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DocuSign Envelope ID: 01157D1 D- 0435 - 4838- A7EA- CE3522B44BDB <br />r HILAUhLFHIA <br />INSURANCE COMPANIES <br />A Member of the Tokio Marine Group <br />One Baia Plaza, Suite too, Bala C'%,nl,o�d, Pennsylvania 19004 <br />61o.617-7900 • Fax 610. 617.7940 • PHLY.com <br />June 13, 2018 <br />Insured's Name: Connie Winstead <br />Insured's Address: 3000 Montgomery St <br />Durham, NC 27705 <br />Re: Auditing Information Request Form <br />Below is the auditing information which you requested from Philadelphia Insurance Companies: <br />Policy Number: <br />Nature of Insurance: <br />Policy Term: <br />Annual Premium: <br />PHPK561270 -008 <br />FT : Fitness Trainers <br />04/30/2018 - 04/30/2019 <br />$116.00 <br />For any other information you need to assist in conducting this audit, please contact your agent <br />listed below: <br />Agency Name: <br />Agency Address: <br />Agency Phone Number: <br />Unassigned (SB) <br />27201 Puerta Real Ste 200 <br />Mission Viejo, CA 92691 <br />Sincerely, <br />Customer Service <br />Philadelphia Insurance Companies <br />