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NATIONWIDE MUTUAL FIRE INSURANCE COMPANY <br />ONE NATIONWIDE PLAZA <br />COLUMBUS, OH 43215-2220 <br />COMMERCIAL GENERAL LIABILITY SCHEDULE <br />Policy Number: ACP GLGO 2205441946 <br />Item No., Location <br />and Description Code Premium Rates Advance Premium <br />of Hazards No. Basis OTHER PR/CO OTHER PR/CO <br />001A NC-002 57752 GROSS SALES PER THOUSAND <br />CANDY OR CONFECTION- 12,000 .255 1.614 $769MIN $279MIN <br />ERY PRODUCTS MFG. <br />500 VALLEY FORGE RD <br />HILLSBOROUGH <br />NC272789502 <br />001 B NC-002 49950 <br />CG2011 $35 <br />Total Advance Other and PR/CO $204MIN $279MIN <br />TOTAL ADVANCE PREMIUM $483 <br />NOTE: For classes based on payroll each Executive Officer, Sole Proprietor or Partner may be subject to a fixed <br />amount. <br />GL-DS (12-93) <br />DIRECT BILL L7JK 12013 AGENT COPY ACP GLGO 2205447946 824637562 22 0024713 <br />