /> To report a claim, call your Agent or 1-800-362-0000 <br /> DS 70 21 11 16 <br /> ncinnr10 G-tmsnv ❑!H cure nen MIrVroofIn Inronvrn rnov nrcnn7 on r_r n[ Inc <br />